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The cells in the human maculae flavae may be sensing the mechanical forces, and
these tissue-specific mechanical forces (vocal fold vibration) could promote cell
differentiation toward the phenotype of the cell residing within the vocal fold tissue.
However, little is known about how force affects biological signaling. It is suggested
that the combination of multiple mechanical and chemical factors may be involved
in more complicated signaling mechanisms and assessment of the relative impor-
tance of each factor needs further investigations.
9.16 Future Prospects
As a result of the latest research, there is growing evidence to suggest that the cells
in the human maculae flavae are adult multipotent stem cells, tissue stem cells or
progenitor cells in the human vocal fold mucosa and that the human maculae flavae
are a candidate for a stem cell niche.
Investigations concerning how to regulate these cells contained in the human
maculae flavae are challenging but important in the field of regenerative medicine of
the human vocal fold.
The manipulation, not only of cells, but also their microenvironment, is one of
the strategies in regenerative medicine. Artificial manipulations of these cells using
cutting-edge methods (e.g. via chemical biology) could lead to advanced develop-
ments in vocal fold regeneration. Understanding the mechanisms responsible for
microenvironmental regulation of the cells in the human maculae flavae will pro-
vide the tools needed to manipulate cells through their microenvironment for the
development of therapeutic approaches to diseases and tissue injuries of the vocal
fold. Translational medicine focused on how to regulate cells and extracellular
matrices (microenvironments) contained in the maculae flavae of the vocal folds
will contribute to our ability to restore and regenerate human vocal fold tissue.
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