Will cochlear implants be obsolete when stem cells comes?

[ecp]

ecp- It will stop when the particular stem cell concentration injections cease. What's the date of that article? Source?

However, ecp, I certainly agree: "the best solution is to let people make their own decisions and respect the decisions of others."

I'm just defending my own position is all.

The stem cells would be instilled once, most likely. They would be primed to develop into a certain type of cell using chemicals (I've done this at work with bone marrow (for a project not associated with hearing)- you just extract the marrow, give it some GCSF and hopefully in 14 days you have your desired neurtophils).
I'm not referring to an article- my statements are from my experience working on restoring hearing in mice at a major research hospital. I am a scientist. I don't know everything but I know quite a bit about the various methods currently being attempted to restore hearing in mammals. The best technique right now is to trick the supporting cells (Deiters cells) into reproducing and then trick them into becoming hair cells. This can be partially accomplished using genetic techniques (using a virus to deliver the genes to the correct cells) but nobody has gotten this to work.
Often the cells keep reproducing (we know how to turn them on but we can't find the off switch). There is no way to ensure that the cells develop into hair cells which are extremely complex.

Also, the cause of deafness is a big factor. For example, the connexin gene is a common cause for hearing loss. The gene codes for gap junction proteins, which are tiny tubes that connect cells. Normally the junctions are "water tight" but when the connexin gene is mutated the protein allows leaks in the hair cells. Ions, which are used to make cells more or less conductive and thus able to transmit an action potential, are supposed to come in and out of hair cells and not stick around for too long. When the junction is leaky, the hair cells are damaged by the ions (Na+, K+ and Ca2+).
For deafness caused by meningitis- nobody is quite sure how the infection damages the hair cells. It could be the bacteria in the cochlea, it could be the chemicals that our bodies release when fighting off infections (the same chemicals cause you to get a fever or inflamation around an infection), it could be both. It could be neither.

Most people with profound hearing loss don't only have damaged stereocillia (the "hairs" of hair cells), we have damage to the inner and outer hair cells and over time the cells are "paved over" This image illustrates it well.

Most methods are based on the fact that birds, most notably chickens, have the ability to regenerate hair cells.

Significant progress IS being made in preventing hair cell death from ototoxic drugs and noise damage. That is an important field because some of the most effective anti-cancer drugs are really good at killing hair cells.

I'd write more but it is 2AM here and I've got some sleeping to do. I'm really not a pessimist, I just know how long science takes.

 

[overthepond]

I am with Faire Jour and Deaf Dyke, John57.

Not everyone can have stem cell... so I think there would be opition of CI or stem cells.

John57, I have no basilar membrane as found out when I had the scan during CI assessment and my surgeon explained to my uncle after my Op, he said it was very easy instertion as i haven't got basilar membrane.

 

[deafdude1]

Also, the cause of deafness is a big factor. For example, the connexin gene is a common cause for hearing loss. The gene codes for gap junction proteins, which are tiny tubes that connect cells. Normally the junctions are "water tight" but when the connexin gene is mutated the protein allows leaks in the hair cells. Ions, which are used to make cells more or less conductive and thus able to transmit an action potential, are supposed to come in and out of hair cells and not stick around for too long. When the junction is leaky, the hair cells are damaged by the ions (Na+, K+ and Ca2+).

Thats probably my cause of deafness. Still, this won't prevent stem cells from working. The question is how long will the new hair cells live? My hearing has dropped twice since 1998 but only in the high frequencies. I can always get more stem cells every 5-10 years to account for any hearing drops, till they can find a way to repair the gene mutation.

Most people with profound hearing loss don't only have damaged stereocillia (the "hairs" of hair cells), we have damage to the inner and outer hair cells and over time the cells are "paved over" This image illustrates it well.

We probably have no outer hair cells and very few inner hair cells and cochlear dead regions in the higher frequencies. I can't hear above 1200Hz on the piano thud test and I experience no improvement in speech scores above 600Hz. That's why im really looking forward for even a 20db improvement, itll go a long way.

Significant progress IS being made in preventing hair cell death from ototoxic drugs and noise damage. That is an important field because some of the most effective anti-cancer drugs are really good at killing hair cells.

An ounce of prevention is worth a pound of cure. Take good care of your ears!

Not everyone can have stem cell... so I think there would be opition of CI or stem cells. John57, I have no basilar membrane as found out when I had the scan during CI assessment and my surgeon explained to my uncle after my Op, he said it was very easy instertion as i haven't got basilar membrane.

Im sure research and technology will advance to the point that more and more people become candidates for stem cells. Im sure early on a small percentage won't be candidates or they won't benefit from stem cells but that will change. I consider CI as a last resort. It worked great for you since your hearing was way worse than mine when comparing audiograms. Have you been able to get better than 30db with CI? What's your speech score up to now? Plan to get stem cells in your 2nd ear or CI or just leave it dead?

