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Reference intervals for lymphocyte subsets in preterm and term neonates without immune defects.

George S Amatuni1, Stanley Sciortino2, Robert J Currier3

  • 1Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, Calif; Stem Cell Institute, Department of Cell Biology, Einstein College of Medicine, Bronx, NY.

The Journal of Allergy and Clinical Immunology
|June 21, 2019
PubMed
Summary

This study establishes reference intervals for lymphocyte subsets in newborns, crucial for identifying potential immune disorders in preterm and term infants. These findings aid clinicians in diagnosing immunodeficiencies.

Keywords:
Flow cytometryT-cell receptor excision circleT-cell subsetsmemory T cellnaive T cellneonatal immunitynewborn screeningpreterm birthreference range/reference intervalsevere combined immunodeficiency

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Area of Science:

  • Immunology
  • Neonatal Medicine
  • Clinical Diagnostics

Background:

  • Newborn screening for severe combined immunodeficiency (SCID) in California involved over 3 million infants.
  • Specific criteria, including T-cell receptor excision circle (TREC) levels and genetic risk, triggered further blood analysis.
  • Infants cleared of immune defects provided data for establishing reference intervals.

Purpose of the Study:

  • To establish reference intervals for lymphocyte subsets in diverse preterm and term newborns.
  • To identify normal lymphocyte subset ranges in infants unaffected by T-lymphopenic immune disorders.

Main Methods:

  • Defined effective gestational age (GA) as GA at birth plus postnatal age.
  • Analyzed demographic, clinical, and blood count data from 301 infants (with serial data from 33).
  • Measured lymphocyte subsets including T cells (total, helper, cytotoxic, naive, memory), B cells, and NK cells via flow cytometry.

Main Results:

  • Generated reference intervals for lymphocyte subsets across effective GAs from 22 to 52 weeks.
  • Found no significant impact of sex or ethnicity on lymphocyte subset counts.
  • Observed an increase in lymphocyte counts postnatally.

Conclusions:

  • Provides a baseline for interpreting lymphocyte data in infants.
  • Aids clinicians in identifying newborns needing further immunodeficiency evaluation.
  • Supports improved diagnostic accuracy in neonatal immunology.