CN105567804A - Application of NR_073415.2 in detecting cytomegalovirus infections of organ transplant patients and kit - Google Patents
Application of NR_073415.2 in detecting cytomegalovirus infections of organ transplant patients and kit Download PDFInfo
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Abstract
The invention belongs to the technical field of early diagnosis for diseases and particularly discloses application of application of NR_073415.2 in detecting cytomegalovirus infections of organ transplant patients and a kit. The makes a first discovery that NR_073415.2 is useful for detecting whether an organ transplant patient is infected by cytomegalovirus or not, in particular, detecting Cq values of a reference gene GAPDH and NR_073415.2 in peripheral blood mononuclear cells of a patient to be detected, measuring at least three times the Cq values of the GAPDH and NR_073415.2, averaging and judging results according a following formula and process: DeltaCT value=AVERGAE(NR_073415.2 Cq value)-AVERAGE(GAPD value Cq value); when the DeltaCT value is greater than or equal to 11, considering the patient has cytomegalovirus infections and the results are positive; when the DeltaCT value is less than 11, considering the patient is free of cytomegalovirus infections and the results are negative. Expression changes of NR_073415.2 can be detected in early infection (on first to third day of infection) without influence from immunosuppressive condition, and the significance to the early diagnosis and treatment is great.
Description
Technical field
The present invention relates to disease early diagnosis technical field, particularly, relate to the application of NR_073415.2 in sense organ transplant patient cytomegalovirus infection and test kit.
Background technology
Cytomegalovirus is the postoperative comparatively common opportunistic virus of organ transplantation, and severe infections person can cause transplant organ to lose function even threat to life.Organ transplant recipients in art and postoperative needs use a large amount of immunosuppressor; cause cellular immune function low; cytomegalovirus specific cytotoxic T-cell and helper cell immunological unresponsiveness, can not remove and infect and produce immunoprotection, easily diagnosing for active human cytomegalovirus infection occur.When not using preventative antiviral therapy, the infection rate of organ transplantation postoperative patient person cytomegalovirus is 60 ~ 80%, and wherein have 17 ~ 28% patients will develop into cytomegalovirus disease, as cytomegaloviral pneumonia, hepatitis, pancreatitis, gastro-enteritis, meningoencephalitis etc.
Along with to the attention of the postoperative preventative antiviral therapy of organ transplantation with prevent and treat improving constantly of level, after transplanting, the incidence of cytomegalovirus infection presents downtrending.There is report display: the incidence of cytomegalovirus disease can be reduced by 58 ~ 80% by appropriate ganciclovir or the valganciclovir prophylactic treatment of using, and the incidence of cytomegalovirus infection is reduced about 40%.But it still has tremendous influence to organ transplantation postoperative patient person, it can increase repulsion or other incidences infected, mortality ratio by directly or indirectly acting on and reduce graft survival time.Therefore, early stage Accurate Diagnosis cytomegalovirus infection seems most important.
The method that can be used for clinical diagnosis cytomegalovirus infection at present has:
1, detect cytomegalovirus specific antibody: CMV-IgG and CMV-IgM in peripheral blood and be usually used in detecting the situation of cytomegalovirus infection.In 70% transplant patient's serum, CMV-IgG is positive, and it is high to diagnosis diagnosing for active human cytomegalovirus infection specificity, but susceptibility is low, and actual diagnostic significance is little.And CMV-IgM can detect after cytomegalovirus generation Active infection 1 week, and its specificity comparatively CMV-IgG is low, therefore it has little significance to diagnosis cytomegalovirus early infection.Because recipients is in immunosuppressive condition, postponing or disappearance appears in CMV-IgG and CMV-IgM, easily cause false negative result, affect positive rate, these factors all limit the effect of Serum Antibody Detection in cytomegalovirus infection diagnosis, therefore, whether these two kinds of antibody tests can infect the screening index of cytomegalovirus as donor and acceptor, played auxiliary reference effect to diagnosis cytomegalovirus infection.
2, cytomegalovirus dna copy number is detected: quantitative nucleic acid detection technique carries out quantitative analysis to the CMV-DNA copy number in serum and white corpuscle, thus judge the situation of cytomegalovirus infection.The method can also detect the CMV-DNA in the samples such as tissue, bronchoalveolar lavage fluid, urine and cerebrospinal fluid, and its susceptibility and detection speed are all apparently higher than other detection method.The method operability is good, requires low, be convenient to popularization and carry out for laboratory condition.In addition, if select a reference gene synchronous amplification, obtain typical curve, then can calculate virus load.But it is comparatively large that the shortcoming of this method is degree of variation, the detection Schwellenwert difference of different experiments room is far away.And, early stage in infection, cytomegalovirus partial copy, do not diffuse into blood time, extracting peripheral blood, to detect the positive rate of CMV-DNA lower, have impact on the early diagnosis of disease.
