吡咯烷酮醇对唐氏综合征患儿反复呼吸道感染的影响：一项意大利的回顾性研究。
Effects of Pidotimod on recurrent respiratory infections in children with Down syndrome: a retrospective Italian study.
机构信息
Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
Immunology Research Area, B-cell development Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
出版信息
Ital J Pediatr. 2020 Mar 13;46(1):31. doi: 10.1186/s13052-020-0797-5.
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.
背景
唐氏综合征（DS）患儿易反复感染（RI），这是由免疫缺陷和气道异常引起的。我们的目标是研究比哚莫特（Pidotimod）对 DS 患儿 RI 预防的作用，比较治疗前后（T0 和 T1）的免疫和临床参数。
方法
该研究在罗马 Bambino Gesù 儿童医院的唐氏综合征门诊中心进行。我们回顾了 2016 年 9 月至 2017 年 2 月期间有 RI 阳性病史并接受过比哚莫特口服预防的所有患儿的病历。
结果
33 名患儿符合纳入标准（男性：51.5%；平均年龄：6 岁±标准差：3 岁）。我们发现，与 T0 时（上呼吸道感染 82%，下呼吸道感染 36%）相比，T1 时（上呼吸道感染 24%，下呼吸道感染 9%）患儿的呼吸道感染数量明显减少（p=0.0001 和 0.003）。我们还发现，T1 时因呼吸道感染住院的患儿数量明显减少（T0 时 18%，T1 时 3%）（p=0.03）。我们在 T0 和 T1 时测量了外周血中的 T 和 B 细胞以及体外 B 细胞功能。我们发现，T1 时 CpG 的反应增强。治疗后，DS 患儿 B 细胞频率（p=0.0009）、B 细胞增殖（p=0.0278）和 IgM 分泌（p=0.0478）显著增加。
结论
我们的研究结果表明，比哚莫特可能能够预防唐氏综合征患儿的 RI。
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