Differentiation of inner ear stem cells to functional sensory neurons.

Inner ear stem cells can be isolated by neurosphere formation from the vestibular organs and the cochlea. The cells are pluripotent, with the potential to become hair cells and neurons, the cochlear cell types whose loss causes deafness. Here we describe the control of cell fate decisions that determine the phenotype adopted by these progenitors, and we determine whether differentiation to sensory neurons is preferred over other types of neurons. Differentiation of progenitor cells recapitulated developmental pathways of embryonic sensory neurons. Based on marker expression, retinoic acid increased the yield of neurons and the percentage of sensory neurons obtained and caused a sharp increase in Pax2, a key transcription factor of cranial placodes. Markers of embryonic auditory and other sensory neurons, GATA3, Brn3a, and islet1, could be detected after 3 days of differentiation of the cells, and markers of the sensory phenotype, peripherin, calretinin, TrkC, and TrkB were expressed after 10 days. The differentiated cells had tetrodotoxin-sensitive sodium currents and fired action potentials, and recordings revealed functional AMPA type-glutamate receptors, further indicating that these cells had developed neuronal features. Neurons differentiated from these stem cells grew processes to hair cells in vitro. Development of functional activity in cells with the markers of sensory neurons suggested that the inner ear stem cells might have the capacity to replace cells lost due to neural degeneration.