CN114152746A - Rv1860蛋白、RV3881c蛋白、Rv2031c蛋白和Rv3803c蛋白在诊断活动性肺结核感染中的用途 - Google Patents
Rv1860蛋白、RV3881c蛋白、Rv2031c蛋白和Rv3803c蛋白在诊断活动性肺结核感染中的用途 Download PDFInfo
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Abstract
本发明涉及疾病诊断领域,具体涉及一种Rv1860蛋白、RV3881c蛋白、Rv2031c蛋白和Rv3803c蛋白在制备诊断活动性肺结核感染中的用途。本发明提供一种检测血清中抗Rv1860抗体、抗RV3881c抗体、抗Rv2031c抗体和抗Rv3803c抗体水平的产品在制备具有鉴别、诊断、辅助诊断、筛查和/或辅助筛查活动性肺结核感染患者用途的产品中的应用。实验证明得到含有4种抗原的生物标志物组合,可有效筛查活动性肺结核感染患者。
Description
技术领域
本发明涉及疾病诊断领域,具体涉及一种Rv1860蛋白、RV3881c蛋白、 Rv2031c蛋白和Rv3803c蛋白在制备诊断活动性肺结核感染中的用途。
背景技术
结核病是由结核分枝杆菌(MTB)感染引起的慢性传染病。它是十大 主要死因之一。根据世界卫生组织结核病报告,到2019年,全球约三分之 一的人口感染结核分枝杆菌,140万人死于结核病。1/4-1/3的结核分枝杆菌 感染者没有任何临床症状,这也被称为潜伏性结核感染(LTBI)。目前约有 20亿人患有LTBI,其中约10%的人在有生之年会发展为活动性结核。随着 感染者个体免疫状态的改变,因此,及时诊断结核病对结核病的治疗和感 染控制至关重要。
在鉴别LTBI和活动性肺结核(ATB)方面由于缺乏有效的诊断方法,阻 碍了结核病的预防和控制。目前结核病的实验室诊断仍依赖于传统的方法, 包括抗酸染色(AFS)、核酸扩增(NAA,如基因Xpert-MTB/RIF),痰及其 他呼吸道标本结核分枝杆菌(MTB)培养。所有的方法都有局限性,痰结 核菌培养更是需要2-8周才能获得培养结果,而且阳性率较低,不能满足临 床要求;痰涂片法虽周期短,但特异性差;尽管基因Xpert-MTB/RIF的检 测速度快、灵敏度高,但不能解决阴性菌的检测问题。干扰素-γ释放试验 也是辅助结核病诊断的一种方法,但仍不能区分ATB和LTBI。因此,临床 诊断迫切需要更准确、更易操作的结核病诊断工具。
预防LTBI人群发展为ATB是结核病防治的重要策略之一。LTBI人群 的筛选和鉴定需要新型生物标志物和技术,特别是对于那些高负担人群, 包括HIV患者、糖尿病患者和免疫缺陷患者。
发明内容
本发明解决的技术问题是如何筛查活动性肺结核感染患者。
检测血清中抗Rv1860抗体、抗RV3881c抗体、抗Rv2031c抗体和抗 Rv3803c抗体水平的产品在制备具有鉴别、诊断、辅助诊断、筛查和/或辅 助筛查活动性肺结核感染患者用途的产品中的应用。
可选的,所述Rv1860是如下a)或b)的蛋白:a)序列表中的SEQ ID NO.1所示的氨基酸序列组成的蛋白质;b)将序列表中的SEQ ID NO.1的 氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与 SEQ ID NO.1所示蛋白具有相同功能的由a)衍生的蛋白质;
所述RV3881c是如下c)或d)的蛋白:c)序列表中的SEQ ID NO.2 所示的氨基酸序列组成的蛋白质;d)将序列表中的SEQ ID NO.2的氨基酸 序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.2所示蛋白具有相同功能的由c)衍生的蛋白质;
所述Rv2031c是如下e)或f)的蛋白:e)序列表中的SEQ ID NO.3 所示的氨基酸序列组成的蛋白质;f)将序列表中的SEQ ID NO.3的氨基 酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.3所示蛋白具有相同功能的由e)衍生的蛋白质;
所述Rv3803c是如下g)或h)的蛋白:g)序列表中的SEQ ID NO.4 所示的氨基酸序列组成的蛋白质;h)将序列表中的SEQ ID NO.4的氨基 酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.4所示蛋白具有相同功能的由g)衍生的蛋白质。
检测血清中抗Rv1860抗体、抗RV3881c抗体、抗Rv2031c抗体和抗 Rv3803c抗体水平的产品在制备区分活动性肺结核感染患者与正常人用途 的产品中的应用;可选的,所述待测患者候选为活动性肺结核患者。
