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Jackson CL, Bottier M. Methods for the assessment of human airway ciliary function. Eur Respir J 2022; 60:13993003.02300-2021. [PMID: 35595315 DOI: 10.1183/13993003.02300-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 04/19/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Claire L Jackson
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK .,School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton, UK
| | - Mathieu Bottier
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
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2
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High-Speed Video Microscopy for Primary Ciliary Dyskinesia Diagnosis: A Study of Ciliary Motility Variations with Time and Temperature. Diagnostics (Basel) 2021; 11:diagnostics11071301. [PMID: 34359383 PMCID: PMC8305583 DOI: 10.3390/diagnostics11071301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 11/28/2022] Open
Abstract
Primary ciliary dyskinesia (PCD) is a rare disease resulting from a defect in ciliary function that generates, among other issues, chronic upper and lower respiratory tract infections. European guidelines recommend studying ciliary function (pattern (CBP) and frequency (CBF)), together with characteristic clinical symptoms, as one of the definitive tests. However, there is no “gold standard”. The present study aims to use high-speed video microscopy to describe how CBF and CBP alter over time and at different temperatures to reduce the error rate in the diagnosis of PCD. Samples of nasal epithelium from 27 healthy volunteers were studied to assess CBF and CBP at 0, 3, 24, 48, and 72 h, at room temperature and 4 °C. It was observed that CBF increased while CBP became dyskinetic, both at room temperature and at 4 °C, as time passed, especially after 3 h. In order to preserve all ciliary function parameters and to perform a reliable analysis to improve the diagnostic process of PCD, analysis should be performed within the first 3 h of sample collection, preferably in reference centers.
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Coles JL, Thompson J, Horton KL, Hirst RA, Griffin P, Williams GM, Goggin P, Doherty R, Lackie PM, Harris A, Walker WT, O’Callaghan C, Hogg C, Lucas JS, Blume C, Jackson CL. A Revised Protocol for Culture of Airway Epithelial Cells as a Diagnostic Tool for Primary Ciliary Dyskinesia. J Clin Med 2020; 9:E3753. [PMID: 33233428 PMCID: PMC7700393 DOI: 10.3390/jcm9113753] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 12/14/2022] Open
Abstract
Air-liquid interface (ALI) culture of nasal epithelial cells is a valuable tool in the diagnosis and research of primary ciliary dyskinesia (PCD). Ex vivo samples often display secondary dyskinesia from cell damage during sampling, infection or inflammation confounding PCD diagnostic results. ALI culture enables regeneration of healthy cilia facilitating differentiation of primary from secondary ciliary dyskinesia. We describe a revised ALI culture method adopted from April 2018 across three collaborating PCD diagnostic sites, including current University Hospital Southampton COVID-19 risk mitigation measures, and present results. Two hundred and forty nasal epithelial cell samples were seeded for ALI culture and 199 (82.9%) were ciliated. Fifty-four of 83 (63.9%) ex vivo samples which were originally equivocal or insufficient provided diagnostic information following in vitro culture. Surplus basal epithelial cells from 181 nasal brushing samples were frozen in liquid nitrogen; 39 samples were ALI-cultured after cryostorage and all ciliated. The ciliary beat patterns of ex vivo samples (by high-speed video microscopy) were recapitulated, scanning electron microscopy demonstrated excellent ciliation, and cilia could be immuno-fluorescently labelled (anti-alpha-tubulin and anti-RSPH4a) in representative cases that were ALI-cultured after cryostorage. In summary, our ALI culture protocol provides high ciliation rates across three centres, minimising patient recall for repeat brushing biopsies and improving diagnostic certainty. Cryostorage of surplus diagnostic samples was successful, facilitating PCD research.
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Affiliation(s)
- Janice L. Coles
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (J.L.C.); (J.T.); (A.H.); (W.T.W.)
- School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton SO16 6YD, UK; (K.L.H.); (P.M.L.)
| | - James Thompson
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (J.L.C.); (J.T.); (A.H.); (W.T.W.)
- School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton SO16 6YD, UK; (K.L.H.); (P.M.L.)
| | - Katie L. Horton
- School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton SO16 6YD, UK; (K.L.H.); (P.M.L.)
| | - Robert A. Hirst
- Centre for PCD Diagnosis and Research, Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, UK; (R.A.H.); (G.M.W.); (C.O.)
| | - Paul Griffin
- Paediatric Respiratory department, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London SW3 6NP, UK; (P.G.); (C.H.)
| | - Gwyneth M. Williams
- Centre for PCD Diagnosis and Research, Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, UK; (R.A.H.); (G.M.W.); (C.O.)
| | - Patricia Goggin
- Biomedical Imaging Unit, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (P.G.); (R.D.)
| | - Regan Doherty
- Biomedical Imaging Unit, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (P.G.); (R.D.)
| | - Peter M. Lackie
- School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton SO16 6YD, UK; (K.L.H.); (P.M.L.)
- Biomedical Imaging Unit, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (P.G.); (R.D.)
| | - Amanda Harris
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (J.L.C.); (J.T.); (A.H.); (W.T.W.)
- School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton SO16 6YD, UK; (K.L.H.); (P.M.L.)
| | - Woolf T. Walker
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (J.L.C.); (J.T.); (A.H.); (W.T.W.)
| | - Christopher O’Callaghan
- Centre for PCD Diagnosis and Research, Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, UK; (R.A.H.); (G.M.W.); (C.O.)
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Claire Hogg
- Paediatric Respiratory department, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London SW3 6NP, UK; (P.G.); (C.H.)
| | - Jane S. Lucas
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (J.L.C.); (J.T.); (A.H.); (W.T.W.)
