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TBNK assay

TBNK assay is used to identify and quantitate T-cell, B-cell, and Natural Killer (NK) subsets. The TBNK assay provides valuable information about the composition of the immune system and is used in research and clinical scenarios to make informed decisions regarding patient care and treatment strategies.
  • T-cells originate in the thymus and are key components of the adaptive immune system [1-15]. Other sections of our website describe T-cell characteristics and the roles they play in cell-mediated immunity in more detail.

  • B-cells created in the bone marrow, are key players in the humoral immune response. B- cell development is a lengthy process of differentiation and maturation. Antigen recognition via the B-cell receptor, either directly or through presentation by an APC, ultimately results in their activation, maturation, immunoglobulin synthesis and immunological memory [19]. Similar to T-cells, B-cells also have a number of subsets, each specialised for their function. The principles behind most vaccinations are based on immunological memory preserved by B-cell subsets, plasma and memory B-cells [20].

  • NK-cells of the innate immune system originate in the bone marrow. The NK cell population constitute 5-20% of all circulating lymphocytes [21]. NK-cells are responsible for detecting and destroying infected and transformed cells. Unlike T-cells and B-cells, NK-cells do not recognize specific antigens. Instead, they use receptors to detect cells that lack self-antigens or express stress-induced molecules [22]. NK-cells utilise several cytolytic mechanisms e.g., death receptor ligation and degranulation, to lyse cells [21]. NKs can also initiate inflammation using pro-inflammatory cytokines. NK-cells do not exhibit immunological memory like T-cells and B-cells; their responses are rapid and largely non-specific.

The examples below highlight some of the key clinical uses of the TBNK assay:
  • Autoimmune and immunodeficiency disorders: The TNBK assay can help diagnose autoimmune and primary immunodeficiency disorders where there is an imbalance or deficiency in lymphocyte subsets.

  • Monitoring HIV/AIDS: The TNBK assay is used to monitor CD4+/CD8+ T-cell ratio in HIV-infected individuals to gauge the progression of the disease and the effectiveness of anti-retroviral therapy. A decrease in the CD4+/CD8+ ratio is indicative of immune system damage caused by the virus.

  • Lymphoma and Leukaemia: TBNK assays are used to identify abnormal lymphocyte to aid in diagnosis and monitoring of lymphomas and leukaemia.  

  • Transplant Medicine: TNBK assays are employed prior to organ transplant to monitor lymphocyte subsets and assess the risk of graft rejection.

  • Medical research: Researchers use TBNK assays to investigate immune responses to various diseases, vaccines, and therapies.

At PeploBio we perform the TBNK assay in technical harmonisation with leading providers of clinical flow cytometry services [23].
The TBNK assay can be used to identify T-cells, B-cells and NK-cells using the expression of the cell surface markers:
  • CD3+ in T-cells

  • CD3+CD4+ in T-helper cells

  • CD3+CD8+ in Cytotoxic T-cells

  • CD19+ in B-cells

  • CD3CD16+CD56+in NK cells

In our laboratories, we only use CE-IVD marked reagents and kits such as the BD Multitest 6-color (CD3 FITC / CD16 PE + CD56 PE / CD45 PerCP-Cy5.5 / CD4 PE-Cy7 / CD19 APC / CD8 APC-Cy7) TBNK kit with or without BD Trucount Tubes for absolute cell counts of lymphocyte subsets [24]. A less comprehensive assay using the 4-color BD Multitest TBNK assay containing CD3 FITC / CD16 PE + CD56 PE / CD45 PerCP / CD19 APC is also available [25]. These kits are especially designed for use with cutting edge flow cytometers such the BD FACS Lyric system we use in our laboratories. As mentioned in other sections of our website, the TBNK assay can be used clinically for the monitoring and diagnosis of a range of diseases including HIV/aids, autoimmune disease, immunodeficiency disorders, and lymphomas.

