RESUMEN
Postmortem examination of the cochlea with a cochlear implant in the scala tympani presents several challenges. It is technologically difficult to section a cochlea with an implant due to the presence of its wires and metal components that are adjacent to the membranous and bony tissues of the cochlea. These metal components damage traditional steel blades of a microtome in celloidin, paraffin or frozen embedded tissues. However, plastic embedded implanted cochleas have been successfully sectioned using specialized methods (Irving et al., 2013). An alternative non-destructive method is to optically section a chemically cleared cochlea using light-sheet microscopy, which we will describe in this publication. However, since this method uses a light-sheet to section the cochlea the opaque and reflective metal components of the implant results in some artifacts in the 2D optical sections. The best image quality using light-sheet fluorescent microscopy is when the implant is removed prior to imaging.
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Implantación Coclear , Implantes Cocleares , Cobayas , Animales , Ratones , Rampa Timpánica , Cóclea/diagnóstico por imagen , Microscopía FluorescenteRESUMEN
Deafness is the most common sensory impairment, affecting approximately 5% or 430 million people worldwide as per the World Health Organization1. Aging or presbycusis is a primary cause of sensorineural hearing loss and is characterized by damage to hair cells, spiral ganglion neurons (SGNs), and the stria vascularis. These structures reside within the cochlea, which has a complex, spiral-shaped anatomy of membranous tissues suspended in fluid and surrounded by bone. These properties make it technically difficult to investigate and quantify histopathological changes. To address this need, we developed a light-sheet microscope (TSLIM) that can image and digitize the whole cochlea to facilitate the study of structure-function relationships in the inner ear. Well-aligned serial sections of the whole cochlea result in a stack of images for three-dimensional (3D) volume rendering and segmentation of individual structures for 3D visualization and quantitative analysis (i.e., length, width, surface, volume, and number). Cochleae require minimal processing steps (fixation, decalcification, dehydration, staining, and optical clearing), all of which are compatible with subsequent high-resolution imaging by scanning and transmission electron microscopy. Since all the tissues are present in the stacks, each structure can be assessed individually or relative to other structures. In addition, since imaging uses fluorescent probes, immunohistochemistry and ligand binding can be used to identify specific structures and their 3D volume or distribution within the cochlea. Here we used TSLIM to examine cochleae from aged mice to quantify the loss of hair cells and spiral ganglion neurons. In addition, advanced analyses (e.g., cluster analysis) were used to visualize local reductions of spiral ganglion neurons in Rosenthal's canal along its 3D volume. These approaches demonstrate TSLIM microscopy's ability to quantify structure-function relationships within and between cochleae.
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Cóclea , Colorantes Fluorescentes , Ratones , Animales , Ligandos , Cóclea/diagnóstico por imagen , Ganglio Espiral de la Cóclea/diagnóstico por imagen , Ganglio Espiral de la Cóclea/patología , Microscopía Fluorescente , Envejecimiento/patologíaRESUMEN
This research is the first to produce induced pluripotent stem cell-derived inner ear sensory neurons in the Neurog1+/- heterozygote mouse using blastocyst complementation. Additionally, this approach corrected non-sensory deficits associated with Neurog1 heterozygosity, indicating that complementation is specific to endogenous Neurog1 function. This work validates the use of blastocyst complementation as a tool to create novel insight into the function of developmental genes and highlights blastocyst complementation as a potential platform for generating chimeric inner ear cell types that can be transplanted into damaged inner ears to improve hearing.
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Oído Interno , Animales , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/genética , Blastocisto , Quimera , Ratones , Proteínas del Tejido Nervioso , Células Receptoras SensorialesRESUMEN
The transcription factor sex determining region Y-box 2 (SOX2) is required for the formation of hair cells and supporting cells in the inner ear and is a widely used sensory marker. Paradoxically, we demonstrate via fate mapping that, initially, SOX2 primarily marks nonsensory progenitors in the mouse cochlea, and is not specific to all sensory regions until late otic vesicle stages. SOX2 fate mapping reveals an apical-to-basal gradient of SOX2 expression in the sensory region of the cochlea, reflecting the pattern of cell cycle exit. To understand SOX2 function, we undertook a timed-deletion approach, revealing that early loss of SOX2 severely impaired morphological development of the ear, whereas later deletions resulted in sensory disruptions. During otocyst stages, SOX2 shifted dramatically from a lateral to medial domain over 24-48â h, reflecting the nonsensory-to-sensory switch observed by fate mapping. Early loss or gain of SOX2 function led to changes in otic epithelial volume and progenitor proliferation, impacting growth and morphological development of the ear. Our study demonstrates a novel role for SOX2 in early otic morphological development, and provides insights into the temporal and spatial patterns of sensory specification in the inner ear.
