title: Clinical value of ciliary assessment in bronchiectasis.
abstract: Although ciliary dysfunction and numerous ultrastructural defects have been described, and these could be etiologically important in the development of bronchiectasis, their correlation with relevant clinical parameters have not been systematically evaluated. We have prospectively evaluated the prevalence and clinical significance of ciliary beat frequency and ultrastructural defects of nasal respiratory mucosa obtained from 152 stable patients with idiopathic bronchiectasis (100F, 57.7 +/- 15.2 yrs) and 127 control subjects (58F, 56.0 +/- 24.2 yrs). Bronchiectasis patients had significantly slower ciliary beat frequency (p < 0.05), and a greater percent of patients had central and peripheral microtubular defects (OR 14.4, 95% CI 5.6-36.8), namely, extra peripheral microtubules, "9 + 1", "8 + 2", and compound cilia (p < 0.05), but not microtubular disarrangement, extra matrix or ciliary tail abnormalities (p > 0.05), than controls. Bronchiectasis patients also had a greater proportion of cilia with any ultrastructural microtubular defects, compound cilia, and ciliary tails than controls (p < 0.05). Ciliary beat frequency did not correlate with clinically relevant parameters (p > 0.05). However, the percent of cilia with central, but not peripheral, microtubular defects correlated with 24 h sputum volume (r = 0.40, p = 0.001, and r = -0.04, p = 0.70, respectively) and FEV1 (r = -0.24, p = 0.01, and r = 0.00, p = 0.99 respectively). Our results strongly suggest a pathogenic role for central microtubular defects in the development of idiopathic bronchiectasis.
authors: University Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong SAR, China. kwttsang@hku.hk
authors: Kenneth W
authors: KW
authors: Tsang
authors: George
authors: G
authors: Tipoe
authors: June
authors: J
authors: Sun
authors: Kathryn C
authors: KC
authors: Tan
authors: Raymond
authors: R
authors: Leung
authors: Christina
authors: C
authors: Yan
authors: Colin
authors: C
authors: Ko
authors: Gaik C
authors: GC
authors: Ooi
authors: James C
authors: JC
authors: Ho
authors: Wah K
authors: WK
authors: Lam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001987:Bronchiectasis / Q000473:pathology*; D002923:Cilia / Q000502:physiology / Q000648:ultrastructure; D006801:Humans; D046529:Microscopy, Electron, Transmission; D008870:Microtubules; D008875:Middle Aged; D009297:Nasal Mucosa / Q000166:cytology* / Q000648:ultrastructure; D011446:Prospective Studies; D013147:Spirometry