Meridional overturning circulation conveys fast acidification to the deep Atlantic Ocean.

Since the Industrial Revolution, the North Atlantic Ocean has been accumulating anthropogenic carbon dioxide (CO2) and experiencing ocean acidification, that is, an increase in the concentration of hydrogen ions (a reduction in pH) and a reduction in the concentration of carbonate ions. The latter causes the 'aragonite saturation horizon'-below which waters are undersaturated with respect to a particular calcium carbonate, aragonite-to move to shallower depths (to shoal), exposing corals to corrosive waters. Here we use a database analysis to show that the present rate of supply of acidified waters to the deep Atlantic could cause the aragonite saturation horizon to shoal by 1,000-1,700 metres in the subpolar North Atlantic within the next three decades. We find that, during 1991-2016, a decrease in the concentration of carbonate ions in the Irminger Sea caused the aragonite saturation horizon to shoal by about 10-15 metres per year, and the volume of aragonite-saturated waters to reduce concomitantly. Our determination of the transport of the excess of carbonate over aragonite saturation (xc[CO32-])-an indicator of the availability of aragonite to organisms-by the Atlantic meridional overturning circulation shows that the present-day transport of carbonate ions towards the deep ocean is about 44 per cent lower than it was in preindustrial times. We infer that a doubling of atmospheric anthropogenic CO2 levels-which could occur within three decades according to a 'business-as-usual scenario' for climate change-could reduce the transport of xc[CO32-] by 64-79 per cent of that in preindustrial times, which could severely endanger cold-water coral habitats. The Atlantic meridional overturning circulation would also export this acidified deep water southwards, spreading corrosive waters to the world ocean.

Global Ocean Spectrophotometric pH Assessment: Consistent Inconsistencies.

Ocean acidification (OA)-or the decrease in seawater pH resulting from ocean uptake of CO2 released by human activities-stresses ocean ecosystems and is recognized as a Climate and Sustainable Development Goal Indicator that needs to be evaluated and monitored. Monitoring OA-related pH changes requires a high level of precision and accuracy. The two most common ways to quantify seawater pH are to measure it spectrophotometrically or to calculate it from total alkalinity (TA) and dissolved inorganic carbon (DIC). However, despite decades of research, small but important inconsistencies remain between measured and calculated pH. To date, this issue has been circumvented by examining changes only in consistently measured properties. Currently, the oceanographic community is defining new observational strategies for OA and other key aspects of the ocean carbon cycle based on novel sensors and technologies that rely on validation against data records and/or synthesis products. Comparison of measured spectrophotometric pH to calculated pH from TA and DIC measured during the 2000s and 2010s eras reveals that (1) there is an evolution toward a better agreement between measured and calculated pH over time from 0.02 pH units in the 2000s to 0.01 pH units in the 2010s at pH > 7.6; (2) a disagreement greater than 0.01 pH units persists in waters with pH < 7.6, and (3) inconsistencies likely stem from variations in the spectrophotometric pH standard operating procedure (SOP). A reassessment of pH measurement and calculation SOPs and metrology is urgently needed.

Decadal acidification in the water masses of the Atlantic Ocean.

Global ocean acidification is caused primarily by the ocean's uptake of CO2 as a consequence of increasing atmospheric CO2 levels. We present observations of the oceanic decrease in pH at the basin scale (50 °S-36 °N) for the Atlantic Ocean over two decades (1993-2013). Changes in pH associated with the uptake of anthropogenic CO2 (ΔpHCant) and with variations caused by biological activity and ocean circulation (ΔpHNat) are evaluated for different water masses. Output from an Institut Pierre Simon Laplace climate model is used to place the results into a longer-term perspective and to elucidate the mechanisms responsible for pH change. The largest decreases in pH (∆pH) were observed in central, mode, and intermediate waters, with a maximum ΔpH value in South Atlantic Central Waters of -0.042 ± 0.003. The ΔpH trended toward zero in deep and bottom waters. Observations and model results show that pH changes generally are dominated by the anthropogenic component, which accounts for rates between -0.0015 and -0.0020/y in the central waters. The anthropogenic and natural components are of the same order of magnitude and reinforce one another in mode and intermediate waters over the time period. Large negative ΔpHNat values observed in mode and intermediate waters are driven primarily by changes in CO2 content and are consistent with (i) a poleward shift of the formation region during the positive phase of the Southern Annular Mode in the South Atlantic and (ii) an increase in the rate of the water mass formation in the North Atlantic.

