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Reference Ranges of Different Lymphocyte Subsets in Indian Children: A Multi-Centric Study
Madhuri Thakar1, Vandana Saxena2, Nalini Janakiram3
1ICMR-National AIDS Research Institute, Pune, Maharashtra, India. Correspondence to: Dr Madhuri Thakar, Head and Scientist-F, Department of Immunology and Serology, ICMR, National AIDS Research Institute, Plot No. 73, G-Block, MIDC, Bhosari, Pune-411026, Maharashtra, India. mthakar@nariindia.org.
Insights
Reference ranges for lymphocyte subsets in Indian children were established. Counts change with age but proportions remain stable, with regional variations noted.
Area of Science:
- Pediatric immunology
- Hematology
- Clinical pathology
Background:
- Accurate reference ranges for lymphocyte subsets are crucial for diagnosing pediatric immune disorders.
- Existing data for Indian children is limited, necessitating region-specific studies.
Purpose of the Study:
- To establish comprehensive reference ranges for lymphocyte subsets in healthy Indian children.
- To analyze age- and gender-related variations in these immune cell populations.
Main Methods:
- A descriptive cross-sectional study was conducted across four geographical regions in India.
- 1104 healthy children, from neonates to 18 years, were enrolled.
- Multicolor flow cytometry was used to measure absolute counts and percentages of T, B, and NK lymphocytes.
Main Results:
- Lymphocyte counts increased from birth to 10 months, then declined until 18 years, while proportions remained stable.
- No significant gender-based differences were observed.
- Geographical location influenced lymphocyte subset counts.
Conclusions:
- The established reference ranges will aid in monitoring and predicting immune status in Indian pediatric populations.
- Regional variations highlight the need for geographically specific reference values.
- Further studies with larger sample sizes are recommended to confirm regional differences.
Objective:
To determine the reference ranges of various lymphocyte subsets in healthy Indian children.
Design:
Descriptive cross-sectional study.
Setting:
Four centers in India representing four geographical regions.
Participants:
1104 children from neonatal age to 18 years of age.
Measurement:
One time measurement of absolute count and percentages of different lymphocyte subsets i.e. T lymphocytes (CD3+T, CD4+T, CD8+T cells), B lymphocytes (CD19+B cells) and Natural Killer lymphocytes (CD15/16+NK cells) in whole blood using multicolor flow cytometry.
Results:
The absolute cell counts of various lymphocytes were found to increase from newborn to 10 months of age, followed by gradual decline until 18 years; however, the proportion of immune cells remained largely similar. Gender did not have a significant impact on the reference ranges, whereas counts were found to vary as per the geographical locations.
Conclusions:
These reference ranges will be useful to monitor and predict the immune status in pediatric population. The variation in region wise ranges could be confirmed by testing more number of samples in the specific age groups.
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