Synergistic effects of silver nanoparticles and cisplatin in combating inflammation and hyperplasia of airway stents

Anti-inflammatory and antihyperplasia activities are essential requirements for the successful use of airway stents.In this work,silver nanoparticles(AgNPs)and cisplatin(DDP)were combined in a synergistic modification strategy to improve the surface function of airway stents.Using polycaprolactone(PCL)as a drug carrier,a dual-functional PCL-AgNPs-DDP fiber film-coated airway stent was fabricated by electrospinning.The physicochemical and biological properties of the obtained fiber films were examined.The ATR-FTIR,XPS,SEM-EDS and TEM results suggested that AgNPs and DDP could be successfully immobilized onto the airway stent surface.The drug release and surface degradation results revealed that AgNPs and DDP can undergo sustained release from films for 30 d,and the weight loss was approximately 50%after 35 d.In addition,the dual-functional fiber film suppressed human embryonic lung fibroblast growth and exhibited excellent antibacterial activity against Staphylococcus aureus,Pseudomonas aeruginosa and Candida albicans.Furthermore,the effectiveness of the dual-functional fiber film-coated airway stent was evaluated by application to the trachea of New Zealand rabbits.The in vivo results indicated that PCL-AgNPs-DDP fiber film-coated airway stent can significantly inhibit granulation tissue formation and collagen deposition,reduced the expression of IL-8,TNF-α,IL-1α,PCNA,α-SMA and CD68,and ultimately achieved anti-inflammatory and antihyperplasia effects.Hence,this study provides a dual-functional surface-coated airway stent to address the clinical complications associated with respiratory tract inflammation and granulation tissue hyperplasia,thus inhibiting tracheal stenosis.

Clinical Comparison of Airway Stent Placement in Intervention Room and Operating Room

Background and objective Airway stent placement is the effective regimen for central airway obstruction(CAO),while its application scenarios varied.This study aimed to make clinical comparison of airway stent placement in the intervention room and operating room.Methods Patients underwent airway stent placement between 2014 and 2018 were included in this retrospective case-control study.Clinical performance of airway stent placement in intervention room and operating room were compared.Results 82 patients were included in this study,including 39 in the intervention room and 43 in the operating room.Patients treated in the intervention room had lower Charlson comorbidity index(CCI)(P=0.018)and received less Y-shaped stents(P<0.001).Better clinical response(P=0.026),more stents placed(P<0.001)and longer length of stent(P<0.001)were observed in operating room,while there was no significantly statistical difference of stent-related complications and post-stent survival rate between the two groups.Extracorporeal membrane oxygenation(ECMO)supported airway stent placement procedures were performed in the operating room,which provided definitive safety support for high-risk intervention.Conclusion Patients with CAO could benefit from the operating room scenario,and airway stent placement in the operating room is more suitable for patients with higher CCI scores and receiving more complicated procedures.