Wee Wallace B, Gatt Dvir, Seidl Elias, Santyr Giles, To Teresa, Dell Sharon D
Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.
ERJ Open Res. 2024 Aug 5;10(4). doi: 10.1183/23120541.00989-2023. eCollection 2024 Jul.
Primary ciliary dyskinesia (PCD) is a rare multisystem genetic disease caused by dysfunctional motile cilia. Despite PCD being the second most common inherited airway disease after cystic fibrosis, PCD continues to be under-recognised globally owing to nonspecific clinical features and the lack of a gold standard diagnostic test. Commonly repeated prevalence estimates range from one in 10 000 to one in 20 000, based on regional epidemiological studies with known limitations. The purpose of this scoping review was to appraise the PCD literature, to determine the best available global PCD prevalence estimate and to inform the reader about the potential unmet health service needs in PCD. The primary objective of the present study was to systematically review the literature about PCD prevalence estimates.
A scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) methodology. Included studies estimated PCD prevalence and used cohort, clinical or genomic data. Case reports, conference abstracts, review articles, animal studies or non-English articles were excluded.
A literature review identified 3484 unique abstracts; 34 underwent full-text review and eight met the inclusion/exclusion criteria. Seven articles were based on epidemiological studies of specific geographical regions and provided prevalence estimates that ranged from approximately one to 44.1 in 100 000. Only one study estimated global prevalence, using two large genomic databases, and calculated it to be ∼13.2 in 100 000 (based on pathogenic variants in 29 disease-causing genes).
A population-based genomic approach for estimating global prevalence has found that PCD is much more prevalent than previously cited in the literature. This highlights the potential unmet health service needs of people living with PCD.
原发性纤毛运动障碍(PCD)是一种由运动性纤毛功能障碍引起的罕见多系统遗传病。尽管PCD是仅次于囊性纤维化的第二常见遗传性气道疾病,但由于临床特征不特异且缺乏金标准诊断测试,PCD在全球范围内仍未得到充分认识。基于存在已知局限性的区域流行病学研究,常见的患病率估计范围为万分之一至两万分之一。本范围综述的目的是评估PCD相关文献,确定全球最佳的PCD患病率估计值,并让读者了解PCD潜在未满足的医疗服务需求。本研究的主要目的是系统评价关于PCD患病率估计的文献。
按照系统评价和Meta分析扩展版的首选报告项目(PRISMA-ScR)方法进行范围综述。纳入的研究估计了PCD患病率,并使用了队列、临床或基因组数据。排除病例报告、会议摘要、综述文章、动物研究或非英文文章。
文献综述共识别出3484篇独特摘要;34篇进行了全文审查,8篇符合纳入/排除标准。7篇文章基于特定地理区域的流行病学研究,提供的患病率估计范围约为十万分之一至十万分之44.1。只有一项研究使用两个大型基因组数据库估计了全球患病率,计算得出约为十万分之13.2(基于29个致病基因中的致病变异)。
一种基于人群的基因组方法用于估计全球患病率,结果发现PCD的患病率比文献中先前引用的要高得多。这凸显了PCD患者潜在未满足的医疗服务需求。