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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 (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>20<\/mml:mn><\/mml:math>,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mtext>mean<\/mml:mtext><mml:mtext>\u2009<\/mml:mtext><mml:mtext>age<\/mml:mtext><mml:mtext>\u2009<\/mml:mtext><mml:mn>8.8<\/mml:mn><mml:mo>\u00b1<\/mml:mo><mml:mtext>SD<\/mml:mtext><mml:mtext>\u2009<\/mml:mtext><mml:mn>5.3<\/mml:mn><\/mml:math>years, female<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>11<\/mml:mn><\/mml:math>) compared to controls (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>15<\/mml:mn><\/mml:math>,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mtext>mean<\/mml:mtext><mml:mtext>\u2009<\/mml:mtext><mml:mtext>age<\/mml:mtext><mml:mtext>\u2009<\/mml:mtext><mml:mn>6.2<\/mml:mn><mml:mo>\u00b1<\/mml:mo><mml:mn>4.2<\/mml:mn><\/mml:math>years, female<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>5<\/mml:mn><\/mml:math>). 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.<\/jats:p>","DOI":"10.1155\/2019\/4068734","type":"journal-article","created":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T23:30:45Z","timestamp":1568331045000},"page":"1-13","source":"Crossref","is-referenced-by-count":23,"title":["Altered Toll-Like Receptor Signalling in Children with Down Syndrome"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0170-8399","authenticated-orcid":true,"given":"Dean","family":"Huggard","sequence":"first","affiliation":[{"name":"Paediatrics, Trinity College, The University of Dublin, Dublin, Ireland"},{"name":"Trinity Translational Medicine Institute (TTMI), Trinity College Dublin, Dublin, Ireland"},{"name":"Paediatrics, Tallaght Hospital, Dublin, Ireland"},{"name":"National Children\u2019s Research Centre, Our Lady\u2019s Children\u2019s Hospital, Crumlin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. J.","family":"Koay","sequence":"additional","affiliation":[{"name":"Paediatrics, Trinity College, The University of Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Kelly","sequence":"additional","affiliation":[{"name":"Paediatrics, Trinity College, The University of Dublin, Dublin, Ireland"},{"name":"Trinity Translational Medicine Institute (TTMI), Trinity College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"McGrane","sequence":"additional","affiliation":[{"name":"Paediatrics, Trinity College, The University of Dublin, Dublin, Ireland"},{"name":"Paediatrics, Tallaght Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emer","family":"Ryan","sequence":"additional","affiliation":[{"name":"Paediatrics, Trinity College, The University of Dublin, Dublin, Ireland"},{"name":"Paediatrics, Tallaght Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niamh","family":"Lagan","sequence":"additional","affiliation":[{"name":"Paediatrics, Trinity College, The University of Dublin, Dublin, Ireland"},{"name":"Paediatrics, Tallaght Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edna","family":"Roche","sequence":"additional","affiliation":[{"name":"Paediatrics, Trinity College, The University of Dublin, Dublin, Ireland"},{"name":"Paediatrics, Tallaght Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Balfe","sequence":"additional","affiliation":[{"name":"Paediatrics, Trinity College, The University of Dublin, Dublin, Ireland"},{"name":"Paediatrics, Tallaght Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Ronan","family":"Leahy","sequence":"additional","affiliation":[{"name":"Paediatrics, Trinity College, The University of Dublin, Dublin, Ireland"},{"name":"Immunology, Our Lady\u2019s Children\u2019s Hospital, Crumlin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orla","family":"Franklin","sequence":"additional","affiliation":[{"name":"Paediatrics, Trinity College, The University of Dublin, Dublin, Ireland"},{"name":"Cardiology, Our Lady\u2019s Children\u2019s Hospital, Crumlin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Moreno-Oliveira","sequence":"additional","affiliation":[{"name":"Paediatrics, Trinity College, The University of Dublin, Dublin, Ireland"},{"name":"Trinity Translational Medicine Institute (TTMI), Trinity College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashanty 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