[HN Gopher] Turns out lowly thymus may be saving your life
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Turns out lowly thymus may be saving your life
Author : birriel
Score : 79 points
Date : 2023-08-10 19:07 UTC (3 hours ago)
(HTM) web link (news.harvard.edu)
(TXT) w3m dump (news.harvard.edu)
| stefantalpalaru wrote:
| [dead]
| gadflyinyoureye wrote:
| What are the chances that I'd see two things about the thymus in
| a week? https://www.youtube.com/watch?v=rVoxfABoHh4&t=2s
|
| This covers a paper that, while small in sample size, shows a
| reduction in age of 6 years. One of the major impacts of the drug
| cocktail is that it removes much of the fat that accumulates in
| the thymus as one ages.
| autokad wrote:
| I was wondering that. what about people who have less fat? what
| if we stop it from fattening? etc. good video
| spandrew wrote:
| This type article declaring a thymus revelation is published
| every few years.
|
| We've known the thymus is saving our lives -- it's where the t in
| t-Cells derives from for years. There are very old studies of
| removing it from older humans and statistically seeing a decline
| in health. Most doctors will not remove it without a decent cause
| in older patients (intractable infection, for example). In those
| cases it's not that removing the thymus was a good approach. It
| was just the least-bad approach the physician had on hand to help
| their patient.
|
| Never forget that everything we do, medically, is a stall. I'm
| glad we have blood pressure pills and better health spans than
| our grandparents. Eat a healthy diet, run 3 times a week, manage
| stress and... die anyway. That's the deal we were given as living
| things.
| xixo wrote:
| I wish I could say my dad's thymus is saving his life, quite
| the opposite. He was discharged from the ICU/hospital yesterday
| after he nearly died from a "myasthenic crisis"--an event that
| most people with Myasthenia Gravis (MG) will experience. From
| what I understand, his thymus produces antibodies that destroys
| receptors connecting the nerves and muscles. He can't keep his
| head up, eyelids up, can't swallow and during the crisis could
| not breathe.
|
| Interestingly, a small portion of MG patients have an
| enlarged/tumorous thymus and end up getting it removed, though
| there aren't necessarily clear benefits. It's also a quite
| invasive procedure they wouldn't perform on older folks like my
| dad (he shows no signs of it anyway).
|
| Overall I agree with you though--this article is not saying
| anything new. As a concerned son who's spent more than his fair
| share of time trying to understand what's going on here, I wish
| it did. I also wish there were some treatments for my dad that
| worked. For now, exercising, eating healthy, lowering stress,
| and a healthy dose of steroids are currently keeping him with
| us. If anyone has advice, I'm all ears.
| [deleted]
| Calavar wrote:
| This is a fluff piece. We've known for decades that the thymus is
| an important part of the immune system. It's not an organ that's
| been believed to be vestigial, like the appendix.
|
| > For the study, Kooshesh mined data from 1,146 adult patients
| who had undergone thymus removal, alongside demographically
| matched control patients who had undergone similar surgeries but
| kept their thymus
|
| Sure, you can demographically match all you want, but I don't
| think this is a research question that can be answered with a
| retrospective analysis. The problem is that you haven't
| controlled for _why_ surgeons decided to remove the thymus in
| some cases and not in others. Was the disease more severe in
| patients who got thymectomies? Was it differences in training
| between the surgeons? Was it just an arbitrary decision on the
| part of the surgeons? This is a critical confounder regardless of
| whether you 've matched the demographics. You really need a
| randomized control study to answer this sort of question.
|
| > Although the risk of autoimmune disease did not differ
| substantially between the groups in the overall primary cohort
| (relative risk, 1.1; 95% CI, 0.8 to 1.4), a difference was found
| when patients with preoperative infection, cancer, or autoimmune
| disease were excluded from the analysis (12.3% vs. 7.9%; relative
| risk, 1.5; 95% CI, 1.02 to 2.2)
|
| What? What is this? Was this subgroup analysis preregistered, or
| did they just go fishing when their primary hypothesis didn't pan
| out?
|
| I'd categorize this study as mildly interesting, but not
| groundbreaking the way the press statement is selling it.
| anon84873628 wrote:
| Well, if the study had found no significant correlation, that
| would have been interesting information. I'll still applaud the
| researchers on this one.
| joe__f wrote:
| I believe that the appendix is now understood to be a store for
| gut flora so that the microbiome can regrow after an infection
| or bad episode of diarrhoea etc.
