Molecular mechanisms involved in cochlear implantation trauma and the protection of hearing and auditory sensory cells by inhibition of c-jun-N-terminal kinase signaling

Objectives/Hypothesis: To investigate the molecular mechanisms involved in electrode insertion trauma (EIT) and to test the otoprotective effect of locally delivered AM‐111. Study Design: An animal model of cochlear implantation. Methods: Guinea pigs' hearing thresholds were measured by auditory brainstem response (ABR) before and after cochlear implantation in four groups: EIT; pretreated with hyaluronate gel 30 minutes before EIT (EIT+Gel); pretreated with hyaluronate gel/AM‐111 30 minutes before EIT (EIT+AM‐111); and unoperated contralateral ears as controls. Neurofilament, synapsin, and fluorescein isothiocyanate (FITC)‐phalloidin staining for hair cell counts were performed at 90 days post‐EIT. Immunostaining for 4‐hydroxy‐2‐nonenal (HNE), activated caspase‐3, CellROX, and phospho‐c‐Jun were performed at 24 hours post‐EIT. Results: ABR thresholds increased post‐EIT in the cochleae of EIT only and EIT+Gel treated animals. There was no significant increase in hearing thresholds in cochleae from either EIT+AM‐111 treated or unoperated control ears. AM‐111 protection of organ of Corti sensory elements (i.e., hair cells [HCs], supporting cells [SCs], nerve fibers, and synapses) was documented at 3 months post‐EIT. Immunostaining of 24‐hour post‐EIT specimens demonstrated increased levels of HNE in HCs and SCs; increased levels of CellROX and activation of caspase‐3 was observed only in SCs, and phosphorylation of c‐Jun occurred only in HCs of the EIT‐only and EIT+Gel specimens. There was no immunostaining for either HNE, CellROX, caspase‐3, or phospho‐c‐Jun in the organ of Corti specimens from AM‐111 treated cochleae. Conclusions: Molecular mechanisms involved in programmed cell death of HCs are different than the ones involved in programmed cell death of SCs. Local delivery of AM‐111 provided a significant level of protection against EIT‐induced hearing losses, HC losses, and damage to neural elements. Laryngoscope, 123:S1–S14, 2013