Toll-like receptors (TLRs) are the key in initiating innate immune responses. TLR2 is crucial in recognising
lipopeptides from gram-positive bacteria and is implicated in chronic
inflammation. Children with
Down syndrome (DS) are prone to
infections from these pathogens and have an increased risk of autoimmunity.
Sparstolonin B (SsnB) is a TLR antagonist which attenuates
cytokine production and improves outcomes in
sepsis. We hypothesised that TLR signalling may be abnormal in children with DS and contribute to their clinical phenotype. We evaluated TLR pathways in 3 ways: determining the expression of TLR2 on the surface of neutrophils and monocytes by flow cytometry, examining the gene expression of key regulatory
proteins involved in TLR signal propagation, MyD88, IRAK4, and TRIF, by quantitative PCR, and lastly determining the
cytokine production by ELISA following
immunomodulation with proinflammatory stimuli (
lipopolysaccharide (LPS), Pam3Csk4) and the
anti-inflammatory agent SsnB. We report TLR2 expression being significantly increased on neutrophils, total monocytes, and intermediate and nonclassical monocytes in children with DS (n = 20, mean age 8.8 ± SD 5.3 years, female n = 11) compared to controls (n = 15, mean age 6.2 ± 4.2 years, female n = 5). At baseline, the expression of MyD88 was significantly lower, and TRIF significantly raised in children with DS. The TLR antagonist SsnB was effective in reducing TLR2 and CD11b expression and abrogating
cytokine production in both cohorts. We conclude that TLR signalling and the TLR2 pathway are dysregulated in DS, and this disparate innate immunity may contribute to chronic
inflammation in DS. SsnB attenuates proinflammatory mediators and may be of therapeutic benefit.