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Nitric oxide levels and ciliary beat frequency in indigenous New Zealand children
E A Edwards1, C Douglas, S Broome
1Department of Paediatrics, University of Auckland and Starship Children's Hospital, Auckland, New Zealand. LizE@adhb.govt.nz
Insights
Subclinical ciliary abnormalities do not explain high respiratory illness in New Zealand children. While ciliary beat frequency was normal, structural defects were common, suggesting environmental or infectious damage.
Area of Science:
- Pediatric respiratory health
- Immunology
- Cell biology
Background:
- New Zealand children experience high rates of respiratory disease.
- The role of subclinical ciliary dysfunction in this increased morbidity, particularly among indigenous populations, is unclear.
Purpose of the Study:
- To investigate if subclinical ciliary abnormalities contribute to the high prevalence of respiratory disease in indigenous New Zealand children.
- To compare ciliary function, nitric oxide (NO) levels, and atopy across different ethnic groups of healthy children.
Main Methods:
- Prospective study of healthy children screened for respiratory disease.
- Measurement of exhaled and nasal nitric oxide (NO) using chemiluminescence.
- Assessment of ciliary structure and function (ciliary beat frequency - CBF) via nasal brushings.
Main Results:
- Ciliary beat frequency (CBF) and NO levels were comparable to international norms and showed no ethnic differences.
- A significantly higher percentage of ciliary structural defects (9%) was observed compared to controls, irrespective of ethnicity.
- Atopy levels did not differ across ethnic groups.
Conclusions:
- Subclinical ciliary abnormalities are unlikely to be the primary cause of increased respiratory disease in indigenous New Zealand children.
- The high prevalence of secondary ciliary defects suggests significant environmental or infective damage impacting respiratory health.
Abstract:
New Zealand children's morbidity from respiratory disease is high. This study examines whether subclinical ciliary abnormalities underlie the increased prevalence of respiratory disease in indigenous New Zealand children. A prospective study enrolled a group of healthy children who were screened for respiratory disease by questionnaire and lung function. Skin-prick tests were performed to control for atopy. Exhaled and nasal NO was measured online by a single-breath technique using chemiluminescence. Ciliary specimens were obtained by nasal brushings for assessment of structure and function. The ciliary beat frequency (CBF) (median CBF, 12.5 Hz; range, 10.4-16.8 Hz) and NO values (median exhaled NO, 5.6 ppb; range, 2.3-87.7 ppb; median nasal NO, 403 ppb; range, 34-1,120 ppb) for healthy New Zealand European (n=58), Pacific Island (n=61), and Maori (n=16) children were comparable with levels reported internationally. No ethnic differences in NO, atopy, or CBF were demonstrated. Despite an apparently normal ciliary beat, the percentage of ciliary structural defects was 3 times higher than reported controls (9%; range, 3.6-31.3%), with no difference across ethnic groups. In conclusion, it is unlikely that subclinical ciliary abnormalities underlie the increased prevalence of respiratory disease in indigenous New Zealand children. The high percentage of secondary ciliary defects suggests ongoing environmental or infective damage.
