K Number
K101911
Device Name
IMMUKNOW-THE CYLEX IMMUNE CELLFUNCTION ASSAY
Manufacturer
Date Cleared
2010-10-18

(101 days)

Product Code
Regulation Number
864.5220
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
ImmuKnow®-the Cylex®™Immune Cell Function Assay measures the concentration of ATP from circulating CD4 cells following in vitro stimulation with phytohemagglutinin (PHA) as an indicator of immune cell function. This measurement is made on heparin anti-coagulated whole blood using a luminometer and luciferin/luciferase. The assay is used for the detection of cell mediated immune response in populations undergoing immunosuppressive therapy for organ transplant.
Device Description
The Cylex Immune Cell Function Assay measures the concentration of ATP from circulating CD4 cells following in vitro stimulation with phytohemagglutinin (PHA) as an indicator of immune cell function. This measurement is made on heparin anti-coagulated whole blood using a luminometer and luciferin/luciferase. The assay is used for the detection of cell mediated immune response in populations undergoing immunosuppressive therapy for organ transplant. Test Description The Cylex Immune Cell Function Assay detects cell-mediated immunity in whole blood after a 15-18 hour incubation with stimulant. During incubation, increased ATP synthesis occurs within the cells that respond to the stimulant phytohemagglutinin (PHA). Concurrently, whole blood is incubated in the absence of stimulant for the purpose of assessing basal ATP activity. Anti-CD4 monoclonal antibody coated magnetic particles are added to immunoselect CD4 cells from both the stimulated and non-stimulated wells. After washing the selected CD4 cells on a magnet tray, Lysis Reagent is added to release intracellular ATP. Addition of Luminescence Reagent (luciferin/luciferase) to the released ATP produces light according to the following equation: Mg24 Luciferin +ATP +O2 Luciferase Oxyluciferin +AMP +Pyrophosphate +CO2 + Light The amount of light measured by a luminometer (emission maximum 562 nm) is proportional to the concentration of ATP. The concentration of ATP (ng/mL) is calculated from a calibration curve and compared to ATP level ranges to characterize the cellular immune function of the sample.
More Information

Not Found

No
The description details a biochemical assay measuring ATP concentration and comparing it to ranges, which is a standard laboratory technique and does not indicate the use of AI or ML. The document explicitly states "Mentions AI, DNN, or ML: Not Found".

No
The device is used to measure ATP concentration as an indicator of immune cell function, which is a diagnostic purpose, not a therapeutic one.

Yes

Explanation: The device is described as an "Immune Cell Function Assay" that "measures the concentration of ATP from circulating CD4 cells" to indicate immune cell function and is "used for the detection of cell mediated immune response in populations undergoing immunosuppressive therapy for organ transplant." This directly fits the definition of a diagnostic device, as it provides information for diagnosis or monitoring of a physiological state or disease.

No

The device description clearly outlines a laboratory-based assay involving physical reagents (heparin, PHA, luciferin/luciferase), magnetic particles, and a luminometer for measurement. This indicates a hardware-dependent in vitro diagnostic device, not a software-only device.

Yes, this device is an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use explicitly states that the assay measures ATP from circulating CD4 cells in whole blood following in vitro stimulation. This indicates that the test is performed on a biological sample taken from the body, outside of the body (in vitro).
  • Device Description: The description details the process of incubating whole blood, adding reagents, and measuring light produced from a reaction with ATP. This is a typical description of an in vitro assay.
  • Sample Type: The assay is performed on heparin anti-coagulated whole blood, which is a biological specimen.
  • Purpose: The assay is used for the "detection of cell mediated immune response in populations undergoing immunosuppressive therapy for organ transplant." This is a diagnostic purpose, providing information about a patient's immune status.

The fact that it uses a luminometer and luciferin/luciferase, and measures ATP concentration from a biological sample (blood) to provide diagnostic information about immune function, firmly places it in the category of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Cylex Immune Cell Function Assay measures the concentration of ATP from circulating CD4 cells following in vitro stimulation with phytohemagglutinin (PHA) as an indicator of immune cell function. This measurement is made on heparin anti-coagulated whole blood using a luminometer and luciferin/luciferase. The assay is used for the detection of cell mediated immune response in populations undergoing immunosuppressive therapy for organ transplant.

Product codes (comma separated list FDA assigned to the subject device)

NID

Device Description

The Cylex Immune Cell Function Assay measures the concentration of ATP from circulating CD4 cells following in vitro stimulation with phytohemagglutinin (PHA) as an indicator of immune cell function. This measurement is made on heparin anti-coagulated whole blood using a luminometer and luciferin/luciferase. The assay is used for the detection of cell mediated immune response in populations undergoing immunosuppressive therapy for organ transplant.

