I can't help but think of the stark contrast between this call to protect people with Down Syndrome and the fact that babies are almost universally aborted currently if their Down Syndrome test comes back positive.
I guess it's good that once they are born we care about them, but it seems that as a society we've decided we'd prefer they just not be born.
Well I think it's a matter of "is it ethical to bring into the world a being who is more likely to have a bad life or lots of suffering?" Once the person is here we are of course obligated to treat them with compassion. BTW, I'm not saying this is my view on DS -- I have met many people with DS who seem to have rich or rewarding lives. But I think clearly some people think that way. Plus, I think parents who have a child with DS are headed down a road of having someone that needs a lot of care for the rest of their lives. I can't blame someone for not wanting to take that on.
That's the complicated part - when does "bring into the world" begin? For the parents (at least that is how we felt), this moment is often much, much closer to conception than to birth.
Indeed. I have read somewhere that until the 19th century, that moment was often months after birth. It was common to give the newborn away to a nurse if you could afford it until it had survived the first year, and only then accept it as part of the family. This way, the parents could safe themselves a bit from the excruciating pain of child loss.
Edit: This is e.g. mentioned in the German Wikipedia on Pox (https://de.wikipedia.org/wiki/Pocken#16._bis_19._Jahrhundert), there is also a citation for it. I have read it several times during the last years, but don't have a better source, sorry.
Could you please provide a citation for this claim? It's fascinating if true, but I wonder which societies did this and what documentation there is for this practice. My understanding was that prior to the 20th century child mortality -- and mothers dying in childbirth -- were both common enough as to be practically mundane, or at least, as mundane as any death ever is.
Prior to 20th century? For my grandparents' generation it was common that about a third of their siblings died during their chilhood, mostly before one year old.
> It was common to give the newborn away to a nurse if you could afford it until it had survived the first year
I wasn't aware of that practice, although before around 1994 there were all kinds of institutions that don't exist now, which is literally why downtown SF is the way it is.
People with Down Syndrome consistently report higher levels of satisfaction with life than the average person. It's just that we look down upon them and it makes us sad. We only care of things from our own point of view. Try to consider their perspective.
As I've said, the people I've met with Down Syndrome seemed to be genuinely happy (and just all-around delightful) people, to the best that I could determine. I've also read that parents and other family members of people with Down Syndrome also report high levels of satisfaction with life. I know what side of the line DS would fall on for me, but I can't make that decision for other people.
That’s interesting- but do think of the challenge it places on parents. Bringing up a child with Down’s syndrome is extremely tough, and they never really become independent adults.
No it's called 'choice'. Women pregnant with babies potentially affected by that malformation are not forced by doctors or the government to abort. Big difference.
Eugenics has always been a 'choice'. The only difference is who is making the choice. As long as it's not the choice of the individual being euthanized; it's still a rebranded form of eugenics.
during the first trimester there is no individual - the fetus brain isn't even at the fish level. There is no electrical activity in the fetus brain at all until the week 6.
In response to the comment below - genetically an egg and sperm combined in the lab is different from either donor, yet it doesn't make it into individual. Or if you just take 2 (or 3, ...) DNA and recombine on computer, and actually synthesize that DNA - genetically distinct, yet definitely not an individual.
More technically, that's euthanasia and it's optional, not government mandated, and no one is sterilized after. Eugenics would be sterilizing any parents that have any possibility of producing unhealthy babies.
I was a late-life child. High risk for Down's. My mother didn't get the test, which could've introduced more problems. She believed I was already alive, because I was, and I was therefore sacred to her, and the outcome of the test would be irrelevant to her choice. Notice in all of this, I didn't have a choice.
I'm glad she didn't abort me. If I don't want to be alive now, now it's my decision.
I guess you can keep arguing that killing unborn children diagnosed with Down's isn't eugenics but my perspective is pretty heavily informed by the fact that I'm alive thanks to my mother being bothered by the idea that she might kill me in utero if I had a developmental disorder.
