T- and B-Cell Quantitation and Lymphocyte Proliferation to Antigens Panel
Assessing antigen-specific T-cell responses and quantitating lymphocyte subsets in a single orderable test
Evaluating patients with immunodeficiencies, where quantitative decreases in T cells can lead to reduced functional antigen responses.
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
If insufficient peripheral blood mononuclear cells (PBMCs) are isolated from the patient's sample due to low WBC counts or specimen volume received, selected dilutions or stimulants may not be tested at the discretion of the laboratory to ensure the most reliable results. Testing with 1 stimulant will always be performed. When adequate specimen is available for both stimulants to be tested, an additional test code will be reflexed and billed separately.
When multiple specimen types are required to perform a panel of tests, the laboratory will perform the tests for which the appropriate specimen type was received and the laboratory will cancel those for which the appropriate specimen was not received. Be advised that this may change the degree of interpretation received with the report.
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
See individual test IDs.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
The appropriate age-related reference values will be provided on the report.
Since the presence of lymphopenia, particularly in the T-cell compartment, can reduce the magnitude of the proliferative response to antigens, it is helpful to perform simultaneous numerical evaluation of lymphocyte subsets to aid in interpretation of the functional (proliferation) data.
See individual test IDs for additional information.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
There is no clinical utility to assessing antigen responses in infants less than 3 months old due to limited antigen exposure and vaccination. The only exception would be infants who develop Candidiasis prior to 3 months of age. This test is not intended for assessment of maternal engraftment.
See individual tests IDs for more information.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Betts MR, Casaza JP, Patterson BA, et al: Putative immunodominant human immunodeficiency virus-specific CD8 T-cell responses cannot be predicted by MHC class I haplotype. J Virol 2000;74:9144-9151
2. Peters PJ, Borst J, Oorschot V, et al: Cytotoxic T-lymphocyte granules are secretory lysosomes, containing both perforin and granzymes. J Exp Med 1991;173:1099-1109
3. Venkataramanan R, Shaw LM, Sarkozi L, et al: Clinical utility of monitoring tacrolimus blood concentrations in liver transplant patients. J Clin Pharmacol 2001;41:542-551
4. Carmichael KF, Abayomi A: Analysis of diurnal variation of lymphocyte subsets in healthy subjects and its implication in HIV monitoring and treatment. 15th Intl Conference on AIDS, Bangkok, Thailand, 2004, Abstract # B11052
5. Dimitrov S, Benedict C, Heutling D, et al: Cortisol and epinephrine control opposing circadian rhythms in T-cell subsets. Blood 2009;113:5134-5143
6. Dimitrov S, Lange T, Nohroudi K, Born J: Number and function of circulating antigen presenting cells regulated by sleep. Sleep 2007;30:401-411
7. Kronfol Z, Nair M, Zhang Q, et al: Circadian immune measures in healthy volunteers: relationship to hypothalamic-pituitary-adrenal axis hormones and sympathetic neurotransmitters. Pyschosom Med 1997;59:42-50
8. Malone JL, Simms TE, Gray GC, et al: Sources of variability in repeated T-helper lymphocyte counts from HIV 1-infected patients: total lymphocyte count fluctuations and diurnal cycle are important. J AIDS 1990;3:144-151
9. Paglieroni TG, Holland PV: Circannual variation in lymphocyte subsets, revisited. Transfusion 1994;34:512-516