Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.516
Filtrar
1.
J Contemp Dent Pract ; 22(7): 850-853, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34615793

RESUMO

AIM AND OBJECTIVE: The aim of this study was to determine the clinical utility of body mass index (BMI), tonsil size, and Mallampati scoring in predicting both the presence of and severity of pediatric obstructive sleep apnea (OSA). MATERIALS AND METHODS: This prospective cross-sectional study comprised 78 growing children in the age range of 11-14 years with polysomnography (PSG)-proven OSA and 86 non-OSA corresponding controls. BMI, tonsil size (Friedman grading scale), and Mallampati score were determined for both groups, and related differences were assessed with a t-test, while their independent association with OSA severity was tested with a regression analysis. Statistical significance was set at p <0.05. RESULTS: Male gender, BMI, tonsil size, and Mallampati score were significantly higher in the OSA group (p < 0.05). A significant correlation was recorded between the Mallampati score and OSA severity (p < 0.01), but not with BMI or tonsil size (p > 0.05). For every 1-point increase in the Mallampati scale, the apnea-hypopnea index (AHI) increased by more than five events per hour in the bivariate analysis and by more than three events per hour in the multivariate analysis. CONCLUSION: Male gender, increased BMI, high tonsil, and Mallampati scores were clinical indicators of the presence of OSA. However, only Mallampati scale had a significant association with OSA severity. Clinical diagnostic indicators should be established and encouraged especially in community-based studies. CLINICAL SIGNIFICANCE: Clinical diagnostic indicators are very useful in examining and screening children who are at risk of developing OSA as PSG is expensive and unsuitable for universal use in the pediatric population.


Assuntos
Tonsila Palatina , Apneia Obstrutiva do Sono , Adolescente , Criança , Estudos Transversais , Humanos , Masculino , Estudos Prospectivos , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia
2.
Trials ; 22(1): 617, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34526073

RESUMO

BACKGROUND: Tonsillar surgery has been used for decades to treat recurrent and chronic tonsillitis in adults. Recurrent and chronic tonsillitis result in disturbing symptoms, treatment costs, sick leave, and impaired quality of life (QoL). Theoretically, removing all or part of the altered pathological palatal lymphoid tissue alleviates the symptoms and enhances the QoL. Whether this is true with total or partial tonsillar resection (tonsillectomy (TE) and tonsillotomy (TT), respectively) has not been reported in a randomised trial yet. METHODS: We conduct a multicentre, partly blinded, randomised, 6-month, parallel-group clinical study including 285 adult participants referred to surgical treatment for chronic or recurrent tonsillitis. The participants will either have TE, TT or watchful waiting (WW). The primary outcome will be the difference between the mean disease-specific Tonsillectomy Outcome Inventory-14 (QoL questionnaire) scores at 6 months. Comparison is made firstly between the combined TE+TT and WW groups (superiority analysis), and secondly between the TE and TT groups (non-inferiority analysis). DISCUSSION: This study will add significant new information to the effects and harms of TE and TT procedures in the treatment of adults with chronic or recurrent tonsillitis. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04657549.


Assuntos
Tonsilectomia , Tonsilite , Adulto , Doença Crônica , Humanos , Estudos Multicêntricos como Assunto , Tonsila Palatina/cirurgia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Tonsilectomia/efeitos adversos , Tonsilite/diagnóstico , Tonsilite/cirurgia
5.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(9): 1167-1171, 2021 Sep 15.
Artigo em Chinês | MEDLINE | ID: mdl-34523283

