title: High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease.
abstract: Chronic tonsillar diseases are an important health problem, leading to large numbers of surgical procedures worldwide. Little is known about pathogenesis of these diseases. In order to investigate the role of respiratory viruses in chronic adenotonsillar diseases, we developed a cross-sectional study to determine the rates of viral detections of common respiratory viruses detected by TaqMan real time PCR (qPCR) in nasopharyngeal secretions, tonsillar tissues and peripheral blood from 121 children with chronic tonsillar diseases, without symptoms of acute respiratory infections. At least one respiratory virus was detected in 97.5% of patients. The viral co-infection rate was 69.5%. The most frequently detected viruses were human adenovirus in 47.1%, human enterovirus in 40.5%, human rhinovirus in 38%, human bocavirus in 29.8%, human metapneumovirus in 17.4% and human respiratory syncytial virus in 15.7%. Results of qPCR varied widely between sample sites: human adenovirus, human bocavirus and human enterovirus were predominantly detected in tissues, while human rhinovirus was more frequently detected in secretions. Rates of virus detection were remarkably high in tonsil tissues: over 85% in adenoids and close to 70% in palatine tonsils. In addition, overall virus detection rates were higher in more hypertrophic than in smaller adenoids (p = 0.05), and in the particular case of human enteroviruses, they were detected more frequently (p = 0.05) in larger palatine tonsils than in smaller ones. While persistence/latency of DNA viruses in tonsillar tissues has been documented, such is not the case of RNA viruses. Respiratory viruses are highly prevalent in adenoids and palatine tonsils of patients with chronic tonsillar diseases, and persistence of these viruses in tonsils may stimulate chronic inflammation and play a role in the pathogenesis of these diseases.
authors.affiliation: Department of Cell Biology, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil.
authors.forename: Jose Luiz
authors.initials: JL
authors.lastname: Proenca-Modena
authors.forename: Fabiana Cardoso
authors.initials: FC
authors.lastname: Pereira Valera
authors.forename: Marcos Gerhardinger
authors.initials: MG
authors.lastname: Jacob
authors.forename: Guilherme Pietrucci
authors.initials: GP
authors.lastname: Buzatto
authors.forename: Tamara Honorato
authors.initials: TH
authors.lastname: Saturno
authors.forename: Lucia
authors.initials: L
authors.lastname: Lopes
authors.forename: Jamila Mendonça
authors.initials: JM
authors.lastname: Souza
authors.forename: Flavia
authors.initials: F
authors.lastname: Escremim Paula
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Silva
authors.forename: Lucas Rodrigues
authors.initials: LR
authors.lastname: Carenzi
authors.forename: Edwin
authors.initials: E
authors.lastname: Tamashiro
authors.forename: Eurico
authors.initials: E
authors.lastname: Arruda
authors.forename: Wilma Terezinha
authors.initials: WT
authors.lastname: Anselmo-Lima
mesh_terms: D000234:Adenoids / Q000473:pathology / Q000821:virology*; D000260:Adenoviruses, Human / Q000235:genetics; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D056661:Human bocavirus / Q000235:genetics; D006801:Humans; D007223:Infant; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology / Q000821:virology*; D012328:RNA Viruses / Q000235:genetics; D012367:RNA, Viral / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D014069:Tonsillitis / Q000453:epidemiology / Q000235:genetics / Q000473:pathology / Q000821:virology*; D014777:Virus Diseases / Q000453:epidemiology / Q000235:genetics / Q000473:pathology / Q000821:virology*
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral