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Brooks HL, de Castro Brás LE, Brunt KR, Sylvester MA, Parvatiyar MS, Sirish P, Bansal SS, Sule R, Eadie AL, Knepper MA, Fenton RA, Lindsey ML, DeLeon-Pennell KY, Gomes AV. Guidelines on antibody use in physiology research. Am J Physiol Renal Physiol 2024; 326:F511-F533. [PMID: 38234298 DOI: 10.1152/ajprenal.00347.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/19/2024] Open
Abstract
Antibodies are one of the most used reagents in scientific laboratories and are critical components for a multitude of experiments in physiology research. Over the past decade, concerns about many biological methods, including those that use antibodies, have arisen as several laboratories were unable to reproduce the scientific data obtained in other laboratories. The lack of reproducibility could be largely attributed to inadequate reporting of detailed methods, no or limited verification by authors, and the production and use of unvalidated antibodies. The goal of this guideline article is to review best practices concerning commonly used techniques involving antibodies, including immunoblotting, immunohistochemistry, and flow cytometry. Awareness and integration of best practices will increase the rigor and reproducibility of these techniques and elevate the quality of physiology research.
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Affiliation(s)
- Heddwen L Brooks
- Department of Physiology, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | | | - Keith R Brunt
- Department of Pharmacology, Faculty of Medicine, Dalhousie University, Saint John, New Brunswick, Canada
| | - Megan A Sylvester
- Department of Physiology, College of Medicine, University of Arizona, Tucson, Arizona, United States
| | - Michelle S Parvatiyar
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida, United States
| | - Padmini Sirish
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of California, Davis, California, United States
| | - Shyam S Bansal
- Department of Cellular and Molecular Physiology, Heart and Vascular Institute, Pennsylvania State University Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Rasheed Sule
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, California, United States
| | - Ashley L Eadie
- Department of Pharmacology, Faculty of Medicine, Dalhousie University, Saint John, New Brunswick, Canada
| | - Mark A Knepper
- Epithelial Systems Biology Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Robert A Fenton
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Merry L Lindsey
- School of Graduate Studies, Meharry Medical College, Nashville, Tennessee, United States
- Research Service, Nashville Veterans Affairs Medical Center, Nashville, Tennessee, United States
| | - Kristine Y DeLeon-Pennell
- Division of Cardiology, Department of Medicine, School of Medicine, Medical University of South Carolina, Charleston, South Carolina, United States
- Research Service, Ralph H Johnson Veterans Affairs Medical Center, Charleston, South Carolina, United States
| | - Aldrin V Gomes
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, California, United States
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2
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Comins-Boo A, Pérez-Pla F, Irure-Ventura J, López-Hoyos M, Blanco-Peris L, Martín Alonso MDC, San Segundo Arribas D. Total error in lymphocyte subpopulations by flow cytometry-based in state of the art using Spanish EQAS data. Clin Chem Lab Med 2024; 62:312-321. [PMID: 37548423 DOI: 10.1515/cclm-2023-0470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVES Flow cytometry analyses of lymphocyte subpopulations (T, B, NK) are crucial for enhancing clinical algorithms and research workflows. Estimating the total error (TE) values for the percentage and absolute number of lymphocyte subpopulations using the state-of-the-art (SOTA) approach with real data from an external proficiency testing (EPT) scheme was performed. A comparison with previously published Biological Variability (BV)-based specifications was carried out. METHODS A total of 44,998 results from 86 laboratories over 10 years were analysed and divided into two five-year periods (2012-2016) and (2017-2021). Data come from the IC-1 Lymphocytes scheme of the Spanish External Quality Assurance System (EQAS) GECLID Program. This quantitative scheme includes percentages and absolute numbers of CD3+, CD3+CD4+, CD3+CD8+, CD19+, and CD3-CD56+CD16+ NK cells. The percentage of TE was calculated as: |reported value - robust mean|*100/robust mean for each laboratory and parameter. The cut-off for TE is set at 80 % best results of the laboratories. RESULTS A significant reduction in the SOTA-based TE for all lymphocyte subpopulations in 2017-2021 was observed compared to 2012-2016. The SOTA-based TE fulfils the minimum BV-based TE for percentages of lymphocyte subpopulations. The parameter with the best analytical performance calculated with SOTA (2017-2021 period)-based TE was the percentage of CD3+ (TE=3.65 %). CONCLUSIONS The values of SOTA-based specifications from external quality assurance program data are consistent and can be used to develop technical specifications. The technological improvement, quality commitment, standardization, and training, reduce TE. An update of TE every five years is therefore recommended. TE assessment in lymphocyte subsets is a helpful and reliable tool to improve laboratory performance and data-based decision-making trust.
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Affiliation(s)
- Alejandra Comins-Boo
- Immunology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain
| | - Fernando Pérez-Pla
- Immunology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain
| | - Juan Irure-Ventura
- Immunology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain
| | - Marcos López-Hoyos
- Immunology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain
| | - Lydia Blanco-Peris
- Centro de Hemoterapia y Hemodonación de Castilla y León, Valladolid, Spain
| | | | - David San Segundo Arribas
- Immunology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain
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3
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Eberst G, Vernerey D, Laheurte C, Meurisse A, Kaulek V, Cuche L, Jacoulet P, Almotlak H, Lahourcade J, Gainet-Brun M, Fabre E, Le Pimpec-Barthes F, Adotevi O, Westeel V. Prognostic value of CD4+ T lymphopenia in non-small cell lung Cancer. BMC Cancer 2022; 22:529. [PMID: 35546670 PMCID: PMC9092669 DOI: 10.1186/s12885-022-09628-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a paucity of data regarding the prognostic influence of peripheral blood CD4+ T lymphopenia in non-small cell lung cancer (NSCLC). Therefore, we investigated the prognostic value of T lymphopenia in NSCLC. MATERIALS Treatment-naive patients with a pathological diagnosis of NSCLC, at clinical stage I to IV were included in the prospective TELOCAP1 study. Lymphocytes count was evaluated in peripheral blood by flow cytometry. CD4+ and CD8+ T lymphopenia were defined as an absolute count of < 500/μL and < 224/μL respectively. The prognostic value of T lymphopenia was analyzed in the whole population, in local/loco-regional (stage I-IIIB) and in advanced (stage IV) NSCLC disease, using the Kaplan-Meier method and Cox regression models for survival curves and multivariate analysis, respectively. RESULTS Between July 2010 and January 2014, 169 evaluable patients with clinical stage I to IV NSCLC were prospectively enrolled. The prevalence of CD4+ and CD8+ T lymphopenia was similar in the study population (around 29%). Patients with CD4+ T lymphopenia showed lower overall survival than those with CD4+ T lymphocytes count > 500/μL (median overall survival (OS) 16.1 versus 21.7 months, hazard ratio (HR): 1.616 [95% CI: 1.1-2.36], p = 0.012). This association with OS was especially marked in local/loco-regional NSCLC stages (median OS, 21.8 versus 72 months, respectively, HR: 1.88 [95% CI: 0.9-3.8], p = 0.035). Multivariate analysis confirmed the worse prognosis associated with CD4+ T lymphopenia in local/loco-regional NSCLC, but not in metastatic patients (HR 2.028 [95% CI = 1.065-3.817] p = 0.02). Restricted cubic spline analysis showed that patients with CD4+ T lymphocytes count ≤500/μL displayed a high risk of death regardless of NSCLC clinical stage. There was no obvious relationship between CD8+ T lymphopenia and clinical outcome. CONCLUSION We identified CD4+ T lymphopenia as an independent prognostic factor in local/loco-regional stages of NSCLC and CD4+ T lymphopenia is also associated with a high risk of death, regardless of NSCLC clinical stage. TRIAL REGISTRATION EUDRACT: 2009-A00642-55.
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Affiliation(s)
- Guillaume Eberst
- Chest Disease Department, University Hospital, 3 Boulevard Fleming, 25030, Besançon, France. .,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France. .,Université de Bourgogne Franche-Comté, EFS BFC, INSERM, UMR1098, RIGHT, Besançon, France.
| | - Dewi Vernerey
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,Université de Bourgogne Franche-Comté, EFS BFC, INSERM, UMR1098, RIGHT, Besançon, France
| | - Caroline Laheurte
- Université de Bourgogne Franche-Comté, EFS BFC, INSERM, UMR1098, RIGHT, Besançon, France.,INSERM CIC-1431, Clinical Investigation Center in Biotherapy, Biomonitoring Platform, F-25000, Besançon, France
| | - Aurélia Meurisse
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France
| | - Vincent Kaulek
- Chest Disease Department, University Hospital, 3 Boulevard Fleming, 25030, Besançon, France
| | - Laurie Cuche
- Chest Disease Department, University Hospital, 3 Boulevard Fleming, 25030, Besançon, France
| | - Pascale Jacoulet
- Chest Disease Department, University Hospital, 3 Boulevard Fleming, 25030, Besançon, France
| | - Hamadi Almotlak
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Jean Lahourcade
- Chest Disease Department, University Hospital, 3 Boulevard Fleming, 25030, Besançon, France
| | - Marie Gainet-Brun
- Chest Disease Department, University Hospital, 3 Boulevard Fleming, 25030, Besançon, France
| | - Elizabeth Fabre
- Department of Medical Oncology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Françoise Le Pimpec-Barthes
- Department of Thoracic surgery, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Olivier Adotevi
- Université de Bourgogne Franche-Comté, EFS BFC, INSERM, UMR1098, RIGHT, Besançon, France.,INSERM CIC-1431, Clinical Investigation Center in Biotherapy, Biomonitoring Platform, F-25000, Besançon, France.,Department of Medical Oncology, University Hospital, Besançon, France
| | - Virginie Westeel
- Chest Disease Department, University Hospital, 3 Boulevard Fleming, 25030, Besançon, France.,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,Université de Bourgogne Franche-Comté, EFS BFC, INSERM, UMR1098, RIGHT, Besançon, France
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4
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Xia Y, Liu A, Li W, Liu Y, Zhang G, Ye S, Zhao Z, Shi J, Jia Y, Liu X, Guo Y, Chen H, Yu J. Reference range of naïve T and T memory lymphocyte subsets in peripheral blood of healthy adult. Clin Exp Immunol 2021; 207:208-217. [PMID: 35020890 PMCID: PMC8982966 DOI: 10.1093/cei/uxab038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 12/20/2021] [Accepted: 12/26/2021] [Indexed: 02/03/2023] Open
Abstract
Naïve T and T memory cell subsets are closely related to immune response and can provide important information for the diagnosis and treatment of immunological and hematological disorders. Lymphocyte compartment undergoes dramatic changes during adulthood; age-related reference values derived from healthy individuals are crucial. However, extensively detailed reference values of peripheral blood lymphocytes in the whole spectrum of adulthood detected by multi-color flow cytometry on a single platform are rare. Three hundred and nine healthy adult volunteers were recruited from Tianjin in China. The absolute counts and percentages of CD3+CD4+ T cells, CD3+CD8+ T cells, naïve T cells (Tn), T memory stem cells (Tscm), central memory T cells (Tcm), effector memory T cells (Tem), and terminal effector T cells (Tte) were detected by flow cytometry with single platform technologies. Reference range of absolute counts and percentage of T lymphocyte subsets were formulated by different age and gender. The results showed that Tn and Tscm cells, which had stem cell properties, decreased with aging; while, Tcm and Tem increased with aging, which increased from 18 to 64 years old but presented no significant change over the 65 years old. Gender had an influence on the fluctuation of lymphocyte subsets, the absolute count of CD3+CD8+, CD8+Tcm, CD8+Tem in males were higher than those in females. The reference values of percentages and absolute numbers of naïve T and T memory cell subsets can help doctors to understand the immune state of patients and evaluate conditions of prognosis then adjust the treatment for patients. (Chinese Clinic Trial Registry number: ChiCTR-IOR-17014139.).
