Biologics for the Treatment of Recurrent Respiratory Papillomatosis.
Biologics for the Treatment of Recurrent Respiratory Papillomatosis.
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DOI：
10.1016/j.otc.2021.05.002
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发表时间：
2021-08
影响因子：
1.7
通讯作者：
Allen CT
中科院分区：
文献类型：
--
作者：
Allen CT
复发性呼吸道乳头状瘤病（RRP）是一种肿瘤性疾病，表现为上呼吸消化道乳头状瘤样生长。症状特征、社会经济影响和标准治疗方法已在最近发表的专家综述中概述1。简而言之，RRP类似于肛门生殖器尖锐湿疣，是由低风险人乳头瘤病毒（HPV）6或11型慢性感染引起的。许多人暴露于HPV 6和11，但很少有患者发展为慢性感染和乳头状瘤病。决定慢性感染或清除低风险HPV病毒的遗传或环境风险因素尚不清楚2。乳头状瘤的诊断通常由训练有素的病理学家是直接的，和疾病的复发性质和解剖位置指向RRP的临床诊断。RRP的治疗历来以乳头状瘤病的维持性手术减积为中心，旨在为患者提供通畅的气道和可用的声音。这是一个非常少的感染性疾病治疗的重复surgery.Given非典型的临床管理治疗慢性感染性疾病（由于假定的免疫功能障碍）与重复手术不导致治愈，辅助治疗结合手术减瘤的疾病或替代治疗用于代替手术进行了研究。建立RRP的体外或体内模型的无能或困难性质使得研究缓慢且具有挑战性3，4。因此，RRP中发表的大多数研究都是临床研究。由于研究新RRP治疗的大型前瞻性临床试验难以资助和累积，因此大多数已发表的临床试验都是在2011年进行的。
Recurrent respiratory papillomatosis (RRP) is a neoplastic disorder that manifests as papillomatous growths in the upper aerodigestive tract. The symptom profile, socioeconomic implications and standard treatment approaches have been outlined in recently published expert reviews1. Briefly, RRP, similar to anogenital condyloma, is caused by a chronic infection with low-risk human papillomavirus (HPV) types 6 or 11. Many are exposed to HPV 6 and 11, but few patients develop chronic infection and papillomatous disease. The genetic or environmental risk factors that dictate the development of a chronic infection or clearance of the low-risk HPV virus are poorly understood2. Diagnosis of papilloma by a trained pathologist is usually straightforward, and the recurrent nature and anatomic locations of disease point to the clinical diagnosis of RRP. Treatment for RRP has historically centered on maintenance surgical debulking of papillomatous disease aimed at providing the patient with a patent airway and a serviceable voice. This is one of the very few infectious disorders treated with repeat surgery.Given the atypical clinical management of treating a chronic infectious disorder (as a result of presumed immune dysfunction) with repeat surgery not resulting in cure, adjuvant treatments used in combination with surgical debulking of disease or alternative treatments used in lieu of surgery have been studied. The inability or difficult nature of establishing in vitro or in vivo models of RRP has made research slow and challenging3, 4. As a result, most published research in RRP is clinical research. Since large prospective clinical trials studying new RRP treatment are difficult to fund and accrue, most published clinical
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