CN111989409A - 用于确定对金属植入物的可能的不相容性的生物标记物 - Google Patents
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Abstract
本公开涉及一种用于预测对金属植入物的不相容倾向提高的风险提高的方法。当前公开的目的在于,改善使用金属植入物时可能的并发症的预测。为了实现该目的,本公开提供了一种用于在受测者中预测对金属植入物的不相容倾向提高的风险提高的方法,其中在包括受测者的遗传物质的离析样品中:a)检查编码白细胞介素1β的基因中的单核苷酸变异rs1143627 AGCCTCCTACTTCTGCTTTTGAAAGC[C/T]ATAAAAACAGCGAGGGAGAACTGG(SEQ ID NO:1),并且确定单核苷酸变异的位置处是否存在C;和/或b)检查编码IL1受体拮抗剂IL1‑AN的基因中具有重复单元ATCCTGGGGAAAGTGAGGGAAATATGGACATCACATGGAACAACATC‑CAGGAGAC TCAGGCCTCTAGGAGTAACTGGGTAGTGTGC(SEQ ID NO:2)的VNTR多态性rs2234663,并且确定重复单元是否存在五次。
Description
技术领域
本公开涉及用于预测对金属植入物的不相容倾向提高的风险提高的一种方法和一种试剂盒。
背景技术
植入物例如在矫形外科和牙科领域中起着越来越重要的作用。这种植入物通常由金属(例如纯钛)或者说金属合金制成。然而,随之而来的是植入物不相容反应数量的升高[1-4]。举例而言,甚至例如镍等金属中的微量杂质或者外部材料都会导致炎症反应或者变态反应。巨噬细胞和单核细胞吸收的磨损颗粒或者腐蚀过程也会触发炎症反应。然而,在内假体中也确认了不能归因于诸如腐蚀产物或者磨损产物或者感染等已知原因的并发症。因此,确认了迄今为止令人费解的过度炎症反应,其例如可能伴随有肿胀、关节反复积液、疼痛、行动受限、植入物松动或者失灵。
根据JACOBI-GRESSER E.等(《基因和免疫标记物预测钛植入物失灵:回顾性研究》(Genetic and immunological markers predict titanium implant failure:aretrospective study);Int.J.OralMaxillofac.Surg.(2013)42(4)537-543),评估了诊断标记物,以便预言钛植入物的失灵。在109位接受了钛植入物外科手术的受检者中评估植入物结果,其在治疗过程中接受了IL1A-889C/T(rs1800587)、IL1B+3954C/T(rs1143634)、IL1RN+2018T/C(rs419598)和TNFA-308G/A(rs1800629)基因分型、体外-IL-1β/TNF-α释放试验和淋巴细胞转化试验。
根据RAMIREZ-PEREZ S.等(《白细胞介素-1受体拮抗剂(IL1RN)的86bp可变数目串联重复(VNTR)多态性与类风湿性关节炎的易感性和临床活性的联系》(Association of 86bp variable number of tandem repeat(VNTR)polymorphism of interleukin-lreceptor antagonist(IL1RN)with susceptibility and clinical activity inrheumatoid arthritis);Clin.Rheumatol.(2017)36(6)1247-1252),报告了多项研究在包括类风湿性关节炎(RA)风险的IL1RN基因的内含子2中具有可变数量的串联重复单元(VNTR)86bp(rs2234663)。在当前研究中,要在患有RA的患者和对照人员(CS)中确定该多态性的频率并且在西部墨西哥人群中确定其与RA的联系。进行了分析性横断面研究,其中包含了350位患有RA的患者和307位CS。借助于聚合酶链反应(PCR)进行了IL1RN VNTR多态性的鉴定,并且基因型与临床变量(DAS28和CRP)有联系。
