Utility: Functional evaluation of T cells proliferation to mitogens.
Specimen: 8 - 15 mL peripheral blood in sodium heparin (green top).
CPT codes: 86353 x 5, 88187.

Clinical indication/general description
Once a defect in T cells is detected, or defective T cell function is suspected, further evaluation involves examination of T cell proliferation in response to mitogens. Activation of T cells with antibodies to the T cell receptor or with plant lectins results in the proliferation of these cells over the next seven to 10 days. Diminished or absent proliferative response to T cell stimuli is consistent with a primary or secondary immunodeficiency disease that affects T lymphocytes (cellular immunity). This assay tests the proliferative function of T cells to T cell receptor antibodies and a variety of mitogens.

Detection methodology
A functional flow cytometric-based assay provides a semi-quantitative assessment of lymphocyte proliferation in response to concanavalin A (ConA)/IL-2, phytohemagglutinin (PHA)/IL-2, phorbol esters and soluble CD3. Lymphocytes are labeled with the fluorescent dye CFSE and activated with mitogens. As lymphocytes divide, the fluorescent label is diluted in half, which can be seen on flow diagrams as peaks of decreasing fluorescence. Lymphocyte proliferative response is demonstrated by an increase in FSC/SSC and a progressive two-fold reduction in a proliferation tracking dye. Lymphocyte proliferative response is demonstrated by an increase in FSC/SSC and a progressive two-fold reduction in a proliferation tracking dye.

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