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Benedict PA, Ruiz R, Yoo M, Verma A, Ahmed OH, Wang B, Dion GR, Voigt A, Merati A, Rosen CA, Amin MR, Branski RC. Laryngeal distribution of recurrent respiratory papillomatosis in a previously untreated cohort. Laryngoscope 2017; 128:138-143. [DOI: 10.1002/lary.26742] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/18/2017] [Accepted: 05/22/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Peter A. Benedict
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - Ryan Ruiz
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - MiJin Yoo
- Department of Otolaryngology-Head and Neck Surgery; University of Washington School of Medicine; Seattle Washington
| | - Avanti Verma
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - Omar H. Ahmed
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - Binhuan Wang
- Department of Population Heath, Division of Biostatistics; New York University School of Medicine; New York New York
| | - Gregory R. Dion
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
- Department of Otolaryngology-Head and Neck Surgery; Brooke Army Medical Center; Fort Sam Houston Texas
| | - Andrew Voigt
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - Albert Merati
- Department of Otolaryngology-Head and Neck Surgery; University of Washington School of Medicine; Seattle Washington
| | - Clark A. Rosen
- University of Pittsburgh Voice Center, Department of Otolaryngology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania U.S.A
| | - Milan R. Amin
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - Ryan C. Branski
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
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Fortes HR, von Ranke FM, Escuissato DL, Araujo Neto CA, Zanetti G, Hochhegger B, Souza CA, Marchiori E. Recurrent respiratory papillomatosis: A state-of-the-art review. Respir Med 2017; 126:116-121. [DOI: 10.1016/j.rmed.2017.03.030] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 03/26/2017] [Accepted: 03/31/2017] [Indexed: 10/19/2022]
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Liu T, Greenberg M, Wentland C, Sepe B, Bowe S, Diercks G, Huynh T, Mino-Kenudson M, Schlegel R, Kodack D, Benes C, Engelman J, Hartnick C. PD-L1 expression and CD8+ infiltration shows heterogeneity in juvenile recurrent respiratory papillomatosis. Int J Pediatr Otorhinolaryngol 2017; 95:133-138. [PMID: 28576522 DOI: 10.1016/j.ijporl.2017.02.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 02/13/2017] [Accepted: 02/17/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Tumor immunotherapy have broadened therapeutic options for tumor treatment. The role of immune function in juvenile recurrent respiratory papillomatosis (JRRP) has not been investigated. Applying immunoblockade inhibitors as a novel disease treatment is unclear. Our study, for the first time, evaluates immune infiltration and immuno-suppressive molecule expression in JRRP. Our study provides insights in possibly treating this disease with tumor immunotherapies. We aimed to determine expression of programmed death-ligand 1 (PD-L1), a cancer escape protein, and presence of CD8+ T cell infiltration in tumor microenvironment. MATERIAL AND METHODS Seven patients with JRRP (mean age: 7.43; age range 3-17) in this study routinely have their tumors surgical debulked at Massachusetts Eye and Ear Infirmary. Following surgery, samples were de-identified and sent to pathology where they were stained and analyzed. RESULTS Six out of seven patients expressed PD-L1 on tumor cells to various extents. Three patients showed concurrent PD-L1 expression on tumor cells and abundant CD8+ tumor infiltrating lymphocytes as well as PD-L1+ stromal lymphocytes, while PD-L1 expression on tumor cells were not associated with CD8+ tumor infiltrating T cells nor PD-L1+ stromal lymphocytes in the other three patients. HPV 6/11 and p16 was detected in all the patients. There appeared to be no correlation between either PD-L1 expression and CD8+ infiltration and clinical severity as measured by both the number of surgeries per year or Derkay score. CONCLUSIONS Despite a small cohort, the expression of p16 and HPV 6/11 in all of the patients confirms the tissues were HPV tumor cells. PD-L1 expression was detected in the vast majority of tumor samples, while inflammatory cell compartments showed a higher degree of variation. Expression of PD-L1 on tumor cells but not inflammatory cells raises the possibility of a tumor cell intrinsic manner of PD-L1 expression. In contrast, a group of patients showed PD-L1 positivity in both tumor and inflammatory cells along with abundant CD8+ tumor infiltrating lymphocytes, suggesting adoptive immune resistance in these tumors and potential benefits from tumor immunotherapy.
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Affiliation(s)
- Tingyu Liu
- Novartis Institutes for Biomedical Research, 250 Massachusetts Ave, Cambridge, MA 02139, United States
| | - Max Greenberg
- Massachusetts General Hospital Cancer Center, 55 Fruit St, Boston, MA 02114, United States
| | - Carissa Wentland
- Department of Otolaryngology Head and Neck Surgery, University Hospital Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, United States
| | - Brandon Sepe
- Massachusetts General Hospital Cancer Center, 55 Fruit St, Boston, MA 02114, United States
| | - Sarah Bowe
- Pediatric Otolaryngology Service, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114, United States
| | - Gillian Diercks
- Pediatric Otolaryngology Service, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114, United States
| | - Tiffany Huynh
- Department of Pathology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
| | - Mari Mino-Kenudson
- Department of Pathology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
| | - Richard Schlegel
- Department of Pathology, Georgetown University Medical School, 3800 Reservoir Rd NW, Washington, DC 20007, United States
| | - David Kodack
- Novartis Institutes for Biomedical Research, 250 Massachusetts Ave, Cambridge, MA 02139, United States
| | - Cyril Benes
- Massachusetts General Hospital Cancer Center, 55 Fruit St, Boston, MA 02114, United States
| | - Jeffrey Engelman
- Novartis Institutes for Biomedical Research, 250 Massachusetts Ave, Cambridge, MA 02139, United States
| | - Christopher Hartnick
- Pediatric Otolaryngology Service, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114, United States.
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Quality of life of young patients with recurrent respiratory papillomatosis. The Journal of Laryngology & Otology 2017; 131:425-428. [PMID: 28193306 DOI: 10.1017/s0022215117000354] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess quality of life of children and teenagers with recurrent respiratory papillomatosis, according to the evidence of infection by human papillomavirus types 6 and 11, compared with healthy volunteers and patients with chronic otitis media. METHOD Participants and their parents completed the Pediatric Quality of Life Inventory 4.0. RESULTS Patients with recurrent respiratory papillomatosis and their parents reported lower quality of life than healthy subjects (p < 0.01), but similar quality of life to patients with chronic otitis media. Those with human papillomavirus type 11 showed the lowest scores among all participants (p < 0.05). CONCLUSION Young Mexican patients with recurrent respiratory papillomatosis and their parents perceive a poor quality of life, and they may experience limitations in interactions with their peers. Infection by human papillomavirus type 11 may increase the impact of the disease on quality of life.
