Quantification of immunofluorescence intensity serves to estimate the
number of defined molecules expressed on or in cells. Clinical applica
tions of this diagnostic tool are increasing, e.g,, aberrant expressio
n of various antigens (Ag) by leukemic blasts or lymphoma cells, inten
sity of CD38 expression by CD8(+) T-lymphocytes to monitor activation
status, and intensity of CD62P to detect platelet activation. In this
report we discuss the quality-control measures required for quantitati
on of fluorescence intensity, and we review seven concepts that have b
een developed to quantify fluorescence intensity during the past 15 ye
ars. Initial work addressed the conversion of logarithmic channel numb
ers into units of relative fluorescence. The design and use of calibra
tion beads labeled with predefined amounts of dye allowed instrument-i
ndependent expression of fluorescence intensity in units of molecules
of equivalent soluble fluorochrome (MESF). This method was refined by
the combined use of such standards with monoclonal antibodies (mAb) co
njugated 1:1 with phycoerythrin (PE), allowing translation of fluoresc
ence intensity into numbers of antibodies bound per cell. Alternativel
y, the use of 1:1 PE-conjugated mAb under the assumption that CD4(+) l
ymphocytes reproducibly bind 50,000 CD4 mAb molecules was proposed to
convert units of relative fluorescence intensity into units of antibod
ies bound per cell. The use of antibody-binding capacity as a surrogat
e marker for quantification of Ag expression was addressed more direct
ly by the development of antibody-binding standards. The quantitative
indirect immunofluorescence assay is based on beads labeled with vario
us amounts of CD5 mAb that calibrate the binding of the secondary anti
body in units of antibody-binding capacity. Alternatively, goat anti-m
ouse-labeled calibration beads have been developed. Published results
obtained with the latter calibrators showed an unexpected inaccuracy.
The different ways in which calibrators and cells under study bind mAb
(i,e,, Fab mediated versus Pc mediated) may have contributed to this
variation. Recently, the use of stabilized cell populations expressing
Ag in a specified range of concentrations has been proposed as an Ag-
specific calibration system of mAb binding. We identify several issues
on the level of instrumentation, reagents, and cells under study that
should be solved to allow standardization of quantitative assessments
of immunofluorescence intensity, (C) 1998 Wiley-Liss, Inc.