CN113981094A

CN113981094A - Kit for predicting sensitivity of chronic myelogenous leukemia patient to tyrosine kinase inhibitor and application thereof

Info

Publication number: CN113981094A
Application number: CN202111437152.4A
Authority: CN
Inventors: 杨承刚; 常鹏; 李昭然
Original assignee: Qingdao Yangshen Biomedical Co Ltd
Current assignee: Qingdao Yangshen Biomedical Co Ltd
Priority date: 2021-11-30
Filing date: 2021-11-30
Publication date: 2022-01-28

Abstract

The invention relates to a kit for predicting sensitivity of chronic myeloid leukemia patients to tyrosine kinase inhibitors and application thereof. Specifically, the invention provides a biomarker for predicting the sensitivity of chronic granulocytic leukemia patients to a tyrosine kinase inhibitor, can improve clinical diagnosis risk stratification, and can more accurately identify patients with drug resistance to the tyrosine kinase inhibitor at an early stage in the tyrosine kinase inhibitor treatment age.

Description

Kit for predicting sensitivity of chronic myelogenous leukemia patient to tyrosine kinase inhibitor and application thereof

Technical Field

The invention belongs to the field of biological medicines, and particularly relates to a kit for predicting sensitivity of chronic granulocytic leukemia patients to a tyrosine kinase inhibitor and application thereof.

Background

Chronic Myelogenous Leukemia (CML), also called chronic myelogenous leukemia, lentil for short, is a malignant myeloproliferative disease that occurs on pluripotent hematopoietic stem cells, accounting for about 15% of all leukemias.

The wide application of Tyrosine Kinase Inhibitor (TKI) remarkably improves the remission rate and long-term survival of chronic myelogenous leukemia patients. However, a small proportion of patients have disease progression and refractory relapse due to drug intolerance and/or drug resistance, for example, imatinib is an effective drug for treating chronic myeloid leukemia in the chronic stage, and approximately 20% to 30% of patients are resistant to imatinib. Therefore, the mechanism of drug resistance of CML patients to tyrosine kinase inhibitors is a difficult point and a hot point in research in the current clinical treatment of CML.

Disclosure of Invention

The invention aims to provide a biomarker for predicting the sensitivity of chronic granulocytic leukemia patients to tyrosine kinase inhibitors, improve clinical diagnosis risk stratification and more accurately identify the patients with TKIs drug resistance in the early stage of TKIs treatment.

In order to achieve the purpose, the invention adopts the following technical scheme:

the invention provides a marker, which comprises RAB27B, VEGFC and/or TRIM 10.

The term "and/or" as used herein in phrases such as "a and/or B" is intended to include both a and B; a or B; a (alone); and B (alone). Likewise, the term "and/or" as used in phrases such as "A, B and/or C" is intended to encompass each of the following embodiments: A. b and C; A. b or C; a or C; a or B; b or C; a and C; a and B; b and C; a (alone); b (alone); and C (alone).

The terms "biomarker", "marker" and "markers" refer to a biological molecule present in an individual at different concentrations that can be used to predict the disease state of the individual. Biomarkers can include, but are not limited to, nucleic acids, proteins, and variants and fragments thereof. A biomarker may be DNA comprising all or part of a nucleic acid sequence encoding the biomarker, or the complement of such a sequence. Biomarker nucleic acids useful in the present invention are considered to include DNA and RNA comprising all or part of any nucleic acid sequence of interest.

In the present invention, biomarkers such as RAB27B (gene ID: 5874), VEGFC (gene ID: 7424), TRIM10(gene ID: 10107), including gene and its encoded protein and homologs, mutations, and isoforms are included. The term encompasses full-length, unprocessed biomarkers, as well as any form of biomarker that results from processing in a cell. The term encompasses naturally occurring variants (e.g., splice variants or allelic variants) of the biomarkers.

The present invention also provides a reagent comprising a reagent capable of detecting the expression level of the aforementioned marker in a sample.