I'd like to see you explain the position that a baby diagnosed with Down's should be aborted to someone with Down's, frankly.
After having two kids and watching those ultrasounds, I’m a lot less sure of this than I was when I was 18.
Abortion is a horrible thing I wish didn’t exist. Given that it does exist, it’s a horrible choice I wish upon no one. Given that choice is ever made, it’s a horrible thought to consider punishing a woman for making it.
All of that said, as a society we have a responsibility to do better than almost a million abortions a year (~20% of all pregnancies) in the US.
I think a better male contraceptive choice would go a long way to reducing that number. As usual, I believe in a technological solution to societal ills.
We know how to drastically reduce abortions. Provide free long term contraceptives to women. We've seen it work in places like Denver who cut their teen pregnancy and abortion rates in half while saving $6 in medical bills for every $1 spent on IUDs. We cannot get programs like this more broadly because half our country thinks outlawing abortion and teaching "personal responsibility" is the solution despite evidence that neither actually work.
People have been justifying killing of Inconvenient babies for decades now.
I mean 3rd trimester babies that could survive outside the womb are fair game.
Actual Honest reason is, “I don’t want a baby” However all sorts of mental games are played to justify / excuse it.
I read that article, and it doesn't seem like some grand revelation. It even explains in the article that people with Down's syndrome are more susceptible to respiratory viruses (the person discussed in the beginning of the article got hospitalized with pneumonia multiple times and got put on a ventilator due to it years before COVID pandemic was even a thing).
So it seems to be less about something special about Down's syndrome that makes COVID more deadly to someone with Down's, but that it is just a subset of people who tend to have increased severity of respiratory infections in general. And COVID, being a somewhat respiratory virus, naturally hits those people harder than those without extra susceptibility to respiratory viruses.
I read that article, and it doesn't seem like some grand revelation. It even explains in the article that people with Down's syndrome are more susceptible to respiratory viruses
What would be vastly more interesting is if someone, somewhere with some medical expertise was wondering why people with Down's Syndrome are, in fact, dying at high rates while people with Cystic Fibrosis -- another genetic disorder and infamous for killing people at young ages via respiratory infection -- are not:
Does cystic fibrosis constitute an advantage in COVID-19 infection?
Edit: And I say it would be vastly more interesting because of the potential to cast light on the pathology of the disease and thereby cast light on how to treat it effectively.
People with CF are probably ridiculously careful and likely almost totally isolating themselves right now.
Someone with Downs isn't necessarily as able to make accurate risk calculations and may find themselves engaging in riskier behavior.
Add to that the fact that many adults with Downs may live in community group homes alongside others with mental health concerns (staff coming in and out - vector of infection), whereas those with CF may be less likely to do so, as (unfortunately in a human sense, fortunately in the sense of comparing with prior decades and the progress of treatment) their average life expectancy in the United States is under 40 y/o and they may be able to isolate with retired adult parents or work from home.
I have a diagnosis of atypical Cystic Fibrosis as does my oldest son. I'm pretty confident we had covid-19 back in March and my respiratory problems got better, not worse.
It felt like having bad anemia. The impact it has on the blood was a big deal but it did not seem to hit my respiratory system hard. If anything, it appeared to have some beneficial side effects for some longstanding issues.
So I think your quick and dirty dismissal of an important biological difference is specious.
I'm happy for you guys. God knows I derive no satisfaction from people being ill. You accuse me of being specious. Good lord, if only that was the nicest thing people accused me of I would be thrilled.
It might be interesting to get an antibody test to confirm that it actually was SARS-CoV-2?
Which organ system is primarily affected by your CFTR mutation? I quickly checked the lit and I gather Atypical CF can mainly affect respiratory, gastrointestinal, endocrine and metabolic, or genitourinary systems and is a little different in this way than classic CF, but you probably know more about it than I do.