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Cóclea/embriología , Oído Interno/embriología , Células Ciliadas Auditivas/fisiología , Morfogénesis/genética , Factores de Transcripción SOXB1/fisiología , Animales , Tipificación del Cuerpo/genética , Diferenciación Celular/genética , Cóclea/citología , Oído Interno/crecimiento & desarrollo , Embrión de Mamíferos , Desarrollo Embrionario/genética , Femenino , Células Ciliadas Auditivas/citología , Masculino , Ratones , Ratones Transgénicos , Embarazo , Factores de Transcripción SOXB1/genética , Factores de TiempoRESUMEN
TMPRSS3 (Trans-membrane Serine Protease 3) is a type II trans-membrane serine protease that has proteolytic activity essential for hearing. Mutations in the gene cause non-syndromic autosomal recessive deafness (DFNB8/10) in humans. Knowledge about its cellular distribution in the human inner ear may increase our understanding of its physiological role and involvement in deafness, ultimately leading to therapeutic interventions. In this study, we used super-resolution structured illumination microscopy for the first time together with transmission electron microscopy to localize the TMPRSS3 protein in the human organ of Corti. Archival human cochleae were dissected out during petroclival meningioma surgery. Microscopy with Zeiss LSM710 microscope achieved a lateral resolution of approximately 80 nm. TMPRSS3 was found to be associated with actin in both inner and outer hair cells. TMPRSS3 was located in cell surface-associated cytoskeletal bodies (surfoskelosomes) in inner and outer pillar cells and Deiters cells and in subcuticular organelles in outer hair cells. Our results suggest that TMPRSS3 proteolysis is linked to hair cell sterociliary mechanics and to the actin/microtubule networks that support cell motility and integrity.
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Proteínas de la Membrana/metabolismo , Proteínas de Neoplasias/metabolismo , Órgano Espiral/enzimología , Serina Endopeptidasas/metabolismo , Actinas/metabolismo , Adulto , Anciano , Femenino , Humanos , Uniones Intercelulares/metabolismo , Uniones Intercelulares/ultraestructura , Masculino , Microtúbulos/metabolismo , Microtúbulos/ultraestructura , Persona de Mediana Edad , Órgano Espiral/citología , Órgano Espiral/ultraestructuraRESUMEN
Globally 360 million people have disabling hearing loss and, of these, 32 million are children. Human hearing relies on 15,000 hair cells that transduce mechanical vibrations to electrical signals in the auditory nerve. The process is powered by the endo-cochlear potential, which is produced by a vascularized epithelium that actively transports ions in conjunction with a gap junction (GJ) system. This "battery" is located "off-site" in the lateral wall of the cochlea. The GJ syncytium contains the GJ protein genes beta 2 (GJB2/connexin26 (Cx26)) and 6 (GJB6/connexin30 (Cx30)), which are commonly involved in hereditary deafness. Because the molecular arrangement of these proteins is obscure, we analyze GJ protein expression (Cx26/30) in human cochleae by using super-resolution structured illumination microscopy. At this resolution, the Cx26 and Cx30 proteins were visible as separate plaques, rather than being co-localized in heterotypic channels, as previously suggested. The Cx26 and Cx30 proteins thus seem not to be co-expressed but to form closely associated assemblies of GJ plaques. These results could assist in the development of strategies to treat genetic hearing loss in the future.
