1
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Kaufman RM, Marks DC, Flamand Y, Acker JP, Brown BL, Olafson C, Marschner S, Pandey S, Papari M, Petraszko T, Serrano K, Ward D, Bazin R. Risk factors for T-cell lymphopenia in frequent platelet donors: The BEST collaborative study. Transfusion 2023; 63:2072-2082. [PMID: 37818894 DOI: 10.1111/trf.17567] [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: 07/20/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Severe T-cell lymphopenia of uncertain clinical significance has been observed in frequent apheresis platelet donors. Two commonly used plateletpheresis instruments are the Trima Accel, which uses a leukoreduction system (LRS) chamber to trap leukocytes and the Fenwal Amicus, which does not use an LRS chamber. STUDY DESIGN AND METHODS We performed an international, multicenter, observational study comparing T-cell populations in frequent platelet donors collected exclusively using the Trima instrument (n = 131) or the Amicus instrument (n = 77). Age- and sex-matched whole blood donors (n = 126) served as controls. RESULTS CD4+ T-cell counts <200 cells/μL were found in 9.9% of frequent Trima (LRS+) platelet donors, 4.4% of frequent Amicus (LRS-) platelet donors, and 0 whole blood donors (p < .0001). CD4+ T-cell counts <200 cells/μL were only seen in platelet donors with ≥200 lifetime donations. In multivariable analysis, age, lifetime donations, and instrument (Trima vs. Amicus) were independent risk factors for lymphopenia. In 40 Trima platelet donors, a plasma rinseback procedure was routinely performed following platelet collections. No Trima platelet donors receiving plasma rinseback had a CD4+ T-cell count <200 cells/μL versus 13/91 Trima platelet donors not receiving plasma rinseback (p = .01). DISCUSSION Recurrent bulk lymphocyte removal appears to contribute to the development of T-cell lymphopenia in frequent, long-term platelet donors. Lymphopenia is more common when an LRS chamber is used during platelet collection but can occur without an LRS chamber. Blood centers using LRS chambers can mitigate donor lymphopenia by performing plasma rinseback.
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Affiliation(s)
- Richard M Kaufman
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Denese C Marks
- Research and Development, Australian Red Cross Lifeblood, Sydney, New South Wales, Australia
| | - Yael Flamand
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jason P Acker
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Bethany L Brown
- American Red Cross, Biomedical Services, Medical and Scientific Office, Washington, DC, USA
| | - Carly Olafson
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
| | | | - Suchitra Pandey
- Department of Pathology, Stanford University School of Medicine and Stanford Blood Center, Palo Alto, California, USA
| | | | - Tanya Petraszko
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katherine Serrano
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Dawn Ward
- Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Renée Bazin
- Héma-Québec, Medical Affairs and Innovation, Quebec City, Quebec, Canada
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2
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Gao J, Luo Y, Li H, Zhao Y, Zhao J, Han X, Han J, Lin H, Qian F. Deep Immunophenotyping of Human Whole Blood by Standardized Multi-parametric Flow Cytometry Analyses. PHENOMICS (CHAM, SWITZERLAND) 2023; 3:309-328. [PMID: 37325713 PMCID: PMC10260734 DOI: 10.1007/s43657-022-00092-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 12/03/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
Immunophenotyping is proving crucial to understanding the role of the immune system in health and disease. High-throughput flow cytometry has been used extensively to reveal changes in immune cell composition and function at the single-cell level. Here, we describe six optimized 11-color flow cytometry panels for deep immunophenotyping of human whole blood. A total of 51 surface antibodies, which are readily available and validated, were selected to identify the key immune cell populations and evaluate their functional state in a single assay. The gating strategies for effective flow cytometry data analysis are included in the protocol. To ensure data reproducibility, we provide detailed procedures in three parts, including (1) instrument characterization and detector gain optimization, (2) antibody titration and sample staining, and (3) data acquisition and quality checks. This standardized approach has been applied to a variety of donors for a better understanding of the complexity of the human immune system. Supplementary Information The online version contains supplementary material available at 10.1007/s43657-022-00092-9.
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Affiliation(s)
- Jian Gao
- State Key Laboratory of Genetic Engineering, Shanghai Public Health Clinical Center, Human Phenome Institute, Zhangjiang Fudan International Innovation Center and School of Life Sciences, Fudan University, Shanghai, 200438 China
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Yali Luo
- State Key Laboratory of Genetic Engineering, Shanghai Public Health Clinical Center, Human Phenome Institute, Zhangjiang Fudan International Innovation Center and School of Life Sciences, Fudan University, Shanghai, 200438 China
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Helian Li
- State Key Laboratory of Genetic Engineering, Shanghai Public Health Clinical Center, Human Phenome Institute, Zhangjiang Fudan International Innovation Center and School of Life Sciences, Fudan University, Shanghai, 200438 China
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Yiran Zhao
- State Key Laboratory of Genetic Engineering, Shanghai Public Health Clinical Center, Human Phenome Institute, Zhangjiang Fudan International Innovation Center and School of Life Sciences, Fudan University, Shanghai, 200438 China
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Jialin Zhao
- State Key Laboratory of Genetic Engineering, Shanghai Public Health Clinical Center, Human Phenome Institute, Zhangjiang Fudan International Innovation Center and School of Life Sciences, Fudan University, Shanghai, 200438 China
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Xuling Han
- State Key Laboratory of Genetic Engineering, Shanghai Public Health Clinical Center, Human Phenome Institute, Zhangjiang Fudan International Innovation Center and School of Life Sciences, Fudan University, Shanghai, 200438 China
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Jingxuan Han
- State Key Laboratory of Genetic Engineering, Shanghai Public Health Clinical Center, Human Phenome Institute, Zhangjiang Fudan International Innovation Center and School of Life Sciences, Fudan University, Shanghai, 200438 China
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Huiqin Lin
- State Key Laboratory of Genetic Engineering, Shanghai Public Health Clinical Center, Human Phenome Institute, Zhangjiang Fudan International Innovation Center and School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Feng Qian
- State Key Laboratory of Genetic Engineering, Shanghai Public Health Clinical Center, Human Phenome Institute, Zhangjiang Fudan International Innovation Center and School of Life Sciences, Fudan University, Shanghai, 200438 China
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, 200438 China
- Institute of Immunophenome, International Human Phenome Institutes (Shanghai), Shanghai, 200433 China
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3
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Civelekoglu O, Wang N, Arifuzzman A, Boya M, Sarioglu AF. Automated lightless cytometry on a microchip with adaptive immunomagnetic manipulation. Biosens Bioelectron 2022; 203:114014. [DOI: 10.1016/j.bios.2022.114014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/13/2021] [Accepted: 01/15/2022] [Indexed: 01/08/2023]
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4
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Kasten-Jolly J, Lawrence DA. Differential blood leukocyte populations based on individual variances and age. Immunol Res 2022; 70:114-128. [PMID: 35023048 PMCID: PMC8754550 DOI: 10.1007/s12026-021-09257-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/09/2021] [Indexed: 12/26/2022]
Abstract
Blood was collected from the New York State Department of Health (NYSDOH) employees to assess variances in leukocyte numbers in January, May, and September throughout a year and over many years. Women and men of ages 20 to 80 volunteered to donate for this program. Most of the blood came from healthy individuals, and many remained healthy throughout the years of their blood donations. The major objective was to determine the extent that blood leukocyte numbers change so that transient vs more lingering changes may be helpful in assessing health status. Since some donors remained in the program for 14 years, age influences over time could be determined. Within a short period of 2-3 years, the flow cytometric immunophenotypic profile of blood lymphocyte is relatively stable with a CV% of < 20%. However, as humans age, the blood CD3+ T cell, CD8+ T cell, B cell, NKT cell, and CD4-/CD8- double-negative T cell (DN-T cell) subsets declined in cell numbers/μL, but the double-positive CD4+/CD8+ T cells (DP-T cells) increased in numbers. The extent and chronology of a variance, e.g., a subset exceeding its 75th or 90th percentile, might be indicative of a transient or chronic physiological or psychosocial stress affecting health or a developing pathology; however, because of the wide ranges of cell numbers/μL for each subset among individuals reported as healthy, everyone's immunity and health must be carefully evaluated. A CD4 to CD8 ratio (4/8R) of < 1 has been used to define an immunodeficiency such as HIV-induced AIDS, but a high 4/8R is less well associated with health status. A high 4/8R or granulocyte to lymphocyte ratio (GLR) might be an indicator of a stress, infection, or immune-related pathology. Sporadic and longitudinal increases of GLRs are reported. The results suggest that there are some age and sex differences in leukocyte numbers; stress influences on the blood profile of leukocytes likely exist. However, some values exceeding 2 standard deviations from means do not necessarily predict a health concern, whereas a longitudinal increase or decline might be indicative of a need for further evaluations.
