Is thymocyte development functional in the aged?
      
    
   
  
      Abstract
       T cells are an integral part of a functional immune system with the majority being produced in the thymus. Of all the changes related to immunosenescence, regression of the thymus is considered one of the most universally recognised alterations. Despite the reduction of thymic size, there is evidence to suggest that T cell output is still present into old age, albeit much diminished; leading to the assumption that thymocyte development is normal. However, current data suggests that recent thymic emigrant from the aged thymus are functionally less responsive, giving rise to the possibility that the generation of naïve T cell may be intrinsically impaired in the elderly. In light of these findings we discuss the evidence that suggest aged T cells may be flawed even before exiting to the periphery and could contribute to the age-associated decline in immune function. 
      
     
    
          
             The role of thymocyte development in T cell immunosenescence
            
                  One of the most universally recognised
                                        changes of the ageing immune system is the dramatic regression of the thymus;
                                        which in part is responsible for the observed clinical features of
                                        immunosenescence [1,2,3]. The
                                        features of age-related thymic atrophy involve a reduction in tissue mass, loss
                                        of tissue structure and abnormal architecture and a decline in thymocyte numbers
                                        leading to a reduction in naïve T cell output [3,4,5].
                                        Despite the decline in the number of T cells exiting the thymus [6,7], there are
                                        no discernable changes in the number of T cells in the periphery with age [8], which
                                        appears to be tightly regulated by homeostatic mechanisms [9,10]. However,
                                        with increasing age peripheral T cells exhibit altered phenotypes, loss of
                                        diversity and modifications in responses, which have been correlated to
                                        shortened telomere and is related to replicative senescence [11,12,13].
                                        These changes are (in part) a consequence of reduced naïve T cell output;
                                        however new evidence has revealed that recent thymic emigrants (RTE) from  the aged thymus exhibit reduced proliferative and
                                        functional activity [7,14,15];
                                        thereby further contributing to T cell senescence. Specifically, aged RTE
                                        undergo phenotypic maturation with delayed kinetics [7] and exhibit
                                        a decreased proliferative capacity and a weak expression of early activation
                                        markers together with a lower production of IL-2 [7].
                                        Furthermore, aged RTE are defective in increasing intracellular calcium
                                        concentration following TCR crosslinking [14] and exhibit
                                        reduced helper and memory activity [15].  Moreover,
                                        these studies also question the notion regarding whether T cell development is
                                        functionally active in the aged thymus; which is often assumed. This is largely
                                        based on the observations that there are no age-related differences in the
                                        proportion of the major subpopulations of thymocytes either in mice [16] or
                                        humans [17] and that T
                                        cell output can still be detected in the aged thymus [6,7]. This
                                        frequently leads to the belief that there is only a quantitative decline but no
                                        age-associated qualitative changes in thymopoiesis. However, with these recent
                                        studies showing intrinsic functional defects in aged RTE, it suggests that
                                        these newly generated T cells are already compromised prior to entry into the
                                        periphery indicating that various stages of differentiation are altered in an
                                        age-dependent manner.
                            
            
            
            
            
            
            
            
            
            
            
            
            
           
          
             An overview of thymopoiesis
                                  
            
                  T cell development involves a series of
                                        sequential developmental steps requiring instructions from the specialised
                                        thymic microenvironment to regulate phases of proliferation, gene rearrangement
                                        and selection [18,19]. Each
                                        maturational stage is reflected by changes in gene and protein expression,
                                        which in turn is mirrored by modifications of cell surface markers, enabling
                                        the identification of thymocytes at various phases of development [20]. Briefly,
                                        thymocyte progenitors entering the thymus are identified by the absence of
                                        either co-receptor molecules CD4 and CD8 and are referred to as double negative
                                        (DN) thymocytes [20]. Within
                                        this subset several critical events occur, including commitment to the T cell
                                        lineage and cellular proliferation [21].
                                        Subsequently, thymocytes become double positive (DP) for the expression of CD4
                                        and CD8 with further maturation dependent on proceeding past positive and
                                        negative selection. Positive and negative selection facilitates the generation
                                        of functionally responsive and self-tolerant T cells [22,23], whereby
                                        DP thymocytes then mature into either single positive (SP) CD4+ T
                                        helper cells or SP CD8+ cytotoxic T lymphocytes before being
                                        exported into the periphery [24].
                            