A robust PCR for the differentiation of potential virulent strains of Haemophilus parasuis.

BACKGROUND: Haemophilus parasuis is the etiological agent of Glässer's disease in swine. H. parasuis comprises strains with heterogeneous virulence capacity, from non-virulent to highly virulent. Determination of the pathogenic potential of the strains is important for diagnosis and disease control. The virulence-associated trimeric autotransporters (vtaA) genes have been used to predict H. parasuis virulence by PCR amplification of their translocator domains. Here, we report a new and improved PCR designed to detect a different domain of the vtaA genes, the leader sequence (LS) as a diagnostic tool to predict virulence. METHODS: A collection of 360 H. parasuis strains was tested by PCR with LS specific primers. Results of the PCR were compared with the clinical origin of the strains and, for a subset of strains, with their phagocytosis and serum resistance using a Chi-square test. RESULTS: LS-PCR was specific to H. parasuis, and allowed the differential detection of the leader sequences found in clinical and non-clinical isolates. Significant correlation was observed between the results of the LS-PCR and the clinical origin (organ of isolation) of the strains, as well as with their phagocytosis and serum susceptibility, indicating that this PCR is a good predictor of the virulence of the strains. In addition, this new PCR showed a full correlation with the previously validated PCR based on the translocator domain. LS-PCR could be performed in a wide range of annealing temperatures without losing specificity. CONCLUSION: This newly described PCR based on the leader sequence of the vtaA genes, LS-PCR, is a robust test for the prediction of the virulence potential of H. parasuis strains.

Relationship between circulating anti-thyroglobulin antibodies (TgAb) and tumor metabolism in patients with differentiated thyroid cancer (DTC): prognostic implications.

PURPOSE: TgAb have been proposed as tumor markers in DTC. Recent evidence links TgAb levels with DTC aggressiveness. We aimed to evaluate the relationship between TgAb and tumor glucose metabolism in DTC patients. METHODS: Seventy-one DTC patients who underwent 18F-FDG PET/CT were included. According to TgAb value and trends, patients were divided into TgAb positive (TgAb+) or negative (TgAb-) as well as in patients with increasing (Inc-TgAb) or decreasing (Dec-TgAb) trend. On the basis of the results of FDG-PET, post-therapy 131I and Tg levels, patients were divided into two groups according to the evidence (ED) or absence (NED) of disease. ED patients were further divided into three subgroups: 1. radioiodine avid with positive 18F-FDG PET/CT (PET+/131I+), 2. radioiodine refractory with positive 18F-FDG PET/CT (PET+/131I-) and 3. radioiodine avid with negative 18F-FDG PET/CT (PET-/131I+). MeanSUV of FDG-avid lesions was assessed and averaged for each patient (SUVmean-pt). T test was performed to assess the difference between SUVmean in TgAb-, TgAb+ and in Inc-TgAb and Dec-TgAb subgroups. Difference in TgAb between ED and NED patients as well as between ED patients and PET+/131I+, PET+/131I- and PET-/131I+ subgroups was compared. RESULTS: SUVmean was significantly higher in Inc-TgAb with respect to Dec-TgAb subgroup (5.2 ± 1.5 vs. 2.9 ± 1.1, p < 0.05). TgAb were higher only in the ED PET+/131I+ subgroup with respect to NED patients (p < 0.01). CONCLUSIONS: The relationship between higher tumor metabolism and trend of TgAb supports a prognostic relevance of TgAb in DTC patients. Significantly higher TgAb in radioiodine avid tumors with positive 18F-FDG PET/CT further testify the role of TgAb as surrogate tumor marker in DTC.

