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| Email: | mcl@mayo.edu |
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Test Id : TNFA
Tumor Necrosis Factor, Plasma
Useful For
Suggests clinical disorders or settings where the test may be helpful
Suggests clinical disorders or settings where the test may be helpful
Evaluation of patients with suspected systemic infection, in particular infection caused by gram-negative bacteria
Evaluation of patients with suspected chronic inflammatory disorders, such as rheumatoid arthritis, inflammatory bowel disease, ankylosing spondylitis, or cancers.
Method Name
A short description of the method used to perform the test
A short description of the method used to perform the test
Electrochemiluminescence
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Yes
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Lists a shorter or abbreviated version of the Published Name for a test
Tumor Necrosis Factor, P
Aliases
Lists additional common names for a test, as an aid in searching
Lists additional common names for a test, as an aid in searching
TNF
TNF-Alpha
Cytokine
Specimen Type
Describes the specimen type validated for testing
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
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
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 1500 x g for 10 minutes and aliquot plasma into plastic vial.
3. Freeze specimen within 30 minutes.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory
0.3 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
| 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
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 (preferred) | 21 days | |
| Refrigerated | 24 hours |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Suggests clinical disorders or settings where the test may be helpful
Evaluation of patients with suspected systemic infection, in particular infection caused by gram-negative bacteria
Evaluation of patients with suspected chronic inflammatory disorders, such as rheumatoid arthritis, inflammatory bowel disease, ankylosing spondylitis, or cancers.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Tumor necrosis factor-alpha (TNF-alpha) is a highly pleiotropic cytokine involved in a spectrum of physiological processes that control inflammation, anti-tumor responses, and homeostasis.(1-3) The main sources of TNF-alpha are macrophages and T cells; however, many other cell types such as B cells, neutrophils, and endothelial cells have been described to produce TNF-alpha. It is expressed as a type II transmembrane protein (mbTNF-alpha) but can be cleaved to its soluble form (sTNF-alpha) with increased biological activity. Targets for TNF-alpha include 2 type I transmembrane receptors, TNF receptor I (TNFR-I or CD120a) and TNF receptor II (TNFR-II or CD120b). (2, 3) TFNR-I is expressed on every cell type except erythrocytes while TNFR-II is found only on endothelial and immune cells and can be activated by mbTNF-alpha.(1-3)
Following infection, TNF-alpha produced by macrophages enhances the proliferation of T cells after stimulation with interleukin-2 (IL-2).(1) In the absence of IL-2, TNF-alpha induces the proliferation and differentiation of B cells. Due to its antitumor property, TNF-alpha can cause cell death via a number mechanisms and is also capable of chemotactic attraction of neutrophils. Additionally, it is capable of stimulating macrophages to produce acid phosphatase and collagenase, and osteoblasts to produce prostaglandin E2 and collagenase. These chemical mediators have been known to lead to bone resorption.(1-3)
Due to the significant proinflammatory and immunoregulatory functions of TNF-alpha, and the wide distribution of TNFRs, the deregulation TNF-alpha is associated with the development of several immunologic disorders and prediction of disease outcomes.(1-7) Indeed, elevated levels of TNF-alpha in serum or plasma levels have been able to predict severity in some infectious diseases such as sepsis in bacterial infections or poor outcomes in coronavirus 2019 infections.(6) In addition, TNF-alpha has been implicated in post-transplant reactions, pathological mechanisms in certain autoimmune diseases (eg, rheumatoid arthritis, inflammatory bowel disease, ankylosing spondylitis), and cancers.(1-5,7) With the FDA approval of biologic and biosimilar therapies targeting TNF-alpha in patients with these diseases, it is likely that measurement of TNF-alpha levels may be useful in management of treatment response.(4-9)
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.
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.
< or =2.8 pg/mL
Clinical Reference
Recommendations for in-depth reading of a clinical nature
Recommendations for in-depth reading of a clinical nature
1. Varfolomeev E, Vucic D. Intracellular regulation of TNF activity in health and disease. Cytokine. 2018;101:26-32
2. Atretkhany KN, Gogoleva VS, Drutskaya MS, Nedospasov SA. Distinct modes of TNF signaling through its two receptors in health and disease. J Leukoc Biol. 2020 107:893-905
3. Salomon BL, Leclerc M, Tosello J, Ronin E, Piaggio E, Cohen JL. Tumor necrosis factor alpha and regulatory T cells in oncoimmunology. Front Immunol. 2018;9:444
4. Ridgley LA, Anderson AE, Pratt AG. What are the dominant cytokines in early rheumatoid arthritis? Curr Opin Rheumatol. 2018;30:207-214
5. Friedrich M, Pohin M, Powrie F: Cytokine networks in the pathophysiology of inflammatory bowel disease. Immunity. 2019;50:992-1006
6. Wilson JG, Simpson LJ, Ferreira AM, et al: Cytokine profile in plasma of severe COVID-19 does not differ from ARDS and sepsis. JCI Insight. 2020;5(17):e140289
7. Li Y, Yuan L, Yang J, et al:. Changes in serum cytokines may predict therapeutic efficacy of tofacitinib in rheumatoid arthritis. Mediators Inflamm. 2019 Oct24;2019:5617431
8. Salomon BL: Insights into the biology and therapeutic implications of TNF and regulatory T cells. Nat Rev Rheumatol. 2021;17:487-504
9. Willrich MAV, Murray DL, Snyder MR: Tumor necrosis factor inhibitors: clinical utility in autoimmune diseases. Trans Res 2015;165:270-282
Method Description
Describes how the test is performed and provides a method-specific reference
Describes how the test is performed and provides a method-specific reference
The tumor necrosis factor (TNF)-alpha cytokine assay measures human cytokines in a 96-well spotted plate. The assay employs a sandwich immunoassay format where capture antibodies are coated on a single spot on the bottom of each well. Diluted samples, calibrators, and controls are added and to the plate. If present, TNF-alpha will bind to the capture antibodies. After incubation, a solution containing detection antibodies conjugated with electrochemiluminescent labels is added. After a final incubation, a buffer is added that creates the appropriate chemical environment for electrochemiluminescence. The plate is then read on the MSD QuickPlex SQ120. The machine applies a voltage that causes bound labels to emit measurable light. The MSD QuickPlex SQ120 measures the intensity of emitted light and correlates it to a set of standards of known quantity via a 4-point logistics curve fitting method.(Package Insert: Human TNF-alpha V-plex. Mesoscale Discovery; 2014)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Indicates whether the report includes an additional document with charts, images or other enriched information
No
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.
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.
Thursday
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.
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.
1 to 8 days
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
14 days
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Indicates the location of the laboratory that performs the test
Rochester
Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.
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.
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. This test 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.
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
Test Setup Resources
Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.
Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.
Normal and Abnormal sample reports are provided as references for report appearance.
SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.