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The Hearing Restoration Project A Groundbreaking Research Consortium to Cure Hearing Loss and Tinnitus A Cure for Hearing Loss and Tinnitus is Coming! A cure for hearing loss and tinnitus is at hand. Hearing Health Foundation, the largest non-profit funder of hearing research, is leading an international, multi-institution research consortium called the Hearing Restoration Project (HRP) that will develop therapies to cure these conditions within the next 10 years. This means that for many living with hearing loss and tinnitus a cure is possible within their lifetimes! The promise of a real, biologic cure is focused on the inner ear hair cells that make hearing possible. Most types of hearing loss are the result of damage to these hair cells, including noise-induced hearing loss, age-related hearing loss and ototoxic hearing loss. Twenty-five years ago, research funded by Hearing Health Foundation revealed something remarkable: birds have the ability to re-grow damaged inner ear hair cells and spontaneously restore their hearing. In humans, hearing loss is permanent once the hair cells are damaged. The goal of the HRP is to develop a biologic cure by applying what we know about chickens to people, and regenerating the hair cells in humans to permanently restore hearing. To achieve a cure, we have assembled a consortium of 11 leading hearing loss research centers and research teams: Baylor College of Medicine Harvard Medical School Imperial College London Oregon Health & Science University Stanford University School of Medicine Stowers Institute for Medical Research University of Michigan University of Southern California University of Toronto University of Washington Washington University School of Medicine Hearing Health Foundation is ideally positioned to lead this world-class consortium and deliver on the goal of a cure. Since 1958, Hearing Health Foundation has led the way in supporting the most cutting-edge research for the prevention, treatment and cure of hearing loss. To support the Hearing Restoration Project, we will need to raise approximately $50 million over the next ten years to fund the medical equipment, genomic testing, bioinformatics and researchers needed to change the course of hearing loss forever. With funding for the HRP coming exclusively from non-government sources, we now seek philanthropic gifts from our supporters and from those who want to see a cure…..mothers, fathers, children, veterans, professionals and people from every walk of life. On behalf of Hearing Health Foundation, we thank you for your interest in our efforts and hope that you will join us in finding a cure. Sincerely, Shari Eberts Chairman Hearing Health Foundation Board 2 Introduction T hroughout history every major medical breakthrough has been achieved from an infusion of research dollars from individuals and institutions. From polio, to breast cancer, to Alzheimer’s disease, great strides have been made when those affected come together to support research. For those touched by hearing loss or tinnitus, there has never been a better time to mobilize to treat and cure hearing loss. For the first time, researchers are on track to develop a genuine, biologically-based cure for most types of acquired hearing loss. We know that just as cochlear implants changed the treatment options for those living with hearing loss, cell regeneration is the next wave of game-changing hearing treatments. With the top hearing research laboratories and researchers working together, sharing data, and collaborating on their research through the Hearing Restoration Project, we will actually be able to speed up the timeline for a cure from 50 years to just 10 years. This means that for many living with hearing loss or tinnitus a cure is possible within their lifetimes! Need: The Time is Now for All of Us Who Are Affected By Hearing Loss As you read this, nearly 50 million Americans are living with some form of hearing loss that is impacting their daily lives at home, at work, at play and at school. Even more astonishing is that hearing loss is affecting people all across our society: 1 in 7 adults, 1 in 5 teenagers and 60% of our returning veterans from Iraq and Afghanistan have a hearing loss. And, by 2030, the total number of people living with hearing loss is expected to double. Hearing loss affects people of every age and from every background: from newborn children, to older Americans, to military personnel, to business professionals, to professionals in our manufacturing and service sectors. And the causes of hearing loss are many: age-related, genetics/family history of hearing