Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

Thymus in Neuro-Endocrine-Immune Network: Hormonal Influences & Immune Implications, Lecture notes of Endocrinology

An overview of the thymus' role in the neuro-endocrine-immune network, focusing on its immunoregulatory functions and the impact of various hormones on its development and activity. The authors discuss the importance of thymic hormones, such as thymosin α1 and triiodotyronine, in regulating thymic lymphopoiesis and immune functions. They also explore the neuro-hormonal influences on the thymus, including the hypothalamo-pituitary axis and sex hormones.

Typology: Lecture notes

2021/2022

Uploaded on 09/27/2022

stifler
stifler 🇮🇹

4

(6)

215 documents

1 / 5

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
Central European Journal of Immunology 2011; 36(3)
188
Review paper
Correspondence: Prof. Wanda Stankiewicz, Military Institute of Hygiene and Epidemiology, Department of Microwave Safety, Kozielska 4,
01-163 Warszawa, e-mail: wanda.stankiewicz@gmail.com
Introduction
The thymus is the first completely developed organ in
our individual life. Its activity, the most vigorous in fetal
and neonatal period, is continued with gradually decreased
intensities till the end of our life. The thymus is the center
of development of immunocompetence of immigrant bone
marrow-derived lymphocytes which progressively differ-
entiate into separate T-lymphocyte subclasses. Intrathymic
environment composed of the network of thymic epithelial
cells (TEC) presents to incoming cells the template of self
histocompatibility antigens of the HLA-first and the HLA-
second class. They are ligands for recombinantly develop-
ing T cell receptors (TCR) which together with co-recog-
nizing structures (CD4 or CD8) create the mechanisms of
immune recognition. The T lymphocytes with the shape of
TCR able to recognize the self histocompatibility antigens
(HLA-restriction), thus able to discriminate between the
correctness of self or incorrectness of self deformed by
influence of foreign elements (including infective antigens),
are positively verified and selected by the supportive influ-
ence of thymic epithelial cells. TEC are producers of some
cytokines, growth factors (e.g. IL-1, IL-7, oxytocine,
enkephalins) and specific polypeptides collectively
described as a “thymic hormones”. These substances are
highly sensitive for enzymatic proteolysis and their life-
span in circulation is very short. Their repeated impulses
delivered by the active thymus are indispensable for com-
pletion and finalization of the process of maturation of T
lymphocytes which takes about two weeks in human [1].
Leaving the thymus, newly matured T lymphocytes repre-
senting the all known classes of the population (T-inducer-
helper, T-cytotoxic, T-regulatory cells), reach the peripher-
al lymphoid system as a recent thymic emigrants (RTE).
This is the physiologic way or replenishment of cellular
resources of immune system exploited by its numerous
defensive, regenerative, tolerant and regulatory functions.
The thymic supplementation of immune system with the
new cellular cohorts to replace the exploited resources is
a whole-life process, the most intensive at the perinatal peri-
od. Nevertheless, even in the adult and elderly individuals
the thymic lymphopoietic and endocrine functions are main-
tained, as indicated by the appearance of the new RTE cells
in the circulation [2-4]. In consequence, the proper activi-
ty of the thymus leads to the functional efficiency of
immune system in the full scope of its activities and the
The thymus in neuro-endocrine-immune
network
MAREK P. DĄBROWSKI , MACIEJ I. DĄBROWSKI, WANDA STANKIEWICZ
Military Institute of Hygiene and Epidemiology, Department of Microwave Safety, Warsaw, Poland
Abstract
On the grounds of concise review of literature comprising the most important findings achieved by
different investigators during over fifty years of intensive research, authors describe the present state-
of-art knowledge on the immunoregulatory role of thymus. Being responsible for creation of immune
competence of T lymphocytes, the thymus is able to control immune functions also by regulation of immu-
nity indirectly by neurohormonal mechanisms. They comprise both synergistic (e.g. growth hormone,
prolactin, enkephalins, thyroid hormones) and antagonistic (e.g. adrenal and sex hormones) connec-
tions between the thymus and neurohormonal system. This way, remaining active for the whole life of
the organism, providing both cellular and hormonal influences, the thymus integrates and maintains the
homeostatic tasks of neuro-endocrine-immune network related to its metabolic, procreative, regenera-
tive, tolerogenic and defensive functions.
Key words: the thymus and neurohormonal regulation of immunity.
(Centr Eur J Immunol 2011; 36 (3): 188-192)
pf3
pf4
pf5

Partial preview of the text

Download Thymus in Neuro-Endocrine-Immune Network: Hormonal Influences & Immune Implications and more Lecture notes Endocrinology in PDF only on Docsity!

