The effect of bacterial products on ciliary function.

Mucociliary clearance protects the respiratory epithelium against inhaled particles. There is in vitro evidence that some bacteria produce factors that cause ciliary slowing, dyskinesia, and stasis. These changes may predominantly affect ciliary function alone or be associated with epithelial disruption and cell death. Some factors act immediately, while others can take up to a number of days to achieve effect. It is postulated that rapidly acting factors may be involved during bacterial colonization, allowing the bacterium time (by slowing clearance) to penetrate the mucociliary barrier and reach putative receptors on the epithelial surface. The compounds might similarly facilitate contiguous spread through the bronchial tree and augment the tissue damage caused by the host inflammatory response during chronic bronchial sepsis. Future work should define more clearly the in vivo significance of the largely in vitro observations made to date.