Inner Hair Cell and Neuron Degeneration Contribute to Hearing Loss in a DFNA2-Like Mouse Model.

DFNA2 is a progressive deafness caused by mutations in the voltage-activated potassium channel KCNQ4. Hearing loss develops with age from a mild increase in the hearing threshold to profound deafness. Studies using transgenic mice for Kcnq4 expressed in a mixed background demonstrated the implication of outer hair cells at the initial phase. However, it could not explain the last phase mechanisms of the disease. Genetic backgrounds are known to influence disease expressivity. To unmask the cause of profound deafness phenotype, we backcrossed the Kcnq4 knock-out allele to the inbred strain C3H/HeJ and investigated inner and outer hair cell and spiral ganglion neuron degeneration across the lifespan. In addition to the already reported outer hair cell death, the C3H/HeJ strain also exhibited inner hair cell and spiral ganglion neuron death. We tracked the spatiotemporal survival of cochlear cells by plotting cytocochleograms and neuronal counts at different ages. Cell loss progressed from basal to apical turns with age. Interestingly, the time-course of cell degeneration was different for each cell-type. While for outer hair cells it was already present by week 3, inner hair cell and neuronal loss started 30 weeks later. We also established that outer hair cell loss kinetics slowed down from basal to apical regions correlating with KCNQ4 expression pattern determined in wild-type mice. Our findings indicate that KCNQ4 plays differential roles in each cochlear cell-type impacting in their survival ability. Inner hair cell and spiral ganglion neuron death generates severe hearing loss that could be associated with the last phase of DFNA2.

Analysis of neuronal nicotinic acetylcholine receptor α4ß2 activation at the single-channel level.

The neuronal nicotinic acetylcholine receptor α4ß2 forms pentameric proteins with two alternate stoichiometries. The high-sensitivity receptor is related to (α4)2(ß2)3 stoichiometry while the low-sensitivity receptor to (α4)3(ß2)2 stoichiometry. Both subtypes share two binding sites at the α4((+))/ß2((-)) interface with high affinity for agonists. (α4)3(ß2)2 has an additional binding site at the α4((+))/α4((-)) interface with low affinity for agonists. We investigated activation kinetics of both receptor subtypes by patch-clamp recordings of single-channel activity in the presence of several concentrations of acetylcholine (0.5 to 300µM). We used kinetic software to fit these data with kinetic models. We found that the high-sensitivity subtype correlates with the low-conductance channel (g-70=29pS) and does not activate with high efficacy. On the contrary, the low-sensitivity subtype correlated with a high-conductance channel (g-70=44pS) and exhibited higher activation efficacy. Opening events of individual nAChRs at high agonist concentrations occurred in clusters, which allowed us to determine kinetic constants for the activation of the triliganded receptor. Our kinetic modeling identified an intermediate state, between resting and open conformation of the receptor. Binding of the third molecule increases the efficacy of receptor activation by favoring the transition between resting and intermediate state around 18 times. The low rate for this transition in the diliganded receptor explains the action of acetylcholine as partial agonist when it binds to the high-affinity sites. The presence of the third binding site emerges as a potent modulator of nicotinic receptor α4ß2 activation which may display different functions depending on agonist concentration.

Genitales ambiguos: utilidad de la genitografía en el diagnóstico y planeamiento quirúrgico / Ambiguous genitalia: genitografía utility in the diagnosis and surgical planning

Los pacientes con genitales ambiguos presentan dificultades diagnósticas y constituyen una emergencia médica. Su estudio apropiado y precoz minimiza las complicaciones médicas, psicológicas y sociales del niño y su familia. El objetivo de este estudio es mostrar la utilidad de la genitografía, accesible y de bajo costo, luego de la evaluación clínica y ultrasonografica. Mostramos la experiencia en 93 pacientes seguidos en nuestra institución durante 17 años. Los síndromes más comunes encontrados fueron: Hierplasia suprarrenales Congénitas, Hermafroditismo Verdadero, Feminización Testicular y Disgenesia gonadal. La genitografía detecta con seguridad el nivel de implantación de la cavidad vaginal en la uretra siendo esencial para elegir la estrategia terapéutica. Utilizamos una nueva clasificación, en 3 tipos, de seno urogenital de acuerdo a la genitografía.