Abstract
Non-coding microRNAs (miRNAs) have a fundamental role in gene regulation and expression in almost every multicellular organism. Only discovered in the last decade, miRNAs are already known to play a leading role in many aspects of disease. In the vertebrate inner ear, miRNAs are essential for controlling development and survival of hair cells. Moreover, dysregulation of miRNAs has been implicated in sensorineural hearing impairment, as well as in other ear diseases such as cholesteatomas, vestibular schwannomas, and otitis media. Due to the inaccessibility of the ear in humans, animal models have provided the optimal tools to study miRNA expression and function, in particular mice and zebrafish. A major focus of current research has been to discover the targets of the miRNAs expressed in the inner ear, in order to determine the regulatory pathways of the auditory and vestibular systems. The potential for miRNAs manipulation in development of therapeutic tools for hearing impairment is as yet unexplored, paving the way for future work in the field.
INTRODUCTION
Hearing loss (HL) is the most prominent neurosensory disorder in humans. Congenital deafness affects at least one in 500 newborns and more than half of these cases are hereditary (National Institutes of Health, NIDCD)1. As HL is also age dependent, more individuals can be affected at later stages of their lives. The ear is a complex transducing organ, which consists of both exterior and interior parts. Vibrations of the middle ear’s bones mirroring incoming sounds are translated into vibration of the basilar membrane, which in turn leads to mechanotransduction at the organ of Corti in specified cells, the hair cells. Mammalian auditory hair cells, surrounded by non-sensory supporting cells, are the main functional components of the cochlea. They are organized in three rows of outer hair cells (OHC) and one row of inner hair cells (IHC). Their apical actin-based microvilli are referred to as stereocilia. The mechanical stimulus sensed by the stereocilia is converted into an action potential, which in turn transfers the detected sound to the brain (). Specifically, coding of sound travels to the higher auditory systems via the brainstem, where there are synapses in the cochlear nuclei and the superior olivary complex (SOC), to the inferior colliculus of the midbrain and finally to the auditory cortex.
For many years, the conventional dogma in molecular biology defined the mammalian genome as one containing protein-coding genes and other repetitive and non-transcribed sequences. The latter was deemed to be non-essential, unless directly involved in RNA synthesis. The last decade has completely reversed this view and the field of non-coding RNAs (ncRNAs) has undergone a dramatic metamorphosis as a portion of these RNAs, microRNAs (miRNAs) are now recognized as having a vital role in gene expression and function. The first recognized miRNAs were lin-7 and let-7 in Caenorhabditis elegans (), but since then the number of these regulatory RNAs has grown to 30,424 mature miRNA sequences in 206 species ()2. miRNAs are the most studied and understood forms of ncRNAs, and have been shown to fulfill regulatory functions in many species, including the mammalian system.
miRNAs are small ~23 nucleotide long RNA species. Pri-miRNAs are transcribed together with other forms of RNA by RNA polymerase II and processed through the Drosha–Dicer pathway (). While still in the nucleus, pri-miRNAs are cleaved by Drosha and exported to the cytoplasm via exportin 5. The product of the cleavage pre-miRNA hairpin is composed of the main -5p and the complementary -3p (formally star) strands that are connected by the stem loop. In the cytoplasm, the pre-miRNA is cleaved by a second enzyme, Dicer, to produce the mature miRNA. miRNAs possess a seed region of 7 nt that determines its target specificity (). Upon sequence complementarity, this region will bind to sequences at the 3′ untranslated region (UTR) of target genes. In this fashion, miRNAs inhibit target mRNAs by translational repression and mRNA destabilization () and regulate gene expression through the RNA interference (RNAi) pathway. Another group of ncRNAs, long intervening noncoding RNAs (lincRNAs), while more elusive in their classification, are considered to have expansive roles in gene regulation ().
