Evaluation of Herpesviruses 1‐6 and Community‐Acquired Respiratory Viruses in Patients with Nasal Polyposis

Abstract

Objectives: Evaluate human herpesviruses 1-6 and community-acquired respiratory virus (CARV) prevalence in nasal polyps, adjacent turbinates, and pre- and post-operative cytological specimens from patients undergoing functional endoscopic sinus surgery (FESS) and to investigate cytomegalovirus (CMV)- and Epstein-Barr virus (EBV)-specific cellular immune response. Methods: Viral occurrence was evaluated in 35 consecutive patients, enrolled between September 2011 and October 2012, at different time points by molecular methods. CMV- and EBV-immune response was evaluated by Elispot assay. Results: Overall, 21 patients (60%) were positive for at least one virus in at least one specimen; in particular, 12.1% of all specimens for HHV-6 and 10.5% for EBV, followed by CMV and HSV-1 (both 1.6%). EBV-positivity tended to be higher in polyps, as well as HHV-6 in turbinate mucosa, although no significant association was found. Only one pre-operative cytological specimen was positive to parainfluenza virus-1. As regards immune response, 63.2% of patients displayed a CMV-responder status, whereas only 11.2% were EBV-responders. Conclusions: The frequent detection of HHV-6 in normal nasal mucosa could be explained by its diffusion in different tissues, whereas the higher EBV frequency in polyps could support a causative role or persistence in the inflammatory lymphoid tissue. No association between the development of nasal polyps, other herpesviruses, and CARVs seems to exist. Preliminary data suggest an altered immune response pattern to CMV and, particularly, EBV. The potential implications in CRSwNP remain to be defined.