Morphological Study of Cells and Extracellular Matrices in the Vocal Fold

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Expression of CD44 (a cell surface receptor for hyaluronic acid) and the distribution of hyaluronic acid were examined in the human vocal fold mucosa.Light microscopic investigation was carried out on 10 normal larynges of newborn, infant, younger and aged adult vocal fold mucosa using Alcian Blue staining, hyaluronidase digestion study and immunohistochemistry for CD44.Prior to the appearance of hyaluronic acid in the newborn vocal fold mucosa, CD44 was expressed on the stellate cells in the macula flava and on the fibroblasts in the Reinke' s space. During infancy, hyaluronic acid appeared and was distributed in the vocal fold mucosa. Many more stellate cells in the macula flava showed CD44 expression, and a large amount of hyaluronic acid was present around the infant stellate cells, however the fibroblasts in the Reinke' s space expressed little CD44. During adulthood, hyaluronic acid was distributed in the VFM. Almost all of the SCs in the MF showed CD44 expression, and much hyaluronic acid existed around the stellate cells in the adult macula flava. However fibroblasts in the adult Reinke' s space expressed little CD44, and hyaluronic acid density in that space was lower than that in the macula flava.Stellate cells in the macula flava and CD44 co-operatively play important roles in maintaining hyaluronic acid in the human vocal fold mucosa as a vibrating tissue.