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Perazzio SF, Palmeira P, Moraes-Vasconcelos D, Rangel-Santos A, de Oliveira JB, Andrade LEC, Carneiro-Sampaio M. A Critical Review on the Standardization and Quality Assessment of Nonfunctional Laboratory Tests Frequently Used to Identify Inborn Errors of Immunity. Front Immunol 2021; 12:721289. [PMID: 34858394 PMCID: PMC8630704 DOI: 10.3389/fimmu.2021.721289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022] Open
Abstract
Inborn errors of immunity (IEI), which were previously termed primary immunodeficiency diseases, represent a large and growing heterogeneous group of diseases that are mostly monogenic. In addition to increased susceptibility to infections, other clinical phenotypes have recently been associated with IEI, such as autoimmune disorders, severe allergies, autoinflammatory disorders, benign lymphoproliferative diseases, and malignant manifestations. The IUIS 2019 classification comprises 430 distinct defects that, although rare individually, represent a group affecting a significant number of patients, with an overall prevalence of 1:1,200-2,000 in the general population. Early IEI diagnosis is critical for appropriate therapy and genetic counseling, however, this process is deeply dependent on accurate laboratory tests. Despite the striking importance of laboratory data for clinical immunologists, several IEI-relevant immunoassays still lack standardization, including standardized protocols, reference materials, and external quality assessment programs. Moreover, well-established reference values mostly remain to be determined, especially for early ages, when the most severe conditions manifest and diagnosis is critical for patient survival. In this article, we intend to approach the issue of standardization and quality control of the nonfunctional diagnostic tests used for IEI, focusing on those frequently utilized in clinical practice. Herein, we will focus on discussing the issues of nonfunctional immunoassays (flow cytometry, enzyme-linked immunosorbent assays, and turbidimetry/nephelometry, among others), as defined by the pure quantification of proteins or cell subsets without cell activation or cell culture-based methods.
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Affiliation(s)
- Sandro Félix Perazzio
- Division of Rheumatology, Universidade Federal de São Paulo, Sao Paulo, Brazil.,Immunology Division, Fleury Medicine and Health Laboratory, Sao Paulo, Brazil
| | - Patricia Palmeira
- Laboratório de Investigação Médica (LIM-36), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
| | - Dewton Moraes-Vasconcelos
- Laboratório de Investigação Médica (LIM-56), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
| | - Andréia Rangel-Santos
- Laboratório de Investigação Médica (LIM-36), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
| | | | - Luis Eduardo Coelho Andrade
- Division of Rheumatology, Universidade Federal de São Paulo, Sao Paulo, Brazil.,Immunology Division, Fleury Medicine and Health Laboratory, Sao Paulo, Brazil
| | - Magda Carneiro-Sampaio
- Laboratório de Investigação Médica (LIM-36), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil.,Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
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Pinto JA, Araujo JM, Gómez HL. Sex, immunity, and cancer. Biochim Biophys Acta Rev Cancer 2021; 1877:188647. [PMID: 34767966 DOI: 10.1016/j.bbcan.2021.188647] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 02/07/2023]
Abstract
The composition of the tumor microenvironment is the complex result of the interaction between tumoral and host factors. Since there are several differences in the regulation of gene circuits between sexes, mainly influenced by sex hormones, the tumor-host interaction presents some differences, leading tumors to evolve under different conditions. Nowadays, it is well known the existence of sexual dimorphism in the regulation of the immune system, where women present an improved immunity to various infectious agents and, on the other hand, a higher incidence of autoimmune diseases than men. In oncology, differences in cancer susceptibility, response to treatment, and clinical outcomes between men and women patients are well known. Recently, sex-specific differences have also been reported in mutations in driver genes and the prognostic value of several biomarkers. Sex has been a widely forgotten biomarker in cancer therapy, but it has recently acquired great relevance due to the different results seen in immunotherapy treatment.
