{"id":17699,"date":"2022-03-08T09:00:27","date_gmt":"2022-03-08T08:00:27","guid":{"rendered":"https:\/\/lifelonghearing.com\/?p=17699"},"modified":"2025-04-17T04:52:16","modified_gmt":"2025-04-17T04:52:16","slug":"vyzkum-budoucnosti-rehabilitace-sluchu","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/cs\/vyzkum-budoucnosti-rehabilitace-sluchu\/","title":{"rendered":"V\u00fdzkum budoucnosti rehabilitace sluchu"},"content":{"rendered":"

Rehabilitace sluchu: Genov\u00e1 terapie a optick\u00fd CI<\/h1><\/div>

Posledn\u00ed den rakousk\u00e9ho ORL kongresu v z\u00e1\u0159\u00ed 2021 v Innsbrucku byl zam\u011b\u0159en na v\u00fdzkum a st\u0159edn\u011bdobou a vzd\u00e1lenou budoucnost rehabilitace sluchu.<\/strong><\/p>\n<\/div>

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V roce 2013 se tohoto setk\u00e1n\u00ed z\u00fa\u010dastnili Priv. Doz. DI DDr. Ingeborg Hochmairov\u00e1, zakladatelka rakousk\u00e9ho v\u00fdrobce implant\u00e1t\u016f MED-EL<\/a>, Prof. Dr. Blake S. Wilson, v\u011bdec z Duke University a Prof. Dr. Graeme M. Clark z University of Melbourne obdr\u017eeli Lasker-DeBakey Clinical Medical Research Award za v\u00fdvoj modern\u00edch kochle\u00e1rn\u00edch implant\u00e1t\u016f. Vzhledem k tomu, \u017ee sluchov\u00e1 implantologie pr\u00e1v\u011b oslavila 30. v\u00fdro\u010d\u00ed sv\u00e9ho vzniku v roce 2021, byla cena Alberta Laskera za z\u00e1kladn\u00ed l\u00e9ka\u0159sk\u00fd v\u00fdzkum ud\u011blena t\u0159em v\u011bdc\u016fm, jejich\u017e v\u00fdzkum by se mohl st\u00e1t v\u00fdznamn\u00fdm pro budoucnost kochle\u00e1rn\u00edch implant\u00e1t\u016f<\/a>. Jsou jimi profesor Karl Deisseroth, doktor medic\u00edny, PhD. ze Stanfordovy univerzity v Kalifornii, profesor Peter Hegemann z Humboldtovy univerzity v Berl\u00edn\u011b a profesor Dieter Oesterhelt z \u00dastavu biochemie Maxe Plancka, kter\u00fd zkoumal b\u00edlkovinn\u00e9 mikroorganismy citliv\u00e9 na sv\u011btlo a jejich vyu\u017eit\u00ed v optogenetice. Tato b\u00edlkovina je p\u0159edpokladem pro v\u00fdvoj optick\u00fdch CI, od kter\u00fdch si odborn\u00edci hodn\u011b slibuj\u00ed.<\/p>\n

Prof. Dr. Stefan Volkenstein na kongresu ORL podal p\u0159ehled budouc\u00edho v\u00fdvoje u\u0161n\u00ed chirurgie, jeho\u017e hnac\u00ed silou je digitalizace a technologizace. To plat\u00ed i pro sluchov\u00e9 implant\u00e1ty. Nap\u0159\u00edklad zdokonalen\u00e9 vizualizace umo\u017e\u0148uj\u00ed individu\u00e1ln\u011b optimalizovan\u00e9 kochle\u00e1rn\u00ed implantace.<\/p>\n

Prof. Volkenstein zm\u00ednil vize budoucnosti s konkr\u00e9tn\u00edm odkazem na CI. Krom\u011b snu mnoha u\u017eivatel\u016f CI o pln\u011b implantovan\u00e9m syst\u00e9mu by optick\u00e1 stimulace a genetick\u00e1 rehabilitace sluchov\u00fdch schopnost\u00ed mohly u\u010dinit implant\u00e1ty zastaral\u00fdmi.<\/p>\n

