Motile Ciliary Disorders in Chronic Airway Inflammatory Diseases: Critical Target for Interventions

Abstract

We have summarized the manifestations of motile ciliary disorders and addressed the underlying associations with chronic airway inflammatory diseases. A panel of established and novel diagnostic tests and therapeutic interventions are outlined. Physicians should be vigilant in screening for motile ciliary disorders, particularly in patients with co-existing upper and lower airway inflammatory diseases. Proper assessment and treatment of motile ciliary disorders may have added value to the management and prevention of chronic airway inflammatory diseases.

Comparative Analysis of Mucociliary Clearance and Mucosal Morphology Using High-Speed Videomicroscopy in Children With Acute and Chronic Rhinosinusitis

“…29 Similarly, exposure to non-typeable Haemophilus influenzae resulted in a significant reduction in ciliary beat frequency and the number of motile cilia through protein kinase C (PKC) up-regulation. 30 It is proposed that inflammatory response may be considered as the potential cause of impaired mucociliary function in rhinosinusitis 31 thus underlying the difference in alteration of mucociliary clearance in children with acute and chronic rhinosinusitis. Specifically, it has been demonstrated that interleukin 13 (IL-13) significantly reduce ciliated cell number, ciliary beat frequency and expression of ciliary b-tubulin IV, while upregulating mucin production in human nasal epithelial cells in vitro.…”

Microarray Assay Reveals Ciliary Abnormalities of the Allergic Nasal Mucosa

“…In light of the chronic airway inflammation, the ciliary abnormalities detected in patients with AR were likely to have arisen from repetitive inflammatory insults. 6 In addition, there have been a considerable number of literature reports demonstrating the pathogenic roles of chronic allergic airway inflammation in impairing the nasal ciliary clearance. Ciliary abnormalities and ultrastructural abnormalities, as revealed by transmission electron microscopy, significantly correlated with the severity of asthma and might have stemmed from the insults of chronic airway inflammation or infection in patients with severe asthma.…”

“…In light of the chronic airway inflammation, the ciliary abnormalities detected in patients with AR were likely to have arisen from repetitive inflammatory insults. 6…”

“…For instance, defective ciliary clearance, evidenced by impaired ultrastructure and/or function of respiratory cilia, has been implicated in chronic airway inflammatory diseases such as AR and warranted further investigations in their contribution to the pathogenesis of AR. 6 To date, most studies of AR focused on genetic analysis and single genes or pathways which have limited ability to delineate the complex transcriptomic regulations and interactions from the panel of canonical genes that play critical roles in driving the pathogenesis of AR. 7,8 By performing microarray analysis, various pathologic processes have been characterized in patients with other chronic inflammatory airway diseases.…”

“…For instance, defective ciliary clearance, evidenced by impaired ultrastructure and/or function of respiratory cilia, has been implicated in chronic airway inflammatory diseases such as AR and warranted further investigations in their contribution to the pathogenesis of AR. 6…”