Test Description The Cylex Immune Cell Function Assay detects cell-mediated immunity in whole blood after a 15-18 hour incubation with stimulant. During incubation, increased ATP synthesis occurs within the cells that respond to the stimulant phytohemagglutinin (PHA). Concurrently, whole blood is incubated in the absence of stimulant for the purpose of assessing basal ATP activity. Anti-CD4 monoclonal antibody coated magnetic particles are added to immunoselect CD4 cells from both the stimulated and non-stimulated wells. After washing the selected CD4 cells on a magnet tray, Lysis Reagent is added to release intracellular ATP. Addition of Luminescence Reagent (luciferin/luciferase) to the released ATP produces light according to the following equation:

Mg24 Luciferin +ATP +O2 Luciferase Oxyluciferin +AMP +Pyrophosphate +CO2 + Light

The amount of light measured by a luminometer (emission maximum 562 nm) is proportional to the concentration of ATP. The concentration of ATP (ng/mL) is calculated from a calibration curve and compared to ATP level ranges to characterize the cellular immune function of the sample.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

The apparently healthy adult population had an age range of 20 - 60 years. The transplant population had an age range of 20 - 64 years.

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

A multi-center study was conducted on freshly drawn blood collected from 44 apparently healthy adults and 78 transplant recipients (17 at discharge from the hospital and 61 post-discharge follow-up). The samples were evaluated with the Cylex Immune Cell Function Assay. The apparently healthy adult population consisted of 11% (5) females, 86% (38) males and 3% (1) unknown, with an age range of 20 - 60 years. The ethnicity of the population was 80% (35) African American, 16% Caucasian (7), and 4% (2) other or unknown. The transplant population consisted of 33% (26) females and 67% (52) males, with an age range of 20 - 64 years. The ethnicity of the population was 15% (12) African American, 74% Caucasian (58), 10% (8) other or unknown. The organs transplanted were 55% (43) liver, 36% (28) kidney, 4% (3) pancreas, and 5% (4) multiple organs.

The means of the two populations were found to be statically different, the results are summarized in the following table.

PopulationApparently HealthyTransplant
Cylex Inc. Immune Cell Function Assay
ATP Resultsn = 44n = 78
Mean / SD (ng/mL)449 / 152274 / 166
Median (ng/mL)430251
Range (ng/mL)205 - 96721 - 759
Becton Dickinson Total CD4 count by
Flow Cytometryn = 44n = 78
Mean / SD (ng/mL)786 / 490487 / 403
Median (ng/mL)654389
Range (ng/mL)130 - 2659260
Total7844

| Patient Status | Transplant
Subjects | Normal
Subjects | Total |
|-------------------------|------------------------|--------------------|-------|
| Total CD4
count ≤350 | 33 | 5 | 38 |
| Total CD4
count >350 | 45 | 39 | 84 |
| Total | 78 | 44 | 122 |

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K971205, K974360

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 864.5220 Automated differential cell counter.

(a)
Identification. An automated differential cell counter is a device used to identify one or more of the formed elements of the blood. The device may also have the capability to flag, count, or classify immature or abnormal hematopoietic cells of the blood, bone marrow, or other body fluids. These devices may combine an electronic particle counting method, optical method, or a flow cytometric method utilizing monoclonal CD (cluster designation) markers. The device includes accessory CD markers.(b)
Classification. Class II (special controls). The special control for this device is the FDA document entitled “Class II Special Controls Guidance Document: Premarket Notifications for Automated Differential Cell Counters for Immature or Abnormal Blood Cells; Final Guidance for Industry and FDA.”

0

January 14, 2002

1101911

OCT 1 8 2010

510(K) SUMMARY

Cylex Inc. Immune Cell Function Assay

Submitted by:

Cylex Inc.

8980-1 Old Annapolis Road Columbia, MD 21045

Contact:

Dr. Judy Britz

Name of Device:

Trade Name:Immune Cell Function Assay
Common Name:CD4 Cell Stimulation Assay
Classification Name:Automated Differential Cell Counter

Predicate Device:

Becton Dickinson TriTest™ CD4 FITC/CD8 PE/CD3 PerCP Reagent; Becton Dickinson MultiTest™ CD3 FITC/CD8 PE/CD45 PerCP/CD4 APC Reagent

Device Description:

Intended Use: The Cylex Immune Cell Function Assay measures the concentration of ATP from circulating CD4 cells following in vitro stimulation with phytohemagglutinin (PHA) as an indicator of immune cell function. This measurement is made on heparin anti-coagulated whole blood using a luminometer and luciferin/luciferase. The assay is used for the detection of cell mediated immune response in populations undergoing immunosuppressive therapy for organ transplant.

Test Description The Cylex Immune Cell Function Assay detects cell-mediated immunity in whole blood after a 15-18 hour incubation with stimulant. During incubation, increased ATP synthesis occurs within the cells that respond to the stimulant phytohemagglutinin (PHA). Concurrently, whole blood is incubated in the absence of stimulant for the purpose of assessing basal ATP activity. Anti-CD4 monoclonal antibody coated magnetic particles are added to immunoselect CD4 cells from both the stimulated and non-stimulated wells. After washing the selected CD4 cells on a magnet tray, Lysis Reagent is added to release intracellular ATP. Addition of Luminescence Reagent (luciferin/luciferase) to the released ATP produces light according to the following equation:

Mg24 Luciferin +ATP +O2 Luciferase Oxyluciferin +AMP +Pyrophosphate +CO2 + Light

The amount of light measured by a luminometer (emission maximum 562 nm) is proportional to the concentration of ATP. The concentration of ATP (ng/mL) is calculated from a calibration curve and compared to ATP level ranges to characterize the cellular immune function of the sample.