loss, noise-induced, infections, trauma and toxic-induced hearing loss. Regardless of the cause, hearing loss has a profound impact on the lives of those who live with it and on their loved ones. Frustration, fear, isolation and depression are common for people living with a hearing loss. Right now there are limited treatment options for hearing loss, including hearing aids, assistive listening devices and cochlear implants. However, these are not effective for everyone and the costs to a person and family are significant. Currently, there are no cures for hearing loss or tinnitus. Blindness separates people from things; deafness separates people from people. —Helen Keller 3 A New Way of Doing Things F or too many years, biomedical research has been conducted in relative isolation: one researcher or one institution working alone to tackle major health issues. Today, we know that research progress is enhanced by the collaboration of scientists with diverse areas of expertise. Simply put, no single laboratory or institution has sufficient breadth of expertise and technology to solve all problems. Furthermore, medical researchers in cell regeneration and hearing science face greater competition for funding each year and from a decreasing pool of funds from the National Institutes of Health (NIH) and other large medical research funders. Hearing Health Foundation is tackling these issues of medical research funding and progress by focusing our efforts on a collaborative, targeted and fully-funded approach: the Hearing Restoration Project. Hearing Health Foundation: Since 1958, the Leading Non-Profit Supporting Research to End Hearing Loss The mission of Hearing Health Foundation is to prevent and cure hearing loss through groundbreaking research. We are America’s leading source of private funding for research into the science of hearing and balance. Since 1958 we have awarded approximately 2,000 grants totaling nearly $30 million through our Emerging Research Grants program. Deafness Research Foundation (now called Hearing Health Foundation) was founded in 1958 because of the vision, strength and determination of one remarkable woman: the late Collette Ramsey Baker. Collette Ramsey Baker. I want to see a cure before I die. I’m so excited for my children’s future because of people like you! —Kille, mother of two kids with hearing loss 4 After living with a substantial hearing loss for many years, at age 35 an early fenestration operation restored Mrs. Ramsey Baker’s hearing. In gratitude, she wanted to donate money to a national non-profit organization that was supporting hearing and balance research, but no such organization existed at the time. That was when she decided to create a non-profit that could support medical research to further hearing loss treatments, prevention and a cure. Under her incredible leadership, we bestowed grants upon colleges and other research institutions for research and improvement of hearing. Mrs. Ramsey Baker received letters of commendation from many leaders, including Presidents Herbert Hoover and Dwight D. Eisenhower, as well as Helen Keller and Cardinal Francis Spellman. Since 1958, the organization has made incredible breakthroughs in research and care, including the co-founding of the National Temporal Bone Banks Program, passing of the Universal Newborn Hearing Screening legislation, contributing to the development of the cochlear implant, and surgery for otosclerosis. Hearing Restoration Project (HRP): The REAL Promise of a Cure H earing Health Foundation has launched its most important research initiative ever: the Hearing Restoration Project. Our goal is to deliver, for the first time, a genuine, biologic cure for the millions of people living with hearing loss and tinnitus. The project is based on the discovery funded by Hearing Health Foundation in 1987 that birds spontaneously regenerate the hair cells necessary for hearing when those cells become damaged; humans cannot. But recent discoveries in stem cell research and gene mapping may make now the time to trigger hair cell regrowth in humans in the near future. The Consortium Model Through the Hearing Restoration Project, leading researchers have committed to our consortium model – working together, fully sharing technologies, data, and credit – to discover the secret of regenerating inner ear hair cells in humans. Their goal is nothing less than a cure for hearing loss and tinnitus. The HRP is collaborative rather than competitive, and relies on the strengths of our researchers towards a common goal. The consortium members are experts within their own right, and are working individually on different aspects of regeneration—including nerve