Growing a cochlear duct
Since the initial description of cochlear defects in the
Fgf3 (
Mansour et al., 1993) and
Pax2 mutants (
Favor et al., 1996;
Torres et al., 1996), we know that specific genes are necessary for growth and development of the organ of Corti. The list of genes has since grown rapidly and includes multiple genes identified as being defected in several human hearing mutations (
Dror and Avraham, 2009;
Friedman et al., 2007;
Hilgert et al., 2009). In addition, microarray data have added hundreds of genes that may need to interact during development to form a single sensory epithelium (
Chen and Corey, 2002;
Sajan et al., 2007). Among these genes, some are known to affect cochlear duct and organ of Corti growth and patterning, such as
Sox2 (
Kiernan et al., 2005),
Jag1 (
Kiernan et al., 2006),
Pax2 (
Bouchard et al., 2010;
Burton et al., 2004),
Gata3 (
Karis et al., 2001;
Lillevali et al., 2006;
Milo et al., 2009),
Eya1 (
Zou et al., 2008),
Lmx1a (
Nichols et al., 2008),
Nr2f1 (
Tang et al., 2005),
Fgfr1 (
Pirvola et al., 2002),
Foxg1 (
Hwang et al., 2009;
Pauley et al., 2006),
Bmp4 (
Ohyama et al., 2010),
Rac1 (Grimsley-Myers et al., 2009) and several micro-RNAs (
Dror and Avraham, 2009;
Soukup et al., 2009). These genes play roles in specifying the position of the cochlear duct, ensuring its growth and defining the competence that allows hair cell formation only in the organ of Corti. How these factors interact in these processes is not yet clear. Below, we first outline vestibular before cochlear canal development, the former being better understood than the latter.
In the vestibular system, sensory epithelia formation governs the development of canals. Mutations in genes such as
Fgf10 (
Pauley et al., 2003),
Otx1 (
Fritzsch et al., 2001;
Morsli et al., 1999),
Foxg1 (
Hwang et al., 2009;
Pauley et al., 2006),
Bmp4 (
Chang et al., 2008) and
Jag1 (
Brooker et al., 2006;
Kiernan et al., 2006) affect primarily crista development but also canal formation. This suggests that the initial formation of a canal crista as a prosensory patch expressing multiple genes is needed to induce the upregulation of genes necessary for canal growth (
Bok et al., 2007). This process ensures proper canal growth leading to endolymph flow during head rotation, thus allowing appropriate angular acceleration mediated stimulation of the canal cristae. The cochlear duct seems to grow by two processes: proliferation of cells and intercalation of existing cells (convergent extension) to extend the duct into the two or more turns as found in mammals. Like in the vestibular system, the growth of the cochlear duct is regulated by the growth of the organ of Corti, which apparently requires convergent extension movements of the developing hair cells (
Chen et al., 2008;
Hwang et al., 2010;
Yamamoto et al., 2009). Disruptions of several genes that affect the appropriate alignment of hair cells result in a shortened and wider organ of Corti. For example, loss of
Foxg1 shortens the cochlea to a half turn and expands the rows of hair cells in the apex to approximately ten or more [(
Pauley et al., 2006); ]. The shape and organization of the hair cells in these mutant cochleae closely resemble those of monotremes (, ). In addition, absence of
Foxg1 also disturbs the polarity of many hair cells (), which is consistent with the idea that convergent extension movements of developing hair cells relate to planar polarity signals (
Chen et al., 2008;
Kelly and Chen, 2009) but may not be needed for the monotreme organ of Corti (). Several other mouse mutants that have a shortened cochlea also display multiple rows of hair cells (), such as
Neurog1 null mice [(
Ma et al., 2000); ],
Neurod1 null mice [(
Jahan et al., 2010b); ] and
Jxc1 null mice (
Chen et al., 2008) whereas Rac1 mutants have a shortened cochlea without extra rows of hair cells (
Grimsley-Myers et al., 2009). These data suggest that morphogenetic movements related to convergent extension elongate the organ of Corti (
Hwang et al., 2010) possibly be acting via planar polarity (
Grimsley-Myers et al., 2009;
Kelly and Chen, 2009) to initiate collective cell movement (
Kim et al., 2010;
Wallingford, 2010).
