Original ArticleRelationship between nasal mucociliary clearance and disease severity in children with allergic rhinitis: A comparative cross-sectional study
Introduction
Allergic rhinitis is a chronic disease in children with a prevalence of 2–25% and leads to impaired quality of life. It is the most common form of non-infectious rhinitis. In allergic rhinitis, IgE-mediated immune response to allergens occurs. Allergic rhinitis is diagnosed by the presence of nasal symptoms, and the presence of ocular symptoms is frequently accompanied by the presence of an allergic response.1, 2, 3
Mucociliary clearance (MCC) is a very important protection system for the protection of the nose from harmful molecules and allergens. With this system, the mucus formed in the nasal mucosa is mobilized by the movement of the nasal ciliates, and the particles are delivered through the nose to the nasopharynx through this movement. The particle that reaches the nasopharynx is either swallowed or removed orally.4
MCC can be evaluated by various methods. Some of these methods are the evaluation with indigo carmine dye, evaluation with gamma scintigraphy, and evaluation with saccharin test.5, 6, 7 The saccharin test is distinguished from other tests because it is easy to be applied in outpatient settings as well as being cheap and non-invasive. The saccharin test is based on the time elapsed between the placement of the saccharin piece in the anterior part of the inferior turbinate and the feeling of the sweet taste in the mouth, and which may be achieved within minutes.7
In allergic rhinitis patients, deterioration of the structure of the cilia, as well as changes in mucus viscosity due to long-term chronic inflammation, has been shown. Mechanical obstruction may also lead to mucus stagnation, causing pericellular compression and nasal MCC deterioration. With the deterioration of MCC, removal of allergens from the nasal cavity becomes difficult, contact with allergens increases, and therefore treatment success decreases.4, 8
The aim of our study was to evaluate MCC by saccharin test in children with allergic rhinitis, to determine its relationship with disease severity, and to evaluate MCC change after nasal irrigation.
Section snippets
Participants
Patients between 6 and 18 years of age diagnosed with allergic rhinitis were recruited as the patient group, and patients who presented to our clinic but were not diagnosed with allergic diseases by diagnostic tests or patients who had allergic diseases other than the involvement of the respiratory system were recruited as the control group. Those who received intranasal, inhaled or systemic steroids in the previous two months; antihistamines in the previous week; nasal or systemic
Results
The mean age of the patients was 9.65 ± 2.70 years and the mean age of the control group was 9.56 ± 2.53 years. 47.5% of the patients were female. Age and gender were not statistically different between the patient and the control groups. (p = 0.867, p = 0.761, respectively).
Forty-three of the patients (84.31%) had no adenoid vegetations according to their otolaryngology examination notes, and eight of the patients (15.68%) reported that they were told by their otolaryngology specialist that they had
Discussion
MCC is a mechanism for protection from allergens and pathogens, which may be impaired due to mucus changes, number and structural as well as molecular defects of the cilia and mechanical obstruction. In this study, it was shown that NMCCT in pediatric patients with allergic rhinitis was longer than the healthy controls, and that NMCCT was associated with disease severity, and that NMCCT improved after nasal irrigation.
In patients with allergic rhinitis, changes in mucus density and
Conflict of interest
The authors have no conflict of interest to declare.
Acknowledgements
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
References (22)
- et al.
Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision
J Allergy Clin Immunol
(2017) - et al.
Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys
Lancet
(2006) - et al.
Reliability, validity, and responsiveness of the Rhinitis Control Assessment Test in patients with rhinitis
J Allergy Clin Immunol
(2013) - et al.
Correlation of mucociliary clearance and symptomatology before and after adenoidectomy in children
Int J Pediatr Otorhinolaryngol
(2011) - et al.
Efficacy of buffered hypertonic saline nasal irrigation in children with symptomatic allergic rhinitis: a randomized double-blind study
Int J Pediatr Otorhinolaryngol
(2012) - et al.
Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen)
Allergy
(2008) - et al.
Mucociliary transport and its assessment: a review
Clin Otolaryngol Allied Sci
(1998) - et al.
Correlation between nasal ciliary beat frequency and mucus transport rate in volunteers
Laryngoscope
(1985) - et al.
Radioisotopic method for measurement of nasal mucociliary activity
Arch Otolaryngol
(1982) - et al.
Nasal clearance in monozygotic twins
Am Rev Respir Dis
(1974)
Mechanosensitive ATP release maintains propermucus hydration of airways
Sci Signal
Cited by (2)
Airway epithelial development and function: A key player in asthma pathogenesis?
2023, Paediatric Respiratory ReviewsVisual analysis of allergic rhinitis in children based on web of science and CiteSpace software
2022, Frontiers in Pediatrics