Enfermedades del timo por exceso y por defecto / Thymus diseases by excess and default

El timo es un órgano cervicotorácico, impar y mediano, situado en la base del cuello y parte superior del mediastino. Junto a la médula ósea es uno de los dos órganos primarios del sistema inmune y ejerce su función en los neonatos y en los niños, fundamentalmente. Entra en regresión a partir de la pubertad, aunque algunos autores plantean que la involución puede comenzar un poco antes, cuando los principales tejidos linfoides están plenamente desarrollados. Interviene sinérgicamente con otras glándulas de secreción interna: tiroides, suprarrenal, hipófisis, para elaborar substancias necesarias para el desarrollo general del organismo. Es un órgano muy sensible a todo influjo. Como todos los órganos de la economía el timo presenta enfermedades producidas tanto por crecimiento exagerado, como por hipoplasias o atrofias. Dentro de las primeras las más comunes son la hiperplasia tímica y el timoma y, entre las últimas el síndrome de DiGeorge ha sido bien caracterizado en la literatura internacional desde la segunda mitad del siglo pasado. Sin embrago, en los últimos tiempos los inmunólogos hablan de la hipoplasia tímica como entidad que puede asociarse o no a estados de inmunodeficiencia. Se describen brevemente estas afecciones(AU)

The thymus is a cervicothoracic organ, odd and medium, located at the base of the neck and upper part of the mediastinum. Next to the bone marrow is one of the two primary organs of the immune system and exerts its function in neonates and children, fundamentally. It regresses after puberty, although some authors suggest that the involution can begin a little earlier, when the main lymphoid tissues are fully developed. It intervenes synergistically with other glands of internal secretion: thyroid, adrenal, pituitary gland, to develop substances necessary for the general development of the organism. It is a very sensitive organ to all influence. Like all the organs of the economy, the thymus presents diseases caused both by exaggerated growth, as by hypoplasias or atrophies. Among the former, the most common are thymic hyperplasia and thymoma and, among the latter, DiGeorge syndrome has been well characterized in international literature since the second half of the last century. However, in recent times immunologists speak of thymic hypoplasia as an entity that may or may not be associated with immunodeficiency states. These conditions are briefly described(AU)

Evaluation of thymic lymphocyte loss of broiler using Digital Analysis of the Lymphoid Depletion System (ADDL) / Avaliação de perda de linfócitos do timo em frangos usando análise digital do sistema de depleção linfóide (ADDL)

The thymus is a lymphoid organ and usually evaluated for the degree of lymphocyte loss with subjective histological techniques. This study aimed to adapt and to apply of the digital analysis of the lymphoid depletion system (ADDL) in the thymus in order to obtain a more accurate analysis. Glucocorticoid was used to induce immunosuppression in 55 broilers at 21 days of age; other 15 broilers were the control group. After euthanasia of the broilers, postmortem examination was made. Both thymic chains were collected and six lobes were selected for histological examination of the degree of lymphocyte depletion (scores 1 to 5) and for submission to all stages of processing by the ADDL system. The artificial constructed neural networks (ANN) obtained 94.03% of correct classifications. In conclusion, it was possible to adopt objective criteria to evaluate thymic lymphoid depletion with the ADDL system.(AU)

O timo é um órgão linfóide, que é normalmente avaliado para o grau de perda de linfócitos a partir de técnicas histológicas subjetivas. Este trabalho teve como objetivo a adaptação e aplicação do sistema de análise digital de depleção linfóide (ADDL) para o timo, a fim de tornar sua análise mais acurada. Glicocorticóides foram utilizados a fim de induzir imunossupressão em 55 aves de 21 dias de idade. Outras 15 aves formaram o grupo controle. Posteriormente, para cada um dos aves, realizou-se a eutanásia e necropsia. Ambas as cadeias do timo foram coletadas e foram selecionadas seis lóbulos para processamento histológico, análise quanto ao grau de depleção linfocitária (escores de 1-5) e submissão a todas as fases do processamento pelo sistema ADDL. Observou-se que a rede neural artificial (RNA) construída obteve 94,03% de classificações corretas. Em conclusão, foi possível adotar critérios objetivos para avaliar a depleção linfóide tímica utilizando o sistema ADDL.(AU)

