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DOI: 10.1055/s-2009-1224357
Stem Cells and Genetic Therapy for Hair Cell–Related Hearing Loss
Introduction: The majority of inner ear diseases are incurable by conventional therapeutic strategies; therefore, new therapeutic strategies for protection or regeneration of inner ear function must be investigated.
Methods: In the early phase of cochlear damage, we should try to rescue inner ear cells from cell death and promote self-repair activity. Experimental and clinical studies were performed to examine the efficacy of a novel local drug delivery system using neurotrophic factors or other drugs in the inner ear.
Induction of transdifferentiation is a next possible strategy. However, if no cell sources remain in the inner ear, cell transplantation then becomes the only choice to restore cell growth through regeneration. The potential of several kinds of stem cells such as embryonic stem (ES) cells, bone marrow stromal cells (BMSCs), and induced pluripotent stem (iPS) cells were examined as donors of transplantation for replacing inner ear hair cells, spiral or Scarpa's ganglion neurons (cochlear nerve), and spiral ligament cells.
Results: The results of these studies were: (1) A novel method for treatment of the inner ear using drug delivery system was effective clinically. (2) The ES cell- and iPS cell-derived neural progenitors were successfully implanted in the cochlear modiolus and differentiated into neurons after transplant. (3) Transplantation of ES cell-derived neural progenitors improved auditory function. (4) The BMSCs transplant improved endocochlear potential.
Conclusions: These new strategies using regenerative medicine provide a sound foundation for the development of therapies to treat inner ear disorders.