Do you guys have a pretty rough history of respiratory infections, or do you see it manifest primarily elsewhere? Are you guys on prophylactic antibiotics for chronic pulmonary infection?
What were the beneficial side effects?
Curious to hear your hypothesis as to how CFTR mutations could lend an advantage to patients with COVID? I haven't got any ideas.
Were you guys much, much more cautious with isolation? Do you work in the community, or were you very cautious about isolation?
Super curious to learn more.
Edit: I looked at the paper and behavior was cited as a possible key factor. "...typical behavior in patients with CF, who might wear protective masks and avoid contact with sick people..." Another idea they floated was disruption of IL-6 signaling, which they didn't figure would totally mask (ba dum tss) the respiratory effects of the virus, but might knock it down a bit. Iono, small sample size too.
There doesn't seem to be much data as to whether or not CF folks have any actual biological protections or if they're not just being more cautious, but I found a couple of papers that hypothesize potential mechanisms:
Peckham, D., McDermott, M.F., Savic, S. et al. COVID-19 meets Cystic Fibrosis: for better or worse?. Genes Immun 21, 260–262 (2020). https://doi.org/10.1038/s41435-020-0103-y
SARS-CoV-2 (COVID-19) and cystic fibrosis. Bruce A. Stanton, Thomas H. Hampton, and Alix Ashare. American Journal of Physiology-Lung Cellular and Molecular Physiology 2020 319:3, L408-L415
Edit Edit: Based on your screen name, and our previous butting-heads over bullying vs. character building on another thread, I'm reminded of the classic Gary Larson/Far Side cartoon with Ed's Dingo Farm adjacent to Doreen's Nursery, and the caption 'Trouble Brewing.' An absolute classic. I'm perfectly willing to embrace the character archetype of Ed in this hypothetical cartoon situation, although I have yet to be graced with ownership of a dingo farm.
I did look up specious before hitting the "publish" button and the internet assured me it simply meant superficially plausible but actually wrong and didn't imply anything about you as a person.
I'm not really interested in answering a whole lot of invasive personal questions. That has a history of going bad places on the internet and just not going there seems to be the only cure for that issue.
Cystic Fibrosis is much more common in Caucasians than in other ethnicities and there are papers out there that posit that this may be because it may protect against cholera and/or tuberculosis, two diseases that ravaged Europe for some time. So it's possible that the mutation became much more common in White Europeans because of it playing a protective role against those diseases.
Tuberculosis is basically a lung disease while cholera is basically an intestinal infection.
The mechanism behind CF is fairly well understood in that we know it boils down to a miscoded CFTR, which is a channel that handles trafficking of certain molecules into and out of the cell. This impacts all cells in the human body, but especially epithelial tissues and especially impacts the mucosa.
Both lungs and gut tissues are epithelial tissues and both are lined with mucus, so CF leads to serious gut and respiratory problems (among other things). The lung issues get the most press, but about 90 percent or 95 percent of people with CF are seriously underweight due to gut issues interfering with their ability to get adequate nourishment.
So people with CF react differently to most lung and gut infections than the average person and in most cases this is very much to their detriment, but not always. There is some evidence that there are cases where the difference serves as a protective factor and that fact is likely why the mutation is more common in some populations than others.
It would be really, really interesting and potentially valuable if someone took that seriously for wondering exactly how Covid-19 works and why it kills some people while others are asymptomatic while infected.
It's too late, I'm deeply, deeply offended. And I simply don't understand your reticence to share private health information with strangers on the internet. /s
Ok, so from what I understand, much of the fallout from a coronavirus infection in severe cases is resulting from an overreaction by the immune system. What I saw in the original paper you shared is that the most plausible mechanism would be increased propensity for isolation and mask wearing, but the IL-6 knockdown would be through CF deactivating elements of the immune system (immune signaling molecules).