 

[ref74]

I don't think we should create a "stem cells vs CI" debate at this point.

The only certain thing is that CI is an actual solution, while stem cells therapy at the moment is simply a perspective. OK there are significant advances in the field, but we are still pretty far away from the clinical application.
I strongly believe stem cells will be the solution for many diseases, hearing loss included, but at the moment no routine therapy based on them does exist. There are many hopes, strong expectations, but there is still a lot to understand before considering stem cells a real option. I would not consider as reliable the cases reported from China or other far east countries, unless coming from a clearly stated (and serious) information source.

FDA approval isn't a joke, it is a scientific certification, based on severe medical parameters, and believe it or not, the pressure of corporations have a very minor, if any, role in that. A therapy can be considered as a safe option only when it gets the FDA approval. Furthermore, there are some ethical implications with stem cells, not really a problem in the US apparently, but much more complicated in Europe, especially in the catholic countries.

Once stem cells will demonstrate to be successful, reproducible, reasonably safe, there will be an FDA mark and they will be a real option. Until that momentwe only have wonderful hopes. There is no doubt anyway, once they will become an official therapy they will be the route to go and there will be less and less space for CI and HA.

 

[sr171soars]

I will agree with those that state it is too early to talk about any comparison between CIs and stem cells.

What we know at this point in time?

CIs have been around and they work. Stem cells?!? Well, there is some promise and hope they can do the trick. Beyond that...nothing. How long? Million dollar question. Probably similar to the odds of winning the lottery and striking it big.

I rather go with something that works right now and not wait potentially for decades before getting a chance to hear well again.

As I have a CI, I have already won the lottery hands down. So, it is not a "cure" as some like to tout. Big fat hairy deal! At least, I'm hearing the best I have ever heard in life and getting on with my life.

As for the dreamers, enjoy! May your wish come true down the road.

In the meanwhile, I think I will give my wife a call on my cell...

 

[neuro]

Regeneration to restore hearing neuritas
Description:

Complutense University of Madrid offers a method to regenerate neuritas of spiral ganglion neurons. This neuronal regeneration is independent of the individual's age, as they reclaimed the neuritas in newborn animals, youth, adults and aged.

This method can develop new ways to improve hearing in patients with sensorineural hearing loss or deafness. For the method of regeneration in humans will require a new product design and biofarmacológico hearing aid that allows the release of growth factors necessary for regeneration and survival of spiral ganglion neurons in vivo.

source: ::: COMPLUTECNO ::: Cartera Tecnológica de la Universidad Complutense de Madrid

I have to say that the "stem cell" solution is very, very far in the future.
The major problem is that you can coax a stem cell to become any type of cell and it will. And it will make more cells. But it won't stop. And which cells should we replace?
Most people with profound hearing loss have badly damaged inner and outer hair cells. In addition, many of the support cells become atrophied.

I really think that the best solution is to let people make their own decisions and respect the decisions of others.

 

[Christer]

<<<< Anti-Cochlear Impants. I voted the first one. No discussions with me

 

[neuro]

stem cells failure?

hi,
Do you think is leading the initiative CBR Center for Regenerative Medicine - Hearing Loss - Cord Blood Stem Cells from Cord Blood Registry (I do not know if now or very soon) will be destined to failure, according to the explanations you have given? Or take decades to know the results?

The stem cells would be instilled once, most likely. They would be primed to develop into a certain type of cell using chemicals (I've done this at work with bone marrow (for a project not associated with hearing)- you just extract the marrow, give it some GCSF and hopefully in 14 days you have your desired neurtophils).
I'm not referring to an article- my statements are from my experience working on restoring hearing in mice at a major research hospital. I am a scientist. I don't know everything but I know quite a bit about the various methods currently being attempted to restore hearing in mammals. The best technique right now is to trick the supporting cells (Deiters cells) into reproducing and then trick them into becoming hair cells. This can be partially accomplished using genetic techniques (using a virus to deliver the genes to the correct cells) but nobody has gotten this to work.
Often the cells keep reproducing (we know how to turn them on but we can't find the off switch). There is no way to ensure that the cells develop into hair cells which are extremely complex.

Also, the cause of deafness is a big factor. For example, the connexin gene is a common cause for hearing loss. The gene codes for gap junction proteins, which are tiny tubes that connect cells. Normally the junctions are "water tight" but when the connexin gene is mutated the protein allows leaks in the hair cells. Ions, which are used to make cells more or less conductive and thus able to transmit an action potential, are supposed to come in and out of hair cells and not stick around for too long. When the junction is leaky, the hair cells are damaged by the ions (Na+, K+ and Ca2+).
For deafness caused by meningitis- nobody is quite sure how the infection damages the hair cells. It could be the bacteria in the cochlea, it could be the chemicals that our bodies release when fighting off infections (the same chemicals cause you to get a fever or inflamation around an infection), it could be both. It could be neither.

