Learning from the Cardiologists and Developing Eluting Stents Targeting the Mtor Pathway for Pulmonary Application; A Future Concept for Tracheal Stenosis

Abstract

Tracheal stenosis due to either benign or malignant disease is a situation that the pulmonary physicians and thoracic surgeons have to cope in their everyday clinical practice. In the case where tracheal stenosis is caused due to malignancy mini-interventional interventions with laser, apc, cryoprobe, balloon dilation or with combination of more than one equipment and technique can be used. On the other hand, in the case of a benign disease such as; tracheomalacia the clinician can immediately upon diagnosis proceed to the stent placement. In both situations however; it has been observed that the stents induce formation of granuloma tissue in both or one end of the stent. Therefore a frequent evaluation of the patient is necessary, taking also into account the nature of the primary disease. Evaluation methodologies identifying different types and extent of the trachea stenosis have been previously published. However; we still do not have an effective adjuvant therapy to prevent granuloma tissue formation or prolong already treated granuloma lesions. There have been proposed many mechanisms which induce the abnormal growth of the local tissue, such as; local pressure, local stress, inflammation and vascular endothelial growth factor overexpression. Immunomodulatory agents inhibiting the mTOR pathway are capable of inhibiting the inflammatory cascade locally. In the current mini-review we will try to present the current knowledge of drug eluting stents inhibiting the mTOR pathway and propose a future application of these stents as a local anti-proliferative treatment.

Inhaled Immunotherapy Administration for Lung Cancer; Efficient? Certainly Possible

“…The device has been modified as for the used to be able to spray the generated droplets directly perpendicular to the laser beam (i.e. 4 , 8 , 13 , 14 ). A refractive index of 1.33 was been used for the sprayed droplets.…”

Drug development of Lung Diseases by way of Drug Repurposing; What a Pulmonary Physician can do in the Laboratory

“…The device can be modified as for the user to be able to spray the generated droplets/powder directly perpendicular to the laser beam (i.e. [5][6][7][8][9]). A refractive index of 1.33 is used for the sprayed droplets.…”

Drug Eluting Stents for Malignant Airway Obstruction: A Critical Review of the Literature

“… 17 Several techniques can be used to open a closed central airway and chemotherapy or radiotherapy can be used to preserve the result. 18 , 19 Debulking of cancer tissue is usually performed with different types of lasers, electrocautery, argon plasma coagulation (APC) or cryotherapy. 20 (Figures 1 - 2 ) In order to keep the airway opened we use additionally stent devices.…”