            
            
            
            
            
            
            
            
            
            
            
            
           
          
             The effect of age on the phenotype and function of
                                      developing thymocytes
                                  
            
                  Whilst it is widely acknowledged that there
                                        is a decline in the frequency and absolute number and precursor activity of
                                        early thymic progenitors (ETP) in older mice [1,25,26,27], it is often attributed to alterations in haematopoietic stem cells [28,29]. However,
                                        there is increasing evidence to suggest that the defects in ETP are due to cell
                                        intrinsic deficits that arise from exposure to an ageing thymic
                                        microenvironment [25,26,30,31].
                                        For instance, there is an increase in the frequency of ageing ETP undergoing
                                        apoptosis in older mice [25,26] which
                                        is accompanied by a significant reduction in frequency of Ki67+ ETP
                                        in the aged thymus [25]; therefore
                                        these observations may account for the reduction in ETP number with age.
                                        Furthermore, these properties of ETP appear to be governed by signals derived
                                        from the thymus. Intravenously injected lineage negative-enriched bone marrow
                                        from young mice into sublethally irradiated one month old and 18 month old mice
                                        showed absolute number of donor cells was similar in young and older hosts
                                        after three days [31]. However,
                                        seven to ten days after injection, the number of donor cells in older thymi was
                                        severely reduced compared to those identified in younger thymi, suggesting a
                                        decline in their proliferative capacity [31]. In
                                        addition, when fetal thymi were grafted onto the kidney capsule of young and
                                        old mice, the thymic grafts had similar total thymic cellularity despite the
                                        native thymus from older animals still having significantly lower actual and
                                        subset numbers [30], suggesting
                                        the age-associated alterations in ETP is related to intrathymic changes.
                                        Moreover, it would not be unreasonable to assume that the defects that arise in
                                        the aged ETP, could also lead to the acquisition of further aberrations
                                        throughout thymopoiesis.
                            
            
            
            
            
            
            
            
            
            
            
            
            
                  ETP are contained within the earliest stages of the DN
                                        subset and various reports have proposed several changes within this
                                        subpopulation; however, the results have not been consistent. Some groups have
                                        observed an increase only in the proportion of DN1 thymocytes but not other
                                        significant changes [30], while
                                        others have depicted an increase in DN1 and a subsequent decrease in DN3 subset
                                        [32].
                                        In contrast, different laboratories have described an increase at the DN3 stage
                                        and a decrease in DN4 thymocytes [16], whilst
                                        no significant differences have been reported in percentage of DN thymocytes by
                                        other groups [33]. These
                                        discrepancies could arise from the different strains of mice analysed and the
                                        timepoints examined. Nevertheless, there is data to indicate that the DN
                                        subpopulation is subject to phenotypical and functional alterations with age.
                                        Interestingly a number of groups, including our own (Figure 1), have observed
                                        an increase in the expression of CD3, the signalling transduction complex of
                                        the T-cell receptor (TCR), within the DN compartment [34].
                                        Corresponding to CD3 upregulation, these cells appear to express high levels of
                                        CD44 [34]. Previously
                                        a population of CD44+CD24-CD3+ DN cells has
                                        been described, which accumulates in older mice, and it has been suggested that
                                        these cells belong to a separate lineage [35]; perhaps
                                        representing NK1.1+ thymocytes, which display a similar phenotype [36].
                                        Interestingly, a similar population has been identified in adult murine bone
                                        marrow and have been associated with a role in downregulation of haematopoiesis
                                        [37]. Therefore,
                                        this expanding population may not only represent an alternate lineage but may
                                        have deleterious affects on developing thymocytes.
                            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
                  
                      
                         
