2. Lipids Health Dis. 2012 Oct 12;11:136. doi: 10.1186/1476-511X-11-136.
Effects of conjugated linoleic acid and high oleic acid safflower oil in the treatment of children with HPV-induced laryngeal papillomatosis: a randomized, double-blinded and crossover preliminary study.
Louw L.
Author information: Department Otorhinolaryngology, Faculty of Health Sciences, University of the Free State, Box 339G42, Bloemfontein 9300, South Africa. gnanll@ufs.ac.za
BACKGROUND: Surgery is the mainstay therapy for HPV-induced laryngeal papillomatosis (LP) and adjuvant therapies are palliative at best. Research revealed that conjugated-linoleic acid (CLA) may improve the outcome of virally-induced diseases. The effects of Clarinol™ G-80 (CLA) and high oleic safflower oil (HOSF) on children with LP (concomitant with surgery) were evaluated. DESIGN: A randomized, double-blinded, crossover and reference-oil controlled trial was conducted at a South African medical university. Study components included clinical, HPV type/load and lymphocyte/cytokine analyses, according to routine laboratory methods. PARTICIPANTS: Overall: ten children enrolled; eight completed the trial; five remained randomized; seven received CLA first; all treatments remained double-blinded. INTERVENTION: Children (4 to 12 years) received 2.5 ml p/d CLA (8 weeks) and 2.5 ml p/d HOSF (8 weeks) with a washout period (6 weeks) in-between. The one-year trial included a post-treatment period (30 weeks) and afterwards was a one-year follow-up period. MAIN OUTCOME MEASURES: Changes in numbers of surgical procedures for improved disease outcome, total/anatomical scores (staging system) for papillomatosis prevention/viral inhibition, and lymphocyte/cytokine counts for immune responses between baselines and each treatment/end of trial were measured. FINDINGS: After each treatment all the children were in remission (no surgical procedures); after the trial two had recurrence (surgical procedures in post-treatment period); after the follow-up period three had recurrence (several surgical procedures) and five recovered (four had no surgical procedures). Effects of CLA (and HOSF to a lesser extent) were restricted to mildly/moderately aggressive papillomatosis. Children with low total scores (seven/less) and reduced infections (three/less laryngeal sub-sites) recovered after the trial. No harmful effects were observed. The number of surgical procedures during the trial (n6/available records) was significantly lower [(p 0.03) (95% CI 1.1; 0)]. Changes in scores between baselines and CLA treatments (n8) were significantly lower: total scores [(p 0.02) (95% CI -30.00; 0.00)]; anatomical scores [(p 0.008) (95% CI -33.00: -2.00)]. Immune enhancement could not be demonstrated. CONCLUSIONS: These preliminary case and group findings pave the way for further research on the therapeutic potential of adjuvant CLA in the treatment of HPV-induced LP.
PMCID: PMC3551644 PMID: 23061633 [PubMed - indexed for MEDLINE]
The impact of cidofovir treatment on viral loads in adult recurrent respiratory papillomatosis.
Mikolajczak S(1), Quante G, Weissenborn S, Wafaisade A, Wieland U, Lüers JC, Klussmann JP, Beutner D.
Author information: (1)Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Kerpener Str. 62, 50924 Cologne, Germany.
Cidofovir is an antiviral agent used in the therapy of recurrent respiratory papillomatosis (RRP). In this study, we hypothesized that cidofovir is effective in decreasing the viral load of human papillomavirus (HPV). We established a type specific real-time PCR and measured HPV DNA loads. The course of viral load of HPV types 6 and 11 after repeated applications of cidofovir intralesionally was compared to the clinical outcome using a modified Derkay score. In 6 of the 8 (75 %) patients, we detected HPV 6. In 2 (25 %) patients, we detected HPV 11. In all of the patients, the viral load and the modified Derkay score decreased significantly during the treatment. We conclude that viral load of HPV can be monitored using the technique described here. Cidofovir in combination with surgical debulking reduces the viral load in patients with RRP. Relapses of the symptoms cannot be avoided but might be delayed.
4. Otolaryngol Clin North Am. 2012 Jun;45(3):671-94, viii-ix. doi: 10.1016/j.otc.2012.03.006.
Recurrent respiratory papillomatosis.
Venkatesan NN(1), Pine HS, Underbrink MP.
Author information: (1)Department of Otolaryngology, University of Texas Medical Branch, 7.104 John Sealy Annex, 301 University Boulevard, Galveston, TX 77555-0521, USA.
Recurrent respiratory papillomatosis (RRP) is a rare, benign disease with no known cure. RRP is caused by infection of the upper aerodigestive tract with the human papillomavirus (HPV). Passage through the birth canal is thought to be the initial transmission event, but infection may occur in utero. HPV vaccines have helped to provide protection from cervical cancer; however, their role in the prevention of RRP is undetermined. Clinical presentation of initial symptoms of RRP may be subtle. RRP course varies, and current management focuses on surgical debulking of papillomatous lesions with or without concurrent adjuvant therapy.
[Basics of tumor development and importance of human papilloma virus (HPV) for head and neck cancer].
