Lymphocyte Activity Profile

The proportion of all immune cells that are T cells

the percentage of white blood cells (lymphocytes) that are CD4 cells.

The proportion of all T cells that are CD8 cells.

receptor for IL2 and is expressed on activated T cells, B cells, and macrophages.

Controversial test to detect/track Lyme disease

% NK (CD56/16): What It Measures and Why It Matters The percentage of natural killer (NK) cells expressing both CD56 and CD16—reported as % NK (CD56/16)—is an important marker used to differentiate NK cell subtypes and assess immune function. NK cells are key components of the innate immune system, and their behavior varies based on surface marker expression: CD56^bright / CD16^low NK cells: These cells specialize in cytokine production, immune regulation, and modulating T cell activity. They are less cytotoxic but play a central role in shaping immune responses. CD56^dim / CD16^high NK cells: These are the cytotoxic subset, responsible for directly killing virus-infected and cancerous cells. Measuring % NK (CD56/16) provides insight into the functional balance between immunoregulatory and cytotoxic NK cells, which is relevant in evaluating immune responses, tracking disease progression, and understanding conditions such as infections, cancer, autoimmune disorders, and immunodeficiencies.

Ab NK (CD56/16) refers to the antibody staining of natural killer (NK) cells to detect the presence of specific surface markers, CD56 and CD16. CD56 is a neural cell adhesion molecule, and CD16 is an Fc receptor. Ab NK (CD56/16) analysis is crucial in identifying and characterizing different subsets of NK cells, including the CD56bright and CD56dim populations, each with distinct functional roles in the immune system. CD56bright NK cells are known for their regulatory functions and cytokine production, while CD56dim NK cells are associated with cytotoxic activities and antibody-dependent cell-mediated cytotoxicity (ADCC). The assessment of Ab NK (CD56/16) provides valuable insights into the composition and function of NK cells, contributing to a better understanding of immune responses and potential implications in various health conditions.

