An international collaborative initiative to screen primary ciliary dyskinesia with high-speed video microscopy and nasal nitric oxide at a tertiary referral centre in South India
An international collaborative initiative to screen primary ciliary dyskinesia with high-speed video microscopy and nasal nitric oxide at a tertiary referral centre in South India
Background and Objective: To screen patients with suspected primary ciliary dyskinesia (PCD) using high-speed video microscopy analysis (HSVA) and/or nasal nitric oxide (nNO) through an international collaborative initiative between GKNM Hospital, Coimbatore, India, and the PCD Centre, University Hospital Southampton, UK. Methods: Children and adults up to 30 years of age with clinical features suggestive of PCD were recruited. HSVA was performed on nasal brushing biopsies for all participants. Nasal NO was measured, when feasible, in patients aged ≥5 years using a portable electrochemical NIOX VERO® device. Online multidisciplinary team meetings involving both centres reviewed and interpreted the results. Patients who tested positive on at least one of the two screening tests were classified as PCD screen-positive. Due to resource constraints, only a subset of screen-positive patients underwent genetic testing. Results: Among the 113 patients screened, 68 (60.1%) were PCD screen-positive. Next-generation sequencing was performed in 26 of these 68 patients, and PCD was genetically confirmed in 14 cases. The median age at diagnosis was 8.5 years. Conclusion: In resource-limited settings, diagnosis of PCD is often delayed. A combined screening strategy using HSVA and nasal NO testing can help identify likely PCD cases and facilitate early intervention. HSVA and nNO testing were found to be complementary in the screening of PCD. Genetic testing was used in a subset of patients to confirm diagnosis and was conclusive in 54% of tested.
High-speed video microscopy, nasal nitric oxide, primary ciliary dyskinesia
116-122
Benjamin, Antony Terance
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Ganesh, Ram
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Muthuswamy, Kalyanasundaram
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Raju, Vijayakumar
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Subramanium, Madhumitha
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Madhumitha, K
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Jackson, Claire
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Coles, Janice
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Iyer, Sharada
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D’souza, Jacinta
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Lucas, Jane
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21 February 2026
Benjamin, Antony Terance
e1aafc54-3cb3-4dbe-aebd-c34dc4134ecc
Ganesh, Ram
3f3cddc1-0fa2-4bb8-84a1-84f3d7901f19
Muthuswamy, Kalyanasundaram
6fd7af14-7853-4429-bd5e-ff3017efa4c7
Raju, Vijayakumar
514d74a3-1452-430a-a13e-9db2df312c94
Subramanium, Madhumitha
93d07fd4-424d-4341-9877-f8559204516c
Madhumitha, K
a423a919-0b13-4527-9964-5e2107d685d2
Jackson, Claire
64cdd6fa-74c3-4ac6-94ef-070620a6efd9
Coles, Janice
fb9d20aa-93b9-42b3-9b9e-bab2f565ea60
Iyer, Sharada
d3125ab3-c911-42d8-8d18-17bff982b564
D’souza, Jacinta
f948d546-1c0d-4510-925a-ef7b9c71a071
Lucas, Jane
5cb3546c-87b2-4e59-af48-402076e25313
Benjamin, Antony Terance, Ganesh, Ram, Muthuswamy, Kalyanasundaram, Raju, Vijayakumar, Subramanium, Madhumitha, Madhumitha, K, Jackson, Claire, Coles, Janice, Iyer, Sharada, D’souza, Jacinta and Lucas, Jane
(2026)
An international collaborative initiative to screen primary ciliary dyskinesia with high-speed video microscopy and nasal nitric oxide at a tertiary referral centre in South India.
Lung India, 43 (2), .
(doi:10.4103/lungindia.lungindia_417_25).
Abstract
Background and Objective: To screen patients with suspected primary ciliary dyskinesia (PCD) using high-speed video microscopy analysis (HSVA) and/or nasal nitric oxide (nNO) through an international collaborative initiative between GKNM Hospital, Coimbatore, India, and the PCD Centre, University Hospital Southampton, UK. Methods: Children and adults up to 30 years of age with clinical features suggestive of PCD were recruited. HSVA was performed on nasal brushing biopsies for all participants. Nasal NO was measured, when feasible, in patients aged ≥5 years using a portable electrochemical NIOX VERO® device. Online multidisciplinary team meetings involving both centres reviewed and interpreted the results. Patients who tested positive on at least one of the two screening tests were classified as PCD screen-positive. Due to resource constraints, only a subset of screen-positive patients underwent genetic testing. Results: Among the 113 patients screened, 68 (60.1%) were PCD screen-positive. Next-generation sequencing was performed in 26 of these 68 patients, and PCD was genetically confirmed in 14 cases. The median age at diagnosis was 8.5 years. Conclusion: In resource-limited settings, diagnosis of PCD is often delayed. A combined screening strategy using HSVA and nasal NO testing can help identify likely PCD cases and facilitate early intervention. HSVA and nNO testing were found to be complementary in the screening of PCD. Genetic testing was used in a subset of patients to confirm diagnosis and was conclusive in 54% of tested.
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Accepted/In Press date: 11 July 2025
Published date: 21 February 2026
Additional Information:
Copyright © 2026 Indian Chest Society.
Keywords:
High-speed video microscopy, nasal nitric oxide, primary ciliary dyskinesia
Identifiers
Local EPrints ID: 511581
URI: http://eprints.soton.ac.uk/id/eprint/511581
ISSN: 0970-2113
PURE UUID: 87935d36-2a3e-4534-88b8-bc06ca25d181
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Date deposited: 21 May 2026 16:42
Last modified: 22 May 2026 01:41
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Contributors
Author:
Antony Terance Benjamin
Author:
Ram Ganesh
Author:
Kalyanasundaram Muthuswamy
Author:
Vijayakumar Raju
Author:
Madhumitha Subramanium
Author:
K Madhumitha
Author:
Claire Jackson
Author:
Janice Coles
Author:
Sharada Iyer
Author:
Jacinta D’souza
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