How have ncRNAs contributed to the study of the auditory and vestibular systems? miRNAs were first described in the zebrafish inner ear in 2005 (), which heralded a number of studies in the mammalian inner ear worldwide. The study of lincRNAs has not yet advanced at the same pace.
miRNAs IN THE INNER EAR
Since miRNAs have become an essential and fascinating aspect of gene regulation in the inner ear, hundreds of miRNAs have been identified using microarrays (; ; ; ; ). The specific expression of a fraction of these miRNAs has been determined by in situ hybridization in the mouse inner ear (Figures 1 and 2). There are still many inner ear-expressing miRNAs waiting to be further characterized, both with regards to expression, targets and mechanisms.
FIGURE 1
FIGURE 2

Spatial expression patterns of miRNAs in the postnatal mouse vestibule. The expression data is based on in situ hybridization experiments of P0 mouse inner ear sections, except for miR-140 at P1, and miR-124a and -100a at P5 (
The miR-183 family is the most characterized miRNA cluster in the inner ear. This conserved miRNA triad, composed of miR-183, miR-182, and miR-96, is transcribed in one polycistronic transcript. In both zebrafish and the mouse, the triad co-expressed in several neurosensory organs, including the ear, nose, and eye (
Further studies on the diminuendo mouse found that miR-96 is responsible for the maturation of the stereocilia bundle of the inner and OHC (
Identification of targets is a key ingredient for deciphering the function of an miRNA. Several studies defined targets for members of the miR-183 triad. In a study on cells derived from mouse otocysts, miR-182 promoted differentiation of these cells to a hair cell-like fate (
Clic5, a chloride intracellular channel that is associated with stereocilia in the inner ear, was identified as a target of both miR-96 and miR-182 (
The triad clearly plays an important role in other sensory systems. Inactivation of the three miRNAs in the mouse led to multiple sensory defects, with an emphasis on the loss of this triad in the retina (
Another well-characterized and highly expressing miRNA in the brain, miR-124 (
LOSS OF DICER IN THE INNER EAR
Dicer is a ribonuclease RNase III-like enzyme that is localized in the nucleus and functions to process double-stranded RNA (dsRNA). Dicer products then exit to the cytoplasm and are further processed into mature miRNAs. Dicer ablation is lethal in zebrafish (
Dicer has been exploited to study miRNA function in the inner ear. Several conditional knock out (CKO) models have been generated. The first ear-specific Dicer1 CKO was generated using Pax2::Cre for specific expression in regions where Pax2 is expressed (
The first viable mice were the Pou4f3::Cre-Dicer CKO mice, using Dicer1 to remove miRNAs from hair cells (
Foxg1 was used for site-specific expression to generate Foxg1::Cre-Dicer CKO mice (
Another hair-cell specific CKO was generated using the gene responsible for hair cell agenesis, Atoh1, to create Atoh1::Cre-Dicer mice (
To study the role of Dicer and subsequent loss of miRNAs in the central auditory pathway, Erg2::Cre-Dicer mice were created (
It is important to note that when drawing conclusions about Dicer1 function at different stages of development, the tissue-specific ablation is gradual and is specific to the Cre promoter used. Therefore residual Dicer1 expression may exist, leading to a less severe phenotype than expected with removal of this essential enzyme. Furthermore, there is no specificity with respect to miRNAs and rather provide an “all or nothing effect.” For specific miRNAs, the approach taken to examine loss of miR-182 in the retina is a relevant approach (
IDENTIFICATION OF miRNA-PROTEIN TARGET PAIRS
Identifying novel or known miRNAs that are involved in specific processes in the inner ear and in the auditory pathways is the relatively easy part of miRNA research. However, discerning the molecular mechanisms, or moreover, the direct targets, is considerably more tedious and challenging. This point is exemplified by the number of miRNAs that have been identified versus the number of validated miRNA targets in the inner ear (Table 1). Potential targets of any miRNA can be predicted via TargetScan (
Table 1
| miRNA | Gene target | Experimental system used | Reference |
|---|---|---|---|
| miR-183 | TAO kinase 1 (Taok1) | Rat cochlear organotypic cultures transfected with antisense morpholinos. | |
| Early growth response 1 (Egr1) | |||
| Insulin receptor substrate 1 (Irs1) | |||
| miR-182 | SRY-box containing transcription factor (Sox2) | In situ hybridization; luciferase assay in HEK293 cells | |
| miR-182 | T-box 1 (Tbx1) | Luciferase assay in COS1 cells; overexpression of miR in cultured otic progenitor/stem cells. | |
| miR-96, miR-182 | Chloride intracellular channel 5 (Clic5) | Co-expression in mouse auditory HEI-OC1 cells; luciferase assay in A549 cells; down-regulation of target. | |
