Increased Pro-inflammatory Cytokine Production in Down syndrome Children Upon Stimulation with Live Influenza A Virus

Purpose Children with down syndrome (DS) have an increased susceptibility to infections, due to altered humoral and/or cellular immunity. The aim of this study was to determine the cytokine production in whole blood of children with DS upon stimulation with live influenza A virus. Methods Whole blood of 61 children with DS and 57 of their healthy siblings was stimulated with 2.5x10(4) TCID50/ml influenza A virus during 6, 24, and 48 h. TNF-alpha, IL-1 beta, IL-6, IL-8, IL-10, IL-12p70, IFN-alpha, IFN-gamma concentrations, and viral load were measured at all time points. Results At most of the time points, TNF-alpha, IL-1 beta, IL-6, and IL-8 concentrations were significantly higher in children with DS following stimulation with live influenza A virus. IFN-alpha and IFN-gamma levels were also significantly higher in the DS group. Viral clearance, however, was equal in both groups. Conclusions Children with DS have an altered immune response to influenza A virus. The production of higher levels of pro-inflammatory cytokines may be responsible for a more severe clinical course of viral disease in these children.