Sorted By Test Name - Mayo Medical Laboratories

LPAGF
60592
Maximum proliferation of Candida albicans as % CD45: > or =5.7%
Maximum proliferation of Candida albicans as % CD3: > or =3.0%
Maximum proliferation of tetanus toxoid as % CD45: > or =5.2%
Maximum proliferation of tetanus toxoid as % CD3: > or =3.3%
LYMPHOCYTE PROLIFERATION TO MITOGENS
Viability of lymphocytes at day 0: > or =75.0%
Maximum proliferation of phytohemagglutinin as % CD45: > or =49.9%
Maximum proliferation of phytohemagglutinin as % CD3: > or =58.5%
Maximum proliferation of pokeweed mitogen as % CD45: > or =4.5%
Maximum proliferation of pokeweed mitogen as % CD3: > or =3.5%
Maximum proliferation of pokeweed mitogen as % CD19: > or =3.9%
Clinical References: 1. Fletcher MA, Urban RG, Asthana D, et al: Lymphocyte proliferation. In
Manual of Clinical Laboratory Immunology. 5th edition. Edited by NR Rose, EC de Macario, JD Folds, et
al. Washington DC. ASM Press, 1997, pp 313-319 2. Bonilla FA, Bernstein IL, Khan DA, et al: Practice
parameter for the diagnosis and management of primary immunodeficiency. Ann Allergy Asthma
Immunol 2005;94:S1-S63 3. 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 4. Dimitrov S, Benedict C, Heutling D, et al: Cortisol
and epinephrine control opposing circadian rhythms in T-cell subsets. Blood 2009;113:5134-5143 5.
Dimitrov S, Lange T, Nohroudi K, Born J: Number and function of circulating antigen presenting cells
regulated by sleep. Sleep 2007;30:401-411 6. Kronfol Z, Nair M, Zhang Q, et al: Circadian immune
measures in healthy volunteers: relationship to hypothalamic-pituitary-adrenal axis hormones and
sympathetic neurotransmitters. Psychosom Med 1997;59:42-50 7. 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 8. Paglieroni TG,
Holland PV: Circannual variation in lymphocyte subsets, revisited. Transfusion 1994;34:512-551
Lymphocyte Proliferation to Antigens, Blood
Clinical Information: Determining impaired T-cell function by culturing human peripheral blood
mononuclear cells (PBMCs) in vitro with recall antigens, including Candida albicans (CA) and tetanus
toxoid (TT) has been part of the diagnostic immunology repertoire for many years.(1,2) The widely used
method for assessing lymphocyte proliferation to antigens has hitherto been the measurement of
3H-thymidine incorporated into the DNA of proliferating cells. The disadvantages with the 3H-thymidine
method of lymphocyte proliferation are: 1. The technique is cumbersome due to the use of radioactivity 2.
It does not allow discrimination of responding cell populations in response to stimulation 3. It does not
provide any information on contribution of activation-induced cell death to the interpretation of the final
result Further, decreased lymphocyte proliferation could be due to several factors, including overall
diminution of T-cell proliferation or decrease in proliferation of only a subset of T cells, or an apparent
decrease in total lymphocyte proliferation due to T-cell lymphopenia and underrepresentation of T cells in
the PBMC pool. None of these can be discriminated by the thymidine uptake assay, but can be assessed
by flow cytometry, which uses antibodies to identify specific responder cell populations. Cell viability can
also be measured within the same assay without requiring additional cell manipulation or sample.
Antigens, like CA and TT, have been widely used to measure antigen-specific recall (anamnestic) T-cell
responses when assessing cellular immunity. In fact, it may be more revealing about cellular immune
compromise than assessing the response of lymphocytes to mitogens because the latter can induce T-cell
proliferative responses even if those T cells are incapable of responding adequately to antigenic
(physiologic) stimuli. Therefore, abnormal T-cell responses to antigens are considered a diagnostically
more sensitive, but less specific, test of aberrant T-cell function.(2) Antigens used in recall assays
measure the ability of T cells bearing specific T-cell receptors (TCRs) to respond to such antigens when
processed and presented by antigen-presenting cells. The antigens used for assessment of the cellular
immune response are selected to represent antigens, seen by a majority of the population, either through
natural exposure (CA) or as a result of vaccination (TT). For this assay, we use a method that directly
measures the S-phase proliferation of lymphocytes through the use of click chemistry. Cell viability,
apoptosis, and death can also be measured by flow cytometry using 7-AAD and Annexin V. The
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