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Affiliation(s)
- Ying Xia
- Oncology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China,Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Aqing Liu
- Oncology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China,Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Wentao Li
- Oncology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yunhe Liu
- Oncology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Guan Zhang
- Oncology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China,Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Songshan Ye
- Oncology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China,Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Zhijieruo Zhao
- Oncology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China,Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Juan Shi
- Oncology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yingjie Jia
- Oncology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xu Liu
- Clinic Laboratory, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yongtie Guo
- Clinic Laboratory, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Huayu Chen
- Clinic Laboratory, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jianchun Yu
- Oncology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China,Correspondence: Jianchun Yu, Oncology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China. E-mail:
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5
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Xu K, Miao L, Chen W, Wu H, Gong Y, Tu X, Guo W, Pan B, Qu C, Wu X, Wang B. Establishment of the reference intervals of lymphocyte subsets for healthy Chinese Han adults and its influencing factors. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1495. [PMID: 34805357 PMCID: PMC8573445 DOI: 10.21037/atm-21-4031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/10/2021] [Indexed: 12/19/2022]
Abstract
Background Cellular immune monitoring is becoming more critical in the clinic, but its application has not yet become sufficiently widespread. One reason may be the different reference intervals among clinical laboratories due to several factors. Percentage and number of lymphocyte subsets are standard indicators of cellular immune detection. The present study aimed to establish standardized reference intervals of lymphocyte subsets in the healthy Chinese Han adult population and examine such influencing factors as age, gender, region, and measurement instruments. Methods A total of 496 healthy Chinese Han people aged 18–59 years from 3 China Mainland regions (north, east, and south) were enrolled. The sample of each center was simultaneously examined by three flow cytometers (FACSCantoTMII, FACSLyricTM, and FACSCaliburTM). A single-platform flow cytometry-based absolute count technique was used to quantify the percentage and number of each lymphocyte subset. The flow cytometry results were analyzed by variance analysis and Z test to determine the influence of age, gender, and instruments on lymphocyte subsets. Results Multi-center, age-specific, and gender-specific reference intervals of healthy Chinese Han adults’ lymphocyte subsets were established. There was no statistical difference in the results from the three flow cytometers. Gender affected the results of CD4+ (%) and the absolute count of CD3−CD16+CD56+, where CD4+ (%) was higher in women, and the absolute count of CD3−CD16+CD56+ was higher in men. Age mainly affected the CD4+/CD8+ ratio, which was statistically higher in groups aged over 40 years; the percentage and number of CD3−CD19+ were more elevated in age groups below 30 years; however, the difference was not statistically significant. Conclusions This study established the reference intervals of lymphocyte subsets for healthy Chinese Han adult populations under the standardized methods. This study was the first nationwide study in China to use a flow cytometry-based single-platform method to establish the reference intervals of lymphocyte subsets of the healthy Chinese Han adult population. Gender and age were shown to influence the results of lymphocyte subsets.
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Affiliation(s)
- Kangli Xu
- Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.,Branch of National Clinical Research Center for Laboratory Medicine, Shanghai, China
| | - Linzi Miao
- Department of Clinical Laboratory, Peking University First Hospital, Beijing, China
| | - Weiye Chen
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hui Wu
- Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.,Branch of National Clinical Research Center for Laboratory Medicine, Shanghai, China
| | - Yan Gong
- Department of Clinical Laboratory, Peking University First Hospital, Beijing, China
| | - Xiaoxin Tu
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei Guo
- Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.,Branch of National Clinical Research Center for Laboratory Medicine, Shanghai, China
| | - Baishen Pan
- Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.,Branch of National Clinical Research Center for Laboratory Medicine, Shanghai, China
| | - Chenxue Qu
- Department of Clinical Laboratory, Peking University First Hospital, Beijing, China
| | - Xinzhong Wu
- Department of Transfusion Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Beili Wang
- Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.,Branch of National Clinical Research Center for Laboratory Medicine, Shanghai, China
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Mannelli F, Gianfaldoni G, Guglielmelli P, Buccisano F, Caporale R, Chiarini M, Rossi G, Venditti A, Fazi P, Crea E, Piciocchi A, Voso MT, Vignetti M, Amadori S, Vannucchi AM. AMELIORATE: early intensification in FLT3-mutated acute myeloid leukemia based on peripheral blast clearance - MYNERVA-GIMEMA AML1919 trial. Future Oncol 2021; 17:3787-3796. [PMID: 34254530 DOI: 10.2217/fon-2021-0388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AMELIORATE is a Phase III, randomized trial aiming to personalize treatment intensity in FLT3-mutated acute myeloid leukemia. The current study provides an early appraisal of chemosensitivity based on peripheral blasts clearance, as assessed by multiparameter flow cytometry, from baseline to day 4 of induction. This biomarker was previously demonstrated to predict complete remission achievement and measurable residual disease status. For patients experiencing low peripheral blast cells (i.e., ≤2.0 logs), two major adjustments of treatment as compared with current standard of care are envisioned in the experimental arm: the immediate switch to intensified induction with high-doses cytarabine (1500 mg/m2 b.i.d. on days 5-7 of induction); and the early allocation of the patient to high-risk disease category, to be further refined later based on postinduction measurable residual disease status.
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Affiliation(s)
- Francesco Mannelli
- SOD Ematologia, AOU Careggi, Firenze 50134, Italy.,Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze 50134, Italy
| | | | - Paola Guglielmelli
- SOD Ematologia, AOU Careggi, Firenze 50134, Italy.,Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze 50134, Italy
| | - Francesco Buccisano
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Tor Vergata, Roma 00133, Italy.,Fondazione Policlinico Tor Vergata, Roma 00133, Italy
| | - Roberto Caporale
- Centro Diagnostico di Citofluorimetria e Immunoterapia, AOU Careggi, Firenze 50134, Italy
| | - Marco Chiarini
- Laboratorio di Citofluorimetria; Dipartimento di Diagnostica di Laboratorio, Spedali Civili, Brescia 25121, Italy
| | - Giuseppe Rossi
- Divisione di Ematologia, Spedali Civili, Brescia 25121, Italy
| | - Adriano Venditti
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Tor Vergata, Roma 00133, Italy.,Fondazione Policlinico Tor Vergata, Roma 00133, Italy
| | | | | | | | - Maria Teresa Voso
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Tor Vergata, Roma 00133, Italy.,Fondazione Policlinico Tor Vergata, Roma 00133, Italy
| | | | | | - Alessandro Maria Vannucchi
- SOD Ematologia, AOU Careggi, Firenze 50134, Italy.,Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze 50134, Italy
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7
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Xia Y, Li W, Li Y, Liu Y, Ye S, Liu A, Yu J, Jia Y, Liu X, Chen H, Guo Y. The clinical value of the changes of peripheral lymphocyte subsets absolute counts in patients with non-small cell lung cancer. Transl Oncol 2020; 13:100849. [PMID: 32866935 PMCID: PMC7475266 DOI: 10.1016/j.tranon.2020.100849] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/13/2020] [Accepted: 08/06/2020] [Indexed: 12/24/2022] Open
Abstract
Introduction Immune function strongly influences the outcome of patients with non-small cell lung cancer (NSCLC). It's vital to understand the immune state of patients through detecting the percentage and number of lymphocyte subsets accurately, and helpful to evaluate conditions of prognosis and adjust treatment for patients. Methods We conducted a retrospective cohort study in First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China. The absolute counts and percentages of CD3+, CD3 + CD4+, CD3 + CD8+, B and NK cells were determined by single platform technologies. 172 patients received treatment including surgery or chemotherapy after surgery. The factors affecting disease progression were analyzed by Binary Logistic regression. Progression free survival (PFS) calculating survivals were with the method of Kaplan-Meier. The log-rank test and cox's proportional hazard regression (enter method) were used for univariable and multivariable analyses respectively. Results Relative to normal controls, patients with NSCLC at different stages showed decreased absolute lymphocyte count obviously, rather than lymphocyte percentages. Different treatments had unlike influence on the homeostasis of lymphocytes and the effects last for a long time. Logistic regression showed CD3 + CD4+ and CD3 + CD8+ could contribute to favorable prognosis. Multivariate analysis of prognostic factors of PFS showed CD3 + CD4+ cell was independent factor for predicting PFS. Conclusions The absolute count of CD3+, CD3 + CD4+, CD3 + CD8+, B and NK cells were better indication of the patient's immune state than percentages of each lymphocyte subsets. Immune function was impaired in patients with non-small cell lung. The high level of baseline absolute CD3 + CD4+ cells count contributed to longer progression free survival. Chinese Clinic Trial Registry number: ChiCTR-IOR-17014139; Registry date: 2017/12/25.
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Affiliation(s)
- Ying Xia
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Oncology Department, Tianjin, China; Tianjin University of Traditional Chinese Medicine, Graduate School, Tianjin, China
| | - Wentao Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Oncology Department, Tianjin, China
| | - Yongmin Li
- Hebei University of Chinese Medicine, Hebei, China
| | - Yunhe Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Oncology Department, Tianjin, China
| | - Songshan Ye
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Oncology Department, Tianjin, China; Tianjin University of Traditional Chinese Medicine, Graduate School, Tianjin, China
| | - Aqing Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Oncology Department, Tianjin, China; Tianjin University of Traditional Chinese Medicine, Graduate School, Tianjin, China
| | - Jianchun Yu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Oncology Department, Tianjin, China.
| | - Yingjie Jia
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Oncology Department, Tianjin, China
| | - Xu Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Clinic Laboratory, Tianjin, China
| | - Huayu Chen
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Clinic Laboratory, Tianjin, China
| | - Yongtie Guo
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Clinic Laboratory, Tianjin, China
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8
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Identification of Urinary Biomarkers for Exercise-Induced Immunosuppression by iTRAQ Proteomics. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3030793. [PMID: 32047808 PMCID: PMC7003279 DOI: 10.1155/2020/3030793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/20/2019] [Accepted: 12/30/2019] [Indexed: 12/16/2022]
Abstract
Purpose To identify noninvasive immune biomarkers of exercise-induced immunosuppression using the iTRAQ proteomics technique. Methods Fifteen healthy males were recruited and subjected to a four-week incremental treadmill running training program. After each week of training, WBC counts and CD4+ and CD8+ lymphocytes were measured to monitor the immune function status. iTRAQ proteomics technology was used to identify differential proteins and their characteristics in urine. Results Our data showed that the WBC counts, CD4+ lymphocytes, and CD4+/CD8+ ratio decreased by more than 10% after four weeks of training, suggesting exercise-induced immunosuppression. A total of 1854 proteins were identified in urine during the incremental running using the iTRAQ technology. Compared with the urine before training, there were 89, 52, 77, and 148 proteins significantly upregulated and 66, 27, 68, and 114 proteins significantly downregulated after each week, respectively. Among them, four upregulated proteins, SEMG-1, PIP, PDGFRL, and NDPK, increased their abundance with the increased exercise intensity. Bioinformatics analysis indicates that these proteins are involved in stress response and immune function. Conclusion Four weeks of incremental treadmill running induced immunosuppression in healthy males. By using iTRAQ proteomics, four proteins in the urine, SEMG-1, PIP, PDGFRL, and NDPK, were found to increase incrementally with the increased exercise intensity, which have the potential to be used as noninvasive immune biomarkers of exercise-induced immunosuppression.