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Cóclea/metabolismo , Conexina 26/metabolismo , Conexinas/metabolismo , Microscopía Fluorescente/métodos , Adulto , Anciano , Cóclea/ultraestructura , Conexina 30 , Femenino , Humanos , Imagenología Tridimensional , Inmunohistoquímica , Transporte Iónico , Masculino , Persona de Mediana Edad , Modelos Biológicos , Canales de Potasio/metabolismoRESUMEN
Decellularized tissues have been used to investigate the extracellular matrix (ECM) in a number of different tissues and species. Santi and Johnson JARO 14:3-15 (2013) first described the decellularized inner ear in the mouse, rat, and human using scanning thin-sheet laser imaging microscopy (sTSLIM). The purpose of the present investigation is to examine decellularized cochleas in the mouse and human at higher resolution using scanning electron microscopy (SEM). Fresh cochleas were harvested and decellularized using detergent extraction methods. Following decellularization, the ECM of the bone, basilar membrane, spiral limbus, and ligament remained, and all of the cells were removed from the cochlea. A number of similarities and differences in the ECM of the mouse and human were observed. A novel, spirally directed structure was present on the basilar membrane and is located at the border between Hensen and Boettcher cells. These septa-like structures formed a single row in the mouse and multiple rows in the human. The basal lamina of the stria vascularis capillaries was present and appeared thicker in the human compared with the mouse. In the mouse, numerous openings beneath the spiral prominence that previously housed the root processes of the external sulcus cells were observed but in the human there was only a single row of openings. These and other anatomical differences in the ECM between the mouse and human may reflect functional differences and/or be due to aging; however, decellularized cochleas provide a new way to examine the cochlear ECM and reveal new observations.
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Cóclea/ultraestructura , Matriz Extracelular/ultraestructura , Animales , Humanos , Ratones , Ratones Endogámicos C57BL , Microscopía Electrónica de Rastreo , Estría Vascular/ultraestructuraRESUMEN
HYPOTHESIS: Thin-sheet laser imaging microscopy (TSLIM) optical sectioning can be used to assess temporal bone soft tissue morphology before celloidin sectioning. BACKGROUND: Traditional human temporal bone (TB) celloidin embedding and sectioning is a lengthy and involved process. Although bone morphology can be assessed with microCT before traditional histology, soft tissue structures are difficult to resolve until after celloidin sectioning. A potential solution is TSLIM, a high-resolution, nondestructive optical sectioning technique first developed to image bone and soft tissue in animal cochleae. METHODS: Two temporal bones from 1 individual were used to evaluate TSLIM's capacity to image human temporal bones (bone and soft tissue) before traditional histology. The right TB was trimmed to the cochlea, prepared for and imaged with TSLIM, then processed for celloidin sectioning. The left TB, serving as a control, was directly prepared for traditional celloidin sectioning. RESULTS: TSLIM imaging of the right TB showed adequate resolution of all major tissue structures but barely resolved cells. Celloidin sections produced from the TSLIM-imaged right TB were equivalent in cytologic detail to those from the traditionally prepared left TB. TSLIM 3-dimensional (3D) reconstructions were superior to those obtained from celloidin sections because TSLIM produced many more sections that were without mechanical sectioning artifacts or alignment issues. CONCLUSION: TSLIM processing disturbs neither gross nor detailed morphology and integrates well with celloidin histology, making it an ideal method to image soft tissue before celloidin sectioning.
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Técnicas Histológicas/métodos , Imagen Óptica/métodos , Hueso Temporal/patología , Humanos , Microscopía Confocal/métodosRESUMEN
OBJECTIVE: Administration of an aminoglycoside antibiotic and loop diuretic causes damage to hair cells in the organ of Corti, resulting in their death and the death of their corresponding spiral ganglion neurons. While this phenomenon has been studied previously, analysis of its effects in the whole cochlea has not been reported. The authors sought to evaluate the effects of a combination dose of kanamycin and furosemide in mice cochlea using an imaging system and computer analysis that allowed for nondestructive, whole-cochlea visualization. STUDY DESIGN: Study using an animal model. SETTING: Cochlear analysis laboratory. SUBJECTS AND METHODS: Five mice received kanamycin and furosemide and 3 mice received saline. Cochleas were harvested and imaged with scanning thin-sheet laser imaging microscopy (sTSLIM) to analyze sensory cells and cochlea structures. RESULTS: The drug-treated animals showed substantial loss of inner hair cells and complete outer hair cell loss. All treated mice showed spiral ganglion neuron loss with fewer neurons than control animals and decreased cell density in the middle turn of the cochlea. The spiral ligament and spiral limbus in the treated animals also showed a decrease in fibrocyte cell density in the middle to apical portion of the cochlea. The stria vascularis appeared normal in all animals. CONCLUSION: Imaging methods that allow for whole-cochlea analysis provide insight into changes that occur in the cochlea after ototoxic insult. Trends that may not be apparent in cross-section samples of the cochlea can be observed. Computer analysis of these trends allows them to be assessed accurately.