RESUMO

Objective: To investigate the effects of gender and age on the posterior cranial fossa linear volume and cerebellar tonsil position in normal populations. Methods: A total of 180 normal adults who underwent cervical MRI examination at the physical examination center were selected, including 90 males and 90 females; the age ranged from 20 to 79 years, with an average of 50.4 years. The posterior cranial fossa linear volume and cerebellar tonsil position were measured by two spine surgeons on the mid-sagittal plane of the cervical MRI T2-weighted image. The posterior cranial fossa linear volume included the length of clivus (AB), anteroposterior diameter of foramen magnum (BC), length of supraocciput (CD), anteroposterior diameter of posterior fossa (DA), posterior fossa height (BE), and clivus angle (∠α). The index of the cerebellar tonsil position was the distance from the lower edge of the cerebellar tonsil to the baseline (MN). The differences of each indicators between males and females were compared, and the correlations between age and each indicators were analyzed. Results: The posterior fossa cranial linear volume AB, BC, CD, BE, and ∠α in males were significantly larger than those in females ( P<0.05); DA in males was larger than that in females, but showing no significant difference ( t=1.978, P=0.050). The cerebellar tonsil position (MN) in females was higher than that in males, but showing no significant difference ( t=0.526, P=0.600). Correlation analysis showed that age was negatively correlated with AB, BC, CD, DA, BE, ∠α, and MN ( r=-0.375, P=0.001; r=-0.417, P=0.001; r=-0.046, P=0.001; r=-0.244, P=0.001; r=-0.326, P=0.001; r=-0.320, P=0.001; r=-0.334, P=0.001). Conclusion: The posterior cranial fossa linear volume of normal adults is significantly larger in males than in females; the posterior cranial fossa linear volume and the cerebellar tonsil position may have a decreasing process of age-related degeneration.


Assuntos
Malformação de Arnold-Chiari , Adulto , Idoso , Fossa Craniana Posterior/diagnóstico por imagem , Feminino , Forame Magno , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tonsila Palatina , Adulto Jovem
6.
J Laryngol Otol ; 135(9): 844-845, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34376269

RESUMO

BACKGROUND: Thyroid and parathyroid surgery often involves the use of heated instruments for dissection. Whilst these are beneficial, accidental thermal damage to the exposed skin edges can occur, resulting in an unsatisfactory cosmetic outcome. Tonsil swabs can be used in head and neck surgery intra-operatively to control bleeding. This paper describes an alternative use for them in protecting wound edges during the procedure. METHOD: Damp tonsil swabs are sutured onto the wound edges after the initial skin incision. They remain present for the duration of the surgery and are removed at the time of skin closure. RESULTS: The tonsil swabs provide protection and help avoid accidental injury to the skin. No complications with this technique have been experienced. CONCLUSION: This paper describes a simple, effective and practical technique for protecting the skin during neck procedures using resources readily available in a standard ENT operating theatre.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Hemostasia Cirúrgica/instrumentação , Pescoço/cirurgia , Tonsila Palatina/cirurgia , Humanos , Glândulas Paratireoides/cirurgia , Paratireoidectomia/efeitos adversos , Paratireoidectomia/instrumentação , Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Tireoidectomia/instrumentação
7.
Int J Mol Sci ; 22(16)2021 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-34445493

RESUMO

Classical swine fever (CSF) is a highly contagious disease caused by the classical swine fever virus (CSFV). The live attenuated C-strain vaccine is highly efficacious, initiating protection within several days of delivery. The vaccine strain is detected in the tonsil early after inoculation, yet little is known of the role that tonsillar immune cells might play in initiating protection. Comparing the C-strain vaccine with the pathogenic CSFV Alfort-187 strain, changes in the myeloid cell compartment of the tonsil were observed. CSFV infection led to the emergence of an additional CD163+CD14+ cell population, which showed the highest levels of Alfort-187 and C-strain infection. There was also an increase in both the frequency and activation status (as shown by increased MHC-II expression) of the tonsillar conventional dendritic cells 1 (cDC1) in pigs inoculated with the C-strain. Notably, the activation of cDC1 cells coincided in time with the induction of a local CSFV-specific IFN-γ+ CD8 T cell response in C-strain vaccinated pigs, but not in pigs that received Alfort-187. Moreover, the frequency of CSFV-specific IFN-γ+ CD8 T cells was inversely correlated to the viral load in the tonsils of individual animals. Accordingly, we hypothesise that the activation of cDC1 is key in initiating local CSFV-specific CD8 T cell responses which curtail early virus replication and dissemination.


