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Journal of Clinical Immunology
Published in: Journal of Clinical Immunology 3/2024

Open Access 01-03-2024 | Interrupted Aortic Arch | Original Article

Thymic Atrophy and Immune Dysregulation in Infants with Complex Congenital Heart Disease

Authors: Sarah-Jolan Bremer, Annika Boxnick, Laura Glau, Daniel Biermann, Simon A. Joosse, Friederike Thiele, Elena Billeb, Jonathan May, Manuela Kolster, Romy Hackbusch, Mats Ingmar Fortmann, Rainer Kozlik-Feldmann, Michael Hübler, Eva Tolosa, Jörg Siegmar Sachweh, Anna Gieras

Published in: Journal of Clinical Immunology | Issue 3/2024

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Abstract

Congenital heart disease (CHD) is the most common birth defect, and up to 50% of infants with CHD require cardiovascular surgery early in life. Current clinical practice often involves thymus resection during cardiac surgery, detrimentally affecting T-cell immunity. However, epidemiological data indicate that CHD patients face an elevated risk for infections and immune-mediated diseases, independent of thymectomy. Hence, we examined whether the cardiac defect impacts thymus function in individuals with CHD. We investigated thymocyte development in 58 infants categorized by CHD complexity. To assess the relationship between CHD complexity and thymic function, we analyzed T-cell development, thymic output, and biomarkers linked to cardiac defects, stress, or inflammation. Patients with highly complex CHD exhibit thymic atrophy, resulting in low frequencies of recent thymic emigrants in peripheral blood, even prior to thymectomy. Elevated plasma cortisol levels were detected in all CHD patients, while high NT-proBNP and IL-6 levels were associated with thymic atrophy. Our findings reveal an association between complex CHD and thymic atrophy, resulting in reduced thymic output. Consequently, thymus preservation during cardiovascular surgery could significantly enhance immune function and the long-term health of CHD patients.
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Metadata
Title
Thymic Atrophy and Immune Dysregulation in Infants with Complex Congenital Heart Disease
Authors
Sarah-Jolan Bremer
Annika Boxnick
Laura Glau
Daniel Biermann
Simon A. Joosse
Friederike Thiele
Elena Billeb
Jonathan May
Manuela Kolster
Romy Hackbusch
Mats Ingmar Fortmann
Rainer Kozlik-Feldmann
Michael Hübler
Eva Tolosa
Jörg Siegmar Sachweh
Anna Gieras
Publication date
01-03-2024
Publisher
Springer US
Published in
Journal of Clinical Immunology / Issue 3/2024
Print ISSN: 0271-9142
Electronic ISSN: 1573-2592
DOI
https://doi.org/10.1007/s10875-024-01662-4

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