The role of the thymus in allogeneic bone marrow transplantation and the recovery of the peripheral T-cell compartment.
Allogeneic hematopoietic stem cell transplantation
Cytoreductive therapies
Immune reconstitution
T-cells
Thymus
Journal
Seminars in immunopathology
ISSN: 1863-2300
Titre abrégé: Semin Immunopathol
Pays: Germany
ID NLM: 101308769
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
15
09
2020
accepted:
14
11
2020
pubmed:
9
1
2021
medline:
25
5
2021
entrez:
8
1
2021
Statut:
ppublish
Résumé
As the thymus represents the primary site of T-cell development, optimal thymic function is of paramount importance for the successful reconstitution of the adaptive immunity after allogeneic hematopoietic stem cell transplantation. Thymus involutes as part of the aging process and several factors, including previous chemotherapy treatments, conditioning regimen used in preparation to the allograft, occurrence of graft-versus-host disease, and steroid therapy that impair the integrity of the thymus, thus affecting its role in supporting T-cell neogenesis. Although the pathways governing its regeneration are still poorly understood, the thymus has a remarkable capacity to recover its function after damage. Measurement of both recent thymic emigrants and T-cell receptor excision circles is valuable tools to assess thymic output and gain insights on its function. In this review, we will extensively discuss available data on factors regulating thymic function after allogeneic hematopoietic stem cell transplantation, as well as the strategies and therapeutic approaches under investigation to promote thymic reconstitution and accelerate immune recovery in transplanted patients, including the use of cytokines, sex-steroid ablation, precursor T-cells, and thymus bioengineering. Although none of them is routinely used in the clinic, these approaches have the potential to enhance thymic function and immune recovery, not only in patients given an allograft but also in other conditions characterized by immune deficiencies related to a defective function of the thymus.
Identifiants
pubmed: 33416938
doi: 10.1007/s00281-020-00828-7
pii: 10.1007/s00281-020-00828-7
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
101-117Références
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