Hormone receptors analysis in idiopathic progressive subglottic stenosis. (9th October 2017)

• Record Type: Journal Article
• Authors: Fiz, Ivana; Bittar, Zeid; Piazza, Cesare; Koelmel, Jan Constantin; Gatto, Federico; Ferone, Diego; Fiz, Francesco; Di Dio, Diana; Bosse, Alexander; Peretti, Giorgio; Sittel, Christian
• Is Part Of: Laryngoscope. Volume 128:Number 2(2018)
• Page Start: E72
• Page End: E77
• Publication Date: 2017-10-09
• Subjects: Idiopathic progressive subglottic stenosis -- pathogenesis -- estrogens -- progesterone -- receptors; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.26931
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Objective: Idiopathic subglottic stenosis predominantly affects fertile and perimenopausal women. Estrogens and/or progesterone have been proposed as mediators of its pathogenesis by stimulating collagen deposition within the upper airway. We evaluated the presence and expression of estrogen‐alpha (ER‐α), estrogen‐beta (ER‐β), and progesterone receptors (PR) in idiopathic stenotic patients. Study Design: A retrospective analysis on 42 surgical specimens from idiopathic stenosis female patients (mean age, 52.4; age range, 31–79) and 28 gender‐ and age‐matched controls. Methods: Immunoreactivity of ER‐α, ER‐β, and PR was calculated as the product of intensity (1 = weak, 2 = moderate, 3 = strong) and positive cell percentage (1–4, for < 10/10–50/50–80/ > 80%). This score was calculated on the stenotic and peristenotic tissues. Influence of menopausal status on hormonal expression and stenotic grade was tested. Results: Stenosis showed ER‐α overexpression versus peristenotic tissue and controls (score 6.6 ± 4.4, 0.3 ± 0.5, and 2.2 ± 1.5, respectively; P < 0.001). Overexpression was even more marked for progesterone receptors (score 8.3 ± 3.6, 0.8 ± 0.6, and 1.0 ± 0.7, respectively; P < 0.001). There was no expression of ER‐β in stenosis (score 0), whereas it was normally expressed in peristenotic tissue and controls (score 0.7 ± 0.5 and 0.5 ± 0.5; P < 0.001 vs. stenosis). Expression of ER‐α was higher in postmenopausal stenotic patients ( P < 0.01). This subgroup included a higher proportion of Cotton‐Myer grade III stenosis than in premenopausal subjects ( P < 0.001). Conclusion: An imbalance between ER‐α, ER‐β, and PR is present in idiopathic stenosis patients. The hormonal background may be involved in inappropriate inflammation and increased stenosis susceptibility. Menopausal changes seem to play a role in both stenosis grade and receptor patterns. Level of Evidence: NA. Laryngoscope, 128:E72–E77, 2018