[Article in German]
Wittekindt C(1), Wagner S, Mayer CS, Klußmann JP.
Author information: (1)Klinik für HNO-Heilkunde, Kopf-/Halschirurgie, Plastische Operationen, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen.
Head and Neck Squamous Cell Carcinoma (HNSCC) are the 6th most common cancers worldwide. While the incidence of larynx-hypopharynx carcinoma decreases, actually an increase in oropharyngeal squamous cell carcinoma (OSCC) is observed. Classical risk factors for HNSCC are smoking and alcohol. Though, it was shown recently for 25 to 60% of OSCC, to be associated with an infection by oncogenic human papilloma virus (HPV). The development of "common" head-neck-tumors is substantially enhanced by an accumulation of genetic changes, which lead to an inactivation of tumor suppressor genes or to an activation of proto-oncogenes. A more or less uniform sequence of different DNA-damages leads to genetic instability. In this context, an early and frequent event is deletion on the short arm of chromosome 9, which results in inactivation of the p16-gene. On the contrary, for HPV-induced carcinogenesis, expression of the viral proteins E6 and E7 is most important, since E6 and E7 lead to inactivation of the cellular tumor-suppressor-proteins p53 and Rb. The process of natural transoral infection is not yet clear. However, as a matter of fact peroral HPV-infection is not seldom and in most cases such an infection heals completely and uneventfully. Smoking seems to increases the probability for developing an HPV-associated tumor. The association of HNSCC with HPV can be proven with established methods in clinical diagnostics. In addition to classical prognostic factors, diagnosis of an HPV-association may become important for future therapies. Prognostic relevance of HPV probably surmounts many known risk-factors, for instance regional metastasis. Until now, no other molecular markers are established in clinical routine. Future therapy concepts may vary for the two subgroups of patients, especially patients with HPV-associated OSCC may take advantage of a less aggressive postoperative treatment. Finally an outlook will be given on possible target-aimed therapies, of which so far only antibodies against EGF-receptors are established in clinical practice.
Epidemiology of recurrent respiratory papillomatosis.
Larson DA(1), Derkay CS.
Author information: (1)Department of Otolaryngology/Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA 23507, USA.
Recurrent respiratory papillomatosis (RRP) was first described in the 1800s, but it was not until the 1980s when it was convincingly attributed to human papilloma virus (HPV). RRP is categorized into juvenile onset and adult onset depending on presentation before or after the age of 12 years, respectively. The prevalence of this disease is likely variable depending on the age of presentation, country and socioeconomic status of the population being studied, but is generally accepted to be between 1 and 4 per 100 000. Despite the low prevalence, the economic burden of RRP is high given the multiple procedures required by patients. Multiple studies have shown that the most likely route of transmission of HPV in RRP is from mother to child during labor. Exceptions to this may include patients with congenital RRP who have been exposed in utero and adult patients who may have been exposed during sexual contact. Although cesarean section may prevent the exposure of children to the HPV virus during childbirth, its effectiveness in preventing RRP is debatable and the procedure itself carries an increased risk of complications. The quadrivalent HPV vaccine holds the most promise for the prevention of RRP by eliminating the maternal reservoir for HPV.
[Respiratory papillomatosis--new methods of treatment].
[Article in Polish]
Nowaczewska K(1), Wójtowicz P, Kukwa A, Ratajczak J, Tulibacki M.
Author information: (1)Klinika Otolaryngologii, Instytutu Stomatologii, Warszawskiego Uniwersytetu Medycznego.
BACKGROUND: Respiratory papillomatosis is caused by HPV. The most common location in head and neck is larynx, palatine tonsils and arches of palate, uvula and mucosa oral and nasal cavity. The disease is benign but recurrent. The aim of this study was to estimate new methods of treatment respiratory papillomatosis based on intralesional injection of cidofovir into sites where papillomas had just been excised. METHODS: The purpose of the study were 59 patients treating in Otolaryngology Clinic Stomatology Department Medical University of Warsaw. The treatment was based on surgical excision of papilloma and after it intralesional injection of cidofovir in after 4-5 weeks. RESULTS: We observed the patients during 28 months. 41 patients had 4 times intralesional injection of cidofovir. 18 patients had increased number of injection of ciodofovir because of recurrent papilloma. Rest of this group of the patients clinical studies showed remission disease. CONCLUSION: Surgery with intralesional cidofovir injection in the place after removal of papilloma is very effective methods. We observed that this treatment caused long lasting remission of papilloma recurrence.
Hey, ich danke dir! Ja, das ist dieses Jahr jetzt die 4. OP, insgesamt seit 2007 die 10..
Ich bin bei dem Cidofovir halt skeptischt, weil kanzerogen. Ich kenne zwei Fälle aus meiner RRP Facebook Gruppe, bei denen die Papillome entartet sind und bei denen die Ärzte das mit Cidofovir in Verbindung bringen. Eine Entartung ist das allerletzte, was ich brauche. Dann geht der Spaß ja erst richtig los.. Meine Ärzte hier benutzen Cidofovir auch nicht mehr und die Profis in den USA (Boston, Dr. Zeitels zB) sind auch davon ab, die setzen stattdessen jetzt Avastin ein. Gibt es auch einige Studien dazu, die gute Ergebnisse zeigen. Aber halt alles immer nur im Sinne einer OP Intervall-Verlängerung, nicht im Sinne einer Remission.
