Recurrent respiratory papillomatosis (RRP) is a chronic viral disease characterized by the formation of benign tumors on the mucous membranes of the upper respiratory tract, in particular, on the larynx, trachea and bronchi. The cause of the disease is the human papillomavirus (HPV), most often types 6 and 11, which cause atypical growth of epithelial cells. RRP can occur in both children and adults, but in children the disease usually becomes more aggressive, which requires special attention from doctors. The recurrent nature of the disease is justified, and despite surgical treatment, relapses are observed in 50-80% cases, which emphasizes the importance of monitoring and supervision of the patient's condition.
History of the disease and interesting historical facts
Recurrent respiratory papillomatosis was first described in the early 20th century. However, systematic work on its study began only in the 1960s, when it was established that papillomatosis is caused by viruses from the HPV group. It is interesting that until the 1980s, it was believed that this disease occurs mainly in adults, but studies have shown that in children, recurrent papillomatosis can manifest itself in much more severe forms. In the 1990s, microscopy was actively introduced to study tissues affected by papillomas, which made it possible to more deeply understand the biological nature of the disease.
Epidemiology
Epidemiological data show that recurrent respiratory papillomatosis affects both children and adults. According to statistics, among patients with RRP, children account for approximately 60-75%. The incidence rate in children varies from 1.7 to 4.4 per 100,000 children, while this figure is significantly lower among adults. Studies show that men suffer from RRP 2-3 times more often than women. The incidence also varies depending on the geographic region, social conditions and level of access to health care. At the same time, despite the rarity of the disease, it has a steady trend towards an increase in cases in recent decades, which may be associated with an increase in HPV incidence.
Genetic predisposition to this disease
Against the background of the viral etiology of the disease, genetic predisposition is an important aspect in the development of recurrent respiratory papillomatosis. Studies have shown that mutations in certain genes can increase the likelihood of developing this disease. Genetic markers of immune response activity and disturbances in the regulation of the cell cycle play a key role in the formation of individual predisposition. In particular, the study of B-cell receptor gene polymorphisms shows that individuals with certain genetic changes demonstrate the greatest sensitivity to HPV. Such findings emphasize the need for more in-depth genetic studies to understand the mechanisms that contribute to the development of RRP at the genetic level.
Risk factors for the development of this disease
There are several risk factors that may predispose to the development of recurrent respiratory papillomatosis. These include:
- Viral infectious diseases: the presence of HPV in the body is a major risk factor.
- Immunodeficiency states: HIV patients and other individuals with suppressed immune systems are more likely to develop the disease.
- Smoking: Damage to the mucous membranes of the respiratory tract due to smoking can facilitate the spread of the virus.
- Age: Infants and young children are at higher risk due to immaturity of their immune systems.
- Environmental factors: Exposure to toxic substances or polluted air can increase the risk of developing respiratory diseases.
Diagnosis of this disease
Diagnosis of recurrent respiratory papillomatosis is based on a combination of clinical examination, laboratory tests, and instrumental diagnostic methods. The main symptoms include hoarseness, difficulty breathing, and frequent respiratory infections. Laboratory tests may include PCR to determine the presence of HPV, as well as histological examination of biopsies obtained during laryngoscopy.
Radiological examinations such as CT scans can help visualize the extent and extent of lesions. Other diagnostic methods include vocal cord stroboscopy and tonsillectomy for complex cases. The differential diagnosis is broad and may include laryngomalacia, malignancies, and other benign lesions.
Treatment
Treatment of recurrent respiratory papillomatosis is a multi-stage process and includes both pharmacological and surgical methods. Surgical intervention is usually the main method of treatment. It is important to remove papillomas with minimal trauma to surrounding tissues to reduce the risk of recurrence. As a pharmacological therapy, interferons and immunotherapy are used in some cases to stimulate the immune response. The possibility of using anti-HPV vaccines for prevention is also being considered.
Other types of interventions include laser therapy, which allows for the effective removal of neoplasms while reducing the level of trauma. At the moment, there is no single standard treatment regimen, which necessitates an individual approach.
List of medications used to treat this disease
The following medications may be used in the treatment of recurrent respiratory papillomatosis:
- Interferons (eg, alpha-2b)
- Immunostimulants (eg, tacrolimus)
- Anti-HPV vaccines
- Drugs for the treatment of concomitant infectious diseases
Disease monitoring
Monitoring of recurrent respiratory papillomatosis plays a key role in disease management. Control stages by the treating physician include regular examinations and studies to assess the patient's condition and detect relapses. The prognosis for patients with RRP varies depending on age, immune response, and disease aggressiveness. Potential complications may include the development of malignancies due to chronic trauma to the respiratory mucosa, which requires special attention from specialists.
Age-related features of the disease
Recurrent respiratory papillomatosis tends to manifest itself differently in different age groups. In newborns and young children, the disease usually progresses more aggressively, with pronounced symptoms and rapid development of the respiratory tract. In adults, RRP often progresses more slowly, although it can also lead to serious complications. It is important to understand that in adolescence, the risk of recurrence can also be significant, which requires regular monitoring and control of the condition.
Questions and Answers
- What is recurrent respiratory papillomatosis?
Recurrent respiratory papillomatosis is a viral disease caused by HPV that results in the formation of benign tumors in the respiratory tract. - What is the main cause of the disease?
The main cause is human papillomavirus, especially types 6 and 11. - What preventive measures can be taken?
Prevention includes HPV vaccination and monitoring in high-risk individuals. - What are the chances of relapse after treatment?
The chances of recurrence are significant and amount to 50-80% even after surgery. - How often should you undergo examination if you have RRP?
It is recommended to undergo regular examinations every 3-6 months to monitor the patient's condition.