Immunocytochemical localization of thymosin-alpha 1 in thymic epithelial cells of normal and myasthenia gravis patients and in thymic cultures

Thymosin α1 represents a potential potent single-molecule-based therapy for cystic fibrosis

Cystic fibrosis (CF) is caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) that compromise its chloride-channel activity. The most common mutation, p.Phe508del, results in the production of a misfolded CFTR protein, which has residual channel activity but is prematurely degraded. Because of the inherent complexity of the pathogenetic mechanisms involved in CF —which include impaired chloride permeability and persistent lung inflammation—a multidrug approach is required for efficacious CF therapy. To date, no individual, drug with pleiotropic beneficial effects for CF is available. Here we report on the ability of thymosin alpha 1 (Tα1)—a naturally occurring polypeptide with an excellent safety profile in the clinic when used as an adjuvant or an immunotherapeutic agent—to rectify the multiple tissue defects in CF mice as well as in cells from subjects with the p.Phe508del mutation. Tα1 displayed two combined properties that favorably opposed CF symptomatology; namely, it reduced inflammation and increased CFTR maturation, stability and activity. By virtue of this two-pronged action, Tα1 offers a strong potential to be an efficacious single molecule-based therapeutic agent in CF.

Thymosin α1: burying secrets in the thymus

Thymosin α1 (Tα1), an epithelial cell (EC)-derived cytokine, has the strong ability to modulate signals delivered through innate immune receptors on dendritic cells (DCs), thus instructing the initiation of appropriate immune responses to T cells. In its ability to activate indoleamine 2,3-dioxygenase 1-dependent tolerogenic programs in DCs, Tα1 pivotally contributes to the maintenance of self-tolerance by regulating the function of regulatory T (Treg) cells. How Tα1 may contribute to the Treg cell ontogeny is not known. The transcriptional regulator autoimmune regulator (AIRE) is known to control central and peripheral tolerance. AIRE is highly expressed in thymic medullary ECs where it controls the ectopic expression of tissue restricted antigens for negative selection. The absence of AIRE-induced tissue-specific antigens in the thymus can lead to autoimmunity in the antigen-expressing target organ. Recently, AIRE protein has been detected in peripheral lymphoid organs, suggesting that peripheral AIRE may play a complementary role. We have addressed the possible relationship between AIRE and Tα1 and discovered an intricate crosstalk, whereby AIRE may promote prothymosin cleavage to Tα1, and Tα1 in turn transcriptionally regulates AIRE expression. Thus, similar to other members of thymic stromal poietins, Tα1 expressed within the thymus and peripheral tissues regulates the EC/DC crosstalk required for salutary immune homeostasis.

Evidence that endogenous thymosin alpha-1 is present in the rat central nervous system

We have previously reported that administration of Thymosin alpha 1 (T-alpha1) can enhance the level of the Nerve Growth Factor and the distribution of its receptor in the developing Central Nervous System (CNS) of rat. To further explore the role of T-alpha1 and verify its presence in cells of rat CNS, we carried out an immunohistochemical study using a polyclonal antibody against T-alpha1. T-alpha1 immunoreactivity was found mainly in neurons of the hippocampus and spinal cord and in several small cells, resembling glial cells, of specific regions of the brain. Moreover, to study whether cerebral cells were receptive to T-alpha1, we injected iodinated T-alpha1 (125I-T-alpha1) i.c.v.. 125I-T-alpha1 labelled neurons were observed in the hypothalamus and septal nuclei. Our results indicate that specific neuronal populations in the rat CNS are able to express and respond to T-alpha1.

Thymic carcinoma of the thymic hormone secretory type in a cow

An 8-year-old Holstein cow had tumor nodules and enlarged lymph nodes in the mediastinum, and metastatic tumor masses in the pelvic cavity. The neoplastic cells were characterized by squamous features and intracytoplasmic vacuoles carrying microvilli, some of which contained periodic acid Schiff-positive globular cores, but tubular structures or goblet cells were absent. Many neoplastic cells stained positively for keratin, and occasional cells were positive for thymosin. The presence of secretory granules in the cytoplasm was confirmed by electron microscopy. This neoplasm was considered to be of thymic hormone-secreting epithelial cell origin.

