CN113817814A - 一种人体免疫力定量评估系统 - Google Patents
一种人体免疫力定量评估系统 Download PDFInfo
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- CN113817814A CN113817814A CN202110987443.4A CN202110987443A CN113817814A CN 113817814 A CN113817814 A CN 113817814A CN 202110987443 A CN202110987443 A CN 202110987443A CN 113817814 A CN113817814 A CN 113817814A
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Abstract
本发明公开了一种人体免疫力定量评估系统,包括血液处理单元,用于从人外周血中分离得到免疫细胞;基因提取单元,用于提取总RNA;测序单元,用于对所提取的RNA进行高通量测序,得到基因表达的图谱;免疫评估单元,用于对基因表达进行加权评分计算,输出免疫力得分。本发明评估结果更全面,准确,对免疫力评价不再是临床上依靠经验而是定量化,此外本发明使分析结果能够模拟和预测真实结果,相对于其他传统的方法大大减少了人为因素的影响。
Description
技术领域
本发明涉及用于免疫评价的医疗设备领域,具体是一种人体免疫力定量评估系统。
背景技术
随着新型冠状病毒肺炎疫情爆发,人们对人体免疫力的关注逐渐大众化,对自身免疫力也前所未有地重视。新冠病毒感染后的病情轻重程度取决于自身免疫力的强弱,尤其“慢性新冠”的损伤并不是由病毒直接引起的,而是自身免疫反应紊乱引起的。其中像北京协和医院,深圳第三人民医院等多地的医疗机构在新冠肺炎诊疗方案中加入了免疫力评估。免疫力是自己免疫的能力,是人体抵抗疾病能力的体现,免疫力低下的人群会加速衰老,易患老年痴呆,易受感染,易发癌症等等。免疫力过强容易引起溃疡,过敏,自身免疫疾病等。人类的衰老、99%的疾病都与自身免疫力有密切的关系。
人体免疫力是一个动态变化的过程。其一方面是由先天遗传背景所决定,另一方面是受后天因素的影响。年龄,营养,睡眠,运动,精神状态等都是免疫力的重要影响因素。北京协和医院感染内科李太生教授课题组对不同年龄组的人群进行免疫分析发现老年人免疫功能有明显的下降。芝加哥大学科学家研究发现每天睡眠7-8小时的人比每天只睡4小时的人,血液中流感抗体水平要高出一倍多。对机体免疫力的监控和评估对于维持和改善人体健康都有着十分重要的意义。
免疫力评估是通过对免疫细胞数量,细胞因子,相关免疫功能进行检测,达到对免疫力评价的目的。常见的免疫细胞包括:T细胞、B细胞、中性粒细胞,巨噬细胞,DC细胞,自然杀伤(NK)细胞等。每种细胞可根据其表面特定抗原分子表达分成各种亚型,如T细胞可细分为Th1型辅助T细胞,Th2型辅助T细胞以及杀伤性T细胞。T细胞介导的细胞免疫功能和B细胞介导的体液免疫功能是人体对抗疾病的主要方式。通过对不同类型免疫细胞以及其分泌的细胞因子的分析,利用免疫学专业知识对不同的指标进行评分,来评价人体各种免疫细胞的平衡度,整体免疫力的高低。评估的总分越高,代表机体免疫能力越强。
通过对人体免疫力的定量评估,能让人们随时可以了解自己的免疫力水平和免疫状态,掌握自己身体健康状况,使人们可以及时调节自己的生活方式防病于未然,也可为患有各种疾病的患者提供病情判断,用药指导以及预后等的重要定量依据。精准量化的免疫力评估,对于大众的健康管理,疾病人群的诊断治疗都有极其重要的意义。
