Clinical strategies to enhance thymic recovery after allogeneic hematopoietic stem cell transplantation

Abstract The thymus is particularly sensitive to injury caused by cytoreductive chemo- or radiation therapy, shock, infection and graft versus host disease. Insufficient thymic recovery has been directly correlated with increased risk of opportunistic infections and poor clinical outcomes in recipie...

Full description

Saved in:
Bibliographic Details
Published inImmunology letters Vol. 155; no. 1; pp. 31 - 35
Main Authors Velardi, Enrico, Dudakov, Jarrod A, van den Brink, Marcel R.M
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier B.V 01.09.2013
Subjects
Allergy and Immunology
Allogeneic hematopoietic stem cell transplantation
Animals
Clinical Trials as Topic
Gonadal Steroid Hormones - metabolism
Hematopoietic Stem Cell Transplantation
Humans
Immune regeneration
Immunomodulation
Intercellular Signaling Peptides and Proteins - metabolism
Interleukin-22
Interleukins - metabolism
Precursor Cells, T-Lymphoid - immunology
Regeneration
Thymus
Thymus Gland - physiology
Transplantation, Homologous
Treatment Outcome
Immune regeneration
Allogeneic hematopoietic stem cell transplantation
Thymus
Online AccessGet full text

Cover

More Information
Summary:Abstract The thymus is particularly sensitive to injury caused by cytoreductive chemo- or radiation therapy, shock, infection and graft versus host disease. Insufficient thymic recovery has been directly correlated with increased risk of opportunistic infections and poor clinical outcomes in recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Prolonged immune deficiency is particularly pronounced in older patients whose thymi are already significantly impaired due to age-related thymic involution. Preclinical and clinical studies have revealed several strategies that can enhance thymic function and immune reconstitution after transplant, including sex steroid ablation, growth factors (growth hormone, keratinocyte growth factor, insulin-like growth factor 1, interleukin-7) and ex vivo generated precursor T cells. In addition, recent studies have shown that other approaches, such as interleukein-22 and nutritional changes, may represent additional candidates to enhance thymic regeneration. In this review we provide updates on these strategies and comment on their potential to be translated into clinical therapies.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-3
content type line 23
ObjectType-Review-2
ISSN:0165-2478
1879-0542
DOI:10.1016/j.imlet.2013.09.016