一种用于鉴别、诊断、辅助诊断、筛查和/或辅助筛查活动性肺结核感 染患者的标志物组合物,由抗Rv1860抗体、抗RV3881c抗体、抗Rv2031c 抗体和抗Rv3803c抗体组成;所述Rv1860是如下a)或b)的蛋白:a)序 列表中的SEQ ID NO.1所示的氨基酸序列组成的蛋白质;b)将序列表中 的SEQ ID NO.1的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失 和/或添加且与SEQ ID NO.1所示蛋白具有相同功能的由a)衍生的蛋白质;
所述RV3881c是如下c)或d)的蛋白:c)序列表中的SEQ ID NO.2 所示的氨基酸序列组成的蛋白质;d)将序列表中的SEQ ID NO.2的氨基酸 序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.2所示蛋白具有相同功能的由c)衍生的蛋白质;
所述Rv2031c是如下e)或f)的蛋白:e)序列表中的SEQ ID NO.3 所示的氨基酸序列组成的蛋白质;f)将序列表中的SEQ ID NO.3的氨基 酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.3所示蛋白具有相同功能的由e)衍生的蛋白质;
所述Rv3803c是如下g)或h)的蛋白:g)序列表中的SEQ ID NO.4 所示的氨基酸序列组成的蛋白质;h)将序列表中的SEQ ID NO.4的氨基 酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.4所示蛋白具有相同功能的由g)衍生的蛋白质。
血清中抗Rv1860抗体、抗RV3881c抗体和/或抗Rv2031c抗体作为标 志物在开发、设计和/或制备具有鉴别、诊断、辅助诊断、筛查和/或辅助 筛查活动性肺结核感染患者用途的产品中的应用;
所述Rv1860是如下a)或b)的蛋白:a)序列表中的SEQ ID NO.1 所示的氨基酸序列组成的蛋白质;b)将序列表中的SEQ ID NO.1的氨基 酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.1所示蛋白具有相同功能的由a)衍生的蛋白质;
所述RV3881c是如下c)或d)的蛋白:c)序列表中的SEQ ID NO.2 所示的氨基酸序列组成的蛋白质;d)将序列表中的SEQ ID NO.2的氨基酸 序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.2所示蛋白具有相同功能的由c)衍生的蛋白质;
所述Rv2031c是如下e)或f)的蛋白:e)序列表中的SEQ ID NO.3 所示的氨基酸序列组成的蛋白质;f)将序列表中的SEQ ID NO.3的氨基 酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.3所示蛋白具有相同功能的由e)衍生的蛋白质;
所述Rv3803c是如下g)或h)的蛋白:g)序列表中的SEQ ID NO.4 所示的氨基酸序列组成的蛋白质;h)将序列表中的SEQ ID NO.4的氨基 酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.4所示蛋白具有相同功能的由g)衍生的蛋白质。
一种用于鉴别、诊断、辅助诊断、筛查和/或辅助筛查活动性肺结核感 染患者的试剂盒,或区分活动性肺结核感染患者与正常人的试剂盒,包括 检测芯片,所述检测芯片上至少连有Rv1860、RV3881c、Rv2031c和Rv3803c 蛋白,上述4种蛋白每种蛋白单独成立一个检测点;优选的,所述检测芯 片上连有Rv1860、RV3881c、Rv2031c和Rv3803c蛋白;
所述Rv1860是如下a)或b)的蛋白:a)序列表中的SEQ ID NO.1 所示的氨基酸序列组成的蛋白质;b)将序列表中的SEQ ID NO.1的氨基 酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.1所示蛋白具有相同功能的由a)衍生的蛋白质;
所述RV3881c是如下c)或d)的蛋白:c)序列表中的SEQ ID NO.2 所示的氨基酸序列组成的蛋白质;d)将序列表中的SEQ ID NO.2的氨基酸 序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.2所示蛋白具有相同功能的由c)衍生的蛋白质;
所述Rv2031c是如下e)或f)的蛋白:e)序列表中的SEQ ID NO.3 所示的氨基酸序列组成的蛋白质;f)将序列表中的SEQ ID NO.3的氨基 酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.3所示蛋白具有相同功能的由e)衍生的蛋白质;
