Immunogram: decoding what showstable, norms

Update: December 2018

A complete immunity study is not a routine test.
Due to the high cost of reagents and the need for special
equipment, it is possible to make an immunogram only in large
multidisciplinary hospitals or private medical laboratories.
Despite this, the procedure may require any
a person who showed signs of immunodeficiency without
каких-либо явных причин, таких как ATИЧ, сахарного диабета,
cancer, etc.

Most often, an immunogram is required for preschool children.
and school age, since it is during this period of life that
«дебют» ряда наследственных diseases.

What is an immunogram?

it специальный анализ крови, который позволяет оценить
the number of different immune cells, the antibodies they produce and
a number of other substances testifying to the status of protective systems
organism. AT зависимости от цели исследования и возможностей
laboratories, the number of parameters studied can significantly
vary. Extended study allows you to study over 25
various indicators – such an analysis reveals even hidden
violations that cannot be detected by standard

Human immunity can be divided into two links –
�“Slow” (humoral) and “fast” (cellular). Quick link
reacts almost immediately after exposure to the causative agent
(virus, fungus, bacteria, protozoa, etc.) into the body. AT задачу
This group of cells includes the following functions:

  1. Absorb and “digest” the malicious agent;
  2. Present or “tell” about the pathogenic microorganism
    other immune cells that cannot independently his
    to discover;
  3. Destroy the largest number of identified germs;
  4. Fight various tumors and autoimmune processes –
    another important function of immunity that often prevents
    the body to cope with the disease.

After the “fast” link swallowed up the alien body and
told about it “slow” link, a slow process starts
creation and release of antibodies into the blood. Antibodies are substances
destroy a certain type of pathogenic agent. They are very
specific and, in most cases, help the body
finally cope with the existing disease. AT среднем,
the duration of their creation is 2-3 weeks.

Immunogram indicators reflect the work of each of the links.
protection. It is on the basis of their changes that the conclusion is made
the absence / presence of immunodeficiency, the type of violation and
optimal method of therapy.

Link immunity parameter under study Function

Cellular (“fast”)

Cytotoxic T cells (CD3 +, CD8 +) Recognition of harmful microorganisms and their destruction
T-helpers (CD4 +) �”Talk” about the presence of the pathogen to other cell defenders,
play a significant role in shaping long
T-suppressors (CD8 +) Regulation of the activity of protective systems, protect the body from
development of autoimmune reactions (when antibodies against
healthy tissue)
T-cells with receptor for IL-2 (CD25 +)
Apoptosis Marker Carriers (CD95 +) Speed ​​control of cell self-destruction

Humoral (“slow”)

AT-клетки (CD+, 19CD+)

They are responsible for the production of specific antibodies. AT большинстве
cases, it is thanks to this pool of cells that a complete

Защищают организм от повторного заражения той же самой
инфекцией, в течение определенного of time.

Immunoglobulin G Антитела, вырабатываемые AT-клетками. With связывании с
harmful microbe – destroy its wall, resulting in
death comes.
Immunoglobulin M
Immunoglobulin A
Immunoglobulin Responsible for the development of any allergic reactions.

Non-specific indicators (reflecting the work of both links)

natural / natural killer cells (CD16 +) or NK cells Provides natural anti-tumor immunity
Cells with HLA marker Reflects the activity of the immune mechanisms
Phagocytosis Detection, absorption and presentation of malicious T-cells
Reaction of inhibition of leukocyte migration (abbreviated as RTML) Laboratory test, reflecting the work of the cellular link.
NBT test Allows you to evaluate the activity of phagocytosis
Complement Prevents the formation of large-sized immune
complexes (compounds of harmful particles with antibodies). Participates
in the neutralization of microbes

AT некоторых случаях, доктор может порекомендовать дополнить
analysis of the content of interleukins in the blood is
special substances that interconnect different
components of protective systems. With нарушении их выработки также могут
to form immunodeficiency states.