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Cóclea/efectos de los fármacos , Células Ciliadas Auditivas/efectos de los fármacos , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional , Kanamicina/toxicidad , Órgano Espiral/efectos de los fármacos , Animales , Cóclea/diagnóstico por imagen , Cóclea/ultraestructura , Enfermedades Cocleares/inducido químicamente , Enfermedades Cocleares/diagnóstico por imagen , Modelos Animales de Enfermedad , Femenino , Furosemida/farmacología , Células Ciliadas Auditivas/patología , Células Ciliadas Auditivas/ultraestructura , Inyecciones Subcutáneas , Kanamicina/farmacología , Ratones , Ratones Endogámicos CBA , Microscopía Confocal/métodos , Órgano Espiral/diagnóstico por imagen , Órgano Espiral/patología , Radiografía , Distribución Aleatoria , Valores de Referencia , Sensibilidad y Especificidad , UltrasonografíaRESUMEN
We made a qualitative and quantitative comparison between a state-of-the-art implementation of micro-Computed Tomography (microCT) and the scanning Thin-Sheet Laser Imaging Microscopy (sTSLIM) method, applied to mouse cochleae. Both imaging methods are non-destructive and perform optical sectioning, respectively, with X-rays and laser light. MicroCT can be used on fresh or fixed tissue samples and is primarily designed to image bone rather than soft tissues. It requires complex back-projection algorithms to produce a two-dimensional image, and it is an expensive instrument. sTSLIM requires that a specimen be chemically fixed, decalcified, and cleared; but it produces high-resolution images of soft and bony tissues with minimum image postprocessing and is less expensive than microCT. In this article, we discuss the merits and disadvantages of each method individually and when combined.
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Cóclea/citología , Cóclea/diagnóstico por imagen , Imagenología Tridimensional/métodos , Microscopía Confocal/métodos , Microtomografía por Rayos X/métodos , Animales , Imagenología Tridimensional/instrumentación , Ratones , Microscopía Confocal/instrumentación , Microtomografía por Rayos X/instrumentaciónRESUMEN
Permanent sensorineural hearing loss is a major medical problem and is due to the loss of hair cells and subsequently spiral ganglion neurons in the cochlea. Since these cells lack the capacity of renewal in mammals, their regeneration would be an optimal solution to reverse hearing loss. In other tissues, decellularized extracellular matrix (ECM) has been used as a mechanical and biochemical scaffold for the induction of stem and other cells toward a target tissue phenotype. Such induced cells have been used for tissue and organ transplants in preclinical animal and human clinical applications. This paper reports for the first time the decellularization of the cochlea and identification of remaining laminin and collagen type IV as a first step in preparing an ECM scaffold for directing stem cells toward an auditory lineage. Fresh ear tissues were removed from euthanized mice, a rat and a human and processed for decellularization using two different detergent extraction methods. Cochleas were imaged with scanning thin-sheet laser imaging microscopy (sTSLIM) and brightfield microscopy. Detergent treatment of fresh tissue removed all cells as evidenced by lack of H&E and DNA staining of the membranous labyrinth while preserving components of the ECM. The organ of Corti was completely removed, as were spiral ganglion neurons, which appeared as hollow sheaths and tubes of basal lamina (BL) material. Cells of the stria vascularis were removed and its only vestige left was its laterally linking network of capillary BL that appeared to "float" in the endolymphatic space. Laminin and type IV collagen were detected in the ECM after decellularization and were localized in vascular, neural and epithelial BL. Further work is necessary to attempt to seed neural and other stem cells into the decellularized ECM to hopefully induce differentiation and subsequent in vivo engraftment into damaged cochleas.
