Disrupted ciliated epithelium shows slower ciliary beat frequency and increased dyskinesia

Abstract

Ciliary function studies for the diagnosis of primary ciliary dyskinesia (PCD) are usually performed on nasal brush biopsy samples. It is not uncommon to find disrupted epithelial strips of tissue in these samples, and occasionally throughout a sample. The aim of the present study was to determine if cilia on disrupted ciliated epithelial edges beat with a normal pattern and frequency similar to that of cilia on undisrupted edges.Nasal brush biopsy samples from 42 children in whom the diagnosis of PCD was excluded were assessed. The epithelial strips were categorised into five groups: intact undisrupted ciliated epithelial edge, ciliated epithelial edge with minor projections, ciliated epithelial edge with major projections, an isolated ciliated cell on an epithelial edge and single unattached ciliated cells. Ciliary beat frequency and beat pattern of 50 samples from each group were determined using high speed digital video microscopy.The cilia on epithelial edges with varying degrees of disruption showed significantly reduced beat frequency and significantly increased dyskinesia compared with those on intact, undisrupted ciliated epithelial edges.Ideally, the assessment of ciliary beat pattern and frequency for PCD diagnosis should only be performed on undisrupted ciliated edges.

Chronic inflammation in the respiratory tract and ciliary dyskinesia

“…In respiratory tract, the mild inflammatory response will modify the composition and biophysical properties of mucus and increases the number of mucosa-infiltrating leukocytes. Usually, it is also accompanied by various morphological and functional changes in epithelium [5]. The enhanced intensity of inflammatory reaction in mucosal and submucosal connective tissue may lead to its remodeling and fibrosis.…”

Many a slip?

“…In some cases, the beat pattern may be strongly suggestive of particular pathological abnormalities [16]. Meticulous attention to detail is essential, and this is underscored by a manuscript in the current issue of the European Respiratory Journal [17]. The group, which has been at the forefront of diagnostic studies in PCD for many years, now report for the first time that CBF varies depending on whether it is measured on single cells or on epithelial strips.…”

“…The study by THOMAS et al [17] is very timely, because diagnostic testing for PCD is a particularly hot topic in Europe. The European Respiratory Society (ERS) Task Force has produced the largest ever survey of cases of PCD, parts of which were presented at the recent congress as posters [20,21] and a hot topic.…”

The Challenges of Diagnosing Primary Ciliary Dyskinesia

“…Biopsy samples should be obtained during a clinically stable baseline period because ciliary dyskinesia is much more common in samples if the patient has had an upper respiratory tract infection within the previous month. Occasionally, repeated biopsies are required because the ciliated epithelium obtained can have a huge amount of secondary damage, making it very difficult to interpret findings (10). Biopsy samples may be cultured to allow redifferentiation to a ciliated phenotype after a few weeks (11).…”