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No immunological parameters identified for Down syndrome children

ERS 2021
It is known that children with Down syndrome suffer more from frequent infections than the general population. Parameters that are predictive of recurrent respiratory tract infections (RRTIs) can be helpful in guiding treatment. The current study aimed to identify blood parameters associated with RRTI, but failed in finding any.

Children with Down syndrome have an increased risk of infections and especially RRTIs due to predisposing factors, both anatomical and physiological ones. Immunological deviations have been described in literature before, including decreased white blood cell (WBC) count, decreased total lymphocyte count, and disturbances in levels of immunoglobulins (Igs). However, the clinical relevance of these aberrations has been unstudied. The aim of the presented study was to compare immunological parameters in Down syndrome children with and without RRTIs with the purpose of identifying values that are predictive for RRTIs in this patient population [1].

A prospective, cross-sectional study was conducted. Children with Down syndrome aged 0 to 18 years were included and stratified based on having RRTIs. Blood samples were collected annually from the cohort determining WBC count and differentiation, lymphocyte subsets, and IgA, IgG, and IgM levels. Additionally, data on infectious burden was collected from patient files.

In total, 69 Down syndrome children were included in the study: 27 with RRTI and 42 without RRTI. Age and gender were equally distributed. The mean age at sampling was 6.3 years. No statistically significant difference was found between the RRTI versus no RTTI group after correction for age. Differences, however not statistically significant, were found for WBC count (P=0.074), neutrophil count (P=0.051), and ratio CD4+/CD8+ cells (P=0.076). Logistic regression showed poor clinical value and poor predictors for RRTI. In the complete Down syndrome cohort, more children with lower total WBC, lymphocytes, Th cells, B cells, IgM, and higher IgG were identified.

No parameter that clearly correlates with RRTIs could be found. Therefore, the authors suspected the higher infectious burden found in Down syndrome children to be multifactorial in origin. Future studies should focus on larger study populations, and should include control groups. In addition, possible confounders should be minimalised, such as airway anomalies.

  1. De Lausnay M, et al. Immunological parameters in Down syndrome in children with and without recurrent lower respiratory tract infections. Abstract 3156. ERS 2021, 5–8 September.


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