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Affiliation(s)
- Jane Kasten-Jolly
- Wadsworth Center, New York State Department of Health, Albany, NY, 12208, USA
| | - David A Lawrence
- Wadsworth Center, New York State Department of Health, Albany, NY, 12208, USA.
- School of Public Health, University of Albany, Rensselaer, NY, USA.
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5
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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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6
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Jansen RT, Cobbaert CM, Weykamp C, Thelen M. The quest for equivalence of test results: the pilgrimage of the Dutch Calibration 2.000 program for metrological traceability. ACTA ACUST UNITED AC 2018; 56:1673-1684. [DOI: 10.1515/cclm-2017-0796] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/17/2017] [Indexed: 01/02/2023]
Abstract
Abstract
Calibration 2.000 was initiated 20 years ago for standardization and harmonization of medical tests. The program also intended to evaluate adequate implementation of the In Vitro Diagnostics (IVD) 98/79/EC directive, in order to ensure that medical tests are fit-for-clinical purpose. The Calibration 2.000 initiative led to ongoing verification of test standardization and harmonization in the Netherlands using commutable external quality assessment (EQA)-tools and a type 1 EQA-design, where feasible. National support was guaranteed by involving all laboratory professionals as well as laboratory technicians responsible for EQA and quality officers. A category 1 EQA-system for general chemistry analytes, harmonizers for specific analytes like hGH and IGF-1, and commutable materials for other EQA-sections have been developed and structurally introduced in the EQA-schemes. The type 1 EQA-design facilitates the dialogue between individual specialists in laboratory medicine and the IVD-industry to reduce lot-to-lot variation and to improve standardization. In such a way, Calibration 2.000 sheds light on the metrological traceability challenges that we are facing and helps the laboratory community to get the issues on the table and resolved. The need for commutable trueness verifiers and/or harmonizers for other medical tests is now seen as paramount. Much knowledge is present in the Netherlands and for general chemistry, humoral immunology and protein chemistry, a few endocrinology tests, and various therapeutic drug monitoring (TDM) tests, commutable materials are available. Also the multi sample evaluation scoring system (MUSE) and the category 1 EQA-design offer many possibilities for permanent education of laboratory professionals to further improve the between and within laboratory variation and the test equivalence.
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Affiliation(s)
- Rob T.P. Jansen
- SKML , Mercator 1, Toernooiveld 214 , 6525EC Nijmegen , The Netherlands
| | | | - Cas Weykamp
- Queen Beatrix Hospital , MCA Laboratory , Winterswijk , The Netherlands
| | - Marc Thelen
- Amphia Hospital, Clinical Chemistry and Haematology , Breda , The Netherlands
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Huenecke S, Bremm M, Cappel C, Esser R, Quaiser A, Bonig H, Jarisch A, Soerensen J, Klingebiel T, Bader P, Koehl U. Optimization of individualized graft composition: CD3/CD19 depletion combined with CD34 selection for haploidentical transplantation. Transfusion 2016; 56:2336-45. [DOI: 10.1111/trf.13694] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 05/04/2016] [Accepted: 05/07/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Sabine Huenecke
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Melanie Bremm
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Claudia Cappel
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Ruth Esser
- GMP Development UnitInstitute of Cellular Therapeutics, IFB‐TX, Hannover Medical SchoolHannover Germany
| | - Andrea Quaiser
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Halvard Bonig
- Division for Cell ProcessingInstitute for Transfusion Medicine and Immunohematology, Goethe‐University Frankfurt/Main
- German Red Cross Blood Donor Service, Baden‐Württemberg‐HessenFrankfurt/Main, Germany
| | - Andrea Jarisch
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Jan Soerensen
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Thomas Klingebiel
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Peter Bader
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
| | - Ulrike Koehl
- Clinic for Pediatric and Adolescent MedicineUniversity HospitalFrankfurt Germany
- GMP Development UnitInstitute of Cellular Therapeutics, IFB‐TX, Hannover Medical SchoolHannover Germany
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8
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WANG XIANWEN, CHEN FENG, CHENG ZHI, DU YAOHUA, WU TAIHU. AUTOMATED GATING OF PORTABLE CYTOMETER DATA BASED ON SKEW t MIXTURE MODELS. J MECH MED BIOL 2015. [DOI: 10.1142/s0219519415500335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A major component of flow cytometry (FCM) data analysis involves gating, which is the process of identifying homogeneous groups of cells. With the rapid development of the portable flow cytometer, manual gating techniques have been unable to meet the demand for accurate and rapid analysis of samples. To provide a practical application for portable devices, we propose a flexible, statistical model-based clustering approach for identifying cell populations in FCM data. This approach, which mimics the manual gating process, employs a finite mixture model with a density function of skew t distribution and estimates parameters via an expectation maximization algorithm. Data analysis from an experiment on a patient’s peripheral blood samples have proven that the proposed methodology yields better results in terms of robustness against outliers than current state-of-the-art automated gating methods, has more flexibility in clustering symmetric data and leads to lower misclassification rates (misclassification rates of skew t method is 0.06442) when handling highly asymmetric data. The method we proposed will improve data analysis of portable flow cytometers, especially when the users have no professional training.
