Genetics of Primary Ciliary Dyskinesia

Completed

• Conditions: Kartagener Syndrome; Primary Ciliary Dyskinesia

• Registration Number: NCT02389049
• Lead Sponsor: University of North Carolina, Chapel Hill

Brief Summary

This study is designed to study DNA sequencings for mutations in a research genetic test panel of genes (which contains all 32 known and/or published genes associated with PCD). The study aims to show that about 70% of PCD patients have biallelic mutations in one of these genes. This project will enroll patients who have already had a clinical evaluation, and have clinical features consistent with PCD.

Detailed Description

The investigators have established a Consortium of 9 geographically-dispersed clinical research sites to study rare disease of the airways, including Primary Ciliary Dyskinesia (PCD). PCD is a genetic disorder with defective mucociliary clearance (MCC), sinus and pulmonary disease with chronic infection, and organs located on the wrong side of the body in about 50% of patients (Kartagener Syndrome). Lung disease occurs early in children with PCD, but establishing a diagnosis remains a major challenge, based on the traditional approaches of using electron microscopy and/or ciliary waveform analysis to define abnormalities of ciliary ultrastructure and/or function.

For this study, blood or buccal samples for DNA will be collected and genetic testing in patients with known or suspected PCD will be performed. This study can include term neonates with respiratory distress of unknown etiology and features of PCD, particular laterality defects (situs inversus or heterotaxy). The key hypothesis for this study is that a genetic test panel of 32 genes will confirm a diagnosis in most patients with PCD.

Study Timeline

• Study Start: 2015-02
• Study First Submitted: 2015-03-09
• Study First Submitted QC: 2015-03-13
• Study First Posted: 2015-03-17
• Primary Completion: 2018-07
• Study Completion: 2018-07
• Status Verified: 2022-08
• Last Update Submitted: 2022-08-09
• Last Update Posted: 2022-08-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 320

Inclusion Criteria

• Any patient who has ≥ 2 clinical features (+/- lab) characteristic of PCD, including:

  • Neonatal respiratory distress after term (or near-term) birth
  • and/or laterality defect ( situs inversus or heterotaxy)
  • and/or daily wet cough before 6 months of age
  • and/or middle ear disease
  • and/or chronic nasal congestion before 6 months of age
  • and/or bronchiectasis
  • and/or male infertility due to sperm tail dysfunction
  • and/or low nasal nitric oxide levels (<77 nanoliters/minute)
  • and/or defective ciliary ultrastructure

Exclusion Criteria

• Known diagnosis of cystic fibrosis with classic clinical presentation and elevated sweat chloride levels and/or two known disease-causing Cystic Fibrosis transmembrane conductance regulator (CFTR) mutations, or documented primary or acquired immunodeficiency.
• Known explanation for bronchiectasis (and other clinical features), such as α1-antitrypsin deficiency (ZZ or ZS), inflammatory bowel disease or rheumatoid arthritis.
• Any patient who is unwilling or unable to provide consent or to comply with the testing required in this protocol

A participant should not be in the study if they have not had a standard clinical evaluation to address other potential causes of chronic oto-sino- pulmonary disease.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Confirm PCD diagnosis in patients using a panel of 32 genes	Up to 5 years	The primary objective is to perform research genetic (Ampliseq panel) testing in patients who are known or suspected to have PCD, based on previous research or future clinical and lab characterization by certified clinical research sites. We will define the prevalence of biallelic PCD-causing mutations in patients who fulfill criteria of very high likelihood of PCD, as well as prevalence in other patients with some features of PCD. We anticipate successful completion of this objective will provide the foundation for development of clinically available genetic test panels, particularly as additional PCD genes are identified.

Secondary Outcome Measures

Name	Time	Method
Identify patients with PCD who do not have a biallelic PCD-causing mutation	Up to 5 years	The secondary objective is to perform research genetic testing to identify patients with PCD who do not have biallelic PCD-causing mutations in known PCD genes, so they can be exome sequenced to discover novel genes associated with PCD. We anticipate that successful completion of this objective will enable the development of more extensive genetic test panels that are more robust to diagnose PCD.

Trial Locations

Locations (8)

The Children's Hospital, Denver; 🇺🇸 Aurora, Colorado, United States

Washington University, St. Louis; 🇺🇸 Saint Louis, Missouri, United States

Riley Hospital for Children; 🇺🇸 Indianapolis, Indiana, United States

The University of North Carolina at Chapel Hill; 🇺🇸 Chapel Hill, North Carolina, United States

McGill University; 🇨🇦 Montreal, Quebec, Canada

Stanford University; 🇺🇸 Palo Alto, California, United States

Children's Hospital and Regional Medical Center, Seattle; 🇺🇸 Seattle, Washington, United States

The Hospital for Sick Children; 🇨🇦 Toronto, Ontario, Canada