Measuring the concentration of soluble interleukin-2 receptor alpha (sIL-2r alpha) in plasma
Aids in the diagnosis and evaluation of patients for lymphoproliferative disorders, including autoimmune lymphoproliferative syndrome, hemophagocytic lymphohistiocytosis, and macrophage activation syndrome
May help monitor patients with sarcoidosis or hematologic malignancies with elevated sIL-2r alpha
This test aids the diagnosis and evaluation of lymphoproliferative disorders, including autoimmune lymphoproliferative syndrome, hemophagocytic lymphohistiocytosis, and macrophage activation syndrome.
Bead-Based Multiplex Immunoassay
CD25
cytokines
IL 2 Receptor
IL-2R
IL2R
Interleukin 2 Receptor
IL2RS
Soluble IL-2 Receptor alpha
Soluble CD25/IL-2 R?
Soluble Interleukin-2 Receptor Alpha
Cytokine
Plasma EDTA
If this test is ordered with CYPAN / Cytokine Panel, Plasma, this test will be canceled as duplicate and CYPAN performed as ordered.
If this test is ordered with CYTH1 / T-Helper Cell Type 1 Cytokine Panel, Plasma, this test will be canceled as duplicate and CYTH1 performed as ordered.
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Lavender-top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Immediately after specimen collection, place tube on wet ice.
2. Centrifuge at 4 degrees C, 1500 x g for 10 minutes.
3. Aliquot plasma into plastic vial.
4. Freeze specimen within 2 hours of collection.
Additional Information:
If a refrigerated centrifuge is not available, it is acceptable to use a room temperature centrifuge, provided the sample is kept on ice before centrifugation and is frozen immediately afterward.
0.3 mL
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Heat-treated specimen | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Plasma EDTA | Frozen | 21 days |
Measuring the concentration of soluble interleukin-2 receptor alpha (sIL-2r alpha) in plasma
Aids in the diagnosis and evaluation of patients for lymphoproliferative disorders, including autoimmune lymphoproliferative syndrome, hemophagocytic lymphohistiocytosis, and macrophage activation syndrome
May help monitor patients with sarcoidosis or hematologic malignancies with elevated sIL-2r alpha
The interleukin-2 (IL-2) receptor (CD25) is a membrane protein that is upregulated on activated T cells. Its soluble form, IL-2 receptor alpha soluble (sIL-2r alpha, soluble CD25) is notably elevated in lymphoproliferative disorders, such as hemophagocytic lymphohistiocytosis (HLH), autoimmune lymphoproliferative syndrome (ALPS), T-cell related leukemia-lymphoma and other conditions associated with T-cell activation.(1) Based on the HLH-2004 trial, the diagnosis of HLH syndrome should be based on compatible clinical presentation in the context of significantly elevated inflammatory markers, including ferritin, sIL-2r alpha, and CXCL9 (C-X-C motif chemokine ligand 9). sIL-2r alpha elevation at a significant level (2SD above age-adjusted laboratory-specific reference range) is a crucial diagnostic criterion.(2)
In addition to activated T cells, IL-2 receptor is also expressed on a certain subset of B cells, Regulatory Teg cells, granulocytes and natural killer (NK) cells.(3) Elevation of sIL-2r alpha can be observed in other chronic inflammatory conditions and malignancies.(4,5) In sarcoidosis patients with cardiac involvement, higher levels of sIL-2r alpha are associated with worse long-term clinical outcomes and increase systemic inflammatory activities.(6) In patients with hematological malignancies that express IL-2 receptors, sIL-2r alpha elevations are associated with poor prognosis or disease relapse.(4,7)
<18 years: Not established
> or =18 years: <959 pg/mL
A significant elevation in soluble interleukin-2 receptor alpha (sIL-2r alpha) concentration (2SD above age-adjusted laboratory-specific reference range) is one of the diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH) syndrome. The diagnosis of HLH syndrome should be based on compatible clinical presentation in the context of significantly elevated inflammatory markers, including ferritin, sIL-2r alpha, and CXCL9 (C-X-C motif chemokine ligand 9).
Soluble interleukin-2 receptor alpha (sIL-2r alpha) testing should only be used in conjunction with clinical presentation and other laboratory testing as part of a patient's overall assessment. Elevations in sIL-2r alpha can be seen in several inflammatory, malignancy, or infectious conditions involving activation of T-cells, B-cells, granulocytes or natural killer cells. Non-elevated concentration of sIL-2r alpha does not exclude the possibility of infection or other inflammatory condition.
There is substantial overlap in elevated sIL-2r alpha in patients with other chronic inflammatory conditions or infections
Soluble interleukin-2 receptor alpha is marker for lymphocyte activation and proliferation; a comprehensive cytokine evaluation, such as CYPAN / Cytokine Panel, Plasma may be more useful in overall disease assessment or pathophysiology.
1. Hayden A, Lin M, Park S, et al. Soluble interleukin-2 receptor is a sensitive diagnostic test in adult HLH. Blood Adv. 2017;1(26):2529-2534
2. Henter JI, Horne A, Arico M, et al. HLH-2004: Diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer. 2007;48(2):124-131
3. Riley, R.S., R. Mageau, and J. Ben-Ezra, Laboratory Evaluation of the Cellular Immune System, in Henry's Clinical Diagnosis and Management by Laboratory Methods. 2011. p. 877-898
4. Yang ZZ, Grote DM, Ziesmer SC, et al. Soluble IL-2Ra facilitates IL-2-mediated immune responses and predicts reduced survival in follicular B-cell non-Hodgkin lymphoma. Blood. 2011;118(10):2809-2820
5. Seidler S, Zimmermann HW, Weiskirchen R, Trautwein C, Tacke F. Elevated circulating soluble interleukin-2 receptor in patients with chronic liver diseases is associated with non-classical monocytes. BMC Gastroenterol. 2012;12:38
6. Kobayashi Y, Sato T, Nagai T, et al. Association of high serum soluble interleukin 2 receptor levels with risk of adverse events in cardiac sarcoidosis. ESC Heart Fail. 2021;8(6):5282-5292
7. Zoref-Lorenz A, Murakami J, Hofstetter L, et al. An improved index for diagnosis and mortality prediction in malignancy-associated hemophagocytic lymphohistiocytosis. Blood. 2022;139(7):1098-1110
Testing for soluble IL-2 receptor alpha (sIL-2r alpha) in plasma is performed using a laboratory-developed immunoassay.(Unpublished Mayo method)
Thursday
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
83520
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
SIL2R | IL-2 receptor alpha soluble, P | 76039-7 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
622328 | IL-2 receptor alpha soluble | 76039-7 |
Change Type | Effective Date |
---|---|
New Test | 2025-02-13 |