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Immunological responses of laryngeal mucosa to short‐term endotracheal intubation
Author(s) -
Hughes O.R.,
Ayling S.M.,
Birchall M.A.
Publication year - 2008
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/j.1749-4486.2008.01747_18.x
Subject(s) - subglottis , medicine , larynx , intubation , glottis , pathology , alemtuzumab , surgery , transplantation
Objectives. Short‐term intubation (<4 h) is common in elective surgery and has been associated with post‐operative changes to the voice. Furthermore, short‐term endotracheal intubation is often used in microlaryngoscopy. Therefore research into laryngeal physiology requires an understanding of the changes to mucosal biology that result from intubation. Very little is known of the early cellular processes involved in laryngeal injury. We aim to establish how the cells of the innate immune system in the larynx are influenced by short‐term intubation. Methods. Biopsies were taken from the supraglottis and subglottis of five pairs of NIH minipigs fully matched at the major histocompatibility complex (MHC) locus. One of each pair was intubated 48 h prior to laryngeal biopsy; the other had not received previous intubation. Multiple‐colour immunofluorescence histology was used to quantify the numbers of immunologically active mucosal cells at each site. Results. At 48 h following endotracheal intubation, there was no significant difference ( P > 0.05) in total number of myeloid cells immunologically active in the supraglottic or subglottic mucosa. In the subglottis there was a small increase in the number of CD14+ and CD16+ cells in three out of four pairs following intubation; largest percentage increase in CD14+ and CD16+ expression between pairs was 74% ( P = 0.011) and 72% ( P = 0.007) respectively. Conclusions. At 48 h post‐intubation our results points to a continued innate immune response in the subglottis; this is consistent with previous histological and clinical studies that have identified the subglottis as the focus for post‐intubation injury. References. 1 Gould S.J. & Howard S. (1985) The histopathology of the larynx in the neonate following endotracheal intubation. J. Pathol. 146, 301–311 2 Beckford N.S., Mayo R., Wilkinson A. & Tierney M. (1990) Effects of short‐term endotracheal intubation on vocal function. Laryngoscope 100, 331–336