AAV-mediated rescue of Eps8 expression in vivo restores hair-cell function in a mouse model of recessive deafness

The transduction of acoustic information by hair cells depends upon mechanosensitive stereociliary bundles that project from their apical surface. Mutations or absence of the stereociliary protein EPS8 cause deafness in humans and mice, respectively. Eps8 knockout mice (Eps8-'-) have hair cells with immature stereocilia and fail to become sensory receptors. Here, we show that exogenous delivery of Eps8 using Anc80L65 in P1-P2 Eps8-'- mice in vivo rescued the hair bundle structure of apical-coil hair cells. Rescued hair bundles correctly localize EPS8, WHIRLIN, MYO15, and BAIAP2L2, and generate normal mechanoelectrical transducer currents. Inner hair cells with normal-looking stereocilia re-expressed adult-like basolateral ion channels (BK and KCNQ4) and have normal exocytosis. The number of hair cells undergoing full recovery was not sufficient to rescue hearing in Eps8-'- mice. Adeno-associated virus (AAV)-transduction of P3 apical-coil and P1-P2 basalcoil hair cells does not rescue hair cells, nor does Anc80L65Eps8 delivery in adult Eps8-'- mice. We propose that AAV-induced gene-base therapy is an efficient strategy to recover the therapeutic approach may need to be performed in utero since, at postnatal ages, Eps8-'- hair cells appear to have matured or accumulated damage beyond the point of repair.