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Thymic output changes in children with clinical findings signaling a probable primary immunodeficiency

Neslihan Karaca1, Elif Azarsız2, Sanem Eren Akarcan1

  • 1Departments of Pediatric Immunology, Ege University Faculty of Medicine, İzmir, Turkey.

The Turkish Journal of Pediatrics
|March 6, 2020
PubMed

Insights

Evaluating thymic output using CD31+ recent thymic emigrant (RTE) cells can rapidly assess T-cell immune dysfunction in children with primary immunodeficiency. This method may serve as an alternative to TRECs for diagnosing combined immunodeficiencies.

Area of Science:

  • Immunology
  • Pediatrics
  • Flow Cytometry

Background:

  • Primary immunodeficiencies (PIDs) encompass a range of disorders affecting the immune system.
  • T-cell immunodeficiencies are particularly severe, necessitating thorough thymic maturation evaluation.
  • Assessing thymic output is crucial for diagnosing and managing PIDs in children.

Purpose of the Study:

  • To evaluate the utility of the T-cell surface molecule CD31 for assessing thymic output in children with suspected primary immunodeficiency.
  • To investigate T-cell subpopulations, including naive, memory, and recent thymic emigrant (RTE) cells, in this patient cohort.
  • To explore the correlation between CD31 expression on RTE cells and specific immunodeficiency diagnoses.

Main Methods:

  • A cohort of 66 children with clinical findings suggestive of PID were studied.
  • Flow cytometry was used to analyze T-cell subpopulations, specifically naive (CD4+CD45RA+) and recent thymic emigrant (CD4+CD45RA+CD31+) cells.
  • Clinical and laboratory data were collected to determine diagnoses and patient history, including cardiac surgery.

Main Results:

  • Combined immunodeficiency and humoral immunodeficiency were the most frequent diagnoses.
  • Significantly lower percentages and absolute counts of naive T-cells and absolute counts of CD31+ RTE cells were observed in the combined immunodeficiency group.
  • Patients with a history of cardiac surgery showed lower percentages of naive T-cells and RTE cells.

Conclusions:

  • Flow cytometric evaluation of CD31+ thymic naive RTE cells offers rapid clinical information regarding T-cell immune dysfunction.
  • CD4+CD45RA+CD31+ RTE cells show potential as an alternative to TRECs in diagnosing combined immunodeficiencies.
  • This approach aids in the comprehensive assessment of primary immunodeficiencies in pediatric patients.

Keywords:
RTEimmunodeficiencyrecent thymic emigrant cells

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