Airway granulation response to lung-implantable medical devices: a concise overview

Roodenburg, Sharyn A; Pouwels, Simon D.; Slebos, Dirk‐Jan

doi:10.1183/16000617.0066-2021

Cited by 13 publications

(10 citation statements)

References 46 publications

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“…Currently, the mechanism of scar hyperplasia has been preliminarily revealed ( Mascharak et al, 2021 ). Chronic airway inflammation caused by pathogen infection is an important driving factor ( Roodenburg et al, 2021 ). Clinical studies also showed that there was a significant correlation between the incidence rate of tracheal stenosis and airway infection ( Ost et al, 2012 ; Grosu et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Vancomycin-Loaded Polycaprolactone Electrospinning Nanofibers Modulate the Airway Interfaces to Restrain Tracheal Stenosis

Tian

Zhou

Feng

et al. 2021

Front. Bioeng. Biotechnol.

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Site-specific release of therapeutics at the infected trachea remains a great challenge in clinic. This work aimed to develop a series of vancomycin (VA)-loaded polycaprolactone (PCL) composite nanofiber films (PVNF-n, n = 0, 1, and 5, respectively) via the electrospinning technique. The physiochemical and biological properties of PVNF-n were evaluated by a series of tests, such as FT-IR, XRD, SEM-EDS, and antibacterial assay. The PVNF-n samples displayed a typical network structure of fibers with random directions. VA was successfully introduced into the PCL nanofibers and could be sustained and released. More importantly, PVNF-5 showed relatively good antibacterial activity against both methicillin-resistant Staphylococcus aureus (MRSA) and Streptococcus pneumoniae (SPn). Thus, PVNF-5 was covered onto the self-expandable metallic stent and then implanted into a New Zealand rabbit model to repair tracheal stenosis. Compared to a metallic stent, a commercial pellosil matrix–covered stent, and a PVNF-0–covered metallic stent, the PVNF-5–covered airway stent showed reduced granulation tissue thickness, collagen density, α-SMA, CD68, TNF-α, IL-1, and IL-6 expression. In conclusion, this work provides an anti-infection film–covered airway stent that in site restrains tracheal stenosis.

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Section: Discussionmentioning

confidence: 99%

Vancomycin-Loaded Polycaprolactone Electrospinning Nanofibers Modulate the Airway Interfaces to Restrain Tracheal Stenosis

Tian

Zhou

Feng

et al. 2021

Front. Bioeng. Biotechnol.

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“…[3][4][5]22 Lung Volume Reduction Surgery After bronchoscopic lung volume reduction, a significant proportion of patients may need a "revision bronchoscopy" due to loss of lung volume reduction effect or other complications. 23,38,39 Revision can lead to improvement in lung function after loss of initial treatment effect. However, if this is unsuccessful or if valves have to be removed permanently due to local granulation tissue formation, other options can be explored.…”

Section: Moderate Hyperinflationmentioning

confidence: 99%

“…Management recommendations and proposed timelines are described in the recently published expert statement by van Dijk et al 22 Later onset complications include granulation tissue formation, which can lead to valve dysfunction, hemoptysis, infectious complications, and cough. 23,38,39 Dedicated follow-up is needed to monitor the treatment effect to effectively deal with the possible complications. In case of valve dysfunction and subsequent loss of effect, a revision bronchoscopy may be needed to try to regain the lung volume reduction effect.…”

Section: Complicationsmentioning

confidence: 99%

Bronchoscopic Lung Volume Reduction for Emphysema: Review and Update

Koster

Dijk

Slebos

2022

Semin Respir Crit Care Med

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In carefully selected patients with severe chronic obstructive pulmonary disease, characterized by emphysema and hyperinflation, lung volume reduction is an option to reduce lung hyperinflation, improve lung function, quality of life, and exercise capacity. Currently, there are several bronchoscopic and surgical treatment options to achieve lung volume reduction. It is important to carefully phenotype these patients, to select the optimal treatment option, with consideration of possible adverse events or contraindications, and it is highly recommended to discuss these treatment strategies in a multidisciplinary team. The treatment with one-way endobronchial valves has been investigated most extensively and more data are available regarding the treatment of more “marginal cases,” or subsequent lung volume reduction surgery. Other bronchoscopic lung volume reduction options include treatment with coils, thermal vapor ablation, and sclerosant agents. In this review, we aim to summarize the current clinical evidence on the bronchoscopic lung volume reduction therapies and important aspects regarding optimal patient selection.

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“…Potential complications related to non-removability stent mainly exacerbate the formation of endobronchial granulation tissue. Long-term effectiveness and sustainability are hampered by tissue responses after stenting 1 – 3 .…”

Section: Introductionmentioning

confidence: 99%

External beam radiotherapy inhibits stent related granulation hyperplasia in rabbit trachea

Zhou

Han

et al. 2023

Sci Rep

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Endobronchial stent exacerbates the formation of granulation tissue. Radiotherapy maybe a durable treatment option for granulation hyperplasia. In this study, we explore the results of external beam radiotherapy (EBRT) for granulation hyperplasia after airway stent placement. A total of 30 New Zealand rabbits were assigned in three groups, Control group (n = 12), low dosage (LD, 12 Gy in 4 fractions and twice a week) group (n = 9) and high dosage (HD, 20 Gy in 4 fractions and twice a week) group (n = 9). Post-stenting 1 week, LD and HD group started to receive EBRT. Bronchoscopy, Haematoxylin–eosin (HE), Masson’s trichrome (MTS), Safranin O (SO) and immunohistochemical (IHC) staining protocols were performed to evaluate the histopathological changes of trachea. A total of 30 stents were successfully implanted in 30 rabbits. No procedure-related death and complications happened. Post-stenting 4 w, 8 w and 12 w, the ventilate area ratio (VAR) and qualitative histological scoring (QHS) in the LD group and HD group lower than the Control group. Post-stenting 12w, the immunohistochemical results revealed that the positive percentage of TGF-β and VEGF in the LD group and HD group were lower than the Control group. In conclusion, the present study investigated the efficacy of EBRT in reducing stent related granulation tissue formation in the rabbit trachea. Higher dosage EBRT with a better result in inhibiting granulation hyperplasia.

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Airway granulation response to lung-implantable medical devices: a concise overview

Cited by 13 publications

References 46 publications

Vancomycin-Loaded Polycaprolactone Electrospinning Nanofibers Modulate the Airway Interfaces to Restrain Tracheal Stenosis

Vancomycin-Loaded Polycaprolactone Electrospinning Nanofibers Modulate the Airway Interfaces to Restrain Tracheal Stenosis

Bronchoscopic Lung Volume Reduction for Emphysema: Review and Update

External beam radiotherapy inhibits stent related granulation hyperplasia in rabbit trachea

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