所述Rv3803c是如下g)或h)的蛋白:g)序列表中的SEQ ID NO.4 所示的氨基酸序列组成的蛋白质;h)将序列表中的SEQ ID NO.4的氨基 酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.4所示蛋白具有相同功能的由g)衍生的蛋白质。
可选的,所述试剂盒还包括配合检测芯片一起使用的试剂,所述试剂 包括下述1)-4):1)pH7.4 PBS溶液,其组成为2mM Na2HPO4、1mM KH2PO4、 10mM NaCl和2mM KCl;2)pH7.4的PBST溶液,其组成为:PBS和Tween-20; 可选的,Tween-20占溶液总体积的1‰;3)含BSA的pH7.4 PBS溶液;4) 荧光标记的抗人第二抗体。
上述试剂盒在制备具有鉴别、诊断、辅助诊断、筛查和/或辅助筛查 活动性肺结核患者用途的产品中的应用。
本发明技术方案,具有如下优点:
1、本发明提供检测血清中抗Rv1860抗体、抗RV3881c抗体、抗Rv2031c 抗体和抗Rv3803c抗体水平的产品在制备区分或辅助区分活动性肺结核患 者与潜伏性结核感染患者用途的产品中的应用。本发明选择了21个文献报 道的MTB蛋白和43个DosR家族的蛋白作为候选抗原。选择酿酒酵母表达 系统重组表达64个MTB候选蛋白。在表达和纯化所有候选蛋白后,构建了 MTB蛋白芯片用于样品筛选。在生物标志物开发的探索阶段,共收集了180份血清样本,包括60份ATB样本、60份LTBI样本和60份健康志愿者样本, 从中筛选出5种蛋白,然后建立模型,得到含有4种抗原的生物标志物组 合,可有效区分ATB患者和LTBI人群。在验证阶段进一步用300多份血清 样品用ELISA方法对生物标志物组合进行了验证,最终结果表明芯片检测 结果与ELISA检测结果基本一致。
2、由于缺乏能够有效区分活动性结核病和潜伏性结核病感染的快速实 验室技术,阻碍了传染病的预防和控制,并导致疾病的进一步传播。本发 明利用基因芯片技术和酶联免疫吸附试验(ELISA)方法,筛选并验证了血 清样本中的候选生物标志物,最终确定了一种高灵敏度、特异性的MTB抗 原组合,用于准确区分ATB与LTBI和健康人。
3、与大多数研究不同之处在于,本发明将系统生物学方法应用于结核 免疫原的筛选,而不是评价已知的免疫原及其组合。已有研究表明,LAM、 Ag85A、Ag85B、ESAT-6、CFP10、MPT64等多种抗原可用于评价结核分枝杆 菌感染,基于T细胞的干扰素γ释放试验(IGRA)是区分MTB感染者和非 MTB感染者的最有效方法,但仍不能区分ATB和LTBI。
4、蛋白质微阵列技术作为一种高通量的技术已被广泛应用。固定在芯 片表面的蛋白质的纯化方法对筛选过程会产生一定影响。之前的报道用大 肠杆菌作为表达系统来产生蛋白质,本发明研究选择了酿酒酵母作为表达 系统。酵母系统表达的蛋白质具有翻译后修饰,更适合于功能蛋白的筛选。 因此采用了合理科学的设计。首先,制备了DosR蛋白和其他广泛报道的MTB 候选抗原,并将其定位到微阵列上,为后续的筛选提供了独特的MTB蛋白 质微阵列。然后先用相对较少的血清样本进行初筛,经过数据分析和模型 建立后,用较大数量的血清样本对ELISA法微阵列的初筛结果进行验证, 以确保两个系统的检测结果一致。
5、研究表明,9种DosR抗原(Rv0569、Rv1996、Rv2030、Rv2031c、 Rv2626、Rv2628、Rv3129、Rv3131、Rv3133)的组合可有效区分潜伏性感 染和活动性结核感染,但该组含有过多的蛋白质,因此削弱了其临床应用 的可能性。
6、ELISA结果显示,本发明中四种候选抗原的敏感性较低,从19.3% 到38.6%。然而,将四种候选抗原组合为一组,检测性能得到显著提高,灵 敏度为93.3%,特异性为97.7%。四种抗原组在区分ATB与LTBI和健康个 体方面表现良好,表明ATB患者的体液免疫应答强于LTBI和健康个体。
7、血清学生物标志物是一种操作简便、快速、无创的疾病诊断技术, 因此,从临床医生的角度出发,筛选新的结核病血清学生物标志物具有重 要意义。四种蛋白(Rv1860、Rv2031c、Rv3881c和Rv3803c)显示,ATB患 者血清抗体水平明显高于LTBI和健康组。在ATB与HC和ATB与LTBI的比 较中,大多数差异抗体都是IgG亚型,表明在MTB感染期间产生的抗体主 要是IgG亚型。
8、本发明所建立的四种抗原的检测小组,在从结核性结核菌患者中筛 选出LTBI患者时,具有准确的检测能力,不仅诊断能力强,而且操作简单, 成本低廉,是一种比较有前途的结核病防治工具。
附图说明
