Study tests inflammatory response of Down Syndrome patients

Almost all people with Down syndrome have periodontal disease, and a Medical College of Georgia dentist suspects that an abnormal inflammatory response is the culprit.

“We believe people with Down syndrome have genetic changes, or polymorphisms, that produce more inflammation than normal, leading to gum disease,” said Dr. Ahmed Khocht, associate professor of periodontics and principal investigator of an approximately half-million-dollar National Institutes of Health study to test his theory.

Periodontal disease is an inflammation of tissue surrounding and supporting the teeth, often caused by excess bacteria that left untreated can lead to tooth loss and systemic disease.

The disease is relatively common in the general population but is highly treatable with twice-yearly visits to the dentist and regular brushing and flossing. Yet proper oral hygiene seems insufficient to protect those with Down syndrome from periodontal disease, Dr. Khocht said.

“Eighty-five to 90 percent of people with Down syndrome have periodontal disease, and nothing else has explained the level of disease,” he said. “We think perhaps there is something in their system that produces more inflammation than normal.”

He plans to take blood samples of 300 adults with Down syndrome during the three-year study, seeking genetic markers that trigger excess inflammation. If he and his colleagues detect those markers, the finding will help dentists develop a treatment protocol specifically for this population.

The study should also provide critical information about the overall health of Down syndrome patients, Dr. Khocht said. “If our theory is correct, then people with Down syndrome are at higher risk for other inflammation-related diseases as well, including cardiac problems,” he said.

Targeting the faulty inflammatory response--for instance, by prescribing anti-inflammatory medication--may have wide-ranging benefits for Down syndrome patients, Dr. Khocht said.

Adults with Down syndrome, with or without periodontal disease, are eligible to participate in Dr. Khocht’s study. The patients are screened for eligibility and, if eligible, come in a for a second visit to have their gums examined. Blood is also drawn during the visit.