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Goutaki M, Meier AB, Halbeisen FS, Lucas JS, Dell SD, Maurer E, Casaulta C, Jurca M, Spycher BD, Kuehni CE. Clinical manifestations in primary ciliary dyskinesia: systematic review and meta-analysis. Eur Respir J 2016; 48:1081-1095. [PMID: 27492829 DOI: 10.1183/13993003.00736-2016] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 05/24/2016] [Indexed: 01/30/2023]
Abstract
Few original studies have described the prevalence and severity of clinical symptoms of primary ciliary dyskinesia (PCD). This systematic review and meta-analysis aimed to identify all published studies on clinical manifestations of PCD patients, and to describe their prevalence and severity stratified by age and sex.We searched PubMed, Embase and Scopus for studies describing clinical symptoms of ≥10 patients with PCD. We performed meta-analyses and meta-regression to explain heterogeneity.We included 52 studies describing a total of 1970 patients (range 10-168 per study). We found a prevalence of 5% for congenital heart disease. For the rest of reported characteristics, we found considerable heterogeneity (I2 range 68-93.8%) when calculating the weighted mean prevalence. Even after taking into account the explanatory factors, the largest part of the between-studies variance in symptom prevalence remained unexplained for all symptoms. Sensitivity analysis including only studies with test-proven diagnosis showed similar results in prevalence and heterogeneity.Large differences in study design, selection of study populations and definition of symptoms could explain the heterogeneity in symptom prevalence. To better characterise the disease, we need larger, multicentre, multidisciplinary, prospective studies that include all age groups, use uniform diagnostics and report on all symptoms.
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Affiliation(s)
- Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland Both authors contributed equally
| | - Anna Bettina Meier
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland Both authors contributed equally
| | - Florian S Halbeisen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Jane S Lucas
- PCD Centre, NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sharon D Dell
- Divisions of Respiratory Medicine and Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Elisabeth Maurer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Carmen Casaulta
- Dept of Pediatrics, University Children's Hospital of Bern, Bern, Switzerland
| | - Maja Jurca
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Ben D Spycher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Kurt AO, Saşmaz T, Buğdayci R, Oner S, Yapici G, Ozdemir O. A five year retrospective surveillance; monitoring and evaluation for the regional tuberculosis control programme in Mersin, Turkey, 2004-2008. Cent Eur J Public Health 2012; 20:144-9. [PMID: 22966741 DOI: 10.21101/cejph.a3713] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM The aim of this study is to identify and evaluate problems in regional tuberculosis control studies, using an international tuberculosis indicator. METHODS In this retrospective cohort study, the records of a total of 1,776 patients diagnosed with tuberculosis, followed up and treated from 2004-2008 in Mersin were evaluated. Indicators recommended by the World Health Organization were used as assessment criteria. Descriptive statistics were used to summarize data. The Mantel-Haenszel test was used for calculation of the risk between urban/rural, and between male/ female which were in different age groups. RESULTS During the five year period, new case notification rates were reduced and tuberculosis risk shifted to advanced age groups in our region. Tuberculosis development risk increased two-fold among males (p < 0.001). One-fifth of the tuberculosis cases had been diagnosed without sputum smears. Sputum microscopy was not done at the end of the initial phase in one-fifth of patients. During the five-year follow-up period, tuberculosis treatment success rate increased from 83% to 91% and cure rate increased from 49% to 67%. The death rate, treatment failure rate, default rate, and transmission rate decreased, and the directly observed treatment implementation increased. CONCLUSION Improvements were seen in diagnosis and treatment indicators beginning from 2006; the year when the directly supervised treatment application started. However, use of sputum smear microscopy is inadequate for the diagnosis and treatment of tuberculosis. Tuberculosis control studies should be monitored and evaluated using a tuberculosis indicator.
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Affiliation(s)
- A Oner Kurt
- Department of Public Health, Mersin University Faculty of Medicine, Mersin, Turkey.