Review paper

Correspondence: Prof. Wanda Stankiewicz, Military Institute of Hygiene and Epidemiology, Department of Microwave Safety, Kozielska 4, 01-163 Warszawa, e-mail: wanda.stankiewicz@gmail.com

Introduction

The thymus is the first completely developed organ in our individual life. Its activity, the most vigorous in fetal and neonatal period, is continued with gradually decreased intensities till the end of our life. The thymus is the center of development of immunocompetence of immigrant bone marrow-derived lymphocytes which progressively differ- entiate into separate T-lymphocyte subclasses. Intrathymic environment composed of the network of thymic epithelial cells (TEC) presents to incoming cells the template of self histocompatibility antigens of the HLA-first and the HLA- second class. They are ligands for recombinantly develop- ing T cell receptors (TCR) which together with co-recog- nizing structures (CD4 or CD8) create the mechanisms of immune recognition. The T lymphocytes with the shape of TCR able to recognize the self histocompatibility antigens (HLA-restriction), thus able to discriminate between the correctness of self or incorrectness of self deformed by influence of foreign elements (including infective antigens), are positively verified and selected by the supportive influ- ence of thymic epithelial cells. TEC are producers of some cytokines, growth factors (e.g. IL-1, IL-7, oxytocine,

enkephalins) and specific polypeptides collectively described as a “thymic hormones”. These substances are highly sensitive for enzymatic proteolysis and their life- span in circulation is very short. Their repeated impulses delivered by the active thymus are indispensable for com- pletion and finalization of the process of maturation of T lymphocytes which takes about two weeks in human [1]. Leaving the thymus, newly matured T lymphocytes repre- senting the all known classes of the population (T-inducer- helper, T-cytotoxic, T-regulatory cells), reach the peripher- al lymphoid system as a recent thymic emigrants (RTE). This is the physiologic way or replenishment of cellular resources of immune system exploited by its numerous defensive, regenerative, tolerant and regulatory functions. The thymic supplementation of immune system with the new cellular cohorts to replace the exploited resources is a whole-life process, the most intensive at the perinatal peri- od. Nevertheless, even in the adult and elderly individuals the thymic lymphopoietic and endocrine functions are main- tained, as indicated by the appearance of the new RTE cells in the circulation [2-4]. In consequence, the proper activi- ty of the thymus leads to the functional efficiency of immune system in the full scope of its activities and the

The thymus in neuro-endocrine-immune

network

MAREK P. DĄBROWSKI , MACIEJ I. DĄBROWSKI, WANDA STANKIEWICZ

Military Institute of Hygiene and Epidemiology, Department of Microwave Safety, Warsaw, Poland

Abstract On the grounds of concise review of literature comprising the most important findings achieved by different investigators during over fifty years of intensive research, authors describe the present state- of-art knowledge on the immunoregulatory role of thymus. Being responsible for creation of immune competence of T lymphocytes, the thymus is able to control immune functions also by regulation of immu- nity indirectly by neurohormonal mechanisms. They comprise both synergistic (e.g. growth hormone, prolactin, enkephalins, thyroid hormones) and antagonistic (e.g. adrenal and sex hormones) connec- tions between the thymus and neurohormonal system. This way, remaining active for the whole life of the organism, providing both cellular and hormonal influences, the thymus integrates and maintains the homeostatic tasks of neuro-endocrine-immune network related to its metabolic, procreative, regenera- tive, tolerogenic and defensive functions.

Key words: the thymus and neurohormonal regulation of immunity.

(Centr Eur J Immunol 2011; 36 (3): 188-192)

abrogation of thymic activity results in progressing immune deficiencies of different kinds.

