Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Am J Rhinol Allergy. 2012 Jan-Feb;26(1):1-6. doi: 10.2500/ajra.2012.26.3716.
Cilia are complex and powerful cellular structures of the respiratory mucosa that play a critical role in airway defense. Respiratory epithelium is lined with cilia that perform an integrated and coordinated mechanism called mucociliary clearance. Mucociliary clearance is the process by which cilia transport the mucus blanket overlying respiratory mucosa to the gastrointestinal tract for ingestion. It is the primary means by which the airway clears pathogens, allergens, debris, and toxins. The complex structure and regulatory mechanisms that dictate the form and function of normal cilia are not entirely understood, but it is clear that ciliary dysfunction results in impaired respiratory defense.
A literature review of the current knowledge of cilia dysfunction in chronic rhinosinsusitis was conducted.
Ciliary dysfunction may be primary, the result of genetic mutations resulting in abnormal cilia structure, or, more commonly, secondary, the result of environmental, infectious, or inflammatory stimuli that disrupt normal motility or coordination. Patients with chronic rhinosinusitis (CRS) have been found to have impaired mucociliary clearance. Many biochemical, environmental, and mechanical stimuli have been shown to influence ciliary beat frequency, and common microbial pathogens of respiratory mucosa such as Pseudomonas aeruginosa and Haemophilus influenzae have developed toxins that appear to interrupt normal mucociliary function. Furthermore, inflammatory mediators known to be present in patients with CRS appear to impair secondarily mucociliary clearance.
The goal of this article is to summarize the recent developments in the understanding of cilia dysfunction and mucociliary clearance in CRS.
纤毛是呼吸道黏膜的复杂而强大的细胞结构，在气道防御中起着关键作用。呼吸道上皮细胞排列着纤毛，执行着一种称为黏液纤毛清除的综合协调机制。黏液纤毛清除是指纤毛将覆盖呼吸道黏膜的黏液毯运送到胃肠道进行摄取的过程。它是气道清除病原体、过敏原、碎片和毒素的主要途径。决定正常纤毛形态和功能的复杂结构和调节机制尚不完全清楚，但显然纤毛功能障碍会导致呼吸道防御受损。
对慢性鼻鼻窦炎纤毛功能障碍的现有知识进行了文献回顾。
纤毛功能障碍可能是原发性的，是基因突变导致纤毛结构异常的结果，或者更常见的是继发性的，是环境、感染或炎症刺激破坏正常运动或协调的结果。患有慢性鼻鼻窦炎（CRS）的患者发现其黏液纤毛清除功能受损。许多生化、环境和机械刺激已被证明会影响纤毛的拍打频率，而呼吸道黏膜常见的微生物病原体如铜绿假单胞菌和流感嗜血杆菌已经产生了似乎中断正常黏液纤毛功能的毒素。此外，已知存在于 CRS 患者中的炎症介质似乎会继发性地损害黏液纤毛清除功能。
本文旨在总结对 CRS 中纤毛功能障碍和黏液纤毛清除的最新认识进展。
