CN117760941A

CN117760941A - Method for detecting activation of drug allergen basophil and application thereof

Info

Publication number: CN117760941A
Application number: CN202311231847.6A
Authority: CN
Inventors: 彭霞; 李莉; 李玮泽
Original assignee: Shanghai First Peoples Hospital
Current assignee: Shanghai First Peoples Hospital
Priority date: 2022-09-23
Filing date: 2023-03-23
Publication date: 2024-03-26
Also published as: CN117760939A; CN117760942A

Abstract

The invention relates to a method for detecting activation of drug allergen basophils and application thereof. In particular, the present invention provides a reagent combination for detection comprising: a first antibody against human CD203c, a second antibody against human CD123, a third antibody against human CD45, a fourth antibody against human CD63, a positive control, and a drug allergen. The method can rapidly and accurately detect the activation of the basophils through blood collection, activating reagent configuration, activation, termination activation, antibody marking, erythrocyte lysis, flow cytometry detection, result analysis and judgment. The invention can be used for diagnosing allergic diseases sensitized by drug allergens, determining the drug allergens and components thereof, predicting the severity of allergy and monitoring the curative effect.

Description

Method for detecting activation of drug allergen basophil and application thereof

The application is a divisional application of an invention patent application with the application number of 2023102925190 and the name of 'a basophil activation detection method and application thereof' which is filed on 23/03/2023.

Technical Field

The invention relates to the field of medical detection, in particular to a basophil activation detection method and application thereof.

Background

Allergic diseases are common clinical conditions. According to WHO statistics, about 22% of people worldwide are interfered by allergic diseases, and the number of people suffering from the allergic diseases is in an annual rising trend, so that a heavy economic burden is brought to society.

The clinical symptoms of allergic diseases often lack specificity, which makes clinical diagnosis difficult. At present, clinical diagnosis of allergic diseases, in addition to medical history and physical examination, laboratory examination is an important auxiliary diagnosis means.

Laboratory tests commonly used today are mainly for the detection of allergens, including in vivo challenge tests and in vitro allergen specific IgE detection (IgE) as well as serum total IgE detection. Although the in vivo test has higher accuracy, the risk of inducing severe allergic reaction exists, the cross reaction result of various antigens in allergy is difficult to judge, and patients, especially children, are painful in detection.

The total IgE levels in vitro assays are affected by a number of factors and have low specificity. Currently, allergen sIgE detection is the most widely used detection means for diagnosis of allergic diseases. However, since the serum concentration of IgE is very low (about 3 to 7 parts per million of IgG), detection is difficult and there are limited allergens (about 30 to 40 species) that can be detected. Furthermore, allergen-specific IgE results do not reflect the in vivo status of the patient.

Thus, there is a great clinical need to develop methods (including laboratory test methods) for the effective and reliable in vitro detection of allergic diseases.

Disclosure of Invention

It is an object of the present invention to provide a method for the efficient and reliable in vitro detection of allergic diseases.

Specifically, the invention provides a basophil activation detection method and a corresponding detection reagent, provides a new solution for diagnosis of allergic diseases, screening of allergens and components thereof, and the like, and can be applied to prediction of the severity of allergy and monitoring of curative effects.

In a first aspect of the invention there is provided a reagent combination for use in a basophil activation assay, wherein the reagent combination comprises: a first antibody against human CD203c, a second antibody against human CD123, a third antibody against human CD45, a fourth antibody against human CD63, a positive control, and an allergen.

In another preferred embodiment, the reagent combination further comprises a stimulation buffer and/or a termination buffer.

In another preferred embodiment, the combination of agents further comprises one or more agents selected from the group consisting of: a staining reagent diluent, a red blood cell lysate and a washing solution.

In another preferred embodiment, the stimulating buffer comprises Hank's balanced salt buffer, naHCO ₃ And HEPES buffer.

In another preferred embodiment, the pH of the stimulus buffer is 7.2-7.5 (preferably 7.35-7.45). The storage conditions used were 4 ℃.

In another preferred embodiment, the allergen comprises a crude extract of a discovered natural allergen, a purified natural allergen component, a recombinant allergen component, or a combination thereof.

In another preferred embodiment, the allergen is selected from the group consisting of: dust mites (body, molt, faeces, etc.), cockroaches, german cockroaches (saliva, faeces, gastrointestinal secretions, dander, molt, cadavers, crusta, what is bitten by it, places contaminated with its faeces, etc.), mugwort, aspergillus fumigatus, dog dander, cat dander, pollen, fungi (hyphae, spores, etc.), catkin (inhalant allergens); insect venom (contact allergen/infusion allergen); shrimp, wheat, rye, barley, oat, corn, peanut, fish, crab, egg, milk, sesame, soybean, common ragweed, quinoa, cocklebur, nuts, lentinus edodes, seafood, mango, kiwi, pineapple (food); antibiotics, biologicals (drugs/injectable allergens), or combinations thereof.