Spectrophotometric Measurements of the Carbonate Ion Concentration: Aragonite Saturation States in the Mediterranean Sea and Atlantic Ocean.

Measurements of ocean pH, alkalinity, and carbonate ion concentrations ([CO3(2-)]) during three cruises in the Atlantic Ocean and one in the Mediterranean Sea were used to assess the reliability of the recent spectrophotometric [CO3(2-)] methodology and to determine aragonite saturation states. Measurements of [CO3(2-)] along the Atlantic Ocean showed high consistency with the [CO3(2-)] values calculated from pH and alkalinity, with negligible biases (0.4 ± 3.4 µmol·kg(-1)). In the warm, salty, high alkalinity and high pH Mediterranean waters, the spectrophotometric [CO3(2-)] methodology underestimates the measured [CO3(2-)] (4.0 ± 5.0 µmol·kg(-1)), with anomalies positively correlated to salinity. These waters also exhibited high in situ [CO3(2-)] compared to the expected aragonite saturation. The very high buffering capacity allows the Mediterranean Sea waters to remain over the saturation level of aragonite for long periods of time. Conversely, the relatively thick layer of undersaturated waters between 500 and 1000 m depths in the Tropical Atlantic is expected to progress to even more negative undersaturation values. Moreover, the northern North Atlantic presents [CO3(2-)] slightly above the level of aragonite saturation, and the expected anthropogenic acidification could result in reductions of the aragonite saturation levels during future decades, acting as a stressor for the large population of cold-water-coral communities.

Anthropogenic carbon pathways towards the North Atlantic interior revealed by Argo-O2, neural networks and back-calculations.

The subpolar North Atlantic (SPNA) is a region of high anthropogenic CO2 (Cant) storage per unit area. Although the average Cant distribution is well documented in this region, the Cant pathways towards the ocean interior remain largely unresolved. We used observations from three Argo-O2 floats spanning 2013-2018 within the SPNA, combined with existing neural networks and back-calculations, to determine the Cant evolution along the float pathways from a quasi-lagrangian perspective. Our results show that Cant follows a stepwise deepening along its way through the SPNA. The upper subtropical waters have a stratified Cant distribution that homogenizes within the winter mixed layer by Subpolar Mode Water formation in the Iceland Basin. In the Irminger and Labrador Basins, the high-Cant footprint (> 55 µmol kg-1) is mixed down to 1400 and 1800 dbar, respectively, by deep winter convection. As a result, the maximum Cant concentration is diluted (<45 µmol kg-1). Our study highlights the role of water mass transformation as a first-order mechanism for Cant penetration into the ocean. It also demonstrates the potential of Argo-O2 observations, combined with existing methods, to obtain reliable Cant estimates, opening ways to study the oceanic Cant content at high spatio-temporal resolution.

Nudibranch predation boosts sponge silicon cycling.

Diatoms play a key role in the marine silica cycle, but recent studies have shown that sponges can also have an important effect on this dynamic. They accumulate large stocks of biogenic silica within their bodies over long periods, which are thought to vary little on an intra-annual scale. The observation of an abrupt decline in sponge biomass in parallel with large increases in abundance of a spongivorous nudibranch (Doris verrucosa) led us to conduct a year-long study on the effect of nudibranch predation on the silicon budget of a sponge (Hymeniacidon perlevis) population. After 5 months of predation, the abundance of sponge individuals did not change but their biomass decreased by 95%, of which 48% was explained by nudibranch predation. About 97% of sponge spicules ingested by nudibranchs while feeding was excreted, most of them unbroken, implying a high rate of sponge silica deposition in the surrounding sediments. After predation, sponges partially recovered their biomass stocks within 7 months. This involved a rapid growth rate and large assimilation of dissolved silicon. Surprisingly, the highest rates of silicon absorption occurred when dissolved silicon concentration in seawater was minimal (< 1.5 µM). These findings suggest that the annual sponge predation-recovery cycle triggers unprecedented intra-annual changes in sponge silicon stocks and boosts the cycling of this nutrient. They also highlight the need for intra-annual data collection to understand the dynamics and resilience of sponge ecosystem functioning.