| miR-15a | Solute carrier family 12 (sodium/potassium/chloride transporters), member 2 (Slc12a2), Claudin (Cldn12) Brain-derived neurotrophic factor (Bdnf) | In situ hybridization; luciferase assay in HEK-293T cells. | |
| miR-21 | Phosphatase and tensin homolog (Pten) | Down-regulation of target in cholesteatoma; inhibition of miR. | |
| miR-21 | Programmed cell death 4 (Pdcd4) | Western blot on cholesteatoma skin samples. | |
| miR-135b | PC4 and SFRS1 interacting protein 1 (Psip1-p75) | Luciferase assay and qRT-PCR on Cal51, breast carcinoma, cells; inhibition of miR. | |
| miR-200b | Zinc finger E-Box binding homeobox 1 (Zeb1) | Global gene expression analysis; complementary patterns of expression validated with in situ and immunohistochemistry |
Validation of miRNA-gene targets found in the inner ear.
After the initial bioinformatic analyzes, each miRNA/gene target must be validated by experimental techniques. There are several approaches for this validation. The most commonly used in vitro technique is the luciferase assay. This quantitative assay system was developed originally to assess promoter strength. In the miRNA field this technique is used to study whether there is a direct interaction of a miRNA and a 3′UTR of a potential target gene. Typically the miRNA is cloned into one vector and a 3′UTR is cloned in-frame with luciferase. If the gene is a “true” target, there will be no bioluminescence. If the miRNA cannot interact with the 3′UTR, luciferase will be produced continuously. If a direct interaction between the miRNA and gene target is found, one must show that the mutation in the seed region of the miRNA can abolish the binding. To demonstrate that miR-182 is a direct target of Sox2, a luciferase assay was performed both with a luciferase reporter vector with the 3′UTR of Sox2 and a mutated version of the 3′UTR at the seed region of miR-182 (
To demonstrate an interaction in a more “in vivo” approach, anti-miRNAs are used. These short oligonucleotides are used to transfect either cell lines or cochlear cultures, and quench the endogenous miRNAs. The outcome of the antagonism is then probed either at the mRNA level, using qRT-PCR, or at the protein level, using western blot analysis, of the gene target. After confirming direct binding between miR-182 and the Tbx1 3′UTR by luciferase assay, degradation of the target on an mRNA level was tested (
Target recognition may be compromised as a result of a mutation, as was suggested for some of the human miR-96 mutations (
MECHANISMS OF miRNA FUNCTION IN THE INNER EAR
Roles of miRNAs in the inner ear can be also studied through identification of the overall intracellular pathways they are involved in. As such, proof of principle methods to check the global effect of the miRNA regulation using cellular assays, such as BrdU incorporation for proliferation or nuclear condensation by propidium iodide and caspase 3 activation for apoptosis. The latter was incorporated into a study to induce HL by means of exposure to high frequency noise and aimed to assess the amount of apoptotic hair cells (
Possibly the most direct method to study the involvement of miRNAs in inner ear mechanisms is in a model animal. Both zebrafish and mice are used to generate knock-out model systems of a single miRNA or miRNA family. Studying these models provides a global indication of phenotypes and can provide information on the targets and the signaling networks in which these miRNAs are involved. More specifically, to study the roles of miR-15a-1 and -18a in zebrafish development, antisense-oligonucleotide MOs were injected into zebrafish 48 h post-fertilization (
EAR-RELATED PATHOLOGIES AND miRNAs
While not prevalent, a number of mutations in miRNAs have been associated with human HL. The first mutations found were in two unrelated Spanish families (
In an effort to determine whether the miRNA-183 cluster is further involved in deafness, predicted target genes of the miR-183 miRNA, expressed in the inner ear, were screened in 150 Americans with autosomal dominant NSHL and 576 Iranians with autosomal recessive NSHL (
miRNAs IN AGE-RELATED HEARING LOSS
While hearing impairment does not spare any population, the aging population is hardest hit with this sensory loss. In the aging population, 43% of individuals over the age of 65–75 have a HL (National Academy on an Aging Society)3. ARHL has both genetic and environmental contributions. There is growing evidence that miRNAs are involved in cell senescence, death and aging (
While it is believed that a major cause of ARHL is the death of hair cells, other age-related changes in the central auditory pathways cannot be ruled out. It would therefore be useful to examine the miRNA expression profile in the SOC of aged mice as well. In addition, with the aid of RNA-Seq techniques that have become relatively common and less expensive, it is anticipated that additional miRNAs will be found to play a role in ARHL using this technology.
