Tinnitus discovery leads to hope for drug treatment
Millions of tinnitus sufferers have been given renewed hope that a drug treatment for the condition is a possibility.
It is all thanks to a discovery that has been made by a group of research scientists from the University of Leicester in the UK.
They have identified a cellular mechanism that could underlie the development of tinnitus following exposure to loud noises.
It is this discovery that could lead to novel tinnitus treatments, and investigations into potential drugs to prevent tinnitus are already underway.
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Tinnitus is thought to affect 10 percent of the population, and in the UK alone it is estimated there are five million sufferers.
It refers to the sensation of phantom sounds, usually a ringing or buzzing in the ears, which the sufferer hears even when there is no external noise.
Commonly it is caused from exposure to loud noises, although there have been suggestions that it can also be caused from damage to nerve cells connected to the ears.
There are currently no treatments available for tinnitus, nor is there anything to prevent or ease the symptoms.
Commenting on the research team’s findings, Dr Martine Hamann, the leader of the study, said: “We need to know the implications of acoustic over exposure, not only in terms of hearing loss but also what's happening in the brain and central nervous system.
“It's believed that tinnitus results from changes in excitability in cells in the brain - cells become more reactive, in this case more reactive to an unknown sound.”
To carry out the investigation, Dr Hamann and her team looked at cells in the dorsal cochlear nucleus part of the brain, which carries signals from nerve cells into the ear to the parts of the brain that decode and make sense of sounds.
Following exposure to loud noises, some of the nerve cells (neurons) in the dorsal cochlear nucleus start to fire erratically, and this uncontrolled activity eventually leads to tinnitus.
“We showed that exposure to loud sound triggers hearing loss a few days after the exposure to the sound,” explained Dr Hamann.
“It also triggers this uncontrolled activity in the neurons of the dorsal cochlear nucleus.
“This is all happening very quickly, in a matter of days.”
In another key breakthrough, the team also identified the specific cellular mechanism that leads to the neurons' over-activity.
Malfunctions in specific potassium channels that help regulate the nerve cell's electrical activity mean the neurons cannot return to an equilibrium resting state.
Ordinarily, these cells only fire regularly and therefore regularly return to a rest state.
However, if the potassium channels are not working properly, the cells cannot return to a rest state and instead fire continuously in random bursts, creating the sensation of constant noise when none exists.
Dr Hamann continued: "In normal conditions the channel helps to drag down the cellular electrical activity to its resting state and this allows the cell to function with a regular pattern.
“After exposure to loud sound, the channel is functioning less and therefore the cell is constantly active, being unable to reach its resting state and displaying those irregular bursts.”
Although many researchers have investigated the mechanisms underlying tinnitus, this is the first time that cellular bursting activity has been characterised and linked to specific potassium channels.
Identifying the potassium channels involved in the early stages of tinnitus opens up new possibilities for preventing tinnitus with early drug treatments.
Dr Hamann's team is currently investigating potential drugs that could regulate the damaged cells, preventing their erratic firing and returning them to a resting state.
If suitable drug compounds are discovered, they could be given to patients who have been exposed to loud noises to protect them against the onset of tinnitus.
However, these investigations are still in the preliminary stages, and any drug treatment would still be years away.
The research was funded by a Research Councils UK fellowship to Dr Hamann, a grant from the Wellcome Trust and a PhD studentship from GlaxoSmithKline, with follow-up investigations funded by a three-month grant from Deafness Research UK.
Also commenting on the research, Vivienne Michael, Chief Executive of Deafness Research UK, said: “We're pleased to hear about this progress in such a debilitating hearing impairment.
“The charity continues to fund research into better treatments for tinnitus, with the ultimate aim of a cure.
“Our free information leaflets offer immediate help to sufferers and our national helpline provides additional support. Regularly tinnitus generates the most requests for help.”
Further pharmaceutical research will be carried out by the University of Leicester in collaboration with Autifony Therapeutics Ltd via a Medical Research Council Case studentship, which is due to start in October 2012.
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How healthcare can safeguard itself against cyberthreats
One of the most fundamental lessons from the COVID crisis is that health should always be a priority. In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.
The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics.
From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world.
The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years.
This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate.
Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.
To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care.
Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change.
It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device.
These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.
Despite this, there are fundamentals that any organisation should implement:
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.
In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.
Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents.
Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.
This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents.
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.
Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.
As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.
Fighting future threats
With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.
To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced.
This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.