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Armengot M, Bonet M, Carda C, Gómez MJ, Milara J, Mata M, Cortijo J. Development and Validation of a Method of Cilia Motility Analysis for the Early Diagnosis of Primary Ciliary Dyskinesia. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2012. [DOI: 10.1016/j.otoeng.2012.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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4
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Síndrome de Kartagener de diagnóstico tardío. Semergen 2011. [DOI: 10.1016/j.semerg.2011.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Armengot M, Bonet M, Carda C, Gómez MJ, Milara J, Mata M, Cortijo J. Development and validation of a method of cilia motility analysis for the early diagnosis of primary ciliary dyskinesia. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2011; 63:1-8. [PMID: 21907944 DOI: 10.1016/j.otorri.2011.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 07/01/2011] [Accepted: 07/10/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND Primary ciliary dyskinesia (PCD) is a clinically uniform entity, but cilia motility and structure can vary between patients, making the diagnostic difficult. The aim of this study was to evaluate the sensitivity and specificity in diagnosing PCD of a system of high-resolution digital high-speed video analysis with proprietary software that we developed for analysis of ciliary motility (Desinsoft-Bio 200). The secondary aim was to correlate nasal ciliary activity with clinical and structural abnormalities in PCD. MATERIAL AND METHODS We analysed nasal mucociliary transport, cilia ultrastructure, nasal ciliary beat frequency and beat pattern studied by high-resolution digital high-speed video in 25 cases of PCD (11 Kartagener syndrome), 27 secondary ciliary dyskinesia and 34 healthy volunteers. RESULTS Nasal mucociliary transport was defective in both primary and secondary ciliary dyskinesia. Ciliary immotility was observed only in 6 patients with Kartagener syndrome and correlated with the absence of dynein. We observed a correlation between partial dynein deficiencies and ciliary dyskinesia. Cilia activity and structure was normal in secondary ciliary dyskinesia. CONCLUSION Nasal mucociliary transport showed high sensitivity for PCD diagnosis with a low specificity. High-resolution digital high-speed video has a high sensitivity and specificity for diagnosing PCD. This system of video analysis is more useful than ultrastructural study and mucociliary transport for PCD screening. Dynein absence is correlated with cilia immotility and is more common in patients with Kartagener syndrome.
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Affiliation(s)
- Miguel Armengot
- Sección de Rinología, Servicio de Otorrinolaringología, Hospital General Universitario, Universidad de Valencia, Valencia, España.
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Armengot M, Milara J, Mata M, Carda C, Cortijo J. Cilia motility and structure in primary and secondary ciliary dyskinesia. Am J Rhinol Allergy 2010; 24:175-80. [PMID: 20537282 DOI: 10.2500/ajra.2010.24.3448] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Primary ciliary dyskinesia (PCD) is a clinically uniform entity, although cilia motility and structure can vary among patients, making diagnosis difficult. Chronic sinusitis, bronchiectasis, sinus hypoplasia, secretory otitis media, and low fertility are common in PCD patients. The aim of this work was to correlate nasal ciliary activity with clinical and structural abnormalities in PCD. A secondary aim was to evaluate the usefulness of high-resolution digital high-speed video (DHSV) in the diagnosis of PCD. METHODS We analyzed nasal mucociliary transport and cilia ultrastructure by electron microscopy and studied nasal ciliary beat frequency (CBF) and beat pattern using high-resolution DHSV imaging in 34 healthy volunteers, 25 individuals with PCD (including 11 with Kartagener's syndrome [KS]with situs inversus), and 27 with secondary ciliary dyskinesia (SCD). RESULTS Nasal mucociliary transport was defective in the PCD and SCD patients. Ciliary immotility was observed in only six KS patients and was correlated with the absence of dynein. We observed a correlation between partial dynein deficiency and an uncoordinated, stiffly vibrating ciliary beat. Cilia activity and structure were normal in the SCD patients. CONCLUSION Nasal mucociliary transport showed a sensitivity of 100% for the diagnosis of PCD but has low specificity. High-resolution DHSV imaging has high sensitivity and specificity for the diagnosis of PCD. Video analysis is probably more useful than the study of mucociliary transport and cilia ultrastructure in screening for PCD. The absence of dynein was correlated with ciliary immotility and was more common in KS patients.
