Minnesota Department of Health (n.d.). Down syndrome (also called trisomy 21). Minnesota Department of Health. https://www.health.state.mn.us/diseases/cy/downsyndrome.html

Linfield, D. T., Raduka, A., Aghapour, M., & Rezaee, F. (2021). Airway tight junctions as targets of viral infections. Tissue Barriers, 9(2), 1883965. https://doi.org/10.1080/21688370.2021.1883965

Article  CAS  PubMed  PubMed Central  Google Scholar 

Thomas, S. N., Niemeyer, B. F., Jimenez-Valdes, R. J., Kaiser, A. J., Espinosa, J. M., Sullivan, K. D., Goodspeed, A., Costello, J. C., Alder, J. K., Cañas-Arranz, R., García-Sastre, A., & Benam, K. H. (2023). Down syndrome is associated with altered frequency and functioning of tracheal multiciliated cells and response to influenza virus infection. iScience, 26(8), 107361. https://doi.org/10.1016/j.isci.2023.107361

Article  CAS  PubMed  PubMed Central  Google Scholar 

Bloom, J. L., Frank, B., Weinman, J. P., et al. (2021). Diffuse alveolar hemorrhage in children with trisomy 21: Case series and literature review. Pediatric Rheumatology, 19(1), 114. https://doi.org/10.1186/s12969-021-00592-4

Article  PubMed  PubMed Central  Google Scholar 

Carlier, F. M., de Fays, C., & Pilette, C. (2021). Epithelial barrier dysfunction in chronic respiratory diseases. Frontiers in Physiology, 12, 691227. https://doi.org/10.3389/fphys.2021.691227

Article  PubMed  PubMed Central  Google Scholar 

Ivanov, A. I., Parkos, C. A., & Nusrat, A. (2010). Cytoskeletal regulation of epithelial barrier function during inflammation. The American Journal of Pathology, 177(2), 512–524. https://doi.org/10.2353/ajpath.2010.100168

Article  CAS  PubMed  PubMed Central  Google Scholar 

Burgoyne, R. A., Fisher, A. J., & Borthwick, L. A. (2021). The role of epithelial damage in the pulmonary immune response. Cells, 10(10), 2763. https://doi.org/10.3390/cells10102763

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ghezzi, M., Garancini, N., De Santis, R., Gianolio, L., Zirpoli, S., Mandelli, A., Farolfi, A., D’Auria, E., & Zuccotti, G. V. (2024). Recurrent respiratory infections in children with Down syndrome: A review. Children, 11(2), 246. https://doi.org/10.3390/children11020246

Article  PubMed  PubMed Central  Google Scholar 

Janoff, E. N., Tseng, H. F., Nguyen, J. L., et al. (2023). Incidence and clinical outcomes of pneumonia in persons with Down syndrome in the United States. Vaccine, 41(31), 4571–4578. https://doi.org/10.1016/j.vaccine.2023.05.063

Article  PubMed  Google Scholar 

Lynn, K. S., Peterson, R. J., & Koval, M. (2020). Ruffles and spikes: Control of tight junction morphology and permeability by claudins. Biochimica et Biophysica Acta (BBA) – Biomembranes, 1862(9), 183339. https://doi.org/10.1016/j.bbamem.2020.183339

Article  CAS  PubMed  PubMed Central  Google Scholar 

Bhattacharya, S., Frauenpreis, A., Cherry, C., Deutsch, G., Glass, I. A., Mariani, T. J., Al Alam, D., Danopoulos, S., & Birth Defects Research Laboratory (BDRL). The transcriptional landscape of developing human trisomy 21 lungs. Am J Respir Cell Mol Biol 2025 Sep 25. https://doi.org/10.1165/rcmb.2025-0217OC. Epub ahead of print. PMID:40997082.

Danopoulos, S. (2021). Prenatal Histological, Cellular, and Molecular Anomalies in Trisomy 21 Lung. The Journal of Pathology. Danopoulos, S., Bhattacharya, S., Deutsch, G., Nih, L. R., Slaunwhite, C., Mariani, T. J., & Al Alam, D. (2021). Prenatal histological, cellular, and molecular anomalies in trisomy 21 lung. The Journal of Pathology, 255(1), 41–51. https://doi.org/10.1002/path.5735 https://doi.org/10.1002/path.5735

Danopoulos, S., Deutsch, G. H., Dumortier, C., Mariani, T. J., & Alam, A., D (2021). Lung disease manifestations in Down syndrome. American Journal of Physiology–Lung Cellular and Molecular Physiology, 321(5), L892–L899. https://doi.org/10.1152/ajplung.00434.2020

