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CD4 & CD8


systemic disease  on t lymphocytes these two co-stimulatory molecules define different functional types; an altered ratio between CD4 and CD8 cells can indicate systemic disease or immune dysfunction neoplasia  expanded populations of CD4 or CD8 cells or t cells with unusual expression patterns of these molecules may represent a malignant clone and the CD4 or CD8 expression may help identify the disease subtype. however restricted CD4 or CD8 expression cannot substitute for molecular clonality analysis.  function CD4 and CD8 are transmembrane-glycoproteins that amplify signal generation by the t cell receptor. t cells acquire simultaneous expression of both CD4 and CD8 during their early the thymic stage of development however when the mature t cells enter the circulation they express either CD4 or CD8 only. CD4 is linked to t-helper cell function interacting with mhc class ii expressed for example on dendritic cells or b lymphocytes but is also expressed by immune-presenting cells including monocytes macrophages and dendritic cells. CD8 is particularly expressed by cytotoxic cells and interacts with mhc class i expressed on all nucleated cells and is also expressed by natural killer cells and dendritic cells. CD4 CD8 in health  * CD4 CD8 ratio for healthy individuals the ratio in blood lies between 1u82e5 and 2u82e5. an inverted ratio is considered an cimmune riskd phenotype occurring in just less than 10 of 20- to 59-year-olds but increasing with age . however there be quite wide variation depending on a range of factors including infection with the hiv virus. * absolute counts these may be more informative than CD4 CD8 ratios the normal CD4 count should be greater than 400 u8cebcl reference range 500-1 500 ; CD8 lymphocyte counts should lie in the range to 200-800 u8cebcl  CD4 CD8 in mature t cell neoplasia  * CD4 proliferations particularly characterise cutaneous lymphomas and t-pll although t-pll may express both CD4 and CD8 or rarely only CD8 * CD8 proliferation typifies atll although simultaneous CD4 expression may occur and t-lgl ---- '),
<div style="background-color: #E0EEEE; {{round corners}} padding: 2em 2emmargin-right: 5px;">
 
 
:<span style="color:navy">'''Summary'''</span>
 
:CD138 is a marker used to identify normal or malignant plasma cells with a high level of specificity, but does not discriminate normal from abnormal plasma cells and in some cases expression in myeloma may be low compared with normal plasma cells so sensitivity can be an issue. Abberancy of expression is low, but expression may be seen in lymphoplamacytic or marginal zone lymphomas (only on those cells that have plasma cell differentiation)
 
</div>
 
 
 
<span style="color:navy">'''Normal expression and function'''</span>
 
CD138 is a membrane protein that supports cell adhesion or binds cytokines and chemokines. In the hematopoietic system expression of CD138 is acquired by B lymphocytes as they develop into plasma cells.
 
 
 
 
<span style="color:navy">'''Diagnostic role'''</span>
 
*Most often CD138 used in conjunction with CD38 to identify plasma cells in the diagnosis or monitoring of myeloma
*There is very little aberrant expression, but neoplastic plasma cells may in some cases have weak, variable, or occasionally undetectable expression
*Expression is also seen cells that have plasmacytic differentiation in lymphoplasmacytoid lymphoma or marginal zone lymphoma 
 
 
 
<span style="color:navy">'''Other useful information'''</span>
 
Outside of haematopoiesis CD138 is expressed by squamous epithelium.
 
----
 
<span style="color:navy">'''''SUMMARY TABLES'''''</span>
 
 
{| class=wikitable style="text-align: center; font-size:80%; width: 87.5%; height 20px;"
|-
!colspan="7"|<span style="font-size:100%">'''Expression: primitive cell types'''  ''Click (i) on table for additional information'' </span></font>
|-
! AML !! B ALL !! Burkitt || T ALL !! ETP ALL ('''[[Early T Precursor ALL (ETP-ALL)|i]]''') !! MPAL ('''[[Mixed Phenotype Acute Leukaemia (MPAL)|i]]) || H.gones ('''[[Haematogones|i]]''')
|-
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|-
|}
 
 
 
{| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
|-
!colspan="8"|'''Expression: mature B cell neoplasms'''
|-
! CLL !! MCL !!FL!! MZL !! HCL !! DLBCL || LPL !! PCL
|-
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 14.25%; background: #006699; color:white"|40-80%
|style="width: 12.5%; background: #004466; color:white"|80-100%
|-
|}
 
<span style="font-size:90%">'''Notes:''' expression is usual in myeloma, and will occur on cells with plasma cell differentiation in LPL or MZL</span>
 
 
 
{| class=wikitable style="text-align: center; font-size:80%; width: 62.4%; height 40px;"
|-
!colspan="7"|'''Expression: mature T cell neoplasms'''
|-
! ATLL !! CTCL Sezary !! T-PLL !! T-LGL !! NK-LGL
|-
|style= "width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|style= "width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|-
|}
 
<span style="font-size:90%">'''Notes:''' limited reports are consistent with expression being very uncommon in T-lymphoproliferative disorders</span>
----

Latest revision as of 20:53, 13 June 2023


Summary
CD138 is a marker used to identify normal or malignant plasma cells with a high level of specificity, but does not discriminate normal from abnormal plasma cells and in some cases expression in myeloma may be low compared with normal plasma cells so sensitivity can be an issue. Abberancy of expression is low, but expression may be seen in lymphoplamacytic or marginal zone lymphomas (only on those cells that have plasma cell differentiation)



Normal expression and function

CD138 is a membrane protein that supports cell adhesion or binds cytokines and chemokines. In the hematopoietic system expression of CD138 is acquired by B lymphocytes as they develop into plasma cells.



Diagnostic role

  • Most often CD138 used in conjunction with CD38 to identify plasma cells in the diagnosis or monitoring of myeloma
  • There is very little aberrant expression, but neoplastic plasma cells may in some cases have weak, variable, or occasionally undetectable expression
  • Expression is also seen cells that have plasmacytic differentiation in lymphoplasmacytoid lymphoma or marginal zone lymphoma


Other useful information

Outside of haematopoiesis CD138 is expressed by squamous epithelium.


SUMMARY TABLES


Expression: primitive cell types Click (i) on table for additional information
AML B ALL Burkitt T ALL ETP ALL (i) MPAL (i) H.gones (i)
<5% <5% <5% <5% <5% <5% <5%


Expression: mature B cell neoplasms
CLL MCL FL MZL HCL DLBCL LPL PCL
<5% <5% <5% 5-20% <5% 5-20% 40-80% 80-100%

Notes: expression is usual in myeloma, and will occur on cells with plasma cell differentiation in LPL or MZL


Expression: mature T cell neoplasms
ATLL CTCL Sezary T-PLL T-LGL NK-LGL
limited limited limited limited limited

Notes: limited reports are consistent with expression being very uncommon in T-lymphoproliferative disorders