Effects of thymosin alpha1 on the development of amoeboid microglial cells in the corpus callosum of neonatal BALB/c and athymic mice

The present study investigated the effects of intraperitoneal injections of thymosin alpha1 on the supraventricular amoeboid microglial cells (SAMC) in the newborn athymic and normal BALB/c mice. The microglial cells labelled by the lectin GSA I-B4 and the antibody Mac-1 showed a 27% reduction in number in the athymic mice receiving thymosin alpha1 injections compared with those receiving vehicle injections, and a 37% reduction in BALB/c mice receiving thymosin alpha1 injections compared with those receiving vehicle injections. Some of the SAMC in both BALB/c and athymic mice receiving thymosin alpha1 injections became ramified, while the remainder still exhibited their normal amoeboid appearance with few filopodial processes. Ultrastructurally, the lectin reaction product was confined to the plasma membrane and some cytoplasmic vacuoles of labelled SAMC. In both BALB/c and athymic mice, some labelled microglial cells became slender or elongated after thymosin alpha1 injections. Also their cytoplasm was reduced and contained fewer organelles. Radioimmunoassay of the plasma of thymosin alpha1 and vehicle-injected mice showed that there was a significant increase in the cortisol level in BALB/c (P < 0.01) and athymic (P < 0.001) mice 5 days after thymosin alpha1 injections, compared with that of the control mice. The results point to a strong correlation between the reduction of SAMC and the increased level of plasma cortisol. Supporting this is the fact that cortisol is known to suppress the production of monocytes considered to be the precursors of amoeboid microglia.

Expression of epidermal and nerve growth factor receptors in human thymus and thymomas

The expression of epidermal growth factor (EGF) and nerve growth factor (NGF) receptors has been investigated by immunohistochemical analysis in eight normal human thymuses and in 15 thymomas. Thymomas were classified into five different histological types--medullary, mixed, predominantly cortical, cortical thymoma and well-differentiated thymic carcinoma. In fetal and paediatric normal thymus, EGF-receptor was expressed by subcapsular, cortical and medullary epithelial cells, whereas immunoreactivity for NGF-receptor was detected on only subcapsular and medullary epithelial cells. In thymomas, independent of their histological type, EGF-receptor was expressed by a large majority of epithelial cells. In contrast, the pattern of expression of NGF-receptor in thymomas was different for the various histological types. These findings indicate that the expression of both EGF and NGF receptors in human thymomas substantially reflects their expression in normal thymus, and suggest that EGF and NGF may play a role in the ontogenesis of the human thymus as well as in the histogenesis of thymomas.

Thymic microenvironment in myasthenia gravis

This study was undertaken to investigate the role of thymic epithelial (TE) cells in the immunopathology of myasthenia gravis (MG). Seventeen thymuses from patients with MG and six normal thymuses were investigated by light and electron microscopy, using a stereologic method. In the myasthenic thymuses the cortex was markedly reduced, while the medulla was hypertrophied and had numerous germinal centers. A subpopulation of cortical TE cells showed a large fibrillar nucleolus and a decreased number of cytoplasmic dense bodies and cysts, indicating decreased function. Medullary TE cells, on the other hand, showed evidence of increased activity with an enlarged euchromatic nucleus and an increased number of cytoplasmic dense bodies. There was a statistically significant negative correlation between the decrease in size of the thymic cortex and the appearance of medullary germinal centers. A significant correlation was also demonstrated between atrophy of cortical TE cells and depletion of cortical thymocytes. Our study shows that both cortical and medullary TE cells are involved in the pathogenesis of MG but have different roles.

Immunohistochemical studies on a human thymic epithelial cell subset defined by the anti-cytokeratin 18 monoclonal antibody

Two monoclonal antibodies respectively recognizing cytokeratins (CK) 18 and 19 were applied to the human thymic epithelium (in vivo and in vitro) in normal and pathological conditions, including 12 thymomas. We observed that in both normal and hyperplastic thymuses (from patients with myasthenia gravis) virtually the entire epithelial network was CK19-positive as were the majority of cells growing in culture. In four thymomas, however, the expression of cytokeratin 19 was not detected by immunofluorescence. On the other hand, CK18 was expressed by a discrete subset of medullary thymic epithelial cells in normal and in hyperplastic thymuses. Among the thymomas a large majority was either negative or contained few isolated CK18-positive cells scattered within the tumour. Conversely, in the two undifferentiated epithelial thymomas, virtually all the tumoral network was strongly labeled with the anti-CK18 monoclonal antibody. The present investigation thus not only defines the human thymic epithelial cell subset on the basis of differential cytokeratin expression but also indicates that anti-CK antibodies with single cytokeratin specificities can be regarded as useful tools to study the heterogeneity of thymomas.

