Anti-transforming growth factor beta as a treatment for laryngotracheal stenosis in a canine model.
OBJECTIVE
Laryngotracheal stenosis (LTS) represents a significant treatment dilemma faced by otolaryngologists. Recent topical use of Mitomycin C as an adjunctive treatment has proved helpful but does not completely prevent stenosis. Current literature suggests that transforming growth factor beta (TGFB) plays a significant role in the development of subglottic stenosis. We modified an existing canine model to test antitransforming growth factor beta (anti-TGFB) as a possible treatment for laryngotracheal stenosis.


METHODS
Pilot study in a modified canine model.


METHODS
Eight mixed-breed dogs underwent cautery injury to the subglottic region creating subsequent laryngotracheal stenosis. Four dogs were treated with saline injection into the injury site and four dogs were treated with a combination of intravenous (5 mg/kg on day 0 and 5 of the experiment) and local injection of anti-TGFB (50 micrograms).


RESULTS
In the canine model of induced subglottic airway injury, a combination of intralesional and intravenous anti-TGFB results in a reduction in tracheal stenosis (P < .05) and an increase in survival time (P < .03) when compared to the saline control subjects.


CONCLUSIONS
Anti-TGFB appears to be a useful adjunct in the treatment of LTS. Further study regarding the optimal dosing, route of administration, and timing of delivery is needed to understand the role of anti-TGFB in the treatment for laryngotracheal stenosis.
Simpson
C Blake
CB
Department of Otolaryngology-Head and Neck Surgery, the University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA. simpsonc@uthscsa.edu
White
Stephen
S
McGuff
H Stan
HS
D000818:Animals; D000906:Antibodies / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004285:Dogs; D007829:Laryngostenosis / Q000188:drug therapy* / Q000473:pathology; D014135:Tracheal Stenosis / Q000188:drug therapy* / Q000473:pathology; D016212:Transforming Growth Factor beta / Q000037:antagonists & inhibitors* / Q000276:immunology*
D000906:Antibodies; D016212:Transforming Growth Factor beta