History of the Tinnitus Research Consortium.

This article describes the creation and accomplishments of the Tinnitus Research Consortium (TRC), founded and supported through philanthropy and intended to enrich the field of tinnitus research. Bringing together a group of distinguished auditory researchers, most of whom were not involved in tinnitus research, over the fifteen years of its life it developed novel research approaches and recruited a number of new investigators into the field. The purpose of this special issue is to highlight some of the significant accomplishments of the investigators supported by the TRC. This article is part of a Special Issue entitled "Tinnitus".

Strategies and accomplishments of the Tinnitus Research Consortium.

The Tinnitus Research Consortium (TRC) is sponsored by a philanthropist who wants to accelerate progress in basic and clinical research on tinnitus. The TRC consists of 12 distinguished auditory scientists who began meeting in 1998 twice a year for brainstorming for new research approaches to tinnitus, developing requests for applications, judging the scientific merit of the applications received and reviewing the progress of funded projects. Through these efforts, common confounding variables in tinnitus research have been identified, and solutions to these problems have been suggested. TRC grants have been made up to $100,000.00 per year for three years. The sponsor had provided $600,000.00 per year; so two new grants could be made each year. The good news is that the sponsor's support has been increased by 50% for 2011 so that three grants have been awarded. Some of the landmark studies supported by the TRC over the last 14 years are reviewed as is the changing conceptualization of the pathogenesis of tinnitus and its management. The effect of strategies of the TRC on the applicants, grantees, scientific field, scientific societies and other funding agencies will be discussed. For example, when the TRC was initiated, sessions devoted to tinnitus research at national scientific meetings were rare. Through the efforts of the TRC, the American Tinnitus Association and the American Academy of Audiology, organizations such as the Association for Research in Otolaryngology and the Society for Neuroscience were encouraged to hold special sessions on tinnitus research. Now such organizations have well attended sessions on tinnitus research each year. The size of the TRC grants, large enough to support a substantial research project, has caused several other voluntary agencies to increase the size of their grants toward the TRC standard. The National Institute on Deafness and Other Communication Disorders and other institutes at the National Institutes of Health have devoted far more emphasis on tinnitus. By supporting sound research on tinnitus and recruiting world-class scientists to the field, the TRC has led in making tinnitus research respectable.

Strategies of the Tinnitus Research Consortium.

CONCLUSIONS: Research supported by private philanthropy complements governmental support of research, and its organization can undertake analysis of the whole field, identify the initial steps required to advance the field, draw attention to the intellectual challenge of a field such as tinnitus, recruit scientists to a neglected area, direct support to the most promising research approaches and opportunities, and dedicate support to those endeavors. OBJECTIVES: The efforts of the Tinnitus Research Consortium (TRC) are to accelerate progress in basic and clinical research on tinnitus. METHODS: The TRC analyzes the field of tinnitus research, brainstorms for new research approaches to tinnitus and provides guidance to the scientific community through requests for applications (RFAs) on promising research approaches and opportunities. The analysis of the research field has focused on the validity of animal models of tinnitus, the need for a standardized outcome measure in clinical trials, and the control of confounding variables in basic and clinical studies of the mechanisms of and site(s) associated with tinnitus. RESULTS: The TRC judged that the existing animal models were worthy of further study and refinement and that additional animal models should be developed. In response to an RFA, a project for the development and validation of the new Tinnitus Functional Index was initiated. A confounding aspect of experimental induction of tinnitus is the occurrence of hearing loss. The experimental manipulation causing the hearing loss may or may not cause tinnitus. Segregation of the correlates of tinnitus from the consequences of hearing loss requires the inclusion of a second control group: animals that have been subjected to the manipulation for the induction of tinnitus and have a hearing loss but fail to exhibit signs of tinnitus. Comparison of normal animals, animals with hearing loss without tinnitus and animals with hearing loss and tinnitus greatly enhances the value of the research. Clinical research on the mechanisms and sites of tinnitus is also confounded by this problem, and the solution is to include controls matched for hearing loss without tinnitus.

Progress in the prevention of otitis media through immunization.

OBJECTIVE: To review the progress that has been made in developing effective vaccines against the major bacterial pathogens responsible for acute otitis media. DATA SOURCE: Review of the literature with the aid of the MEDLINE database using the search terms otitis media and otitis media and vaccine. DATA EXTRACTION: Data were collected from clinical trials and laboratory studies. FINDINGS: The heptavalent pneumococcal conjugated vaccine, Prevnar, reduced the incidence of acute otitis media from all causes by 7% in one study and by 6% in another study. For culture-positive pneumococcal otitis media, the point estimate of efficacy was 66.7% in one study, and the reduction in incidence was 34% in another study. A Phase I clinical trial has been completed successfully for a conjugated vaccine against nontypeable Haemophilus influenzae (NTHi), which has high immunogenicity for mice and rabbits, induces complement-mediated bactericidal activity against NTHi in rabbits, and is protective against NTHi otitis media in chinchillas. A conjugated vaccine against Moraxella catarrhalis elicits strong immune responses in mice and rabbits and induces complement-mediated bactericidal activity in rabbits. CONCLUSION: The prevention of otitis media is likely to require multivalent pneumococcal, NTHi, and M. catarrhalis vaccines, and these vaccines likely can be developed within a decade.