{
  "abstract": "Cleft lip and/or palate (CL/P) is associated with recurrent upper respiratory tract complications, yet the immunoregulatory mechanisms accompanying this defect remain insufficiently understood. This study aimed to characterize cellular and soluble parameters associated with PD-1, PD-L1, and CTLA-4 in children with CL/P and to analyze their associations with selected clinical and hematological characteristics. This single-center cross-sectional study included 32 children with CL/P and 16 healthy children as controls. Serum concentrations of sPD-1, sPD-L1, and sCTLA-4 were measured, and the percentages of cells expressing PD-1, PD-L1, and CTLA-4 within T-lymphocyte (CD3+ CD4+ and CD3+ CD8+) and B-lymphocyte (CD19+) populations were assessed using flow cytometry. We analyzed relationships between immunological and clinical parameters, as well as differences between subgroups by gender and mode of delivery. Children with CL/P exhibited significantly higher serum concentrations of sPD-1, sPD-L1, and sCTLA-4, as well as higher percentages of T and B lymphocytes expressing these immune checkpoint molecules, compared to the control group (p < 0.0001 in all cases). We observed significant associations among selected immune checkpoint-related parameters, including a positive correlation between sPD-1 and sCTLA-4 and an inverse correlation between the percentages of CD19+ PD-L1+ and CD19+ CTLA-4+ B lymphocytes. The markers clearly distinguished children with CL/P from healthy children in the study cohort; however, we found no consistent differences by gender or mode of delivery. Children with CL/P exhibited distinct cellular and soluble immune checkpoint-related profiles compared to the control group. However, given the limited sample size and the study’s cross-sectional design, these results should be considered preliminary and require confirmation in larger, independent cohorts.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Plastic, Reconstructive and Microsurgery, Medical University of Lublin, ul. Jaczewskiego 8, 20-090 Lublin, Poland",
    "Department of Pediatric Pulmonology and Rheumatology, Medical University of Lublin, ul. Prof. Antoniego Gębali 6, 20-093 Lublin, Poland",
    "Department of Jaw Orthopaedics, Medical University of Lublin, ul. Chodźki 6, 20-093 Lublin, Poland",
    "Department of Pediatric Pulmonology and Rheumatology, University Children’s Hospital, ul. Prof. Antoniego Gębali Street 6, 20-093 Lublin, Poland",
    "Department of Experimental Immunology, Medical University of Lublin, ul. Chodźki 4a, 20-093 Lublin, Poland",
    "College of Medicine, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea",
    "Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, ul. Długa 1/2, 61-848 Poznań, Poland",
    "Department of Precision Medicine in Medical Surgical and Critical Area, University of Palermo, 90134 Palermo, Italy"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Margareta Budner"
    },
    {
      "affs": [
        0
      ],
      "name": "Kamil Torres"
    },
    {
      "affs": [
        1
      ],
      "name": "Violetta Opoka-Winiarska"
    },
    {
      "affs": [
        2
      ],
      "name": "Agnieszka Lasota",
      "orcid": "0000-0003-3654-3042"
    },
    {
      "affs": [
        3
      ],
      "name": "Małgorzata Gdak"
    },
    {
      "affs": [
        4
      ],
      "name": "Paulina Mertowska",
      "orcid": "0000-0001-9530-6659"
    },
    {
      "affs": [
        4
      ],
      "name": "Sebastian Mertowski",
      "orcid": "0000-0002-7121-1396"
    },
    {
      "affs": [
        4
      ],
      "name": "Krzysztof Gosik"
    },
    {
      "affs": [
        5
      ],
      "name": "Minseung Kang",
      "orcid": "0009-0001-6144-5543"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Tomasz Urbanowicz",
      "orcid": "0000-0001-8080-2764"
    },
    {
      "affs": [
        4
      ],
      "name": "Ewelina Grywalska"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4xpsgpyw8rv82.bib",
  "cited_by": 0,
  "doi": "10.3390/ijms27219488",
  "fulltext_url": null,
  "id": "4xpsgpyw8rv82",
  "issns": [
    "1422-0067"
  ],
  "landing_url": "https://www.mdpi.com/1422-0067/27/21/9488",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "1311|Cleft Lip and Palate Research"
    ]
  ],
  "openalex": "W7223943771",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-24",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/4xpsgpyw8rv82.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:57Z",
      "native_id": "10.3390/ijms27219488",
      "source": "crossref",
      "url": "https://www.mdpi.com/1422-0067/27/21/9488"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:1311|Cleft Lip and Palate Research",
      "subfield": "genetics-genomics"
    }
  ],
  "title": "Checkpoint Pathways in Childhood Cleft Lip and Palate—Associations of PD1 and CTLA4 with Clinical Parameters",
  "title_text": "Checkpoint Pathways in Childhood Cleft Lip and Palate—Associations of PD1 and CTLA4 with Clinical Parameters",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:57Z",
  "url": "https://research.draconitic.com/paper/4xpsgpyw8rv82",
  "venue": "International Journal of Molecular Sciences",
  "versions": []
}