Abstract

Preservation of the excitability of spiral ganglion neurons (SGN) may contribute to an improved speech perception after cochlear implantation. Thus, the application of exogenous neurotrophic factors such as the neurotrophin brain-derived neurotrophic factor (BDNF) to increase SGN survival in vitro and in vivo is a promising pharmacological approach in cochlear implant (CI) research. Due to the difficult pharmacokinetic profile of proteins such as BDNF, there is a quest for small molecules to mediate the survival of SGN or to increase the efficacy of BDNF. The C3 exoenzyme from Clostridium botulinum could be a potential new candidate for the protection and regeneration of SGN. Inhibition of the RhoA GTPase pathway which can be mediated by C3 is described as a promising strategy to enhance axonal regeneration and to exert pro-survival signals in neurons. Nanomolar concentrations of C3, its enzymatically inactive form C3E174Q, and a 26mer C-terminal peptide fragment covering amino acid 156–181 (C3156-181) potentiated the neuroprotective effect on SGN mediated by BDNF in vitro. The neuroprotective effect of C3/BDNF was reduced to the neuroprotective effect of BDNF alone after the treatment with wortmannin, an inhibitor of the phosphatidylinositol-3-kinase (PI3K).The exoenzyme C3 (wild-type and enzyme-deficient) and the C3 peptide fragment C3154–181 present novel biologically active compounds for the protection of the SGN. The exact underlying intracellular mechanisms that mediate the neuroprotective effect are not clarified yet, but the combination of BDNF (TrkB stimulation) and C3 exoenzyme (RhoA inhibition) can be used to protect SGN in vitro.

Highlights

  • According to the World Health Organization, over 460 million people worldwide suffer from hearing loss (WHO, 2020)

  • The hair cell loss is compensated with the aid of a cochlear implant (CI) which is an electrode array that directly stimulates the residual spiral ganglion neurons (SGN) enabling the transport of acoustic signals to the brain (Lenarz, 2017; Perenyi et al, 2018)

  • The neuroprotective effect of brain-derived neurotrophic factor (BDNF) is mediated by the binding to the high-affinity tyrosine kinase receptor B (TrkB), which is expressed in the SGN

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Summary

Introduction

According to the World Health Organization, over 460 million people worldwide suffer from hearing loss (WHO, 2020). The most common form is the sensorineural hearing loss caused by irreversible damage to the inner hair cells, followed by the degeneration of the spiral ganglion neurons (SGN). It is therapeutically desirable to preserve healthy and to regenerate damaged neurons by neuroprotective factor application. Several neuroprotective factors have been identified that regulate neuronal differentiation, survival, and axonal outgrowth (Wefstaedt et al, 2005; Schmidt et al, 2018). Several in vitro and in vivo studies showed that exogenous application of BDNF increased the survival of SGN and further enhanced the protective effects of electrical stimulation of the auditory nerve (McGuinness and Shepherd, 2005; Warnecke et al, 2007; Agterberg et al, 2009). BDNF protects cortical neurons from phenylalanine-induced apoptosis by inactivation of Rho (Zhang et al, 2010). Despite being acknowledged as a potent neuroprotective agent, the effect and function of C3 have not been analyzed in the auditory system, especially not in SGN up to now

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