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HelpTest Code TCP T-Cell Subsets, Naive, Memory, and Activated, Blood
Reporting Name
T Cell Phenotyping, AdvancedUseful For
Determining the presence of naive, memory, and activated T cells in various clinical contexts including autoimmune diseases, immunodeficiency states, T-cell recovery post-hematopoietic stem cell transplant, DiGeorge syndrome, and as a measure for T-cell immune competence
Naive T-cells results can be used as a surrogate marker for thymic-derived T-cell reconstitution, when used in conjunction with assessment of T-cell receptor excision circles (TRECS / T-Cell Receptor Excision Circles Analysis, Blood)
Assessing a patient's relative risk for infections
Evaluating patients with cellular or combined primary immunodeficiencies
Evaluating T-cell reconstitution after hematopoietic stem cell transplant, chemotherapy, biological therapy, immunosuppression, or immunomodulator therapy
Evaluating patients with autoimmune diseases
Evaluating patients who are HIV-positive for naive and memory subsets
Evaluating T-cell immune competence (presence of memory and activated T cells) in patients with recurrent infections
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Whole Blood EDTAOrdering Guidance
This assay provides quantitative information on various T-cell subsets in blood; it does not provide any information on the antigen-specific or otherwise functional state of the T cells.
To assess the overall functional state of T cells, order either LPMGF / Lymphocyte Proliferation to Mitogens, Blood or LPAGF / Lymphocyte Proliferation to Antigens, Blood (using Candida and tetanus antigens).
To assess cytomegalovirus (CMV)-specific immune competence, order CMVC8 / Cytomegalovirus (CMV) CD8 T-Cell Immune Competence, Quantitative Assessment by Flow Cytometry, Blood.
Shipping Instructions
Testing performed Monday through Friday. Specimens not received by 4 p.m. Central time on Fridays may be canceled.
Specimens arriving on the weekend and observed holidays may be canceled.
Collect and package specimen as close to shipping time as possible.
It is recommended that specimens arrive within 24 hours of collection.
Necessary Information
Ordering healthcare professional's name and phone number are required.
Specimen Required
Container/Tube: Lavender top (EDTA)
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.
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole Blood EDTA | Ambient | 72 hours | PURPLE OR PINK TOP/EDTA |
Reference Values
The appropriate age-related reference values will be provided on the report.
Day(s) Performed
Monday through Friday
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 x 7
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TCP | T Cell Phenotyping, Advanced | 96493-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 609282 | CD4 (T Cells) | 24467-3 |
| 609283 | CD8 (T Cells) | 14135-8 |
| 29151 | %CD4+CD45RA+ naive T cells | 89360-2 |
| 29152 | %CD4+CD62L+CD27+ naive T cells | 89340-4 |
| 29153 | %CD8+CD45RA+ naive T cells | 82744-4 |
| 29154 | %CD8+CD62L+CD27+naive T cells | 89339-6 |
| 29155 | %CD4+CD45RO+ memory T cells | 89362-8 |
| 29156 | %CD4+CD62L+CD27+CD45RO+ (Tcm) | 89338-8 |
| 29157 | %CD4+CD62L-CD27-CD45RO+ (Tem) | 89337-0 |
| 29158 | %CD8+CD45RO+ memory T cells | 89336-2 |
| 29159 | %CD8+CD62L+CD27+CD45RO+ (Tcm) | 89335-4 |
| 29160 | %CD8+CD62L-CD27-CD45RO+ (Tem) | 89334-7 |
| 29161 | %Activated CD4 T cells (4+CD25+) | 89431-1 |
| 29162 | %CD4+HLA DR+CD28+ T cells | 89333-9 |
| 29163 | %CD8+HLA DR+CD28+ T cells | 89332-1 |
| 29164 | CD4+CD45RA+ naive T cells | 26759-1 |
| 29165 | CD4+CD62L+CD27+ naive T cells | 89331-3 |
| 29166 | CD8+CD45RA+ naive T cells | 82743-6 |
| 29167 | CD8+CD62L+CD27+naive T cells | 89330-5 |
| 29168 | CD4+CD45RO+ memory T cells | 85792-0 |
| 29169 | CD4+CD62L+CD27+CD45RO+ (Tcm) | 89329-7 |
| 29170 | CD4+CD62L-CD27-CD45RO+ (Tem) | 89328-9 |
| 29171 | CD8+CD45RO+ memory T cells | 85790-4 |
| 29172 | CD8+CD62L+CD27+CD45RO+ (Tcm) | 96492-4 |
| 29173 | CD8+CD62L-CD27- CD45RO+ (Tem) | 89327-1 |
| 29174 | Activated CD4 T cells (4+CD25+) | 26982-9 |
| 29175 | CD4+HLA DR+CD28+ T cells | 89326-3 |
| 29176 | CD8+HLA DR+CD28+ T cells | 89325-5 |
| 29178 | Interpretation | 69052-9 |
Interpretation
Absence or reduction of naive T cells with or without T-cell lymphopenia indicates absent or impaired T-cell reconstitution or thymic output. Reduction in activated T cells can also indicate a reduced T-cell immune competent state.