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Covarrubias R, Ismahil MA, Rokosh G, Hamid T, Accornero F, Singh H, Gumina RJ, Prabhu SD, Bansal SS. Optimized protocols for isolation, fixation, and flow cytometric characterization of leukocytes in ischemic hearts. Am J Physiol Heart Circ Physiol 2019; 317:H658-H666. [PMID: 31373510 DOI: 10.1152/ajpheart.00137.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Immune activation post-myocardial infarction is an orchestrated sequence of cellular responses to effect tissue repair and healing. However, excessive and dysregulated inflammation can result in left ventricular remodeling and pathological alterations in the structural and mechanical attributes of the heart. Identification of key pathways and critical cellular mediators of inflammation is thus essential to design immunomodulatory therapies for myocardial infarction and ischemic heart failure. Despite this, the experimental approaches to isolate mononuclear cells from the heart are diverse, and detailed protocols to enable maximum yield of live cells in the shortest time possible are not readily available. Here, we describe optimized protocols for the isolation, fixation, and flow cytometric characterization of cardiac CD45+ leukocytes. These protocols circumvent time-consuming coronary perfusion and density-mediated cell-separation steps, resulting in high cellular yields from cardiac digests devoid of contaminating intravascular cells. Moreover, in contrast to methanol and acetone, we show that cell fixation using 1% paraformaldehyde is most optimal as it does not affect antibody binding or cellular morphology, thereby providing a considerable advantage to study activation/infiltration-associated changes in cellular granularity and size. These are highly versatile methods that can easily be streamlined for studies requiring simultaneous isolation of immune cells from different tissues or deployment in studies containing a large cohort of samples with time-sensitive constraints.NEW & NOTEWORTHY In this article, we describe optimized protocols for the isolation, fixation, and flow cytometric analysis of immune cells from the ischemic/nonischemic hearts. These protocols are optimized to process several samples/tissues, simultaneously enabling maximal yield of immune cells in the shortest time possible. We show that the low-speed centrifugation can be used as an effective alternative to lengthy coronary perfusion to remove intravascular cells, and sieving through 40-μm filter can replace density-mediated mononuclear cell separation which usually results in 50-70% cell loss in the sedimented pellets. We also show that cell fixation using 1% paraformaldehyde is better than the organic solvents such as methanol and acetone for flow cytometric analysis.
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Affiliation(s)
- Roman Covarrubias
- Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, Ohio.,The Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio.,Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Mohamed Ameen Ismahil
- Division of Cardiovascular Disease and Comprehensive Cardiovascular Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gregg Rokosh
- Division of Cardiovascular Disease and Comprehensive Cardiovascular Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Tariq Hamid
- Division of Cardiovascular Disease and Comprehensive Cardiovascular Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Federica Accornero
- Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, Ohio.,The Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Harpreet Singh
- Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, Ohio.,The Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Richard J Gumina
- Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, Ohio.,The Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio.,Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Sumanth D Prabhu
- Division of Cardiovascular Disease and Comprehensive Cardiovascular Center, University of Alabama at Birmingham, Birmingham, Alabama.,Medical Service, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
| | - Shyam S Bansal
- Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, Ohio.,The Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio.,Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
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10
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Acceptable “Real‐Life” Variability for Lymphocyte Counts by Flow Cytometry. CYTOMETRY PART B-CLINICAL CYTOMETRY 2018; 96:379-388. [DOI: 10.1002/cyto.b.21751] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/09/2018] [Accepted: 10/23/2018] [Indexed: 11/07/2022]
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11
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Abstract
HIV diagnostics have played a central role in the remarkable progress in identifying, staging, initiating, and monitoring infected individuals on life-saving antiretroviral therapy. They are also useful in surveillance and outbreak responses, allowing for assessment of disease burden and identification of vulnerable populations and transmission "hot spots," thus enabling planning, appropriate interventions, and allocation of appropriate funding. HIV diagnostics are critical in achieving epidemic control and require a hybrid of conventional laboratory-based diagnostic tests and new technologies, including point-of-care (POC) testing, to expand coverage, increase access, and positively impact patient management. In this review, we provide (i) a historical perspective on the evolution of HIV diagnostics (serologic and molecular) and their interplay with WHO normative guidelines, (ii) a description of the role of conventional and POC testing within the tiered laboratory diagnostic network, (iii) information on the evaluations and selection of appropriate diagnostics, (iv) a description of the quality management systems needed to ensure reliability of testing, and (v) strategies to increase access while reducing the time to return results to patients. Maintaining the central role of HIV diagnostics in programs requires periodic monitoring and optimization with quality assurance in order to inform adjustments or alignment to achieve epidemic control.
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12
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Gossez M, Malcus C, Demaret J, Frater J, Poitevin-Later F, Monneret G. Evaluation of a novel automated volumetric flow cytometer for absolute CD4+ T lymphocyte quantitation. CYTOMETRY PART B-CLINICAL CYTOMETRY 2016; 92:456-464. [PMID: 26804473 DOI: 10.1002/cyto.b.21360] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 12/12/2015] [Accepted: 01/20/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Bead-based single platform cytometry technology (SPT) is the gold standard when performing CD4 absolute counting. However, it presents drawbacks as precision depends on various critical steps (for example, pipetting methodology, overtime stability of beads, stability of fluidics, regular recalibration…) and thus requires skilled operators. The fully automated volumetric SPT AQUIOS CL (Beckman Coulter) has recently emerged as an alternative with no need of beads. It may help improving results standardisation and fulfilling requirements for certification (ISO 15189). In this study, we assessed SPT AQUIOS CL performances in accordance to requirements for ISO 15189 accreditation. METHODS We evaluated repeatability and reproducibility (precision), bias (trueness), uncertainty (total error), range limits (linearity, quantification, detection limits), and inter-reagent/inter-sample contaminations in enumerating CD4+ T-cells. Concomitantly, we compared AQUIOS CL CD4+ T-cell values with the results obtained with our routine bead-based SPT (that is, FC500 Beckman Coulter, bead-based SPT), on blood samples from 148 patients representative of clinical laboratory routine workload. RESULTS Every result (repeatability, reproducibility, trueness, total error) was below the acceptable thresholds proposed in international recommendations. Contamination results and range limits (linearity, quantification, and detection limits) were all found perfectly suitable to routine analysis. The comparison between AQUIOS CL and FC500 exhibited excellent correlation and agreement (Pearson R = 0.99, P < 0.001; Lin's concordance correlation coefficient: Lin ρc = 0.991, Cb = 0.999), and Bland-Altman analysis did not reveal any systematic error. CONCLUSIONS Our results demonstrate that, upon subsequent validation in more routine conditions, the AQUIOS CL could be a suitable tool for clinical flow cytometry laboratories facing accreditation process. © 2016 International Clinical Cytometry Society.
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Affiliation(s)
- Morgane Gossez
- Hospices Civils De Lyon, Hôpital Edouard Herriot, Laboratoire D'immunologie, Lyon, F-69003, France.,Université Claude Bernard Lyon 1, Lyon, F-69008, France
| | - Christophe Malcus
- Hospices Civils De Lyon, Hôpital Edouard Herriot, Laboratoire D'immunologie, Lyon, F-69003, France
| | - Julie Demaret
- Hospices Civils De Lyon, Hôpital Edouard Herriot, Laboratoire D'immunologie, Lyon, F-69003, France.,Université Claude Bernard Lyon 1, Lyon, F-69008, France
| | | | - Françoise Poitevin-Later
- Hospices Civils De Lyon, Hôpital Edouard Herriot, Laboratoire D'immunologie, Lyon, F-69003, France
| | - Guillaume Monneret
- Hospices Civils De Lyon, Hôpital Edouard Herriot, Laboratoire D'immunologie, Lyon, F-69003, France.,Université Claude Bernard Lyon 1, Lyon, F-69008, France
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13
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Peeling RW, Sollis KA, Glover S, Crowe SM, Landay AL, Cheng B, Barnett D, Denny TN, Spira TJ, Stevens WS, Crowley S, Essajee S, Vitoria M, Ford N. CD4 enumeration technologies: a systematic review of test performance for determining eligibility for antiretroviral therapy. PLoS One 2015; 10:e0115019. [PMID: 25790185 PMCID: PMC4366094 DOI: 10.1371/journal.pone.0115019] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 11/17/2014] [Indexed: 12/04/2022] Open
Abstract
Background Measurement of CD4+ T-lymphocytes (CD4) is a crucial parameter in the management of HIV patients, particularly in determining eligibility to initiate antiretroviral treatment (ART). A number of technologies exist for CD4 enumeration, with considerable variation in cost, complexity, and operational requirements. We conducted a systematic review of the performance of technologies for CD4 enumeration. Methods and Findings Studies were identified by searching electronic databases MEDLINE and EMBASE using a pre-defined search strategy. Data on test accuracy and precision included bias and limits of agreement with a reference standard, and misclassification probabilities around CD4 thresholds of 200 and 350 cells/μl over a clinically relevant range. The secondary outcome measure was test imprecision, expressed as % coefficient of variation. Thirty-two studies evaluating 15 CD4 technologies were included, of which less than half presented data on bias and misclassification compared to the same reference technology. At CD4 counts <350 cells/μl, bias ranged from -35.2 to +13.1 cells/μl while at counts >350 cells/μl, bias ranged from -70.7 to +47 cells/μl, compared to the BD FACSCount as a reference technology. Misclassification around the threshold of 350 cells/μl ranged from 1-29% for upward classification, resulting in under-treatment, and 7-68% for downward classification resulting in overtreatment. Less than half of these studies reported within laboratory precision or reproducibility of the CD4 values obtained. Conclusions A wide range of bias and percent misclassification around treatment thresholds were reported on the CD4 enumeration technologies included in this review, with few studies reporting assay precision. The lack of standardised methodology on test evaluation, including the use of different reference standards, is a barrier to assessing relative assay performance and could hinder the introduction of new point-of-care assays in countries where they are most needed.
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Affiliation(s)
- Rosanna W. Peeling
- London School of Hygiene and Tropical Medicine, London, WC1E 7HT, England
- * E-mail:
| | - Kimberly A. Sollis
- London School of Hygiene and Tropical Medicine, London, WC1E 7HT, England
| | - Sarah Glover
- London School of Hygiene and Tropical Medicine, London, WC1E 7HT, England
| | - Suzanne M. Crowe
- Centre for Biomedical Research, Burnet Institute, Melbourne, 3004, Victoria, Australia
| | - Alan L. Landay
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL, 60612, United States of America
| | - Ben Cheng
- Pangaea Global AIDS Foundation, Oakland, CA, 94607, United States of America
| | - David Barnett
- UK NEQAS for Leucocyte Immunophenotyping, Sheffield, S10 2QD, England
| | - Thomas N. Denny
- Duke Human Vaccine Institute and Center for HIV/AIDS, Immunology and Virology Quality Assessment Center, Durham, NC, 27710, United States of America
| | - Thomas J. Spira
- Division of AIDS, STD, &TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30333, United States of America
| | | | - Siobhan Crowley
- Director Health Programs, ELMA Philanthropies, New York, NY, United States of America
| | - Shaffiq Essajee
- Clinton Health Access Initiative, Boston, MA, 02127, United States of America
| | | | - Nathan Ford
- World Health Organization, Geneva, Switzerland
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14
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Kagan JM, Sanchez AM, Landay A, Denny TN. A Brief Chronicle of CD4 as a Biomarker for HIV/AIDS: A Tribute to the Memory of John L. Fahey. FORUM ON IMMUNOPATHOLOGICAL DISEASES AND THERAPEUTICS 2015; 6:55-64. [PMID: 27182452 PMCID: PMC4864990 DOI: 10.1615/forumimmundisther.2016014169] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Foundational cellular immunology research of the 1960s and 1970s, together with the advent of monoclonal antibodies and flow cytometry, provided the knowledge base and the technological capability that enabled the elucidation of the role of CD4 T cells in HIV infection. Research identifying the sources and magnitude of variation in CD4 measurements, standardized reagents and protocols, and the development of clinical flow cytometers all contributed to the feasibility of widespread CD4 testing. Cohort studies and clinical trials provided the context for establishing the utility of CD4 for prognosis in HIV-infected persons, initial assessment of in vivo antiretroviral drug activity, and as a surrogate marker for clinical outcome in antiretroviral therapeutic trials. Even with sensitive HIV viral load measurement, CD4 cell counting is still utilized in determining antiretroviral therapy eligibility and time to initiate therapy. New point of care technologies are helping both to lower the cost of CD4 testing and enable its use in HIV test and treat programs around the world.
