(lighthearted music) (upbeat music) - Eye On Education, I'm Fred Martino.

Do you know someone with hearing loss?

It's one of the most common ailments in the US population even more so within the military and agricultural sectors.

All of us lose some of our range of hearing as we age some also experience tinnitus, a persistent ringing in the ear that the brain creates.

Hearing loss has always been thought to be irreversible, but is it really?

Research scientists at the SIU School of Medicine study hearing loss.

They don't accept the status quo and think they can cut through the noise that nature dealt.

We'll talk with them in a moment but first, this report from the SIU School of Medicine.

(lighthearted music) - Well, tinnitus or tinnitus, ringing in the ears is sound in your head that really isn't there.

So you hear a sound, a buzzing, a ringing, or a pure tone in your head even if you cut the acoustic nerve that sound would be there.

1 or 2% of the people with tinnitus or the 10% of the general population that has tinnitus are severely impacted, causing depression, occasional suicide.

We were given money by the Department of Defense to study possible drug therapy for tinnitus, there's actually two parts of that grant.

The first part is to look at what the neural circuitry that goes bad in tinnitus is at the level of cortex and then test the drug on that model and then actually give the drug to whole animals who are experiencing tinnitus.

(lighthearted music) - Dr. Caspary and I both study the auditory system but we study very different parts of the auditory system.

I study the inner ear, the cells that detect sound, and initiate the process of hearing by activating the auditory nerve and sending those signals to the brain.

And Don studies the central parts of the auditory system, the parts of the brain that interpret that sound and figure out what is a real sound to pay attention to, what is background noise, what is language, what is music and what does everything mean.

- Because of collaboration with Tom using the animal model and Brandon's impeccable knowledge of the nicotinic receptor, we were able to come up with a drug that we'd never heard of, but Brandon knew of called, Sazetidine.

And for the last three or four years, we've been looking into Sazetidine as a treatment for tinnitus.

- So the idea of using Sazetidine is because it acts on a receptor that regulates our attention.

And so if we can use this drug to interfere with the attention that our brain is placing on this phantom noise of tinnitus, then perhaps those patients who suffer the most would have some benefits.

- Doctors Caspary and Cox had approached our office and asked if their discovery was something worth protecting and pursuing by the university.

After reviewing the technology, we thought that there might be some market potential there and definitely some patentable subject matter.

So we recommended to the university that we protect the idea in hopes of further advancing the technology in a commercial setting.

- Dr. Caspary has 40 plus years of continuous federal funding for his research projects.

His collaborations here at SIU has put the School of Medicine on the map for auditory research.

His partnership with Brandon Cox, who brings new sets of ideas, new approaches to the problem, has been very synergistic.

Brandon shares that passion that Dr. Caspary has, that hearing loss tinnitus is preventable if not reversible.

And collectively between those two, their labs have been extremely productive.

We see it with their manuscripts, productivity, and grants.

(lighthearted music) - And finally, you have to love what you do or you wouldn't do it.

I'm well past retirement age and I still enjoy what I'm doing very much.

(cheerful music) - Great report from the SIU School of Medicine.

Now, I am pleased to welcome Dr. Don Caspary.

Dr. thank you so much for being with us today.

- Well, thank you for having us.

- It is good to have you here.

I wanna start with the Department of Defense Grants and patents.

What does this explore in regard to tinnitus?

What is commonly called ringing in the ears?

- Well, tinnitus or tinnitus, as you said, ringing in the ears occurs in maybe 10 to 15% of the population.

And somewhere between 1 and 2% of the population is severely impacted.

And we thought for a long time that those most impacted or those people who cannot divert their attention away from the sound in their heads.

So that most people can sort of go about their daily lives and are not too troubled by their tinnitus or tinnitus but some people that 1 or 2% can become depressed, they can't concentrate and a small percentage even commit suicide.

So it's a very severe problem.

And so we decided, not so much to attack the sound in the head point of view but to see if we could develop something that maybe would divert people's attention away from the sound in their head.

And there's a system in the brain that uses acetylcholine, one of the neurobiological receptors that is involved in circuits that mediate attention.

And we thought that if we could maybe disable this in people with tinnitus, we could help them.

And so that was the thesis of the DoD grant.

Those people who are really bound to that sound in their heads could we in some way make that less severe?