- School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton SO16 6YD, UK; (K.L.H.); (P.M.L.)
| | - Cornelia Blume
- School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton SO16 6YD, UK; (K.L.H.); (P.M.L.)
| | - Claire L. Jackson
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (J.L.C.); (J.T.); (A.H.); (W.T.W.)
- School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton SO16 6YD, UK; (K.L.H.); (P.M.L.)
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Kempeneers C, Seaton C, Garcia Espinosa B, Chilvers MA. Ciliary functional analysis: Beating a path towards standardization. Pediatr Pulmonol 2019; 54:1627-1638. [PMID: 31313529 DOI: 10.1002/ppul.24439] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/30/2019] [Accepted: 06/17/2019] [Indexed: 12/24/2022]
Abstract
Primary ciliary dyskinesia is an inherited disorder in which respiratory cilia are stationary, or beat in a slow or dyskinetic manner, leading to impaired mucociliary clearance and significant sinopulmonary disease. One diagnostic test is ciliary functional analysis using digital high-speed video microscopy (DHSV), which allows real-time analysis of complete ciliary function, comprising ciliary beat frequency (CBF) and ciliary beat pattern (CBP). However, DHSV lacks standardization. In this paper, the current knowledge of DHSV ciliary functional analysis is presented, and recommendations given for a standardized protocol for ciliary sample collection and processing. A proposal is presented for a quantitative and qualitative CBP evaluation system, to be used to develop international consensus agreement, and future DHSV research areas are identified.
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Affiliation(s)
- Céline Kempeneers
- Division of Respirology, Department of Pediatrics, University Hospital Liège, Liège, Belgium
| | - Claire Seaton
- Division of Respirology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Bernardo Garcia Espinosa
- Division of Respirology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Mark A Chilvers
- Division of Respirology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
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Nenna R, Hunt KA, Dassios T, Collins JJ, Rottier RJ, Liu NM, Rottier B, Goutaki M, Karadag B, Prayle A, Fernandes RM, Parisi G, Barben J, Rubbo B, Snijders D, Makrinioti H, Hall G, Pijnenburg MW, Grigg J. Key paediatric messages from the 2018 European Respiratory Society International Congress. ERJ Open Res 2019; 5:00241-2018. [PMID: 31044141 PMCID: PMC6487274 DOI: 10.1183/23120541.00241-2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/23/2019] [Indexed: 11/29/2022] Open
Abstract
In this article, the Group Chairs and early career members of the European Respiratory Society (ERS) Paediatric Assembly highlight some of the most interesting findings in the field of paediatrics which were presented at the 2018 international ERS Congress.
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Affiliation(s)
- Raffaella Nenna
- Dept of Paediatrics, Sapienza University of Rome, Rome, Italy
- Asthma and Airway Disease Research Center, The University of Arizona, Tucson, AZ, USA
| | - Katie A. Hunt
- Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Theodore Dassios
- Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Jennifer J.P. Collins
- Dept of Paediatric Surgery, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Robbert J. Rottier
- Dept of Paediatric Surgery, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Norrice M. Liu
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University London, London, UK
| | - Bart Rottier
- Beatrix Children's Hospital, University Medical Centre Groningen, Groningen, The Netherlands
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Bülent Karadag
- Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Andrew Prayle
- Child Health, Obstetrics and Gynaecology, The University of Nottingham, Nottingham, UK
| | - Ricardo M. Fernandes
- Dept of Pediatrics, Santa Maria Hospital, Lisbon, Portugal
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | | | - Jürg Barben
- Division of Paediatric Pulmonology, Children's Hospitals of Eastern Switzerland, St. Gallen, Switzerland
| | - Bruna Rubbo
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- University of Southampton, Faculty of Medicine, Academic Unit of Clinical and Experimental Science, Southampton, UK
| | - Deborah Snijders
- Dept of Women's and Children Health, University of Padova, Padova, Italy
| | | | - Graham Hall
- Telethon Kids Institute and Curtin University, Perth, Australia
| | - Mariëlle W. Pijnenburg
- Dept of Paediatrics, Division of Paediatric Pulmonology and Allergology, Erasmus MC-Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Jonathan Grigg
- Centre for Paediatrics, Queen Mary University London, London, UK
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Accuracy of High-Speed Video Analysis to Diagnose Primary Ciliary Dyskinesia. Chest 2019; 155:1008-1017. [PMID: 30826306 DOI: 10.1016/j.chest.2019.01.036] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 01/08/2019] [Accepted: 01/29/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Diagnosis of primary ciliary dyskinesia (PCD) relies on a combination of tests. High-speed video microscopy analysis (HSVA) is widely used to contribute to the diagnosis. It can be analyzed on the day of diagnostic consultation, but the qualitative analyses are subjective. Diagnostic accuracy and reliability of assessing ciliary function have not been robustly evaluated. We aimed to establish the accuracy of HSVA to diagnose PCD compared with a combination of tests, and to assess the interobserver reliability of HSVA analysis. METHODS We randomly selected and anonymized archived videos from 120 patients seen at three UK PCD centers. Three experienced scientists independently reviewed six videos per patient, using a standardized proforma, blinded to diagnostic and clinical data. We compared study outcomes with two references: (1) a combination of diagnostic tests in accordance with the European Respiratory Society PCD diagnostic guidelines and (2) original clinical outcome determined by all available diagnostic tests. RESULTS HSVA had excellent sensitivity and specificity to diagnose PCD: (1) 100% and 96%, respectively, compared with ERS guidelines, and (2) 96% and 91% compared with diagnostic outcomes. There was high interobserver agreement for "PCD-positive" outcomes (κ = 0.7). CONCLUSIONS Specialist scientists accurately diagnosed PCD using HSVA, with high interobserver agreement. HSVA can be reliably used to counsel patients and commence treatment on the day of testing while awaiting confirmatory investigations.
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