Ephrins and Ephs in cochlear innervation and implications for advancing cochlear implant function.

OBJECTIVES/HYPOTHESIS: Determine if the neuronal pathfinding cues resulting from Eph/ephrin interaction in the inner ear play a role in establishing the tonotopic innervation of the cochlea. STUDY DESIGN: Protein expression of Ephs and ephrins was evaluated in the inner ear of mice and chicks. Subsequently, in vitro, in vivo, and functional electrophysiologic studies were performed to indicate that Ephs and ephrins play a role regulating the normal innervation patterns in the mouse inner ear. METHODS: Eph and ephrin protein expression was identified in the inner ear by western blotting and localized by fluorescence immunohistochemistry and X-gal staining. Eph/ephrin effects on neurite outgrowth was assessed via co-culture with EphB2 expressing COS-1 cells. Anatomic effects of disrupting Eph/ephrin signaling on cochlear innervation were determined with lipophilic dye tracing and functional effects with auditory brainstem response (ABR). RESULTS: Expression of several different Ephs and ephrins were found in the inner ear of chicks and mice. The changes in ephrin-A2 immunoreactivity after gentamicin ototoxicity coincide with the spatio-temporal pattern of hair cell loss and regeneration in the chick cochlea. EphB2 inhibited outgrowth of spiral ganglion cell neurites. Knockout mice with null function of EphB1, EphB2, and EphB3 demonstrated abnormal inner ear innervation and elevated ABR thresholds, indicating hearing loss. CONCLUSIONS: Ephrin-A2 may be involved in the guidance of ganglion cells to hair cells in the chick. Disruption of Eph/ephrin signaling results in abnormal innervation and hearing loss, suggesting that these proteins play a role in establishing normal innervation patterns in the mouse cochlea. LEVEL OF EVIDENCE: NA

Ototopic applications of povidone iodine/dexamethasone in the rat.

HYPOTHESIS: Repeated applications of low-concentration povidone iodine (PI) combined with dexamethasone (Dex) through a tympanic membrane ventilation tube will not cause ototoxic changes in the rat. BACKGROUND: Otitis externa (OE) and acute otitis media (AOM) are 2 of the most common otologic disorders requiring outpatient antibiotic treatment. The development of topical treatments that are easy to administer would help to limit systemic exposure to antibiotics in these patients. Topical formulations containing Dex and low-dose PI were designed to provide both antimicrobial and anti-inflammatory effects for the treatment of OE and AOM. Treatment with PI alone has shown mixed results in studies designed to determine PI. Low concentrations of PI combined with Dex should yield less ototoxicity while maintaining effectiveness. METHODS: We performed tympanostomies on rats, inserting a ventilation tube to administer 1% or 2% PI, plus 0.1% Dex over a period of 7 days. Hearing was accessed via auditory brainstem response (ABR) testing over the duration of the study and histologic analysis was performed 15 days after the initial application to determine the effect of administration of PI/Dex on middle and inner ear structures. CONCLUSION: The preparations used in the present investigation were formulated to allow repeated applications to both the external and middle ear, without risk to hearing or equilibrium. Neither of the PI/Dex formulations tested caused pathologic changes in the ear that significantly affected equilibrium, hearing function or morphology.

Effects of cochlear drilling with Piezosurgery Medical device in rats.

OBJECTIVES/HYPOTHESIS: Drilling on the otic capsule for cochleostomy should be less traumatic to the cochlea with the Piezosurgery Medical device (PZ) than with a standard diamond drill (DD). "Soft" cochleostomy is used for preservation of residual hearing in cochlear implant patients. PZ drilling can be used for accurate cochleostomy placement with minimal soft-tissue damage and may be superior for atraumatic drilling on the cochlea, as compared with a DD. This study compared inner ear effects after drilling the rat otic capsule with the PZ versus the DD. STUDY DESIGN: Prospective animal study using rats. METHODS: Otic capsule drilling was performed on the left ear with the DD (n = 5) or the PZ (n = 5), while otic capsule temperature was monitored. Contralateral ears served as controls. The animals were sacrificed after 1 week. Organ of Corti damage was morphologically evaluated and compared between groups. RESULTS: Basal turn hair cell loss was observed in all ears in the PZ group, regardless of drilling depth. However, no cochlear damage was found in any ears in the DD group. CONCLUSIONS: Otic capsule drilling with the PZ results in greater trauma to the rat inner ear than drilling using conventional methods.

