Observations on the levels of gamma G, gamma A, gamma M globulins, anti-A and anti-B agglutinins, and antibodies to Escherichia coli in Down's anomaly

Association of decreased T-cell-mediated natural cytotoxicity and interferon production in Down's syndrome

Total peripheral blood lymphocytes (PBL) and isolated subpopulations from children with Down's Syndrome (DS) and age-matched healthy controls were investigated for their (1) natural killer (NK) and antibody-dependent cellular cytotoxic activities, (2) interleukin 2 (IL-2)-induced augmentation of NK activity, (3) lectin-dependent cellular cytotoxicity (LDCC), (4) ability of serum- and culture-derived soluble suppressor factor(s) to inhibit NK activity of normal lymphocytes, and (5) capacity to produce interferon (IFN) against tumor targets in vitro. T lymphocytes from DS patients demonstrated significantly decreased NK activity against K562 target cells compared to controls. DS lymphocytes also demonstrated a significant reduction in LDCC activity and IL-2-induced enhancement of NK activity. Furthermore, the ability of DS lymphocytes to produce IFN in vitro against K562 target cells was also significantly lower than that for normal PBL. Although sera from DS patients showed a significantly greater inhibitory effect on the NK activity of allogeneic normal PBL than normal sera, culture supernates from DS lymphocytes demonstrated suppressive effects comparable to culture supernates from normal PBL. These studies suggest an association between the decreased NK activity of T-cell subpopulations and lower IFN production by PBL from patients with DS.

Antibody response to pneumococcal vaccine in patients with trisomy-21 (Down's syndrome)

The antibody response to pneumococcal vaccine was lower in adults with trisomy-21 (Down's syndrome) than in controls. Males gave lower response than females, significantly so among the 21-trisomic patients. The antibody response to different polysaccharides differed between the groups.

Decreased cord blood IgM and IgA in trisomy 21

Disagreement as to whether Ig levels are high, low, or normal at different ages in different groups of trisomic children has interfered with defining the associated immunodeficiency state. Fetal Ig production was assessed by measuring cord blood IgM and IgA of five trisomy 21, 97 normal, and 37 control newborns with other birth defects. Trisomic infants showed significantly lower values. Cord blood IgG values showed no differences between groups when corrected for fetal blood weight. The data indicate that children with trisomy 21 have an impaired humoral immune response to utero.

Clinical aspects of Down's syndrome from infancy to adult life

Clinical pictures of mongoloid persons are demonstrated during different phases of life, with particular reference to the later one. Psychological and intellectual problems, immunologic deficiencies, and early aging are discussed. Histopathologic changes in the thymus are demonstrated. Because of the early aging of mongoloids, we examined the blood serum triglycerides, the cholesterol, and the LDL- and HDL-cholesterol in Down's syndrome.

Immunodeficiency in Down's syndrome. Titres of "natural" antibodies to E. coli and rabbit erythrocytes at different ages

"Natural" antibody titres to E. coli O antigens of different serotypes and to rabbit red blood cells were determined in 86 subjects with Down's syndrome and 79 mentally retarded but chromosomally normal controls ranging in age from 10 months to 52 years. Subjects in the two groups were matched for sex, age and socio-environmental conditions. Titres of both antibodies, assessed by haemagglutination, were significantly lower in subjects with DS in the 1 to 5 year old group. E. coli antibodies transiently increased to normal values in subjects with DS during the second 5 years of life, thereafter rapidly declining to levels significantly lower than those observed in controls. The titres of antibodies to rabbit erythrocytes in subjects with Down's syndrome showed a more variable course transiently approaching normal values in the 7-10 year group and after 20 years of age. These data are interpreted as further evidence for the existence of a congenital immunodeficiency in Down's syndrome.

Serum antibody to poliovirus in patients in a mental deficiency hospital, with particular reference to Down's syndrome

Neutralization tests for poliovirus antibodies were carried out on 74 patients in an adult mental deficiency hospital: 37 patients with Down's syndrome and 37 non-Down's mental defectives. The distribution of antibody titres to poliovirus types 1, 2 and 3 did not differ significantly between the two groups. Most patients had antibody to at least one poliovirus type but less than a third had antibodies at a titre of 1/8 or greater to all three types. The low level of poliovirus immunity in this population may be of epidemiological importance.