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Affiliation(s)
- Jonathan M. Kagan
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, United States Department of Health and Human Services, Rockville, MD
| | - Ana M. Sanchez
- Duke Human Vaccine Institute and Center for HIV/AIDS, Duke University, Durham, NC
| | | | - Thomas N. Denny
- Duke Human Vaccine Institute and Center for HIV/AIDS, Duke University, Durham, NC
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15
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Changes of peripheral blood lymphocyte subtypes in patients with end stage cancer administered localized radiotherapy and bojungikki-tang. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:207613. [PMID: 24696700 PMCID: PMC3950642 DOI: 10.1155/2014/207613] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 01/06/2014] [Accepted: 01/11/2014] [Indexed: 11/17/2022]
Abstract
Localized radiotherapy (RT) can cause immune dysfunction. Bojungikki-tang is known to restore immune function. We investigated the absolute counts and percentages of peripheral blood (PB) lymphocyte subtypes in end stage cancer patients before and after RT and after oral administration of Bojungikki-tang water extract (BJITE) and to evaluate the changes mediated by RT and BJITE. Absolute counts and percentages of lymphocyte and lymphocyte subsets were determined in whole blood using the TetraONE System (Beckman Coulter, USA). Flow cytometry results were compared before and after RT and after administration of BJITE. Absolute numbers of CD3+, CD4+, and CD8+ T cells and CD19+ B cells decreased significantly after RT (P < 0.05). Absolute numbers of CD3-CD56+ cells did not change in both groups. No significant differences were observed in the absolute counts of lymphocyte subtypes before and after administration of BJITE or vitamin group. When BJITE group was compared with vitamin group, absolute numbers of CD19+ B cells increased. RT-induced decrease in T cells and B cells in PB suggests that immune deterioration occurs after RT. Administration of BJITE might be effective in the restoration of number of B cells.
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16
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Whitby L, Whitby A, Fletcher M, Helbert M, Reilly JT, Barnett D. Comparison of methodological data measurement limits in CD4+T lymphocyte flow cytometric enumeration and their clinical impact on HIV management. CYTOMETRY PART B-CLINICAL CYTOMETRY 2013; 84:248-54. [DOI: 10.1002/cyto.b.21094] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 03/11/2013] [Accepted: 03/26/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Liam Whitby
- UK NEQAS for Leucocyte Immunophenotyping; 4th Floor, Pegasus House, 463a Glossop Road; Sheffield S10 2QD; United Kingdom
| | - Alison Whitby
- UK NEQAS for Leucocyte Immunophenotyping; 4th Floor, Pegasus House, 463a Glossop Road; Sheffield S10 2QD; United Kingdom
| | - Matthew Fletcher
- UK NEQAS for Leucocyte Immunophenotyping; 4th Floor, Pegasus House, 463a Glossop Road; Sheffield S10 2QD; United Kingdom
| | - Matthew Helbert
- Department of Immunology; Manchester Royal Infirmary; Manchester M13 9WL; United Kingdom
| | - John T. Reilly
- UK NEQAS for Leucocyte Immunophenotyping; 4th Floor, Pegasus House, 463a Glossop Road; Sheffield S10 2QD; United Kingdom
| | - David Barnett
- UK NEQAS for Leucocyte Immunophenotyping; 4th Floor, Pegasus House, 463a Glossop Road; Sheffield S10 2QD; United Kingdom
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17
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Koyalta D, Jenabian MA, Nadjiouroum N, Djouater B, Djemadji-Oudjeil N, Ndjoyi-Mbiguino A, Bélec L. Single-platform, volumetric, CD45-assisted pan-leucogating flow cytometry for CD4 T lymphocytes monitoring of HIV infection according to the WHO recommendations for resource-constrained settings. BMC Res Notes 2013; 6:169. [PMID: 23631664 PMCID: PMC3653683 DOI: 10.1186/1756-0500-6-169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 04/25/2013] [Indexed: 11/25/2022] Open
Abstract
Background Validation of new affordable CD4 T cell measurement technologies is crucial specifically in resource-poor countries for antiretroviral treatment eligibility and immunologic CD4 monitoring of HIV-infected patients. Methods The absolute and percentage CD4 T cell counts of 258 HIV-1-infected blood samples (182 adults and 76 children), living in N’Djamena, Chad, were performed by single-platform, volumetric, CD45-assisted pan-leucogating Auto40 flow cytometer (Apogee Flow Systems Ltd, Hemel Hempstead, UK) comparing to the FACSCalibur flow cytometer as a reference method. Results Absolute and percentage CD4 T cell counts obtained by Auto40 and FACSCalibur of 258 HIV-1-infected blood samples were highly correlated (r = 0.99 and r = 0.96, respectively). The mean absolute bias and percent bias between Apogee Auto40 and FACSCalibur absolute CD4 T cell counts, were −9.4 cells/μl with limits of agreement from −15 to 93 cells/μl, and +2.0% with limits of agreement from −0.9 to 4.9%, respectively. The mean of absolute bias and percent bias between Apogee Auto40 and FACSCalibur of CD4 percentage results were +0.4% (95% CI: -0.02 – 0.86) with limits of agreement from −2.4 to 0.3%, and +3.0% with limits of agreement from −6.6 to 0.6%, respectively. The Auto40 counting allowed to identify the majority of adults with CD4 T cells below 200 cells/μl (sensitivity: 89%; specificity: 99%) or below 350 cells/μl (sensitivity: 94%; specificity:98%); and of children below 750 cells/μl (sensitivity: 99%; specificity: 96%) or below 25% CD4+ (sensitivity: 94%; specificity: 98%). Conclusion The Auto40 analyzer is an alternative flow cytometer for CD4 T lymphocyte enumeration to be used in routine for immunological monitoring according to the current WHO recommendations in HIV-infected adults as well as children living in resource-constrained settings like Chad.
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18
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Olteanu H, Schur BC, Harrington AM, Kroft SH. Time and temperature stability of T-cell subsets evaluated by a dual-platform method. AMERICAN JOURNAL OF BLOOD RESEARCH 2012; 2:128-135. [PMID: 22762032 PMCID: PMC3384401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 05/17/2012] [Indexed: 06/01/2023]
Abstract
INTRODUCTION T-cell subset enumeration in HIV patients is routinely performed for monitoring infection stage and response to antiretroviral therapy. Studies have examined the effect of specimen refrigeration and age for single-platform (SP) methods, but there is limited data for time and temperature requirements of dual-platform (DP) methods. METHODS Using a DP method, we analyzed peripheral blood (PB) from 52 HIV patients at room temperature (RT) at 24, 72, and 96 hours. PBs from 34 HIV patients had baseline RT analysis within 24 hours, and then were refrigerated and analyzed at 24, 48, and 72 hours. The coefficient of variation (CV) and residuals (changes in lymphocyte subsets) were recorded at each time point and compared to assess the precision and bias under the various conditions. Testing performance under different conditions was compared by linear regression. RESULTS Mean CV was ≤7.3% and median residuals were <30/μl for absolute CD4 and CD8 determinations. There was good correlation between baseline analysis data at RT and at various time points, both at RT and 4°C. CONCLUSIONS Our results are similar to those published for SP methods for aging or refrigerated specimens. The high level of agreement between measurements supports the robustness of this DP methodology.
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Affiliation(s)
- Horatiu Olteanu
- Department of Pathology, Medical College of WisconsinMilwaukee, WI, USA
| | | | | | - Steven H Kroft
- Department of Pathology, Medical College of WisconsinMilwaukee, WI, USA
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19
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Validation of a single-platform, volumetric, CD45-assisted PanLeucogating Auto40 flow cytometer to determine the absolute number and percentages of CD4 T cells in resource-constrained settings using Cameroonian patients' samples. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:609-15. [PMID: 22336291 DOI: 10.1128/cvi.00023-12] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The study evaluated the single-platform, volumetric, CD45-assisted PanLeucogating Auto40 flow cytometer (Apogee Flow Systems Ltd., Hemel Hempstead, United Kingdom) for CD4 T cell numeration, compared to the reference FACSCalibur flow cytometer. Results of absolute counts and percentages of CD4 T cells by Auto40 and FACSCalibur of 234 tripotassium EDTA (K3-EDTA)-blood samples from 146 adults and 88 children (aged from 18 months to 5 years), living in Yaoundé, Cameroon, were highly correlated (r(2) = 0.97 and r(2) = 0.98, respectively). The mean absolute bias and relative bias between Apogee Auto40 and FACSCalibur absolute CD4 T cell counts were +9.6 cells/μl, with limits of agreement from -251 to 270 cells/μl, and +4.1%, with limits of agreement from -16.1 to 24.4%, respectively. The mean absolute bias and relative bias between Apogee Auto40 and FACSCalibur CD4 T cell results expressed as percentages were +0.05% CD4 (95% confidence interval [CI], -0.03 to 0.41), with limits of agreement from -6.0 to 5.9% CD4, and +1.0%, with limits of agreement from -32.3 to 34.4%, respectively. The Auto40 counting allowed identification of the majority of adults with CD4 T cell counts below 200 cells/μl (sensitivity, 87%; specificity, 98%) or below 350 cells/μl (sensitivity, 92%; specificity, 98%) and of children with CD4 T cell counts below 750 cells/μl (sensitivity, 82%; specificity, 98%) or below 25% CD4(+) (sensitivity, 96%; specificity, 99%). The Auto40 analyzer is a reliable alternative flow cytometer for CD4 T lymphocyte enumeration to be used in routine immunological monitoring according to the WHO recommendations for HIV-infected adults as well as children living in resource-constrained settings.
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20
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Courivaud C, Bamoulid J, Ferrand C, Tiberghien P, Chalopin JM, Saas P, Ducloux D. The COX-2 gene promoter polymorphism -765 delays CD4 T-cell reconstitution after lymphocyte depletion with antithymocyte globulins. Hum Immunol 2011; 72:1060-3. [PMID: 21782872 DOI: 10.1016/j.humimm.2011.05.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 05/10/2011] [Accepted: 05/20/2011] [Indexed: 11/19/2022]
Abstract
Polyclonal antithymocyte globulins (ATG) induce persistent changes in T-lymphocyte subsets characterized by low CD4 T. The mechanisms remain partly unknown. Prostaglandin E(2) (PGE(2)) is involved in lymphocyte homeostasis. Whether PGE(2) may be involved in persistent CD4 T-cell lymphopenia after ATG is unknown. We examined the association between this polymorphism and CD4 T-cell count in 159 renal transplant recipients (RTR) who received ATG. Analysis of these patients identified 6 CC (3.8%), 32 GC (22.6%), and 117 GG (73.6%) genotypes. Patients with the GG genotype had significantly higher serum PGE(2) concentrations, leading us to compare C carriers with GG patients. Carriers of the C allele had lower CD4 T cell count 1 year (235 ± 96 vs 323 ± 227/mm(3); p = 0.022) and 2 years posttransplant (325 ± 79 vs 422 ± 231/mm(3); p = 0.024). In multivariate analysis, the C allele (p = 0.029) conferred an increased risk of posttransplant CD4 T-cell lymphocytopenia. Pretransplant T-cell receptor excision circle levels were lower in C carriers. COX-2 gene promoter polymorphism at position -765 (G → C) is associated with persistent CD4 T-cell lymphopenia after ATG in RTR. This effect is likely to be mediated by the actions of PGE(2) on thymus function and viability.
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Chan C, Lin L, Frelinger J, Hérbert V, Gagnon D, Landry C, Sékaly RP, Enzor J, Staats J, Weinhold KJ, Jaimes M, West M. Optimization of a highly standardized carboxyfluorescein succinimidyl ester flow cytometry panel and gating strategy design using discriminative information measure evaluation. Cytometry A 2011; 77:1126-36. [PMID: 21053294 DOI: 10.1002/cyto.a.20987] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The design of a panel to identify target cell subsets in flow cytometry can be difficult when specific markers unique to each cell subset do not exist, and a combination of parameters must be used to identify target cells of interest and exclude irrelevant events. Thus, the ability to objectively measure the contribution of a parameter or group of parameters toward target cell identification independent of any gating strategy could be very helpful for both panel design and gating strategy design. In this article, we propose a discriminative information measure evaluation (DIME) based on statistical mixture modeling; DIME is a numerical measure of the contribution of different parameters towards discriminating a target cell subset from all the others derived from the fitted posterior distribution of a Gaussian mixture model. Informally, DIME measures the "usefulness" of each parameter for identifying a target cell subset. We show how DIME provides an objective basis for inclusion or exclusion of specific parameters in a panel, and how ranked sets of such parameters can be used to optimize gating strategies. An illustrative example of the application of DIME to streamline the gating strategy for a highly standardized carboxyfluorescein succinimidyl ester (CFSE) assay is described.
