Histopathologic alterations of nasal epithelium in chronic respiratory patients
Abstract
The epithelial lining of the respiratory airways and mucociliary transport play an important role in the primary defense mechanism of the respiratory system. Conditions that disrupt epithelium integrity or impair mucociliary clearance lead or favor chronic respiratory disease. In the present study we analyzed the nasal epithelium of 33 chronic respiratory patients using high-resolution histology and scanning electron microscopy. All the biopsies analyzed showed some degree of epithelial abnormality, and in no case the normal ciliated columnar pseudostratified epithelium was observed. In 17 patients, ciliated epithelia showing different types of alterations were recognized, whereas in the remaining 16 cases, ciliated cells were completely substituted by non-ciliated cell types, such as basal, goblet and squamous cells. In 27% of patients, epithelial alterations were seen in patients diagnosed of primary ciliary diskinesia, whereas in 52% of the cases, they appeared associated with secondary ciliary alterations or lack of cilia. In the remaining 21% of cases, disrupted epithelia were observed in patients with normal ciliary ultrastructure. These observations indicate that epithelial alterations may be the consequence of primary ciliary disorders or result from the sustained injury provoked by several chronic respiratory diseases, such as pneumonia, bronchitis, rhinitis, sinusitis and asthma. Considering that chronic inflammation and infection delay regeneration of the normal epithelium, early diagnosis is recommended to avoid installation of irreversible non-ciliated epithelial morphologies.
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