根据JACOBI-GRESSER E.等(《根据实验室参数预测钛植入物的愈合率——回顾性研究》(Prognose der Einheilquote von Titanimplantaten anhand vonLaborparametern-eine retrospektive Studie);umweltmedizin-gesellschaft26(2/2013)98-103),作者在其研究中评估了用于预言钛植入物失灵的诊断标记物。回顾性地在109位接受过钛植入物手术的受检者中评估植入物结果,其在治疗过程中接受了IL1A-889C/T(rs1800587)、IL1B+3954C/T(rs1143634)、IL1RNN+2018T/C(rs419598)和TNFA-308G/A(rs1800629)基因分型、体外IL-1β/TNF-a释放试验和淋巴细胞转化试验。基于钛刺激的TNF-a和体外IL-1β释放明显高于忍受植入物损失的患者(TNF-a:256.89pg/ml比81.4pg/ml;p<0.0001;IL-1β:159.96pg/ml比54.01pg/ml;p<0.0001)。
根据LIU Y.H.等(《中国台湾患者中白细胞介素-1β(IL1B)多态性与甲状腺眼病的联系》(Association of interleukin-1beta(IL1B)polymorphisms with Graves'ophthalmopathy in Taiwan Chinese patients);Invest.Ophthalmol.Vis.Sci.(2010)51(12)6238-46),研究了是否可以将IL1B基因中的变异与患有格雷夫斯氏病(GD)的患者的甲状腺眼病(GO)相关联。在所研究的IL1B SNP中,rs1143634的C等位基因与GD有联系,而SNPrs1143634和rs16944的T/T基因型与疾病的联系较小。具有最强相互作用的SNP rs3917368和rs1143643的A/A基因型会提高GO的风险(P=0.024或者说P=0.017)。鉴定出了多种GD敏感和不敏感单倍体型IL1B,并且由八个SNP构成并且与低循环IL1β值有关的Ht4-GCGCCTCC单倍体型可以防止GO的发展(P=0.025)。IL1B多态性的数据以及GD和GO与血浆IL1β的联系表明了,IL1B多态性可能与GD和GO的发展有联系。
发明内容
当前公开的目的在于,改善使用金属植入物时可能的并发症的预测。
为了实现该目的,本公开提供了一种用于在受测者中预测对金属植入物的不相容倾向提高的风险提高的方法,其中在包括受测者的遗传物质的离析样品中:
a)检查编码白细胞介素1β的基因中的单核苷酸变异rs1143627AGCCTCCTACTTCTGCTTTTGAAAGC[C/T]ATAAAAACAGCGAGGGAGAACTGG(SEQ ID NO:1),并且确定单核苷酸变异的位置处是否存在C;和/或
b)检查编码IL1受体拮抗剂IL1-RN的基因中具有重复单元ATCCTGGGGAAAGTGAGGGAAATATGGACATCACATGGAACAACATCCAGGAGACTCAGGCCTCTAGGAGTAACTGGGTAGTGTGC(SEQ IDNO:2)的VNTR多态性rs2234663,并且确定重复单元是否存在五次。
令人惊讶地证实,多态性rs1143627和rs2234663适合作为生物标记物,用以测定应接受或者已经接受金属植入物的人表现出与植入物的不相容性的可能提高的风险。在此,如果在单核苷酸变异rs1143627中,C而不是T在单核苷酸变异的位置处,和/或如果在VNTR多态性rs2234663中,重复单元(“repeat”)串联式依次存在五次,则可以认为风险提高。不相容性可以特别地表现在提高的发炎倾向,其导致植入物松动(伴随骨质溶解)、疼痛、积液、功能恶化(例如关节假体的活动性降低)。
为了不受特定理论的束缚,假定生物标记物显示出由遗传基因决定的炎症调节失衡。这导致对“异物”植入物的不相容性。人类免疫系统对同一炎症刺激(例如细菌、植入物材料)也会有不同程度的反应,其中免疫应答的进程由在防御机制中起重要作用的促炎性和抗炎性信使物质(例如细胞因子)彼此之间的比例决定。细胞因子IL-1属于最重要的促炎性信使物质。例如由遗传多态性决定的过高的信使物质释放可能会导致免疫系统的过度反应。IL-1的促炎性效果通常由拮抗剂IL-RN下调。然而,如果在此还有降低效果的多态性,则缺乏抵消发炎信使物质IL-1的抗炎作用,由此会出现过度的炎症反应。这可以至少部分地解释在没有可识别的原因的前提下,在植入物上出现强烈炎性反应的情况。
根据本公开的方法例如可以用于在植入前为需要植入物的人确定,是否在此必须在使用金属植入物时考虑到出现并发症,特别是过度的炎症反应的更高的可能性。在这种情况下,可以例如选择另一种植入物材料,诸如陶瓷。不仅例如在矫形外科或者内修复领域,而且在牙科植入物中,本公开都是有利的。
术语“对金属植入物的不相容倾向提高”被理解为相对于平均总人口而言提高的可能性,理解为对金属植入物的不相容反应,特别是炎症反应。
