An in vivo Biomarker to Characterize Ototoxic Compounds and Novel Protective Therapeutics

Joseph A Bellairs, Van A Redila, Patricia Wu, Ling Tong, Alyssa Webster, Julian A Simon, Edwin W Rubel, David W Raible, Joseph A Bellairs, Van A Redila, Patricia Wu, Ling Tong, Alyssa Webster, Julian A Simon, Edwin W Rubel, David W Raible

Abstract

There are no approved therapeutics for the prevention of hearing loss and vestibular dysfunction from drugs like aminoglycoside antibiotics. While the mechanisms underlying aminoglycoside ototoxicity remain unresolved, there is considerable evidence that aminoglycosides enter inner ear mechanosensory hair cells through the mechanoelectrical transduction (MET) channel. Inhibition of MET-dependent uptake with small molecules or modified aminoglycosides is a promising otoprotective strategy. To better characterize mammalian ototoxicity and aid in the translation of emerging therapeutics, a biomarker is needed. In the present study we propose that neonatal mice systemically injected with the aminoglycosides G418 conjugated to Texas Red (G418-TR) can be used as a histologic biomarker to characterize in vivo aminoglycoside toxicity. We demonstrate that postnatal day 5 mice, like older mice with functional hearing, show uptake and retention of G418-TR in cochlear hair cells following systemic injection. When we compare G418-TR uptake in other tissues, we find that kidney proximal tubule cells show similar retention. Using ORC-13661, an investigational hearing protection drug, we demonstrate in vivo inhibition of aminoglycoside uptake in mammalian hair cells. This work establishes how systemically administered fluorescently labeled ototoxins in the neonatal mouse can reveal important details about ototoxic drugs and protective therapeutics.

Keywords: aminoglycloside; biomarker; hair cell; mouse model; otoprotection; ototoxicity.

Conflict of interest statement

JAS, EWR, and DWR are cofounders of Oricula Therapeutics, which has licensed patents covering ORC-13661 from the University of Washington. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Bellairs, Redila, Wu, Tong, Webster, Simon, Rubel and Raible.