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Affiliation(s)
- XIANWEN WANG
- Institute of Medical Equipment, Academy of Military Medical Sciences, Wandong Road 106, Hedong District, Tianjin 300161, P. R. China
| | - FENG CHEN
- Institute of Medical Equipment, Academy of Military Medical Sciences, Wandong Road 106, Hedong District, Tianjin 300161, P. R. China
| | - ZHI CHENG
- Institute of Medical Equipment, Academy of Military Medical Sciences, Wandong Road 106, Hedong District, Tianjin 300161, P. R. China
| | - YAOHUA DU
- Institute of Medical Equipment, Academy of Military Medical Sciences, Wandong Road 106, Hedong District, Tianjin 300161, P. R. China
| | - TAIHU WU
- Institute of Medical Equipment, Academy of Military Medical Sciences, Wandong Road 106, Hedong District, Tianjin 300161, P. R. China
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9
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Al-Mawali A, Pinto AD, Al Busaidi R, Al-Zakwani I. Lymphocyte subsets: reference ranges in an age- and gender-balanced population of Omani healthy adults. Cytometry A 2013; 83:739-44. [PMID: 23839863 DOI: 10.1002/cyto.a.22322] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 05/20/2010] [Accepted: 05/28/2013] [Indexed: 11/10/2022]
Abstract
Country-specific reference ranges for adult peripheral blood lymphocyte subsets have been established in a few countries around the world; however, there have been no specific comprehensive studies in the Gulf Cooperation Council (GCC) and Middle East, which investigated age and gender-specific reference ranges. Demographic and environmental factors may contribute to variations in these subsets around the world, and thus there is a great necessity for each country to establish its own reference ranges. Hence, the aim of this study is to establish lymphocyte subsets reference ranges for Omani healthy adults. Total, age, and gender-specific reference ranges were established using four-color flow cytometry analysis with an extensive panel of monoclonal antibodies in 50 healthy adult males and females aged between 18 and 57. Reference values were expressed as median and 95% confidence intervals for T cells-CD3(+) : 76.5 (57-89), CD4(+) : 45 (31-58), CD5(+) : 75 (58-85), CD7(+) : 80 (70-89), CD8(+) : 29.5 (19-43); B cells-CD10(+) : 1 (1-3), CD19(+) : 14 (6-23), CD20(+) : 14 (6-23), and NK cells-CD16(+) : 9 (3-22), CD56(+) : 13 (5-24), CD3(-) /(CD16(+) /CD56(+) ): 7 (3-20). In comparison with other published studies, the lymphocyte subsets reference ranges in healthy Omani adults were similar to those reported in the rest of the world. These observations have important clinical implications in lymphocyte subset analysis in Oman, especially in the management of immunological disorders. The reference ranges established by this study can be adopted as a reference for clinical practice decisions.
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Affiliation(s)
- Adhra Al-Mawali
- Directorate of Research and Studies, Ministry of Health, Muscat, Sultanate of Oman.
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Rollins-Raval MA, Fisher J, Craig FE. Monoclonal B lymphocytosis versus chronic lymphocytic leukemia: Factors affecting implementation of an absolute threshold. CYTOMETRY PART B-CLINICAL CYTOMETRY 2013; 84:149-56. [DOI: 10.1002/cyto.b.21077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 11/28/2012] [Accepted: 01/07/2013] [Indexed: 11/12/2022]
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11
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Park J, Han K. Single-color multitarget flow cytometry using monoclonal antibodies labeled with different intensities of the same fluorochrome. Ann Lab Med 2012; 32:171-6. [PMID: 22563550 PMCID: PMC3339295 DOI: 10.3343/alm.2012.32.3.171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 01/02/2012] [Accepted: 02/01/2012] [Indexed: 11/19/2022] Open
Abstract
Background We developed a single-color multitarget flow cytometry (SM-FC) assay, a single-tube assay with graded mean fluorescence intensities (MFIs). We evaluated the repeatability of SM-FC, and its correlation with multicolor flow cytometry (MFC), to assess its application as a routine FC assay. Methods We selected CD19, CD3, CD4, and CD8 as antigen targets to analyze a lymphocyte subset. MFIs were graded by adjusting monoclonal antibody (mAb) volumes to detect several cell populations. Dimly labeled mAb was prepared by decreasing mAb volume and the optimum diluted volume was determined by serial dilution. SM-FC repeatability was analyzed 10 times in 2 normal controls. The correlation between SM-FC and MFC was evaluated in 20 normal and 23 patient samples. Results CV values (0.8-5.0% and 1.3-4.1% in samples 1 and 2, respectively) acquired by SM-FC with CD3-fluorescein α-isothyocyanate (FITC)dim+CD4-FITCbright and with CD19-FITCdim+CD3-FITCbright showed good repeatability, comparable to that acquired by MFC (1.6-3.7% and 1.0-4.8% in samples 1 and 2, respectively). Excellent correlation was observed between the 2 methods in the 20 normal samples (B cells, T cells, non-Thelper cells, and Thelper cells; r2=0.87, 0.97, 0.97, and 0.98, respectively; P<0.05). There were also linear relationships between SM-FC with CD19-FITCdim+CD3-FITCbright and CD8-PEdim+CD4-PEbright, and MFC, in the 23 patient samples (B cells, T cells, Tcytotoxic cells, and Thelper cells; r2≥0.98, 0.99, 0.99, and 0.99, respectively; P<0.05). Conclusions The multicolor, single-tube SM-FC technique is a potential alternative tool for identifying a lymphocyte subset.
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Affiliation(s)
- Joonhong Park
- Department of Laboratory Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea
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12
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Thakar MR, Abraham PR, Arora S, Balakrishnan P, Bandyopadhyay B, Joshi AA, Devi KR, Vasanthapuram R, Vajpayee M, Desai A, Mohanakrishnan J, Narain K, Ray K, Patil SS, Singh R, Singla A, Paranjape RS. Establishment of reference CD4+ T cell values for adult Indian population. AIDS Res Ther 2011; 8:35. [PMID: 21967708 PMCID: PMC3198876 DOI: 10.1186/1742-6405-8-35] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 10/03/2011] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND CD4+ T lymphocyte counts are the most important indicator of disease progression and success of antiretroviral treatment in HIV infection in resource limited settings. The nationwide reference range of CD4+ T lymphocytes was not available in India. This study was conducted to determine reference values of absolute CD4+ T cell counts and percentages for adult Indian population. METHODS A multicentric study was conducted involving eight sites across the country. A total of 1206 (approximately 150 per/centre) healthy participants were enrolled in the study. The ratio of male (N = 645) to female (N = 561) of 1.14:1. The healthy status of the participants was assessed by a pre-decided questionnaire. At all centers the CD4+ T cell count, percentages and absolute CD3+ T cell count and percentages were estimated using a single platform strategy and lyse no wash technique. The data was analyzed using the Statistical Package for the Social Scientist (SPSS), version 15) and Prism software version 5. RESULTS The absolute CD4+ T cell counts and percentages in female participants were significantly higher than the values obtained in male participants indicating the true difference in the CD4+ T cell subsets. The reference range for absolute CD4 count for Indian male population was 381-1565 cells/μL and for female population was 447-1846 cells/μL. The reference range for CD4% was 25-49% for male and 27-54% for female population. The reference values for CD3 counts were 776-2785 cells/μL for Indian male population and 826-2997 cells/μL for female population. CONCLUSION The study used stringent procedures for controlling the technical variation in the CD4 counts across the sites and thus could establish the robust national reference ranges for CD4 counts and percentages. These ranges will be helpful in staging the disease progression and monitoring antiretroviral therapy in HIV infection in India.