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Diferenciación Celular , Cóclea/citología , Células Madre/citología , Ingeniería de Tejidos/métodos , Andamios del Tejido , Animales , Colágeno Tipo IV/metabolismo , Matriz Extracelular/metabolismo , Humanos , Laminina/metabolismo , Ratones , Ratones Endogámicos CBA , Modelos Animales , Órgano Espiral/citología , Ratas , Ratas Sprague-Dawley , Estría Vascular/citologíaRESUMEN
We report replacement of one side of a static illumination, dual sided, thin-sheet laser imaging microscope (TSLIM) with an intensity modulated laser scanner in order to implement structured illumination (SI) and HiLo image demodulation techniques for background rejection. The new system is equipped with one static and one scanned light-sheet and is called a scanning thin-sheet laser imaging microscope (sTSLIM). It is an optimized version of a light-sheet fluorescent microscope that is designed to image large specimens (<15 mm in diameter). In this paper we describe the hardware and software modifications to TSLIM that allow for static and uniform light-sheet illumination with SI and HiLo image demodulation. The static light-sheet has a thickness of 3.2 µm; whereas, the scanned side has a light-sheet thickness of 4.2 µm. The scanned side images specimens with subcellular resolution (<1 µm lateral and <4 µm axial resolution) with a size up to 15 mm. SI and HiLo produce superior contrast compared to both the uniform static and scanned light-sheets. HiLo contrast was greater than SI and is faster and more robust than SI because as it produces images in two-thirds of the time and exhibits fewer intensity streaking artifacts.
RESUMEN
Thin-sheet laser imaging microscopy (TSLIM) was used to serially section five whole cochleas from 4-wk-old CBA/JCr mice. Three-dimensional reconstructions of Rosenthal's canal (RC) were produced in order to measure canal length and volume, to generate orthogonal cross sections for area measurements, and to determine spiral ganglion neuron (SGN) number. RC length averaged 2.0 mm ± 0.04 (SEM) as measured along the centroid of the canal compared to an average basilar membrane (BM) length of 5.9 ± 0.05 (SEM). RC volume averaged 0.036 mm(3) ± 0.009 (SEM). Significant increases in the radial area of RC were observed at the base (13%), middle (62%), and apex (90%) of its length. The total number of spiral ganglion neurons (SGNs) in RC in each of the five animals averaged 8626 ± 96 (SEM). SGN number increased at the expanded regions of RC. Increased area and cell number at the base and apex are likely related to extensions of the organ of Corti past the length of RC in these areas. The increase in area and cell number in the middle of the RC appears to be related to the most sensitive frequency region of the organ of Corti. Volume imaging or tomography of the cochlea as provided by TSLIM has the potential to be an efficient and accurate semi-automated method for the quantitative assessment of the number of SGNs and hair cells of the organ of Corti.
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Ganglio Espiral de la Cóclea/anatomía & histología , Animales , Recuento de Células , Femenino , Imagenología Tridimensional , Ratones , Ratones Endogámicos CBA , Microscopía Confocal , Modelos Anatómicos , Modelos Neurológicos , Neuronas/citología , Ganglio Espiral de la Cóclea/citología , Ganglio Espiral de la Cóclea/inervaciónRESUMEN
Light sheet fluorescence microscopy (LSFM) functions as a non-destructive microtome and microscope that uses a plane of light to optically section and view tissues with subcellular resolution. This method is well suited for imaging deep within transparent tissues or within whole organisms, and because tissues are exposed to only a thin plane of light, specimen photobleaching and phototoxicity are minimized compared to wide-field fluorescence, confocal, or multiphoton microscopy. LSFMs produce well-registered serial sections that are suitable for three-dimensional reconstruction of tissue structures. Because of a lack of a commercial LSFM microscope, numerous versions of light sheet microscopes have been constructed by different investigators. This review describes development of the technology, reviews existing devices, provides details of one LSFM device, and shows examples of images and three-dimensional reconstructions of tissues that were produced by LSFM.