目前广泛应用的免疫力评估手段是利用流式细胞术,ELISA技术分别对各种免疫细胞亚群和细胞因子进行测定。流式细胞术利用特定荧光标记的抗体靶向不同类型CD分子来检测不同类型免疫细胞亚群的比例以及功能分子的表达情况,从而实现对机体免疫水平的分析。ELISA技术通过双抗夹心等方式对特定的分泌到细胞外的游离细胞因子进行检测。这些技术方法都是针对常见的特定分子,所以检测通量小。针对每一种细胞类型的检测,所能选用的分子标记物也有限,使得检测结果的特异性受限。实验过程中,应用单克隆抗体进行实验,成本昂贵,实验性价比低。流式细胞术在画门时,人为主观因素比较大,不利于真是结果的判断。此外,另外传统的细胞学方法得到的结果不利于数字化定量评分模型的建立。
鉴于现有的免疫力评估手段的诸多不足之处,本发明旨在高通量测序基础上通过生物信息学分析建立人体免疫力的定量评估模型。高通量测序被正式报到以来,革新了基因组的测序领域,大大降低了测序成本。得以使该技术在疾病的临床诊断上得到了广泛的应用。高通量测序技术具有极高的通量,得到的生物信息全面,一次运行可以获得高达数百G的数据。而且测序成本不断降低。
发明内容
鉴于现有的免疫力评估手段的不足之处,利用高通量测序结果作为数据来源,并结合免疫学专业知识对数据进行生物信息学分析和评分,用于人体健康状态的分析。本系统利用测序与生物信息学和免疫学专业知识相结合,可以很好地弥补现有免疫力评估体系中的缺点。高通量测序相比于目前的免疫评估手段可以提供更全面深入的数据支撑,针对于每一种细胞类型,可以选取多种分子进行标记可以大大提高检测标准的特异性和准确性。此外高通量测序数据本身为数字基因表达谱,更利于数据后期处理和数字化定量评估模型的构建。
为了实现上述目的,本发明采用的技术方案是:一种人体免疫力定量评估系统,包括
血液处理单元,用于从人外周血中分离得到免疫细胞;
基因提取单元,用于提取总RNA;
测序单元,用于对所提取的RNA进行高通量测序,得到基因表达的图谱;
n为此次免疫评估所选基因总的数量,Wi为基因平均权重,Ei为基因表达fpkm值,Refi为参照值,是表达量符合正态分布的正常人群某基因fpkm值的平均值。
报告打印单元,用于根据免疫力得分打印出报告结果。
进一步,所述免疫评估单元选取了23种免疫细胞亚型中的一种或多种,对选取的各免疫细胞所对应的特征基因的基因表达进行加权评分计算。
在上述方案中,所述23种免疫细胞亚型包括嗜碱性粒细胞,嗜酸性粒细胞,嗜中性粒细胞,经典型单核细胞,中间型单核细胞,非经典型单核细胞,髓系DCs,pDCs,NKs,幼稚B细胞,记忆性B细胞,γδT细胞,黏膜相关恒定T细胞,幼稚CD4T细胞,记忆性CD4T细胞,幼稚CD8T细胞,记忆性CD8T细胞,滤泡辅助性T细胞,Th1型辅助T细胞,Th2型辅助T细胞,Th17型辅助T细胞,激活型CD4T细胞和激活型CD8T细胞。
本发明提供一个基于高通量测序利用生物信息学分析建立的人体免疫力评估系统。通过本系统可以对人体的免疫功能水平进行评估,得知健康人或者患者的健康状况,预测患病风险可患者病情变化,用药效果与预后进行判断,指导用药。本发明相对于现有模型的优点:相对于利用单个或者多个表面蛋白标记物的流式细胞术或者ELISA等手段,本发明对特定免疫细胞的评估是高通量的高特异性的。评估结果更加全面,准确。对免疫力评价不再是临床上依靠经验而是定量化,此外本发明使分析结果能够模拟和预测真实结果,相对于其他传统的方法大大减少了人为因素的影响。在样品处理方面也比传统的方法要更加简单。