为了更清楚地说明本发明具体实施方式或现有技术中的技术方案,下 面将对具体实施方式或现有技术描述中所需要使用的附图作简单地介绍, 显而易见地,下面描述中的附图是本发明的一些实施方式,对于本领域普 通技术人员来讲,在不付出创造性劳动的前提下,还可以根据这些附图获 得其他的附图。
图1是本发明实施例1筛选并鉴别ATB和LTBI/健康人血清生物标志 物的流程示意图;
图2是本发明实施例1结核相关蛋白微阵列的质量控制;图2A左边 的图像是抗GST信号检测到的代表性结核相关蛋白质微阵列的全视图;统 计分析显示结核蛋白检出率为98.4%,每个微阵列上有14个区块,结核相 关蛋白质微阵列上14个区块之一的放大图像显示在右侧,图2B前景(F) 和背景(B)信号强度直方图表明,大多数印刷点含有大量的重组蛋白;
图3是本发明实施例1基于结核相关蛋白微阵列筛选ATB或LTBI或 HC组血清样本中抗体水平不同有差异的抗原;
A图为ATB组和HC组抗体水平有差异抗原;
B火山图显示了ATB和LTBI组抗体水平有差异抗原;黑色虚线:cutoff 值(比值>1.1,p值<0.05);在ATB组中抗体水平较高的5种抗原被标注;
C:韦恩图,在ATB与HC和ATB与LTBI的比较中均存在5种抗原; ATB中检测到这5种抗原高水平的抗体;
D:5种蛋白作为候选生物标志物的微阵列结果。
图4不同组间候选生物标志物抗体检测结果;上面一组显示:ATB组各 候选生物标志物的信号强度明显高于HC和LTBI对照组;下面一组显示: 每个候选生物标志物的ROC曲线;
图5使用结核相关蛋白质微阵列样本的生物标志物组的ROC曲线; A:ATB与健康志愿者(HC)的比较,ATB vs HC train set指的是ATB与 HC训练集比较,ATB vs HCvalidation set指的是ATB与HC验证集比较; B:ATB与LTBI比较,ATB vs LTBI train set指的是ATB与LTBI训练 集比较,ATB vs LTBI validation set指的是ATB与LTBI验证集比较; C:ATB与LTBI加HC比较,ATB vs ATB LTBI plus HC train set指的 是ATB与LTBI加HC训练集比较,ATB vs ATB LTBI plus HC validation set 指的是ATB与LTBI加HC验证集比较;(A-C)中ROC曲线的AUC值均>0.9, 每个生物标志物组ROC曲线的AUC值均高于任何单个生物标志物的AUC 值。
图6是本发明一个实施例1中的使用Elisa样本的生物标志物面板的 ROC曲线;a:ATB与HC的比较;ATB vs HC train set指的是ATB与HC训 练集比较,ATB vs HCvalidation set指的是ATB与HC验证集比较;b: ATB与LTBI比较,ATB vs LTBI train set指的是ATB与LTBI训练集比 较,ATB vs LTBI validation set指的是ATB与LTBI验证集比较;c:ATB 与LTBI加HC比较,ATB vs ATB LTBI plus HC train set指的是ATB与 LTBI加HC训练集比较,ATB vs ATB LTBI plus HC validation set指的 是ATB与LTBI加HC验证集比较;在每个不同的比较中,每个生物标志物 组的ROC曲线的AUC值高于任何单个生物标志物。
具体实施方式
实施例1
1.1研究资料
收集活动性肺结核(ATB),潜伏性肺结核感染(LTBI)患者及健康志 愿者血清各160份。患者年龄16~93岁。在训练阶段,用三组180份血清 样品(每组60份)进行微阵列检测;在验证阶段,用ELISA法进一步检测 三组300份血清样品(每组100份)。所有样本均于2019年12月至2020 年9月在江西省胸科医院采集,样本采集均经江西省胸科医院伦理委员会 批准(编号:(2019)50)。参与者在获得书面同意后登记,并根据《赫尔 辛基宣言》(2013年修订)进行的。
根据临床症状、抗酸杆菌(AFB)痰涂片、细菌培养结果等标准对ATB 患者进行诊断。ATB组纳入依据为:结核特异性临床症状、痰AFB阳性和/ 或细菌培养阳性。LTBI组纳入依据为:无结核特异性临床症状、痰AFB阴 性和IGRA阳性(X.DOT-TB,中国佛山结核病医疗中心)的患者。HC组纳入 依据为IGRA阴性的健康志愿者(X.DOT-TB,中国佛山结核病医疗中心)。三组患者均于治疗前收集。所有患者均无其他免疫相关疾病。所有患者的 临床资料见表1。
1.2 MTB抗原微阵列的构建
MTB抗原来自中国科学院生物物理研究所。经测序验证后,通过 Gateway-LR反应将基因导入目的载体pEGH-A27,构建表达载体。所构建的 载体可表达N端GST标记的重组蛋白,便于后续纯化。
