Mario Canciani

School air quality related to dry cough, rhinitis and nasal patency in children

Controls for indoor air quality (IAQ) in schools are not usually performed throughout Europe. The aim of this study was to assess the effects of IAQ on respiratory health of schoolchildren living in Norway, Sweden, Denmark, France and Italy. In the cross-sectional European Union-funded HESE (Health Effects of School Environment) Study, particulate matter with a 50% cut-off aerodynamic diameter of 10 µm (PM10) and CO2 levels in a day of normal activity (full classroom) were related to wheezing, dry cough at night and rhinitis in 654 children (10 yrs) and to acoustic rhinometry in 193 children. Schoolchildren exposed to PM10 >50 μg·m−3 and CO2 >1,000 ppm (standards for good IAQ) were 78% and 66%, respectively. All disorders were more prevalent in children from poorly ventilated classrooms. Schoolchildren exposed to CO2 levels >1,000 ppm showed a significantly higher risk for dry cough (OR 2.99, 95% CI 1.65–5.44) and rhinitis (OR 2.07, 95% CI 1.14–3.73). By two-level (child, classroom) hierarchical analyses, CO2 was significantly associated with dry cough (OR 1.06, 95% CI 1.00–1.13 per 100 ppm increment) and rhinitis (OR 1.06, 95% CI 1.00–1.11). Nasal patency was significantly lower in schoolchildren exposed to PM10 >50 μg·m−3 than in those exposed to lower levels. A poor IAQ is frequent in European classrooms; it is related to respiratory disturbances and affects nasal patency.

Total viable molds and fungal DNA in classrooms and association with respiratory health and pulmonary function of European schoolchildren.

To cite this article: Simoni M, Cai G‐H, Norback D, Annesi‐Maesano I, Lavaud F, Sigsgaard T, Wieslander G, Nystad W, Canciani M, Viegi G, Sestini P. Total viable molds and fungal DNA in classrooms and association with respiratory health and pulmonary function of European schoolchildren. Pediatr Allergy Immunol 2011: 22: 843–852.

The Association of Supernumerary Microtubules and Immotile Cilia Syndrome and Defective Neutrophil Chemotaxis

Several ciliary defects are associated with poor motility or immotility of respiratory cilia. The defects include abnormalities in the axonemal structures or in the basal apparatus (1). Patients suffering from immotile cilia syndrome (ICS) show a heterogeneous clinical disease in which respiratory symptoms (viz. bronchiectasis, chronic bronchitis, otitis media) related to the ciliary dysfunction may be associated with other pathological conditions (i.e. situs viscerum inversus and male infertility). Even if numerous studies in humans and in experimental animals provide more information to explain, a t molecular level, the association between ICS and the above mentioned pathological states, to date, the association between ICS and a defective neutrophil chemotaxis is still object of debate (2). This report deals with four unrelated female patients (aged from 7 to 20 years) suffering from ICS in which a peculiar defect in ciliary configuration was found to be associated with a defective neutrophil chemotaxis. ICS was diagnosed by studying the mucociliary clearance and by examining the ultrastructural morphology of nasal cilia. Nasal mucociliary clearance time was tested by the saccharin method, measuring the time between placing saccharin (1 mm diameter particle) on the inferior turbinate and the moment when the subject tasted its sweetness on swallowing (3). Neutrophil chemotaxis was assessed, in symptom-free periods, “in vivo” and “in vitro” according to Senn (4) and Wilkinson ( 5 ) , respectively. In all patients immunological data were normal, whereas “in vivo” (36.1-17.6-15.9-16.1 x 10’ cells/cm2/24 h; normal values 68+ 10) and “in vitro” (chemotactic index: 121-123-119-1 13; normal values 145+ 11) neutrophil chemotaxis was impaired. The saccharin test (two or more different evaluations for each subject) was abnormal in all patients. In particular the clearance time (reference values 8-30 min) was >60 min in 3 patients, and about 50 min in one of the patients (50-52-55 min). The ultrastructural examination of respiratory cilia showed in all patients the presence of additional solitary peripheral microtubules outside or inside the 9+2 complex (Fig. 1). Cilia with axonemal supernumerary microtubules are reported to be associated to a ciliary dyskinesia (actually those cilia are classified as type V dyskinetic cilia) (1). Although data reported by several authors showed that an impairment of neutrophil chemotaxis is not a constant feature in ICS, the data presented here strongly suggest that a defective neutrophil

Cilia-lacking respiratory cells in ciliary aplasia

This report describes the ultrastructural alterations observed in the nasal and bronchial mucosa of an 11‐yr‐old male suffering from immotile cilia syndrome (ICS).