术语“植入物”或者“内假体”被理解为种植到体内的人造材料,该人造材料应永久地或者至少在较长时间段内保留在那里。植入物的例子是髋关节植入物、膝关节植入物、肩关节植入物或者牙科植入物。然而,该术语也包括种植到体内的骨合成材料,诸如板、钉或螺钉。
术语“金属植入物”在此被理解为钴铬钼基植入物、不锈钢基植入物或者钛植入物,特别地被理解为髋假体/膝假体或者牙科植入物。
在此,特别地关于关节内假体的使用,即用异基因(即外生)的、非生物学的材料代替一个或多个关节面,使用术语“关节成形术”(也被称为“人工关节成形术”)。
术语“多态性”描述种群基因中的序列变异。由于这种序列变异,种群的不同个体或者不同的个体细胞可以在相同的基因位点(Locus)处具有特定基因的不同变体,其也被称为“等位基因”。该术语包括例如单个核苷酸(SNV或者SNP)中的变异或者不同数量的序列重复的出现(例如小卫星序列,VNTR)。
术语“单核苷酸变异rs1143627”(必要时也被称为IL-1B-31)在此描述一种变异,其涉及编码白细胞介素1β(IL-1B、IL-1β)的基因的启动子区域中的位置31(关于起始密码子)处的单个核苷酸,其中在该位置处会产生C或者T(例如根据HGVS命名规则,NG_008851.1:g.4970C>T,参见[11])。在下文中再现了包括单核苷酸变异(SNV,singlenucleotide variation)的相关区域的序列:
AGCCTCCTACTTCTGCTTTTGAAAGC[C/T]ATAAAAACAGCGAGGGAGAACTGG(SEQ ID NO:1)
在方括号中给出所讨论的核苷酸变体(在此为C或者T)。代替表述“单核苷酸变异”或者SNV,必要时也同义地使用术语“单核苷酸多态性”或者SNP(single nucleotidepolymorphism)。
术语“VNTR多态性rs2234663”(必要时也被称为“内含子2VNTR rs2234663”或者“内含子2VNTR”)被理解为一种多态性,其中在编码IL1受体拮抗剂(IL1-AN或者IL1-RN)的基因中存在可变数量(2-6)的串联式依次存在的重复单元(VNTR,可变数目串联重复(variable number tandem repeat)),其序列为
ATCCTGGGGAAAGTGAGGGAAATATGGACATCACATGGAACAACATCCAGGAGACTCAGGCCTCTAGGAGTAACTGGGTAGTGTGC(SEQ ID NO:2)。例如在LRG序列(LRG=位点参考基因组序列(LocusReference Genomic sequence))LRG_188中再现包括四个重复单元的序列(参见http://ftp.ebi.ac.uk/pub/databases/lrgex/LRG_188.xml;也参见登记号为NG_021240.1的NCBI参考序列)。根据HGVS命名规则(参见[11]),包括五个重复单元的VNTR多态性被标记为g.17637_17722[5]。
术语“特应性疾病”被理解为基于由遗传基因决定的预备状态的疾病,该预备状态以速发型变态反应(I型变态反应),即以加快的IgE形成,对与天然或者人造环境物质的空气传输的接触、胃肠接触或者皮肤接触做出反应。特应性疾病通常涉及呼吸道黏膜和胃肠黏膜的边界面和皮肤。特应性疾病的例子是过敏性支气管哮喘、过敏性鼻炎(过敏性鼻结膜炎)和特应性皮炎(特应性湿疹、神经性皮炎)。
优选地,在根据本公开的方法中,检查编码IL1受体拮抗剂IL1-RN的基因中具有重复单元
ATCCTGGGGAAAGTGAGGGAAATATGGACATCACATGGAACAACATCCAGGAGACTCAGGCCTCTAGGAGTAACTGGGTAGTGTGC(SEQ ID NO:2)的VNTR多态性rs2234663,并且确定重复单元是否存在五次。
特别优选地,在根据本公开的方法中,额外地测定了受测者是否患有特应性疾病。特应性疾病的例子是支气管哮喘、过敏性鼻结膜炎和特应性皮炎。特别是在存在包括五个重复单元的VNTR多态性rs2234663和特应性疾病的组合中,可以推断出在植入金属植入物时相关人员出现并发症(特别是增强的炎症反应)的风险提高。
在另一方面中,本公开还涉及一种用于执行根据本公开的方法的试剂盒。根据本公开的试剂盒包括在表1中给出的引物序列:
表1
具体实施方式
在下文中,纯粹出于说明性目的,根据实施例详细地描述本公开。
进行了一项研究,195位具有完全内假体的患者在知情同意下参加了这项研究。该研究已获当地伦理委员会批准并以研究编号230-12,登记在ClinicalTrials.gov上。
