TABLE 7

Overview of primary ciliary dyskinesia causing genes and their associated findings by transmission electron microscopy (TEM) and immunofluorescence analyses

Gene[Ref.]LocusTEMImmunofluorescence
DNAH5[65]5p15ODAAbsent DNAH5 and DNAH9 [67, 94, 95]
DNAH11[49]7p15–21NormalDNAH11 is absent in patients with DNAH11 loss-of function mutations, DNAH5 and DNALI1 present [96, 97]
DNAI1[66]9p21-p13ODADNAH5 staining may be present proximally but absent distally,
DNAH9 absent within the ciliary axonemes [67, 94]
DNAI2[67]17q25.1ODADNAH5, DNAI2 and DNAH9 absent or aberrant [67]
NME8 (TXNDC3)[68]7p14.1ODANot reported
DNAL1[69]14q24.3ODANot reported
CCDC151[70]19p13.2ODADNAH5, CDC151, CCDC114 and ARMC4 absent, DNALI1 present [70]
CCDC114[71]19q13.33ODACCDC114 severely reduced, DNAH5 absent, DNALI1 undisturbed [71]
ARMC4[72]10p21ODAReduced ARMC4 staining along cilia, complete distal loss of DNAH5, DNAH5 only on proximal ciliary end, DNALI1 present [72, 98]
CCDC103[73]17q12ODA+IDADNAH5, DNAH9 and DNALI1 are missing or reduced in a small number of patients [73]
DYX1C1 (DNAAF4)[74]15q21ODA+IDADNAH5, DNAH9 and DNAI2 absent [74]
SPAG1[75]8q22ODA+IDAAbsent DNAH5 and DNALI1 [75]
LRRC6[76]8q24ODA+IDALRRC6, DNALI1 and DNAI2 absent or very reduced [76, 82, 99]
DNAAF2 (KTU)[77]14q21.3ODA+IDADNAH5 and DNAI2 absent distally with some residual staining,
DNAH9 and DNALI1 absent [77]
DNAAF1 (LRRC50)[78, 79]16q24ODA+IDADNAH5, DNAH9 and DNALI1 absent [79]
C21orf59[80]21q22.1ODA+IDADNAH5 and DNALI1 absent [80]
DNAAF3[81]19q13ODA+IDADNAH5, DNAH9 and DNALI1 absent [81]
ZMYND10[82]3p21.3ODA+IDADNAH5, DNAI2 and DNALI1 absent [82, 100]
DNAAF5 (HEATR2)[83]7p22.3ODA+IDADNAI1, DNAH5 and DNALI1 absent, HEATR2 reduced [83, 101]
HYDIN[84]16q22Normal/subtle: increased frequency of transposition defectsNormal IDA (DNALI1) and ODA (DNAH5) [84]
RSPH1[32]21q22.3Intermittent central pair/transposition defectsRSPH1 and RSPH9 absent, RSPH4A present [32, 86, 102]
RSPH3[85]6q25.3Intermittent central pair/near absence of radial spokesRSPH3 and RSPH11 absent, RSPH1, RSPH4A and RSPH23 present (RSPH9 not reported), DNALI1 present [85]
RSPH9[86]6p21Intermittent central pair defect/transpositionAbsent RSPH9, RSPH1 and RSPH4A present [86]
RSPH4A[86]6q22Intermittent central pair defect/transpositionRSPH4A, RSPH9 and RSPH1 absent [86]
DRC1 (CCDC164)[87]2p23Normal/subtle: N-DRC links missing with occasional MT disorganisationGAS8 and LRRC48 absent from ciliary axonemes [87]
GAS8 (DRC4)[30]16q24.3Normal/subtly abnormal: increased frequency of MT misalignmentDNALI1 and DNAH5 present, GAS8 absent [30]
CCDC65 (DRC2)[88]12q13.12Normal/N-DRC links missing with occasional MT disorganisationCCDC65 and GAS8 reduced [88]
CCDC39[89]3q26MT disorganisation+IDAAbsent CCDC39 protein, ODA normal distribution (DNAH5, DNAI2, DNAH9), DNALI1 (IDA) absent, GAS8 in cytoplasm but absent from axoneme [89, 103]
CCDC40[90]17q25MT disorganisation+IDAAbsent CCDC39 protein, RSPH4A and ROPN1 L/RSP11 present in axonemes [90, 103]
RPGR#[91]Xp21.1VariableNormal, DNAH5 and DNALI1 present [104]
OFD1[92]Xp22UnknownNot reported
CCNO[64]5q11.2Reduction of cilia numberDNAH5 present, rootletin mislocated in deeper regions of cytoplasm, CCNO not detectable [64]
MCIDAS[93]5q11.2Reduction of cilia numberMCIDAS, CCNO, DNAH5, CCDC39 and CCDC78 absent [93]

ODA: outer dynein arm; IDA: inner dynein arm; N-DRC: nexin link-dynein regulatory complex; MT: microtubular. #: retinitis pigmentosa usually detected in adult patients; : rare syndromic phenotype.