The Role of Cytokines in Modulating Vocal Fold Fibrosis: A Contemporary Review

Laryngoscope. 2021 Jan;131(1):139-145. doi: 10.1002/lary.28507. Epub 2020 Apr 15.

Abstract

Objectives: Vocal fold (VF) scarring and laryngeal stenosis are a significant clinical challenge. Excessive scar formation causes low voice quality or even life-threatening obstructions. Cytokines are thought to modulate multiple steps of the establishment of VF fibrosis, but there is no systematic report regarding their role in modulating VF fibrosis. This review aims to investigate the role of cytokines in modulating vocal fold fibrosis.

Study design: Literature review.

Methods: This review searched for all relevant peer publications in English for the period 2009 to 2019 in the PubMed database using search terms: "laryngeal stenosis," "vocal fold scarring," and "cytokines." A thorough investigation of the methods and results of the reviewed studies was performed.

Results: Comprehensive research in various studies, including analyses of prostaglandin E2 (PGE2), granulocyte-macrophage colony-stimulating factor (GM-CSF), hepatocyte growth factor (HGF), basic fibroblast growth factor (bFGF), transforming growth factor-β3 (TGF-β3), and interleukin-10 (IL-10), supports cytokine therapy for VF scarring and laryngeal stenosis to some extent. A few clinical studies on this topic support the conclusion that HGF and bFGF can be selected as effective drugs, and no serious side effects were found.

Conclusions: This review describes the potential of cytokines for modulating the process of VF fibrogenesis, although cytokines are still an unproven treatment method. As no ideal drugs exist, cytokines may be considered the candidate treatment for preventing VF fibrogenesis. Laryngoscope, 131:139-145, 2021.

Keywords: Cytokines; antifibrotic effect; laryngeal stenosis; vocal fold scarring; wound healing.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cicatrix / etiology*
  • Cytokines / physiology*
  • Fibroblast Growth Factor 2 / therapeutic use
  • Fibrosis / drug therapy
  • Fibrosis / etiology
  • Hepatocyte Growth Factor / therapeutic use
  • Humans
  • Laryngeal Diseases / drug therapy
  • Laryngeal Diseases / etiology*
  • Vocal Cords / pathology*

Substances

  • Cytokines
  • Fibroblast Growth Factor 2
  • Hepatocyte Growth Factor