Praveen Kavita, Davis Erica E, Katsanis Nicholas
Center for Human Disease Modeling, Duke University Medical Center Durham, NC 27701 USA.
F1000Prime Rep. 2015 Mar 10;7:36. doi: 10.12703/P7-36. eCollection 2015.
Primary ciliary dyskinesia (PCD) is a ciliopathy, but represents the sole entity from this class of disorders that results from the dysfunction of motile cilia. Characterized by respiratory problems appearing in childhood, infertility, and situs defects in ~50% of individuals, PCD has an estimated prevalence of approximately 1 in 10,000 live births. The diagnosis of PCD can be prolonged due to a lack of disease awareness, coupled with the fact that symptoms can be confused with other more common genetic disorders, such as cystic fibrosis, or environmental insults that result in frequent respiratory infections. A primarily autosomal recessive disorder, PCD is genetically heterogeneous with >30 causal genes identified, posing significant challenges to genetic diagnosis. Here, we provide an overview of PCD as a disorder underscored by impaired ciliary motility; we discuss the recent advances towards uncovering the genetic basis of PCD; we discuss the molecular knowledge gained from PCD gene discovery, which has improved our understanding of motile ciliary assembly; and we speculate on how accelerated diagnosis, together with detailed phenotypic data, will shape the genetic and functional architecture of this disorder.
原发性纤毛运动障碍(PCD)是一种纤毛病,但却是这类疾病中唯一由运动性纤毛功能障碍导致的病症。PCD的特征包括儿童期出现的呼吸问题、不孕不育,约50%的患者存在内脏反位缺陷,据估计其在活产婴儿中的患病率约为万分之一。由于对该疾病认识不足,加上其症状可能与其他更常见的遗传疾病(如囊性纤维化)或导致频繁呼吸道感染的环境因素相混淆,PCD的诊断可能会被延迟。PCD主要是一种常染色体隐性疾病,其遗传具有异质性,已确定有30多个致病基因,这给基因诊断带来了重大挑战。在此,我们概述了作为一种由纤毛运动受损所突显的疾病的PCD;我们讨论了在揭示PCD遗传基础方面的最新进展;我们讨论了从PCD基因发现中获得的分子知识,这增进了我们对运动性纤毛组装的理解;并且我们推测加速诊断以及详细的表型数据将如何塑造这种疾病的遗传和功能结构。