RESUMO
The role of human adenovirus (HAdV) infection in different acute diseases, such as febrile exudative tonsillitis, conjunctivitis, and pharyngoconjunctival fever is well established. However, the relationships, if any, of HAdV persistence and reactivation in the development of the chronic adenotonsillar disease is not fully understood. The present paper reports a 3-year cross-sectional hospital-based study aimed at detecting and quantifying HAdV DNA and mRNA of the HAdV hexon gene in adenoid and palatine tonsil tissues and nasopharyngeal secretions (NPS) from patients with adenotonsillar hypertrophy or recurrent adenotonsillitis. HAdV C, B, and E were detectable in nearly 50% of the patients, with no association with the severity of airway obstruction, nor with the presence of recurrent tonsillitis, sleep apnea or otitis media with effusion (OME). Despite the higher rates of respiratory viral coinfections in patients with HAdV, the presence of other viruses, including DNA and RNA viruses, had no association with HAdV replication or shedding in secretions. Higher HAdV loads in adenoids showed a significant positive correlation with the presence of sleep apnea and the absence of OME. Although this study indicates that a significant proportion (~85%) of individuals with chronic adenotonsillar diseases have persistent nonproductive HAdV infection, including those by HAdV C, B, and E, epithelial and subepithelial cells in tonsils seem to be critical for HAdV C production and shedding in NPS in some patients, since viral antigen was detected in these regions by immunohistochemistry in four patients, all of which were also positive for HAdV mRNA detection.
Assuntos
Tonsila Faríngea/virologia , Infecções por Adenovirus Humanos/virologia , Tonsila Palatina/virologia , Replicação Viral , Tonsila Faríngea/patologia , Infecções por Adenovirus Humanos/diagnóstico , Adenovírus Humanos/classificação , Adenovírus Humanos/isolamento & purificação , Adenovírus Humanos/fisiologia , Adolescente , Criança , Pré-Escolar , Estudos Transversais , DNA Viral/isolamento & purificação , Feminino , Humanos , Hipertrofia , Lactente , Masculino , Tonsila Palatina/patologia , Tonsilite/virologiaRESUMO
INTRODUCTION: In order to better understand the pathophysiology of rhinosinusitis, several attempts have been made to create the disease in an animal model. Among the studied rodents each has its advantages and disadvantages. Rabbits are considered more appropriate for studies that require surgical manipulation or invasive procedures. OBJECTIVES: To evaluate the most viable experimental model of rhinosinusitis in rabbits to be adopted in future studies. METHODS: An electronic search for studies with experimental models of rhinosinusitis in rabbits published in English and Portuguese between July of 1967 and January of 2013 was conducted in Medline, Pub Med, Cochrane, and CAPES databases, using the keywords "sinusitis", "rabbits", and "polyps". RESULTS: A total of 256 studies were retrieved, but in accordance with the inclusion and exclusion criteria, only ten studies were selected. Many different methods of response assessment were used in these studies. CONCLUSION: To date, there is no ideal experimental model for induction of acute or chronic rhinosinusitis in rabbits, but the rhinogenic model appears to be the most viable option for the continuity of studies of the disease.