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55
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Viscidi RP, Gravitt PE. Papillomaviruses. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00167-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Acoustical and Perceptual Voice Profiling of Children With Recurrent Respiratory Papillomatosis. J Voice 2016; 30:600-5. [DOI: 10.1016/j.jvoice.2015.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 06/15/2015] [Indexed: 11/19/2022]
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Ahmed MM, Connor MP, Palazzolo M, Thompson ME, Lospinoso J, O'Connor P, Howard NS, Maturo SC. Effect of high-dose vocal fold injection of cidofovir and bevacizumab in a porcine model. Laryngoscope 2016; 127:671-675. [DOI: 10.1002/lary.26185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 05/16/2016] [Accepted: 06/23/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Mostafa. M. Ahmed
- San Antonio Military Medical Center; Fort Sam Houston; San Antonio Texas U.S.A
| | - Matthew. P. Connor
- San Antonio Military Medical Center; Fort Sam Houston; San Antonio Texas U.S.A
| | - Mitzi Palazzolo
- San Antonio Military Medical Center; Fort Sam Houston; San Antonio Texas U.S.A
| | - Michelle E. Thompson
- Wilford Hall USAF Medical Center; Lackland Air Force Base; San Antonio Texas U.S.A
| | - Josh Lospinoso
- Portia Statistical Consulting LLC; San Antonio Texas U.S.A
| | - Peter O'Connor
- San Antonio Military Medical Center; Fort Sam Houston; San Antonio Texas U.S.A
| | - N. Scott Howard
- San Antonio Military Medical Center; Fort Sam Houston; San Antonio Texas U.S.A
| | - Stephen. C. Maturo
- San Antonio Military Medical Center; Fort Sam Houston; San Antonio Texas U.S.A
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Epidemiology of Low-Risk Human Papillomavirus. CURRENT OTORHINOLARYNGOLOGY REPORTS 2016. [DOI: 10.1007/s40136-016-0112-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Suzuki S, Sekizawa A, Tanaka M, Matsuda H, Okai T, Kinoshita K, Kitamura T. Current Status of Condylomata Acuminata in Pregnant Japanese Women. Jpn J Infect Dis 2016; 69:347-9. [PMID: 26902221 DOI: 10.7883/yoken.jjid.2015.561] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Shunji Suzuki
- Japan Association of Obstetricians and Gynecologists
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Hu X, Shen X. Airway loss during inhalation induction of anesthesia with sevoflurane in a pediatric patient with laryngeal papillomatosis: A case report. Exp Ther Med 2015; 10:2429-2431. [PMID: 26668652 DOI: 10.3892/etm.2015.2805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 09/14/2015] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to report a failed inhalation induction of anesthesia with sevofluran in a pediatric patient with grade III laryngeal obstruction caused by laryngeal papillomatosis. Inhalation induction is recommended for the induction of anesthesia in pediatric patients. In the present case, due to the respiratory depression properties of the anesthetics, the partial airway obstruction developed into complete airway obstruction, followed by cardiac arrest. The patient survived after the surgeon managed to reconvert the complete airway obstruction into partial airway obstruction through the removal of part of the laryngeal papillomas. In conclusion, the reaction of the patient in the present case to sevoflurane inhalation induction suggests that this technique is not recommended for patients with pre-existing severe airway obstruction. In such cases, special consideration and preparation is required.
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Affiliation(s)
- Xiao Hu
- Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai Medical College of Fudan University, Shanghai 200031, P.R. China
| | - Xia Shen
- Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai Medical College of Fudan University, Shanghai 200031, P.R. China
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Molecular subtypification of human papillomavirus in male adult individuals with recurrent respiratory papillomatosis. Auris Nasus Larynx 2015; 42:385-9. [DOI: 10.1016/j.anl.2015.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 02/17/2015] [Accepted: 03/18/2015] [Indexed: 11/23/2022]
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Carifi M, Napolitano D, Morandi M, Dall'Olio D. Recurrent respiratory papillomatosis: current and future perspectives. Ther Clin Risk Manag 2015; 11:731-8. [PMID: 25999724 PMCID: PMC4427257 DOI: 10.2147/tcrm.s81825] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Although recurrent respiratory papillomatosis is a benign disease of the upper aerodigestive tract caused by infection with human papillomavirus, the disease process is unpredictable, ranging from mild disease and spontaneous remission to an aggressive disease with pulmonary spread and requirement for frequent surgical debulking procedures. It can present a protracted clinical course and cause potentially life-threatening compromise of the airways. Over recent decades, a number of alternative medical therapies to standard surgical treatment have been investigated, with modest outcomes overall. Currently, some additional therapies are being explored, together with novel surgical instrumentation that can help to avoid inevitable long-term stenotic complications, ultimately affecting quality of life. Hopefully, clinicians might soon be able to significantly improve the quality of treatment and outcomes for patients affected with recurrent respiratory papillomatosis, with human papillomavirus vaccination having a potentially important role.
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Affiliation(s)
- Marco Carifi
- Department of Otolaryngology, Azienda Ospedaliera di Rilievo Nazionale A Cardarelli, Naples, Italy
| | - Domenico Napolitano
- Department of Otolaryngology, Azienda Ospedaliera di Rilievo Nazionale A Cardarelli, Naples, Italy
| | - Morando Morandi
- Department of Otolaryngology, Azienda Ospedaliera di Rilievo Nazionale A Cardarelli, Naples, Italy
| | - Danilo Dall'Olio
- Department of Otolaryngology, Ospedale Maggiore CA Pizzardi, Bologna, Italy
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Correia S, Dionísio J, da Costa JD. Recurrent respiratory papillomatosis of the airway: The experience of an endoscopic unit. REVISTA PORTUGUESA DE PNEUMOLOGIA 2015; 21:82-9. [PMID: 25926371 DOI: 10.1016/j.rppnen.2014.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Accepted: 07/29/2014] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Recurrent respiratory papillomatosis (RPP) is a rare benign neoplasm caused by human papillomavirus (HPV). RPP is characterized by recurrent proliferation of the papillomata in the respiratory tract. OBJECTIVES AND METHODS Retrospective analysis of all adult patients with diagnosis of recurrent respiratory papillomatosis admitted to our endoscopic unit between 2000 and 2013 with histological proved papillomatosis. RESULTS Four patients were included (3 women) with an average age of 53±19 years (27-72). Before endoscopy unit admission, all the patients have been previously submitted to surgical removal of the papillomas with a median number of surgeries per patient of 6.5. These patients were submitted to therapeutic endoscopy and the most frequent endoscopic treatments were Laser YAG and local injection of cidofovir. All the patients treated with cidofovir presented complete remission of the disease. The median follow-up was 6 years: 2 presented malignant transformation to epidermoid carcinoma and 1 had severe dysplasia on the histological examination. We describe the four cases due to different forms of presentation. CONCLUSION Papillomatosis of the airway is a rare condition predisposing to malignant transformation. RRP tends to recur and repeated surgeries are needed to remove papillomatas. Endoscopic treatment is important for the removal of the papillomas that are not accessible via laryngoscopy (YAG Laser, cryotherapy, etc.) and for resistant moderate/severe cases of RPP because it allows intralesional administration of adjuvant therapy like cidofovir.
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Affiliation(s)
| | - Jorge Dionísio
- Bronchology Unit of the Pneumology Department of IPOLFG, Lisbon, Portugal
| | - José Duro da Costa
- Bronchology Unit of the Pneumology Department of IPOLFG, Lisbon, Portugal
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Estimating the incidence and prevalence of juvenile-onset recurrent respiratory papillomatosis in publicly and privately insured claims databases in the United States. Sex Transm Dis 2014; 41:300-5. [PMID: 24722383 DOI: 10.1097/olq.0000000000000115] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Juvenile-onset recurrent respiratory papillomatosis (JORRP) is a chronic disease caused by human papillomavirus types 6 and 11. It is associated with significant morbidity that places intense physical, psychological, and financial strain on patients and their families. Few studies have assessed the incidence and prevalence of JORRP in the United States. METHODS This retrospective, longitudinal cohort study was performed using data from a pair of large insurance claims databases in the United States. The Optum Clinformatics and Truven MarketScan Medicaid databases represent a sample of privately and publicly insured children, respectively. Cohorts of children aged 0 to 17 years were created within each database to estimate the incidence and prevalence of JORRP in 2006. Claims-based algorithms were designed to capture as many potential cases as possible. To improve the accuracy of the incidence and prevalence estimates, chart validation was performed to estimate the positive predictive value (PPV) of the claims-based algorithms. RESULTS The overall PPV-adjusted incidence of JORRP in 2006 was 0.51 per 100,000 in Optum and 1.03 per 100,000 in the MarketScan Medicaid population. Peak incidence was observed among 0- to 4-year-olds in both databases. The PPV-adjusted prevalence of JORRP in 2006 was 1.45 and 2.93 per 100,000 in the Optum and MarketScan Medicaid cohorts, respectively. CONCLUSIONS Although relatively uncommon, JORRP represents a disease with significant morbidity. The incidence and prevalence of JORRP in publicly insured children were consistently higher than those covered by private insurance plans, suggesting an increased burden of illness among those with lower socioeconomic status.