Evaluation of thymic lymphocyte loss of broiler using Digital Analysis of the Lymphoid Depletion System (ADDL) / Avaliação de perda de linfócitos do timo em frangos usando análise digital do sistema de depleção linfóide (ADDL)

The thymus is a lymphoid organ and usually evaluated for the degree of lymphocyte loss with subjective histological techniques. This study aimed to adapt and to apply of the digital analysis of the lymphoid depletion system (ADDL) in the thymus in order to obtain a more accurate analysis. Glucocorticoid was used to induce immunosuppression in 55 broilers at 21 days of age; other 15 broilers were the control group. After euthanasia of the broilers, postmortem examination was made. Both thymic chains were collected and six lobes were selected for histological examination of the degree of lymphocyte depletion (scores 1 to 5) and for submission to all stages of processing by the ADDL system. The artificial constructed neural networks (ANN) obtained 94.03% of correct classifications. In conclusion, it was possible to adopt objective criteria to evaluate thymic lymphoid depletion with the ADDL system.(AU)

O timo é um órgão linfóide, que é normalmente avaliado para o grau de perda de linfócitos a partir de técnicas histológicas subjetivas. Este trabalho teve como objetivo a adaptação e aplicação do sistema de análise digital de depleção linfóide (ADDL) para o timo, a fim de tornar sua análise mais acurada. Glicocorticóides foram utilizados a fim de induzir imunossupressão em 55 aves de 21 dias de idade. Outras 15 aves formaram o grupo controle. Posteriormente, para cada um dos aves, realizou-se a eutanásia e necropsia. Ambas as cadeias do timo foram coletadas e foram selecionadas seis lóbulos para processamento histológico, análise quanto ao grau de depleção linfocitária (escores de 1-5) e submissão a todas as fases do processamento pelo sistema ADDL. Observou-se que a rede neural artificial (RNA) construída obteve 94,03% de classificações corretas. Em conclusão, foi possível adotar critérios objetivos para avaliar a depleção linfóide tímica utilizando o sistema ADDL.(AU)

Low thymic output, peripheral homeostasis deregulation, and hastened regulatory T cells differentiation in children with 22q11.2 deletion syndrome.

OBJECTIVE: To perform an extensive analysis of the immune status of asymptomatic children with the 22q11.2 deletion syndrome, with special emphasis on the regulatory T cells (Treg) population. STUDY DESIGN: Analysis of thymic function, frequency and absolute counts of immune subsets, and phenotype of Treg were performed in 10 asymptomatic children bearing the 22q11.2 deletion and compared with 12 age-matched, healthy children. RESULTS: Children with 22q11.2 deletion syndrome showed a curtailed thymic output, lower T-cell levels, and a homeostatic deregulation in the CD4 T-cell compartment, characterized by a greater proliferative history in the naïve CD4 T-cell subset. Treg numbers were markedly reduced in children with 22q11.2 deletion syndrome, and remaining Treg showed mostly an activated phenotype. CONCLUSIONS: Reduced thymic output in children with 22q11.2 deletion syndrome could be related with an increased proliferation in the naïve CD4 T-cell compartment and the consequent Treg activation to ensure that T-cell expansion remains under control. Deregulated peripheral homeostasis and loss of suppressive capacity by Treg could compromise the integrity of T-cell immunity during adulthood and play a relevant role in the increased incidence of autoimmune diseases reported in patients with the 22q11.2 deletion syndrome.

Aspectos actuales de la organogénesis. Función e involución del timo / Present aspects of organogenesis. Function and thymic involution

El timo es un órgano linfoide central o primario localizado en la parte anterosuperior del tórax. Constituye el principal sitio de diferenciación y maduración de las células T. En esta revisión se detallan aspectos actuales de la embriología, la histología y la función tímica y en la generación de los diferentes subtipos de timocitos y su diferenciación a células T maduras efectoras, la inducción de las células T tímicas reguladoras involucradas en el mantenimiento de la tolerancia a lo propio y la involución que sufre este órgano durante el proceso de inmunosenescencia(AU)

Thymus is a primary organ located in the antesuperior area of the torax. It is the principal place of differentiation and maduration of T cells. In this review present aspects of the embriology, histology and thymic function are detailed, as well as its role in the generation of different kinds of thymic cells; its differentiation to mature cells and of regulator T cells has a crucial role in tolerance induction. Moreover, thymic involution during of immunosenescence process is shown(AU)

