Method and culture solution for detecting drug resistance of in vitro living cells
Technical Field
The invention relates to the field of rapid detection of cell drug resistance, in particular to a rapid, sensitive and accurate detection method for drug resistance of living cells.
Background
Currently, the detection method commonly used in laboratories mainly comprises three major parts, namely bacteriology, immunology and molecular biology. The modern clinical microorganism drug sensitivity experiment in China at present has a plurality of problems, for example, the detection time is long, the result is not accurate enough, the diagnosis result is influenced, some identification equipment is expensive, and some small and medium-sized hospitals are incapable of using the method.
At present, the bacteria drug sensitivity detection method mainly comprises a paper diffusion method (K-B method) for qualitative determination, a dilution method for quantitative determination, an E method and a full-automatic drug sensitivity instrument method, and generally 1 day is needed for obtaining a result.
At present, various methods can be used for detecting tubercle bacillus in laboratories and clinics, and the most common methods mainly comprise sputum smear microscopy, Roche solid culture, BACTEC MGIT960 system culture, real-time fluorescence quantitative Polymerase Chain Reaction (PCR) and the like.
The existing drug sensitive detection method for mycobacterium tuberculosis has the following problems: sputum smear has high requirement on film production, and the microscopic examination needs to be completed by manpower, which greatly increases the workload of clinical laboratory staff and is easy to omit; due to the characteristics of growth of the mycobacterium tuberculosis, the solid culture method takes long time; the rapid culture instrument for mycobacteria and the real-time fluorescence quantitative Polymerase Chain Reaction (PCR) can shorten the culture time, and are convenient to operate, but are not live bacteria, have low accuracy and high price, and are not beneficial to popularization.
The problems in the prior art are partly caused by the limitation of the detection means, but the characteristics of the marker which needs to be cultured to obtain the required concentration in the process of detecting the drug resistance of the cells cause the defects of long time, low accuracy and the like of the detection means.
Therefore, a better detection means needs to be established by combining the characteristics of cell drug sensitivity detection on the basis of the prior art.
Disclosure of Invention
Aiming at the defect of long drug sensitivity detection time of cells in the prior art, the invention provides a rapid, sensitive and accurate detection method for drug resistance of living cells. In addition, in practical application, the rapid detection method also has the advantages of high detection accuracy, capability of carrying out quantitative detection and the like.
In order to achieve the purpose, the invention can adopt the following technical scheme:
a rapid, sensitive and accurate detection method for drug resistance of living cells comprises the following specific steps: incubating the living cells to be detected before detecting the living cells to be detected, and detecting the concentration of the marker after incubation to realize the detection; adding a detection compound capable of being utilized by the living cells to be detected and a test compound for drug resistance detection before incubation; the incubation refers to adding the living cells to be detected into a culture solution with a determined concentration for culture. Viable cells that can be used include fungi, bacteria, and parts of human cells, but cells that have died cannot be detected under the procedures described in the method because the number of dead cells is zero and no detection compound is available; in addition, although the detection instrument used in the embodiments of the present application includes an instrument that can detect the absorbance of a solution or the like and can detect the color of a solution, these instruments may be existing instruments or instruments having a detection function as claimed in the present application. The incubation refers to the culture of the living cells to be detected through a culture solution, and the number of the living cells to be detected is increased as a general culture result, but the technical scheme described in the application does not require that the living cells living at the moment of adding the detection compound before the incubation are continuously alive after the incubation is finished, and does not require that the number of the living cells after the incubation is absolutely increased. Generally, the technical scheme of the application only requires that the detection compound can be utilized by living cells, and the aim of rapid detection can be achieved by detecting products after the cells are utilized. The culture solution used in the incubation may be any mixed solution that allows the growth of the living cells to be detected, for example, MH broth for bacteria, RPMI for fungi, and 7H9 medium for tubercle bacillus. The test compound used in the examples of the present application is EZMTT, and other water-soluble tetrazolium disulfonate WST series WST8, WST1, and the like can be selected, so that although EZMTT is non-toxic or substantially non-toxic to cells, those compounds that are toxic to cells can still be used as test compounds, but obviously, due to the toxicity to cell production, growth is inhibited but not to the extent that it is unable to grow, the methods described herein can still be used, and provide certain IC50 values despite deviations in the results obtained. The test compound used in the present application is a compound that requires drug sensitivity (drug resistance) test on a specific cell, in the examples of the present application, ampicillin, streptomycin, isoniazid, rifampicin, ethambutin and the like are used as test compounds, and the living cells used are escherichia coli, mycobacterium tuberculosis, gram-negative bacteria pseudomonas aeruginosa, candida albicans, mammalian cells, gram-positive bacteria, fungal cells, tumor cells, blood cells, and particularly, various drug-resistant and drug-intolerant cells. The living cells, the test compound, can be determined by one skilled in the art according to the needs of the cell, the compound to be subjected to the drug sensitivity test.
