ASPECTS OF THE FORK GLAND (THIMUS) CHILD (PART III)
Main Article Content
Abstract
The thymus gland (thymus) is a huge mystery of biology, medicine (primarily immunology) and, in particular, pediatrics. Despite the fact that it has been calling attention of researchers for over 4 centuries. Only in the 20th century, the attitude of scientists to the organ as to a generator and regulator of immune reactions, a participant in the production and differentiation of many populations of immunocompetent cells, and so on, was determined.
The thymus is now regarded as a derivative of the immune system and, to a greater extent, as its central organ. Infectious diseases, systemic autoimmune diseases, oncology, the problem of tissue incompatibility determine the life expectancy of a person and therefore the scientific interest to the functions of the immune system and its central organ - the thymus gland is understandable. The key challenge of the study is in the huge number of integral connections of the thymus gland with other components of the immune system, microbiome, neuroendocrine, hematopoietic and connective tissues, organs (and cells) providing barrier function, etc. To isolate functions directly related to the thymus from this continuum is a high-tech task of extreme complexity.
The interest of pediatricians in this area of knowledge is associated with a certain understanding of human ontogenesis from birth to old age, where the thymus plays a major role in the antenatal and early postnatal periods. The purpose of this review, as far as possible, is to isolate and focus on some, in our opinion, «white spots» of an ambiguous assessment of morphological transformations and functions attributed to the thymus gland, its structures and cell pool.
Downloads
Article Details
Issue
Section
Author Biographies
Юрий Иванович Ровда, Kemerovo State Medical University
Rovda Yuryi Ivanovich
MD, PhD, professor
He is the Honoured Doctor of the Russian Federation, the Head of the Department of Pediatrics and Neonatology. He graduated from the Pediatric Faculty of Kemerovo Medical Institute in 1973. On his initiative the Regional Pediatric Cardiac Center was organized. His researches concerning the metabolic syndrome, purinosis, hypertension in children are priorities in the Russian Federation.
He is an expert of the Russian Task Group of Federal Service on Surveillance in Healthcare, dealing with mentioned diseases.
He was the first who developed and implemented method of diagnostics of visceral fat deposition in children with echocardiography and a number of different new scientific-practical methods (the prevention of purine metaboliс imbalance, prenosological diagnostics and prevention of arterial hypertension and metabolic syndrome in children and adolescents, alternative methods of prevention and treatment of metabolic syndrome, allergodermia in children – ozone therapy, etc.).Светлана Александровна Шмулевич, Research Institute of Complex Problems of Cardiovascular Diseases, Kemerovo
candidate of medical sciences, pediatric cardiologist, cardiac surgery departmentАлена Владимировна Ведерникова, Kemerovo State Medical University, Kemerovo
assistant, department of pediatrics and neonatologyНаталья Николаевна Миняйлова, Kemerovo State Medical University
doctor of medical sciences, docent, professor of the department of pediatrics and neonatologyАндрей Владимирович Шабалдин, Kemerovo State Medical University
doctor of medical sciences, professor of the department of microbiology, immunology and virologyСергей Фадеевич Зинчук, Kemerovo State Medical University
candidate of medical sciences, docent, head of the department of morphology and forensic medicineЯна Вячеславовна Юнкина, Kuzbass Regional Clinical Hospital named after S.V. Belyaev, Kemerovo
candidate of medical sciences, head of the pediatric specialized departmentЕлена Борисовна Лукоянычева, Kuzbass Regional Clinical Hospital named after S.V. Belyaev, Kemerovo
doctor of clinical laboratory diagnostics, head of the immunological laboratoryReferences
