Cochlear Regeneration: A treatment for severe hearing loss in our lifetime? Moderator: George Gates, MD Panelists: Doug Cotanche PhD, Neil Segil PhD, Hinrich Staecker MD PhD HLA Annual Meeting, Nashville, June 19 2009 Generation and Regeneration • All mammals originate from a single cell – the fertilized ovum – which is the ultimate stem cell • Some tissues are regularly replaced by regeneration (blood cells, bone, skin, etc) • Discovery by Cotanche and Rubel 1987 that birds regenerate their inner ears after damage opened a new field of science Regeneration • Requires cells to enter the cell cycle, divide, and exit the cycle on cue. • The possible factors that control this complex process are being evaluated • Too many cells could be as bad as too few • Unresolved issues about how to start and stop, which cells to stimulate, and how to control their interactions with existing cells. Regenerative Medicine • A new field of medicine • Growing tissues in culture and implanting them is evolving (skin, cartilage) • Inner ear regeneration involves 30 + cell types with complex associations • Best guess is that inner ear regeneration will require injecting material into the ear Hearing Regeneration • Will require accurate cell and functional diagnoses • Probable first candidates will be recent onset deafness from a specific cause (ototoxicity, e.g.) • Timeline for clinical application is unknown today – may be decades away Hearing Regeneration Initiative • Consortium of key laboratories under Deafness Research aegis • Will require $50M over 10 years to bring inner ear regeneration to the point of developing and testing an agent or agents • Timeline for trials is unknown today – may be decades away Presentation Schedule • Where are we? Douglas Cotanche, PhD Boston University • Next steps: Neil Segil, PhD. House Ear Institute • Vestibular Regeneration. Hinrich Staecker, MD, PhD, U. Kansas.