TEST CATALOG ORDERING & RESULTS SPECIMEN HANDLING CUSTOMER SERVICE EDUCATION & INSIGHTS
Test Catalog

Test ID: CYPAN    
Cytokine Panel, Plasma

Useful For Suggests clinical disorders or settings where the test may be helpful

Understanding the etiology of infectious or chronic inflammatory diseases, when used in conjunction with clinical information and other laboratory testing

 

Research studies in which an assessment of cytokine responses is needed

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Cytokines are important mediators of cell-to-cell communication within the innate and adaptive immune systems. The expression of most cytokines is highly regulated and generally occurs in response to foreign or self-antigenic stimulation. The functions of cytokines are extremely varied, with many cytokines also displaying pleiotropic effects, depending on their cellular target. Some cytokines, such as tumor necrosis factor (TNF), interleukin (IL)-1 beta, IL-6, interferon (IFN)-alpha and beta, IL-10, and IL-18 are particularly important in the innate immune response. For example, TNF, IL-1 beta, and IL-6 induce expression of acute phase proteins in the liver. TNF and IL-1 beta also lead to endothelial activation and are critical regulators of the hypothalamus, which can result in elevated body temperature. IL-6, in comparison, is a bridge to the adaptive immune response, by acting on B cells to induce proliferation. In contrast, IFN-alpha and IFN-beta (members of the type I IFN family) are key components of the innate immune response to viral infections. IFN-gamma, which is a type II IFN, has roles in both the innate and adaptive immune responses, including macrophage activation, induction of B-cell isotype switching, and T helper type 1 cell differentiation. Other cytokines, such as monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-1alpha (MIP-1alpha), are categorized as chemokines because they function primarily to attract leukocytes to the site of inflammation. Further, some cytokines act on hematopoietic stem cells to induce differentiation of various leukocytes. For example, granulocyte-monocyte colony stimulating factor (GM-CSF) induces myeloid progenitor cells to differentiate into neutrophils and monocytes. Lastly, for some cytokines, soluble forms of the receptor can be found in the peripheral circulation. The IL-2 soluble receptor is produced from proteolytic cleavage of the membrane-bound receptor, which occurs during T-cell activation. As a group, cytokines and their receptors represent a highly complex and critical regulator of a normal immune response.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Tumor necrosis factor: <10.0 pg/mL

Interleukin (IL)-6: <5.0 pg/mL

Interferon (IFN)-beta: <20.0 pg/mL

IL-10: <7.0 pg/mL

Monocyte chemoattractant protein-1: < or =198 pg/mL

IL-1 beta: <20.0 pg/mL

IFN-gamma: <60.0 pg/mL

Macrophage inflammatory protein-1 alpha: <220 pg/mL

Granulocyte-monocyte colony stimulating factor: <15.0 pg/mL

IL-2 receptor alpha soluble: < or =959 pg/mL

IFN-alpha: <20.0 pg/mL

IL-18: < or =468 pg/mL

Interpretation Provides information to assist in interpretation of the test results

Elevated cytokine concentrations could be consistent with the presence of infection or other inflammatory process.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Results from cytokine testing should not be used to establish or exclude a specific diagnosis.

 

Cytokine testing should only be used in conjunction with clinical information and other laboratory testing as part of a patient’s overall assessment.

 

Normal concentrations of cytokines do not exclude the possibility of infection or other inflammatory condition.

 

Cytokine concentrations could be affected by immunomodulatory agents.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Bozza FA, Salluh JI, Japiassu AM, et al: Cytokine profiles as markers of disease severity in sepsis: a multiplex analysis. Crit Care. 2007;11(2):R49. doi: 10.1186/cc5783. 

2. Milman N, Karsh J, Booth RA: Correlation of a multi-cytokine panel with clinical disease activity in patients with rheumatoid arthritis. Clin Biochem. 2010;43(16-17):1309-1314. doi: 10.1016/j.clinbiochem.2010.07.012.

3. Teijara JR: Type I interferons in viral control and immune regulation. Curr Opin Virol. 2016;16: 31-40. doi: 10.1016/j.coviro.2016.01.001.

4. Tisoncki JR, Korth MJ, Simmons CP, Farrar J, Martin TR, Katze MG: Into the eye of the cytokine storm. Microbiol Mol Biol Rev. 2010;76(1):16-32. doi: 10.1128/MMBR.05015-11. 

5. Garcia Borrega J, Godel P, Ruger, MA, et al: In the eye of the storm: Immune-mediated toxicities associated with CAR-T cell therapy. Hemasphere. 2019;3(2):e191. doi: 10.1097/HS9.0000000000000191.