Dallakyan DN, Razumovskiy AYu. Thoracoscopic thymectomy in children. Russian Journal of Pediatric Surgery. 2012; 5: 46-50. Russian (Даллакян Д.Н., Разумовский А.Ю. Торакоскопическая тимэктомия у детей //Детская хирургия. 2012. № 5. С. 46-50)
Kogut KA, Bufo AJ, Rothenberg S, Love T. Pediatr Endosurg Innov Techn. 2001; 5(2): 20-22)
Miller JF. Immunological functions of the thymus. Lancet. 1961; 2: 748-749
Zinger FB, Mikhaylova TN, Bavykina MN. The state of natural defense factors in thymectomized rats. The role of the thymus in health and pathology: collection of articles scientific works ed. ED Goldberg. Tomsk, 1979. P. 59-63. Russian (Зингер Ф.Б., Михайлова Т.Н., Бавыкина М.Н. Состояние естественных факторов защиты у тимэктомированных крыс //Роль тимуса в норме и патологии: сб. научных работ под ред. Е.Д. Гольдберга. Томск, 1979. С. 59-63)
Degtyareva EA, Kuzmenko LG, Tyurin NA. Immunotropic drugs in pediatric cardiology. Vestnik aritmologii. 2000; 18: 20-21. Russian (Дегтярева Е.А., Кузьменко Л.Г., Тюрин Н.А. Иммунотропные средства в детской кардиологии //Вестник аритмологии. 2000. № 18. С. 20-21)
Frolenko AL. Clinical and immunological characteristics of children after thymectomy: abstr. dis. ... cand. med. sciences. M., 2011. 26 p. Russian (Фроленко А.Л. Клинико-иммунологическая характеристика детей после тимэктомии: автореф. дис. … канд. мед. наук. М., 2011. 26 с.)
Brearley S, Gentle TA, Baynham MI, Roberts KD, Abrams LD, Thompson RA. Immunodeficiency following neonatal thymectomy in man. Clin exp immunol. 1987; 70(2): 322-327
Smolyagin AI, Frolenko AL, Prodeus AP, Yarilin AA. The immune status of children after surgical treatment for congenital heart defects. Journal of Ural Medical Academic Science. 2011; 2-1(35): 200-201. Russian (Смолягин А.И., Фроленко А.Л., Продеус А.П., Ярилин А.А. Иммунный статус детей после оперативного лечения по поводу врожденных пороков сердца //Вестник Уральской медицинской академической науки. 2011. № 2-1(35). С. 200-201)
Mussatto KA, Hoffmann RG, Hoffman GM, Tweddell JS, Bear L, Cao Yu, Brosig C. Risk and prevalence of developmental delay in young children with congenital heart disease. Pediatrics. 2014; 133(3): e570-577. doi: 10.1542/peds.2013-2309
Nesterova IV. Principles of immunorehabilitation in children with secondary immunodeficiency conditions. Issues of protection of motherhood and childhood. 1992; 2: 93-100. Russian (Нестерова И.В: Принципы проведения иммунореабилитации у детей с вторичными иммунодефицитными состояниями //Вопросы охраны материнства и детства. 1992. № 2. С. 93-100)
Samuilova DSh. Diagnostic and prognostic informational content of the functional state of neutrophils and humoral immunity in patients of a cardiac surgery hospital: abstr. dis. ... doctor biol. sciences. M., 1999. 47 p. Russian (Самуилова Д.Ш. Диагностическая и прогностическая информативность функционального состояния нейтрофилов и гуморального иммунитета у пациентов кардиохирургического стационара: автореф. дис. ... докт. биол. наук. М., 1999. 47 с.)
Ceyran AB, Senol S, Güzelmeriç F, Tunçer E, Tongut A, Özbek B, et al. Effects of hypoxia its relationship with apoptosis, stem ceiis, and angiogenesis on the thymus of children with congenital heart defects: a morphological and immunohistochemical stude. Int J Clin Exp Pathol. 2015; 8(7): 8038-8047
Sharykin AS. The first experience of using derinat in young children after the correction of congenital heart defects of the blue type. Medical Department. 2002; 4: 78-80. Russian (Шарыкин А.С. Первый опыт использования дерината у детей раннего возраста после коррекции врожденных пороков сердца синего типа //Медицинская кафедра. 2002. № 4. С. 78-80)
Kostrykin MYu. Surgical treatment of congenital heart defects in young children with preservation of the thymus gland: abstr. dis. ... cand. med. sciences. Rostov-on-Don, 2006. 21 p. Russian (Кострыкин М.Ю. Хирургическое лечение врожденных пороков сердца у детей раннего возраста с сохранением вилочковой железы: автореф. дис. ... канд. мед. наук. Ростов-на-Дону, 2006. 21 с.)