MicroELISA detection of thymosin alpha 1 released in thymic organ cultures

Using a polyclonal specific rabbit anti-thymosin alpha 1 a highly sensitive enzyme-linked immunosorbent assay (ELISA) has been developed to measure thymosin alpha 1. Production of thymosin alpha 1 was detected in both thymic organ cultures and in mouse serum. The method is rapid (5 h), reproducible and easy to perform.

Thymic hormone containing cells--IX. Steroids in vitro modulate thymulin secretion by human and murine thymic epithelial cells

We investigated the in vitro effects (kinetics and dose-response) of adrenal and sexual steroid hormones on the secretion of thymulin, a thymic hormone, by human thymic epithelial cells in primary cultures as well as in a rat epithelial cell line. We demonstrated that all steroids tested, in a range of physiological doses, stimulated thymulin production to various extents. Progesterone and estradiol, however, were revealed to be the most efficient. Specific steroid antagonists abrogated the steroid-induced stimulation of thymulin production. These findings confirm our previous in vivo results and demonstrate that steroid hormones can act directly on thymic epithelial cells to modulate their endocrine production.

Thymic hyperplasia. II. Lymphofollicular hyperplasia of the thymus. An immunohistologic study

The so-called lymphofollicular hyperplasia, which is caused by the occurrence of hyperplastic lymph follicles within the organ, is constantly associated with autoimmune diseases (e.g., myasthenia gravis) and in rare instances with malignant tumors. The architecture of lymphofollicular hyperplasia was studied immunohistochemically using antibodies against epithelial, vascular, lymphocytic, and histiocytic antigens. There is evidence, that the configuration, microtopography, cellular composition, and immunohistological findings of the lymph follicles with germinal centers in the myasthenic thymus are essentially the same as in those occurring in lymph nodes and in other lymphatic tissue. Furthermore it could be shown that the follicles originate in the interlobular septal space and displace the thymic parenchyma by extension.

Myasthenia gravis: immunohistological heterogeneity in microenvironmental organization of hyperplastic and neoplastic thymuses suggesting different mechanisms of tolerance breakdown

Four samples of thymoma obtained from patients affected by myasthenia gravis have been immunohistologically analysed on cryostat sections using a panel of antisera and monoclonal antibodies specific for antigens which define different stages of intrathymic lymphocyte differentiation and antigens specific for different types of thymic epithelial cells (cortical, medullary). When the thymoma samples were compared to age-matched normal thymuses and hyperplastic thymuses obtained from patients with myasthenia gravis some evident microenvironmental differences could be demonstrated using these reagents. In all the thymoma samples in fact the neoplastic lobules appeared as grossly enlarged cortical-type areas, formed by accumulations of T lymphocytes exhibiting the cortical immature phenotype (TdT+, T6+, etc.) within a network of putatively neoplastic epithelial cells characterized by cortical phenotype as defined by reactivity with various monoclonal antibodies (RFD4-, MR3+). These 'cortical' epithelia showed some abnormal features such as lack or irregular distribution of HLA-DR and enhanced keratin expression. Small areas of 'medullary' differentiation could be observed in 3/4 thymoma samples. In thymic hyperplasia, on the other hand, the cortical areas appeared somewhat compressed (but comparable to those observed in normal age-matched samples) by enlarged medullary areas. The expansion of medullary areas was due to the infiltration of 'peripheral' lymphoid tissue intruding through the extraparenchymal zone and forming organized B and T areas. These observations are discussed in the light of the clinical heterogeneity observed in myasthenia gravis.

Thymosin beta 4 is a shared antigen between lymphoid cells and oligodendrocytes of normal human brain

In the normal human brain, immunoreactive thymosin beta 4, a well-characterized thymic extract, was demonstrated specifically in the cell bodies and processes of a subset of interfascicular and satellite oligodendrocytes with their stained processes terminating around myelin sheaths. Antisera directed against two other thymic polypeptides, thymosin alpha 1 and alpha 7, did not react. In lymphoid tissues, thymosin beta 4 was present in macrophages, Langerhans' cells of the skin, and the interdigitating cells of the thymus. Thus, a subset of oligodendrocytes shares a common antigen of thymic origin with the reticular-dendritic and phagocytic lymphoid cells--all Ia+ immunocompetent cells that participate in the presentation of antigens to T cells. The subset of thymosin beta 4-positive oligodendrocytes is antigenically distinct and may play a role in the immune surveillance of the central nervous system or the demyelinating processes induced by antigen-presenting activated macrophages.