In another preferred embodiment, the allergen comprises a food or a drug.

In another preferred embodiment, the medicament comprises: anti-infective drugs, anesthetics and adjuvants thereof, neurologics, psychotropic drugs, antitumor drugs, cardiovascular drugs, respiratory drugs, digestive drugs, urinary system drugs, etc.

In another preferred embodiment, the medicament comprises: beta-lactamase drugs (including penicillins, cephalosporins, cephalomycins, etc.), neuromuscular blockers (NMBAs) drugs (anesthetics) (including succinylcholine, panuronium bromide, tubocurarine, atracurium, vecuronium bromide, rocuronium bromide, mevalonate, etc.), quinolones (including ciprofloxacin, moxifloxacin, levofloxacin, etc.), non-steroidal anti-inflammatory drugs (including aspirin, ibuprofen, diclofenac, phenylbutazone, acetaminophen, indomethacin, naproxen, etc.), iodinated contrast agents (including sodium iodide, diatrizamine, opalescent, iodotomato acid, cholestyramine, etc.), biologicals (including monoclonal antibodies, fusion proteins, cytokines, etc.).

In another preferred embodiment, the allergen comprises an inhaled allergen, an infused allergen, a coated/contacted allergen, an oral/oral allergen.

In another preferred embodiment, the allergen comprises a transdermal or transdermal allergen.

In another preferred embodiment, the inhalant allergen comprises: pollen, fungi, dust mites, animal allergens (cats, dogs, guinea pigs, horses, rabbits, etc., e.g., animal hair, dander, also including sebaceous glands, salivary glands, anus Zhou Xianti, etc.).

In another preferred embodiment, the injectable allergen comprises an insect injectable allergen (e.g., insect venom) and the insect comprises bee, wasp, ant, mosquito, etc.

In another preferred embodiment, the injectable allergen is a peptide, preferably a bee venom polypeptide.

In another preferred embodiment, the bee venom polypeptide comprises: melittin (Melittin), melittin gelatin (Apamin), mast Cell Decellularization Peptide (MCDP), an Du leveled (adolopin), or a combination thereof.

In another preferred embodiment, the allergen is selected from the group consisting of: dust mites (e.g., house dust mites, dust mites), cockroaches, german cockroaches, dog dander, cat dander, milk, eggs, antibiotics, or combinations thereof.

In another preferred embodiment, the allergen comprises a dust mite allergen (e.g. a dust mite allergen crude extract and a recombinant dust mite allergen main component Der f 2).

In another preferred embodiment, the concentration of the allergen is 0.01-20. Mu.g/mL, preferably 0.05-15. Mu.g/mL, more preferably 0.1-10. Mu.g/mL.

In another preferred embodiment, the stop buffer comprises PBS buffer containing EDTA or a salt thereof.

In another preferred embodiment, the concentration of EDTA or salts thereof in the stop buffer is 5-20mmol/L and the pH is 7.2-7.5 (preferably 7.35-7.45).

In another preferred embodiment, the positive control is selected from the group consisting of: anti-human IgE antibodies, fMLP, or a combination thereof.

In another preferred embodiment, the positive control is a double positive control comprising anti-human IgE antibodies and fMLP.

In another preferred embodiment, the human IgE is IgE from an allergic patient (e.g., allergen specific IgE (IgE), or serum total IgE).

In another preferred embodiment, the anti-human IgE antibody concentration is 0.1-20. Mu.g/mL, preferably 0.5-15. Mu.g/mL, more preferably 1-10. Mu.g/mL.

In another preferred embodiment, the first, second, third, and fourth antibodies bear different fluorescent labels.

In another preferred embodiment, the detection antibodies (i.e., the first antibody, the second antibody, the third antibody, and the fourth antibody) with different fluorescent labels are used as staining reagents, respectively.

In another preferred embodiment, the fluorescent marker molecule is selected from the group consisting of: FITC, PE, ECD, perCP-Cyanine5.5, PE-Cyanine, APC-Alexa750、APC、Alexa/>Dyes, pacific Blue, KO, or combinations thereof.

In another preferred embodiment, the staining reagent diluent consists of PBS buffer containing BSA.

In another preferred embodiment, the red blood cell lysate contains potassium bicarbonate, ammonia chloride, and EDTA-Na2.

In another preferred embodiment, the washing solution consists of PBS buffer containing BSA.