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Affiliation(s)
- Madhuri R Thakar
- Department of Immunology, National AIDS Research Institute, G-73, MIDC, Bhosari, Pune, 411026, India
| | - Philip R Abraham
- Department of Immunology, National AIDS Research Institute, G-73, MIDC, Bhosari, Pune, 411026, India
| | - Sunil Arora
- Department of Immunopathology, Postgraduate Institute of Medical education & Research, Sector:12, Chandigarh-160012, India
| | - Pachamuthu Balakrishnan
- Infectious Diseases Laboratory, YRG Centre for AIDS Research and Education, Rajiv Gandhi Salai, Taramani, Chennai-600113, India
| | - Bhaswati Bandyopadhyay
- Department of Virology, School of Tropical Medicine, C.R.Avenue, Kolkata-700073, West Bengal, India
| | - Ameeta A Joshi
- Department of Microbiology, Grant Medical College & Sir J J Hospital, Byculla, Mumbai-400008, India
| | - K Rekha Devi
- Division of Enteric Diseases, Regional Medical Research Centre, N.E.Region, Indian Council of Medical Research, Dibrugarh-786001, Assam, India
| | - Ravi Vasanthapuram
- Department of Neurovirology, National Institute of Mental Health and Neuro Sciences Hosur Road, Bangalore-560029, India
| | - Madhu Vajpayee
- Laboratory Head, HIV & Immunology division, Department of Microbiology,All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029 India
| | - Anita Desai
- Department of Neurovirology, National Institute of Mental Health and Neuro Sciences Hosur Road, Bangalore-560029, India
| | - Janardhanan Mohanakrishnan
- Infectious Diseases Laboratory, YRG Centre for AIDS Research and Education, Rajiv Gandhi Salai, Taramani, Chennai-600113, India
| | - Kanwar Narain
- Division of Enteric Diseases, Regional Medical Research Centre, N.E.Region, Indian Council of Medical Research, Dibrugarh-786001, Assam, India
| | - Krishnangshu Ray
- Department of Clinical and Experimental Pharmacology, School of Tropical Medicine, C.R.Avenue, Kolkata-700073, West Bengal, India
| | - Shilpa S Patil
- Department of Microbiology, Grant Medical College & Sir J J Hospital, Byculla, Mumbai-400008, India
| | - Ravinder Singh
- Laboratory Head, HIV & Immunology division, Department of Microbiology,All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029 India
| | - Anuj Singla
- Department of Immunopathology, Postgraduate Institute of Medical education & Research, Sector:12, Chandigarh-160012, India
| | - Ramesh S Paranjape
- Department of Immunology, National AIDS Research Institute, G-73, MIDC, Bhosari, Pune, 411026, India
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Abstract
We have developed flowMeans, a time-efficient and accurate method for automated identification of cell populations in flow cytometry (FCM) data based on K-means clustering. Unlike traditional K-means, flowMeans can identify concave cell populations by modelling a single population with multiple clusters. flowMeans uses a change point detection algorithm to determine the number of sub-populations, enabling the method to be used in high throughput FCM data analysis pipelines. Our approach compares favorably to manual analysis by human experts and current state-of-the-art automated gating algorithms. flowMeans is freely available as an open source R package through Bioconductor.
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Affiliation(s)
- Nima Aghaeepour
- Terry Fox Laboratory, BC Cancer Agency, Vancouver, British Columbia, Canada
- Department of Bioinformatics, University of British Columbia, British Columbia, Canada
| | - Radina Nikolic
- Terry Fox Laboratory, BC Cancer Agency, Vancouver, British Columbia, Canada
- Department of Statistics, University of Oxford, Oxford, United Kingdom
| | - Holger H. Hoos
- Department of Computer Science, University of British Columbia, British Columbia, Canada
| | - Ryan R. Brinkman
- Terry Fox Laboratory, BC Cancer Agency, Vancouver, British Columbia, Canada
- Department of Medical Genetics, University of British Columbia, British Columbia, Canada
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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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15
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Kraan J, Sleijfer S, Strijbos MH, Ignatiadis M, Peeters D, Pierga JY, Farace F, Riethdorf S, Fehm T, Zorzino L, Tibbe AGJ, Maestro M, Gisbert-Criado R, Denton G, de Bono JS, Dive C, Foekens JA, Gratama JW. External quality assurance of circulating tumor cell enumeration using the CellSearch(®) system: a feasibility study. CYTOMETRY PART B-CLINICAL CYTOMETRY 2010; 80:112-8. [PMID: 21337491 DOI: 10.1002/cyto.b.20573] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 08/24/2010] [Accepted: 08/30/2010] [Indexed: 12/18/2022]
Abstract
BACKGROUND Circulating tumor cells (CTCs) are cells that have detached from solid tumors and entered the blood. CTCs can be detected, among others, by semi-automated immunomagnetic enrichment and image cytometry using CellSearch® (Veridex, Raritan, NJ). We studied the feasibility of external quality assurance (EQA) of the entire CellSearch procedure from blood draw to interpretation of results in multiple laboratories. METHODS Blood samples from six cancer patients and controls were distributed to 14 independent laboratories to test between-laboratory, between-assay, and between-instrument variation. Additionally, between-operator variability was assessed through the interpretation of blinded images of all blood samples on a website. RESULTS Shipment and storage of samples had no influence on CTC values. Between-instrument (coefficient of variation (CV) < 12%) and between-assay variation was low (CV ≤ 20%), indicating high reproducibility. However, between-laboratory CV ranged from 45 to 64%. Although inter-operator agreement on image interpretation (Fleiss' κ statistics) ranged from "substantial" to "almost perfect," image interpretation, particularly of samples containing high numbers of apoptotic cells, was the main contributor to between-laboratory variation. CONCLUSIONS This multicenter study shows the feasibility of an EQA program for CTC detection in patient samples, and the importance of continuation of such a program for the harmonization of CTC enumeration.
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Affiliation(s)
- Jaco Kraan
- Department of Medical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands.
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16
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Merging mixture components for cell population identification in flow cytometry. Adv Bioinformatics 2009:247646. [PMID: 20049161 PMCID: PMC2798116 DOI: 10.1155/2009/247646] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Revised: 07/06/2009] [Accepted: 08/22/2009] [Indexed: 11/21/2022] Open
Abstract
We present a framework for the identification of cell subpopulations in
flow cytometry data based on merging mixture components using the
flowClust methodology. We show that the cluster merging algorithm
under our framework improves model fit and provides a better
estimate of the number of distinct cell subpopulations than
either Gaussian mixture models or flowClust, especially for
complicated flow cytometry data distributions. Our framework
allows the automated selection of the number of distinct cell
subpopulations and we are able to identify cases where the
algorithm fails, thus making it suitable for application in a high
throughput FCM analysis pipeline. Furthermore, we demonstrate a
method for summarizing complex merged cell subpopulations in a
simple manner that integrates with the existing flowClust
framework and enables downstream data analysis. We demonstrate the
performance of our framework on simulated and real FCM data. The
software is available in the flowMerge package through the
Bioconductor project.
