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.

Hormone receptors analysis in idiopathic progressive subglottic stenosis / I. Fiz, Z. Bittar, C. Piazza, J.C. Koelmel, F. Gatto, D. Ferone, F. Fiz, D. Di Dio, A. Bosse, G. Peretti, C. Sittel. - In: LARYNGOSCOPE. - ISSN 0023-852X. - 128:2(2018), pp. E72-E77. [10.1002/lary.26931]

Hormone receptors analysis in idiopathic progressive subglottic stenosis

C. Piazza;
2018

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.
estrogens; Idiopathic progressive subglottic stenosis; pathogenesis; progesterone; receptors; Adult; Aged; Contraception Behavior; Female; Hormone Replacement Therapy; Humans; Immunohistochemistry; Laryngostenosis; Larynx; Menopause; Middle Aged; Receptors, Estrogen; Receptors, Progesterone; Retrospective Studies; Otorhinolaryngology; 2734; Pathology and Forensic Medicine
Settore MED/31 - Otorinolaringoiatria
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/622300
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