Clinical and morphological condition of respiratory system in various forms of rhinitis and bronchial asthma

Objective. The aim of the paper is to find out morphofunctional modification criteria in airways in various forms of rhinitis and to define their role in the pathogenesis of bronchial asthma (BA). Materials and Methods. Nasal mucosal scrapings, biopsy and bronchoalveolar lavage of patients with rhinitis and BA were examined. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were used for this purpose. Results. While studying the light-optical and semifine sections of the upper respiratory tract (RT) the most sensitive sections of the mucous membrane of the inferior turbinate were identified. The epithelial cells were the first to suffer, especially ciliated epithelium (CE) and apical membrane. In CE cilia were damaged. In all types of rhinitis light microscopy revealed similar changes both in the epithelium and lamina propria (LP), especially the microvasculature, which responded to the pathology with endothelial cells polymorphism. They either became thinner or thickened. There occurred the sequence of «light» and «dark» endothelial cells, indicating microvasculature instability and serious changes in the permeability of cell membranes. In non-allergic rhinitis with eosinophilic syndrome intraepithelial lymphocytes and plasma cells were detected. In the lamina propria contact of macrophages and fibroblasts and a large number of mast cells were observed. Intraepithelial platelets are often detected in allergic rhinitis (AR), while electron-microscopic examination revealed that lymphocytes and plasma cells in the epithelium were extremely rare. In polypous rhinosinusitis (PRS) and vasomotor rhinitis (VMR) intraepithelial cells of the immune series were also rare. The mucosal surface of the upper RT demonstrated similar changes in case of allergic rhinitis and BA. Significant extrusion of goblet cells secretion was observed in certain parts of epithelium. It was accompanied by accumulation of mucin in the affected areas. Conclusion. Intraepithelial platelets were often detected in allergic rhinitis (AR), while electron-microscopic examination revealed that lymphocytes and plasma cells in the epithelium were extremely rare. In polypous rhinosinusitis (PRS) and vasomotor rhinitis (VMR) intraepithelial cells of the immune series were also rare. The mucosal surface of the upper RT demonstrated similar changes in case of allergic rhinitis and BA. Along with clinical findings it confirmed the hyperactivity of these organs. Significant extrusion of goblet cells secretion was observed in certain parts of epithelium, so that the injured zones were covered with a thick layer of mucin. These changes were mainly typical for upper RT.