Aspectos actuales de la organogénesis. Función e involución del timo / Present aspects of organogenesis. Function and thymic involution

El timo es un órgano linfoide central o primario localizado en la parte anterosuperior del tórax. Constituye el principal sitio de diferenciación y maduración de las células T. En esta revisión se detallan aspectos actuales de la embriología, la histología y la función tímica y en la generación de los diferentes subtipos de timocitos y su diferenciación a células T maduras efectoras, la inducción de las células T tímicas reguladoras involucradas en el mantenimiento de la tolerancia a lo propio y la involución que sufre este órgano durante el proceso de inmunosenescencia

Thymus is a primary organ located in the antesuperior area of the torax. It is the principal place of differentiation and maduration of T cells. In this review present aspects of the embriology, histology and thymic function are detailed, as well as its role in the generation of different kinds of thymic cells; its differentiation to mature cells and of regulator T cells has a crucial role in tolerance induction. Moreover, thymic involution during of immunosenescence process is shown

Behavioral and neuroendocrine effects of the exposure to chronic restraint or variable stress in early adolescent rats.

Stress events during adolescence may contribute to the expression or exacerbation of physical and behavioral disorders. However, little attention has been given to the physiological and behavioral changes promoted by stress during this period of ontogeny. In the present study we investigated, in adolescent male rats, the effects of repeated exposure to restraint or variable stress on: (a) locomotor activity and corticosterone levels after exposure to a novel environment; (b) corticosterone levels in response to the exposure to restraint stress; and (c) changes in body, thymus and adrenal weights. The results demonstrated that repeated exposure to restraint or variable stress reduced the locomotor response, but did not affect corticosterone secretion, in response to a novel environment. Moreover, both chronic stress procedures did not change corticosterone secretion in response to acute restraint stress. Furthermore, our results showed that repeated restraint, but not variable stress, produced a decrease in body weight along the stress exposure. Finally, we observed that the exposure to variable stress reduced the thymus relative weight. Taken together our results suggest that behavioral and physiological changes induced by exposure to chronic stress during adolescence depend on the stress regimen.

Efecto de las hormonas tímicas sobre la síntesis de IL-4 / Effect of thymic hormones over the synthesis of IL-4

A thymic hormone baptized as thymostimulin coming from children aged between 5-10 years who died after car accidents was obtained by Sephadex G-50 column fractionation. This polypeptide was incubated with atopic and non-atopic human lymphocytes. The level of IL-4 in the supernatant was measured by ELISA. The atopic lymphocytes stimulated by the thymostimulin produced a great quantity of IL-4 (p>0.000001) in comparison with those coming from non-atopic patients. Thus, we postulate that thymic hormones should not be used in the treatment of allergic conditions with high levels of IL-4. The function of this polypeptide was compared with that of bovine timomodulin, which showed lower level of IL-4 (p>_ 0.001).

Nutritional imbalances and infections affect the thymus: consequences on T-cell-mediated immune responses.

The thymus gland, where T lymphocyte development occurs, is targeted in malnutrition secondary to protein energy deficiency. There is a severe thymic atrophy, resulting from massive thymocyte apoptosis (particularly affecting the immature CD4+CD8+ cell subset) and decrease in cell proliferation. The thymic microenvironment (the non-lymphoid compartment that drives intrathymic T-cell development) is also affected in malnutrition: morphological changes in thymic epithelial cells were found, together with a decrease of thymic hormone production, as well as an increase of intrathymic contents of extracellular proteins. Profound changes in the thymus can also be seen in deficiencies of vitamins and trace elements. Taking Zn deficiency as an example, there is a substantial thymic atrophy. Importantly, marginal Zn deficiency in AIDS subjects, children with diarrhoea and elderly persons, significantly impairs the host's immunity, resulting in an increased risk of opportunistic infections and mortality; effects that are reversed by Zn supplementation. Thymic changes also occur in acute infectious diseases, including a severe thymic atrophy, mainly due to the depletion of CD4+CD8+ thymocytes, decrease in thymocyte proliferation, in parallel to densification of the epithelial network and increase in the extracellular matrix contents, with consequent disturbances in thymocyte migration and export. In conclusion, the thymus is targeted in several conditions of malnutrition as well as in acute infections. These changes are related to the impaired peripheral immune response seen in malnourished and infected individuals. Thus, strategies inducing thymus replenishment should be considered as adjuvant therapeutics to improve immunity in malnutrition and/or acute infectious diseases.

