scholarly journals Nasal nitric oxide screening for primary ciliary dyskinesia: systematic review and meta-analysis

2014 ◽  
Vol 44 (6) ◽  
pp. 1589-1599 ◽  
Author(s):  
Samuel A. Collins ◽  
Kerry Gove ◽  
Woolf Walker ◽  
Jane S.A. Lucas
Keyword(s):  
Nitric Oxide ◽  
Systematic Review ◽  
Primary Ciliary Dyskinesia ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Breath Hold ◽  
Healthy Controls ◽  
Tidal Breathing ◽  
Nasal Nitric Oxide ◽  
Ciliary Dyskinesia

Nasal nitric oxide (nNO) concentrations are low in patients with primary ciliary dyskinesia (PCD) providing a noninvasive screening test.We conducted a systematic review of the literature to examine the utility of nNO in screening for PCD, in particular 1) different respiratory manoeuvres during sampling (velum closure, tidal breathing, etc.), 2) accuracy in screening young/uncooperative children, 3) stationary versus portable analysers, and 4) nNO in “atypical” PCD.96 papers were assessed according to modified PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria and 22 were included in this review.Meta-analysis of 11 studies comparing nNO during a velum closure breath hold gave a mean±sd nNO of 19.4±18.6 nL·min-1 in PCD (n = 478) and 265.0±118.9 nL·min-1 in healthy controls (n = 338). Weighted mean difference for PCD versus healthy controls was 231.1 nL·min-1 (95% CI 193.3–268.9; n = 338) and 114.1 nL·min-1 (95% CI 101.5–126.8; n = 415) for PCD versus cystic fibrosis. Five studies of nNO measurement during tidal breathing demonstrated that this is an acceptable manoeuvre in young children where velum closure is not possible, but the discriminatory value was reduced. Four small studies of portable NO analysers suggest these are reliable tools for screening for PCD. However, nNO must be interpreted alongside clinical suspicion. Future studies should focus on standardising sampling techniques and reporting.

scholarly journals How to use nasal nitric oxide in a child with suspected primary ciliary dyskinesia

2017 ◽  
Vol 102 (6) ◽  
pp. 314-318 ◽  
Author(s):  
Kim Simpson ◽  
Malcolm Brodlie
Keyword(s):  
Nitric Oxide ◽  
Primary Ciliary Dyskinesia ◽  
Clinical Utility ◽  
Diagnostic Testing ◽  
Older Children ◽  
Tidal Breathing ◽  
Closure Technique ◽  
Nasal Nitric Oxide ◽  
Ciliary Function ◽  
Ciliary Dyskinesia

Measuring nasal nitric oxide (nNO) is increasingly used as part of testing for primary ciliary dyskinesia (PCD). The diagnosis of PCD is often delayed until after bronchiectasis is established and auditory damage has occurred. It is important that all paediatricians are aware of clinical features that are suggestive of PCD that should prompt diagnostic testing. nNO levels are recognised to be low in people with PCD and results generated by static chemiluminescence analysers using velum closure technique in older children have good sensitivity and specificity. However, to conclusively rule PCD in or out, further tests of ciliary function are required and assessment of cilia ultrastructure, immunohistochemistry studies and genotyping may also be indicated. These tests are more complex, invasive and expensive than nNO. nNO is less well studied in younger children where tidal breathing measurements are required. Portable nitric oxide analysers are also increasingly used in practice. This paper discusses when to consider PCD as a possible diagnosis in a child along with the indications, physiological and technical background and clinical utility of nNO as a test for PCD in children.

Use caution interpreting nasal nitric oxide: Overlap in primary ciliary dyskinesia and primary immunodeficiency

2021 ◽  
Author(s):  
Andrew T. Barber ◽  
Stephanie D. Davis ◽  
Hannah Boutros ◽  
Maimoona Zariwala ◽  
Michael R. Knowles ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Primary Immunodeficiency ◽  
Primary Ciliary Dyskinesia ◽  
Nasal Nitric Oxide ◽  
Ciliary Dyskinesia

scholarly journals Nasal nitric oxide and nitric oxide synthase expression in primary ciliary dyskinesia

2011 ◽  
Vol 37 (3) ◽  
pp. 572-577 ◽  
Author(s):  
M. Pifferi ◽  
A. Bush ◽  
F. Maggi ◽  
A. Michelucci ◽  
V. Ricci ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Nitric Oxide Synthase ◽  
Primary Ciliary Dyskinesia ◽  
Nasal Nitric Oxide ◽  
Oxide Synthase ◽  
Ciliary Dyskinesia
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