Hormone pathway comparison in non-idiopathic and idiopathic progressive subglottic stenosis

Fiz, Ivana; Antonopoulos, Wiebke; Kölmel, Jan-Constantin; Rüller, K; Fiz, Francesco; Piazza, Cesare; Peretti, Giorgio; Flechtenmacher, Christa; Schirmacher, Peter; Sittel, Christian

doi:10.1007/s00405-022-07615-0

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…Interestingly, they found no difference in the ER expression between the female idiopathic and the subgroup of female non-idiopathic cases. On the contrary all of our ITS cases showed the ER expression but just 50% of the female PTTS patients ( 18 ).…”

Section: Discussioncontrasting

confidence: 62%

The role of local expression of hormone receptors in the genesis of idiopathic tracheal stenosis

Schweipert¹,

Riediger²,

Balandat³

et al. 2023

J Thorac Dis

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Background Tracheal stenosis in adults is usually the result of mechanical injuries either from direct trauma, tracheotomy or intubation. Idiopathic stenosis in the cricotracheal section is a rare condition and occurs almost exclusively in females. Therefore, an influence of the female sexual hormones estrogen and progesterone has been assumed previously. Methods Tracheal specimens of 27 patients who received tracheal resection for either idiopathic tracheal stenosis (ITS) (n=11) or posttraumatic tracheal stenosis (PTTS) (n=16) between 2008 and 2019 in our surgical department were included and retrospectively analyzed. Immunohistochemical staining of tracheal specimens concerning the hormone receptor status of progesterone and estrogen was performed. Results While post-tracheotomy stenosis occurred in males (n=6) as well as in females (n=10), none of the patients with idiopathic stenosis were males. All of the idiopathic stenosis (n=11; 100%) showed a strong expression of the estrogen receptors (ERs) in the fibroblasts and expression of progesterone receptors (PRs) in fibroblasts in 8 of 11 (72.7%). In the post-tracheotomy patients, only 3/16 (18.8%) showed slight staining of PRs and 6/16 (37.5%) of ERs. Of those, only one male patient presented with expression of ERs and PRs and another male patient presented with isolated PRs. Oral intake of hormone compounds was seen in 11/27 (40.7%) patients: 7/11 (63.6%) in the ITS group and 4/16 (25%) in the PTTS (noteworthy that the PTTS group included 6 male patients). Conclusions Although the number of patients is small, our results show that the expression of female sexual hormone receptors in the fibroblasts of the trachea is a persistent finding in ITS. Surgery provided good results with a favorable long-term outcome without recurrence of stenosis for ITS and PTTS. Further investigation with a special focus on hormones is needed to assist in the prevention of this rare disease.

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Section: Discussioncontrasting

confidence: 62%

The role of local expression of hormone receptors in the genesis of idiopathic tracheal stenosis

Schweipert¹,

Riediger²,

Balandat³

et al. 2023

J Thorac Dis

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“…The theory of a hormonal imbalance in perimenopausal females has been previously studied to explain the onset of idiopathic SGS in that age group. Estrogen receptors are thought to be expressed either unproportionally compared to progesterone receptors and more extensively in females with idiopathic SGS compared to patients with a nonidiopathic type of SGS [ 30 , 31 ]. Moreover, there is evidence of an age-related elevation in peripheral estrogen formation occurring in adipose tissue [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Balloon dilatation is superior to CO2 laser excision in the treatment of subglottic stenosis

