Toll-Like Receptor Function
| Label Mnemonic: | TLR |
| Epic code: | LAB4609 |
| Downtime form: | A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery |
Commercial Mailout Laboratory
6240-8 RCP
356-8593
6240-8 RCP
356-8593
Specimen(s):
Whole Blood
Specimen
Instructions:
Patient and control samples must be collected within 48 hours of test
performance.
The control specimen needs to be drawn from a normal, healthy individual who is not biologically related to the patient, and drawn at approximately the same time as and under similar conditions to the patient specimen.
The control specimen needs to be drawn from a normal, healthy individual who is not biologically related to the patient, and drawn at approximately the same time as and under similar conditions to the patient specimen.
Collection Medium:
 | and | | plus control | | and | |
| Yellow top tube 8.5 mL (ACD solution A) | Yellow top tube 8.5 mL (ACD solution A) | Yellow top tube 8.5 mL (ACD solution A) | Yellow top tube 8.5 mL (ACD solution A) |
Minimum:
Preferred Minimum: One 10 mL whole blood and one 10 mL normal control from a healthy non-related individual. Absolute Minimum: 7 mL whole blood and 7 mL normal control from a healthy non-related individual. Infant Minimum: 3 mL whole blood and 7 mL normal control from a healthy non-related individual.
Rejection Criteria:
Yellow (ACD Solution B). Refrigerated or frozen specimens. Specimens
in transport longer than 48 hours.
Delivery Instructions:
Submit specimen to laboratory as soon as possible after collection.Turn Around
Time:
9-10 days upon receipt at reference laboratory
Reference Range:
By report
Interpretive Data:
Toll-like receptors (TLR) are tested independently by stimulation with TLR-specific ligands in a peripheral blood mononuclear cell (PBMC) culture. PBMC production of IL-1 beta, IL-6, and TNF alpha is determined by multiplex bead assay for TLR 1,2,4-8.
TLR-specific ligands include Pam3CSK4, a synthetic bacterial lipoprotein (TLR2-TLR1 ligand); zymosan cell wall particles from Saccharomyces cerevisiae (TLR6-TLR2 ligand); lipopolysaccharide (LPS) ultra-pure S. minnesota LPS (TLR4 ligand); flagellin purified from S. typhimurium (TLR5 ligand); and CL097 imidazoquinoline compound (TLR7-TLR8 ligand).
TLR-specific ligands include Pam3CSK4, a synthetic bacterial lipoprotein (TLR2-TLR1 ligand); zymosan cell wall particles from Saccharomyces cerevisiae (TLR6-TLR2 ligand); lipopolysaccharide (LPS) ultra-pure S. minnesota LPS (TLR4 ligand); flagellin purified from S. typhimurium (TLR5 ligand); and CL097 imidazoquinoline compound (TLR7-TLR8 ligand).
Comments:
Results for TNF alpha, IL-1 beta, and IL-6 are reported as pg/mL. Interpretation comparing the patient results to the simultaneously
collected client normal control and the laboratory normal control will
be provided by the reference laboratory.
This mailout test requires pathologist approval for orders during inpatient encounters. Mailouts staff will not process order without approval. The pathologist covering mailouts approval can be reached at pager #3724. If approval is given, the name of the pathologist can be selected in the drop-down menu to the right of the approval warning in Epic when ordering the test.
This mailout test requires pathologist approval for orders during inpatient encounters. Mailouts staff will not process order without approval. The pathologist covering mailouts approval can be reached at pager #3724. If approval is given, the name of the pathologist can be selected in the drop-down menu to the right of the approval warning in Epic when ordering the test.
Test
Limitations:
Defects in IRAK-4 and MyD88 result in compromised TLR signaling. Exception is endosomal TLR4, which is IRAK-4 and MyD88 independent.
Methodology:
Cell Culture/Quantitative Multiplex Bead Assay
CPT Code:
86353(x5), 83520(x3)