Down syndrome and pulmonary epithelial apoptosis

http://www.ncbi.nlm.nih.gov/pubmed/22369036

Pediatr Dev Pathol. 2012 Feb 27. [Epub ahead of print]
Pulmonary epithelial apoptosis in fetal Down syndrome: not higher than normal.
Bruijn M, von der Thüsen JH, van der Loos CM, de Krijger RR, van Loenhout RB, Bos AP, van Woensel JB.
Source
a Emma Children's Hospital, Pediatric Intensive Care Unit.

Abstract
Introduction
Children with Down syndrome (DS) are at high risk for acute lung injury (ALI). Pulmonary epithelial apoptosis is an important factor in the pathophysiology of ALI. If the risk of ALI in DS is associated with a high level of pulmonary epithelial apoptosis is not known. Aim We hypothesized that the percentage of apoptotic epithelial cells is higher in DS than in control lungs.

Methods
Lung tissue sections from autopsies of 21 fetuses with DS and 12 controls were stained with antibodies against the epithelial marker pan-cytokeratin (CK) and apoptosis marker activated caspase-3 (aC3). Spectral imaging software was used to quantify the mean percentage of pixels that showed colocalization of CK and aC3.

Results
Mean (SD) gestational age in weeks was 18.7 (1.4) in DS and 18.9 (2.0) in controls (p=0.67). The mean (SD) percentage of CK-positive pixels was 27.2% (4.7) in DS compared to 27.1% (6.2) in controls (p=0.97). The median (IQR) percentage of CK-positive pixels that showed colocalization of aC3 was 0.16% (0.18) in DS compared to 0.27% (0.24) in controls (p=0.45). The mean (SD) number of CK-positive pixels increased from 22.5% (5.2) to 30.4% (4.6) with the appearance of saccular morphology in controls but not in DS (p=0.01).

Conclusion
The percentage of apoptotic epithelial cells in DS fetal lungs does not differ from controls. However, we did find a difference in the development of epithelial structures between DS and controls that may be associated with anomalies in alveolar development found at birth in DS.