Specific immunity to human papilloma virus (HPV) in patients with genital warts.

A study of human papilloma virus (HPV) specific cellular and humoral immunity in 30 patients with genital warts is reported. By in vivo testing with purified, inactivated plantar wart virus, a cell-mediated immunity to HPV was determined in 60% of patients. Circulating antibodies, evaluated by immunofluorescence testing, were rare, but these increased after an intradermal test had been carried out, especially in patients with a positive skin test, suggesting a booster effect. No significant difference was found between this group of patients and those having skin warts. Our results showed a specific immune response to HPV in most patients, confirming the role of the viral agent in the induction of genital warts.     

Specific immunity to human papilloma virus (HPV) in patients with genital warts.

A study of human papilloma virus (HPV) specific cellular and humoral immunity in 30 patients with genital warts is reported. By in vivo testing with purified, inactivated plantar wart virus, a cell-mediated immunity to HPV was determined in 60% of patients. Circulating antibodies, evaluated by immunofluorescence testing, were rare, but these increased after an intradermal test had been carried out, especially in patients with a positive skin test, suggesting a booster effect. No significant difference was found between this group of patients and those having skin warts. Our results showed a specific immune response to HPV in most patients, confirming the role of the viral agent in the induction of genital warts.     

Hunan wart-virus antibodies in patients with genital and skin warts.

A comparative follow-up study of the antibody response against human wart-virus was performed, using the immunodiffusion and complement fixation methods on patients with condylomas and skin warts. By the immunodiffusion method, 13% of the patients with skin warts and 3% of the patients with condylomas showed greater than or equal to fourfold increase of antibody titre during the follow-up of 2--35 months. The findings show some typical features of the weak antibody response of a chronic virus infection and suggest a serological overlapping between condyloma viruses and certain group of skin wart-viruses. The antibody prevalence in age-matched controls is shown to be significantly higher than that in the wart or condyloma patients' initial serum samples. This is indicative of the protective function of antibodies against warts and condylomas. Also the analysis of the history of warts in patients with condylomas suggests that protection against condylomas can be acquired from previous warts, evidently by immunological mechanisms. In a control group of medical students, human wart-virus antibodies were frequently (52%) found in subjects without any history of warts. This finding supports the view that human wart-virus can frequently induce latent or subclinical infections in human beings.     

Therapy for genital warts.

This article presents the spectrum of genital wart infection, including possible subclinical infection and reinfection from partners. Present therapy is effective in warts of recent onset but usually requires multiple treatments and is painful, and warts are frequently recurrent. Trials of combination therapy appear to have greater efficacy than does single-agent treatment. Problems for the future include the best management of warts in the sexually abused child, the immunocompromised host, and the pregnant patient. Genital warts are increasingly linked with the potential development of carcinoma, mandating more effective treatment regimens in the future.     

Thymus derived lymphocytes (T cells) in patients with genital warts.

Thymus derived lymphocytes (T cells) were counted in the peripheral blood of 30 patients with genital warts and in 20 healthy controls. The control group was made up of 10 healthy patients with no history of warts and 10 who had been cured of warts for at least 12 months. We found that patients with genital warts had a significantly lower number of T cells despite an adequate number of circulating lymphocytes in the peripheral blood. We therefore suggest that a functional defect of lymphocytes ("dyslymphocytosis") could be the cause of genital warts either in their primary or recurrent form. These abnormal lymphocytes return to their normal function after the disappearance of genital warts.     

Decreased T cell levels in patients with warts.

Thymus-derived lymphocyte (T cell) levels were determined in 72 healthy patients who had viral warts, in 21 healthy patients who had been cured of warts from one to 15 years previously, and in 35 age-matched normal controls who had no history of warts. The mean percentage of lymphocytes that formed rosettes with sheep erythrocytes was less in patients with warts and patients previously cured of warts than in normal controls (P less than .001 and P less than .001, respectively). The number of total T cells/cu mm was decreased in untreated patients with warts (P less than .01) but was normal in patients cured of warts for more than one year. In addition, the morphology of the rosettes in the two patient groups differed from the controls; 32% had small numbers of sheep erythrocytes bound loosely to T cells compared with a rosette of numerous erythrocytes closely adherent to the T cell in 91% of the controls. The results suggest a defect of cellular immunity in many healthy patients with warts.     

