Emerging Inner Ear Therapies

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Background

Disorders associated with the inner ear have multiple causes. The disorders might be congenital or acquired through exposure to ototoxic drugs, noise, infections or simply due to aging. If manifested early in life, hearing disorders can greatly impair the development of speech. Later in life, hearing impairment provides challenges for education and career development and can lead to social isolation. Although great efforts have been done in recent years, no drugs have been approved for the generic treatment of hearing loss, but the situation is changing quickly with many new drugs, therapeutic approaches and methods of drug delivery that are at different stages of pre-clinical and clinical trials. It, thus, is timely to have a Research Topic to highlight the most novel and promising approaches for the prevention of hearing loss or the treatment and restoration of function in the inner ear.

The Topic’s aim is to highlight recent advances in ototherapeutics and their delivery with an emphasis on the novelty of the approaches. Once damaged, the delicate structure of the inner ear cannot regenerate. This is true for both the cochlear sensory cells, which are the most susceptible to noise and ototoxic effect of drugs, and for the supporting cells in the organ of Corti that are the targets in many types of congenital deafness. Age-related hearing loss, associated with cochlear deafferentation and compromised vasculature, is also currently lacking efficacious treatments. While there is no current treatment to restore damaged inner ear function, extensive research along a few promising lines is being carried out. Otoprotection, involving apoptosis inhibitors, neurotransmitters and their antagonists, monoclonal antibodies, growth factors and agents providing protection from ototoxic drugs, is a good non-limiting example of research that could soon lead to clinical application. Advances in genetic and stem cell therapies provide future exciting directions for achieving the goal of regenerating inner ear function when it is compromised as consequences of hereditary fate and life experience. A challenge of targeted delivery of therapeutics to the poorly-accessible inner ear cellular structures is currently being addressed through the development of a wide range of invasive and non-invasive drug delivery methods.

Original research and review papers which address the following broad themes, but are not limited to them, are, therefore, welcome:

1. Increasing efficacy of the currently used formulations using sustained release either from the middle ear or from nanocarriers within the inner ear; targeted delivery of drugs to their specific targets within the inner ear using systemic or topical approaches using carriers of different type and affinity.

2. Novel candidates for inner ear therapy including local anaesthetics, antioxidants, apoptosis inhibitors, neurotransmitters and their antagonists, monoclonal antibodies, growth factors, signalling pathway regulators and genetic constructs; progress in stem cell research for regenerative therapy of the inner ear.

3. Pharmacokinetic and pharmacodynamic studies at the organ and cellular level; modification of drug availability and clearance; specific and non-specific side-effects; mechanisms of drug ototoxicity and protection from it.

The emphasis should be made on the novelty and originality of approaches and their future potential.

Topic Editor Monica Serban is the President and co-founder of Maana Discoveries.
Topic Editor Tal Teitz is co-founder of Ting Therapeutics, LLC.
Topic Editors Athanasia Warnecke and Nils Prenzler received catheters for their work provided by Med-El.
The other Topic Editors declare no competing conflicts of interest in regard to the Research Topic subject.

Keywords: Hearing disorders, vestibular disorders, hearing restoration, cochlear synaptopathy, otoprotection, ototoxicity, noise-induced hearing loss, age-related hearing loss, tinnitus, inner ear drug delivery, systemic delivery, trans-tympanic delivery

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