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Treatment of combined immunodeficiency with thymic extract (Thymostimulin)
Insights
Thymostimulin therapy successfully treated a neonate with combined immunodeficiency, restoring B cell function and immune responses. This bovine thymic extract treatment showed lasting effectiveness without requiring ongoing therapy.
Area of Science:
- Immunology
- Pediatric Medicine
- Biotherapy
Background:
- A 14-day-old infant presented with severe combined immunodeficiency (SCID) and extensive skin lesions.
- Infections included Staphylococcus aureus, Acinetobacter anitratus, Enterobacter cloacae, Candida albicans, and group A beta-Streptococcus hemolyticus.
Observation:
- The patient exhibited profoundly low lymphocyte counts, impaired immunoglobulin (IgG, IgA) production, and deficient T cell populations (Tac+ T cells, total T cells, subsets).
- Lymph node biopsy revealed absent follicular formation and lymphocyte depletion in both thymic-dependent and -independent areas.
- Poor lymphoproliferative responses to mitogens and decreased migration inhibitory factor production to Candida antigen were noted.
Findings:
- Thymostimulin (TP-1), a bovine thymic extract, was administered.
- Post-treatment lymph node biopsy showed germinal center formation with IgA- and IgM-bearing cells, indicating B cell maturation.
- Serum immunoglobulins (IgG, IgA, IgM) and peripheral blood B cells became detectable, alongside improved T cell counts and function.
- In vitro immunoglobulin synthesis and lymphoproliferative responses normalized.
Implications:
- Thymostimulin demonstrated significant therapeutic efficacy in combined immunodeficiency, both histologically and immunologically.
- Successful reconstitution of B cell function was achieved, suggesting a potential treatment for similar pediatric immune disorders.
- The positive outcomes were sustained without the need for continued Thymostimulin therapy.
Abstract:
A 14-day-old Chinese male baby was admitted with extensive skin lesions. A wound culture grew Staphylococcus aureus, Acinetobacter anitratus, Enterobacter cloacae, and Candida albicans and a blood culture grew group A beta-Streptococcus hemolyticus. The patient's lymphocyte counts were low and his lymphocytes were unable to produce IgG and IgA in vitro. The immunoglobulin-bearing cell studies also failed to demonstrate IgG and IgA bearing cells. Active Tac+ T cells, total T cells, and T cell subsets were at very low levels. Lymphoproliferative response to mitogens was also poor. Migration inhibitory factor production to Candida antigen was also decreased. The initial lymph node biopsy demonstrated no follicular formation and extensive depletion of lymphocytes in both thymic-dependent and thymic-independent areas. After Thymostimulin (a specific bovine thymic extract, TP-1) treatment, the second lymph node biopsy demonstrated germinal centers containing IgA-bearing cells and IgM-bearing cells and, subsequently, cortical and medullary differentiation. Serum IgG, IgA, and IgM became detectable at low levels and IgG-, IgA-, and IgM-bearing lymphocytes appeared in the peripheral blood. This also correlated with in vitro immunoglobulin synthesis. Active Tac+ T cells, total T cells, T cell subsets and lymphoproliferative response to mitogens increased gradually after thymostimulin therapy. This investigation demonstrated the therapeutic effectiveness of Thymostimulin in combined immunodeficiency both histologically and immunologically and the successful reconstitution of B cell function that did not require continued therapy.