102位患者(72位女性,30位男性,41-81岁)接受了关节成形术并且伴随有并发症。对照组由93位关节成形术正常起作用的患者(70位女性,23位男性,18-96岁)构成。
问卷调查
发起了一份问卷支持的既往病史,其中包含关于吸烟、药物服用、植入物类型、金属过敏史和特应性疾病史(诸如过敏性鼻炎、特应性湿疹或者哮喘)的信息。额外地,使用了矫形外科的WOMAC问卷(Western Ontario and McMaster Universities OsteoarthritisIndex,WOMAC),以便量化患者关于人工关节在疼痛、刚性和功能限制等方面的性能的自我评估[5]。
过敏原和斑贴试验
在斑贴试验中变态反应学地测试了所有患者。为此,使用了Almirall Hermal斑贴测试试剂和Finn-Chambers on Scanpor(Almirall Hermal,赖因贝克,德国)。在第0天,将物质施用在上背部上。测试了符合德国接触性皮炎研究组(DKG)的指南的包括29种过敏原的标准系列、常规补充系列和骨水泥系列(如果相应的患者具有渗碳的内假体)[6]。由过敏科医生在第2天、第3天和第6天进行测量。在此描述为阳性的反应就是被分类为+、++和+++的反应。
淋巴细胞转化试验(LTT)
根据Summer等人[7],进行了淋巴细胞转化试验(LTT)。简而言之,通过密度离心法离析外周血单核细胞(PBMC),并且在四个平行配方中用不同浓度的NiSO4、CoCl2或者CrCl3刺激四天。对照刺激物是2.4μg/ml的T细胞促有丝分裂植物血凝素(PHA,Biochrom,柏林,德国)、5μg/ml的作为对照召回抗原的破伤风类毒素(TT,Chiron Behring,柏林,德国)。在5天后,用3H胸腺嘧啶核苷使PBMC流动,并且在孵育过夜后,通过测量吸收的放射性来测定增殖。结果作为刺激指数(SI)给出,这相当于被刺激的对照培养物与未刺激的对照培养物分别吸收的放射性的比例。SI≥3被视为阳性反应。
多态性分析
根据制造商的协议,用“peqGOLD Blood DNA Mini Kit”(Peqlab,埃尔兰根,德国),从患者的外周血中离析DNA。用蒸馏水将获得的DNA稀释至40ng/μl的最终浓度。通过PCR,用限制酶Taql、Alu1或者Ava1进行消化,随后进行凝胶电泳法,分析三种多态性IL-1B-3954(rs1143634)、IL-1B-31(rs1143627)、IL1-B-511(rs16944)以及小卫星序列IL-1RN内含子2VNTR(rs2234663)。在表1中给出多态性的DNA序列。
表2:所检查的多态性和对应的DNA序列
在表2中给出包括其相应限制酶的多态性和所得的片段。
表2:所分析的多态性,包括相应限制酶和所得的DNA片段长度
根据多个作者[8-10],与路德维希-马克西米利安-慕尼黑大学的统计学院合作,根据包括用等位基因模型进行的精确费舍尔试验和风险分析(优势比)的交叉表,进行了统计学评价。
结果
患有关节成形术并发症的患者表现出各种症状,例如疼痛(84.1%),其次是行动自由度降低(78.4%)、肿胀(71.6%)等。WOMAC值也反映了这一点,其中100分表示完美功能性。在此,关节成形术对照患者以82.13±18.11的高平均值确认了内假体的良好性能。另一方面,患有关节成形术并发症的患者表现出42.06±10.12的低平均WOMAC值。在患有关节成形术并发症的组中,特应性疾病的比率(24.5%比16.1%)更高,其中花粉症占最大比例(18.7%比11.8%)。在患有关节成形术并发症的组中,有金属过敏史的患者也更多(24.05%比9.7%)。阳性金属斑贴试验的结果如下:镍19.6%比9.7%,钴6.9%比3.2%,铬2.0%比1.1%。更多患者在LTT中呈阳性。在此,28.4%的患有关节成形术并发症的患者表现出对镍的LTT阳性,2.9%表现出对钴的LTT阳性,2.9%表现出对铬的LTT阳性。对照组的少量患者表现出LTT阳性,其中19.4%的对镍阳性,1.1%的对钴阳性,并且没有表现出对铬阳性。在表3中列举出了问卷调查、斑贴试验和LTT的结果。
表3:患者组中的问卷调查、斑贴试验和LTT的结果。MW=平均值,SD=标准偏差
吸烟:
特应性:
斑贴试验:
LTT:
IL-1B-多态性3954的两个不同等位基因C或者T的等位基因频率没有差异。有或者没有特应性、斑贴试验或者LTT阳性或者阴性的患者中的亚组分析也没有表现出任何重大差异。在对照组中,特别是在没有特应性、没有阳性斑贴试验或者阳性LTT反应的患者中,稍微有C等位基因频率更高的趋势。在表4中列举出了IL1B多态性3954的结果。