Studies of some other mutants support the notion that the numbers of organ of Corti precursor cells may determine the overall extension of the cochlear duct. For example, deletion of
Shh derails cochlear formation entirely through massive reduction of proliferation (
Riccomagno et al., 2002). Later in development,
Shh is released from the forming sensory neurons and disrupted
Shh signaling through a mutated
Gli3 results in aberrations of organ of Corti organization (
Driver et al., 2008), including formation of vestibular-like hair cells in the greater epithelial ridge (GER, also referred to as Koelliker’s organ).
Neurog1 null mice also lack sensory neurons and thus
Shh signaling from them. Like
Gli3 mutants,
Neurog1 mutant mice have a shortened organ of Corti with multiple rows of hair cells (
Ma et al., 2000) and formation of ectopic hair cells () in the GER (
Matei et al., 2005) and
Rac1 null mice have fewer hair cells and a shortened cochlea (
Grimsley-Myers et al., 2009).
However, some mutations require modifications of this basic idea. For example,
Atoh1 null mice do not differentiate hair cells and lose many organ of Corti cells (
Chen et al., 2002), but show a near normal extension of the cochlear duct (
Fritzsch et al., 2005;
Pan et al., 2010a). Such data could be reconciled with the convergent extension hypothesis by assuming that the apparently limited degree of development and viability of organ of Corti precursors nevertheless provide the convergent extension movement. In contrast to the data on
Atoh1 mutant mice, a shortened cochlear duct forms in
Sox2 null mice (
Kiernan et al., 2005). Sox2 protein is essential for the specification of hair cell precursors that never differentiate to hair cells. In contrast to
Atoh1, which is upregulated after hair cells have exited the cell cycle (
Lee et al., 2006;
Matei et al., 2005;
Ruben, 1967),
Sox2 expression precedes cell cycle exit of hair cells (
Mak et al., 2009;
Nichols et al., 2008). The Sox2 transcription factor may affect proliferative expansion of organ of Corti precursors and their concomitant convergent extension movements. A correlation of aberrant proliferation with reduction of convergent extension of the organ of Corti has been claimed for
Foxg1 and
Neurog1 null mice (
Matei et al., 2005;
Pauley et al., 2006), but there has been no investigation of this possibility in
Sox2 null mice.
Shh and
Fgf’s regulate an important gene for cochlear development,
Pax2. Earlier work has shown that deletion of
Pax2 blocks initial formation of a cochlear duct (
Burton et al., 2004;
Torres et al., 1996), but others have suggested the formation of a cochlear sac either within the otic capsule (
Favor et al., 1996) or extruding into the cranial cavity in
Pax2 null mice (
Bouchard et al., 2010). The later sizable growth of the cochlear duct happens in the absence of sensory epithelia formation, implying that cochlear duct growth can be uncoupled from organ of Corti development (
Bouchard et al., 2010).
Gata3 is yet another gene that is tightly involved in cochlea formation. Absence of
Gata3 arrests the ear development at the otocyst stage (
Karis et al., 2001), but more recent work shows that some degree of cochlear growth without sensory or neuronal development is possible in the absence of
Gata3 (Duncan et al., 2011). These defects in the organ of Corti are consistent with the hearing defects found in
Pax2 and
Gata3 haplo-insufficient patients (
Favor et al., 1996;
van Looij et al., 2005). It is possible that
Gata3 affects the development of the organ of Corti at multiple levels: competence, proliferation and convergent extension. Another set of factors that affect cochlear duct growth and hair cell formation are micro-RNAs. These 21–22 nucleotides long RNA molecules are essential for organ of Corti differentiation and may lead to patchy loss of hair cells (
Soukup et al., 2009) or complete absence of all hair cells (
Kersigo et al., 2011), but nevertheless form a cochlear duct.