3, antigen detects: detect cytomegalovirus-pp65 antigen by methods such as sxemiquantitative fluorescence analysis method, mark streptothricin-vitamin H combined techniqueses and reactivity cytomegalovirus in body can be pointed out to have copied, it can reach more than 90% to the accuracy rate of diagnosis cytomegalovirus infection.But cytomegalovirus-pp65 Detection of antigen is the principle relying on Ag-Ab to combine, therefore higher to the requirement of sample, and fresh blood preparation requires censorship in 8h, and positive rate is directly related with sample freshness.In addition, this detection means complex operation, technical requirements are high, affect many by experimenter's subjective experience.Therefore, this detection method does not obtain extensive propagation and employment.
4, other detection methods: Viral isolation by specimen inoculation after human desmocyte parent cell, judge whether to there is cytomegalovirus virus by the pathological change of observation of cell, but because cytomegalovirus is comparatively slow in the propagation of human desmocyte parent cell, high to technical requirements, virus susceptibility is low, about 4 ~ 6 weeks of culture cycle, is therefore not suitable for using in clinical diagnosis.Whether graft tissue Immunohistochemical detection transplant organ of can clarifying a diagnosis infects cytomegalovirus disease, but the method needs have wound property to detect to graft, and there is no the test kit in clinical diagnosis at home, and therefore the method is only for scientific research.Immunological detection method, transplants the T lymphocyte in the peripheral blood of receptor by Flow Cytometry dynamic monitoring, analyze the risk that the reaction of cytomegalovirus specific T-cells can reflect cytomegalovirus infection.But the method technical requirements is high, not yet in clinical diagnosis.
Summary of the invention
The object of the invention is the above-mentioned deficiency in order to overcome prior art, a kind of sense organ transplant patient cytomegalovirus infection mark is provided.
Another object of the present invention is, provides a kind of sense organ transplant patient the test kit of cytomegalovirus infection.Patent of the present invention is subsidized by national high-tech research evolutionary operation(EVOP) (863 Program).
To achieve these goals, the present invention is achieved by the following technical programs:
Organ transplantation postoperative patient person long-term taking immunosuppressor, body is weak for the resistibility of cytomegalovirus infection, and progression of disease is rapid, and its early diagnosis is more difficult.When lacking enough diagnosis basis, adding the treatment cost and the economical load that not only increase patient by antiviral, too increasing the occurrence risk of untoward reaction.Therefore, the present invention is by setting up the post-transplantation mouse model of cytomegalovirus infection, infected early stage peripheral blood lymphocytes (PBMC) to preserve, method for gene chip is used to screen the long-chain non-coding RNA (lncRNA) of its differential expression, finally confirm in clinical infection patient peripheral blood specimen, thus find that NR_073415.2 may be used for early diagnosis Organ Transplantation Patients and whether infects cytomegalovirus.The gene order of NR_073415.2 is as shown in SEQIDNO:1.
Therefore, the application of the claimed NR_073415.2 of this invention in preparation sense organ transplant patient cytomegalovirus infection test kit.
NR_073415.2 is as the application in sense organ transplant patient cytomegalovirus infection mark.
The test kit of a kind of sense organ transplant patient cytomegalovirus infection, the Cq value of GAPDH and NR_073415.2 in patient peripheral's blood monocyte to be measured is detected respectively by this test kit, the Cq value of GAPDH and NR_073415.2 at least measures 3 times, after averaging according to the following formula with method judged result:
The Cq value of △ CT value=AVERAGE(NR_073415.2) the Cq value of-AVERAGE(GAPDH)
Result judges: when △ CT value is more than or equal to 11, considers that patient exists cytomegalovirus infection, and result is positive; When △ CT value is less than 11, consider that patient does not exist cytomegalovirus infection, result is negative.
Preferably, detected the Cq value of GAPDH by Q-PCR, primer sequence when Q-PCR detects is as shown in SEQIDNO:2 ~ 3.
Preferably, detected the Cq value of NR_073415.2 by Q-PCR, primer sequence when Q-PCR detects is as shown in SEQIDNO:4 ~ 5.
