[PAGID] Cylex test

[Marc Riedl]

Andrew,

 

I have a bit of experience with this test at our institution.  Our
transplant services have are using it quite frequently as a data point in
guiding immunosuppressive therapy.  My impression is that there is a great
deal of interindividual variability in the test, so it's primary usefulness
may be in following cellular immune function in an individual over time.
Anecdotally, I've ordered it on a few occasions in CVID patients or the rare
adult patient with suspected cellular immunodeficiency to compare results
with lymphocyte proliferation assays.  Patients with absent proliferative
responses to antigens have generally shown a "moderate" response on the
Cylex assay. A large cohort of normal controls looked at by the Univ. of
Miami had a mean value in the "moderate" range as well.  So in our
population, the test won't discriminate between normals and patients with
cellular immunodeficiency vs. antigens and I wouldn't trust it as a
screening tool at present.  This may obviously be different in pediatric
patients with more profound cellular immunodeficiency, but I don't know of
any such data.

 

Best,

 

Marc

 

Marc Riedl, M.D., M.S.
Assistant Professor of Medicine
Section Head, Clinical Immunology and Allergy
UCLA - David Geffen School of Medicine
10833 Le Conte Ave, 37-131 CHS
Los Angeles, CA  90095-1680 
Tel 310.206.4345  Fax 310.267.0090 

 

 

 

 

From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of MacGinnitie, Andrew
Sent: Wednesday, July 02, 2008 6:27 AM
To: pagid at list.clinimmsoc.org
Subject: [PAGID] Cylex test

 

I wonder if anyone is using or has thoughts on this test

 

http://www.cylex.net/assayprinciple.html

 

Basically it is a simplified, automated mitogen stimulation of CD4 cells.
It apparently is fast (24 hours or less) and requires much less blood than
traditional proliferation assays.  At our institution it is also done
in-house whereas we have to send out traditional proliferation assays

 

Our bone marrow transplantation colleagues are using it routinely because it
is so convenient and it is apparently also being marketed to guide
immunosupression after solid organ transplant.  

 

I often struggle about whether I need to send proliferation on a kid who I
don't have a super-high suspicion (e.g. DiGeorge with low, but present
T-cells) and wonder if this might not be a better alternative


Andy

 

Andrew J. MacGinnitie MD PhD

Assistant Professor of Pediatrics

Division of Pulmonary Medicine, Allergy and Immunology

Children's Hospital of Pittsburgh

3705 Fifth Ave, Pittsburgh, PA 15213

andrew.macginnitie at chp.edu

412/692-8903 (office)

412/692-8499 (fax)

 


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