男性尖锐湿疣患者合并解脲支原体感染的临床特点分析

目的:探讨男性尖锐湿疣患者合并解脲支原体感染的临床特点分析。方法:选择86例男性尖锐湿疣患者为观察组,86例健康男性为对照组,根据患者主诉记录临床特征,采用醋酸白试验和UU培养基检测判定复发情况。结果:86例CA患者中,共41例患者检出解脲支原体感染,占47.7%。86例对照组中,共9例检出解脲支原体感染,占10.5%;二者检出率比较具有显著性差异(P0.05);单纯CA组患者复发7例,复发率为15.6%;CA合并UU组患者复发16例,复发率为39.0%,二者复发率比较具有显著性差异,合并UU感染更易复发;41例UU阳性患者中,21例患者出现尿道口黏膜明显充血发红,占51.2%;24例患者镜检出现多形核白细胞,占58.5%;5例患者主诉提及尿急、尿频、尿道不适,尿道分泌物等尿道炎症状,占12.2%。结论:尖锐湿疣合并解脲支原体感染是导致尖锐湿疣复发的重要因素,需尽早进行常规检查和化验,并进行规范化治疗。     

Cryotherapy compared with trichloroacetic acid in treating genital warts.

In an observer blind comparative study, 130 men with penile warts were randomly allocated to treatment with either cryotherapy or trichloroacetic acid (TCAA). There was no significant difference in response to treatment, side effects, or recurrence rates between the two treatments. Warts resolved in 81% of patients treated with TCAA compared with 88% of those treated with cryotherapy. Early recurrence occurred in 36% of patients treated with TCAA and in 39% of those treated with cryotherapy.     

Colposcopic evaluation of men with genital warts

Colposcopy, which is the examination of the female genital tract that generally is performed after the application of acetic acid, has been an effective tool in the diagnosis of genital warts (condyloma acuminatum) in women for years. With the help of colposcopy, both microscopic and flat warts that cannot be visualized with traditional, noncolposcopic methods can be seen and, hence, treated. Recently, studies reported in the gynecologic and urologic literature have evaluated the usefulness of colposcopy in male patients. We present a patient whose genital warts were recalcitrant to treatment. When examined with colposcopy he was noted to have multiple additional areas of involvement. In view of the neoplastic potential of the human papillomavirus, the ease with which it is transmitted sexually, and the difficulty in discerning certain kinds of warts without colposcopy, we believe colposcopic examination should be routine in all men with genital warts and in those whose sexual partners have tested positive for human papillomavirus.     

Specific cell-mediated immunity in patients with epidermodysplasia verruciformis and plane warts

The characterization of different types of human papilloma viruses made it possible to study the specific immune responses to purified viral antigens in patients with warts. The specific cell-mediated immunity was investigated by means of a leukocyte migration inhibition factor test in 9 patients with epidermodysplasia verruciformis and 4 patients with regressing plane warts. The results show a significant increase in specific cell-mediated reactivity concomitant with the regression of the warts.     

Possible role of interleukin 21 and interleukin 33 in patients with genital warts

Genital warts (GWs) are most prevalent sexually transmitted infections, presenting especially among the sexually active young population of both sexes. Efficient cell‐mediated immunity is needed for regression of GWs. To clarify the reactivity of cellular immunity among patients with GWs by means of measurements of their levels of serum interleukin (IL)‐21 and IL‐33, hence, to identify the possible role of IL‐21 and IL‐33 in GWs, this study aimed to evaluate serum levels of IL‐21 and IL‐33 among patients with GWs in comparison with the results of the controls. Levels of serum IL‐21 and IL‐33 were assayed utilizing commercially enzyme‐linked immune‐sorbent assay kits in 45 patients with GWs and 45 healthy control subjects. Levels of serum IL‐21 and IL‐33 were significantly decreased among patients with GWs in comparison with the controls (p < .0001). There was a highly significant positive correlation between IL‐21 and IL‐33 (r = .73, p < .0001). Low levels of serum IL‐21 and IL‐33 could have a contributive role in development, persistence, severity, and recurrence of GWs which rely basically on the defectiveness of cell‐mediated immunity. This could receive new light on nonconventional strategies for the prospective medical therapies of GWs by means of regulation of IL‐21 and IL‐33.