Narula Gaurav, Khodaiji Shanaz, Bableshwar Arun, Bindra Manjeet Singh
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
PD Hinduja National Hospital and Medical Research Center, Mumbai, Maharashtra, India.
Indian J Pathol Microbiol. 2017 Jul-Sep;60(3):360-364. doi: 10.4103/IJPM.IJPM_542_16.
In children, innate and adaptive immunity varies with age, disease status, and ethnicity, reflected by lymphocyte subsets and serum immunoglobulin (Ig) levels. The paucity of such data from the Indian subcontinent necessitated this study.
This study aims to determine reference ranges of Ig and lymphocyte subsets in Indian children from birth to 5 years.
Neonates, infants, and children from a tertiary care hospital were selected and categorized into 5 groups from cord blood/newborn to 5 years.
Samples were taken from cord blood and healthy children up to 5 years of age. Complete blood counts, serum Ig levels (by turbidimetry), and lymphocyte subsets (by flow cytometry) were studied, and reference ranges calculated.
Four hundred and three samples were analyzed; 53 from cord blood and 350 from children 1 month to 5 years. High IgG levels were noted at birth, which decreased in the first 6 months followed by a rise thereafter. IgM remained low in infancy and peaked at 13-36 months. IgA levels were very low at birth but increased with age. CD4 counts were high in cord blood till 3 years of age and then declined. CD8 and CD19 counts remained steady till 5 years of age. CD56 increased after the age of 2 years.
While our data correlated well with published literature, notable differences were higher IgM levels seen in 1-3 years' age group and higher natural killer cells through all age groups in our study. Our results provide the largest database of its kind from our country.
在儿童中，先天性和适应性免疫会随年龄、疾病状态和种族而变化，这通过淋巴细胞亚群和血清免疫球蛋白（Ig）水平得以体现。印度次大陆此类数据匮乏，因此有必要开展本研究。
本研究旨在确定印度出生至5岁儿童的免疫球蛋白和淋巴细胞亚群的参考范围。
选取一家三级护理医院的新生儿、婴儿和儿童，并将其分为从脐带血/新生儿到5岁的5组。
采集脐带血和5岁以下健康儿童的样本。研究全血细胞计数、血清免疫球蛋白水平（通过比浊法）和淋巴细胞亚群（通过流式细胞术），并计算参考范围。
共分析了403份样本；其中53份来自脐带血，350份来自1个月至5岁的儿童。出生时IgG水平较高，在头6个月下降，此后上升。IgM在婴儿期保持较低水平，并在13 - 36个月达到峰值。IgA水平在出生时非常低，但随年龄增长而增加。CD4计数在3岁前的脐带血中较高，然后下降。CD8和CD19计数直到5岁时保持稳定。CD56在2岁后增加。
虽然我们的数据与已发表的文献相关性良好，但值得注意的差异是，在我们的研究中，1 - 3岁年龄组的IgM水平较高，且所有年龄组的自然杀伤细胞水平较高。我们的结果提供了我国此类最大的数据库。
