title: T(H)2-like chemokine patterns correlate with disease severity in patients with recurrent respiratory papillomatosis.
abstract: Recurrent respiratory papillomatosis (RRP), characterized by the recurrent growth of benign tumors of the respiratory tract, is caused by infection with human papillomavirus (HPV), predominantly types 6 and 11. Surgical removal of these lesions can be required as frequently as every 3 to 4 wks to maintain a patent airway. There is no approved medical treatment for this disease. In this study, we have characterized the T(H)2-like chemokine profile (CCL17, CCL18, CCL20, CCL22) in patients with RRP and asked whether it was modulated in patients who had achieved significant clinical improvement. CCL17, CCL18 and CCL22 messenger RNAs (mRNAs) were increased in papillomas compared with clinically normal laryngeal epithelium of the RRP patients. Overall, CCL20 mRNA expression was not increased, but there was intense, selective CCL20 protein expression in the basal layer of the papillomas. Patients with RRP expressed more CCL17 (p = 0.003), CCL18 (p = 0.0003), and CCL22 (p = 0.007) in their plasma than controls. Plasma CCL18 decreased over time in three patients enrolled in a pilot clinical trial of celecoxib, and the decrease occurred in conjunction with clinical improvement. There was a significant correlation between sustained clinical remission in additional patients with RRP and reduced levels of CCL17 (p = 0.01), CCL22 (p = 0.002) and CCL18 (p = 0.05). Thus, the change in expression of these three plasma T(H)2-like chemokines may, with future studies, prove to serve as a useful biomarker for predicting disease prognosis.
authors.affiliation: Elmezzi Graduate School of Molecular Medicine, Manhasset, New York, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Rosenthal
authors.forename: James A
authors.initials: JA
authors.lastname: DeVoti
authors.forename: Bettie M
authors.initials: BM
authors.lastname: Steinberg
authors.forename: Allan L
authors.initials: AL
authors.lastname: Abramson
authors.forename: Vincent R
authors.initials: VR
authors.lastname: Bonagura
mesh_terms: D016022:Case-Control Studies; D000068579:Celecoxib; D018925:Chemokines / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D007830:Larynx / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D010212:Papilloma / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D030361:Papillomavirus Infections / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology*; D011720:Pyrazoles / Q000494:pharmacology / Q000627:therapeutic use; D012074:Remission Induction; D012141:Respiratory Tract Infections / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology*; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000494:pharmacology / Q000627:therapeutic use; D018418:Th2 Cells / Q000187:drug effects / Q000276:immunology*
chemical_list: D018925:Chemokines; D011720:Pyrazoles; D013449:Sulfonamides; D000068579:Celecoxib