- I'm so glad that you mentioned how serious this is.

I read an article recently online about the most serious situation that could come, suicide, that is happening sometimes from people who have severe tinnitus.

Unfortunately, a growing number of people who are developing it after getting Covid, I myself suffer from this.

But as you were saying, you don't notice it as much during the day perhaps.

You can divert your attention away from it.

But when I'm in bed at night and there are no other sounds around, I find I have to turn on a white noise machine because it's that difficult for me.

So I have a personal connection to this and it's so important to have research in this area.

Tell me how you became interested in this particular area of research.

- Well, I'd worked for many years.

You started out by talking about hearing loss, nature related hearing loss and then you very rightly pointed to the fact that this is a brain problem.

If you take away some of the input to the ear, if you lower the normal input to the ear through aging or sound exposure or drug exposure, then the brain says, "Hey, I'm not getting the input I used to get," and tries to compensate for that.

And so it changes some of the circuitry and some of the neurochemicals in the brain at different levels and all of a sudden the brain becomes sort of hyperresponsive to sound.

And one of the manifestations of that is tinnitus.

And those people who maybe think that the tinnitus is...

They got their tinnitus after, if they're in the military, after seeing a buddy blown up by an IED or it was a traumatic event or they believe that tinnitus is caused by a tumor or something like that, those people can be really severely impacted.

And as you mentioned, people with Covid who had tinnitus before sometimes suffer severe... An increase in the level of tinnitus that they had before, like the CEO of Texas Roadhouse Kent Taylor actually committed suicide after Covid and in exacerbation of his tinnitus.

- Yeah.

That was the case I read about and very tragic and it's so important to raise awareness about this.

Until I had read that article about that gentleman, I was not aware of how severe this can be and until preparing to do this interview.

Even though I've covered health issues for many, many years, I was not aware how common it is to have tinnitus, how common it is to have hearing loss.

It's extremely common and important that we do this research.

How has your work at SIU been aided by collaborations?

- Okay.

We need to talk before I tell you about the collaboration, which is the perfect lead in, we need to talk about Sazetidine, the drug that we're working on.

- Yes.

- And that was a collaboration with Brandon, who you're gonna be talking to shortly, who is an expert in the nicotinic receptor, the receptor that we're dealing with in these attentional circuits.

So we focused in on the attentional aspects of tinnitus or tinnitus and we specifically looked at a drug called Sazetidine which Brandon knew about from her thesis work at Georgetown and really was quite expert in her knowledge about this drug.

And so we were able to conduct some preliminary studies and show that in an animal model we could ameliorate tinnitus using Sazetidine and so we got together and got a patent.

Now, you might ask, how do we know if an animal has tinnitus or not?

And one of the things we have here at SIU, thanks to two people who were here for many years, Dr. Carol Bauer and Tom Brozoski, is we have an animal model for tinnitus so we can test these drugs.

And the animals are taught to stop lever pushing in silence.

They're taught to stop pushing in silence and those animals that continue to push, we assume they have tinnitus.

And so we tested them with this drug and the animals with tinnitus became more like the animals without.

- Interesting.

As you mentioned, I'm gonna be talking to Dr. Brandon Cox in a moment.

Tell me about working with her.

- It's a pleasure.

We've been working together for some time on the aging stuff as well as on the tinnitus stuff and I just came out of our weekly lab meetings where we said, "Now, is there a drug that would inactivate the attentional system selectively?"

And she said, "Well, we could try Sazetidine."

And Sazetidine resembles the smoking cessation drug Varenicline, which is already given to humans.

And so we thought it would be a good avenue to try.

It's much more specific than Varenicline and we were pretty surprised that it actually worked.

So we have reproduced that a couple of times and we're gonna proceed with those studies going forward.

- You've talked about your work with Dr. Cox.

I wanna get a sense from you Dr. Caspary about collaboration in general.

How important that is in research and you've done so much with others.

And I know personally from doing my own research, how important collaboration is and how much that enhances research.

- Well, you can't emphasize it enough, especially today where communication is so easy and these conversations can occur over thousands of miles in Europe or wherever and you can talk to people about your research.

And I would say that without the weekly lab meetings where we all talk about things without interactions with my peers at other universities, it would just be a fraction of the work that I do because I think we all benefit tremendously by collaboration.

