Cell Activation and Cytokine Release Ex Vivo: Estimation of Reproducibility of the Whole-Blood Assay with Fresh Human Blood

The whole-blood assay (WBA) with human fresh blood may provide insight into the features of an individual's innate immunity. To assess this, ex vivo cytokine release is measured after stimulation of whole blood with various stimuli, for instance, endotoxin in vitro. The aim of the present study was to evaluate WBA reproducibility with fresh blood using different calculation models. The blood was collected from 16 healthy volunteers on 6 different days. Ex vivo stimulation was performed in each individual's blood sample for 22 h, using different endotoxin concentrations. Interleukin (IL)-1 beta and IL-8 release were quantified using specific immunoassays in the cell-free supernatant. We found that a dose-response relationship between endotoxin and cytokine concentration could be verified for all blood donors in all tests. The median coefficient of variation repeated tests was 29% for IL-1 beta and 52% for IL-8. Upon stimulation with 40 pg/mL endotoxin, a confidence interval of 60-140% was calculated for IL-1 beta and 70-271% for IL-8 regarding test reproducibility. Furthermore, the classification into high or low responder was reproducible. We conclude that repeated blood collection offers an opportunity to evaluate the variability of WBA. Considering a high intragroup variability, an individual range assessment has been suggested to evaluate exposure effects.