X chromosome complement and serum levels of IgM in man and mouse

The levels of IgM were measured in sera from mice with different chromosome complements, including 39,XO mice and phenotypically male mice bearing the sex-reversed gene (Sxr) (XX,Sxr/+ and XY,Sxr/+). The mean values of IgM were found to be higher in normal female mice than in the males belonging to two different strains. This is in agreement with the higher mean serum levels of IgM observed in two groups of sera from normal human females and males. However, while we could confirm that the mean level of IgM was lower in 45,XO women than in normal females and comparable to the mean value of normal males, the same effect was not seen in 39,XO mice. In fact, the mean concentration of serum IgM in 39,XO mice was similar to that in normal females. Furthermore, it was observed that the mean values of serum IgM in the two groups of sex-reversed male mice (XX,Sxr/+ and XY,Sxr/+) were also not statistically different from those in normal males. Thus the role that the number of X chromosomes plays in the control of the serum levels of IgM is different in man and the mouse, in agreement with the observed different phenotypic manifestations, and in particular with the hormonal situations existing in X chromosome abnormalities in these two species.

On the influence of age on immunity in Down's syndrome

In 23 subjects of different ages with Down's syndrome a number of parameters of non-specific defense of humoral and cellular immunity were investigated. While in all age groups complement factors C3, C4 and C5 as well as phagocytosis and NBT indices were in the normal range, a dysgammaglobulinaemia increasing with age with a hyperglobulinaemia of the IgG, IgA and IgD types was found, sparing immunoglobulins IgM and IgE. In addition the transformation capacity of peripheral blood lymphocytes decreased with age. This is understood as the consequence of premature aging of the thymus-dependent immune system.

Alpha-1-antitrypsin (Pi) types in Down's syndrome

Alpha-1-antitrypsin (Pi) phenotypes have been determined in 40 patients suffering from Down's syndrome. Thirty-six of the patients were found to have a normal M phenotype, whereas two deficient phenotypes of the MS variety were observed. In addition, two M variants were noted. The significance of an M variant phenotype in some patients with Down's syndrome is not completely understood and is currently under investigation. Since the majority of the patients had a normal alpha-1-antitrypsin phenotype, the results of this study indicate that a deficiency in alpha-1-antitrypsin plays no role in the respiratory fragility of individuals with Down's syndrome.

Defective antibody response to bacteriophage phichi 174 in Down syndrome

Antibody responses to bacteriophage phichi 174 were studied in 17 institutionalized patients with trisomy 21 and in six mentally retarded control patients with normal karyotype. Primary antibody response was significantly impaired in 11 of the 17 patients. Secondary immune response was normal in one, moderately impaired in seven, and very low in nine patients. Tertiary immunization further differentiated the two groups: those with moderately impaired secondary immune responses developed normal serum titers of predominantly IgG antibody; patients with low secondary immune responses had extemely impaired tertiary immune responses consisting mainly of serum IgM antibody.

Gm antigenic titres in adults with Down's syndrome (mongolism), non-mongoloid mental defectives and healthy blood donors

IgG was studied in adults with Down's syndrome, non-mongoloid mental defectives accommodated in the same institution and in healthy blood donors. Total serum IgG concentration was significantly higher in Down's syndrome than in the other two groups. Maximal inhibiting titres of Gm factors 1, 4, 5, 10 and 11 were measured by haemagglutination inhibition tests. Higher Gm titres were found in homozygotes than heterozygotes. In mongols the titres of Gm 4, and to a greater extent, Gm 5, 10 and 11, were higher than would be expected from the rise in total IgG concentration. The findings suggest that in mongolism an uneven increase occurs in the H chain subgroups and allotypes of IgG. In non-mongoloid mental defectives, although total IgG concentration was similar to that found in healthy normal subjects the Gm titre findings more closely resembled those in mongols.

Serum globulins and infection in mongolism

Comparisons are made between a large group of mongols cared for in institutions and their carefully matched controls in respect of (a) serum levels of immuno-gamma-globulin (gammaA, gammaG, and gammaM) and (b) the incidence of pyrexial illnesses over a retrospective five-year period. Male mongols are found to have higher levels of gammaA-globulin than their male controls and a higher incidence of pyrexial illnesses. Otherwise no significant differences were found. The findings are discussed in the light of previous studies.