Phlorotannin-combined photobiomodulation for prevention of tracheal stomal stenosis post-tracheostomy: in-vitro and in-vivo evaluations

Yeachan Lee; Hyoung Shin Lee; Hyeonsoo Kim; Hyun Wook Kang

doi:10.1117/12.2626052

11 January 2022 Phlorotannin-combined photobiomodulation for prevention of tracheal stomal stenosis post-tracheostomy: in-vitro and in-vivo evaluations

Yeachan Lee, Hyoung Shin Lee, Hyeonsoo Kim, Hyun Wook Kang

Author Affiliations +

Proceedings Volume 12159, SPIE Advanced Biophotonics Conference (SPIE ABC 2021); 121590D (2022) https://doi.org/10.1117/12.2626052
Event: SPIE Advanced Biophotonics Conference (SPIE ABC 2021), 2021, Busan, Republic of Korea

Abstract

Tracheal stomal stenosis is the most common complication that exists in patients after tracheostomy and prolonged intubation due to inflammatory and fibrotic responses. Various surgical techniques, such as Y-V and two circular incisions, have been attempted to minimize the stenosis. However, the current incision methods still have a risk of infection related to the enlarged stoma. The aim of this study is to develop a novel combined treatment of photobiomodulation (PBM) and phlorotannin (PT) to prevent the stenosis after tracheostomy. The therapeutic effect of the combined treatment was evaluated in tracheal fibroblast and the tracheostomy-developed rodent models. A 405 nm wavelength light was applied for PBM in a continuous-wave mode after treatment with Ecklonia cava-derived PT. MTT assay and western blot analysis showed that 12 J/cm² of PBM and 100 μg/ml of PT were an insignificant cytotoxicity (less than 20%). The combined treatment significantly inhibited cell migration (51.7%) and suppressed the expressions of alpha-smooth muscle actin (38.3%) and type-1 collagen (54.2%) due to the downregulation of SMAD 2/3 and MAPK signalling pathways. In vivo tests confirmed that control group showed obstruction by tissue granulation in the incised tissue seven days after tracheostomy, whereas the combined group still maintained the stoma with minimal fibrosis. The current study demonstrated that PT-combined PBM could minimize the tracheal stomal stenosis in fibrotic conditions as a result of modulated fibrotic responses. Therefore, the combination of PBM and PT can warrant an effective prevention of the tracheal stomal stenosis post-tracheostomy.

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Yeachan Lee, Hyoung Shin Lee, Hyeonsoo Kim, and Hyun Wook Kang "Phlorotannin-combined photobiomodulation for prevention of tracheal stomal stenosis post-tracheostomy: in-vitro and in-vivo evaluations", Proc. SPIE 12159, SPIE Advanced Biophotonics Conference (SPIE ABC 2021), 121590D (11 January 2022); https://doi.org/10.1117/12.2626052

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KEYWORDS

Tissues

In vitro testing

Collagen

Medical research

Modulation

Biomedical engineering

Biomedical optics

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