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Omland T, Akre H, Lie KA, Jebsen P, Sandvik L, Brøndbo K. Risk factors for aggressive recurrent respiratory papillomatosis in adults and juveniles. PLoS One 2014; 9:e113584. [PMID: 25419846 PMCID: PMC4242649 DOI: 10.1371/journal.pone.0113584] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 10/26/2014] [Indexed: 01/03/2023] Open
Abstract
In this cohort study we examined whether gender, age at onset, observation time or human papillomavirus (HPV) genotype are risk factors for an aggressive clinical course in Recurrent Respiratory Papillomatosis (RRP). Clinical data from patient records comprised gender, age at onset, date of first endolaryngeal procedure with biopsy, date of last follow-up, total number of endolaryngeal procedures, and complications during the observation period. Disease was defined as juvenile (JoRRP) or adult onset (AoRRP) according to whether the disease was acquired before or after the age of 18. Aggressive disease was defined as distal spread, tracheostomy, four surgical operations annually or >10 surgeries in total. DNA was extracted from formalin-fixed paraffin-embedded tissue. HPV genotyping was performed by quantitative PCR assay identifying 15 HPV genotypes. The study included 224 patients. The majority were males (141/174 in AoRRPs and 31/50 in JoRRPs; p = 0.005). The median follow-up from initial diagnosis was 12.0 years (IQR 3.7-32.9) for JoRRPs and 4.0 years (IQR 0.8-11.7) for AoRRPs. The disease was more aggressive in juveniles than adults (p<0.001), a difference that disappeared after 10 years' observation. JoRRPs with aggressive disease were younger at onset (mean difference 4.6 years, 95%CI [2.4, 6.8], p = 0.009). HPV6 or -11 was present in all HPV-positive papillomas. HPV11 was more prevalent in aggressive disease, and HPV6 in non-aggressive disease (p<0.001). Multiple logistic regression revealed that only age at onset (OR = 0.69, 95% CI [0.53, 0.88], p = 0.003) was associated with aggressive disease in juveniles, while HPV11 (OR = 3.74, 95% CI [1.40, 9.97], p = 0.008) and observation time >10 years (OR = 13.41, 95% CI [5.46, 32.99[, p<001) were risk factors in adults. In conclusion, the only significant risk factor for developing aggressive disease in JoRRPs was age at onset, but both HPV11 and observation time >10 years were risk factors for an aggressive disease course in AoRRPs.
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Affiliation(s)
- Turid Omland
- Department of Otorhinolaryngology/Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway
- * E-mail:
| | - Harriet Akre
- Department of Otorhinolaryngology/Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Kathrine A. Lie
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Peter Jebsen
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Leiv Sandvik
- Department of Biostatistics, Oslo University Hospital, Oslo, Norway
- University of Oslo, Faculty of Dentistry, Oslo, Norway
| | - Kjell Brøndbo
- Department of Otorhinolaryngology/Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway
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Niyibizi J, Rodier C, Wassef M, Trottier H. Risk factors for the development and severity of juvenile-onset recurrent respiratory papillomatosis: a systematic review. Int J Pediatr Otorhinolaryngol 2014; 78:186-97. [PMID: 24367938 DOI: 10.1016/j.ijporl.2013.11.036] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 11/28/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Juvenile-onset recurrent respiratory papillomatosis (JoRRP) is a rare yet aggressive disease caused by human papillomavirus (HPV). Although many newborns are likely exposed to HPV, few develop JoRRP and the clinical course of the disease varies from one child to another. This systematic review seeks to provide an up-to-date understanding of the risk factors for acquisition and severity. METHODS We conducted a comprehensive literature search in EMBASE, MEDLINE and EBMR databases using various combinations of keywords related to JoRRP etiology, risk factors and severity. We also searched Google Scholar and the reference lists of eligible studies. Our search was limited to original studies published in French or English between 1995 and July 2012 and to patients under 20 years of age. RESULTS Of 1362 citations, we retrieved 102 articles and found 14 additional studies. We retained 32 studies meeting inclusion criteria. All were observational and together included 2296 JoRRP cases. Risk factors could be classified mainly as maternal and birth history, viral genotype, and host factors. A history of genital warts during pregnancy and delivery was strongly linked to the development of JoRRP. Depending on ethnicity, specific human leukocyte antigen class II alleles and immune response factors were important determinants of JoRRP acquisition and severity. HPV-11 genotype and younger age at onset of JoRRP were important predictors of severity. CONCLUSIONS Genetic and immunological profiles underlying the acquisition and clinical course are not readily modifiable. Thus, preventing condylomas in women of childbearing age could reduce the burden of this life-threatening disease.
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Affiliation(s)
- Joseph Niyibizi
- Department of Social and Preventive Medicine, University of Montreal, Public Health School 7101, Avenue du Parc, 3rd Floor, Montreal, Quebec H3N 1X9, Canada; Sainte Justine Hospital (CHU Sainte-Justine), 3175 Chemin de la Côte Ste-Catherine, Room A-830, Montreal, Quebec H3T 1C5, Canada
| | - Caroline Rodier
- Department of Social and Preventive Medicine, University of Montreal, Public Health School 7101, Avenue du Parc, 3rd Floor, Montreal, Quebec H3N 1X9, Canada; Merck Canada Inc., 16711 Route Transcanadienne, Kirkland, Quebec H9H 3L1, Canada
| | - Maggy Wassef
- Sainte Justine Hospital (CHU Sainte-Justine), 3175 Chemin de la Côte Ste-Catherine, Room A-830, Montreal, Quebec H3T 1C5, Canada
| | - Helen Trottier
- Department of Social and Preventive Medicine, University of Montreal, Public Health School 7101, Avenue du Parc, 3rd Floor, Montreal, Quebec H3N 1X9, Canada; Sainte Justine Hospital (CHU Sainte-Justine), 3175 Chemin de la Côte Ste-Catherine, Room A-830, Montreal, Quebec H3T 1C5, Canada.
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Yi L, Vaudaux B, Sandu K, Nisa L. Prolonged remission of juvenile-onset respiratory papillomatosis: a post-expositional role of the tetravalent anti-HPV vaccine? Int J Pediatr Otorhinolaryngol 2014; 78:388-90. [PMID: 24388316 DOI: 10.1016/j.ijporl.2013.12.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 12/10/2013] [Accepted: 12/12/2013] [Indexed: 11/26/2022]
Abstract
Juvenile-onset recurrent respiratory papillomatosis (JORRP) is an HPV-related neoplasm affecting primarily the larynx. JORRP often requires repeated surgical debridement, which yield variable but generally moderate remission periods. We report the case of a 6-year-old boy with severe course JORRP since the age of 2, requiring tracheostomy, that underwent prolonged remission and was decannulated some months after administration of the HPV vaccine. The post-exposure use for the anti-HPV vaccine in JORRP is a topic of capital interest but still poorly characterized. Some published cases suggest a potential post-exposure role of the vaccine in JORRP, but prospective multicentric trials are still needed.