                        Figure 1. CD3 expression on DN thymocytes shows an age-dependent increase.  Thymocytes from different aged
                                                                    mice were stained with anti-CD3, anti-CD4 and anti-CD8 mAb, analysed by
                                                                    flow cytometry and CD3 on DN cells was determined gating the appropriate
                                                                    population. This study revealed that the proportion of CD3+ DN
                                                                    thymocytes showed an age-dependent increase.  (One month n=5; six months
                                                                    n=5; 12 months n=8; 18 months n=4). *P<0.05; **P<0.01;
                                                                    ***P<0.001.
                                                
                        
                       
            
            
            
            
            
                  Despite an increase in the proportion of
                                        DN thymocytes expressing CD3, there is a declining trend in the percentage of
                                        CD3+ thymocytes from both humans [17] and mice [38]. This is
                                        accompanied by a significant decrease in CD3 median fluorescence index (MFI) on
                                        murine thymocytes with age, corresponding to the average number of complexes
                                        per cell (Figure 2). This alteration could have gross implications for the
                                        developing thymocytes. Considering that the CD3 complex is integral for relaying
                                        TCR signals [39], a decrease
                                        in the number of CD3 molecules would affect the ability of T cells to respond
                                        to such TCR-dependent signals and hence impair thymopoiesis [40]. Indeed,
                                        studies by Li and colleagues showed that murine thymocytes stimulated with
                                        ConA, which acts through the TCR, together with interleukin-2 (IL-2) displayed
                                        an age-related decline in proliferation as measured by trititated thymidine
                                        incorporation [16]. A similar
                                        finding was also observed using rat thymocytes [41]. Cell cycle
                                        analysis by propidium iodine conducted in our laboratory provides further
                                        support for a defect in the proliferative response to ConA and IL-2 by
                                        thymocytes from older mice with the results suggesting the deficiency is an
                                        inability to progress from S phase to the G2/M phase of the cell cycle (Figure 3). Although these studies suggest there is an impairment of TCR-expressing
                                        thymocytes to proliferate, it is unclear whether this reflects a shortcoming in
                                        all thymocyte populations or if this is related to the age-associated decrease
                                        in CD3 expression. However, an in vivo method to assess intrathymic
                                        proliferation in humans, employing T cell receptor excision circle (TREC) ratio
                                        analysis, implied that not all thymocyte populations undergo an age-dependent
                                        deficit to proliferate, and only thymocytes in later stages of maturation are
                                        affected [42]. This
                                        appears to correlate with the changes observed in RTE of older mice, which
                                        display a decline in proliferation and activation [7,14].
                                        Therefore, the proliferative impairments observed in RTE from ageing mice could
                                        arise from intrinsic defects imprinted on the developing T cells in the thymus.
                            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
                  
                      
                         
                        Figure 2. CD3 expression is altered on aged thymocytes.  Thymocytes from different aged mice were stained with
                                                                anti-CD3 mAb and analysed by flow cytometry. The top histogram shows the percentage of CD3+ cells
                                                                positive and the bottom shows mean fluorescent intensity (MFI) of CD3 expression for one month old,
                                                                six month old, 12 month old and an 18 month old animals. MFI was obtained by gating on the entire population.
                                                                Although there were no age-related changes in the proportion of CD3+ thymocytes, a significant decrease
                                                                in the number of CD3 molecules on thymocytes associated with age was observed.
                                                                (One month n=5; six months n=5; 12 months n=8; 18 months n=4). **P<0.01; ***P<0.001.
                                                
                        
                       
            
            
            
            
            
            
            
            
            
            
                  
                      
                         
                        Figure 3. Cell cycle analysis on stimulated thymocytes from young and old mice.  The various stages of the cell
                                                                    cycle in thymocytes from young and old mice following treatment with ConA
                                                                    and IL-2 after 24 hours was determined by flow cytometry. Data is expressed
                                                                    as fold increase compared to time zero. It was observed that there was a
                                                                    significant increase in the proportion of thymocytes from young mice at the
                                                                    G2-M phase compared to thymocytes from older animals. One month
                                                                    n=4; 18 months n=4. *P<0.05.
                                                
                        
                       
            
            
            
            
