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2014 ; 3
(2
): 491-503
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Genetic Testing in the Diagnosis of Primary Ciliary Dyskinesia: State-of-the-Art
and Future Perspectives
#MMPMID26237387
Collins SA
; Walker WT
; Lucas JS
J Clin Med
2014[May]; 3
(2
): 491-503
PMID26237387
show ga
Primary ciliary dyskinesia (PCD) is a heterogeneous autosomal recessive condition
affecting around 1:15,000. In people with PCD, microscopic motile cilia do not
move normally resulting in impaired clearance of mucus and debris leading to
repeated sinopulmonary infection. If diagnosis is delayed, permanent
bronchiectasis and deterioration of lung function occurs. Other complications
associated with PCD include congenital heart disease, hearing impairment and
infertility. A small number of longitudinal studies suggest that lung function
deteriorates before diagnosis of PCD but may stabilise following diagnosis with
subsequent specialist management. Early diagnosis is therefore essential, but for
a number of reasons referral for diagnostic testing is often delayed until older
childhood or even adulthood. Functional diagnostic tests for PCD are expensive,
time consuming and require specialist equipment and scientists. In the last few
years, there have been considerable developments to identify genes associated
with PCD, currently enabling 65% of patients to be identified by bi-allelic
mutations. The rapid identification of new genes continues. This review will
consider the evidence that early diagnosis of PCD is beneficial. It will review
the recent advances in identification of PCD-associated genes and will discuss
the role of genetic testing in PCD. It will then consider whether screening for
PCD antenatally or in the new born is likely to become a feasible and acceptable
for this rare disease.