Geny pro dobr\u00fd sluch<\/h2>\n

V p\u0159\u00edpad\u011b z\u00edskan\u00e9 ztr\u00e1ty sluchu (vznikl\u00e9 v pozd\u011bj\u0161\u00edm v\u011bku) z negenetick\u00fdch p\u0159\u00ed\u010din je nejpokro\u010dilej\u0161\u00ed genov\u00e1 terapie, jej\u00edm\u017e c\u00edlem je p\u0159\u00edm\u00e1 regenerace smyslov\u00fdch bun\u011bk ucha. \u201eMnoho studi\u00ed ukazuje, \u017ee tato regenerace je mo\u017en\u00e1,\u201c vysv\u011btlila ve sv\u00e9 prezentaci profesorka Ellen Reisingerov\u00e1 z Univerzitn\u00ed nemocnice v T\u00fcbingenu. \u201eAle zat\u00edm jen jedna studie ukazuje, \u017ee zlep\u0161uje i sluch. Probl\u00e9mem je, \u017ee tento \u00fa\u010dinek se zat\u00edm nepoda\u0159ilo reprodukovat.\u201c Proto zat\u00edm nelze p\u0159edv\u00eddat, zda a kdy by takov\u00e1 terapie mohla b\u00fdt mo\u017en\u00e1. Probl\u00e9my se sluchem v ran\u00e9m d\u011btstv\u00ed jsou z 80 procent zp\u016fsobeny geneticky a v\u00edce ne\u017e 70 procent t\u011bchto genetick\u00fdch odchylek ovliv\u0148uje v\u00fdhradn\u011b sluch. T\u011bchto gen\u016f je v\u0161ak mnoho: v p\u0159\u00edpad\u011b recesivn\u00edch variant je zn\u00e1mo 78 r\u016fzn\u00fdch gen\u016f, kter\u00e9 mohou b\u00fdt jejich p\u0159\u00ed\u010dinou.<\/p>\n

U dal\u0161\u00edch nejm\u00e9n\u011b 23 gen\u016f existuje podez\u0159en\u00ed na souvislost a mo\u017en\u00e9 jsou i dal\u0161\u00ed nezn\u00e1m\u00e9 p\u0159\u00ed\u010diny.<\/p>\n

Slibn\u00fd p\u0159\u00edstup ke genov\u00e9 terapii<\/h2>\n

Vzhledem k velk\u00e9mu po\u010dtu r\u016fzn\u00fdch gen\u016f, kter\u00e9 jsou p\u0159\u00ed\u010dinou ztr\u00e1ty sluchu, nem\u016f\u017ee existovat jedna genov\u00e1 terapie pro ztr\u00e1tu sluchu. Krom\u011b toho takov\u00e1 terapie vy\u017eaduje, aby u ka\u017ed\u00e9ho pacienta byla objasn\u011bna nejen samotn\u00e1 ztr\u00e1ta sluchu, ale tak\u00e9 p\u0159\u00edslu\u0161n\u00fd gen, kter\u00fd ji zp\u016fsobuje. V mnoha p\u0159\u00edpadech je pro \u00fasp\u011b\u0161nou terapii rozhoduj\u00edc\u00ed v\u010dasn\u00e9 pou\u017eit\u00ed genov\u00e9 terapie. Nap\u0159\u00edklad speci\u00e1ln\u00ed terapeutick\u00fd p\u0159\u00edstup uk\u00e1zal v pokusech na my\u0161\u00edch slibn\u00e9 v\u00fdsledky, ale p\u0159i t\u00e9to terapii by musela b\u00fdt hluchota diagnostikov\u00e1na ji\u017e v d\u011bloze. Z\u00e1kladn\u00ed genov\u00e1 vada by musela b\u00fdt identifikov\u00e1na v genetick\u00e9m materi\u00e1lu p\u0159ed 18. t\u00fddnem t\u011bhotenstv\u00ed! \u201eNemysl\u00edm si, \u017ee je to zcela vylou\u010den\u00e9, ale je to stejn\u011b daleko jako kolonizace Marsu,\u201c spekuluje profesorka Reisingerov\u00e1, specialistka na genovou terapii.<\/p>\n

Sama se zab\u00fdv\u00e1 v\u00fdvojem genov\u00e9 terapie, kter\u00e1 by m\u011bla pomoci s mutac\u00ed, je\u017e se vyskytuje ve dvou procentech v\u0161ech p\u0159\u00edpad\u016f geneticky podm\u00edn\u011bn\u00e9 ztr\u00e1ty sluchu. V sou\u010dasn\u00e9 dob\u011b prob\u00edhaj\u00ed klinick\u00e9 testy. Slibn\u00fd je v\u00fdvoj t\u011bch genov\u00fdch terapi\u00ed, kter\u00e9 jsou p\u0159edpokladem pro protetickou l\u00e9\u010dbu pomoc\u00ed budouc\u00edch optick\u00fdch kochle\u00e1rn\u00edch implant\u00e1t\u016f.<\/p>\n

Zlep\u0161en\u00ed vn\u00edm\u00e1n\u00ed zvuku pomoc\u00ed CI<\/h2>\n

Ve zdrav\u00e9m vnit\u0159n\u00edm uchu je v\u00fd\u0161ka t\u00f3nu zak\u00f3dov\u00e1na podle m\u00edsta ve vnit\u0159n\u00edm uchu, kde je konkr\u00e9tn\u00ed zvuk stimulov\u00e1n. Kochle\u00e1rn\u00ed implant\u00e1ty stimuluj\u00ed co nejbl\u00ed\u017ee p\u0159irozen\u00e9mu m\u00edstu stimulace pomoc\u00ed pulzu elektrick\u00e9ho proudu a tuto stimulaci ozna\u010dujeme jako iontovou stimulaci. Pouze CI MED-EL pou\u017e\u00edvaj\u00ed popsan\u00e9 \u010dasov\u00e9 k\u00f3dov\u00e1n\u00ed i pro n\u00edzk\u00e9 zvuky.<\/p>\n

