CD25

Immunity

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Flow cytometry panel of immune cell surface markers.

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CD25 Test Information Guide

Why is it done?
- CD25, also known as interleukin-2 receptor alpha (IL-2Rα), is a cell surface marker primarily found on activated T lymphocytes, B lymphocytes, and macrophages that is measured to assess immune system activation and function
- Diagnose and monitor autoimmune diseases including systemic lupus erythematosus (SLE), rheumatoid arthritis, and autoimmune thyroid disease
- Evaluate immunological disorders and primary immunodeficiencies affecting T cell function
- Assess disease activity and progression in patients with HIV/AIDS by measuring CD4+CD25+ T cell populations
- Monitor patients with hematologic malignancies, particularly T-cell lymphomas and adult T-cell leukemia
- Evaluate immune reconstitution in patients receiving immunosuppressive therapy or undergoing transplantation
- Assess disease activity in inflammatory conditions such as sarcoidosis and granulomatosis with polyangiitis (GPA)
Normal Range
- Reference Range Values: Soluble CD25 (sCD25): typically 150-680 pg/mL or U/mL (varies by laboratory and method)
- CD4+CD25+ T cells (flow cytometry): Approximately 5-10% of CD4+ cells express CD25 (regulatory T cells); exact ranges depend on laboratory standards
- Interpretation of Results:
- Normal/Low CD25: Indicates quiescent immune system with minimal T cell activation; suggests absence of active immune stimulation or disease
- Elevated CD25: Indicates enhanced immune activation; suggests active infection, autoimmune disease, malignancy, or inflammatory condition
- Units of Measurement: Picograms per milliliter (pg/mL), International Units per milliliter (U/mL), or percentage of CD4+ cells (%)
- Normal values indicate appropriate immune regulation and minimal systemic immune activation; abnormal values warrant further investigation to determine underlying etiology
Interpretation
- Mildly Elevated CD25 (1-2x upper limit of normal):
- May indicate mild immune activation from recent infection, vaccination, or minor inflammatory process
- May represent early stages of autoimmune disease or subclinical inflammation
- Moderately Elevated CD25 (2-5x upper limit of normal):
- Suggests active autoimmune disease, significant infection, or inflammatory condition requiring medical attention
- Common in SLE, rheumatoid arthritis, and other connective tissue diseases with active disease
- Markedly Elevated CD25 (>5x upper limit of normal):
- Indicates significant immune activation; may suggest T-cell lymphoma, adult T-cell leukemia, or severe active disease
- Associated with poor prognosis in certain malignancies; requires urgent investigation
- Factors Affecting CD25 Results:
- Disease activity level and disease duration in chronic conditions
- Immunosuppressive medications such as corticosteroids, methotrexate, and biologics (TNF inhibitors) typically decrease CD25 levels
- Recent infections or vaccinations may transiently elevate CD25
- CD4 count in HIV-positive patients; CD25 may increase with immune reconstitution
- Time of day and circadian rhythm variations may affect measurement
- Laboratory methodology and reference laboratory standards; results vary between institutions
Associated Organs
- Primary Organ Systems:
- Immune system - specifically lymphoid organs including thymus, lymph nodes, and spleen where T cells are produced and activated
- Bone marrow - site of lymphocyte production and maturation
- Diseases Associated with Abnormal CD25 Results:
- Systemic lupus erythematosus - often shows significantly elevated CD25 correlating with disease activity
- Rheumatoid arthritis - elevated CD25 reflects T cell activation in joint inflammation
- HIV/AIDS - CD4+CD25+ cells important marker of immune function; decreases with disease progression
- Adult T-cell leukemia (HTLV-1 associated) - markedly elevated CD25, often >5000 pg/mL
- Peripheral T-cell lymphomas - elevated CD25 assists in diagnosis and prognosis assessment
- Sarcoidosis - elevated CD25 reflects granulomatous inflammation; correlates with disease activity
- Granulomatosis with polyangiitis (GPA) - CD25 elevation indicates active vasculitic disease
- Hashimoto's thyroiditis and Graves' disease - elevated CD25 reflects thyroid-specific T cell activation
- Chronic viral infections (EBV, CMV, hepatitis) - sustained CD25 elevation during active infection
- Potential Complications of Abnormal CD25:
- Elevated CD25 in malignancies associated with poor prognosis and increased mortality risk
- Uncontrolled immune activation may lead to tissue damage and multi-organ involvement
- Dysregulated CD25 in immunodeficiencies increases susceptibility to opportunistic infections
Follow-up Tests
- If CD25 is Elevated:
- CD4 and CD8 T cell count (flow cytometry) - assess overall immune status and T cell populations
- Antinuclear antibody (ANA) - screen for systemic lupus erythematosus and other autoimmune conditions
- Rheumatoid factor and anti-CCP antibodies - evaluate for rheumatoid arthritis
- Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) - markers of inflammation
- Complete blood count (CBC) - assess lymphocyte counts and detect hematologic abnormalities
- Flow cytometry panel with CD25 and other T cell markers - detailed immune phenotyping
- HTLV-1 serology - test for Adult T-cell leukemia if markedly elevated CD25
- HIV antibody or RNA testing - assess HIV status and viral load if immunosuppression suspected
- Peripheral blood smear - evaluate for abnormal lymphocytes suggesting malignancy
- Liver and kidney function tests - assess for end-organ involvement in systemic disease
- Disease-Specific Monitoring:
- SLE patients: repeat CD25 every 3-6 months to monitor disease activity; correlate with clinical symptoms and other markers
- Rheumatoid arthritis: CD25 measured alongside joint examination and imaging to assess treatment response
- HIV patients: CD4+CD25+ monitoring every 3-6 months, more frequently if CD4 <200 cells/μL
- T-cell lymphoma patients: baseline CD25 with repeat testing following chemotherapy/treatment to assess response
- Complementary Tests:
- Interleukin-2 (IL-2) levels - correlates with CD25 expression and immune activation
- Foxp3+ regulatory T cells - assess proportion of suppressor T cells in immune regulation
- T cell receptor (TCR) clonality studies - differentiate polyclonal activation from monoclonal proliferation
- Imaging studies (CT, PET) - evaluate for lymphadenopathy or organomegaly if malignancy suspected
Fasting Required?
- Fasting Required:No
- Dietary Restrictions:None required; normal diet can be maintained prior to testing
- Medications:
- Continue all regularly prescribed medications; do not discontinue without consulting physician
- Immunosuppressive drugs (corticosteroids, methotrexate, biologics) will lower CD25 levels but should not be held
- Inform laboratory of all medications being taken for proper interpretation
- Other Preparation Requirements:
- Wear loose-fitting clothing to facilitate venipuncture
- Hydration: drink adequate water to help with venipuncture; avoid excessive caffeine or stimulants immediately before test
- Timing: blood can be drawn at any time of day; morning collection preferred for consistency in serial testing
- Stress level: minimize physical and emotional stress before testing as this may transiently affect immune markers
- Recent infections: inform healthcare provider of recent infections or vaccinations; these may affect CD25 levels
- Blood sample collection: standard peripheral venipuncture into appropriate tube (EDTA or heparin depending on assay method)

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