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Luz , Microscopía Fluorescente/métodos , Animales , Procesamiento de Imagen Asistido por Computador , Rayos Láser , Microscopía Fluorescente/instrumentación , Manejo de EspecímenesRESUMEN
We describe 2 cases of bilateral Ménière disease with features resembling autoimmune inner ear disease in patients who were found to be carriers of human leukocyte antigen (HLA) B27. For immunohistochemical analysis, mouse inner ear sections were used as the tissue substrate for reaction with serum. Both patients demonstrated an increased immunofluorescence reaction compared with a normal control. We suggest that an antibody-mediated mechanism may be responsible for HLA-B27-associated Ménière disease.
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Antiinflamatorios/uso terapéutico , Dexametasona/uso terapéutico , Antígeno HLA-B27/genética , Enfermedad de Meniere/tratamiento farmacológico , Enfermedad de Meniere/genética , Prednisona/uso terapéutico , Administración Tópica , Anciano , Alelos , Genotipo , Pérdida Auditiva Bilateral/diagnóstico , Pérdida Auditiva Bilateral/etiología , Humanos , Masculino , Enfermedad de Meniere/complicaciones , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Vértigo/diagnóstico , Vértigo/etiologíaRESUMEN
We report development of a continuous scanning procedure and the use of a time delay integration (TDI) line scan camera for a light-sheet based microscope called a thin-sheet laser imaging microscope (TSLIM). TSLIM is an optimized version of a light-sheet fluorescent microscope that previously used a start/stop scanning procedure to move the specimen through the thinnest portion of a light-sheet and stitched the image columns together to produce a well-focused composite image. In this paper, hardware and software enhancements to TSLIM are described that allow for dual sided, dual illumination lasers, and continuous scanning of the specimen using either a full-frame CCD camera and a TDI line scan camera. These enhancements provided a ~70% reduction in the time required for composite image generation and a ~63% reduction in photobleaching of the specimen compared to the start/stop procedure.
RESUMEN
We report the development of a modular and optimized thin-sheet laser imaging microscope (TSLIM) for nondestructive optical sectioning of organisms and thick tissues such as the mouse cochlea, zebrafish brain/inner ear, and rat brain at a resolution that is comparable to wide-field fluorescence microscopy. TSLIM optically sections tissue using a thin sheet of light by inducing a plane of fluorescence in transparent or fixed and cleared tissues. Moving the specimen through the thinnest portion of the light sheet and stitching these image columns together results in optimal resolution and focus across the width of a large specimen. Dual light sheets and aberration-corrected objectives provide uniform section illumination and reduce absorption artifacts that are common in light-sheet microscopy. Construction details are provided for duplication of a TSLIM device by other investigators in order to encourage further use and development of this important technology.
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Encéfalo/anatomía & histología , Cóclea/anatomía & histología , Procesamiento de Imagen Asistido por Computador/métodos , Microscopía Confocal/métodos , Animales , Técnicas de Preparación Histocitológica , Ratones , Ratas , Pez CebraRESUMEN
The mouse cochlea database (MCD) provides an interactive, image database of the mouse cochlea for learning its anatomy and data mining of its resources. The MCD website is hosted on a centrally maintained, high-speed server at the following URL: (http://mousecochlea.umn.edu). The MCD contains two types of image resources, serial 2D image stacks and 3D reconstructions of cochlear structures. Complete image stacks of the cochlea from two different mouse strains were obtained using orthogonal plane fluorescence optical microscopy (OPFOS). 2D images of the cochlea are presented on the MCD website as: viewable images within a stack, 2D atlas of the cochlea, orthogonal sections, and direct volume renderings combined with isosurface reconstructions. In order to assess cochlear structures quantitatively, "true" cross-sections of the scala media along the length of the basilar membrane were generated by virtual resectioning of a cochlea orthogonal to a cochlear structure, such as the centroid of the basilar membrane or the scala media. 3D images are presented on the MCD website as: direct volume renderings, movies, interactive QuickTime VRs, flythrough, and isosurface 3D reconstructions of different cochlear structures. 3D computer models can also be used for solid model fabrication by rapid prototyping and models from different cochleas can be combined to produce an average 3D model. The MCD is the first comprehensive image resource on the mouse cochlea and is a new paradigm for understanding the anatomy of the cochlea, and establishing morphometric parameters of cochlear structures in normal and mutant mice.
