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Review
. 2023 Jan 20;12(3):386.
doi: 10.3390/cells12030386.

Methods to Assess Proliferation of Stimulated Human Lymphocytes In Vitro: A Narrative Review

Affiliations
Review

Methods to Assess Proliferation of Stimulated Human Lymphocytes In Vitro: A Narrative Review

Nirosha Ganesan et al. Cells. .

Abstract

The ability to monitor lymphocyte responses is critical for developing our understanding of the immune response in humans. In the current clinical setting, relying on the metabolic incorporation of [3H] thymidine into cellular DNA via a lymphocyte proliferation test (LPT) is the only method that is routinely performed to determine cell proliferation. However, techniques that measure DNA synthesis with a radioactive material such as [3H] thymidine are intrinsically more sensitive to the different stages of the cell cycle, which could lead to over-analyses and the subsequent inaccurate interpretation of the information provided. With cell proliferation assays, the output should preferably provide a direct and accurate measurement of the number of actively dividing cells, regardless of the stimuli properties or length of exposure. In fact, an ideal technique should have the capacity to measure lymphocyte responses on both a quantitative level, i.e., cumulative magnitude of lymphoproliferative response, and a qualitative level, i.e., phenotypical and functional characterization of stimulated immune cells. There are many LPT alternatives currently available to measure various aspects of cell proliferation. Of the nine techniques discussed, we noted that the majority of these LPT alternatives measure lymphocyte proliferation using flow cytometry. Across some of these alternatives, the covalent labelling of cells with a high fluorescence intensity and low variance with minimal cell toxicity while maximizing the number of detectable cell divisions or magnitude of proliferation was achieved. Herein, we review the performance of these different LPT alternatives and address their compatibility with the [3H] thymidine LPT so as to identify the "best" alternative to the [3H] thymidine LPT.

Keywords: LPT; carboxyfluorescein succinimidyl ester; flow cytometry; in vitro; lymphocyte proliferation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Lymphocyte proliferation assay—[3H] thymidine incorporation. The classic thymidine incorporation assay or lymphocyte proliferation test (LPT) relies on the use of a radioactive nucleoside, [3H] thymidine, that is incorporated into newly dividing strands of DNA during mitotic cell division. Radioactivity in DNA is then recovered from peripheral blood mononuclear cells (PBMCs) and measured to determine the extent of cell division/proliferation that has occurred in response to any antigen of interest.
Figure 2
Figure 2
Lymphocyte proliferation assay—CFSE assay. Peripheral blood mononuclear cells (PBMCs) are labelled with a fluorescent cytoplasmic proliferation dye known as carboxyfluorescein succinimidyl ester (CFSE). Since the dye eventually dilutes out per generation of daughter cells upon cell division, each round of division can be tracked individually over time. This flow-cytometry-based analysis further allows for the simultaneous quantification and characterization of various individual cell types alongside proliferation determination.

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This research was funded by KU Leuven Internal Funding C2 (C24/18/085).

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