表4:IL-1B-3954多态性的等位基因频率,也包括子群分析。给出了费舍尔精确试验和费舍尔优势比(+95%置信区间,KI(Konfidenzintervall))的结果。
包括等位基因T的IL-1B-31多态性在对照组中具有更高的频率(84.3%比48%)。这可以反映“保护”基因型,其可以减少对植入物的免疫应答。T等位基因频率的这一差异也存在于亚组分析中。在表5中列举出了IL-1B-31等位基因频率的结果。
表5:IL-1B-31多态性的等位基因频率,包括亚组分析。给出了费舍尔精确试验和优势比(+95%置信区间,KI)的结果。
IL-1B-511多态性的等位基因频率没有任何重大差异。在对照组中,存在该多态性的C等位基因频率更高的趋势,然而,这在统计学上还不够显著。在表6中列举出了IL-1B-511多态性的结果。
表6:IL-1B-511多态性的等位基因频率,包括亚组分析。给出了费舍尔精确试验和优势比(+95%置信区间,KI)的结果。
在IL-1B-RN-内含子-2-VNTR中,存在高得多的关节成形不适的风险,其与等位基因3(498bp,5个重复单元)相关。有趣的是,如果患者额外患有特应性疾病,则该风险提高。该风险与斑贴试验反应或者LTT反应性无关。在表7中列举出了IL-1B-RN内含子2VNTR的结果。
表7:IL-1B-RN-VNTR多态性的等位基因频率,包括亚组分析。给出了费舍尔精确试验和优势比(+95%置信区间,KI)的结果。
参考文献列表
1.Sharkey PF et al;Why are total knee arthroplasties failing today;JArthroplasty 2017;29:1774-1778
2.Thomsen M et al;Adverse Reaktionen gegenüberMetallimplantaten nach Kniegelenkersatz;Hautarzt2016;67:347-351
3.Granchi D et al;Sensitivity to implant materials in patientsundergoing total hip replacement;J Biomed Mater Res B Appl Biomater 2006;77(2):257-64
4.Thomas P,Summer B;Diagnosis and management of patients with allergyto metal implants;Exp Rev Clin Immunol.2015;11(4):501-509
5.Stucki G et al;Evaluation einer deutschen Version des WOMAC(WesternOntario und McMaster Universities)Arthroseindex;Z Rheumatol1996;55(1):40-49
6.Schnuch A et al;Durchführung des Epikutantests mitKontaktallergenen;Leitlinie der Deutschen Dermatologischen Gesellschaft undder Deutschen Gesellschaft für Allergie und klinische Immunologie;JDDG2008;6(9):770-775
7.Summer B et al;Nickel(Ni)allergic patients with complications to Nicontaining joint replacement show preferential IL-17type reactivity to Ni;Contact Dermatitis 2010;63:15-22
8.Colhoun HM et al;Problems of reporting genetic associations withcomplex outcomes;Lancet.2003;361(9360):865-72
9.Yang H et al;Association of interleukin gene polymorphisms with therisk of coronary artery disease;Genetics and molecular research:GMR.2015;14(4):12489-96.
