Tonsillar swabs and sputum predict SLPI‑ and AnxA2 expression in tonsils: A prospective study on smoking dependent SLPI‑ and AnxA2‑expression, and tonsillar HPV infection

Quabius,Elgar Susanne; Heinrichs,Alessa; Kühnel,André; Laudien,Martin; Hoppe,Florian; Mlynski,Robert; Ambrosch,Petra; Hoffmann,Markus

doi:10.3892/ol.2022.13284

Tonsillar swabs and sputum predict SLPI‑ and AnxA2 expression in tonsils: A prospective study on smoking dependent SLPI‑ and AnxA2‑expression, and tonsillar HPV infection

Authors:
- Elgar Susanne Quabius
- Alessa Heinrichs
- André Kühnel
- Martin Laudien
- Florian Hoppe
- Robert Mlynski
- Petra Ambrosch
- Markus Hoffmann
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Affiliations: Department of Otorhinolaryngology, Head and Neck Surgery, University Clinic Schleswig‑Holstein, D‑24105 Kiel, Germany, Department of Otorhinolaryngology, Head and Neck Surgery ‘Otto Koerner’, University of Rostock, D‑18057 Rostock, Germany, Department of Otorhinolaryngology, Head and Neck Surgery, Asklepios Hospital Harburg, D‑21075 Hamburg, Germany, Department of Otorhinolaryngology‑Head and Neck Surgery, Klinikum Oldenburg, D‑26133 Oldenburg, Germany, Department of Otorhinolaryngology, Head and Neck Surgery ‘Otto Koerner’, University of Rostock, D‑18057 Rostock, Germany
Published online on: March 28, 2022 https://doi.org/10.3892/ol.2022.13284
Article Number: 164

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Abstract

Previous retrospective studies have elucidated a correlation between secretory leucocyte protease inhibitor (SLPI) and Annexin A2 (AnxA2), patient smoking status and tonsillar human papilloma virus (HPV) status. The current study assessed these parameters prospectively and to the best of our knowledge, analyzed SLPI‑/AnxA2‑expression for the first time in tonsillar swabs and sputum. Samples were obtained from 52 patients with tonsillar squamous cell carcinoma and 163 patients with tonsillar hyperplasia (H; n=56) and chronic or recurrent tonsillitis (CRT; n=107). HPV‑DNA, SLPI and AnxA2 gene expression was analyzed in sputum, tonsillar swabs and tissue by performing reverse transcription‑quantitative PCR. Results were compared with smoking status, revealing that smoking resulted in significantly increased SLPI gene expression in all biomaterials of all cases. SLPI‑gene expression was significantly decreased in all HPV‑DNA‑positive samples (tissue/swab/sputum), while AnxA2 was significantly increased in all HPV‑DNA‑positive samples. Results from swabs and sputum were able to predict SLPI‑ and AnxA2 gene expression of the corresponding tonsil. The current prospective study confirmed previous retrospective results underlining this hypothesis: Smoking enhances SLPI‑expression, preventing HPV‑binding to AnxA2. HPV‑binding to AnxA2 appears essential for successful cell‑entry. SLPI/AnxA2‑gene expression in swabs and sputum reflect their expression in tonsillar tissue. Accordingly, a positive AnxA2/SLPI‑ratio in sputum/swabs could possibly be used to reduce HPV‑associated carcinogenesis, by performing tonsillectomy or HPV‑vaccination in patients with positive AnxA2/SLPI‑ratios.

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