People with a healthy thymus live longer and are less likely to get sick. Additionally, immunotherapy is more successful in patients with a healthy thymus. This is shown by two international studies of the Frankfurt Medical University. The results, now published in the journal Nature, open up a new approach to maintaining health during the aging process.
The thymus gland is a small organ located in the upper chest that plays a central role in the immune system. It produces T cells (specialized immune cells that recognize and fight pathogens). For a long time, the thymus was considered a “childhood organ” with little relevance to adults because it shrinks and gains fat throughout life. New research fundamentally questions this assumption.
The paper published in Nature highlights the extraordinary scientific and clinical relevance of this research. These impressively demonstrate the contribution that modern image processing can make in revealing previously underappreciated biological relevance. Being able to analyze the health of the thymus early and reliably will allow individuals to identify their risk of disease earlier and respond in a targeted manner, long before clinical symptoms appear. ”
Professor Thomas Vogl, Director of the Radiology and Nuclear Medicine Clinic at Frankfurt Medical University
Therefore, the health status of the thymus, determined using regularly collected computed tomography imaging data, could provide a new approach to identify disease risk at an early stage and initiate targeted preventive measures. Imaging tests can assess the health of the thymus gland based on the degree of fatty degeneration. Generally, lower levels of fatty infiltration indicate better immune function.
Breakthrough insights from long-term research
Two international studies led by Harvard University (Boston) and research partners in Maastricht, Aarhus, London, and Frankfurt support this hypothesis. “Our analysis shows for the first time that thymic health can independently predict survival and disease risk. What is particularly remarkable is that we were able to obtain this information from routine computed tomography (CT) scans,” explains Dr. Simon Bernat, lead author of the publication and a physician and researcher at the Clinic of Radiology and Nuclear Medicine at the University of Frankfurt.
Researchers have developed a deep learning framework (artificial intelligence system) to quantify CT images. They analyzed more than 27,000 CT scans collected as part of two major long-term studies in the United States. One is the National Lung Screening Trial (NLST), which examined the lung health of current and former smokers over a 12-year period, and the other is the Framingham Heart Study (FHS), one of the most famous and enduring studies of cardiovascular health.
In both independent cohorts, good thymic health was closely associated with better health outcomes. In the NLST study, it was associated with lower overall mortality (50 percent), lower lung cancer incidence (36 percent), and lower cardiovascular mortality (63 to 92 percent). In the FHS cohort, we found an association with reduced cardiovascular mortality, independent of age, sex, and smoking status.
A new perspective in cancer medicine: the thymus as a biomarker
A second recent study by the same authors significantly extends these findings and suggests that thymic health may also predict the success of modern cancer immunotherapies. The study analyzed more than 3,400 cancer patients treated with immune checkpoint inhibitors. The results showed that patients with good thymic health had significantly better treatment outcomes. This is especially true for lung cancer and melanoma, but also for breast cancer and kidney cancer.
Of note, this association was independent of established tumor-based biomarkers such as PD-L1 and tumor mutational burden (TMB). Therefore, additional information is provided because the health of the thymus reflects the performance of the immune system rather than the tumor itself. At the same time, good thymic function has been shown to be associated with more diverse T-cell receptors and an overall stronger immune response.
“Our results suggest that thymic health is also a crucial and previously underappreciated factor in the success of immunotherapy. In the future, it may help us select treatments more precisely and tailor them more individually to patients,” said Dr. Simon Barnats.
Thymus as a key organ for healthy aging
The findings provide the first comprehensive evidence that the thymus remains active and plays an important role in adulthood. A healthy thymus gland is thought to help maintain long-term immune stability, better control inflammatory processes, and more effectively protect the body from age-related diseases. This places the thymus centrally as a key regulator of immune-mediated aging and susceptibility to common diseases in adulthood.
Another important insight is that thymic health is closely related to modifiable lifestyle factors. Negative effects can result from chronic inflammatory processes promoted by smoking, obesity, lack of physical activity, as well as an unhealthy diet and long-term stress, among others. Conversely, the findings suggest that a healthy lifestyle can positively impact thymic function, thereby improving overall health and potentially leading to medical success.
Implications for research and treatment
These results fundamentally changed our understanding of the thymus, transforming it from a neglected organ in childhood to a central organ controlling immune aging and disease susceptibility in adulthood. As a biomarker, it may in the future improve the early detection of at-risk patients, guide the selection of appropriate immunotherapy, and optimize the timing of treatment. Additionally, targeted strategies to strengthen or regenerate the thymus are a focus of research. The health of this small organ can have a decisive impact on quality of life, life expectancy, and treatment success.
sauce:
Goethe University Frankfurt am Main
References:
