TOP1 and Hearing impairment: CircIPO11 can interact with miR-106a-3p, miR-424-5p, and miR-659-3p or recruit DNA Topoisomerase I (TOP1) onto the GlI Family Zinc Finger 1 (Gli1) promoter to activate hedgehog signaling to drive self-renewal of liver cancer-initiating cells.38, 39, 40 However, the role of circIPO11 in cochlea tissue-related hearing impairment and hearing acclimatization requires further analysis.