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Wang C, Pan Y, Huang H, Liu K, Yu Z. Global trends and hotspots on recurrent respiratory papillomatosis: A 20-year bibliometric analysis. Laryngoscope Investig Otolaryngol 2024; 9:e1271. [PMID: 38835332 PMCID: PMC11149765 DOI: 10.1002/lio2.1271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/25/2024] [Indexed: 06/06/2024] Open
Abstract
Objectives Recurrent respiratory papillomatosis (RRP) is the most common benign laryngeal tumor in children. It can cause serious psychological and mental burden on patients since RRP requires repeated surgical treatment. This study aims to delineate the global trends and identify hotspots related to RRP over the past two decades. Methods We systematically gathered research findings on RRP from 2004 to 2023, utilizing the Web of Science as our data source. Subsequently, we performed a comprehensive bibliometric analysis of the literature using Vosviewer, CiteSpace, and Bibliometrics online analysis platform. Results A total of 839 publications were finally identified on RRP from 2004 to 2023. The United States has the largest number of publications (392), accounting for 46.7%. The Capital Medical University is the most productive organization (24), followed by the Centers for Disease Control and Prevention (18). The most productive journal was the Laryngoscope, with 86 publicatios. Comparatively, Vaccine is the most cited journal (2297). Craig S. Derkay ranked highest among all authors in publication (16). Burst detection shows onset, adjuvant therapy, management, juvenile-onset RRP, systemic bevacizumab, avastin, human papillomavirus vaccine are recent keywords of great interest to researchers. Conclusion Research on RRP has progressed significantly over the past two decades, especially in terms of therapeutic strategies. We strongly believe that this article will provide new research directions for other researchers and may contribute to future breakthroughs in the field.
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Affiliation(s)
- Chao Wang
- Department of Otolaryngology-Head and Neck Surgery, BenQ Medical Center The Affiliated BenQ Hospital of Nanjing Medical University Nanjing Jiangsu China
- Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm Nanjing Jiangsu China
- School of Medicine, Southeast University Nanjing Jiangsu China
| | - Yufei Pan
- Department of Otolaryngology-Head and Neck Surgery, BenQ Medical Center The Affiliated BenQ Hospital of Nanjing Medical University Nanjing Jiangsu China
- Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm Nanjing Jiangsu China
- School of Medicine, Southeast University Nanjing Jiangsu China
| | - Huili Huang
- Department of Otolaryngology-Head and Neck Surgery, BenQ Medical Center The Affiliated BenQ Hospital of Nanjing Medical University Nanjing Jiangsu China
- Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm Nanjing Jiangsu China
| | - Kai Liu
- Department of Otolaryngology-Head and Neck Surgery, BenQ Medical Center The Affiliated BenQ Hospital of Nanjing Medical University Nanjing Jiangsu China
- Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm Nanjing Jiangsu China
| | - Zhenkun Yu
- Department of Otolaryngology-Head and Neck Surgery, BenQ Medical Center The Affiliated BenQ Hospital of Nanjing Medical University Nanjing Jiangsu China
- Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm Nanjing Jiangsu China
- School of Medicine, Southeast University Nanjing Jiangsu China
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Zagzoog FH, Mogharbel AM, Alqutub A, Bukhari M, Almohizea MI. Intralesional cidofovir vs. bevacizumab for recurrent respiratory papillomatosis: a systematic review and indirect meta-analysis. Eur Arch Otorhinolaryngol 2024; 281:601-627. [PMID: 37831132 DOI: 10.1007/s00405-023-08279-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Specific HPV types cause recurrent respiratory papillomatosis (R.R.P.). When administered intralesionally, cidofovir, an antiviral agent, has shown favorable outcomes in reducing papilloma. Bevacizumab, an angiogenesis inhibitor, has demonstrated improved R.R.P. However, both treatments lack FDA approval for R.R.P. Our study aims to