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Combinatorial prophylactic effect of phlorotannins with photobiomodulation against tracheal stenosis.

ABSTRACT: Several conventional treatments are used to manage tracheal stenosis after intubation and surgical procedures; however, patients are at risk of restenosis because of the absence of effective preventative therapy. In this study, we evaluate the biomodulatory effect of PT-combined blue light (BL) PBM in tracheostomal stenosis-induced animal models. The PT-combined BL group showed a significant decrease in the fibrotic protein synthesis by downregulating the release of stenosis-triggering fibrotic signals, without cytotoxicity or thermal damage. Moreover, the combined treatment ameliorated excessive granulation and collagen formation, and consequently preserved the opening of the tracheostoma ten days after fenestration. The current study demonstrated the biomodulatory effect of PT-combined BL on human tracheal fibroblasts and tracheal fenestration rodent models. Hence, PT-combined BL has the potential to be an effective preventative treatment for tracheal stenosis but also as an alternative option for fibrotic disorders.

SUBMITTER: Lee Y

PROVIDER: S-EPMC9664362 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Combinatorial prophylactic effect of phlorotannins with photobiomodulation against tracheal stenosis.

Lee Yeachan Y Heo Seong-Yeong SY Lee Hyoung Shin HS Oh Sun-Ju SJ Kim Hyeonsoo H Lim Seonghee S Shin Hwarang H Jung Won-Kyo WK Kang Hyun Wook HW

iScience 20221019 11

Several conventional treatments are used to manage tracheal stenosis after intubation and surgical procedures; however, patients are at risk of restenosis because of the absence of effective preventative therapy. In this study, we evaluate the biomodulatory effect of PT-combined blue light (BL) PBM in tracheostomal stenosis-induced animal models. The PT-combined BL group showed a significant decrease in the fibrotic protein synthesis by downregulating the release of stenosis-triggering fibrotic ...[more]

PMID: 36388989

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Project description:BackgroundBenign airway stenoses are complex disorders that present with progressive dyspnoea, stridor, and significant respiratory distress. These conditions have a high recurrence rate and despite the plethora of endoscopic and open techniques available for treatment, the outcomes are variable. Our primary was to determine the pre-operative factors associated with an increased hazard of cricotracheal resection (CTR)/tracheal resection (TR) and reconstruction in cases of benign subglottic and tracheal strictures.MethodsWe performed a retrospective analysis of a prospectively maintained database of all patients ages 16 years and over with benign subglottic and tracheal stenoses that underwent endoscopic or surgical treatment at our institution between 2008 and 2022.ResultsNinety-seven patients were included in our series, with a strong female preponderance (n=79; 81%). Forty-one patients underwent formal resection and reconstruction, and 56 patients were managed conservatively. Subglottic stenosis (SGS) was the most common site of disease in the trachea (79%), and the common aetiology of all stenoses was idiopathic (52%). The median interval between first dilatation and formal resection was 5 [interquartile range (IQR), 0-173] months. Pre-operative tracheostomy rate was significantly higher in those who underwent TR (51% vs. 18%, P<0.001) yet the number of dilatations was equivocal between the surgical and non-surgical groups (P=0.30). The most significant independent predictors of TR were pre-operative tracheostomy, advanced Myer-Cotton grading and an increased number of involved airway subsites. Risk modelling using these parameters identified a low and a high-risk group for TR and the latter had a significantly reduced time to resection (P<0.001).ConclusionsBenign airway stenoses are a heterogeneous group of conditions which respond to both endoscopic and open surgical airway intervention. The underlying aetiology will influence the treatment paradigm. We found that more complex lesions, patients with pre-operative tracheostomy and previous smoking history conferred a higher hazard for resection.

Project description:The current treatments for benign tracheal stenosis are inefficient. The present study examined the expression of histone deacetylase 2 (HDAC2) in different tracheal stenosis models and explored its association with the proliferation of tracheal granulation tissue and its ability to constitute a potential therapy for tracheal stenosis. Animal tracheal stenosis models were established, as indicated by hematoxylin and eosin (H&E) staining. A total of 24 New Zealand White rabbits were randomly divided into control, erythromycin, budesonide and vorinostat groups. Stenotic tracheal tissues were collected on day 11 after drug administration for 10 days. The degree of tracheal stenosis in each group was calculated, and pathological alterations were observed using H&E staining. The mRNA expression of HDAC2, interleukin-8 (IL-8), transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF) was examined via reverse transcription-quantitative PCR. The protein expression of HDAC2 was examined via immunofluorescence, while the expression of type I and type III collagen was assessed using immunohistochemistry. The results of the present study demonstrated that tracheal epithelial hyperplasia in the erythromycin group was improved, the degree of hyperplasia being the lowest among all groups, and tracheal stenosis was reduced compared with the control group. In the vorinostat group, tracheal epithelial tissue hyperplasia was aggravated and stenosis was increased. The HDAC2 mRNA and protein levels were increased and decreased in the erythromycin and vorinostat groups, respectively. In contrast, the IL-8 mRNA expression levels were decreased and increased in the erythromycin and vorinostat groups, respectively. TGF-β1, VEGF, type I and type III collagen expression was decreased in the erythromycin group, while TGF-β1, VEGF and type III collagen expression was increased in the vorinostat group. Compared with the control, the budesonide group did not exhibit any alterations in all of the indicators examined, including TGF-β1, VEGF, IL-8, HDAC2 and collagen. Erythromycin treatment upregulated the expression of HDAC2, inhibited the inflammatory responses and reduced the proliferation of tracheal granulation tissue. In contrast, vorinostat treatment downregulated HDAC2 expression, promoted the inflammatory responses and increased the proliferation of tracheal granulation tissue. These results suggest that regulating HDAC2 may be used as a potential treatment for benign tracheal stenosis.

Dataset Information

Combinatorial prophylactic effect of phlorotannins with photobiomodulation against tracheal stenosis.

Publications

Combinatorial prophylactic effect of phlorotannins with photobiomodulation against tracheal stenosis.

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