Solov'yev GM. NTSSSKH im. A.N. Bakuleva. Institut kardiokhirurgii im. V.I. Burakovskogo RAMN. Institut koronarnoy i sosudistoy khirurgii. T. 2. M., 1987. P. 183, 303-311. Russian (Соловьев Г.М. /НЦССХ им. А.Н. Бакулева. Институт кардиохирургии им. В.И. Бураковского РАМН. Институт коронарной и сосудистой хирургии. Т. 2. М., 1987. С. 183, 303-311)
Crumpton MJ, Sewell WA, Brown MH, Fink PJ, Kozak CA. The murine homologue of the T lymphocyte CD2 antigen: molecular cloning, chromosome assignmentand cell surface expression. Eur J Immunol. 1987; 17: 1015-1020
Basargina EN, Leontyeva IV, Kotlukova NP, Kovalev IA, Sharykin AS. Diagnostics and treatment of chronic heart failure in children and adolescents: Methodical recommendations. M., 2010. 80 p. Russian (Басаргина Е.Н., Леонтьева И.В., Котлукова Н.П., Ковалев И.А., Шарыкин А.С. Диагностика и лечение хронической сердечной недостаточности у детей и подростков: Методические рекомендации. М., 2010. 80 с.)
Artemenko OI. Clinical, biochemical and immunological features of the development of pulmonary hypertension in congenital heart defects in young children. Bulletin of RSMU. 2007; 2/551: 194-195. Russian (Артеменко О.И. Клинико-биохимические и иммунологические особенности развития легочной гипертензии при врожденных пороках сердца у детей раннего возраста //Вестник РГМУ. 2007. № 2/551. С. 194-195)
Frolenko AL. Clinical and immunological characteristics of children after thymectomy: abstr. dis. ... cand. med. sciences. Orenburg, 2011. 24 p. Russian (Фроленко А.Л. Клинико-иммунологическая характеристика детей после тимэктомии: автореф. дис. … канд. мед. наук. Оренбург, 2011. 24 с.)
Halnon NJ, Gooper P, Chen DYH, Boechat MI, Uittenbogaart CH. Immune dysregulation after cardiothoracic surgery and incidental thymectomy: maintenance of regulatory T cells despite impaired thymopoiesis. Clin Dev Immunol. 2011; 2011: 915864. doi: 10.1155/2011/915864
Donetskova AD, Nikonova MF, Vaganov PD, Smyslova ZV, Kuz'menko LG, Pashchenkov MV, et al. New way to thymopoiesis research in children with thymomegaly rheumatoid arthritis. Immunology. 2014; 4: 264-268. Russian (Донецкова А.Д., Никонова М.Ф., Ваганов П.Д., Смыслова З.В., Кузьменко Л.Г., Пащенков М.В. и др. Новый подход к исследованию тимопоэза при тимомегалии у детей //Иммунология. 2014. № 4. С. 264-268)
Mancebo E, Clemente J, Sanchez J, Ruiz-Contreras J, De Pablos P, Cortezon S, et al. Longitudinal analysis of immune function in the first 3 years of life in thymectomized neonates during cardiac surgery. Clin Exp Immunol. 2008; 154(3): 375-383. doi: 10.1111/j.1365-2249.2008.03771.x
Van Gent R, Schadenberg AWL, Otto SA, Nievelstein RAJ, Sieswerda GT, Haas F, et al. Long-term restoration of the human T-cell compartment after thymectomy during infancy: a role for thymic regeneration? Blood. 2011; 118(3): 627-634. doi: 10.1182/blood-2011-03-341396
Brearley S, Gentle ТА, Baynham МI, Robert KD s, Abrams LD, Thompson RA. Immunodeficiency following neonatal thymectomy in man. Clin Exp Immunol. 1987; 70(2): 322-327
Sauce D, Larsen М, Fastenackels S, Duperrier A, Keller M, Grubeck-Loebenstein B, et al. Evidence of premature immune aging in patients thymectomized during early childhood. J Clin Invest. 2009; 119(10): 3070-3078. doi: 10.1172/JCI39269
