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If you ever muse about which parts of your body are most impacted by getting older, your heart, brain or perhaps your muscles may come to mind.
One that you probably wouldn’t think of is the thymus, a walnut-sized organ in your upper chest.
The thymus has long been known to help form the immune system in babies in the womb, but in adults, it was thought to be mostly useless, shrinking as we age.
Recent research, though, has revealed the thymus plays a major role in maintaining the immune system all our lives.
More broadly, thymus function could be a major factor in healthy ageing, governing our resilience to a host of ailments – not just infections, but also cancer and heart disease.
Why is this overlooked organ so important, and how could we reverse its decline?
School for immune cells
The role of the thymus was only discovered in the 1960s – it was the last major organ to have its function revealed.
In the womb and early childhood, it is where immune cells develop and “learn” to attack harmful microbes, as well as to recognise and leave alone cells that are part of the person’s own body.
“It’s like a school or training place,” said Professor Paola Bonfanti, a stem cell researcher at the Francis Crick Institute in London. “It is where the cells are exposed to a mini-representation of the world of our body before they face the real world.”
Thymus is what the “T” stands for in T-cells, a major branch of the immune system, whose jobs include killing virus-infected cells and cancer cells.
The thymus’s role was discovered when newborn mice that had theirs removed quickly succumbed to infections.
But for decades after this discovery, it was still thought that the thymus didn’t do much in adulthood. That’s because the organ literally shrivels over the years, becoming less than half of the size it reached by puberty, and with much of the functional tissue replaced by fat.
One of the first signs that we had been underestimating the thymus was a study in 2023, which looked at people who’d had heart operations, when the thymus is sometimes simply removed and thrown in the bin, because it is in the way.
If the thymus is so useless, its presence or absence shouldn’t make any difference to health. But in fact, people who’d had it removed had three times the risk of dying over the next five years, compared with those where it was left alone.
People who had lost their thymus were more likely to die, not just from cancer – which might have been predicted – but also heart disease.
Having your thymus removed is unusual, but since then other research has suggested the findings are more widely applicable. This year, two studies showed that people whose thymus has shrunk more with age have worse health and are more likely to die within a certain period.
It is unclear exactly what causes some people’s thymus to shrink faster. Some well-known markers of unhealthy lifestyles, like smoking and obesity, correlate with smaller thymus size. But in case you are wondering if they could be the real explanation for the worse health, the researchers adjusted their results to take account of that.
So, it looks increasingly likely that, far from being vestigial, the thymus plays a major role in healthy ageing, said Professor Bonfanti.
The good news is there are hints from nature that it may be possible to slow or even reverse the thymus’s decline, because this sometimes happens spontaneously. In pregnancy, the organ shrinks and then regrows afterwards. It also shrinks during chemo or radiotherapy for cancer and may then grow again, with the expansion probably helpful in killing cancer cells.
Thymus rejuvenation is one of the hottest topics in anti-ageing research, according to a recent article in the journal Nature which said an “explosion of thymus research has taken place over the past three years”.
Professor Bonfanti told me she has had several approaches from private investors in anti-ageing research, wanting to discuss funding her work, when most scientists have to scrabble around seeking out grant money.
Living forever
She thinks the field is seen as having such potential because the thymus seems to be involved in so many different areas of medicine – heart disease, infections, response to vaccines, autoimmune disease – and perhaps longevity too. “Everyone wants to live for a long time, and some want to live forever,” she said.
Strategies can be put into three broad categories. Some aim to mimic thymus function by supplying the body with substances that help immune cells mature, which are normally produced by the organ itself, such as one called thymulin.
Others are designed to rejuvenate the thymus from within, by supplying the organ with substances that encourage cell growth, such as one called KGF (for keratinocyte growth factor).
Perhaps most futuristic are strategies for growing thymus cells in the lab, before transplanting them into the body.
It is too soon to say which has the most potential, as all are in their early stages – which is worth remembering when thymus research starts getting hyped up, something that happens a lot in the anti-ageing field.
Nevertheless, even if the thymus’s role in longevity is being overblown, it is at least intriguing that research into healthy ageing has a new avenue to explore.
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