Lymphocyte MAP

The Lymphocyte MAP™ by Cyrex Laboratories is a diagnostic tool designed to provide an in-depth analysis of the immune system's functionality and integrity at the cellular level.

This test sets a new benchmark in immune system screening by evaluating 28 key biomarkers and determinants, offering a comprehensive snapshot of a patient's immune status and identifying specific immunotypes. Such detailed analysis can be pivotal for clinicians in diagnosing, managing, and monitoring various health conditions, especially those related to immune dysregulation.

Who should get a Lymphocye MAP™?

The Lymphocyte MAP™ by Cyrex Laboratories is particularly beneficial for a wide range of individuals due to its comprehensive assessment of the immune system at the cellular level. Here are some groups who may find the Lymphocyte MAP™ especially useful:

Individuals with Autoimmune Disorders: Given its detailed analysis of immune cell types and their ratios, such as TH1/TH2 and TH17/TReg, this test can provide valuable insights for those with autoimmune conditions. Understanding the underlying immune cell imbalances can help tailor treatments to modulate the immune response more effectively. [1.]

People with Chronic Infections: Those experiencing chronic viral or bacterial infections may benefit from the Lymphocyte MAP™ to assess the functionality and integrity of their immune response. Identifying specific deficiencies or imbalances in immune cells like CD57+ NK cells can offer clues for targeted therapies. [5., 8.]

Patients with Unexplained Immune Symptoms: Individuals suffering from symptoms like chronic fatigue, unexplained inflammation, or allergic reactions without a clear diagnosis might use the Lymphocyte MAP™ to uncover underlying immune dysfunctions or imbalances.  [7., 10.]

Those Undergoing Immunotherapy or Immune-Modulating Treatments: For patients receiving treatments that affect the immune system, such as biologic agents for autoimmune conditions, the Lymphocyte MAP™ can provide crucial baseline and follow-up assessments of immune status to optimize therapy. [12.]

Individuals Interested in Immune System Health: People looking to proactively manage their health and prevent disease may use the Lymphocyte MAP™ for a detailed immune system checkup. This can help identify potential areas of concern before they manifest into more significant health issues.

Healthcare Professionals Specializing in Immune-Related Conditions: Practitioners focusing on diseases with an immune component, such as rheumatologists, allergists, and functional medicine doctors, can utilize the Lymphocyte MAP™ to enhance their diagnostic and treatment strategies.

People with Family Histories of Immune Disorders: Individuals with a family history of autoimmune diseases or immune-related conditions may choose to undergo the test to understand their immune system's status and take preemptive steps if necessary. [2.]

The Lymphocyte MAP™ offers a unique opportunity to delve deep into the immune system's workings, providing actionable insights for a wide array of clinical situations and personal health objectives. It's a powerful tool for anyone seeking to optimize their immune health or understand complex immune-related health issues.

Key Biomarkers Analyzed in the Lymphocyte MAP™

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TH1/TH2 Ratio: This ratio is crucial for understanding the balance between Type 1 helper T cells (TH1), which are involved in cellular immunity, and Type 2 helper T cells (TH2), which are involved in humoral immunity. An imbalance can indicate a predisposition to certain types of autoimmune diseases or allergies. [5.]

CD4/CD8 Ratio: This measures the ratio of CD4+ T cells (T-helper cells) to CD8+ T cells (cytotoxic T cells). It's a critical marker for evaluating the immune system's health, particularly in the context of HIV/AIDS and other conditions that affect immune competency. [3.]

T Cell/B Cell Ratio, % B Cells, B Cell Count: These markers assess the balance and health of T cells and B cells, the two primary components of the adaptive immune system. Alterations can indicate immune deficiencies, autoimmune conditions, or other immune-related disorders. [2., 11.]

CD8 T Cell Count, TH2 Cell Count, TH1 Cell Count, TH17 Cell Count, Regulatory T Cell Count: These counts provide insights into the specific populations of T cells within the immune system, each playing unique roles in immune response and regulation. Imbalances can suggest specific immune responses or dysregulations. [6.]

