HHV-6 infection of tonsils and adenoids in children with hypertrophy and upper airway recurrent infections
HHV-6 infection of tonsils and adenoids in children with hypertrophy and upper airway recurrent infections
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DOI：
10.1016/j.ijporl.2009.10.008
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发表时间：
2010-01-01
影响因子：
1.5
通讯作者：
Campello, Cesare
中科院分区：
文献类型：
--
作者：
Comar, Manola;Grasso, Domenico;Campello, Cesare
目的：人类疱疹病毒6 （HHV-6）是一种儿童期自限性体检疾病的病原体，在继发性淋巴器官中持续处于沉默状态，其再激活以HHV-6诱导的炎症细胞因子为特征。本研究探讨HHV-6在扁桃体和腺样体肥大儿童中可能的病因作用。方法：对80例因组织肥大而行择期扁桃体切除和/或腺样体切除术的患儿（平均年龄4.8岁，女性43.5%）采集扁桃体55份、腺样体新鲜组织80份、血液74份。此外，5岁以下的患者记录的上呼吸道复发感染与急性扁桃体炎复发无关。进行特异性IgG抗体和病毒检测（PCR、变异A/B酶基因分型和实时PCR）。结果：在我们的系列中，HHV-6血清阳性率检测为50%。HHV-6变体B是在25%的腺样体、12.7%的扁桃体和4%的外周血单个核细胞（PBMCs）中发现的唯一菌株。HHV-6-B在受上呼吸道感染的儿童扁桃体中普遍存在（17.8%对7.4%），而在肥大患者中，腺样体是更常见的宿主（30.7%对19.5%）。HHV-6病毒载量较低，在80 - 600拷贝/10(6)个细胞之间，提示感染处于潜伏/持续阶段。结论：这些结果强化了次级淋巴器官作为HHV-6B病毒重要储存库的作用。然而，由低水平复制维持的淋巴样细胞感染可能足以通过自体炎症机制增加局部损伤。2009爱思唯尔爱尔兰有限公司版权所有。
Objective: Human herpes virus 6 (HHV-6), the agent of a self-limiting exanthematic disease in childhood, persists in a silent state in the secondary lymphoid organs and the reactivation is characterized by HHV-6-induced inflammatory cytokines. This study investigates the possible etiological role of HHV-6 in children affected by tonsil and adenoid hypertrophy.Methods: 55 tonsils, 80 adenoids fresh tissues and 74 blood samples were collected from 80 children (mean age 4.8 years, 43.5% female) undergoing elective tonsillectomy and/or adenoidectomy for tissue hypertrophy. Moreover, patients with < 5 years old documented upper airway recurrent infections not related to relapsing of acute tonsillitis. Specific IgG antibodies and virus detection (by PCR, variant A/B enzymatic genotyping and real-time PCR) were performed.Results: In our series, HHV-6 seroprevalence was tested at 50%. HHV-6 variant B was the unique strain finding in 25% of adenoids, in 12.7% of tonsils and in 4% of peripheral blood mononuclear cells (PBMCs). HHV-6-B was prevalent in tonsils of children affected by upper airway infections (17.8% vs 7.4%) while the adenoids represented the more frequent reservoir (30.7% vs 19.5%) in patients with hypertrophy. HHV-6 viral load was low, ranging from 80 to 600 copies/10(6) cells suggesting a latent/persistent phase of infection.Conclusion: These results reinforce the role of the secondary lymphoid organs as an important reservoir for HHV-6B. Nevertheless, infection of lymphoid cells, sustained by a low level of replication, could be sufficient to increase the local injury through an autologous mechanism of inflammation. (C) 2009 Elsevier Ireland Ltd. All rights reserved.