Familial hypercholesterolaemia (FH) is associated with accelerated thymic ageing, evidenced by reduced circulating CD4+ recent thymic emigrants (RTEs) and diminished T-cell receptor excision circles (TRECs).
FH patients reach median thymic output levels typical of healthy controls approximately six years earlier, suggesting premature immune ageing.
Highly pathogenic LDLR gene variants intensify reduction in thymic output, especially in young adults aged 18-30 years.
Lipid-lowering therapy with statins partially restores circulating CD4+ RTE levels, predominantly in female patients, reinforcing the immunologic benefits of early treatment.
