The immotile cilia syndrome: characterization of the inflammatory response in nonsmoking patients with dysfunction of the cilia.
In order to demonstrate how patients with immotile cilia syndrome (ICS) are associated with lower respiratory tract inflammation, bronchoscopy and fractionated BAL were performed on eight ICS patients. Their VC was 84.5 +/- 16.7% (mean +/- SD) and FEV1 73.1 +/- 19.9% of predicted. Endobronchial signs of bronchitis were observed in all patients. The total cell concentrations in the BAL fluid were increased, compared to healthy nonsmokers (n = 10), both in the bronchial (BP) and alveolar portion (AP) (p < 0.01 for both). In the BP, this was mainly due to a high concentration of neutrophils (p < 0.001), whereas in the AP, the concentrations of lymphocytes (p < 0.01) as well as all types of granulocytes (p < 0.001-0.01) were elevated. The signs of active inflammation in the lower respiratory tract were confirmed by the concomitantly elevated (p < 0.001-0.05) concentrations of the soluble BAL components albumin, fibronectin and hyaluronan. Thus, the inflammatory response is not restricted to the ciliated conducting airways, but also occurs in the alveolar space and results-surprisingly-in only a slightly impaired lung function.
Sköld
C M
CM
Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
Barck
C
C
Johard
U
U
Dahl
M
M
Eklund
A
A
D000328:Adult; D018893:Bronchoalveolar Lavage / Q000379:methods; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology* / Q000276:immunology; D001999:Bronchoscopy; D002925:Ciliary Motility Disorders / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000209:etiology; D018709:Statistics, Nonparametric