Compared with prior art, the present invention has following beneficial effect:
The present invention proposes the expression by detecting NR_073415.2 in peripheral blood lymphocytes first, carrys out the cytomegalovirus infection of clear and definite organ transplantation postoperative patient person, thus provides a kind of new approaches for early diagnosis.Infecting early stage (infecting 1st ~ 3 days), test kit of the present invention can detect that the expression of NR_073415.2 changes, and not by the impact of immunosuppressive condition, for early diagnosis, early treatment, significant.In addition, the positive rate that the present invention detects compared to the antibody test of routine or DNA copy number is high, and detection sample is peripheral blood in patients, and be easy to draw materials, wound is little, and technology is convenient and simple, easy to utilize.
Accompanying drawing explanation
Fig. 1 is the △ CT value of organ transplantation postoperative patient person peripheral blood lymphocytes NR_073415.2.
Embodiment
To make the present invention below in conjunction with Figure of description and specific embodiment and elaborating further, described embodiment, only for explaining the present invention, is not intended to limit scope of the present invention.The test method used in following embodiment if no special instructions, is ordinary method; The material used, reagent etc. if no special instructions, are the reagent that can obtain from commercial channels and material.
Embodiment 1
A test kit for sense organ transplant patient cytomegalovirus infection, this test kit is with GAPDH and NR_073415.2 for Testing index, and test kit specifically comprises two to detection primer, Q-PCR detection reagent, 1 part of working instructions.
The sequence that the two pairs of detections are quoted is as follows:
GAPDHPrimer-F sequence: 5 '-CGGAGTCAACGGATTTGGTCGTAT-3 '
GAPDHPrimer-R sequence: 5 '-AGCCTTCTCCATGGTGGTGAAGAC-3 '
NR_073415.2-F sequence: 5 '-TGGGTTCCGATGAGGAGGAT-3 '
NR_073415.2-R sequence: 5 '-AAGGGAGCCTGATGAGGGAT-3 '
The determination methods of this test kit is: the Cq value detecting GAPDH and NR_073415.2 in patient peripheral's blood monocyte to be measured respectively, and the Cq value of GAPDH and NR_073415.2 at least measures 3 times, after averaging according to the following formula with method judged result:
The Cq value of △ CT value=AVERAGE(NR_073415.2) the Cq value of-AVERAGE(GAPDH)
Result judges: when △ CT value is more than or equal to 11, considers that patient exists cytomegalovirus infection, and result is positive; When △ CT value is less than 11, consider that patient does not exist cytomegalovirus infection, result is negative.
The use step of mentioned reagent box is as follows:
Collect peripheral blood in patients 2 ~ 4ml to be detected with EDTA pipe, 4 DEG C of refrigerators can be placed in and preserve 24 hours; With pasteur pipet, peripheral blood is transferred in 15ml centrifuge tube, in 4 DEG C with 450g centrifugal (accelerate 4, slow down 7) 5min, siphons away supernatant liquid with pasteur pipet, leave underlayer red deposit thing; Add 3 ~ 5 times of volume erythrocyte cracked liquids, and blow and beat mixing gently with pasteur pipet, leave standstill room temperature 5 minutes; By aforesaid liquid in 4 DEG C with 450g centrifugal (accelerate 4, slow down 7) 10min, siphon away supernatant liquid with new pasteur pipet, leave lower floor's white depositions; With pasteur pipet, 10mlPBS damping fluid is joined in white depositions, in 4 DEG C with 450g centrifugal (accelerate 4, slow down 7) 10min, siphon away supernatant liquid with new pasteur pipet, and repeat this step 1 time again; Obtain white depositions and be peripheral blood lymphocytes (PBMC).The method of this area routine is adopted to extract the total serum IgE of peripheral blood lymphocytes.Then UV spectrophotometer measuring RNA concentration and purity is used.
Concentration and the good RNA sample of purity are carried out reverse transcription and Q-PCR amplification.Transcriptive process,reversed operates with reference to PrimeScript RTMasterMix (PerfectRealTime) (RR036A, TAKARA company) Reverse Transcription box specification sheets, is cDNA by the lncRNA reverse transcription in total serum IgE.
Utilize PowerSYBRPCRMasterMix(4367659, Genecopoeia) etc. reagent complete the detection of GAPDH and NR_073415.2 expression (when Q-PCR detects the Cq value of GAPDH, the primer of use be as shown in SEQIDNO:2 ~ 3; The primer that Q-PCR uses when detecting the Cq value of NR_073415.2 is as Suo Shi SEQIDNO:4 ~ 5).Q-PCR reaction system is in table 1, and reaction conditions: 95 DEG C of denaturation 5min, reacts 50 circulations with 95 DEG C of sex change 30sec, 60 DEG C of annealing 30sec, 60 DEG C of extension 30sec, terminate first 72 DEG C and extend 10min.