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Affiliation(s)
- Laurent Yi
- Division of Pediatric Infectious Diseases and Vaccinology, Department of Pediatrics, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Bernard Vaudaux
- Division of Pediatric Infectious Diseases and Vaccinology, Department of Pediatrics, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Kishore Sandu
- Division of Pediatric Airway Surgery, Department of Otorhinolaryngology - Head & Neck Surgery, Lausanne University Hospital, Lausanne, Switzerland; Department of Otorhinlaryngology, Hôpital de Sion - CHCVs/RSV, Av. Grand Champsec 80, 1950 Sion, Switzerland
| | - Lluís Nisa
- Department of Otorhinlaryngology, Hôpital de Sion - CHCVs/RSV, Av. Grand Champsec 80, 1950 Sion, Switzerland.
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Rodier C, Lapointe A, Coutlée F, Mayrand MH, Dal Soglio D, Roger M, Trottier H. Juvenile respiratory papillomatosis: risk factors for severity. J Med Virol 2013; 85:1447-58. [PMID: 23765781 DOI: 10.1002/jmv.23615] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2013] [Indexed: 11/10/2022]
Abstract
Juvenile recurrent respiratory papillomatosis is caused mainly by human papillomavirus genotypes 6 or 11, acquired at birth or during pregnancy from an infected mother. Recurrent respiratory papillomatosis is characterized by recurring warts growing most commonly in the larynx. Multiple surgical procedures and the risk of airway obstruction contribute to the devastating impact of this disease. Some children will go into remission after a few surgeries whereas others will require repeated interventions over several years. Further understanding of the risk factors associated with severity may contribute to tailored treatments. A retrospective study of cases diagnosed between January 1995 and December 2008 was conducted to study determinants of severe forms of juvenile recurrent respiratory papillomatosis. Demographic and clinical variables were abstracted from children's medical charts and mothers' delivery charts. Viral factors (HPV genotyping and viral load) were studied from archived biopsies. Specific HLA class II alleles and killer-cell immunoglobulin-like receptors genes were tested from saliva samples. Logistic regression was performed to identify risk factors for severity. Overall, 31 pediatric cases of recurrent respiratory papillomatosis were identified. The only significant factor associated with severe forms of recurrent respiratory papillomatosis was the maternal history of condylomas during pregnancy (OR: 12.05 [P=0.05]). The analysis failed to identify risk factors that could be used clinically to identify recurrent respiratory papillomatosis cases likely to take a severe course. Although too early to determine, vaccination against the HPV types involved most commonly in recurrent respiratory papillomatosis may provide the best hope to prevent severe forms of this disease.
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Affiliation(s)
- Caroline Rodier
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada
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69
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Avelino MAG, Zaiden TCDT, Gomes RO. Surgical treatment and adjuvant therapies of recurrent respiratory papillomatosis. Braz J Otorhinolaryngol 2013; 79:636-42. [PMID: 24141682 PMCID: PMC9442437 DOI: 10.5935/1808-8694.20130114] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 06/29/2013] [Indexed: 11/20/2022] Open
Abstract
Objective Method Results Conclusion
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70
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Chansaenroj J, Theamboonlers A, Junyangdikul P, Supiyaphan P, Poovorawan Y. Whole genome analysis of human papillomavirus genotype 11 from cervix, larynx and lung. Asian Pac J Cancer Prev 2013; 13:2619-23. [PMID: 22938430 DOI: 10.7314/apjcp.2012.13.6.2619] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The prevalence of human papillomavirus genotypes differs in various target organs. HPV16 is the most prevalent genotype in the cervix while genotypes 6 and 11 are highly prevalent in skin and aero-digestive tract infections. In this study HPV11 positive specimens were selected from cervix, larynx and lung biopsy tissue to analyze the whole genome by PCR and direct sequencing. Five HPV11 whole genomes were characterized, consisting of two cervical specimens, two laryngeal specimens and one lung specimen. The results showed high homology of HPV11 in these organs. Phylogenetic analysis showed that all HPV11 derived from various organs belonged to the same lineage. Molecular characterization and functional studies can further our understanding of virulence, expression or transmission. Additional studies on functional protein expression at different organ sites will also contribute to our knowledge of HPV infection in various organs.
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Affiliation(s)
- Jira Chansaenroj
- Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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71
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Recommendations for the diagnosis of human papilloma virus (HPV) high and low risk in the prevention and treatment of diseases of the oral cavity, pharynx and larynx. Guide of experts PTORL and KIDL. Otolaryngol Pol 2013; 67:113-34. [PMID: 23719268 DOI: 10.1016/j.otpol.2013.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 01/09/2013] [Indexed: 11/20/2022]
Abstract
The role of human papilloma viruses (HPV) in malignant and nonmalignant ENT diseases and the corresponding epidemiological burden has been widely described. International head and neck oncology community discussed growing evidence that oral HPV infection contributes to the risk of oro-pharyngeal carcinoma (OPC) and recommended HPV testing as a part of the work up for patients with OPC. Polish Society of ENT Head Neck Surgery and National Chamber of Laboratory Diagnosticians have worked together to define the minimum requirements for assigning a diagnosis of HPV-related conditions and testing strategy that include HPV specific tests in our country. This paper briefly frames the literature information concerning low risk (LR) and high risk (HR) HPV, reviews the epidemiology, general guidance on the most appropriate biomarkers for clinical assessment of HPV. The definition of HPV-related cancer was presented. The article is aiming to highlight some of major issues for the clinician dealing with patients with HPV-related morbidities and to introduce the diagnostic algorithm in Poland.
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72
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Moldan MM, Bostrom BC, Tibesar RJ, Lander TA, Sidman JD. Epidermal growth factor receptor inhibitor therapy for recurrent respiratory papillomatosis. F1000Res 2013; 2:202. [PMID: 24795806 PMCID: PMC3999927 DOI: 10.12688/f1000research.2-202.v1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2013] [Indexed: 11/20/2022] Open
Abstract
The epidermal growth factor pathway has been implicated in various tumors, including human papillomavirus (HPV) lesions such as recurrent respiratory papillomatosis (RRP). Due to the presence of epidermal growth factor receptors in RRP, epidermal growth factor receptor (EGFR) inhibitors have been utilized as adjuvant therapy. This case series examines the response to EGFR inhibitors in RRP. Four patients with life-threatening RRP were treated with EGFR inhibitors. Operative frequency and anatomical Derkay scores were calculated prior to, and following EGFR inhibitor treatment via retrospective chart review. The anatomical Derkay score decreased for all four patients after initiation of EGFR inhibitor therapy. In one patient, the operative frequency increased after switching to an intravenous inhibitor after loss of control with an oral inhibitor. In the other patients there was a greater than 20% decrease in operative frequency in one and a more than doubling in the time between procedures in two. This study suggests that EGFR inhibitors are a potential adjuvant therapy in RRP and deserve further study in a larger number of patients.
