Association Between The Expression Characteristics Of Ciliary Biomarkers Of Bronchiectasis And The Disease Severity And Inflammatory Endotypes

Background: Airway mucosal epithelial ciliary damage exists in COPD,asthma and other chronic airway inflammatory diseases,and bronchiectasis is also a chronic airway inflammatory disease.However,the expression of ciliary markers in patients with bronchiectasis and their clinical significance remain unclear.Objective: To investigate the correlation between the expression characteristics of airway ciliary markers and the severity of bronchiectasis and inflammation types in patients with bronchiectasis.Methods: This is a prospective,observational cohort study involving 180 patients with bronchiectasis and 39 healthy subjects.Mucosal specimens from nasal brushes and fibrobronchoscopy brushes were collected,and airway inflammation types and disease severity were assessed.By immunofluorescence staining technique in patients with the expansion of the nasal mucosa specimens with fiber lens brush brush check test specimens for research,evaluation of the cilia markers in the expression and localization of cilia,including fluorescent results of ciliated cells with fluorescent score statistics and calculate the average intensity of fluorescence,the fluorescence score using semi-quantitative scoring system to exception hierarchy of each patient,Average fluorescence intensity was calculated using Image J.Result: A total of 253 nasal brush specimens and 13 fibrobronchoscopy brush specimens were obtained from 180 patients with bronchiectasis and 39 healthy subjects.Compared with patients with upper airway disease,there was no statistical difference in the level of ciliary markers in bronchiectasis patients without upper airway disease,and there was a high degree of consistency in the expression levels of ciliary markers in upper and lower airway.Among them,37 patients underwent genetic testing,and it was found that 67.6% of patients had simple secondary ciliary abnormalities and 16.2% had mixed ciliary abnormalities.Compared with healthy subjects,the expression levels of DNAH5,DNAI1,RSPH9 and Ezrin in upper airway of patients with bronchiectasis were significantly lower,and the abnormal expression levels of ciliary markers were higher in the bronchiectasis group,among which ciliary ultrastructural markers(DNAH5 and DANI1)had certain identification efficacy for patients with bronchiectasis {AUC were: 0.716(0.651-0.774),0.602(0.534-0.667)},and the higher the severity of bronchiectasis disease,the higher the abnormal expression of ciliary markers DNAH5 and RSPH9.There was no statistical difference in ciliary length between the bronchiectasis group and the healthy control group.In the bronchiectaisis group,etiological stratification was performed,or compared with the healthy control group after the exclusion of asthma,the abnormal expression of ciliary ultramarkers was higher in the bronchiectasis group,which was consistent with the results of overall bronchiectasis compared with the healthy control group.The types of inflammation did not affect the expression characteristics of ciliary markers in patients with bronchiectasis.Conclusion: The expression level of upper airway cilium markers was abnormal in patients with bronchiectasis and correlated with the degree of bronchiectasis,and was not affected by upper airway disease.