CD25 is the receptor for IL2 and is expressed on activated T cells, B cells, and macrophages. CD25 is expressed in certain types of B-cell lymphoma (hairy cell leukemia) and T-cell lymphoma (adult T-cell lymphoma/leukemia [ATLL]). The interleukin-2 receptor is designated CD25. Originally isolated from T-lymphocytes, it is now known to be expressed on hairy cell leukemia and adult T-cell leukemia/lymphoma, classical Hodgkin lymphoma, and a subset of other peripheral T-cell lymphomas. General information: Lymphocytes in peripheral blood (circulation) are heterogeneous and can be broadly classified into T cells, B cells, and natural killer (NK) cells. There are various subsets of each of these individual populations with specific cell-surface markers and function. This assay provides absolute (cells/mcL) and relative (%) quantitation for the main categories of T cells, B cells, and NK cells, in addition to a total lymphocyte count (= CD45+). - Each of these lymphocyte subpopulations have distinct effector and regulatory functions and are maintained in homeostasis under normal physiological conditions. - Each of these lymphocyte subsets can be identified by a combination of one or more cell surface markers. T-cell: The CD3 antigen is a pan-T-cell marker, and T cells can be further divided into 2 broad categories, based on the expression of CD4 or CD8 coreceptors. B cells: B cells can be identified by expression of CD19. NK cells: NK cells are typically identified by the coexpression of CD16 and CD56. Summary: Total T-cells (CD3+) B-cells (CD3-/CD19+) Natural killer (NK) cells (CD3-/CD56+CD16+) Helper/inducer (CD3+/CD4+) T-cell subset cytotoxic/suppressor (CD3+/CD8+) T-cell subset Total CD45+ lymphocyte count CD4:CD8 ratio ----------------------------- The absolute counts of lymphocyte subsets are known to be influenced by a variety of biological factors, including hormones, the environment, and temperature. The studies on diurnal (circadian) variation in lymphocyte counts have demonstrated progressive increase in CD4 T-cell count throughout the day, while CD8 T cells and CD19+ B cells increase between 8:30 a.m. and noon with no change between noon and afternoon. NK-cell counts, on the other hand, are constant throughout the day. Circadian variations in circulating T-cell counts have been shown to be negatively correlated with plasma cortisol concentration. In fact, cortisol and catecholamine concentrations control distribution and, therefore, numbers of naive versus effector CD4 and CD8 T cells. It is generally accepted that lower CD4 T-cell counts are seen in the morning compared to the evening and during summer compared to winter. These data, therefore, indicate that timing and consistency in timing of blood collection is critical when serially monitoring patients for lymphocyte subsets. Abnormalities in the number and percent of T (CD3, CD4, CD8), B (CD19), and NK (CD16+CD56) lymphocytes have been described in a number of different disease conditions. In patients who are infected with HIV, the CD4 count is measured for AIDS diagnosis and for initiation of antiviral therapy. The progressive loss of CD4 T lymphocytes in patients infected with HIV is associated with increased infections and complications. The Public Health Service has recommended that all patients who are HIV-positive be tested every 3 to 6 months for the level of CD4 T lymphocytes. Lymphocyte subset quantitation is also very useful in the evaluation of patients with primary immunodeficiencies of all ages, including follow-up for newborn screening for severe combined immunodeficiency and immune monitoring following immunosuppressive therapy for transplantation, autoimmunity, or any other relevant clinical condition where immunomodulatory treatment is used. It is also helpful as a preliminary screening assay for gross quantitative anomalies in any lymphocyte subset, whether related to malignancies or infection. The 2008 guidelines for diagnosis and treatment of Chronic Lymphocytic Leukemia (CLL) from the International Workshop on Chronic Lymphocytic Leukemia recommends changing the diagnostic criteria for CLL from an absolute lymphocyte count greater than 5 x 10(9)/L to a circulating B-cell count greater than 5 x 10(9)/L(8,9) previously defined in the 1996 National Cancer Institute (NCI) guidelines for CLL. This flow cytometric assay enables accurate quantitation of circulating B cells using a single platform technology with absolute quantitation through the use of flow cytometry beads. Sources: https://www.mayocliniclabs.com/test-catalog/Overview/9336#Clinical-and-Interpretive https://www.cancer.gov/publications/dictionaries/cancer-terms/def/t-cell https://www.rcpa.edu.au/Manuals/RCPA-Manual/Pathology-Tests/L/Lymphocyte-immunophenotyping References: Milioglou I, Kalaitzidou I, Ladomenou F. Interpretation of lymphocyte subset counts by the general pediatrician. Pediatr Int. 2019 Jan;61(1):16-22. doi: 10.1111/ped.13701. Epub 2018 Dec 10. PMID: 30248214.