evaluate the efficacy and safety of intralesional Cidofovir and Bevacizumab for R.R.P. and compare the two interventions. METHODS We searched five electronic databases to find relevant studies. After the screening, data were extracted from the included studies. Pooled ratios with 95% confidence intervals (CIs) were used for categorical outcomes, and mean difference (MD) was used for continuous outcomes. Statistical heterogeneity was evaluated using the chi-squared test for I2 statistics. The Cochrane Risk of Bias assessment tool was used to assess the methodological quality of randomized controlled trials (RCTs), while the National Institutes of Health's tool was used for observational studies. Analysis was done by Review Manager software. RESULTS In our comprehensive meta-analysis of 35 articles involving 836 patients, cidofovir demonstrated an overall remission ratio of (0.90 [95% CI: 0.83, 0.98], p = 0.01), while bevacizumab (0.92 [95% CI: 0.79, 1.07]), p = 0.3). The complete remission ratio for cidofovir was (0.66 [95% CI: 0.57, 0.75], p > 0.0001), while bevacizumab was (0.29 [95% CI: 0.12, 0.71], p = 0.07). In partial remission, Bevacizumab showed a higher ratio than Cidofovir 0.74 [0.55, 0.99] vs. 0.40 [0.30, 0.54]. Bevacizumab had a pooled ratio of 0.07 [95% CI: 0.02, 0.30] in terms of no remission, indicating better outcomes compared to Cidofovir with a ratio of 0.28 [95% CI: 0.16, 0.51]. Additionally, Cidofovir showed a favorable decrease in the Derkay Severity Score (DSS) with a mean difference (MD) of 1.98 [95% CI: 1.44, 2.52]. CONCLUSION Cidofovir had a higher impact on complete remission compared to Bevacizumab. Both showed partial remission, with Bevacizumab having a higher ratio. Moreover, Cidofovir showed a significant decrease in DSS. Bevacizumab had lower rates of no remission and recurrence and fewer adverse events compared to Cidofovir. However, the difference between the two treatments was not significant, except for partial remission.
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Affiliation(s)
- Faisal H Zagzoog
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Ahmed M Mogharbel
- Department of Otolaryngology, Head and Neck Surgery, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Abdulsalam Alqutub
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Manal Bukhari
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed I Almohizea
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Almutairi N, Alshathri A, Alshareef W, Sindi A, Aljasser A, Alammar A. Clinical evaluation of pediatric patients with recurrent respiratory papillomatosis.: A longitudinal study at a Saudi Arabian tertiary care center. Saudi Med J 2024; 45:205-210. [PMID: 38309731 PMCID: PMC11115423 DOI: 10.15537/smj.2024.45.2.20230529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/27/2023] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVES To study the clinical evaluation of recurrent respiratory papillomatosis (RRP) patients and the factors associated with the improvement in the Derkay's score as a measure of disease severity. METHODS A retrospective cohort that included all juvenile RRP patients who were admitted to King Abdulaziz University Hospital, Riyadh, Saudi Arabia, between September 2015 and June 2022 and underwent surgical debulking. RESULTS A total of 16 patients were eligible to join our study. Among them, 7 patients were males. Hoarseness of voice was the most frequent symptom. The median period of the follow-up was 56 months. Complete remission was achieved in 31.3%. The univariate linear regression model revealed that the cidofovir-treated patients had a significant reduction in the change value of Derkay's score compared to those without treatment (regression coefficient= -5.83, 95% confidence interval [CI]: [-11.5 to -0.143], p=0.045). Also, the increased first Derkay's score decreased the change value and subsequently increased the improvement chance of the disease (regression coefficient= -0.424, 95% CI: [-0.764 to -0.083], p=0.018). However, in the multivariate regression model, both variables showed non-significant results. CONCLUSION cidofovir treatment and higher Derkay's scores affected the disease improvement.