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Brooimans RA, Boyce CS, Popma J, Broyles DA, Gratama JW, Southwick PC, Keeney M. Analytical performance of a standardized single-platform MHC tetramer assay for the identification and enumeration of CMV-specific CD8+ T lymphocytes. Cytometry A 2008; 73:992-1000. [PMID: 18792106 DOI: 10.1002/cyto.a.20641] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Major histocompatibility complex (MHC) multimers that identify antigen-specific T cells, coupled with flow cytometry, have made a major impact on immunological research. HLA Class I multimers detect T cells directed against viral, tumor, and transplantation antigens with exquisite sensitivity. This technique has become an important standard for the quantification of a T cell immune response. The utility of this method in multicenter studies, however, is dependant on reproducibility between laboratories. As part of a clinical study using a standardized two-tube three-color single-platform method, we monitored and characterized performance across multiple sites using tetramers against the T cell receptors (TCR) specific for MHC Class I, A*0101--VTEHDTLLY, A*0201--NLVPMVATV and B*0702--TPRVTGGGAM CMV peptides. We studied the analytical performance of this method, focusing on reducing background, maximizing signal intensity, and ensuring that sufficient cells are enumerated to provide meaningful statistics. Inter and intra-assay performance were assessed, which included inherent variability introduced by shipping, type of flow cytometer used, protocol adherence, and analytical interpretation across a range of multiple sample levels and specificities under routine laboratory testing conditions. Using the described protocol, it is possible to obtain intra- and interlab CV's of <20%, with a functional sensitivity for absolute tetramer counts of 1 cell/microL and 0.2% tetramer+ percent for A*0101, A*0201, and B*0702 alleles. The standardized single-platform MHC tetramer assay is simple, rapid, reproducible, and useful for assessing CMV-specific T cells, and will allow for reasonable comparisons of clinical evaluations across multiple centers at clinically relevant thresholds (2.0-10.0 cells/microL).
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Affiliation(s)
- Rik A Brooimans
- Department of Internal Oncology, Erasmus MC-Daniel Den Hoed Cancer Center, Rotterdam, The Netherlands.
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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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19
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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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20
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Peter T, Badrichani A, Wu E, Freeman R, Ncube B, Ariki F, Daily J, Shimada Y, Murtagh M. Challenges in implementing CD4 testing in resource-limited settings. CYTOMETRY PART B-CLINICAL CYTOMETRY 2008; 74 Suppl 1:S123-30. [PMID: 18348208 DOI: 10.1002/cyto.b.20416] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The scale-up of HIV antiretroviral therapy in recent years has led to a rapid increase in CD4 and CD4% count capacity to meet the diagnostic needs of staging and monitoring disease progression and treatment efficacy in adults and infants. The speed of implementation of this technology has been unrivalled in recent years and has met challenges with technology selection, laboratory infrastructure development, human resource limitations, cost-effectiveness, instrument maintenance, and ensuring testing access and quality. The lessons learned from dealing with these challenges have helped strengthen existing laboratory systems for other diagnostics. They may also facilitate the implementation of new diagnostics in future.
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Affiliation(s)
- Trevor Peter
- Clinton Foundation HIV/AIDS Initiative, 225 Water Street, Quincy, Massachusetts 02169, USA
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21
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Evaluation of a multicolor, single-tube technique to enumerate lymphocyte subpopulations. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2008; 15:1124-7. [PMID: 18448621 DOI: 10.1128/cvi.00481-07] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To evaluate the fully automated FACSCanto software, we compared lymphocyte subpopulation counts obtained using three-color FACSCalibur-CELLQuest and six-color FACSCanto-FACSCanto software techniques. High correlations were observed between data obtained with these techniques. Our study indicated that FACSCanto clinical software is accurate and sensitive in single-platform lymphocyte immunophenotyping.
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Levering WHBM, Wind H, Granger V, Sintnicolaas K, Hooijkaas H, Reilly JT, Gratama JW, Barnett D. Long-term stabilized blood samples as controls for flow cytometric HLA-B27 screening: a feasibility study. CYTOMETRY PART B-CLINICAL CYTOMETRY 2008; 74:169-81. [PMID: 18200592 DOI: 10.1002/cyto.b.20388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Long-term stabilized blood samples are potentially useful as positive or negative procedure controls for flow cytometric HLA-B27 screening, and could serve as test samples in an external quality assessment (EQA) scheme. We evaluated long-term stabilized whole blood specimens as prepared for the UK NEQAS for Leucocyte Immunophenotyping EQA scheme (Sheffield, UK). METHODS Peripheral blood samples were obtained from nine blood bank donors with known HLA-B typing. Short-term stabilization with Trans-FIXtrade mark was performed before shipment to Sheffield. Thereafter, long-term stabilization was performed. Commercially available HLA-B27 mAb were tested periodically between 1 week and 12 months on (i) fresh, (ii) short-term stabilized, and (iii) long-term stabilized blood samples using a stain, lyse, and wash technique. We compared the forward scatter (FSC), sideward scatter (SSC), and fluorescence signals of lymphocytes as a function of time. Furthermore, a pilot send-out with stabilized blood samples of four blood bank donors was distributed among the participants to the Benelux EQA scheme for HLA-B27 screening, and results were compared with historical EQA data obtained using nonstabilized blood samples from the same donors. RESULTS There were no major effects on FSC and SSC characteristics of lymphocytes. Background fluorescence of stabilized samples increased and specific fluorescence of stabilized HLA-B27 positive samples decreased as compared with fresh samples. However, discrimination between the investigated HLA-B27 positive and HLA-B27 negative samples remained feasible poststabilization. In the pilot send-out, the results obtained with stabilized samples were less concordant than with the corresponding fresh samples due to variable quality of the stabilized samples. CONCLUSION Long-term stabilized whole blood samples are potentially useful as true HLA-B27 positive and true HLA-B27 negative control cells for daily and longitudinal quality control of flow cytometric HLA-B27 screening. In the same way, long-term stabilized samples may be used for EQA purposes. However, these samples are currently not feasible for reagent validation purposes. Extensive quality control of long-term stabilized samples is necessary before distribution in multicenter surveys.
