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
Method Name
A short description of the method used to perform the test
Bead-Based Multiplex Immunoassay
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Cytokine storm
Cytokines
Tumor necrosis factor alpha
Interleukin-6
Interferon Beta
Interleukin-10
CCL2/MCP-1
Monocyte Chemoattractant Protein-1
Interleukin-1 beta
IL-1B/IL-1F2
Interferon gamma
CCL3/MIP-1A
Macrophage Inflammatory Protein-1A
Granulocyte Macrophage Colony Stimulating Factor
CD25/IL-2 RA
Interleukin-2 Soluble Receptor Alpha
Interferon alpha-2a
IL-18/IL-1F4
Interleukin-18
Specimen Type
Describes the specimen type validated for testing
Plasma EDTA
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Lavender-top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Immediately after specimen collection, place the tube on wet ice.
2. Centrifuge at 4 degrees C, 1500 x g for 10 minutes.
3. Aliquot plasma into plastic vial.
4. Freeze specimen within 2 hours of collection.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
0.3 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
| Heat-treated specimen | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma EDTA | Frozen | 21 days |
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 and macrophage inflammatory protein-1 alpha, 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 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.
Interleukin-6 (IL-6) concentrations may be elevated in patients receiving IL-6 receptor inhibitors, such as tocilizumab, due to receptor blockade and reduced clearance of IL-6. As a result, IL-6 concentrations are not reflective of adequate tocilizumab response. Additionally, patients receiving anti-IL-6 monoclonal antibodies such as siltuximab may also exhibit interference in IL-6 measurements. For both patient cohorts, a more reliable assessment of IL-6-mediated inflammation can be obtained by measuring downstream acute-phase reactants, such as C-reactive protein.
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
Method Description
Describes how the test is performed and provides a method-specific reference
Analyte-specific antibodies are pre-coated onto color-coded magnetic microparticles. Samples are diluted 1:2 in a mixing plate and then standards, samples, and microparticles are pipetted into wells and the immobilized antibodies capture the analytes of interest. Unbound substances are washed away while the magnetic microparticles are immobilized. Next, a biotinylated analyte specific antibody cocktail is added to each well. Following a wash to remove any unbound biotinylated antibody, streptavidin-phycoerythrin conjugate (Streptavidin-PE), is added to each well. After removal of unbound Streptavidin-PE and resuspension of the microparticles in buffer, the plate is analyzed using a Luminex FLEXMAP 3D analyzer. A charged-coupled device camera captures an image of each well and data reduction is performed using the XPONENT software.(Unpublished Mayo method)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Wednesday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
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Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
83520 x 10
83529
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| CYPAN | Cytokine Panel, P | 82335-1 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 610307 | TNF | 3074-2 |
| 610308 | IL-6 | 26881-3 |
| 610309 | IFN-beta | 97051-7 |
| 610310 | IL-10 | 26848-2 |
| 610311 | MCP-1 | 97052-5 |
| 610312 | IL-1 beta | 13629-1 |
| 610313 | IFN-gamma | 27415-9 |
| 610314 | MIP-1 alpha | 97053-3 |
| 610315 | GM-CSF | 97054-1 |
| 610316 | IL-2 receptor alpha soluble | 76039-7 |
| 610317 | IFN-alpha | 33820-2 |
| 610318 | IL-18 | 33823-6 |