For the price of a sports car, you can have a pint of your blood drawn and a month later receive your entire genome—all 6 billion base pairs—encoded in a 1.5-gigabyte data file. That means the price has dropped to 1/50 000 of what it was less than a decade ago (the first genome, after all, cost US $3 billion). Yet the price is expected to fall to 1/1000 of the current price in the next four years.

The cultural ramifications of a $100 genome—which is where we’re headed, whether it takes 4 years or 10—are as wide and deep as those of any other recent innovation, including search engines and cellphones.

Keep Reading ↓Show less

This article is for IEEE members only. Join IEEE to access our full archive.

Join the world’s largest professional organization devoted to engineering and applied sciences and get access to all of Spectrum’s articles, podcasts, and special reports. Learn more →

If you're already an IEEE member, please sign in to continue reading.

Membership includes:

  • Get unlimited access to IEEE Spectrum content
  • Follow your favorite topics to create a personalized feed of IEEE Spectrum content
  • Save Spectrum articles to read later
  • Network with other technology professionals
  • Establish a professional profile
  • Create a group to share and collaborate on projects
  • Discover IEEE events and activities
  • Join and participate in discussions

Restoring Hearing With Beams of Light

Gene therapy and optoelectronics could radically upgrade hearing for millions of people

13 min read
A computer graphic shows a gray structure that’s curled like a snail’s shell. A big purple line runs through it. Many clusters of smaller red lines are scattered throughout the curled structure.

Human hearing depends on the cochlea, a snail-shaped structure in the inner ear. A new kind of cochlear implant for people with disabling hearing loss would use beams of light to stimulate the cochlear nerve.

Lakshay Khurana and Daniel Keppeler
Blue

There’s a popular misconception that cochlear implants restore natural hearing. In fact, these marvels of engineering give people a new kind of “electric hearing” that they must learn how to use.

Natural hearing results from vibrations hitting tiny structures called hair cells within the cochlea in the inner ear. A cochlear implant bypasses the damaged or dysfunctional parts of the ear and uses electrodes to directly stimulate the cochlear nerve, which sends signals to the brain. When my hearing-impaired patients have their cochlear implants turned on for the first time, they often report that voices sound flat and robotic and that background noises blur together and drown out voices. Although users can have many sessions with technicians to “tune” and adjust their implants’ settings to make sounds more pleasant and helpful, there’s a limit to what can be achieved with today’s technology.


8 channels


64 channels

Since optogenetic therapies are just beginning to be tested in clinical trials, there’s still some uncertainty about how best to make the technique work in humans. We’re still thinking about how to get the viral vector to deliver the necessary genes to the correct neurons in the cochlea. The viral vector we’ve used in experiments thus far, an adeno-associated virus, is a harmless virus that has already been approved for use in several gene therapies, and we’re using some genetic tricks and local administration to target cochlear neurons specifically. We’ve already begun gathering data about the stability of the optogenetically altered cells and whether they’ll need repeated injections of the channelrhodopsin genes to stay responsive to light.

Our roadmap to clinical trials is very ambitious. We’re working now to finalize and freeze the design of the device, and we have ongoing preclinical studies in animals to check for phototoxicity and prove the efficacy of the basic idea. We aim to begin our first-in-human study in 2026, in which we’ll find the safest dose for the gene therapy. We hope to launch a large phase 3 clinical trial in 2028 to collect data that we’ll use in submitting the device for regulatory approval, which we could win in the early 2030s.

We foresee a future in which beams of light can bring rich soundscapes to people with profound hearing loss or deafness. We hope that the optical cochlear implant will enable them to pick out voices in a busy meeting, appreciate the subtleties of their favorite songs, and take in the full spectrum of sound—from trilling birdsongs to booming bass notes. We think this technology has the potential to illuminate their auditory worlds.

Keep Reading ↓Show less
{"imageShortcodeIds":[]}