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Affiliation(s)
- Cliburn Chan
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, USA.
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Hultin LE, Chow M, Jamieson BD, O'Gorman MRG, Menendez FA, Borowski L, Denny TN, Margolick JB. Comparison of interlaboratory variation in absolute T-cell counts by single-platform and optimized dual-platform methods. CYTOMETRY PART B-CLINICAL CYTOMETRY 2010; 78:194-200. [PMID: 19813263 DOI: 10.1002/cyto.b.20500] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Previous studies have reported that the adoption of a single-platform flow cytometry cell counting method resulted in lower interlaboratory variation in absolute T cell counts as compared to predicate dual-platform flow cytometry methods which incorporate independent automated lymphocyte counts (Schnizlein-Bick et al., Clin Diagn Lab Immunol 2000;7:336-343; Reimann et al., Clin Diagn Lab Immunol 2000;7:344-351). In the present study, we asked whether use of a single-platform method could reduce variation in absolute cell counts across the laboratories in the Multicenter AIDS Cohort Study (MACS) (n = 4), as suggested by the studies cited. METHODS Identical study samples were shipped overnight to the MACS laboratories either by the National Institute of Allergy and Infectious Diseases, Division of AIDS Immunology Quality Assessment (NIAID- IQA) proficiency-testing program (n = 14), or by the Los Angeles site of the MACS (n = 10). For each sample, two tubes of blood were received; one was used for an automated complete blood count and differential, and the other for flow cytometry. The latter was performed using both our current dual-platform method (three-color CD45 gating and automated hematology) and the single-platform method (with TruCOUNT beads to generate the absolute counts). RESULTS The median percent coefficients of variation (%CVs) for the dual-platform and single-platform methods were 6.6 and 9.9, respectively, for CD4 T cell counts, and 5.9 and 8.5, respectively, for CD8 T cell counts (n = 24). These differences were not statistically significant. The differences in absolute T-cell counts between the MACS sites and the median of all laboratories participating in the NIAID-IQA were smaller for the dual-platform than for single-platform absolute count method. CONCLUSION In contrast to previous reports, we did not observe lower interlaboratory variation across the MACS sites for single-platform absolute lymphocyte subset counting relative to dual-platform methods. This result may be at least partly explained by the lower interlaboratory variation with the optimized dual-platform method in this study relative to the previous reports.
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Affiliation(s)
- Lance E Hultin
- Department of Medicine, Cellular Immunology and Cytometry, University of California, Los Angeles, CA, USA
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Bergeron M, Ding T, Elharti E, Oumzil H, Soucy N, Harmouche H, Chaouch S, Aouad RE, Chabot C, Mandy F. Evaluation of a dry format reagent alternative for CD4 T-cell enumeration for the FACSCount system: a report on a Moroccan-Canadian study. CYTOMETRY PART B-CLINICAL CYTOMETRY 2010; 78:188-93. [PMID: 19847883 DOI: 10.1002/cyto.b.20501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Efforts to improve alternative CD4 T-cell counting methods are critical to accelerate the implementation of HIV antiretroviral therapy in resources limited regions. Substituting liquid format reagents to eliminate cold-chain transportation and refrigerated storage with dry format reagents contributes to higher efficiency supply management solution especially for laboratories at remote locations. ReaMetrix has developed dry format reagent kits compatible with the FACSCount system, a dedicated flow cytometer for T-cell subset enumeration widely used in resource limited settings. A dual site collaborative study was designed to compare T-cell subsets using both the new dry format ReaMetrix reagent and the original BD Biosciences liquid reagents. METHOD A total of 167 HIV positive samples prepared with Rea T Count (ReaMetrix) and FACSCount (BD Biosciences) reagents were analyzed using FACSCount Systems. To compare both methods, Bland-Altman, Pollock, Scott % similarity and correlation coefficient statistical analysis was applied. Immuno-Trol served as an assay processing control and quality indicator of interlaboratory and intralaboratory variation. RESULTS The mean bias and limits of agreement for CD4 T-cell measurements between Rea T Count and FACSCount reagents were -16 cells/microl (-4.6%) and -74 to +43, respectively. The correlation obtained was 0.988 with a similarity of 97.9%. Between laboratory variation data was very good with %CV below 10%. CONCLUSION The introduction of dry reagents permits the elimination of cold-chain transportation and the on-site refrigerated storage without compromise to assay quality. The substitution of dry reagents facilitates easier supply management practice that will assure wider access to quality HIV treatment.
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Affiliation(s)
- Michèle Bergeron
- National HIV Immunology Laboratory, Public Health Agency of Canada, Ottawa, Ontario, Canada K1A 0K9.
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Frelinger J, Ottinger J, Gouttefangeas C, Chan C. Modeling flow cytometry data for cancer vaccine immune monitoring. Cancer Immunol Immunother 2010; 59:1435-41. [PMID: 20563720 PMCID: PMC2892609 DOI: 10.1007/s00262-010-0883-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Accepted: 06/09/2010] [Indexed: 11/30/2022]
Abstract
Flow cytometry (FCM) is widely used in cancer research for diagnosis, detection of minimal residual disease, as well as immune monitoring and profiling following immunotherapy. In all these applications, the challenge is to detect extremely rare cell subsets while avoiding spurious positive events. To achieve this objective, it helps to be able to analyze FCM data using multiple markers simultaneously, since the additional information provided often helps to minimize the number of false positive and false negative events, hence increasing both sensitivity and specificity. However, with manual gating, at most two markers can be examined in a single dot plot, and a sequential strategy is often used. As the sequential strategy discards events that fall outside preceding gates at each stage, the effectiveness of the strategy is difficult to evaluate without laborious and painstaking back-gating. Model-based analysis is a promising computational technique that works using information from all marker dimensions simultaneously, and offers an alternative approach to flow analysis that can usefully complement manual gating in the design of optimal gating strategies. Results from model-based analysis will be illustrated with examples from FCM assays commonly used in cancer immunotherapy laboratories.
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Affiliation(s)
- Jacob Frelinger
- Institute for Genome Sciences and Policy, Duke University, Durham, NC 27708, USA
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The Use of Glutaraldehyde-Fixed Chicken Red Blood Cells as Counting Beads for Performing Affordable Single-Platform CD4+ T-Lymphocyte Count in HIV-1-Infected Patients. J Acquir Immune Defic Syndr 2010; 53:47-54. [DOI: 10.1097/qai.0b013e3181c4b8ae] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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From research tool to routine test: CD38 monitoring in HIV patients. CYTOMETRY PART B-CLINICAL CYTOMETRY 2009; 76:375-84. [DOI: 10.1002/cyto.b.20478] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Sugita K, Kabashima K, Yoshiki R, Ikenouchi-Sugita A, Tsutsui M, Nakamura J, Yanagihara N, Tokura Y. Inducible nitric oxide synthase downmodulates contact hypersensitivity by suppressing dendritic cell migration and survival. J Invest Dermatol 2009; 130:464-71. [PMID: 19727121 DOI: 10.1038/jid.2009.288] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Nitric oxide (NO) has several important roles in various physiological settings; one of the NO synthases, inducible NO synthase (iNOS), is induced by external stimulation of the skin. A prototypic example of external stimulation is hapten exposure, which induces the T-cell-mediated immune response known as contact hypersensitivity (CHS). We herein report on cutaneous dendritic cell (DC) function in the presence of an iNOS-specific inhibitor during the sensitization phase of CHS. First, we examined epidermal cell (EC) suspensions using flow cytometry with an iNOS antibody and confirmed that iNOS was expressed in the cytoplasm of Langerhans cells (LCs). We then studied the role of iNOS in CHS, and found that responses to DNFB were enhanced by the addition of an iNOS inhibitor during sensitization. Similarly, the iNOS inhibitor augmented FITC-induced migration of cutaneous DCs, including Langerin(+) LCs and Langerin(-) dermal DCs, to draining lymph nodes. Finally, we showed that iNOS inhibitor enhanced LC survival in vitro. We concluded that NO suppresses migration and survival of cutaneous DCs, resulting in a downmodulation of CHS.
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Affiliation(s)
- Kazunari Sugita
- Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan.
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Satué K, Hernández A, Lorente C, O'Connor JE. Immunophenotypical characterization in Andalusian horse: variations with age and gender. Vet Immunol Immunopathol 2009; 133:219-27. [PMID: 19735948 DOI: 10.1016/j.vetimm.2009.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Revised: 08/10/2009] [Accepted: 08/14/2009] [Indexed: 10/20/2022]
Abstract
Assessment of lymphocyte subsets is an effective method for characterizing disorders such as leukemia, lymphomas, autoimmune and infectious diseases. In order to clinically interpret these parameters, normal reference values should be set, estimating age- and gender-related variations. This research aimed to: (1) characterize lymphocyte subpopulations in Andalusian horse, and (2) evaluate age and gender-related variations of lymphocyte subsets. Jugular blood samples were obtained from 159 animals, 77 males and 82 females, belonging to four age groups-1: 1-2 years (N=39; 21 males and 18 females), 2: 2-3 years (N=38; 16 males and 22 females), 3: 3-4 years (N=41; 19 males and 22 females) and 4: 4-7 years (N=41; 21 males and 20 females). T lymphocytes subsets were quantified by flow cytometry with monoclonal antibodies specific for CD2, CD4 and CD8 cell markers. B and NK cell counts were estimated by using a mathematical formula. No variations were found in T, B lymphocytes and NK cells between males and females. Animals of group 1 and 2 had a higher number of CD2, T, CD4+, CD8+, B lymphocytes and NK cells than animals of groups 3 and 4. The percentage of CD2 in group 1 was significantly lower than in group 4. The percentage of T and CD4+ lymphocytes in the group 1 were significantly higher than groups 2 and 3, respectively. Whereas the percentage of B cells calculated by flow cytometry was significantly lower in group 2 compared to group 4, the percentage of B cells calculated by a mathematical formula was higher in group 1. NK cells percentage was significantly lower in group 3 and 4 than in younger animals. In conclusion, in Andalusian horse, gender does not influence absolute numbers and percentages of T, B and NK. There is an age-related decline in absolute number of CD2, T, CD4+ and CD8+ lymphocytes, B lymphocytes and NK cells, with increasing percentage of CD2, T, CD4+ and B lymphocytes, and a decrease in NK with no differences in CD4/CD8 ratio. The decline of lymphocyte population numbers with age is a natural process in many animal species, and could be the origin for immune dysfunction observed in geriatric individuals.
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Affiliation(s)
- K Satué
- Department of Medicine and Surgery, Faculty of Veterinary Medicine, Cardenal Herrera-CEU University, Valencia, Spain.
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Toussirot E, Saas P, Deschamps M, Pouthier F, Perrot L, Perruche S, Chabod J, Tiberghien P, Wendling D. Increased production of soluble CTLA-4 in patients with spondylarthropathies correlates with disease activity. Arthritis Res Ther 2009; 11:R101. [PMID: 19570209 PMCID: PMC2745776 DOI: 10.1186/ar2747] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 06/06/2009] [Accepted: 07/01/2009] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Spondylarthropathies (SpA) are characterized by abnormal immune responses including T cell activation. Cytotoxic T lymphocyte associated molecule-4 (CTLA-4) is involved in down-regulating immune responses. A soluble form of CTLA-4 (sCTLA-4), resulting from an alternative splicing, has been identified and was found increased in several autoimmune diseases. Here, we evaluated circulating levels of sCTLA-4 as a marker of immune dysregulation in SpA. Intracellular CTLA-4 and levels of CTLA-4 transcript expression in peripheral blood lymphocytes (PBL) were also studied. METHODS Sera from 165 patients with SpA were evaluated for sCTLA-4 measurements. Results were compared with those from 71 patients with rheumatoid arthritis (RA) and 88 healthy subjects. In 32 patients with SpA, 22 patients with RA and 15 healthy controls, we analyzed the intracellular CTLA-4 expression in CD4+ T cells, CD8+ T cells, activated (HLA-DR+Foxp3-) CD4+ T cells, CD4+ regulatory (CD25+Foxp3+) T cells and in CD3 negative cells by flow cytometry. Expression of the full length (coding for membrane CTLA-4) and spliced form (coding for sCTLA-4) of CTLA-4 transcripts in PBL were analyzed by quantitative real-time polymerase chain reaction (QRT-PCR). RESULTS High levels of sCTLA-4 were found in the SpA group compared to the RA group and healthy controls (P < 0.0001). Soluble CTLA-4 serum levels strongly correlated with clinical index of disease activity BASDAI (r = 0.42, P < 0.0001) and C-reactive protein (CRP) levels (r = 0.17, P = 0.037). In contrast to RA patients, SpA patients did not exhibit changes in intracellular CTLA-4 expression in the different PBL subsets tested. Finally, the SpA group showed a preferential expression of the spliced CTLA-4 mRNA (P = 0.0014) in PBL. CONCLUSIONS SpA patients exhibit high levels of circulating sCTLA-4 that may result from an alternative splicing of CTLA-4 transcripts. This may influence immune activation and regulation in SpA.
