Amelioration of Subglottic Stenosis by Antimicrobial Peptide Eluting Endotracheal Tubes

抗菌肽洗脱气管插管改善声门下狭窄

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作者:Matthew R Aronson, Amrita Mehta, Ryan M Friedman, Daniel D Ghaderi, Ryan C Borek, Hoang C B Nguyen, Kendra S McDaid, Ian N Jacobs, Natasha Mirza, Riccardo Gottardi

Conclusion

We developed an AMP-ET platform that reduces T cell and macrophage responses and reduces SGS in vivo via airway microbiome modulation.

Methods

We fabricated mouse-sized ETs coated with a polymeric AMP-eluting layer, quantified AMP release over 10 days, and validated bactericidal activity for both planktonic and biofilm-resident bacteria against Staphylococcus aureus and Pseudomonas aeruginosa. Ex vivo testing: we inserted AMP-ETs and ET controls into excised laryngotracheal complexes (LTCs) of C57BL/6 mice and assessed biofilm formation after 24 h. In vivo testing: AMP-ETs and ET controls were inserted in sham or SGS-induced LTCs, which were then implanted subcutaneously in receptor mice, and assessed for immune response and SGS severity after 7 days.

Results

We achieved reproducible, linear AMP release at 1.16 µg/day resulting in strong bacterial inhibition in vitro and ex vivo. In vivo, SGS-induced LTCs exhibited a thickened scar tissue typical of stenosis, while the use of AMP-ETs abrogated stenosis. Notably, SGS airways exhibited high infiltration of T cells and macrophages, which was reversed with AMP-ET treatment. This suggests that by modulating the microbiome, AMP-ETs reduce macrophage activation and antigen specific T cell responses resolving stenosis progression.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12195-023-00769-9.

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