Reinke’s Edema: investigations on the role of MIB-1 and hepatocyte growth factor

Abstract

Reinke's edema is a benign disease of the human vocal fold, which mainly affects the sub-epithelial layer of the vocal fold. Microscopic observations show a strongly oedematous epithelium with loosened intercellular junctions, a disruption of the extracellular connections between mucosal epithelium and connective tissue, closely adherent to the thyroarytenoid muscle. Thickening of the basal layer of epithelium, known as Reinke's space, high deposition of fibronectin and chronic inflammatory infiltration it is also visible. We analyzed, together with the hepatocyte growth factor (HGF), the expression level of MIB-1 in samples harvested from patients affected by Reinke's edema, in order to define its biological role and consider it as a possible prognostic factor in the follow-up after surgical treatment. We observed a moderate expression of HGF in the lamina propria of the human vocal fold and in the basal membrane of the mucosal epithelium. Our finding suggests that this growth factor acts as an anti - fibrotic agent in Reinke's space and affects the fibronectin deposition in the lamina propria. MIB-1, on the contrary, showed a weak expression in the basement membrane of the mucosal epithelium and a total absence in the lamina propria deep layer, thus suggesting that only the superficial layer is actively involved in the reparatory process with a high regenerative capacity, together with a high deposition of fibronectin. The latter is necessary for the cellular connections reconstruction, after the inflammatory infiltration.

The Protective Role of Autophagy in Human Vocal Fold Fibroblasts under Cigarette Smoke Extract Exposure: A New Insight into the Study of Reinke's Edema

“…In addition to smoking, environmental and genetic factors have also been associated with malignant transformation. Artico et al [36] speculated that the microenvironment of RE, including the absence of a neoangiogenic network, the chronic inflammatory infiltration, the presence of edematous tissue with a total disarrangement of collagenous and elastic fibers, and the high fibroblastic proliferation attributed to its low incidence of malignancy. Recently, the role of autophagy in cancer development was investigated, and defects in autophagy activity were associated with genome damage and instability, ultimately facilitating tumorigenesis [37].…”

Reinke's edema management and voice outcomes

“…This is necessary for cellular connection reconstruction, after the inflammatory infiltration. 23 Toohill suggested in 1997 that uncontrolled laryngopharyngeal reflux could be a causative factor in the polypoid degeneration of the vocal folds. The authors go on to assert that this patient population predominately consists of elderly females who do now rely on their voice for their profession but do have a long history of smoking.…”

“…The absence of MIB‐1 in the deep layer of the lamina propria indicates that only the superficial layer is actively involved in the reparatory process with a high regenerative capacity, together with a high deposition of fibronectin. This is necessary for cellular connection reconstruction, after the inflammatory infiltration 23 …”

The state of the larynx in the patients presenting with chronic obstructive pulmonary disease

“…Диагностированный у 6 пациентов отек Рейнке соответствовал I стадии согласно классификации Н. Yonekawa [11]. Стробоскопическая картина при катаральной форме ларингита, как правило, была представлена малой амплитудой колебаний истинных голосовых складок.…”