regeneration, stria development, and hair cell regeneration across multiple species—and then pooling their resources and findings to help find a cure for hearing loss through collaborative projects and data sharing. If you really want to cure hearing loss, hair cell research is the only game in town. —Dr. Edwin Rubel, Department of Otolaryngology, Graduate Program in Neurobiology and Behavior, University of Washington; Hearing Restoration Project Consortium Member. The Best and Brightest The consortium is comprised of the best and brightest researchers in hearing science from the following institutions: Baylor College of Medicine Harvard Medical School Imperial College London Oregon Health & Science University Stanford University School of Medicine Stowers Institute for Medical Research University of Michigan University of Southern California University of Toronto University of Washington Washington University School of Medicine Hair Cells, Explained Hair cells are specialized sensory cells located in the inner ear. Hair cells in the cochlea convert sound information into electrical signals that are sent to the brain. Once hair cells die or are damaged – whether from noise, age, sudden deafness, or drugs – hearing is lost. Because hair cells are not regenerated in humans or other mammals, most hearing deficits are permanent. Birds and fish have the natural ability to regenerate damaged hair cells. Our challenge is to replicate this regeneration in humans. HRP consortium members discussing their latest collaborative research. 5 Our Research Strategy C onsortium members of the Hearing Restoration Project (HRP) highlighted two major issues with regard to our current understanding of hair cell regeneration. First, it is clear that “supporting cells” of the inner ear give rise to new hair cells after injury. Yet we have identified only a small number of molecules that influence the ability of supporting cells to yield new hair cells. Second, we know very little about how supporting cells change over time following hair cell damage. This information is key for identifying potential targets for regeneration therapy. The two general approaches outlined below are highly integrated and involve the efforts of the majority of consortium members. We are hopeful that these approaches will lead to development of a targeted strategy to promote hair cell regeneration in mammals in ten years. PHASE I – Discovery Research (Years 1-5) The goal of Phase I is to 1) discover the factors that block regeneration, and 2) identify the missing factors that can promote regeneration. Two broad approaches are envisioned. Scientific Approach 1. Comparative Genomics: Genetic and epigenetic regulation of pro-regenerative behaviors in supporting cells compared across species Diagram of the Inner Ear We will determine how birds, fish, and mammals differ with respect to gene expression after hair cell damage. This approach should pinpoint biomarkers that are permissive or restrictive for supporting cell division and transdifferentiation. Such biomarkers could include individual transcription factors or complete signaling pathways. These biomarkers will serve as the next targets for experimental manipulation in vitro and in vivo. A related and complimentary approach is to make similar comparisons between supporting cells in the mammalian inner ear at different ages. Analyses will be done across laboratories, and large amounts of genomic data will be generated. Experienced specialists will help extract the data, and raw and processed data will be posted online for consortium members to view. This process will allow immediate hypothesis generation and testing, which will hasten progress toward our goals. Scientific Approach 2. Cell Tracking Analyses: Supporting cell fate mapping in genetically modified mice after injury We need to know which cell types remain in inner ear epithelia (sensory tissue) at early and late periods following different forms of damage to hearing and balance organs. We will use transgenic mice to allow the identification and tracking of specific subtypes of supporting cells or cells outside the sensory epithelium. This approach will use these mice to determine the fates of all supporting cells in the mouse organ of Corti and in the utricle, a sensory organs in the inner ear specialized for balance function, after different forms of hair cell damage 6 There’s a way to do it better—find it. —Thomas Alva Edison, Man of the Millennium and American Innovator who lived with a severe hearing loss are induced. This analysis will also help identify markers for the cell types that remain after damage, facilitating genetic manipulation of these