Abstract [eng] |
Adult-onset recurrent respiratory papillomatosis (AORRP) is a rare disease characterized by the formation of papillomas in the lining of the larynx because of human papillomavirus infection. The most common causes of the disease are virus types 6 and 11. The virus localizes in the cells of the basal layer of the epithelium. The most common symptoms are coughing, hoarseness and phonation problems. Currently, the standard treatment for AORRP is endolaryngeal surgery using a variety of lasers or shavers. The gold standard is CO2 lasers, which have good cutting and coagulation properties. However, recent advancements have introduced promising laser technologies that aim to minimize the need for general anesthesia and facilitate better access to papillomas, even at challenging angles. Despite the innovations, surgical methods do not eliminate the viral infection, leaving patients to suffer from repeated episodes of recurring disease and re-operations. Consequently, researchers have been exploring novel therapeutic strategies that not only target the papillomas and alleviate symptoms but also target the underlying viral infection, addressing the etiology of the disease. Most of the drugs that are now being tested work by immunomodulating and inhibiting viral replication and proliferation. Currently, the literature mostly focuses on α-interferon, antiviral agents such as cidofovir and human vascular endothelial growth factor inhibitors such as bevacizumab. The mechanisms of action, advantages and disadvantages of these drugs are reviewed here. In addition, the undeniable benefits of vaccines not only as both preventive and therapeutic option are also discussed. Due to the rarity of the disease, progress in identifying the most effective treatments that can significantly improve patients' quality of life, reduce recurrence rates, and minimize treatment costs has been slow. Therefore, collaboration among clinical centers and further clinical trials are crucial in advancing our understanding and management of this condition. |