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Affiliation(s)
- Eric Toussirot
- Department of Rheumatology, University Hospital Jean Minjoz, Boulevard Fleming, Besançon cedex, France.
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Li X, Breukers C, Ymeti A, Lunter B, Terstappen LWMM, Greve J. CD4 and CD8 enumeration for HIV monitoring in resource-constrained settings. CYTOMETRY PART B-CLINICAL CYTOMETRY 2009; 76:118-26. [DOI: 10.1002/cyto.b.20445] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Stevens W, Gelman R, Glencross DK, Scott LE, Crowe SM, Spira T. Evaluating new CD4 enumeration technologies for resource-constrained countries. Nat Rev Microbiol 2008; 6:S29-38. [PMID: 22745957 DOI: 10.1038/nrmicro2000] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Mandy F, Brando B. Enumeration of absolute cell counts using immunophenotypic techniques. ACTA ACUST UNITED AC 2008; Chapter 6:Unit 6.8. [PMID: 18770719 DOI: 10.1002/0471142956.cy0608s13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Absolute counting of cells or cell subsets has a number of significant clinical applications: monitoring the disease status of HIV-infected patients, enumerating residual white blood cells in leukoreduced blood products, and assessing immunodeficiency in a variety of situations. The single-platform method (flow cytometry alone) has emerged as the method of choice for absolute cell enumeration. This technology counts only the cells of interest in a precisely determined blood volume. Exact cell identification is accomplished by a logical electronic gating algorithm capable of identifying lineage-specific immunofluorescent markers. Exclusion of unwanted cells is automatic. This extensive and detailed unit presents protocols for both volumetric and flow-rate determination of residual white blood cells and of leukocyte subsets.
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Affiliation(s)
- F Mandy
- Health Canada, Ottawa, Canada
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Pattanapanyasat K, Chimma P, Sratongno P, Lerdwana S. CD4+T-lymphocyte enumeration with a flow-rate based method in three flow cytometers with different years in service. CYTOMETRY PART B-CLINICAL CYTOMETRY 2008; 74:310-8. [DOI: 10.1002/cyto.b.20425] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Chattopadhyay PK, Roederer M. Immunophenotyping of T cell subpopulations in HIV disease. ACTA ACUST UNITED AC 2008; Chapter 12:Unit 12.12. [PMID: 18432939 DOI: 10.1002/0471142735.im1212s65] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This unit illustrates the challenges associated with measurements of T cell subpopulations, and describes how those challenges can be overcome by using polychromatic (5+ color) approaches to flow cytometry. Such approaches are immensely powerful and directly applicable to studies of T cell biology in HIV disease; however, their development requires careful consideration of the antibodies and fluorochromes employed, as discussed here. Furthermore, factors generally known to influence T cell counts can also govern the success or failure of polychromatic experiments; therefore, these factors are reviewed and provide recommendations for minimizing their influence on polychromatic measurements of T cell subsets.
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Glencross DK, Aggett HM, Stevens WS, Mandy F. African regional external quality assessment for CD4 T-cell enumeration: development, outcomes, and performance of laboratories. CYTOMETRY PART B-CLINICAL CYTOMETRY 2008; 74 Suppl 1:S69-79. [PMID: 18228560 DOI: 10.1002/cyto.b.20397] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND An independent African Regional External Quality Assessment Scheme (AFREQAS) was implemented from Johannesburg. The aim was to establish a network of CD4 laboratories supporting HIV/AIDS anti-retroviral therapy programs and improve the quality of regional CD4 testing with EQA assessment, feedback, remedial action, and technical training. The overall performance from 2002 to 2006 (Trials 1-20) is reported, together with cumulative longitudinal performance of the different CD4 methods used. METHODS Stabilized blood samples with "normal" and/or "low" CD4 values were shipped over 20 Trials. Data was analyzed for each trial including trimmed mean, standard deviation, and percentage coefficient of variation (%CV); "Residual" and SDI values were also calculated for each participating laboratory for both absolute CD4 counts (CD4abs) and CD4 percentage of lymphocytes values (CD4%/Ly). Standardized individual laboratory SDI values across 20 trials were analyzed according to CD4 method. RESULTS Average participation was 91.5%. Overall AFREQAS between-laboratory reproducibility (trimmed %CV) was 10.5% and 9.1% for absolute CD4 and CD4%/Ly, respectively. For the respective CD4abs and CD4%/Ly values in the trials where "normal" material was shipped trimmed %CV of 10.9 and 7.3% were noted, and in "low" value shipments %CV of 13.8% and 12.4% were noted. Cumulative absolute CD4 SDI analysis revealed the best between-laboratory precision amongst FACSCount and PanLeucogating (PLG-CD4) users (both SD of SDI = <1.2 and %CV of <<8%). Dual Platform or Single Platform algorithm-based systems and certain volumetric methods (laboratories who used Partec CyFlow instruments) had higher numbers of outlying laboratories (>12-25%CV and SD(SDI) > 2.2 noted), indicating that additional technical training and/or manufacturer support was required. CONCLUSIONS Participation in an AFREQAS with feedback and remedial action improves the quality of CD4 testing. African laboratory professionals can easily master CD4 counting technologies. However, the introduction of the simplest and most cost-effective methodologies is required to take ownership, and enable the delivery of quality CD4 counts in vast numbers necessary to support expansion of African ART programs.
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Affiliation(s)
- Deborah K Glencross
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Faculty of Health Sciences and the South African National Health Laboratory Service, Johannesburg, South Africa.
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Denny TN, Gelman R, Bergeron M, Landay A, Lam L, Louzao R, Mandy FF, Schmitz J, Spira T, Wilkening C, Glencross DK. A North American multilaboratory study of CD4 counts using flow cytometric panLeukogating (PLG): a NIAID-DAIDS Immunology Quality Assessment Program Study. CYTOMETRY PART B-CLINICAL CYTOMETRY 2008; 74 Suppl 1:S52-64. [PMID: 18351622 DOI: 10.1002/cyto.b.20417] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The global HIV/AIDS pandemic and guidelines for initiating anti-retroviral therapy (ART) and opportunistic infection prophylaxis demand affordable, reliable, and accurate CD4 testing. A simple innovative approach applicable to existing technology that has been successfully applied in resource-challenged settings, PanLeukogated CD4 (PLG), could offer solutions for cost saving and improved precision. METHODS Day-old whole blood from 99 HIV+ donors was simultaneously studied in five North-American laboratories to compare the performance of their predicate methods with the dual-platform PLG method. The predicate technology included varying 4-color CD45/CD3/CD4/CD8 protocols on different flow cytometers. Each laboratory also assayed eight replicate specimens of day-old blood from 10 to 14 local donors. Bias and precision of predicate and PLG methods was studied between- and within-participating laboratories. RESULTS Significantly (P < 0.0001) improved between-laboratory precision/coefficient of variation (CV%) was noted using the PLG method (overall median 9.3% vs. predicate median CV 13.1%). Within-laboratory precision was also significantly (P < 0.0001) better overall using PLG (median 4.6% vs. predicate median CV 6.2%) and in 3 of the 5 laboratories. PLG counts tended to be 11% smaller than predicate methods (P < 0.0001) for shipped (median of predicate-PLG = 31) and local specimens (median of predicate-PLG = 23), both overall and in 4 of 5 laboratories (median decreases of 4, 16, 20, and 21% in shipped specimens); the other laboratory had a median increase of 5%. CONCLUSION Laboratories using predicate CD4 methods similar to those in this study could improve their between-laboratory and their within-laboratory precision, and reduce costs, by switching to the PLG method after adequate training, if a change (usually, a decrease) in CD4 counts is acceptable to their health systems.
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Affiliation(s)
- Thomas N Denny
- Human Vaccine Institute, Duke University Medical Center, Durham, USA.
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Janossy G. The changing pattern of "smart" flow cytometry (S-FC) to assist the cost-effective diagnosis of HIV, tuberculosis, and leukemias in resource-restricted conditions. Biotechnol J 2008; 3:32-42. [PMID: 18064612 DOI: 10.1002/biot.200700200] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There is a need to introduce cytometry into areas of the globe that have remained virtually untouched by modern laboratory medicine. With the demand to carry out tests on 100,000 s of individuals requiring antiretroviral therapy (ART), flow cytometry must remain simple and cost-effective - while being sustainable and industry supported as well as proven by quality assessment (QA). This outlook is referred to as "smart flow cytometry" (S-FC). There are five main areas where the power of S-FC is demonstrated. These are: (i) the use of CD45 to assist precise cell counting in blood and tissue samples; (ii) the primary CD4 gating to count CD4+ T cells in patients waiting for ART, including the combination (i) and (ii) in the panleucogating (PLG) protocol; (iii) monitoring of human immunodeficiency virus (HIV+) patients during ART by the decreasing levels of lymphocyte activation in a CD8/CD38 test - leading to economies of viral-load assays; (iv) in tuberculosis and HIV-TB coinfections the use of TB-antigen-stimulated cytokine-synthetic CD4+ T cells to identify active disease; and (v) the utilization of "minimal residual disease (MRD)-Lite" technology in patients 19 days after the start of antileukemic therapy to detect MRD. These methods of S-FC have been successfully introduced in "resource-restricted" countries with international and local QA.
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Affiliation(s)
- George Janossy
- Royal Free and University College Medical School, University College London, London, UK.
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Glencross DK, Janossy G, Coetzee LM, Lawrie D, Scott LE, Sanne I, McIntyre JA, Stevens W. CD8/CD38 activation yields important clinical information of effective antiretroviral therapy: Findings from the first year of the CIPRA-SA cohort. CYTOMETRY PART B-CLINICAL CYTOMETRY 2008; 74 Suppl 1:S131-40. [DOI: 10.1002/cyto.b.20391] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Glencross DK, Janossy G, Coetzee LM, Lawrie D, Aggett HM, Scott LE, Sanne I, McIntyre JA, Stevens W. Large-scale affordable Panleucogated CD4+testing with proactive internal and external quality assessment: In support of the South African national comprehensive care, treatment and management programme for HIV and AIDS. CYTOMETRY PART B-CLINICAL CYTOMETRY 2008; 74 Suppl 1:S40-51. [DOI: 10.1002/cyto.b.20384] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Levering WHBM, van Wieringen WN, Kraan J, van Beers WAM, Sintnicolaas K, van Rhenen DJ, Gratama JW. Flow cytometric lymphocyte subset enumeration: 10 years of external quality assessment in the Benelux countries. CYTOMETRY PART B-CLINICAL CYTOMETRY 2008; 74:79-90. [PMID: 17849485 DOI: 10.1002/cyto.b.20370] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A biannual external quality assessment (EQA) scheme for flow cytometric lymphocyte immunophenotyping is operational in the Benelux countries since 1996. We studied the effects of the methods used on assay outcome, and whether or not this EQA exercise was effective in reducing between-laboratory variation. Eighty test samples were distributed in 20 biannual send-outs. Per send-out, 50-71 participants were requested to enumerate CD3+, CD4+, and CD8+ T cells, B cells, and NK cells, and to provide methodological details. Participants received written debriefings with personalized recommendations after each send-out. For this report, data were analyzed using robust multivariate regression. Five variables were associated with significant positive or negative bias of absolute lymphocyte subset counts: (i) platform methodology (i.e., single-platform assays yielded lower CD4+ and CD8+ T-cell counts than did dual-platform assays); (ii) sample preparation technique (i.e., assays based on mononuclear cells isolation yielded lower T-cell counts than those based on red cell lysis); (iii) gating strategies based on CD45 and sideward scatter gating of lymphocytes yielded higher CD4+ T-cell counts than those based on "backgating" of lymphocytes guided by CD45 and CD14); (iv) stabilized samples were generally associated with higher lymphocyte subset counts than nonstabilized samples; and (v) laboratory. Platform methodology, sample stabilization, and laboratory also affected assay variability. With time, assay variability tended to decline; this trend was significant for B-cell counts only. In addition, significant bias and variability of results, independent of the variables tested for in this analysis, were also associated with individual laboratories. In spite of our recommendations, participants tended to standardize their techniques mainly with respect to sample preparation and gating strategies, but less with absolute counting techniques. Failure to fully standardize protocols may have led to only modest reductions in variability of results between laboratories.