- Yeah.

You have taught hundreds and hundreds of students during your career at SIU and conducted thousands of experiments.

Tell me what keeps you going?

- It's fun.

It's fun to...

It's fun to find out something new.

Discovery is fun, you never know what you're gonna find out.

You make a hypothesis, your hypothesis is wrong, but you learn something new and then you have to think of what it means.

It's really just a fun sort of game that you play and if you do it long enough you can see the ball move and you can see some progress in understanding and I guess it's something I really enjoy.

- You've been doing this research a long time.

I'm curious to find out from you, is it easier today to get subjects for research studies like the work that you do?

Or is it harder?

Tell me about that whole process.

- Well, I think in some ways it's easier and in some ways it's harder.

So I think the technology aspects is really becoming advanced and a lot of people believe that high tech approaches are maybe the only way.

But on the other hand, it's so much easier to communicate with people and the search, the literature, we hardly ever go to the library anymore we just Google it and we get onto Google Scholar and read papers and you can use keywords to search papers and you can see who cited what and other papers.

So you have a lot of tools at your disposal that makes it easier and yet it's more complex and there's more things out there to look at.

- Yeah.

As I mentioned at the very beginning of this conversation, you rely on grants to do the work including the Department of Defense Grant.

As we conclude, I wanna give you the opportunity to talk about the importance of that because everyone watching here pays taxes in one way or another.

And it's something we talk about very little in the media, the importance of grant funding that is funded by taxpayers but we all benefit from and society benefits from.

- Well, you've done a very good job of summarizing that.

It is, I am internally grateful to the taxpayer of the United States for all the years of NIH funding and DoD funding that I've had.

I think of that all the time, it doesn't....

I don't lose sight of that and it's something that the US public, the people out there have sponsored me and I feel very, very good about that and I appreciate that and I hope we've given something back.

- Absolutely you are, Dr. Caspary.

Thank you so much for being with us today.

- It's been a pleasure.

Thank you for having me.

(upbeat music) - Thanks again for joining us for this special edition of, "Eye On Education," I'm Fred Martino.

We're continuing our look at hearing loss research at the SIU School of Medicine.

And now I am very pleased to welcome Dr. Brandon Cox.

Dr. Cox, thank you for being with us.

- Happy to be here.

- Let's start off with a little bit more information about the focus of your research.

- So I study hearing loss from a different perspective than Dr. Caspary.

I'm interested in the cells of the inner ear that allow us to detect sound.

They're called hair cells because they have stereocilia bundles at their tops but they're nothing like the hair on our heads.

And so these cells are the cells that are most likely damaged by noise exposure, by aging, by certain types of drugs that will kill them and once the cells are dead, they cannot be replaced and there's permanent hearing loss.

So my work is studying mechanisms to drive or ways to drive regeneration or replacement of those hair cells after damage has happened.

- Tell me how your earlier work led to the current collaboration with Dr. Caspary.

- Sure.

So one of the reasons that tinnitus happens or one of the main causes of tinnitus is loss of hearing, loss of hair cells coming into the brain.

And as Dr. Caspary explained, there's lots of changes that happens in the brain and the circuits and the chemistry of how sound is interpreted causing that phantom ringing.

In my previous graduate training at Georgetown University, I studied a totally different system.

I was working in the visual system and I was studying a type of receptor called, nicotinic receptors that are also important for attention.

They allow us to focus on things that are important for the task at hand or important for survival.

And so in learning about what Dr. Caspary was interested in, the connection between tinnitus and hearing loss, the connection between tinnitus and attention, I suggested looking at this drug, Sazetidine as a potential intervention to separate that patient who is highly focused on their tinnitus and cannot defer their attention away.

And so that's how the collaboration began.

Was just through our common interest in hearing loss, conversations in lab meetings, and kind of a shared interest in the attentional system of our brain.

- Give me a better understanding of the challenges in the study using this drug, Sazetidine.

- Well, that's a much better question for Dr. Caspary.

I basically acted as a consultant.

I have the knowledge of the drug and how it works and how it might be a better choice than some of the other drugs we could choose.

But the nitty gritty details of how we tested the drug and the animal models were done in Dr. Caspary's lab.