Thymoma epithelial cells secrete thymic hormone but do not express class II antigens of the major histocompatibility complex

17 thymomas were studied by indirect immunofluorescence for the presence of thymic hormones and antigens of the major histocompatibility complex (MHC). The thymoma epithelial cells (specifically identified by their keratin content) contained thymic hormones (thymulin and thymosin alpha 1), a finding corroborated by the observation of elevated thymulin serum levels. In contrast with normal or hyperplastic thymuses, thymoma epithelial cells did not express HLA-DR and HLA-DC antigens as assessed by immunofluorescence as well as immunoblot analyses. Conversely, MHC class I antigens (HLA-ABC) were normally expressed. Thus, we conclude that thymoma epithelial cells are endocrinologically active but are defective for the expression of some MHC products (class II molecules) known to play an essential role in intrathymic T cell differentiation.

Receptors for thymosin alpha 1 on mouse thymocytes

Thymosin alpha 1 is able to act in vitro to stimulate T-cell precursors and to induce surface markers. The initial mechanism by which alpha 1 activates T cells could be the binding of alpha 1 to cell membranes. Using a specific anti-alpha 1 antibody and an indirect immunofluorescence procedure it was found that thymosin alpha 1 binds to the surface of a large portion of murine lymphocytes. Furthermore, thymocytes have been fractionated into immature and mature subpopulations by using the peanut agglutinin (PNA) technique. It was found that PNA+, immature cells showed specific receptors for alpha 1 on the cell membrane.

Thymic hormone-containing cells VI. Immunohistologic evidence for the simultaneous presence of thymulin, thymopoietin and thymosin alpha 1 in normal and pathological human thymuses

The localization of the three best-defined thymic hormones, namely, thymulin, thymopoietin and thymosin alpha 1 was studied by immunofluorescence using antibodies directed against these three molecules. With both human thymus frozen sections and cultured cells, thymic hormones were found exclusively in the epithelial component (recognized by its keratin content), in normal as well as pathological thymuses. The double-labeling experiments using the different anti-thymic hormone antibodies showed that the same epithelial cells contained the three hormones. These results suggest that the production of different hormones in the thymus is accomplished by the same epithelial cells.

Exacerbation of myasthenia gravis after removal of a thymoma having a membrane phenotype of suppressor T cells

We describe a case of myasthenia gravis associated with a thymoma having a membrane phenotype of suppressor T cells, as defined by monoclonal antibodies. Thymectomy resulted in exacerbation of the disease, a drastic increase in serum acetylcholine receptor-antibody titer, and a decrease of the circulating suppressor T cell population. The findings indicate that the etiopathogenic relationship between the thymus and myasthenia gravis is variable and complex.

Immunoreactive thymosin alpha 1 is associated with murine T-cell lymphomas

Growth of murine spontaneous and transplanted AKR T-cell lymphomas results in marked elevations of serum immunoreactive thymosin alpha 1. Thymosin alpha 1 is one of the peptide hormones believed to be secreted primarily by the thymic epithelium. This elevation, however, is not mediated by the thymus but rather, seems to be directly associated with the tumor cells. Growth of a B-cell lymphoma does not generate elevated immunoreactive thymosin alpha 1 in the serum, thus, a thymosin alpha 1-like peptide is selectively associated with these T-cell lymphomas. The possible relationship between expression of T-leukemia viruses and alpha 1 expression is discussed.

Splenic and total-body irradiation treatment of myasthenia gravis

X-irradiation is introduced as a new therapeutic technique in the treatment of otherwise intractable myasthenia gravis (MG) and polymyositis (PM), on the basis that these dysimmune diseases are "lymphocyte dyscrasias" and that lymphocytes are the circulating cells most sensitive to x-irradiation. Splenic irradiation, 1000 rads per two-week course, repeated up to three courses, in five MG patients produced objective improvement in three and subjective improvement in another. The improvement was transient and accompanied by a temporary lymphocytopoenia. Total Body Irradiation (TBI), 150 rads over five weeks, in one polymyositis patient was followed by remarkable improvement, sustained and still increasing now after one year, associated with a sustained lymphocytopoenia. One MG patient has had definite improvement, maintained to the present, seven months after TBI, associated with persistent lymphocytopoenia. We suggest TBI may also be a treatment applicable to other types of dysimmune (autoimmune) diseases.