Why use the CD57 test? The CD57 test is offered in some clinical laboratories and is being used by some health practitioners to evaluate and follow patients diagnosed with chronic Lyme disease. What is Lyme disease? Lyme disease, the most common vector-borne illness in the United States, is caused by Borrelia burgdorferi and transmitted by the bite of the Ixodes sp. tick (the deer tick). The disease usually begins with erythema migrans, an expanding skin lesion at the site of the tick bite. Within several days or weeks, there is hematogenous dissemination of the spirochetes, and patients may present with dermatologic, neurological, cardiac, and rheumatologic involvement. What is chronic lyme disease? Chronic Lyme disease is a controversial term applied to a broad spectrum of patients, including individuals with Lyme disease and those with post-Lyme disease syndrome (PLDS), as well as patients with no evidence of current or past Borrelia burgdorferi infection. PLDS is defined as the persistence or relapse of nonspecific symptoms (such as fatigue, musculoskeletal pain, and cognitive complaints) in patients who have had Lyme disease and have received an adequate course of antibiotic therapy. It has been reported that people with “chronic Lyme disease” have a decreased number of natural killer cells (NK cells), as defined by the CD57 marker. Although acute infections can be treated with antibiotics, failure to treat may result in a chronic, debilitating illness characterized by musculoskeletal and neurologic symptoms. Chronic Lyme disease may be difficult to treat, but also to diagnose What are white blood cells? White blood cells (=leukocytes) help the body to fight infections and other diseases. The human immune system consists of several different types of white blood cells with one category being called Lymphocytes. Lymphocytes attack antigens (foreign proteins). Lymphocytes consists of 3 subcategories of white blood cells known as B-Cells, T-Cells, and Natural Killer Cells. B-cells – responsible for antibody production T-cells – responsible for killing foreign invaders. natural killer (NK) cells – responsible for killing foreign invaders. Natural killer cells versus T-cells: Natural killer cells are the first line of defense against foreign pathogens and they belong to the innate immune system. They are not specific in their immune response and recognize a wide variety of pathogens. T-cells, on the other side, belong to the adaptive immune system. They are much more focused and highly specialized. What are CD markers? CD stands for cluster designation. CD is a glycoprotein molecule on the cell surface that acts as an identifying marker. Each different marker (or CD) on a cell is named with a number, which signifies the order in which the CD was discovered. Cells that have a certain kind of CD present on their surface are denoted as “+” for that CD type (e.g., a cell with CD57 markers on its surface is “CD57+”. What are CD57 cells? CD57 is a natural killer cell. A below-normal count of CD57+ cells has been associated with chronic Lyme disease. No one knows for sure why CD57+ NK cells are low in Lyme disease patients, but it is important to note that many disease states that are often confused with chronic Lyme (such as MS, systemic lupus, rheumatoid arthritis) are not associated with low CD57+ counts. Borrelia are believed to be capable of reducing the total amount of CD57 natural killer cells in the human body. It is generally believed that the lower the amount of CD57 natural killer cells in the body, the more chronic or progressive Lyme disease is, and the higher the amount, the closer a person is to remission. What are CD8 cells? The CD8 cells are generally referred to as T-cells, not to be confused with natural killer cells. Controversy around using this test: The utility of this test is controversial. Marques et. al. (2009 Clin. Vaccine Immunol. 16:1249-50) reported that there was no difference between the CD57 NK cell counts among patients with Lyme disease and normal controls. There have been instances where high amounts of CD57 natural killers cells have been found in those with chronic Lyme disease, and low amounts of CD57 natural killer cells have been found in those who were believed to be in remission. Possible treatment options: There are various stages of Lyme infection, and treatments differ according to the stage of infection. It’s important to be aware of the various treatment options so that you can help your doctor determine what’s right for you. Treatment options include one or multiple rounds of antibiotics (oral, intravenous, intramuscular, etc). When a patient is diagnosed with Chronic Lyme Disease, doctors work to develop an extended treatment plan. Treating Chronic Lyme can last months, years or even longer. Decisions about the treatment of the patient with chronic Lyme disease need to be individually shaped by the clinician’s experience, the patient’s clinical profile and history of antibiotic responsiveness, and the emerging medical literature. References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2725528/ https://academic.oup.com/cid/article/61/7/1084/289719 https://lymescience.org/wp-content/uploads/2018/11/CD57-unavailable.pdf https://www.sciencedirect.com/science/article/pii/S0399077X18306760 https://cvi.asm.org/content/16/11/1704 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196523/ https://canlyme.com/just-diagnosed/treatment/chronic-lyme-disease/ Disclaimer: The information on healthmatters.io is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Reference Range(s): CD57+/CD3- of % Lymphs 1-10 % Lymphocytes CD57+/CD3- of % WBC 1-4 % WBC CD57+/CD3- Cells/uL 20-258 Cells/uL CD57+/CD3-/CD8- of % Lymphs 1-5 % Lymphocytes CD57+/CD3-/CD8- of % WBC 1-3 % WBC CD57+/CD3-/CD8- Cells/uL 20-114 Cells/uL CD57+/CD8- of % Lymphs 1-15 % Lymphocytes CD57+/CD8- of % WBC 1-4 % WBC CD57+/CD8-Cells/uL 20-248 Cells/uL

CD3 cells are total T lymphocytes

The CD4 cells are Helper T-cells expressing both CD3 and CD4.

