Acquired cilia dysfunction in chronic rhinosinusitis

被引:143
作者
Gudis, David [1 ]
Zhao, Ke-qing [1 ,2 ]
Cohen, Noam A. [1 ,3 ]
机构
[1] Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA
[2] Fudan Univ, Eye & Ear Nose & Throat Hosp, Dept Otorhinolaryngol Head & Neck Surg, Sch Shanghai Med, Shanghai 200433, Peoples R China
[3] Philadelphia Vet Affairs Med Ctr, Div Otolaryngol, Philadelphia, PA USA
关键词
CIGARETTE-SMOKE EXPOSURE; OUTER DYNEIN ARMS; SIGNAL-TRANSDUCTION MECHANISMS; MAMMALIAN RESPIRATORY-TRACT; BRONCHIAL EPITHELIAL-CELLS; SURFACE LIQUID VOLUME; BEAT FREQUENCY; CHRONIC SINUSITIS; MUCOCILIARY CLEARANCE; AIRWAY EPITHELIUM;
D O I
10.2500/ajra.2012.26.3716
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Background: 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. Methods: A literature review of the current knowledge of cilia dysfunction in chronic rhinosinsusitis was conducted. Results: 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. Conclusion: The goal of this article is to summarize the recent developments in the understanding of cilia dysfunction and mucociliary clearance in CRS. (Am J Rhinol Allergy 26, 1-6, 2012; doi: 10.2500/ajra.2012.26.3716)
引用
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页码:1 / 6
页数:6
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