As used herein, the term "sample" refers to a biological sample obtained or derived from a source of interest as described herein. In some embodiments, the source of interest comprises an organism, such as an animal or human. In some embodiments, the biological sample comprises a biological tissue or fluid. In some embodiments, the biological sample may be or comprise bone marrow; blood; blood cells; ascites fluid; tissue or fine needle biopsy samples; a body fluid containing cells; free floating nucleic acids; sputum; saliva; (ii) urine; cerebrospinal peritoneal fluid; pleural fluid; feces; lymph; a skin swab; orally administering the swab; a nasal swab; washings or lavages such as catheter lavages or bronchoalveolar lavages; (ii) an aspirate; scraping scraps; bone marrow specimen; a tissue biopsy specimen; a surgical specimen; feces, other body fluids, secretions and/or excretions; and/or cells therein, and the like. In some embodiments, the biological sample is or comprises cells obtained from an individual. In some embodiments, the sample is a "primary sample" obtained directly from a source of interest by any suitable means. For example, in some embodiments, the primary biological sample is obtained by a method selected from the group consisting of: biopsies (e.g., fine needle aspirates or tissue biopsies), surgical tissue, collection of bodily fluids (e.g., blood, lymph, stool, etc.), and the like. In some embodiments, as will be apparent from the context, the term "sample" refers to a preparation obtained by processing (e.g., by removing one or more components of a primary sample and/or by adding one or more reagents to a primary sample). For example, filtration using a semipermeable membrane. Such "processed samples" may comprise, for example, nucleic acids or proteins extracted from the sample or obtained by subjecting a primary sample to techniques such as amplification or reverse transcription of mRNA, isolation and/or purification of certain components, and the like.

In a preferred embodiment, the sample is a cell, and more preferably, the cell is a CD34+ cell.

Further, the reagent includes a reagent for measuring the expression level of the biomarker by a digital imaging technology, a protein immunization technology, a dye technology, a nucleic acid sequencing technology, a nucleic acid hybridization technology, a chromatography technology and a mass spectrometry technology.

As an alternative embodiment, the expression level of the gene can be detected using advanced sequencing methods. For example, Illumina can be used to detect biomarkers. Next generation Sequencing (e.g., Sequencing-By-Synthesis or TruSeq methods using, for example, the HiSeq, HiScan, genome Analyzer, or MiSeq systems). Biomarkers can also be detected using ion beam sequencing or other suitable semiconductor sequencing methods.

As an alternative embodiment, RNase profiling (mapping) can be used to quantify biomarkers using mass spectrometry. The isolated RNA may be enzymatically digested with an RNA endonuclease (RNase) having high specificity (e.g., RNase T1, which cleaves 3' to all unmodified guanosine residues) prior to analysis of the isolated RNA by MS or tandem MS (MS/MS) methods. The first method developed used reverse phase HPLC coupled directly to ESI-MS to perform on-line chromatographic separation of endonuclease digests. The presence of post-transcriptional modifications can be revealed by mass shifts from those expected based on the RNA sequence. Ions of abnormal mass/charge values can then be isolated for tandem MS sequencing, thereby locating the sequence position of the post-transcriptionally modified nucleoside.

Matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS) has also been used as an analytical method to obtain information about post-transcriptionally modified nucleosides. MALDI-based methods can be distinguished from ESI-based methods by separation steps. In MALDI-MS, mass spectrometry is used to separate biomarkers.

Further, the reagent comprises:

a primer or probe that specifically binds to the biomarker gene;

an antibody, peptide, aptamer, or compound that specifically binds to the biomarker protein.

The term "primer" as used herein refers to a nucleic acid sequence having a short free 3' -hydroxyl group, which is a short nucleic acid that can form a base pair with a complementary template and serves as an origin of replication for the template strand. The primers can prime DNA synthesis in the presence of reagents for polymerization (i.e., DNA polymerase or reverse transcriptase) and four different nucleoside triphosphates in appropriate buffer solutions and temperatures. The PCR conditions and the lengths of the sense and antisense primers can be appropriately selected according to the techniques known in the art.

The term "probe" as used herein refers to a nucleic acid fragment (e.g., RNA or DNA) corresponding to several bases to several hundred bases that can specifically bind to mRNA, and the presence or absence and expression level of a particular mRNA can be confirmed by a tag. The probe may be prepared in the form of an oligonucleotide probe, a single-stranded DNA probe, a double-stranded DNA probe, or an RNA probe. Suitable probes and hybridization conditions may be appropriately selected according to techniques known in the art.

The term "antibody" as used herein is well known in the art and refers to a specific immunoglobulin directed against an antigenic site. The antibody of the present invention refers to an antibody that specifically binds to the biomarker protein of the present invention, and can be produced according to a conventional method in the art. Forms of antibodies include polyclonal or monoclonal antibodies, antibody fragments (such as Fab, Fab ', F (ab')2, and Fv fragments), single chain Fv (scfv) antibodies, multispecific antibodies (such as bispecific antibodies), monospecific antibodies, monovalent antibodies, chimeric antibodies, humanized antibodies, human antibodies, fusion proteins comprising an antigen binding site of an antibody, and any other modified immunoglobulin molecule comprising an antigen binding site, so long as the antibody exhibits the desired biological binding activity.