The Nature paper suggests upregulation of inflammation, which seems implausible to me: "Activation of furin, which is increased in CF, together with the cellular damage induced by viroporins, might be expected to upregulate NLRP3 and cause inflammation"
The proposed mechanism in the Physio paper is as follows: "Our analysis revealed that ACE2 mRNA is elevated and TMPRSS2 mRNA is decreased in CF airway epithelial cells compared with non-CF cells. Increased ACE2 is predicted to enhance SARS-CoV-2 binding to epithelial cells but would increase conversion of ANG II, which is proinflammatory, to angiotensin-1–7, which is anti-inflammatory. Thus, increased ACE2 would reduce inflammation and lung damage due to SARS-CoV-2. Moreover, decreased TMPRSS2 would reduce SARS-CoV-2 entry into airway epithelial cells"
So, again, there isn't hard evidence that this is happening at all, but here are a couple of proposed mechanisms that could potentially explain it if it is happening.
I'm not qualified to continue this discussion. I have no idea what in heck furins are. I'm just a former homemaker with the rude habit of failing to keel over dead from my condition. I don't speak medicalese.
> I read that article, and it doesn't seem like some grand revelation.
Does every article of interest have to be some grand revelation? Science is all about incremental gains, with very rare leaps.
Part of the why was very interesting here imo:
> But genetics may also make them particularly susceptible to SARS-CoV-2, the pandemic coronavirus. They have three copies of a gene on chromosome 21, TMPRSS2, which codes for an enzyme that the virus hijacks to help it enter human cells. The TMPRSS2 enzyme cleaves the spike protein that studs the virus’ surface, launching a series of steps that allows the virus to invade the host cell.
> Cells from people with DS typically express 1.6 times more TMPRSS2 than those from people without the condition
This highlights why those with down syndrome are even more susceptible than those vulnerable groups you mentioned.
Nonetheless, it's perhaps a good call out to be mindful of the vulnerable in our society. It's easily forgotten by the many selfish who can't see past their own perceived invulnerability to the "China virus" (paraphrasing how I perceive their attitudes into those quote marks here).
As a parent I would be absolutely devastated if my child had Downs and was killed(#) because of the poor behaviours at display in society.
(# Speaking as someone living in Australia where appropriate measures were eventually taken to protect everyone; my son has a different disability which impacts him, and us, greatly, so perhaps I empathize stronger for that reason. My opinion is that not taking easy
preemptive measures to stop the spread is akin to reckless endangerment with completely needless death being the outcome. Thus "killed".).
Would there be any reason that people with DS would react poorly to the vaccine (not because of the DS but because of the specific immune issues the article points out)? I really hope not, because wow is it clear that they should be near or at the top of the access list if we are going based on risk.
It's unfair you've been down voted. Given that people with DS have weaker immune systems and the vaccine relies on prompting the immune system, my non-immunologist brain assumes there is a reasonable concern here...
No, it's not specific to COVID-19. People with Down Syndrome have weaker immune systems and they are much more susceptible to many infections, including flu. They also often suffer from congenital heart defects and respiratory issues which may decrease their resilience to COVID etc.
Yes, it is rather specific to COVID-19. From the article:
> But genetics may also make them particularly susceptible to SARS-CoV-2, the pandemic coronavirus. They have three copies of a gene on chromosome 21, TMPRSS2, which codes for an enzyme that the virus hijacks to help it enter human cells. The TMPRSS2 enzyme cleaves the spike protein that studs the virus’ surface, launching a series of steps that allows the virus to invade the host cell.
> Cells from people with DS typically express 1.6 times more TMPRSS2 than those from people without the condition
Well, yes, the mechanism that causes people with Down Syndrome to be susceptible to COVID is specific to COVID.
But I understood the questioner to be asking about respiratory infections in general (including flu) since the linked article already addresses COVID susceptibility.
