1. Reference intervals for lymphocyte subsets in preterm and term neonates without immune defects
- Author
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Joseph A. Church, Stanley J. Naides, Robert J. Currier, Stanley Sciortino, Jennifer M. Puck, and George S. Amatuni
- Subjects
0301 basic medicine ,Male ,Allergy ,Helper-Inducer ,Lymphocyte ,T-Lymphocytes ,reference range/reference interval ,T-cell subsets ,memory T cell ,Reproductive health and childbirth ,CD8-Positive T-Lymphocytes ,Low Birth Weight and Health of the Newborn ,Polymerase Chain Reaction ,0302 clinical medicine ,Receptors ,Infant Mortality ,Immunology and Allergy ,Flow cytometry ,Immunodeficiency ,Pediatric ,education.field_of_study ,B-Lymphocytes ,T-cell receptor excision circles ,T-Lymphocytes, Helper-Inducer ,severe combined immunodeficiency ,medicine.anatomical_structure ,Antigen ,Female ,Sample collection ,Infant, Premature ,Population ,Immunology ,Receptors, Antigen, T-Cell ,Gestational Age ,neonatal immunity ,Vaccine Related ,03 medical and health sciences ,naive T cell ,Clinical Research ,Preterm ,030225 pediatrics ,White blood cell ,medicine ,Genetics ,Humans ,Lymphocyte Count ,education ,Premature ,T-cell receptor excision circle ,Newborn screening ,business.industry ,newborn screening ,Inflammatory and immune system ,Infant, Newborn ,Infant ,preterm birth ,Perinatal Period - Conditions Originating in Perinatal Period ,medicine.disease ,T-Cell ,Newborn ,030104 developmental biology ,Dried Blood Spot Testing ,business ,Memory T cell - Abstract
Background In 6.5 years of newborn screening for severe combined immunodeficiency in California, 3,252,156 infants had DNA from dried blood spots (DBSs) assayed for T-cell receptor excision circles. Infants with T-cell receptor excision circle values of less than a designated cutoff on a single DBS, 2 DBS samples with insufficient PCR amplification, or known genetic risk of immunodeficiency had peripheral blood complete blood counts and lymphocyte subsets assayed in a single flow cytometry laboratory. Cases in which immune defects were ruled out were available for analysis. Objective We sought to determine reference intervals for lymphocyte subsets in racially/ethnically diverse preterm and term newborns who proved to be unaffected by any T-lymphopenic immune disorder. Methods Effective gestational age (GA) was defined as GA at birth plus postnatal age at the time of sample collection. After determining exclusion criteria, we analyzed demographic and clinical information, complete and differential white blood cell counts, and lymphocyte subsets for 301 infants, with serial measurements for 33 infants. Lymphocyte subset measurements included total T cells, helper and cytotoxic T-cell subsets, naive and memory phenotype of each T-cell subset, B cells, and natural killer cells. Results Reference intervals were generated for absolute numbers and lymphocyte subsets from infants with effective GAs of 22 to 52 weeks. Sex and ethnicity were not significant determinants of lymphocyte subset counts in this population. Lymphocyte counts increased postnatally. Conclusion This study provides a baseline for interpreting comprehensive lymphocyte data in preterm and term infants, aiding clinicians to determine which newborns require further evaluations for immunodeficiency.
- Published
- 2019