|LETTER TO THE EDITOR
|Year : 2016 | Volume
| Issue : 1 | Page : 147
The immune system in infants thymectomized during surgical correction of congenital heart defects
Dhaval Kanu Thakkar1, VM Kulkarni1, Tanmayi Vilas Kulkarni2, Amarjit Singh3, Mansi Jantre4
1 Department of Radio-diagnosis, Dr. D. Y. Patil Medical College, Hospital, and Research Centre, Dr DY Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
2 Department of Pathology, Dr. D. Y. Patil Medical College, Hospital, and Research Centre, Dr DY Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
3 Department of Radiology, Dr. D. Y. Patil Medical College, Dr DY Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
4 Department of Radiology, Dr DY Patil Medical College, Hospital, and Research Centre, Dr DY Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
|Date of Web Publication||22-Dec-2015|
Dhaval Kanu Thakkar
403, Alaknanda, Neelkanth Valley, Ghatkopar (East), Mumbai - 400 077, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Thakkar DK, Kulkarni V M, Kulkarni TV, Singh A, Jantre M. The immune system in infants thymectomized during surgical correction of congenital heart defects. Med J DY Patil Univ 2016;9:147
|How to cite this URL:|
Thakkar DK, Kulkarni V M, Kulkarni TV, Singh A, Jantre M. The immune system in infants thymectomized during surgical correction of congenital heart defects. Med J DY Patil Univ [serial online] 2016 [cited 2020 Aug 9];9:147. Available from: http://www.mjdrdypu.org/text.asp?2016/9/1/147/172457
Adequate surgical access during correction of congenital heart defects necessitates removal of the neonatal/infantile thymus.  Though the thymus plays an established crucial role in embryonic T-cell development, its precise role in postnatal life, and the long-term impact of neonatal thymectomy require further elucidation.  It was previously believed that thymic involution in adults suggested its negligible role. However, T-cell receptor excision circles assays show that the thymus does indeed participate in T-cell-based immune responses in adults. 
Thymectomy in human neonates has not been shown to produce any clinically obvious consequences.  However, immunological investigations reveal that children/young people thymectomized as neonates have immune profiles similar to those seen in the elderly. Such immune profiles are associated with an inability to fight off new pathogens and the increased morbidity and mortality seen in old-age.  Therefore, thymectomized adults, though clinically asymptomatic, do demonstrate immune disturbances in the form of prematurely "aged" immune systems. The patients being young still, their "progeria" immune systems may have encountered only a limited number of pathogens, which they could successfully battle with the restricted T-cell repertoire at their disposal, thereby avoiding any life-threatening situations.  Hence, even though no clinical consequences have been observed, complete neonatal/infantile thymectomy should be avoided where possible in order to curtail accelerated immunosenescence and its possible ensuing complications. 
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Kurobe H, Tominaga T, Sugano M, Hayabuchi Y, Egawa Y, Takahama Y, et al
. Complete but not partial thymectomy in early infancy reduces T-cell-mediated immune response: Three-year tracing study after pediatric cardiac surgery. J Thorac Cardiovasc Surg Am Assoc Thorac Surg 2013;145:656-62.e2.
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;154:375-83.
Sauce D, Larsen M, 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;119:3070-8.