Letter to the Editor
Reply to “Lophomonas or Ciliated Epithelial Cells?”
Respuesta a «¿Lophomonas o células epiteliales ciliadas?»
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Cells?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "726" "paginaFinal" => "727" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿<span class="elsevierStyleItalic">Lophomonas</span> o células epiteliales ciliadas?" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 735 "Ancho" => 1255 "Tamanyo" => 118649 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cytological sputum smear. Left: Ciliocytophthoria phenomenon, and an accompanying polymorphonuclear leukocyte (Papanicolaou, 1000×). Right: <span class="elsevierStyleItalic">Lophomonas blattarum</span>. Bar scale 20 μm (Wheatley trichrome stain, 1000×).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rafael Martínez-Girón, Cristina Martínez-Torre" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Rafael" "apellidos" => "Martínez-Girón" ] 1 => array:2 [ "nombre" => "Cristina" "apellidos" => "Martínez-Torre" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289621001046" "doi" => "10.1016/j.arbres.2021.03.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289621001046?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921003062?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000011/v1_202111020702/S1579212921003062/v1_202111020702/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Reply to “Lophomonas or Ciliated Epithelial Cells?”" "tieneTextoCompleto" => true "saludo" => "To the Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "727" "paginaFinal" => "728" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Solmayra Agreda Orellana, Nathalie Pinos Vélez" "autores" => array:2 [ 0 => array:3 [ "nombre" => "Solmayra" "apellidos" => "Agreda Orellana" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:4 [ "nombre" => "Nathalie" "apellidos" => "Pinos Vélez" "email" => array:1 [ 0 => "nathaliepinos@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital José Carrasco Arteaga, Cuenca, Ecuador" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Universitario del Río, Cuenca, Ecuador" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta a «¿<span class="elsevierStyleItalic">Lophomonas</span> o células epiteliales ciliadas?»" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1133 "Ancho" => 1508 "Tamanyo" => 252638 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">400× magnification of slide-mounted bronchial brushing sample.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have read in detail the letter published by Martínez-Girón et al. entitled “Lophomonas or ciliated epithelial cells?”<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>, in which they question the evidence of the findings of flagellated parasites in patient samples from bronchoscopy samples.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">It is true that it is unusual to find this type of protozoan in bronchial lavage samples and it is also true to say that they may go unnoticed due to the lack of expertise of the microscopist, as they can be easily confused with ciliated cells originating in the bronchial tree. No specific culture media have been identified to date, but molecular techniques for confirming lophomoniasis were published by Fakhar et al. in 2019<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We reported the presence of <span class="elsevierStyleItalic">Lophomona</span> sp. in patient specimens using the wet-mount technique with 400× magnification post-centrifugation and subsequent Giemsa staining. This was used to distinguish between ciliated respiratory cells and the protozoan and also to analyze various morphological characteristics of the parasite, including its rounded or ovoid form (20-60 mm long × 12-20 mm wide); the double strand of flagellae at the anterior end; the absence of a terminal bar; and a certain cytoplasmic plasticity. It also helped detect the presence of thick granules and some vacuoles along with a difficult-to-visualize nucleus and the main characteristic of these protozoa, namely, asynchronous movements that generate vibratory, rotational and revolving movements in the protozoan cytoplasm (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">These characteristics distinguish them from ciliated cells originating in the tracheobronchial tree, which are characterized by a basophilic cytoplasm, a basal end with a sharp conical insertion, and an apical end with a reinforced edge corresponding to the terminal bar from which the cilia arise. The nucleus is central, round, or oval with fine chromatin and a discrete nucleolus can be seen<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a>.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Martínez-Girón et al. also mention that the protozoa were perhaps confused with the phenomenon called ciliocytophthoria, which is defined as a degenerative process of the ciliated cells as a consequence of viral infections and characterized by typical morphological changes. As we stated in our article, our lophomoniasis cases did not present any viral process at the time of diagnosis nor did we detect any evidence of carcinoma, another typical cause of these phenomena<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>.</p><p id="par0030" class="elsevierStylePara elsevierViewall">It is true that the species of <span class="elsevierStyleItalic">Lophomonas</span> sp. cannot be distinguished in fresh mounts, but they can be distinguished from ciliated cells using stains such as Giemsa and by observing the internal characteristics of the protozoan.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "⋆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Agreda Orellana S, Pinos Vélez N. Respuesta a «¿<span class="elsevierStyleItalic">Lophomonas</span> o células epiteliales cilidas?». Archivos de Bronconeumología. 2021;57:727–728.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1133 "Ancho" => 1508 "Tamanyo" => 252638 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">400× magnification of slide-mounted bronchial brushing sample.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "¿Lophomonas o células epiteliales cilidas?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Martínez-Girón" 1 => "C. Martínez-Torre" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2021.03.006" "Revista" => array:2 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2021" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "First molecular diagnosis of lophomoniasis: the end of a controversial story" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Fakhar" 1 => "M. Nakhaei" 2 => "A. Sharifpour" 3 => "H. Kalani" 4 => "E.S. Banimostafavi" 5 => "S. Abedi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2478/s11686-019-00084-2" "Revista" => array:5 [ "tituloSerie" => "Acta Parasit" "fecha" => "2019" "volumen" => "64" "paginaInicial" => "390" "paginaFinal" => "393" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Lophomonas blattarum</span>: is it only its morphology that prevents its recognition?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.C. Van Woerden" 1 => "R. Martinez-Giron" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0366-6999.196579" "Revista" => array:4 [ "tituloSerie" => "Chin Med J (Engl)" "fecha" => "2017" "volumen" => "130" "paginaInicial" => "117" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Fichas de citología SA. Ciliocitoftoria. Sociedad Argentina de Citología [Accessed 30 March 2021]. Available from: http://sociedaddecitologia.org.ar/sac/ciliocitoftoria/." ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ciliocytophthoria of nasal epithelial cells after viral infection: a sign of suffering cell" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. Matteo" 1 => "C. Giorgio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.23750/abm.v90i2-S.8103" "Revista" => array:6 [ "tituloSerie" => "Acta Biomed" "fecha" => "2019" "volumen" => "90" "paginaInicial" => "7" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31821277" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005700000011/v1_202111020702/S1579212921003128/v1_202111020702/en/main.assets" "Apartado" => array:4 [ "identificador" => "45358" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005700000011/v1_202111020702/S1579212921003128/v1_202111020702/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921003128?idApp=UINPBA00003Z" ]
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