The functional connections between

the thymus and neuro-endocrine system

The thymus is a composition of the three cellular sys- tems originating from embrional, ectodermal, endodermal and mesenchymal elements, thus representing the main con- structive elements of developing organism. During ontoge- ny the endodermal TEC which developed from pharyngeal pouch and ectodermal TEC which developed from brachial cleft, all connected with mesenchymal elements, make the two-lobe organ located primarily in the cervical region and finally descending to the mediastinum. The non-lymphoid portion of the embryonic thymus elaborates chemotactic factors attracting immigration of fetal liver and bone mar- row stem cells which create thymic lymphoid cell popula- tions (thymocytes, macrophages). The organ receives its innervation form several nerves: the vagus, the phrenic nerve, the recurrent laryngeal nerve and the descendens cervicales (ansa hypoglossi). Both adren- ergic and cholinergic terminals regulate the thymic devel- opment and function by influence of respective neurotrans- mitters [5]. For example, cortisone injection into mice activate cholinergic nerves increasing acetylocholine (AChE) activity within the areas of thymocyte disintegration [6]. On the other hand, the propranolol, an adrenergic blocker, giv- en to newborn mice evoked an arrest of the thymic devel- opment and consequent impairment of thymic dependent immune functions [7]. The high susceptibility of the thymus to the stress is well known feature of the organ. The stress- ing signals of the physical (temperature, radioactivty, strong electromagnetic fields), chemical (toxins) or even psycho- logical nature (dramatic events, accidents, lost of spouse) may lead to the thymic atrophy with the immunodeficient consequences remembering to the some degree those observed in animals after neonatal thymectomy (wasting disease). The symptoms of wasting disease observable after neonatal thymectomy in mice [8] demonstrate the negative reflection of the full range of beneficial influences of the thymus and T lymphocytes in the organism. They show what was lost. The lack of T cells is observed in subcortical regions of lymph nodes, in periarteriolal sheets in the spleen, in the lymph, blood and tissues. In contrast to the presence of B, NK , K cells, monocytes and macrophages and their products, the symptoms of immunodeficiency develop including severe infections of the skin, mucous membranes, respiratory, digestive and urogenital tracts. The growth of animal is inhibited and general atrophy destructs different tissues and organs, including bone marrow. The immune autoagressive reactions and spontaneous tumors will fre- quently develop before the animals die. The thymus is strongly subdued in its functions to the influences of central nervous system and endocrine system.

From its own side, the thymus directly by hormonal influ- ences or indirectly by immune functions, affects the neu- ro-endocrine system.

Neuro-hormonal influences on the thymus Numerous products of hypothalamo-pituitary axis (HP) regulate thymic development, involution, endocrine activ- ity and generation of T lymphocyte repertoire. Under the supervision of HP, also hormones of peripheral endocrine organs (thyroxine, corticosteroids and sex hormones) exert the regulatory influences on the thymus. Kelley et al. [9] has demonstrated for the first time com- plete regeneration of the thymus in old rats after implanta- tion of pituitary derived epithelial cell line GH3 secreting growth hormone and prolactin. Further investigations detected that growth hormone (GH) appeared to stimulate several functions of the thymus including secretion of thymic hormones, bone marrow cell immigration, produc- tion of extracellular matrix proteins regulatory for intrathymic traffic of maturing thymocytes, their prolifer- ation and export [10-14]. The treatment with somatotropin of growth hormone deficient patients resulted in several fold increase of the concentration of thymic hormone thy- mosin α1 in the serum [15]. Prolactin (PRL), the other hormone of anterior part of pituitary, highly active post partum efficiently contributes to the regeneration and activity of the thymus temporarily inhibited during pregnancy by influence of progesterone [16]. Similar effects are exerted by pituitary oxytocin which is also produced by thymic neural-crest derived neuropep- tide secreting cells. The local oxytocin is potent to replace the lacking IL-2 for costimulation of thymocyte prolifera- tion [17]. The prolactin combining with specific PRL recep- tors present on TEC stimulates them to synthetise the thymic hormone thymulin [18]. The hypothalamo-pituitary- adrenal axis (HPA) exerts complex modulatory influences on the whole immune system with the thymus at the top. Direct influence of ACTH on the cultures of TEC appeared to stimulate their endocrine activity. In contrast to that, ACTH increasing adrenal production of corticosteroids ini- tiates their immunosuppressive effects by abrogation of thymic hormonal activity and reducing the number of thy- mocytes and peripheral T cells [1, 19-21]. The only excep- tion with no direct immunosuppressive influences in the whole steroid family is dihydroepiandrostendiol (DHEA), the precursor of corticosteroids and sex hormones which, in turn, appear to exert strong immunosuppressive influ- ences with the leading role of progesterone in this respect [16]. The other hormonal agent representing strong stimu- latory influence on thymic lymphopoiesis is product of thy- roid - triiodotyronine (fT3). The positive correlation exists between fT3 concentration in the serum and endocrine activity of TEC [22-24]. Triiodotyronine activates the expression of receptors and ligands in extracellular matrix (fibronectin, laminine, VLA-5, VLA-6), accelerating the

