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Reproducibility of Immunological Tests Used To Assess Multiple Chemical Sensitivity Syndrome

Department of Statistics and Institute for Health, Health Care Policy and Aging Research,¹ Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey,⁷ Department of Environmental Health Sciences,³ Department of Molecular Microbiology and Immunology,⁵ Johns Hopkins Bloomberg School of Public Health, and MCS Referral and Resources, Baltimore, Maryland,² Emmitsburg, Maryland,⁴ Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, Washington,⁶ Department of Pathology, Scripps Research Institute, La Jolla, California,⁸ Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia,⁹ FAST Systems, Inc., Gaithersburg, Maryland,¹⁰

Received 12 February 2003/ Returned for modification 10 April 2003/ Accepted 2 July 2003

Whether persons with multiple chemical sensitivity syndrome (MCS) have immunological abnormalities is unknown. To assess the reliability of selected immunological tests that have been hypothesized to be associated with MCS, replicate blood samples from 19 healthy volunteers, 15 persons diagnosed with MCS, and 11 persons diagnosed with autoimmune disease were analyzed in five laboratories for expression of four T-cell surface activation markers (CD25, CD26, CD38, and HLA-DR) and in four laboratories for autoantibodies (to smooth muscle, thyroid antigens, and myelin). For T-cell activation markers, the intralaboratory reproducibility was very good, with 90% of the replicates analyzed in the same laboratory differing by 3%. Interlaboratory differences were statistically significant for all T-cell subsets except CD4⁺ cells, ranging from minor to eightfold for CD25⁺ subsets. Within laboratories, the date of analysis was significantly associated with the values for all cellular activation markers. Although reproducibility of autoantibodies could not be precisely assessed due to the rarity of abnormal results, there were inconsistencies across laboratories. The effect of shipping on all measurements, while sometimes statistically significant, was very small. These results support the reliability of fresh and shipped samples for detecting large (but perhaps not small) differences between groups of donors in the T-cell subsets tested. When comparing markers that are not well standardized, it may be important to distribute samples from different study groups evenly over time.