Sputum and ciliary inhibition in asthma.

Abstract

Twenty-eight sputum samples collected from 20 patients with chronic bronchial asthma of atopic and intrinsic clinical types were incubated with human bronchial explants to study their influence on ciliary motility. Of these, 19 (68%) of the sputa exerted a ciliary inhibitory effect of varying degree in a two-hour period. Analysis of the data indicates that (1) the ciliary inhibitory effect was invariably present when patients produced a distinctive slurry sputum; (2) this occurred more frequently during clinical exacerbations; (3) the induced ciliary inhibition was reversible on removal of the sputum; (4) the intensity of the ciliary inhibitory effect decreased with clinical improvement of the patient; (5) the inhibitory effect was unrelated to the medications used; (6) it was equally common in the atopic and the intrinsic types of asthmatic patients; (7) the effect was not pH dependent or related to the degree of eosinophilia. The ciliary inhibitory factor in sputum was identified as having a molecular weight of 6000-8000. It may play a part in the pathogenesis of asthma and recognition of sputum containing it carries implications for treatment.

Ciliary dysfunction and ultrastructural abnormalities are features of severe asthma

“…The marked reduction in ciliary beat frequency and abnormal beat pattern seen in asthmatic airway epithelium, particularly in those with severe disease, is likely to be multifactorial in causation. Evidence from previous studies 27,28 suggests that sputum from patients with asthma and products of inflammatory cells such as eosinophil major basic protein possess ciliostatic activity. Environmental factors such as exposure to irritants or chronic infection may cause secondary ultrastructural defects of the cilia that may affect the ciliary beat frequency, as indicated in a number of reports.…”

Airway Epithelial Cell Cilia and Obstructive Lung Disease

“…Application of Sputum from asthma patients to frogs’ isolated palates to determine the effect on CBF resulted in ciliostasis which disappeared with clinical improvement [139,140]. In comparison, samples obtained from normal volunteers and from most patients, excluding those with asthma, had no effect on ciliary beating.…”

“…The inhibitory effect on CBF was independent of medications used and was shown in atopic and intrinsic types of asthmatic patients. In addition, the effect was not pH dependent or related to the degree of eosinophilia [140]. Additionally, tracheal mucus velocity (TMV) was significantly less (6.3 ± 2.3 mm per min, mean ± SD, n = 6) in asymptomatic asthmatic patients than in normal subjects (11.6 ± 3.6 mm per min, n = 7) [141], and tracheal mucociliary transport rates were decreased in patients with allergic asthma [142,143].…”

Bronchial Asthma

“…16 Indeed, a recent study has demonstrated that sputum obtained from patients with asthma impairs ciliary activity in vitro. 17…”