Chan-Yeung, MMW

Ho, JCM

Ip, MSM

Ko, C

Lam, WK

Leung, R

Mak, JCW

Ooi, CGC

Sun, JZ

Tipoe, GL

Tsang, KWT

Yan, C

Hong Kong Medical Journal

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Title Clinical value of ciliary assessment in bronchiectasis - a crosssectional studyAuthor(s)Tsang, KWT; Tipoe, GL; Sun, JZ; Mak, JCW; Leung, R; Yan, C;Ko, C; Ooi, CGC; Ho, JCM; Ip, MSM; Chan-Yeung, MMW; Lam,WKCitationThe 8th Medical Research Conference Abstracts, Hong KongMedical Journal, Hong Kong, China, 25-26 January 2003, v. 9 n. 1Supp 1, p. 85Issued Date 2003URL http://hdl.handle.net/10722/45656Rights Creative Commons: Attribution 3.0 Hong Kong LicenseHKMJ Vol 9 No 1 February 2003 Supplement      85Inhaled steroid therapy and Pseudomonas aeruginosa infection and exhaled nitricoxide in bronchiectasisLam J, Leung R, #Tipoe GL, Ho JC, Yan C, *Ooi GC, Fung PC, Ip MS, Chan-Yeung M, Lam WK, Tsang KWT. Depts ofMedicine, #Anatomy and *Diagnostic Radiology, University of Hong Kong, Hong Kong SAR, China.Purpose: Endogenous NO metabolism is involved in the pathogenesis of many respiratory and other systemicdiseases. We have recently shown that exhaled (e)NO production is not significantly different between healthyvolunteers and patients with bronchiectasis, except those with chronic Pseudomonas aeruginosa (PA) infection hadsignificantly lower eNO than their counterparts and controls. While eNO is reduced by treatment with inhaledcorticosteroid in asthma, the effects of such treatment on eNO in patients with bronchiectasis, who also havesignificant airway inflammation, is unknown.Methods: eNO was measured by using an automatic chemiluminescence analyzer (Sievers NO Analyser280) atsteady expiration on 60 stable patients with bronchiectasis, who received either fluticasone 500µg BID (n=30, 9F,54.1±16.1yr) or matched placebo (n=30, 13F, 52.7±15.8yr). Patients with PA (n=16) at steady state were alsoassessed.Results: There was no significant difference in eNO levels between fluticasone and placebo patients over the studyperiod. There was no correlation between baseline eNO with age, FEV1, FVC, 24h sputum volume or the number ofbronchiectatic segments. Patients with Pseudomonas aeruginosa (PA) infection, but not their counterparts, dis-played a correlation between 0- and 52-week eNO levels. PA infection was associated with significantly lower eNOlevels among the patients.Conclusion: Our data, derived from the first controlled study, showed that inhaled corticosteroid therapy has nosignificant effect on eNO production in bronchiectasis. The data of this longitudinal study also confirm our previ-ous finding that eNO is reduced on PA-infected patients with bronchiectasis, and this phenomenon is likely toreflect a down-regulatory effect of PA infection on intrinsic airway NO production.Clinical value of ciliary assessment in bronchiectasis—a cross sectional studyTsang KW, +Tipoe GL, Sun J, Mak JC, Leung R, Yan C, Ko C, #Ooi GC, Ho JC, Ip MS, Chan-Yeung M, Lam WK. UniversityDepartments of Medicine, +Anatomy and #Diagnostic Radiology, University of Hong Kong, Hong Kong SAR.Introduction: Although ciliary abnormalities have been studied for several decades, probably owing to technicalrequirements, a large scale prospective study on the clinical significance of abnormalities of ciliary beat (other thanfrank immotility and dyskinesia) and ultrastructure has not been conducted.Methods: We have evaluated the prevalence and clinical significance of ciliary beat frequency and ultrastructuraldefects on the nasal respiratory mucosa obtained from 152 stable patients with idiopathic bronchiectasis(100F, 57.7±15.2 yrs) and 127 control non-smoking subjects (58F, 56.0±24.2 yrs). Ciliary beat assessment wasperformed by using a photomultiplier method established in our laboratory, and ultrastructure was assessed byusing high resolution transmission electron microscopy.Results: Bronchiectasis patients had significantly slower ciliary beat frequency (p<0.05), and more percent ofpatients showing central and peripheral microtubular defects (OR 14.4, 95% CI 5.6-36.8), namely extra peripheralmicrotubules, “9+1”, “8+2”, and compound cilia (p<0.05), but not microtubular disarrangement, extra matrix orciliary tail abnormalities (p>0.05), than controls. Bronchiectasis patients also had more percent cilia with anyultrastructural, microtubular defects, compound cilia, and ciliary tails than controls (p<0.05). Ciliary beat fre-quency did not correlate with clinically relevant parameters (p>0.05). However, the percent of cilia with central, butnot peripheral, microtubular defects correlated with 24h sputum volume (r=0.40, p=0.001, and r=–0.04, p=0.70respectively) and FEV1 (r=-0.24, p=0.01, and r=0.00, p=0.99 respectively).Conclusions: Our results, therefore, strongly suggest a pathogenic role for central microtubular defects in thedevelopment of idiopathic bronchiectasis. It is hoped that future research into ciliary ultrastructural phenotypingcould help diagnose and prognosticate, and further the understanding of the pathogenesis of this distressing anduntreatable disease.(Supported by a Hong Kong RGC Grant)RM-01RM-02

Clinical value of ciliary assessment in bronchiectasis - a cross sectional study

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Clinical value of ciliary assessment in bronchiectasis - a cross sectional study

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