Further, the detection method described in the present application is mainly used in the case where the marker is a product produced by cell utilization, in other words, the detection compound is utilized by living cells, and then the detectable marker is continuously produced and the production rate of the marker is correlated with the cell growth rate or the inhibition rate of the detection compound on the cells; therefore, if a detection reagent can directly react with a compound existing in a cell or on a cell membrane without affecting the growth of a living cell or with little effect, it is not necessary to use the procedure described in the present application.
Further as an optional solution, in the embodiment of the present application, an incubation concentration adjustment step is further included: the concentration of the culture medium used for incubation is adjusted before incubation so that the living cells to be detected reach approximately the optimal growth rate, where the growth rate is defined as the time period during which the incubation is carried out. The optimized growth rate refers to the concentration of the culture solution, under the condition that other incubation conditions are given, the living cells to be detected have the maximum or the culture solution concentration close to the maximum growth rate in a certain incubation time.
Further as an alternative, in the embodiment of the present application, a pre-culture step is further included: before incubating the living cells to be detected, culturing the living cells to be detected and determining the concentration of a culture solution capable of obtaining the optimal growth rate of the living cells to be detected, wherein the culture solution used in the step is the same as the culture solution used in the step. This step is generally used to determine the concentration of the culture medium that will allow the living cells to be detected to achieve approximately the optimal growth rate. No test compound is added in this step. In addition, this step has the effect that the concentration of bacteria in the experiment (relative to the culture medium concentration) can be selected according to the specificity of the cells.
Further as an optional solution, in the embodiment of the present application, the method further includes the step of accelerating the culture: after the concentration of the culture solution capable of obtaining the optimal growth rate of the living cells to be detected is obtained, the concentration of the culture solution is increased in the incubation process. Compared with the pre-culture step, the method has the advantages that the cell growth rate in a short time is improved by increasing the concentration of the culture solution, the required detection time is shortened, and the detection speed is increased.
As a further alternative, in the embodiments of the present application, the utilization refers to the fact that the detection compound can enter the living cell to be detected, and generally, the reaction with the components located on the cell membrane is also included. In addition, whether the product after utilization can stay in living cells or be released by the cells in vitro or released into the culture solution during incubation due to cell death does not affect the use of the method described herein. As a further alternative, in the embodiments of the present application, the utilization means that the detection compound is capable of reacting with at least a part of the components of the cells to be detected.
Further alternatively, in the examples of the present application, the marker is a product having a color, where the color refers to a color having a certain wavelength range on a spectrum, and thus white is not the color described in the present application.
As a further alternative, in the embodiments of the present application, the detection compound is a compound that can be oxidized or reduced to a product that can develop color in the living cells to be detected, and the detection compound is different according to the detection compound used. In the case of EZMTT, the product is orange-yellow formazan.
As a further alternative, in the examples of the present application, the detection compound is a compound capable of reacting with nad (p) H in the living cells to be detected and being reduced to a product capable of developing a color in the presence of an electron coupling agent.
Further as an optional scheme, in an embodiment of the present application, the method further includes a step of detecting an inhibition rate: adding an equal amount of living cells to be detected into a culture solution with the same concentration while incubating the living cells to be detected to prepare a control group, adding a control compound with the same amount and the same concentration as the compound to be detected before incubating the control group, detecting the concentration of a marker after incubating the control group, comparing the concentration of the marker, and obtaining the inhibition rate of the detection compound on the living cells to be detected by using detection compounds with different toxicity.
