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HelpTest Code QNKS Natural Killer (NK)/Natural Killer T-Cell Subsets, Quantitative, Blood
Useful For
Quantitation of the major natural killer (NK)-cell subsets relative to total NK cells (NK cell subsets) or total lymphocytes (NK T cells)
Assessment in the following clinical contexts: HIV, primary immune deficiencies with NK cell defects, NK-cell lymphocytosis, solid-organ transplantation, immune reconstitution following bone marrow or hematopoietic cell transplantation
This test is not useful for diagnosis or classification of NK cell malignancies.
This test should not be used for assessing NK cell cytotoxic function.
Reporting Name
Quantitative NK/NKT SubsetsSpecimen Type
WB Sodium HeparinSpecimen Minimum Volume
0.2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| WB Sodium Heparin | Ambient | 30 hours | GREEN TOP/HEP |
Reference Values
The appropriate age-related reference values will be provided on the report. Pediatric reference values are not available for patients younger than 7 years and therefore, interpretation will be based on the 7- to 17-year old ranges with appropriate cautionary statements in the interpretation.
Interpretation
Interpretive comments will be provided, where applicable, along with reference range values for adult patients and pediatric patients from age 7 to 17 years. Since a separate pediatric reference range could not be established for patients younger than 7 years at this time, interpretation of these samples will be made using the 7- to 17-year old reference range as an approximate guideline.
Clinical Reference
1. Fan YY, Yang BY, Wu CY. Phenotypically and functionally distinct subsets of natural killer cells in human PBMCs. Cell Biol Int. 2008;32(2):188-197
2. Cooper MA, Fehniger TA, Caligiuri MA. The biology of human natural killer-cell subsets. Trends Immunol. 2001;22(11):633-640
3. Poli A, Michel T, Theresine M, Andres E, Hentges F, Zimmer J. CD56bright natural killer (NK) cells: an important NK cell subset. Immunology. 2009126(4):458-465. doi:10.1111/j.1365-2567.2008.03027.x
4. von Bubnoff D, Andres E, Hentges F, Bieber T, Michel T, Zimmer Jl. Natural killer cells in atopic and autoimmune diseases of the skin. J Allergy Clin Immunol. 2010;125(1):60-68. doi:10.1016/j.jaci.2009.11.020
5. Vossen MT, Matmati M, Hertoghs KM, et al. CD27 defines phenotypically and functionally different human NK cell subsets. J Immunol. 2008;180(6):3739-3745. doi:10.4049/jimmunol.180.6.3739
6. Suarez-Alvarez B, Lopez-Vazquez A, Baltar JM, Ortega F, Lopez-Larrea C. Potential role of NKG2D and its ligands in organ transplantation: a new target for immunointervention. Am J Transplant. 2009;9(2):251-257. doi:10.1111/j.1600-6143.2008.02526.x
7. Borrego F, Robertson MJ, Ritz J, Pena J, Solana R. CD69 is a stimulatory receptor for NK cell and its cytotoxic effect is blocked by CD94 inhibitory receptor. Immunology. 1999;97(1):159-165. doi:10.1046/j.1365-2567.1999.00738.x
8. Takahashi K, Aranami T, Endoh M, Miyake S, Yamamura T. The regulatory role of natural killer cells in multiple sclerosis. Brain. 2004;127(Pt 9):1917-1927. doi:10.1093/brain/awh219
9. Alter G, Malenfant JM, Altfeld M: CD107a as a functional marker for the identification of natural killer cell activity. J Immunol Methods. 2004;294(1-2):15-22
10. Mathew PA, Chuang SS, Vaidya SV, Kumaresan PR, Boles KS, Pham HTK. The LLT1 receptor induces IFN-gamma production by human natural killer cells. Mol Immunol. 2004;40(16):1157-1163. doi:10.1016/j.molimm.2003.11.024
11. Godfrey DI, Stankovic S, Baxter AG. Raising the NKT cell family. Nat Immunol. 2010;11(3):197-206. doi:10.1038/ni.1841
12. Orange JS. Human natural killer cell deficiencies. Curr Opin Allergy Clin Immunol. 2006;6(6):399-409
13. Marsh RA, Villaneuva J, Kim MO, et al. Patients with X-linked lymphoproliferative disease due to BIRC4 mutation have normal invariant natural killer T-cell populations. Clin Immunol. 2009;132(1):116-123. doi:10.1016/j.clim.2009.03.517
14. Rigaud S, Fondaneche MC, Lambert N, et al. XIAP deficiency in humans causes an X-linked lymphoproliferative syndrome. Nature. 2006;444:110-114. doi:10.1038/nature05257
