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Asthma Evaluation II


Wednesday, November 2, 2005

12:30 PM - 2:00 PM

MORPHOLOGY OF TISSUES USED FOR CILIARY STUDIES

Thorsten Stein, MD*, Mohamed Abdel-Aziz, MD, Inge Wissen-Siegert, MD, Christine Eidner, MD and Hans L. Hahn, MD

Deutsche Klinik für Diagnostik, Wiesbaden, Germany

PURPOSE: We have shown previously that the allergic reaction does not change the beat frequency of nasal cilia (Europ. Respir. J., Vol. 22, Suppl. 45, 291s). Increasing allergen dose and length of exposure did not change this (CHEST, Vol. 124, Suppl. 4, 140s). It might be argued that significant components of the allergic reaction were lacking in our biopsy specimens.

METHODS: We obtained surgical specimens during turbinate surgery. All patients (n = 17, 10M, 7F, age 35 ± 14) had allergic rhinitis (allergy testing and clinical history). From each specimen we obtained at least five biopsies with a bronchoscopy forceps. We processed these biopsies histologically and stained them with H.E. and Giemsa. The sections were 3 µ thick with a distance of 10 µ in between; we analyzed a total of 8 sections. We overlaid them with a grid (integration plate I, Zeiss) and counted hits over the different tissue structures. We also counted single cells (mast cells, eosinophils, and polymorphonuclear leukocytes attached to the vessel wall [marginating PMN]) and expressed them per total grid area.

RESULTS: Tissue composition derived from percent hits over each structure was as follows: epithelium 20,65%, blood vessels 10,32%, connective tissue 55,59%, serous glands 10,34%, mucous glands 3,10%, mast cells 47/mm2, marginating PMN 210/mm2, eosinophils 13/mm2.

CONCLUSION: We conclude that all tissue components of the allergic reaction were contained in even the smallest of our biopsy specimens. Similarly, isolated blood or tissue cells that are known to be involved in the allergic reaction were present in our specimens in sufficient numbers.

CLINICAL IMPLICATIONS: We suggest that a full blown allergic response with mediator release and mucosecretion was possible in our specimens and must have taken place following allergen challenge. Equivalence of mediator release from specimens challenged in vivo and in vitro has been shown (Nakamura et al., J. Allergy Clin. Immunol. 2000;105:1146-52). Nevertheless ciliary beating was unchanged and thus appears to be remarkably resistant to effects of the allergic reaction.

DISCLOSURE: Thorsten Stein, None.







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