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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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23
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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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24
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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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Koehl U, Bochennek K, Esser R, Brinkmann A, Quaritsch R, Becker M, Soerensen J, Bader P, Schwabe D, Klingebiel T, Fischer J, Zimmermann SY. ISHAGE-based single-platform flowcytometric analysis for measurement of absolute viable T cells in fresh or cryopreserved products: CD34/CD133 selected or CD3/CD19 depleted stem cells, DLI and purified CD56+CD3− NK cells. Int J Hematol 2007; 87:98-105. [DOI: 10.1007/s12185-007-0018-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Revised: 08/27/2007] [Accepted: 09/27/2007] [Indexed: 01/25/2023]
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Ashman M, Sachdeva N, Davila L, Scott G, Mitchell C, Cintron L, Rathore M, Asthana D. Influence of 4- and 6-color flow cytometers and acquisition/analysis softwares on the determination of lymphocyte subsets in HIV infection. CYTOMETRY PART B-CLINICAL CYTOMETRY 2007; 72:380-6. [PMID: 17226862 DOI: 10.1002/cyto.b.20178] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Lymphocyte immunophenotyping provides valuable information for the diagnosis and monitoring of patients with cellular immunodeficiencies, such as HIV/AIDS. In this study, we have assessed the influence of 4-color and 6-color flow cytometers, and respective analytical softwares on the enumeration of lymphocytes in HIV infected individuals. METHODS The expression of various cell surface markers on lymphocytes was measured from the EDTA blood of 66 HIV infected patients on the FACSCalibur (4-color) and FACSCanto (6-color) flow cytometers. Percentage of lymphocytes expressing a particular cell surface marker was analyzed on FACSCalibur using the Cell Quest Pro software (v 5.2), while the analysis on FACSCanto was done using FACSCanto (v 1.0.3) and FACSDiva (v 4.1) softwares respectively. RESULTS The data shows significantly higher mean CD3 T-cell counts on FACSCalibur, Cell Quest Pro (1,864 +/- 1,044 cells/microl) as compared to FACSCanto (1,840 +/- 1,040 cells/microl) (P < 0.05). The CD4 T-cell counts were also higher on FACSCalibur, Cell Quest Pro (885 +/- 770 cells/microl), and FACSDiva (892 +/- 773 cells/microl) versus FACSCanto (867 +/- 767 cells/microl) (P < 0.05). FACSCalibur, Cell Quest Pro, and FACSDiva showed similar values except for CD8 T-lymphocytes where FACSDiva had significantly lower values (P < 0.05). The B-cell counts were unaffected when either of the instruments or softwares were used, while the natural killer (NK) cells (CD16 + 56 positive cells) showed similar trend like CD3 and CD4 counts with significant differences in the mean cell counts between FACSCalibur, Cell Quest Pro (240 +/- 165 cells/microl), and FACSDiva (238 +/- 163 cells/microl) versus FACSCanto with higher NK cell counts (260 +/- 176 cells/microl). CONCLUSIONS The enumeration of lymphocyte subsets was comparable between FACSCalibur, Cell Quest Pro, and FACSDiva, based analysis and it was significantly different than FACSCanto software based analysis. Our observations suggest that FACSDiva software should be preferred over the FACSCanto software for immunophenotyping on FACSCanto flow cytometer and the laboratories should report the instrument and software used for the specimen analysis while reporting immunophenotyping results.
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Affiliation(s)
- M Ashman
- University of Miami-Miller School of Medicine, Miami, Florida 33136, USA
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Brando B, Gatti A, Chianese R, Gratama JW. Twenty years of external quality assurance in clinical cell analysis--a tribute to Jean-Luc D'Hautcourt. CYTOMETRY PART B-CLINICAL CYTOMETRY 2007; 72:2-7. [PMID: 17177196 DOI: 10.1002/cyto.b.20154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
External quality assurance (EQA) programs in clinical cell analysis are now a consolidated item of laboratory practice. All the flow cytometric testings with an impact on clinical decision making have been submitted to regular EQA programs during the last 20 years, and this has produced internationally homogeneous guidelines, with a remarkable improvement in result reproducibility.Jean-Luc D'Hautcourt was a pioneer in this field, and his valuable contributions to flow cytometric method standardization and to the dissemination of the educational aspects of EQA programs are recognized. The different methodological approaches undertaken in the United States and Europe are discussed. The educational role of SIHON in the Benelux Countries and of UKNEQAS for Leucocyte Immunophenotyping worldwide is emphasized. Accredited and accreditating EQA programs require an impressive degree of organization and technical knowledge, so that only major international providers can afford such a task nowadays. However, small local studies still provide the necessary stimulus to the continuous improvement of the scientifical aspects of EQA schemes.
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Affiliation(s)
- Bruno Brando
- Haematology Laboratory and Transfusion Center, Legnano Hospital, Via Candiani 2, 20025 Legnano, Milan, Italy.
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Bürgisser P, Vaudaux J, Bart PA. Severe interference between retinal angiography and automated four-color flow cytometry analysis of blood mononuclear cells. Cytometry A 2007; 71:632-6. [PMID: 17487891 DOI: 10.1002/cyto.a.20414] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Retinal angiography has become a widely used diagnostic tool. It requires the intravenous administration of the fluorescent dyes fluorescein and indocyanin green. We recently received blood taken 8 h after retinal angiography, without our knowing it. We describe the failure of an automated flow cytometry system in the enumeration of lymphocyte subpopulations in this sample. METHODS Cell enumeration was achieved by the use of the lyse-no wash MultiTEST procedure (Becton-Dickinson) together with the FACSCalibur cytometer. Absolute cell counts were obtained using TruCount beads. Data were analyzed automatically by the MultiSET and manually with the CellQuest softwares. RESULTS The dot plots obtained with this sample looked quite abnormal. All monuclear cells stained brightly in the FITC channel irrespective of anti-CD3-FITC conjugate binding. This resulted in a major undercompensation for the increased spillover of the fluorescein emission into the PE-channel. PE-labeled cell and TruCount bead events coalesced. The MultiSET software failed to draw proper gatings and proved useless. Alternative manual gatings could partially rescue the analysis. CONCLUSIONS Clinicians and cytometrists should be aware that, because of dye entry or binding, blood mononuclear cells collected shortly after retinal angiography are not suitable even for common cytometry applications.
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Affiliation(s)
- Philippe Bürgisser
- Division of Immunology and Allergy, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
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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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Schmidt B, Fujimura SH, Martin JN, Levy JA. Variations in plasmacytoid dendritic cell (PDC) and myeloid dendritic cell (MDC) levels in HIV-infected subjects on and off antiretroviral therapy. J Clin Immunol 2006; 26:55-64. [PMID: 16418803 DOI: 10.1007/s10875-006-8401-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2005] [Accepted: 09/08/2005] [Indexed: 11/26/2022]
Abstract
Plasmacytoid and myeloid dendritic cells are reduced in AIDS patients. The number of these circulating cells was assessed cross-sectionally and longitudinally in 27 uninfected and 72 HIV-infected subjects on and off antiretroviral therapy. The plasmacytoid dendritic cell numbers were significantly reduced in the HIV-infected subjects compared to controls (p < 0.001). This reduction correlated directly with CD4+ cell counts (p < 0.001) and inversely with viral load (p < 0.001). These associations were found to a lesser degree for the myeloid dendritic cells. Intra-assay variability of these dendritic cell counts was < 10%. Antiretroviral therapy significantly increased plasmacytoid dendritic cell (p < 0.001) and CD4+ cell (p = 0.05) counts at 8 months by 76.9% and 19%, respectively. The plasmacytoid dendritic cell levels responded more readily to viral load increases and decreases than CD4+ cells. Circulating plasmacytoid dendritic cells may provide important additional information about immune function in HIV-infected subjects receiving or not receiving antiretroviral therapy.