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Affiliation(s)
- Wilfried H B M Levering
- Laboratory for Histocompatibility and Immunogenetics, Sanquin Blood Bank South West Region, Rotterdam, The Netherlands.
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O'Gorman MR, Zijenah LS. CD4 T cell measurements in the management of antiretroviral therapy-A review with an emphasis on pediatric HIV-infected patients. CYTOMETRY PART B-CLINICAL CYTOMETRY 2008; 74 Suppl 1:S19-26. [DOI: 10.1002/cyto.b.20398] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Li X, Ymeti A, Lunter B, Breukers C, Tibbe AGJ, Terstappen LWMM, Greve J. CD4+ T lymphocytes enumeration by an easy-to-use single platform image cytometer for HIV monitoring in resource-constrained settings. CYTOMETRY PART B-CLINICAL CYTOMETRY 2007; 72:397-407. [PMID: 17311352 DOI: 10.1002/cyto.b.20165] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND HIV monitoring in resource-constrained settings demands affordable and reliable CD4(+) T lymphocytes enumeration methods. We developed a simple single platform image cytometer (SP ICM), which is a dedicated volumetric CD4(+) T lymphocytes enumeration system that uses immunomagnetic and immunofluorescent technologies. The instrument was designed to be a low-cost, yet reliable and robust one. In this article we test the instrument and the immunochemical procedures used on blood from HIV negative and HIV positive patients. METHODS After CD4 immunomagnetic labeling in whole blood, CD4(+) T lymphocytes, CD4(+dim) monocytes and some nonspecifically labeled cells are magnetically attracted to an analysis surface. Combining with CD3-Phycoerythrin (PE) labeling, only CD3(+)CD4(+) T lymphocytes are fluorescently labeled and visible in a fluorescent image of the analysis surface. The number of CD4(+) T lymphocytes is obtained by image analysis. Alternatively, CD3 immunomagnetic selection in combination with CD4 immunofluorescent labeling can also be applied for CD4(+) T lymphocytes enumeration. RESULTS The SP ICM system was compared with two single platform flow cytometer (SP FCM) methods: tetraCXP and TruCount methods. The SP ICM system has excellent precision, accuracy and linearity for CD4(+) T lymphocytes enumeration. Good correlations were obtained between the SP ICM and the SP FCM methods for blood specimens of 44 HIV(-) patients, and of 63 HIV(+) patients. Bland-Altman plots showed interchangeability between the SP ICM and the SP FCM methods. CONCLUSIONS The immunolabeling methods and the instrumentation are simple and easy-to-handle for less-trained operators. The SP ICM system is a good candidate for CD4(+) T lymphocytes enumeration in point-of-care settings of resource-constrained countries.
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Affiliation(s)
- Xiao Li
- University of Twente, Faculty of Science and Technology, Biophysical Engineering Group, Building Zuidhorst, Dienstweg 1, 7522 ND Enschede, The Netherlands.
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Hirasaka K, Kohno S, Goto J, Furochi H, Mawatari K, Harada N, Hosaka T, Nakaya Y, Ishidoh K, Obata T, Ebina Y, Gu H, Takeda S, Kishi K, Nikawa T. Deficiency of Cbl-b gene enhances infiltration and activation of macrophages in adipose tissue and causes peripheral insulin resistance in mice. Diabetes 2007; 56:2511-22. [PMID: 17601987 DOI: 10.2337/db06-1768] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE c-Cbl plays an important role in whole-body fuel homeostasis by regulating insulin action. In the present study, we examined the role of Cbl-b, another member of the Cbl family, in insulin action. RESEARCH DESIGN AND METHODS C57BL/6 (Cbl-b(+/+)) or Cbl-b-deficient (Cbl-b(-/-)) mice were subjected to insulin and glucose tolerance tests and a hyperinsulinemic-euglycemic clamp test. Infiltration of macrophages into white adipose tissue (WAT) was assessed by immunohistochemistry and flow cytometry. We examined macrophage activation using co-cultures of 3T3-L1 adipocytes and peritoneal macrophages. RESULTS Elderly Cbl-b(-/-) mice developed glucose intolerance and peripheral insulin resistance; serum insulin concentrations after a glucose challenge were always higher in elderly Cbl-b(-/-) mice than age-matched Cbl-b(+/+) mice. Deficiency of the Cbl-b gene significantly decreased the uptake of 2-deoxyglucose into WAT and glucose infusion rate, whereas fatty liver was apparent in elderly Cbl-b(-/-) mice. Cbl-b deficiency was associated with infiltration of macrophages into the WAT and expression of cytokines, such as tumor necrosis factor-alpha, interleukin-6, and monocyte chemoattractant protein (MCP)-1. Co-culture of Cbl-b(-/-) macrophages with 3T3-L1 adipocytes induced leptin expression and dephosphorylation of insulin receptor substrate 1, leading to impaired glucose uptake in adipocytes. Furthermore, Vav1, a key factor in macrophage activation, was highly phosphorylated in peritoneal Cbl-b(-/-) macrophages compared with Cbl-b(+/+) macrophages. Treatment with a neutralizing anti-MCP-1 antibody improved peripheral insulin resistance and macrophage infiltration into WAT in elderly Cbl-b(-/-) mice. CONCLUSIONS Cbl-b is a negative regulator of macrophage infiltration and activation, and macrophage activation by Cbl-b deficiency contributes to the peripheral insulin resistance and glucose intolerance via cytokines secreted from macrophages.
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Affiliation(s)
- Katsuya Hirasaka
- Department of Nutritional Physiology, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan
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Higgins J, Hill V, Lau K, Simpson V, Roayaei J, Klabansky R, Stevens RA, Metcalf JA, Baseler M. Evaluation of a single-platform technology for lymphocyte immunophenotyping. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2007; 14:1342-8. [PMID: 17761524 PMCID: PMC2168127 DOI: 10.1128/cvi.00168-07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2007] [Revised: 05/25/2007] [Accepted: 08/19/2007] [Indexed: 11/20/2022]
Abstract
An accurate and reproducible CD4 count is a fundamental clinical tool for monitoring and treating human immunodeficiency virus infection and its complications. Two methods exist for calculating absolute CD4 counts: dual-platform technology (DPT) and single-platform technology (SPT). Numerous studies have documented the unacceptably wide range of variation in absolute CD4 counts between laboratories. SPT was introduced in 1996 to reduce the interlaboratory variation in absolute CD4 counts. The aim of this study was to compare DPT with the BD Biosciences Trucount method (an SPT method). Both the percentages of CD4 (r = 0.986; P = 0.0541) and the absolute CD4 counts (r = 0.960; P = 0.0001) had very good correlation between the two methods. However, poor correlation was observed for the CD8(+) RO(-) (r = 0.314; P = 0.0002), CD8(+) DR(+) (r = 0.666; P = 0.0138), CD3(+) CD38(+) (r = 0.8000; P = 0.0004), CD3(+) CD25(+) (r = 0.464; P = 0.0082), and CD4(+) CD38(+) (r = 0.357; P = 0.0127) measurements.
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Affiliation(s)
- Jeanette Higgins
- AIDS Monitoring Laboratory, Clinical Services program, SAIC-Frederick, Inc., NCI-Frederick, Frederick, MD 21702, USA.
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Manasa J, Musabaike H, Masimirembwa C, Burke E, Luthy R, Mudzori J. Evaluation of the Partec flow cytometer against the BD FACSCalibur system for monitoring immune responses of human immunodeficiency virus-infected patients in Zimbabwe. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2007; 14:293-8. [PMID: 17267593 PMCID: PMC1828850 DOI: 10.1128/cvi.00416-06] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A single-platform volumetric flow cytometer, the Partec Cyflow SL_3, was evaluated against a BD FACSCalibur/Sysmex XT1800i dual platform for measuring CD4(+) lymphocytes, total lymphocytes, and the percentage of CD4 lymphocytes in whole-blood samples for monitoring the immune systems of human immunodeficiency virus (HIV)/AIDS patients. Statistical analyses for precision, correlation, and agreement were performed. Coefficients of variation (CV) of 5.8, 4.6, and 3.9% were obtained for low, medium, and high CD4(+) cell counts, respectively, using the SL_3, and CV of 3.7, 4.0, and 0.94 were obtained for the same categories, using the BD FACSCalibur. Significant correlations (P < 0.005) between the two assays for CD4 counts, total lymphocyte counts, and percentages of CD4 were obtained, with correlation coefficients of 0.99, 0.96, and 0.99, respectively (n = 229). Using the Bland-Altman plot, mean biases of -18 cell/microl (95% confidence interval (CI); -91 to 54 cells/microl), -0.8% (95% CI; -3.6 to 2%), and -36.8 cells/microl (95% CI; -477 to 404 cells/microl) were obtained for comparisons of CD4 counts, percentages of CD4 cells, and total lymphocyte counts, respectively. The effects of the age of the samples on the three parameters were also analyzed by comparing results from the same samples analyzed at 6, 24, and 48 h after collection. The correlation coefficients for comparisons among different time points for the same machine and among all the time points for the two different machines were greater than 0.90. These data showed that the Partec Cyflow SL_3 assay is comparable to the BD FACSCalibur/Sysmex XT1800i dual-platform method for measuring the amount of CD4(+) cells and total lymphocytes and the percentages of CD4 cells in blood samples for the purpose of monitoring HIV/AIDS patients.
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Affiliation(s)
- Justen Manasa
- Molecular Diagnostics Unit, African Institute of Biomedical Science and Technology, P.O. Box 2294, Harare, Zimbabwe.
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Aswald JM, Wang XH, Aswald S, Lutynski A, Minden MD, Messner HA, Keating A. Flow cytometric assessment of autologous gammadelta T cells in patients with acute myeloid leukemia: potential effector cells for immunotherapy? CYTOMETRY PART B-CLINICAL CYTOMETRY 2006; 70:379-90. [PMID: 16977635 DOI: 10.1002/cyto.b.20115] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Gammadelta T cells are a rare component of the circulating innate immune system capable of exerting anti-neoplastic activity. This population may be suitable for the adoptive immunotherapy of acute myeloid leukemia (AML). Little is known however, about the frequency and function of circulating gammadelta T cells in AML. The aim of the study was to enumerate peripheral blood gammadelta T cells in patients with AML and explore the feasibility of their use clinically. METHODS We compared the absolute circulating gammadelta T cell levels in 33 AML patients before and after treatment versus 20 healthy volunteers using flow cytometry. The function of gammadelta T cells was assessed by detection of intracelluar interferon-gamma (IFN-gamma) and cytotoxicity against leukemic blasts. RESULTS AML patients with high blast counts prior to induction chemotherapy had marginally decreased gammadelta T cell levels compared with healthy controls: median 38/microL versus 83/microL; P = 0.051. Sequential gammadelta T cell enumeration after induction showed significantly decreased counts in patients with a persistently high blast burden compared to patients with reduced but detectable residual disease (molecular maker or borderline bone marrow infiltration): median 7/microL versus 105/microL; P = 0.008. Patients with residual disease had significantly higher gammadelta T cell counts compared to those retested after they had achieved complete remission (CR); P = 0.0025. In CR, gammadelta T cell counts remained lower than those of healthy individuals: median 33/microL versus 83/microL, P = 0.030. We detected a sharp increase (on average, four-fold higher than values in CR) of gammadelta T cells in patients in very early morphologic or molecular relapse. We also tested the functional properties of gammadelta T cells from patients with AML in CR. Flow cytometric assessment of IFN-gamma revealed similar numbers of gammadelta T cells expressing the T1 cytokine compared with healthy controls. We also showed that gammadelta T cells were able to kill leukemic target cells in vitro. CONCLUSION Flow cytometric assessment of gammadelta T cells in patients with AML revealed quantitative shifts with respect to disease status. Our data suggest that gammadelta T cells warrant further investigation as potential therapeutic agents.
