Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia.
I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia.
Am J Rhinol Allergy. 2021 Sep;35(5):656-663. doi: 10.1177/1945892420988804. Epub 2021 Jan 19.
evaluation of mucociliary clearance and mucosal morphology using high-speed videomicroscopy, and their association with markers of disease severity in children with acute (ARS) and chronic rhinosinusitis (CRS).
A total of 67 children aged from 6 to 17 years including 15 healthy children, 20 pediatric patients with acute rhinosinusitis, and 32 cases with chronic rhinosinusitis were enrolled in the present study. SNOT20, Lund-Kennedy, and Lund-Mackay scores were also evaluated.
Children with rhinosinusitis were characterized by significantly lower number of cells with motile cilia, ciliary beat frequency, cilia length, and cell viability, as well as ciliary beat asynchrony, epithelia dystrophy and reduced epithelial cell height, being more severe in ARS group. Neutrophil infiltration of sinonasal mucosa was more profound in children with ARS, whereas the number of lymphocytes was significantly reduced. Markers of ciliary function were characterized by a significant correlation with epithelia dystrophia and neutrophil infiltration. Discriminant analysis demonstrated significant group separation based on the parameters of mucociliary clearance and mucosal morphology. In regression models mucociliary function was also associated with SNOT20, Lund-Kennedy, and Lund-Mackay scores.
The results of the present study demonstrate significant alteration of mucociliary clearance and mucosal morphology and its association with sinonasal inflammation and disease severity in patients with rhinosinusitis. Given a tight association between altered mucociliary clearance and severity of the disease, modulation of inflammation and ciliary function both in acute and chronic rhinosinusitis may be considered as the potential tool in therapeutic and surgical management of the disease.
使用高速视频显微镜评估黏液纤毛清除功能和黏膜形态，并将其与急性（ARS）和慢性鼻-鼻窦炎（CRS）患儿疾病严重程度的标志物相关联。
本研究共纳入 67 名年龄在 6 至 17 岁的儿童，包括 15 名健康儿童、20 名急性鼻-鼻窦炎患儿和 32 名慢性鼻-鼻窦炎患儿。还评估了 SNOT20、Lund-Kennedy 和 Lund-Mackay 评分。
患有鼻-鼻窦炎的儿童表现出明显较低的活动纤毛细胞数量、纤毛摆动频率、纤毛长度和细胞活力，以及纤毛摆动不同步、上皮组织营养不良和上皮细胞高度降低，在急性鼻-鼻窦炎组中更为严重。急性鼻-鼻窦炎患儿的鼻黏膜中性粒细胞浸润更为明显，而淋巴细胞数量明显减少。纤毛功能标志物与上皮组织营养不良和中性粒细胞浸润呈显著相关性。判别分析表明，基于黏液纤毛清除和黏膜形态的参数，可显著区分不同组别。在回归模型中，黏液纤毛功能也与 SNOT20、Lund-Kennedy 和 Lund-Mackay 评分相关。
本研究结果表明，鼻-鼻窦炎患儿的黏液纤毛清除功能和黏膜形态发生显著改变，与鼻-鼻窦炎症和疾病严重程度相关。鉴于黏液纤毛清除功能改变与疾病严重程度之间存在紧密关联，在急性和慢性鼻-鼻窦炎中调节炎症和纤毛功能可能被视为疾病治疗和手术管理的潜在工具。