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Affiliation(s)
- Nasser Almutairi
- From the Department of Otolaryngology-Head and Neck Surgery (Almutairi), King Faisal Specialist Hospital and Research Center, from the Department of Otolaryngology-Head and Neck Surgery (Almutairi, Alshathri, Alshareef, Sindi, Aljasser, Alammar), King Saud University Medical City, and from the College of Medicine (Almutairi), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
| | - Alanoud Alshathri
- From the Department of Otolaryngology-Head and Neck Surgery (Almutairi), King Faisal Specialist Hospital and Research Center, from the Department of Otolaryngology-Head and Neck Surgery (Almutairi, Alshathri, Alshareef, Sindi, Aljasser, Alammar), King Saud University Medical City, and from the College of Medicine (Almutairi), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
| | - Waleed Alshareef
- From the Department of Otolaryngology-Head and Neck Surgery (Almutairi), King Faisal Specialist Hospital and Research Center, from the Department of Otolaryngology-Head and Neck Surgery (Almutairi, Alshathri, Alshareef, Sindi, Aljasser, Alammar), King Saud University Medical City, and from the College of Medicine (Almutairi), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
| | - Abdullah Sindi
- From the Department of Otolaryngology-Head and Neck Surgery (Almutairi), King Faisal Specialist Hospital and Research Center, from the Department of Otolaryngology-Head and Neck Surgery (Almutairi, Alshathri, Alshareef, Sindi, Aljasser, Alammar), King Saud University Medical City, and from the College of Medicine (Almutairi), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
| | - Abdullah Aljasser
- From the Department of Otolaryngology-Head and Neck Surgery (Almutairi), King Faisal Specialist Hospital and Research Center, from the Department of Otolaryngology-Head and Neck Surgery (Almutairi, Alshathri, Alshareef, Sindi, Aljasser, Alammar), King Saud University Medical City, and from the College of Medicine (Almutairi), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
| | - Ahmed Alammar
- From the Department of Otolaryngology-Head and Neck Surgery (Almutairi), King Faisal Specialist Hospital and Research Center, from the Department of Otolaryngology-Head and Neck Surgery (Almutairi, Alshathri, Alshareef, Sindi, Aljasser, Alammar), King Saud University Medical City, and from the College of Medicine (Almutairi), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Lau WC, Lau CB, Frangos JE, Nambudiri VE. Intralesional cidofovir for the management of refractory cutaneous verrucae: a review of applications and opportunities. Ther Adv Infect Dis 2023; 10:20499361231165862. [PMID: 37056449 PMCID: PMC10088403 DOI: 10.1177/20499361231165862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/09/2023] [Indexed: 04/15/2023] Open
Abstract
Viral warts - manifestations of cutaneous infection by human papilloma virus - can be a significant physical and emotional burden for patients when common treatments fail, particularly for individuals who are immunocompromised or with multiple lesions. Cidofovir, an antiviral agent typically used for the treatment of cytomegalovirus infection, has emerged as an alternative treatment option for viral warts when administered topically or intralesionally. In this review, we highlight the scientific rationale, published evidence, and practical clinical uses of intralesional cidofovir for the management of cutaneous warts as well as ongoing questions requiring further research and exploration of this emerging therapy for refractory verrucae.
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Affiliation(s)
| | | | - Jason E. Frangos
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Solarz P, Bodnar M, Czech J, Mackiewicz-Nartowicz H, Sinkiewicz A, Szylberg Ł, Borowczak J, Rutkiewicz P, Zwierz A, Burduk P. Assessment of immunomodulation and regulation of cell cycle in epithelium and stroma after Cidofovir injection in patients with recurrent respiratory papillomatosis-Pilot study. J Med Virol 2023; 95:e28303. [PMID: 36369954 DOI: 10.1002/jmv.28303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/22/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022]
Abstract
Recurrent respiratory papillomatosis is strictly connected with human papillomavirus (HPV) infection of the epithelium of the upper respiratory tract. The main treatment of lesions located in the larynx or lower pharynx includes microsurgical excision by using a CO2 laser. To decrease the amount of surgical procedures gain in importance combined therapy with antiviral agents. The aim of this study was to investigate the effect of the intralesional application of Cidofovir on the tissue of laryngeal papillomas. We have shown that simultaneous microsurgery with adjuvant therapy of Cidofovir reduces chronic inflammation (by measuring the expression of CD4 and CD8 in tissue samples), cell proliferation, and regulates the cell cycle of HPV-infected cells by reducing the expression of p53 and p63 proteins. In addition, this strategy reduces the multiple surgical procedures and regrowth of the pathology.
