Department of Pediatrics, St Marianna University School of Medicine, Kawasaki, Japan.
Vaccine Education Center.
J Pediatric Infect Dis Soc. 2017 Nov 24;6(4):380-385. doi: 10.1093/jpids/pix063.
Although juvenile-onset recurrent respiratory papillomatosis (JoRRP) generally involves a benign tumor on the larynx and other respiratory tract areas, almost all patients with this disease require repeated surgical intervention (to prevent airway obstruction during the course of illness) and various adjuvant therapies such as interferon, cidofovir, acyclovir, ribavirin, indole-3-carbinol, HspE7, mumps vaccine, photodynamic therapy, propranolol, cimetidine, and bevacizumab. Some case reports recently described the effectiveness of the quadrivalent human papillomavirus vaccine (HPV4) as an adjuvant therapy. On the basis of these reports, we administered HPV4 to a 2-year-old boy with JoRRP. However, no therapeutic effect was found. A review of the available literature revealed that current evidence for the effectiveness of therapeutic HPV4 and other adjuvant therapies for JoRRP is inconsistent. Therefore, the prophylactic use of currently available HPV vaccine for adolescents is the most effective strategy for preventing not only anogenital cancers but also genital warts, which might be a risk factor for JoRRP among their children in the future.
虽然青少年复发性呼吸道乳头瘤病(JoRRP)通常涉及喉部和其他呼吸道区域的良性肿瘤,但几乎所有患有这种疾病的患者都需要反复进行手术干预(以防止疾病过程中的气道阻塞)和各种辅助治疗,如干扰素、西多福韦、阿昔洛韦、利巴韦林、吲哚-3-甲醇、HspE7、腮腺炎疫苗、光动力疗法、普萘洛尔、西咪替丁和贝伐单抗。最近有一些病例报告描述了四价人乳头瘤病毒疫苗(HPV4)作为辅助治疗的有效性。基于这些报告,我们对一名患有 JoRRP 的 2 岁男孩使用了 HPV4,但未发现治疗效果。对现有文献的回顾表明,目前关于治疗性 HPV4 和其他辅助治疗 JoRRP 的有效性的证据并不一致。因此,青少年使用目前可用的 HPV 疫苗进行预防接种是最有效的策略,不仅可以预防肛门生殖器癌,还可以预防生殖器疣,这可能是未来他们孩子患 JoRRP 的一个风险因素。