In addition, the invention also discloses a culture solution for incubating the living cells, which comprises a culture medium and a detection compound; the detection compound has the following general structural formula:
wherein,
a1 is as defined aboveA linked aromatic or heterocyclic group;
a2 is as defined aboveA linked aromatic or heterocyclic group;
a3 is as defined aboveA linked phenyl group;
r1 is H or at least one R1 substituent attached to said a1, said R1 substituents each independently selected from-NO 2, -SO3H, -SO2NH2, halogen elements, and heterocyclic groups fused to said a1, alkyl; especially the R1 substituent located para to a 1;
r2 is H or at least one R2 substituent attached to said a2, said R2 substituents each being independently selected from NO2, methoxy, alkyl, phenyl and its derivatives linked through azido, halogen atoms, sulfonic acid groups and their salts, and phenyl or heterocyclic groups fused to said a 1; especially the R2 substituent located ortho or para to a 2.
R3 is the R3 substituent attached to the A3; the R3 substituent is respectively and independently selected from sulfonic acid group, carboxylic acid group, substituted sulfonic acid group and substituted carboxylic acid group; in particular toFrom Especially the R3 substituent located ortho to a 3.
The heterocyclic group includes 1-2 heteroatoms each independently selected from Se, N, S or O.
The above aromatic or heterocyclic groups are each independently selected from
In addition, additional sensitizers, such as PMS (commonly known as phenazine methosulfate) derivatives, especially methyl or ethyl derivatives thereof, may also be added to the above-mentioned culture broth.
The culture solution can be prepared by selecting the following culture media in proportion: LB, MH broth was used for gram-negative, positive bacteria; (0.5-2 times) suton (Sauton) medium, Middle brook7H9, Middle brook7H 10, Middle brook7H11, Middle brook7H 12, kunkel medium, Proskauer medium, sodium pyruvate cytochrome C medium, BACTEC MGIT960 medium for tubercle bacillus; RPMI medium is used for fungi; basel medium Eagle, RPMI, DMEM/F12, RPMI-HEPES, MEM, IMDM, HamF10, M199, L15, McCoy5A and the like, and the above medium is usually diluted 0.5 to 2 times. For the sake of clarity, a considerable part of the above names are trade names for commercially available media.
In addition, a growth accelerator, a bacteriostatic agent and a bacteriostatic synergist can be added into the culture solution; various types of blood, hormone, oyster mushroom liquid, bean extract, OADC and the like can be selected, and trace malachite green, penicillin, nalidixic acid, polymyxin B, carbenicillin C, amphotericin B, trimethoprim or mgit Pant antibiotics for inhibiting infectious microbes are used for adding the mycobacterium tuberculosis culture medium; serum-free medium such as 1-20% BSA or B-27 is added to the culture medium of mammalian cells;
the selected detection compound EZMTT is a novel synthetic tetrazolium monosulfonate, the detection principle is based on that in living cells, NAD (P) H can enable EZMTT to be reduced into a soluble orange-yellow formazan product in the presence of an electron coupling agent, the light absorption value of the formazan product can be measured at 450nm by using an enzyme labeling instrument, and dead cells do not have the effect. The bacteria survival condition is indirectly reflected by detecting the absorbance through a microplate reader, and the color variation of EZMTT is in direct proportion to the bacteria amount in a certain range and is non-toxic. It is therefore possible to establish a rapid drug sensitisation method.
The invention has the following remarkable technical effects:
the invention can select the concentration of bacteria in a drug sensitivity experiment according to the specificity of the bacteria. The invention has no lethal influence on bacteria, can continuously detect and has reliable data. The invention can realize short drug sensitivity detection time (3-4 hours is needed for detecting EZMTT by clinical fast-growing bacteria, 1 day is needed for the tradition, 4-6 days is needed for tubercle bacillus EZMTT, 4-10 days is needed for the tradition and 1 month is solid), can detect partial inhibition (the EZMTT obtains percent inhibition rate, but the tradition visual detection method can only qualitatively 'have/not have' and can quickly obtain accurate results. The invention can detect a plurality of bacteria and a plurality of antibiotics in a large scale with high flux and can detect the bacteria and the antibiotics quickly. The invention can provide the optimal matching of the medicines for clinic and realize accurate treatment. Compared with other detection reagents, the detection reagent provided by the invention is low in price, easy to popularize and capable of reducing economic burden.
