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Zhao P, Jiang Z, Li X, Ainiwaer M, Li L, Wang D, Fan L, Chen F, Liu J. Airway stenosis: classification, pathogenesis, and clinical management. MedComm (Beijing) 2025; 6:e70076. [PMID: 39866837 PMCID: PMC11769711 DOI: 10.1002/mco2.70076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 12/27/2024] [Accepted: 01/02/2025] [Indexed: 01/28/2025] Open
Abstract
Airway stenosis (AS) is a fibroinflammatory disease characterized by abnormal activation of fibroblasts and excessive synthesis of extracellular matrix, which has puzzled many doctors despite its relatively low prevalence. Traditional treatment such as endoscopic surgery, open surgery, and adjuvant therapy have many disadvantages and are limited in the treatment of patients with recurrent AS. Therefore, it is urgent to reveal the pathogenesis of AS and accelerate its clinical transformation. Based on the discovered pathogenesis, including fibrosis, inflammation, epithelial-mesenchymal transition, metabolic reprogramming, microbiome, genetic susceptibility, and other mechanisms, researchers have developed a series of treatments, such as drug therapy, gene therapy, stem cell therapy, growth factor therapy, protein therapy, and photodynamic therapy. This review introduces the classification of AS, explores the existing pathogenesis and preclinical treatments developed based on the pathogenesis, and finally summarizes the current clinical management. In addition, the prospect of exploring the interaction between different types of cells and between microorganisms and cells to identify the intersection of multiple mechanisms based on single-cell RNA sequencing, 16S rRNA gene sequencing and shotgun metagenomic sequencing is worth looking forward to.
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Affiliation(s)
- Pengwei Zhao
- Department of Otolaryngology ‐ Head & Neck SurgeryWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Otolaryngology ‐ Head & Neck SurgeryHead and Neck Surgical CenterWest China HospitalSichuan UniversityChengduSichuanChina
| | - Zheng Jiang
- Department of Otolaryngology ‐ Head & Neck SurgeryWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Otolaryngology ‐ Head & Neck SurgeryHead and Neck Surgical CenterWest China HospitalSichuan UniversityChengduSichuanChina
| | - Xuexin Li
- Department of Otolaryngology Head and Neck SurgeryQilu Hospital (Qingdao)Cheeloo College of MedicineShandong UniversityQingdaoShandongChina
| | - Mailudan Ainiwaer
- Department of Otolaryngology ‐ Head & Neck SurgeryWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Otolaryngology ‐ Head & Neck SurgeryHead and Neck Surgical CenterWest China HospitalSichuan UniversityChengduSichuanChina
| | - Leyu Li
- Department of Otolaryngology ‐ Head & Neck SurgeryWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Otolaryngology ‐ Head & Neck SurgeryHead and Neck Surgical CenterWest China HospitalSichuan UniversityChengduSichuanChina
| | - Dejuan Wang
- Department of Otolaryngology ‐ Head & Neck SurgeryWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Otolaryngology ‐ Head & Neck SurgeryHead and Neck Surgical CenterWest China HospitalSichuan UniversityChengduSichuanChina
| | - Lixiao Fan
- Department of Otolaryngology ‐ Head & Neck SurgeryWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Otolaryngology ‐ Head & Neck SurgeryHead and Neck Surgical CenterWest China HospitalSichuan UniversityChengduSichuanChina
| | - Fei Chen
- Department of Otolaryngology ‐ Head & Neck SurgeryWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Otolaryngology ‐ Head & Neck SurgeryHead and Neck Surgical CenterWest China HospitalSichuan UniversityChengduSichuanChina
| | - Jun Liu
- Department of Otolaryngology ‐ Head & Neck SurgeryWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Otolaryngology ‐ Head & Neck SurgeryHead and Neck Surgical CenterWest China HospitalSichuan UniversityChengduSichuanChina
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Yu JB, Padanilam BJ, Kim J. Activation of Yes-Associated Protein Is Indispensable for Transformation of Kidney Fibroblasts into Myofibroblasts during Repeated Administration of Cisplatin. Cells 2024; 13:1475. [PMID: 39273045 PMCID: PMC11393901 DOI: 10.3390/cells13171475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 08/22/2024] [Accepted: 08/30/2024] [Indexed: 09/15/2024] Open
Abstract
Cisplatin is a potent chemotherapy medication that is used to treat various types of cancer. However, it can cause nephrotoxic side effects, which lead to acute kidney injury (AKI) and subsequent chronic kidney disease (CKD). Although a clinically relevant in vitro model of CKD induced by repeated administration of low-dose cisplatin (RAC) has been established, its underlying mechanisms remain poorly understood. Here, we compared single administration of high-dose cisplatin (SAC) to repeated administration of low-dose cisplatin (RAC) in myofibroblast transformation and cellular morphology in a normal rat kidney fibroblast NRK-49F cell line. RAC instead of SAC transformed the fibroblasts into myofibroblasts as determined by α-smooth muscle actin, enlarged cell size as represented by F-actin staining, and increased cell flattening as expressed by the semidiameter ratio of attached cells to floated cells. Those phenomena, as well as cellular senescence, were significantly detected from the time right before the second administration of cisplatin. Interestingly, inhibition of the interaction between Yes-associated protein (YAP) and the transcriptional enhanced associated domain (TEAD) using Verteporfin remarkedly reduced cell size, cellular senescence, and myofibroblast transformation during RAC. These findings collectively suggest that YAP activation is indispensable for cellular hypertrophy, senescence, and myofibroblast transformation during RAC in kidney fibroblasts.
