TREC and KREC Levels as a Predictors of Lymphocyte Subpopulations Measured by Flow Cytometry

Korsunskiy, Ilya and Blyuss, Oleg and Gordukova, Maria and Davydova, Nataliia and Gordleeva, Susanna and Molchanov, Robert and Asmanov, Alan and Peshko, Dmitrii and Zinovieva, Nataliia and Zimin, Sergey and Lazarev, Vladimir and Salpagarova, Aminat and Filipenko, Maxim and Kozlov, Ivan and Prodeus, Andrey and Korsunskiy, Anatoliy and Peter, Hsu and Munblit, Daniel (2019) TREC and KREC Levels as a Predictors of Lymphocyte Subpopulations Measured by Flow Cytometry. Frontiers in Physiology, Vol. 9. Article 1877. ISSN 1664-042X


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Primary immunodeficiency diseases (PID) is a heterogeneous group of disorders caused by genetic defects of the immune system, which manifests clinically as recurrent infections, autoimmune diseases, or malignancies. Early detection of other PID remains a challenge, particularly in older children due to milder and less specific symptoms, a low level of clinician PID awareness and poor provision of hospital laboratories with appropriate devices. T-cell recombination excision circles (TREC) and kappadeleting element recombination circle (KREC) in a dried blood spot and in peripheral blood using real-time polymerase chain reaction (PCR) are used as a tool for severe combined immune deficiency but not in PID. They represent an attractive and cheap target for a more extensive use in clinical practice. This study aimed to assess TREC/KREC correspondence with lymphocyte subpopulations, measured by flow cytometry and evaluate correlations between TREC/KREC, lymphocyte subpopulations and immunoglobulins. We carried out analysis of data from children assessed by clinical immunologists at Speransky Children’s Hospital, Moscow, Russia with suspected immunodeficiencies between May 2013 and August 2016. Peripheral blood samples were sent for TREC/KREC, flow cytometry (CD3, CD4, CD8, and CD19), IgA, IgM, and IgG analysis. A total of 839 samples were analyzed for using TREC assay and flow cytometry and 931 KREC/flow cytometry. TREC demonstrated an AUC of 0.73 (95% CI 0.70–0.76) for CD3, 0.74 (95% CI 0.71–0.77) for CD4 and 0.67 (95% CI 0.63–0.70) for CD8, respectively, while KREC demonstrated an AUC of 0.72 (95% CI 0.69–0.76) for CD19. Moderate correlation was found between the levels of TREC and CD4 (r = 0.55, p < 0.01) and KREC with CD19 (r = 0.56, p < 0.01). In this study, promising prediction models were tested. We found that TREC and KREC are able to moderately detect abnormal levels of individual lymphocyte subpopulations. Future research should assess associations between TREC/KREC and other lymphocyte subpopulations and approach TREC/KREC use in PID diagnosis.

Item Type: Article
Additional Information: THIS ARTICLE IS PART OF THE RESEARCH TOPIC Multiscale Modelling of Rhythm, Pattern and Information Generation: from Genome to Physiome
Uncontrolled Keywords: SEVERE COMBINED IMMUNODEFICIENCY; RECEPTOR EXCISION CIRCLES; CLASSIFICATION; DISEASES. Ключевые слова автора:TREC; KREC; primary immune deficiency; PID; flow cytometry; lymphocyte subpopulations; immunoglobulins.
Subjects: Immunogenetics
Divisions: Departments > Department of Surgery №1
Depositing User: Елена Шрамко
Date Deposited: 21 Feb 2019 13:19
Last Modified: 21 Feb 2019 13:19

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