Trends in TRECs values according to age and gender in Chinese children,
and their clinical application
Abstract
T cell receptor excision circles (TRECs) are small circularized DNA
elements produced during rearrangement of T cell receptor (TCR) genes.
Because TRECS are fairly stable, do not replicate during mitosis, and
are not diluted during division of naïve T cells1, they are suitable for
assessing the number of newly formed T cells 2. In this study, we
detected TRECs in 475 healthy Chinese children aged 0–18 years in
different clinical settings. We found a strong correlation between TRECs
levels and peripheral CD4 naïve T cell numbers, but not between TRECs
levels and effector or memory CD4 and CD8 T cell numbers. TRECs levels
fell significantly compared with normal controls in patients with severe
combined immunodeficiencies (SCID) (n=7), wiskott-aldrich syndrome (WAS)
(n=22), or activated PI3Kδ syndrome (APDS) (n=5). TRECs levels in those
with signal transducer and activator of transcription 1 (STAT1)
deficiency (n=8) decreased or did not change significantly, a finding
consistent with that for CD4 naïve T cells. We also measured TRECs
levels in seven PIDs after hematopoietic stem cell transplantation
(HSCT) (WAS=5; chronic granulomatous disease (CGD)=2), and found the
complications after HSCT may reduce TRECs levels by interfering with
production of naïve T cells. In conclusion, we established reference
values for TRECs, which can be used to screen for primary
immunodeficiency diseases (PIDs) during early life and track immune
reconstitution after HSCT.