> But genetics may also make them particularly susceptible to SARS-CoV-2, the pandemic coronavirus. They have three copies of a gene on chromosome 21, TMPRSS2, which codes for an enzyme that the virus hijacks to help it enter human cells. The TMPRSS2 enzyme cleaves the spike protein that studs the virus’ surface, launching a series of steps that allows the virus to invade the host cell.
> Cells from people with DS typically express 1.6 times more TMPRSS2 than those from people without the condition
The saddest image I saw was in a documentary on the virus in Italy, footage of the death pages in the newspaper. Old person after old person, except for an ultra quick image of a younger man with Down syndrome, unseen by the reporter.
The doco was in released in April.
Why is there "raising calls for early vaccination" in December? This should have been decided months ago.
I'm not sure "10 times deadlier" makes sense either. For young people it's ~0. So 10 times 0 is still zero. But people with Down syndrome often work with others with Down syndrome so I think it's obvious what to do.
Up front disclosures: I'm the parent of a (prenatally-diagnosed) child with Down syndrome, and I'm pro-choice as a matter of public health and self-sovereignty.
It's been really nice to see the civil discourse in this thread, with people taking their respective positions and no one being a jerk. Thank you!
If you or someone you know has just received a diagnosis of a child with Down syndrome, prenatal or not, please help them find one of the several awesome support organizations out there. When we got our diagnosis, it was devastating and scary. The truth is, there's a huge spectrum of outcomes on a large number of dimensions. Heart trouble != intellectual delays != physical delays, etc. So far, raising my typically-developing daughter has been just as hard, just as much work, and just as unknown in a lot of ways as raising my son with Ds.
My wish and hope for the world is that every prospective parent makes decisions informed by facts and not fear. Folks who still choose not to continue a pregnancy (or choose to otherwise give up the baby) will receive absolutely no judgement from me and many people like me. But there's a lot of misinformation and misinterpretation available to you during one of the most emotional and confusing times you may ever encounter.
One such organization is the DSDN [1], which I'm familiar with because my spouse is currently a volunteer with them. There are others including national and local advocacy groups, Gigi's Playhouse, and more. Just please, talk to some new (and long-time) parents who've been there.
56 comments
[ 3.2 ms ] story [ 42.5 ms ] threadI guess it's good that once they are born we care about them, but it seems that as a society we've decided we'd prefer they just not be born.
That's the complicated part - when does "bring into the world" begin? For the parents (at least that is how we felt), this moment is often much, much closer to conception than to birth.
Edit: This is e.g. mentioned in the German Wikipedia on Pox (https://de.wikipedia.org/wiki/Pocken#16._bis_19._Jahrhundert), there is also a citation for it. I have read it several times during the last years, but don't have a better source, sorry.
And I'm not so old ;)
> It was common to give the newborn away to a nurse if you could afford it until it had survived the first year
I wasn't aware of that practice, although before around 1994 there were all kinds of institutions that don't exist now, which is literally why downtown SF is the way it is.
https://en.wikipedia.org/wiki/Deinstitutionalisation
https://www.washingtonpost.com/news/posteverything/wp/2017/0...
I don't mind taking care of them for the rest of my life, but who takes care of them after I'm gone?
People with down syndrome end up homeless all the time.
More technically, that's eugenics.
After having flirted with that practice in the last century, I thought we'd decided that it was a bad idea. But I guess ideas are hard to kill.
No it's called 'choice'. Women pregnant with babies potentially affected by that malformation are not forced by doctors or the government to abort. Big difference.
during the first trimester there is no individual - the fetus brain isn't even at the fish level. There is no electrical activity in the fetus brain at all until the week 6.
In response to the comment below - genetically an egg and sperm combined in the lab is different from either donor, yet it doesn't make it into individual. Or if you just take 2 (or 3, ...) DNA and recombine on computer, and actually synthesize that DNA - genetically distinct, yet definitely not an individual.
I was a late-life child. High risk for Down's. My mother didn't get the test, which could've introduced more problems. She believed I was already alive, because I was, and I was therefore sacred to her, and the outcome of the test would be irrelevant to her choice. Notice in all of this, I didn't have a choice.
