In conditions of severe T cell depletion, such as HIV-1 infection, limited T cell production by the thymus can thwart the immune response, putting individuals at increased risk of infection with opportunistic pathogens. In this issue of the JCI, Napolitano et al. report, in a prospective, randomized study, that treatment of HIV-1–infected adults with growth hormone may reverse thymic atrophy, as reflected by increased de novo thymic T cell production accompanied by increased peripheral T cell production (see the related article beginning on page 1085). While the long-term immunological and clinical benefits of growth hormone treatment remain unclear, the data suggest a way in which to enhance thymopoiesis and peripheral T cell production in immunodeficient individuals.
Kiki Tesselaar, Frank Miedema