Most people with profound hearing loss don't only have damaged stereocillia (the "hairs" of hair cells), we have damage to the inner and outer hair cells and over time the cells are "paved over" This image illustrates it well.

Most methods are based on the fact that birds, most notably chickens, have the ability to regenerate hair cells.

Significant progress IS being made in preventing hair cell death from ototoxic drugs and noise damage. That is an important field because some of the most effective anti-cancer drugs are really good at killing hair cells.

I'd write more but it is 2AM here and I've got some sleeping to do. I'm really not a pessimist, I just know how long science takes.

 

[SkullChick]

uh phi, what drawbacks?
also did anyone listen to this, "genetic hearing loss it will die with new nerves being put in because its genetically programmed to be deaf its dead in the first place for REASON lie in the genes"
could be certain part of hearing system is flawed from mutated in te genes, connexins mutations, enlarged vestibular aqueduct, the fluids will damages the cochlea cells when you have any kind of trauma.
only way stem cell will work is to genetically alter the human dna by putting in normal sequence of genes to have hearing then insert stem cell in the cochlea and it will succeed, or car accident, severe trauma from force, medications, any physical damages probably will succeed too but for deaf from birth, progressive hearing loss from genes/aqueducts no way it'll ever be used to treat the hearing loss, thus the reason CI is there for, its to treat profoundly genetic hearing loss Im know for fact it will not work for me i have progressive hearing loss it will just kill the new nerves off.

 

[ref74]

hi,
Do you think is leading the initiative CBR Center for Regenerative Medicine - Hearing Loss - Cord Blood Stem Cells from Cord Blood Registry (I do not know if now or very soon) will be destined to failure, according to the explanations you have given? Or take decades to know the results?

Clinical trials aren't an easy task. Often they take several years.
Anyway, the thing will be much much more complicated than it seems to some of you. Genetic theraphy, in vivo tissue growth, cellular proliferation and self-organization are largely unknown phenomena, there are so many things still to be discovered and studied before stating we have THE cure.
Nobody has an idea of the complications, side effects, expected success rate for the various kind of hearing losses.
It won't at all be like having an injection and boom, my cochlea is healed. Unfortunately it won't be that easy. Nevertheless it will be possible and we are facing this new age. Nobody can forecast when the first solid effects of this new age will really appear. It is much more probable we need decades than it will happen tomorrow. (Of course I would be happy it will really be tomorrow!)

 

[faire_jour]

Also, if you haven't heard for 40 years, why do you think some stem cells will make your brain suddenly able to decode sound? It won't! And there will be a huge backlash from the profoundly deaf since birth group because they thought this was going to be better.

The time to hear is now, not later.

Phi, also, if someone loses their hearing suddenly, like from menengitis, there is a hurry to get them a CI, it doesn't take years. And they can attest to the fact that it sounds just like it always did, by 6 months post. The longer you are without hearing, the longer it takes for your brain to get used to it.

 

[deafdude1]

Also, if you haven't heard for 40 years, why do you think some stem cells will make your brain suddenly able to decode sound? It won't! And there will be a huge backlash from the profoundly deaf since birth group because they thought this was going to be better.

Id like to see you explain how CI works so well for many prelinguals who were born profoundly deaf and haven't heard much even with powerful HAs

The time to hear is now, not later.

Most people already hear now with the right HAs. CI is great for those who can't tell if their HAs are on or off.

Phi, also, if someone loses their hearing suddenly, like from menengitis, there is a hurry to get them a CI, it doesn't take years. And they can attest to the fact that it sounds just like it always did, by 6 months post. The longer you are without hearing, the longer it takes for your brain to get used to it.

By 6 months, they forget what it's like to be hearing. They are comparing deafness vs. the improvement CI gives them. Phi also has many good points in the long reply to you.

 

[kokonut]

uh phi, what drawbacks?
also did anyone listen to this, "genetic hearing loss it will die with new nerves being put in because its genetically programmed to be deaf its dead in the first place for REASON lie in the genes"
could be certain part of hearing system is flawed from mutated in te genes, connexins mutations, enlarged vestibular aqueduct, the fluids will damages the cochlea cells when you have any kind of trauma.
only way stem cell will work is to genetically alter the human dna by putting in normal sequence of genes to have hearing then insert stem cell in the cochlea and it will succeed, or car accident, severe trauma from force, medications, any physical damages probably will succeed too but for deaf from birth, progressive hearing loss from genes/aqueducts no way it'll ever be used to treat the hearing loss, thus the reason CI is there for, its to treat profoundly genetic hearing loss Im know for fact it will not work for me i have progressive hearing loss it will just kill the new nerves off.