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Affiliation(s)
- Matthew M Moldan
- Department of Otolaryngology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bruce C Bostrom
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA
| | - Robert J Tibesar
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA ; Department of Otolaryngology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Timothy A Lander
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA ; Department of Otolaryngology, University of Minnesota, Minneapolis, MN 55455, USA
| | - James D Sidman
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA ; Department of Otolaryngology, University of Minnesota, Minneapolis, MN 55455, USA
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73
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[Human papillomavirus prophylactic vaccine]. Uirusu 2012. [PMID: 23189827 DOI: 10.2222/jsv.62.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Human papillomavirus causes viral-dependent cancers, including cervical, anal, vulvar, penile, vaginal, and oropharyngeal, and condyloma acuminata. In the last decade, HPV prophylactic vaccine has been developed and spread worldwide after many large-scale clinical studies. These studies demonstrate significant clinical efficacy for prevention of HPV16/18/6/11-related diseases. In particular, prevention of cervical cancer should be the most important role in the world. In Japan, incidence of cervical cancer does not increase, but the peak of age of the patients at 2005 is 25-45 years old and became 20 years younger than that at 1985. The current two HPV vaccines can prevent the infection of HPV16/18 among high-risk HPVs and will provide a significant impact especially on young-age onset cervical cancer. Furthermore, quadrivalent HPV vaccine, Gardasil, has shown population impact that is decrease of patients with condyloma acuminate in several countries. The clinical efficacy seems to be convincing. Here HPV vaccine will be reviewed based on the literatures.
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Ongkasuwan J, Friedman EM. Juvenile recurrent respiratory papilloma: Variable intersurgical intervals. Laryngoscope 2012; 122:2844-9. [PMID: 22847877 DOI: 10.1002/lary.23534] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 05/02/2012] [Accepted: 05/30/2012] [Indexed: 11/08/2022]
Affiliation(s)
- Julina Ongkasuwan
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
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Sato Hermann J, Pontes P, Maurice Weckx LL, Fujita R, Avelino M, Nagata Pignatari SS. Laryngeal sequelae of recurrent respiratory papillomatosis surgery in children. Rev Assoc Med Bras (1992) 2012. [DOI: 10.1590/s0104-42302012000200016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Hermann JS, Pontes P, Maurice Weckx LL, Fujita R, Avelino M, Nagata Pignatari SS. Laryngeal sequelae of recurrent respiratory papillomatosis surgery in children. Rev Assoc Med Bras (1992) 2012. [DOI: 10.1016/s0104-4230(12)70181-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Sanchez GI, Jaramillo R, Cuello G, Quintero K, Baena A, O'Byrne A, Reyes AJ, Santamaria C, Cuello H, Arrunategui A, Cortez A, Osorio G, Reina JC, Quint WGV, Muñoz N. Human papillomavirus genotype detection in recurrent respiratory papillomatosis (RRP) in Colombia. Head Neck 2012; 35:229-34. [PMID: 22367608 DOI: 10.1002/hed.22953] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2011] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Knowledge on human papillomavirus (HPV) genotype distribution in recurrent respiratory papillomatosis (RRP) is essential to assess the impact of HPV vaccine. It is provided information for Colombia. METHODS In all, 189 RRP primary cases diagnosed between 1985 and 2009 were identified from 5 pathology laboratories of Cali and Medellin, Colombia. HPV DNA testing in 129 cases that fulfilled inclusion criteria (available paraffin blocks, amplifiable DNA, and confirmed histologic diagnosis of RRP) was performed by the SPF-10/LiPA25 assay (version 1). RESULTS Of all cases 36.1% were juvenile (<12 years old) and a majority of adults were males (p = .09); 95% of cases were HPV positive. HPV 6, 11, and 16 contributed to 69%, 27.1%, and 7.8% of all HPV positive cases. Twelve cases (9.3%) showed multiple infections; 8 of these were HPV 6 or 11 positive. CONCLUSIONS HPV prophylactic vaccine including HPV 6 and 11 may have a major impact against RRP.
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Affiliation(s)
- Gloria I Sanchez
- Infection and Cancer Group, School of Medicine, University of Antioquia, Medellin, Colombia.
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In situ hybridization signal patterns in recurrent laryngeal squamous papillomas indicate that HPV integration occurs at an early stage. Head Neck Pathol 2011; 6:32-7. [PMID: 22052184 PMCID: PMC3311939 DOI: 10.1007/s12105-011-0308-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 10/28/2011] [Indexed: 10/15/2022]
Abstract
Laryngeal papillomas are benign tumors that frequently recur and can compromise airways. We investigated HPV genotype, physical status, and protein expression in juveniles versus adults. Thirty-five laryngeal papilloma specimens were obtained from ten juveniles (1-16 years) and eleven adults (24-67 years). In cases of recurrent papillomatosis (7 juveniles, 7 adults), the first and last papillomas were assayed. HPV type was determined by GP5+/6+ PCR and dot blot hybridization. In situ hybridization (ISH) was performed on 34 specimens; the data were recorded in terms of diffuse (episomal HPV) and punctate (integrated HPV) signal patterns. Immunohistochemistry for the HPV L1 capsid protein, a marker of HPV productive status, was performed on 32 samples. All samples tested HPV positive: HPV 11 in 2/10 (20.0%) juveniles and 5/11 (45.5%) adults; HPV 6 in 7/10 (70%) juveniles and 5/11 (45.5%) adults; and HPV 6/11 double infection was noted in one juvenile and one adult. ISH signals (punctate ± diffuse) were detected among 7/10 (70.0%) juveniles and 7/11 (63.6%) adults. L1 staining was detected in 1/9 (11.1%) juveniles and 6/10 (60.0%) adults (P = 0.06). These data support the idea that integration of low-risk HPV types into the cell genome is an early and common event in the etiology of juvenile and adult recurrent laryngeal papillomas. Productive HPV infections may be more common in adults; accordingly, constant laryngeal re-infection by HPV shed from a productive lesion may contribute to adult recurrent lesions, whereas the mechanism of papilloma recurrence in juveniles may be more attributable to HPV integration.
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Gáll T, Kis A, Fehér E, Gergely L, Szarka K. Virological failure of intralesional cidofovir therapy in recurrent respiratory papillomatosis is not associated with genetic or epigenetic changes of HPV11: Complete genome comparison of sequential isolates. Antiviral Res 2011; 92:356-8. [DOI: 10.1016/j.antiviral.2011.09.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 08/23/2011] [Accepted: 09/11/2011] [Indexed: 11/29/2022]
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Jit M, Chapman R, Hughes O, Choi YH. Comparing bivalent and quadrivalent human papillomavirus vaccines: economic evaluation based on transmission model. BMJ 2011; 343:d5775. [PMID: 21951758 PMCID: PMC3181234 DOI: 10.1136/bmj.d5775] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To compare the effect and cost effectiveness of bivalent and quadrivalent human papillomavirus (HPV) vaccination, taking into account differences in licensure indications, protection against non-vaccine type disease, protection against disease related to HPV types 6 and 11, and reported long term immunogenicity. DESIGN A model of HPV transmission and disease previously used to inform UK vaccination policy, updated with recent evidence and expanded to include scenarios where the two vaccines differ in duration of protection, cross protection, and end points prevented. SETTING United Kingdom. Population Males and females aged 12-75 years. MAIN OUTCOME MEASURE Incremental cost effectiveness ratios for both vaccines and additional cost per dose for the quadrivalent vaccine to be equally cost effective as the bivalent vaccine. RESULTS The bivalent vaccine needs to be cheaper than the quadrivalent vaccine to be equally cost effective, mainly because of its lack of protection against anogenital warts. The price difference per dose ranges from a median of £19 (interquartile range £12-£27) to £35 (£27-£44) across scenarios about vaccine duration, cross protection, and end points prevented (assuming one quality adjusted life year (QALY) is valued at £30,000 and both vaccines can prevent all types of HPV related cancers). CONCLUSIONS The quadrivalent vaccine may have an advantage over the bivalent vaccine in reducing healthcare costs and QALYs lost. The bivalent vaccine may have an advantage in preventing death due to cancer. However, considerable uncertainty remains about the differential benefit of the two vaccines.