Assuntos
Modelos Animais de Doenças , Rinite/fisiopatologia , Sinusite/fisiopatologia , Animais , CoelhosRESUMO
Chronic tonsillar diseases are an important health problem, leading to large numbers of surgical procedures worldwide. Little is known about pathogenesis of these diseases. In order to investigate the role of respiratory viruses in chronic adenotonsillar diseases, we developed a cross-sectional study to determine the rates of viral detections of common respiratory viruses detected by TaqMan real time PCR (qPCR) in nasopharyngeal secretions, tonsillar tissues and peripheral blood from 121 children with chronic tonsillar diseases, without symptoms of acute respiratory infections. At least one respiratory virus was detected in 97.5% of patients. The viral co-infection rate was 69.5%. The most frequently detected viruses were human adenovirus in 47.1%, human enterovirus in 40.5%, human rhinovirus in 38%, human bocavirus in 29.8%, human metapneumovirus in 17.4% and human respiratory syncytial virus in 15.7%. Results of qPCR varied widely between sample sites: human adenovirus, human bocavirus and human enterovirus were predominantly detected in tissues, while human rhinovirus was more frequently detected in secretions. Rates of virus detection were remarkably high in tonsil tissues: over 85% in adenoids and close to 70% in palatine tonsils. In addition, overall virus detection rates were higher in more hypertrophic than in smaller adenoids (pâ=â0.05), and in the particular case of human enteroviruses, they were detected more frequently (pâ=â0.05) in larger palatine tonsils than in smaller ones. While persistence/latency of DNA viruses in tonsillar tissues has been documented, such is not the case of RNA viruses. Respiratory viruses are highly prevalent in adenoids and palatine tonsils of patients with chronic tonsillar diseases, and persistence of these viruses in tonsils may stimulate chronic inflammation and play a role in the pathogenesis of these diseases.
Assuntos
Tonsila Faríngea/virologia , Tonsila Palatina/virologia , Tonsilite/virologia , Viroses/virologia , Tonsila Faríngea/patologia , Adenovírus Humanos/genética , Adolescente , Criança , Pré-Escolar , Doença Crônica , DNA Viral/genética , Feminino , Bocavirus Humano/genética , Humanos , Lactente , Masculino , Tonsila Palatina/patologia , Vírus de RNA/genética , RNA Viral/genética , Reação em Cadeia da Polimerase em Tempo Real , Tonsilite/epidemiologia , Tonsilite/genética , Tonsilite/patologia , Viroses/epidemiologia , Viroses/genética , Viroses/patologiaRESUMO
INTRODUCTION: In order to better understand the pathophysiology of rhinosinusitis, several attempts have been made to create the disease in an animal model. Among the studied rodents each has its advantages and disadvantages. Rabbits are considered more appropriate for studies that require surgical manipulation or invasive procedures. OBJECTIVES: To evaluate the most viable experimental model of rhinosinusitis in rabbits to be adopted in future studies. METHODS: An electronic search for studies with experimental models of rhinosinusitis in rabbits published in English and Portuguese between July of 1967 and January of 2013 was conducted in Medline, Pub Med, Cochrane, and CAPES databases, using the keywords "sinusitis", "rabbits", and "polyps". RESULTS: A total of 256 studies were retrieved, but in accordance with the inclusion and exclusion criteria, only ten studies were selected. Many different methods of response assessment were used in these studies. CONCLUSION: To date, there is no ideal experimental model for induction of acute or chronic rhinosinusitis in rabbits, but the rhinogenic model appears to be the most viable option for the continuity of studies of the disease. .
INTRODUÇÃO: Como forma de tornar possível o entendimento da fisiopatologia da rinossinusite é fundamental a transposição da doença em animais. Os coelhos são, dentre os roedores estudados, os animais considerados mais adequados para o estudo que exija manipulação cirúrgica ou procedimentos invasivos. Cada modelo experimental tem seus pontos favoráveis e desfavoráveis. OBJETIVO: Avaliar, em coelhos, o modelo experimental de rinossinusite mais viável a ser adotado em estudos futuros. MÉTODO: Foi realizada busca eletrônica de estudos com modelos experimentais de rinossinusite em coelhos usando as palavras-chave (sinusite/coelhos/pólipos) em inglês e português nas principais bases de dados eletrônicas: Medline, PubMed, Cochrane e CAPES, publicados no período de julho de 1967 a janeiro de 2013. RESULTADOS: Foram encontrados 256 artigos, mas de acordo com os critérios de inclusão e exclusão apenas 10 foram selecionados. Muitos métodos distintos de avaliação de resposta foram utilizados nesses estudos. CONCLUSÃO: Não existe, até o momento, um modelo experimental ideal para a indução de rinossinusite aguda ou crônica em coelhos, porém o modelo rinogênico parece ser a proposta mais viável para a continuidade dos estudos sobre a doença. .