Evolutionary aspects of thymology in pediatric practice

The thymus is now considered a derivative of the immune system being, to greater extent, its central organ. Immunodeficiency states and immune dysregulation also depend on the quality of the thymus, which may be determined both genetically and by fetopathic approach as well as due to the possibility...

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Main Authors: Yu. I. Rovda, N. N. Minyailova, A. V. Vedernikova, A. V. Shabaldin, I. K. Khalivopulo, S. F. Zinchuk, O. V. Shmakova, A. A. Lobykina
Format: Article
Language:Russian
Published: St. Petersburg branch of the Russian Association of Allergologists and Clinical Immunologists 2023-02-01
Series:Медицинская иммунология
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Online Access:https://www.mimmun.ru/mimmun/article/view/2544
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author Yu. I. Rovda
N. N. Minyailova
A. V. Vedernikova
A. V. Shabaldin
I. K. Khalivopulo
S. F. Zinchuk
O. V. Shmakova
A. A. Lobykina
author_facet Yu. I. Rovda
N. N. Minyailova
A. V. Vedernikova
A. V. Shabaldin
I. K. Khalivopulo
S. F. Zinchuk
O. V. Shmakova
A. A. Lobykina
author_sort Yu. I. Rovda
collection DOAJ
description The thymus is now considered a derivative of the immune system being, to greater extent, its central organ. Immunodeficiency states and immune dysregulation also depend on the quality of the thymus, which may be determined both genetically and by fetopathic approach as well as due to the possibility and mode of its intravital injuries, age-related involution over different periods of life. Not accidentally, there are various morphometric bipolar states of the thymus gland in the pediatric population (3-7%), whereas its size may be sufficiently larger or smaller than the reference variable values. In certain cases, the phenomenon of thymomegaly (for example, in newborns) is considered a result of genetic errors (neuro-endocrine-immune syndrome with thymomegaly) induced by the mutated Hox genes. This syndrome may also be associated with congenital heart disorders. Moreover, the excessive morbidity in respiratory infections (commonly, viral by their etiology) among young children with bipolar thymus conditions remains the subject of sharp discussions. Some works assessing immune status in the children subjected to forced thymectomy, e.g., during heart surgery, yielded quite controversial results, even in cases of subtotal removal of thymus gland.Dialectically, the concepts of “morphology” and “organ function” could not be separated from one another. The morphometric transformations in organs (even transient ones) occuring within the range of > 95 and < 5 percentiles, should be almost always underlied by a certain pathomorphosis which require verification of their causes and origin. Even today, however, the assessment of thymus pathomorphology in the deceased children is not always critical, being often descriptive. This situation is, probably, associated with extreme complexity of thymic morphology assessment. The final point seems to be not set in the discussion about immunodeficiency states or immune dysregulation among children with bipolar thymus transformations. This is due to current absence of reliable immune-mediated biomarkers, the limited availability of genetic diagnostics in primary immunodeficiency conditions, and a decreased interest of clinical science in the issues of bipolar conditions of the thymus gland at the early age, in the absence of longitudinal observations in this category of patients, etc. In this article, the authors attempt to draw attention of researchers to this problem.
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spelling doaj-art-764d4e04d4f949d1a3b1eb68a0f17eb92025-08-20T03:37:57ZrusSt. Petersburg branch of the Russian Association of Allergologists and Clinical ImmunologistsМедицинская иммунология1563-06252313-741X2023-02-01251596810.15789/1563-0625-EAO-25441628Evolutionary aspects of thymology in pediatric practiceYu. I. Rovda0N. N. Minyailova1A. V. Vedernikova2A. V. Shabaldin3I. K. Khalivopulo4S. F. Zinchuk5O. V. Shmakova6A. A. Lobykina7Kemerovo State Medical UniversityKemerovo State Medical UniversityKemerovo State Medical UniversityResearch Institute of Complex Problems of Cardiovascular DiseasesResearch Institute of Complex Problems of Cardiovascular DiseasesKemerovo State Medical UniversityKemerovo State Medical UniversityKemerovo State Medical UniversityThe thymus is now considered a derivative of the immune system being, to greater extent, its central organ. Immunodeficiency states and immune dysregulation also depend on the quality of the thymus, which may be determined both genetically and by fetopathic approach as well as due to the possibility and mode of its intravital injuries, age-related involution over different periods of life. Not accidentally, there are various morphometric bipolar states of the thymus gland in the pediatric population (3-7%), whereas its size may be sufficiently larger or smaller than the reference variable values. In certain cases, the phenomenon of thymomegaly (for example, in newborns) is considered a result of genetic errors (neuro-endocrine-immune syndrome with thymomegaly) induced by the mutated Hox genes. This syndrome may also be associated with congenital heart disorders. Moreover, the excessive morbidity in respiratory infections (commonly, viral by their etiology) among young children with bipolar thymus conditions remains the subject of sharp discussions. Some works assessing immune status in the children subjected to forced thymectomy, e.g., during heart surgery, yielded quite controversial results, even in cases of subtotal removal of thymus gland.Dialectically, the concepts of “morphology” and “organ function” could not be separated from one another. The morphometric transformations in organs (even transient ones) occuring within the range of > 95 and < 5 percentiles, should be almost always underlied by a certain pathomorphosis which require verification of their causes and origin. Even today, however, the assessment of thymus pathomorphology in the deceased children is not always critical, being often descriptive. This situation is, probably, associated with extreme complexity of thymic morphology assessment. The final point seems to be not set in the discussion about immunodeficiency states or immune dysregulation among children with bipolar thymus transformations. This is due to current absence of reliable immune-mediated biomarkers, the limited availability of genetic diagnostics in primary immunodeficiency conditions, and a decreased interest of clinical science in the issues of bipolar conditions of the thymus gland at the early age, in the absence of longitudinal observations in this category of patients, etc. In this article, the authors attempt to draw attention of researchers to this problem.https://www.mimmun.ru/mimmun/article/view/2544thymusthymus glandchildrenimmunodeficiency statesthymectomy
spellingShingle Yu. I. Rovda
N. N. Minyailova
A. V. Vedernikova
A. V. Shabaldin
I. K. Khalivopulo
S. F. Zinchuk
O. V. Shmakova
A. A. Lobykina
Evolutionary aspects of thymology in pediatric practice
Медицинская иммунология
thymus
thymus gland
children
immunodeficiency states
thymectomy
title Evolutionary aspects of thymology in pediatric practice
title_full Evolutionary aspects of thymology in pediatric practice
title_fullStr Evolutionary aspects of thymology in pediatric practice
title_full_unstemmed Evolutionary aspects of thymology in pediatric practice
title_short Evolutionary aspects of thymology in pediatric practice
title_sort evolutionary aspects of thymology in pediatric practice
topic thymus
thymus gland
children
immunodeficiency states
thymectomy
url https://www.mimmun.ru/mimmun/article/view/2544
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AT avshabaldin evolutionaryaspectsofthymologyinpediatricpractice
AT ikkhalivopulo evolutionaryaspectsofthymologyinpediatricpractice
AT sfzinchuk evolutionaryaspectsofthymologyinpediatricpractice
AT ovshmakova evolutionaryaspectsofthymologyinpediatricpractice
AT aalobykina evolutionaryaspectsofthymologyinpediatricpractice