Assuntos
Linfócitos T CD8-Positivos/metabolismo , Vírus da Febre Suína Clássica/imunologia , Peste Suína Clássica/prevenção & controle , Tonsila Palatina/imunologia , Vacinas Virais/administração & dosagem , Animais , Antígenos CD/metabolismo , Antígenos de Diferenciação Mielomonocítica/metabolismo , Peste Suína Clássica/imunologia , Peste Suína Clássica/virologia , Vírus da Febre Suína Clássica/fisiologia , Células Dendríticas/metabolismo , Interferon gama/metabolismo , Receptores de Lipopolissacarídeos/metabolismo , Células Mieloides/metabolismo , Tonsila Palatina/citologia , Tonsila Palatina/virologia , Receptores de Superfície Celular/metabolismo , Suínos , Vacinas Atenuadas/administração & dosagem , Vacinas Atenuadas/imunologia , Carga Viral , Vacinas Virais/imunologia
8.
Immunity ; 54(8): 1628-1630, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34380060

RESUMO

Fibroblasts are the immunological architects of lymph nodes. In this issue of Immunity, Mourcin et al. describe the human tonsil fibroblast landscape and predicted T and B cell interactions. Transcriptomic changes in follicular lymphoma could provide untapped clinical targets.


Assuntos
Linfoma Folicular , Fibroblastos , Humanos , Linfonodos , Tonsila Palatina
9.
Int J Pediatr Otorhinolaryngol ; 149: 110867, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34385038

RESUMO

OBJECTIVE: The study aims to investigate into the correlation between clinical characteristics of pediatric obstructive sleep apnea (OSA) and the results of polysomnography (PSG), sleep apnea screening test (SAST) and cardiopulmonary coupling (CPC) respectively and compare their diagnostic values for pediatric OSA patients. METHODS: We recruited 239 pediatric OSA patients aged between 2 and 12 from Jan 1, 2017 to Jun 30, 2018. All the patients received PSG, SAST and CPC simultaneously and the results of these three different tests were compared and analyzed together with their clinical features. The relationship between the size of adenoid/tonsil and the severity of OSA was also analyzed. RESULTS: No statistically significant differences were noted between SAST and PSG in the oxygen desaturation index (ODI3) and lowest oxygen saturation (LsO2) respectively. No significant statistical difference was noted in the proportion of rapid eye movement sleep between CPC and PSG. The apnea-hypopnea index (AHI) from CPC was significantly lower than that from PSG. In the severe OSA group, no significant statistical difference was noted in AHI between these two tests. However, AHI from CPC was significantly lower than that from PSG in other groups. No statistically significant difference was noted in AHI and ODI3 among different groups graded by the size of adenoid or tonsil, suggesting that the size of adenoid/tonsil may not be highly related to the severity of OSA. CONCLUSION: SAST is an acceptable fast screening tool in the assessments of blood oxygen desaturation and further pediatric OSA screening. CPC is capable to screen severe pediatric OSA, but its results should be interpreted with caution for pediatric patients with non-severe OSA. The size of adenoid/tonsil may not be highly related to the severity of OSA.


Assuntos
Síndromes da Apneia do Sono , Apneia Obstrutiva do Sono , Criança , Pré-Escolar , Humanos , Tonsila Palatina , Polissonografia , Apneia Obstrutiva do Sono/diagnóstico , Sono REM
10.
Int J Mol Sci ; 22(16)2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34445351

RESUMO

Multiplexed single-cell analysis of proteins in their native cellular contexts holds great promise to reveal the composition, interaction and function of the distinct cell types in complex biological systems. However, the existing multiplexed protein imaging technologies are limited by their detection sensitivity or technical demands. To address these issues, here, we develop an ultrasensitive and multiplexed in situ protein profiling approach by reiterative staining with off-the-shelf antibodies and cleavable fluorescent tyramide (CFT). In each cycle of this approach, the protein targets are recognized by antibodies labeled with horseradish peroxidase, which catalyze the covalent deposition of CFT on or close to the protein targets. After imaging, the fluorophores are chemically cleaved, and the antibodies are stripped. Through continuous cycles of staining, imaging, fluorophore cleavage and antibody stripping, a large number of proteins can be quantified in individual cells in situ. Applying this method, we analyzed 20 different proteins in each of ~67,000 cells in a human formalin-fixed paraffin-embedded (FFPE) tonsil tissue. Based on their unique protein expression profiles and microenvironment, these individual cells are partitioned into different cell clusters. We also explored the cell-cell interactions in the tissue by examining which specific cell clusters are selectively associating or avoiding each other.


