Chronic Lung Disease in Canadian Aboriginal Children Is Not Caused by Abnormal Cilia

Abstract

BACKGROUND: It has been suggested that abnormalities of the airway cilia are responsible for some of the increased prevalence of bronchiectasis among the Polynesian population of New Zealand.OBJECTIVE: To determine whether abnormalities of the ciliary axoneme were present in Cree children with recurrent pneumonia.DESIGN: Retrospective identification of Cree children under 18 years of age with three or more documented episodes of pneumonia, at least one of which was severe enough to require hospitalization. Physical examination and nasal brushing for ciliary ultrastructure were performed on those who consented to participate in the study.SETTING: Out-patient department of Moose Factory General Hospital, the referral hospital for the James Bay Region of Northern Ontario.PATIENTS: Ten children (seven males; three females) met the diagnostic criteria and lived in Moose Factory or Moosonee. Six patients (five boys, one girl, mean age 7 years 2 months) consented to examination and nasal brushing.RESULTS: Although the percentage of abnormal cilia (21%) was three to seven times greater than that reported for the control population, the abnormalities seen were characteristic of acquired axonemal defects rather than primary ciliary dyskinesia.CONCLUSIONS: In this population, recurrent pneumonia did not appear to be associated with congenital defects of the ciliary axoneme (primary ciliary dyskinesia). This is consistent with a review of published transmission electron microscopy studies of nasal cilia from the Maori of New Zealand.