• Title/Summary/Keyword: Mucociliary Clearance

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The Expression of ECP in the Perennial Allergic Rhinitis and Correlations with Mucociliary Clearance (통년성 알레르기성 비염에서의 ECP의 발현양상과 점액섬모수송기간과의 관계)

  • 오승철;김찬우;이상학
    • Korean Journal of Bronchoesophagology
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    • v.4 no.1
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    • pp.85-90
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    • 1998
  • The role of the ECP(Eosinophilic cationic protein) is still unknown in the allergic rhinitis. In bronchial asthma, ECP can induce the exposure of the neuropeptidergic nerve to environments destroying the bronchial mucosa, aggravating the bronchial hypersensitivity and delay the mucociliary clearance. In the clinical aspect, we can (md that patients with perennial allergic rhinitis sometimes have sinusitis. The purpose of this article is to evaluate whether mucosal damage by ECP can play a role to develop the sinusitis by delaying the mucociliary clearance, and relationship between long symptom duration of allergic rhinitis and mucociliary clearance. In 32 perennial allergic rhinitis patients, we elucidated there is correlation among ECP presence, mucociliary clearance, sinusitis, and symptom durations. The obtained results were as follows : 1. ECP appeared in all mucosa of each specimen. 2. Mean mucociliary clearance time is 6 mins. 12 sec. in allergic patients with sinusitis, 6 mins. 36 sec in allergic patients without sinusitis. 3. n out of 32 cases have mucosal destruction. 4. Symptom duration is not correlated with the development of sinusitis. This study suggests that ECP may destroy the mucosa in allergic rhinitis and the mucociliary clearance of allergic rhinitis is not related to sinusitis and symptom dotation. Therefore development of sinusitis in allergic rhinitis seems not to be caused by delaying of mucociliary clearance due to mucosal destruction, but by some other factors.

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Clinical Study for Mucociliary clearance of Pediatric Chronic Sinusitis after KamiHyunggyeyungotang Therapy (가미형개연교탕(加味荊芥蓮翹湯)이 만성부비동염(慢性副鼻洞炎)의 비강섬모운동(鼻腔纖毛運動)에 미치는 영향(影響))

  • Yang, Mi-Ra;Park, Eun-Jeung;Im, Tae-Hyung;Jin, Kyong-Sun
    • The Journal of Pediatrics of Korean Medicine
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    • v.17 no.1
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    • pp.1-16
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    • 2003
  • Background: Delayed mucociliary clearance develops the pooling of nasal secretion in the nasal cavity and is a common cause of vicious cycle of symptoms in chronic sinusitis. mucociliary clearance depends on the ciliary activity, the rheological property of the secretion and on the interaction between cilia and the mucous blanket. Objective: To demonstrate the therapeutic effect of herbal medicine (Hyunggyeyungotang) on the mucociliary transport in the chronic sinusitis using saccharine Materials and methods: Forty patients treated in our hospital between september 2000 and september 2001 were studied. Before and after therapy group are composed of twenty patients. Kamihyunggyeyungyotang was administered mainly. We analyzed the saccharine mucociliary transport time of patients. Results: 1) In the control group, the transport time is about 13.4 minutes. 2) In chronic sinusitis before Kamihyunggyeyungotang therapy, the transport time is about 27.7 minutes. 3) In chronic sinusitis after Kamihyunggyeyungotang therapy, the transport time is about 13.8 minutes. Conclusion: Delayed mucociliary transport time in chronic sinusitis is earlier after Kamihyunggyeyungotang therapy.

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Mucociliary Clearance in the Children with Bronchial Asthma (기관지 천식 환아에서의 점액섬모 청소율(Mucociliary Clearance))