Article  CAS  PubMed  PubMed Central  Google Scholar 

Tantaleán, D., Fieno, J., León Paredes, R., Palomo Luck, P., Águila, D., Villar, C., & Patrón, R., E (2025). Down syndrome and outcomes in critically ill pediatric patients. Frontiers in Pediatrics, 12, 1483944. https://doi.org/10.3389/fped.2024.1483944

Article  Google Scholar 

Kutsuzawa, N., et al. (2023). Dexamethasone restores TNFα-induced epithelial barrier dysfunction in primary rat alveolar epithelial cells. PLOS ONE, 18(12), e0295684. https://doi.org/10.1371/journal.pone.0295684

Article  CAS  PubMed  PubMed Central  Google Scholar 

Saco, T. V., Breitzig, M. T., Lockey, R. F., & Kolliputi, N. (2018). Epigenetics of mucus hypersecretion in chronic respiratory diseases. American Journal of Respiratory Cell and Molecular Biology, 58(3), 299–309. https://doi.org/10.1165/rcmb.2017-0072TR

Article  CAS  PubMed  PubMed Central  Google Scholar 

Craven, V. E., Daw, W. J., Wan, J. W. Y., & Elphick, H. E. (2025). Respiratory and airway disorders in children with Down syndrome: A review of the clinical challenges and management. Frontiers in Pediatrics, 13, 1553984. https://doi.org/10.3389/fped.2025.1553984

Article  CAS  PubMed  PubMed Central  Google Scholar 

Respiratory complications of Down syndrome (n.d.). In Kendig’s disorders of the respiratory tract in children (9th ed.). Elsevier. https://thoracickey.com/respiratory-complications-of-down-syndrome/

DeBoer, E., Wolter-Warmerdam, K., Hickey, F., & Weinman, J. (2025). Large airway and lung findings in symptomatic children and young adults with Down syndrome. Pediatric Pulmonology, 60, e71339. https://doi.org/10.1002/ppul.71339

Article  PubMed  Google Scholar 

Chorvinsky, E., Bhattacharya, S., S. Bera, B., et al. (2025). Down syndrome alters type III interferon and pro-inflammatory airway epithelial responses to RSV infection. American Journal of Respiratory Cell and Molecular Biology. https://doi.org/10.1165/rcmb.2025-0068OC. Advance online publication.

Article  PubMed  PubMed Central  Google Scholar 

De Lausnay, M., Ides, K., Wojciechowski, M., Boudewyns, A., Verhulst, S., & Van Hoorenbeeck, K. (2021). Pulmonary complications in children with Down syndrome: A scoping review. Paediatric Respiratory Reviews, 40, 65–72. https://doi.org/10.1016/j.prrv.2021.04.006

Article  PubMed  Google Scholar 

Fitzpatrick, V., Rivelli, A., Chaudhari, S., Chicoine, L., Jia, G., Rzhetsky, A., & Chicoine, B. (2022). Prevalence of infectious diseases among 6,078 individuals with Down syndrome in the United States. Journal of Patient-Centered Research and Reviews, 9(1), 64–69. https://doi.org/10.17294/2330-0698.1876

Article  PubMed  PubMed Central  Google Scholar 

Fockens, M. M., Hölscher, M., Limpens, J., & Dikkers, F. G. (2021). Tracheal anomalies associated with Down syndrome: A systematic review. Pediatric Pulmonology, 56(5), 814–822. https://doi.org/10.1002/ppul.25203

Article  PubMed  PubMed Central  Google Scholar 

Zhi, C., Wang, J., Zhang, Y., et al. (2025). Single-cell transcriptome analysis revealed critical causative candidates for Down syndrome–related lung diseases. Journal of Genetics and Genomics, 52(5), 450–462. https://doi.org/10.1016/j.jgg.2025.05.009

Article  Google Scholar 

Rimmer, C., Hetelekides, S., Eliseeva, S. I., Georas, S. N., & Veazey, J. M. (2021). Budesonide promotes airway epithelial barrier integrity following double-stranded RNA challenge. PLOS ONE, 16(12), e0260706. https://doi.org/10.1371/journal.pone.026070626

Article  CAS  PubMed  PubMed Central  Google Scholar 

Jiang, X., Lin, S., Wu, R., Zhang, Y., Liu, C., & Zhang, J. (2025). Airway organoid models as pivotal tools for unraveling airway epithelium biology. Frontiers in Cell and Developmental Biology, 13, 12205757. https://doi.org/10.3389/fcell.2025.12205757

Article  Google Scholar