Um, there is a different kind of "CI" that could address those with progressive hearing loss. It's called a brainstem implant.

Auditory Brainstem Implants: Update 2009
O'Driscoll (2009) reports that approximately 1,000 people worldwide have received an auditory brainstem implant (ABI). The majority of ABI recipients are neurofibromatosis type 2 (NF2) patients, previously diagnosed and treated for bilateral acoustic neuromas. Other candidates for ABI may include people with cochlear or auditory nerve agenesis or hypoplasia (people without eight nerves, people without cochleas, or people with malformed cochleas) and those with totally ossified cochleas, which may present after meningitis.

The ABI electrode array consists of 21 platinum disks (0.7 mm diameter). The array is surgically placed on the surface of the cochlear nucleus, along the lateral recess of the 4th ventricle. An electrically-evoked ABR is used intraoperatively to confirm optimal response and placement of the electrode.

Post-operatively, the ABI is mapped in a manner similar to the cochlear implant. However, the well-known tonotopic organization of the cochlear implant is not always apparent with the ABI. Nonetheless, thresholds and comfortable loudness levels are established for each electrode and fine-tuning based on patient feedback and preferences occurs over time.

Auditory Brainstem Implants: Update 2009

 

[faire_jour]

So, if I lost my hearing tomorrow, you actually think in 6 months I would forget what it was like to have normal hearing? That is just ridiculous. I have had excellent hearing for 30 years, there is no way I could ever "forget" it. That is just laughable.

 

[faire_jour]

Um, there is a different kind of "CI" that could address those with progressive hearing loss. It's called a brainstem implant.



Auditory Brainstem Implants: Update 2009

No, this is for people without an auditory nerve.

 

[deafskeptic]

Id like to see you explain how CI works so well for many prelinguals who were born profoundly deaf and haven't heard much even with powerful HAs



Most people already hear now with the right HAs. CI is great for those who can't tell if their HAs are on or off.

I got a CI and I always could tell if my HA was off or on and so could most people around me. My loss was in the 115s in most fequenices before I got the CI. But since my HA just amped the sound and I had severe damage to my hair cells in my cochlear, sound was quite distorted. My HA was alright for hearing environmental sounds but not so good for understanding people.

When I got my CI, I had to relearn many of the sounds and there are still sounds that I can hear but not really recognize. I remember that I died a lot to rogues on World of Warcraft because I didn't learn to recongize the woosh sound for six months.

At first a certain bubbling sound had no meaning to me though I could hear it till I burned my rice and ruined my cooking pot. Now every time I hear that sound, it has taken on an ominous meaning and I run to the kitchen when I hear it.

Speech was much easier for me to understand.

 

[kokonut]

No, this is for people without an auditory nerve.

Note the quotation "ci" which is not CI per se, it's a brainstem implant that does not involve the cochlea at all but still produces the sensation of sound.

 

[Phi4Sius]

So, if I lost my hearing tomorrow, you actually think in 6 months I would forget what it was like to have normal hearing? That is just ridiculous. I have had excellent hearing for 30 years, there is no way I could ever "forget" it. That is just laughable.

You may not "forget" and the memory may certainly be there, but you'll lose a certain approximation of what normal excellent hearing actually IS. Any audiologist will tell you that the longer you go without hearing the more the nerve starts to atrophy. The CI is a totally robotic, electronic sound. Go to YouTube and check out the CI activation videos. In nearly every single one, you'll hear the comment that "hmmm...this sounds really robotic" or "this sounds like it's "pulsating"" or something along those lines. Once you get used to hearing through something like that, of course it will seem like normal hearing. But NEVER at the START.

I'm surprised there hasn't been a study performed on this - how long between when someone who is hearing and when they get the CI how much of a sound they truly hear vs. real, true NORMAL sound.

I bet the results of such a study would surprise everyone.

 

[deafdyke]

The major problem is that you can coax a stem cell to become any type of cell and it will. And it will make more cells. But it won't stop. And which cells should we replace?

Agreed. They are already using stem cells for things like bone marrow transplants or to cure things like Bubble Boy Disease or the lekeodysrophies.
and ecn.....I TOTALLY agree.....Stem cells are still very much in the " could happen, but might not be sucessful" stage.

 

[deafdyke]

You know.....in past decades there have been "cures" like airplane rides (1920's and 30's) and in the 70's it was chiropratic. What makes you think that stem cells are any different? You know..........hearing and sight and mobilty disabilites can be ADAPTED to and lived with! We need to concentrate cures on stuff that REALLY affects people like Alizhiemers, mental illness, profound mental retardation etc.