Epidemiology of recurrent respiratory papillomatosis LARSON, DANIEL A; DERKAY, CRAIG S
APMIS : acta pathologica, microbiologica et immunologica Scandinavica,
June/July 2010, Letnik:
118, Številka:
6-7
Journal Article
Recenzirano
Odprti dostop
Larson DA, Derkay CS. Epidemiology of recurrent respiratory papillomatosis. APMIS 2010; 118: 450-454. Recurrent respiratory papillomatosis (RRP) was first described in the 1800s, but it was not until ...the 1980s when it was convincingly attributed to human papilloma virus (HPV). RRP is categorized into juvenile onset and adult onset depending on presentation before or after the age of 12 years, respectively. The prevalence of this disease is likely variable depending on the age of presentation, country and socioeconomic status of the population being studied, but is generally accepted to be between 1 and 4 per 100 000. Despite the low prevalence, the economic burden of RRP is high given the multiple procedures required by patients. Multiple studies have shown that the most likely route of transmission of HPV in RRP is from mother to child during labor. Exceptions to this may include patients with congenital RRP who have been exposed in utero and adult patients who may have been exposed during sexual contact. Although cesarean section may prevent the exposure of children to the HPV virus during childbirth, its effectiveness in preventing RRP is debatable and the procedure itself carries an increased risk of complications. The quadrivalent HPV vaccine holds the most promise for the prevention of RRP by eliminating the maternal reservoir for HPV.
Papillomaviruses (PVs) are epitheliotropic viruses that cause benign proliferative lesions in the skin (warts or papillomas) and mucous membranes of their natural hosts. In bovines specifically, 13 ...types of Bovine papillomaviruses (BPVs) are currently described in the literature, although the actual number may be greater than 20. BPV types are classified into four genera based on homology within the genomic regions of the L1 ORF, the most conserved sequence. This study conducted molecular typing of BPV in dairy cows with different papillomatosis cases and investigated the presence of co-infections across distinct BPV types in the same sample. After carrying out PCR using degenerate primers and type specific primers, 35 BPV suspected samples were detected as positive for BPV and these samples were used for typing using sequence analysis/PCR with type-specific primers. This analysis identified BPV-1, -2, -3, -4, -6, -7, -9 and -10, new putative types (BPV/BR/UEL6-like viruses) and the previously described putative type viruses (BAPV-6) in the 35 BPV-positive samples. In addition, co-infections across different BPV types were widely detected in the BPV-positive samples. This study shows that PCR assays using degenerate primers to amplify partial fragments of the L1 gene followed by sequencing is useful for genotyping BPV. However, results need confirmation using type-specific primers in order to consider co-infections. In addition, this study identified a new putative type (in the same cluster as BPV/BR/UEL6-like viruses) and the previously described putative type viruses (BAPV-6) in teat papillomatosis of Turkish dairy cows. The study shows that it is essential to identify BPV types and their prevalence/distribution, and also to determine the clinical consequences of infection for the development of prophylactic and/or therapeutic procedures.
Objectives/Hypothesis:
To perform a systematic review and formal meta‐analysis of the literature reporting on HPV detection in sinonasal papillomas. Since first reported in 1983, the etiological role ...for human papillomavirus (HPV) in sinonasal papillomas has been subject to increasing interest.
Study Design:
A systematic review, with meta‐analysis and formal meta‐regression.
Methods:
Literature was searched through April 2012. The effect size was calculated as event rates (95% confidence interval CI), with homogeneity testing using Cochran's Q and I2 statistics. Meta‐regression was used to test the impact of study‐level covariates (HPV detection method, geographic origin, papilloma type) on effect size, and potential publication bias was estimated using funnel plot symmetry.
Results:
Seventy‐six studies were eligible covering 1,956 sinonasal papillomas from different geographic regions. Altogether, 760 (38.8%) cases tested HPV‐positive; effect size 0.421 (95% CI 0.359‐0.485, random effects model). The summary HPV prevalence was highest (65.3%) in exophytic papillomas (EP), followed by inverted papillomas (37.8%) and cylindrical cell papillomas (22.5%). In meta‐analysis stratified by 1) HPV detection technique, 2) geographic study origin, and 3) papilloma type, the between‐study heterogeneity was significant only for the papilloma types (P = .001). In meta‐regression, HPV detection method (P = .102), geographic origin (P = .149), or histological type (P = .240) were not significant study‐level covariates. Some evidence for publication bias was found only for studies on EP. In sensitivity analysis, all meta‐analytic results were robust to all one‐by‐one study removals.
Conclusions:
Variability in HPV detection rates in sinonasal papillomas is explained by their histological types (not by HPV detection method or geographic origin of study), but none of the three were significant study‐level covariates in formal meta‐regression. Laryngoscope, 2013
•Canine papillomavirus types 1 and 2 (CPV1 and CPV2) were very prevalent in benign non-plaque papillomas.•CPV1 and CPV2 DNA was often co-detected in papillomas.•CPV L1 antigen was expressed in skin ...and oral, exophytic and endophytic papillomas.•Histopathology and immunohistochemistry results aligned well in viral non-plaque papillomas.•Eyelid and conjunctival papillomas were often not papillomavirus-associated.
Canine papillomatosis is mainly attributed to papillomavirus infections. Papillomavirus DNA is also frequently identified in healthy skin, and evidence of high papillomavirus diversity complicates this simplistic view of causality. The aim of this study was to determine how frequently canine papillomas contain papillomavirus DNA and express viral protein, and how these factors correlate to the histology and anatomic location. Fifty-three archived, formalin-fixed samples of canine papillomas and eight samples of other proliferative skin lesions from dogs were included. Samples were re-evaluated histologically, tested for papillomavirus L1-antigen using immunohistochemistry, and for papillomavirus DNA with PCR assays and molecular sequencing.
