Cent Eur J Public Health 2004, 12(3):119-125

Immune System Parameters in Children of Central and Eastern Europe: The Cesar Study

Timová S.¹, Leonardi G.S.², Hrubá F.³, Lochman I.⁴, Lochmanová A.⁴, Erdei E.⁵, Jazwiec-Kanyion B.⁶, Niciu E.M.⁷, Steerenberg P.A.⁸, van Loveren H.⁸

¹ Department of Clinical Immunology, F.D.Roosevelt Hospital, Banská Bystrica, Slovak Republic

² Environmental Epidemiology Unit, London School of Hygiene and Tropical Medicine, United Kingdom

³ Department of Informatics and Health Statistics, State Institute of Public Health, Banská Bystrica, Slovak Republic

⁴ Department of Immunology and Allergology, Regional Institute of Public Health, Ostrava, Czech Republic

⁵ Department of Biological Monitoring, J. Fodor National Public Health Center, National Institute of Environmental Health, Budapest, Hungary

⁶ Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland

⁷ Department of Environmental Medicine, Institute of Public Health, Bucharest, Romania

⁸ Laboratory of Pathology and Immune Biology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands

Objective of this paper is to compare observed values of immune parameters obtained in the CESAR study (The Central Europe Study of Air Pollution and Respiratory Health, funded by EC PHARE program) with ranges derived from other large population-based studies.
Study design: Data were collected in healthy school children aged 9-11 years, in 6 countries: Bulgaria, the Czech Republic, Hungary, Poland, Romania and the Slovak Republic with the same standard approach in 1996. Random samples of 85 children per country, from 19 communities were selected from children having completed the health questionnaire, in total 495 children were analyzed. Lymphocyte subsets were determined by two-colour flow cytometric immunophenotyping using the lysed whole blood method (Becton-Dickinson). For determination of immunoglobulin concentration in sera nephelometric method (Behring Nephelometer system) was used.

Results: Medians, (5th-95th percentiles) of the lymphocyte subsets absolute count (x 109/l) were as follows: CD19+ B cells 0.36 (0.13-0.66), total CD3+ T cells 1.74 (0.98-2.90), CD3+CD4+ helper-inducer T cells 0.95 (0.47-1.78), CD3+CD8+ suppressor/cytotoxic T cells 0.71 (0.38-1.22), CD3-CD16+56+ NK cells 0.36 (0.14-0.78), and for CD3+CD4+/ CD3+CD8+ ratio 1.4 (0.8-2.4). Medians, (5th-95th percentiles) of percentages of lymphocyte subpopulations (%) were as follows: CD19+ B 13 (7-22), CD3+ T 70 (59-80), CD3+CD4+ T 38 (27-48), CD3+CD8+ T 28 (20-39), CD3-CD16+56+ NK cells 14 (6-27). Medians, (2.5th-97.5th percentiles) of the total immunoglobulin [g/l] were 11.7 (7.4-18.2) for IgG, 1.2 (0.5-2.5) for IgM, and 1.5 (0.5-3.4) for IgA.
Based on the aspects of the size of the CESAR immune biomarker study and on the use of the standardized protocols we recommend to use the reference ranges on lymphocyte subsets and immunoglobulin in Europe as provided by this study.

Keywords: lymphocyte subsets, flow cytometry, immunoglobulin, reference intervals

Received: December 1, 2003; Revised: April 5, 2004; Accepted: April 5, 2004; Published: September 1, 2004  Show citation