利用酿酒酵母Y258菌株表达MTB微阵列候选抗原,通过高通量策略进 行以下纯化。首先将菌株接种于12孔平板上,在SC-URA/D-Raffinose培 养基中培养,直到OD600达到1.0,然后将半乳糖添加到最终浓度20%(w/v) 以诱导蛋白表达。诱导后,当OD600达到2.0时收集细胞。将收获的细胞 与200μL裂解缓冲液混合,并转移到96×0.5mL培养皿(中国上海桑光生 物科技有限公司)中,培养皿中含有100μL冷冻玻璃珠。在4℃下进行细胞 裂解并立即应用于谷胱甘肽珠。GST融合蛋白用GST亲和层析法纯化,并按 标准方法进行纯化。在使用抗GST抗体进行免疫印迹分析后(Sangon Biotech,上海,中国),纯化的抗原在微阵列载玻片上被标记。
MTB蛋白质微阵列由广州博翀生物科技有限公司(中国佛山)构建,包 含64种重组MTB(H37Rv)蛋白(包括43种DosR蛋白和21种文献报道的 蛋白,见表1)。以人IgG(Sigma,美国)和IgM(Rockland,美国)为阳 性对照,牛血清蛋白(BSA)为阴性对照,用抗GST抗体(CWBIO,中国北 京)孵育微阵列进行质量评价。所有纯化的MTB蛋白和对照品在一个玻片上重复出现。蛋白质微阵列的质量通过抗GST抗体的探测来评估(图2)。 MTB蛋白质微阵列在使用前储存于-80℃。
表1
#:表示蛋白质的不成功重组表达。
1.3MTB蛋白质微阵列检测血清样本
首先,MTB蛋白质微阵列从-80℃,室温预热半小时,然后在37℃ 下的封闭缓冲液(在PBS缓冲液中含有3%(w/v)BSA和0.1%(v/v)吐温 20)中孵育1h。
其次,将用封闭缓冲液按封闭缓冲液与血清样本体积比为1:1000稀释 血清样本,MTB蛋白质微阵列测,37℃孵育1h。用PBST洗涤3次后,将微 阵列与Alexa647结合的山羊抗人IgG在黑暗中孵育1h。
最后,用PBST溶液(pH7.4)洗涤3次后,用双蒸馏水冲洗微阵列, 干燥。用GenePix4000B微阵列扫描仪(分子器件,Sunnyvale,CA)扫描 微阵列,并使用GenePix Pro 6.0软件(分子器件,Sunnyvale,CA)进行 分析。
1.4蛋白质微阵列数据分析
对于MTB蛋白质微阵列,利用GenePix-pro6.0软件对阵列上每个点的 中位前景和背景强度进行了测量。将每个点的前景信号与背景信号的比值 作为点的信号值,然后以每对重复的平均信号值作为蛋白质的信号值。将 信号值截止设置为2.0,以识别正信号。采用SAM(芯片的显著性分析,R 软件(v3.6.1))进行差异蛋白鉴定。选择t检验,根据信号值评估各组间 各蛋白的差异意义。用p值<0.05和差异倍数变化>1.1筛选结核特异性候 选自身抗原。此外,用受试者工作曲线(ROC)来区分区分活动性结核病和 非(活动性)结核病。本发明定义了每个候选生物标志物的疾病判别能力 (判别能力=(敏感性+特异性)/2)。为了进一步提高活性肺结核组临床检 测的敏感性和特异性,从上述多个候选标记蛋白中筛选出了构建模型的最 佳候选标记蛋白。
1.5 ELISA分析
MTB抗原用包被缓冲液(碳酸缓冲液,pH9.6)稀释至1μg/mL,在4℃ 下培养过夜,包被于96孔板上。平板用PBST洗涤3次,室温下用封闭缓 冲液(PBS,3%(w/v)BSA,0.1%(v/v)tween20)封闭3h。用PBST缓冲液 以1:100稀释100μL血清样品,加入涂有涂层的平板中,然后在室温下培 养30分钟。用PBST洗涤平板5次后,用PBST按抗人IgG抗体与PBST体 积比为1:10000稀释抗人IgG抗体(CWBiotech,中国北京),添加并在室 温下培养30分钟。在用PBST再洗涤五次后,使用TMB底物(InnoRegents, 浙江,中国)在37℃下在黑暗中对平板着色10分钟。使用2M硫酸溶液停 止反应。使用微孔板读取器(Perlong,中国北京)在450nm/620nm处测 定光密度。
1.6统计方法
使用Kolmogorov-Smirnov检验数据分布的正态性。组间差异采用 Fisher精确检验或Pearson卡方检验(分类数据)和t检验或Mann-Whitney 检验(连续数据)进行分析。通过ROC分析和计算曲线下面积(AUC)评价 潜在生物标志物的诊断价值。随机森林被用来建立结核病生物标志物面板 的模型。在随机森林分析中,使用R软件包randomForest(版本4.6.14) 构建了1000棵树,并进行了10次交叉验证,重复100次。统计显著性的 临界值设为p值<0.05。所有数据分析均使用R统计软件(3.6.1版)和相 关软件包进行。
2.结果
2.1研究设计