Combined, these data suggest that some cochlear duct growth is possible even without any sensory epithelia formation. This uncoupling of cochlear duct growth from the organ of Corti is consistent with the presence of a cochlear/lagenar duct without hair cells in certain amphibians (
Fritzsch and Wake, 1988). However, full extension of the cochlear duct and the organ of Corti requires convergent extension movements of organ of Corti precursors. Reduced proliferation of organ of Corti precursors or disrupting their convergent extension movements will affect overall organ of Corti growth and patterning. Thus, while not as clear at the molecular level as the regulation of canal growth by the canal cristae, there is a connection between the elongation of cochlear duct and the organ of Corti: the proper elongation to a coiled cochlea is proportional to the organ of Corti precursor formation and their intercalation to achieve convergent extension.
Specifying the position and the molecular competence to form an organ of Corti
Interactions between the developing cochlea and the surrounding (periotic) mesenchyme define the position and coiling of the cochlea. This initial insight (
Van de Water, 1983) has been characterized at the molecular level. Expression studies and deletion of several genes such as
Tbx1,
Pou3f4/Brn4 (
Braunstein et al., 2008;
Braunstein et al., 2009;
Phippard et al., 1999),
Fgf9 (
Pirvola et al., 2004) and
Sox9 (
Mak et al., 2009;
Trowe et al., 2010) suggest a critical interaction between periotic mesenchyme and proper cochlear development. Interestingly,
Sox9 has been described in
Xenopus but seems to have no effect on basilar papilla (
Park and Saint-Jeannet, 2010), the non-coiled evolutionary precursor of the organ of Corti (
Fritzsch, 2003). In frogs, the basilar papilla sits on thick periotic mesenchyme instead of a basilar membrane on top of the scala tympani (
Lewis et al., 1985). This indicates that the extension and coiling of the organ of Corti might in part be related to the transformation of the periotic mesenchyme underneath the basilar membrane into the scala tympani, one of the least understood aspects of cochlear development in terms of its molecular basis (
Montcouquiol and Kelley, 2003). Beyond these observations, there is no molecular causality established that directs the formation of the organ of Corti only in that particular area of the cochlear duct adjacent to the scala tympani.
Similar to the unresolved issues around the positioning of the organ of Corti, the molecular basis that guides that the inner and outer spiral sulcus brackets the organ of Corti for appropriate mobility remains unclear. This process can be broken down into the early prosensory specification to develop competence in the otic epithelium and the upregulation of
Atoh1 gene to translate this competence into hair cell differentiation. Mutations of
Eya1, Pax2, Jag1, Sox2 and
Gata3 apparently disrupt the sensory competence, resulting in limited formation of hair cells in the cochlear duct. This implies that the proteins produced by these genes are necessary for sensory development in the cochlea duct and do so through a stepwise refinement and restriction of sensory specification and competence to specify the organ of Corti (
Zou et al., 2008). They also interact with other factors expressed adjacent to or within the developing organ of Corti such as
Bmp4 (
Hwang et al., 2010;
Ohyama et al., 2010),
Fgf10 (
Pauley et al., 2003),
Lmx1a (
Nichols et al., 2008),
Prox1 (
Bermingham-McDonogh et al., 2006;
Fritzsch et al., 2010b),
Fgf8 (
Jahan et al., 2010b),
Fgf20 (
Hayashi et al., 2008). Together, these genes provide the context to allow prosensory cells, after cell cycle exit, to appropriately respond to
Atoh1 expression and differentiate as hair cells. If true, defining the cochlea prior to its
Atoh1 mediated differentiation would be equivalent to defining the minimal essential (spatial and/or temporal) co-expression of genes that allows this process to work. Mutations in the genes expressed in or adjacent to the organ of Corti prior to onset of hair cell differentiation (
Sox2, Jag1, Gata3, Fgfr3, Fgf20, and
Bmp2/4) result in disruption of the organ of Corti differentiation (
Fritzsch et al., 2010b;
Hayashi et al., 2008;
Hwang et al., 2010;
Karis et al., 2001;
Kiernan et al., 2006;
Kiernan et al., 2005;
Nichols et al., 2008;
Ohyama et al., 2010;
Pirvola et al., 2002;
Puligilla et al., 2007). Unfortunately, most work conducted on these mutants has not tested the effects of a given null mutation on the expression of all these prosensory genes, simply because many were not known at the time of initial descriptions of the mutants.