510(k) Summary - 1

81

1

510(K) SUMMARY

Cvlex Inc. Immune Cell Function Assay (cont.)

Substantial Equivalence:

The Cylex Inc. Immune Cell Function Assay has been found to be substantially equivalent to the Becton Dickinson TriTest™ CD4 FITC/CD8 PE/CD3 PerCP Reagent (K971205) and MultiTest™ CD3 FITC/CD8 PE/CD45 PerCP/CD4 ACP Reagent (K974360). All assays differentiate CD4 cells; the Cylex assay determines the responsiveness of those cells and the Becton Dickinson assays count the number of those cells.

A multi-center study was conducted on freshly drawn blood collected from 44 apparently healthy adults and 78 transplant recipients (17 at discharge from the hospital and 61 post-discharge follow-up). The samples were evaluated with the Cylex Immune Cell Function Assay. The apparently healthy adult population consisted of 11% (5) females, 86% (38) males and 3% (1) unknown, with an age range of 20 - 60 years. The ethnicity of the population was 80% (35) African American, 16% Caucasian (7), and 4% (2) other or unknown. The transplant population consisted of 33% (26) females and 67% (52) males, with an age range of 20 - 64 years. The ethnicity of the population was 15% (12) African American, 74% Caucasian (58), 10% (8) other or unknown. The organs transplanted were 55% (43) liver, 36% (28) kidney, 4% (3) pancreas, and 5% (4) multiple organs.

The means of the two populations were found to be statically different, the results are summarized in the following table.

PopulationApparently HealthyTransplant
Cylex Inc. Immune Cell Function Assay
ATP Resultsn = 44n = 78
Mean / SD (ng/mL)449 / 152274 / 166
Median (ng/mL)430251
Range (ng/mL)205 - 96721 - 759
Becton Dickinson Total CD4 count by
Flow Cytometryn = 44n = 78
Mean / SD (ng/mL)786 / 490487 / 403
Median (ng/mL)654389
Range (ng/mL)130 - 2659260
Total7844

| Patient Status | Transplant
Subjects | Normal
Subjects | Total |
|-------------------------|------------------------|--------------------|-------|
| Total CD4
count ≤350 | 33 | 5 | 38 |
| Total CD4
count >350 | 45 | 39 | 84 |
| Total | 78 | 44 | 122 |

*U.S. Patent No. 5,773,232

510(k) Summary - 2

82

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is a staff with two snakes entwined around it. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the caduceus. The logo is in black and white.

Food & Drug Administration 10903 New Hampshire Avenue Building 66 Silver Spring, MD 20993

Cylex Inc. c/o Ms. Judi Smith President, Judi Smith LLC 8980 I Old Annapolis Road Columbia, MD 21045

0CT 1-8 2010

Re: K101911

Trade/Device Name: Immuknow® Immune Cell Function Assay Regulation Number: 21 CFR§864.5220 Regulation Name: Automated Differential cell counter Regulatory Class: Class II Product Code: NID Dated: August.20, 2010 Received: September 1, 2010

Dear Ms. Smith:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into class II (Special Controls), it may be subject to such additional controls. Existing major regulations affecting your device can be found in Title 21, Code of Federal Regulations (CFR), Parts 800 to 895. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Parts 801 and 809); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); and good manufacturing practice

3

Page 2 - Ms. Judi Smith

requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820). This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Parts 801 and 809), please contact the Office of In Vitro Diagnostic Device Evaluation and Safety at (301) 796-5450. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,
maria m chan

Maria M. Chan, Ph.D. Director Division of Immunology and Hematology Devices Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

4

Indication for Use

510(k) Number (if known): K101911

Device Name: Immune Cell Function Assay

Indication For Use:

ImmuKnow®-the Cylex®™Immune Cell Function Assay measures the concentration of ATP from circulating CD4 cells following in vitro stimulation with phytohemagglutinin (PHA) as an indicator of immune cell function. This measurement is made on heparin anti-coagulated whole blood using a luminometer and luciferin/luciferase. The assay is used for the detection of cell mediated immune response in populations undergoing immunosuppressive therapy for organ transplant.

Prescription Use × (21 CFR Part 801 Subpart D) And/Or

Over the Counter Use (21 CFR Part 801 Subpart C)

1/10/9/1

OCT 1 8 2010

(PLEASE DO NOT WRITE BELOW THIS LINE; CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of In Vitro Diagnostic Device Evaluation and Safety (OIVD)

Reena Philip

Division Sign-Off Office of Device Evaluation

510(k) K101911

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