% Regulatory T Cells, TH17/TReg Ratio: These indicators help evaluate the balance between pro-inflammatory responses (TH17 cells) and regulatory mechanisms (TReg cells). An imbalance is often associated with autoimmunity and inflammatory conditions.  [4.]

NKT Cell Count, Cytotoxic NK Cell Count, NK Cell Count: Natural Killer (NK) and Natural Killer T (NKT) cells are critical for innate immune responses against tumors and virally infected cells. Quantifying these cells helps assess the body's innate immune capacity. [9.]

CD57+ Markers (CD57+CD3- NK Cell Count, CD57+CD16+ NK Cell Count, CD57+CD8+ T Cell Count): These markers are often evaluated in the context of chronic infections and certain health conditions, providing insight into the immune system's state and its capacity to respond to chronic challenges. [9.]

The Lymphocyte MAP™ offers a unique window into the immune system's complexities, allowing healthcare providers to tailor treatment strategies more effectively. By pinpointing specific imbalances and dysfunctions, clinicians can develop targeted interventions aimed at modulating immune responses, enhancing immune resilience, and addressing the root causes of immune-related health issues. 

This approach represents a significant advancement in personalized medicine, offering potential benefits across a wide spectrum of conditions, from autoimmune diseases and infections to general immune health optimization.

Sample type and collections

Here's a comprehensive guide on the sample type needed and the collection process:

Test Details

• Lab Company: Cyrex Laboratories
• Sample Type: Whole Blood
• Collection Location: In Lab, requiring phlebotomy

Key Collection Instructions

• Timing for Collection: Blood sample collection is to be done by a professional phlebotomist from Monday to Thursday only. This scheduling is crucial to ensure the sample's viability and timely processing.
• Phlebotomy Fee: Be aware that there may be a separate fee for the phlebotomy service, which is not covered by the test kit payment.
• Same-Day Shipping: Your collected blood sample must be shipped the same day it is drawn to maintain the integrity of the sample for accurate testing.
• Dietary Preparation: Avoid eating a high-fat meal before your blood draw. Such meals can affect the clarity and quality of the sample.
• Hydration: Ensure you are well-hydrated before the blood draw to facilitate an easier and more efficient collection process.

Preparation & Timing

• Phlebotomy Appointment: Schedule your blood draw appointment for a Monday through Thursday. Resources for scheduling and details about Cyrex-contracted draw sites are available online. Patients under 15 years old cannot use Cyrex-contracted draw sites and should consult provided resources for alternative locations.
• Pre-Appointment Preparation: Do not eat high-fat meals before your appointment and ensure you are hydrated.

Collection Instructions

• Bring to Appointment: Your test kit, a completed test requisition form, and, if applicable, your blood draw authorization form for Cyrex-contracted sites.
• Phlebotomist's Role: The phlebotomist will collect, prepare, and ship your blood sample using the provided materials in the test kit. Detailed instructions for phlebotomists are available through specified resources.

Requisition & Payment

• Kit Prepayment: Your test kit has been prepaid, but remember, a separate phlebotomy fee may apply.
• Requisition Form: Complete and include your requisition form with your sample. Payment information does not need to be filled in due to prepayment.

Shipping

• Tracking: Note the tracking number on your return mailer to track your sample back to the lab.
• Phlebotomist's Responsibility: The phlebotomist will handle the shipping using the materials provided. Remember, samples must be shipped the same day as the draw, Monday to Thursday only.

Results

• Turnaround Time: Results are expected to be released to your provider within 14 business days after the lab receives the samples. However, processing times cannot be guaranteed by Rupa Health.

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References

[1.] Butcher MJ, Zhu J. Recent advances in understanding the Th1/Th2 effector choice. Fac Rev. 2021 Mar 15;10:30. doi: 10.12703/r/10-30. PMID: 33817699; PMCID: PMC8009194.

[2.] Cossarizza A, et al. Guidelines for the use of flow cytometry and cell sorting in immunological studies (second edition). Eur J Immunol. 2019 Oct;49(10):1457-1973. doi: 10.1002/eji.201970107. PMID: 31633216; PMCID: PMC7350392.