miRNAs IN THE MIDDLE EAR
Otitis media (OM) is the most common cause of HL in children. OM is an inflammatory disease of the middle ear mucosa (
miRNAs AND APOPTOSIS IN THE INNER EAR
Reactive oxygen species (ROS) are important intercellular messengers; however, when in excess, these species underlie processes such as cell death and apoptosis by modulating the expression of many genes (
Antibiotic-induced HL is a major factor in ototoxicity. The potential link between aminoglycoside toxicity and miRNA regulation and its effect on the inner ear was examined (
miRNAs AND REGENERATION IN THE INNER EAR
An early study in miRNAs and regeneration appeared soon after the first report of miRNAs in the mammalian inner ear (
The avian auditory sensory epithelium, the basilar papilla, is different from the mammalian sensory epithelium not only in its structural organization, but also in its ability to regenerate following hair cell loss. As in the mammalian cochlea, in the basilar papilla, both hair cells and supporting cells can be found. Upon injury of any kind, such as noise or ototoxicity, there are new hair cells produced from de-differentiation of supporting cells (
To elucidate the role of miRNAs in the intracellular signaling pathways of chick hair cell regeneration, forskolin, a compound known to induce proliferation of supporting cells to hair cells, was applied on basilar papilla cultures (
FUTURE OF miRNAs IN THE INNER EAR
High-throughput sequencing for RNA, dubbed RNA-seq, has facilitated the study of miRNAs dramatically (
The field on ncRNAs in the mammalian inner ear is still very much in development. While there has been tremendous progress in the last decade, there are areas that are still in their infancy. One such area is that of lincRNAs. lincRNAs are relatively long stretches of RNA larger than 200nt (
LincRNAs have been shown to play a critical role in the development and regulation of the sensory systems. As for the long ncRNA species, lincRNAs have been found expressed in the mouse retina (
One of the most exciting developments in the field has been the generation of a novel in vitro model system for the inner ear (
CONCLUSION
miRNAs are being developed as therapeutics for breast cancer (
Statements
Acknowledgments
Research in the Avraham laboratory is supported by the Israel Science Foundation 1320/11, National Institutes of Health (NIDCD) R01DC011835, I-CORE Gene Regulation in Complex Human Disease Center No. 41/11, Human Frontier Science Program RGP0012/2012, and Ministry of Immigrant Absorption (Kathy Ushakov).
Conflict of interest
The 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.
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Summary
Keywords
deafness, inner ear, cochlea, vestibule, microRNAs
Citation
Ushakov K, Rudnicki A and Avraham KB (2013) MicroRNAs in sensorineural diseases of the ear. Front. Mol. Neurosci. 6:52. doi: 10.3389/fnmol.2013.00052
Received
19 September 2013
Accepted
04 December 2013
Published
23 December 2013
Volume
6 - 2013
Edited by
Hermona Soreq, The Hebrew University of Jerusalem, Israel
Reviewed by
Hansen Wang, University of Toronto, Canada; Baojin Ding, University of Massachusetts Medical School, USA
Copyright
© 2013 Ushakov, Rudnicki and Avraham.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Karen B. Avraham, Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 69978, Israel e-mail: karena@post.tau.ac.il
This article was submitted to the journal Frontiers in Molecular Neuroscience.
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