title: HLA-B27 screening by flow cytometry.
abstract: A flow cytometric assay for lymphocyte HLA-B27 expression using a two-color direct immunofluorescent assay was compared to traditional microlymphocytotoxicity testing on 209 clinical samples. For the flow cytometric assay, whole blood was mixed with a monoclonal anti-B27 conjugated to fluorescein-isothiocyanate (FITC) and anti-CD3 conjugated to phycoerythrin (PE). The samples were analyzed with flow cytometry by gating on CD3 positive events and anti-B27 staining intensity was evaluated as median channel fluorescence of the histogram peak. The median channel fluorescence was least with B27 negative and B7 negative samples (84 +/- 17), intermediate with samples that were B27 negative but B7 positive (118 +/- 13), and greatest with samples that were B27 positive (155 +/- 13). In addition to cross-reactivity with the B7 antigen (n = 38), the monoclonal anti-B27 cross-reacted with HLA-B37 positive samples (n = 3) and HLA-B39 positive samples (n = 3). Using a median channel fluorescence cutoff of 136, 39 of the 40 B27 positive samples gave positive results in the flow cytometric assay for a sensitivity of 97.6%. The specificity was 95.9% with 7 false positives of 169 B27 negative samples. The flow cytometric HLA-B27 assay is a convenient, useful screening test. For greatest specificity, samples positive by flow cytometry should be confirmed by conventional microlymphocytotoxicity or by use of other monoclonal antibodies directed against B27.
authors.affiliation: Department of Pathology, University of Utah, Salt Lake City, USA.
authors.forename: B
authors.initials: B
authors.lastname: Lingenfelter
authors.forename: T C
authors.initials: TC
authors.lastname: Fuller
authors.forename: L
authors.initials: L
authors.lastname: Hartung
authors.forename: J
authors.initials: J
authors.lastname: Hunter
authors.forename: C
authors.initials: C
authors.lastname: Wittwer
mesh_terms: D005434:Flow Cytometry; D019085:Fluorescent Antibody Technique, Direct; D015796:HLA-B27 Antigen / Q000097:blood*; D006801:Humans; D016130:Immunophenotyping; D008403:Mass Screening / Q000379:methods*; D012016:Reference Values
chemical_list: D015796:HLA-B27 Antigen