Prevalence of Chronic Rhinosinusitis in Bronchiectasis Patients Suspected of Ciliary Dyskinesia
| Autor: | Justin McCormick, Christopher G. Weeks, Do-Yeon Cho, George M. Solomon, David R. Kelly, Bradford A. Woodworth, Nicholas J. Rivers, Steven M. Rowe, Jacob D. Owen |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Rhinology
Male medicine.medical_specialty Mucociliary clearance medicine.medical_treatment Ciliary dyskinesia Comorbidity Gastroenterology Article 03 medical and health sciences 0302 clinical medicine Microscopy Electron Transmission Internal medicine medicine otorhinolaryngologic diseases Prevalence Immunology and Allergy Humans Cilia Sinusitis 030223 otorhinolaryngology Primary ciliary dyskinesia Rhinitis Bronchiectasis Bacteria business.industry Cilium Middle Aged medicine.disease Curettage 030228 respiratory system Otorhinolaryngology Chronic Disease Female business Microtubule-Associated Proteins Ciliary Motility Disorders |
| Zdroj: | Int Forum Allergy Rhinol |
| Popis: | BACKGROUND Mucociliary clearance is a main defense mechanism of the airway and is impaired in ciliary dyskinesia. The objective of this study was to evaluate the prevalence of chronic rhinosinusitis (CRS) and its characteristics in bronchiectasis patients suspected of harboring ciliary dyskinesia. METHODS Bronchiectasis patients referred to a rhinology clinic for nasal brush biopsy (NBB) were included in this study. NBB was performed using a curettage technique whereby ciliated epithelial cells were obtained from the surface of the inferior nasal turbinate. Results of transmission electron microscopy findings, primary ciliary dyskinesia (PCD) gene (35 genes) analyses (Invitae), and sinus computed tomography (CT) scans were reviewed. RESULTS Twenty-three patients (age, 54 ± 2.9 years) were referred for NBB between 2015 and 2018. Thirteen patients (56.5%) met the criteria for diagnosis of CRS. Nineteen patients had ciliary ultrastructural defects. The most common finding was compound cilia (n = 11, 47.8%). Five patients (21.7%) had central microtubule defects (CMD) with higher forced expiratory volume in 1 second (FEV1 ) at the time of referral than those without CMD (CMD+ , 91 ± 3.7%; CMD- , 73.5 ± 5.7%; p = 0.023). Of 15 subjects with a PCD gene panel, 67% (9 of 15) carried at least 1 gene associated with PCD. Only 1 patient reached diagnosis of PCD. Approximately 50% of non-PCD carriers had a smoking history (p < 0.05). Lund-Mackay scores did not significantly differ between PCD and non-PCD carriers (p = 0.72). CONCLUSION Nearly half of bronchiectasis patients referred for NBB had concurrent CRS. The presence of ciliary abnormalities was not amplified in bronchiectasis patients with CRS compared to those without CRS. Extrinsic factors may be related to ciliary structural abnormalities in non-PCD gene carriers. |
| Databáze: | OpenAIRE |
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