Kolesteatom etyolojisinde mantar ve EBV etken mi?

Yıl 2022, Cilt: 8 Sayı: 2, 123 - 128, 30.08.2022

Ayşegül İsal Arslan Sevil Karabağ Tolga Ersözlü

https://doi.org/10.30569/adiyamansaglik.1034935

Öz

Amaç: Kolesteatom, patogenezi bilinmeyen, toplumda sık görülen bir hastalıktır. Neoplastik bir süreç olmamasına rağmen lokal kemik destrüksiyonu ile mortal hastalık olabilir. Çalışmamızda inflamatuvar süreç ile tetiklenen kolesteatometyolojisine yönelik yeni bilgiler sunmayı hedefledik.
Gereç ve Yöntem: Çalışmaya 2011-2019 yılları arasında mastoidektomi yapılankolesteatom tanılı 34 hasta dahil edildi. Olgular, immünohistokimyasal yöntem kullanılarak Epstein‐Barr virüsü (EBV)’nın kodladığı gizli membran proteini (LMP-1) ve Grocott's methenamine silver boyası ile mantar varlığı araştırıldı.
Bulgular: 34 hastada GMSII boyama ile mantar tespit edilmedi. Bu 34 hastanın 32’si immunohistokimyasal EBV antikoru ile negatif, ancak 2’si şüpheli değerlendirildi. Bu 2 olguya silver in situ hibriditasyon yöntemiyle EBER uygulandı ve reaksiyon elde edilmedi.
Sonuç: Araştırmamızda inflamatuvar süreci tetikleyebilecek mantar, EBV varlığını araştırdık. Ancak dokularda EBV, mantar tespit edilmedi. Çalışmamız agresif kolesteatom olgularında formalin fikse dokuda EBV ve mantar varlığını araştıran ilk araştırmadır.

Anahtar Kelimeler

Kolesteatom, Etyoloji, Mantar, EBV

Destekleyen Kurum

Çalışmayı araştırmacılar kendi imkanları ile yapmıştır.

Are fungi and EBV effective in cholesteatoma etiology?

Öz

Aim: Cholesteatoma is a commonly seen disease whose pathogenesis remains unknown. Although not a neoplastic process, it may progress to a fatal condition with local bone destruction. In this study, we aimed to present new insights concerning the etiology of cholesteatoma triggered by an inflammatory process.
Materials and Methods: The study included 34 patients diagnosed with cholesteatoma upon mastoidectomy performed between 2011-2019. Due to a provisional diagnosis of cholesteatoma. The cases were investigated for the latent membrane protein (LMP-1) encoded by the Epstein-Barr Virus (EBV) using the immunohistochemical method and for the presence of fungi using Grocott’s methenamine silver (GMSII) stain.
Results: No fungi was detected in any of the 34 patients by GMSII staining. Thirty-two of the 34 patients were negative with but a suspicious result was seen in 2 patients with the immunohistochemical EBV antibody. EBV-encoded RNA (EBER) analysis was applied to these 2 cases with the silver in situ hybridization method and no reaction was observed.
Conclusion: In our study, we investigated the presence of fungi and EBV, which can trigger the inflammatory process. However, no EBV or fungi was detected in the tissues. Our study is the first to investigate the presence of EBV and fungi in formalin-fixed tissue in cases of aggressive cholesteatoma.

Anahtar Kelimeler

Cholesteatoma, Etiology, Fungi, EBV

Kaynakça

• Castle JT. Cholesteatoma pearls: practical points and update modern pathology. Head and Neck Pathology. 2018; 12:419–429.
• Gilberto N, Custodio S, Colaço T, Santos R, Sousa P, Escada P. Middle ear congenital cholesteatoma: systematic review, meta‑analysis and insights on its pathogenesis. European Archives of Oto-Rhino-Laryngology. 2020; 277:987–998.
• Chao WY, Chang SJ, Jin YT. Detection of human papillomavirus in cholesteatomas. Eur Arch Otorhinolaryngol. 2000;257:1203.
• Shihada R, Brodsky A, Luntz MI. Giant cholesteatoma of the temporal bone. Med Assoc J. 2006; 8(10):718-9.
• Shohet JA, de Jong AL. The management of pediatric cholesteatoma. Otolaryngologic Clinics of North America. 2002; 35(4):841-51.
• Rahman R, Poomsawat S, Juengsomjit R, Buajeeb W. Overexpression of Epstein-Barr virusencoded latent membrane protein-1 (LMP-1) in oral squamous cell carcinoma. BMC Oral Health 2019; 19:142
• Manıu A, Harabagıu O, Schrepler M, Catana A, Fanuţa B, Mogoanta C. Molecular biology of cholesteatoma. Rom J Morphol Embryol 2014; 55(1):7–13.
• Ferekidis E, Nikolopoulos TP, Yiotakis J, Ferekidou E, Kandiloros D, Papadimitriou K et al. Correlation of clinical and surgical findings to histological features (koilocytosis, papillary hyperplasia) suggesting papillomavirus involvement in the pathogenesis of cholesteatoma. Med Sci Monit, 2006; 12(9): CR368-371.
• Schürmann M, Greiner FWJ, Volland-Thurn V, Oppel F, Kaltschmidt C, Sudhoff H et al. Stem Cell-Induced Inflammation in Cholesteatoma IsöInhibited by the TLR4 Antagonist LPS-RS. Cells. 2020; 9, 199; doi:10.3390/cells9010199.
• Effat KG, Madan NM. Mycological study on cholesteatoma keratin obtained during primary mastoid surgery. J LaryngolOtol 2014;128(10):881-4. doi: 10.1017/S0022215114002059.
• Owen HH, Rosborg J, Gaihede M. Cholesteatoma of the external ear canal: etiological factors, symptoms and clinical findings in a series of 48 cases. BMC ear, nose and throat disorders.2006: 1-9.
• Singh GB, Solo M, Kaur R, Arora R, Kumar S. Mycology of chronic suppurative otitismedia-cholesteatoma disease: an evaluative study. American Journal of Otolaryngology. 2018;39 157–161.
• Sham CL, To KF, Chan PKS, Lee DLY, Tong MCF, Hasselt CAV. Prevalence of human papillomavirus, epstein–barr virus, p21, and p53 expressioninsinonasalinverted papilloma, nasal polyp, and hypertrophied turbinate in Hong Kong patients. Head Neck 2012;34(4):520-33.
• Tsai ST, Jin YT, Mann RB, Ambinder RF. Epstein–barr virus detection in nasopharyngeal tissues of patients with suspected nasopharyngeal carcinoma. Cancer. 1998;82(8):1449-53.