| runnerup wrote:
| I believe it's only posited to be useful for isolated small
| groups where everyone might get the same stomach bug at the
| same time, and have no other humans around with a healthy gut
| biome to "re-infect" them. Which explains why in dense modern
| society we couldn't find a difference that the appendix
| makes, because we get reinfected with healthy microbiome from
| sharing germs with all the other humans in our big cities -
| some of whom didn't just get a terrible stomach bug at the
| same time as us.
| bookmark1231 wrote:
| It's been conjectured by some researchers that maybe this is
| the case, particularly for infants. But there's very little
| evidence for it. As far as I'm aware there have been no
| studies that are able to statistically distinguish between
| people with and without an appendix in terms of actual heath
| outcomes
| delfinom wrote:
| Otoh, I wouldn't say that dismisses the appendix having a
| potential role. Part of the problem is we barely have a
| grasp on gut flora and it's full impact on human health,
| and several studies show that impact can be over years
| including potentially being one cause of dementia.
| contravariant wrote:
| I take it a relative risk of 1 is a null result?
|
| If so a confidence interval of 1.02 to 2.2 _after_ arbitrarily
| excluding some data is not exactly ground breaking.
| nerdponx wrote:
| It's suggestive of p-hacking. "Look, the bottom of the
| interval is just above 1! Finally I can publish this."
| mlyle wrote:
| This is a research question you can't answer with a prospective
| analysis either, because it's not ethical in most cases to
| randomize whether you're removing a body part.
|
| The best we're going to do is a careful case control study (and
| research in animal models). And the evidence is enough to imply
| strongly that we should expend a little more effort to avoid
| removing the thymus.
| Calavar wrote:
| > This is a research question you can't answer with a
| prospective analysis either, because it's not ethical to
| randomize whether you're removing a body part.
|
| But that's exactly what we did with the appendix, multiple
| times [1, 2].
|
| [1] https://pubmed.ncbi.nlm.nih.gov/26080338/
|
| [2] https://www.nejm.org/doi/full/10.1056/nejmoa2014320
| mlyle wrote:
| I had thought about this and had amended this to "in most
| cases" before you posted.
|
| If the standard of care is removing the appendix, and you
| have a strong reason to believe that something less may be
| superior, you may be able to conduct a randomized trial.
|
| But any other combination of facts is going to be hard for
| an IRB to swallow.
| jjtheblunt wrote:
| Isn't the universally known T cell named with a T because of
| the thymus which imparts their programming? Like known for
| decades?
| readthenotes1 wrote:
| More now, since I was a part of the other universe that
| didn't know this!
| anon84873628 wrote:
| Yes, but some believed this function was most relevant in
| adolescence, with the importance fading in adulthood. The
| purpose of the research is to understand the role of the
| organ in later age.
| FollowingTheDao wrote:
| Ascorbic Acid, crucial to protecting the thymus:
|
| https://pubmed.ncbi.nlm.nih.gov/25608928/
| DantesKite wrote:
| There's an amino acid chain synthesized from the thymus of a cow
| that helped double my lymphocytes (they were low for months).
| Called Thymic Protein-A. Readily accessible. One of the few
| things that made a change. Nothing else really helped me out.
|
| What I find interesting how the thymus becomes essentially a blog
| of fat as we get older and partially explains why infections tend
| to hit us harder as we age.
| cma wrote:
| I can't remember what it was but there was a talk about some
| kind of tradeoff with thymus function and age that was supposed
| to explain its atrophy, something like pneumonia death vs auto
| immune or cancer or something?
| zingababba wrote:
| I haven't dug deep into it but the TRIIM trial
| (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826138/) seemed to
| show promising results with a combination of rHGH, metformin, and
| DHEA on thymus regrowth.
| xeromal wrote:
| I've always felt us removing things like tonsils and appendix
| without a high barrier was always premature. I remember kids
| wanting to have their tonsils removed to eat ice cream for a few
| weeks. lol.
|
| Even if we have legacy parts in out body, I'm fine just letting
| it fester in my body as long as it's not trying to kill me.
|
| Feels very similar to thinking farming just needs 3 nutrients.
| Turns out better farming requires a lot more.