The onset of
Atoh1 mediated hair cell differentiation causes expression changes in several prosensory genes, relegating them to supporting cell expression (
Dabdoub et al., 2008), and ultimately shutting down their expression over time (
Kwan et al., 2009;
Pan et al., 2010a;
White et al., 2006). Suppression and possible re-activation of the embryonic transcription factors could be of crucial importance in the transformation of the “flat epithelium” that remains after hair cell loss into proliferating and subsequently
Atoh1 induced differentiating hair cells. Without such “priming”, the flat epithelium seems to have only a very limited, if any, capacity to proliferate and transform into hair cells in response to
Atoh1 action (
Batts et al., 2009;
Izumikawa et al., 2008;
Wang et al., 2010).
Molecular development of prosensory domains and differentiation into hair cells and supporting cells
One of the least understood mechanisms in cochlear development is how the upregulation of
Atoh1 is accomplished and what the molecular basis is for the differentiation of distinct hair cell and supporting cell types. bHLH proteins, like Atoh1, are positive regulators for cell fate determination and differentiation of sensory neurons and hair cells in the vertebrate ear, much like the proneural genes that drive sensory development in flies (
Garcia-Bellido and de Celis, 2009). Clearly, a single gene is unable to specify the multitude of hair cells and supporting cells. Recent data show multiple proneural and neurogenic bHLH genes in ear development (
Doetzlhofer et al., 2009;
Fritzsch et al., 2010a), suggesting a high degree of similarity to fly sensory development (
Garcia-Bellido and de Celis, 2009). The complexity of neurogenic bHLH factors has recently been reviewed in the context of hair cell regeneration (
Groves, 2010). Below we focus on
Atoh1 and two other proneural bHLH genes that affect cochlear hair cell development,
Neurog1 and
Neurod1..
Atoh1 is in many respects an unusual bHLH transcription factor (
Bertrand et al., 2002;
Guillemot, 2007). It is the only proneural bHLH transcription factor that is expressed in proliferating precursors to guide their expansion while maintaining their fate specification [the cerebellum is a prime example for this expression (
Bermingham et al., 2001;
Pan et al., 2009)]. Alternatively, it is expressed in both premitotic proliferative precursors and in the postmitotic differentiating cells [the endothelial precursors that give rise to both paneth cells and enteroenteric neurons are a major example (
Shroyer et al., 2007)]. In contrast to the neuronal expression, in the ear
Atoh1 is only upregulated in postmitotic hair cells (, 6) to guide their differentiation (
Bermingham et al., 1999;
Fritzsch et al., 2005;
Lee et al., 2006;
Matei et al., 2005). The molecular selection mechanism of these cells to upregulate
Atoh1 for hair cell differentiation in a highly stereotyped pattern is unknown. The well-known Delta/Notch system of lateral inhibition is unlikely for this selection process, as this would result in a random and not a stereotyped pattern of hair cells, a process that has been well demonstrated in fly development (
Garcia-Bellido and de Celis, 2009). Prime candidates for
Atoh1 upregulation would be the six mammalian
Iroquois genes. Iroquois proteins bind to the enhancers of bHLH genes to initiate bHLH gene expression (
Garcia-Bellido and de Celis, 2009;
Gomez-Skarmeta et al., 2003). However, only limited expression of iroquois genes has been reported in the developing mouse ear, leaving the question open about the involvement of these factors in the regulation of
Atoh1 expression.
Prox1 has been proposed as a possible selector of hair cell fate (
Bermingham-McDonogh et al., 2006;
Kirjavainen et al., 2008), but
Prox1 null mice show little to no defects in hair cell development except for a reduction in hair cells in the canal cristae (
Fritzsch et al., 2010b). Fgfs and Fgfrs could certainly specify bHLH gene upregulation but typically show a wider expression. They also can diffuse away from the cells and thus are difficult to direct the stereotyped
Atoh1 upregulation in postmitotic hair cells by themselves. In the cochlea, Fgfs may interact with Bmp4 signaling for hair cell specification (
Ohyama et al., 2010) in agreement with such interactions in neuronal specification of epidermis (
Fritzsch et al., 2006;
Gaspard and Vanderhaeghen, 2010).
