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Low naive T and naive B

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GreyOwl

Dx: strong belief system, avoidance, hypervigilant
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Hi, I would appreciate some opinions on the following immune function test results. Blood was taken 12 weeks following one dose of OTC antihistamine. Subsequent immune response to polysaccharide vaccine 3 months later was "very strong". Thank you.

Memory B Cells:
Absolute Lymphocytes: 2.38 x10e9/L (1.5-6.5)
B Cells (% lymphs): 21.0% (7.7-24.3)
B Cells (Absolute): 0.50 x10e9/L (0.21-0.80)
Memory B (%B Cells): 19.1% (11.0-27.0)
Memory B (Absolute): 0.10 x10e9/L (0.06-0.23)
MZ Memory B (%B Cells): 6.0% (4.7-17)
MZ Memory B (Absolute): 0.03 x10e9/L (0.02-0.09)
Sw Memory B (%B Cells): 9.7% (3.85-16.5)
Sw Memory B (Absolute): 0.05 x10e9/L (0.01-0.08)
Naïve B (%B Cells): 28.6% (74.3-77.0)
Naïve B (Absolute): 0.14 x10e9/L (0.13-0.46)

B Cells: CD19+; Memory B: CD19+/CD27+; MZ Memory B: CD19+/CD27+/IgM+/IgD+; Sw Memory B: CD19+/CD27+/IgM-/IgD-; Naïve B: CD19+/CD27-/IgM+/IgD+

Naïve T Cells:
Naïve CD4 T Cells (%): 28% (42-74)
Naïve CD4 T Cells (Absolute): 0.21 x10e9/L (0.31-1.00)
Naïve CD8 T Cells (%): 29% (39-73)
Naïve CD8 T Cells (Absolute): 0.18 x10e9/L (0.20-0.65)


Naïve CD4 T Cells: CD3+/CD4+/CD45RA+/CD62L+
Naïve CD8 T Cells: CD3+/CD8+/CD45RA+/CD62L+

Subsets:
Absolute Lymphocytes: 2.38 x10e9/L (1.5-6.5)
CD3+ (%): 62% (55-78)
Absolute CD3+: 1.47 x10e9/L (0.7-4.2)
CD3+/CD4+ (%): 31% (27-53)
Absolute CD3+/CD4+: 0.74 x10e9/L (0.3-2.0)
CD3+/CD8+ (%): 26% (19-34)
Absolute CD3+/CD8+: 0.62 x10e9/L (0.3-1.8)
CD19+ (%): 21% (10-31)
Absolute CD19+: 0.50 x10e9/L (0.2-1.6)
CD3-/CD16&56+ (5): 15% (4-26)
Absolute CD3-/CD16&56+: 0.36 x10e9/L (0.09-0.9)

Subset analysis using CD45 gating.
 

CFS_for_19_years

Hoarder of biscuits
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2,396
Location
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Naïve B (%B Cells): 28.6% (74.3-77.0)

This study shows results opposite to yours. I don't know if perusing the study will help you find the answer to your question or not.

Altered functional B cell subset populations in patients with chronic fatigue syndrome compared to healthy controls
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719933
In conclusion, we have observed patients with moderate CFS to have increased proportions of transitional and naive B cells and reduced plasmablasts. The precise basis for these findings is unclear, and our work does not allow clarification of whether or not these changes are the cause of the CFS symptoms or the result of patient inactivity, sleep disturbance or raised stress.
 

Jonathan Edwards

"Gibberish"
Messages
5,256
Hi, I would appreciate some opinions on the following immune function test results. Blood was taken 12 weeks following one dose of OTC antihistamine. Subsequent immune response to polysaccharide vaccine 3 months later was "very strong". Thank you.

Memory B Cells:
Absolute Lymphocytes: 2.38 x10e9/L (1.5-6.5)
B Cells (% lymphs): 21.0% (7.7-24.3)
B Cells (Absolute): 0.50 x10e9/L (0.21-0.80)
Memory B (%B Cells): 19.1% (11.0-27.0)
Memory B (Absolute): 0.10 x10e9/L (0.06-0.23)
MZ Memory B (%B Cells): 6.0% (4.7-17)
MZ Memory B (Absolute): 0.03 x10e9/L (0.02-0.09)
Sw Memory B (%B Cells): 9.7% (3.85-16.5)
Sw Memory B (Absolute): 0.05 x10e9/L (0.01-0.08)
Naïve B (%B Cells): 28.6% (74.3-77.0)
Naïve B (Absolute): 0.14 x10e9/L (0.13-0.46)