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Affiliation(s)
- Joseph A Pinto
- Escuela de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Panamericana Sur Km. 305, 11004 Ica, Peru.
| | - Jhajaira M Araujo
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 41, Peru
| | - Henry L Gómez
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Surquillo, Lima 34, Peru
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Melzer S, Zachariae S, Bocsi J, Engel C, Löffler M, Tárnok A. Reference intervals for leukocyte subsets in adults: Results from a population-based study using 10-color flow cytometry. CYTOMETRY PART B-CLINICAL CYTOMETRY 2015; 88:270-81. [DOI: 10.1002/cyto.b.21234] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 01/19/2015] [Accepted: 02/10/2015] [Indexed: 12/17/2022]
Affiliation(s)
- Susanne Melzer
- LIFE; Leipzig Research Center for Civilization Diseases; Universität Leipzig; Philipp-Rosenthal-Straße 27 Leipzig D-04103 Germany
- Department of Pediatric Cardiology; Heart Center Leipzig GmbH, Universität Leipzig; Strümpellstr. 39 Leipzig D-04289 Germany
| | - Silke Zachariae
- LIFE; Leipzig Research Center for Civilization Diseases; Universität Leipzig; Philipp-Rosenthal-Straße 27 Leipzig D-04103 Germany
- Institute for Medical Informatics, Statistics and Epidemiology; Universität Leipzig; Härtelstraße 16-18 Leipzig D- 04107 Germany
| | - Jozsef Bocsi
- LIFE; Leipzig Research Center for Civilization Diseases; Universität Leipzig; Philipp-Rosenthal-Straße 27 Leipzig D-04103 Germany
- Department of Pediatric Cardiology; Heart Center Leipzig GmbH, Universität Leipzig; Strümpellstr. 39 Leipzig D-04289 Germany
| | - Christoph Engel
- LIFE; Leipzig Research Center for Civilization Diseases; Universität Leipzig; Philipp-Rosenthal-Straße 27 Leipzig D-04103 Germany
- Institute for Medical Informatics, Statistics and Epidemiology; Universität Leipzig; Härtelstraße 16-18 Leipzig D- 04107 Germany
| | - Markus Löffler
- LIFE; Leipzig Research Center for Civilization Diseases; Universität Leipzig; Philipp-Rosenthal-Straße 27 Leipzig D-04103 Germany
- Institute for Medical Informatics, Statistics and Epidemiology; Universität Leipzig; Härtelstraße 16-18 Leipzig D- 04107 Germany
| | - Attila Tárnok
- LIFE; Leipzig Research Center for Civilization Diseases; Universität Leipzig; Philipp-Rosenthal-Straße 27 Leipzig D-04103 Germany
- Department of Pediatric Cardiology; Heart Center Leipzig GmbH, Universität Leipzig; Strümpellstr. 39 Leipzig D-04289 Germany
- Translational Centre for Regenerative Medicine (TRM) Leipzig; Philipp-Rosenthal-Str. 55 Leipzig D-04103 Germany
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4
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Determination of lymphocyte subset reference ranges in peripheral blood of healthy adults by a dual-platform flow cytometry method. Immunol Lett 2015; 163:96-101. [DOI: 10.1016/j.imlet.2014.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 11/02/2014] [Accepted: 11/04/2014] [Indexed: 11/22/2022]
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Al-Thani A, Hamdi WS, Al-Marwani A, Alnaqdy A, Sharafeldin H. Reference ranges of lymphocyte subsets in healthy Qatari adults. Biomark Med 2014; 9:443-52. [PMID: 25275858 DOI: 10.2217/bmm.14.83] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Determine reference ranges of lymphocyte subsets in healthy Qatari adults. PATIENTS & METHODS Blood samples (n = 150) were investigated using four colors flow cytometery. RESULTS The mean percentage and absolute values of the lymphocyte subsets were: CD3: 73.6 ± 6.1%; 2,072 ± 644 cells/μl; CD4: 41.1 ± 7.9%; 1,167 ± 396 cells/μl; CD8: 33.8 ± 7.1%; 967 ± 364 cells/μl; B cells (CD19(+)): 11.3 ± 3.9%; 318 ± 144 cells/μl and natural killer (NK) cells (CD16/56(+)): 16.5 ± 6.3%, 440 ± 401 cells/μl, respectively. The CD4/CD8 ratio was 1.3 ± 0.5. The ratio, CD3(+) and CD4(+) percentage and CD4(+) cell counts were significantly higher in females; CD8(+) and NK cell count and CD8(+) percentage were significantly higher in males. The impact of age was less certain. CONCLUSION The reference values of lymphocyte subsets appear to be specific to this population, demonstrating the importance of establishing local reference ranges.
