A comparison of risk factors in juvenile‐onset and adult‐onset recurrent respiratory papillomatosis

Kashima, Haskins K.; Shah, Farida; Lyles, Alan; Glackin, Robert; Muhammad, Nadayah; Turner, Laurie; Zandt, Shirley Van; Whitt, Sheila; Shah, Keerti V.

doi:10.1288/00005537-199201000-00002

Cited by 185 publications

(128 citation statements)

References 9 publications

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“…Also, conversion to laryngeal carcinoma occurs more frequently in juveniles [6,7]. In addition to having a different clinical course, JO-RRP differs in its route of acquisition; while numerous studies have indicated that vertical transmission from maternal genital condylomas is the primary mode of juvenile papillomas, adult papillomas apparently spread secondary to oral-genital contact [8,9]. The differences in incidence, transmission, and clinical course of JO-RRP versus AO-RRP suggest that the HPV phenotype may also vary between the two.…”

Section: Introductionmentioning

confidence: 99%

In Situ Hybridization Signal Patterns in Recurrent Laryngeal Squamous Papillomas Indicate that HPV Integration Occurs at an Early Stage

Brooks

Evans

Adamson

et al. 2011

Head and Neck Pathol

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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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Section: Introductionmentioning

confidence: 99%

In Situ Hybridization Signal Patterns in Recurrent Laryngeal Squamous Papillomas Indicate that HPV Integration Occurs at an Early Stage

Brooks

Evans

Adamson

et al. 2011

Head and Neck Pathol

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“…Benign tumors are caused by low risk types such as HPV 1, 2, 3, 4, 6, 10, 11 and others. 9) No simple culture method or serologic test is available for identifying HPV infection. Techniques for identifying the virus are based on nucleic acid detection, either direct hybridization or PCR amplification.…”

Section: Discussionmentioning

confidence: 99%

“…In juvenile onset RRP, HPV is thought to be acquired at the time of vaginal delivery. 3) In one case control study, 9) adult onset RRP patients had more sexual partners and oral sex than their controls. HPVs cause latent airway infection, in addition to the active infection, that induces papillomas, and activation of latent HPV DNA, which appears to persist for the life of the patient, is considered to be the cause of recurrent disease.…”

Section: Discussionmentioning

confidence: 99%

A Case of Multiple Squamous Cell Papillomas of the Trachea

Ogata-Suetsugu

Izumi

Takayama

et al. 2011

ATCS

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We report a case of 68-year-old woman suffering from breathlessness on exertion with stridor. A chest computed tomography showed a tumor arising from the posterior wall of the trachea. The diagnosis was squamous cell papilloma of the surgically removed tumor, which had caused the asphyxiation. After removal of the tumor, the patient received radical therapy: semiconductor laser transpiration. Polymerase chain reaction (PCR) detected human papilloma virus (HPV) type 6, thought to be the cause of the respiratory papilloma.Key words: papilloma, human papilloma virus, polymerase chain reaction, semiconductor laser, trachea Case ReportA 68-year-old woman was admitted to our hospital because of breathlessness with stridor, which gradually worsened over the previous 2 months. She was a nonsmoker and had no history of radiotherapy to the trachea. Physical examinations were normal, except for inspiratory and expiratory stridor. Her routine laboratory results were normal. Pulmonary function test revealed a severe obstructive impairment: a forced vital capacity (FVC) of 3.09 L (135.5% of predicted), a forced expiratory volume in 1 s (FEV1.0) of 0.91 L (53.2% of predicted), and FEV1.0 to FVC ratio of 29.5%. Flow volume loop pattern showed intrathoracic upper airway obstruction. Chest computed tomography (CT) and flexible bronchoscopy documented a cauliflower-like, warty tumor. The main tumor size was 15 × 10 × 10 mm and was located 30 mm below the vocal cords ( Fig. 1a and 1b). In addition, we observed two other small polypoid lesions. We started an emergency tracheostomy of the patient under local anesthesia to remove the tumors and secure her airway.During the tracheostomy, she became nearly asphyxiated. Then, we administered general anesthesia. After completing the tracheostomy, we successfully removed the main tumor without preparing an extracorporeal cardiopulmonary bypass. Histologically, the tumor specimen contained squamous cell papilloma with mild, atypical koilocytes; thus, the diagnosis was multiple respiratory papillomas ( Fig. 1c and 1d). Polymerase chain reaction (PCR) amplification (Fig. 2) detected human papilloma virus (HPV) type 6 DNA in the tumor specimen. Otherwise, there was no viral DNA in normal tissue. After removal of the primary tumor, we used semiconductor laser transpiration, a radical therapy, to remove the remaining tumors. The patient got relief from her symptoms with no recurrence 8 months after treatment. DiscussionRespiratory papilloma has been reported in children and adults. Onset during adulthood is more common among men and often occurs in the third or fourth Ann

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“…Infection with low-oncogenic risk HPVs (LR-HPV), such as HPV-6 and 11, can cause benign lesions of the anogenital areas known as Condylomata acuminate (genital warts), a large proportion of low-grade squamous intraepithelial lesions (LSIL) of the cervix, oral papillomas as well as conjunctival papillomas. HPV-6 or 11 may also cause in rare instance recurrent respiratory papillomatosis, which in infants and young children can be very morbid and usually perinatally transmitted (Armstrong et al 2000) whereas in adult it is usually sexually transmitted and less severe than in children (Kashima et al, 1992). 18,31,33,35,39,45,51,52,56,58,11,13,26,30,32,34,42,44,53,54,61,62,66,67,68,69,70,71,72,73,74,81,82,83,84,85,86,87,89,90 Cutaneous 1,2,4,5,8,9,12 ,1 4,15 ,17,19,20,21,…”

Section: Alpha-papillomavirusmentioning

confidence: 99%

Epidemiology of Mucosal Human Papillomavirus (HPV) Infections Among Adult and Children

Trottier¹

2012

Human Papillomavirus and Related Diseases - From Bench to Bedside - Research Aspects

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A comparison of risk factors in juvenile‐onset and adult‐onset recurrent respiratory papillomatosis

Cited by 185 publications

References 9 publications

In Situ Hybridization Signal Patterns in Recurrent Laryngeal Squamous Papillomas Indicate that HPV Integration Occurs at an Early Stage

In Situ Hybridization Signal Patterns in Recurrent Laryngeal Squamous Papillomas Indicate that HPV Integration Occurs at an Early Stage

A Case of Multiple Squamous Cell Papillomas of the Trachea

Epidemiology of Mucosal Human Papillomavirus (HPV) Infections Among Adult and Children

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