Timo: caracterização ultra-sonográfica / Thymus: ultrasound characterization

O timo é uma pequena glândula responsável pela produção de linfócitos T, importante na resposta imunitária do organismo. É órgão relativamente grande no período perinatal e pode estender-se superiormente, atingindo o pescoço, com variantes anatômicas. É possível identificar o timo normal, por meio da ultra-sonografia, pelo acesso supra-esternal, paraesternal e esternal e também na região cervical quando em localização atípica. A partir do início da puberdade, devido à sua involução com diminuição progressiva do seu tamanho e porque o pulmão aerado se interpõe entre o timo e o feixe sonoro, a sua visualização é mais difícil. O padrão da ecotextura normal tímica é característica: hipoecogênico em relação ao parênquima normal da tireóide e apresenta múltiplas estruturas ecogênicas lineares e focais, dispersas pelo parênquima, que correspondem aos septos e vasos sanguíneos. O reconhecimento pela ultra-sonografia de tecido tímico pode ser importante para evitar investigações desnecessárias ou cirurgias num timo normal que mimetiza massa patológica.

Miastenia gravis: análise de 90 casos tratados com timectomia / Myasthenia gravis: analysis of 90 cases treated with thymectomy

A Miastenia Gravis é uma doença auto-imune caracterizada por auto-anticorpos contra receptores nicotínicos de acetilcolina da placa neural. O tratamento clínico básico para as formas generalizadas é feito com drogas anticolenesterásicas, mas em algumas fases podem ser necessários outras modalidades de tratamento, tais como a corticoterapia e a plasmaferese. O tratamento cirúrgico, a timectomia, é uma forma de abordar a causa base da doença e tem resultados bastante encorajadores, visto que é atribuída ao timo a produção dos auto-anticorpos. Apresentamos neste trabalho o quadro clínico, os resultados cirúrgicos e as alteração anátomo-patológicas dos 90 casos estudados.

¿La disminución de la imagen radiográfica del timo se asocia a infección bacteriana grave en los lactantes febriles menores de 3 meses? / Is the reduction of the thymus size on chest radiograph an indicator of severe bacterial infection in febrile infants less than 90 days of age?

Introducción:En la evaluación de lactantes febriles menores de 3 meses,muchos pediatras usan la disminución radiográfica del timo como probable indicador de infección bacteriana grave(IBG).A pesar de que muchos estudios anatomopatológicos describen la disminución tímica en procesos infecciosos severos y muchos radiólogos mencionan que el timo disminuye de tamaño en la radiografía de torax en las IBG,nosotros no hemos encontrado ningún trabajo que avale la disminución radiológica del timo como indicador de IBG.El objetivo de este trabajo fue determinar esta asociación.Concluimos que la disminución radiológica del timo en la radiografía de tórax frente,no se asoció a IBG en los lactantes menores de 3 meses

¿La disminución de la imagen radiográfica del timo se asocia a infección bacteriana grave en los lactantes febriles menores de 3 meses? / Is the reduction of the thymus size on chest radiograph an indicator of severe bacterial infection in febrile infants less than 90 days of age?

Introducción:En la evaluación de lactantes febriles menores de 3 meses,muchos pediatras usan la disminución radiográfica del timo como probable indicador de infección bacteriana grave(IBG).A pesar de que muchos estudios anatomopatológicos describen la disminución tímica en procesos infecciosos severos y muchos radiólogos mencionan que el timo disminuye de tamaño en la radiografía de torax en las IBG,nosotros no hemos encontrado ningún trabajo que avale la disminución radiológica del timo como indicador de IBG.El objetivo de este trabajo fue determinar esta asociación.Concluimos que la disminución radiológica del timo en la radiografía de tórax frente,no se asoció a IBG en los lactantes menores de 3 meses

[Thymus gland cervical cysts]. / Quiste tímico cervical.

We present a cervical thymic cyst clinically manifest as a lateral neck mass and studied preoperatively with ultrasound. We point to the sonographic findings that allow us to include the cervical thymic cyst as one of the diagnostic possibilities.