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Proposed mechanisms of hair cell regeneration. Supporting cells can classically regenerate hair cells via two mechanisms: mitotic hair cell regeneration and direct transdifferentiation. Enhancing the Wnt/β-catenin signaling pathway or inhibiting cell cycle inhibitors such as p27Kip1 may constitute approaches to enhance mitotic regeneration. By contrast, Notch inhibition and Atoh1 overexpression may promote the direct conversion of supporting cells into hair cells.
