Review Article

Thymus Atrophy and Double-Positive Escape Are Common Features in Infectious Diseases

Box 2

Box 2. Thymic atrophy and negative selection in experimental acute Chagas disease.
It is largely established that interactions between TEC and thymocytes control the development of
the thymic microenvironment and T-cell development. Furthermore, many tissue-specific self-
proteins are known to be synthesized by medullary thymic epithelial cells (mTEC) that express
Aire. For this reason, Aire-expressing mTEC have a central role in the deletion of self-reactive
thymocytes during the process of negative selection [58ā€“61]. In T. cruzi infection we showed that
the expression of Aire and highly selective tissue restricted antigens was readily detectable in
whole thymus by real-time PCR analysis from infected mice, suggesting an expression of peripheral
antigens which would be sufficient to modulate the tolerance induction by the negative selection
process [62].
During the acute phase of infection, as the thymic atrophy becomes evident, there is an increase
in numbers of apoptotic intrathymic DP cells, compared to their respective normal counterparts.
Although this phenomenon may be a consequence of the changes observed in the organ, our data
show that along the DP depletion there is sustained expression of Bim, a proapoptotic factor
essential for thymocyte negative selection. Further analysis, by using an OTII TCR transgenic
system, revealed that the administration of the cognate OVA peptide in the acutely infected mice
undergoing thymic atrophy can induce TCR-stimulation-induced apoptosis of semimature
thymocytes. These data point out that negative selection operates normally during infection-
promoted thymic atrophy, since the DP cells can be negatively selected in the infected thymus by
antigen-induced depletion [62].