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. 2024 Oct 30;18:1486740. doi: 10.3389/fncel.2024.1486740

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Copyright © 2024 Manickam, Maity, Murali, Gawande, Stothert, Batalkina, Cardona and Kaur.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Working model for soluble FKN restores IHC ribbon synapses after NICS. Prolonged or loud exposure to noise results in rapid loss of IHC ribbon synapses known as cochlear synaptopathy. Locally (transtympanically) delivered immune factor, soluble FKN reaches into the cochlea near the sensory epithelium and is effective in restoring the noise-induced loss of IHC ribbon synapses and hearing via cochlear macrophages expressing CX₃CR1 and suppresses cochlear inflammation in response to noise insult. The precise mechanisms by which sFKN–macrophage interactions contribute to synaptic and functional recovery remain to be elucidated. The figure was created with BioRender.com.