help fight cancer and germs that live inside your cells

Overview of CD19 CD19 is a protein that serves as a cell surface marker found on B-lymphocytes (B-cells), which are a type of white blood cell crucial to the adaptive immune system. As part of the B-cell receptor complex, CD19 functions as a co-receptor that enhances the sensitivity and response of B-cells to antigens. This protein plays a vital role in B-cell development, activation, proliferation, and differentiation. Key Functions of CD19 - B-cell Development: CD19 is expressed early in B-cell development and remains present throughout the lifespan of B-cells. It is essential for their proper maturation and function. - Signal Transduction: CD19 amplifies the signaling cascade initiated when the B-cell receptor (BCR) binds to an antigen. This amplification is critical for B-cell activation and the subsequent immune response. - Immune Response: By enhancing BCR signaling, CD19 aids B-cells in producing antibodies—proteins that specifically bind to and neutralize pathogens such as bacteria and viruses. Clinical Significance - Immunophenotyping: CD19 is utilized as a marker in flow cytometry and other immunophenotyping techniques to identify and quantify B-cells in blood and tissue samples. - Diagnosis and Monitoring: CD19 levels are important for diagnosing and monitoring certain hematologic malignancies, such as B-cell lymphomas and leukemias. Abnormal levels of CD19+ B-cells can indicate the presence and progression of these diseases. - Therapeutic Target: CD19 is a target for specific immunotherapies, including CAR-T cell therapy. In this treatment, a patient’s T-cells are genetically modified to express chimeric antigen receptors (CARs) that specifically target and kill CD19-expressing cancer cells. Summary CD19 is a critical marker and functional component of B-cells, playing a significant role in the immune response. Its presence on B-cells is leveraged in both diagnostic and therapeutic contexts to manage and treat various immune-related conditions and cancers.

a type I transmembrane glycoprotein

Overview of CD20 CD20 is a cell surface protein primarily found on B-lymphocytes (B-cells), which are essential white blood cells in the adaptive immune system. CD20 plays a crucial role in regulating B-cell activation, growth, and differentiation, particularly in the immune response to pathogens. Key Functions and Clinical Importance of CD20 B-cell Development and Activation: CD20 is expressed during the early stages of B-cell development and remains present until the cells differentiate into plasma cells, which produce antibodies. It helps regulate calcium influx, which is critical for B-cell activation and function. Target for Immunotherapy: CD20 is a target for specific immunotherapy treatments, particularly for B-cell non-Hodgkin lymphomas and chronic lymphocytic leukemia (CLL). Monoclonal antibodies, such as rituximab, are designed to target CD20 and deplete B-cells, aiding in the treatment of these cancers. It is also utilized in treating certain autoimmune diseases, where reducing B-cell numbers can help control disease activity. Diagnostic Marker: CD20 is used as a marker in flow cytometry and immunohistochemistry to identify and quantify B-cells in various diagnostic tests. This application is useful in diagnosing and monitoring diseases like lymphomas, leukemias, and certain immune disorders. Research Applications: CD20 is widely studied in immunology and cancer research to understand B-cell biology and develop new therapeutic approaches. Monitoring CD20 levels and the presence of CD20+ B-cells can provide valuable insights into immune system functioning and the progression of certain diseases. In clinical settings, assessing CD20 expression helps guide treatment decisions and evaluate the effectiveness of therapies targeting B-cells. In summary, CD20 is a critical protein involved in B-cell development and function, with significant implications for immunotherapy, diagnostics, and research in immunology and cancer.

The proportion of all immune cells that are T cells

the percentage of white blood cells (lymphocytes) that are CD4 cells.

CD4 cells lead the fight against infections. CD8 cells can kill cancer cells and other invaders.

a marker for activated human B cells

highly expressed in acute T-cell leukemia

The proportion of all T cells that are CD8 cells.

cluster found on the surface of various immune cells

cluster found on the surface of various immune cells

a protein found on the surface of B-cells

CD3 cells are total T lymphocytes

CD4 cells lead the fight against infections. CD8 cells can kill cancer cells and other invaders.

The CD4 cells are Helper T-cells expressing both CD3 and CD4.

also known as neural cell adhesion molecule

also known as neural cell adhesion molecule

vital for immune defense, key in disease diagnosis, treatment.

identifies NK cells, crucial for diagnosing and monitoring immune disorders.

help fight cancer and germs that live inside your cells