The thymus in neuro-endocrine-immune network

The thymus in neuro-endocrine-immune network

axis. The oogenesis and spermatogenesis may develop in prepubertal period and to be continued after puberty under influence of pituitary gonadotropins (FSH and LH). Their absence in nude mice results in infertility of the animals. Over 30 years of investigations clarified the mechanisms of the influence of the thymus on hypothalamo-pituitary- gonadal axis. In late 70. Lintern-Moore and Pantelouris [32] have observed that administration of gonadotropins to athymic mice normalizes ovarial development. In 80. Rebar and coworkers [33, 34] investigating the hormonal sequence in young and adult athymic mice have determined that the deficits comprised consequent steps of hormonal hierarchy. They were observed at the level of hypothalamus (deficient production of releasing hormone for luteinizing hormone LH-RH), through the level of pituitary (gonadotropin deficits), descending to the level of ovary and serum (decreased concentrations of estrogens and progesterone). The sequenced hormonal deficits observed in athymic nude mice could suggest that the lacking thymic hormonal influ- ence was the reason for the appearance of the deficits. To answer the questions if the endocrine thymic influence can stimulate hypothalamo-pituitary-gonadal hormonal cascade, and if so, which of the thymic products can do it, and at which level, the Rebar’s team in cooperation with A.L. Goldstein and his coworkers performed next series of exper- iments [33]. The hypothalamic and pituitary tissues were cultured in the environment containing thymosin β4 or thy- mosin α1, both well known and sequenced thymic hor- monal products. The experiments have shown that only in the system comprising both hypothalamic and pituitary tis- sues increased production of LH-RH and LH took place under influence of thymosin β4. No thymosin α1 was active in this respect, nor thymosin β4 was able to stimulate the hormonal production if pituitary tissues were cultured in the absence of hypothalamic tissues [33, 34]. These obser- vations, valid for animals, have its respective reflection also in the humans. Post-mortem investigations in girls who died from inherited syndromes of thymic atrophy (DiGeorge, ataxia-teleangiectasia) revealed the total absence of oocytes in atrophied ovaries. The influence of thymic hormones on the hypothalamo- pituitary system is not limited to the gonadal axis. Healy et al. [35] discovered in 1983 the similar effect of thymic prod- ucts (thymosin fr.5 and tymosin α1) on the hypothalamo- pituitary-adrenal axis. The experiments were performed on thymectomised monkeys (Macaca fascicularis) in which the concentrations of ACTH, β-endorphin and cortisol were esti- mated by radioimmunoassay. The animals were equipped with special vests to provide location of the catheter inside the vein vessel for collection of blood specimens and for administration of thymic hormones (thymosin fr. 5, thymosin α1, thymosin β4). These precautions have made the animals safe from possible stressing direct contacts with the scien- tific staff. In thymectomised monkeys the levels of ACTH, β-endorphins and cortisol were significantly lower 6 weeks

after thymectomy as compared to the levels estimated 6 weeks before thymectomy. The administration of thymosin fr. 5 but not thymosin α1 or thymosin β4 increased the con- centrations of ACTH, β-endorphin and cortisol in tested blood specimens. To find out at which level (hypothalamus?, pituitary?, adrenals?) the administered thymic hormones were active, Hall and coworkers [36] continued the inves- tigations on rats in which two weeks before the experiment the catheter was introduced directly to the hypothalamus. Thymosin fr. 5 and thymosin α1administered this way increased the production of adrenal steroids. None of thymic hormones was active in this respect if was injected intra- venously or intra-peritoneally.

