A Method of Assessment of Human Natural Killer Cell Phenotype and Function in Whole Blood

Front Immunol. 2020 May 20;11:963. doi: 10.3389/fimmu.2020.00963. eCollection 2020.


The majority of data on human Natural Killer (NK) cell phenotype and function has been generated using cryopreserved peripheral blood mononuclear cells (PBMCs). However, cryopreservation can have adverse effects on PBMCs. In contrast, investigating immune cells in whole blood can reduce the time, volume of blood required, and potential artefacts associated with manipulation of the cells. Whole blood collected from healthy donors and cancer patients was processed by three separate protocols that can be used independently or in parallel to assess extracellular receptors, intracellular signaling protein phosphorylation, and intracellular and extracellular cytokine production in human NK cells. To assess extracellular receptor expression, 200 μL of whole blood was incubated with an extracellular staining (ECS) mix and cells were subsequently fixed and RBCs lysed prior to analysis. The phosphorylation status of signaling proteins was assessed in 500 μL of whole blood following co-incubation with interleukin (IL)-2/12 and an ECS mix for 20 min prior to cell fixation, RBC lysis, and subsequent permeabilization for staining with an intracellular staining (ICS) mix. Cytokine production (IFNγ) was similarly assessed by incubating 1 mL of whole blood with PMA-ionomycin or IL-2/12 prior to incubation with ECS and subsequent ICS antibodies. In addition, plasma was collected from stimulated samples prior to ECS for quantification of secreted IFNγ by ELISA. Results were consistent, despite inherent inter-patient variability. Although we did not investigate an exhaustive list of targets, this approach enabled quantification of representative ECS surface markers including activating (NKG2D and DNAM-1) and inhibitory (NKG2A, PD-1, TIGIT, and TIM-3) receptors, cytokine receptors (CD25, CD122, CD132, and CD212) and ICS markers associated with NK cell activation following stimulation, including signaling protein phosphorylation (p-STAT4, p-STAT5, p-p38 MAPK, p-S6) and IFNγ in both healthy donors and cancer patients. In addition, we compared extracellular receptor expression using whole blood vs. cryopreserved PBMCs and observed a significant difference in the expression of almost all receptors. The methods presented permit a relatively rapid parallel assessment of immune cell receptor expression, signaling protein activity, and cytokine production in a minimal volume of whole blood from both healthy donors and cancer patients.

Keywords: NKG2D; cytokine stimulation; flow cytometry; interferon gamma; natural killer cells; whole blood.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / blood
  • Case-Control Studies
  • Cryopreservation
  • Feasibility Studies
  • Female
  • Flow Cytometry*
  • Humans
  • Immunophenotyping*
  • Interferon-gamma / blood*
  • Intracellular Signaling Peptides and Proteins / blood*
  • Killer Cells, Natural / immunology
  • Killer Cells, Natural / metabolism*
  • Male
  • Middle Aged
  • Neoplasms / blood*
  • Neoplasms / immunology
  • Phenotype
  • Phosphorylation
  • Proof of Concept Study
  • Receptors, Immunologic / blood*
  • Workflow


  • Biomarkers
  • IFNG protein, human
  • Intracellular Signaling Peptides and Proteins
  • Receptors, Immunologic
  • Interferon-gamma

Grant support