采用两阶段策略来识别ATB的新生物标记物(图1)。在探索阶段,在 含有64M的蛋白质微阵列上分析了60名ATB患者、60名LTBI患者和60名 健康志愿者的血清样本。根据ATB和LTBI的敏感性和特异性,筛选出可能 的候选蛋白。用SAM(significance analysis ofmicroarray)方法来筛 选出一组具有最佳敏感性和特异性的四种蛋白质。在随后的验证阶段,在 单独的ELISA实验中对另外300份独立血清样本进行了评估(100份来自 ATB的血清样本,100份用于LTBI患者,100份用于HC患者图1)。
2.2抗原的纯化与鉴定
在本实施中,MTB抗原在酿酒酵母中表达。每个抗原的N-末端都用GST 标记,以利于抗原的纯化和鉴定。候选蛋白经GST亲和层析纯化,抗GST 抗体鉴定。
2.3蛋白质微阵列来分析试验可靠性
在玻片上发现纯化的重组蛋白和对照(洗脱缓冲液、GST、BSA和组蛋 白)一式两份,并通过抗GST抗体探测评估微阵列的质量(图2A)。由64 个MTB H37Rv蛋白组成的微阵列,包括43个DosR蛋白(图2A)和21个文 献报道的MTB蛋白(见表1)。对荧光信号的前景强度(F)和背景强度(B) 的分析表明,蛋白质微阵列具有较低的背景信号(平均信号强度值为100), 而前景荧光信号强度较高(平均信号强度值为13796)。前景强度曲线(图 2B)和背景强度曲线几乎完全分离,表明微阵列上的蛋白质可用于随后的 血清样本检测。
为了评估实验间的稳定性和重复性,在总共7个独立阵列上测定相同 的混合血清样品(QC样品)。阵列间的平均相关系数为0.98,每对复制蛋 白点的皮尔逊相关系数(R2)均大于0.99(HC,0.99;LTBI,0.99,ATB, 1),表明从微阵列获得的结果是稳定和可重复的。HC为健康人。
2.4 MTB蛋白质微阵列鉴定出差异抗体
如上所述,在探索阶段使用MTB蛋白质微阵列来分析相对较少的血清 样本(来自ATB患者的60个样本、来自LTBI患者的60个样本和来自健康 志愿者的60个样本)。每个血清样本在MTB蛋白质微阵列上孵育,微阵列 上针对蛋白质的抗体通过开发具有Cy3标记的抗人IgG抗体和Cy5标记的 抗人IgM抗体的阵列来鉴定。从微阵列获得的数据首先使用微阵列显著性 分析(SAM)算法进行处理。根据微阵列的中值对信号强度进行标准化,并 在两组之间进行比较以确定差异抗体,阈值设置为p值<0.05且差异倍数变 化>1.1。使用这些标准,在ATB与HC、ATB与LTBI的比较中分别鉴定了19 种和12种差异蛋白(图3A、3B)。韦恩图比较分析结果显示,五种蛋白质 (Rv1860、Rv2031c、Rv3881c、Rv3803c和Rv0526)在ATB与HC和ATB与 LTBI之间存在显著差异(图3C)。蛋白质微阵列的荧光信号结果表明,这 五种蛋白质可以区分ATB组与HC和LTBI组(图3D)。
2.5 ROC分析与推导出ATB诊断标记物组合
为了确定诊断活动性肺结核的潜在血清生物标志物,绘制了这五种蛋 白的受试者操作特征(ROC)曲线,并计算了曲线下面积(AUCs)。还进行 了箱线图分析来比较五种抗原组间的差异。血清中5种蛋白的抗体在ATB、 LTBI和HC组之间存在显著差异(p值<0.05)(图4)。分别计算每种蛋白的 敏感性和特异性。用ROC曲线下面积评价5种蛋白的诊断价值。五种蛋白 质的AUC值在0.599到0.725之间(图4),灵敏度在19.3%到38.6%之间。 虽然在血清中发现了一系列与ATB相关的抗体,但没有任何一种抗体在区 分ATB与LTBI和HC个体方面有突出的表现。
通过对候选抗原不同组合的分析计算,最终筛选出4种蛋白(Rv1860、 Rv3881c、Rv2031c和Rv3803c)进行模型构建。首先,将数据随机分为两 组,一组作为训练集(70%样本),另一组作为测试集(30%样本)。然后利 用随机森林建立模型,得到一个具有良好性能的面板,用于区分ATB与 LTBI/HC个体。在训练集中,ATB与HC、ATB与LTBI和LTBI与HC的ROC曲线下面积分别达到0.973、0.981和0.964(图5)。优化后的四种蛋白组 合检测对区分ATB患者与健康人的敏感性为86%,特异性为97.6%,对区分 ATB患者与LTBI患者的敏感性为93.3%,特异性为97.7%。在测试集中,ROC 曲线下的面积值相似(>0.9)(图5),表明该面板在区分ATB与LTBI个体 和健康个体方面的稳定性。结果表明,4种蛋白(rv1860、Rv3881c、Rv2031c 和Rv3803c)的标记物组合具有良好的诊断性能,可用于活动性和潜伏性结 核感染的诊断。
2.6用ELISA法验证ATB生物标志物组合