            
                  Aged peripheral T cells from either humans or mice
                                        demonstrate an increased resistance to apoptosis [43,44].
                                        Although these cells may represent the most terminally differentiated T cells,
                                        suggesting that increased resistance to apoptosis is the outcome of senescence,
                                        a study investigating in vivo responses to activation induced cell death of T
                                        cells from aged mice implies age-related impairment of apoptosis can occur in
                                        previously unchallenged T cells and is perhaps intrinsically acquired [45]. In
                                        this study, male SCID mice receiving adoptively transferred T cells from old
                                        female HY TCR transgenic mice had a three-fold increase in the percentage of
                                        autoreactive CD8+ HY antigen-reactive T cells in contrast to mice
                                        receiving T cells from young female transgenic mice. Moreover, in our laboratory
                                        we have observed an age-dependent resistant to spontaneous and
                                        dexamethasone-induced apoptosis in murine thymocytes (Figure 4), which has also
                                        been reported in rat thymocytes [41].  Therefore,
                                        the resistance to apoptosis observed in thymocytes from older mice may be
                                        reflected in decreased susceptibility of peripheral T cells to undergo cell
                                        death.
                            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
                  
                      
                         
                        Figure 4. Aged thymocytes have increased resistance to spontaneous and dexamethasone-induced apoptosis.  Spontaneous (A) and
                                                                    dexamethasone (dex)-induced (B) apoptosis at 0.5nM was assessed by
                                                                    flow cytometry. Graphs show the percentage of viable thymocytes defined as
                                                                    Annexin V- 7AAD- (top graphs)and
                                                                    those undergoing early apoptosis as Annexin V+ 7AAD-
                                                                    (bottom graphs). Closed square/circle with dotted line symbolise
                                                                    young thymocytes cultured in media or with the addition of 0.5nM dex
                                                                    respectively. Whereas, open square/circle with solid line signify
                                                                    thymocytes from 18 month old mice cultured in media or with the addition of
                                                                    0.5nM dex respectively. The data revealed that there is an
                                                                    age-associated increased resistance to spontaneous and dex-induced
                                                                    apoptosis with a higher percentage of viable thymocytes from older mice
                                                                    compared to younger mice and delayed kinetic of older thymocytes to
                                                                    initiate apoptosis. Data representative of four experiments. *P<0.05;
                                                                    **P<0.01.
                                                
                        
                       
            
            
            
            
            
                  Collectively these studies corroborate to argue for
                                        the occurrence of age-related deficiencies in T cell development that are
                                        similar to those seen in aged RTE and therefore the abnormalities observed in
                                        these cells are likely to have been acquired during thymopoiesis; primarily due
                                        to a defective microenvironment [15,30,31]. Thus,
                                        thymocytes may be defective before export into the periphery and could
                                        contribute to T cell immunosenescence. However, it is clear that this area
                                        warrants further investigation, including assessing the diversity of thymocyte
                                        receptors with age and evaluating the affect of ageing on selection.
                            
            
            
            
            
            
            
            
            
            
            
            
            
           
          
             What is the significance of defective thymopoiesis in
                                      the elderly?
                                  
            
                  Considering these findings, the question then arises,
                                        what are the implications of defective thymopoiesis? Especially, given
                                        the significant decrease in T cell output by the thymus with age [6,7,46] and
                                        that maintenance of the peripheral T cell pool is believed to be predominantly
                                        maintained by homeostatic proliferation [9], how much
                                        can alterations in the properties of newly generated T cells in the elderly
                                        contribute to immunosenescence? The rate of daily export has been determined as
                                        1-2% of the total thymocyte population [47] and is
                                        under control of mechanisms independent of the peripheral T cell pool.
                                        Furthermore, RTE are excluded from the niche-based regulation of peripheral T
                                        cell numbers [48] and are
                                        preferentially selected for survival in the periphery over existing resident T
                                        cells [47]. Therefore,
                                        the thymus is able to influence the T cell pool throughout adult life with
                                        considerable control over the composition of the peripheral T cell pool
                                        repertoire.
                            
