Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czech Republic.
Department of Pathology, University Hospital Ostrava, Ostrava, Czech Republic.
Clin Otolaryngol. 2021 Mar;46(2):373-379. doi: 10.1111/coa.13681. Epub 2020 Dec 30.
Human papillomavirus (HPV) causes adult-onset recurrent respiratory papillomatosis (AORRP), but AORPP prevalence is much lower than HPV prevalence. Thus, HPV infection is necessary, but not sufficient, to cause AORRP and other factors likely contribute to its pathogenesis. The present study aimed to investigate whether co-infection with herpetic viruses may contribute to the pathogenesis of AORRP.
Prospective case-control study conducted from January 2018 to November 2019.
Tertiary referral centre.
Eighteen consecutive patients with AORRP and 18 adults with healthy laryngeal mucosa (control group) undergoing surgery.
Cytomegalovirus, Epstein-Barr virus (EBV), herpes simplex viruses 1 and 2, human herpesvirus 6, varicella zoster virus and HPV (including genotyping) were detected in biopsies of papilloma or healthy mucosa using real-time polymerase chain reaction and reverse line blot. Dysplasia and Ki67 levels were determined in papilloma specimens.
EBV was present in 6 (33.3%) AORRP patients and no control patients (P = .019). Presence was not dependent on tobacco exposure (P = .413) or HPV genotype or concentration (P > .999). EBV presence was strongly related to increased cell proliferation (P = .005) and number of previous surgeries (P = .039), but not dysplasia (P > .999). Human herpesvirus 6 was found in 3 (16.7%) AORRP biopsies, with one false positive. No other herpetic virus was found.
Unlike other herpetic viruses, EBV seems to interact with HPV, enhancing cell proliferation and contributing to the pathogenesis and progression of AORRP. Further research is required to elucidate specific interactions and their role in the pathogenesis of AORRP.
人乳头瘤病毒（HPV）可引起成人复发性呼吸道乳头瘤病（AORRP），但 AORPP 的患病率远低于 HPV 患病率。因此，HPV 感染是必要的，但不是充分的，导致 AORRP 和其他因素可能有助于其发病机制。本研究旨在探讨疱疹病毒的合并感染是否有助于 AORRP 的发病机制。
2018 年 1 月至 2019 年 11 月进行的前瞻性病例对照研究。
三级转诊中心。
18 例连续的 AORRP 患者和 18 例接受手术的健康喉黏膜成人（对照组）。
采用实时聚合酶链反应和反向线印迹法检测乳头状瘤或健康黏膜活检组织中的巨细胞病毒、EB 病毒（EBV）、单纯疱疹病毒 1 型和 2 型、人类疱疹病毒 6 型、水痘带状疱疹病毒和 HPV（包括基因分型）。在乳头状瘤标本中测定异型增生和 Ki67 水平。
6 例（33.3%）AORRP 患者和 0 例对照组患者存在 EBV（P =.019）。EBV 的存在与吸烟无关（P =.413）或 HPV 基因型或浓度无关（P>.999）。EBV 的存在与细胞增殖增加密切相关（P =.005）和先前手术次数（P =.039），但与异型增生无关（P>.999）。在 3 例（16.7%）AORRP 活检组织中发现人类疱疹病毒 6，其中 1 例为假阳性。未发现其他疱疹病毒。
与其他疱疹病毒不同，EBV 似乎与 HPV 相互作用，增强细胞增殖，有助于 AORRP 的发病机制和进展。需要进一步研究以阐明特定相互作用及其在 AORRP 发病机制中的作用。