Table 1Q-PCR reaction system
| PCR system | 10 μ Lindenmayer systems (μ L) |
| 2× Power SYBR Green PCR Master Mix | 5 |
| Primer-F（10μM） | 0.3 |
| Primer-R（10μM） | 0.3 |
| dd H 2O | 2.4 |
| cDNA * | 2 |
* the meaning is that cDNA re-uses by after 10 times of dilutions.
Data analysis and judgement: the sample of every patient detects each three times of GAPDH and NR_073415.2 by the multiple hole of technology, 2700PCRsystem(AppliedBiosystem company) will each Cq value detected be calculated, three of NR_073415.2 times are detected the mean value of Cq value, deduct the mean value that GAPDH detects Cq value for tri-times, its △ CT value can be calculated.
Formula: △ CT value=AVERAGE(NR_073415.2Cq value)-AVERAGE(GAPDHCq value)
Result judges: when △ CT value is more than or equal to 11, considers that patient exists cytomegalovirus infection, and result is positive; When △ CT value is less than 11, consider that patient does not exist cytomegalovirus infection, result is negative.
Embodiment 2
The △ CT value situation of the NR_073415.2 in 28 routine organ transplantation postoperative fungi infestation patient peripheral blood monocyte is have detected with the test kit of embodiment 1, comprising 3 routine patients with liver transplantations, 25 routine patients after renal transplants.Simultaneously, we also have detected the △ CT value situation of the NR_073415.2 in 74 postoperative normal subjects's peripheral blood lymphocytes of organ transplantation in contrast, comprising 34 patients with liver transplantations, patient after 39 patients after renal transplants and 1 pancreas-kidney simultaneous transplantation.The results are shown in Figure 1 and table 2.
Table 2
In this clinical detection, the gold standard of employing is for utilizing CMV-DNA copy number in Q-PCR technology for detection peripheral blood.Known by table 2, the True Positive Rate of this detection method is 67.86%, and true negative rate is 87.84%, and false positive rate is 12.16%, and false negative rate is 32.14%.
SEQUENCELISTING
<110> No.1 Hospital Affiliated to Zhongshan Univ.
The application of <120>NR_073415.2 in sense organ transplant patient cytomegalovirus infection and test kit
<130>
<160>5
<170>PatentInversion3.3
<210>1
<211>3135
<212>DNA
The gene order of <213>NR_073415.2
<400>1
atgtaagtctgtattgcaattcaatttaatttttctttatgatagaggtaagggtcaagg60
gtaatatttttcacatggatataaattttttagcatcactttttgaaaaacctatcaatt120
ctttgaattgccatgatctatatatgttgagacctatttatatattcttaggtctttcat180
ttcattgatctgtctatatttttatgccactgtttggttactgtagctttatggtacatg240
tgctaagcaaggtccatttacgaggcagaatccatacagtaaattgaagaatgaaatttt300
agtataaagaattagctcttgagtcacccctgtgcagccttggtgccgtgtgcattttgg360
acactcagcccaccttgctctctagtacttgtaagccttttcctttcaagatgcctgcag420
aggtgtaccatggagaaggggaggtggcgacttttgccttttaggcagaaattgcccaac480
tcatgtctctcataatcaataccttctattccaacaaggagattttccttcaggagttga540
tctctaatgcttctgatgccttagacaagattcgctatgagagcctgacagacccttcca600
agttggacggtggtaaagaactgaaaattgacatcatccccaaccctcgggaatgcatcc660
tgactttggtcaacacaggcattggcatgaccaaggctgatctcataaataatttgggag720
ccattgccaagtctggtactgaagcatttatggaggcttttcagtcttgtgcagaaatct780
ccatgattgggcaatttggtgttggcttttattctgcctacctggtggcagagaaagtag840
ccatcacaaagcacaatgacgaagaacagtattcctgggtatcttctgctgggagttcct900
tcactttacatgttgaccatggtgagcccattgacagggataccaaagtgatccttcacc960
ttaaagaagatcagacagagtacttagaagagaggtgggtcaaagaagtagtgaagaagc1020
accctcagttcataggctgtcttatcgccgtttatttggagaaggaaccagagaaggaaa1080
tcagtgatgatgaggaagagaaaggtgagaaagaagaggaagataaagatgataaagaaa1140
agcccaagactgaagatgtgggttccgatgaggaggatgacactgataagaataataaga1200
agaaaacaaagaagatcaaggagaaatacactgatcgggaagaactaaaccagaccaagc1260
cgatttggaccagaaaccctgatgacatcacccaggaagagtgtggagaattctacaaga1320
gcctcaccagtgcctgggaagaccacttggcagtcaagcaattccctgtagaaggtcatt1380
tggaattcagggcattgctgttcatccctcatcaggctccctttgaccttttttagaaca1440
agaggaaaatgaacaactctgtgtccatcatgtgtggatcatggacagctttgatgattt1500