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Affiliation(s)
| | | | - Asma Al-Marwani
- 2Hematology Department, Hamad General Hospital, Hamad Medical Corporation, Doha
| | - Adel Alnaqdy
- 3Immunolgy Department, Hamad General Hospital, Hamad Medical Corporation, Doha
| | - Hend Sharafeldin
- 4Laboratory Department, Qatar Armed Forces Medical Services, Doha, Qatar
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Al-Mawali A, Pinto AD, Al Busaidi R, Al-Zakwani I. Lymphocyte subsets: reference ranges in an age- and gender-balanced population of Omani healthy adults. Cytometry A 2013; 83:739-44. [PMID: 23839863 DOI: 10.1002/cyto.a.22322] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 05/20/2010] [Accepted: 05/28/2013] [Indexed: 11/10/2022]
Abstract
Country-specific reference ranges for adult peripheral blood lymphocyte subsets have been established in a few countries around the world; however, there have been no specific comprehensive studies in the Gulf Cooperation Council (GCC) and Middle East, which investigated age and gender-specific reference ranges. Demographic and environmental factors may contribute to variations in these subsets around the world, and thus there is a great necessity for each country to establish its own reference ranges. Hence, the aim of this study is to establish lymphocyte subsets reference ranges for Omani healthy adults. Total, age, and gender-specific reference ranges were established using four-color flow cytometry analysis with an extensive panel of monoclonal antibodies in 50 healthy adult males and females aged between 18 and 57. Reference values were expressed as median and 95% confidence intervals for T cells-CD3(+) : 76.5 (57-89), CD4(+) : 45 (31-58), CD5(+) : 75 (58-85), CD7(+) : 80 (70-89), CD8(+) : 29.5 (19-43); B cells-CD10(+) : 1 (1-3), CD19(+) : 14 (6-23), CD20(+) : 14 (6-23), and NK cells-CD16(+) : 9 (3-22), CD56(+) : 13 (5-24), CD3(-) /(CD16(+) /CD56(+) ): 7 (3-20). In comparison with other published studies, the lymphocyte subsets reference ranges in healthy Omani adults were similar to those reported in the rest of the world. These observations have important clinical implications in lymphocyte subset analysis in Oman, especially in the management of immunological disorders. The reference ranges established by this study can be adopted as a reference for clinical practice decisions.
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Affiliation(s)
- Adhra Al-Mawali
- Directorate of Research and Studies, Ministry of Health, Muscat, Sultanate of Oman.
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Touil N, Hadef R, Lemnouer A, Zrara A, Sbai AI, Belfquih B, Mrani S, Benkirane A, Ouaaline M, Mrabet M. Range-reference determination of lymphocyte subsets in Moroccan blood donors. Afr Health Sci 2012; 12:334-8. [PMID: 23382749 DOI: 10.4314/ahs.v12i3.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Information on lymphocyte populations (T, B, and Natural killer cells) and subpopulations (CD4 and CD8) in Morocco is scarce if not inexistent. OBJECTIVE To establish a reference value of these cells in 242 Moroccan young adult blood donors by flow cytometry. RESULTS Smokers had significantly higher total leukocyte count (p < 0.001), total lymphocyte count (p < 0.0001) and higher CD3+CD4+ cells (p < 0.0001). The percentage of CD3-CD56+ subsets was affected by smoking (p < 0.01). Our analysis positively correlate with previous observations of an increase of absolute CD4+ T cells, with no changes in other lymphocyte subset cells in smokers. The lymphocyte subpopulation distributions for all antigens were found to be similar to those reported in Saudi and Italian adults, while higher levels were reported for the same gender in other countries, especially Ghana and Kuwait. CONCLUSION The international classification standards of the HIV-infected subjects according to their rates of CD4 are applicable to the present study's population.
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Affiliation(s)
- N Touil
- Laboratoire de Virologie, Hôpital Militaire d'Instruction Med V Rabat, Um5, Souissi, Morocco.