在本发明中共选取了285种免疫相关的基因用于免疫力的评估,这些基因都是免疫功能聚类后的基因群,免疫细胞类型上涉及了常见免疫细胞的所有类型,相对于传统方法上最多几十个目标分子的检测,其通量有了大大的提高,更能精确地反应真实的结果。评分计算公式充分考虑了每种细胞类型的权重,更加客观地反应每种细胞所发挥功能。
附图说明
图1为不同人群的免疫力评分图;
图2为本发明与临床结果中各个细胞亚群的相关性统计图;
图3为本发明各类型的量化评分结果与对应的功能评价结果。
具体实施方式
本发明通过高通量测序得到样品基因表达的图谱,结合免疫学数据库首先甄选出每种免疫细胞所对应的特定表达的基因群,对每一群内每一个基因进行加权评分计算,通过群内基因得分加和得到某种免疫细胞的加权得分,将每种免疫细胞的加权得分作和,得到免疫力的总得分。
本发明中的免疫力定量评估系统,可以按照以下步骤进行分析评估:
步骤1:在检测之前,对受测人员进行咨询,了解其生活习惯,病史等信息,获得其知情同书,并告知其抽血前24小时不得饮酒。对受测人员进行健康自测,这些有利于了解其健康状况,判断其是否处于亚健康状态,以及避免一些个人人为因素影响免疫状态的变化,并进行针对性的健康指导方案的拟定。
步骤2:采取5mL人体外周血,利用人外周血白细胞分离液中分离得到免疫细胞:取新鲜的抗凝血(EDTA),在离心管中加入等体积分离液(人外周血白细胞分离液试剂盒,索宝来公司,商品货号:P8670),室温,水平离心500-1000g,20分钟,离心后出现明显分层,上层为血浆层,血浆层和分离液之间为淋巴细胞层,分离液中为粒细胞层,下层为红细胞层。小心吸取淋巴细胞层以及分离液层至15mL的无菌离心管中,加入补PBS至10mL,250g,离心10分钟,然后弃掉上清,重复洗涤一次,重悬细胞备用。
步骤3:利用TaKaRa MiniBEST Universal提取试剂盒提取总RNA并利用纯化试剂盒进行纯化(RNA纯化试剂盒,Qiagen 74904)。
步骤4:将提取的RNA通过离子打断的方式将mRNA打断到200-300bp,以RNA为模板,用随机引物和逆转录酶合成cDNA的第一链,并以第一链cNDA为模板进行第二链cDNA的合成,DNA建库。
步骤5:利用Illumina测序平台进行高通量测序。
步骤6:免疫力评估用特定基因的筛选。根据免疫学专业知识并结合ImmuNet等免疫数据库甄选出多种免疫细胞亚型和每种免疫细胞类型所特有的特征基因。根据所选基因的免疫功能赋予每一个基因相应的平均权重评分,共筛选出23个免疫细胞类型和285个基因,这些基因的选择充分考虑了其在相应免疫细胞中表达的特异性,并结合其在外周血的占比情况分配想对应的权重,结果如下表所示:
步骤7:免疫力量化评分:
根据基因表达测序结果中每种基因表达fpkm值和平均权重计算评分,具体公式如下:
S1=W1*E1/Ref1
S1=W2*E2/Ref2
…
S285=W285*E285/Ref285
W:基因平均权重;
1,2,…285:为对应的基因序号;
E:为每个样品的某基因表达fpkm值;
Ref:为参照值,是表达量符合正态分布的正常人群某基因fpkm值的平均值;
下标数字为对应基因的序号。
总得分:S总=S1+S2+…Sn(n为此次免疫评估所选基因总的数量)。
总评分标准说明:<60(免疫功能缺陷);60-70(免疫功能低下);71-80(免疫功能不足);81-90分(免疫功能良好);91-100(免疫功能优秀);101-110分(免疫功能过强);111-120分(免疫功能过度);>120分(免疫功能亢进)
针对每一种细胞亚型,可选取相对应的特定基因组分别进行计算。可以将每种免疫细胞的变化应用于临床,比如NK细胞与病毒感染有密切的关系;中性粒细胞与细菌感染有密切的关系;嗜酸性粒细胞与寄生虫感染关系密切;嗜碱性粒细胞与过敏关系密切等。