Sox2, while essential for hair cell differentiation (
Kiernan et al., 2005), is expressed prior to
Atoh1 (
Mak et al., 2009) and could thus determine specification of the organ of Corti (Fig. 6). However,
Sox2 is expressed much wider than
Atoh1 and thus cannot be the factor that specifies
Atoh1 upregulation.
Jag1 null mice have only partial loss of cochlear hair cells indicating that it is not essential for hair cell differentiation (
Brooker et al., 2006;
Kiernan et al., 2006). Interestingly, misexpression of
Jag1 (
Pan et al., 2010b) and deletion of
Lmo4 (
Deng et al., 2010) result in formation of extra hair cells, indicating that the competence to express
Atoh1 is widely distributed in the cochlear duct. Most interesting is the formation of only inner hair cells in some areas of the developing cochlea of
Jag1 null mice, suggesting a possible convergence of
Neurod1/Neurog1 mutation defects (see below) with
Jag1 signaling. In older embryos
Pax2 is expressed in hair cells and seems to be essential for cochlear hair cell formation (
Bouchard et al., 2010), but in early embryos its expression appears to be much wider than the cochlea (
Burton et al., 2004;
Lawoko-Kerali et al., 2002) and could not be the determining factor for
Atoh1 upregulation.
Another transcription factor that is expressed in the organ of Corti is
Gata3, an ortholog of the fly Gata zinc finger factor
pannier that plays a role to topographically restrict bHLH gene activation in flies (
Garcia-Bellido and de Celis, 2009;
Gomez-Skarmeta and Modolell, 2002).
Gata3 is essential for ear morphogenesis (
Lillevali et al., 2006) and has been suggested to play the role of an upstream regulator of early neurosensory specification (
Karis et al., 2001). The expression of
Gata3 in the cochlea and the progressive hearing loss found in
Gata3 haploinsufficient mice (
van Looij et al., 2005) seem to indicate that Gata3 protein is needed for neurosensory development (Fig. 6). However, a direct connection of
Gata3 with hair cell development requires conditionally knocking out the floxed
Gata3 gene using a cre that is expressed as soon as hair cells start to differentiate, such as
Atoh1-cre (
Matei et al., 2005;
Yang et al., 2010).
Atoh1 protein regulates directly, or through unknown intermediates, other crucial genes for hair cell development and maintenance such as
Pou4f3 (previously Brn3c),
Gfi1 (a homologue of the fly
senseless gene) and
Barhl1. Loss of each of these genes results in delayed loss of hair cells (
Chellappa et al., 2008;
Hertzano et al., 2004;
Li et al., 2002;
Pauley et al., 2008;
Wallis et al., 2003). In flies, senseless directly interacts with bHLH proteins to regulate subtype specification (
Acar et al., 2006) and can compensate for lost bHLH proteins. It is unclear if
Gfi1 plays similar function in mammalian hair cell development.
Atoh1 activates the Delta/Notch system of lateral inhibition, forcing adjacent cells to assume a non-hair cell phenotype. Mis-regulation of
Atoh1 through changes in the lateral inhibition of the Delta/Notch system (
Zine et al., 2001) or simple mis-expression in the GER (
Gao, 2003;
Gubbels et al., 2008;
Zheng and Gao, 2000) can result in hair cell differentiation. This suggests that the competence to respond to
Atoh1 with hair cell differentiation is much broader than the final upregulation of
Atoh1. Indeed, the enhancer region of
Atoh1 shows consistent expression in supporting cells such as the inner pillar cells (
Matei et al., 2005) and transcription of
Atoh1 seems to occur as well in inner pillar cells (
Yang et al., 2010). This suggests a more widespread pattern of low-level expression of
Atoh1, comparable to developing fly sensory organs (
Garcia-Bellido and de Celis, 2009).
