Associated Immunological Disorders and Cellular Immune Dysfunction in Thymoma: A Study of 87 Cases from Thailand
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ORIGINAL ARTICLE
Associated Immunological Disorders and Cellular Immune Dysfunction in Thymoma: A Study of 87 Cases from Thailand Charat Thongprayoon • Pakpoom Tantrachoti • Parkpoom Phatharacharukul • Supranee Buranapraditkun Jettanong Klaewsongkram
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Received: 16 May 2012 / Accepted: 21 September 2012 / Published online: 11 December 2012 Ó L. Hirszfeld Institute of Immunology and Experimental Therapy, Wroclaw, Poland 2012
Abstract Several immune disorders are often associated with thymoma. The aim of this study was to analyze the correlation between clinicopathological features of Thai patients with thymoma and concomitant immune-mediated diseases. Medical records of 87 patients diagnosed with thymoma during a 10-year period were retrospectively reviewed. Peripheral blood T cell subsets along with cytokine responses in 15 thymoma patients and 15 healthy controls were comparatively analyzed. The results demonstrated that thymoma type AB and B2 were the most common types among patients diagnosed with thymoma. The most common presentation was incidentaloma, followed by local chest symptoms and autoimmune diseases. The prevalence of autoimmune diseases, immunodeficiency states, and secondary neoplasms was 34.5, 10.3, and 10.3 %, respectively. Autoimmune diseases were most frequently found in thymoma type B2 and sometimes associated with clinical immunodeficiency, although classic Good’s syndrome was rare. Patients with thymoma had significantly lower percentage CD4?ve T cells and interferon c response, but higher percentage regulatory T cells than those in healthy controls. This study indicated that the aberrant immunologic disorders comprising autoimmune
C. Thongprayoon, P. Tantrachoti and P. Phatharacharukul contributed equally to this work. C. Thongprayoon P. Tantrachoti P. Phatharacharukul Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand S. Buranapraditkun J. Klaewsongkram (&) Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand e-mail: [email protected]
diseases, immunodeficiency states, and secondary neoplasms were found in almost 40 % of Thai patients with thymoma and possibly related to defectiva cytokine responses and altered T cell subsets. Keywords Thymoma Paraneoplastic syndromes Autoimmunity Immunologic deficiency syndrome Neoplasms
Introduction The thymus gland is one of the key organs of the immune system and serves as the nurture site for thymocyte differentiation and maturation, especially in early childhood and adolescence (Douek and Koup 2000). Although thymic function declines with age, there is evidence that the thymus maintains an active thymopoiesis throughout adult life and even in the elderly (Ferrando-Martı´nez et al. 2009). It also plays an important role in maintaining immunologic self-tolerance by balancing between effector and regulatory T cells (Tregs) (Itoh et al. 1999; Pennington et al. 2006). Thymoma, the epithelial tumor of thymus, is the most common tumor
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