The term "peptide" as used herein has the ability to bind to a target substance to a high degree and does not undergo denaturation during heat/chemical treatment. Also, due to its small size, it can be used as a fusion protein by attaching it to other proteins. In particular, since it can be specifically attached to a high molecular protein chain, it can be used as a diagnostic kit and a drug delivery substance.

The term "aptamer" as used herein refers to a polynucleotide composed of a specific type of single-stranded nucleic acid (DNA, RNA or modified nucleic acid) which itself has a stable tertiary structure and has the property of being able to bind with high affinity and specificity to a target molecule. As described above, since the aptamer can specifically bind to an antigenic substance like an antibody, but is more stable and has a simple structure than a protein, and is composed of a polynucleotide that is easily synthesized, it can be used instead of an antibody.

As used herein, the term "specific binding" refers to a non-random binding reaction between two molecules (i.e., a binding molecule and a target molecule), such as a reaction between an antibody and an antigen against which it is directed. The binding affinity between two molecules can be described by the KD value. The KD value refers to the dissociation constant derived from the ratio of KD (the dissociation rate of a particular binding molecule-target molecule interaction; also known as koff) to ka (the association rate of a particular binding molecule-target molecule interaction; also known as kon), or KD/ka expressed as molarity (M). The smaller the KD value, the more tightly bound the two molecules and the higher the affinity. In certain embodiments, an antibody that specifically binds to (or is specific for) an antigen means that the antibody is present in an amount less than about 10^-5M, e.g. less than about 10^-6M、10^-7M、10^-8M、10^-9M or 10^-10M or less binds to the antigen with an affinity (KD). KD values can be determined by methods well known in the art, for example in a BIACORE instrument using Surface Plasmon Resonance (SPR).

The invention also provides the use of any one of the following:

(1) use of the aforementioned markers for the construction of a system for predicting the sensitivity of a patient with chronic myeloid leukemia to a tyrosine kinase inhibitor;

(2) use of the aforementioned agent for the manufacture of a product for predicting the sensitivity of a patient with chronic myeloid leukemia to a tyrosine kinase inhibitor.

Further, the tyrosine kinase inhibitor comprises a Bcr/Abl tyrosine kinase inhibitor, an epidermal growth factor receptor tyrosine kinase inhibitor and a vascular endothelial growth factor receptor tyrosine kinase inhibitor. Preferably a Bcr/Abl tyrosine kinase inhibitor.

More preferably, the Bcr/Abl tyrosine kinase inhibitor comprises imatinib, dasatinib, nilotinib, AZD9291, and preferably imatinib.

Further, the product comprises a kit and a chip.

Furthermore, the kit also comprises CD34+ cell immunomagnetic beads.

Further, the kit also comprises a bone marrow mononuclear cell separation reagent.

Furthermore, the chip comprises a gene chip and a protein chip.

The gene chip comprises a solid phase carrier and oligonucleotide probes fixed on the solid phase carrier, wherein the oligonucleotide probes comprise oligonucleotide probes for detecting the transcription level of the biomarker genes and aiming at the biomarker genes; the protein chip comprises a solid phase carrier and a specific antibody of the biomarker coding protein fixed on the solid phase carrier; the gene chip can be used for detecting the expression level of a plurality of genes including the biomarker genes. The protein chips can be used to detect the expression levels of a plurality of proteins, including proteins encoded by the biomarkers.

Further, the system comprises:

1) a detection unit: comprises a biomarker detection module;

2) an analysis unit: inputting the expression level of the biomarker obtained by the detection of the detection unit as an input variable into a model for predicting whether the chronic myelogenous leukemia patient has drug resistance to the tyrosine kinase inhibitor for analysis;

3) an evaluation unit: and outputting the risk value of the tyrosine kinase inhibitor drug resistance of the subject corresponding to the sample.

The biomarkers include RAB27B, VEGFC and/or TRIM 10.

Further, the model for predicting whether a chronic myeloid leukemia patient is resistant to a tyrosine kinase inhibitor is determined using one or more algorithms selected from the group consisting of: XGboost, random forest, glmnet, cforest, machine learning classification and regression trees, treebag, K-adjacency, neural networks, support vector machine radial, support vector machine linear, naive Bayes, or multi-layer perception.