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Affiliation(s)
- Mark Jit
- Health Protection Agency, London NW9 6BT, UK.
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81
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Patel NJ, Jenzarli A. Does food intolerance play a role in recurrent respiratory papillomatosis? Int Forum Allergy Rhinol 2011; 2:85-8. [PMID: 22311847 DOI: 10.1002/alr.20094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 07/04/2011] [Accepted: 08/02/2011] [Indexed: 01/25/2023]
Abstract
BACKGROUND The purpose of this study is to evaluate the potential role of food intolerances in the management of recurrent respiratory papillomatosis (RRP). METHODS This is a retrospective case review of 4 pediatric patients with RRP. All of the patients, cared for by the primary author between 2005 and 2010, were managed using microdebrider resection, intralesional injection of cidofovir, and required multiple surgeries. Skin prick test (SPT) and/or radioallergosorbent test (RAST) were obtained for 2 patients. Oral food challenge was utilized in all 4 patients. RESULTS Standard SPT and RAST did not identify any immunoglobulin E (IgE)-based allergens. A detailed medical history followed by an oral food challenge was successful at identifying food intolerances in all 4 patients. When specific food elimination was implemented in these patients' treatments in addition to microdebrider resection and cidofovir injection, statistically significant long-term remissions were achieved. CONCLUSION Food intolerance and its impact on RRP and immune dysfunction deserve further investigation and may benefit some patients with RRP.
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Affiliation(s)
- Nalin J Patel
- Tampa Ear Nose and Throat Associates, Tampa, FL 33613, USA.
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Katsenos S, Becker HD. Recurrent respiratory papillomatosis: a rare chronic disease, difficult to treat, with potential to lung cancer transformation: apropos of two cases and a brief literature review. Case Rep Oncol 2011; 4:162-71. [PMID: 21526134 PMCID: PMC3081647 DOI: 10.1159/000327094] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Recurrent respiratory papillomatosis (RRP), which is caused exclusively by human papilloma virus (HPV), is a rare condition characterized by recurrent growth of benign papillomata in the respiratory tract. The papillomata can occur anywhere in the aerodigestive tract but most frequently in the larynx, affecting both children and adults. The management of this entity remains still challenging since no specific definitive treatment exists. Nevertheless, novel surgical interventions as well as several adjuvant therapies have shown promising results in the long-term palliative management of this debilitating disease. Despite its mostly benign nature, RRP may cause significant morbidity and mortality because of its unpredictable clinical course and especially its tendency, albeit infrequent, for malignant transformation. In this article, we present two patients with RRP; one underwent bronchoscopic laser ablation in combination with inhaled interferon-alpha administration that led to a long-term regression of the disease while the other patient was diagnosed with transformation to squamous cell lung carcinoma with fatal outcome. We include a review of the current literature with special emphasis on RRP management and the potential role of HPV in the development of lung cancer.
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Affiliation(s)
- Stamatis Katsenos
- Department of Interdisciplinary Endoscopy, Thoraxklinik at Heidelberg University, Heidelberg, Germany
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Maturo S, Tse SM, Kinane TB, Hartnick CJ. Initial experience using propranolol as an adjunctive treatment in children with aggressive recurrent respiratory papillomatosis. Ann Otol Rhinol Laryngol 2011; 120:17-20. [PMID: 21370676 DOI: 10.1177/000348941112000103] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We performed a retrospective chart review with a 6-month follow-up to examine the initial use of propranolol as an adjunctive treatment in children with severe recurrent respiratory papillomatosis. This is the first such report. Two of 3 children with severe recurrent respiratory papillomatosis demonstrated a response to oral propranolol therapy, as evidenced by an improved voice and by an increased time between surgical interventions. One child demonstrated no response to propranolol, and medication was halted. Both children who demonstrated a response had undergone more than 10 surgical interventions in the previous year, along with prior treatment including surgical excision and adjuvant therapy. Both children more than doubled the interval between treatments after propranolol administration, and the parents of both children noted marked improvement of the child's voice as measured by their Pediatric Voice-Related Quality of Life score (from 40 to 67.5 in one child and from 27 to 60 in the other child). No child experienced hypoglycemia or blood pressure abnormalities. We conclude that initial use of propranolol as an adjunctive measure in severe recurrent respiratory papillomatosis shows it to have some efficacy in delaying surgical intervention and improving voice. Previous reports have demonstrated relatively safe use of propranolol in children with hemangiomas. Further studies are needed to determine the long-term effectiveness, dosing strategies, and side-effect profile of propranolol for treatment of recurrent respiratory papillomatosis.
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Affiliation(s)
- Stephen Maturo
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114-3914, USA
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Ilmarinen T, Nissilä H, Rihkanen H, Roine RP, Pietarinen-Runtti P, Pitkäranta A, Aaltonen LM. Clinical features, health-related quality of life, and adult voice in juvenile-onset recurrent respiratory papillomatosis. Laryngoscope 2011; 121:846-51. [DOI: 10.1002/lary.21332] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2010] [Indexed: 11/06/2022]
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85
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Position paper--HPV and the primary prevention of cancer; improving vaccine uptake by paediatricians. Eur J Pediatr 2011; 170:309-21. [PMID: 20686784 DOI: 10.1007/s00431-010-1265-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Accepted: 07/15/2010] [Indexed: 10/19/2022]
Abstract
A large proportion of sexually active adults are infected with the human papillomaviruses (HPVs). Although largely asymptomatic, some types of HPVs (HPV-16, HPV-18) which infect the genitalia are known to cause cancers, including cervical cancer. Cervical cancer is an important public health concern and is the second most clinically important cancer to breast cancer in women aged 15-44 years. Until recently, cervical cancer strategies focussed on screening. However, as adolescents become sexually active at a much younger age, the focus is on the use of vaccination as an effective measure to prevent progression of HPV infection to cancer. HPV is also involved in the aetiology of cancers of the anus, vagina, vulva and penis as well as genital warts and laryngeal papillomatosis in young children. Primary prevention through vaccination is now possible in Europe using either the quadrivalent HPV vaccine, Gardasil® (Sanofi Pasteur MSD), or the bivalent HPV vaccine, Cervarix® (GSK), which are both highly immunogenic, with their effects persisting for at least 5 years. HPV vaccines are well tolerated, with serious vaccine-related events occurring in less than 0.1% of patients for both vaccines. Here, we review the possibilities for utilising vaccination programmes alongside current cervical cancer screening in comprehensive cervical cancer prevention programmes. The European Academy of Paediatrics Scientific Working Group on Vaccination concluded that the use of HPV vaccines will have a significant impact in primary prevention of cancers and other HPV-related disease.
