Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
J Med Virol. 2019 Jul;91(7):1250-1262. doi: 10.1002/jmv.25441. Epub 2019 Mar 18.
The role of human adenovirus (HAdV) infection in different acute diseases, such as febrile exudative tonsillitis, conjunctivitis, and pharyngoconjunctival fever is well established. However, the relationships, if any, of HAdV persistence and reactivation in the development of the chronic adenotonsillar disease is not fully understood. The present paper reports a 3-year cross-sectional hospital-based study aimed at detecting and quantifying HAdV DNA and mRNA of the HAdV hexon gene in adenoid and palatine tonsil tissues and nasopharyngeal secretions (NPS) from patients with adenotonsillar hypertrophy or recurrent adenotonsillitis. HAdV C, B, and E were detectable in nearly 50% of the patients, with no association with the severity of airway obstruction, nor with the presence of recurrent tonsillitis, sleep apnea or otitis media with effusion (OME). Despite the higher rates of respiratory viral coinfections in patients with HAdV, the presence of other viruses, including DNA and RNA viruses, had no association with HAdV replication or shedding in secretions. Higher HAdV loads in adenoids showed a significant positive correlation with the presence of sleep apnea and the absence of OME. Although this study indicates that a significant proportion (~85%) of individuals with chronic adenotonsillar diseases have persistent nonproductive HAdV infection, including those by HAdV C, B, and E, epithelial and subepithelial cells in tonsils seem to be critical for HAdV C production and shedding in NPS in some patients, since viral antigen was detected in these regions by immunohistochemistry in four patients, all of which were also positive for HAdV mRNA detection.
人腺病毒（HAdV）感染在不同的急性疾病中的作用，如发热性渗出性扁桃体炎、结膜炎和咽结膜热已得到充分证实。然而，HAdV 持续存在和重新激活与慢性腺样体扁桃体疾病发展之间的关系尚不完全清楚。本文报告了一项为期 3 年的基于医院的横断面研究，旨在检测和定量分析腺样体和扁桃体组织以及鼻咽分泌物（NPS）中 HAdV 六邻体基因的 HAdV DNA 和 mRNA，这些组织和分泌物来自腺样体扁桃体肥大或复发性腺样体扁桃体炎患者。将近 50%的患者可检测到 HAdV C、B 和 E，但其与气道阻塞的严重程度、复发性扁桃体炎、睡眠呼吸暂停或分泌性中耳炎（OME）的存在均无相关性。尽管 HAdV 患者的呼吸道病毒合并感染率较高，但其他病毒（包括 DNA 和 RNA 病毒）的存在与 HAdV 在分泌物中的复制或脱落均无相关性。腺样体中较高的 HAdV 载量与睡眠呼吸暂停的存在和 OME 的不存在呈显著正相关。尽管本研究表明，约 85%的慢性腺样体扁桃体疾病患者存在持续性非增殖性 HAdV 感染，包括 HAdV C、B 和 E，但在一些患者中，扁桃体的上皮细胞和上皮下细胞似乎对 HAdV C 在 NPS 中的产生和脱落至关重要，因为免疫组化在 4 名患者的这些区域检测到了病毒抗原，这 4 名患者均检测到 HAdV mRNA 呈阳性。
