Percentage Ciliation in Bronchiectasis Patient Upper and Lower Airways

<bold>Introduction:</bold> Mucociliary dysfunction is a key part of the pathophysiology of the chronic lung condition bronchiectasis (BE). Inflammation and infection are thought to reduce ciliation of airway epithelial cells. However there is very little information on number of ciliated cells and cilia function in the airways in bronchiectasis. <bold>Methods:</bold> In an observational cohort study, epithelial samples from the nose, a disease affected airway and least affected airway were taken using a biopsy brush during bronchoscopy. Percentage ciliation was assessed by expression of acetylated tubulin, using immunofluorescence staining. Patient’s infection status was indicated by presence of microbiota in the sputum measured by molecular PCR (Biofire). Cilia function was analysed using high-speed video microscopy. <bold>Results:</bold> 31 patients with BE were included. Ciliated cells were successfully obtained from at least one site in all patients. The percentage ciliation was significantly reduced in the nasal site samples of the BE patients compared to the lower airway samples (p=0.003). There was no significant difference in ciliation between samples from a site affected by BE and a site least affected by BE. There was a correlation between both airway sites (r=0.52, p=0.01) and also between the nasal site and the unaffected site (r=0.43,p=0.04). There was a correlation between percentage ciliation and cilia beat amplitude per second (r=0.38, p=0.002). There was no relationship with percentage ciliation and infection in BAL/sputum. <bold>Conclusions:</bold> The percentage ciliation correlates across diseased and non-diseased areas of the lung in bronchiectasis and does not relate to bacterial or viral infection but does correlate with cilia function.