But I would say, as with any study involving behavior, there's gonna be some variability.

Not every person is gonna respond the same, not every animal's gonna respond the same and so that's probably been the biggest challenge is just the variability of the system.

And I think the same thing happens with tinnitus.

Tinnitus is not constant all the time, different times a day it's more intense or less, different days of the week it might bother you more or less.

And I think that happens in our animal model too.

- Give me an understanding from your view about the potential benefits of the work that you're doing.

- So in regards to the tinnitus study and the patent, I think there's great opportunity to have an impact on patients who just cannot conduct their daily activities.

They're going to work their normal routine because that tinnitus is driving them nuts.

I think we still have a challenge of getting that drug to people.

We've only tested it in animals so far, we need to collaborate with some clinicians to do a clinical trial, collaborate with the drug company to do a clinical trial.

But I think there's a lot of potential impact there.

On the other side of things, I study hair cell regeneration as a treatment not only for tinnitus but for any kind of hearing loss and we still have a long ways to go.

What we're we're able to have some regenerated cells in a very young mouse but we still have a long ways to go before a treatment is ready for the human population.

So in that avenue, there's much more research in the works but in the context of tinnitus, I think we've landed on something that seems quite promising in our animal model and we just need to find the right partners to get it to our patients.

- Tell me how you became interested in this area of scientific research.

- So growing up, my great uncle was deaf.

He had meningitis when he was very young and so he signed and read lips and I was always fascinated by that.

I always loved spending time with my Uncle Benny, learning new sign language words and as I was doing research in my PhD, I was interested in what I was doing but I felt like what I was studying had been studied for over a century and I needed to kind of switch fields to make an impact.

And so through my job search of looking for postdoc training, I came across a lab studying hearing loss and hair cell regeneration and it really kind of reignited my childhood memories of my time with my Uncle Benny and the beautiful structure of the cochlea also is very inspiring.

It's a nice spiral shaped structure with very organized rows of cells and very easy to tell if there's something wrong, if there's a gene is causing a problem or if there's damage, it's a very great structure to work with.

So the combination of those things and also the fact that the inner ear where the hair cells are found it's housed in this teeny tiny bony structure and it's very difficult to dissect.

You have to have very specialized equipment to measure hearing.

So there's a lot of very basic science questions that we are just now being able to answer.

So there was a lot of opportunity that I felt like I could contribute to the field and make a difference - Working in this field, I can only imagine your reaction as you see the immense proliferation of people who are now wearing earbuds and listening to music sometimes so loud that you can hear and identify the tune as you are near them.

As our final time, we just have a little bit of time left the warning for people that you can give to them knowing about hearing loss and knowing about the damage that that really loud music in your ears can do.

- Right.

So it's really underappreciated, especially if you're a teenager, you think you're invincible.

And that loud noise exposure from the earbuds or from the lawn and equipment or the tractors is doing permanent damage and it can lead to tinnitus.

There's also some really impactful new studies showing that hearing loss can lead to cognitive decline and potentially even dementia.

And so there are some lifelong consequences from listening to your music too loud.

What I found to be most impactful when I talk to high school students or college students is to do a test of how old are your ears.

So if you google mosquito ringtones, there's a website where you can play different frequencies of sound and it will tell you if you're under 20, you should hear this, if you're under 30, you should be able to hear this.

And I think high school students are really shocked when I play a sound that if you're under 30, they should be able to hear and half the room can't hear it.

So I think that's really one of the best ways to translate this important information.

So mosquito ringtones, play these different frequency of the sound, test the age of your ears, how sensitive you're able to hear these high frequency sounds, and maybe that will help people be a bit more cautious.

- Mosquito ringtones.

I hadn't heard of that before.

I learned some... That's why I love this field.

I learn something new every day.

But this, I'm glad we had a chance to leave folks with that because I see it all the time and as someone who has some hearing loss from getting blasted due to an accident in this field, believe it or not, with the IFB, it's very sensitive topic for me and I always warn people, this is serious business and your hearing is so important.

Dr. Brandon Cox, thank you so much for being with us today.

- Thank you for your invitation to join you.

- Good to have you here.

And thank you at home for being with us for this special edition of, "Eye On Education."

For everyone at WSIU, I'm Fred Martino, have a great week.

(upbeat music)