P\u0159esto je slabinou modern\u00edch kochle\u00e1rn\u00edch implant\u00e1t\u016f jejich relativn\u011b n\u00edzk\u00e9 frekven\u010dn\u00ed rozli\u0161en\u00ed ve srovn\u00e1n\u00ed se zdrav\u00fdm uchem. Zvukov\u00e9 rozd\u00edly tak nelze vn\u00edmat stejn\u011b dob\u0159e. Je to zp\u016fsobeno t\u00edm, \u017ee pou\u017eit\u00e9 proudov\u00e9 impulsy vytv\u00e1\u0159ej\u00ed sv\u00e9 elektrick\u00e9 pole i v okol\u00ed aktivn\u00edho kontaktu, a tak koexcituj\u00ed sousedn\u00ed oblasti. \u201eZ tohoto d\u016fvodu nen\u00ed rozd\u00edl, zda se pou\u017e\u00edv\u00e1 12 nebo 24 kan\u00e1l\u016f,\u201c vysv\u011btlil Prof. Dr. Tobias Moser, \u0159editel Institutu pro audiologickou neurov\u011bdu na L\u00e9ka\u0159sk\u00e9 univerzit\u011b v G\u00f6ttingenu. \u201eZde p\u0159ich\u00e1z\u00ed ke slovu optick\u00fd CI, proto\u017ee s n\u00edm m\u016f\u017eete dob\u0159e svazovat.\u201c Douf\u00e1me v 64 kan\u00e1l\u016f.<\/p>\n

Optick\u00e9 kochle\u00e1rn\u00ed implant\u00e1ty<\/h2>\n

Lidsk\u00fd nervov\u00fd impulz je p\u0159irozen\u011b iontov\u00fd impulz, a proto se k n\u011bmu hod\u00ed elektronick\u00fd stimula\u010dn\u00ed impulz. Naproti tomu bu\u0148ky zelen\u00e9 \u0159asy jsou citliv\u00e9 na sv\u011btlo. \u201eTrik spo\u010d\u00edv\u00e1 v roz\u0161\u00ed\u0159en\u00ed takov\u00e9 genetick\u00e9 informace ze zelen\u00e9 \u0159asy a jej\u00ed p\u0159enesen\u00ed do lidsk\u00e9 nervov\u00e9 bu\u0148ky,\u201c vysv\u011btlil profesor Moser. Deisseroth, Hegemann a Oesterhelt, v\u011bdci, kte\u0159\u00ed ned\u00e1vno z\u00edskali Laskerovu cenu za z\u00e1kladn\u00ed v\u00fdzkum, se o to pokusili u my\u0161\u00ed. Objektivn\u00ed m\u011b\u0159en\u00ed ABR i experimenty behavior\u00e1ln\u00ed anal\u00fdzy uk\u00e1zaly, \u017ee lze dos\u00e1hnout sluchov\u00fdch vjem\u016f.<\/p>\n

\u201eV\u00fdvoj prob\u00edh\u00e1, ale je\u0161t\u011b n\u00e1s \u010dek\u00e1 spousta pr\u00e1ce!\u201c uvedl profesor Moser s odkazem na genovou terapii a l\u00e9ka\u0159skou technologii s optick\u00fdmi stimula\u010dn\u00edmi moduly a vhodn\u00fdmi k\u00f3dovac\u00edmi strategiemi.<\/p>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"

Posledn\u00ed den rakousk\u00e9ho ORL kongresu v z\u00e1\u0159\u00ed 2021 v Innsbrucku byl zam\u011b\u0159en na st\u0159edn\u011bdobou a vzd\u00e1lenou budoucnost rehabilitace sluchu.<\/p>\n","protected":false},"author":4,"featured_media":31932,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[470],"tags":[445,422,412],"class_list":["post-17699","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-veda","tag-development","tag-hearing-implant-reliability","tag-hearing-implants"],"yoast_head":"\nV\u00fdzkum budoucnosti rehabilitace sluchu - Czech<\/title>\n<meta name=\"description\" content=\"Posledn\u00ed den rakousk\u00e9ho ORL kongresu v roce 2021 byl zam\u011b\u0159en na v\u00fdzkum a budoucnost rehabilitace sluchu.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/lifelonghearing.com\/cs\/vyzkum-budoucnosti-rehabilitace-sluchu\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"V\u00fdzkum budoucnosti rehabilitace sluchu - 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