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Affiliation(s)
- Barbara Schmidt
- Division Hematology/Oncology, Department of Medicine, University of California, San Francisco, California 94143-1270, USA
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31
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Edwards C, Belgrave D, Janossy G, Bradley NJ, Stebbings R, Gaines-Das R, Thorpe R, Sawle A, Arroz MJ, Brando B, Gratama JW, Orfao de Matos A, Papa S, Papamichail M, Lenkei R, Rothe G, Barnett D. Multicentre evaluation of stable reference whole blood for enumeration of lymphocyte subsets by flow cytometry. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2005. [PMID: 15973699 DOI: 10.1002/cyto.b.20061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND: Clinical indications for lymphocyte subset enumeration by flow cytometry include monitoring of disease progression and timing of therapeutic intervention in infection with human immunodeficiency virus. Until recently international standardisation has not been possible due to a lack of suitable stable reference material. METHODS: This study consisted of two trials of a stabilised whole blood preparation. Eleven participants were sent two standard protocols for staining plus gating strategy and asked to report absolute counts for lymphocyte subsets. RESULTS: No significant difference was detected between the two methods when results from the two assays and all partners were pooled. Significant differences in results from the different partners were observed. However, representative mean counts were obtained for geometric means, geometric coefficient of variation, and 95% confidence interval for CD3 910 cells/mul, 9%, and 888 to 933, respectively), CD4 (495 cells/mul, 12%, and 483 to 507), and CD8 (408 cells/mul, 13%, and 393 to 422). CONCLUSION: We have introduced a stabilised blood preparation and a well-characterized biological standard. The availability of this reference material greatly simplifies the validation of new techniques for CD4(+) T-cell enumeration and the expansion of external quality assurance programmes for clinical laboratories, including those that operate in resource-restricted environments. (c) 2005 Wiley-Liss, Inc.
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Affiliation(s)
- Cherry Edwards
- National Institute for Biological Standards and Control, Potters Bar, United Kingdom
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Heijnen IAFM, Barnett D, Arroz MJ, Barry SM, Bonneville M, Brando B, D'hautcourt JL, Kern F, Tötterman TH, Marijt EWA, Bossy D, Preijers FWMB, Rothe G, Gratama JW. Enumeration of antigen-specific CD8+ T lymphocytes by single-platform, HLA tetramer-based flow cytometry: a European multicenter evaluation. CYTOMETRY PART B-CLINICAL CYTOMETRY 2005; 62:1-13. [PMID: 15468327 DOI: 10.1002/cyto.b.20028] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND HLA class I peptide tetramers represent powerful diagnostic tools for detection and monitoring of antigen-specific CD8(+) T cells. The impetus for the current multicenter study is the critical need to standardize tetramer flow cytometry if it is to be implemented as a routine diagnostic assay. Hence, the European Working Group on Clinical Cell Analysis set out to develop and evaluate a single-platform tetramer-based method that used cytomegalovirus (CMV) as the antigenic model. METHODS Absolute numbers of CMV-specific CD8(+) T cells were obtained by combining the percentage of tetramer-binding cells with the absolute CD8(+) T-cell count. Six send-outs of stabilized blood from healthy individuals or CMV-carrying donors with CMV-specific CD8(+) T-cell counts of 3 to 10 cells/microl were distributed to 7 to 16 clinical sites. These sites were requested to enumerate CD8(+) T cells and, in the case of CMV-positive donors, CMV-specific subsets on three separate occasions using the standard method. RESULTS Between-site coefficients of variation of less than 10% (absolute CD8(+) T-cell counts) and approximately 30% (percentage and absolute numbers of CMV-specific CD8(+) T cells) were achieved. Within-site coefficients of variation were approximately 5% (absolute CD8(+) T-cell counts), approximately 9% (percentage CMV-specific CD8(+) T cells), and approximately 17% (absolute CMV-specific CD8(+) T-cell counts). The degree of variation tended to correlate inversely with the proportion of CMV-specific CD8(+) T-cell subsets. CONCLUSIONS The single-platform MHC tetramer-based method for antigen-specific CD8(+) T-cell counting has been evaluated by a European group of laboratories and can be considered a reproducible assay for routine enumeration of antigen-specific CD8(+) T cells.
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Affiliation(s)
- Ingmar A F M Heijnen
- Division of Immunology, Department of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland.
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Poláková K, Kuba D, Russ G. The 4H84 monoclonal antibody detecting beta2m free nonclassical HLA-G molecules also binds to free heavy chains of classical HLA class I antigens present on activated lymphocytes. Hum Immunol 2005; 65:157-62. [PMID: 14969770 DOI: 10.1016/j.humimm.2003.10.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2003] [Revised: 10/10/2003] [Accepted: 10/13/2003] [Indexed: 10/26/2022]
Abstract
We have found that 4H84 monoclonal antibody (mAb) used for detection of beta2m free HLA-G molecules also binds to free heavy chains of classical HLA class I antigens generated on the cell surface by mild acid treatment. Here we demonstrate that beta2m free classical HLA class I molecules induced on the surface of activated lymphocytes not expressing HLA-G also bind 4H84 mAb. These results demonstrate that 4H84 mAb should be used for detection of HLA-G in cells and tissues with backing by other HLA-G specific mAbs.
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MESH Headings
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/metabolism
- Antigens, CD/analysis
- Antigens, CD/immunology
- Antigens, Differentiation, B-Lymphocyte/analysis
- Antigens, Differentiation, B-Lymphocyte/immunology
- Cell Line, Tumor
- Cross Reactions/immunology
- Flow Cytometry
- Gene Expression/drug effects
- HLA Antigens/analysis
- HLA Antigens/genetics
- HLA Antigens/immunology
- HLA-G Antigens
- Histocompatibility Antigens Class I/analysis
- Histocompatibility Antigens Class I/genetics
- Histocompatibility Antigens Class I/immunology
- Histocompatibility Antigens Class I/metabolism
- Humans
- Hydrogen-Ion Concentration
- Leukocyte Common Antigens/analysis
- Leukocyte Common Antigens/immunology
- Leukocytes, Mononuclear/drug effects
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/metabolism
- Lymphocyte Activation/immunology
- Lymphocytes/drug effects
- Lymphocytes/immunology
- Lymphocytes/metabolism
- Phytohemagglutinins/pharmacology
- Receptors, Transferrin
- Reverse Transcriptase Polymerase Chain Reaction
- beta 2-Microglobulin/chemistry
- beta 2-Microglobulin/immunology
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Affiliation(s)
- Katarína Poláková
- Cancer Research Institute, Slovak Academy of Sciences, Institute of Preventive and Clinical Medicine, Bratislava, Slovak Republic
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Bisset LR, Lung TL, Kaelin M, Ludwig E, Dubs RW. Reference values for peripheral blood lymphocyte phenotypes applicable to the healthy adult population in Switzerland. Eur J Haematol 2004; 72:203-12. [PMID: 14962239 DOI: 10.1046/j.0902-4441.2003.00199.x] [Citation(s) in RCA: 155] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Use of domestic reference values is known to improve the accuracy of flow cytometric analysis by integrating local variation due to race, gender, and age. In the absence of previously published estimates, we now report establishment of reference values for a wide range of peripheral blood lymphocyte phenotypes applicable to the healthy adult population in Switzerland and other regions with similar demographic characteristics. METHODS A representative sample population was recruited from among well characterized local blood donors (n = 70) and quantitative multiparametric flow cytometry used to estimate absolute and proportional values for a range of T-, B-, and NK-cell subsets, including those associated with activation and maturity. Distribution-free methods were then applied to generate 95% reference values and to estimate the significance of gender and age-related differences. RESULTS Reference values were obtained for the absolute and proportional levels of total CD3(+) T cells (536-1787 cells/microL, 54.90-84.03%), helper CD4(+) T cells (309-1139 cells/microL, 32.53-62.88%), cytotoxic CD8(+) T cells (137-823 cells/microL, 11.55-38.60%), activated CD3(+) T cells expressing CD25 (7-94 cells/microL, 0.50-5.95%), CD38 (102-554 cells/microL, 5.98-26.80%), HLA-DR (18-186 cells/microL, 1.25-9.68%) or CD38/HLA-DR (4-52 cells/microL, 0.30-2.30%), activated CD4(+) T cells expressing CD25 (7-52 cells/microL, 0.33-2.80%), CD38 (69-547 cells/microL, 6.13-32.20%), HLA-DR (11-55 cells/microL, 0.80-4.43%) or CD38/HLA-DR (4-22 cells/microL, 0.30-1.35%), activated CD8(+) T cells expressing CD25 (0-12 cells/microL, 0.00-0.69%), CD38 (13-124 cells/microL, 0.93-7.03%), HLA-DR (6-108 cells/microL, 0.33-6.38%) or CD38/HLA-DR (2-47 cells/microL, 0.13-2.68%), naive CD4(+) T cells expressing CD45RA(+)/CD62L(+) (84-761 cells/microL, 9.48-41.88%), naive CD8(+) T cells expressing CD45RA(+)/CD62L(+) (42-360 cells/microL, 3.68-19.23%), memory CD4(+) T cells expressing CD45RO(+) (247-807 cells/microL, 16.50-42.15%), memory CD8(+) T cells expressing CD45RO(+) (72-377 cells/microL, 3.78-22.80%), B-cells expressing CD19 (72-460 cells/microL, 4.70-19.13%) or CD20 (66-529 cells/microL, 4.63-21.00%), total CD3(-)/(CD16(+)/CD56(+)) NK-cells (77-427 cells/microL, 5.35-30.93%), and activated NK-cells expressing CD25 (0-10 cells/microL, 0-0.50%) or HLA-DR (3-99 cells/microL, 0.20-7.28%). CONCLUSION It is anticipated that availability of localized reference values for an extended range of peripheral blood lymphocyte phenotypes should supplement previously published reference values and enhance the utility of flow cytometric analysis undertaken in Switzerland.