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Affiliation(s)
- Jorg M Aswald
- Department of Medical Oncology and Hematology, Princess Margaret Hospital/Ontario Cancer Institute, Toronto, Ontario, Canada M5G 2M9
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Shams'ili S, de Beukelaar J, Gratama JW, Hooijkaas H, van den Bent M, van 't Veer M, Sillevis Smitt P. An uncontrolled trial of rituximab for antibody associated paraneoplastic neurological syndromes. J Neurol 2006; 253:16-20. [PMID: 16444604 DOI: 10.1007/s00415-005-0882-0] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2004] [Revised: 03/27/2005] [Accepted: 04/12/2005] [Indexed: 12/21/2022]
Abstract
Anti-CD20 monoclonal antibody (rituximab) is effectively used in the treatment of B-cell lymphomas. Recent reports in the literature suggest that antibody associated autoimmune disorders may respond to rituximab. We therefore treated nine patients with anti-Hu or anti-Yo associated paraneoplastic neurological syndromes (PNS) with a maximum of four monthly IV infusions of rituximab (375mg/m(2)). In this uncontrolled, unblinded trial of rituximab, three patients improved > or =1 point on the Rankin Scale (RS). One patient with limbic encephalitis improved dramatically (RS from 5 to 1). Further studies of rituximab in autoantibody associated PNS are warranted.
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Affiliation(s)
- Setareh Shams'ili
- Dept. of Neurology, Erasmus MC, Dr Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
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Walker CL, Whitby L, Granger V, Storie I, Reilly JT, Barnett D. Flow rate calibration. III. The use of stabilized biostandards to calibrate the flow rate and calculate absolute CD4+ T-cell counts. CYTOMETRY PART B-CLINICAL CYTOMETRY 2006; 70:154-62. [PMID: 16572418 DOI: 10.1002/cyto.b.20103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND We have previously reported a flow rate calibration method for the determination of absolute CD4(+) T-lymphocyte counts that removes the need for the addition of latex beads to each sample. However, a limitation with this approach is that a calibration factor (CF) needs to be applied to adjust for differences in viscosity between latex bead suspensions and biological specimens. We have also demonstrated the value of using stabilized whole blood samples in external quality assessment (EQA) studies; such samples have a stable absolute lymphocyte count for over 1 year, at 4 degrees C. It was successfully demonstrated that this material can be used as a flow rate biocalibration (FRB) material for use as a flow cytometric control to provide a sample with a known CD4(+) T-lymphocyte count. Such material has advantages over latex bead technology as it can act as a full process control as well as having the same matrix and viscosity characteristics as the test material, thus removing the need for a CF. METHODS In this study, we have analyzed 268 consecutive normal, abnormal, and HIV(+) samples using FRB, incorporating the PanLeucoGating approach and compared this to the MultiSet method, defined as the predicate. RESULTS Percentage similarity statistics revealed the following: 0-3,000 CD4(+) cells/mul mean percentage difference (MPD; bias) 1.2%, 95% CI of 5.6-8%; 0-200 CD4(+) cells/microl MPD of 1.25%, 95% CI of 11.63-14.13%; 201-500 CD4(+) cells/microl MPD of 1%, 95% CI of 4.6-6.6%. DISCUSSION This study demonstrates that stabilized whole blood can be used for FRB. It has the advantage of being a full process control, in addition to costing less than latex beads with highly comparable results. As bench top flow cytometers are extremely stable, this is a low cost and robust alternative to bead based methods for generating absolute CD4 counts.
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Affiliation(s)
- Clare L Walker
- UK NEQAS for Leucocyte Immunophenotyping, Department of Haematology, Royal Hallamshire Hospital, Sheffield
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Oyekunle A, Koehl U, Schieder H, Ayuk F, Renges H, Fehse N, Zabelina T, Fehse B, Klingebiel T, Sputtek A, Zander A, Kröger N. CD34+-selected stem cell boost for delayed or insufficient engraftment after allogeneic stem cell transplantation. Cytotherapy 2006; 8:375-80. [PMID: 16923613 DOI: 10.1080/14653240600735784] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Poor graft function without rejection may occur after stem cell transplantation (SCT). CD34(+) stem cell boost (SCB) can restore marrow function but may induce or exacerbate GvHD. We therefore investigated the feasibility and efficacy of CD34(+)-selected SCB in some patients with poor graft function. We present the results for eight patients (median age 46 years) transplanted initially for myelofibrosis, acute leukemia, myeloma and NHL. Six patients had received HLA-matched and two mismatched grafts (PB, BM; n=5, 3). After a median of 128 days post-transplant, the median leukocyte and platelet counts were, respectively, 2.05/nL and 18/nL. None had achieved platelet counts >50/nL even though donor chimerism was >95% in seven recipients. METHODS Positive selection of CD34(+) stem cells was performed on a CliniMACS device, observing GMP and achieving a median of 98.5% purity. The patients received a median of 1.7 x 10(6)/kg CD34(+) cells and 2.5 x 10(3)/kg CD3(+) T lymphocytes. RESULTS Hemograms at days +30, +60 and +90, respectively, showed steadily increasing median leukocyte (2.55, 3.15 and 4.20/nL) and platelet (29, 39 and 95/nL) counts. After a median follow-up of 144 days, five patients remained alive. No patient had developed acute or chronic GvHD. One patient died of leukemic relapse and two others of systemic mycosis. DISCUSSION These preliminary results point to the possibility of safely improving graft function using CD34(+) positively selected stem cells without necessarily increasing the incidence of GvHD in patients with poor graft function post-SCT. Experience with more patients and longer follow-up should clarify the optimal role for this procedure.
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Affiliation(s)
- Aa Oyekunle
- Department of BM Transplantation, University Hospital Hamburg, University of Hamburg, Hamburg, Germany
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Maecker HT, Rinfret A, D'Souza P, Darden J, Roig E, Landry C, Hayes P, Birungi J, Anzala O, Garcia M, Harari A, Frank I, Baydo R, Baker M, Holbrook J, Ottinger J, Lamoreaux L, Epling CL, Sinclair E, Suni MA, Punt K, Calarota S, El-Bahi S, Alter G, Maila H, Kuta E, Cox J, Gray C, Altfeld M, Nougarede N, Boyer J, Tussey L, Tobery T, Bredt B, Roederer M, Koup R, Maino VC, Weinhold K, Pantaleo G, Gilmour J, Horton H, Sekaly RP. Standardization of cytokine flow cytometry assays. BMC Immunol 2005; 6:13. [PMID: 15978127 PMCID: PMC1184077 DOI: 10.1186/1471-2172-6-13] [Citation(s) in RCA: 183] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2004] [Accepted: 06/24/2005] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cytokine flow cytometry (CFC) or intracellular cytokine staining (ICS) can quantitate antigen-specific T cell responses in settings such as experimental vaccination. Standardization of ICS among laboratories performing vaccine studies would provide a common platform by which to compare the immunogenicity of different vaccine candidates across multiple international organizations conducting clinical trials. As such, a study was carried out among several laboratories involved in HIV clinical trials, to define the inter-lab precision of ICS using various sample types, and using a common protocol for each experiment (see additional files online). RESULTS Three sample types (activated, fixed, and frozen whole blood; fresh whole blood; and cryopreserved PBMC) were shipped to various sites, where ICS assays using cytomegalovirus (CMV) pp65 peptide mix or control antigens were performed in parallel in 96-well plates. For one experiment, antigens and antibody cocktails were lyophilised into 96-well plates to simplify and standardize the assay setup. Results ((CD4+)cytokine+ cells and (CD8+)cytokine+ cells) were determined by each site. Raw data were also sent to a central site for batch analysis with a dynamic gating template. Mean inter-laboratory coefficient of variation (C.V.) ranged from 17-44% depending upon the sample type and analysis method. Cryopreserved peripheral blood mononuclear cells (PBMC) yielded lower inter-lab C.V.'s than whole blood. Centralized analysis (using a dynamic gating template) reduced the inter-lab C.V. by 5-20%, depending upon the experiment. The inter-lab C.V. was lowest (18-24%) for samples with a mean of > 0.5% IFNgamma + T cells, and highest (57-82%) for samples with a mean of < 0.1% IFNgamma + cells. CONCLUSION ICS assays can be performed by multiple laboratories using a common protocol with good inter-laboratory precision, which improves as the frequency of responding cells increases. Cryopreserved PBMC may yield slightly more consistent results than shipped whole blood. Analysis, particularly gating, is a significant source of variability, and can be reduced by centralized analysis and/or use of a standardized dynamic gating template. Use of pre-aliquoted lyophilized reagents for stimulation and staining can provide further standardization to these assays.
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Affiliation(s)
| | - Aline Rinfret
- Université de Montreal and CANVAC, the Canadian Network for Vaccines and Immunotherapeutics, Montreal, Canada
| | - Patricia D'Souza
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA
| | - Janice Darden
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA
| | - Eva Roig
- Université de Montreal and CANVAC, the Canadian Network for Vaccines and Immunotherapeutics, Montreal, Canada
| | - Claire Landry
- Université de Montreal and CANVAC, the Canadian Network for Vaccines and Immunotherapeutics, Montreal, Canada
| | - Peter Hayes
- Chelsea and Westminster Hospital and IAVI, London, UK
| | | | - Omu Anzala
- Kenya AIDS Vaccine Initiative (KAVI), University of Nairobi, Kenya
| | - Miguel Garcia
- Centre Hospitalier Universitaire Vaudois and EUROVAC, Lausanne, Switzerland
| | - Alexandre Harari
- Centre Hospitalier Universitaire Vaudois and EUROVAC, Lausanne, Switzerland
| | - Ian Frank
- University of Washington and HVTN, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - Ruth Baydo
- University of Washington and HVTN, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - Megan Baker
- Duke University Medical Center and HVTN, Durham, USA
| | | | | | - Laurie Lamoreaux
- Vaccine Research Center, National Institutes of Health, Bethesda, USA
| | | | | | | | | | | | | | | | - Hazel Maila
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Ellen Kuta
- Henry Jackson Foundation, Rockville, USA
| | | | - Clive Gray
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | | | | | - Jean Boyer
- University of Pennsylvania, Philadelphia, USA
| | | | | | - Barry Bredt
- University of California, San Francisco, USA
| | - Mario Roederer
- Vaccine Research Center, National Institutes of Health, Bethesda, USA
| | - Richard Koup
- Vaccine Research Center, National Institutes of Health, Bethesda, USA
| | | | - Kent Weinhold
- Duke University Medical Center and HVTN, Durham, USA
| | - Giuseppe Pantaleo
- Centre Hospitalier Universitaire Vaudois and EUROVAC, Lausanne, Switzerland
| | - Jill Gilmour
- Chelsea and Westminster Hospital and IAVI, London, UK
| | - Helen Horton
- University of Washington and HVTN, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - Rafick P Sekaly
- Université de Montreal and CANVAC, the Canadian Network for Vaccines and Immunotherapeutics, Montreal, Canada
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