Ex vivo cadaveric human temporal bone study. (A): Schematized midmodiolar cross-section of a mammalian cochlea, showing injection needle approaching the modiolus. (B-C): Photomicrograph of the basal turn of the left cochlea in a cadaveric temporal bone (B) and in humans (C). Black arrows indicate direction of injection with IKVAV-PA gels. Note the direction of the fine needle for injection of IKVAV gel containing hESCs. A blue-dotted line shows the cochleostomy site. A white dotted line: round window. (D and E): Endoscopic IKVAV-PA gel injection into human modiolus. View of cochleostomy site using a 16-mm 0˚rigid 0˚rigid endoscope. A black dashed line marks cochleostomy boundary. A white dashed line indicates presumed plane of the scala vestibuli. (F): Artist's rendition of the superior view of the human skull base, with black arrow showing the direction of injection of IKVAV gels with hESCs and anatomical landmarks. Black square corresponds to sectioned area in subsequent figures. (G-L): IKVAV-PA gels with hESCs in the IAC in two sets of human cadaveric temporal bones. (G and J): Middle cranial fossa view of the human cadaveric temporal bone before the hESC injection. TAMRA-tagged IKVAV gels (H) and corresponding autofluorescence measurement observed in normal temporal bone tissue abutting the IAC (I). TRA-1-81 tagged hESCs with magnified inset (K) and corresponding autofluorescence measurement (L). Abbreviations: RW: round window; C: cochleostomy site; ST: scala tympani; SV: scala vestibule; M: modiolus; N: spinal needle; ACF: anterior cranial fossa; MCF: middle cranial fossa; PCF: posterior cranial fossa. Cranial nerves are denoted by Roman numerals. https://doi.org/10.1371/journal.pone.0190150.g006 

Ex vivo cadaveric human temporal bone study. (A): Schematized midmodiolar cross-section of a mammalian cochlea, showing injection needle approaching the modiolus. (B-C): Photomicrograph of the basal turn of the left cochlea in a cadaveric temporal bone (B) and in humans (C). Black arrows indicate direction of injection with IKVAV-PA gels. Note the direction of the fine needle for injection of IKVAV gel containing hESCs. A blue-dotted line shows the cochleostomy site. A white dotted line: round window. (D and E): Endoscopic IKVAV-PA gel injection into human modiolus. View of cochleostomy site using a 16-mm 0˚rigid 0˚rigid endoscope. A black dashed line marks cochleostomy boundary. A white dashed line indicates presumed plane of the scala vestibuli. (F): Artist's rendition of the superior view of the human skull base, with black arrow showing the direction of injection of IKVAV gels with hESCs and anatomical landmarks. Black square corresponds to sectioned area in subsequent figures. (G-L): IKVAV-PA gels with hESCs in the IAC in two sets of human cadaveric temporal bones. (G and J): Middle cranial fossa view of the human cadaveric temporal bone before the hESC injection. TAMRA-tagged IKVAV gels (H) and corresponding autofluorescence measurement observed in normal temporal bone tissue abutting the IAC (I). TRA-1-81 tagged hESCs with magnified inset (K) and corresponding autofluorescence measurement (L). Abbreviations: RW: round window; C: cochleostomy site; ST: scala tympani; SV: scala vestibule; M: modiolus; N: spinal needle; ACF: anterior cranial fossa; MCF: middle cranial fossa; PCF: posterior cranial fossa. Cranial nerves are denoted by Roman numerals. https://doi.org/10.1371/journal.pone.0190150.g006 

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... Additionally, IKVAV-PA gels (peptide based hydrogels) were injected into the temporal bone of a human cadaver and showed promising results for the delivery of SC in a clinical setting. Therefore, it is recommended to combine injectable self-assembled PA gels with ESC transplantation to provide the ideal microenvironment for inner ear regeneration [144] (Figure 2). ...
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... Moreover, the elasticity modulus provided by Matrigel is insufficient to provide adequate support for cells (Soofi et al., 2009). To address these problems, hydrogels with defined components and improved mechanical properties have been investigated for their biological effects on inner ear regeneration (Rajasingh et al., 2017;Pouraghaei et al., 2020;Shi et al., 2023). One study demonstrated that Matrigel mixed with a certain ratio of alginate induced better differentiation of human gingival mesenchymal stem cells into auditory progenitor cells than Matrigel alone (Pouraghaei et al., 2020). ...
... Moreover, alginate modified by the Arg-Gly-Asp (RGD) sequence, a common cell adhesion peptide mainly derived from fibronectin, could also provide bioactive sites for cell-hydrogel interaction (Chikar et al., 2012). A single-component hydrogel crosslinked by self-assembling peptide amphiphiles with an Ile-Lys-Val-Ala-Val (IKVAV) epitope, another signal peptide epitope from laminin, has also been shown to promote the differentiation of hESCs into otic neural progenitors, as well as cell survival and localization after transplantation (Rajasingh et al., 2017). Interestingly, bacterial cellulose can also be fabricated into hydrogels for the differentiation and functional maintenance of SGNs (Shi et al., 2023). ...
... Multidirectional ECM-cytoskeleton binding has been verified to be conducive to the formation of cellular actin-rich extension (Langevin et al., 2005), which may contribute to neurite growth. Hydrogels with modified cell adhesion-related signaling peptide epitopes, such as RGD (Chikar et al., 2012) or IKVAV (Frick et al., 2017;Rajasingh et al., 2017), have been reported to promote cellhydrogel interactions and neuronal differentiation, which further demonstrated the importance of cell adhesion for inner ear cell regeneration. ...