gatgccagagtatgtcggctttgtccgtggtatggttgactcttaaggatctttccccaa1560
acatctcccgggaaatgctccagcagagcaaaatcttggaagtcatttgcaaaaacattg1620
ttaagaaatgccggctgggcatggtggctcacgcctgtaatcctagcactttgggaggct1680
gaggcgggcagatcacctgaggtcaggagttcaagaccagcctggtcaacatggtgaaag1740
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gggaggctgaggcaggagaattgcttgaacctgggaggcggaagttgcagtgagccaaga1860
tcatgccactgcactaagcctgggcgacagaagaaggctctgtctcaaaaaaaaaaaaaa1920
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gagaataacaagaaattagatgaggtattctctaaaatctcgtggcttggaatccatgag2040
gactctattaactggcgacacctgtctgaactgctgtggtctcacaccttccagtctgga2100
gatgagatgacatctctgtcagagtatgtgtcttgcatgaaggaggcacagaagtccatc2160
tgtgacatcattggtgagtgcaaagagcaggtagccaactctgcttttgtggagcaagag2220
tggaagaagggcttcgaggtaatatatatgagtgagcccattgatgagtactgtgtgcag2280
cagctcaaggaatttgatgggaagagcctgctgtcagttaccaaggagggtctggagcta2340
cctgaggatgaggaggagaagaagataatggaggagagcaacgtaaagtttgagaacctc2400
tgcaggctcatgaaagaaatcttagataagaaggttgagcgggtgacaatctccagtagg2460
cttgtgtcttcaccctgccgcattgtgaccagcacctacagctagatagccaatatgaag2520
tggatcatgaaagcgcaggcattttgggacaactctatgatgggttatatgatggctaaa2580
aagcacctggagatcaaccccaaccaccccattgtggagacactacagcagaaggctgag2640
gcagacaagaacaacgaggctgtcagtgacccggtggtgctgctgtttgaaaccacactg2700
ctctcttctggcttctcccttgaggatcctcagacctatccagctgcatctaccacatga2760
tcaagctaggttagctattgatgaagatgaagtggcaacagaggaactcagtgctgctgt2820
tcctgatgtgatgtgttcctgaggatgtgtttcacatggaagaagtagattaagagttta2880
tacctgcaaaccttgtgcccttgcatagtgtccccatggctcccactgcagctttgagtg2940
gtcctgtcccacctggctctctctgctgatatctagtattttttctcttctgtccttgtg3000
tctaaggcaggaaacaagggcatcaagccccattccctctctactttgacagcagaattg3060
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<210>2
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<213>GAPDHPrimer-F
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cggagtcaacggatttggtcgtat24
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<212>DNA
<213>GAPDHPrimer-R
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agccttctccatggtggtgaagac24
<210>4
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<212>DNA
<213>NR_073415.2-F
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<210>5
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<213>NR_073415.2-R
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Claims (5)
1.NR_073415.2 the application in preparation sense organ transplant patient cytomegalovirus infection test kit.
2.NR_073415.2 as the application in sense organ transplant patient cytomegalovirus infection mark.
3. the test kit of sense organ transplant patient cytomegalovirus infection, it is characterized in that, the Cq value of GAPDH and NR_073415.2 in patient peripheral's blood monocyte to be measured is detected respectively by this test kit, the Cq value of GAPDH and NR_073415.2 at least measures 3 times, after averaging according to the following formula with method judged result:
The Cq value of △ CT value=AVERAGE(NR_073415.2) the Cq value of-AVERAGE(GAPDH)
Result judges: when △ CT value is more than or equal to 11, patient exists cytomegalovirus infection, and result is positive; When △ CT value is less than 11, there is not cytomegalovirus infection in patient, and result is negative.
4. test kit according to claim 3, is characterized in that, is detected the Cq value of GAPDH by Q-PCR, and primer sequence when Q-PCR detects is as shown in SEQIDNO:2 ~ 3.
5. test kit according to claim 3, is characterized in that, is detected the Cq value of NR_073415.2 by Q-PCR, and primer sequence when Q-PCR detects is as shown in SEQIDNO:4 ~ 5.
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| CN109797152A (en) * | 2019-02-22 | 2019-05-24 | 华中科技大学同济医学院附属同济医院 | Human cytomegalovirus infection's correlation host miRNAs express spectra occurs for Post kidney transplantation early stage |
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