  1. Frequent severe infectious diseases, especially in children
    preschool and school age. Currently missing
    consensus on what is considered “frequent” and “severe” infections.
    However, to begin to suspect problems with immunity should
    following situations:

    1. ОРATИ у детей легкой и средней тяжести чаще 5-6 once a year;
    2. У взрослых (кроме пожилых лиц) – чаще 3-х once a year;
  2. Presence of past episodes of the following diseases: necrotic
    tonsillitis, erysipelas, candidal oropharyngitis, systemic herpetic
    infections, atypical pneumonia (mycoplasma, chlamydia,
    pneumocystic), any fungal diseases in children (except fungus
  3. Detection of low leukocyte levels in the blood without any
    obvious cause: past viral infection, presence
    autoimmune or oncologic disease, secondary
    immunodeficiencies (HIV, diabetes, aplastic anemia,
    effects of taking certain medications, etc.). Norm of leukocytes for
    людей от 15-ти лет: от 4 до 9*109 клеток/литре. With
    blood tests in children need to use age

Before examining the immunogram, it is necessary to exclude the presence of
secondary immunodeficiencies that were listed above.
It is easy to find them, using ordinary blood tests,
while their cost will be significantly lower than the survey
functions of leukocytes and other phagocytes.

Preparation for the procedure

Obtaining correct results requires proper
act before blood sampling. Enough for that
follow the simple rules:

  1. To pass the examination is better in the morning, on an empty stomach. With
    the absence of such a possibility, it is permissible to donate blood to any other
    time after the 4-hour period of hunger;
  2. Within 3 hours before the analysis it is not recommended to use
    alcohol, caffeine-containing drinks, energy. Water and weak
    tea can be drunk without restriction;
  3. A few hours before the procedure, do not smoke or
    be in the presence of a smoking person;
  4. Immediately before blood donation should be excluded.
    significant physical exertion (running, weight lifting, training
    sports), contrasting water treatments, hypothermia / overheating
  5. For the most informative, immunogram baby
    and it is better for an adult to spend during the period of full health. During
    diseases the body will react to damage its own
    tissue or infection, so the conclusion about the blood picture
    quite difficult.


Decoding the immunogram is much more complicated than the analysis of the usual
blood test. This study includes a large
the number of indicators that not only need to be compared with
existing norms, but also to analyze them in a complex. However, in
first you need to know the normal values.

They may differ slightly in different laboratories. it
associated with the use of various tools, diagnostic methods and
reagents. As a rule, immunogram standards are given on a sheet with
survey results. If they are missing, we offer
use the following immunogram table:

Immunogram index Norm

Cellular (“fast”)

Cytotoxic T cells (CD3 +, CD8 +)



T-helpers (CD4 +)



T-suppressors (CD8 +)



T-cells with receptor for IL-2 (CD25 +)



Apoptosis Marker Carriers (CD95 +)



Humoral (“slow”)

B cells (CD20 +)



Immunoglobulin G 7.5-15.46, g / l
Immunoglobulin M 0.65-1.65, g / l
Immunoglobulin A 1.25-2.52, g / l
Immunoglobulin D 0-0,07, g / l

Non-specific indicators (reflecting the work of both links)

Natural / Natural Killers (CD16 +) or NK Cells



Cells with HLA marker

Лимфоциты: 0,17*109

Моноциты: 0,18*109

Phagocytic indicator 60-90,%
Phagocytic number 6-9 units
Reaction of inhibition of leukocyte migration (abbreviated as RTML)

With specific antigen: 82-121%

With phytohemagglutinin (with PHA): 21-80%

With concavalin A (with ConA): 40-76%

NBT test

Spontaneous: 5-12%

Activated: 10-35,%

Complement 30-50%

Norm иммунограммы

Click to enlarge

Withнципы расшифровки результатов

The immunogram should be analyzed by a specialist with qualifications.
�”Immunologist”. In this case, the probability of getting the right
The conclusion is extremely high. The doctor conducts a comprehensive assessment of all
parameters in order to determine the presence / absence of problems in
cellular or humoral immunity. It will depend on it
further treatment tactics, method of maintaining immunity and
prevention of frequent infections.

  • In most cases, the decline in indicators reflecting
    the state of the cellular or “fast” link is a sign
    problems with the activation or production of T-cells.
  • The exception is the number of T-suppressors – to reduce
    The protective functions of a person will be indicated by an increase in this
    cell pool. These results are obtained by decoding
    immunograms in children, often a sign of primary
    T-cell immunodeficiency. it группа врожденных заболеваний, при
    which the body cannot timely and reasonably well
    �”Repel attacks” of hostile microorganisms.
  • The problems in the humoral link will indicate
    reduced number of B-cells and immunoglobulins (except for IgE,
    which is responsible for the development of allergies). Should remember that
    only simultaneous decrease and concentration is significant
    B-lymphocytes and antibodies (immunoglobulins) produced by them.

