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Table 2. Laboratory Tests of Immune Function
Screening tests Advanced tests
Humoral immunity
Serum immunoglobulin levels Flow cytometry to enumerate B-cell
subsets (eg, naïve and switched memory
cells)
Serum specific antibody titers In vitro immunoglobulin production in
response to mitogens or other stimuli
Antibody response to booster
immunization
Antibody response to immunization with
ΦΧ174
Flow cytometry to enumerate total B cells
Cellular immunity
TREC newborn screening Flow cytometry to enumerate T-cell
subsets (eg, naïve, memory, and activated
cells)
Flow cytometry to enumerate CD4 and
CD8 T cells and NK cells
In vitro proliferative response to mitogens
and antigens
Cutaneous delayed hypersensitivity T-cell cytotoxicity
Spontaneous NK cytotoxicity In vitro surface marker expression and
cytokine production in response to stimuli
Cytoplasmic protein phosphorylation in
response to stimuli
Phagocytic cells
Blood cell count with differential Chemotaxis and/or phagocytosis assay
Neutrophil staining, morpholog y on a
peripheral blood smear
Enzyme assays (myeloperoxidase,
G6PDH)
DHR reduction or nitroblue tetrazolium WBC turnover
Flow cytometry for adhesion molecules Bacterial or fungal killing
Bone marrow biopsy
Complement
CH50 assay (total hemolytic complement
activity)
Level or function of individual
complement components
AH50 assay (alternative pathway
hemolytic activity)
Lectin pathway function
Genetic tests
Microarray for copy number variation Targeted gene sequencing
Whole-exome/genome sequencing