Drawings
Fig. 1 is a graph of the signal for 24 hours following e.coli growth using different tetrazolium salts; the water-soluble tetrazolium salts all have signals; similar results were obtained in LB medium.
FIG. 2 is a graph of signals following the growth of Mycobacterium tuberculosis using different tetrazolium salts for seven days; among them, the signal obtained by the EZMTT test is most preferable.
FIG. 3 is a graph of signals following the growth of Mycobacterium tuberculosis using different media for seven days. The best signal was obtained after growth of M.tuberculosis using medium Middlebrook7H 9.
FIG. 4 is a graph of signals following the growth of Mycobacterium tuberculosis using different additives for seven days. The use of the growth accelerator OADC signal is preferred.
FIG. 5 shows the results of tracking H22 tumor cells for 5 days using different media.
FIGS. 6-1, 6-2 detection of ampicillin resistance in various cell amounts (from 20-fold to 640-fold unit cell amount) of resistant E.coli (FIG. 6-1) and sensitive E.coli (FIG. 6-2) for testing using EZMTT under optimal conditions; the 4h detection result shows that the IC50 and MIC values are slightly increased (about 2 times) under the condition of higher bacterial concentration, but the drug sensitive detection result is not influenced.
FIG. 7. alignment for testing ampicillin resistance in clinically isolated and characterized E.coli using EZMTT as a test indicator, samples of known resistance (from left to right, in top to bottom series): (drug resistance) testing using EZMTT as the test compound also showed drug resistance; (drug resistance) testing using EZMTT as the test compound also showed drug resistance; (sensitive) detection using EZMTT as the test compound also showed a sensitive IC50 ═ 13 ug/ml; (sensitive) detection using EZMTT as test compound also showed some sensitivity IC50 ═ 14ug/ml, but was not completely inhibitory. Belonging to a partially suppressed state.
FIGS. 8-1 and 8-2 are graphs showing the comparison of the results of drug sensitivity of E.coli (FIG. 8-1) in FIG. 7 using EZMTT as an indicator for detection and the same samples (FIG. 8-2) using conventional nephelometry (24 hours), where the left side is more clear in color, the sensitivity is high, the right side is not sensitive enough, and partial inhibition of cell growth is not detected. The cell growth curve shows that the sensitivity of the EZMTT method is 10 times higher than that of the nephelometric method.
FIGS. 9-1, 9-2, and 9-3 are comparisons of the use of EZMTT as a detection indicator and other soluble tetrazolium salts (WST8/CCK8) where both agents were detectable for resistant bacteria but were toxic to sensitive bacteria, WST8, and were not detectable for bacterial resistance.
FIG. 10 is a graph comparing the detection of clinically resistant bacteria using EZMTT as a detection indicator and the detection of conventional liquid fluorescence after tracking for 4-7 days (R-resistant, S-sensitive, PR-partially resistant) per day. Different cell mass and addition of nutrients OADC can increase the signal while EZMTT can be quantitatively analyzed and the time effect of cell growth measured.
FIG. 11 shows the results of a 4-hour drug susceptibility test using Staphylococcus aureus, a gram-positive bacterium (diluted 40-fold in fresh 0.5 MCF), where A is IC50 ═ 129ng/ml after ampicillin treatment; b is IC50 ═ 872ng/ml after kanamycin drug treatment; c is IC50 ═ 87ng/ml after treatment with cefazolin drug.
FIG. 12 shows the gram-negative bacterium Pseudomonas aeruginosa (diluted 40 times with fresh bacterial liquid of 0.5 MCF) for 4-hour gentamicin susceptibility test (IC)500.17ug/ml) results.
FIG. 13 shows the result of ampicillin resistance detection in 4-hour drug sensitivity test using Candida albicans (diluted 40-fold with fresh bacterial solution of 0.5 MCF).
FIGS. 14-1, 14-2, and 14-3 are graphs showing the detection of drug resistance and partial drug resistance in tumor cells using EZMTT medium. The 5-day drug sensitivity test shows that complete inhibition (FIG. 14-2) and partial inhibition (FIG. 14-3) can be distinguished by the novel EZMTT culture medium and detection method (no drug, dose effect of cell growth) of the patent; this explains the tumor resistance reported by drugs with partial inhibition, and provides guidance for early prediction of tumor resistance.
