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Published on: December 29, 2014
Levels of recent thymic emigrant cells decrease in children undergoing partial thymectomy during cardiac surgery
Ashish B Madhok1, A Chandrasekran, Vincent Parnell
1North Shore-Long Island Jewish Research Institute and Schneider Children's Hospital, North Shore-Long Island Jewish Health System, Manhasset, New York, USA.
Insights
Partial thymectomy in children significantly reduces thymic recent emigrants (TRECs), indicating a drop in T-cell output. Long-term effects of this reduced thymic function require further investigation.
Area of Science:
- Immunology
- Pediatric Surgery
Background:
- The thymus is crucial for T-cell development in fetal life.
- Postnatal thymectomy does not typically lead to immunodeficiency.
- Thymic recent emigrants (TRECs) reflect ongoing T-cell production.
Purpose of the Study:
- To assess the impact of partial thymectomy on TREC levels in children.
- To quantify changes in thymic output following cardiac surgery involving partial thymectomy.
Main Methods:
- Real-time PCR was used to measure TREC levels in peripheral blood lymphocytes.
- TREC levels were analyzed in 24 children (0-12 years) pre- and post-partial thymectomy.
- Paired analysis was conducted on 11 children, with additional data from 8 children post-surgery.
Main Results:
- A significant decrease in TREC values was observed immediately after partial thymectomy compared to pre-operative levels (P = 0.014).
- Mean TREC levels dropped from 47916 +/- 9271 pre-surgery to 33157 +/- 8479 post-surgery.
- Lower TREC counts were also noted in children with longer intervals post-thymectomy.
Conclusions:
- Partial thymectomy leads to a significant, immediate reduction in thymic T-cell output.
- The long-term consequences of diminished thymic output following partial thymectomy in children remain to be determined.
Abstract:
The human thymus is required for establishment of a T-cell pool in fetal life, but postnatal thymectomy is not known to cause immunodeficiency. T-cell emigration from thymus (thymic recent emigrants [TRECs]) is a continuous thymic-dependent process. We studied TREC levels pre- and post-partial thymectomy in children undergoing cardiac surgery. TRECs were quantitated by real-time PCR in peripheral blood lymphocytes of 24 children (0 to 12 years). TREC values were 47916 +/- 9271 pre-partial thymectomy and 33157 +/- 8479 post-partial thymectomy in 11 paired patients (P = 0.014). Interval between pre- and post-partial thymectomy was 8.8 days +/- 5.8 days. Another group of 8 children had 30384 +/- 9748 TRECs 16 days to 6 years post-partial thymectomy. There was a significant drop in TREC values post-partial thymectomy in the immediate postoperative period compared to prethymectomy TREC levels. While decreased thymic output may persist, the long-term implications were not evaluated in this patient population.
