Early Thymectomy Is Associated With Long-Term Impairment of the Immune System: A Systematic Review

Background and AimsCongenital heart diseases (CHDs) are diagnosed in approximately 9 in 1,000 newborns, and early cardiac corrective surgery often requires partial or complete thymectomy. As the long-term effect of early thymectomy on the subsequent development of the immune system in humans has not...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Nara Vasconcelos Cavalcanti, Patrícia Palmeira, Marcelo Biscegli Jatene, Mayra de Barros Dorna, Magda Carneiro-Sampaio
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	thymus thymectomy congenital heart defect lymphocytopenia T lymphocyte TRECs Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/6292c1099ffc4f168328cc69af6dceaf
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:6292c1099ffc4f168328cc69af6dceaf
record_format	dspace
spelling	oai:doaj.org-article:6292c1099ffc4f168328cc69af6dceaf2021-12-01T02:31:04ZEarly Thymectomy Is Associated With Long-Term Impairment of the Immune System: A Systematic Review1664-322410.3389/fimmu.2021.774780https://doaj.org/article/6292c1099ffc4f168328cc69af6dceaf2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.774780/fullhttps://doaj.org/toc/1664-3224Background and AimsCongenital heart diseases (CHDs) are diagnosed in approximately 9 in 1,000 newborns, and early cardiac corrective surgery often requires partial or complete thymectomy. As the long-term effect of early thymectomy on the subsequent development of the immune system in humans has not been completely elucidated, the present study aimed to evaluate the effects of thymus removal on the functional capacity of the immune system after different periods.MethodsA systematic review of the literature was performed using MEDLINE, EMBASE, LILACS and Scopus. The inclusion criteria were original studies that analyzed any component of the immune system in patients with CHD who had undergone thymectomy during cardiac surgery in the first years of life. The results were evaluated for the quality of evidence.ResultsTwenty-three studies were selected and showed that patients who underwent a thymectomy in the first years of life tended to exhibit important alterations in the T cell compartment, such as fewer total T cells, CD4+, CD8+, naïve and CD31+ T cells, lower TRECs, decreased diversity of the TCR repertoire and higher peripheral proliferation (increased Ki-67 expression) than controls. However, the numbers of memory T cells and Treg cells differed across the selected studies.ConclusionsEarly thymectomy, either partial or complete, may be associated with a reduction in many T cell subpopulations and TCR diversity, and these alterations may persist during long-term follow-up. Alternative solutions should be studied, either in the operative technique with partial preservation of the thymus or through the autograft of fragments of the gland.Systematic Review RegistrationProspero [157188].Nara Vasconcelos CavalcantiPatrícia PalmeiraMarcelo Biscegli JateneMayra de Barros DornaMagda Carneiro-SampaioMagda Carneiro-SampaioFrontiers Media S.A.articlethymusthymectomycongenital heart defectlymphocytopeniaT lymphocyteTRECsImmunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	thymus thymectomy congenital heart defect lymphocytopenia T lymphocyte TRECs Immunologic diseases. Allergy RC581-607
spellingShingle	thymus thymectomy congenital heart defect lymphocytopenia T lymphocyte TRECs Immunologic diseases. Allergy RC581-607 Nara Vasconcelos Cavalcanti Patrícia Palmeira Marcelo Biscegli Jatene Mayra de Barros Dorna Magda Carneiro-Sampaio Magda Carneiro-Sampaio Early Thymectomy Is Associated With Long-Term Impairment of the Immune System: A Systematic Review
description	Background and AimsCongenital heart diseases (CHDs) are diagnosed in approximately 9 in 1,000 newborns, and early cardiac corrective surgery often requires partial or complete thymectomy. As the long-term effect of early thymectomy on the subsequent development of the immune system in humans has not been completely elucidated, the present study aimed to evaluate the effects of thymus removal on the functional capacity of the immune system after different periods.MethodsA systematic review of the literature was performed using MEDLINE, EMBASE, LILACS and Scopus. The inclusion criteria were original studies that analyzed any component of the immune system in patients with CHD who had undergone thymectomy during cardiac surgery in the first years of life. The results were evaluated for the quality of evidence.ResultsTwenty-three studies were selected and showed that patients who underwent a thymectomy in the first years of life tended to exhibit important alterations in the T cell compartment, such as fewer total T cells, CD4+, CD8+, naïve and CD31+ T cells, lower TRECs, decreased diversity of the TCR repertoire and higher peripheral proliferation (increased Ki-67 expression) than controls. However, the numbers of memory T cells and Treg cells differed across the selected studies.ConclusionsEarly thymectomy, either partial or complete, may be associated with a reduction in many T cell subpopulations and TCR diversity, and these alterations may persist during long-term follow-up. Alternative solutions should be studied, either in the operative technique with partial preservation of the thymus or through the autograft of fragments of the gland.Systematic Review RegistrationProspero [157188].
format	article
author	Nara Vasconcelos Cavalcanti Patrícia Palmeira Marcelo Biscegli Jatene Mayra de Barros Dorna Magda Carneiro-Sampaio Magda Carneiro-Sampaio
author_facet	Nara Vasconcelos Cavalcanti Patrícia Palmeira Marcelo Biscegli Jatene Mayra de Barros Dorna Magda Carneiro-Sampaio Magda Carneiro-Sampaio
author_sort	Nara Vasconcelos Cavalcanti
title	Early Thymectomy Is Associated With Long-Term Impairment of the Immune System: A Systematic Review
title_short	Early Thymectomy Is Associated With Long-Term Impairment of the Immune System: A Systematic Review
title_full	Early Thymectomy Is Associated With Long-Term Impairment of the Immune System: A Systematic Review
title_fullStr	Early Thymectomy Is Associated With Long-Term Impairment of the Immune System: A Systematic Review
title_full_unstemmed	Early Thymectomy Is Associated With Long-Term Impairment of the Immune System: A Systematic Review
title_sort	early thymectomy is associated with long-term impairment of the immune system: a systematic review
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/6292c1099ffc4f168328cc69af6dceaf
work_keys_str_mv	AT naravasconceloscavalcanti earlythymectomyisassociatedwithlongtermimpairmentoftheimmunesystemasystematicreview AT patriciapalmeira earlythymectomyisassociatedwithlongtermimpairmentoftheimmunesystemasystematicreview AT marcelobisceglijatene earlythymectomyisassociatedwithlongtermimpairmentoftheimmunesystemasystematicreview AT mayradebarrosdorna earlythymectomyisassociatedwithlongtermimpairmentoftheimmunesystemasystematicreview AT magdacarneirosampaio earlythymectomyisassociatedwithlongtermimpairmentoftheimmunesystemasystematicreview AT magdacarneirosampaio earlythymectomyisassociatedwithlongtermimpairmentoftheimmunesystemasystematicreview
_version_	1718405905598382080

Early Thymectomy Is Associated With Long-Term Impairment of the Immune System: A Systematic Review

Ejemplares similares