Spatial and temporal variation of methane emissions in the coastal Balearic Sea, Western Mediterranean.

Methane (CH4) gas is the most important GHG after carbon dioxide, with open ocean areas acting as discreet CH4 sources and coastal regions as intense but variable CH4 sources to the atmosphere. Here, we report CH4 concentrations and air-sea fluxes in the coastal area of the Balearic Islands Archipelago (Western Mediterranean Basin). CH4 levels and related biogeochemical variables were measured in three coastal sampling sites between 2018 and 2021, with two located close to the densely populated island of Mallorca and one in a pristine area in the Cabrera Archipelago National Park. CH4 concentrations in seawater during the study period ranged from 2.7 to 10.9 nM, without significant differences between the sampling sites. Averaged estimated CH4 fluxes during the sampling period for the three stations oscillated between 0.2 and 9.7 µmol m-2 d-1 according to a seasonal pattern and in general all sites behaved as weak CH4 sources throughout the sampling period.

Regulatory cross-talk of mouse liver polyamine and methionine metabolic pathways: a systemic approach to its physiopathological consequences.

Both polyamines and methionine derivatives are nitrogen compounds directly related to the regulation of gene expression. In silico predictions and experimental evidence suggest a cross-talk between polyamine and methionine metabolism in mammalian tissues. Since liver is the major organ that controls nitrogen metabolism of the whole organism, it is the best tissue to further test this hypothesis in vivo. In this work, we studied the effects of the chronic administration of a methionine-supplemented diet (0.5% Met in drinking water for 5 months) on the liver of mice (designated as MET-mice). Metabolic and proteomic approaches were performed and the data obtained were subjected to biocomputational analysis. Results showed that a supplemental methionine intake can indeed regulate biogenic amine metabolism in an in vivo model by multiple mechanisms including metabolic regulation and specific gene demethylation. Furthermore, putative systemic effects were investigated by molecular and cellular biology methods. Among other results, altered expression levels of multiple inflammation and cell proliferation/death balance markers were found and macrophage activation was observed. Overall, the results presented here will be of interest across a variety of biomedical disciplines, including nutrition, orphan diseases, immunology and oncology.

Distant supervision for imaging-based cancer sub-typing in Intrahepatic Cholangiocarcinoma.

Finding effective ways to perform cancer sub-typing is currently a trending research topic for therapy opti-mization and personalized medicine. Stemming from genomic field, several algorithms have been proposed. In the context of texture analysis, limited efforts have been attempted, yet imaging information is known to entail useful knowledge for clinical practice. We propose a distant supervision model for imaging-based cancer sub-typing in Intrahepatic Cholangiocar-cinoma patients. A clinically informed stratification of patients is built and homogeneous groups of patients are characterized in terms of survival probabilities, qualitative cancer variables and radiomic feature description. Moreover, the contributions of the information derived from the ICC area and from the peri tumoral area are evaluated. The findings suggest the reliability of the proposed model in the context of cancer research and testify the importance of accounting for data coming from both the tumour and the tumour-tissue interface. Clinical relevance - In order to accurately predict cancer prognosis for patients affected by ICC, radiomic variables of both core cancer and surrounding area should be exploited and employed in a model able to manage complex information.

pH trends and seasonal cycle in the coastal Balearic Sea reconstructed through machine learning.

