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Upper airway virus - driver or passenger on the journey to chronic infection?

Research group Upper airway virus - driver or passenger on the journey to chronic infection can we protect ourselves?

We study the upper airway respiratory mucosa in relation to viruses, where some viruses develop chronic infection with secondary diseases and others do not.

Human papillomavirus (HPV) can be linked to cancer of the tongue base and tonsil and Epstein-Barr virus to cancer behind nose.

We want to know where in the upper respiratory tract these viruses are located, in order to be able to prevent and treat disease e.g.through the use of pre-existing vaccines. These diseases are fatal in the untreated condition, the treatment is surgical and recurrent, with great impact on quality of life.

We have a translational approach with a focus on health promotion and prevention for optimal patient benefit. We use multidimensional methods such as SF-36, dyspnea index, PCR / microarray (PapilloCheck®), real-time PCR, IHC and EBER in situ hybridization (EBER-ISH).

Purpose and goals

To study airway stenosis in relation to treatment, virus and the impact on quality of life. We have been reporting data on respiratory viruses for many years.

Introduction

The overall purpose is patient and population benefit. We study the upper airway in relation to viruses. Human papillomavirus (HPV) can be linked to cancer of the tongue base and tonsil and Epstein-Barr virus to cancer behind the nose. P16 is a site-specific tumor marker for HPV, which inhibits tumor growth, EBV can down-regulate p16. We do not know the role of these viruses in upper airway; drivers or passengers

SGS is an airway stenosis that occurs in 1 in 400,000 cases / year. Unknown cause. Our research group reports a high incidence of EBV (33%) in vocal cord cancer. The vocal cords are located about 1 cm above the site of the SGS. Respiratory papilloma (RRP) is due to infection with HPV6 and 11 in the larynx usually on the vocal cords. In both RRP and SGS, the disease heals in some while others develop chronic infection with a recurring need for surgical treatment.

Hypotheses

There is virus in SGS, balloon dilation is a better treatment option than laser and patients show significantly improved breathing and quality of life after surgery.

Material/method

Work package (WP) I and IV is ongoing as observational, descriptive cross-sectional studies, based on diagnostic codes within the Västerbotten Region. WP II-III; ongoing material collection. In WP II, we use SF36 and dyspnea index as effect measures for quality of life and respiratory function over time. When analyzing tissue virus (III) we use a multidimensional methodology; PCR / microarray (PapilloCheck®), real-time PCR and EBER in situ hybridization (EBER-ISH). The statistical size of the material is based on the ongoing pilot study (index study). We have an inclusion rate that enables analysis of material 2023 Q4 / 2024 Q1-2 without a multicenter approach.

Clinical benefit

Outcomes will influence the choice of surgical method for SGS, especially in the light of a parallel quality of life study. If viruses is present I GS (II), we can use existing vaccines against e.g. HPV to extend treatment intervals, such as in RRP. We can also better protect healthcare staff when patients are undergoing surgery

Head of research

Katarina Olofsson
Adjunct professor
E-mail
Email

Overview

Participating departments and units at Umeå University

Department of Clinical Sciences

Research area

Cancer, Infection biology