为了评价所鉴定抗原的应用价值,采用ELISA方法对这些生物标志物 进行了验证,并添加300份独立血清进行ELISA实验,纯化了4种候选抗 原(Rv1860、Rv3881c、Rv2031c和Rv3803c)并用于ELISA检测。结果与 使用蛋白质微阵列的发现阶段的结果一致。四种蛋白质在ATB组显示出明 显高于HC或LTBI组的信号。小组在ELISA方法的训练集和测试集中有效 地区分了ATB和LTBI(图6)。还使用ELISA实验的结果来评估随机森林模 型生物标记物面板的性能。ROC曲线下面积分别为:训练集中ATB组与HC 组、ATB组与LTBI组、LTBI组与LTBI/HC组的ROC曲线下面积分别为0.976、 0.971和0.972。区分ATB和HC的敏感性和特异性分别为91.2%和98.8%。 区分ATB和LTBI的敏感性和特异性分别为93.3%和97.7%。
显然,上述实施例仅仅是为清楚地说明所作的举例,而并非对实施方 式的限定。对于所属领域的普通技术人员来说,在上述说明的基础上还可 以做出其它不同形式的变化或变动。这里无需也无法对所有的实施方式予 以穷举。而由此所引伸出的显而易见的变化或变动仍处于本发明创造的保 护范围之中。
序列表
<110> 江西省胸科医院
<120> Rv1860蛋白、RV3881c蛋白、Rv2031c蛋白和Rv3803c蛋白在诊断活动性肺结核感染中的用途
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Ala Met Ile Gly Gln Ala Ala Glu Ala Met Gly Asn Ser Arg Met Phe
245 250 255
Tyr Asn Gln Tyr Arg Ser Val Gly Gly His Asn Gly His Phe Asp Phe
260 265 270
Pro Ala Ser Gly Asp Asn Gly Trp Gly Ser Trp Ala Pro Gln Leu Gly
275 280 285
Ala Met Ser Gly Asp Ile Val Gly Ala Ile Arg
290 295
Claims (8)
1.检测血清中抗Rv1860抗体、抗RV3881c抗体、抗Rv2031c抗体和抗Rv3803c抗体水平的产品在制备具有鉴别、诊断、辅助诊断、筛查和/或辅助筛查活动性肺结核感染患者用途的产品中的应用。
2.根据权利要求1所述的应用,其特征在于:所述Rv1860是如下a)或b)的蛋白:a)序列表中的SEQ ID NO.1所示的氨基酸序列组成的蛋白质;b)将序列表中的SEQ ID NO.1的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.1所示蛋白具有相同功能的由a)衍生的蛋白质;
所述RV3881c是如下c)或d)的蛋白:c)序列表中的SEQ ID NO.2所示的氨基酸序列组成的蛋白质;d)将序列表中的SEQ ID NO.2的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.2所示蛋白具有相同功能的由c)衍生的蛋白质;
所述Rv2031c是如下e)或f)的蛋白:e)序列表中的SEQ ID NO.3所示的氨基酸序列组成的蛋白质;f)将序列表中的SEQ ID NO.3的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.3所示蛋白具有相同功能的由e)衍生的蛋白质;
所述Rv3803c是如下g)或h)的蛋白:g)序列表中的SEQ ID NO.4所示的氨基酸序列组成的蛋白质;h)将序列表中的SEQ ID NO.4的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.4所示蛋白具有相同功能的由g)衍生的蛋白质。
3.检测血清中抗Rv1860抗体、抗RV3881c抗体、抗Rv2031c抗体和抗Rv3803c抗体水平的产品在制备区分活动性肺结核感染患者与正常人用途的产品中的应用。
4.一种用于鉴别、诊断、辅助诊断、筛查和/或辅助筛查活动性肺结核感染患者的标志物组合物,由抗Rv1860抗体、抗RV3881c抗体、抗Rv2031c抗体和抗Rv3803c抗体组成;所述Rv1860是如下a)或b)的蛋白:a)序列表中的SEQ ID NO.1所示的氨基酸序列组成的蛋白质;b)将序列表中的SEQ ID NO.1的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.1所示蛋白具有相同功能的由a)衍生的蛋白质;
所述RV3881c是如下c)或d)的蛋白:c)序列表中的SEQ ID NO.2所示的氨基酸序列组成的蛋白质;d)将序列表中的SEQ ID NO.2的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.2所示蛋白具有相同功能的由c)衍生的蛋白质;