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Affiliation(s)
- Jia-Bin Yu
- Interdisciplinary Graduate Program in Advanced Convergence Technology & Science, Jeju National University, Jeju 63243, Republic of Korea;
| | - Babu J. Padanilam
- Department of Urology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Jinu Kim
- Interdisciplinary Graduate Program in Advanced Convergence Technology & Science, Jeju National University, Jeju 63243, Republic of Korea;
- Department of Anatomy, College of Medicine, Jeju National University, Jeju 63243, Republic of Korea
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Cruz DRD, Zheng A, Debele T, Larson P, Dion GR, Park YC. Drug delivery systems for wound healing treatment of upper airway injury. Expert Opin Drug Deliv 2024; 21:573-591. [PMID: 38588553 PMCID: PMC11208077 DOI: 10.1080/17425247.2024.2340653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/04/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Endotracheal intubation is a common procedure to maintain an open airway with risks for traumatic injury. Pathological changes resulting from intubation can cause upper airway complications, including vocal fold scarring, laryngotracheal stenosis, and granulomas and present with symptoms such as dysphonia, dysphagia, and dyspnea. Current intubation-related laryngotracheal injury treatment approaches lack standardized guidelines, relying on individual clinician experience, and surgical and medical interventions have limitations and carry risks. AREAS COVERED The clinical and preclinical therapeutics for wound healing in the upper airway are described. This review discusses the current developments on local drug delivery systems in the upper airway utilizing particle-based delivery systems, including nanoparticles and microparticles, and bulk-based delivery systems, encompassing hydrogels and polymer-based approaches. EXPERT OPINION Complex laryngotracheal diseases pose challenges for effective treatment, struggling due to the intricate anatomy, limited access, and recurrence. Symptomatic management often requires invasive surgical procedures or medications that are unable to achieve lasting effects. Recent advances in nanotechnology and biocompatible materials provide potential solutions, enabling precise drug delivery, personalization, and extended treatment efficacy. Combining these technologies could lead to groundbreaking treatments for upper airways diseases, significantly improving patients' quality of life. Research and innovation in this field are crucial for further advancements.
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Affiliation(s)
- Denzel Ryan D. Cruz
- Medical Scientist Training Program, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Avery Zheng
- Chemical Engineering Program, College of Engineering and Applied Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Tilahun Debele
- Chemical Engineering Program, College of Engineering and Applied Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Peter Larson
- Department of Otolaryngology – Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Gregory R. Dion
- Department of Otolaryngology – Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Yoonjee C. Park
- Chemical Engineering Program, College of Engineering and Applied Sciences, University of Cincinnati, Cincinnati, OH, USA
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Dong J, Li Y, Wang X, Liu Y, Ren K, Liu X, Zhang H, Li Z, Han X, Uyama H, Li Q. Microinjection Molded Biopolymeric Airway Stent with Antibacterial and Anti-Hyperplastic Properties. Macromol Biosci 2023; 23:e2300113. [PMID: 37326455 DOI: 10.1002/mabi.202300113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/18/2023] [Indexed: 06/17/2023]
Abstract
Central airway stenosis is a condition that the diameter of the trachea or main bronchus shrinkage is caused by external compression or internal tissue hyperplasia, which can cause difficulty breathing, asphyxia, and even death. Airway stenting is an easy way to restore the patency of the central airway, but airway stents commonly used in clinical practice can lead to complications such as mucus plugging, bacterial infection, and granulation tissue hyperplasia. Moreover, the non-degradable characteristic makes it requires a second operation to remove, which has the potential to cause tissue damage. In this study, a biodegradable airway stent is fabricated by microinjection molding using the bioelastomer of poly (L-lactide-co-ε-caprolactone) as the matrix material. The airway stent has excellent mechanical properties and an appropriate degradation rate. The hydrophilic surface of the airway stent can inhibit mucus plugging. The loading of silver nanoparticles and cisplatin endows the stent with antibacterial and anti-hyperplastic functions. In vitro and in vivo experiments demonstrate that this study provides an antibacterial and anti-hyperplastic biodegradable airway stent with elastic properties to avoid secondary removal operation and reduce complications associated with mucus plugging, bacterial infection, and granulation tissue hyperplasia.