10.Lopez-Mejias R et al;Interleukin 1 beta(IL1ss)rs16944geneticvariant as a genetic marker of severe renal manifestations and renalsequelae in Henoch-Schonlein purpura;Clinical and experimentalrheumatology.20l6;34(3 Suppl 97):S84-8.
11.den Dunnen et al;HGVS Recommendations for the Description ofSequence Variants:2016 Update;HUMAN MUTATION;Vol.37;No.6;564-569,2016,doi10.1002/humu.22981。
序列表
<110> 慕尼黑大学医院(Klinikum der Universität München)
<120> 用于确定对金属植入物的可能的不相容性的生物标记物
<130> PPI20024012DE
<160> 13
<170> BiSSAP 1.3.6
<210> 1
<211> 51
<212> DNA
<213> 智人
<220>
<223> rs1143627
<400> 1
agcctcctac ttctgctttt gaaagcyata aaaacagcga gggagaactg g 51
<210> 2
<211> 86
<212> DNA
<213> 智人
<220>
<223> rs2234663 重复
<400> 2
atcctgggga aagtgaggga aatatggaca tcacatggaa caacatccag gagactcagg 60
cctctaggag taactgggta gtgtgc 86
<210> 3
<211> 52
<212> DNA
<213> 智人
<220>
<223> rs1143634
<400> 3
ctccacattt cagaacctat cttcttygac acatgggata acgaggctta tg 52
<210> 4
<211> 52
<212> DNA
<213> 智人
<220>
<223> rs16944
<400> 4
ctaccttggg tgctgttctc tgcctcrgga gctctctgtc aattgcagga gc 52
<210> 5
<211> 205
<212> DNA
<213> 智人
<220>
<223> rs2234663 两个重复
<400> 5
actcctattg acctggagca caggtatcct ggggaaagtg agggaaatat ggacatcaca 60
tggaacaaca tccaggagac tcaggcctct aggagtaact gggtagtgtg catcctgggg 120
aaagtgaggg aaatatggac atcacatgga acaacatcca ggagactcag gcctctagga 180
gtaactgggt agtgtgcttg gttta 205
<210> 6
<211> 291
<212> DNA
<213> 智人
<220>
<223> rs2234663 三个重复
<400> 6
actcctattg acctggagca caggtatcct ggggaaagtg agggaaatat ggacatcaca 60
tggaacaaca tccaggagac tcaggcctct aggagtaact gggtagtgtg catcctgggg 120
aaagtgaggg aaatatggac atcacatgga acaacatcca ggagactcag gcctctagga 180
gtaactgggt agtgtgcatc ctggggaaag tgagggaaat atggacatca catggaacaa 240
catccaggag actcaggcct ctaggagtaa ctgggtagtg tgcttggttt a 291
<210> 7
<211> 377
<212> DNA
<213> 智人
<220>
<223> rs2234663 四个重复
<400> 7
actcctattg acctggagca caggtatcct ggggaaagtg agggaaatat ggacatcaca 60
tggaacaaca tccaggagac tcaggcctct aggagtaact gggtagtgtg catcctgggg 120
aaagtgaggg aaatatggac atcacatgga acaacatcca ggagactcag gcctctagga 180
gtaactgggt agtgtgcatc ctggggaaag tgagggaaat atggacatca catggaacaa 240
catccaggag actcaggcct ctaggagtaa ctgggtagtg tgcatcctgg ggaaagtgag 300
ggaaatatgg acatcacatg gaacaacatc caggagactc aggcctctag gagtaactgg 360
gtagtgtgct tggttta 377
<210> 8
<211> 463
<212> DNA
<213> 智人
<220>
<223> rs2234663 五个重复
<400> 8
