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ResearchIn-Press PreviewCell biologyPulmonology Open Access | 10.1172/JCI193367

Loss of RPGR disrupts motile cilia and causes primary ciliary dyskinesia by affecting F-actin dynamics

Yang Wu,1 Erika Tavares,2 Binrun Liang,1 Wallace B Wee,3 Vito Mennella,4 Han-Chao Feng,1 Jiaying Cao,1 Pui Yee Wong,1 Jiayi Zheng,5 Mu He,5 Kirk AJ Stephenson,6 Liran Hanan Hochma,6 Janice Min Li,2 Nan-Peng Chen,7 Sharon D Dell,3 Elise Heon,2 and ZHEN LIU1

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Wu, Y. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Tavares, E. in: PubMed | Google Scholar |

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Liang, B. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Wee, W. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Mennella, V. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Feng, H. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Cao, J. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Wong, P. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Zheng, J. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by He, M. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Stephenson, K. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Hanan Hochma, L. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Li, J. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Chen, N. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Dell, S. in: PubMed | Google Scholar

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by Heon, E. in: PubMed | Google Scholar |

1Department of Life Science, The Hong Kong University of Science and Technology, Sai Kung, Hong Kong

2Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada

3Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

4Department of Biochemistry, Queen Mary University of London, London, United Kingdom

5School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong

6Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada

7Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen, China

Find articles by LIU, Z. in: PubMed | Google Scholar

Published March 31, 2026 - More info

J Clin Invest. https://doi.org/10.1172/JCI193367.
Copyright © 2026, Wu et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published March 31, 2026 - Version history
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Abstract

Cilia are cellular organelles extruding from the surface of various cell types, serving either sensory or motile functions. Retinitis pigmentosa GTPase regulator (RPGR) variants affect both photoreceptor sensory cilia and airway motile cilia, leading to retinitis pigmentosa (RP) and primary ciliary dyskinesia (PCD), respectively. Not all patients develop PCD, and it remains unclear which RPGR variants predispose patients to PCD. Here, we leverage 2D organoids, super-resolution microscopy, and live-cell imaging to characterize the multiciliated cells (MCCs) from patients with different RPGR variants and CRISPR-modified RPGR KO MCCs. We demonstrate that MCCs with RPGR variants have reduced ciliation, shorter cilia, impaired cilia beat, or cilia beat incoordination, potentially resulting in compromised mucociliary clearance and lung diseases. Moreover, we show that RPGR regulates motile cilia through interfering with F-actin dynamics, evidenced by the undissolved F-actin meshwork in RPGR-deficient MCCs, and the defects can be ameliorated with either Latrunculin A or Y27632 treatment. Though PCD was observed only in patients with variants that affect both isoforms, patients with RPGRORF15 variants also showed cilia and airway anomalies. All RPGR variants affect motile cilia one way or another, and the mechanisms involve the accumulation of apical F-actin.

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