NASAL CILIARY ULTRASTRUCTURE AND FUNCTION IN PATIENTS WITH PRIMARY CILIARY DYSKINESIA COMPARED WITH THAT IN NORMAL SUBJECTS AND IN SUBJECTS WITH VARIOUS RESPIRATORY-DISEASES

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Abstract
To establish the relevance of ciliary ultrastructure to the pathophysiologic aspects of respiratory tract disease, the ultrastructure and function of cillia from healthy subjects (atopic and nonatopic nonsmokers, asymtomatic smokers) and patients with a variety of respiratory diseases (cystic fibrosis, chronic rhinitis, bronchiectasis associated with hypogammaglobulinemia, chronic bronchitis) were quantitatively compared with cilia from patients with primary ciliary dyskinesia (PCD). In healthy subjects and patients with non-PCD respiratory disease, .apprx. 5% of the cilia evaluated had ultrastructural abnormalities. Ciliary beat frequency was significantly higher in the chronic rhinitis group (15.3 .+-. 1.2 Hz) than in the other non-PCD groups, which were within the normal range (12.5 .+-. 1.7 Hz), and in all non-PCD cases ciliary wave form was normal. Normal mucociliary transport had been previously demonstrated. In patients with PCD, the proportion of cilia with ultrastructural abnormalities was significantly greater than in the normal subjects and those with non-PCD respiratory disease (P < 0.0001). Beat frequency was significantly reduced, ciliary wave form was grossly abnormal, and pulmonary and nasal mucociliary transport were virtually absent. The relevance of ciliary ultrastructural abnormalities to altered ciliary function and the primary role of the demonstrated abnormalities in the respiratory tract disease of PCD were supported.