上気道粘液繊毛輸送不全とその原因

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  • Pathogenesis of mucociliary dysfunction in the upper respiratory tract.
  • ウエ キドウ ネンエキ センモウ ユソウ フゼン ト ソノ ゲンイン

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Mucociliary function is the transport of the mucous blanket with trapped foreign materials toward the pharynx. This function is one of the fundamental and irreplaceable defense mechanisms of the respiratory tract against environmental agents. Mucociliary transport can be determined by soluble or insoluble indicators.<br>Mucociliary transport is governed by three factors;cilia, mucus, and their interaction. A defect of any one of these governing factors or a combination of them causes mucociliary dysfunction. It is, moreover, possible to analyze the causes of mucociliary dysfunction.<br>Mucociliary dysfunction found in primary ciliary dyskinesia(PCD), including Kartagener's syndrome, is due to abnormal cilia. The dysfunction in the nose in colds lasting for more than 8 weeks is due mainly to decreased numbers of cilia and ciliary beat frequency. Reduced mucociliary transport in the nose of chickens infected by Newcastle disease virus is also due to abnormality of cilia.<br>High viscoelasticity of mucus could be a cause of mucociliary dysfunction in otitis media with effusion and chronic sinusitis. Decrease of periciliary fluid also could be a cause of dysfunction in these diseases. In chronic sinusitis there is a tethering phenomenon;the mucous blanket is tethered by threads of mucus from secretory cells at multiple points. In this situation, mucociliary stasis occurs with active cilia. Since thetethering phenomenon is found in infection, dehydration, and exposure to SO2, it is probably a universal response to stimulation of the respiratory tract.<br>Now we can determine mucociliary transport and analyze the cause of mucociliary dysfunction. This knowledge may help to establish the prevention and treatment of mucociliary dysfunction.

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