SOUND: In landmark clinical trial, researchers successfully restored hearing in 10 deaf participants aged 18 months to 24…
By Own Correspondent
NANJING, China — A groundbreaking clinical trial has achieved what many thought impossible: restoring meaningful hearing in people born profoundly deaf, including teenagers and young adults who were previously considered too old for such treatment.
Researchers in China successfully used gene therapy to improve hearing in 10 participants ranging from 18 months to nearly 24 years old, dramatically expanding the age range where this revolutionary treatment can work. Some patients went from being unable to hear anything to having conversations with their families within months of treatment. “Participant 4 was able to carry on daily conversation with her mom 4 months after treatment without activating the cochlear implant and lip-reading,” the researchers noted in their study published in Nature Medicine.
Another patient could identify specific words like “scissors,” “excavator,” “tomato,” and “banana” just one month after receiving the therapy.
This represents a major breakthrough for people with a genetic condition called DFNB9 deafness. Unlike traditional hearing aids or cochlear implants that amplify or bypass damaged parts of the ear, this gene therapy actually repairs the underlying genetic defect causing deafness.
How does this gene therapy work?
DFNB9 deafness affects people born with faulty versions of the OTOF gene. This gene produces a protein called otoferlin that’s essential for transmitting sound signals from the ear to the brain. Without working otoferlin, the ear can’t properly convert sound waves into the electrical signals the brain needs to perceive hearing.
The treatment works by injecting a modified virus carrying healthy copies of the OTOF gene directly into the inner ear. The virus acts like a molecular delivery truck, carrying the healthy genes specifically to hair cells in the inner ear where they’re needed most.
Surgeons access the inner ear through the mastoid bone behind the ear, the same approach used for cochlear implant surgery. A hair-thin needle then delivers 30-40 micro-litres of the gene therapy solution through a thin membrane into the inner ear’s fluid-filled chambers.
All 10 participants showed hearing improvements within the first month of treatment. On average, participants’ hearing improved from baseline levels of 106 decibels to 52 decibels. That’s roughly the difference between needing to shout to be heard and being able to have a normal conversation.
The therapy worked well beyond infancy and early childhood, ages previously thought to represent the only window for successful intervention. A 14.5-year-old participant improved from profound deafness to being able to hear sounds at 59 decibels, while a 23-year-old adult showed meaningful hearing gains.
However, participants between 5 and 8 years old showed the most dramatic improvements, with some achieving nearly normal heari ng. Younger toddlers and older participants still benefited but showed more modest gains. As the researchers noted: “The poor outcome in these toddlers is counterintuitive, as younger ages should be associated with better outcomes because ‘young’ inner ears presumably have more complete cellular structure and better-preserved functions.”
Safety and side effects
Throughout the 12-month follow-up period, the treatment proved remarkably safe. All 162 adverse events reported were mild to moderate, with the most common being decreased neutrophil counts in blood tests. This is a manageable side effect that didn’t require treatment.
One participant received a second injection in the same ear four months after the first, demonstrating that repeat treatments are both safe and potentially beneficial for optimising results. Most hearing improvement occurred within the first month, with benefits maintaining or slightly improving over the following months.
While this gene therapy only works for DFNB9 deafness, which accounts for a small percentage of genetic hearing loss cases, the success opens doors for developing similar treatments for other genetic forms of deafness. The study represents a proof-of-concept that gene therapy can safely and effectively restore hearing when properly targeted.
“This is a huge step forward in the genetic treatment of deafness, one that can be life-changing for children and adults,” says Maoli Duan, a consultant and docent at the Karolinska Institutet, Sweden, and one of the study’s corresponding authors, in a statement. “Hearing was greatly improved in many of the participants, which can have a profound effect on their life quality. We will now be following these patients to see how lasting the effect is.”
For families affected by genetic hearing loss, this research transforms what was once a permanent condition into something that might be treatable, regardless of whether that person is 2 or 22 years old. The trial continues with plans to follow participants for five years to assess long-term safety and durability of hearing improvements.
With only 10 participants, including just one adult, larger trials are needed to confirm these results across diverse populations. Researchers are working to expand enrolment to better understand optimal timing and dosing strategies for this revolutionary approach to treating inherited deafness. – Study Finds