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Cóclea/anatomía & histología , Bases de Datos Factuales , Animales , Simulación por Computador , Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional , Internet , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos CBA , Microscopía Fluorescente , Modelos AnatómicosRESUMEN
OBJECTIVE: To determine the distribution of alpha1, alpha3, and alpha5 chains of type IV collagen in the cochlea in Alport syndrome. DESIGN: Case-control study. PATIENTS: Two patients with sensorineural hearing loss due to Alport syndrome. Both patients had known mutations in the COL4A5 gene. MAIN OUTCOME MEASURES: Immunostaining was used to study the distribution of type IV collagen (alpha1, alpha3, and alpha5 chains) within the cochlea. Immunostaining was also performed in the cochlear tissues of an unaffected individual used as a control. RESULTS: In the control ear, alpha1 staining was observed in the basement membrane overlying the basilar membrane, in the basement membrane of cochlear blood vessels and Schwann cells, and within the spiral limbus. In the control ear, we also observed strong staining for alpha3 and alpha5 chains in the basement membrane overlying the basilar membrane and within the spiral ligament. In both cases with Alport syndrome, no immunostaining was observed for alpha3 or alpha5 chains within the cochlea, whereas alpha1 staining was present in locations similar to that seen in the control ear. CONCLUSIONS: The results indicate that isotype switching does not occur within the cochlea in Alport syndrome. The results are also consistent with the hypothesis that the sensorineural hearing loss in Alport syndrome may be due to alterations in cochlear micromechanics and/or dysfunction of the spiral ligament.
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Cóclea/metabolismo , Colágeno Tipo IV/metabolismo , Nefritis Hereditaria/metabolismo , Adulto , Membrana Basal/metabolismo , Estudios de Casos y Controles , Cóclea/irrigación sanguínea , Cóclea/citología , Colágeno Tipo IV/genética , Colorantes , Eosina Amarillenta-(YS) , Femenino , Colorantes Fluorescentes , Pérdida Auditiva Sensorineural/etiología , Pérdida Auditiva Sensorineural/metabolismo , Hematoxilina , Humanos , Masculino , Microscopía de Polarización , Persona de Mediana Edad , Mutación/genética , Nefritis Hereditaria/complicaciones , Células de Schwann/metabolismoRESUMEN
OBJECTIVE: To determine the histopathologic abnormalities within the cochlea in Alport syndrome. BACKGROUND: Alport syndrome, which manifests as hereditary nephritis and sensorineural hearing loss (SNHL), is caused by mutations in genes that code for the proportional, variant3, proportional, variant4, and proportional, variant5 chains of type IV collagen. The proportional, variant3, proportional, variant4, and proportional, variant5 chains of type IV collagen are present in the basement membrane of the organ of Corti. Previous temporal bone studies have failed to identify histopathologic correlates for the SNHL. METHODS: We examined temporal bones from nine individuals with a clinical diagnosis of Alport syndrome. One of our cases also had genetic testing that showed a mutation in the type IV collagen proportional, variant5 chain gene. RESULTS: By light microscopy, eight of nine cases demonstrated two unique pathologic changes: 1) a "zone of separation" between the basilar membrane and overlying cells of the organ of Corti and 2) presence of cells filling the tunnel of Corti and extracellular spaces of Nuel. The cytologic losses of hair cells, stria vascularis, and cochlear neuronal cells were insufficient to account for the observed SNHL in our cases. Electron microscopy was performed in four cases; all four demonstrated the following: 1) the zone of separation that was observed at light microscopy occurred between the basement membrane and the basilar membrane, 2) the cells within the tunnel of Corti and spaces of Nuel were morphologically similar to supporting cells, and 3) the basement membrane of strial capillaries and the spiral vessel (under the basilar membrane) were normal. CONCLUSIONS: The histopathologic correlates of cochlear involvement in Alport syndrome are abnormalities of the basement membrane of cells of the organ of Corti and dysmorphogenesis (cellular infilling of the tunnel and extracellular spaces) of the organ of Corti. We hypothesize that these abnormalities result in SNHL by altering cochlear micromechanics.