I'm glad she didn't abort me. If I don't want to be alive now, now it's my decision.
I guess you can keep arguing that killing unborn children diagnosed with Down's isn't eugenics but my perspective is pretty heavily informed by the fact that I'm alive thanks to my mother being bothered by the idea that she might kill me in utero if I had a developmental disorder.
I'd like to see you explain the position that a baby diagnosed with Down's should be aborted to someone with Down's, frankly.
Abortion is a horrible thing I wish didn’t exist. Given that it does exist, it’s a horrible choice I wish upon no one. Given that choice is ever made, it’s a horrible thought to consider punishing a woman for making it.
All of that said, as a society we have a responsibility to do better than almost a million abortions a year (~20% of all pregnancies) in the US.
I think a better male contraceptive choice would go a long way to reducing that number. As usual, I believe in a technological solution to societal ills.
I do think contraception is obviously a powerful tool to reducing elective abortion, as a matter of policy.
Actual Honest reason is, “I don’t want a baby” However all sorts of mental games are played to justify / excuse it.
Got a citation on that?
Deliver the baby feet first. Before the head comes outs. Stick in a tube in its neck and suck the brains out.
https://www.govinfo.gov/content/pkg/CREC-1996-09-27/html/CRE...
Of Course sometimes they alter the procedure to make money off the body parts.
https://pregnancyhelpnews.com/planned-parenthood-officials-a...
fetuses are being aborted, and I'm not just nitpicking here. Down Syndrome screening is done in the first trimester.
So it seems to be less about something special about Down's syndrome that makes COVID more deadly to someone with Down's, but that it is just a subset of people who tend to have increased severity of respiratory infections in general. And COVID, being a somewhat respiratory virus, naturally hits those people harder than those without extra susceptibility to respiratory viruses.
What would be vastly more interesting is if someone, somewhere with some medical expertise was wondering why people with Down's Syndrome are, in fact, dying at high rates while people with Cystic Fibrosis -- another genetic disorder and infamous for killing people at young ages via respiratory infection -- are not:
Does cystic fibrosis constitute an advantage in COVID-19 infection?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537774/
Edit: And I say it would be vastly more interesting because of the potential to cast light on the pathology of the disease and thereby cast light on how to treat it effectively.
Someone with Downs isn't necessarily as able to make accurate risk calculations and may find themselves engaging in riskier behavior.
Add to that the fact that many adults with Downs may live in community group homes alongside others with mental health concerns (staff coming in and out - vector of infection), whereas those with CF may be less likely to do so, as (unfortunately in a human sense, fortunately in the sense of comparing with prior decades and the progress of treatment) their average life expectancy in the United States is under 40 y/o and they may be able to isolate with retired adult parents or work from home.
It felt like having bad anemia. The impact it has on the blood was a big deal but it did not seem to hit my respiratory system hard. If anything, it appeared to have some beneficial side effects for some longstanding issues.
So I think your quick and dirty dismissal of an important biological difference is specious.
It might be interesting to get an antibody test to confirm that it actually was SARS-CoV-2?
Which organ system is primarily affected by your CFTR mutation? I quickly checked the lit and I gather Atypical CF can mainly affect respiratory, gastrointestinal, endocrine and metabolic, or genitourinary systems and is a little different in this way than classic CF, but you probably know more about it than I do.
Do you guys have a pretty rough history of respiratory infections, or do you see it manifest primarily elsewhere? Are you guys on prophylactic antibiotics for chronic pulmonary infection?
What were the beneficial side effects?
Curious to hear your hypothesis as to how CFTR mutations could lend an advantage to patients with COVID? I haven't got any ideas.
Were you guys much, much more cautious with isolation? Do you work in the community, or were you very cautious about isolation?
Super curious to learn more.
