Local expression of hormone receptors seems to play a role in the genesis of idiopathic tracheal stenosis

Abstract

Objectives: Tracheal stenosis in adults usually is the result of mechanical injuries either from direct trauma, tracheotomy or intubation. Idiopathic stenosis in the cricotracheal section is a more rare condition and occurs almost exclusively in females. Therefore an influence of the female sexual hormones estrogen and progesterone has been assumed previously. Methods: We performed a retrospective immunohistochemical staining of our tracheal specimens concerning the hormone receptor status of progesterone and estrogen. Between 2008 and 2016 nineteen patients (5 males, mean age 68 years; 14 females, mean age 55 years) underwent a tracheal or cricotracheal resection due to a subglottic posttracheotomy (11), postintubation (1) or idiopathic (7) stenosis in our clinic. Results: While posttracheotomy stenosis occured in males (6) as well as in females (5), none of the idiopathic stenosis patients were male. All of the idiopathic stenosis showed a strong expression of the progesterone and estrogen receptors in the fibroblasts, while only in one of the seven female posttracheotomy patients a slight staining was seen. None of the male patients showed any expression of the hormone receptors. Conclusion: Although our number of patients is small our results show that the expression of female sexual hormone receptors in the fibroblasts of the trachea is a persistent finding in idiopathic tracheal stenosis. The role of the intake of contraceptives or other hormone products as a predisposing factor for developing a stenosis should be further investigated.