Determining reference ranges for immunological cells of healthy indigenous individuals from a region in Brazil

Morais, Isa Rita Brito de; Barbosa, Dyjaene de Oliveira; Almeida, Gabriel Barroso de; Costa, Regina Rossoni da; Silva, Bruna Oliveira da; Oliveira, Laís Albuquerque de; Arantes, Julia Pimentel; Leite, Layla Oliveira Campos; Rossato, Luana; Ribeiro, Marcos Borges; Marchioro, Silvana Beutinger; Freire, Songelí Menezes; Nascimento, Roberto José Meyer; Simionatto, Simone; Torres, Alex José Leite

doi:10.31744/einstein_journal/2023AO0291

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ORIGINAL ARTICLE • einstein (São Paulo) 21 • 2023 • https://doi.org/10.31744/einstein_journal/2023AO0291 copy

Determining reference ranges for immunological cells of healthy indigenous individuals from a region in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Visual Abstract

In Brief

Morais et al. conducted a pioneering study with Brazilian indigenous populations to determine reference values for immunologic cells from healthy adult individuals. The main findings included a higher relative median for T lymphocyte subsets in females than males, and T CD3+, T CD4+, and T CD8+ relative values were statistically different when compared with Brazilian populations from other Brazilian regions.

Highlights

The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population.

Demographic and ethnic diversity of the Brazilian population can be associated with quantitative modifications in the immunologic cells of healthy individuals.

ABSTRACT

Objective

The establishment of reference values for a subset of leukocytes is common in clinical practice, and ethnic variations are strongly associated with disease development. In Brazil, indigenous people are vulnerable to infections, and few studies have described the health and disease conditions of this population. This study aimed to provide reference values for immunological cell subsets in indigenous Brazilians living in the state of Mato Grosso do Sul.

Methods

Flow cytometry and 4-color combinations of monoclonal antibodies were used to characterize cells. A total of 115 healthy adults, mostly females (72%), were included in the study. The results are presented as mean and median (2.5%-97.5% percentiles) for T and B lymphocytes, CD4+ T cells, CD8+ T cells, Natural Killer cells, monocytes, and dendritic cells, providing an average immunological profile for the population in question.

Results

The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population.

Conclusion

To our knowledge, cell reference data from indigenous Brazilians are unknown in the literature. The immune cell results presented in this pioneering study will contribute to the clinical and laboratory evaluation of the Brazilian indigenous population, especially given the important differences when compared with other Brazilian ethnic groups.

Reference values; Indigenous peoples; Lymphocytes; Monocytes; Antibodies; monoclonal; Immune system; Health services; indigenous; Brazil

Cells	Median (%cells/µL)	Normal range (%cells/µL)
Total T lymphocytes	64.3	(48.7-77.2
CD4+ T lymphocytes	33.4	(18.2-49.8)
CD8+ T lymphocytes	22.6	(12.6-34.3)
CD4+CD8+ (Double positive T cells)	1.4	(0.7-2.6)
Memory CD4+ T lymphocytes	6.2	(3.7-9.2)
B Lymphocytes	10.3	(5.4-17.7)
Regulatory T cells	3.8	(2.5-6.1)
Natural Killers	14.1	(2.4-18.9)

	CD3+ T lymphocyte	CD4+ T lymphocytes	CD8+ T lymphocytes	Memory CD4+T cells	B lymphocytes	Regulatory T cells	Natural Killers
Age
18-35	62	31	22		10.4
36-67	58	35	27		10.1
Sex
Male	62*	26*	18*	5.9	9.8	3.3	15.4
Female	71*	38*	24*	6.3	10.7	3.9	13.9
Smoker
Yes	64	33	20	5.9	10	3.7	14
No	63	33	23	6.7	10.5	4	14.1
Alcohol use
Yes	62	30	20	6	9.6	4	13
No	61	32	22	6.4	10.9	4.5	15

Cities	TCD4+ median (%cells/µL)	TCD8+ median (%cells/µL)	TCD3+ median (%cells/µL)
Indigenous from Mato Grosso do Sul	33.40 ^†	22.60 ^†	64.13 ^†
Salvador-BA	37.24 ^†	22.08 ^†	64.69 ^†
Belém-PA	36.69 ^†	19.20 ^†	60.12 ^†
Goiânia-GO	38.24 ^†	24.36 ^†	65.95 ^†
Ribeirão Preto-SP	47.14 ^†	26.20 ^†	76.16 ^†
Porto Alegre-RS	43.71 ^†	24.85 ^†	71.46 ^†

Cells	Median (%cells/µL)	Normal range (%cells/µL)
Classical monocytes	83.9	(70.1-90.7)
Non-classical monocytes	7.8	(5.1-8.9)
Intermediary monocytes	7.3	(4.3-7.5)
Dendritic cells	0.18	(0.07-0.31)

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[1] Corresponding author: Alex José Leite Torres Avenida Reitor Miguel Calmon, s/n, Vale do Canela Zip code: 40110-905 - Salvador, BA, Brazil Phone: (55 73) 3283-8888 Email: ajltorres@gmail.com