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Down Syndrome

DOWN SYNDROME (also called tnsomy 21) is a genetic disorder caused by the abnormal presence of the entire or a part of an extra chromosome 21. The disease is named after John Langdon Down, a British doctor who described it in 1866. Down pointed out the striking similarity of facial features among children with the disease when they were compared with those of Blumenbach's Mongolian race. Hence, the disease is sometimes referred to as “mongolism” and “mongolian idiocy.” The disorder was identified as a chromosome 21 trisomy by Jérôme Lejeune in 1959.

The typical patient suffering from Down syndrome has a total of 47 chromosomes in all the somatic cells of his body. Such an abnormality accounts for the impaired growth and development of the child. Down syndrome is the leading genetic cause of mental retardation. Latest statistics report the incidence of Down syndrome to be 1 per 800 live births, making it one of the most frequently inherited chromosomal abnormalities of modern medicine. These statistics are profoundly influenced by the age of the mother at the time of birth.

Patients with Down syndrome have certain common physical features, which may include a single transverse palmer crease (a single instead of a double crease across one or both palms), almond—shaped eyes, epicanthic folds of the eyelids, up—slanting palpebral fissures, shorter limbs, a larger—than-normal space between the big and second toes, poor muscle tone, and a protruding tongue. Individuals with Down syndrome are at a greater risk for congenital heart defects, gastro—esophageal reflux disease, recurrent ear infections, obstructive sleep apnea, thyroid dysfunction, and rarely, leukemia and Alzheimer's disease.

Stem Cell Research

The neurological signs and symptoms of Down syndrome are recognized during the prenatal and early postnatal period in humans. Stem cell research offers the generation of human neural tissue in culture—a novel model system to study alterations in developmental disorders such as Down syndrome. An article published in the Lancet in 2002 described an intriguing model used to study Down syndrome, devised at the University of Cambridge by Bahn and Emson.

Every fetus begins as one cell, which then divides repeatedly. These cells are pluripotent, that is, they have the capability to differentiate into multiple lineages of cells, virtually giving rise to all the cells in the body. Embryonic stem cells are often collected at a developmental stage when they are just about to differentiate into a particular cell lineage.

Bahn and Emson used stem cells from the developing human brain that are precursors to neural tissue and grew them as spherical aggregates called neurospheres. They used neurospheres from postmortem fetuses (with and without Down syndrome) that were biochemically induced to form neurons. The RNA proteins were extracted from the neurospheres and compared with the RNA proteins from normal neurospheres. Through vigorous experimental procedures, it was found that one specific protein was absent from the neurospheres of Down syndrome patients. The SCG10 gene was relatively or absolutely functionally deficient. Further investigation discovered that certain other genes were also underexpressed; namely, LI, Synapsin, and β4-tubulin. The neurons from the defective stem cells were shorter, had misshapen axons, and fewer den—drites projected from the main body of the neuron when compared with the control.

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