The decreasing seawater pH trend associated with increasing atmospheric carbon dioxide levels is an issue of concern due to possible negative consequences for marine organisms, especially calcifiers. Globally, coastal areas represent important transitional land-ocean zones with complex interactions between biological, physical and chemical processes. Here, we evaluated the pH variability at two sites in the coastal area of the Balearic Sea (Western Mediterranean). High resolution pH data along with temperature, salinity, and also dissolved oxygen were obtained with autonomous sensors from 2018 to 2021 in order to determine the temporal pH variability and the principal drivers involved. By using environmental datasets of temperature, salinity and dissolved oxygen, Recurrent Neural Networks were trained to predict pH and fill data gaps. Longer environmental time series (2012-2021) were used to obtain the pH trend using reconstructed data. The best predictions show a rate of [Formula: see text] pH units year[Formula: see text], which is in good agreement with other observations of pH rates in coastal areas. The methodology presented here opens the possibility to obtain pH trends when only limited pH observations are available, if other variables are accessible. Potentially, this could be a way to reliably fill the unavoidable gaps present in time series data provided by sensors.

Anthropogenic CO2 and ocean acidification in Argentine Basin Water Masses over almost five decades of observations.

The chemical conditions of the Argentine Basin (western South Atlantic Ocean) water masses are evaluated with measurements from eleven hydrographic cruises to detect and quantify anthropogenic and natural stressors in the ocean carbon system. The database covers almost half-century (1972-2019), a time-span where the mean annual atmospheric carbon dioxide concentration (CO2atm) increased from 325 to 408 ppm of volume (ppm). This increase of atmospheric CO2 (83 ppm, the 64% of the total anthropogenic signal in the atmosphere) leads to an increase in anthropogenic carbon (Cant) across all the water column and the consequent ocean acidification: a decrease in excess carbonate that is unequivocal in the upper (South Atlantic Central Water, SACW) and intermediate water masses (Sub Antarctic Mode Water, SAMW and Antarctic Intermediate Water, AAIW). For each additional ppm in CO2atm the water masses SACW, SAMW and AAIW lose excess carbonate at a rate of 0.39 ± 0.04, 0.47 ± 0.05 and 0.23 ± 0.03 µmol·kg-1·ppm-1 respectively. Modal and intermediate water masses in the Argentine Basin are very sensitive to carbon increases due low buffering capacity. The large rate of AAIW acidification is the synergic effect of carbon uptake combined with deoxygenation and increased remineralization of organic matter. If CO2 emissions follows the path of business-as-usual emissions (SSP 5.85), SACW would become undersaturated with respect to aragonite at the end of the century. The undersaturation in AAIW is virtually unavoidable.

Contrasting drivers and trends of ocean acidification in the subarctic Atlantic.

The processes of warming, anthropogenic CO2 (Canth) accumulation, decreasing pHT (increasing [H+]T; concentration in total scale) and calcium carbonate saturation in the subarctic zone of the North Atlantic are unequivocal in the time-series measurements of the Iceland (IS-TS, 1985-2003) and Irminger Sea (IRM-TS, 1983-2013) stations. Both stations show high rates of Canth accumulation with different rates of warming, salinification and stratification linked to regional circulation and dynamics. At the IS-TS, advected and stratified waters of Arctic origin drive a strong increase in [H+]T, in the surface layer, which is nearly halved in the deep layer (44.7 ± 3.6 and 25.5 ± 1.0 pmol kg-1 yr-1, respectively). In contrast, the weak stratification at the IRM-TS allows warming, salinification and Canth uptake to reach the deep layer. The acidification trends are even stronger in the deep layer than in the surface layer (44.2 ± 1.0 pmol kg-1 yr-1 and 32.6 ± 3.4 pmol kg-1 yr-1 of [H+]T, respectively). The driver analysis detects that warming contributes up to 50% to the increase in [H+]T at the IRM-TS but has a small positive effect on calcium carbonate saturation. The Canth increase is the main driver of the observed acidification, but it is partially dampened by the northward advection of water with a relatively low natural CO2 content.

The Mediterranean mussel Mytilus galloprovincialis: responses to climate change scenarios as a function of the original habitat.