15. Villanueva J, Lee S, Giannini EH, et al. Natural killer cell dysfunction is a distinguishing feature of systemic onset juvenile rheumatoid arthritis and macrophage activation syndrome. Arthritis Res Ther. 2005;7:R30-R37. doi:10.1186/ar1453
16. Tarazona R, Casado JG, Delarosa O, et al. Selective depletion of CD56(dim) NK cell subsets and maintenance of CD56(bright) NK cells in treatment-naive HIV-1-seropositive individuals. J Clin Immunol. 2002;22(3):176-183. doi:10.1023/a:1015476114409
17. Mavilio D, Lombardo G, Benjamin J, et al. Characterization of CD56-/CD16+ natural killer (NK) cells: a highly dysfunctional NK subset expanded in HIV-infected viremic individuals. Proc Natl Acad Sci USA. 2005;102(8):2886-2891. doi:10.1073/pnas.0409872102
18. Timmons BW, Cieslak T. Human natural killer subsets and acute exercise: a brief review. Exerc Immunol Rev. 2008;14:8-23
19. Muntasell A, Magri G, Pende D, Angulo A, Lopez-Botet M. Inhibition of NKG2D in NK cells by cytokines secreted in response to human cytomegalovirus infection. Blood. 2010;115(25):5170-5179. doi:10.1182/blood-2009-11-256479
20. Trempat P, Tabiasco J, Andre P, et al. Evidence for early infection on nonneoplastic natural killer cells by Epstein-Barr virus. J Virol. 2002;76(21):11139-11142. doi:10.1128/jvi.76.21.11139-11142.2002
21. Pacheco SE, Gottschalk SM, Gresik MV, Dishop MK, Okmaura T, McCormick TG. Chronic active Epstein-Barr virus infection of natural killer cells presenting as severe skin reaction to mosquito bites. J Allergy Clin Immunol. 2005 Aug;116(2):470-472. doi:10.1016/j.jaci.2005.04.044
22. Mace EM, Orange JS. Emerging insights into human health and NK cell biology from the study of NK cell deficiencies. Immunol Rev. 2019;287(1):202-225
23. Delmonte OM, Fleisher TA. Flow cytometry: Surface markers and beyond. J Allergy Clin Immunol. 2019;143(2):528-537
24. Knight V, Heimall JR, Chong H, et al. A toolkit and framework for optimal laboratory evaluation of individuals with suspected primary immunodeficiency. J Allergy Clin Immunol Pract. 2021;9(9):3293-3307.e6
Day(s) Performed
Monday through Friday
Report Available
3 to 4 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86356 x3
86359
86357
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| QNKS | Quantitative NK/NKT Subsets | 98073-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| QNKSI | Quantitative NK/NKT Interpretation | 69052-9 |
| NKA45 | Total Lymphs (CD45+) | 27071-0 |
| NKP3N | % Total CD45+CD3- cells | 89311-5 |
| NKA3N | Total CD45+CD3- cells | 89313-1 |
| NKP | % Total NK Cells | 8112-5 |
| NKA | Total NK Cells | 9728-7 |
| NKPCY | % Cytotoxic NK (CD16++CD56+) | 42189-1 |
| NKACY | Cytotoxic NK (CD16++CD56+) | 42188-3 |
| NK56P | % Cytokine-Producing NK (CD56++) | 8133-1 |
| NK56A | Cytokine-Producing NK (CD56++) | 14113-5 |
| NKPL3 | % Total CD45+CD3+ Cells | 56907-9 |
| NKAL3 | Total CD45+CD3+ Cells | 89312-3 |
| NKTP | % NKT cells (CD3+CD56+) | 17135-5 |
| NKTA | NKT cells (CD3+CD56+) | 26858-1 |
Method Name
Flow Cytometry
Ordering Guidance
This assay does not measure cell-surface or intracellular proteins on natural killer or natural killer T-cell subsets.
A minimum CD45 lymph count (as measured by flow cytometry in the laboratory) is required to report this test. If that requirement is not met (eg, patients with severe lymphopenia), the test will be canceled and an alternate test will be suggested (TBBS / Quantitative Lymphocyte Subsets: T, B, and Natural Killer [NK] Cells, Blood).
Shipping Instructions
Send specimen Monday through Thursday only. Specimen must arrive within 24 hours of collection and by 10 a.m. Central time on Friday.
Collect and package specimen as close to shipping time as possible. Ship specimen overnight.
Necessary Information
The ordering healthcare professional's name and phone number are required.
Specimen Required
Container/Tube: Green top (sodium heparin)
Specimen Volume: 3 mL
Collection Instructions: Send whole blood specimen in original tube. Do not aliquot.
Additional Information: For serial monitoring, it is recommended that specimens are collected at the same time of day.