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Affiliation(s)
- Leslie R Bisset
- Department of Internal Medicine, University Hospital, Zürich, Switzerland.
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Chng WJ, Tan GB, Kuperan P. Establishment of adult peripheral blood lymphocyte subset reference range for an Asian population by single-platform flow cytometry: influence of age, sex, and race and comparison with other published studies. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2004; 11:168-73. [PMID: 14715565 PMCID: PMC321350 DOI: 10.1128/cdli.11.1.168-173.2004] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2003] [Revised: 09/25/2003] [Accepted: 11/07/2003] [Indexed: 11/20/2022]
Abstract
We established a normal reference range for peripheral blood lymphocyte subsets in a multiracial adult population by using single-platform flow cytometry. Further analysis of our cohort showed that the CD8+-cell counts decrease with age, there is a gender difference in NK cell percentages and counts, and there are significant differences in the CD3+-, CD4+-, and CD19+-cell counts between Indians and other racial groups. Overall, our results are significantly different from other published data. This difference further stresses the need for different populations to establish their own reference ranges as these may have important implications for the management of patients with human immunodeficiency virus and AIDS. The use of single-platform flow cytometry will eliminate some of the variability between different study centers, making studies more comparable. This platform should be used for future studies into the effects of age, sex, and race on lymphocyte subsets.
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Affiliation(s)
- Wee J Chng
- Department of Haematology-Oncology, National University Hospital, Singapore, Republic of Singapore.
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Wölfl M, Schalk S, Hellmich M, Huster KM, Busch DH, Berthold F. Quantitation of MHC tetramer-positive cells from whole blood: Evaluation of a single-platform, six-parameter flow cytometric method. Cytometry A 2003; 57:120-30. [PMID: 14750134 DOI: 10.1002/cyto.a.10116] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Quantitation of antigen-specific T cells provides an insight into the development and dynamics of T-cell responses in tumor immunology and infectious diseases. Soluble major histocompatibility class I tetramers are widely used to monitor immune responses; however, variations due to handling and analysis are likely to confound comparisons between different experiments and laboratories. METHODS Whole blood from healthy donors was stained with HLA-A*0201/tetramers specific for an epitope of phosphoprotein 65, the immunodominant antigen in cytomegalovirus infection. With the help of Trucount tubes, a single-platform, four-color flow cytometric assay was established to obtain absolute counts of tetramer-positive cells. Various staining and gating strategies were evaluated. RESULTS The no-wash method was a quick and straightforward procedure for the quantitation of tetramer-positive events from whole blood. The level for background staining was low. This information about the intra-assay-related variation and the physiologic variation will allow validation and interpretation of data in future studies. CONCLUSIONS The method is highly reliable and can be standardized for multiple experiments. It is therefore suitable for the direct ex vivo analysis of antigen-specific T cells in a variety of clinical settings such as infectious, autoimmune, or neoplastic diseases and can be implemented as a tool for multicenter studies.
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Affiliation(s)
- Matthias Wölfl
- Children's Hospital, Department of Pediatric Hematology and Oncology, University of Cologne, Cologne, Germany.
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Whitby L, Granger V, Storie I, Goodfellow K, Sawle A, Reilly JT, Barnett D. Quality control of CD4+ T-lymphocyte enumeration: results from the last 9 years of the United Kingdom National External Quality Assessment Scheme for Immune Monitoring (1993-2001). CYTOMETRY 2002; 50:102-10. [PMID: 12116352 DOI: 10.1002/cyto.10094] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The human immunodeficiency virus (HIV) global epidemic has necessitated the routine enumeration of T-lymphocyte subsets, which has created a need for external quality assurance (EQA). The United Kingdom National External Quality Assessment Scheme (UK NEQAS) for Immune Monitoring provides EQA for 296 laboratories in 40 countries. In 1993, UK NEQAS developed and incorporated into its program stabilized whole blood that enables the accurate monitoring of laboratory performance. Overall, the mean interlaboratory coefficient of variation (CV) for percentage CD4(+) T-lymphocyte subset enumeration has fallen from 15% to less than 5%, as a direct result of the increased use of CD45/ side scatter (SSC) gating. Laboratories using alternative gating strategies (i.e., CD45/CD14 or forward scatter [FSC]/SSC) were about 7.4 times more likely to fail an EQA exercise. Furthermore, the adoption of single-platform technology resulted in a reduction of the overall mean interlaboratory CV for absolute CD4(+) T lymphocytes from 56% (prior to the widespread use of single-platform technology) to 9.7%. Individual laboratory deficiencies were also identified using a performance monitoring system and, through re-education by collaboration with the coordinating center, satisfactorily resolved. In conclusion, during the last 9 years, the UK NEQAS for Immune Monitoring program has highlighted the significant technological advances made by laboratories worldwide that undertake lymphocyte subset enumeration.
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Affiliation(s)
- Liam Whitby
- UK NEQAS for Leucocyte Immunophenotyping, Department of Haematology, Royal Hallamshire Hospital, 1st Floor, Rutledge Mews, 3 Southbourne Road, Sheffield S10 2QN, United Kingdom
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