Potential treatment for vocal fold scar with pirfenidone

Kodama, Haruka; Kumai, Yoshihiko; Nishimoto, Kohei; Toya, Yutaka; Miyamaru, Satoru; Furushima, Shinobu; Yumoto, Eiji

doi:10.1002/lary.26999

Cited by 12 publications

(19 citation statements)

References 21 publications

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“…We previously showed in a preliminary in vitro study that PFD exerted antifibrotic effects, especially in terms of reducing collagen type I expression levels and gel contraction, but it did not affect the mRNA level of α‐SMA in fibroblasts isolated from ferret VF scars . We also showed that, based on its gross and microscopic VF anatomies, surgical feasibility, and response to scar‐producing injury, the ferret seems to be an excellent model for VF studies .…”

Section: Discussionmentioning

confidence: 94%

“…Then, saline alone or PFD resuspended in saline (1.0 mg/mL) was injected into the right LP of each scarred VF. The concentration was determined following studies that have used PFD in vitro . The VFs were exposed as described above, and transoral injections (~200 μL) were performed (under an operating microscope) using a Cattelan needle (Zeitels infusion needle) attached to a microsyringe.…”

Section: Methodsmentioning

confidence: 99%

“…First, we examined the antifibrotic effects of PFD (especially reductions in collagen expression and collagen gel contraction) using an in vitro ferret model of VF scarring that we developed previously. 4,18 PFD exhibited promising antifibrotic effects in vitro. Here, we immunohistochemically examine the antifibrotic effects of PFD on the scarred ferret VF, especially including collagen type I and type III, fibronectin, and alpha-smooth muscle actin (α-SMA) in vivo.…”

Section: Introductionmentioning

confidence: 94%

“…The concentration was determined following studies that have used PFD in vitro. [18][19][20] The VFs were exposed as described above, and transoral injections (~200 μL) were performed (under an operating microscope) using a Cattelan needle (Zeitels infusion needle) attached to a microsyringe. All injections were confirmed visually; the microscope revealed expansion of the LP layer (and not the muscle layer).…”

Section: Endoscopic and Macroscopic Observations Of The Normal And Scmentioning

confidence: 99%

“…We focused on PFD as a potential treatment for VF scarring. First, we examined the antifibrotic effects of PFD (especially reductions in collagen expression and collagen gel contraction) using an in vitro ferret model of VF scarring that we developed previously . PFD exhibited promising antifibrotic effects in vitro.…”

Section: Introductionmentioning

confidence: 99%

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Effect of pirfenidone injection on ferret vocal fold scars: A preliminary in vivo study

et al. 2019

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Objectives This study examined the antifibrotic effect of pirfenidone (PFD), which has received regulatory approval in the United States and Japan for treatment of idiopathic pulmonary fibrosis, on the scarred ferret vocal fold (VF) in vivo. Methods Eight male ferrets were divided into two groups: saline and PFD. All animals underwent unilateral scarring under anesthesia. The right VF was electrocauterized with ablation of the entire lamina propria. PFD (1.0 mg/mL) or saline injections into right‐side scarred VFs were performed (under an operating microscope) 4 weeks later. After an additional 4 weeks, the larynges were harvested for histological analysis. Prior to harvesting, the ferrets were re‐anesthetized, and the VFs were observed and recorded using a rigid video laryngoscope. We immunohistochemically evaluated the expression of collagen types I and III, alpha‐smooth muscle actin (α‐SMA), and fibronectin in the entire lamina propria. We compared the affected areas (calculated using ImageJ software) between the treated (right) and untreated (left) sides within the same animals and between groups. Results Collagen type I (P = 0.0021) and α‐SMA (P = 0.0021) expression levels were lower in the PFD group, but the collagen type III and fibronectin levels did not differ significantly between the two groups. Conclusion PFD injection into the scarred VF is a potentially promising novel antifibrotic treatment. Level of Evidence NA Laryngoscope, 130:726–731, 2020

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Section: Discussionmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Endoscopic and Macroscopic Observations Of The Normal And Scmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of pirfenidone injection on ferret vocal fold scars: A preliminary in vivo study

et al. 2019

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Prevention of tracheal stenosis with pirfenidone after tracheotomy: An experimental study

Türkmen

Pata

2018

The Laryngoscope

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Objectives In this study, pirfenidone's role about reducing tracheal stenosis by suppressing fibrosis and inflammation was examined. Methods Tracheotomy was performed on 14 rats, and their cannulas were fixed to tracheotomy area by stoma suture. Two working groups were established. Rats in the first group were given 15 mg/kg/day (1 mL pirfenidone solution) pirfenidone intraperitoneally for 10 days. In the second group as a control group, 1 mL saline solution was applied intraperitoneally. Ten days later, rats were decanulated and kept alive for 3 more weeks. Anesthetized rats were sacrificed on day 30. All rat tracheas were resected between the first and seventh rings. Epithelial damage, inflammation, and fibrosis were determined histopathologically; diameters of intratracheal lumen and their mucosal thickness parameters were determined histomorphometrically; and TGFβ‐1 (the growth factor beta), TNFα (tumor necrosis factor alpha), and IL‐1β (Interleukin‐1 beta) values were determined immunohistochemically. Results According to the parameters of the control group, fibrosis; diameters of intratracheal lumen; and values of TGFβ‐1, TNFα, and IL‐1β were found to be statistically significant. Conclusion In our study, it was found that pirfenidone reduces fibrosis and narrowing of intratracheal lumen diameter significantly. Level of Evidence NA Laryngoscope, 129:E178–E186, 2019

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Duration of Clinical Response After In‐Office Steroid Injection for Vocal Fold Scar

et al. 2023

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ObjectiveTo assess the duration of clinical response after in‐office vocal fold steroid injection (VFSI) for vocal fold (VF) scar.MethodsDemographic and clinical data for in‐office VFSI occurring from 2017 to 2020 were collected. Two Speech‐Language Pathologists (SLPs) used perceptual evaluation of voice and functional scales to evaluate blinded voice and laryngovideostroboscopy (LVS) samples collected pre‐ and post‐injection across multiple timepoints.ResultsBlinded SLP ratings were used for 30 individual VFs undergoing initial injection in 18 patients. Persistent improvement in voice past 6 months was seen in 57% of patients after VFSI. Multiple measures of voice and amplitude, percent vibrating tissue, and closed phase predominance significantly improved at various follow‐up timepoints on average.ConclusionAccounting for patient heterogeneity and disease progression, in‐office VFSI for VF scar is associated with sustained improvement in a subset of patients. Approximately half of patients can expect to experience a lasting improvement in voice. Future studies of larger scale are required to identify patient factors associated with long‐term benefit.Level of Evidence4 Laryngoscope, 133:2333–2339, 2023

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Potential treatment for vocal fold scar with pirfenidone

Abstract: NA. Laryngoscope, 128:E171-E177, 2018.

Cited by 12 publications

References 21 publications

Effect of pirfenidone injection on ferret vocal fold scars: A preliminary in vivo study

Effect of pirfenidone injection on ferret vocal fold scars: A preliminary in vivo study

Prevention of tracheal stenosis with pirfenidone after tracheotomy: An experimental study

Duration of Clinical Response After In‐Office Steroid Injection for Vocal Fold Scar

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