Hinni M L, McCaffrey T V, Kasperbauer J L
Department of Otorhinolaryngology, Mayo Graduate School of Medicine, Rochester, MN.
Otolaryngol Head Neck Surg. 1992 Oct;107(4):537-48. doi: 10.1177/019459989210700405.
Normal mucociliary flow is a significant defense mechanism in the prevention of acute sinusitis. We have undertaken a study to examine the early sinus mucosal and mucociliary changes that occur in response to acute infection. Twenty rabbits were evaluated for 5 days after an obstructed maxillary sinus was inoculated with either Streptococcus pneumoniae, Hemophilus influenzae, Pseudomonas aeruginosa, or a sterile saline solution. Data collected included measurements of sinus mucosal ciliary beat frequency, quantitation of ciliated cell losses, and electron microscopic observations. Results demonstrate statistically significant (p < 0.05) changes in mucosal ciliary beat frequency that were either excitatory or inhibitory, depending both on the length of the infection and the specific organism. No changes in ciliary beat frequency were observed in the control animals (p > 0.55). Control animals likewise demonstrated no loss of ciliated cells from mucosal epithelium; however, dramatic losses of ciliated cells from the sinus mucosa of the experimental groups were observed. These losses occurred at different rates, depending on the infecting organism, but all infected groups demonstrated a > 86% decrease in the number of viable ciliated cells from the sinus mucosa after sinusitis of 5 days duration. We conclude that a significant loss of ciliated cells from sinus mucosa and a corresponding disruption of normal mucociliary flow occurs early after exposure to pathogenic organisms and is a significant predisposing factor in the development of acute sinusitis.
正常的黏液纤毛流动是预防急性鼻窦炎的一项重要防御机制。我们开展了一项研究，以检查因急性感染而发生的早期鼻窦黏膜及黏液纤毛变化。在用肺炎链球菌、流感嗜血杆菌、铜绿假单胞菌或无菌盐溶液接种阻塞性上颌窦后，对20只兔子进行了5天的评估。收集的数据包括鼻窦黏膜纤毛摆动频率的测量、纤毛细胞损失的定量分析以及电子显微镜观察结果。结果表明，黏膜纤毛摆动频率发生了具有统计学意义（p < 0.05）的变化，这些变化既有兴奋性的，也有抑制性的，这取决于感染的时长和特定的病原体。在对照动物中未观察到纤毛摆动频率的变化（p > 0.55）。对照动物同样未显示出黏膜上皮的纤毛细胞有损失；然而，在实验组的鼻窦黏膜中观察到了纤毛细胞的显著损失。这些损失以不同的速率发生，取决于感染的病原体，但所有感染组在持续5天的鼻窦炎后，鼻窦黏膜中存活的纤毛细胞数量均减少了86%以上。我们得出结论，暴露于致病生物后，鼻窦黏膜中的纤毛细胞会显著损失，正常的黏液纤毛流动也会相应中断，这是急性鼻窦炎发生发展的一个重要诱发因素。
