{"id":17699,"date":"2022-03-08T09:00:27","date_gmt":"2022-03-08T08:00:27","guid":{"rendered":"https:\/\/lifelonghearing.com\/?p=17699"},"modified":"2025-02-17T15:22:11","modified_gmt":"2025-02-17T15:22:11","slug":"cercetari-privind-viitorul-reabilitarii-auditive","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/ro\/cercetari-privind-viitorul-reabilitarii-auditive\/","title":{"rendered":"Cercet\u0103ri privind viitorul reabilit\u0103rii auditive"},"content":{"rendered":"

Reabilitarea auditiv\u0103: Terapia Gen \u0219i optic IC<\/h1><\/div>

\u00cen ultima zi a Congresului ORL austriac, desf\u0103\u0219urat \u00een septembrie 2021 la Innsbruck, focusul a fost asupra viitorului pe termen mediu \u0219i \u00eendep\u0103rtat al reabilit\u0103rii auditive.<\/strong><\/p>\n<\/div>

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\u00cen 2013, Priv. Doc. DI DDr. Ingeborg Hochmair, fondatoarea produc\u0103torului austriac de implanturi MED-EL<\/a>, Prof. Dr. Blake S. Wilson, om de \u0219tiin\u021b\u0103 la Universitatea Duke \u0219i Prof. Dr. Graeme M. Clark de la Universitatea din Melbourne au primit premiul Lasker-DeBakey Clinical Medical Research Award pentru dezvoltarea implanturilor cohleare moderne. \u00cen timp ce implantologia auditiv\u0103 tocmai \u0219i-a s\u0103rb\u0103torit cea de-a 30-a aniversare \u00een 2021, Premiul Albert Lasker Basic Medical Research Award a fost acordat celor trei oameni de \u0219tiin\u021b\u0103 ale c\u0103ror cercet\u0103ri ar putea deveni semnificative pentru viitorul implanturilor cohleare<\/a>. Ace\u0219tia sunt Prof. Karl Deisseroth, M.D., Ph.D. de la Universitatea Stanford din California, Prof. Peter Hegemann de la Universitatea Humboldt din Berlin \u0219i Prof. Dieter Oesterhelt de la Institutul Max Planck de Biochimie, care au cercetat microorganismele proteice sensibile la lumin\u0103 \u0219i utilizarea lor \u00een optogenetic\u0103. Aceast\u0103 protein\u0103 este o condi\u021bie prealabil\u0103 pentru dezvoltarea IC optic\u0103, \u00een care exper\u021bii au mari a\u0219tept\u0103ri.<\/p>\n

La Congresul ORL, Prof. Dr. Stefan Volkenstein a oferit o imagine de ansamblu asupra viitoarelor evolu\u021bii \u00een chirurgia urechii, pentru care digitalizarea \u0219i tehnologizarea sunt for\u021bele conduc\u0103toare. Acest lucru este valabil \u0219i \u00een cazul implanturilor auditive. De exemplu, vizualiz\u0103rile \u00eembun\u0103t\u0103\u021bite asigur\u0103 implanturi cohleare optimizate individual.<\/p>\n

Prof. Volkenstein a men\u021bionat viziunile viitorului cu referire specific\u0103 la IC. Pe l\u00e2ng\u0103 visul multor utilizatori de IC de a avea un sistem complet implantat, stimularea optic\u0103 \u0219i reabilitarea genetic\u0103 a capacit\u0103\u021bii auditive ar putea face ca implanturile s\u0103 devin\u0103 inutile.<\/p>\n

Genele pentru un auz bun<\/h2>\n

\u00cen cazul hipoacuziei dob\u00e2ndite din cauze non-genetice (care apare mai t\u00e2rziu \u00een via\u021b\u0103), cea mai avansat\u0103 terapie genetic\u0103 este cea care vizeaz\u0103 regenerarea direct\u0103 a celulelor senzoriale ale urechii. “Multe studii arat\u0103 c\u0103 aceast\u0103 regenerare este posibil\u0103”, a explicat profesoara Ellen Reisinger de la Spitalul Universitar din T\u00fcbingen \u00een prezentarea sa. “Dar, p\u00e2n\u0103 acum, doar un singur studiu arat\u0103 c\u0103 \u00eembun\u0103t\u0103\u021be\u0219te \u0219i auzul. Problema este c\u0103 acest efect nu a fost \u00eenc\u0103 reprodus.” Prin urmare, nu se poate prevedea \u00eenc\u0103 dac\u0103 \u0219i c\u00e2nd o astfel de terapie ar putea deveni posibil\u0103. Problemele de auz din copil\u0103rie sunt cauzate \u00een propor\u021bie de 80 la sut\u0103 de cauze genetice, iar peste 70 la sut\u0103 dintre aceste varia\u021bii genetice afecteaz\u0103 exclusiv auzul. Dar aceste gene sunt numeroase: \u00een cazul variantelor recesive, se \u0219tie c\u0103 78 de gene diferite sunt posibile cauze.<\/p>\n

Se suspecteaz\u0103 o leg\u0103tur\u0103 pentru cel pu\u021bin alte 23 de gene iar \u0219i alte cauze necunoscute sunt posibile.<\/p>\n