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86
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Jeyakumar A, Mitchell R. HPV Vaccination and Recurrent Respiratory Papillomatosis. Otolaryngol Head Neck Surg 2010; 144:133. [DOI: 10.1177/0194599810390481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Craig BM, Brisson M, Chesson H, Giuliano AR, Jit M, Moffitt HL. Proceedings of the Modeling Evidence in HPV Pre-Conference Workshop in Malmö, Sweden, May 9-10, 2009. Clin Ther 2010; 32:1546-64. [PMID: 20728767 PMCID: PMC4095755 DOI: 10.1016/j.clinthera.2010.06.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Prominent published and active human papillomavirus (HPV) modelers from around the world were invited to participate in the inaugural Modeling Evidence in HPV (MEHPV) Pre-Conference Workshop on May 9-10, 2009, in Malmö, Sweden. The workshop took place directly before the 25th International Papillomavirus Conference. OBJECTIVES The aim of the workshop was to develop an international network of investigators engaged in HPV modeling and to facilitate open discussion about the structure and parameterization of models, as well as other methodologic concerns. METHODS Thirty-four participants from more than a dozen countries and a variety of settings, representing the authors or coauthors of 82% of the HPV modeling literature, exchanged ideas on fundamental questions in the field. These proceedings, based on the 217-page transcript, were assembled by the Scientific Committee to summarize the ideas of workshop participants in a deidentified, readable fashion. They represent the work and recorded opinions of session participants and do not constitute the official positions of participants as a whole or individually, the Scientific Committee, or any sponsoring organization or entity. RESULTS In charting a path forward, 3 topics emerged as most pressing: best practices for HPV modeling, comparative modeling, and modeling in developing countries. CONCLUSION This summary of the proceedings of the preconference workshop on HPV modeling characterizes many of the prominent contemporary issues in the field.
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Affiliation(s)
- Benjamin M. Craig
- Health Outcomes & Behavior, Moffitt Cancer Center; Department of Economics, University of South Florida, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612-9416, Phone: (813) 745-6710, Fax: (813) 745-6525,
| | - Marc Brisson
- Mathematical Modeling and Health Economics of Infectious Diseases, Unité de recherche en santé des populations, Hôpital Du Saint-Sacrement, Centre Hospitalier Affilié Universitaire de Québec, 1050, chemin Ste-Foy, Québec G1S 4 L8, Canada, Tél: (418) 682-7511 poste 2720 OR 418-682-7386, Fax: (418) 682-7949,
| | - Harrell Chesson
- Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E-80, Atlanta, GA 30333, USA, Phone: 404-639-8182,
| | - Anna R. Giuliano
- Risk Assessment, Detection & Intervention; Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, Phone: (813) 745-6820,
| | - Mark Jit
- Modelling and Economics Unit, Centre for Infections, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, Tel: +44 (0)20 8327 7803, Fax: +44 (0)20 8327 7868,
| | - H. Lee Moffitt
- Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL 33612
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Markowitz LE, Hariri S, Unger ER, Saraiya M, Datta SD, Dunne EF. Post-licensure monitoring of HPV vaccine in the United States. Vaccine 2010; 28:4731-7. [DOI: 10.1016/j.vaccine.2010.02.019] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 02/03/2010] [Accepted: 02/10/2010] [Indexed: 01/03/2023]
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89
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Donne AJ, Clarke R. Recurrent respiratory papillomatosis: an uncommon but potentially devastating effect of human papillomavirus in children. Int J STD AIDS 2010; 21:381-5. [DOI: 10.1258/ijsa.2010.010073] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Human papillomavirus (HPV) causes disease not only in the genital tract, but also in the larynx. Within the larynx HPV 6/11 causes recurrent respiratory papillomatosis (RRP). RRP is relatively uncommon, yet it is devastating for the patient who requires many surgical procedures over years to control it. The cost of HPV-related genital tract disease is thought to be around £31 million per annum, whereas RRP costs in the region of £4 million annually despite RRP being comparatively rare. The HPV vaccination programme has brought great hope, although it is unfortunate that the current UK programme only targets high-risk HPV. Targeting both low- and high-risk HPV would have had additional benefits for the UK.
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Affiliation(s)
- A J Donne
- Alder Hey Children's NHS Foundation Trust and University of Liverpool, Eaton Road, West Derby, Liverpool L12 2AP, UK
| | - R Clarke
- Alder Hey Children's NHS Foundation Trust and University of Liverpool, Eaton Road, West Derby, Liverpool L12 2AP, UK
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The epidemiology of juvenile onset recurrent respiratory papillomatosis derived from a population level national database. Laryngoscope 2010; 120:1233-45. [DOI: 10.1002/lary.20901] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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91
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Viscidi RP, Shah KV. Papillomaviruses. Infect Dis (Lond) 2010. [DOI: 10.1016/b978-0-323-04579-7.00156-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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92
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Novakovic D, Cheng ATL, Cope DH, Brotherton JML. Estimating the prevalence of and treatment patterns for juvenile onset recurrent respiratory papillomatosis in Australia pre-vaccination: a pilot study. Sex Health 2010; 7:253-61. [DOI: 10.1071/sh09142] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 04/13/2010] [Indexed: 11/23/2022]
Abstract
Background: Recurrent respiratory papillomatosis (RRP) causes serious morbidity. RRP in Australia may be eliminated in the near future following the implementation of a national vaccination program using a human papillomavirus (HPV) vaccine that protects against infection with HPV types 6 and 11, those responsible for RRP. Baseline data on RRP prevalence and disease burden in Australia are lacking. Methods: Three study methods were used to estimate the burden of juvenile onset RRP in Australia. We conducted a retrospective chart review of RRP cases treated at The Children’s Hospital at Westmead over 10 years, examined the coding of these cases, and then calculated and applied the positive predictive value of the codes to national data to estimate the prevalence of RRP in Australia. We also conducted an online survey of otolaryngologists in Australia who manage RRP. Results: Nineteen patients were treated at the hospital over 10 years, involving 359 admissions. We estimate that between 33 and 56 RRP cases aged <20 are being treated nationally per year (0.6–1.1 per 100 000 persons), with children 5–9 years having a higher estimated rate of 1.2–1.8 per 100 000. Among 39 otolaryngologists treating juvenile onset RRP, the majority (73%) treated RRP in a paediatric tertiary hospital, and used the microdebrider for ablation of lesions. Conclusions: Our estimates of RRP disease burden agree with international estimates. As a small number of clinicians treat RRP nationally, we believe that establishment of a national RRP register is both feasible and necessary to monitor the impact of vaccination.
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Voice Outcomes Following Repeated Surgical Resection of Laryngeal Papillomata in Children. Otolaryngol Head Neck Surg 2009; 141:522-6. [DOI: 10.1016/j.otohns.2009.06.080] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 05/14/2009] [Accepted: 06/17/2009] [Indexed: 11/19/2022]
Abstract
OBJECTIVES: 1) To apply perceptual and acoustic voice assessments to children treated for juvenile-onset recurrent respiratory papillomatosis (JORRP); 2) to compare voice outcomes following treatment for JORRP using microdebrider versus carbon dioxide (CO2) laser. STUDY DESIGN: Prospective cohort study. SETTING: This study was conducted at a tertiary pediatric academic center (March 2008-March 2009). SUBJECTS AND METHODS: Children with active JORRP were assessed using perceptual and acoustic voice analysis following treatment with either CO2 laser or microdebrider. Outcome measures included overall severity rating, jitter, shimmer, and noise-to-harmonic ratio (NHR). The unpaired Student t test and Pearson correlation tests were used to explore the statistical significance of hypothesis tests. RESULTS: Eleven patients (8 male, 3 female) aged three to 17 years were enrolled. There were six children in the CO2 laser cohort and five children in the microdebrider cohort. The immediate postoperative scores were significantly lower in the microdebrider cohort (vs the CO2 cohort) for jitter, shimmer, NHR, and perceptual scores ( P < 0.05), indicating a better voice quality in the microdebrider group. Jitter, shimmer, and NHR showed a significant positive correlation with the proportion of CO2 laser procedures ( P < 0.05). CONCLUSION: This is the first study to use perceptual and objective acoustic evaluations to compare voice outcomes following microdebrider or CO2 laser treatment of JORRP. The results of this study suggest that treatment with the microdebrider results in a better immediate and early postoperative voice outcome. Moreover, the data demonstrate a correlation of worsening voice quality with increased exposure to the CO2 laser.