The impact of simulated seawater acidification and warming conditions on specimens of the mussel Mytilus galloprovincialis locally adapted to very distinct, widely separated sites in the Mediterranean Sea (Tunisia) and Atlantic Sea (Galicia, NW Spain) was evaluated in relation to key behavioural and eco-physiological parameters. Over the 2-month exposure to the experimental conditions, mussels were fed optimally to ensure that there are no synergistic interactions between climate change drivers and energetic status of the individuals. In general, regardless of origin (Atlantic or Mediterranean), the mussels were rather resilient to acidification for most of the parameters considered and they were able to grow in strongly acidified seawater through an increased feeding activity. However, shell strength decreased (40%) consistently in both mussel populations held in moderately and highly acidified seawater. The observed reduction in shell strength was not explained by slight alterations in organic matter, shell thickness or aragonite:calcite ratio. The combined effects of high acidification and warming on the key response of byssus strength caused a strong decline in mussel performance, although only in Galician mussels, in which the valve opening time decreased sharply as well as condition index (soft tissue state) and shell growth. By contrast, the observed negative effect of highly acidified scenario on the strength of Tunisian mussel shells was (partly but not totally) counterbalanced by the higher seawater temperature. Eco-physiological and behavioural interactions in mussels in relation to climate change are complex, and future scenarios for the ecology of the species and also the feasibility of cultivating them in Atlantic and Mediterranean zones are discussed.

The Northeast Atlantic is running out of excess carbonate in the horizon of cold-water corals communities.

The oceanic uptake of atmospheric carbon dioxide (CO2) emitted by human activities alters the seawater carbonate system. Here, the chemical status of the Northeast Atlantic is examined by means of a high-quality database of carbon variables based on the GO-SHIP A25 section (1997-2018). The increase of atmospheric CO2 leads to an increase in ocean anthropogenic carbon (Cant) and a decrease in carbonate that is unequivocal in the upper and mid-layers (0-2,500 m depth). In the mid-layer, the carbonate content in the Northeast Atlantic is maintained by the interplay between the northward spreading of recently conveyed Mediterranean Water with excess of carbonate and the arrival of subpolar-origin waters close to carbonate undersaturation. In this study we show a progression to undersaturation with respect to aragonite that could compromise the conservation of the habitats and ecosystem services developed by benthic marine calcifiers inhabiting that depth-range, such as the cold-water corals (CWC) communities. For each additional ppm in atmospheric pCO2 the waters surrounding CWC communities lose carbonate at a rate of - 0.17 ± 0.02 µmol kg-1 ppm-1. The accomplishment of global climate policies to limit global warming below 1.5-2 â„ƒ will avoid the exhaustion of excess carbonate in the Northeast Atlantic.

Behavioural responses to predators in Mediterranean mussels (Mytilus galloprovincialis) are unaffected by elevated pCO2.

Ocean acidification is expected to affect marine organisms in the near future. Furthermore, abrupt short-term fluctuations in seawater pCO2 characteristic of near-shore coastal regions and high-density aquaculture sites currently have the potential to influence organismal and community functioning by altering animal behaviour. While anti-predator responses in fishes exposed to elevated pCO2 are well documented, such responses in benthic marine invertebrates are poorly studied. We used high frequency, non-invasive biosensors to test whether or not short term (3-week) exposure to elevated pCO2 could impact behavioural responses to the threat of predation in adult Mediterranean mussels from Galicia on the northwestern coast of Spain. Predator alarm cues (crushed conspecifics) resulted in a prolonged (1 h) reduction in the degree of valve opening (-20%) but had no clear effect on overall valve movement activity, while elevated pCO2 did not affect either response. Our results add to the increasing body of evidence suggesting that the effects of end-of-century pCO2 levels on marine animal behaviour are likely weak. Nonetheless, longer-term exposures spanning multiple generations are needed to better understand how ocean acidification might impact behavioural responses to predation in marine bivalves.

Decadal acidification in Atlantic and Mediterranean water masses exchanging at the Strait of Gibraltar.