嗜碱性粒细胞评分:S=S1+…+S12;
嗜酸性粒细胞评分:S=S13+…+S24;
嗜中性粒细胞评分:S=S25+…+S35;
经典型单核细胞:S=S36+…+S56;
中间型单核细胞:S=S57+…+S68;
非经典型单核细胞:S=S69+…+S88;
髓系DCs:S=S89+…+S99;
pDCs:S=S100+…+S111;
NKs:S=S112+…+S129;
幼稚B细胞:S=S130+…+S155;
记忆性B细胞:S=S156+…+S167;
γδT细胞:S=S168+…+S179;
黏膜相关恒定T细胞:S=S180+…+S191;
幼稚CD4T细胞:S=S192+…+S203;
记忆性CD4T细胞:S=S204+…+S213;
幼稚CD8T细胞:S=S214+…+S225;
记忆性CD8T细胞:S=S226+…+S236;
滤泡辅助性T细胞:S=S237+…+S242;
Th1型辅助T细胞:S=S243+…+S251;
Th2型辅助T细胞:S=S252+…+S261;
Th17型辅助T细胞:S=S262+…+S269;
激活型CD4T细胞:S=S270+…+S277;
激活型CD8T细胞:S=S278+…+S285。
步骤8:检测报告生成和分析:收到样本后5个工作日出免疫力评估报告,给出免疫力评估和健康指导意见。
按照上面的步骤进行以下实验:选取健康人群,老年与儿童,亚健康人群,感染性疾病人群,免疫缺陷人群及自身免疫疾病人群等不同分组的人群进行检测,每组选用样本在10-15人之间。分别采取5mL外周血,对免疫细胞进行分离,并提取总RNA,进行测序。针对于测序的表达数据,选取上述列表中的基因并利用公式计算每组的免疫力评分,如图1所示。
由图1结果可知健康人群组和老人与小孩组结果都介于80-100之间,属于免疫功能正常;亚健康人群和免疫缺陷疾病人群免疫力评分<80,免疫功能相对不足;感染性疾病人群和自身免疫疾病人群组免疫力评分>100分,免疫功能亢进。这一评分结果与其生理病理状态相一致的。说明本发明系统的高度可行性。对本发明中各个细胞类型量化评分与临床血常规检测结果进行相关性分析可以发现,本发明与临床结果中各个细胞亚群都具有高度的相关性(如图2)。对细胞功能验证,本发明进行了吞噬细胞的吞噬实验,B细胞的溶血空斑形成实验以及CD8T细胞杀伤性实验,实验结果显示各类型的量化评分结果与对应的功能评价结果有高度的相关性(如图3)。这些结果充分证明了本免疫力评估体系较客观地反应了免疫力的真实水平,具有很好的科学性和实用性。
本发明中所涉及到一些参数在上面描述中不可能全部的体现,此不应当视为此方案的公开不充分。所属领域中的技术人员应该明了,对本发明的任何改进,对本发明中涉及到的各种材料,参数以及辅助成分的添加,与具体方式选择等,都落在本发明的保护范围内。
Claims (7)
1.一种人体免疫力定量评估系统,其特征在于:包括
血液处理单元,用于从人外周血中分离得到免疫细胞;
基因提取单元,用于提取总RNA;
测序单元,用于对所提取的RNA进行高通量测序,得到基因表达的图谱;
免疫评估单元,用于对基因表达进行加权评分计算,输出免疫力得分。
2.根据权利要求1所述一种人体免疫力定量评估系统,其特征在于:所述免疫评估单元选取了23种免疫细胞亚型中的一种或多种,对选取的各免疫细胞所对应的特征基因的基因表达进行加权评分计算。
3.根据权利要求2所述一种人体免疫力定量评估系统,其特征在于:所述23种免疫细胞亚型包括嗜碱性粒细胞,嗜酸性粒细胞,嗜中性粒细胞,经典型单核细胞,中间型单核细胞,非经典型单核细胞,髓系DCs,pDCs,NKs,幼稚B细胞,记忆性B细胞,γδT细胞,黏膜相关恒定T细胞,幼稚CD4T细胞,记忆性CD4T细胞,幼稚CD8T细胞,记忆性CD8T细胞,滤泡辅助性T细胞,Th1型辅助T细胞,Th2型辅助T细胞,Th17型辅助T细胞,激活型CD4T细胞和激活型CD8T细胞,调节性T细胞。