  • Lee, Myung-Hyun;Sun, Yong-Han;Nam, Seung-Gon;Koh, Young-Yull;Chung, June-Key
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.173-181
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    • 1996
  • Background : Several studies have suggested that impaired mucociliary clearance plays a role in the pathophysiology of bronchial asthma. Cough productive of mucoid sputum is common, and mucous plugs in the airways are frequently observed. These clinical features are in keeping with the histologic lesions of asthma, which involve primarily the epithelial and mucous-producing structures of the conducting airways. Some studies have shown that the mucociliary clearance is impaired in adult asthma, but it has not been studied in childhood asthma. The objectives of this study were to examine whether the mucociliary clearance is impaired in childhood asthma and to estimate the degree of impairment in comparison with that of immotile cilia syndrome. Method : Thirteen children with mild stable asthma and eight patients with immotile cilia syndrome completed this study. Ten healthy children were recruited as a normal control group. The whole-lung mucociliary clearance was measured by the radioaerosol technique. Aerosols, tin colloid particles tagged with the radionuclide technetium-99m($^{99m}Tc$), were generated by means of nebulizer, and inhaled via a mouthpiece. The retention of radioactivity was measured at 30, 60, 90 and 120 minutes by gamma camera, and mucociliary clearance was calculated as percent retention at each time. Results: 1) In each subject, the percent retention decreased variably with the lapse of time. 2) The percent retention of radionuclide decreased at each time in order of normal control, bronchial asthma and immotile cilia syndrome and the percent retention of immotile cilia syndrome was significantly higher than that of normal control at each time(p<0.05). 3) At two hours, the percent retention of bronchial asthma($65.0{\pm}1.8$(SE)%) was significantly higher than that of the normal control($54.4{\pm}3.5%$, p<0.05), and significantly lower than that of immotile cilia syndrome($73.3{\pm}1.4%$, p<0.01). 4) When the percent retention was analyzed according to $PC_{20}$ in the children with bronchial asthma, they had no relationship with each other. Conclusion: Mucociliary clearance in the children with bronchial asthma was significantly lower than normal control. This finding indicates that impaired mucociliary clearance operates in childhood asthma as well, and suggests that it may be one contributing factor in the pathogenesis of asthma. The degree of impairment, however, was not so severe as immotile cilia syndrome.

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Airway Mucus: Its Components and Function

  • Lillehoj, Erik-P.;Kim, K.-Chul
    • Archives of Pharmacal Research
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    • v.25 no.6
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    • pp.770-780
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    • 2002
  • The airway surface liquid (ASL), often referred to as mucus, is a thin layer of fluid covering the luminal surface of the airway. The major function of mucus is to protect the lung through mucociliary clearance against foreign particles and chemicals entering the lung. The mucus is comprised of water, ions, and various kinds of macromolecules some of which possess the protective functions such as anti-microbial, anti-protease, and anti-oxidant activity. Mucus glycoproteins or mucins are mainly responsible for the viscoelastic property of mucus, which is crucial for the effective mucociliary clearance. There are at least eight mucin genes identified in the human airways, which will potentially generate various kinds of mucin molecules. At present, neither the exact structures of mucin proteins nor their regulation are understood although it seems likely that different types of mucins are involved in different functions and might also be associated with certain airway diseases. The fact that mucins are tightly associated with various macromolecules present in ASL seems to suggest that the defensive role of ASL is determined not only by these individual components but rather by a combination of these components. Collectively, mucins in ASL may be compared to aircraft carriers carrying various types of weapons in defense of airborne enemies.

Korean Red Ginseng aqueous extract improves markers of mucociliary clearance by stimulating chloride secretion

  • Cho, Do-Yeon;Skinner, Daniel;Zhang, Shaoyan;Lazrak, Ahmed;Lim, Dong Jin;Weeks, Christopher G.;Banks, Catherine G.;Han, Chang Kyun;Kim, Si-Kwan;Tearney, Guillermo J.;Matalon, Sadis;Rowe, Steven M.;Woodworth, Bradford A.
    • Journal of Ginseng Research
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    • v.45 no.1
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    • pp.66-74
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    • 2021
  • Background: Abnormal chloride (Cl-) transport has a detrimental impact on mucociliary clearance in both cystic fibrosis (CF) and non-CF chronic rhinosinusitis. Ginseng is a medicinal plant noted to have anti-inflammatory and antimicrobial properties. The present study aims to assess the capability of red ginseng aqueous extract (RGAE) to promote transepithelial Cl- secretion in nasal epithelium. Methods: Primary murine nasal septal epithelial (MNSE) [wild-type (WT) and transgenic CFTR-/-], fisher-rat-thyroid (FRT) cells expressing human WT CFTR, and TMEM16A-expressing human embryonic kidney cultures were utilized for the present experiments. Ciliary beat frequency (CBF) and airway surface liquid (ASL) depth measurements were performed using micro-optical coherence tomography (μOCT). Mechanisms underlying transepithelial Cl- transport were determined using pharmacologic manipulation in Ussing chambers and whole-cell patch clamp analysis. Results: RGAE (at 30㎍/mL of ginsenosides) significantly increased Cl- transport [measured as change in short-circuit current (ΔISC = ㎂/㎠)] when compared with control in WT and CFTR-/- MNSE (WT vs control = 49.8±2.6 vs 0.1+/-0.2, CFTR-/- = 33.5±1.5 vs 0.2±0.3, p < 0.0001). In FRT cells, the CFTR-mediated ΔISC attributed to RGAE was small (6.8 ± 2.5 vs control, 0.03 ± 0.01, p < 0.05). In patch clamp, TMEM16A-mediated currents were markedly improved with co-administration of RGAE and uridine 5-triphosphate (8406.3 +/- 807.7 pA) over uridine 5-triphosphate (3524.1 +/- 292.4 pA) or RGAE alone (465.2 +/- 90.7 pA) (p < 0.0001). ASL and CBF were significantly greater with RGAE (6.2+/-0.3 ㎛ vs control, 3.9+/-0.09 ㎛; 10.4+/-0.3 Hz vs control, 7.3 ± 0.2 Hz; p < 0.0001) in MNSE. Conclusion: RGAE augments ASL depth and CBF by stimulating Cl- secretion through CaCC, which suggests therapeutic potential in both CF and non-CF chronic rhinosinusitis.