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Affiliation(s)
- Paweł Solarz
- Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No. 2, Bydgoszcz, Poland
| | - Magdalena Bodnar
- Department of Perinatology, Gynaecology and Gynaecologic Oncology, Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Bydgoszcz, Poland.,Chair of Pathology, University Hospital No. 2 im. Dr. Jan Biziel in Bydgoszcz, Bydgoszcz, Poland
| | - Joanna Czech
- Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No. 2, Bydgoszcz, Poland
| | - Hanna Mackiewicz-Nartowicz
- Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No. 2, Bydgoszcz, Poland.,Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Bydgoszcz, Poland
| | - Anna Sinkiewicz
- Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Bydgoszcz, Poland
| | - Łukasz Szylberg
- Department of Perinatology, Gynaecology and Gynaecologic Oncology, Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Bydgoszcz, Poland.,Chair of Pathology, University Hospital No. 2 im. Dr. Jan Biziel in Bydgoszcz, Bydgoszcz, Poland.,Department of Tumor Pathology and Pathomorphology, Oncology Centre-Prof. Franciszek Łukaszczyk Memorial Hospital, Bydgoszcz, Poland
| | - Jędrzej Borowczak
- Department of Perinatology, Gynaecology and Gynaecologic Oncology, Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Bydgoszcz, Poland
| | - Paula Rutkiewicz
- Chair of Pathology, University Hospital No. 2 im. Dr. Jan Biziel in Bydgoszcz, Bydgoszcz, Poland
| | - Aleksander Zwierz
- Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No. 2, Bydgoszcz, Poland.,Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Bydgoszcz, Poland
| | - Paweł Burduk
- Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No. 2, Bydgoszcz, Poland.,Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Bydgoszcz, Poland
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Donne AJ, Kinshuck A. Pharmacotherapy for recurrent respiratory papillomatosis (RRP): a treatment update. Expert Opin Pharmacother 2021; 22:1901-1908. [PMID: 34080517 DOI: 10.1080/14656566.2021.1935870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Recurrent respiratory papillomatosis is a rare human papillomavirus (HPV)-induced condition where warts grow within the airway and especially the larynx to effect voice and restrict breathing.Areas covered: A PubMed search using the following search terms was performed: respiratory papillomatosis and cidofovir, alpha-interferon, bevacizumab, PD1, and HPV vaccines. Surgery remains the mainstay of treatment. There has been a change in options available for adjuvant therapies with systemic bevacizumab and the potential benefits of prophylactic HPV vaccine. Despite efforts to identify a drug therapy to control RRP, no therapy yet remains which is predictable and effective in all. The current status of therapeutic vaccines and immunotherapy is discussed.Expert opinion: The current adjuvant therapies do offer a reasonable expectation of control but the effect for the individual is unpredictable despite the therapies being based on good science. The current therapies would allow an escalating treatment strategy to be formulated, however a single therapy is unlikely to be curative. Multi-center trials are required such that adequate numbers to show an effect are achieved.
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Affiliation(s)
- Adam J Donne
- Consultant Paediatric Otolaryngologist, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Andy Kinshuck
- Consultant in Otolaryngology/Head & Neck Surgery, Aintree University Hospital, Liverpool, UK
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Bai K, Allen C. How Enhancing Immunity to Low-Risk HPV Could Cure Recurrent Respiratory Papillomatosis. Laryngoscope 2021; 131:2041-2047. [PMID: 33720393 DOI: 10.1002/lary.29153] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/13/2020] [Accepted: 09/09/2020] [Indexed: 12/12/2022]
Abstract
Recurrent respiratory papillomatosis (RRP) is currently treated with repeat surgical resection of papillomatous disease that does not address the fundamental underlying issue of chronic infection with low-risk human papillomavirus. Here, we review the biology and immunology of low-risk human papillomavirus (HPV) infections. Antiviral or antiangiogenic adjuvant treatments similarly address the papillomatous disease itself but do not activate HPV immunity. It is likely that only through immune-mediated clearance of low-risk HPV infection can patients with RRP be cured. In some patients, this occurs spontaneously. In others with more aggressive disease, adjuvant immunotherapy to activate immunity may be needed. Based on current understanding of antiviral immune responses, the only rational strategy to clear HPV-infected epithelial cells is through activation of the T-lymphocyte arm of the adaptive immune response. Translation of immunotherapies that are Food and Drug Administration-approved or under clinical study for cancer, such as immune checkpoint blockade or engineered therapeutic vaccines, may provide a path toward tolerable and efficacious adjuvant immunotherapy for RRP. LEVEL OF EVIDENCE: NA Laryngoscope, 131:2041-2047, 2021.
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Affiliation(s)
- Ke Bai
- Section on Translation Tumor Immunology, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, U.S.A
| | - Clint Allen
- Section on Translation Tumor Immunology, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, U.S.A
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