4.根据权利要求3所述一种人体免疫力定量评估系统,其特征在于:所述23种免疫细胞亚型所特有的特征基因包括:
所述嗜碱性粒细胞的特征基因包括CPA3,MS4A3,HDC,MS4A2,IL4,GCSAML,GATA2,TPSAB1,CD200R1L,TEX101,SLC45A3,TRIM64B;
所述嗜酸性粒细胞的特征基因包括CEBPE,SEMG1,ALOX15,CCL23,PRSS41,PRSS33,THBS4,FOXI1,SIGLEC8,EPX,SVOPL,FAM170B;
所述嗜中性粒细胞的特征基因包括PI3,CHI3L1,CXCL8,ANXA3,CXCL1,TGM3,BTNL3,C4BPA,MMP9,MME,OTX1;
所述经典型单核细胞的特征基因包括S1PR3,CCL13,PTGFR,CCL7,RXFP2,SPATA12,LGI2,CLEC5A,CCL8,TRPV4,CYP1B1,ADAMTS5,S100A8,S100A12,CD14,CD163,STAB1,CLEC4E,ASGR2,F13A1,CYP27A1;
所述中间型单核细胞的特征基因包括PLPPR4,SYTL5,TNFSF18,PRTG,LYPD2,EPO,CABP4,L1TD1,KRT78,CKB,VMO1,DCSTAMP;
所述非经典型单核细胞的特征基因包括CDKN1C,CLEC4F,NCF2,ACP5,PLA2G7,IGSF6,BCL2A1,BHLHE41,CXCL5,IL7R,C5AR1,AQP9,SLC15A3,ADAMDEC1,EGR2,PPP1R17,SFTPD,LYNX1,C1QB,CKB;
所述髓系DCs的特征基因包括GPR31,ODF3L1,PRB2,CD207,CLEC14A,MRC1,EBLN1,CRIP3,CD1E,CRABP1,ADGRG6;
所述pDCs的特征基因包括TPM2,LRRC26,ASIP,GPM6B,KRT5,NTM,SCT,SHD,KCNA5,SCARA5,EPHA2,MYMX;
所述NKs的特征基因包括COX6A2,ZMAT4,KIR2DL4,EXOC1L,MAPK12,TTLL10,IL37,GHSR,BAALC,GPC6,C12orf71,EPS8L3,GZMB,KLRF1,KIR3DL1,KIR2DL1,NCAM1,KIR2DL3;
所述幼稚B细胞的特征基因包括VPREB3,AC233755.1,IGLL5,COL19A1,PAX5,AC233755.2,AC141272.1,AC136616.2,WNT16,CPNE5,KLHL14,FMO1,SYN3,KCNG1,CRMP1,CXorf65,SPATA18,FOXD4L1,DAZL,GRB7,PRSS45,DSP,PTH2,MS4A1,CD22,CD19;
所述记忆性B细胞的特征基因包括TAS1R3,AMPD1,FA2H,PPP1R37,TUBB2B,SAA4,PROX1,OR4C6,SDC1,EYA2,ARL14,TMEM74;
所述γδT细胞的特征基因包括TMEM132C,GALNT18,FBXO39,NFASC,HNF4G,KRT84,CYP2C8,LIM2,GSC,TFCP2L1,KLKB1,MFAP2;
所述黏膜相关恒定T细胞的特征基因包括DAB2IP,TUSC3,TBL1Y,FERMT2,NTN4,CFAP157,DUOXA1,PRSS35,TRPC3,ITPKA,ME1,SLC4A10;