A Heterogeneous Genetic Disorder: Primary Ciliary Dyskinesia

  • Ahn, Ji Young
    • Journal of Interdisciplinary Genomics
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    • v.4 no.1
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    • pp.11-14
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    • 2022
  • Primary ciliary dyskinesia (PCD) is a genetic disorder that affects approximately 1 in 15,000-30,000 people, with the majority of patients inheriting the disorder via autosomal recessive inheritance. PCD is characterized by abnormal ciliary ultrastructure and/or function, which results in impaired mucociliary clearance and recurrent respiratory infections. Despite the presence of symptoms from birth, many patients with PCD remain undiagnosed until adulthood. Many advances in the diagnosis of PCD have occurred in recent years, including nasal nitric oxide assays, ciliary motility tests, and genetic sequencing. Early diagnosis and symptom management may reduce morbidity and mortality from PCD improving the patient's quality of life.

Nonpharmacological Treatment for Nontuberculous Mycobacterial Pulmonary Disease

  • Hyung-Jun Kim
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.4
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    • pp.451-457
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    • 2024
  • Nontuberculous mycobacterial pulmonary disease (NTM-PD) results from the exposure of susceptible hosts to a diverse group of environmental mycobacteria. The emphasis on nonpharmacological strategies is motivated by the widespread presence of NTM in various environments, and the inconsistent success rates of pharmacological treatments. Modifiable factors contributing to NTM-PD development include impaired airway clearance, low body mass index, gastroesophageal reflux disease, and exposure to NTM habitats. This suggests that lifestyle and environmental modifications could affect disease development and progression. The review highlights several modalities that can modify the risk factors. Airway clearance techniques, informed by the "gel-on-brush" model of the bronchial epithelium, aim to enhance mucociliary clearance, and have the potential to alleviate symptoms and improve lung function. The impact of nutritional status is also examined, with a lower body mass index linked to an increased risk and progression of NTM-PD, indicating the importance of targeted nutritional support. Additionally, the theoretical and epidemiological links between gastroesophageal reflux disease and NTM-PD advocate careful management of reflux episodes. Understanding the risk of NTM transmission through environmental exposure to contaminated water and soil is also crucial. Strategies to mitigate this risk, including effective water management and minimizing soil contact, are presented as vital preventive measures. The review supports the inclusion of nonpharmacological treatments within a comprehensive NTM-PD management strategy, alongside conventional pharmacological therapies. This integrated approach seeks to improve the overall understanding and handling of NTM-PD.

Chronic osteitic rhinosinusitis as a manifestation of cystic fibrosis: A case report

  • Jadhav, Aniket B.;Lurie, Alan G.;Tadinada, Aditya
    • Imaging Science in Dentistry
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    • v.44 no.3
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    • pp.243-247
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    • 2014
  • A 28-year-old male patient with a history of cystic fibrosis (CF) was referred to the University of Connecticut School of Dental Medicine for an evaluation of a cystic lesion in the right maxilla using cone-beam computed tomography (CBCT). CF is an autosomal recessive disease characterized by an abnormal production of viscous mucus, affecting the mucociliary clearance. The CBCT scan revealed a large cystic lesion in the right maxilla extending from the right maxillary second molar to the midline in the region of the right central incisor with a significant buccal expansion. Further evaluation revealed complete opacification of the paranasal sinuses with medial bulging of the lateral maxillary sinus walls. The maxillary and sphenoid sinuses also appeared hypoplastic. The peculiar finding seen in this case was the presence of marked sclerosis and an increase in the thickness of the adjacent bony framework. This report aimed to describe the common sinonasal findings associated with CF and its underlying pathophysiology.