Concluding remarks

The cited historical experiments performed by Rebar, Healy and Hall and next confirmed by more recent inves- tigations [20-22, 25, 26, 28-30, 37] indicate that the hypo- thalamus is a common central point of action for different thymic hormones and that thymic influence on hypothala- mus finally results in respective changes of activity of peripheral endocrine organs. Thus, the thymus occupies the central position in the neuro-endocrine-immune network integrating its homeostatic tasks in the range of metabolic, procreative, regenerative, tolerogenic and defensive func- tions of the organism. The time of thymic activity is not limited to the childhood but the organ remains or should remain active, albeit with changing intensities adjusted to different periods of life (e.g. pregnancy, illness stress, recov- ery from illnesses), for the whole life-span. Being respon- sible for creation of immune competence represented by multifunctional population of T lymphocytes, the thymus is able to control immune functions not only by supple- mentation of immune system with T cells but also by reg- ulation of immunity indirectly by neurohormonal mecha- nisms. They comprise both synergistic (e.g. growth hormone, prolactin, enkephalins, thyroid hormones) and antagonistic (e.g. adrenal and sex hormones) connections between the thymus and neurohormonal system. In this respect, whereas immunoinhibitory influences of hypo- thalamo-pituitary-adrenal and –gonadal axis create impor- tant feedback control system in physiological circum- stances, the excessive clinical use of corticosteroids or sex hormones, what is inhibitory for thymic functions, may bring the harmful effects for balanced activity of neuro- endocrine-immune network.

