Blocking acid-sensing ion channel 1a attenuates bilirubin-induced ototoxicity in cochlear organotypic culture

Neonatal hyperbilirubinemia leads to neural dysfunction, including sensorineural hearing loss. Our previous studies demonstrated that elevated bilirubin induced apoptotic pathway activation and led to cell malformation in spiral ganglion neurons of neonatal rat cochlear organotypic explants. However, the underlying mechanisms remained unclear. Concurrent hyperbilirubinemia and acidemia would exacerbate neuronal damage. Acid-sensing ion channels (ASICs), which belong to the epithelial Na⁺ channel/degenerin (ENaC/DEG) superfamily, were activated during acidic pH fluctuations. To elucidate the roles of ASICs in bilirubin-induced ototoxicity, we treated postnatal cochlear explants of Sprague-Dawley rats with ASIC blockers and characterized the morphological and molecular alterations. Briefly, the basilar membrane and spiral ganglion neurons of the Sprague-Dawley rats at postnatal day 3 were cultured. The organotypic explants were randomly divided into control, bilirubin only, and bilirubin with ASIC blocker treatment groups. After 24 h of treatment, samples were taken for morphological molecular analysis. Our results showed that bilirubin-induced ototoxicity was alleviated in the alkalized environment and blocking ASIC1a protected cochleae from bilirubin-induced apoptosis. Transcriptomic analysis indicated that the profiles in ASIC1a blocker-treated group were similar to those in the control group, compared with the bilirubin-only treated cochleae group. The inhibition of ASIC1a suggests a potential attenuation of bilirubin-induced SGN degeneration, possibly through regulation of the MAPK signaling pathway. Taken together, our findings suggest that inhibiting ASIC1a alleviated bilirubin-induced ototoxicity in cochlear explants, with the protective effects being mediated, at least partially, via the MAPK signaling pathway. These findings shed light on the potential therapeutic targets for treating bilirubin-induced ototoxicity.