Increases in naive T cells with corresponding decreases in the memory T-cell compartment indicates a failure of further differentiation and effector function or selective loss of memory T cells and an increased risk for infection.
Clinical Reference
1. Bettelli E, Oukka M, Kuchroo VK. T(H)-17 cells in the circle of immunity and autoimmunity. Nat Immunol. 2007;8(4):345-350
2. De Rosa SC, Herzenberg LA, Herzenberg LA, Roederer M. 11-color, 13-parameter flow cytometry: identification of human naive T-cells by phenotype, function, and T-cell receptor diversity. Nat Med. 2001;7(2):245-248
3. Sallusto F, Lenig D, Forster R, Lipp M, Lanzavecchia A. Two subsets of memory T-lymphocytes with distinct homing potentials and effector functions. Nature. 1999;401(6754):708-712
4. Picker LJ, Treer JR, Ferguson-Darnell B, Collins PA, Buck D, Terstappen LW. Control of lymphocyte recirculation in man. I. Differential regulation of the peripheral lymph node homing receptor L-selectin on T-cells during the virgin to memory cell transition. J Immunol. 1993;150(3):1105-1121
5. Morimoto C, Schlossman SF. P. Rambotti lecture. Human naive and memory T-cells revisited: New markers (CD31 and CD27) that help define CD4+ T-cell subsets. Clin Exp Rheumatol. 1993;11(3):241-247
6. LaRosa DF, Orange JS. Lymphocytes. J Allergy Clin Immunol. 2008;121(2 Suppl):S364-369
7. Foster AE, Marangolo M, Sartor MM, et al. Human CD62L-memory T-cells are less responsive to alloantigen stimulation than CD62L+ naive T-cells: potential for adoptive immunotherapy and allodepletion. Blood. 2004;104(8):2403-2409
8. Brenchley JM, Douek DC, Ambrozal DR, Chatterji M, Betts MR, Davis LS, Koup RA. Expansion of activated human naive T-cells preceded effector function. Clin Exp Immunol. 2002;130(3):431-440
9. Holling TM, van der Stoep N, Quinten E, van den Elsen PJ. Activated human T-cells accomplish MHC class II expression through T-cell specific occupation of class II transactivator promoter III. J Immunol. 2002;168(2):763-770
10. Thompson CB, Lindsten T, Ledbetter JA, et al. CD28 activation pathway regulates the production of multiple T-cell-derived lymphokines/cytokines. Proc Natl Acad Sci USA. 1989;86(4):1333-1337
11. Carmichael KF, Abayomi A. Analysis of diurnal variation of lymphocyte subsets in healthy subjects and its implication in HIV monitoring and treatment. 15th Intl Conference on AIDS, Bangkok, Thailand, 2004, Abstract B11052
12. Dimitrov S, Benedict C, Heutling D, Westermann J, Born J, Lange T: Cortisol and epinephrine control opposing circadian rhythms in T cell subsets. Blood. 2009;113(21):5134-5143
13. Dimitrov S, Lange T, Nohroudi K, Born J. Number and function of circulating antigen presenting cells regulated by sleep. Sleep. 2007;30(4):401-411
14. Kronfol Z, Nair M, Zhang Q, Hill EE, Brown MB. Circadian immune measures in healthy volunteers: relationship to hypothalamic-pituitary-adrenal axis hormones and sympathetic neurotransmitters. Psychosom Med. 1997;59(1):42-50
15. Malone JL, Simms TE, Gray GC, Wagner KF, Burge JR, Burke DS. Sources of variability in repeated T-helper lymphocyte counts from HIV 1-infected patients: total lymphocyte count fluctuations and diurnal cycle are important. J Acquir Immune Defic Syndr (1988). 1990;3:144-151
16. Paglieroni TG, Holland PV. Circannual variation in lymphocyte subsets, revisited. Transfusion. 1994;34(6):512-516
17. Delmonte OM, Fleisher TA. Flow cytometry: Surface markers and beyond. J Allergy Clin Immunol. 2019;143(2):528-537
18. 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
Report Available
3 to 4 daysMethod Name
Flow Cytometry