References

  1. Dąbrowski MP, Dąbrowska-Bernstein BK (1990): Immunoreg- ulatory role of thymus. CRC Press, Boca Raton Fl.
  2. Bertho JM, Demarquay C, Moulian C, et al. (1997) : Pheno- typic and immunohistologic analysis of the human adult thy- mus: evidence for an active thymus during adult life. Cell Immunol 179: 30-40.
  1. Jamieison BD, Douck DC, Killian S, et al. (1999): Generation of functional thymocytes in the human adult. Immunity 10: 569-575.
  2. Zhang L, Lewin SR, Markowitz M, et al. (1999): Measuring recent thymic emigrants in blood of normal and HIV-1 – infect- ed individuals before and after effective therapy. J Exp Med 190: 725-732.
  3. Bulloch K, Moore RY (1981): Innervation of the thymus gland by brainstem and spinal cord in mouse and rat. Am J Anat 163: 157.
  4. Bulloch K (1986): The role of nerve-related AChE in the development and function of the thymus. 2 nd^ Int. Workshop Neuroimmunomodulation, Dubrovnik abstr 43.
  5. Sympson JG, Gay SE, Michie W, et al. (1975) : The influence of preoperative drug treatment on the extent of hyperplasia of the thymus in primary thyrotoxicosis. Clin Exp Immunol 22: 249
  6. Miller JFAP, Marshall AHE, White RG (1962): The immuno- logical significance of the thymus. Adv Immunol 2: 111-162.
  7. Kelley KW, Brief S, Westly HJ, et al. (1987): Hormonal reg- ulation of age-associated decline in immune function. Ann NY Acad Sci 496: 91-96.
  8. de Mello-Coelho V, Villa-Verde DMS, Dardenne M, Savino W (1997): Pituitary hormones modulate cell-cell interactions between thymocytes and thymic epithelial cells. J Neuroim- munol 76, 39-49.
  9. Napolitano LA, Lo JC, Gotway MB, et al. (2002): Increased thymic mass and circulating nai¨ve CD4 T cells in HIV-1 infect- ed adults treated with growth hormone. AIDS 16, 1103-1111.
  10. Scimone W, Aifantis I, Apostolou I, et al. (2006): A multistep adhesion cascade for lymphoid progenitor cell homing to the thymus. Proc Natl Acad Sci USA, 103; 7006-7011.
  11. Smaniotto S, Mello-Coelho V, Villa-Verde DMS, et al. (2005): Growth hormone modulates thymocyte development in vivo through a combined action of laminin and CXCL12. Endocrinology 146; 3005-3017.
  12. Smaniotto S, Ribeiro-Carvalho MM, Dardenne M, et al. (2004): Growth hormone stimulates the selective trafficking of thymic CD+CD– emigrants to peripheral lymphoid organs. Neuroimmunomodulation 11; 299-306.
  13. Goldstein AL, Low TLK, Thurman GB, et al. (1981): Current status of thymosin and other hormones of the thymus gland. Rec Progr Horm Res 37: 369-375.
  14. Seiki K, Sakabe K (1997): Sex hormones and the thymus in relation to thymocyte proliferation and maturation. Arch His- tol Cytol 60; 29-38.
  15. Haynes BF, Shimizu H, Eisenbarth GS (1983): Identification of human and rodent thymic epithelium using tetanus toxin and monoclonal antibody A2B5. J Clin Invest 71: 9-13.
  16. Dardenne M, Savino W, Gagnerault MC, et al. (1989): Neu- roendocrine control of thymic hormonal production.I. Prolactin stimulates in vivo and in vitro the production of thymulin by human and murine thymic epithelial cells. Endocrinology 125: 3-12.
  17. Besedovsky HO, Del Rey A, Sorkin E: Neuroendocrine immunoregulation. In: Immunoregulation , Fabris N, Garaci E, Hadden J, Mitchison NA (eds), New York Plenum Press, 1983, 315-339.
  18. Goya RG, Brown OA, Bolognani F (1999): The thymus-pitu- itary axis and its changes during aging. Neuroimmunomodu- lation 6: 137-142.
  19. Sternberg EM (2001): Neuroendocrine regulation of autoim- mune/inflammatory disease. J Endocrinol 169: 429-435.
  20. Mocchegiani E, Imberti R, Testasecca D, et al. (1995): Thy- roid and thymic endocrine function and survival in severely traumatized patients with or without head injury. Intensive Care Med 21: 334-341.
  21. Fabris N, Mocchegiani S, Mariotti S, et al. (1986): Thyroid function modulates thymic endocrine activity. J Clin Endocrinol Metab 62: 474-478.
  22. Ribeiro-Carvalho M, Ferias-de-Oliveira D, Villa-Verde D et al. (2002/2003): Triiodothyronine modulates extracellular matrix-mediated interactions between thymocytes and thymic microenvironmental cells. Neuroimunomodulation 10: 142-152.
  23. Savino W, Dardenne M (2000): Neuroendocrine control of thy- mus physiology. Endocr Rev 21: 412-443.
  24. Savino W, Villa-Verde DM, Alves LA, Dardenne M. (1998): Neuroendocrine control of the thymus. Ann NY Acad Sci 840: 470-479.
  25. Yener S, Secit M, Kocdor MA, et al. (2008): Thymic hyper- plasia presenting as a neck mass in Graves’ disease., European Congress of Endocrinology, Berlin, May 3-7, Endocrine Abstracts 16, P699.
  26. Dardenne M, Savino W, Bach J-F (1988): Modulation of thymic endocrine function by thyroid and steroid hormones. Int J Neurosci 1988; 39: 325-334.
  27. Savino W, Arzt E, Dardenne M (1999): Immunoendocrine con- nectivity : the paradigm of the thymus-hypothalamus/pituitary axis. Neuroimmunomodulation 6: 126-136.
  28. Stankiewicz W, Dąbrowski MP, Rosiak E, et al. (2010): Patho- genetic interdependence of thyroid endocrine dysfunction and disturbances of thymic-dependent immunoregulation. Centr Europ J Immunol 35: 94-99.
  29. Piantanelli L, Fattoretti P, Viticchi C (1980): Beta-adrenocep- tor changes in submandibular glands of old mice. Mech Age Develop 14: 155-164.
  30. Lintern-Moore S, Pantelouris EM (1976): Ovarian develop- ment in athymic nude mice. V. The effects of PMSG upon the numbers and growth of follicles in the early juvenile ovary. Mech Age Develop 5: 259-265.
  31. Rebar RW, Miyake A, Low TLK, et al. (1981): Thymosin stim- ulates secretion of luteinizing hormone – releasing factor. Science 214: 669-671.
  32. Rebar RW: Effects of thymic peptides on hypothalamo-pitu- itary function, in: Thymic hormones and lymphokines, Gold- stain AL ed. Plenum Press New York 1984, 325-333.
  33. Healy DL, Hodgen GD, Schulte HM, et al. (1983): The thy- mus-adrenal connection: thymosin has corticotrophin-releas- ing activity in primates. Science 222: 1353-1355.
  34. Hall NR, Goldstein AL (1983): The thymus-brain connection: interaction between thymosin and the neuroendocrine system. Lymphokine Res 2: 1-6.
  35. Hall NR, O’Grady MP, Menzies RA (1992): Thymic regulation of the hypothalamo-pituitary-gonadal axis. Int J Immunopharmacol 14: 353-359.

Marek P. Dąbrowski , Maciej I. Dąbrowski et al.