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

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Our previous study on the idiopathic progressive subglottic stenosis (IPSS) highlighted a possible hormonal mechanism, with over-expression of estrogen receptors alpha (ER-α) and progesterone receptors (PR). We tested whether such over-expression take place in non-idiopathic subglottic stenosis (NISS) as well.

Methods

37 specimens of iatrogenic NISS were analyzed (20 females; mean age, 59 ± 12 years; range 41–85). Immunoreactivity of ER-α and PR was calculated as the product of intensity (1 = weak, 2 = moderate, 3 = strong) and positive cells percentage (1 to 4, for < 10%, 10–50%, 50–80%, and > 80%). This score was calculated on the stenotic tissue (ST), and stenosis margins (SM).

Results

The expression of PR was significantly higher in ST of IPSS compared with female and male NISS patients (8.7 ± 3.1 vs. 4.9 ± 3.2, p < 0.001 for IPSS vs. female and 8.7 ± 3.1 vs. 2.1 ± 2.7, p < 0.01 for IPSS vs. male NISS patients). Contrarily, ER-α showed gender differences, as both IPSS and female NISS patients had similar, yet higher ER-α expression compared with male NISS patients (7.0 ± 4.2 vs. 6.5 ± 2.5, p = NS for IPSS vs. female and 7.0 ± 4.2 vs. 3.4 ± 2.0, p < 0.02 for IPSS vs. male NISS patients). There was no difference in fibroblast receptor expression between ST and SM. However, ER-α and PR expression was significantly lower in marginal mucous glands when compared with ST.

Conclusions

The IPSS pathogenesis appears to be driven by hormonal mechanisms, in particular, by over-expression of PR. Marginal cells display a reduced hormone receptor density. This finding could be interpreted as a compensatory mechanism. These findings could open up for targeted IPSS treatment.

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Acknowledgements

The authors have no funding, financial relationship, or conflicts of interest to disclose

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, IRCCS Instituto Giannina Gaslini, Genoa, Italy

    Ivana Fiz

  2. Institute of Pathology, University Hospital, Heidelberg, Germany

    Wiebke Antonopoulos, Christa Flechtenmacher & Peter Schirmacher

  3. Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum Stuttgart, Stuttgart, Germany

    Jan-Constantin Kölmel, Karina Rüller & Christian Sittel

  4. Nuclear Medicine Unit, Department of Radiology, University of Tübingen, Tübingen, Germany

    Francesco Fiz

  5. Nuclear Medicine Unit, E.O. Ospedali Galliera, Genoa, Italy

    Francesco Fiz

  6. Department of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy

    Cesare Piazza

  7. Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy

    Cesare Piazza

  8. Department of Otorhinolaryngology-Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Giorgio Peretti

  9. Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy

    Giorgio Peretti

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  1. Ivana Fiz
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Correspondence to Karina Rüller.

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Fiz, I., Antonopoulos, W., Kölmel, JC. et al. Hormone pathway comparison in non-idiopathic and idiopathic progressive subglottic stenosis. Eur Arch Otorhinolaryngol 280, 775–780 (2023). https://doi.org/10.1007/s00405-022-07615-0

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  • DOI: https://doi.org/10.1007/s00405-022-07615-0

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