actcctattg acctggagca caggtatcct ggggaaagtg agggaaatat ggacatcaca 60
tggaacaaca tccaggagac tcaggcctct aggagtaact gggtagtgtg catcctgggg 120
aaagtgaggg aaatatggac atcacatgga acaacatcca ggagactcag gcctctagga 180
gtaactgggt agtgtgcatc ctggggaaag tgagggaaat atggacatca catggaacaa 240
catccaggag actcaggcct ctaggagtaa ctgggtagtg tgcatcctgg ggaaagtgag 300
ggaaatatgg acatcacatg gaacaacatc caggagactc aggcctctag gagtaactgg 360
gtagtgtgca tcctggggaa agtgagggaa atatggacat cacatggaac aacatccagg 420
agactcaggc ctctaggagt aactgggtag tgtgcttggt tta 463
<210> 9
<211> 549
<212> DNA
<213> 智人
<220>
<223> rs2234663 六个重复
<400> 9
actcctattg acctggagca caggtatcct ggggaaagtg agggaaatat ggacatcaca 60
tggaacaaca tccaggagac tcaggcctct aggagtaact gggtagtgtg catcctgggg 120
aaagtgaggg aaatatggac atcacatgga acaacatcca ggagactcag gcctctagga 180
gtaactgggt agtgtgcatc ctggggaaag tgagggaaat atggacatca catggaacaa 240
catccaggag actcaggcct ctaggagtaa ctgggtagtg tgcatcctgg ggaaagtgag 300
ggaaatatgg acatcacatg gaacaacatc caggagactc aggcctctag gagtaactgg 360
gtagtgtgca tcctggggaa agtgagggaa atatggacat cacatggaac aacatccagg 420
agactcaggc ctctaggagt aactgggtag tgtgcatcct ggggaaagtg agggaaatat 480
ggacatcaca tggaacaaca tccaggagac tcaggcctct aggagtaact gggtagtgtg 540
cttggttta 549
<210> 10
<211> 22
<212> DNA
<213> 人工序列
<220>
<223> 引物
<400> 10
tcttttcccc tttcctttaa ct 22
<210> 11
<211> 23
<212> DNA
<213> 人工序列
<220>
<223> 引物
<400> 11
gagagactcc cttagcacct agt 23
<210> 12
<211> 17
<212> DNA
<213> 人工序列
<220>
<223> 引物
<400> 12
cccctcagca acactcc 17
<210> 13
<211> 17
<212> DNA
<213> 人工序列
<220>
<223> 引物
<400> 13
ggtcagaagg gcagaga 17
Claims (5)
1.一种用于在受测者中预测对金属植入物的不相容倾向提高的风险提高的方法,其中在包括受测者的遗传物质的离析样品中:
a)检查编码白细胞介素1β的基因中的单核苷酸变异rs1143627AGCCTCCTACTTCTGCTTTTGAAAGC[C/T]ATAAAAACAGCGAGGGAGAACTGG(SEQ ID NO:1),并且确定单核苷酸变异的位置处是否存在C;和/或
b)检查编码IL1受体拮抗剂IL1-RN的基因中具有重复单元ATCCTGGGGAAAGTGAGGGAAATATGGACATCACATGGAACAACATCCAGGAGACTCAGGCCTCTAGGAGTAACTGGGTAGTGTGC(SEQ ID NO:2)的VNTR多态性rs2234663,并且确定重复单元是否存在五次。
2.根据权利要求1所述的方法,其中不相容倾向提高指的是发炎倾向提高。
3.根据权利要求1或2所述的方法,其中额外地测定了特应性疾病的可能存在。
4.根据权利要求3所述的方法,其中测定了特应性疾病的可能存在,所述特应性疾病选自过敏性支气管哮喘、过敏性鼻炎和特应性皮炎。
5.一种用于执行根据权利要求1至4中任一项所述的方法的试剂盒,所述试剂盒包括下列PCR引物:
a)TCTTTTCCCCTTTCCTTTAACT和GAGAGACTCCCTTAGCACCTAGT,和/或
b)CCCCTCAGCAACACTCC和GGTCAGAAGGGCAGAGA。
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WO2019161853A1 (de) | 2019-08-29 |
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