Dept of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Eur Respir Rev. 2021 Aug 3;30(161). doi: 10.1183/16000617.0066-2021. Print 2021 Sep 30.
Increasing numbers of endoscopically implantable devices are implanted in the airways, such as airway stents, one-way valves and coils, to treat both malignant and benign diseases. They significantly improve patient outcomes, but their long-term effectiveness and sustainability is hampered by the reaction of the formation of granulation tissue. Factors including procedural-related tissue injury; micro-organism presence; device-related factors, such as the material, design and sizing in relation to the airway; and patient-related factors, including genetic susceptibility, comorbidities and medication use, might all effect the severity of the tissue response and the subsequent degree of granulation tissue formation. However, research into the underlying mechanism and risk factors is scarce and therefore our knowledge is limited. Joint efforts from the scientific community, both pre-clinical and clinical, are needed to gain a deeper understanding and eventually improve the long-term treatment effectiveness of lung-implantable devices.
越来越多的可经内镜植入的设备被植入气道,例如气道支架、单向阀和线圈,以治疗恶性和良性疾病。它们显著改善了患者的预后,但由于肉芽组织的反应,其长期效果和可持续性受到了阻碍。包括与操作相关的组织损伤;微生物的存在;与设备相关的因素,例如材料、设计和与气道的匹配程度;以及与患者相关的因素,包括遗传易感性、合并症和药物使用,所有这些因素都可能影响组织反应的严重程度以及随后的肉芽组织形成程度。然而,对于潜在机制和风险因素的研究还很匮乏,因此我们的认识是有限的。需要来自临床前和临床科学界的共同努力,以更深入地了解并最终提高肺植入设备的长期治疗效果。