Hormone pathways in subglottic laryngeal stenosis

Background:

Subglottic laryngeal stenosis (LS) is a progressive narrowing of the laryngeal lumen, either iatrogenic or with no apparent causes. Our previous study on the idiopathic subtype highlighted a possible hormonal mechanism, with over-expression of estrogen receptors alpha (ER-α) and progesterone receptor (PR). In this study, we tested whether such overexpression takes place in post-trauma LS as well.

Methods:

43 specimens of iatrogenic LS were analyzed (25 females, age 54 ± 16 years, range 19 – 85). Immunoreactivity of ER-α 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 (ST) and peri-stenotic (PT) tissues. The population was further separated in two subgroups, based on age median.

Results:

Mean ST expression of ER-α was 7.4 ± 4.8, PT expression was significantly lower (2.6 ± 1.9, p < 0.05). ST Expression of PR was also higher than in the PT area (6 ± 4.2 Vs. 1.8 ± 1, p < 0.05). Moreover, ER-α Score was correlated to the one of PR, in ST (R = 0.95, p < 0.001) as well as in the PT (R = 0.68, p < 0.05). Younger patients had a stronger ER-α expression in the ST when compared to the older group (p < 0.05); similarly, expression of PR (both in ST and PT) was stronger in the younger group (p < 0.05).

Finally, expressions of ER-Alpha and PR in ST were significantly higher in female than in male subjects (p < 0.05).

Conclusions:

Hormone regulation appear to play a relevant role in the LS's pathogenesis. This could allow a targeted therapy, especially in young women, which present the most marked overexpression of hormone receptors.

Publication History

Publication Date:
23 April 2019 (online)