To understand how the hair cell specific upregulation of
Atoh1 is accomplished and how it relates to different hair cell types, we will briefly outline the multitude of bHLH genes and their interaction in neurosensory development of the ear (
Fritzsch et al., 2000;
Fritzsch et al., 2010a).
Neurogenin1 (
Neurog1, formerly
Ngn1) expression can be demonstrated by
in situ hybridization at embryonic day (E) 8.75 (
Ma et al., 1998) prior to upregulation of any genes of the Delta/Notch signaling pathway (
Brooker et al., 2006;
Fritzsch et al., 2006). In
Neurog1 null mice, there is no formation of sensory neurons and the initial activation of the Delta/Notch system as shown by
Rbpj upregulation never happens (
Ma et al., 1998). A follow-up study showed that absence of
Neurog1 not only eliminates neuronal formation in the ear but also has massive effects on hair cell development (
Ma et al., 2000). Saccular hair cells nearly completely disappear in
Neurog1 null mice and the cochlea is significantly shortened with multiple rows of inner and outer hair cells in the apex (
Ma et al., 2000). In addition, the appearance of ectopic hair cells in the GER and the Ductus reuniens (), indicate that
Neurog1 can suppress
Atoh1 upregulation and truncate sensory hair cell precursor populations, possibly by changing the cell cycle exit and spatiotemporal expression of other bHLH genes such as
Atoh1 (
Matei et al., 2005). Studies using a tamoxifen inducible
Neurog1-cre transgene construct showed that hair cells in the utricle and saccule could be labeled after the induction of the
Neurog1-cre, indicating that many utricular and saccular hair cells have a lineage relationship to
Neurog1 positive cells (
Koundakjian et al., 2007;
Raft et al., 2007). Interestingly, little evidence for such a lineage relationship was revealed in canal cristae and none in the cochlea, which also show a profound reduction in hair cells in
Neurog1 null mice (
Matei et al., 2005). In addition,
Neurog1 mutant mice show changes in sensory/non-sensory specification such as transformation of the non-sensory cruciate eminence of the anterior and posterior canal crista into hair cells (
Jahan et al., 2010b;
Ma et al., 2000). One of the possible explanations for these differences is that only some hair cells have lineage relationship to non-hair cells while others do not (
Fritzsch et al., 2006;
Raft et al., 2007). Alternatively, there is an early and near complete segregation of sensory and neuronal precursors in some epithelia such as the cochlea, which precludes the discovery of the lineage tracing with current techniques. Clearly, more work is necessary to understand how absence of
Neurog1 mechanistically affects hair cell formation in the developing organ of Corti and upregulates hair cell formation in the GER.
Neurod1 is the second bHLH gene to be expressed in the developing ear and this early expression depends on
Neurog1 in neurons (
Ma et al., 1998).
Neurod1 null mutants lose most sensory neurons, generate hair cells inside the ganglia and show defects in hair cell development in the organ of Corti (
Jahan et al., 2010a;
Jahan et al., 2010b;
Kim et al., 2001;
Liu et al., 2000).
Neurod1 seems to be able to suppress
Atoh1 in differentiating hair cells and neurons (
Jahan et al., 2010b;
Pan et al., 2009). Previous work using an
Atoh1-cre mediated upregulation of LacZ suggested a transient and weak expression of
Atoh1 in delaminating sensory neurons. However, the Atoh1 expression as revealed by the Lac-Z marker system seems to become more profound with age (
Matei et al., 2005). Recently we demonstrated that this early expression is more prominent in
Neurod1 null mice and leads to the formation of cells that express hair cell markers, including
Atoh1, in the remaining ganglia (
Jahan et al., 2010b). Not only do hair cells differentiate in these ganglia, but also these hair cells have the ability to organize surrounding cells to form vesicles (). What exactly the cellular source of these hair cells is in terms of lineage relationship remained somewhat unclear (). Using
Pax2-cre to knock-out the floxed
Neurod1 and simultaneously activate a
Rosa-26 LacZ reporter, we show that many hair cells that form in these ganglia also express
LacZ (which transcribes the enzyme β-galactosidase) and Myo7a, a hair cell marker ().