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8
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Mhmoud NA, Fahal AH, van de Sande WWJ. CD4+ T-lymphocytopenia in HIV-negative tuberculosis patients in Sudan. J Infect 2012; 65:370-2. [PMID: 22728173 DOI: 10.1016/j.jinf.2012.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 06/09/2012] [Indexed: 11/30/2022]
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9
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Alamooti AA, Ardalan FA, Abdolahi A, Zeidi M, Firouzjaie F. Determination of lymphocyte subsets reference values in healthy Iranian men by a single platform flow cytometric method. Cytometry A 2010; 77:890-4. [DOI: 10.1002/cyto.a.20912] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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10
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Chama CM, Morrupa JY, Abja UA, Kayode A. Normal CD4 T-lymphocyte baseline in healthy HIV-negative pregnant women. J OBSTET GYNAECOL 2009; 29:702-4. [PMID: 19821661 DOI: 10.3109/01443610903182920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The CD4 count is frequently used as a surrogate marker for immune suppression associated with HIV infection and to monitor antiretroviral treatment. The aim of this study is to establish the normal reference values of CD4 count in healthy pregnant women in our environment. Pregnant women attending the antenatal clinic of the University of Maiduguri Teaching Hospital (UMTH) received voluntary counselling and testing for HIV. Those who tested negative had their CD4 count assessed using the cyflow method. Healthy non-pregnant women attending the family planning clinic of the UMTH as well as healthy men coming to donate blood at the blood bank of the same hospital were recruited as controls. A total of 128 pregnant women, 228 non-pregnant women and 185 men were recruited for the study. The mean CD4 count of the pregnant women was 751.41 cells/microl which was significantly lower than the mean CD4 count of 869 cells/microl for the non-pregnant women. Primigravidas had a lower mean CD4 count than both multiparas and grandmultiparas. Similarly, the mean CD4 count was higher in the first trimester than in the later parts of pregnancy. There was no significant difference in the mean CD4 count across all age groups. There is a slight fall in the mean CD4 count in pregnancy, which is more in the first trimester of pregnancy and in primigravidas. This should not affect the reference values for the initiation of antiretroviral drugs in pregnancy.
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Affiliation(s)
- C M Chama
- Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.
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Aina O, Dadik J, Charurat M, Amangaman P, Gurumdi S, Mang E, Guyit R, Lar N, Datong P, Daniyam C, Kanki P, Abimiku A. Reference values of CD4 T lymphocytes in human immunodeficiency virus-negative adult Nigerians. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2005; 12:525-30. [PMID: 15817761 PMCID: PMC1074389 DOI: 10.1128/cdli.12.4.525-530.2005] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A cross-sectional study that involved secondary analysis of data collected from 681 pregnant women and 183 miners (94 men and 89 women; ratio of men to women, 1:0.95) in Jos, Nigeria, was carried out to determine the reference ranges for CD4(+)-cell counts in healthy HIV-negative adult Nigerians. The main results of interest were CD4(+)-cell counts and odds ratios (ORs) of low CD4(+)-cell counts, defined as below 350 cells per microl. CD4(+)-cell counts were similar in men and nonpregnant women, with a mean (standard deviation) of 828 (203) cells per microl, but pregnant women had a lower value of 771 (250) cells per microl. None of the factors assessed was related to the odds of having a low CD4(+)-cell count among men and nonpregnant women, but age, age of marriage, and alcohol usage were significant predictors in pregnant women. Compared to pregnant women less than 20 years old, older women had significantly lower odds of a low CD4(+)-cell count (ORs were 0.06 for women aged 20 to 29 years and 0.22 for those aged 30 to 39 years). When compared with those pregnant women who were married before 20 years of age, those who married at 20 to 29 years and 30 to 39 years had odds ratios of 6.41 and 9.40, respectively. Previous alcohol use was also associated with low CD4(+)-cell counts (OR, 5.15). The 95% confidence interval for CD4(+)-cell counts in healthy adult Nigerians is 547 to 1,327 cells per microl, and this is the first time this has been determined.
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Affiliation(s)
- Olumuyiwa Aina
- Division of Epidemiology and Prevention, Institute of Human Virology, Baltimore, Maryland 21201, USA
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Yaman A, Cetiner S, Kibar F, Taşova Y, Seydaoğlu G, Dündar IH. Reference ranges of lymphocyte subsets of healthy adults in Turkey. Med Princ Pract 2005; 14:189-93. [PMID: 15863994 DOI: 10.1159/000084638] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2003] [Accepted: 02/18/2004] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED The aim of this study was to determine the reference ranges of lymphocyte subsets in serologically HIV-negative healthy adults in Turkey. MATERIALS AND METHODS Blood samples from 220 healthy adults, 105 female and 115 male, collected into tubes containing EDTA were investigated for lymphocyte subsets using flow cytometry. The age range was 18-80 years (44.80 +/- 16.69). RESULTS The mean percentage and absolute values of the lymphocyte subsets were as follows: CD3: 72.70 +/- 8.44%, 1,680 +/- 528 cells/microl; CD4: 47.37 +/- 9.10%, 1,095 +/- 391 cells/microl; CD8: 28.99 +/- 5.99%, 669 +/- 239 cells/microl; CD19: 10.96 +/- 4.44%, 254 +/- 122 cells/microl and CD56: 7.03 +/- 3.26%, 161 +/- 92 cells/microl, respectively. The ratio of CD4/CD8 was 1.68 +/- 0.43. There was no statistically significant difference in the percentages and absolute values of lymphocyte subsets between the genders (p > 0.05). CONCLUSION Immunophenotyping has been used to establish reference values of lymphocyte subsets in normal healthy adults in Turkey.
