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Müller L, Savas ST, Tschanz SA, Stokes A, Escher A, Nussbaumer M, Bullo M, Kuehni CE, Blanchon S, Jung A, Regamey N, Haenni B, Schneiter M, Ingold J, Kieninger E, Casaulta C, Latzin P. A Comprehensive Approach for the Diagnosis of Primary Ciliary Dyskinesia-Experiences from the First 100 Patients of the PCD-UNIBE Diagnostic Center. Diagnostics (Basel) 2021; 11:1540. [PMID: 34573882 PMCID: PMC8466881 DOI: 10.3390/diagnostics11091540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 11/17/2022] Open
Abstract
Primary ciliary dyskinesia (PCD) is a rare genetic disease characterized by dyskinetic cilia. Respiratory symptoms usually start at birth. The lack of diagnostic gold standard tests is challenging, as PCD diagnostics requires different methods with high expertise. We founded PCD-UNIBE as the first comprehensive PCD diagnostic center in Switzerland. Our diagnostic approach includes nasal brushing and cell culture with analysis of ciliary motility via high-speed-videomicroscopy (HSVM) and immunofluorescence labeling (IF) of structural proteins. Selected patients undergo electron microscopy (TEM) of ciliary ultrastructure and genetics. We report here on the first 100 patients assessed by PCD-UNIBE. All patients received HSVM fresh, IF, and cell culture (success rate of 90%). We repeated the HSVM with cell cultures and conducted TEM in 30 patients and genetics in 31 patients. Results from cell cultures were much clearer compared to fresh samples. For 80 patients, we found no evidence of PCD, 17 were diagnosed with PCD, two remained inconclusive, and one case is ongoing. HSVM was diagnostic in 12, IF in 14, TEM in five and genetics in 11 cases. None of the methods was able to diagnose all 17 PCD cases, highlighting that a comprehensive approach is essential for an accurate diagnosis of PCD.
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Affiliation(s)
- Loretta Müller
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (S.T.S.); (A.S.); (A.E.); (M.N.); (M.B.); (C.E.K.); (E.K.); (C.C.); (P.L.)
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Sibel T. Savas
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (S.T.S.); (A.S.); (A.E.); (M.N.); (M.B.); (C.E.K.); (E.K.); (C.C.); (P.L.)
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Stefan A. Tschanz
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (B.H.); (M.S.); (J.I.)
| | - Andrea Stokes
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (S.T.S.); (A.S.); (A.E.); (M.N.); (M.B.); (C.E.K.); (E.K.); (C.C.); (P.L.)
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Anaïs Escher
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (S.T.S.); (A.S.); (A.E.); (M.N.); (M.B.); (C.E.K.); (E.K.); (C.C.); (P.L.)
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Mirjam Nussbaumer
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (S.T.S.); (A.S.); (A.E.); (M.N.); (M.B.); (C.E.K.); (E.K.); (C.C.); (P.L.)
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Marina Bullo
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (S.T.S.); (A.S.); (A.E.); (M.N.); (M.B.); (C.E.K.); (E.K.); (C.C.); (P.L.)
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Claudia E. Kuehni
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (S.T.S.); (A.S.); (A.E.); (M.N.); (M.B.); (C.E.K.); (E.K.); (C.C.); (P.L.)
- Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland
| | - Sylvain Blanchon
- Pediatric Pulmonology and Cystic Fibrosis Unit, Service of Pediatrics, Department Woman–Mother–Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland;
| | - Andreas Jung
- Division of Respiratory Medicine, University Children’s Hospital Zurich, 8032 Zurich, Switzerland;
| | - Nicolas Regamey
- Division of Paediatric Pulmonology, Children’s Hospital Lucerne, 6000 Lucerne, Switzerland;
| | - Beat Haenni
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (B.H.); (M.S.); (J.I.)
| | - Martin Schneiter
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (B.H.); (M.S.); (J.I.)
- Institute of Applied Physics, University of Bern, 3012 Bern, Switzerland
| | - Jonas Ingold
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (B.H.); (M.S.); (J.I.)
| | - Elisabeth Kieninger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (S.T.S.); (A.S.); (A.E.); (M.N.); (M.B.); (C.E.K.); (E.K.); (C.C.); (P.L.)
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Carmen Casaulta
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (S.T.S.); (A.S.); (A.E.); (M.N.); (M.B.); (C.E.K.); (E.K.); (C.C.); (P.L.)
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (S.T.S.); (A.S.); (A.E.); (M.N.); (M.B.); (C.E.K.); (E.K.); (C.C.); (P.L.)
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
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