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



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.


Whole blood of 61 children with DS and 57 of their healthy siblings was stimulated with 2.5 × 104 TCID50/ml influenza A virus during 6, 24, and 48 h. TNF-α, IL-1β, IL-6, IL-8, IL-10, IL-12p70, IFN-α, IFN-γ concentrations, and viral load were measured at all time points.


At most of the time points, TNF-α, IL-1β, IL-6, and IL-8 concentrations were significantly higher in children with DS following stimulation with live influenza A virus. IFN-α and IFN-γ levels were also significantly higher in the DS group. Viral clearance, however, was equal in both groups.


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.

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Fig. 1
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Down syndrome


Respiratory tract infection


Respiratory syncytial virus

TCID50 :

Median tissue culture infective dose


Phosphate-buffered saline


Standard error of the mean


Toll-like receptor


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The authors thank Jacqueline Cloos, Petra van den Pangaart, and Eva Brandse for their excellent advice and technical support.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Corresponding author

Correspondence to Chantal J. M. Broers.

Additional information

The study has been approved by the appropriate ethics committee and have been performed in accordance with the 1964 Declaration of Helsinki and its later amendments.

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Broers, C.J.M., Gemke, R.J.B.J., Weijerman, M.E. et al. Increased Pro-inflammatory Cytokine Production in Down syndrome Children Upon Stimulation with Live Influenza A Virus. J Clin Immunol 32, 323–329 (2012).

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  • Down syndrome
  • children
  • cytokines
  • influenza A virus
  • viral infection