Effects of Pidotimod on recurrent respiratory infections in children with down syndrome: A retrospective Italian study: Italian Journal of Pediatrics

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Abstract

Background: Children with Down syndrome (DS) show a high susceptibility to recurrent infections (RI), caused by immune defects and abnormalities of the airways. Our goal was to investigate the effects of Pidotimod on RI prevention in children with DS, comparing immune and clinical parameters before (T0) and after (T1) the treatment with Pidotimod. Methods: The study was conducted at the Down syndrome outpatient Center of Bambino Gesù Children's Hospital, in Rome. We reviewed the medical records of all children with a positive history for RI and who received oral prophylaxis of Pidotimod from September 2016 to February 2017. Results: Thirty-three children met the inclusion criteria (males: 51.5%; average age: 6 years ±SD: 3). We found a significant decrease in the number of children with upper respiratory infections (82% at T0 vs 24% at T1; p = 0,0001) and with lower respiratory infections (36% at T0 vs 9% at T1; p = 0.003) after treatment with Pidotimod. We also demonstrated a significant decrease in the number of children hospitalized for respiratory infections (18% at T0 vs 3% at T1; p = 0.03). We measured T and B cells in the peripheral blood and B cell function in vitro at T0 and T1. We found that the response to CpG improved at T1. A significant increase of B cell frequency (p = 0.0009), B cell proliferation (p = 0.0278) and IgM secretion (p = 0.0478) were observed in children with DS after treatment. Conclusions: Our results provided evidence that Pidotimod may be able to prevent RI in children with Down syndrome. © 2020 The Author(s).
Original languageEnglish
JournalItal. J. Pediatr.
Volume46
Issue number1
DOIs
Publication statusPublished - 2020

Keywords

  • Down syndrome
  • Pidotimod
  • Recurrent respiratory infections
  • immunoglobulin M
  • pidotimod
  • immunoglobulin class
  • immunological adjuvant
  • pyroglutamic acid
  • thiazolidine derivative
  • Article
  • B lymphocyte
  • child
  • clinical article
  • clinical feature
  • controlled study
  • drug effect
  • female
  • hospitalization
  • human
  • human cell
  • immune response
  • immunoglobulin production
  • in vitro study
  • infection prevention
  • Italy
  • lower respiratory tract infection
  • lymphocyte count
  • lymphocyte function
  • lymphocyte proliferation
  • male
  • medical record review
  • outpatient
  • preschool child
  • recurrent infection
  • retrospective study
  • T lymphocyte
  • upper respiratory tract infection
  • blood
  • complication
  • immunology
  • recurrent disease
  • respiratory tract infection
  • Adjuvants, Immunologic
  • Child
  • Child, Preschool
  • Down Syndrome
  • Female
  • Humans
  • Immunoglobulin Isotypes
  • Male
  • Pyrrolidonecarboxylic Acid
  • Recurrence
  • Respiratory Tract Infections
  • Retrospective Studies
  • Thiazolidines

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