Kempeneers Celine, Seaton Claire, Chilvers Mark A
Division of Respirology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, BC, Canada.
Division of Respirology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, BC, Canada.
Chest. 2017 May;151(5):993-1001. doi: 10.1016/j.chest.2016.09.015. Epub 2016 Sep 29.
Digital high-speed video microscopy (DHSV) allows analysis of ciliary beat frequency (CBF) and ciliary beat pattern (CBP) of respiratory cilia in three planes. Normal reference data use a sideways edge to evaluate ciliary dyskinesia and calculate CBF using the time needed for a cilium to complete 10 beat cycles. Variability in CBF within the respiratory epithelium has been described, but data concerning variation of CBP is limited in healthy epithelium. This study aimed to document variability of CBP in normal samples, to compare ciliary function in three profiles, and to compare CBF calculated over five or 10 beat cycles.
Nasal brushing samples from 13 healthy subjects were recorded using DHSV in three profiles. CBP and CBF over a 10-beat cycle were evaluated in all profiles, and CBF was reevaluated over five-beat cycles in the sideways edges.
A uniform CBP was seen in 82.1% of edges. In the sideways profile, uniformity within the edge was lower (uniform normal CBP, 69.1% [sideways profile]; 97.1% [toward the observer], 92.0% [from above]), and dyskinesia was higher. Interobserver agreement for dyskinesia was poor. CBF was not different between profiles (P = .8097) or between 10 and five beat cycles (P = .1126).
Our study demonstrates a lack of uniformity and consistency in manual CBP analysis of samples from healthy subjects, emphasizing the risk of automated CBP analysis in limited regions of interest and of single and limited manual CBP analysis. The toward the observer and from above profiles may be used to calculate CBF but may be less sensitive for evaluation of ciliary dyskinesia and CBP. CBF can be measured reliably by evaluation of only five-beat cycles.
数字高速视频显微镜（DHSV）能够在三个平面上分析呼吸道纤毛的纤毛摆动频率（CBF）和纤毛摆动模式（CBP）。正常参考数据使用侧面边缘来评估纤毛运动障碍，并利用纤毛完成10个摆动周期所需的时间来计算CBF。呼吸道上皮内CBF的变异性已有描述，但关于健康上皮内CBP变异的数据有限。本研究旨在记录正常样本中CBP的变异性，比较三个剖面的纤毛功能，并比较通过五个或十个摆动周期计算的CBF。
使用DHSV在三个剖面记录了13名健康受试者的鼻刷样本。在所有剖面中评估10个摆动周期内的CBP和CBF，并在侧面边缘重新评估五个摆动周期内的CBF。
在82.1%的边缘观察到均匀的CBP。在侧面剖面中，边缘内的均匀性较低（均匀正常CBP，69.1%[侧面剖面]；97.1%[朝向观察者]，92.0%[从上方]），且运动障碍较高。观察者间对运动障碍的一致性较差。不同剖面之间的CBF无差异（P = 0.8097），五个和十个摆动周期之间的CBF也无差异（P = 0.1126）。
我们的研究表明，对健康受试者样本进行手动CBP分析缺乏均匀性和一致性，强调了在有限感兴趣区域进行自动CBP分析以及单一和有限的手动CBP分析的风险。朝向观察者和从上方的剖面可用于计算CBF，但对纤毛运动障碍和CBP评估的敏感性可能较低。仅通过评估五个摆动周期就可以可靠地测量CBF。
