A NEW study published revealed a strong association between primary ciliary dyskinesia (PCD) and asthma in children, suggesting that asthma should be routinely considered a comorbidity in patients with PCD. PCD, a genetic disorder affecting motile cilia, is more prevalent than previously thought, occurring in approximately 1 in 7,600 individuals.
Researchers analysed electronic health records (EHRs) from two large databases: the Indiana Network for Patient Care Research (INPCR) and TriNetX, focusing on cases of PCD indicated by the co-occurrence of bronchiectasis and situs inversus totalis (B-SIT). The study included 266 children aged 18 years or younger, matched with controls for age, sex, ethnicity, and race.
The results were striking. In the INPCR cohort, all 9 children with B-SIT had asthma, compared with only 1 child in the control group. Similarly, in the TriNetX cohort of 115 B-SIT children, 84 had asthma, a significantly higher proportion than the 12 asthma cases among the matched controls. Overall, children with B-SIT had an adjusted odds ratio of 22.3 for asthma, indicating a highly significant association.
This connection between PCD and asthma aligns with prior studies and in vitro research suggesting that antigen stasis in PCD airways may promote asthma-like inflammation. The researchers also highlighted the potential overlap of symptoms, such as chronic rhinitis and allergic asthma, while noting that nasal nitric oxide levels—typically high in allergic asthma—are characteristically low in PCD.
The findings underscore the need for healthcare providers to evaluate children with PCD for asthma and to consider whether certain asthma cases might exhibit features of PCD. Further prospective studies using standardised airway reactivity testing are necessary to validate the results and deepen the understanding of the immunological mechanisms linking these conditions.
Aleksandra Zurowska, EMJ
Reference
Zein J et al. Asthma Among Children With Primary Ciliary Dyskinesia. JAMA Netw Open. 2024;7(12):e2449795.
