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Vol. 90, No. 4, 2006
Issue release date: November 2006
Biol Neonate 2006;90:252–257

Thymus Involution and Cerebral White Matter Damage in Extremely Low Gestational Age Neonates

Kuban J.D. · Allred E.N. · Leviton A.
Boston University School of Public Health, Children’s Hospital Boston and Harvard Medical School, Boston, Mass., USA

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Background: Among newborns who die, those who have cerebral white matter damage are more likely than others to have thymus involution and low thymus weights. Objective: We sought to evaluate in a population of preterm newborns who did not die if those who developed a cerebral white matter damage (as defined by an echolucency) are more likely than others to have thymus involution as assessed on chest radiographs. Method: The 89 infants whose data were evaluated were born before the 28th week of gestation, had at least one chest radiograph within the first 2 days of life (to determine thymus size), and at least one cranial ultrasonogram to assess for white matter echolucency. Results: Eighty-five percent of these infants had a small thymus within the first 2 weeks of life. Median time to thymus involution in those born before the 26th week of gestation was 36 h, and in those born during or after the 26th week of gestation was 140 h. Infants who developed involution before the median time in their respective gestational age groups were classified as early involuters (group 1) and were compared to their peers with late/no involution (group 2). Infants with an echolucency were more likely to have had early involution than infants without an echolucency (89% vs. 44%) (p = 0.01). This relationship was not distorted by potential confounders. The echolucency odds ratio associated with early thymus involution was consistently above 8 in all strata of the sample. Conclusion: These results are consistent with the possibility that early thymus involution and neonatal white matter damage are not independent phenomena and may have common antecedents.

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  1. Kwong KL, Wong YC, Fong CM, et al: Magnetic resonance imaging in 122 children with spastic cerebral palsy. Pediatr Neurol 2004;31:172–176.
  2. Tran U, Gray PH, O’Callaghan MJ: Neonatal antecedents for cerebral palsy in extremely preterm babies and interaction with maternal factors. Early Hum Dev 2005;81:555–561.
  3. Dammann O, Durum S, Leviton A: Do white cells matter in white matter damage? Trends Neurosci 2001;24:320–324.
  4. Duggan PJ, Maalouf EF, Watts TL, et al: Intrauterine T-cell activation and increased proinflammatory cytokine concentrations in preterm infants with cerebral lesions. Lancet 2001;358:1699–1700.
  5. Kadhim H, Tabarki B, De Prez C, et al: Interleukin-2 in the pathogenesis of perinatal white matter damage. Neurology 2002;58:1125–1128.
  6. Nelson KB, Dambrosia JM, Grether JK, Phillips TM: Neonatal cytokines and coagulation factors in children with cerebral palsy. Ann Neurol 1998;44:665–675.
  7. Kaukola T, Satyaraj E, Patel DD, et al: Cerebral palsy is characterized by protein mediators in cord serum. Ann Neurol 2004;55:186–194.
  8. Wu YW: Systematic review of chorioamnionitis and cerebral palsy. Ment Retard Dev Disabil Res Rev 2002;8:25–29.
  9. Jacobsson B, Hagberg G: Antenatal risk factors for cerebral palsy. Best Pract Res Clin Obstet Gynaecol 2004;18:425–436.
  10. De Felice C, Toti P, Santopietro R, Stumpo M, Pecciarini L, Bagnoli F: Small thymus in very low weight infants born to mothers with subclinical chorioamnionitis. J Pediatrics 1999;135:384–386.
  11. Toti P, De Felice C, Stumpo M: Acute thymic involution in fetuses and neonates with chorioamnionitis. Hum Pathol 2000;31:1121–1128.
  12. Leviton A, Gilles FH, Vawter GF: The thymus in infants with perinatal telencephalic leukoencephalopathy. Arch Neurol 1978;35:377–381.
  13. Teele R, Share J: Ultrasonography of Infants and Children. Philadelphia, Saunders, 1991.
  14. Meyers A, Shah A, Cleveland R, Cranley W, Wood B, Sunkle S, Husak S, Cooper E: Thymic size on chest radiograph and rapid disease progression in human immunodeficiency virus 1-infected children. Pediatr Infect Dis 2001;20:1112–1118.
  15. De Felice C, Latini G, Del Vecchio A, Toti P, Bagnoli F, Petraglia F: Small thymus at birth: a predictive radiographic sign of bronchopulmonary dysplasia. Pediatrics 2002;110:386–388.
  16. Dales LG, Ury HK: An improper use of statistical significance testing in studying covariables. Int J Epidemiol 1978;7:373–375.
  17. Dammann O, Leviton A: Role of the fetus in perinatal infection and neonatal brain damage. Curr Opin Pediatr 2000;12:99–104.
  18. Tarcic N, Ovadia H, Weiss DW, Weidenfeld J: Restraint stress-induced thymic involution and cell apoptosis are dependent on endogenous glucocorticoids. J Neuroimmunol 1998;82:40–46.
  19. Dominguez-Gerpe L, Rey-Mendez M: Role of pre-T-cells and chemoattractants on stress-associated thymus involution. Scand J Immunol 2000;52:470–476.
  20. Fujiwara R, Shibata H, Komori T: The mechanisms of immune suppression by high-pressure stress in mice. J Pharm Pharmacol 1999;51:1397–1404.
  21. Glavina-Durdov M, Springer O, Capkun V, Saratlija-Novakovic J, Rozic D, Barle M: The grade of acute thymus involution in neonates correlates with the duration of acute illness and with the percentage of lymphocytes in peripheral blood smear. Biol Neonate 2003;83:229–234.
  22. Yarilin AA, Belyakov IM: Cytokines in the thymus: production and biological effects. Curr Med Chem 2004;11:447–464.
  23. Li L, Hsu HC, Stockard CR, Yang P, Zhou J, Wu Q, Grizzle WE, Mountz JD: IL-12 inhibits thymic involution by enhancing IL-7 and IL-2 induced thymocyte proliferation. J Immunol 2004;172:2909–2916.
  24. Morrissey PJ, Charrier K, Alpert A, Bressler L: In vivo administration of IL-1 induces thymic hypoplasia and increased levels of serum corticosterone. J Immunol 1988;141:1456–1463.
  25. Bornstein SR, Rutkowski H, Vrezas I: Cytokines and steroidogenesis. Mol Cell Endocrinol 2004;215:135–141.
  26. Kadhim H, Tabarki B, Verellen G, De Prez C, Rona A, Sebire G: Inflammatory cytokines in the pathogenesis of periventricular leukomalacia. Neurology 2001;56:1278–1284.
  27. Dammann O, Leviton A: Inflammatory brain damage in preterm newborns: dry numbers, wet lab, and causal inferences. Early Hum Dev 2004;79:1–15.
  28. Ville Y: Premature delivery and inflammation. J Gynecol Obstet Biol Reprod 2001;30:12–16.
  29. Yoon BH, Park CW, Chaiworapongsa T: Intrauterine infection and the development of cerebral palsy. BJOG 2003;20:124–127.

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