所述幼稚CD4T细胞的特征基因包括CAPN9,OR2T34,PHKA1,CAPSL,ALB,KRT72,SORCS3,FAM78B,GRIA3,WFDC10A,WFDC13,GYS2;
所述记忆性CD4T细胞的特征基因包括IGFL2,SPACA6,KRTAP4-3,NDP,ADAM23,IL20RA,ART5,CYP4B1,PRY,NEFL;
所述幼稚CD8T细胞的特征基因包括PRM3,SLC7A3,PCDHGB1,CFAP97D2,NDNF,GAP43,MXRA8,ZCCHC12,REG4,CD248,NRCAM,SFRP5;
所述记忆性CD8T细胞的特征基因包括CH25H,OR4A47,NKX2-3,IRGC,IFNA21,OVOL1,OGDHL,NR2F2,PCDHB15,FAM180B,KRT74;
所述滤泡辅助性T细胞的特征基因包括GAS6,HTR6,B4GALNT4,STK24-AS1,CLYBL-AS2,RPL7L1P12;
所述Th1型辅助T细胞的特征基因包括PDE4D,SLC4A10,ADAM23,KIT,IL23R,TPBG,RBM24,SLC44A3,CHCHD2P8;
所述Th2型辅助T细胞的特征基因包括SEMA5A,CHCHD3,KRT1,PKP2,AKAP12,CDO1,HPGDS,MRGPRD,CDH1,CLC;
所述Th17型辅助T细胞的特征基因包括IL17RE,AIRE,CPNE7,NMU,DOCK9,TPTE2,BRD7,CLYBL;
所述激活型CD4T细胞的特征基因包括CD40LG,IL2,CCL20,CD109,IL21,HCAR1,CLDN1,TNIP3;
所述激活型CD8T细胞的特征基因包括CRTAM,LAYN,N4BP3,XCL1,CNIH2,SH2D5,AK4,CCDC173。
所述调节性T细胞的特征基因包括BTBD16,KRT24,SPACA5B,RPRM,BDKRB1,BTG4,PCDHB4,SEMA3G,FANK1,KRTAP7-1,OR13C8,BMP10。
6.根据权利要求5所述一种人体免疫力定量评估系统,其特征在于:所述基因平均权重由所属的免疫细胞亚型确定,其中嗜碱性粒细胞的基因平均权重为0.005~0.01,嗜酸性粒细胞的基因平均权重为0.005~0.01,嗜中性粒细胞的基因平均权重为1~2,经典型单核细胞的基因平均权重为0.5~1,中间型单核细胞的基因平均权重为0.01~0.05,非经典型单核细胞的基因平均权重为0.01~0.05,髓系DCs的基因平均权重为0.5~1,pDCs的基因平均权重为0.5~1,NKs的基因平均权重为0.5~1,幼稚B细胞的基因平均权重为0.5~1,记忆性B细胞的基因平均权重为0.1~0.5,γδT细胞的基因平均权重为0.05~0.1,黏膜相关恒定T细胞的基因平均权重为0.05~0.1,幼稚CD4T细胞的基因平均权重为0.5~1,记忆性CD4T细胞的基因平均权重为0.05~0.1,幼稚CD8T细胞的基因平均权重为0.5~1,记忆性CD8T细胞的基因平均权重为0.05~0.1,滤泡辅助性T细胞的基因平均权重为0.5~1,Th1型辅助T细胞的基因平均权重为0.1~0.2,Th2型辅助T细胞的基因平均权重为0.1~0.2,Th17型辅助T细胞的基因平均权重为0.2~0.4,激活型CD4T细胞的基因平均权重为0.25~0.5和激活型CD8T细胞的基因平均权重为0.25~0.5。
7.根据权利要求1或2或3或4或6所述一种人体免疫力定量评估系统,其特征在于:还包括报告打印单元,用于根据免疫力得分打印出报告结果。
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