Establishment of reference ranges of CD3 CD4 and CD8 lymphocyte subsets among healthy Kenyans
Bosire, Maosa Erick
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Flow cytometric analysis of peripheral blood lymphocyte phenotypes Iike CD4 and CD8 has proven to be useful in managing a wide range of medical conditions, including autoimmunity, immunodeficiency, infection, malignancy, and transplantation. Essential to the effective application of this approach is availability of accurate reference values against which results can be meaningfully compared. Reference ranges may be influenced by among other factors, age, gender, race, geographical area and social factors. Normal CD4 and CD8 reference ranges for both children and adults in Kenya have not been comprehensively established. Reference ranges that are currently used in Kenya are derived from data that mainly refer to Caucasian subjects who are not Kenyan The aim of this study was to establish the reference ranges for lymphocyte subsets name]', CD3, CD4 and CD8 among healthy Kenyans. Healthy blood donors of varied ages from different regions (Nairobi, Coast, Rift valley Eastern highlands and Lake Victoria bash) of the country were recruited into this study. Cluster sampling was used to collect samples from the different regions. Serological tests were used to confirm HIV and Hepatitis ,status of the subjects. Blood was collected by venipuncture into EDTA BD vacutainer blood collection tubes. Anti-coagulated blood stained with monoclonal antibodies (CD4/CD8/CD45) was analyzed by flow cytometry. BD FACS Calibur flow cytometer which has a sample loader was used. The FACS caliber provided CD3, CD4 and CD8 absolute counts, ratios and percentages. Analysis of these immune markers was made with reference to age, sex and geographical region. Results are expressed as median values with 95% double sided reference intervals. Reference ranges for the lymphocyte subsets were determined as pooled ranges. The 95th - percentile reference ranges were determined by using 2.5 and 97.5 percentiles. The general, 95% ranges for the whole study population were as follows CD3 (426.3992-3133.832), CD4 (228-1758.96), and CD8 (123.8997-1374.168). Significant differences were observed in the absolute count means of the lymphocytes in males and females than is CD3 (P<0.05) and CD4 (P<0.05). There were however no significant differences in the mean absolute counts between males and females (P<0.05). In females the means were CD3 (1787.1), CD4 (1009.8), CD8 (658.9) whereas in males the means were CD3 (1609.5), CD4 (888.9) and CD8 (644.1). Differences were also observed in the means and medians of the lymphocyte subsets in the different ages although the differences were not significance (P<0.05). The mean absolute counts for the different geographical regions were significantly different (P<0.05).The ranges that have been developed are different from the ranges that have been established by studies in other populations. These ranges are slightly lower than those of multiset (CD3 (690-2540), CD4 (410-1590) and CD8 (190-1140) and those developed in Germany (CD3 (780-2240) and CD4 490-1640). The ranges were close to the ones established in Tanzania that is CD4 (312.2-1367.6) and CD8 (168.2-1)96.8). These data can serve as reference ranges for adults in Kenya. Therefore the current guidelines on the normal CD4 and CD8 in Kenya should be revised to adopt the population specific reference ranges.
- MST-Zoological Sciences