Evaluation of nasal mucociliary clearance in rheumatoid arthritis: a comparative analysis using saccharin test

Shelja Deswal, Jyoti Yadav, Mohit Deswal, Harpreet Singh


Background: Rheumatoid arthritis (RA) is a chronic multisystem disease of unknown etiology characterized by persistent inflammatory synovitis, usually involving peripheral joints in a symmetric distribution. RA is a systemic disease often associated with cutaneous and organ-specific extra-articular manifestations the mucociliary clearance system protects the lower respiratory system by trapping and removing inhaled pathogenic viruses and bacteria, in addition to nontoxic and toxic particulates (e.g., pollen, ash, mineral dust, mold spores, and organic particles), from the lungs. Effective clearance requires both ciliary activity and the appropriate balance of periciliary fluid and mucus.

Methods: This was a case control study conducted in the Department of Physiology, Pt. B.D. Sharma PGIMS, Rohtak in 50 females of age group 30-50 years. Control group comprised of 25 healthy volunteer females while study group comprised of 25 rheumatoid arthritis female patients with disease duration of more than five years. Proven cases of RA (as per 1987 ACR criteria) were taken with disease duration of more than five years from Rheumatology clinic of Pt. B.D. Sharma PGIMS, Rohtak. Nasal mucociliary clearance time was evaluated by saccharin method.

Results: The results of our study showed abnormal mucociliary clearance in rheumatoid arthritis patients.

Conclusions: The study shows an abnormal mucociliary clearance in rheumatoid arthritis patients. Impairment of mucociliary clearance seems to be the result of qualitative and quantitative alterations in respiratory secretions.


Joints, Nasal mucociliary clearance, Rheumatoid arthritis, Saccharin

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Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis.Res. 2002;4:265-7

Karlson EW, Deane K. Environmental and gene-environmental interactions and risk of rheumatoid arthritis. Rheum Dis Clin North Am. 2012;28:405-26.

Pandya VK, Tiwari RS. Nasal mucociliary clearance in health and disease. Indian J Otolaryngol Head Neck Surg. 2006;58:332-4.

Robinson M, Bye PT. Mucociliary clearance in cystic fibrosis. Pediatr Pulmonol. 2002;33:293-306.

Baby MK, Muthu PK, Johnson P, Kannan S. Effect of cigarette smoking on nasal mucociliary clearance: A comparative analysis using saccharin test. Lung India 2014;31:39-42.

Andersen I, Proctor DF. Measurement of nasal mucociliary clearance. Eur J Respir Dis Suppl. 1983;127:37–40.

Yergin BM, Saketkhoo K, Michaelson ED, Serafini SM, Kovitz K, Sackner MA. A roentgenographic method for measuring nasal mucous velocity. J Appl Physiol. 1978;44:964-8.

Andersen I, Camner P, Jensen PL, Philipson K, Proctor DF. Nasal clearance in monozygotic twins. Am Rev Respir Dis. 1974;110:301-5.

Demoruelle MK, Deane KD, Holers VM. When and where does inflammation begin in rheumatoid arthritis? Curr Opin Rheumatol. 2014;26:64-71.

Svard A, Kastbom A, Soderlin MK, Reckner-Olsson A, Skogh T. A comparison between IgG and IgA class antibodies to cyclic citrullinated peptides and to modified citrullinated vimentin in early rheumatoid arthritis and very early arthritis. J Rheumatol. 2011;38:1265-72.

Gudis DA, Cohen NA. Cilia dysfunction. Otolaryngol Clin North Am. 2010;433:461-72.

Corbo GM, Foresi A, Bonfitto P, Mugnano A, Agabiti N, Cole PJ. Measurement of nasal mucociliary clearance. Arch Dis Childhood. 1989;64:546-50.

Andersen I, Camner P, Jensen PL, Philipson K, Proctor DF. A comparison of nasal and tracheobronchial clearance. Arch Environ Health. 1974;29:290-3.

Mezey RJ, Cohn MA, Fernandez RJ, Januszkiewicz AJ, Wanner A. Mucociliary transport in allergic patients with antigen-induced bronchospasm. Am Review Respir Dis. 1978;118:677-84.