Развернутая иммунограмма (Лейкоциты, лимфоциты, Т-, В-лимфоциты, ИРИ, CD3-4-8-16-19-45-56-69-95, Иммуноглобулины IgA, IgM, IgG, IgE, циркулирующие

This test, multicolor flow cytometric immunophenotyping of T-lymphocyte subsets (CD3+CD19− total T cells; CD3+CD4+CD45+ T-helper cells; CD3+CD8+CD45+ cytotoxic T cells; CD4+CD25brightCD45+ regulatory T cells; CD3+HLA‑DR+CD38+ activated T cells), assesses the cellular arm of immunity. It supports evaluation of primary and secondary immunodeficiency, characterization of infection-related immune responses (including acute viral infections and HIV), and assessment of immune dysregulation in autoimmunity, malignancy, and post-transplant immune reactions. The CD4+ T-cell count and the CD4/CD8 ratio inform prognosis and disease staging in HIV infection, while shifts in CD8+ T cells and activation markers help gauge responses to intracellular pathogens and vaccines and monitor lymphoproliferative processes.

Flow cytometric immunophenotyping characterizes lymphocyte populations using fluorescently labeled monoclonal antibodies directed at cluster of differentiation (CD) antigens. These markers define lineage and functional state, allowing quantitative analysis of T-cell subsets in peripheral blood. Laser-based cytometry measures light scatter and fluorescence as individual cells pass the interrogation point, providing high-throughput, multiparametric data. CD3 identifies total mature T lymphocytes. Enumeration of CD3+ cells supports workup of primary and secondary immunodeficiencies, acute viral infections (including HIV), intracellular bacterial and parasitic diseases (for example, tuberculosis, leprosy, leishmaniasis), malignant neoplasms, transplant rejection and graft-versus-host disease, and T-lineage lymphoproliferative disorders such as acute T-lymphoblastic leukemia. Reductions in CD3+ T cells are reported in diabetes mellitus. CD4 marks T-helper/inducer cells, which include Th1 and Th2 subsets distinguished by cytokine profiles: Th1 cells secrete IL‑2, IL‑3, interferon‑γ, TNF‑α, and TNF‑β (with interferon‑γ as the discriminant), while Th2 cells secrete IL‑3, IL‑4, IL‑5, IL‑6, IL‑10, IL‑13, and TNF‑β (with IL‑4 as the discriminant). CD4+ counts inform disorders of antibody production and cell-mediated immunity and play a central role in prognosis and staging of HIV infection; functional competence can be inferred from cytokine secretion patterns (interferon‑γ for Th1, IL‑4 for Th2). CD8 denotes cytotoxic T cells that recognize peptides in the context of MHC class I. The CD4/CD8 ratio serves as an immunoregulatory index; progressive decline in this ratio in HIV infection signals progression toward AIDS. CD8+ assessment contributes to evaluating antiviral cytotoxic responses and vaccine effectiveness. Decreases in CD8+ cells or function have been described in autoimmune thyroid disease (including Graves disease), primary chronic adrenal insufficiency (Addison disease), and diabetes mellitus; the concept of a distinct CD8+ T-suppressor lineage is no longer supported. Activation and regulatory markers add functional context. HLA‑DR, an MHC class II activation antigen, appears on B cells, monocytes/macrophages, and a subset of activated T cells; its expression on peripheral T cells increases markedly after mitogenic stimulation. CD25 (the IL‑2 receptor α chain) forms a high-affinity IL‑2 receptor together with CD122 and CD132 and is upregulated on activated T and B cells, macrophages, and NK cells; a soluble IL‑2 receptor may be released during inflammation. Regulatory T cells are identified as CD4+CD25brightCD45+ and exert immunosuppressive effects. Activated T cells (CD3+HLA‑DR+CD45+ and CD3+CD8brightCD38+) reflect ongoing immune activation. Activated T-cell frequencies tend to rise with infections, autoimmune disease, allergy, malignancy, alcoholic cirrhosis, and during pregnancy, whereas a low proportion of activated T cells lacks specific diagnostic value.