- Patient Preparation
- Collect control specimen from a healthy individual unrelated to patient at approximately the same time as and under similar conditions to the patient.
- Green (sodium heparin) (patient) AND green (sodium heparin) (control). Also acceptable: Yellow (ACD solution A) (patient) AND yellow (ACD solution A) (control). Patient and control specimens must be collected within 48 hours of test performance.
- Specimen Preparation
- Transport 10 mL whole blood (patient) AND 10 mL whole blood (control) in original collection tubes. (Min: 7 mL (patient) AND 7 mL (control)) Do not refrigerate or freeze. LIVE CELLS REQUIRED.
Infant Minimum: 3 mL whole blood (patient) AND 7 mL whole blood (control).
- Storage/Transport Temperature
- CRITICAL ROOM TEMPERATURE.
- Unacceptable Conditions
- Yellow (ACD Solution B). Refrigerated or frozen specimens. Specimens in transport longer than 48 hours.
- Ambient: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable
TLR-specific ligands include Pam3CSK4, a synthetic bacterial lipoprotein (TLR2-TLR1 ligand); zymosan cell wall particles from Saccharomyces cerevisiae (TLR6-TLR2 ligand); poly (I:C), a synthetic analog of dsRNA (TLR3 ligand); lipopolysaccharide (LPS) ultra-pure S. minnesota LPS (TLR4 ligand); flagellin purified from S. typhimurium (TLR5 ligand); and CL097 imidazoquinoline compound (TLR7-TLR8 ligand).
Limitation: Defects in TLR3 associated with Herpes Simplex Encephalitis may not be detected in this assay based on the reported instance of a patient with compound heterozygous mutations in TLR3 leading to decreased cytokine production in response to Poly I:C in fibroblasts but not PBMCs1.
Proteins IRAK-4 and MyD88 play essential roles in TLR-mediated signaling. Defects in IRAK-4 and MyD88 result in compromised TLR signaling. Exceptions are , TLR3 and endosomal TLR4, which, are IRAK-4 and MyD88 independent.
1. Guo Y, Audry M, Ciancanelli M, Alsina L, Azevedo J, Herman M, et al. Herpes simplex virus encephalitis in a patient with complete TLR3 deficiency: TLR3 is otherwise redundant in protective immunity. J Exp Med. 2011;208(10):2083-98.
|Component Test Code*||Component Chart Name||LOINC|
|0051589||Toll-Like Receptor Function|
- TLR Function