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New Risk Factors for Respiratory Papillomatosis


Authors: M. Formánek 1,2;  Karol Zeleník 1,2;  R. Tomanová 3;  Pavel Komínek 1,2
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku FN Ostrava přednosta prof. MUDr. P. Komínek, Ph. D., MBA 1;  Katedra kraniofaciálních oborů, Lékařská fakulta, Ostravská Univerzita vedoucí katedry prof. MUDr. P. Komínek, Ph. D., MBA 2;  Ústav patologie FN Ostrava přednostka doc. MUDr. J. Dvořáčková, Ph. D. 3
Published in: Otorinolaryngol Foniatr, 66, 2017, No. 1, pp. 23-27.
Category: Original Article

Overview

Background:
Recurrent respiratory papillomatosis is caused by human papillomavirus. However, the prevalence of respiratory papillomatosis is much lower than prevalence of human papillomavirus infection. Therefore other factors may contribute to recurrent respiratory papillomatosis. This study investigated whether patients with respiratory papillomatosis are more often infected with herpes simplex virus type 2 and chlamydia trachomatis and whether they more often have laryngopharyngeal reflux.

Methods:
The prospective case-control study included 27 patients with recurrent respiratory papillomatosis and 27 patients with no pathology of laryngeal mucosa (control group). Immunohistochemical analysis of pepsin, human papillomavirus, herpes simplex virus type 2, and chlamydia trachomatis was performed in biopsy specimens of laryngeal papillomas and of healthy laryngeal mucosa (control group) obtained during microlaryngoscopy procedures.

Results:
Pathologic laryngopharyngeal reflux (pepsin in tissue) was diagnosed in 13/27 (48.1%) patients with papillomatosis and in 0/27 control patients (P < 0.001). Herpes simplex virus type 2 was present in 12/27 (44.4%) patients with papillomatosis and in 1/27 (3.7%) control patients (P = 0.001). Seven specimens were positive for both pepsin and herpes simplex virus type 2. No samples were positive for chlamydia trachomatis. The groups were homogenous.

Conclusions:
Laryngopharyngeal reflux and herpes simplex virus type 2 infection could be possible risk factors for recurrent respiratory papillomatosis.

Keywords:
recurrent respiratory papillomatosis, human papillomavirus, laryngopharyngeal reflux, herpes simplex virus type 2


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