Thymic Atrophy and Immune Dysregulation in Infants with Complex Congenital Heart Disease
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Thymic Atrophy and Immune Dysregulation in Infants with Complex Congenital Heart Disease. / Bremer, Sarah-Jolan; Boxnick, Annika; Glau, Laura; Biermann, Daniel; Joosse, Simon A; Thiele, Friederike; Billeb, Elena; May, Jonathan; Kolster, Manuela; Hackbusch, Romy; Fortmann, Mats Ingmar; Kozlik-Feldmann, Rainer; Hübler, Michael; Tolosa, Eva; Sachweh, Jörg Siegmar; Gieras, Anna.
in: J CLIN IMMUNOL, Jahrgang 44, Nr. 3, 69, 23.02.2024.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Thymic Atrophy and Immune Dysregulation in Infants with Complex Congenital Heart Disease
AU - Bremer, Sarah-Jolan
AU - Boxnick, Annika
AU - Glau, Laura
AU - Biermann, Daniel
AU - Joosse, Simon A
AU - Thiele, Friederike
AU - Billeb, Elena
AU - May, Jonathan
AU - Kolster, Manuela
AU - Hackbusch, Romy
AU - Fortmann, Mats Ingmar
AU - Kozlik-Feldmann, Rainer
AU - Hübler, Michael
AU - Tolosa, Eva
AU - Sachweh, Jörg Siegmar
AU - Gieras, Anna
N1 - © 2024. The Author(s).
PY - 2024/2/23
Y1 - 2024/2/23
N2 - Congenital heart disease (CHD) is the most common birth defect, and up to 50% of infants with CHD require cardiovascular surgery early in life. Current clinical practice often involves thymus resection during cardiac surgery, detrimentally affecting T-cell immunity. However, epidemiological data indicate that CHD patients face an elevated risk for infections and immune-mediated diseases, independent of thymectomy. Hence, we examined whether the cardiac defect impacts thymus function in individuals with CHD. We investigated thymocyte development in 58 infants categorized by CHD complexity. To assess the relationship between CHD complexity and thymic function, we analyzed T-cell development, thymic output, and biomarkers linked to cardiac defects, stress, or inflammation. Patients with highly complex CHD exhibit thymic atrophy, resulting in low frequencies of recent thymic emigrants in peripheral blood, even prior to thymectomy. Elevated plasma cortisol levels were detected in all CHD patients, while high NT-proBNP and IL-6 levels were associated with thymic atrophy. Our findings reveal an association between complex CHD and thymic atrophy, resulting in reduced thymic output. Consequently, thymus preservation during cardiovascular surgery could significantly enhance immune function and the long-term health of CHD patients.
AB - Congenital heart disease (CHD) is the most common birth defect, and up to 50% of infants with CHD require cardiovascular surgery early in life. Current clinical practice often involves thymus resection during cardiac surgery, detrimentally affecting T-cell immunity. However, epidemiological data indicate that CHD patients face an elevated risk for infections and immune-mediated diseases, independent of thymectomy. Hence, we examined whether the cardiac defect impacts thymus function in individuals with CHD. We investigated thymocyte development in 58 infants categorized by CHD complexity. To assess the relationship between CHD complexity and thymic function, we analyzed T-cell development, thymic output, and biomarkers linked to cardiac defects, stress, or inflammation. Patients with highly complex CHD exhibit thymic atrophy, resulting in low frequencies of recent thymic emigrants in peripheral blood, even prior to thymectomy. Elevated plasma cortisol levels were detected in all CHD patients, while high NT-proBNP and IL-6 levels were associated with thymic atrophy. Our findings reveal an association between complex CHD and thymic atrophy, resulting in reduced thymic output. Consequently, thymus preservation during cardiovascular surgery could significantly enhance immune function and the long-term health of CHD patients.
KW - Infant
KW - Humans
KW - Thymus Gland
KW - T-Lymphocytes
KW - Heart Defects, Congenital/surgery
KW - Atrophy/pathology
U2 - 10.1007/s10875-024-01662-4
DO - 10.1007/s10875-024-01662-4
M3 - SCORING: Journal article
C2 - 38393459
VL - 44
JO - J CLIN IMMUNOL
JF - J CLIN IMMUNOL
SN - 0271-9142
IS - 3
M1 - 69
ER -