Thymic characteristics in patients with autoimmune diseases: a multicentre radiological observational study

作者：Haoxiao Chang, Junqiang Yan, Anxin Wang, Ningning Wang, Peng Liu, Yemin Shi, Zhao Xin, Jinqiao Zhu, Yuan Cai, Xue Xia, Yunyi Hao, Shiyi Yin, Jing Wang, Xinli Wang, Lina Sun, Jia Ma, Xiaoyu Huang, Haonan Guan, De‐Cai Tian, Kaibin Shi, Ganqin Du, Wenhao Huang, Guoyan Qi, Zhengwei Li, Yongjun Wang, Fu‐Dong Shi, Zhang Zhang, Wei-Na Jin · 发表于：The Lancet Regional Health - Western Pacific · 年份：2025 · DOI：10.1016/j.lanwpc.2025.101615 · 被引用次数：2 · 研究领域：Myasthenia Gravis and Thymoma、Adrenal Hormones and Disorders、Systemic Lupus Erythematosus Research

Background: Autoimmune diseases comprise a spectrum of illnesses stemming from a common etiology: the loss of self-tolerance. The organ crucial for the establishment and maintenance of central and peripheral tolerance, namely the thymus, has rarely been explored across these diseases. Methods: In a multicentre radiological case-control study, we characterized the thymus in 16 prevalent autoimmune diseases using chest computed tomography (CT) images from patients and age- and sex-1:1 matched healthy controls. Participants underwent a routine CT examination, and baseline information on demographic, clinical, and potential risk factors was gathered at the time of enrollment. A semi-automatic algorithm was developed and employed for the analysis of thymic radiological characteristics, encompassing structural features and density. Thymic fatty replacement was evaluated using a four-point visual scoring scale (0-3). This study is registered with the Chinese Clinical Trial Registry (ChiCTR2300078417). Findings: After matching, 2441 participants in each group were included in case-control study. As individuals age, the thymus undergoes involution, leading to marked changes in thymic features over time, yet the degree of thymic feature alterations varies among groups. Compared to healthy controls, multiple characteristics of the thymus were distinct in the autoimmune disease patients, featuring higher trapezoidal proportions (68.21% vs 46.29%; p < 0.0001), larger bilobed size, and red...