Defective mechanosensory transduction of the new inner hair cells prevents hearing recover in the damaged cochlea

Hearing loss is a major health problem worldwide. Numerous attempts at regenerating functional hair cells (HCs) have been unsuccessful, but little is known about the main barrier that prevents us from achieving it and improving the hearing ability after damage. Here, we developed an in vivo genetic mouse model, by which the inner HCs (IHCs), the primary sound receptors innervated by the auditory neurons, were specifically damaged and the neighboring nonsensory supporting cells (SCs) were transformed into IHCs by ectopic expression of transient Atoh1 and permanent Tbx2. Despite ~477 new IHCs were regenerated per cochlea and their differentiation status was more advanced than reported previously, no significant hearing improvement was achieved. By taking advantage of this unique model, we further found that the new IHCs expressed the functional marker vGlut3, harbored the similar transcriptomic profiles and electrophysiological properties as the endogenous IHCs. However, the mechanosensory transduction (MET) current could not be recorded in the new IHCs. Thus, our study indicated that the defective MET should be the main barrier that stops us from restoring the hearing capacity in the damaged cochlea and would pave the way for regenerating IHCs in vivo. ### Competing Interest Statement The authors have filed a hair cell regeneration patent based on results of this manuscript.