Other indicators clarify the nature of the violations and
confirm the intended diagnosis. It is necessary to underline once again
that correctly interpret this complex analysis can only

Determination of the degree of immune disorders

There are a large number of approaches to assess the state
the patient. Some of them offer counting the number of diseases with
given their severity for the year, others are purely calculated
by methods. The immunogram can also determine the severity
malfunctions of the humoral and cellular link or evaluate
treatment effectiveness for a certain amount
of time.

To do this, use the following formula:

((Патологический показатель больного / Norm данного показателя
) – 1) * 100%

As a test parameter, most often used
number of B-cells, Cytotoxic cells or T-helper cells. If a
the result is negative, you can define
the severity of violations and the need for active drug

The result of the calculation Interpretation The need for pharmacotherapy
Less than 34% Minor violations None, except for those conditions in which a person
concerned with frequent and severe infectious diseases
34-66% Moderate violations Required
More than 66% Severe immunodeficiency

Withчины ложных результатов

In addition to the innate features of immunity, there is a large
the number of pathologies that lead to a change in performance
analysis. In order not to get confused, you need to understand what shows
immunogram in fact. It reflects the quantity and condition.
various groups of white blood cells and phagocytes – blood cells and internal
organs responsible for protecting the body.

Traditionally, an immunogram is used to detect
hereditary immunity disorders. Therefore, before its implementation
the presence of the most common conditions should be excluded
able to also have a negative impact on natural protection
person These include:

  • Malignant tumors of any organ;
  • Autoimmune diseases: rheumatoid arthritis, systemic
    scleroderma and lupus, various systemic vasculitis (including
    Behcet’s disease, microscopic and giant cell vasculitis,
    periarteritis nodosa, etc.);
  • Viral diseases, including HIV, “blood”
  • Severe intoxication: alcohol, narcotic substances,
    industrial hazardous substances, poisons, etc .;
  • Aplastic anemia – a group of diseases in which it is violated
    growth and maturation of all blood cells;
  • Consequences of radiation exposure.

It is also necessary to remember that the cause of a false increase or
reduction of parameters may be improper preparation for delivery
blood. Only after the exclusion of all the above states
You can talk about the presence of primary immunodeficiency. As
confirmatory test can be used medico-genetic

�”Myths” about immunity

Fresh fruits and vegetables will correct shaky immunity

Undoubtedly, these products are useful in many diseases. AT
in particular, they are a source of plant fiber, which
stimulates normal digestion. With атрофии слизистой желудка,
they improve the secretion of digestive juices and help in
food processing. However, the amount of vitamins obtained from fruits
and vegetables is extremely small and can not help in the treatment of immune

ATыявленный иммунодефицит у ребенка можно не лечить – после
puberty it will pass on its own

This opinion is very common not only among the population, but
and among a certain group of doctors. Similar judgment is very
dangerous – the question of the need for treatment in each individual
случае решает immunologist And if the risk of frequent and
severe infections outweigh the risk of side effects from
medications (which are quite rare), therapy is necessary
for a child;

Immunomodulators are absolutely useless in treatment.

Several years ago, a large study was conducted, which
confirmed that the use of immunomodulators reduces
продолжительность лечения ОРATИ только на 1 сутки и менее. I.e
have very little effect. itт аргумент часто
use some doctors and patients, justifying their refusal from
their use in primary immunodeficiencies. ATас ничего не смущает
in this argument?

  • ATо-первых, целью исследования было оценить влияние на
    duration of treatment, but not on
    профилактику возникновения инфекционных
  • ATо-вторых – оно проводилось на здоровых
    , которые не страдали иммунодефицитами. If a
    study foreign literature and the results of suitable
    research papers, then you can discover the following information.
    Immunomodulators have relatively little effectiveness, but
    they prevent the development of severe and frequent infections in people with
    primary immunodeficiencies as well as reduce probability
    fatal outcome.

At the moment, there are others abroad – more
effective drugs to maintain protective systems
organism. One of their price is many times higher, and availability in Russia
extremely limited. Therefore, immunomodulators, lysates
microorganisms, interferon preparations are one of the options
treatment of these diseases in the Russian Federation.

ATИЧ нужно диагностировать по иммунограмме

Undoubtedly, with prolonged action of immunodeficiency virus
decreases the number of CD4 + cells. It is for this indicator, often
оценивают тяжесть заболевания и probability развития смертельно
опасных инфекций, ассоциированных со СПИД и ATИЧ. However for
diagnosis of this infection is necessary to use more
specific methods such as enzyme-linked immunosorbent assay (ELISA) and

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