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Simplified Dynabeads Method Using Light Microscopy for Enumerating TCD4+ Lymphocytes in Resource-Limited Settings

DOI:10.21767/2386-5180.1000138 期刊:Annals of Clinical and Laboratory Research 出版年份:2016 更新时间:2025-09-11 14:15:04
摘要: Background: We demonstrated feasibility of implanting the Dynabeads method for CD4+ T lymphocyte enumeration in resource-poor settings (ANRS 1226 study). However, as this technique requires a fluorescence microscope which is not usually available in these settings, WHO has encouraged to simplify the method allowing TCD4+ lymphocyte counting under a light microscope. Methods: TCD4+ lymphocytes enumeration was assessed using Dynabeads after staining cells nuclei with non-fluorescent dyes and readings under light microscope (DLM). A total of 305 triple of values of CD4 cells counts were generated by both Dynabeads method using a light microscopy (DLM), Dynabeads method using a fluorescent microscope (DFM) and the single-platform flow cytometry technique (FCM). The accuracy of DLM was analyzed using 4 fresh blood samples showing 200, 400, 500 and 1000 cells/μl in FCM respectively. Correlations have been studied between the 3 methods. The DLM was then evaluated for its ability to correctly segregate absolute TCD4+ lymphocyte values at the thresholds of 200 cells/μl and 350 cells/μl. Findings: Cells nuclei staining with Sternheimer-Malbin, Turck1, and Giemsa allows TCD4+ lymphocytes enumeration using DLM. FCM has shown the greatest standard deviations and amplitudes. The reproducibility of DLM was better than FCM. The correlation coefficient between FCM and DFM was 0.975 and it was 0.973, 0.972 and 0.969 with DLM using Sternheimer-Malbin, Turck1 and Giemsa, respectively. The ability of DLM to correctly segregate TCD4+ lymphocyte values at the threshold of 200 cells/μl and 350 cells/μl was good. Conclusion: Reliable TCD4+ enumeration can be obtained with DLM. These results will contribute in resource-limited-settings to further reduce the cost of TCD4+ lymphocytes counting and make it more widely available in peripheral laboratories and even in central laboratories that face problems with maintenance and stock-out of reagents for flow cytometers.
作者: Serge Diagbouga,Dézemon Zingué,Eloi Bahembera,Antoinette Kaboré,Hervé Hien,Adama Ouiminga,Laurent Caignault
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To evaluate several staining methods allowing an optimal counting of TCD4+ lymphocyte using Dynabeads method with light microscopy (DLM) and to analyze its usefulness for TCD4+ lymphocyte enumeration in comparison to the Dynabeads method using fluorescence microscopy (DFM) and to the flow cytometry single platform method (FCM).

Reliable TCD4+ enumeration can be obtained with the Dynal T4 Quant Kit, in light microscopy with the Sternheimer-Malbin, Turck1 and Giemsa solutions. These results could contribute to further reduce the cost of TCD4+ lymphocytes counting and make it more widely available in peripheral laboratories and even in central laboratories that face problems with maintenance and stock-out of reagents for flow cytometers.

The main limitations of Dynabeads technique include its requirements several steps, its chronophage nature and its precision that could be rely on operator expertise. The technique could seem complex for a new user but after long time of using the technique become simple and easy to use. Dynabeads technique requires refrigeration of reagents, a microscope with a 40X objective, a hemocytometer, calibrated pipettes, test tubes, and a manual counter.

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