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HelpTest Code LAB8672 T-Cell Subsets, Regulatory (Tregs), Blood
Additional Codes
TREGS
Useful For
Evaluating patients with clinical features of IPEX (immune dysregulation, polyendocrinopathy, enteropathy, X-linked inheritance) and other primary immunodeficiencies, autoimmune diseases, allergy and asthma, and graft-vs-host disease post-hematopoietic stem cell transplantation
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Whole Blood EDTAShipping Instructions
Testing performed Monday through Friday. Specimens not received by 4 p.m. Central time on Fridays may be canceled
Specimens arriving on the weekend and observed holidays may be canceled.
Collect and package specimen as close to shipping time as possible. It is recommended that specimens arrive within 24 hours of collection.
Necessary Information
The ordering healthcare professional's name and phone number are required.
Specimen Required
Container/Tube: Lavender top (EDTA)
Specimen Volume: 3 mL
Collection Instructions: Send whole blood specimen in original tube. Do not aliquot.
Additional Information: For serial monitoring, it is recommended that specimens are collected at the same time of day.
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole Blood EDTA | Ambient | 72 hours | PURPLE OR PINK TOP/EDTA |
On-campus collections: Tube to 99 or deliver to University Extension Hospital Room EH318
1. Send specimen in original tube, Ambient. DO NOT SPIN! DO NOT SHARE! DO NOT ALIQUOT!
2. Draw and package specimen as close to shipping time as possible.
3. It is recommended that specimens arrive within 24 hours of draw.
4. Samples arriving on the weekend and observed holidays may be canceled.
Off-campus collections: DO NOT SPIN! DO NOT SHARE! DO NOT ALIQUOT! Specimen to be stored/transported at Ambient temp.
Reference Values
The appropriate age-related reference values will be provided on the report.
Day(s) Performed
Monday through Friday
CPT Code Information
86359
86361
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TREGS | T Cell Subsets, Regulatory (Tregs) | 90413-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 609282 | CD4 (T Cells) | 24467-3 |
| 29143 | % Activated CD4+ T cells (4+CD25+) | 13332-2 |
| 29144 | % Natural Tregs | 89320-6 |
| 29145 | % N. Naive Tregs | 89319-8 |
| 29146 | % CD4+CD25-CD127+ (Tr1/Th3) | 89318-0 |
| 29147 | Activated CD4+ T cells (4+CD25+) | 26982-9 |
| 29148 | CD4+CD25+CD127loCD45RO+ (Nat Tregs) | 89316-4 |
| 29149 | CD4+CD25+CD127loCD45RA+ Naive Tregs | 89315-6 |
| 29150 | CD4+CD25-CD127+ (Tr1/Th3) | 89317-2 |
| 29177 | Interpretation | 69052-9 |
Interpretation
The lack of regulatory T cells (Tregs) is associated with variants in the FOXP3 gene. Low Tregs are also seen in the context of other inborn errors of immunity. Reduced Nn Tregs and natural Tregs are likely to predispose to autoimmunity, while reductions in Th3/Tr1 cells may impair oral and peripheral tolerance, also facilitating the development of autoimmunity.
The presence of expanded naive Tregs may indicate a process of malignant transformation, if other clinical features of malignant disease are present.
Increased Tregs in donor stem cell allografts have been associated with a reduced incidence of graft-versus-host disease (ie, mediating a protective effect) after allogeneic stem cell transplantation.
Method Description
EDTA-anticoagulated blood is incubated with antibodies to various T-cell markers (ie, CD4, CD127, CD45RO, CD45RA, and CD25). After red blood cell lysis, the sample is washed to remove any unbound antibodies prior to analysis. The assay uses 2 antibody tubes for data acquisition, but analysis is performed as a single panel. Each Treg subset is expressed as a percentage of total CD4+ T cells. The regulatory T-cell panel is linked to the TCD4 test (TCD4 / CD4 Count for Immune Monitoring, Blood) within the experiment and, therefore, the CD3, CD4, and CD8 T-cell reference ranges are provided within the TCD4 assay. The regulatory T cell results are interpreted using a reference range derived from data of normal healthy adult and pediatric donors. Isotype controls are used in each assay to measure background fluorescence of the samples. A normal, healthy control is also included in each experiment to ensure the optimal performance of the assay.(Unpublished Mayo information)
Report Available
3 to 4 daysSpecimen Retention Time
4 daysReject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
Method Name
Flow Cytometry