|
| I am just a plain old bozo though so I could be talking out me
| ass
| maximilianburke wrote:
| I think we're getting better about non-surgical interventions
| when it's not necessary. Appendicitis can, and is, treated with
| antibiotics, but the timing has to be spot on otherwise it
| needs to come out. I had to have mine removed because by the
| time I was seen in the hospital it had already burst. I think
| the only time that people pre-emptively remove appendixes is
| when you can't risk the chance of a burst; like if you're the
| over-winter physician at Amunden Scott South Pole station
| bluepod4 wrote:
| > Appendicitis can, and is, treated with antibiotics
|
| Yeah, kids don't get tonsils removed anymore either. Just
| antibiotics.
| ReallyAnonymous wrote:
| surgeon here: antibiotic treatment works great as long as
| there's no peritonitis and/or no appendicolith seen on CT.
| However, statistics show that 30% of successfully treated
| patients go on to get appendicitis again within 1 year.
|
| Anyway, I offer my patients a choice. Most choose surgery.
| Those conscientious enough without insurance usually choose
| nonoperative management because it's much cheaper.
| nicup12345689 wrote:
| The 30% is because people do not change their diet so
| they'll once again be susceptible.
| robbiep wrote:
| No it's not, you've got no idea what you're talking
| about. There isn't an 'appendicitis' diet
| readthenotes1 wrote:
| Chesterton's Fence
| hinkley wrote:
| I had my tonsils out for what at the time we thought was
| legitimate reasons, but well after they started phasing out the
| practice.
|
| I recall when I woke up my throat didn't hurt (possibly due to
| painkillers), and when they brought ice cream and popsicles to
| sooth my pain I felt like a fraud. But the experience up to
| that point was traumatic to put it lightly, so you're damned
| right I was going to get all of the treats I could wrangle.
| hsur8192 wrote:
| It appears that Chesterton's Fence applies to bio-science as
| well!
| xeromal wrote:
| Very applicable to programming too. I'm pretty conservative
| as a programmer and I've had coworkers want to completely
| change a segment but you never know why some weird
| programming was done. There be dragons sometimes.
| jaggederest wrote:
| As a software engineer who has sometimes specifically
| specialized in handling dragons, I always try to leave
| (sometimes voluminous) comments about why a thing was
| handled that way when it's not obvious to a surface
| reading.
|
| Good practice in general but particularly so when you find
| a heisenbug that must be exterminated.
| tgv wrote:
| The ice cream was to ease the pain. The cold calms the exposed
| nerves.
| xeromal wrote:
| Makes sense. I was very jealous of my friends at the time but
| I never took mine out.
|
| I just get mad tonsil stones now. lol
| sam36 wrote:
| My grandmother had hers taken out in the 1940's. Now she
| has a small pocket/hole that food gets stuck in which can
| cause her to gag and/or sometimes throw up.
| xeromal wrote:
| I have those even with tonsils. The gunk produced by it
| can STINK
| orev wrote:
| They did not express any indication that they didn't
| understand why ice cream is often recommended, so you don't
| need to be explaining it. The point of the comment is that
| kids don't understand what's going on, only hear about the
| ice cream thing, and then want the same procedure just so
| they can eat ice cream for a week.
| [deleted]
| randomdata wrote:
| Except they demonstrated interest in the response. Further,
| they are not the only person who reads the comments. Others
| may be interested to know the relationship between ice
| cream and tonsils.
| tjohns wrote:
| The ice cream was a lie.
|
| After I had my tonsils removed, even the thought of solid
| food was out of the question. It was just too painful.
|
| You can have as much ice cream as you want. What they don't
| tell you is you won't want any. :P
| adolph wrote:
| Wouldn't the exposed nerves make the pain of "brain freeze"
| more likely?
|
| Anyway, the relationship of tonsils and ice cream was
| established by Richard Scarry in "What do people do all day?"
| [0]
|
| 0. https://books.google.com/books?id=tuqKDQAAQBAJ&pg=PA45
| ipython wrote:
| I encourage you to read the book "Madeline" for more
| information on this phenomenon.
| SamBam wrote:
| All the little girls cried "Boohoo, we want to have our
| appendix out, too!"
| darkclouds wrote:
| I thought tryptophan used to be added to icecream in the 70's
| and 80's until the tryptophan scare that caused Eosinophilia-
| myalgia.
|
| https://en.wikipedia.org/wiki/Eosinophilia%E2%80%93myalgia_s.
| ..
| [deleted]
| mjfl wrote:
| You mean the place where your T cells mature and develop immune
| responses? Duh.
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