Glucocorticoids in laryngology: A review

Rafii, Benjamin; Sridharan, Shaum; Taliercio, Salvatore; Govil, Nandini; Paul, Benjamin C.; Garabedian, Michael J.; Amin, Milan R.; Branski, Ryan C.

doi:10.1002/lary.24556

Cited by 22 publications

(18 citation statements)

References 42 publications

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“…Management could be coordinated by the ICU team and involve a variety of other disciplines. Treatment might include prescribing glucocorticoids 42 and anti-reflux medications, 43 procedures such as stenosis dilation 44 and vocal fold medialization by anesthesiology and otolaryngology, 45,46 therapy by speech-language pathology for voice 47,48 and swallowing, 49,50 and other complementary therapies for improving patient function and quality of life. 51,52 One finding worth highlighting is that approximately half of all patients experienced dysphagia after extubation and that 1 in 5 patients had vocal fold immobility.…”

Section: Discussionmentioning

confidence: 99%

Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care: A Systematic Review*

Brodsky

Levy

Jedlanek

et al. 2018

Critical Care Medicine

225

216

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Laryngeal injury from intubation is common in the ICU setting. Guidelines for laryngeal assessment and postextubation surveillance do not exist. A systematic approach to more robust investigations could increase knowledge of the association between particular injuries and corresponding functional impairments, improving understanding of both time course and prognosis for resolution of injury. Our findings identify targets for future research and highlight the long-known, but understudied, clinical outcomes from endotracheal intubation with mechanical ventilation in ICU.

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Section: Discussionmentioning

confidence: 99%

Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care: A Systematic Review*

Brodsky

Levy

Jedlanek

et al. 2018

Critical Care Medicine

225

216

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“…However, the mechanism(s) underlying the antifibrotic effects of GCs remain unclear, and GCs are a large class of compounds with diverse pharmacokinetic properties. Clinically, no clear guidelines exist regarding GC use for VF scarring . The acquisition of preclinical, mechanistic insight into factors relevant to optimal therapeutic outcomes is critical to ultimately develop novel, targeted treatments for this challenging patient population.…”

Section: Introductionmentioning

confidence: 99%

“…Clinically, no clear guidelines exist regarding GC use for VF scarring. 6,7 The acquisition of preclinical, mechanistic insight into factors relevant to optimal therapeutic outcomes is critical to ultimately develop novel, targeted treatments for this challenging patient population.…”

Section: Introductionmentioning

confidence: 99%

Phosphorylation of the glucocorticoid receptor alters SMAD signaling in vocal fold fibroblasts

Mukudai¹,

Hiwatashi²,

Bing³

et al. 2018

The Laryngoscope

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Objectives/Hypothesis Direct glucocorticoid (GC) injection for vocal fold (VF) scarring has evolved as a therapeutic strategy, but the mechanisms underlying the antifibrotic effects remain unclear. GCs act via the glucocorticoid receptor (GR), which is phosphorylated at multiple serine residues in a hormone‐dependent manner to affect bioactivity. We hypothesize that GCs regulate SMAD signaling via GR phosphorylation in vocal fold fibroblasts (VFFs). Study Design In vitro. Methods Human VFFs were treated with dexamethasone (DM; 10−5–10−7M) ± transforming growth factor (TGF)‐β1 (10 ng/mL). RU486 (10−6M) was employed to isolate the regulatory effects of GR. Total GR, Ser211, and Ser203 phosphorylation was examined via sodium dodecyl sulfate‐polyacrylamide gel electrophoresis and immunocytochemistry. Quantitative polymerase chain reaction was employed to determine GR‐mediated effects of DM on genes related to fibrosis. Results Total GR and Ser211 phosphorylation was observed predominantly in the nucleus 1 hour after DM administration. DM decreased total GR expression, but Ser203 and Ser211 phosphorylation increased. RU486 limited the effects of DM. SMAD3 and SMAD7 mRNA expression significantly decreased 4 hours after DM administration (P < 0.05); this response was negated by RU486. COL1A1 remained unchanged, and ACTA2 significantly increased following 24 hours of DM treatment (P < 0.05). Conclusion DM regulated TGF‐β1 signaling via altered SMAD3 and SMAD7 expression. This response was associated with altered GR phosphorylation. These findings provide insight into the mechanisms of steroidal effects on vocal fold repair; ultimately, we seek to enhance therapeutic strategies for these challenging patients. Level of Evidence NA Laryngoscope, 129:E187–E193, 2019

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“…Für die Behandlung und Prophylaxe von Heiserkeiten mit Glukokortikoiden sind viele Indikationen für die lokale Injektion in die Stimmlippen und für die systemische Behandlung (orale Verabreichung oder intravenöse Injektion) beschrieben worden [5] Betablocker werden in der Stufenbehandlung des Bluthochdrucks eingesetzt und daher von sehr vielen Menschen verwendet. Künstler nehmen sie manchmal in Selbstmedikation, um das beim Auftritt als störend empfundene "Herzklopfen" des Lampenfiebers zu unterdrücken.…”

Section: Benigne Neubildungen Der Stimmlippen (J381 J382)unclassified

Medikamentöse Stimmbehandlung und stimmliche Medikamentennebenwirkungen: Update

Schönweiler

2019

Sprache Stimme Gehör

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In 2007, the author published a review on medication for voice disorders together with an overview on side effects of medication on the voice 1. Since the past twelve years, many new findings and even reviews and meta-analyses on these issues have been published that are important for an update. Included are: medications for diseases of the larynx, diseases of internal medicine, neuromuscular diseases, and mental illness.

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Glucocorticoids in laryngology: A review

Abstract: Glucocorticoids are effective in the treatment of a number of laryngeal pathologies, through both systemic and intralesional administration. However, a clear consensus for utilization of glucocorticoids in the treatment of specific laryngeal disorders has yet to be published.

Cited by 22 publications

References 42 publications

Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care: A Systematic Review*

Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care: A Systematic Review*

Phosphorylation of the glucocorticoid receptor alters SMAD signaling in vocal fold fibroblasts

Medikamentöse Stimmbehandlung und stimmliche Medikamentennebenwirkungen: Update

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