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Affiliation(s)
- Jiahui Dong
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou, 450001, China
- School of Mechanics and Safety Engineering, National Center for International Research of Micro-Nano Molding Technology, Zhengzhou University, Zhengzhou, 450001, China
- Department of Applied Chemistry, Osaka University, Suita, Osaka, 565-0871, Japan
| | - Yahua Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xiaofeng Wang
- School of Mechanics and Safety Engineering, National Center for International Research of Micro-Nano Molding Technology, Zhengzhou University, Zhengzhou, 450001, China
| | - Yajing Liu
- School of Mechanics and Safety Engineering, National Center for International Research of Micro-Nano Molding Technology, Zhengzhou University, Zhengzhou, 450001, China
| | - Kewei Ren
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Engineering Technology Research Center for Minimally Invasive Interventional Tumors of Henan Province, Zhengzhou, 450052, China
| | - Xuedi Liu
- School of Mechanics and Safety Engineering, National Center for International Research of Micro-Nano Molding Technology, Zhengzhou University, Zhengzhou, 450001, China
| | - Han Zhang
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou, 450001, China
- School of Mechanics and Safety Engineering, National Center for International Research of Micro-Nano Molding Technology, Zhengzhou University, Zhengzhou, 450001, China
| | - Zongming Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xinwei Han
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, China
| | - Hiroshi Uyama
- Department of Applied Chemistry, Osaka University, Suita, Osaka, 565-0871, Japan
| | - Qian Li
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou, 450001, China
- School of Mechanics and Safety Engineering, National Center for International Research of Micro-Nano Molding Technology, Zhengzhou University, Zhengzhou, 450001, China
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Synergistic effects of silver nanoparticles and cisplatin in combating inflammation and hyperplasia of airway stents. Bioact Mater 2021; 9:266-280. [PMID: 34820570 PMCID: PMC8586718 DOI: 10.1016/j.bioactmat.2021.07.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/04/2021] [Accepted: 07/26/2021] [Indexed: 12/17/2022] Open
Abstract
Anti-inflammatory and antihyperplasia activities are essential requirements for the successful use of airway stents. In this work, silver nanoparticles (AgNPs) and cisplatin (DDP) were combined in a synergistic modification strategy to improve the surface function of airway stents. Using polycaprolactone (PCL) as a drug carrier, a dual-functional PCL-AgNPs-DDP fiber film-coated airway stent was fabricated by electrospinning. The physicochemical and biological properties of the obtained fiber films were examined. The ATR-FTIR, XPS, SEM-EDS and TEM results suggested that AgNPs and DDP could be successfully immobilized onto the airway stent surface. The drug release and surface degradation results revealed that AgNPs and DDP can undergo sustained release from films for 30 d, and the weight loss was approximately 50% after 35 d. In addition, the dual-functional fiber film suppressed human embryonic lung fibroblast growth and exhibited excellent antibacterial activity against Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans. Furthermore, the effectiveness of the dual-functional fiber film-coated airway stent was evaluated by application to the trachea of New Zealand rabbits. The in vivo results indicated that PCL-AgNPs-DDP fiber film-coated airway stent can significantly inhibit granulation tissue formation and collagen deposition, reduced the expression of IL-8, TNF-α, IL-1α, PCNA, α-SMA and CD68, and ultimately achieved anti-inflammatory and antihyperplasia effects. Hence, this study provides a dual-functional surface-coated airway stent to address the clinical complications associated with respiratory tract inflammation and granulation tissue hyperplasia, thus inhibiting tracheal stenosis. This study provides a dual-functional PCL-AgNPs-DDP nanofiber film-coated airway stent. The airway stent processes antibacterial activity and suppress CCC-HPF-1 growth. The stent inhibits tracheal stenosis by antiinflammatory and antihyperplasia treatment.
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