As the thymus represents the primary site of T-cell development, optimal thymic function is of paramount importance for the successful reconstitution of the adaptive immunity after allogeneic hematopoietic stem cell transplantation. Thymus involutes as part of the aging process and several factors, including previous chemotherapy treatments, conditioning regimen used in preparation to the allograft, occurrence of graft-versus-host disease, and steroid therapy that impair the integrity of the thymus, thus affecting its role in supporting T-cell neogenesis. Although the pathways governing its regeneration are still poorly understood, the thymus has a remarkable capacity to recover its function after damage. Measurement of both recent thymic emigrants and T-cell receptor excision circles is valuable tools to assess thymic output and gain insights on its function. In this review, we will extensively discuss available data on factors regulating thymic function after allogeneic hematopoietic stem cell transplantation, as well as the strategies and therapeutic approaches under investigation to promote thymic reconstitution and accelerate immune recovery in transplanted patients, including the use of cytokines, sex-steroid ablation, precursor T-cells, and thymus bioengineering. Although none of them is routinely used in the clinic, these approaches have the potential to enhance thymic function and immune recovery, not only in patients given an allograft but also in other conditions characterized by immune deficiencies related to a defective function of the thymus.

由于胸腺代表T细胞发育的主要部位，因此，最佳的胸腺功能对于异基因造血干细胞移植后成功重建适应性免疫至关重要。胸腺退化是衰老过程的一部分，包括几个因素，包括以前的化学疗法，准备用于同种异体移植的条件疗法，发生移植物抗宿主病以及类固醇治疗，这些都会损害胸腺的完整性，从而影响其作用。支持T细胞新生。尽管控制其再生的途径仍然知之甚少，但胸腺具有在受损后恢复其功能的显着能力。测量最近的胸腺迁徙者和T细胞受体切除圈是评估胸腺输出并了解其功能的有价值的工具。在这篇综述中，我们将广泛讨论有关异基因造血干细胞移植后调节胸腺功能的因素的可用数据，以及正在研究的促进胸腺重构和加速移植患者免疫恢复的策略和治疗方法，包括使用细胞因子，性类固醇消融，前体T细胞和胸腺生物工程。尽管这些方法在临床上都没有常规使用，但是这些方法具有增强胸腺功能和免疫恢复的潜力，