CN101206225A - 化学发光免疫分析检测心肌钙蛋白t的方法 - Google Patents
化学发光免疫分析检测心肌钙蛋白t的方法 Download PDFInfo
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Abstract
一种用化学发光免疫分析法检测心肌肌钙蛋白T(cTnT)的分析方法。
Description
技术领域
本发明属于临床血液免疫分析领域,建立了化学发光免疫分析法检测心肌肌钙蛋白T以早期、敏感、特异地诊断急性心肌梗死。此外本发明也可用于实验室作生理、病理、药理等多项研究。
技术背景
心血管疾病是常见病和多发病,是威胁人类健康的首要疾病。急性心肌梗死(acutemyocardial infarction,AMI)是常见的心血管疾病,正确诊断及时救治对挽救濒死心肌,改善预后降低急性期病死率和死亡率具有重要意义。在AMI的生化诊断方面,肌酸激酶(CK)及其同工酶(CK-MB)、乳酸脱氢酶(LDH)等是目前常用的心肌酶谱。但是心肌酶谱并非心脏所特有,在正常人骨骼肌中也有少量存在。非心脏手术或骨骼肌损伤患者CK-MB也可升高,且CK-MB在AMI发病后4-8小时才开始升高,持续时间又短(48-72小时),因而临床应用受到限制。1987年英国Cummins等首先报告用测定周围血中心肌钙蛋白(cTn)浓度来诊断AMI(Cummins,et al.infarction Am heart J,1987,113:1333-1334)。1991年Katus等人最早报道了cTnT对诊断AMI具有高度敏感性和特异性(clin.chem.1991;83:902-912.)。近年来研究表明,心肌肌钙蛋白(Cardiac Troponin)是心肌特异的调节蛋白,其亚单位肌钙蛋白T(cTnT)和肌钙蛋白I(cTnI)在AMI时释放入血是心肌损伤的特异性标志物,并具有灵敏度高,在血中出现时间早,诊断窗口时间长等优点。此外cTnT在预测梗塞面积,评价溶栓疗效,AMI预后心功能判定,不稳定心绞痛预后评估,围手术期心肌损伤的判定等方面均具有重要的临床价值。
以往学者们对cTnT诊断AMI的特异性有些争论。1991年katus发现cTnT与骨骼肌有1%-2%交叉反应(clin.Chem.1991;83:902-912.)。但也有学者认为cTnT与骨骼肌的基因编码不同,两者在结构和免疫原方面有很大差别。在检测cTnT的方法改进后,用两种均为心肌特异的单克隆抗体检测cTnT时,与骨骼肌交叉反应阳性率<0.5%(Katus HA.etal.Clin.chem.1992,38:386)。Baum等人对75名无心脏病的骨骼肌患者(其中33名Duchenne病,42例马拉松运动员长跑后)用改进后的检测方法检测cTnT,未发现一例阳性反应(BodorGS.etal.Clin.chem.1992,38:2203.)。由此可以认为,在无心脏病的骨骼肌中及运动员血浆中未发现cTnT存在,所以cTnT对诊断急性心肌梗死与cTnI同样具有心肌特异性。然而当发生AMI时,cTnT在升高倍数和持续时间上优于cTnI,因为cTnT在正常人血清中含量很低,在心肌细胞中含量高,一旦少量释放入血浆,cTnT即可升高30-200倍,而cTnI仅升高10-20倍(杨振华:中华医学杂志。1992,72(1)51-52)。另外cTnT在血液和淋巴液中消除速率慢,AMI时cTnT升高可持续2-3周,较cTnI持续时间长。
因为cTnT在血中正常含量很低,测定方法需有很低的可测限和较高的灵敏度。最初建立检测血清cTnT的ELISA方法是基于亲和纯的一种多抗和一种单抗建立起来的,以后又发展了更敏感特异的ELISA单抗一步法,整个反应90分钟完成,检测范围0.1-15μg/L。由于全部采用单抗,检测结果重复性较高,与骨骼肌交叉反应性率<0.5%(Katus HA.etal.Clin.chem.,1992,38:386)。快速定性测定方法采用金免疫层析法(郑佐娅,陶义训,上海医学检验杂志,1996,11,57-58。)。
1977年Arakawe创建了化学发光免疫分析(Chemiluminescent immunoassay,CLIA)。该方法可以使检测范围达到6个数量级,并且敏感度可达10的负18次方摩尔水平。
同化学发光免疫分析方法相比,酶免疫分析法和金免疫层析法在敏感度上要低得多。
发明内容
亲合素-生物素双单抗夹心一步法检测cTnT方法:该方法需要两种同cTnT反应具有不同结合位点的单抗。需制备单抗(1)同生物素的复合物,单抗(2)同酶的复合物,将链霉亲合素固化于固相载体上。当单抗(1)同生物素的复合物、单抗(2)同酶的复合物和样品(或标准品)一起加入反应池后,通过一步法生成复合物:固相载体-链霉亲合素-生物素-单抗(1)-cTnT-单抗(2)-酶,经过洗涤后加入底物、氧化剂、增强剂便可法光。
