Abstract
In vitro, aminoglycosides increase the stiffness of cochlear hair cell stereocilia, altering bundle motion and transduction kinetics. Aminoglycosides also permeate the mechanosensitive transduction channel and rapidly initiate cytotoxicity in hair cells. If these effects occur in vivo, aminoglycosides would need to enter endolymph. The most direct route for systemically-administered aminoglycosides to enter endolymph is by trafficking from strial capillaries across the stria vascularis. An as-yet-unidentified active transporter is required to translocate aminoglycosides from the intra-strial space into the cytoplasm of marginal cells. Once in marginal cells, aminoglycosides would passively flow down the electrochemical gradient into endolymph. We present data that support a trans-strial trafficking route of aminoglycosides into endolymph, where they can then interfere with the mechanosensitive hair bundles.