Primary Ciliary Dyskinesia in Adult Bronchiectasis

April 27, 2026 updated by: Michael D. Davis, Indiana University

Novel Use of Combined High-Speed Video Microscopy and Nasal Nitric Oxide Screening for Identification of Primary Ciliary Dyskinesia in Adult Bronchiectasis

The purpose of this study is to help determine how often primary ciliary dyskinesia (PCD) is present but undiagnosed in adults with bronchiectasis.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Bronchiectasis is a chronic respiratory disease characterized by irreversible bronchial dilatation, impaired mucociliary clearance, and recurrent infection. Despite comprehensive evaluation, 40-80% of adults with non-cystic fibrosis (CF) bronchiectasis have no identifiable cause. This diagnostic absence limits opportunities for targeted therapy, individualized prognostication, and potential genetic counseling.

Primary ciliary dyskinesia (PCD) is an inherited disorder of motile cilia that leads to chronic otosinopulmonary disease. Nearly 100% of affected individuals develop bronchiectasis by adulthood (4). Diagnosis is complex with no 'gold standard' test and requires multiple specialized diagnostics-most available only at large referral centers. In current North American practice, evaluation of suspected PCD frequently begins with measurement of nasal nitric oxide (nNO), an accurate screening tool when performed correctly. However, testing errors occur due to discrepancies in technique, and false negatives are well-described in a growing list of PCD genotypes harboring preserved ciliary ultrastructure, as well as in select primary immunodeficiencies.

High-speed video microscopy analysis (HSVA) is a key PCD diagnostic tool that directly visualizes ciliary beating ex vivo, providing detailed assessment of ciliary beat frequency, waveform, and pattern. As a functional assay, HSVA has substantial diagnostic value in cases where PCD would otherwise remain unrecognized (e.g., patients with normal nNO, normal/nondiagnostic transmission electron microscopy (TEM), or incomplete genetic testing). When performed using standardized protocols and blinded review, multicenter studies demonstrate excellent diagnostic performance, with sensitivities and specificities of of 96-100% and 91-96% respectively. Air-liquid interface (ALI) culture further refines accuracy by differentiating inherent ciliary defects from secondary, inflammation-induced abnormalities.

Growing evidence suggests that PCD remains significantly underrecognized worldwide. Large-scale genomic analyses now estimate a global prevalence as high as 1 in 7,500-two to four times higher than previous estimates. These findings are amplified in adults with bronchiectasis: a recent genomic sequencing study of patients with idiopathic bronchiectasis revealed that more than 10% carried pathogenic variants in motile ciliopathy genes, yet the vast majority had never undergone targeted testing for PCD.

Collectively, these data indicate that a substantial proportion of adults with bronchiectasis may have undiagnosed PCD. Identifying this population has meaningful clinical implications. Confirmation of PCD enables precise airway clearance and infection-control strategies, recognition and treatment of potential cardiac and multi-organ manifestations, and appropriate genetic counseling. Moreover, as disease-modifying and gene-targeted therapies advance toward clinical use, timely and accurate diagnosis will be essential to ensuring equitable access to emerging treatments.

Hypothesis: Unrecognized PCD is prevalent within a significant and measurable proportion of adults with non-CF bronchiectasis. The combined use of upfront nNO and HSVA of ALI-cultured ciliated nasal epithelia represents a unique, highly sensitive, and potentially diagnostic method to help identify this patient population.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Lisa Bendy
  • Phone Number: (317) 278-7152
  • Email: lbendy@iu.edu

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults (≥18) with CT-confirmed bronchiectasis

Exclusion Criteria:

  • Pre-existing diagnosis of cystic fibrosis
  • Pre-existing diagnosis of primary ciliary dyskinesia
  • Inability to perform testing
  • Refusal of consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Bronchiectasis
patients with a known or new diagnosis of bronchiectasis
Procedure: Nasal Nitric Oxide Measurement
Subjects will have their nasal nitric oxide measured using commercially available chemiluminescence analyzer in accordance with American Thoracic Society/European Respiratory Society guidelines
Procedure: Nasopharyngeal (Nasal) Samples
Human nasal epithelial cells will be collected via nasal swab, nasal curettage or nasal brush from each nostril.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of participants with a screen positive result
Time Frame: From Baseline through study completion, approximately two years.
Percentage of participants with a screen positive result. This will be defined as abnormal nNO and/or abnormal HSVA and confirmatory genetic testing or TEM findings of classic pathogenic variants.
From Baseline through study completion, approximately two years.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Indiana University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

May 1, 2026

Primary Completion (Estimated)

January 31, 2028

Study Completion (Estimated)

January 31, 2028

Study Registration Dates

First Submitted

April 20, 2026

First Submitted That Met QC Criteria

April 27, 2026

First Posted (Actual)

May 5, 2026

Study Record Updates

Last Update Posted (Actual)

May 5, 2026

Last Update Submitted That Met QC Criteria

April 27, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 29887

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

No IPD will be shared

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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