Peppi M, Marie A, Belline C, Borenstein JT. Intracochlear Drug Delivery Systems: A Novel Approach Whose Time Has Come.
Summary: There is a growing prevalence of hearing loss across the globe, with over 360 million patients worldwide suffering from this condition. Factors such an increasingly aging population, overexposure to noise in youth and in the military, and exposure to ototoxic lifesaving drugs such as aminoglycoside antibiotics and platinum-based chemotherapy exacerbate the spreading of hearing loss disability. Recent advances in molecular biology and in understanding mechanisms involved in inner ear diseases have accelerated the development of therapeutic approaches for hearing loss, including the emergence of novel regenerative molecules, apoptosis inhibitors, gene therapies and small interfering RNA therapies. Despite these remarkable advances, progress towards new treatments remains limited, in large measure because the cochlea is one of the most remote, delicate and protected spaces in the body. Here we address challenges and opportunities of inner ear delivery technology, and emerging approaches toward safe and efficacious dosing of arising therapeutic compounds.