Assuntos
Diagnóstico por Imagem/métodos , Proteínas/metabolismo , Análise de Célula Única/métodos , Anticorpos/metabolismo , Comunicação Celular , Imunofluorescência/métodos , Corantes Fluorescentes/química , Corantes Fluorescentes/farmacocinética , Formaldeído/química , Peroxidase do Rábano Silvestre/análise , Peroxidase do Rábano Silvestre/metabolismo , Humanos , Técnicas Imunoenzimáticas/métodos , Tonsila Palatina/química , Tonsila Palatina/citologia , Tonsila Palatina/metabolismo , Inclusão em Parafina , Proteínas/análise , Sensibilidade e Especificidade , Coloração e Rotulagem/métodos
11.
Artigo em Chinês | MEDLINE | ID: mdl-34304480

RESUMO

Airway obstruction caused by adenotonsillar hypertrophy is one of the most common otolaryngological diseases in children. In recent years, Epstein Barr virus has been found to be closely related to adenotonsillar hypertrophy. This review summarizes the mechanism and epidemiology of adenotonsillar hypertrophy and obstructive sleep apnea syndrome caused by Epstein Barr virus.


Assuntos
Tonsila Faríngea , Infecções por Vírus Epstein-Barr , Criança , Herpesvirus Humano 4 , Humanos , Hipertrofia , Tonsila Palatina
12.
Artigo em Chinês | MEDLINE | ID: mdl-34304528

RESUMO

Objective:To investigate the effect of preventive measures in reducing postoperative bleeding, which is made for children day surgery on tonsils and adenoids in our hospital, and to clarify its safety and feasibility. Methods:A retrospective analysis of 649 patients with children day surgery due to obstructive sleep apnea(OSA) caused by adenoid hypertrophy of tonsil was conducted. All of the patients were admitted to Shanghai Children's Hospital from February 2021 to April 2021. According to whether preventive measures were taken or not, they were divided into the control group and the observation group. The postoperative bleeding rate, bleeding time, and bleeding-related factors of the two groups were compared. Results:There were 4 cases(1.22%) in the observation group and 12 cases(3.74%) in the control group, the postoperative bleeding rate of the observation group was lower than that of the control group(χ²=4.28, P=0.039). The postoperative bleeding in the observation group occurred(8.25±2.75) days after surgery while the control group(7.42±1.98) days, which shows no significant difference in postoperative bleeding time between the two groups(χ²=2.601, P=0.321). There was no case of postoperative infection in the observation group while 7 cases(58.3%) in the control group(χ²=7.658, P=0.036). Conclusion:For children with day surgery of tonsils and adenoids, appropriate optimization measures can be taken for hospital admission evaluation, infection prevention, postoperative observation, publicity and education, which can effectively reduce the incidence of postoperative complications and improve the treatment effect of day surgery.


Assuntos
Tonsila Faríngea , Tonsilectomia , Adenoidectomia , Tonsila Faríngea/cirurgia , Procedimentos Cirúrgicos Ambulatórios , Criança , China , Humanos , Hipertrofia , Tonsila Palatina/cirurgia , Hemorragia Pós-Operatória/prevenção & controle , Estudos Retrospectivos
13.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 35(8): 746-747;751, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34304538

RESUMO

Clear cell carcinoma is a rare head and neck malignancy, which has a good prognosis. Its diagnosis requires a combination of histology, immunohistochemistry and molecular testing. We present a case of tonsil clear cell carcinoma, which was treated with extended tumor resection. The patient did not receive postoperative adjuvant therapy, and no recurrence or metastasis was found in the follow-up of 13 months.


Assuntos
Adenocarcinoma de Células Claras , Neoplasias das Glândulas Salivares , Humanos , Imuno-Histoquímica , Recidiva Local de Neoplasia , Tonsila Palatina
14.
Artigo em Chinês | MEDLINE | ID: mdl-34304541

RESUMO

Obstructive sleep apnea(OSA) is a common disease in otolaryngology in children, and its incidence rate is increasing gradually, which seriously endangers children's growth and development, behavior cognition and so on. There are many etiologies of OSA in children. Besides tonsil hypertrophy and/or adenoid hypertrophy, the most common one, there are many different levels of airway obstruction caused by inflammation, dysplasia, obesity and other reasons. Different individualized treatment plan should be taken according to different etiology. This paper summarizes the different treatment methods of children OSA.