Abordare promi\u021b\u0103toare a terapiei genetice<\/h2>\n

Av\u00e2nd \u00een vedere acest num\u0103r mare de gene diferite ca \u0219i cauz\u0103 a hipoacuziei, este imposibil s\u0103 existe o singur\u0103 terapie genetic\u0103 pentru hipoacuzie. \u00cen plus, o astfel de terapie necesit\u0103 ca nu numai pierderea de auz \u00een sine, ci \u0219i gena care o provoac\u0103 s\u0103 fie clarificat\u0103 la fiecare pacient. \u00cen multe cazuri, o introducere timpurie a terapiei genetice este decisiv\u0103 pentru o terapie de succes. De exemplu, o abordare terapeutic\u0103 special\u0103 a ar\u0103tat rezultate promi\u021b\u0103toare \u00een experimentele pe \u0219oareci, dar cu aceast\u0103 terapie surditatea ar trebui s\u0103 fie diagnosticat\u0103 \u00een uter. Defectul genetic de baz\u0103 ar trebui s\u0103 fie identificat \u00een materialul genetic \u00eenainte de cea de-a 18-a s\u0103pt\u0103m\u00e2n\u0103 de sarcin\u0103! “Nu cred c\u0103 acest lucru este complet exclus, dar este la fel de \u00eendep\u0103rtat\u0103 ca \u0219i colonizarea planetei Marte”, speculeaz\u0103 profesoara Reisinger, specialist\u0103 \u00een terapie genic\u0103.<\/p>\n

Ea \u00eens\u0103\u0219i investigheaz\u0103 dezvoltarea unei terapii genetice care ar trebui s\u0103 ajute \u00een cazul unei muta\u021bii care este prezent\u0103 \u00een dou\u0103 procente din toate cazurile de hipoacuzie cauzate genetic. Testele clinice sunt \u00een curs de desf\u0103\u0219urare. Promi\u021b\u0103toare sunt acele dezvolt\u0103ri \u00een domeniul terapiei genice care reprezint\u0103 o condi\u021bie prealabil\u0103 pentru tratamentele prostetice cu viitoarele implanturi cohleare optice.<\/p>\n

\u00cembun\u0103t\u0103\u021birea percep\u021biei sonore cu ajutorul IC<\/h2>\n

\u00cen urechea intern\u0103 s\u0103n\u0103toas\u0103, tonul este codificat de loca\u021bia din urechea intern\u0103 \u00een care este stimulat un anumit sunet. Implanturile cohleare stimuleaz\u0103 c\u00e2t mai aproape posibil de punctul natural de stimulare folosind un impuls de curent electric \u0219i ne referim la aceasta ca fiind o stimulare ionic\u0103. Doar IC-urile MED-EL utilizeaz\u0103 codificarea temporal\u0103 descris\u0103 \u0219i pentru sunetele joase.<\/p>\n

\u00cen ciuda acestui fapt, punctul slab al implanturilor cohleare moderne este rezolu\u021bia relativ sc\u0103zut\u0103 a frecven\u021belor \u00een compara\u021bie cu urechile s\u0103n\u0103toase. Diferen\u021bele de sunet nu pot fi percepute la fel de bine. Acest lucru se datoreaz\u0103 faptului c\u0103 impulsurile de curent utilizate creeaz\u0103, de asemenea, un c\u00e2mp electric \u00een jurul contactului activ, coexcit\u00e2nd astfel zonele \u00eenvecinate. “Din acest motiv, nu conteaz\u0103 dac\u0103 se folosesc 12 sau 24 de canale”, a explicat Prof. Dr. Tobias Moser, director al Institutului de Neuro\u0219tiin\u021be Audiologice de la Universitatea de Medicin\u0103 din G\u00f6ttingen. “Aici intervine \u0219i IC-ul optic, pentru c\u0103 se poate grupa bine cu el.” Sper\u0103m la 64 de canale.<\/p>\n

Implanturi cohleare optice<\/h2>\n

Impulsul nervos uman este \u00een mod natural un impuls ionic, ceea ce face ca impulsul de stimulare electronic\u0103 s\u0103 se potriveasc\u0103 perfect. \u00cen schimb, celulele algei verzi sunt sensibile la lumin\u0103. “Trucul este s\u0103 extindem o astfel de informa\u021bie genetic\u0103 de la alga verde \u0219i s\u0103 o aducem \u00een celula nervoas\u0103 uman\u0103”, a explicat profesorul Moser. Deisseroth, Hegemann \u0219i Oesterhelt, oameni de \u0219tiin\u021b\u0103 care au c\u00e2\u0219tigat recent Premiul Lasker pentru cercetare fundamental\u0103, au \u00eencercat s\u0103 fac\u0103 acest lucru la \u0219oareci. At\u00e2t m\u0103sur\u0103torile obiective ABR, c\u00e2t \u0219i experimentele de analiz\u0103 comportamental\u0103 au ar\u0103tat c\u0103 se pot ob\u021bine impresii auditive.<\/p>\n

“Suntem \u00een plin proces de dezvoltare, dar mai avem mult de lucru!” a spus profesorul Moser, referindu-se la terapia genetic\u0103 \u0219i la tehnologia medical\u0103 cu module de stimulare optic\u0103 \u0219i strategii de codificare adecvate.<\/p>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"

On the last day of the Austrian ENT Congress, in September 2021 in Innsbruck, the focus was on the medium-term and distant future of hearing rehabilitation.<\/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":[488],"tags":[700,658,659],"class_list":["post-17699","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stiinta","tag-dezvoltare","tag-implanturi-cohleare","tag-siguranta-implantului-cohlear"],"yoast_head":"\nCercet\u0103ri privind viitorul reabilit\u0103rii auditive - Romanian<\/title>\n<meta name=\"description\" content=\"On the last day of the Austrian ENT Congress in 2021, the focus was on the research and the future of hearing rehabilitation.\" \/>\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\/ro\/cercetari-privind-viitorul-reabilitarii-auditive\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cercet\u0103ri privind viitorul reabilit\u0103rii auditive - 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