Abstract
Down syndrome (DS) patients prematurely show clinical manifestations usually associated with aging. Their immune system declines earlier than healthy individuals, leading to increased susceptibility to infections and higher incidence of autoimmune phenomena. Clinical features of accelerated aging indicate that trisomy 21 increases the biological age of tissues. Based on previous studies suggesting immune senescence in DS, we hypothesized that induction of cellular senescence may contribute to early thymic involution and immune dysregulation. Immunohistochemical analysis of thymic tissue showed signs of accelerated thymic aging in DS patients, normally seen in older healthy subjects. Moreover, our whole transcriptomic analysis on human Epcam-enriched thymic epithelial cells (hTEC), isolated from three DS children, which revealed disease-specific transcriptomic alterations. Gene set enrichment analysis (GSEA) of DS TEC revealed an enrichment in genes involved in cellular response to stress, epigenetic histone DNA modifications and senescence. Analysis of senescent markers and oxidative stress in hTEC and thymocytes confirmed these findings. We detected senescence features in DS TEC, thymocytes and peripheral T cells, such as increased β-galactosidase activity, increased levels of the cell cycle inhibitor p16, telomere length and integrity markers and increased levels of reactive oxygen species (ROS), all factors contributing to cellular damage. In conclusion, our findings support the key role of cellular senescence in the pathogenesis of immune defect in DS while adding new players, such as epigenetic regulation and increased oxidative stress, to the pathogenesis of immune dysregulation.
Highlights
Down syndrome (DS) is the most common chromosomal anomaly among live-born infants, typically characterized by complete or partial trisomy of chromosome 21 (Chr21) [OMIM#190685] [1]
To further characterize TEC senescence in DS patients, SA-b-gal levels were quantified by fluorescent microscopy (Figures 3A, B) and flow cytometry (Figure 3C) and we reported a significant increase in DS patients as compared to age-matched Healthy Donors (HD)
DS patients present with specific conditions associated with earlier aging as compared to general population, including premature skin wrinkling, greying of hair, hypogonadism, early menopause, hypothyroidism, Alzheimer’s disease and declining immune function [12]
Summary
Down syndrome (DS) is the most common chromosomal anomaly among live-born infants, typically characterized by complete or partial trisomy of chromosome 21 (Chr21) [OMIM#190685] [1]. Its incidence ranges between 1:100 and 1:1000 live births in general population and is influenced by maternal age [2, 3]. DS is one of the most common genetic cause of intellectual disability [4] and its complex phenotype results from a dosage imbalance of genes located on human Chr. In addition to learning disabilities, there are various common features occurring in all DS patients, such as craniofacial abnormalities and hypotonia in early infancy [5]. DS is associated with a group of clinical manifestations of accelerated aging [7]
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