Airway stenosis: classification, pathogenesis, and clinical management

Area of Science:

• Pulmonary Medicine
• Pathology
• Biomedical Engineering

Background:

• Airway stenosis (AS) is a fibroinflammatory condition involving abnormal fibroblast activation and extracellular matrix deposition.
• Current treatments for AS, including surgery and adjuvant therapies, have limitations, especially for recurrent cases.
• Urgent need exists to elucidate AS pathogenesis for improved clinical management.

Purpose of the Study:

• To review the classification and pathogenesis of airway stenosis.
• To explore preclinical treatments targeting identified disease mechanisms.
• To summarize current clinical management strategies for AS.

Main Methods:

• Literature review of pathogenesis mechanisms (fibrosis, inflammation, EMT, metabolic reprogramming, microbiome, genetics).
• Analysis of preclinical treatment modalities (drug, gene, stem cell, growth factor, protein, photodynamic therapy).
• Examination of current clinical management approaches.

Main Results:

• AS pathogenesis involves multiple interconnected pathways including fibrosis, inflammation, and epithelial-mesenchymal transition.
• Diverse preclinical treatments show promise by targeting specific pathogenic mechanisms.
• Current clinical management often relies on invasive procedures with limited efficacy for recurrent disease.

Conclusions:

• A comprehensive understanding of AS pathogenesis is crucial for advancing treatment options.
• Targeted therapies based on elucidated mechanisms offer potential for improved AS management.
• Future research should integrate multi-omics approaches like single-cell sequencing to uncover cellular and microbial interactions in AS.