所述Rv2031c是如下e)或f)的蛋白:e)序列表中的SEQ ID NO.3所示的氨基酸序列组成的蛋白质;f)将序列表中的SEQ ID NO.3的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.3所示蛋白具有相同功能的由e)衍生的蛋白质;
所述Rv3803c是如下g)或h)的蛋白:g)序列表中的SEQ ID NO.4所示的氨基酸序列组成的蛋白质;h)将序列表中的SEQ ID NO.4的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.4所示蛋白具有相同功能的由g)衍生的蛋白质。
5.血清中抗Rv1860抗体、抗RV3881c抗体和/或抗Rv2031c抗体作为标志物在开发、设计和/或制备具有鉴别、诊断、辅助诊断、筛查和/或辅助筛查活动性肺结核感染患者用途的产品中的应用;
所述Rv1860是如下a)或b)的蛋白:a)序列表中的SEQ ID NO.1所示的氨基酸序列组成的蛋白质;b)将序列表中的SEQ ID NO.1的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.1所示蛋白具有相同功能的由a)衍生的蛋白质;
所述RV3881c是如下c)或d)的蛋白:c)序列表中的SEQ ID NO.2所示的氨基酸序列组成的蛋白质;d)将序列表中的SEQ ID NO.2的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.2所示蛋白具有相同功能的由c)衍生的蛋白质;
所述Rv2031c是如下e)或f)的蛋白:e)序列表中的SEQ ID NO.3所示的氨基酸序列组成的蛋白质;f)将序列表中的SEQ ID NO.3的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.3所示蛋白具有相同功能的由e)衍生的蛋白质;
所述Rv3803c是如下g)或h)的蛋白:g)序列表中的SEQ ID NO.4所示的氨基酸序列组成的蛋白质;h)将序列表中的SEQ ID NO.4的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.4所示蛋白具有相同功能的由g)衍生的蛋白质。
6.一种用于鉴别、诊断、辅助诊断、筛查和/或辅助筛查活动性肺结核感染患者的试剂盒,或区分活动性肺结核感染患者与正常人的试剂盒,包括检测芯片,所述检测芯片上至少连有Rv1860、RV3881c、Rv2031c和Rv3803c蛋白,上述4种蛋白每种蛋白单独成立一个检测点;优选的,所述检测芯片上连有Rv1860、RV3881c、Rv2031c和Rv3803c蛋白;
所述Rv1860是如下a)或b)的蛋白:a)序列表中的SEQ ID NO.1所示的氨基酸序列组成的蛋白质;b)将序列表中的SEQ ID NO.1的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.1所示蛋白具有相同功能的由a)衍生的蛋白质;
所述RV3881c是如下c)或d)的蛋白:c)序列表中的SEQ ID NO.2所示的氨基酸序列组成的蛋白质;d)将序列表中的SEQ ID NO.2的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.2所示蛋白具有相同功能的由c)衍生的蛋白质;
所述Rv2031c是如下e)或f)的蛋白:e)序列表中的SEQ ID NO.3所示的氨基酸序列组成的蛋白质;f)将序列表中的SEQ ID NO.3的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ ID NO.3所示蛋白具有相同功能的由e)衍生的蛋白质;
所述Rv3803c是如下g)或h)的蛋白:g)序列表中的SEQ ID NO.4所示的氨基酸序列组成的蛋白质;h)将序列表中的SEQ ID NO.4的氨基酸序列经过一个或几个氨基酸残基的取代和/或缺失和/或添加且与SEQ IDNO.4所示蛋白具有相同功能的由g)衍生的蛋白质。
7.根据权利要求6所述的试剂盒,其特征在于:所述试剂盒还包括配合检测芯片一起使用的试剂,所述试剂包括下述1)-4):1)pH7.4 PBS溶液,其组成为2mM Na2HPO4、1mMKH2PO4、10mM NaCl和2mM KCl;2)pH7.4的PBST溶液,其组成为:PBS和Tween-20;3)含BSA的pH7.4 PBS溶液;4)荧光标记的抗人第二抗体。
8.权利要求6或7所述试剂盒在制备具有鉴别、诊断、辅助诊断、筛查和/或辅助筛查活动性肺结核患者用途的产品中的应用。
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