Figures

FIGURE 1
FIGURE 1
G418-TR is taken up by neonatal mammalian hair cells following systemic administration. (A) At 6 h after systemic injection with G418-TR, neonatal mice (P5) were sacrificed, cochlear sensory epithelia was dissected and fixed, and tissue was immunolabeled for myosin VIIa. Representative single z-plane images captured from the middle turn of the cochlea in the region between the cuticular plate and nucleus demonstrate dose-dependent uptake of G418-TR in OHCs. Scale bar = 10 μm. (B) 6 h after systemic administration of G418-TR, blood was collected from neonatal mice, serum was extracted, and fluorescence was quantified with a fluorescence plate reader. Increasing doses of G418-TR results in a dose-dependent increase in serum fluorescence [One-way ANOVA; F(3,16) = 25.02, P < 0.0001]. (C) Mean G418-TR fluorescence intensity of IHCs by tonotopic region 6 h after systemic treatment. IHCs demonstrate similar dose-dependent uptake of G418-TR in base, middle, and apex. (D) Mean G418-TR fluorescence intensity of OHCs by tonotopic region 6 h after systemic treatment. OHCs demonstrate significant dose-dependent and tonotopic G418-TR uptake [Mixed effects analysis; F(6,36) = 5.127, P = 0.0007]. ncochlea and nmice represent the number of cochlea and mice examined, respectively. When two cochlea from the same animal were analyzed, the animal mean was calculated and used for all statistics and graphs. Error bars are standard deviations. AU, arbitrary unit.
FIGURE 2
FIGURE 2
G418-TR is taken up by mature mammalian hair cells following systemic administration. (A) At 6 h after systemic injection with G418-TR, juvenile mice (P25-30) were sacrificed, cochlear sensory epithelia was dissected and fixed, and tissue was immunolabeled for myosin VIIa. Representative maximum projection images captured from the middle turn of the cochlea demonstrate dose-dependent uptake of G418-TR in inner and outer hair cells. Scale bar = 10 μm. (B) 6 h after systemic administration of G418-TR, blood was collected from juvenile mice, serum was extracted, and fluorescence was quantified with a fluorescence plate reader. Increasing doses of G418-TR results in a dose-dependent increase in serum fluorescence [One-way ANOVA; F(3,17) = 28.28, P < 0.0001]. (C) Mean G418-TR fluorescence intensity of IHCs by tonotopic region 6 h after systemic treatment. IHCs demonstrate low uptake at most doses of G418-TR with no significant tonotopic variation. (D) Mean G418-TR fluorescence intensity of OHCs by tonotopic region 6 h after systemic treatment. OHCs demonstrate dose-dependent uptake but not tonotopic variation in G418-TR uptake. ncochlea and nmice represent the number of cochlea and mice examined, respectively. When two cochlea from the same animal were analyzed, the animal mean was calculated and used for all statistics and graphs. Error bars are standard deviations. AU, arbitrary unit.
FIGURE 3
FIGURE 3
Characteristics of G418-TR uptake in neonatal and juvenile hair cells. (A) Pooled analysis of the ratio of OHC to IHC uptake (FOHC/FIHC) was calculated for all neonatal animals treated with G418-TR (2.5, 5, and 10 mg/kg) and sorted by tonotopic region. In neonatal hair cells, there is significant variation in FOHC/FIHC by region [Mixed-effects Analysis; F(2,52) = 11.81, P < 0.0001]. (B) Pooled analysis for all juvenile animals treated with G418-TR (5, 10, and 20 mg/kg) demonstrates no significant tonotopic variation in FOHC/FIHC [Mixed-effects Analysis; F(2,31) = 0.1442, P = 0.8662]. ncochlea and nmice represent the number of cochlea and mice examined, respectively. When two cochlea from the same animal were analyzed, the animal mean was calculated and used for all statistics and graphs. Error bars are standard deviations. **P < 0.01, ****P < 0.0001; P-values generated from multiple comparisons post hoc test (Tukey’s multiple comparison test).
FIGURE 4
FIGURE 4
Hair cells accumulate and retain G418-TR after systemic injection. (A) 30 min–72 h after systemic injection with 10 mg/kg G418-TR, neonatal mice (P5) were sacrificed, cochlear sensory epithelia was dissected and fixed, and tissue was immunolabeled for myosin VIIa. Representative images captured from the middle turn of the cochlea demonstrate uptake and retention of G418-TR. Images shown are single z-plane images capturing the region between the nucleus and cuticular plate. Arrowhead highlights transition from diffuse G418-TR distribution to accumulation in puncta with time. Scale bar = 10 μm. (B) Serum kinetics of G418-TR after systemic injection. After systemic injection with 10 mg/kg G418-TR, neonatal mice were sacrificed at different time points, serum was collected, and fluorescence was quantified. Fluorescence was converted to concentration in μg/mL utilizing a calibration curve of G418-TR diluted in fetal bovine serum. Quantification shows that serum levels of G418-TR peak at 3 h and are undetectable 24 h post-injection. (C) Mean hair cell fluorescence from the middle turn of the cochlea was calculated over 72 h. Both IHCs and OHCs show uptake and retention. Animals examined [t (hours), n] = (0,4), (0.5,4), (3,5), (6,6), (12,5), (24,5), (48,5), (72,5). Error bars are standard deviations. AU, arbitrary unit. Significant differences between IHC and OHCs denoted with: *P < 0.05, ***P < 0.001. P-values calculated from multiple comparisons post hoc test (Šídák’s multiple comparison test).
FIGURE 5
FIGURE 5
Selective aminoglycoside retention in proximal convoluted tubule cells of the kidney. (A) 0 min–72 h after systemic injection with G418-TR, neonatal mice (P5) were sacrificed, and kidneys were removed. Tissues were fixed, embedded and cryostat sectioned at a thickness of 12 μm. Tissue sections were stained with phalloidin and DAPI. Representative maximum projection images from the renal cortex show proximal convoluted tubule (p) uptake and retention, but minimal uptake in the distal convoluted tubule (d) and glomeruli (g). Like hair cells, PCT cells also show apical puncta (arrow) accumulation of G418-TR. Scale bar = 20 μm. (B) Mean fluorescence from proximal convoluted tubules (PCTs), distal convoluted tubules (DCTs), and glomeruli was calculated over 72 h. PCTs demonstrate G418-TR uptake and retention like that observed in cochlear hair cells. Animals examined n = 4 for each time point. Error bars are standard deviations. AU, arbitrary unit.
FIGURE 6
FIGURE 6
Differential aminoglycoside uptake and retention within the cochlea. Cochlea from neonatal mice treated with G418-TR were fixed, cryostat sectioned, and signed in order to analyze the organ of Corti, stria vascularis, and spiral ganglia neurons. In order to compare relative G418-TR uptake between specific tissue types, fluorescence was quantified for outer hair cells (OHCs), pillar cells, stria vascularis, and spiral ganglia neurons. Note that while OHCs take up and retain G418-TR fluorescence, stria vascularis tissue has an early peak but then declines while SGNs show consistent low level uptake. PCs display an intermediate level of uptake with some retention. Error bars are standard deviations. Animal numbers [time (hours), n] = (0,3), (6,4), (24,4), and (48,4).
FIGURE 7
FIGURE 7
ORC-13661 blocks G418-TR accumulation in mammalian hair cells. (A) Short (3 h) G418-TR exposure paradigm. Neonatal mice were pretreated with ORC-13661 or vehicle for 2 h, injected with 10 mg/kg G418-TR, and sacrificed 3 h after aminoglycoside injection. Basal turn OHC mean fluorescence for animals treated with either vehicle or ORC-13661 followed by 10 mg/kg G418-TR. OHC mean fluorescence was quantified and normalized to animals pre-treated with vehicle within each experimental replicate. [One-way ANOVA; F(3,20) = 23.55, P < 0.0001]. (B) Long (6 h) G418-TR exposure paradigm. Neonatal mice were pretreated with ORC-13661 or vehicle for 2 h, injected with 10 mg/kg G418-TR, and sacrificed 6 h after aminoglycoside injection. [One-way ANOVA; F(3,30) = 19.62, P < 0.0001]. (C) Booster dosing strategy with a single pretreatment injection of ORC-13661 followed by a second booster dose 3 h after G418-TR injection. Basal turn OHC mean fluorescence for animals treated with a pretreatment dose ORC-13661 (10–100 mg/kg) followed by 10 mg/kg G418-TR with an additional booster of ORC-13661 (same as pretreatment dose) 3 h after aminoglycoside administration. Note that data for single dose are non-normalized data from part B. Error bars are standard deviations. *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001; P-values generated from multiple comparisons post hoc test (A,B: Dunnett’s multiple comparison test; C: Šídák’s multiple comparison test).

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Source: PubMed

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