FIGS. 15-1, 15-2, 15-3 are graphs showing growth inhibition of lentivirus after partial infection of tumor cells HEK293t with the novel EZMTT medium, wherein the effect of viral infection on HEK293t cell growth, and the middle graphs are growth curves. The upper line was 2000 HEK293t cells grown. The next line is the growth of 2000 HEK293t cells after transfection with the virus. Transfected cells are shown on the left and virus-containing transfected cells are shown on the right.
Detailed Description
The present invention will be described in further detail with reference to examples.
Example 1
Susceptibility testing was performed using e.coli: ampicillin liquid medicine (0-12.8 mg/ml; concentration gradient of two-fold dilution) is prepared for standby. And taking 2 mul of ampicillin standby liquid medicine into a 96-well plate by using a discharge gun for standby. Coli strains were adjusted to a concentration of 0.5MCF using MH broth, diluted 20-640 times (preferably 40 times) with MH broth containing EZMTT (EZMTT can be replaced with various tetrazolium salts and PMS derivatives including methyl PMS) detection reagents, and 200 μ l was taken in a 96-well plate. Setting a control hole, wherein 2ul of ampicillin in the control hole is to be used for replacing the liquid medicine with sterilized water, and the rest is consistent with the operation of the administration hole. And (3) putting the 96-well plate into an incubator at 37 ℃ for culture, and detecting OD450 and OD600 values after 4 hours.
Example 2
Drug susceptibility experiments were performed using mycobacterium tuberculosis: preparing streptomycin, isoniazid, rifampicin and ethambutol medicinal liquid for later use. According to the conventional medicine concentration detection, taking the liquid medicine to be used into the screw tube. Freshly cultured Mycobacterium tuberculosis are adjusted to a concentration of 0.5MCF using 7H9 medium, diluted 4-40 fold (preferably 20 fold) with 7H9 medium containing EZMTT (which may also be replaced with other tetrazolium salts and PMS derivatives, including methyl PMS, as described in the examples below) detection reagents, and 4ml are added to the drug-containing tube. And (4) setting a control hole, replacing the liquid medicine to be used by sterilized water in the control hole, and taking a positive control (signal) when bacteria are added and taking a negative control (background) when bacteria are not added. The tube was incubated at 37 ℃ for 5 days, and then the OD450 and OD600 values were measured every day. When the signal/background is greater than 2 times, the inhibition rate is calculated to judge drug resistance. After an additional day, when the signal/background was > 4-fold, the detection was terminated.
Example 3
Drug susceptibility experiments were performed using the gram-negative bacterium pseudomonas aeruginosa (40-fold dilution of fresh bacterial fluid at 0.5 MCF): ampicillin liquid medicine (0-12.8 mg/ml; concentration gradient of two-fold dilution) is prepared for standby. And taking 2 mul of ampicillin standby liquid medicine into a 96-well plate by using a discharge gun for standby. Coli strains were adjusted to a concentration of 0.5MCF using MH broth culture, diluted 20-640 times (preferably 40-fold) with MH broth containing EZMTT detection reagents, and 200 μ l was dispensed into a 96-well plate. Setting a control hole, wherein 2ul of ampicillin in the control hole is to be used for replacing the liquid medicine with sterilized water, and the rest is consistent with the operation of the administration hole. And (3) putting the 96-well plate into an incubator at 37 ℃ for culture, and detecting OD450 and OD600 values after 4 hours.
Example 4
Drug susceptibility experiments were performed using the gram-negative bacterium pseudomonas aeruginosa (40-fold dilution of fresh bacterial fluid at 0.5 MCF): ampicillin liquid medicine (0-12.8 mg/ml; concentration gradient of two-fold dilution) is prepared for standby. And taking 2 mul of ampicillin standby liquid medicine into a 96-well plate by using a discharge gun for standby. Coli strains were adjusted to a concentration of 0.5MCF using MH broth culture, diluted 20-640 times (preferably 40-fold) with MH broth containing EZMTT detection reagents, and 200 μ l was dispensed into a 96-well plate. Setting a control hole, wherein 2ul of ampicillin in the control hole is to be used for replacing the liquid medicine with sterilized water, and the rest is consistent with the operation of the administration hole. And (3) putting the 96-well plate into an incubator at 37 ℃ for culture, and detecting OD450 and OD600 values after 4 hours.