Neurod1 is not only suppressing
Atoh1 and the expression of other transcription factors in the developing neurons but also in the developing cochlea. One of the most puzzling aspects of cochlear development has been the apex to base progression of cell cycle exit (
Lee et al., 2006;
Matei et al., 2005;
Ruben, 1967) followed, with a delay, by the base to apex upregulation of
Atoh1 () and subsequent hair cell differentiation (
Chen et al., 2002). Our data in
Neurod1 null mice show that every gene associated with hair cell differentiation that was tested showed an apex to base upregulation, opposite to the normal base to apex progression (
Jahan et al., 2010b). These data demonstrate that
Neurod1 affects gene upregulation in postmitotic hair cells and this altered expression changes the fate acquisition of hair cells.
Certain correlations of non-transcription factors such as the motor proteins Myo6 and Myo7a have been found with inner and outer hair cells (
Cotanche and Kaiser, 2010). However,
Neurod1 is the only transcription factor thus far recognized to be required for outer hair cell development. In
Neurod1 null mice, outer hair cells in the apex acquire either an inner hair cell phenotype or do not develop at all (
Jahan et al., 2010b).
Like
Neurod1 null mutants
, Neurog1 null mutants have a shorter cochlea (
Jahan et al., 2010b) and disorganization of hair cells in the apex (): they develop multiple rows of inner and outer hair cells near the apex (
Ma et al., 2000) that end in a single row of inner hair cells as in
Neurod1 null mice (
Jahan et al., 2010b). These data indicate that the
Neurog1/Neurod1/Atoh1 interactions in the cochlea are profound but not yet understood mechanistically. This is reminiscent of the
Ac/Sc interactions that control the specification of subsets of sensory cells (
Garcia-Bellido and de Celis, 2009). What other transcription factor (s) is (are) complementary to
Neurod1/Neurog1 and support outer hair cell differentiation in the base and middle turn remains unclear. Further work will have to include other bHLH genes now known to be expressed in the ear (
Nhlh1,
Nhlh2) that may mediate in part the apparent cross-regulation of the currently investigated bHLH genes (
Fritzsch et al., 2010a).
Given the multitude of genes thus far identified to disrupt organ of Corti development in the respective null mutants, we like to propose that it is not a single factor that ultimately defines upregulation of
Atoh1 in future hair cells of the organ of Corti. In parallel to data generated in flies (
Garcia-Bellido and de Celis, 2009), we propose that a yet-to-be fully defined combinatorial code of partially overlapping expression of transcription factors, including multiple proneural bHLH proteins, is interacting with
Atoh1 to differentiate specific types of hair cells in defined positions.
In conclusion, progress has been made towards understanding how the organ of Corti grows, is molecularly specified and differentiates, but even more questions about genetic interactions abound. The next few years will require going beyond appreciating the complexity of the molecular interactions and should aim to establish the quantitative aspects of these interactions using newly developed tools, such as next generation sequencing. This will establish expression profile changes of all genes in reasonably well understood mutant lines in order to generate testable models of gene networks (
Roy et al., 2010). Given the emerging complexity of molecular interactions during development, and the stochastic interaction of genes in a given cell, it is possible that our current approaches to verify the functions of critical genes one or two at a time will not allow elucidation of such complex interactions. A better understanding of the interactions of transcription factors during development is needed to reconstitute an organ of Corti that has lost all hair cells and has transformed into a ‘flat epithelium’ with little to no cellular differentiation. Clearly, such epithelia have lost the ability to respond to
Atoh1, a powerful transcription factor that drives hair cell differentiation during development and regeneration (
Bermingham et al., 1999;
Izumikawa et al., 2008). Deconstructing the molecularly guided development that establishes cochlear duct formation, positioning of the organ of Corti and bestowing competence to allow
Atoh1 to differentiate appropriate types and numbers of hair cells in the correct position may provide such information. Translating the current rudimentary insight without such in depth understanding may lead to short-lived success stories, but is not useful for a consistent effective treatment of patients with complete loss of hair cells. In essence, we may be able to re-activate the developmental program so that Atoh1 expression will be driven in the organ of Corti position by the same transcription factors that guide that process during development.