Edit: I looked at the paper and behavior was cited as a possible key factor. "...typical behavior in patients with CF, who might wear protective masks and avoid contact with sick people..." Another idea they floated was disruption of IL-6 signaling, which they didn't figure would totally mask (ba dum tss) the respiratory effects of the virus, but might knock it down a bit. Iono, small sample size too.
There doesn't seem to be much data as to whether or not CF folks have any actual biological protections or if they're not just being more cautious, but I found a couple of papers that hypothesize potential mechanisms:
Peckham, D., McDermott, M.F., Savic, S. et al. COVID-19 meets Cystic Fibrosis: for better or worse?. Genes Immun 21, 260–262 (2020). https://doi.org/10.1038/s41435-020-0103-y
https://www.nature.com/articles/s41435-020-0103-y
SARS-CoV-2 (COVID-19) and cystic fibrosis. Bruce A. Stanton, Thomas H. Hampton, and Alix Ashare. American Journal of Physiology-Lung Cellular and Molecular Physiology 2020 319:3, L408-L415
https://journals.physiology.org/doi/full/10.1152/ajplung.002...
Hope you find them interesting.
Edit Edit: Based on your screen name, and our previous butting-heads over bullying vs. character building on another thread, I'm reminded of the classic Gary Larson/Far Side cartoon with Ed's Dingo Farm adjacent to Doreen's Nursery, and the caption 'Trouble Brewing.' An absolute classic. I'm perfectly willing to embrace the character archetype of Ed in this hypothetical cartoon situation, although I have yet to be graced with ownership of a dingo farm.
I'm not really interested in answering a whole lot of invasive personal questions. That has a history of going bad places on the internet and just not going there seems to be the only cure for that issue.
Cystic Fibrosis is much more common in Caucasians than in other ethnicities and there are papers out there that posit that this may be because it may protect against cholera and/or tuberculosis, two diseases that ravaged Europe for some time. So it's possible that the mutation became much more common in White Europeans because of it playing a protective role against those diseases.
Tuberculosis is basically a lung disease while cholera is basically an intestinal infection.
The mechanism behind CF is fairly well understood in that we know it boils down to a miscoded CFTR, which is a channel that handles trafficking of certain molecules into and out of the cell. This impacts all cells in the human body, but especially epithelial tissues and especially impacts the mucosa.
Both lungs and gut tissues are epithelial tissues and both are lined with mucus, so CF leads to serious gut and respiratory problems (among other things). The lung issues get the most press, but about 90 percent or 95 percent of people with CF are seriously underweight due to gut issues interfering with their ability to get adequate nourishment.
So people with CF react differently to most lung and gut infections than the average person and in most cases this is very much to their detriment, but not always. There is some evidence that there are cases where the difference serves as a protective factor and that fact is likely why the mutation is more common in some populations than others.
It would be really, really interesting and potentially valuable if someone took that seriously for wondering exactly how Covid-19 works and why it kills some people while others are asymptomatic while infected.
Ok, so from what I understand, much of the fallout from a coronavirus infection in severe cases is resulting from an overreaction by the immune system. What I saw in the original paper you shared is that the most plausible mechanism would be increased propensity for isolation and mask wearing, but the IL-6 knockdown would be through CF deactivating elements of the immune system (immune signaling molecules).
The Nature paper suggests upregulation of inflammation, which seems implausible to me: "Activation of furin, which is increased in CF, together with the cellular damage induced by viroporins, might be expected to upregulate NLRP3 and cause inflammation"
The proposed mechanism in the Physio paper is as follows: "Our analysis revealed that ACE2 mRNA is elevated and TMPRSS2 mRNA is decreased in CF airway epithelial cells compared with non-CF cells. Increased ACE2 is predicted to enhance SARS-CoV-2 binding to epithelial cells but would increase conversion of ANG II, which is proinflammatory, to angiotensin-1–7, which is anti-inflammatory. Thus, increased ACE2 would reduce inflammation and lung damage due to SARS-CoV-2. Moreover, decreased TMPRSS2 would reduce SARS-CoV-2 entry into airway epithelial cells"
So, again, there isn't hard evidence that this is happening at all, but here are a couple of proposed mechanisms that could potentially explain it if it is happening.