Example 5
Drug susceptibility experiments were performed using the fungus candida albicans (40-fold dilution of fresh bacterial fluid at 0.5 MCF): ampicillin liquid medicine (0-12.8 mg/ml; concentration gradient of two-fold dilution) is prepared for standby. And taking 2 mul of ampicillin standby liquid medicine into a 96-well plate by using a discharge gun for standby. Coli strains were adjusted to a concentration of 0.5MCF using MH broth culture, diluted 20-640 times (preferably 40-fold) with MH broth containing EZMTT detection reagents, and 200 μ l was dispensed into a 96-well plate. Setting a control hole, wherein 2ul of ampicillin in the control hole is to be used for replacing the liquid medicine with sterilized water, and the rest is consistent with the operation of the administration hole. And (3) putting the 96-well plate into an incubator at 37 ℃ for culture, and detecting OD450 and OD600 values after 4 hours.
Example 6
Drug susceptibility experiments were performed using tumor cells HCT116 (1000-: preparing the antitumor drug liquid (concentration gradient of two-fold dilution or combined medication) for standby. Take 2 μ l of the liquid medicine into a 96-well plate by a discharge gun for later use. Freshly cultured HCT116 was diluted (1000 wells) with RPMI or the like medium containing serum of EZMTT detection reagent, and 200. mu.l thereof was taken into a 96-well plate. Setting up control holes, replacing 2ul of the liquid medicine to be used in the control holes with sterilized water, and operating the rest holes in accordance with the administration holes. The 96-well plate was cultured in a 37 ℃ incubator for 4 hours, 1 day, 2 days, 3 days, 4 days, and 5 days, and then the OD450 and OD600 values were measured.
Example 7
Viral infection experiments were performed using tumor cells HEK293T (1000-8000): freshly cultured HEK293T was diluted (1000 wells) with RPMI or the like medium containing serum of EZMTT detection reagents and 200. mu.l was taken into a 96-well plate. Adding a large amount of lentivirus, setting up a control hole, replacing the lentivirus in the control hole with sterilized water, and performing the same operation except for the control hole. The 96-well plate was cultured in a 37 ℃ incubator for 4 hours, 1 day, 2 days, 3 days, 4 days, and 5 days, and then the OD450 and OD600 values were measured.
Example 8
In addition to the above examples 1 to 6, the following compounds can be used as the test compounds in place of the EZMTT component in example 1, and the test compounds used in this example can be used in concentrations equivalent to those of EZMTT in example 1, and an approximate concentration range of 0.1 to 50mM is proposed, and the test compounds used in this example are all low-toxic, high-potency compounds, which are low-toxic to the living cells to be tested, and some of the compounds are non-toxic or substantially non-toxic to the living cells.
Further description with respect to the figures
FIGS. 1-15 are graphs showing the results of different experiments, which are based on the experimental procedure described in example 1, and are an alignment of data obtained by performing experiments after substituting the compounds and experimental conditions described in the figure description with the corresponding contents described in example 1. Therefore, the duplicated data in the drawings correspond to a plurality of experiments in which the contents described in example 1 are partially replaced. As shown in fig. 10, the results of detection of drug resistance of clinical drug-resistant bacteria using EZMTT as a detection indicator and the contents described in example 1; for further comparison with the above results, the conventional liquid fluorescence method is used as a reference, and the following table 1 shows the results of detecting clinical drug-resistant bacteria by the conventional liquid fluorescence method:
TABLE 1
In addition to the test compound described in example 1, any combination of groups A1-3 and R1-3 described in the claims of the present application; some of the more important combinations of groups are listed individually here:
using the procedure described in example 1 for the test compound CPD1-51, a drug sensitivity test was performed using e.coli, in which ampicillin was used as the test compound; the rest of the procedure is the same as in example 1; after experiments are carried out one by one, the result is similar to the turbidity 600nm detection result in FIG. 8, but the detection time is greatly shortened, and the sensitivity is higher.
In summary, the above-mentioned embodiments are only preferred embodiments of the present invention, and all equivalent changes and modifications made in the claims of the present invention should be covered by the claims of the present invention.