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Affiliation(s)
- Miguel Armengot
- Rhinology Unit, General and University Hospital, Medical School, Valencia University, Valencia, Spain.
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Milara J, Armengot M, Mata M, Morcillo EJ, Cortijo J. Role of adenylate kinase type 7 expression on cilia motility: possible link in primary ciliary dyskinesia. Am J Rhinol Allergy 2010; 24:181-5. [PMID: 20537283 DOI: 10.2500/ajra.2010.24.3468] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Adenylate kinase 7 (AK7) mediates the reaction 2ADP <--> ATP + AMP, providing energy for the beating of cilia. A study recently showed that AK7 expression may be correlated with the primary ciliary dyskinesia (PCD) phenotype in mice. In this study, we characterized AK7 expression in vitro in an air-liquid interface (ALI) model and in middle nasal turbinate biopsy specimens from a cohort of patients with PCD to elucidate whether AK7 expression is correlated with ciliary malfunction. METHODS AK7 expression was measured by real-time reverse-transcription polymerase chain reaction and Western blotting. In vitro differentiated nasal human epithelial cell siRNA experiments were performed to investigate the effect of AK7 expression on ciliary beat frequency (CBF). Ciliary motility and ultrastructure were evaluated in a cohort of 29 patients with PCD (PCD, n = 17; Kartagener's syndrome, n = 12) and 26 healthy control donors. RESULTS AK7 expression was mainly located on the apical surface of differentiated nasal ALI cells, and targeted suppression of the AK7 gene decreased CBF by 41%. AK7 expression was diminished significantly in patients with PCD (0.54 +/- 0.1-fold; p < 0.05) compared with healthy controls (1.1 +/- 0.08-fold). Furthermore, AK7 expression was correlated with CBF in patients with PCD (r = 0.5; p = 0.009). CONCLUSION AK7 expression was correlated with CBF in vitro and in nasal biopsy specimens from patients with PCD, which may have contributed to the ciliary malfunction observed in our patients with PCD.
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Affiliation(s)
- Javier Milara
- Research Unit, University General Hospital Consortium, Avenida tres cruces s/n, Valencia, Spain.
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Moreno Galdó A, Vizmanos Lamotte G, Reverte Bover C, Gartner S, Cobos Barroso N, Rovira Amigo S, Liñán Cortés S, Lloreta Trull J, Busquets Monge R. [Value of nasal nitric oxide in the diagnosis of primary ciliary dyskinesia]. An Pediatr (Barc) 2010; 73:88-93. [PMID: 20335083 DOI: 10.1016/j.anpedi.2009.10.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2009] [Revised: 10/24/2009] [Accepted: 10/26/2009] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE The aim of this study is to report nasal nitric oxide (nNO) values in children with primary ciliary dyskinesia (PCD) and to compare them with nNO values in healthy children, asthmatic children, children with cystic fibrosis and children with post infectious bronchiectasis. PATIENTS AND METHODS We determined nNO values in 9 children with PCD, 36 asthmatic children, 31 children with cystic fibrosis, 8 children with post infectious bronchiectasis and 37 healthy children. We compared nNO values between these different conditions and calculated sensitivity and specificity of nNO to diagnose PCD. RESULTS All children with PCD - except one (nNO 348 ppb) - had nNO values below 112 ppb, mean 88 ppb (95%CI 9.6-166). The nNO mean was 898 ppb (95%CI 801-995) in healthy children, 1023 ppb (95%CI 911-1137) in asthmatic children, 438 ppb (95%CI 367-508) in cystic fibrosis children and 361 ppb (95%CI 252-470) in children with post infectious bronchiectasis. The mean concentration of nNO was lower (P<0.05) in PCD patients, compared to the other groups. The measurement of nasal NO in our study population showed, at a cut-off level of < or =112 ppb, a sensitivity of 88.9% and a specificity of 99.1% in the diagnosis of PCD [ROC 0.98 (95%CI 0.94-0.99); P<0.0001; probability ratio 95.1]. CONCLUSIONS The measurement of nasal NO appears to be a useful tool for screening children for PCD, in which a cut-off level of < or =112 ppb suggests the disease, although nNO above 112 ppb does not exclude PCD.