Comparison of systemic and otic administration of ofloxacin.

OBJECTIVES: To assess the feasibility of delivering ofloxacin across the intact tympanic membrane; to compare middle ear bioavailability of ofloxacin after otic and systemic administrations; to determine distribution of otically delivered ofloxacin to other tissues. STUDY DESIGN: A prospective, controlled animal study. METHODS: Rats underwent surgery wherein the middle ear cavity was opened and filled with saline. An equivalent amount of ofloxacin was delivered intraperitoneally or into the external ear canal. Saline within the middle ear was sampled and completely replaced in 15-minute intervals for 3 hours. Blood was collected twice after the initial application of ofloxacin for high-performance liquid chromatography (HPLC). Animals were sacrificed 3 hours after the initial addition of ofloxacin; the temporal bones were harvested for histological analysis; urine and colon mucosa were collected for HPLC analysis. RESULTS: Both systemic and otic applications led to a comparable accumulation of ofloxacin in the middle ear over the 3-hour period after the initial administration. The pharmacokinetics of ofloxacin penetration into the middle ear was sporadic and subject-dependent. Both methods of administration led to drug accumulation in blood serum, urine, and colonic mucosa. CONCLUSIONS: Topical application of ofloxacin to the intact tympanic membrane allows for drug penetration into the middle ear space. Similar middle ear ofloxacin levels could be achieved with systemic and topic applications, but drug concentrations were inconsistent. The accumulation of ofloxacin in other tissues suggests applications designed to be ototopical may also result in systemic absorption.

Ototoxicity of topical azithromycin solutions in the guinea pig.

OBJECTIVE: To investigate possible ototoxic effects of topical azithromycin (AZ) in the guinea pig. DESIGN: A prospective, controlled animal study. SETTING: The University of Texas Southwestern Medical Center at Dallas. PARTICIPANTS: Twenty-three pigmented guinea pigs were given single, unilateral middle ear applications of a solution containing 3% (n = 3), 2% (n = 5), 1% (n = 5), or 0.5% (n = 5) AZ or saline (n = 5). The contralateral ear served as the untreated control. MAIN OUTCOME MEASURES: The animals were observed for behavioral changes for 2 weeks and then humanely killed. The ears were processed for anatomical evaluation. Morphologic changes were analyzed by quantitation of middle ear changes and cochlear inner and outer hair cell loss. Statistical analysis was performed to examine effects by dose. RESULTS: Analysis revealed extensive middle and inner ear changes associated with all formulations of AZ. Moderate correlation was found between the extent of middle ear changes and AZ concentration (r(2) = 0.59), whereas a strong correlation was seen between inner ear damage and AZ concentration (r(2) = 0.94). Both inner and outer hair cells were affected, with inner hair cell damage consistently greater than outer hair cell damage. CONCLUSIONS: The results of this study demonstrate that ototopical AZ can cause middle ear changes and significant hair cell loss in the guinea pig. This finding, together with previous clinical reports, indicates that topical AZ should be used with caution in the clinical setting.

Relative structural and functional roles of multiple deubiquitylating proteins associated with mammalian 26S proteasome.

