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Stent‐induced tracheal stenosis can be predicted by IL ‐8 expression in rabbits
Author(s) -
ArellanoOrden Elena,
Serrano Carolina,
MontesWorboys Ana,
SánchezLópez Verónica,
Laborda Alicia,
Lostalé Fernando,
Lahuerta Celia,
RodríguezPanadero Francisco,
Gregorio Miguel Ángel
Publication year - 2017
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12706
Subject(s) - stent , medicine , stenosis , in vivo , tracheal stenosis , granulation tissue , inflammation , venous blood , bare metal stent , paclitaxel , restenosis , pathology , radiology , surgery , drug eluting stent , chemotherapy , biology , wound healing , microbiology and biotechnology
Background Bare metal stents may cause complications like fibrous encapsulation, granulation and tracheal stenosis. We investigated the behaviour of three commercially available stents in vivo (rabbits) and in vitro (coculture of those stents with epithelial and fibroblast cell lines). Also, we investigated whether development of tracheal stenosis could be predicted by any biological marker. Materials and methods The tracheae of 30 rabbits were implanted with either nitinol stents, with or without paclitaxel elution, or a cobalt‐based stent. An additional ten rabbits underwent mock implantation (controls). Serial peripheral venous blood samples were taken throughout the study, and several cytokines measured. Animals were euthanized on day 90, with immediate tracheal endoscopy and lavage performed, then necropsy. Results Rabbits with cobalt‐based stent exhibited more inflammation and the highest stenosis incidence, with reduced survival. Both in vivo and in vitro, this stent induced higher IL ‐8 levels than nitinol stents. Most important, the presence of stent‐induced tracheal stenosis was closely associated to increase in IL ‐8 expression in blood just 1 day after tracheal stent implantation: a 1·19‐fold increase vs. baseline had 83% sensitivity, 83% specificity, 77% positive predictive value, 88% negative predictive value and 83% accuracy to predict development of stenosis. Conclusions The cobalt‐based stent had the highest incidence of tracheal inflammation and stenosis. On the other hand, the paclitaxel‐eluting nitinol stent did not prevent those complications and provoked a marked reaction compared with the bare nitinol stent. Early increase in IL ‐8 expression in blood after stent implantation could predict development of tracheal stenosis in rabbits.