Regulation of Tmem30b-mediated apical membrane homeostasis in auditory outer hair cells is critical for hearing

M Miao Chang (Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences) G Guodong Hong (Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences) S Shan Gao C Cheng Cheng J Jia Yuan (Key Laboratory of Seed Innovation, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences) Y Yu Xiao R Ruifeng Qiao (Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial Ear, Nose and Throat Hospital, Cheeloo College of Medicine, Shandong University) J Jing Ke (Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences) X Xinhao Wu (Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences) T Tiancheng Zhang (Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences) S Siwei Guo (Hunan Provincial Key Laboratory of Anti-Resistance Microbial Drugs) R Runze Jiang (Department of Tissue Regeneration and Wound Repair, Traditional Chinese Medicine Innovation Research Institute, Shandong University of Traditional Chinese Medicine) Z Ziyi Liu (New Energy Research Institute, School of Environment and Energy) J Jing Zhou (Zhejiang Institute of Photoelectronics) X Xiaohan Zhang (Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences) Y Yunhao Wu (Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences) X Xiaoxu Zhao W Wen Li S Shuyuan Shen (Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences) Z Zuhong He X Xiuli Bi (Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences) R Renjie Chai X Xiaolong Fu

Abstract

Mechanotransduction within the cochlea depends on the precise architecture of hair bundles, yet our comprehension of the mechanisms that govern the formation and maintenance of the sound-receptive structure is still limited. Here, we identify Tmem30b, a phospholipid-flippase chaperone, as a critical regulator expressed in outer hair cells (OHCs). Although initially localized to the nuclear membrane at P5, Tmem30b translocates to and stabilizes within the stereocilia and the underlying cuticular plate during maturation. The Tmem30b −/− mice exhibit an early-onset hearing loss with preserved vestibular and retinal functions. Notably, the disorganization of OHC stereocilia in mutants initiates at P7, coinciding with the initial presence of Tmem30b in stereocilia. Mechanistically, Tmem30b partners with Atp8b1 to regulate phospholipid asymmetry; disruption of this complex destabilizes OHC bundles. Crucially, AAV-mediated delivery of Tmem30b t o hair cells alleviates stereocilia defects in both Tmem30b −/− and Atp8b1 −/− mice. Furthermore, hair cell specific overexpression of Tmem30b protects mice from noise-induced and aminoglycoside-induced hearing loss. In summary, our findings establish Tmem30b as a pivotal organizer of OHC hair bundles and highlight Tmem30b–Atp8b1–mediated lipid regulation as a therapeutic target for hearing loss.

Article Details

Volume / Issue Vol. 123, Issue 18
Published May 05, 2026
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (23)

M

Miao Chang

Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences

G

Guodong Hong

Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences

S

Shan Gao

C

Cheng Cheng

J

Jia Yuan

Key Laboratory of Seed Innovation, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences

Y

Yu Xiao

R

Ruifeng Qiao

Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial Ear, Nose and Throat Hospital, Cheeloo College of Medicine, Shandong University

J

Jing Ke

Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences

X

Xinhao Wu

Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences

T

Tiancheng Zhang

Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences

S

Siwei Guo

Hunan Provincial Key Laboratory of Anti-Resistance Microbial Drugs

R

Runze Jiang

Department of Tissue Regeneration and Wound Repair, Traditional Chinese Medicine Innovation Research Institute, Shandong University of Traditional Chinese Medicine

Z

Ziyi Liu

New Energy Research Institute, School of Environment and Energy

J

Jing Zhou

Zhejiang Institute of Photoelectronics

X

Xiaohan Zhang

Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences

Y

Yunhao Wu

Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences

X

Xiaoxu Zhao

W

Wen Li

S

Shuyuan Shen

Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences

Z

Zuhong He

X

Xiuli Bi

Department of Otolaryngology, Shandong Provincial Hospital, Medical Science and Technology Innovation Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences

R

Renjie Chai

X

Xiaolong Fu