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NIDCD Director James Battey's 2017 Testimony to the Senate Subcommittee on Labor-HHS-Education Appropriations

DEPARTMENT OF HEALTH AND HUMAN SERVICES
NATIONAL INSTITUTES OF HEALTH

Fiscal Year 2017 Budget Request

Statement for the Record
Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies

James F. Battey, Jr., M.D., PhD.
Director, National Institute on Deafness and Other Communication Disorders

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Mr. Chairman and Members of the Subcommittee:

I am pleased to present the President’s Fiscal Year (FY) 2017 budget request for the National Institute on Deafness and Other Communication Disorders (NIDCD) of the National Institutes of Health (NIH).

The NIDCD conducts and supports research and research training in the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language. The NIDCD focuses on disorders that affect the quality of life of millions of Americans in their homes, workplaces, and communities. The physical, emotional, and economic impact for individuals living with these disorders is tremendous. The NIDCD continues to make investments to improve our understanding of the underlying causes of communication disorders, as well as their treatment and prevention. It is a time of extraordinary promise, and I am excited to be able to share with you some of the NIDCD’s ongoing research and planned activities on communication disorders.

Inner Ear Blueprint May Lead to Treatment for Hearing Loss and Balance Disorders

Approximately 50 percent of Americans ages 75 and older have a disabling hearing loss. In addition, more than 1 in 20 children in the United States between the ages of 3 and 17 have a dizziness or balance problem. To determine the causes of hearing loss and balance disorders, it is important to understand how the cells in the inner ear form. To do this, scientists are identifying gene expression maps of the inner ear cells. Understanding inner ear cell development could lead to ways to regenerate lost or damaged cells and restore hearing and balance.

Specialized sensory epithelial cells in the inner ear are responsible for hearing and balance. These cells, which include hair cells and supporting cells, are located in the cochlea, the snail-shaped structure in the inner ear, and work together to detect sound. Similar types of hair cells and supporting cells are also found in the utricle, a fluid-filled pouch located near the cochlea, which plays a critical role in helping us maintain our balance. These cells detect how we move our heads, how our heads are positioned and whether we are moving or stationary; this information tells our brain, for example, whether we are standing or lying down. The utricle is one of several structures and organs in the body that provide our sense of balance.

Hair cells and supporting cells can be damaged by medications, infections or disease, injury, exposure to loud noises, or aging, leading to hearing loss and balance problems. In humans, these cells cannot naturally repair themselves, so effective treatments are limited. In addition, there are only a few thousand of these sensory cells and they are located in a bony channel embedded in the skull, making them difficult to study.

Using a sensitive new technology called single-cell RNA-seq, NIDCD intramural scientists have created the first high-resolution gene expression map of a single cell within the newborn mouse inner ear. By analyzing the cell’s gene activity profiles, the scientists were able to identify genes that are active at different stages of development. The findings provide new insights into how epithelial cells in the inner ear develop and differentiate into the specialized cells that serve critical functions for hearing and maintaining balance. Understanding how these important cells form may provide a foundation for the potential development of cell-based therapies for treating hearing loss and balance disorders.

Mini Inner-Ear Drug Delivery Device Could Help Common Hearing and Balance Problems

Approximately 37.5 million American adults report some degree of hearing loss and almost eight million adults report a chronic problem with balance. Common examples include middle-ear infections (otitis media), Ménière's disease, noise-induced hearing loss, tinnitus, age-related hearing loss, dizziness, and vertigo. Hearing and balance disorders also decrease quality of life, and they cross all ethnic and socioeconomic lines.

Developing drug treatments is a long and costly process. One of the first hurdles is developing drugs that are safe and effective. For drug therapies to treat hearing loss and balance disorders, a second hurdle is getting the drugs where they need to go, which is deep inside the skull to the inner ear. Developing a safe and efficient route to the inner ear represents a significant technical challenge. Another challenge is to determine the appropriate concentration or dosage of a drug to be delivered into the ear.

NIDCD-supported scientists are tackling these hurdles. Using microfluidic and microelectromechanical systems technologies, researchers developed a wearable miniaturized pump system that safely and effectively delivers drugs in various dosages over time to the inner ear in animal studies. The device can also take samples of the inner ear fluid, which will aid scientists in drug development and treatment.

The investigators hope to use this device in preclinical animal studies. They plan to make the micro-pump and its electronic components so small that someday the entire system can be implanted in an individual’s mastoid cavity, an opening in the bone behind the ear. The device would enable programmable, automated, and long-term delivery of therapeutic compounds to the inner ear. Because it can target inner ear fluid precisely, the device will serve as a useful tool for investigating the molecular mechanisms associated with inner ear diseases and testing new drug treatments for hearing and balance problems.

Problems with Ability to Taste or Smell Are Common in Middle-Aged and Older Adults

People who have a poor ability to taste or smell can miss important cues to help them avoid dangers such as gas leaks, fire, and spoiled food. Scientists in the NIDCD Epidemiology and Statistics Program collaborated with the Centers for Disease Control and Prevention to conduct the first nationally representative survey about perceived taste and smell problems in more than 3,600 adults aged 40 and older. About 19 percent of U.S. adults ages 40 and older report having had a problem with their ability to taste, and approximately 23 percent report having had a problem with their ability to smell. The likelihood that a person will report a diminished sense of taste and/or smell increases with age. In adults ages 80 or older, nearly 31 percent report having had a problem with their sense of smell, and more than 27 percent have had a problem with their sense of taste. This survey was part of the Healthy People 2020 national objectives for improving the health of all Americans. The data help us gauge the scope of the problem. Future data releases will also include results of taste and smell tests and will give us our first look at prevalence of taste and smell problems in the United States.

Scientists Grow Vocal Fold Tissue in the Lab

Vocal fold tissue is a complex biological structure that is responsible for normal voice production. About 7.5 million people in the United States have trouble using their voices. Voice problems can cause significant personal and occupational difficulties, loss of income, and reduced quality of life. People who have sustained injuries to the larynx or have undergone head and neck surgery can exhibit voice disorders. These disorders can range in severity from mild to total voice loss if the surgery was extensive for removal of a malignancy. NIDCD-supported voice scientists in collaboration with other NIH-supported researchers have bioengineered vocal fold tissue in the lab using human cells. Moreover, the tissue had physical qualities that allowed it to “behave” like normal vocal fold tissue. To see if it could transmit sound, the researchers transplanted the tissue into an animal model. The bioengineered tissue performed well and was not rejected by the recipient, which is usually a major obstacle in these types of surgeries. This proof-of-principle study provides hope that one day individuals who have lost the use of their voice because of loss of their laryngeal tissue will have better treatment options.

James F. Battey, Jr., M.D., Ph.D.
Director, National Institute on Deafness and Other Communication Disorders

James F. Battey, Jr., received his Bachelor of Science degree in physics from the California Institute of Technology in 1974. He received an M.D. and Ph.D. in biophysics from Stanford University School of Medicine in 1980. After receiving training in pediatrics, he pursued a postdoctoral fellowship in genetics at Harvard Medical School under the mentorship of Dr. Philip Leder. Since completing his postdoctoral fellowship in 1983, he has held a variety of positions at the National Institutes of Health, serving in the National Cancer Institute, National Institute of Neurological Disorders and Stroke, and the National Institute on Deafness and Other Communication Disorders (NIDCD). Currently, he is the director of the NIDCD. He is married to Frances Battey, and has two sons, Michael and JJ.

Last Updated Date: 
August 1, 2016