A "model" is any mathematical equation, algorithm, analytical or programmed process or statistical technique that takes one or more continuous or categorical inputs and calculates an output value, sometimes referred to as an "index," index value, "" predictor, "" predicted value, "" probability, "or" probability score. Non-limiting examples of "formulas" include sums, ratios, and regression operators, such as coefficients or indices, biomarker value conversion and normalization, rules and guidelines, statistical classification models, and neural networks trained on historical populations. Of particular interest in group (panel) and combinatorial constructs are structural and syntactic statistical classification algorithms, as well as risk index construction methods that utilize pattern recognition features, including established techniques such as cross-correlation, Principal Component Analysis (PCA), factor rotation, log regression (LogReg), Linear Discriminant Analysis (LDA), Eigengene Linear Discriminant Analysis (ELDA), Support Vector Machines (Support Vector Machines, SVMs), Random Forest (Random Forest, RF), recursive partition Trees (RPART), xgboost (xgb), and other related Decision tree classification techniques, shrunken centroids (sc), stepic, Nearest-Neighbor, Boosting, Decision Trees (Decision Trees), neural networks, bayesian networks, Support Vector Machines, and Hidden markov models (Hidden markov, etc. Many such algorithmic techniques are further implemented to perform feature (locus) selection and regularization (regularization) regularization, for example in ridge regression, lasso and elastic net, among others. Other techniques may be used in time to event hazard analysis (time to event hazard analysis), including Cox, Weibull, Kaplan-Meier, and Greenwood models, which are well known to those skilled in the art. Many of these techniques can be used in conjunction with biomarker selection techniques, such as forward selection, backward selection, or stepwise selection, complete enumeration of all potential biomarker sets or groups of a given size, genetic algorithms, or themselves can include biomarker selection methods. These can be used in conjunction with Information criteria, such as Akaike's Information Criterion (AIC) or Bayesian Information Criterion (BIC), to quantify the trade-off between other biomarkers and model improvement and to help minimize overfitting. The generated predictive models can be validated in other studies, or cross-validated in studies in which they were originally trained, using techniques such as Bootstrap, Leave-One-out (LOO) and 10-Fold cross-validation (10-Fold cross-validation) (10-Fold CV). At various steps, the false discovery rate may be estimated by value permutation according to techniques known in the art.

The present invention also provides a method for screening a drug capable of improving sensitivity of a patient with chronic myelogenous leukemia to a tyrosine kinase inhibitor, the method comprising:

1) administering a test agent to a subject to be tested in a test group, and detecting the expression level of the biomarker in a sample derived from the subject in the test group V1; in a control group, administering a blank control to the subject to be tested, and detecting the expression level of the biomarker in the sample derived from the subject in the control group, V2;

2) comparing the level V1 and the level V2 detected in the previous step to determine whether the test compound is a candidate drug for increasing the sensitivity of patients with chronic myelogenous leukemia to tyrosine kinase inhibitors.

The biomarkers include RAB27B, VEGFC and/or TRIM 10.

Further, the tyrosine kinase inhibitor comprises a Bcr/Abl tyrosine kinase inhibitor, an epidermal growth factor receptor tyrosine kinase inhibitor and a vascular endothelial growth factor receptor tyrosine kinase inhibitor, and is preferably a Bcr/Abl tyrosine kinase inhibitor.

Drawings

Fig. 1 is a boxplot of the differential representation of RAB 27B;

FIG. 2 is a boxplot of differential expression of VEGFC;

FIG. 3 is a boxplot of the differential expression of TRIM 10;

FIG. 4 is a ROC plot of RAB27B and VEGFC combined prediction of chronic myelogenous leukemia patient sensitivity to imatinib;

FIG. 5 is a ROC plot of VEGFC and TRIM10 combined to predict chronic myelogenous leukemia patient sensitivity to imatinib;

FIG. 6 is a ROC plot of RAB27B and TRIM10 in combination to predict the sensitivity of chronic myelogenous leukemia patients to imatinib;

FIG. 7 is a ROC plot of RAB27B + VEGFC + TRIM10 in combination with predicting chronic myelogenous leukemia patient sensitivity to imatinib.

Detailed Description

The following examples are presented to describe certain preferred embodiments of the invention and certain aspects of the invention and should not be construed as limiting the scope of the invention. The following examples are presented to further detail the embodiments of the present invention in conjunction with the attached tables and figures.

Example 1 differential expression of genes

GSE14671 is downloaded from a GEO database, difference analysis is carried out on the GSE14671 by using an R language limma package to obtain 1126 difference expression genes, and the screening standard is as follows: pvale < 0.05.

