Thymectomy in early childhood: Significant alterations of the CD4+CD45RA+CD62L+ T cell compartment in later life

The study was aimed to assess indicators of immunosenescence, such as the total counts of peripheral blood CD4+CD45RA+CD62L+ (naive) T cells, the numbers of T cell receptor excision circles (TRECs), and Ki67-expression as marker of peripheral replication in thymectomized patients (TP) (n = 101) compared to age-matched healthy donors (HD) (n = 81).In TP, there was an inverse correlation between naive T cells and chronological age (p < 0.001) or time post thymectomy (p < 0.001). TP demonstrated lower TREC numbers in naive T cells compared to HD (p < 0.001). TREC numbers negatively correlated with time post thymectomy (p < 0.001). Percentages of Ki67-expresssing naive T cells were higher in TP compared to HD (p < 0.05).The findings of the presented long-term follow up cohort of thymectomized patients indicate that changes of the peripheral naive T cell subset in TP may resemble the findings of an aging immune system in elderly persons after thymic involution. Our data provide evidence that peripheral T cell homeostasis in TP is maintained at minimal levels mainly by extrathymic expansion of existing naive T cells in the periphery to compensate the diminished thymic output.