B Cells: CD19+; Memory B: CD19+/CD27+; MZ Memory B: CD19+/CD27+/IgM+/IgD+; Sw Memory B: CD19+/CD27+/IgM-/IgD-; Naïve B: CD19+/CD27-/IgM+/IgD+

Naïve T Cells:
Naïve CD4 T Cells (%): 28% (42-74)
Naïve CD4 T Cells (Absolute): 0.21 x10e9/L (0.31-1.00)
Naïve CD8 T Cells (%): 29% (39-73)
Naïve CD8 T Cells (Absolute): 0.18 x10e9/L (0.20-0.65)


Naïve CD4 T Cells: CD3+/CD4+/CD45RA+/CD62L+
Naïve CD8 T Cells: CD3+/CD8+/CD45RA+/CD62L+

Subsets:
Absolute Lymphocytes: 2.38 x10e9/L (1.5-6.5)
CD3+ (%): 62% (55-78)
Absolute CD3+: 1.47 x10e9/L (0.7-4.2)
CD3+/CD4+ (%): 31% (27-53)
Absolute CD3+/CD4+: 0.74 x10e9/L (0.3-2.0)
CD3+/CD8+ (%): 26% (19-34)
Absolute CD3+/CD8+: 0.62 x10e9/L (0.3-1.8)
CD19+ (%): 21% (10-31)
Absolute CD19+: 0.50 x10e9/L (0.2-1.6)
CD3-/CD16&56+ (5): 15% (4-26)
Absolute CD3-/CD16&56+: 0.36 x10e9/L (0.09-0.9)

Subset analysis using CD45 gating.


The B cells look normal. There is a typo in the reference range. It should be 24.3% rather than 74.3%. (You can tell that from the absolute reference range.) The lowish naive T cell levels are not significant. I suspect that you are over 30 years old, although I apologise if that is wrong!
 

Marky90

Science breeds knowledge, opinion breeds ignorance
Messages
1,253
@Jonathan Edwards do you know if FLuge/Mella are monitoring b-cell subsets before and after rtx-treatment in the phase 3 trial? Thought the content in the paper was intriguing (about possible maturation problems), although i`m sure the idea in itself is not new..
 

Jonathan Edwards

"Gibberish"
Messages
5,256
@Jonathan Edwards do you know if FLuge/Mella are monitoring b-cell subsets before and after rtx-treatment in the phase 3 trial? Thought the content in the paper was intriguing (about possible maturation problems), although i`m sure the idea in itself is not new..

They will be monitoring B cells but what they will see will be pretty obvious and gross - the B cells go away and come back!

Others including ourselves have not been able to repeat the Bradley and Bansal findings - at least not quite in that form.
 

GreyOwl

Dx: strong belief system, avoidance, hypervigilant
Messages
266
Thank you @Jonathan Edwards.

74.3% is not a typo, it's the correct minimum reference range for an 8yo child.

Thanks also for the reference @CFS_for_19_years :)

Is anyone able to point me in the direction of ways to improve T-cell levels?
 

CFS_for_19_years

Hoarder of biscuits
Messages
2,396
Location
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Thank you @Jonathan Edwards.

74.3% is not a typo, it's the correct minimum reference range for an 8yo child.

Thanks also for the reference @CFS_for_19_years :)

Is anyone able to point me in the direction of ways to improve T-cell levels?

It would have been helpful to have the following information from your first ever introductory post from November 11th when you started writing this current thread.
I am writing for a child, younger than 10, and fatigue is not a major symptom. It has been 3.5 years. The story is not mine to tell.

I am heading over to the immunology forum to, hopefully, get some help with some test results.

You should have started this thread by saying you were writing on behalf of an 8-year-old child for whom fatigue is not a major symptom. This is a forum for persons afflicted with Myalgic Encephalomyelitis (chronic fatigue syndrome). Has your child been diagnosed with ME/CFS? It seems unlikely to be the case if your child does not have fatigue.
 
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Jonathan Edwards

"Gibberish"
Messages
5,256
Thank you @Jonathan Edwards.

74.3% is not a typo, it's the correct minimum reference range for an 8yo child.

Thanks also for the reference @CFS_for_19_years :)

Is anyone able to point me in the direction of ways to improve T-cell levels?