Also I skimmed these things, so grain of salt.
Does every article of interest have to be some grand revelation? Science is all about incremental gains, with very rare leaps.
Part of the why was very interesting here imo:
> But genetics may also make them particularly susceptible to SARS-CoV-2, the pandemic coronavirus. They have three copies of a gene on chromosome 21, TMPRSS2, which codes for an enzyme that the virus hijacks to help it enter human cells. The TMPRSS2 enzyme cleaves the spike protein that studs the virus’ surface, launching a series of steps that allows the virus to invade the host cell.
> Cells from people with DS typically express 1.6 times more TMPRSS2 than those from people without the condition
This highlights why those with down syndrome are even more susceptible than those vulnerable groups you mentioned.
As a parent I would be absolutely devastated if my child had Downs and was killed(#) because of the poor behaviours at display in society.
(# Speaking as someone living in Australia where appropriate measures were eventually taken to protect everyone; my son has a different disability which impacts him, and us, greatly, so perhaps I empathize stronger for that reason. My opinion is that not taking easy preemptive measures to stop the spread is akin to reckless endangerment with completely needless death being the outcome. Thus "killed".).
How can that be if there is a net new virus and emergency?
> But genetics may also make them particularly susceptible to SARS-CoV-2, the pandemic coronavirus. They have three copies of a gene on chromosome 21, TMPRSS2, which codes for an enzyme that the virus hijacks to help it enter human cells. The TMPRSS2 enzyme cleaves the spike protein that studs the virus’ surface, launching a series of steps that allows the virus to invade the host cell.
> Cells from people with DS typically express 1.6 times more TMPRSS2 than those from people without the condition
But I understood the questioner to be asking about respiratory infections in general (including flu) since the linked article already addresses COVID susceptibility.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074212/
> But genetics may also make them particularly susceptible to SARS-CoV-2, the pandemic coronavirus. They have three copies of a gene on chromosome 21, TMPRSS2, which codes for an enzyme that the virus hijacks to help it enter human cells. The TMPRSS2 enzyme cleaves the spike protein that studs the virus’ surface, launching a series of steps that allows the virus to invade the host cell.
> Cells from people with DS typically express 1.6 times more TMPRSS2 than those from people without the condition
The doco was in released in April.
Why is there "raising calls for early vaccination" in December? This should have been decided months ago.
I'm not sure "10 times deadlier" makes sense either. For young people it's ~0. So 10 times 0 is still zero. But people with Down syndrome often work with others with Down syndrome so I think it's obvious what to do.
It's been really nice to see the civil discourse in this thread, with people taking their respective positions and no one being a jerk. Thank you!
If you or someone you know has just received a diagnosis of a child with Down syndrome, prenatal or not, please help them find one of the several awesome support organizations out there. When we got our diagnosis, it was devastating and scary. The truth is, there's a huge spectrum of outcomes on a large number of dimensions. Heart trouble != intellectual delays != physical delays, etc. So far, raising my typically-developing daughter has been just as hard, just as much work, and just as unknown in a lot of ways as raising my son with Ds.
My wish and hope for the world is that every prospective parent makes decisions informed by facts and not fear. Folks who still choose not to continue a pregnancy (or choose to otherwise give up the baby) will receive absolutely no judgement from me and many people like me. But there's a lot of misinformation and misinterpretation available to you during one of the most emotional and confusing times you may ever encounter.
One such organization is the DSDN [1], which I'm familiar with because my spouse is currently a volunteer with them. There are others including national and local advocacy groups, Gigi's Playhouse, and more. Just please, talk to some new (and long-time) parents who've been there.
[1] https://www.dsdiagnosisnetwork.org/