This data set was derived from gene expression analysis of CD34+ cells from CML patients treated with imatinib. In this data set, NR: R ═ 18:41, R denotes the responder group (i.e. the susceptible group) and NR denotes the non-responder group (i.e. the resistant group). The responder group was defined as patients who had at least a partial cytogenetic response within 12 months after treatment, and the non-responder group was defined as other patients.

The expression levels of the differentially expressed genes RAB27B, VEGFC, TRIM10 according to the present invention are shown in Table 1 and FIGS. 1-3.

TABLE 1 differentially expressed genes

Gene	t	P.Value	Up/Down
				RAB27B	-3.039	0.004	down
VEGFC	-2.377	0.021	down
				TRIM10	2.357	0.022	up

Example 2 diagnostic efficacy

The Receiver Operating Curve (ROC) was plotted using the R package "pROC" (version 1.15.0) and the AUC values, sensitivity and specificity were analyzed, the results are shown in table 2 and fig. 4-7.

TABLE 2 biomarker/biomarker combination diagnostic potency data

Biomarker/biomarker combinations	AUC value
		RAB27B	0.733
VEGFC	0.683
		TRIM10	0.669
RAB27B+VEGFC	0.749
		VEGFC+TRIM10	0.787
RAB27B+TRIM10	0.825
		RAB27B+VEGFC+TRIM10	0.866

The results prove that the biomarkers provided by the invention have good diagnostic efficacy in predicting the sensitivity of chronic granulocytic leukemia patients to imatinib, and the diagnostic efficacy of the biomarker combination is superior to that of a single biomarker.

The above-mentioned embodiments only express several embodiments of the present invention, and the description thereof is more specific and detailed, but not construed as limiting the scope of the invention. It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the inventive concept, which falls within the scope of the present invention. Therefore, the protection scope of the present patent shall be subject to the appended claims.

Claims

1. A marker comprising RAB27B, VEGFC and/or TRIM 10.

2. A reagent comprising an agent capable of detecting the level of expression of the marker of claim 1 in a sample, preferably a cell, preferably a CD34+ cell.

3. The reagent of claim 2, wherein the reagent comprises a reagent for measuring the level of biomarker expression by digital imaging techniques, protein immunization techniques, dye techniques, nucleic acid sequencing techniques, nucleic acid hybridization techniques, chromatography techniques, mass spectrometry techniques,

preferably, the reagent comprises:

a primer or probe that specifically binds to the biomarker gene;

4. Use according to any one of the following:

(1) use of the marker of claim 1 for constructing a system for predicting the sensitivity of a patient with chronic myelogenous leukemia to tyrosine kinase inhibitors;

(2) use of the reagent according to claim 2 or 3 for the preparation of a product for predicting the sensitivity of a patient with chronic myeloid leukemia to tyrosine kinase inhibitors;

preferably, the tyrosine kinase inhibitor comprises a Bcr/Abl tyrosine kinase inhibitor, an epidermal growth factor receptor tyrosine kinase inhibitor and a vascular endothelial growth factor receptor tyrosine kinase inhibitor, preferably, the tyrosine kinase inhibitor is a Bcr/Abl tyrosine kinase inhibitor, preferably, the Bcr/Abl tyrosine kinase inhibitor comprises imatinib, dasatinib, nilotinib and AZD9291, preferably, the Bcr/Abl tyrosine kinase inhibitor is imatinib.

5. The use of claim 4, wherein the product comprises a kit or chip.

6. The use of claim 5, wherein the kit further comprises CD34+ cell immunomagnetic beads, and preferably, the kit further comprises a bone marrow mononuclear cell separation reagent.

7. The use of claim 5, wherein the chip comprises a gene chip or a protein chip.

8. The use according to claim 4, wherein said system comprises:

1) a detection unit: comprises a biomarker detection module;

3) an evaluation unit: outputting a risk value of the tyrosine kinase inhibitor resistance of the subject corresponding to the sample;

the biomarkers include RAB27B, VEGFC and/or TRIM 10.

9. The use according to claim 8, wherein the model is determined using one or more algorithms selected from the group consisting of: XGboost, random forest, glmnet, cforest, machine learning classification and regression trees, treebag, K-adjacency, neural networks, support vector machine radial, support vector machine linear, naive Bayes, or multi-layer perception.

10. A method of screening for a drug that increases the sensitivity of a chronic myeloid leukemia patient to a tyrosine kinase inhibitor, said method comprising:

2) comparing the level V1 and the level V2 detected in the previous step to determine whether the test compound is a candidate drug for increasing the sensitivity of a patient with chronic myelogenous leukemia to tyrosine kinase inhibitors;

the biomarkers comprise RAB27B, VEGFC and/or TRIM 10;