Hillel Alexander T, Namba Daryan, Ding Dacheng, Pandian Vinciya, Elisseeff Jennifer H, Horton Maureen R
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA Otolaryngol Head Neck Surg. 2014 Oct;140(10):961-6. doi: 10.1001/jamaoto.2014.1663.
Laryngotracheal stenosis (LTS) lacks an ideal animal model to study its unique wound-healing pathophysiology and the effect of interventions.
To present an in vivo, in situ mouse model of LTS that can be used to investigate its pathophysiology, mechanisms, and interventions for treatment.
DESIGN, SETTING, AND SUBJECTS: Prospective controlled animal study performed at an academic animal research facility on 87 C57BL/6 mice.
Experimental mice (n = 40) underwent bleomycin-coated wire-brush injury to the larynx and trachea, while mechanical injury controls (n = 32) underwent phosphate-buffered saline-coated wire-brush injury. Normal controls (n = 9) underwent no intervention, and mock surgery controls (n = 6) underwent anterior transcervical tracheal exposure only. Laryngotracheal complexes were harvested at days 7, 14, and 21 after injury. At the respective time points, mice in the chemomechanical and mechanical injury groups were killed, and their laryngotracheal complexes were harvested for histologic analysis. Normal and mock surgery controls were killed and then underwent histologic analysis.
The primary outcome measure was lamina propria thickness.
The chemomechanical injury group maintained a significant increase in lamina propria thickness through day 21 compared with uninjured controls at day 7 (82.7 vs 41.8 μm; P<.05), day 14 (93.5 vs 26.0 μm; P<.05), and day 21 (91.2 vs 40.8 μm; P<.05). Compared with the mechanical injury group, the chemomechanical injury group demonstrated a significantly increased thickness at 21 days (91.2 vs 33.7 μm; P<.05).
Chemomechanical initiation of fibrosis in situ creates a viable mouse model of LTS that incorporates the physiologic circulatory supply and airflow. This small-animal model may be used to investigate the pathogenesis and inflammatory mechanisms of iatrogenic LTS and test therapeutic interventions to reverse or reduce the development of fibrosis.
喉气管狭窄(LTS)缺乏理想的动物模型来研究其独特的伤口愈合病理生理学及干预措施的效果。
建立一种可用于研究LTS病理生理学、机制及治疗干预措施的体内原位小鼠模型。
设计、地点和研究对象:在一家学术性动物研究机构对87只C57BL/6小鼠进行的前瞻性对照动物研究。
实验小鼠(n = 40)接受用博来霉素包被的钢丝刷对喉和气管进行损伤,而机械损伤对照组(n = 32)接受用磷酸盐缓冲盐水包被的钢丝刷损伤。正常对照组(n = 9)不接受干预,假手术对照组(n = 6)仅接受经颈部前路气管暴露。在损伤后第7、14和21天采集喉气管复合体。在各个时间点,化学机械损伤组和机械损伤组的小鼠被处死,其喉气管复合体被采集用于组织学分析。正常对照组和假手术对照组被处死,然后进行组织学分析。
主要结局指标是固有层厚度。
与第7天未受伤的对照组相比,化学机械损伤组在第21天前固有层厚度持续显著增加(82.7对41.8μm;P<0.05),第14天(93.5对26.0μm;P<0.05),第21天(91.2对40.8μm;P<0.05)。与机械损伤组相比,化学机械损伤组在第21天时厚度显著增加(91.2对33.7μm;P<0.05)。
原位化学机械诱导纤维化创建了一种可行的LTS小鼠模型,该模型整合了生理循环供应和气流。这种小动物模型可用于研究医源性LTS的发病机制和炎症机制,并测试逆转或减少纤维化发展的治疗干预措施。