Herpesviruses in the oral cavity of patients subjected to allogeneic hematopoietic stem cell transplantation and its rel
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ORIGINAL ARTICLE
Herpesviruses in the oral cavity of patients subjected to allogeneic hematopoietic stem cell transplantation and its relationship with oral mucositis Wanessa Miranda-Silva 1 & Franciele Hinterholz Knebel 2 & Tania Regina Tozetto-Mendozo 3 & Michelle Palmieri 4 & Felipe Paiva da Fonseca 5 & Anamaria Aranha Camargo 2 & Paulo Henrique Braz-Silva 3,4 & Eduardo Rodrigues Fregnani 1 Received: 10 November 2019 / Accepted: 29 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives This study was performed to characterise oral shedding of herpesviruses in patients who underwent allogeneic hematopoietic stem cell transplantation (alloHSCT) and to investigate its relationship with oral mucositis (OM). Materials and Methods PCR and enzymatic digestion were conducted to identify oral shedding of herpesviruses and its correlation with OM development in 31 patients. The samples were collected at three sites in the oral cavity and at 5 times during follow-up; two additional collections were made from patients who developed ulcerative OM. Results HSV-1, EBV, CMV, HHV-6A, HHV-6B, and HHV-7 were detected in 4.97%, 16.02%, 4.41%, 2.20%, 3.31%, and 68% of the oral mucosal samples, respectively; 4.41%, 16.57%, 5.52%, 2.20%, 5.52%, and 63.53% of supragingival samples, respectively, and 4.41%, 18.23%, 2.76%, 1.65%, 2.75%, and 35.91% of subgingival samples, respectively. OM was diagnosed in 13 patients. The presence of HHV-7 in C1 (oral mucosa: p = 0.032) and C2 (supragingival: p = 0.009; subgingival: p = 0.002) was significantly increased in patients who developed OM, and patients exhibiting HHV-7 shedding in the oral cavity were 3.32fold more likely to develop OM. Conclusions Patients who developed OM showed higher HHV-7 shedding in the oral cavity at nadir (immediately prior to OM development), suggesting modifications to the inflammatory microenvironment. Clinical Relevance HHV-7 may be involved in oral dysbiosis in HSCT-related OM; enhanced understanding of its role in the pathogenesis of OM may lead to the development of strategies for managing and preventing this common side effect of alloHSCT. Keywords DNA virus infections . Herpesviridae . Oral mucositis . Hematopoietic stem cell transplantation . Dysbiosis
* Eduardo Rodrigues Fregnani [email protected]
Paulo Henrique Braz-Silva [email protected]
Wanessa Miranda-Silva [email protected]
1
Franciele Hinterholz Knebel [email protected]
Department of Oral Medicine, Hospital Sírio Libanês, Rua Dona Adma Jafet, 91-Bela Vista, São Paulo, SP, Brazil
2
Sociedade Beneficente de Senhoras Hospital Sírio Libanês, São Paulo, Brazil
3
Laboratory of Virology, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
4
Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
5
Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
Tania Regina Tozetto-Mendozo [email protected] Michelle Pa
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