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Diagnosis of primary ciliary dyskinesia.

Olm MA, Caldini EG, Mauad T - J Bras Pneumol (2015 May-Jun)

Bottom Line: It results in mucus accumulation and bacterial colonization of the respiratory tract which leads to chronic upper and lower airway infections, organ laterality defects, and fertility problems.We review the respiratory signs and symptoms of PCD, as well as the screening tests for and diagnostic investigation of the disease, together with details related to ciliary function, ciliary ultrastructure, and genetic studies.In addition, we describe the difficulties in diagnosing PCD by means of transmission electron microscopy, as well as describing patient follow-up procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil.

ABSTRACT
Primary ciliary dyskinesia (PCD) is a genetic disorder of ciliary structure or function. It results in mucus accumulation and bacterial colonization of the respiratory tract which leads to chronic upper and lower airway infections, organ laterality defects, and fertility problems. We review the respiratory signs and symptoms of PCD, as well as the screening tests for and diagnostic investigation of the disease, together with details related to ciliary function, ciliary ultrastructure, and genetic studies. In addition, we describe the difficulties in diagnosing PCD by means of transmission electron microscopy, as well as describing patient follow-up procedures.

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Schematic illustration and electron micrograph of a normal airway cilium. In A, schematic illustration of an axial section of a normal cilium in a ciliated airway epithelial cell, in which the peripheral microtubular doublets (comprising the A and B tubules) are numbered from 1 to 9; the central microtubules are designated C1 and C2. The A tubule contains the outer and inner dynein arms, which interact dynamically with the B tubule of the adjacent microtubule and produce the sliding of the peripheral microtubular doublets relative to one another. The illustration also shows nexin links, which connect the microtubular doublets (thus preventing structural disarray during their sliding motion), and radial spokes, which extend from the periphery to the center of the ciliary axis. In B, electron micrograph (original magnification, ×50,000) showing the ultrastructural appearance of an axial section of a normal airway cilium. Source: Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil, 2010.
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f01: Schematic illustration and electron micrograph of a normal airway cilium. In A, schematic illustration of an axial section of a normal cilium in a ciliated airway epithelial cell, in which the peripheral microtubular doublets (comprising the A and B tubules) are numbered from 1 to 9; the central microtubules are designated C1 and C2. The A tubule contains the outer and inner dynein arms, which interact dynamically with the B tubule of the adjacent microtubule and produce the sliding of the peripheral microtubular doublets relative to one another. The illustration also shows nexin links, which connect the microtubular doublets (thus preventing structural disarray during their sliding motion), and radial spokes, which extend from the periphery to the center of the ciliary axis. In B, electron micrograph (original magnification, ×50,000) showing the ultrastructural appearance of an axial section of a normal airway cilium. Source: Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil, 2010.

Mentions: An axial view of a cilium (Figure 1) shows nine peripheral microtubule doublets. Each doublet consists of the A and B tubules. The uniform space between the microtubule doublets is maintained by nexin, which keeps the adjacent microtubules together. In addition, there are the outer and inner dynein arms throughout the A tubule, a central pair of isolated microtubules connected and surrounded by a discontinuous central sheath of protein, and radial spokes, which connect the central microtubules to the peripheral microtubules.


Diagnosis of primary ciliary dyskinesia.

Olm MA, Caldini EG, Mauad T - J Bras Pneumol (2015 May-Jun)

Schematic illustration and electron micrograph of a normal airway cilium. In A, schematic illustration of an axial section of a normal cilium in a ciliated airway epithelial cell, in which the peripheral microtubular doublets (comprising the A and B tubules) are numbered from 1 to 9; the central microtubules are designated C1 and C2. The A tubule contains the outer and inner dynein arms, which interact dynamically with the B tubule of the adjacent microtubule and produce the sliding of the peripheral microtubular doublets relative to one another. The illustration also shows nexin links, which connect the microtubular doublets (thus preventing structural disarray during their sliding motion), and radial spokes, which extend from the periphery to the center of the ciliary axis. In B, electron micrograph (original magnification, ×50,000) showing the ultrastructural appearance of an axial section of a normal airway cilium. Source: Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil, 2010.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541762&req=5

f01: Schematic illustration and electron micrograph of a normal airway cilium. In A, schematic illustration of an axial section of a normal cilium in a ciliated airway epithelial cell, in which the peripheral microtubular doublets (comprising the A and B tubules) are numbered from 1 to 9; the central microtubules are designated C1 and C2. The A tubule contains the outer and inner dynein arms, which interact dynamically with the B tubule of the adjacent microtubule and produce the sliding of the peripheral microtubular doublets relative to one another. The illustration also shows nexin links, which connect the microtubular doublets (thus preventing structural disarray during their sliding motion), and radial spokes, which extend from the periphery to the center of the ciliary axis. In B, electron micrograph (original magnification, ×50,000) showing the ultrastructural appearance of an axial section of a normal airway cilium. Source: Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil, 2010.
Mentions: An axial view of a cilium (Figure 1) shows nine peripheral microtubule doublets. Each doublet consists of the A and B tubules. The uniform space between the microtubule doublets is maintained by nexin, which keeps the adjacent microtubules together. In addition, there are the outer and inner dynein arms throughout the A tubule, a central pair of isolated microtubules connected and surrounded by a discontinuous central sheath of protein, and radial spokes, which connect the central microtubules to the peripheral microtubules.

Bottom Line: It results in mucus accumulation and bacterial colonization of the respiratory tract which leads to chronic upper and lower airway infections, organ laterality defects, and fertility problems.We review the respiratory signs and symptoms of PCD, as well as the screening tests for and diagnostic investigation of the disease, together with details related to ciliary function, ciliary ultrastructure, and genetic studies.In addition, we describe the difficulties in diagnosing PCD by means of transmission electron microscopy, as well as describing patient follow-up procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil.

ABSTRACT
Primary ciliary dyskinesia (PCD) is a genetic disorder of ciliary structure or function. It results in mucus accumulation and bacterial colonization of the respiratory tract which leads to chronic upper and lower airway infections, organ laterality defects, and fertility problems. We review the respiratory signs and symptoms of PCD, as well as the screening tests for and diagnostic investigation of the disease, together with details related to ciliary function, ciliary ultrastructure, and genetic studies. In addition, we describe the difficulties in diagnosing PCD by means of transmission electron microscopy, as well as describing patient follow-up procedures.

Show MeSH
Related in: MedlinePlus