Nasal nitric oxide measurements for the screening of primary ciliary dyskinesia

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Abstract
Primary ciliary dyskinesia (PCD) presents to general practitioners with symptoms pertinent to a variety of specialists because of the involvement of ciliated epithelium in the upper/lower respiratory tract, ears, eyes and genital tract. There is no easy, reliable screening test for PCD, and thus, the majority of patients remain undiagnosed. Nitric oxide (NO) is measurable in nasal air of normal subjects and found to be low in cystic fibrosis (CF) and very low in PCD. Recently, it was suggested to play an important role in regulating ciliary motility. The aim of this study was to evaluate whether measurements of nasal NO could be used to screen for PCD.Nasal NO was measured from the nasal cavity by a chemiluminescence analyser in subjects with PCD, healthy controls, CF, idiopathic bronchiectasis, Young's syndrome and lone sinusitis.Nasal NO was significantly lower in PCD (64.0±36.6) compared with normal controls (759±145.8), idiopathic bronchiectasis (734±163.7), CF (447.5±162.6), lone sinusitis (1487±734) and Young's syndrome (644±129.9). Nasal NO was also significantly lower in PCD than CF patients.Measurement of nasal nitric oxide may therefore be used clinically in various specialities to screen suspected patients for primary ciliary dyskinesia.