Wells PR, Parkman R, Smogorzewska E, Barr M. Neonatal thymectomy: does it affect immune function? J Thorac Cardiovasc Surg. 1998; 115: 1041-1046. doi: 10.1016/S0022-5223(98)70403-9
Arron ST, Ribeiro RM, Gettie A, Bohm R, Blanchard J, Yu J, et al. Impact of thymectomy on the peripheral T cell pool in rhesus macaques before and after infection with simian immunodeficiency virus. Eur J Immunol. 2005; 35(1): 46-55. doi: 10.1002/eji.200424996
Madhok AB, Chandrasekran А, Parnell V, Gandhi M, Chowdhury D, Pahwa S. Levels of recent thymic emigrant cells decrease in children undergoing partial thymectomy during cardiac surgery. Clin Diagn Lab Immunol. 2005; 12(5): 563-565. doi: 10.1128/CDLI.12.5.563-565.2005
Hirotsugu K, Tominaga T, Sugano M, Hayabuchi Y, Egawa Y, Takahama Y, Kitagawa T. Complete but not partial thymectomy inearly infancy reduces T-cell-mediated immune response: three-year tracing studi after pediatric cardiac surgery. J Thorac Cardiovasc Surg. 2013; 145(3): 656-662, 662.e1-2
Donetskova AD, Frolenko AL, Troshina VV, Smolyagin AI, Yarilin AA. Thymus excision rings in peripheral blood lymphocytes. Age dynamics and influence of thymectomy. Immunology. 2010; 6: 293-299. Russian (Донецкова А.Д., Фроленко А.Л., Трошина В.В., Смолягин А.И., Ярилин А.А. Тимусные эксцизионные кольца в лимфоцитах периферической крови. Возрастная динамика и влияние тимэктомии //Иммунология. 2010. № 6. С. 293-299)
Donetskova AD. A new approach to the study of T-lymphopoiesis using the determination of T-excision rings in experiment and clinic: abstr. dis. ... doctor med. sciences. M., 2013. 48 p. Russian (Донецкова А.Д. Новый подход к исследованию Т-лимфопоэза с помощью определения Т-эксцизионных колец в эксперименте и клинике: автореф. дис. … докт. мед. наук. М., 2013. 48 с.)
Prelog M, Keller M, Geiger R, Brandstätter A, Würzner R, Schweigmann U, et al. Thymectomy in early childhood: significant alterations of the CD4(+)CD45RA(+) CD62L(+) T cell compartment in later life. Clin Immunol. 2009; 130(2): 123-132. doi: 10.1016/j.clim.2008.08.023
Eysteinsdottir JH, Freysdottir J, Haraldsson A, Stefansdottir J, Skaftadottir I, Helgason A, Ogmundsdottir HM. The influence of partial or total thymectomy during open heart surgery in infants on the immune function later in life. Clin Exp Immunol. 2004; 136(2): 349-355. doi: 10.1111/j.1365-2249.2004.02437.x
Rovda Y I, Shmulevich SA, Shabaldin AV, Shabaldina EV, Minyaylova NN, Sizova IN, Lukoyanycheva EB. Clinical and immunological characteristics of children in a catamnesis after surgery for congenital heart diseases, combined with induced thymectomy. Pediatria. 2018; 97(4): 50-58. Russian (Ровда Ю.И., Шмулевич С.А., Шабалдин А.В., Шабалдина Е.В., Миняйлова Н.Н., Сизова И.Н., Лукоянычева Е.Б. Клинико-иммунологические характеристики детей в катамнезе, после операции по поводу врожденного порока сердца, сочетанной с вынужденной тимусэктомией //Педиатрия. 2018. Т. 97, № 4. С. 50-58)
Shmulevich SA. The influence of risk factors on the formation of congenital heart defects and clinical indicators of children and adolescents: abstr. dis. … cand. med. sciences. Tomsk, 2018. 22 p. Russian (Шмулевич С.А. Влияние факторов риска на формирование врожденных пороков сердца и клинические показатели детей и подростков: автореф. дис. канд. мед. наук. Томск, 2018. 22 с.)
