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CT scan can reveal immune system ageing, research finds

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The thymus, a small and relatively unknown organ, may play a bigger role in the immune system of adults than was previously believed, according to a recent study.

Researchers from Linkoping University in Sweden have found that with age, the glandular tissue in the thymus is replaced by fat and the level of its degeneration reflects the ageing of the immune system.

The rate at which this happens is linked to sex, age and lifestyle factors, the study found.

“We doctors can assess the appearance of the thymus from largely all chest CT scans, but we tend to not see this as very important,” said researcher Mårten Sandstedt of the Faculty of Medicine and Health Sciences.

“But now it turns out that the appearance of the thymus can actually provide a lot of valuable information that we could benefit from and learn more about.”

Fatty degeneration

The thymus is a gland located in the upper part of the chest. It has been long known that this small organ is important for immune defence development in children.

After puberty, the thymus decreases in size and is eventually replaced by fat, in a process known as fatty degeneration.

This has been taken to mean that it loses its function, which is why the thymus has for a long time been considered as being not important in adult life.

This view has however been challenged in some minor research studies that indicate that having an active thymus as an adult may be an advantage and could provide increased resilience against infectious disease and cancer.

Only very few studies so far have examined the thymus in adults.

In the latest study, published in Immunity & Ageing, the researchers examined the thymus’ appearance in chest CT scans of more than 1,000 Swedish individuals aged 50 to 64.

They were participating in the large SCAPIS study, which includes both extensive imaging and comprehensive health assessments including lifestyle factors, such as dietary habits and physical activity.

In their sub-study of SCAPIS, the researchers also analysed immune cells in the blood.

“We saw a huge variation in thymus appearance,” Sandstedt said.

“Six out of ten participants had complete fatty degeneration of thymus, which was much more common in men than in women, and in people with abdominal obesity.

“Lifestyle also mattered. Low intake of fibres in particular was associated with fatty degeneration of thymus.”

Immune system

The Linköping researchers’ study provides new knowledge by associating thymus appearance with lifestyle and health factors, and the immune system.

In the development of the immune system, the thymus acts like a school for a type of immune cells known as T-cells.

This is where the T-cells learn to recognise bacteria, viruses and other things that are alien to the body.

They also learn to be tolerant and not attack anything that is part of the person’s own body, which could otherwise lead to various autoimmune diseases.

Researchers saw that individuals with fatty degeneration of the thymus showed lower T-cell regeneration.

“This association with T-cell regeneration is interesting. It indicates that what we see in CT scans is not only an image, it actually also reflects the functionality of the thymus,” said researcher Lena Jonasson.

“You can’t do anything about your age and your sex, but lifestyle-related factors can be influenced. It might be possible to influence immune system ageing.”

But more research is needed before it will be possible to know whether thymus appearance, and thereby immune defence ageing, will have any implications for general health.

The researchers are now moving on to follow-up studies of the thymus of all 5,000 participants in SCAPIS Linköping to see whether CT scan thymus images can provide information on future risk of disease.

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