Immune-endocrine status and coeliac disease in children with Down's syndrome: Relationships with zinc and cognitive efficiency

Immune defects, thyroid abnormalities, plasma zinc levels, and the presence of gastrointestinal disease were investigated in 43 children with Down's s yndrome (DS). Peripheral T lymphocytes with the phenotype of helper cells o r cluster of differentiation 4 (CD4) were decreased. Circulating activated T cells (CD3/HLA-DR-positive cells) and large granular lymphocytes (CD16/CD 56 positive cells) were increased. Plasma levels of interleukin-6 were high er in DS children than in controls. Serum levels of thyroid-stimulating hor mone were increased in DS. Coeliac disease was over-represented in the grou p of DS children and many of these children also showed increased serum lev els of immunoglobulin-G (IgG) specific for gliadin antigen. The increment o f serum interleukin-6 was age-related and correlated with anti-gliadin IgG levels in DS. Plasma zinc levels were lower in DS children with coeliac dis ease and in those with anti-gliadin IgG than in DS without detectable antig liadin IgG. Dietary antigens may represent a continuous stimulus for the im mune system in this syndrome and interfere with normal immune responses. Al tered intestinal absorption of nutrients may in turn affect endocrine funct ions, brain development, and cognitive performances. (C) 2001 Elsevier Scie nce Inc.