            
            
            
            
            
            
            
            
            
            
            
            
                  Since diversity in the elderly is
                                        dependant on the generation of RTE, defects in their development have as a
                                        profound affect on T cell immunosenescence as those acquired in the periphery.
                                        This has major implication for new and emerging diseases in the elderly, given
                                        the importance of these cells in immune protection. Moreover in light of these
                                        recent findings, methods that are designed to increase thymic output should
                                        also consider targeting the thymic microenvironment. Indeed, where successful
                                        strategies have reversed thymic involution in old mice, they appear to have
                                        done so by targeting the thymic microenvironment [32,49,50].
                            
            
            
            
            
            
            
            
            
            
            
            
            
           
          
             Impact on the aged thymic microenvironment
                                  
            
                  The consequence of defective thymopoiesis may also
                                        have more local effects. Thymocytes and the thymic stroma exist in a
                                        bidirectional symbiotic relationship. Several experiments have now provided
                                        evidence that whilst initial patterning of the thymic epithelial compartment is
                                        thymocyte independent, maintenance and continued development requires the
                                        presence of differentiating T cells. Indeed, abrogation of thymopoiesis at
                                        different stages determines the severity and disruption of the thymic architecture
                                        [51,52,53,54]. In mice with defects affecting the later stages of
                                        thymocyte development concerning the DP to SP transition, the thymic medulla,
                                        which is the thymic niche responsible for ensuring tolerance and directing
                                        egression from the thymus, is absent [51,52].
                                        Thymopoiesis blocked at earlier stages of development involving the DN
                                        compartment results in a loss of medulla and cortex, with the latter necessary
                                        to initiate T lineage commitment and provide signals for gene rearrangement and
                                        survival [53,54].
                                        Furthermore, impairment of the bidirectional relationship between thymocytes
                                        and TEC causes alterations in thymic epithelial cell numbers [55].
                                        The absence of either lymphotoxin β rector on thymic epithelial cells, its ligand on
                                        thymocytes or its intracellular signaling molecule nuclear
                                        factor-κB-inducing kinase, results in the disorganization of medullary
                                        thymic epithelial cells [55]. Therefore,
                                        considering the age-related alterations throughout T cell development, it may
                                        induce alterations in the thymic microenvironment. Indeed, we have found a
                                        decline in definitive thymic epithelial cell markers and disruption of the
                                        cortex and medulla [4], concurrent
                                        to alterations in the three dimensional structure [56]. It remains
                                        unclear whether changes in thymopoiesis are cause or effect of the altered
                                        thymic microenvironment, although recent data implies the thymic stroma might
                                        be the initiator [4,30,31].
                                        Nevertheless, thymic involution could be exacerbated by the formation of a
                                        negative feedback loop with deterioration in the stromal compartment
                                        influencing a decline in thymocyte development, which in turn intensifies the
                                        changes in thymic epithelial cells.
                            
            
            
            
            
            
            
            
            
            
            
            
            
           
          
             Concluding
                                      remarks
                                  
            
                  The
                                        qualitative contribution of newly generated T cells to the process of
                                        immunosenescence is often overlooked, despite alterations in their quantity
                                        being widely acknowledged. However, considering the evidence, we propose that
                                        in spite of continual T cell output from the thymus throughout life, the thymocytes
                                        from which they are derived are inherently defective and these shortcomings are
                                        acquired during thymopoiesis. Furthermore, we believe that these cells can
                                        significantly contribute to the age-associated changes observed in the
                                        periphery and exacerbate the alterations in thymocyte development through their
                                        interaction with the thymic microenvironment.
                            
            
            
            
            
            
            
            
            
            
            
            
            
           
          Acknowledgments
              Many
                        thanks to Dr. Bradley Cobb for critical reading of the manuscript. We also
                        thank Drs Andrew Pitsillides, Roberto Souza, Rebecca Collinson, Leanne Saxon,
                        John Burford, Professors Tim Skerry, Lance Lanyon, and staff at the Royal
                        Veterinary College BSU for donation of tissue samples and care of the animals.
                        Additionally, our great appreciation to Shanta Cariese for assistance with the
                        flow cytometer. D.A is supported by Research into Ageing, A.B.S is supported by
                        the Thomas Brown Fellowship (University of London).
            
            Conflicts of Interest
            
              The
                            authors in this manuscript have no conflict of interests to declare.
                
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