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Affiliation(s)
- Akgun Yaman
- Department of Microbiology, Faculty of Medicine, Cukurova University, Balcali-Adana, Turkey.
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Contamin H, Loizon S, Bourreau E, Michel JC, Garraud O, Mercereau-Puijalon O, Behr C. Flow cytometry identification and characterization of mononuclear cell subsets in the neotropical primate Saimiri sciureus (squirrel monkey). J Immunol Methods 2005; 297:61-71. [PMID: 15777931 DOI: 10.1016/j.jim.2004.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2004] [Revised: 11/22/2004] [Accepted: 11/24/2004] [Indexed: 11/30/2022]
Abstract
BACKGROUND The neotropical primate squirrel monkey is used in many areas of biomedical research including neuroendocrinology, immunology and infectious diseases. However, research has been hampered by the lack of immunological tools for this primate. METHODS A series of 67 commercially available monoclonal antibodies to human CD antigens or cytokines were tested on Saimiri mononuclear cells and the specificity was assessed by double staining using flow cytometry. RESULTS Monoclonal antibodies defining the main mononuclear cells subsets (monocytes, B, T, including CD4 and CD8 T cells) as well as activation markers have been identified. The conditions to specifically identify the various cell subsets using two color flow cytometry and establish their relative proportions have been set-up. We also have established normal values of the main circulating mononuclear cell subsets for adult Saimiri sciureus monkeys from the breeding unit of Institut Pasteur in French Guiana. The distribution between spleen, blood and lymph nodes has been compared. CONCLUSIONS These tools allow documenting the phenotype of most Saimiri mononuclear cell subsets and assessing their activation level. This opens new perspectives for vaccinology and immunopathology research in this experimental non-human primate host, in particular for malaria research.
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Affiliation(s)
- Hugues Contamin
- Institut Pasteur de la Guyane, BP 6010, 97306 Cayenne Cedex, French Guiana
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Kaaba SA, Al Fadhli S, Burhamah M, Al Jafar H, Khamis A. Lymphocyte subsets in healthy adult Kuwaiti Arabs with relative benign ethnic neutropenia. Immunol Lett 2004; 91:49-53. [PMID: 14757369 DOI: 10.1016/j.imlet.2003.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Relative and absolute neutropenia is frequently seen in the healthy adult Kuwaiti Arab population. Fluorescent monoclonal antibody labelling followed by flow cytometry was used to determine the lymphocyte subsets in 48 normal healthy individuals in the Kuwaiti adult population (24 males and 24 females, age 17-59 years) with relative or absolute neutropenia, and this was compared to age-matched controls (64 males and 63 females). The mean haemoglobin levels were 13.6+/-1.5 and 13.7+/-1.5 g/dl in the neutropenic and control groups, respectively. White blood cell counts, absolute neutrophil and lymphocyte counts in neutropenic individuals with the corresponding reference range, taken from the control subjects (in parenthesis) were: WBC, 6.7+/-1.6 x 10(9)/l (4-10.4 x 10(9)/l), neutrophils, 2.7+/-0.8 x 10(9)/l (1.87-6.63 x 10(9)/l), lymphocytes, 3.3+/-0.9 x 10(9)/l (1.4-3.62 x 10(9)/l). Absolute values of lymphocytes, CD2+, CD3+, CD19+, CD4+, CD8+, HLADR+ and CD45RA+ cells were significantly higher in the neutropenic group. The range of values with the corresponding reference ranges, in parenthesis, were: CD2+, 1.61-4.30 x 10(9)/l (0.95-2.99 x 10(9)/l), CD3+, 1.37-4.16 x 10(9)/l (0.83-2.71 x 10(9)/l), CD19+, 0.16-1.09 x 10(9)/l (0.05-0.61 x 10(9)/l), CD4+, 0.70-2.89 x 10(9)/l (0.45-1.65 x 10(9)/l), CD8+, 0.57-1.80 x 10(9)/l (0.29-1.17 x 10(9)/l), HLADR+ 0.27-1.74 x 10(9)/l (0.02-0.62 x 10(9)/l), CD45RA, 0.90-4.63 x 10(9)/l (0.34-2.05 x 10(9)/l), respectively. The levels of natural killer cells, CD56+ cells were significantly lower compared to controls while the values of memory T lymphocytes, CD45RO+ were comparable to controls. These results indicate that difference in the leukocyte subpopulations may also be indicative of differences in the lymphocyte subpopulations and that reference ranges for these cell types in healthy neutropenic and non-neutropenic individuals should be established.
