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Stent-induced tracheal stenosis can be predicted by IL-8 expression in rabbits.

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2016-12-20

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Arellano-Orden, Elena
Serrano, Carolina
Montes-Worboys, Ana
Sánchez-López, Verónica
Laborda, Alicia
Lostalé, Fernando
Lahuerta, Celia
Rodríguez-Panadero, Francisco
de Gregorio, Miguel Ángel

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Abstract

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. 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. 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. 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.

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MeSH Terms

Alloys
Animals
Antineoplastic Agents
Cell Line
Drug-Eluting Stents
Epithelial Cells
Female
Fibroblasts
Humans
In Vitro Techniques
Interleukin-8
Kaplan-Meier Estimate
Paclitaxel
Prosthesis Design
Rabbits
Respiratory System
Stents
Tracheal Stenosis
Vitamin B 12

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Keywords

Cytokine, fibrosis, rabbits, stents, tracheal stenosis

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