Huggard D, Kelly L, Ryan E, et al. - In order to gain insights into the significance of the anti-inflammatory mediators IL-1ra and IL-10, as well as cytokines Epo and VEGF, which could influence pathogenesis as well as consequences in congenital heart disease (CHD) which is more prevalent in Down syndrome (DS), researchers analyzed a comprehensive array of pro-(IL-2, IL-6, IL-8, IL-18, IL-1β, TNF-α, IFN-γ), and anti-inflammatory (IL-10 and IL-1ra) mediators, cytokines implicated in inflammation in response to hypoxia (EPO), propagating angiogenesis (VEGF), and myelopoiesis (GM-CSF). They also focused on the potential influence of significant CHD and Lipopolysaccharide endotoxin on these mediators. Recruitment of 114 children with DS and 60 age and gender-matched controls was done. Significantly greater concentrations of pro and anti-inflammatory cytokines; IL-2, IL-6, IL-10, IL-1ra, as well as increased Epo, VEGF and GM-CSF at baseline were detected in children with DS. CHD did not appear to have any influence on circulating cytokines beyond the acute surgical phase. The observed responses to LPS stimulation were similar in both cohorts. Findings are indicative of the possible contribution of these differences to varied clinical results, acutely like in sepsis, and over time in autoimmunity.