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Objective Investigate the impact of Surgery‐induced stress (SIS) on the normal airway repair process after airway reconstruction using a mouse microsurgery model, mass spectrometry (MS), and bioinformatic analysis. Methods Tracheal tissue from non‐surgical ( N = 3) and syngeneic tracheal grafts at 3 months post‐replacement ( N = 3) were assessed using mass spectrometry. Statistical analysis was done using MASCOT via Proteome Discoverer™. Proteins were categorized into total, dysregulated, suppressed, and evoked proteins in response to SIS. Dysregulated proteins were identified using cut‐off values of −1 1 and t ‐test ( p value <0.05). Enriched pathways were determined using STRING and Metascape. Results At the three‐month post‐operation mark, we noted a significant increase in submucosal cellular infiltration (14343 ± 1286 cells/mm 2 , p = 0.0003), despite reduced overall thickness (30 ± 3 μm, p = 0.01), compared to Native (4578 ± 723 cells/mm 2 ; 42 ± 6 μm). Matrisome composition remained preserved, with proteomic analysis identifying 193 commonly abundant proteins, encompassing 7.2% collagens, 34.2% Extracellular matrix (ECM) glycoproteins, 6.2% proteoglycans, 33.2% ECM regulators, 14.5% Extracellular matrix‐affiliated, and 4.7% secreted factors. Additionally, our analysis unveiled a unique proteomic signature of 217 “Surgery‐evoked proteins” associated with SIS, revealing intricate connections among neutrophils, ECM remodeling, and vascularization through matrix metalloproteinase‐9 interaction. Conclusions Our study demonstrated the impact of SIS on the extracellular matrix, particularly MMP9, after airway reconstruction. The novel identification of MMP9 prompts further investigation into its potential role in repair. Level of Evidence NA Laryngoscope , 134:4052–4059, 2024
Calyeca et al. (Tue,) studied this question.