Assuntos
Tonsila Faríngea , Apneia Obstrutiva do Sono , Tonsilectomia , Adenoidectomia , Criança , Humanos , Tonsila Palatina , Apneia Obstrutiva do Sono/cirurgia
15.
Artigo em Chinês | MEDLINE | ID: mdl-34304542

RESUMO

Adenoid and tonsil hypertrophy in children are closely related to asthma. Their pathogenesis and clinical symptoms are interacted on each other. The unified airway theory believes that the upper and lower respiratory tracts are connected through the release of systemic inflammatory factors. Studies have shown that adenoid and tonsillectomy surgery have a positive effect on the control and development of asthma. The symptoms of postoperative asthma, frequency of attacks, control medication and asthma severity related indicators in children were significantly reduced compared with those before surgery. It has been shown that asthma can increase the incidence of respiratory complications after adenoidectomy and tonsillectomy, so postoperative care after adenotonsillectomy is also important to control asthma. Understanding the relationship between diseases can help clinicians make a more comprehensive diagnosis and treatment.


Assuntos
Tonsila Faríngea , Asma , Tonsilectomia , Adenoidectomia , Tonsila Faríngea/cirurgia , Criança , Humanos , Hipertrofia , Tonsila Palatina/cirurgia
16.
Head Neck ; 43(10): 3076-3085, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34288202

RESUMO

BACKGROUND: Human papillomavirus (HPV)-positive tonsil and base of tongue (BOT) cancers have been considered together. However, important differences may exist. METHODS: Demographic and tumor characteristics, and survival, were compared by oropharyngeal cancer subsite from 2004 to 2016 in the National Cancer Database (NCDB). Trends in tonsillectomy from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 were examined. RESULTS: HPV-positive BOT (N = 13 081) were older than HPV-positive tonsil patients (N = 16 874; mean 61.5 vs. 58.4 years, p < 0.001), and individuals 70+ years were significantly more likely to have BOT tumors compared with individuals <50 (adjusted odd ratio [aOR] = 2.9, 95% confidence interval = 2.6-3.2). BOT patients were also more likely to be white, male, and have advanced tumor classification. Among 7418 NHANES participants, tonsillectomy was associated with older age and white race. CONCLUSIONS: There are epidemiologic and tumor-related differences among HPV-positive tonsil and BOT carcinomas. Demographic differences may be attributable to tonsillectomy trends.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Orofaríngeas , Infecções por Papillomavirus , Neoplasias Tonsilares , Idoso , Humanos , Masculino , Inquéritos Nutricionais , Neoplasias Orofaríngeas/epidemiologia , Tonsila Palatina , Infecções por Papillomavirus/epidemiologia , Língua , Neoplasias Tonsilares/epidemiologia
17.
Nat Commun ; 12(1): 4372, 2021 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-34272370

RESUMO

Intrarenal B cells in human renal allografts indicate transplant recipients with a poor prognosis, but how these cells contribute to rejection is unclear. Here we show using single-cell RNA sequencing that intrarenal class-switched B cells have an innate cell transcriptional state resembling mouse peritoneal B1 or B-innate (Bin) cells. Antibodies generated by Bin cells do not bind donor-specific antigens nor are they enriched for reactivity to ubiquitously expressed self-antigens. Rather, Bin cells frequently express antibodies reactive with either renal-specific or inflammation-associated antigens. Furthermore, local antigens can drive Bin cell proliferation and differentiation into plasma cells expressing self-reactive antibodies. These data show a mechanism of human inflammation in which a breach in organ-restricted tolerance by infiltrating innate-like B cells drives local tissue destruction.


Assuntos
Aloenxertos/imunologia , Linfócitos B/metabolismo , Rejeição de Enxerto/imunologia , Inflamação/metabolismo , Transplante de Rim/efeitos adversos , Animais , Autoanticorpos/imunologia , Linfócitos B/imunologia , Linfócitos B/patologia , Regulação da Expressão Gênica/genética , Regulação da Expressão Gênica/imunologia , Ontologia Genética , Antígenos de Histocompatibilidade Classe I/imunologia , Antígenos de Histocompatibilidade Classe II/imunologia , Humanos , Imunoglobulina G/imunologia , Rim/imunologia , Rim/metabolismo , Camundongos , Tonsila Palatina/imunologia , Tonsila Palatina/metabolismo , RNA-Seq , Análise de Célula Única , Transplante Homólogo
18.
Int J Pediatr Otorhinolaryngol ; 149: 110841, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34303126

