Ciliary ultrastructure and nasal mucociliary clearance in chronic and allergic rhinitis

The authors have studied nasal specimens collected by means of nasal brushing in eight patients affected by allergic rhinitis and in eight affected by chronic rhinitis, while in other four patients affected by allergic rhinitis a lower turbinate biopsy was performed. All twenty patients showed an increased mucociliary clearance time and a reduced velocity regardless to the pathology during a previously performed saccharin test. Different ultrastructural alterations have been observed, such as: both central and peripheral microtubules alterations; absence of dynein arms; absence of radial spokes; ciliary membrane alterations; "compound" cilia; disorientation of central tubules. These alterations have been observed variously associated in both allergic and chronic rhinitis patients groups. Basing on their data, the authors state that ciliary abnormalities cannot be considered specific of a particular pathology but they can coexist in different situations. They also think that the mucociliary clearance parameters determination represents the only method to evaluate, even if in an indirect fashion, the percentage of ciliary abnormalities, as no direct quantitative method has been described. Ciliary ultrastructural alterations can be of diagnostic value only if associated with mucociliary clearance time and velocity determination.