Ntouniadakis

Sundh

Magnuson

et al. 2023

Eur Arch Otorhinolaryngol

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Introduction Endoscopic treatment of subglottic stenosis (SGS) is regarded as a safe procedure with rare complications and less morbidity than open surgery yet related with a high risk of recurrence. The abundance of techniques and adjuvant therapies complicates a comparison of the different surgical approaches. The primary aim of this study was to investigate disease recurrence after CO2 laser excisions and balloon dilatation in patients with SGS and to identify potential confounding factors. Materials and methods In a tertiary referral center, two cohorts of previously undiagnosed patients treated for SGS were retrospectively reviewed and followed for 3 years. The CO2 laser cohort (CLC) was recruited between 2006 and 2011, and the balloon dilatation cohort (BDC) between 2014 and 2019. Kaplan‒Meier and multivariable Cox regression analyzed time to repeated surgery and estimated hazard ratios (HRs) for different variables. Results Nineteen patients were included in the CLC, and 31 in the BDC. The 1-year cumulative recurrence risk was 63.2% for the CLC compared with 12.9% for the BDC (HR 33.0, 95% CI 6.57–166, p < 0.001), and the 3-year recurrence risk was 73.7% for the CLC compared with 51.6% for the BDC (HR 8.02, 95% CI 2.39–26.9, p < 0.001). Recurrence was independently associated with overweight (HR 3.45, 95% CI 1.16–10.19, p = 0.025), obesity (HR 7.11, 95% CI 2.19–23.04, p = 0.001), and younger age at diagnosis (HR 8.18, 95% CI 1.43–46.82, p = 0.018). Conclusion CO2 laser treatment is associated with an elevated risk for recurrence of SGS compared with balloon dilatation. Other risk factors include overweight, obesity, and a younger age at diagnosis.

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“…In combination with the clear gender predisposition, this has always been interpreted as an indication of a possible connection with the metabolism of female sex hormones. Studies to date have been contradictory in this regard, but recently there has been evidence that an imbalance between different types of estrogen and progesterone receptors may be etiologically significant, the importance of which for wound healing has been documented elsewhere [4][5][6]. The endoscopic appearance is inconsistent, but always shows an inconspicuous epithelial surface, mostly with submucosal, corkscrew-like scar strands.…”

Section: Idiopathic Progressive Subglottic Stenosis (Ipss)mentioning

confidence: 99%

“…In Kombination mit der eindeutigen Geschlechtsdisposition wurde dies von jeher als Hinweis auf einen möglichen Zusammenhang mit dem Stoffwechsel weiblicher Sexualhormone gewertet. Die Studienlage ist bislang hierzu widersprüchlich, in jüngster Zeit gibt es jedoch Hinweise, dass eine Dysbalance zwischen verschiedenen Typen von Östrogen- und Progesteronrezeptoren ätiologisch bedeutsam sein könnten, deren Bedeutung für die Wundheilung an anderer Stelle dokumentiert werden konnte 4 5 6 . Das endoskopische Erscheinungsbild ist uneinheitlich, zeigt jedoch immer eine unauffällige epitheliale Oberfläche, zumeist mit submukösen, korkenzieherartigen Narbensträngen.…”

Section: Atemwegsstenosen Im Erwachsenenalterunclassified

Rekonstruktive Chirurgie des laryngo-trachealen Übergangs

Sittel,

Koitschev,

Schön

et al. 2024

Laryngorhinootologie

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ZusammenfassungDer laryngotracheale Übergang ist eine anatomische Region mit pathophysiologischen Besonderheiten. Vorliegende Übersichtsarbeit stellt Krankheitsbilder und Fehlbildungen vor, die sich im Kindes- und Jugendalter als auch bei Erwachsenen prädilektiv an dieser Lokalisation manifestieren. Das diagnostische Vorgehen wird erörtert. Die Möglichkeiten der operativen Rekonstruktion werden in Abhängigkeit von Pathologie und Lebensalter des Patienten dargestellt.

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Hormone pathway comparison in non-idiopathic and idiopathic progressive subglottic stenosis

Cited by 6 publications

References 30 publications

The role of local expression of hormone receptors in the genesis of idiopathic tracheal stenosis

The role of local expression of hormone receptors in the genesis of idiopathic tracheal stenosis

Balloon dilatation is superior to CO2 laser excision in the treatment of subglottic stenosis

Rekonstruktive Chirurgie des laryngo-trachealen Übergangs

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