Most papillomas from haired skin contained papillomavirus DNA (96%) and antigen (92%). Of oral papillomas, 88% were positive for both papillomavirus DNA and antigen. Approximately 50% of non-papilloma proliferations and papillomas from eyelid/conjunctiva specimens contained viral DNA, but antigen was present in only 12% of eyelid/conjunctiva papillomas and in none of the non-papilloma proliferations. The presence of viral antigen was highly correlated with histological indicators of viral infection, including intranuclear inclusions, koilocytes, cytoplasmatic vacuolation and dysplasia. The viruses found were mainly CPV1 and CPV2. CPV1 dominated in oral infections, while CPV2 dominated in cutaneous endophytic papillomas. Co-infections with CPV1 and CPV2 accounted for about 20% of all detected infections. These results support a role for papillomaviruses in canine cutaneous and oral, exophytic and endophytic papillomas and support previously raised doubts about their role in squamous papillomas from eyelid/conjunctiva specimens.
Summary
Sinonasal inverted papillomas (IPs) are rare tumours arising from the nasal epithelial mucosa. Most lesions are benign, but a subset of IPs progress to dysplasia and squamous cell carcinoma. ...Although the epidemiology and clinical features of IPs are well known, the pathogenesis is still unclear. Given the established role of human papillomaviruses (HPVs) in the formation of other mucosal tumours including cervical and oropharyngeal cancer, some have suggested the virus may play a role in IP development. However, the association between HPV and IPs has not yet been proven, and the variable detection of HPV DNA in IPs has cast uncertainty on whether the virus plays a major role in pathogenesis. In this review, we summarize early clinical reports and synthesize recent studies that may elucidate the association between HPV and IPs. We also discuss the role HPV may have in the progression of benign IP to dysplasia and malignancy, as well as potential pathological mechanisms. We hope that synthesizing the initial and recent studies on this topic will not only lead to a better understanding of research in the role of HPV in IP development, but also help guide and contextualize future studies.
Objective The purpose of this study was (1) to estimate the direct medical costs of 7 major noncervical human papillomavirus (HPV)–related conditions that include genital cancers, mouth and ...oropharyngeal cancers, anogenital warts, and juvenile-onset recurrent respiratory papillomatosis, and (2) to approximate the economic burden of noncervical HPV disease. Study Design For each condition, we synthesized the best available secondary data to produce lifetime cost per case estimates, which were expressed in present value. Using an incidence-based approach, we then applied these costs to develop an aggregate measure of economic burden. Results The economic burden that was associated with noncervical HPV-6–, -11–, -16–, and -18–related conditions in the US population in the year 2003 approximates $418 million (range, $160 million to $1.6 billion). Conclusion The economic burden of noncervical HPV disease is substantial. Analyses that assess the value of investments in HPV prevention and control programs should take into account the costs and morbidity and mortality rates that are associated with these conditions.
Highlights ► HPV16 is necessary for initiation/malignant phenotype of some oropharynx cancers. ► Infection by HPV16 is associated with elevated odds of oropharynx cancer. ► Tumor HPV status is an ...important prognostic factor for oropharynx cancer. ► HPV-positive oropharynx cancer incidence is increasing in developed countries. ► Respiratory papillomatosis is caused by peripartum/sexual transmission of HPV6/11.
If esophageal papilloma (EP) is a rare condition, esophageal papillomatosis (EPS) is a distinct rarity. To date, only 53 well documented cases have been described in English literature. However, the ...number of reports on EPS significantly increased to over 40 cases during the past 20 years. Perhaps, this is due to the broad use of endoscopy and related research achievements. Most of the cases are individual and it seems that there are no associations between them. And up to now no guidelines can be followed. To further understand this exceedingly rare disease, we had a comprehensive review of the epidemiology, etiology, clinical manifestations, pathogenesis, treatment, and clinical course of EPS.
Objectives
To examine the epidemiology, subtypes, trends over time, and predictive factors for recurrence and malignant transformation of sinonasal papillomas.
Methods
A retrospective chart review of ...118 patients with sinonasal papillomas from 2009 to 2019 was conducted at the University of California, Los Angeles. This study is a follow-up to a previously published study from 2000 to 2009 at the same academic center.
Results
The mean age was at presentation was 58.5 years, with a 2:1 male to female ratio, and average follow-up of 30.1 months. The rate of recurrence after complete resection was 19% with an average of 32.6 months to recurrence. The time to recurrence followed a bimodal distribution with 57% of cases recurring within 24 months (mean = 10) and 43% from 40 to 103 months (mean = 61). The proportion of the inverted papillomas rose from 38% in 2000-2004 to 89.6% in 2015-2019. Patients presenting at a younger age had a higher chance of recurrence (mean age 52 with recurrence vs. 61 without recurrence). Age did not correlate with histopathologic transformation in surgical pathology. Furthermore, histopathological transformation did not raise the chance of recurrence. Smoking, alcohol use, chronic rhinosinusitis, and allergic rhinitis were not associated with any of the outcome measures in this study. The most significant factor predicting recurrence, beside age at presentation, was the history of two or more prior sinus surgeries for papillomas or other reasons (OR = 3.52 and 5.81).
Conclusion
This study explored the features of sinonasal papillomas as well as the risk factors for recurrence and transformation. Younger age at presentation and two or more prior surgeries for papillomas were associated with recurrence. Time to recurrence followed a bimodal distribution, with late recurrences happenning from 40 to 103 months after surgery, emphasizing the importance of long-term follow-up for timely resection of tumors and prevention of malignancy.
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