potential target cells in future experiments. PHASE II – Pre-Translational Research (Years 3-8) In parallel with ongoing projects of Phase I, additional projects will be initiated to determine how best to implement the results of Phase I. In addition, we will determine whether regenerated hair cells are functional or whether other steps are required to restore hearing. PHASE III – Translational Research (Years 6-10) Phase III will entail pre-clinical translational research that implements strategies culminating from research during Phases I and II. We estimate that Phase I will be completed in Years Hearing Restoration Project 1-5, and we expect that early results in Phase II will allow us to start to establish new hair Strategic Plan cells in damaged mammalian ears by Year 6. Projects in Phase III will focus on manipulating specific target genes, pathways, and/or cells in the injured mammalian organ of Corti and utricle. Results from these projects will indicate manipulations, or treatments, that will likely lead Phase 1 Discovery Research to improvements in hearing or balance function, Years 1 - 5 first in animal models, and later in humans. Conclusion: Comparative genomics Department of Otolaryngology/Head and Neck Surgery and the Virginia Merrill Bloedel Hearing Research Center, in Seattle, WA and Peter BarrGillespie, Ph.D., Scientific Director of the Hearing Restoration Project and researcher at Oregon Health & Science University. Identify cells remaining in Organ of Corti after damage Animals that readily regenerate Researchers estimate that with current levels of funding in hearing science and without the Hearing Restoration Project consortium, it will take 50 years to achieve human inner ear restoration. Today, through the collaborative model of the Hearing Restoration Project and our consortium of experts, we have the opportunity to accelerate the research and shorten the timeline for discovery to 10 years or less. This strategy was summarized by Jennifer Stone, Ph.D., and Edwin Rubel, Ph.D., members of the Hearing Restoration Project consortium and researchers at the University of Washington’s Cell tracking analyses Identify genes that drive supporting cells to form new hair cells Mature Zebrafish Mature Chickens Mouse Organ of Corti Degeneration Developing Chicks Developing Mouse Genes X, Y, Z Mature Mouse Animals that do not regenerate Phase 2 Translational Research Years 5 + Drive remaining cells to form new hair cells Regeneration Genes X, Y, Z Damaged Mouse Organ of Corti Repaired Mouse Organ of Corti 7 How You Can Help/ Funding Opportunities R arely have scientists had such a clear view of the nature of a cure for a major health issue. We are tantalizingly close to it … yet there is much work still to be done. We need your help. Please join Hearing Health Foundation and help us make hearing loss and tinnitus a thing of the past. The Hearing Restoration Project is the biggest reason I contribute. Such an organized effort, with so many top-notch scientists, provides a real possibility that Hearing Loss will be cured. —Anthony Bartoli, a monthly donor who has hearing loss Doug Olson, CFRE Director of Development [email protected] (212) 257-6144 For more information and to learn more about funding opportunities contact: Hearing Health Foundation 363 Seventh Avenue, 10th Floor New York 10001-3904 or online at www.hhf.org/JoinUs. We’ve made it easy to support Hearing Health Foundation and the Hearing Restoration Project in the way that is most convenient for you: • Naming Opportunities • Major Gifts • Tribute Gifts • Monthly Giving • Fundraising Events: Fundraise for a Cure for Hearing Loss • Workplace Giving • Gifts of Appreciated Stock or through your IRA • Planned Giving Through Your Estate Plans (Collette Ramsey Baker Society) • Name a Research Grant • Partner With Us (companies and community groups) Hearing Health Foundation Board of Directors Shari S. Eberts, Chairman; Mark Angelo; Robert Boucai; Judy R. Dubno, Ph.D.; Rebecca Ginzburg; Roger M. Harris; David S. Haynes, M.D.; Elizabeth Keithley, Ph.D.; Richard Miyamoto, M.D.; Michael C. Nolan; Paul E. Orlin; Chris Smith; Peter Steyger, Ph.D.; Clifford P. Tallman, Jr.; Elizabeth Thorp; Ronald E. West, Nancy M. Williams. Hearing Restoration Project Consortium Members John Brigande, Ph.D.; Alain Dabdoub, Ph.D.; Albert Edge, Ph.D.; Andy Groves, Ph.D.; Stefan Heller, Ph.D.; Michael Lovett, Ph.D.; Liz Oesterle, Ph.D.; Tatjana Piotrowski, Ph.D.; David Raible, Ph.D.; Yehoash Raphael, Ph.D.; Ed Rubel, Ph.D.; Neil Segil, Ph.D.; Jennifer Stone, Ph.D.; Mark Warchol, Ph.D. Hearing Health Foundation is a non-profit 501 (c)(3) tax exempt charity (Tax ID: 13-1882107).