Not necessarily apropos to the discussion, it amazes me that there are not more discussions regarding the sternum. There probably isn’t a bone that has more going on or can be more effected by PsA than the sternum. Assid from everything that is connected to it (literally dozens of enteses points and the fact that it protects and overs the thymus there is that pesky little thing called the xiphoid process, which begins life as a region of flexible hyaline cartilage attached to the end of the body of the sternum. The xiphoid process slowly ossifies throughout childhood and adulthood until around age 40 when all of its cartilage is replaced by bone. Regardless of its degree of ossification, the xiphoid process serves as an important attachment point for the tendons of the diaphragm, rectus abdominis, and transverse abdominis muscles, basically the whole gut and chest. It is something that comes more into play as we start to age…
Thethymus is composed principally of two types of cells, called, respectively, lymphocytes and reticular cells. The reticular cells form a loose meshwork, as in a lymph node, while the spaces between them are packed with lymphocytes. The cortex, characterized by its heavy lymphocyte concentration, is the site of much lymphocytic proliferation. Proliferation of lymphocytes in the thymus is distributed evenly throughout the cortex, instead of in germinal centres, as occurs in other lymphoid tissue. Some of the daughter cells—called T (thymus-derived) cells—that are produced in the cortex migrate to the medulla, where they enter the bloodstream through the medullary veins, adding to the lymphocytes seen in the peripheral blood and the lymphoid organs. For us we call them T-Cells - the cause inflammation in PsA
During the involution, or shrinking, of the thymus the cortex becomes thin. Lymphocytes disappear and are replaced by fat tissue from the partitions between the lobules. The process of involution is never complete, and the bits of thymus tissue that remain are probably sufficient to maintain its function for most. For US not so much.
The functions of the thymus that have so far been observed relate chiefly to the newborn. Removal of the organ in the adult has little effect, but when the thymus is removed in the newborn, T cells in the blood and lymphoid tissue are depleted, and failure of the immune system causes a gradual, fatal wasting disease. The animal whose thymus has been removed at birth is less able to reject foreign-tissue grafts or to make antibodies to certain antigens. Moreover, certain parts of the white pulp of the spleen and lymph nodes are much reduced in size. These results demonstrate that the T cells produced in the thymus and transported to the lymphoid tissues are crucial elements in the development of immunity.
It is known that most of the lymphocytes that are produced in the thymic cortex die without leaving the organ. Since those T cells that do leave the thymus are equipped to react against foreign antigens, it is assumed that the thymus destroys lymphocytes that would engage in an autoimmune reaction—that is, would react against the individual’s own tissues
Its no wonder there is pain in the area. Its been theorized that the failure of the the thymus as we age is why we also develop Autoimmune disease as we age.
All the biologics in the simplest terms attempt to duplicate what the thymus does in newborns. There is a HUGE body of research trying to figure out a way to get the thymus working again. The lab south of has developed some “vaccines” St Judes has developed some custom cancer vaccines using stem cells which have cured some forms of childhood cancer. One of the immunologists there has told me its because the thymus is still functiong to a small degree
The bottom line is the ability to treat PsA will sometime actually become the ability to cure PsA. Not long ago the Chinese developed a process to edit human embryos which COULD eliminate a number of diseases (their study gene-editing technique was used to modify a gene in human embryos that causes a fatal blood disorder.)
In some quiet action our illustrious Congress made it illegal for fear we would have designer babies. None of thee human embryos were viable at any point as they we fertilized with two different sperms to eliminate ethical issues. They also missed the point the technique was developed and put into use years ago by a Hamilton Montana NIH lab in cattle. (a form of mastitis)
Anyway not sure what this has to do with anything other than the xyphioid process is way overlooked THING in PsA.and am gald you have a smart enough Doc to isolate the problem for you. AND I get to comment on 30 years of my life… Wack a mole enough and the little bugger finally does give up. Hang in there!