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References

[1] Kumar BV, Connors TJ, Farber DL. Human T cell development, localization, and function throughout life. Immunity. 2018 Feb 20;48(2):202-13.
[2] Caccamo N, Joosten SA, Ottenhoff TH, Dieli F. Atypical human effector/memory CD4+ T cells with a naive-like phenotype. Frontiers in immunology. 2018 Dec 3; 9:2832.
[3] Larbi A, Fulop T. From “truly naïve” to “exhausted senescent” T cells: when markers predict functionality. Cytometry Part A. 2014 Jan;85(1):25-35.
[4] Van den Broek T, Borghans JA, Van Wijk F. The full spectrum of human naive T cells. Nature Reviews Immunology. 2018 Jun;18(6):363-73.
[5] Barry M, Bleackley RC. Cytotoxic T lymphocytes: all roads lead to death. Nature Reviews Immunology. 2002 Jun 1;2(6):401-9.
[6] Mousset CM, Hobo W, Woestenenk R, Preijers F, Dolstra H, van der Waart AB. Comprehensive phenotyping of T cells using flow cytometry. Cytometry Part A. 2019 Jun;95(6):647-54
[7] Schorer M, Kuchroo VK, Joller N. Role of co-stimulatory molecules in T helper cell differentiation. Co-signal Molecules in T Cell Activation: Immune Regulation in Health and Disease. 2019:153-77.
[8] Murphy K, Weaver C. (2017) Janeway's immunobiology (9th edition). New York and London: Garland Science.
[9] Wan YY, Flavell RA. How diverse—CD4 effector T cells and their functions. Journal of molecular cell biology. 2009 Oct 1;1(1):20-36.
[10] Végran F, Apetoh L, Ghiringhelli F. Th9 cells: a novel CD4 T-cell subset in the immune war against cancer. Cancer research. 2015 Feb 1;75(3):475-9.
[11] Laurent C, Fazilleau N, Brousset P. A novel subset of T-helper cells: follicular T-helper cells and their markers. Haematologica. 2010 Mar;95(3):356.
[12] Pepper M, Jenkins MK. Origins of CD4+ effector and central memory T cells. Nature immunology. 2011 Jun;12(6):467-71.
[13] Sakaguchi S, Yamaguchi T, Nomura T, Ono M. Regulatory T-cells and immune tolerance. cell. 2008 May 30;133(5):775-87.
[14] Santegoets SJ, Dijkgraaf EM, Battaglia A, Beckhove P, Britten CM, Gallimore A, Godkin A, Gouttefangeas C, de Gruijl TD, Koenen HJ, Scheffold A. Monitoring regulatory T-cells in clinical samples: consensus on an essential marker set and gating strategy for regulatory T cell analysis by flow cytometry. Cancer Immunology, Immunotherapy. 2015 Oct; 64:1271-86.
[15] Manuszak C, Brainard M, Thrash E, Hodi FS, Severgnini M. Standardized 11-color flow cytometry panel for the functional phenotyping of human T regulatory cells. Journal of Biological Methods. 2020;7(2).
[16] Veglia F, Sanseviero E, Gabrilovich DI. Myeloid-derived suppressor cells in the era of increasing myeloid cell diversity. Nature Reviews Immunology. 2021 Aug;21(8):485-98.
[17] Gabrilovich DI. Myeloid-derived suppressor cells. Cancer immunology research. 2017 Jan 1;5(1):3-8.
[18] Hegde S, Leader AM, Merad M. MDSC: Markers, development, states, and unaddressed complexity. Immunity. 2021 May 11;54(5):875-84.
[19] Batista FD, Harwood NE. The who, how and where of antigen presentation to B cells. Nature Reviews Immunology. 2009 Jan;9(1):15-27.
[20] Akkaya M, Kwak K, Pierce SK. B cell memory: building two walls of protection against pathogens. Nature Reviews Immunology. 2020 Apr;20(4):229-38.
[21] Abel AM, Yang C, Thakar MS, Malarkannan S. Natural killer cells: development, maturation, and clinical utilization. Frontiers in immunology. 2018 Aug 13;9:1869.
[22] Long EO, Rajagopalan S. Stress signals activate natural killer cells. The Journal of experimental medicine. 2002 Dec 2;196(11):1399-402.
[23] Omana-Zapata I, Mutschmann C, Schmitz J, Gibson S, Judge K, Aruda Indig M, Lu B, Taufman D, Sanfilippo AM, Shallenberger W, Graminske S. Accurate and reproducible enumeration of T-, B-, and NK lymphocytes using the BD FACSLyric 10-color system: a multisite clinical evaluation. PLoS One. 2019 Jan 28;14(1):e0211207.
[24] BD Bioscience; BD Multitest™ 6-Color TBNK; 2022 [cited Nov 2023]. Available from: https://www.bdbiosciences.com/content/dam/bdb/products/global/reagents/flow-cytometry-reagents/clinical-diagnostics/multicolor-cocktails-and-kits-ivd-ce-ivds/644xxx/6446xx/644611_base/pdf/23-10834.pdf
[25] BD Bioscience; BD Multitest ™ CD3/CD16+CD56/CD45/CD19; 2016 [cited Nov 2023]. Available from: https://www.bdbiosciences.com/content/dam/bdb/products/global/reagents/flow-cytometry-reagents/clinical-diagnostics/multicolor-cocktails-and-kits-ivd-ce-ivds/342xxx/3424xx/342416_base/pdf/23-5345.pdf

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