Abstract
Histologic study of the thymus glands of patients who have died of AIDS reveals changes consistent with an organ-specific immunocomplex attack by polyclonal immunoglobulins directed against the thymic epithelial cells and Hassall's corpuscles, resulting in marked architectural alteration and eventual disappearance of the corpuscles. The epithelial cells become spindled with pyknotic nuclei, thymocyte depletion, and patchy fibrosis. Thymosin α1 appears to be elevated, especially in the early stages. Thymulin levels are undetectable or markedly reduced, probably reflecting cellular damage. Thymic hormones may be excellent surrogate laboratory markers. Immunoglobulins directed against thymic epithelial components appear to be a specific test. These studies ask more questions than they can answer. A coordinated national research program is mandatory. Success will not only benefit many victims of AIDS but will also help unlock many secrets of the immune system.
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