CLA und HOSF kannte ich noch nicht, da werde ich mich einlesen. Ich nehme jetzt seit gestern Astragalus oral und als Spray. Das soll ja p53 aktivieren, welches bei RRP wohl inaktiv ist. Mal schauen, ob da was passiert. Ich beles mich auch grad über Immunotherapie im Sinne einer Tumorimpfung. Theoretisch müsste es möglich sein, auch bei RRP tumorspezifische Immunantworten auszulösen (Dendritenbeladung, in dem Fall E6 und E7?). Aber ich hab noch niemanden ergoogeln können, der mir dabei behilflich sein könnte, außerdem ist das sauteuer. Wahrscheinlich braucht es dazu noch ein paar Jahre... Der Austausch mit dir tut mir voll gut, endlich beschäftigt sich mal jemand mit der Materie. Kann man von meinen Ärzten leider nicht behaupten, die fahren ihr Standardprocedere und interessieren sich kaum für meine schönen Studien und Überlegungen. Und das, obwohl ich Selbstzahler und bei den Uni-Chefärzten direkt bin. Das ist übrigens der andere Frustfaktor dieser Erkrankung... Zu selten, also voll uninteressant für alle (Ärzte, big pharma etc). Wenn das eine Prävalenz von 1:2000 hätte und nicht 1:100000, gäbe es schon lange ein Gegenmittel.
Vielleicht ist in Mexiko irgendwas einfach nicht gut für dich: Luft, Lärm, Wasser(-rückstände), Essen..? Bis Januar ist nicht mehr lang. Geh einfach davon aus, dass danach alles wieder in Ordnung ist. Ich tu's in deinem Fall. Fest dran glauben, dann wird das. Psychoneuroimmunologie und so... auch spannend übrigens.
Gut. Ich bin hier, im Rahmen meiner Möglichkeiten greife ich gerne unter die Arme.
Ich habe bei mir die Vermutung, dass das "etwas" im Mund vielleicht Fordyce Drüsen sind. Das auf der Lippe scheint das mit ziemlicher Sicherheit zu sein, dagegen lässt sich nix machen, ist aber halt gaaar keine Krankheit. Ein Kompromiss mit dem ich leben könnte.
Hey hey, wie gehts dir? Bestätigt sich deine Diagnose der Fordyce Drüsen?
Ich bin dann mal im Krankenhaus, jaj. Bin ca. Freitag zurück. Thrombosespritze hab ich mir verpasst, ist jedes Mal eklig das Ding. Aber sie und der ganze andere Anästhesiequark belohnt mich hoffentlich mit einer feinen Stimme.
Ich Drück dir die Daumen. Mich würde ja mal eine vorher nacher Aufnahme interessieren. Hast du dafür noch Zeit. Ich hasse Spritzen auch, trotzdem bin ich 2 mal die Woche beim Plasmaspenden, hier in MX natürlich nicht.
Ich bin immernoch heiser, oder anders, meine Stimme ist anders. Das mit diesen Drüsen - was man so googlen kann ähnelt dem was ich habe. Passt also. Eine Last weniger.
Human papillomaviruses (HPV) are associated with certain oral soft tissue lesiona, such as papillomas, warts, condylomata, and focal epithelial hyperplasia (FEH). HPV types 2, 6, 11, 16, and 18 have been identified in some of these oral lesions, while HPV 13 and 32 are associated with FEH.
Hallo, ich freue mich, das ich ein Forum gefunden habe, wo diese Erkrankung mal von Betroffenen besprochen wird. Ich habe seit ca. 6 Monaten damit zu tun. Bis jetzt 2 OP's, die letzte vor 2 Wochen. Die nächste vermutlich in den kommenden Tagen/Wochen, da schon wieder etwas nachgewachsen ist. Ich bin 41 Jahre alt, männlich und im Moment echt etwas niedergeschlagen, da ich kaum sprechen kann und die Prognose dieser Erkrankung nun auch nicht gerade gute Laune machen. Da ich in einem sozialen Beruf arbeite, in dem ich viel sprechen muss, mache ich mir auch darüber Gedanken, ob ich meinen Beruf weiterhin so ausüben kann... Würde mich sehr freuen, mich mit anderen Betroffenen hier austauschen zu können...
Hi all, willkommen macjoe und vielen Dank an Licht, dass du fragst. Ich kann aktuell ganz gut sprechen nach der Op im Dezember. Stimme hat sich zwar schon wieder verändert (=es wächst und gedeiht), aber die Funktionseinschränkung hält sich bisher in Grenzen. Ich genieße das sehr und plaudere fleißig und versuche, dem Thema nicht soviel Raum zu geben. Kommt früh genug wieder, wenn ich nicht mehr sprechen kann.
Feigwarzen und HPV
Thema drucken
09.12.2014 15:47
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