We determined composition and relative roles of deubiquitylating proteins associated with the 26S proteasome in mammalian cells. Three deubiquitylating activities were associated with the 26S proteasome: two from constituent subunits, Rpn11/S13 and Uch37, and one from a reversibly associated protein, Usp14. RNA interference (RNAi) of Rpn11/S13 inhibited cell growth, decreased cellular proteasome activity via disrupted 26S proteasome assembly, and inhibited cellular protein degradation. In contrast, RNAi of Uch37 or Usp14 had no detectable effect on cell growth, proteasome structure or proteolytic capacity, but accelerated cellular protein degradation. RNAi of both Uch37 and Usp14 also had no effect on proteasome structure or proteolytic capacity, but inhibited cellular protein degradation. Thus, proper proteasomal processing of ubiquitylated substrates requires Rpn11 plus either Uch37 or Usp14. Although the latter proteins feature redundant deubiquitylation functions, they also appear to exert noncatalyic effects on proteasome activity that are similar to but independent of one another. These results reveal unexpected functional relationships among multiple deubiquitylating proteins and suggest a model for mammalian 26S proteasome function whereby their concerted action governs proteasome function by linking deubiquitylation to substrate hydrolysis.

Apoptosis in cerebellar granule neurons is associated with reduced interaction between CREB-binding protein and NF-kappaB.

Cerebellar granule neurons undergo apoptosis when switched from medium containing depolarizing levels of potassium (high K+ medium, HK) to medium containing low K+ (LK). NF-kappaB, a ubiquitously expressed transcription factor, is involved in the survival-promoting effects of HK. However, neither the expression nor the intracellular localization of the five NF-kappaB proteins, or of IkappaB-alpha and IkappaB-beta, are altered in neurons primed to undergo apoptosis by LK, suggesting that uncommon mechanisms regulate NF-kappaB activity in granule neurons. In this study, we show that p65 interacts with the transcriptional co-activator, CREB-binding protein (CBP), in healthy neurons. The decrease in NF-kappaB transcriptional activity caused by LK treatment is accompanied by a reduction in the interaction between p65 and CBP, an alteration that is accompanied by hyperphosporylation of CBP. LK-induced CBP hyperphosphorylation can be mimicked by inhibitors of protein phosphatase (PP) 2A and PP2A-like phosphatases such as okadaic acid and cantharidin, which also causes a reduction in p65-CBP association. In addition, treatment with these inhibitors induces cell death. Treatment with high concentrations of the broad-spectrum kinase inhibitor staurosporine prevents LK-mediated CBP hyperphosphorylation and inhibits cell death. In vitro kinase assays using glutathione-S-transferase (GST)-CBP fusion proteins map the LK-regulated site of phosphorylation to a region spanning residues 1662-1840 of CBP. Our results are consistent with possibility that LK-induced apoptosis is triggered by CBP hyperphosphorylation, an alteration that causes the dissociation of CBP and NF-kappaB.

Definition of additional functional ligands for Ly49I(B6) using FVBLy49I(B6) transgenic mice and B6 natural killer cell effectors.

BACKGROUND: Natural killer (NK) cells use inhibitory Ly49 receptors to differentiate self from foreign cells based on interactions with major histocompatibility (MHC) class I molecules. Inhibitory receptors may recognize multiple MHC class I molecules. Studies to define ligands for the Ly49 receptors are complicated by the fact that receptors are expressed in overlapping subsets on NK cells. Binding studies can predict which MHC class I molecules are ligands for Ly49 receptors, but functional tests are required to substantiate results from binding studies. METHODS: We developed Ly49 receptor transgenic mice and studied the function of Ly49I(B6) in FVB.Ly49I(B6) transgenic mice using bone marrow transplantation assays to determine additional functional ligands for Ly49I(B6). We have also used fluorescence-activated cell sorting to isolate specific populations of B6 NK cells bearing Ly49I for use as effectors in chromium-release assays against a panel of Concanavalin A blast targets. RESULTS: Bone marrow transplantation studies indicate that H2-K(b), H2(s), and H2(v) serve as functional ligands for Ly49I(B6). In vitro cytotoxicity assays indicate that Ly49I recognizes H2(q), but not H2(d) or H2(k), target cells to inhibit NK killing. CONCLUSIONS: These data add support to previous binding studies by showing functional interactions between the B6-strain Ly49I and H2-K(b), H2(s), H2(v), and H2(q) class I antigens.