Kuzmenko LG. Conceptual look at the genesis of congenital thymomegaly. Pediatria. 2012; 93(3): 37-43. Russian (Кузьменко Л.Г. Концептуальный взгляд на генез врожденной тимомегалии //Педиатрия. 2012. Т. 93, № 3. С. 37-43)
Nichols JG, Martin AR, Wallas BJ. From neuron to brain: Translation from English. 4th ed. M.: URRS, 2003. P. 523-531. Russian (Николс Дж.Г., Мартин А.Р., Валлас Б.Дж. От нейрона к мозгу: Пер. с англ. 4-е изд. М.: УРРС, 2003. С. 523-531)
Tertichnyj AS. Clinical and morphological changes in the thymus gland in children with congenital heart defects: abstr. dis. … cand. med. sciences. M., 2000. 21 p. Russian (Тертичный А.С. Клинико-морфологические изменения вилочковой железы у детей с врожденными пороками сердца: автореф. дис. ... канд. мед. наук. М., 2000. 21 с.
Zajrat'janc OV, Serov VV, Kuzmenko LG. New evidence on thymomegaly and immune deficiency syndrome. Archive of Pathology. 1990; 52(6): 33-39. Russian (Зайратьянц О.В., Серов В.В., Кузьменко Л.Г. Новые данные о тимомегалии и синдроме иммунного дефицита //Архив патологии. 1990. Т. 52, № 6. С. 33-39)
Ivanovskaja TE, Zajrat'janc OV, Leonova LV, Voloshhuk IN. Thymus pathology in children. SPb.: Sotis, 1996. 270 p. Russian (Ивановская Т.Е., Зайратьянц О.В., Леонова Л.В., Волощук И.Н. Патология тимуса у детей. СПб.: Сотис, 1996. 270 с.)
Kuzmenko LG. Thymomegaly in children during the first three years of life: abstr. dis. … dr. med. sciences. M., 1988. 29 p. Russian (Кузьменко Л.Г. Тимомегалия у детей первых трех лет жизни: автореф. дис. … докт. мед. наук. М., 1988. 29 с.)
Doneckova AD, Nikonova MF, Vaganov PD, Mitin AN. Features of T-lymphopoiesis in children with thymomegaly. Molecular Diagnostics 2017: Proceedings of the IX All-Russian scient. and pract. conf. with intern. participation. M., 2017. P. 512-513. Russian (Донецкова А.Д., Никонова М.Ф., Ваганов П.Д., Митин А.Н. Особенности Т-лимфопоэза у детей с тимомегалией //Молекулярная диагностика 2017: сб. трудов IХ Всерос. науч.-практ. конф. с междунар. участием. М., 2017. С. 512-513)
Nezelof C. Thymic pathology in primary and secondary immunodeficiencies. Histopathology. 1992; 21(6): 499-511. doi: 10.1111/j.1365-2559.1992.tb00437.x
Deya-Martinez A, Flinn AM, Gennery AR. Neonatal thymectomy in children-accelerating the immunologic clock? J Allergy Clin Immunol. 2020; 146(2): 236-243. doi: 10.1016/j.jaci.2020.02.028