[Ultrastructural changes in the human nasal respiratory epithelium in hypersensitivity reactions]

In immunoallergic syndromes, the structure of normal respiratory nasal mucous membrane is modified. The epithelial lining (which is responsible for the effectiveness of the mucociliary synergy), is secondarily affected. Its modifications depend, generally, on the severity and chronicity of the clinical case. Normal and pathologic material obtained from inferior turbinate bone (of similar structure and response to the rest of the respiratory nasal mucous membrane) were studied through transmission and scanning electron microscopies, employing both methods as complementary analysis. In normal cases, the presence of different kinds of cells was confirmed. Some additional characteristics about intercellular spaces and junctions as well as the possible role of the above mentioned structures in transudation were also described. In pathologic cases, increasing lesion staging grades could be determined. In the first stage, structural alterations could not be observed despite the existence of functional disturbances (i.e. ciliary dyskinesia and non-synergic motility). In an advanced stage, ciliary abnormalities could be observed with abnormalities in the number, morphology, spatial orientation and distortion in the number of different cell types. With cellular linkage affectation, the severity of the lesion increased and the cells were easily desquamated, giving rise to intercellular spaces which communicated freely with the organ lumen. Finally, in the most severe cases, the epithelial lining was diminished to a monolayer, with complete cellular dissociation and lack of differentiation. This cellular disarrangement allowed free passage of substances in both directions through the monolayer.