AUTOIMMUNE HYPOTHESIS OF ACQUIRED SUBGLOTTIC STENOSIS - LACK OF SUPPORT AT TIME OF SURGICAL REPAIR IN CHILDREN

Numerous mechanisms have been suggested for the development of subglot tic stenosis. This study sought serum antibody and cricoid cartilage i mmunohistologic evidence of an autoimmune process. The autoimmune hypo thesis is that subglottic inflammation may extend into the cricoid car tilage, degrade the extracellular matrix and expose normally-sequester ed type II collagen to the afferent arm of the immune system. The resu ltant anti-collagen antibodies are hypothesized to contribute to furth er injury and scarring. Specimens were obtained from 10 patients. Immu nofluorescent stains for antibodies in histologic specimens, and serum antibodies to type II and type IX collagen were sought. No evidence f or an autoimmune process was found in these specimens with the techniq ues used. The negative findings may be attributable to the autoimmune process being inactive at the mature stage of the disease in the patie nts studied. Copyright (C) 1997 Elsevier Science Ireland Ltd.