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... Additionally, IKVAV-PA gels were successfully injected into the human cadaveric temporal bone and revealed positive effects for SC delivery in the clinic. So, the combination of ESC transplantation with injectable PA gels is suggested to create an appropriate microenvironment for inner ear regeneration [281]. ...
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... PA-based hydrogels with incorporated IKVAV sequences were successfully used to create a niche in mice inner ear to increase the survival and support the differentiation of neuron progenitors to regenerate the spiral ganglion [79]. While in all other previous cases the differentiation of stem cells was externally induced, and only supported and enhanced by IKVAV, a recent work reported the successful differentiation of BMSCs induced only by this peptide sequence contained in a PA-based hydrogel [80]. ...
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... Therefore, stem cells, for example embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs), are an important tool for studying the molecular mechanisms underlying the innerear pathology as well as for generating cells for replacement therapies. Several groups have reported that mouse and human ESCs/iPSCs can be differentiated into inner-ear cells, including hair cells, supporting cells, progenitor cells and sensory neurons by in vitro differentiation in adherent culture and/or floating aggregation culture (21)(22)(23)(24)(25)(26)(27)(28). Previously, we described the generation of CX26 gap junction-forming cells from iPSCs (induced CX26 gap junction-forming cells; hereafter, iCX26GJC) derived from mice by using a floating culture (serumfree culture of embryoid body-like aggregates with quick aggregation culture; hereafter, SFEBq culture) and adherent culture systems. ...
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... Among them, one of the most explored class is peptide amphiphiles (PAs), which are short peptide sequences attached to a hydrophobic tail. 88,[177][178][179][180][181][182][183][184][185] The key structure of most designed peptide amphiphiles comprises of 4-8 amino acid β-sheet forming peptide sequence attached to an alkyl tail. The final structure of the peptide amphiphile is completed by the addition of charged residues to aid in solubility and gelation. ...
... The final structure of the peptide amphiphile is completed by the addition of charged residues to aid in solubility and gelation. 177,178,182,184 Additionally, in order to impart bioactivity to these peptide amphiphiles, various bioactive sequences can be attached covalently after the charged residues. 88,177,178,184 Under aqueous conditions, the hydrophobic interactions among the alkyl tails and subsequent β-sheet formation triggers the self-assembly of PAs to form high aspect ratio cylindrical nanofibers. ...
... 177,178,182,184 Additionally, in order to impart bioactivity to these peptide amphiphiles, various bioactive sequences can be attached covalently after the charged residues. 88,177,178,184 Under aqueous conditions, the hydrophobic interactions among the alkyl tails and subsequent β-sheet formation triggers the self-assembly of PAs to form high aspect ratio cylindrical nanofibers. 177 In self-assembled systems based on peptide amphiphiles, the core of the fiber is composed of packed alkyl tails thus exposing the peptide motifs towards the aqueous environment. ...
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... ONPs enhanced neural survival and differentiation after transplantation into X-SCID rat cochlea. 70 The same group used 3D-spheroid system, ECM (ie, nanofibrillar cellulose hydrogel), and a neurotrophic factor delivery to artificially create a stem cell niche that allowed hESC-derived ONP engraftment as well as neuronal differentiation. 71 Despite the recent progress in cell transplantation to the inner ear, the optimization of this regenerative strategy is a phenomenal task, since there are multiple variables to consider in each experimental paradigm. ...
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The sense of hearing depends on a specialized sensory organ in the inner ear, called the cochlea, which contains the auditory hair cells (HCs). Noise trauma, infections, genetic factors, side effects of ototoxic drugs (ie, some antibiotics and chemotherapeutics), or simply aging lead to the loss of HCs and their associated primary neurons. This results in irreversible sensorineural hearing loss (SNHL) as in mammals, including humans; the inner ear lacks the capacity to regenerate HCs and spiral ganglion neurons. SNHL is a major global health problem affecting millions of people worldwide and provides a growing concern in the aging population. To date, treatment options are limited to hearing aids and cochlear implants. A major bottleneck for development of new therapies for SNHL is associated to the lack of human otic cell bioassays. Human induced pluripotent stem cells (hiPSCs) can be induced in two-dimensional and three-dimensional otic cells in vitro models that can generate inner ear progenitors and sensory HCs and could be a promising preclinical platform from which to work toward restoring SNHL. We review the potential applications of hiPSCs in the various biological approaches, including disease modeling, bioengineering, drug testing, and autologous stem cell based-cell therapy, that offer opportunities to understand the pathogenic mechanisms of SNHL and identify novel therapeutic strategies.
... For example, scaffolds such as the self-assembling peptide amphiphiles (Sato et al., 2018) developed in recent years is an example of how these scaffolds can be specifically designed to suit regeneration of different tissues such as muscle (Sleep et al., 2017) and nerves (Cheng et al., 2013;Matsuoka et al., 2017). In these studies, peptides mimicking various ECM proteins, such as collagen (Gore et al., 2001;Luo and Tong, 2011), laminin (Cheng et al., 2013), heparin (Mammadov et al., 2011), and TNC (Sever et al., 2014), were incorporated into peptide amphiphiles. ...
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... Hydrogels based on other peptide amphiphiles with bioactive domains as IKVAV, or with a tenascin-C-mimetic configuration, showed potential as cell encapsulation and regeneration matrices for inner ear and neural repair. [367][368][369][370] Native tissues can display different degrees of anisotropy and spatially varying stiffness, that are key players in guiding cell migration, organization, and function. [340] Beyond their flexibility for designing self-assembled hydrogels with tunable Adv. ...
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