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Armengot Carceller M, Mata Roig M, Milara Payá X, Cortijo Gimeno J. Discinesia ciliar primaria. Ciliopatías. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010; 61:149-59. [DOI: 10.1016/j.otorri.2009.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2008] [Accepted: 01/12/2009] [Indexed: 10/20/2022]
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Armengot Carceller M, Mata Roig M, Milara Payá X, Cortijo Gimeno J. Primary ciliary dyskinesia. Ciliopathies. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010. [DOI: 10.1016/s2173-5735(10)70023-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Plaza Valía P, Carrión Valero F, Marín Pardo J, Bautista Rentero D, González Monte C. Test de la sacarina en el estudio del aclaramiento mucociliar. Valores de referencia en una población española. Arch Bronconeumol 2008. [DOI: 10.1157/13126834] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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12
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Durant AM. What is your diagnosis? Thoracic and abdominal situs inversus totalis. J Am Vet Med Assoc 2008; 232:197-8. [PMID: 18275384 DOI: 10.2460/javma.232.2.197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- April M Durant
- Hollywood Animal Hospital, 2864 Hollywood Blvd, Hollywood, FL 33020, USA
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Valía PP, Valero FC, Pardo JM, Rentero DB, Monte CG. Saccharin Test for the Study of Mucociliary Clearance: Reference Values for a Spanish Population. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1579-2129(08)60100-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tanaka K, Sutani A, Uchida Y, Shimizu Y, Shimizu M, Akita M. Ciliary ultrastructure in two sisters with Kartagener's syndrome. Med Mol Morphol 2007; 40:34-9. [PMID: 17384988 DOI: 10.1007/s00795-007-0354-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2006] [Accepted: 01/16/2007] [Indexed: 11/25/2022]
Abstract
Kartagener's syndrome (KS) is a clinical variant of primary ciliary dyskinesia involving situs inversus associated with chronic airway infections. We studied two sisters; the elder one had dextrocardia and scoliosis, and the younger one had situs inversus of the lung, liver, and stomach as well as dextrocardia. Both patients had chronic sinusitis and chronic bronchitis with bronchiectasis. In both cases, the ciliary defect associated with this syndrome is the absence of inner dynein arms.
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Affiliation(s)
- Kayoko Tanaka
- Division of Morphological Science, Biomedical Research Center, Saitama Medical University, 38 Moroyama, Iruma-gun, Saitama 350-0495, Japan
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Alonso J, Marin JM. [The ARCHIVOS archive, 2005: and overview of research published in Archivos De Bronconneumología]. Arch Bronconeumol 2006; 42:475-83. [PMID: 17120348 DOI: 10.1016/s1579-2129(06)60570-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- José Alonso
- Servicio de Neumología, Hospital Miguel Servet, Zaragoza, España
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Abstract
The nose and lungs have both histological and functional similarities and differences. Sinonasal and bronchial involvement are associated in many diseases. Cystic fibrosis, primary ciliary dyskinesia, Young's syndrome, and alpha-1 antitrypsin deficiency are diseases in which bronchiectasis and rhinosinusitis are both present. This review considers the diseases in which bronchiectasis occurs along with sinonasal manifestations. We propose examining sinonasal disease from a new perspective by observing it in patients with bronchiectasis.
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Affiliation(s)
- J M Guilemany
- Unitat de Rinologia, Servei d'ORL (ICEMEQ), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
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Guilemany J, Mullol J, Picado C. Relaciones entre rinosinusitis y bronquiectasias. Arch Bronconeumol 2006. [DOI: 10.1157/13085563] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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