Seawater pH is undergoing a decreasing trend due to the absorption of atmospheric CO2, a phenomenon known as ocean acidification (OA). Biogeochemical processes occurring naturally in the ocean also change pH and hence, for an accurate assessment of OA, the contribution of the natural component to the total pH variation must be quantified. In this work, we used 11 years (2005-2015) of biogeochemical measurements collected at the Strait of Gibraltar to estimate decadal trends of pH in two major Mediterranean water masses, the Western Mediterranean Deep Water (WMDW) and the Levantine Intermediate Water (LIW) and assess the magnitude of natural and anthropogenic components on the total pH change. The assessment was also performed in the North Atlantic Central Water (NACW) feeding the Mediterranean Sea. Our analysis revealed a significant human impact on all water masses in terms of accumulation of anthropogenic CO2. However, the decadal pH decline found in the WMDW and the NACW was markedly affected by natural processes, which accounted for by nearly 60% and 40% of the total pH decrease, respectively. The LIW did not exhibit a significant pH temporal trend although data indicated natural and anthropogenic perturbations on its biogeochemical signatures.

The oceanic sink for anthropogenic CO2 from 1994 to 2007.

We quantify the oceanic sink for anthropogenic carbon dioxide (CO2) over the period 1994 to 2007 by using observations from the global repeat hydrography program and contrasting them to observations from the 1990s. Using a linear regression-based method, we find a global increase in the anthropogenic CO2 inventory of 34 ± 4 petagrams of carbon (Pg C) between 1994 and 2007. This is equivalent to an average uptake rate of 2.6 ± 0.3 Pg C year-1 and represents 31 ± 4% of the global anthropogenic CO2 emissions over this period. Although this global ocean sink estimate is consistent with the expectation of the ocean uptake having increased in proportion to the rise in atmospheric CO2, substantial regional differences in storage rate are found, likely owing to climate variability-driven changes in ocean circulation.

Predictors of recurrence after surgical treatment of idiopathic progressive subglottic stenosis.

Idiopathic progressive subglottic stenosis is a rare cause of tracheal narrowing. Partial cricotracheal resection and anastomosis can cure idiopathic stenosis, even if some patients may require multiple interventions and experience voice and swallowing deterioration. We investigated risk factors for retreatment and assessed the impact of crico-tracheal resection on functional parameters. We conducted a retrospective multicentric study on 44 female patients (mean age 52.6 ± 13.1 years) affected by idiopathic stenosis and treated by crico-tracheal resection between 2002 and 2016. Functional outcomes after crico-tracheal resection were assessed by the airway-dyspnoea-voice-swallowing score (range 1-5, with "1" expressing normal and "5" completely altered function). Previous treatments, grade of stenosis, site, airway comorbidities, age and resection length were tested as predictors of postoperative complications and number of additional treatments, using bivariate and multivariate analysis. The overall decannulation rate was 97.3%. The dyspnoea score improved (mean variation 1.4 ± 1.0; p < 0.001), while voice and swallowing were negatively affected (mean variation 1.6 ± 0.9 and 0.5 ± 0.7, respectively; p < 0.001). Airway comorbidities were associated with a higher rate of complications (p < 0.05). Retreatments were more frequent in patients with postoperative complications (p < 0.05). The length of resection correlated with the number of subsequent treatments (R = 0.52; p < 0.01). At multivariate analysis, post-operative complications were predicted by comorbidities and disease stage (p < 0.05); number of retreatments was linked to the length of resection (p < 0.05) as well as with the application of mitomycin C (p < 0.001). Crico-tracheal resection for idiopathic progressive subglottic stenosis offers good functional results in terms of airway patency. These data suggest that a higher complication rate can be expected in patients affected by comorbidities. Moreover, more extensive surgical resection seems to be associated with the occurrence and number of subsequent retreatments. On the contrary, the local application of an anti-proliferative drug does not seem to be of use in preventing recurrences.