[3.] Domínguez-Domínguez L, Rava M, Bisbal O, Lopez-Cortés L, Portilla J, Podzamczer D, Olalla J, Fuster D, Rubio R, Jarrín I, Iribarren JA, Moreno S; Cohort of the Spanish HIV/AIDS Research Network (CoRIS). Low CD4/CD8 ratio is associated with increased morbidity and mortality in late and non-late presenters: results from a multicentre cohort study, 2004-2018. BMC Infect Dis. 2022 Apr 15;22(1):379. doi: 10.1186/s12879-022-07352-z. PMID: 35428209; PMCID: PMC9013070.

[4.] Garfias S, Tamaya Domínguez B, Toledo Rojas A, et al. Peripheral blood lymphocyte phenotypes in Alzheimer and Parkinson’s diseases. Neurología (English Edition). 2022;37(2):110-121. doi:https://doi.org/10.1016/j.nrleng.2018.10.022

[5.] Howard FHN, Kwan A, Winder N, Mughal A, Collado-Rojas C, Muthana M. Understanding Immune Responses to Viruses-Do Underlying Th1/Th2 Cell Biases Predict Outcome? Viruses. 2022 Jul 8;14(7):1493. doi: 10.3390/v14071493. PMID: 35891472; PMCID: PMC9324514.

[6.] Kamphorst AO, Araki K, Ahmed R. Beyond adjuvants: immunomodulation strategies to enhance T cell immunity. Vaccine. 2015 Jun 8;33 Suppl 2(0 2):B21-8. doi: 10.1016/j.vaccine.2014.12.082. PMID: 26022562; PMCID: PMC4449453.

[7.] Khan MF, Wang H. Environmental Exposures and Autoimmune Diseases: Contribution of Gut Microbiome. Front Immunol. 2020 Jan 10;10:3094. doi: 10.3389/fimmu.2019.03094. PMID: 31998327; PMCID: PMC6970196.

[8.] Lepretre F, Gras D, Chanez P, Duez C. Natural killer cells in the lung: potential role in asthma and virus-induced exacerbation? Eur Respir Rev. 2023 Jul 12;32(169):230036. doi: 10.1183/16000617.0036-2023. PMID: 37437915; PMCID: PMC10336552.

[9.] Murdock BJ, Famie JP, Piecuch CE, Pawlowski KD, Mendelson FE, Pieroni CH, Iniguez SD, Zhao L, Goutman SA, Feldman EL. NK cells associate with ALS in a sex- and age-dependent manner. JCI Insight. 2021 Jun 8;6(11):e147129. doi: 10.1172/jci.insight.147129. PMID: 33974561; PMCID: PMC8262328.

[10.] Russell A, Hepgul N, Nikkheslat N, Borsini A, Zajkowska Z, Moll N, Forton D, Agarwal K, Chalder T, Mondelli V, Hotopf M, Cleare A, Murphy G, Foster G, Wong T, Schütze GA, Schwarz MJ, Harrison N, Zunszain PA, Pariante CM. Persistent fatigue induced by interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome. Psychoneuroendocrinology. 2019 Feb;100:276-285. doi: 10.1016/j.psyneuen.2018.11.032. Epub 2018 Dec 17. PMID: 30567628; PMCID: PMC6350004.

[11.] Suzuki A, Hirokawa M, Kanematsu R, Tanaka A, Yamao N, Higuchi M, Hayashi T, Kuma S, Miyauchi A. B-cell to T-cell ratio as a novel indicator in flow cytometry in the diagnosis of thyroid lymphoma. Endocr J. 2022 Mar 28;69(3):291-297. doi: 10.1507/endocrj.EJ21-0451. Epub 2021 Oct 21. PMID: 34670907.

[12.] van Wijk, F., de Bruin, M., Leavis, H. et al. Immune monitoring and treatment in immune-mediated inflammatory diseases. Nat Commun 13, 3245 (2022). https://doi.org/10.1038/s41467-022-30891-7