RESUMO

OBJECTIVES: The effectiveness of adenotonsillectomy for obstructive sleep disorder breathing (OSDB) in children under age 2 years is unclear. The present study aimed to identify the perioperative symptoms and clinical outcomes of adenoidectomy and tonsillectomy in very young children. PATIENTS AND METHODS: The present, single-center, retrospective cohort study, conducted from January 2010 to April 2020, enrolled patients under age 2 years with moderate to severe upper airway obstruction who underwent an adenoidectomy or tonsillectomy. The patients were divided according to The Brodsky grading scale into group 1 (Grade 0 to 1 tonsils) or group 2 (Grade 2 or higher tonsils), who received only an adenoidectomy. Group 3 comprised patients with a concomitant adenoidectomy and tonsillectomy. Perioperative symptoms among the groups and the cumulative revision-free status and recurrence-free status rates in groups 1 and 2 were analyzed. RESULTS: Fifty-three patients were enrolled. The median standard deviation score (SDS) for height and weight was -0.79 and -0.31, respectively. No postoperative complications, such as bleeding, were observed. However, two patients underwent intubation preoperatively due to severe obstruction. Seven patients underwent revision surgery. The cumulative revision-free and recurrence-free rates at week 60 were 81% and 100% for Group 1 and 42% and 48.5% for Group 2, respectively. The cumulative revision-free rate and cumulative recurrence-free rate were significantly higher in Group 1 (P < 0.0001; HR: 47.9; 95% CI: 1.12-2050 and P < 0.007; HR: 4.62; 95% CI: 1.37-15.6, respectively). None of the patients in Group 3 had revision surgery or symptom recurrence. CONCLUSION: Simple adenoidectomy in children with large tonsils carries a high risk of revision surgery. However, given the high risk of severe obstruction in very young children with OSDB, timely surgery is recommended. LEVEL OF EVIDENCE: 3.


Assuntos
Obstrução das Vias Respiratórias , Tonsilectomia , Adenoidectomia , Obstrução das Vias Respiratórias/diagnóstico , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/cirurgia , Criança , Pré-Escolar , Humanos , Tonsila Palatina , Estudos Retrospectivos , Tonsilectomia/efeitos adversos
19.
PLoS Comput Biol ; 17(6): e1009072, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34153032

RESUMO

Epstein-Barr virus (EBV) is transmitted by saliva and is a major cause of cancer, particularly in people living with HIV/AIDS. Here, we describe the frequency and quantity of EBV detection in the saliva of Ugandan adults with and without HIV-1 infection and use these data to develop a novel mathematical model of EBV infection in the tonsils. Eligible cohort participants were not taking antiviral medications, and those with HIV-1 infection had a CD4 count >200 cells/mm3. Over a 4-week period, participants provided daily oral swabs that we analysed for the presence and quantity of EBV. Compared with HIV-1 uninfected participants, HIV-1 coinfected participants had an increased risk of EBV detection in their saliva (IRR = 1.27, 95% CI = 1.10-1.47) and higher viral loads in positive samples. We used these data to develop a stochastic, mechanistic mathematical model that describes the dynamics of EBV, infected cells, and immune response within the tonsillar epithelium to analyse potential factors that may cause EBV infection to be more severe in HIV-1 coinfected participants. The model, fit using Approximate Bayesian Computation, showed high fidelity to daily oral shedding data and matched key summary statistics. When evaluating how model parameters differed among participants with and without HIV-1 coinfection, results suggest HIV-1 coinfected individuals have higher rates of B cell reactivation, which can seed new infection in the tonsils and lower rates of an EBV-specific immune response. Subsequently, both these traits may explain higher and more frequent EBV detection in the saliva of HIV-1 coinfected individuals.


Assuntos
Coinfecção/virologia , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/virologia , Infecções por HIV/complicações , HIV-1 , Tonsila Palatina/virologia , Adolescente , Adulto , Linfócitos B/imunologia , Estudos de Coortes , Coinfecção/imunologia , Biologia Computacional , Infecções por Vírus Epstein-Barr/imunologia , Feminino , Infecções por HIV/imunologia , Herpesvirus Humano 4/imunologia , Herpesvirus Humano 4/isolamento & purificação , Herpesvirus Humano 4/fisiologia , Humanos , Imunidade Celular , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Tonsila Palatina/imunologia , Saliva/virologia , Processos Estocásticos , Uganda , Carga Viral , Eliminação de Partículas Virais , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...