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Evaluating Thymic Function After Human Hematopoietic Stem Cell Transplantation in the Personalized Medicine Era
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- Gaballa, Ahmed (author)
- Karolinska Institutet
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- Clave, Emmanuel (author)
- Hop St Louis, AP HP, INSERM UMR 1160, Inst Rech St Louis, Paris, France.;Univ Paris, Paris, France.
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- Uhlin, Michael (author)
- Karolinska Institutet,KTH,Biofysik,Science for Life Laboratory, SciLifeLab,Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
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- Karolinska Institutet Hop St Louis, AP HP, INSERM UMR 1160, Inst Rech St Louis, Paris, France;Univ Paris, Paris, France. (creator_code:org_t)
- 2020-07-31
- 2020
- English.
- In: Frontiers in Immunology. - : Frontiers Media SA. - 1664-3224. ; 11
- Research review (peer-reviewed)
Abstract
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- Hematopoietic stem cell transplantation (HSCT) is an effective treatment option for several malignant and non-malignant hematological diseases. The clinical outcome of this procedure relies to a large extent on optimal recovery of adaptive immunity. In this regard, the thymus plays a central role as the primary site forde novogeneration of functional, diverse, and immunocompetent T-lymphocytes. The thymus is exquisitely sensitive to several insults during HSCT, including conditioning drugs, corticosteroids, infections, and graft-vs.-host disease. Impaired thymic recovery has been clearly associated with increased risk of opportunistic infections and poor clinical outcomes in HSCT recipients. Therefore, better understanding of thymic function can provide valuable information for improving HSCT outcomes. Recent data have shown that, besides gender and age, a specific single-nucleotide polymorphism affects thymopoiesis and may also influence thymic output post-HSCT, suggesting that the time of precision medicine of thymic function has arrived. Here, we review the current knowledge about thymic role in HSCT and the recent work of genetic control of human thymopoiesis. We also discuss different transplant-related factors that have been associated with impaired thymic recovery and the use of T-cell receptor excision circles (TREC) to assess thymic output, including its clinical significance. Finally, we present therapeutic strategies that could boost thymic recovery post-HSCT.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Immunologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Immunology in the medical area (hsv//eng)
Keyword
- T-cells
- thymus
- hematopoietic stem cell transplantation
- TREC
- immune reconstitution
- thymic function
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