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Moguillansky NI, Raj M, Keenan R, Singh A. A CASE OF A 19 YEAR OLD WOMAN WITH SQUAMOUS CELL CARCINOMA OF THE LUNG. Chest 2009. [DOI: 10.1378/chest.136.4_meetingabstracts.31s-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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95
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The EVER proteins as a natural barrier against papillomaviruses: a new insight into the pathogenesis of human papillomavirus infections. Microbiol Mol Biol Rev 2009; 73:348-70. [PMID: 19487731 DOI: 10.1128/mmbr.00033-08] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Infections by human papillomaviruses (HPVs) are the most frequently occurring sexually transmitted diseases. The crucial role of genital oncogenic HPV in cervical carcinoma development is now well established. In contrast, the role of cutaneous HPV in skin cancer development remains a matter of debate. Cutaneous beta-HPV strains show an amazing ubiquity. The fact that a few oncogenic genotypes cause cancers in patients suffering from epidermodysplasia verruciformis is in sharp contrast to the unapparent course of infection in the general population. Our recent investigations revealed that a natural barrier exists in humans, which protects them against infection with these papillomaviruses. A central role in the function of this HPV-specific barrier is played by a complex of the zinc-transporting proteins EVER1, EVER2, and ZnT-1, which maintain cellular zinc homeostasis. Apparently, the deregulation of the cellular zinc balance emerges as an important step in the life cycles not only of cutaneous but also of genital HPVs, although the latter viruses have developed a mechanism by which they can break the barrier and impose a zinc imbalance. Herein, we present a previously unpublished list of the cellular partners of EVER proteins, which points to future directions concerning investigations of the mechanisms of action of the EVER/ZnT-1 complex. We also present a general overview of the pathogenesis of HPV infections, taking into account the latest discoveries regarding the role of cellular zinc homeostasis in the HPV life cycle. We propose a potential model for the mechanism of function of the anti-HPV barrier.
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Gallagher TQ, Derkay CS. Pharmacotherapy of recurrent respiratory papillomatosis: an expert opinion. Expert Opin Pharmacother 2009; 10:645-55. [PMID: 19284366 DOI: 10.1517/14656560902793530] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Recurrent respiratory papillomatosis is caused by the human papillomavirus types (HPV) 6 and 11. It affects both children and adults. In a small number of cases, the disease can be very aggressive causing significant morbidity and possibly death. Surgical therapy is the primary treatment but in patients with aggressive disease, adjunctive therapy is initiated. The majority of these adjuncts center on immunomodulation, disruption of molecular signaling cascades or interruption of viral replication to help decrease the severity of the disease. Recently, a preventative vaccine has become available but data on its effectiveness will be at least a decade away. In the mean time, researchers are examining other vaccination strategies in the fight against HPV disease. OBJECTIVE We will review the following pharmacotherapies used in the adjunct treatment of RRP: interferon, acyclovir, ribivirin, cidofovir, COX-2 inhibitors, retinoids, anti-reflux medications, zinc, indole-3-carbinol, therapeutic/preventative vaccines. METHODS This is a review paper. Utilizing Medline and Pubmed from 1966 to present, the key words as well as the above listed adjunct treatments were searched for relevant papers. CONCLUSION The evidence supporting each of these adjuncts varies with a majority having only case reports or cases-series to support their use. However, there is hope on the horizon with regard to the HPV vaccine and its potential to prevent future transmission of this disease.
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Carvalho CM, Huot L, Charlois AL, Khalfallah SA, Chapuis F, Froehlich P. Prognostic factors of recurrent respiratory papillomatosis from a registry of 72 patients. Acta Otolaryngol 2009; 129:462-70. [PMID: 19235575 DOI: 10.1080/00016480902737986] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSIONS The database revealed severity factors relating to human papillomavirus (HPV) type and age at diagnosis. While not exhaustive, the database is easy to use and could serve for a European multicentre epidemiological study. OBJECTIVES To propose a database as a starting point for a national registry and to estimate prognostic factors in recurrent respiratory papillomatosis (RRP). MATERIALS AND METHODS This was a retrospective study carried out in a tertiary care teaching hospital. From January 2005 to July 2007, epidemiological, clinical and treatment information on patients undergoing endoscopy for RRP in the department was entered in a database. Data were collected on three forms: the first comprised information about disease history before assessment in the department, the second about the disease and its treatment in the department, and the third about evolution after treatment. RESULTS Data on 72 patients were entered into an RRP database between January 2005 and July 2007. In all, 82% had already been treated for RRP in a different centre; 24 had juvenile-onset (JORRP) and 48 adult-onset (AORRP) papillomatosis. Cidovir injections had been administered to 91% of the patients. Histology found nine cases of dysplasia, one of carcinoma in situ and one of invasive carcinoma. Subglottic and tracheal locations were significantly more frequent in JORRP than in AORRP, as were the maximum Derkay scores and annual numbers of endoscopies. Patients with type 11 HPV had significantly more endoscopies per year than those with type 6.
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98
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Kovalenko S, Lukashenko P, Romanovskaya A, Soldatski IL, Bakanov SI, Pfister H, Gerein V. Distribution and density of CD1a+ and CD83+ dendritic cells in HPV-associated laryngeal papillomas. Int J Pediatr Otorhinolaryngol 2009; 73:249-56. [PMID: 19062106 DOI: 10.1016/j.ijporl.2008.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2008] [Accepted: 10/21/2008] [Indexed: 01/16/2023]
Abstract
BACKGROUND Respiratory papillomatosis associated with human papilloma virus (HPV) infection is the most common benign laryngeal neoplasm. The age of patients at disease onset, HPV type, number of surgeries are well known prognostic factors of the disease course. The correlation between dendritic cell (DC) density in tumor tissue and clinical prognosis was established. AIM The aim of our study was to estimate the density of DC in laryngeal papillomas associated with HPV types 6/11 infection and to evaluate the relationship between the number of DC and the disease severity. MATERIALS AND METHODS Our study included 40 randomly selected biopsy specimens from patients with HPV-positive laryngeal papillomatosis aged from 1.7 to 20 year. DC were immunohistochemically labelled with anti-CD1a antibodies and anti-CD83 antibodies. The density of DC was analysed in epithelial layer and lamina propria. RESULTS In the epithelial layer of papillomas the number of CD1a+ and CD83+ DC was 86.2 (47.5-119.9) cells/mm(2) and 2.6 (0.6-7.9) cells/mm(2), respectively. In lamina propria - 15.3 (5.1-27.9) and 16.0 (6.7-33.2) cells/mm(2). For subgroups of patients with high number of operations (more than 3), early disease onset (children under 3 years of age) and lingering duration of disease (more than 1 year) we detected an increase of CD83+ DC in the epithelial layer. However, our data did not demonstrate a statistically significant difference in CD1a+ DC count neither in the epithelium nor in the lamina propria. Probably, the increase of CD83+ DC density in epithelial layer of patients with severe course of disease can be an evidence of impaired migration of matured DC.
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Affiliation(s)
- Sergey Kovalenko
- Department of Pediatric Pathology, Institute of Pathology, Johannes Gutenberg University of Mainz, Mainz, Germany.
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Chesson HW, Forhan SE, Gottlieb SL, Markowitz LE. The potential health and economic benefits of preventing recurrent respiratory papillomatosis through quadrivalent human papillomavirus vaccination. Vaccine 2008; 26:4513-8. [DOI: 10.1016/j.vaccine.2008.06.045] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Revised: 06/10/2008] [Accepted: 06/12/2008] [Indexed: 10/21/2022]
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