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Scaffold-Forming Collagen and Motor-Endplate Expressing Muscle Cells for Porcine Laryngoplasty
Elizabeth O Shay1, Rachel A Morrison2, Lujuan Zhang1
1Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
The Laryngoscope
|July 16, 2024
Summary
Injectable collagen with muscle cells shows promise for treating vocal fold paralysis by increasing muscle volume and promoting nerve regeneration. This novel therapy offers hope for improving quality of life in patients with this condition.
Area of Science:
- Regenerative Medicine
- Otolaryngology
- Biomaterials Science
Background:
- Vocal fold paralysis significantly impacts quality of life.
- Current injectable therapies for vocal fold paralysis are limited.
- Recurrent laryngeal nerve (RLN) regeneration is crucial for restoring vocal fold function.
Purpose of the Study:
- To evaluate a novel in situ polymerizing collagen scaffold for vocal fold medialization.
- To assess the efficacy of collagen combined with muscle-derived motor-endplate expressing cells (MEEs) in promoting RLN regeneration.
- To investigate the therapeutic potential in a porcine model of unilateral vocal fold paralysis.
Main Methods:
- Unilateral RLN transection was performed in 12 Yucatan minipigs.
- Autologous muscle progenitor cells were differentiated into MEEs.
- Injections of collagen, collagen with MEEs, or saline were administered into the paralyzed vocal fold.
- Functional assessments included laryngeal electromyography and acoustic vocalization.
- Histologic and gene expression analyses were conducted.
Main Results:
- Collagen scaffold injections were well-tolerated and immunotolerant.
- Collagen with MEEs significantly increased laryngeal adductor muscle volume.
- Gene expression analysis revealed upregulation of neurotrophic, motor-endplate, and myogenic factors.
- MEEs remained viable within the collagen scaffold.
Conclusions:
- In situ polymerizing collagen, with or without MEEs, enhanced vocal fold muscle volume in a porcine model.
- The treatment modulated key neurotrophic and myogenic gene expression.
- No adverse immune responses were observed, indicating material safety.
- Further research is required to determine long-term functional outcomes.