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Affiliation(s)
- Salim A Kaaba
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, PO Box 31470, 90805 Sulaibikhat, Kuwait.
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Shearer WT, Rosenblatt HM, Gelman RS, Oyomopito R, Plaeger S, Stiehm ER, Wara DW, Douglas SD, Luzuriaga K, McFarland EJ, Yogev R, Rathore MH, Levy W, Graham BL, Spector SA. Lymphocyte subsets in healthy children from birth through 18 years of age. J Allergy Clin Immunol 2003; 112:973-80. [PMID: 14610491 DOI: 10.1016/j.jaci.2003.07.003] [Citation(s) in RCA: 603] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Peripheral blood lymphocyte subsets need to be determined in a large, urban, minority-predominant cohort of healthy children to serve as suitable control subjects for the interpretation of the appearance of these cells in several disease conditions, notably pediatric HIV-1 infection. OBJECTIVE We sought to determine the distribution of lymphocyte subsets in healthy urban-dwelling infants, children, and adolescents in the United States. METHODS Lymphocyte subsets were determined by means of 3-color flow cytometry in a cross-sectional study of 807 HIV-unexposed children from birth through 18 years of age. RESULTS Cell-surface marker analysis demonstrated that age was an extremely important variable in 24 lymphocyte subset distributions measured as percentages or absolute counts--eg, the CD4 (helper) T cell, CD8 (cytotoxic) T cell, CD19 B cell, CD4CD45RACD62L (naive helper) T cell, CD3CD4CD45RO (memory helper) T cell, CD8HLA-DRCD38 (activated cytotoxic) T cell, and CD8CD28 (activation primed cytotoxic) T cell. The testing laboratory proved to be an important variable, indicating the need for using the same laboratory or group of laboratories to assay an individual's blood over time and to assay control and ill or treated populations. Sex and race-ethnicity were much less important. CONCLUSION The results of this study provide a control population for assessment of the effects of HIV infection on the normal development and distribution of lymphocyte subsets in children of both sexes, all races, and all ethnic backgrounds from birth through 18 years of age in an urban population. This study's findings will also prove invaluable in interpreting the immune changes in children with many other chronic diseases, such as primary immunodeficiency, malignancy, rheumatoid arthritis, and asthma.
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Ford J, Hoggard PG, Owen A, Khoo SH, Back DJ. A simplified approach to determining P-glycoprotein expression in peripheral blood mononuclear cell subsets. J Immunol Methods 2003; 274:129-37. [PMID: 12609539 DOI: 10.1016/s0022-1759(02)00509-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
P-glycoprotein (P-gp), encoded by the MDR-1 (multidrug resistance) gene mediates the cellular efflux of several therapeutic agents with the potential of treatment failure. The differential expression of P-gp in many localised tissues and cells of the hematopoietic system implies diverse physiological and pharmacological roles. The exact function of P-gp involved in multidrug resistance remains unclear owing to the numerous discrepancies between different laboratories. The ability to characterise accurately P-gp expression has important clinical implications. However, a complete consensus recommendation regarding methods of P-gp detection has been difficult to reach. With the advancement in immune technology and new commercially available antibodies, we describe a simplified direct immunofluorescent assay capable of detecting surface P-gp expression in peripheral blood mononuclear cells (PBMCs) and subpopulations of lymphocytes in vivo by dual colour flow cytometry. Results were expressed as mean increase in fluorescence (MI) compared to isotypically matched controls. Using this assay, differential basal P-gp expression was found to exist in the following significant hierarchy CD56+ (MI=0.684+/-0.273; n=15)>CD8+ (MI=0.312+/-0.117; n=15)>CD4+ (MI=0.194+/-0.086; n=15). This method is rapid and reproducible and has potential use for in vitro and in vivo application.
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Affiliation(s)
- J Ford
- Department of Pharmacology and Therapeutics, University of Liverpool, 70 Pembroke Place, Block H, First Floor, L69 3GF, Liverpool, UK.
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