It must be a typo GreyOwl. The absolute count below has to be in proportion to the percentage count because the percentage count is by definition a proportion of the total. So if the range for absolute is 0.13-0.46 (a threefold plus range) then the range for percentage has to be a roughly threefold plus range. And being a B cell immunologist who has worked on B cell subsets for fifteen years I know that naive B cell percentages range from well below half to above half - there is a huge difference between people for reasons nobody knows. The lower value for percentage should be about 22, so it seems likely that it is 24.3 and there is a one number typo.
 

GreyOwl

Dx: strong belief system, avoidance, hypervigilant
Messages
266
@Jonathan Edwards - that is remarkable, thank you so much. It's actually a really significant error in this case.

I'll try to find another forum @CFS_for_19_years, as you feel I don't meet criteria for membership here. I think I may be looking at an acquired mito issue which has a lot in common with ME/CFS, except in this case not predominantly the fatigue. But as the trigger is different, it makes sense to me that it works via a different mechanism.

Also, there is no diagnosis. There is a very good reason for that. It has five letters, the first and last of which are 'l'.

One of the 99% of similarities is the accusation of psychogenic/MBP (especially in light of the above) and the major damage this causes to families; joining here was a lifeline. I cried a lot last night after your post.
 

GreyOwl

Dx: strong belief system, avoidance, hypervigilant
Messages
266
Before I go I'm going to be bold and ask one more thing from @Jonathan Edwards (who is very clever and you are all very lucky to have him): please, is there any significance to low MZ Memory B and naive B absolutes in an 8yo? Is this something to work on? Thank you.
 

CFS_for_19_years

Hoarder of biscuits
Messages
2,396
Location
USA
@Jonathan Edwards - that is remarkable, thank you so much. It's actually a really significant error in this case.

I'll try to find another forum @CFS_for_19_years, as you feel I don't meet criteria for membership here. I think I may be looking at an acquired mito issue which has a lot in common with ME/CFS, except in this case not predominantly the fatigue. But as the trigger is different, it makes sense to me that it works via a different mechanism.

Also, there is no diagnosis. There is a very good reason for that. It has five letters, the first and last of which are 'l'.

One of the 99% of similarities is the accusation of psychogenic/MBP (especially in light of the above) and the major damage this causes to families; joining here was a lifeline. I cried a lot last night after your post.

I'm sorry if something I said made you cry. If I had known it would cause that reaction in you I never would have said anything at all. I will simply now urge you to disclose a little more background when you request information here, such as age of the patient and possible diagnosis, or how the illness began, otherwise we will assume the information is meant for an adult with ME/CFS. While you did mention a "strong reaction" to a vaccine, in the future I would recommend giving more information, rather than less. We are accustomed to seeing symptom lists a mile long, so don't hold back in that regard if you continue to post.

When I gave you the link to B cell studies I assumed the information was meant for an adult with ME/CFS. While you never stated in your request for information who it was for, their age or possible diagnosis, I wonder now how useful that information was. Unless we are told otherwise, we assume that requests for help and information are for patients with ME/CFS or their care providers (we do have a number of parents here). I don't know where you would go to search for more information on acquired mitochondrial disorders.

Getting back to the discussion about the typo in the reported reference range: I don't hold one-hundredth the weight that Dr. Edwards does in discussing matters regarding B cells, but I do have experience in reporting relative and absolute numbers of neutrophils (white cells) in blood cell differentials. The relative numbers and absolute numbers in the reported reference range are definitely out of whack. (I was a medical technologist prior to taking an early unplanned retirement due to ME/CFS. Tomorrow will be my 25th year anniversary of being ill.)

Obviously you are a very loving parent to try to find more information that can help your daughter. I wish you the best and hope you can find the help you need.
 
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GreyOwl

Dx: strong belief system, avoidance, hypervigilant
Messages
266
Sorry to hear that's it's your anniversary @CFS_for_19_years.

Just to clarify, the pneumococcal vaccine was given when the T-cell count came back low. That the response to that was strong is a good thing, because it showed there is no underlying immunodeficiency.

The original "issue" was a systemic exposure to an antimicrobial.

Thanks also for your input. Are you saying that my child's results are out of whack or that you agree with Dr Edwards' point about the typo or that you can see yet another issue with the reference ranges? We haven't received full and open communication (as you can probably tell).
 

CFS_for_19_years

Hoarder of biscuits
Messages
2,396
Location
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Thanks also for your input. Are you saying that my child's results are out of whack or that you agree with Dr Edwards' point about the typo or that you can see yet another issue with the reference ranges? We haven't received full and open communication (as you can probably tell).

I just meant that I agreed with Dr. Edward's point about the typo, nothing else. Sorry I didn't make myself more clear on that point.
 
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