竞争法检测cTnT的方法只需用一种单抗。首先制备cTnT-链霉亲合素的复合物,酶-生物素的复合物,将单抗固化于固相载体上。当样品(或标准品)同cTnT-链亲合素复合物、酶-生物素复合物一起加入反应池,经过反应、洗涤后加入酶的底物、氧化剂、增强剂便可发光。
若底物是二酰基肼的衍生物,则单抗(2)所结合的酶为辣根过氧化物酶;若底物是环1,2-二氧乙烷衍生物(AMPPD),则单抗(2)所结合的酶为碱性磷酸酶。
酶促化学发光免疫分析法可采用全自动检测仪,也可采用半自动发光仪。根据需要,固相载体可选用多孔板或磁微粒。
单克隆抗体同酶或生物素的结合已有多处报道,现已成常规方法:
1、J.Immunological Methods,1979,31:231-236。
2、J.Histochem.Cytochem,1979,22:1084-1091。
3、尹伯元、王仁芝、李振甲、许以平等编著《标记免疫学》:41-50页。
4、Peters JH,Baumgarten H eds.Monoklonale.1988:1349-53。
具体实施方式
实施例1
cTnT的提取、纯化及其单克隆抗体的制备。参照文献〔Jin J-P,J.Biol.Chem.1988,263(15):7309;傅朝平等细胞与分子免疫学杂志,1996,12(1):39;周国华等,中国生理学杂志,2004,6(2):198;张海珠等,郑州大学学报(医学版),2003年,03期;李志梁、傅朝平等,生物化学与生物物理进展,1996,第五期〕,将新鲜无心脏病的心肌组织无盐匀浆,70℃高盐萃取,硫酸铵盐析,DEAE纤维素柱层析,获得cTnT纯品。100g心肌组织获得4.5mg cTnT。经凝胶电泳cTnT为一条带,经免疫印迹鉴定证实DEAE纤维柱层析第二峰为cTnT的活性峰。
cTnT免疫BALB/c小鼠。首次用35μg cTnT同等体积不完全佐剂混合(含2.0mg卡介苗)腹腔注射,以后每周脾内注射cTnT 35μg,共免疫3次。第4次为加强免疫,cTnT 50μg脾内注射,3-5天内进行融合。
细胞融合及单抗产生:小鼠脾细胞同Sp2/0骨髓瘤细胞按1∶5进行融合。克隆化培养,3次间接ELISA筛选阳性杂交瘤细胞珠。接种BALB/c:成年小鼠基础免疫用0.2ml降植烷和不完全佐剂腹腔注射,1周后腹腔注射杂交瘤细胞悬液,10-12天处死接种小鼠,收集腹水,其效价在1.5×10的负6次至1.0×10的负7次方。经硫酸铵分级沉淀、透析、浓缩后加甘油置-20℃保存。。相加试验证实,A3、D6可识别cTnT不同位点。该单抗不与cTnI及骨骼肌反应。A3称为单抗(1),D6称为单抗(2)。
实施例2
辣根过氧化物酶发光体系的配制方法:发光底物二酰基肼的衍生物(优选鲁米诺)浓度为1.0mMol/L。复合氧化剂:过硼酸钠-H2O2各为1.0mMol/L。复合增强剂:对羟基肉硅酸-对碘酚各为0.05mMol/L。用0.1Mol/L,pH8.60的Tris-HCl缓冲液调整pH。
实施例3
亲合素-生物素双单抗夹心一步法检测cTnT化学发光免疫分析方法的建立:
1、按前述文献制备单抗(1)同生物素的复合物,单抗(2)同辣根过氧化物酶的复合物,将链霉亲合素结合于Nunc板上。
2、建立亲合素-生物素双单抗夹心一步法检测cTnT的CLIA法。将待测血清(或cTnT的标准品)、单抗(1)同生物素的复合物、单抗(2)同辣根过氧化物酶的复合物各50μl加入经链霉亲合素包被的Nanc板孔中,37℃温育60分钟,用PBST洗涤3次,加入鲁米诺底物溶液(具体配制见实施例2),用化学发光免疫分析仪检测425nm发光值,由微机软件算出样品含量。该方法的灵敏度经测定(Bo+2SD)为0.005ng/ml,检测范围0.01-1.50ng/ml。
实施例4
正常人与AMI患者血液内cTnT含量测定。正常人51例,AMI患者19例,正常人组cTnT的含量为0.02±0.01ng/mL,AMI组为0.95±0.22ng/mL。
Claims (3)
1.心肌钙蛋白T(cTnT)化学发光免疫分析方法,其特征在于用辣根过氧化物酶促化学发光体系。
2.根据权利要求1所述免疫分析方法,其特征在于用双单抗夹心法和/或竞争法检测cTnT。
3.根据权利要求1所述辣根过氧化物酶促化学发光体系,其特征在于用二酰基肼衍生物作为发光底物,过氧硼酸钠-H2O2作为复合氧化剂,对羟基肉硅酸-对碘酚作为复合增强剂,辣根过氧化物酶作为酶促催化剂。
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