In a second aspect of the invention, there is provided an in vitro assay for basophil activation, wherein the method comprises the steps of:

(a) Providing a sample to be detected, wherein the sample is anticoagulated whole blood, and the anticoagulated whole blood is divided into n parts, wherein n is a positive integer (such as 3-10 parts, for example, 3, 4, 5 and 6 parts) more than or equal to 3;

(b) Setting a negative control group, a positive control group and an activation test group, adding the anticoagulated whole blood to form a test mixture, and performing stimulation incubation on the test mixture;

wherein, the test conditions of the negative control group, the positive control group and the activation test group are the same, and the difference is that: incubating at least one portion of the anticoagulated whole blood with a positive control in a positive control group; incubating at least one portion of said anticoagulated whole blood with an allergen in an activation test group; in the negative control group, at least one part of the anticoagulated whole blood is incubated in the absence of a positive control and in the absence of a allergen;

(c) Determining the target basophils in the negative control group, the positive control group and the activation test group by measuring the test mixtures in the negative control group, the positive control group and the activation test group, wherein the target basophils are CD203c ⁺ CD123 ⁺ CD45 ⁺ SS ^low A type cell; and determining CD63 in said target basophils ⁺ Cell number and/or ratio of (a); and

(d) CD63 for negative control group, positive control group and activation test group ⁺ Is compared to determine qualitatively and/or quantitatively the degree of activation of basophils in the sample to be tested.

In another preferred example, the positive control group comprises an anti-human IgE antibody positive control group and/or an fMLP positive control group;

preferably, in the step (a), n=4, and in the step (b), the positive control group includes a positive control group a and a positive control group b, wherein the positive control in the positive control group a is anti-human IgE antibody, and the positive control in the positive control group b is fMLP.

In another preferred embodiment, in step (b), the stimulus is incubated for a time t1 of 10-45 minutes, preferably 15-30 minutes, more preferably 15-25 minutes.

In another preferred embodiment, in step (d), comprising calculating a first SI value for the positive control group and a second SI value for the activation test group, wherein,

the first SI value is calculated as follows: SI = percentage of activated basophils of positive control/percentage of activated basophils of negative control; and also

The second SI value is calculated as follows: SI = percentage of activated basophils after stimulation in the activated test group/percentage of activated basophils in the negative control group;

or alternatively

The first SI value is calculated as follows: SI = number of activated basophils of positive control/number of activated basophils of negative control; and also

The second SI value is calculated as follows: SI = number of activated basophils after stimulation in the activated test group/number of activated basophils in the negative control group.

In another preferred embodiment, the number of activated basophils is determined by the mean fluorescence intensity of basophils CD 63.

In another preferred example, the first SI value = basophil CD63 mean fluorescence intensity of the positive control group/basophil CD63 mean fluorescence intensity of the negative control group.

In another preferred embodiment, the second SI value = basophil CD63 mean fluorescence intensity after stimulation in the activated test group/basophil CD63 mean fluorescence intensity in the negative control group.

In another preferred embodiment, in step (d), it comprises calculating a Z1 value for the positive control group and a Z2 value for the activation test group, wherein,

the Z1 value is calculated as follows: z1 = percentage of activated basophils of positive control group-percentage of activated basophils of negative control group; and also

The Z2 value is calculated as follows: z2 = percentage of activated basophils after stimulation in the activated test group-percentage of activated basophils in the negative control group.

In another preferred embodiment, the test is considered valid when Z1 is greater than or equal to 5% and the first SI value SI-1 is greater than or equal to 2, otherwise the test is not valid.

In another preferred example, when Z2 is not less than 5% and the second SI value SI-2 is not less than 2, the subject from which the sample is derived is judged to be an allergic patient or an allergic high risk group, otherwise, is judged to be a non-allergic patient or an allergic low risk group.

In another preferred embodiment, said qualitative and/or quantitative determination comprises determining: whether the basophils in the sample to be tested are activated, and/or the degree of activation.

In another preferred embodiment, in step (c), the target basophils in the negative control group, the positive control group and the activation test group are determined by flow cytometry.

In another preferred embodiment, in step (c), further comprising: the target basophil numbers and/or ratios in the negative control group, the positive control group, and the activation test group were determined.

In another preferred embodiment, the human IgE is IgE (e.g., allergen specific IgE (IgE), or serum total IgE) of an allergic patient.

In another preferred embodiment, the anticoagulated whole blood is heparin anticoagulated whole blood.

In the step (b), 50-500 mu L of anticoagulated whole blood is respectively added into each test tube in a negative control group, a positive control group and an activation test group, and then a stimulation buffer solution is respectively added, or a positive control substance and a stimulation buffer solution are respectively added, or an allergen and a stimulation buffer solution are respectively added;

in another preferred embodiment, the method comprises the steps of:

(1) Providing a sample: fresh heparin anticoagulated whole blood (preferably no more than 24 hours), preferably 1-5mL in volume;

(2) Grouping and stimulating: taking a flow tube, and dividing the flow tube into 3 tubes, namely a negative control tube, a positive control tube and a test tube; adding heparin anticoagulation into each tube, diluting the positive control and the allergen to 0.1-10 mug/mL by using a stimulating buffer, respectively adding the stimulating buffer, the diluted positive control and the allergen into a negative control tube, a positive control tube and a test tube, and stimulating for a period of time t1 (preferably t1 is 15-30 min) at 37+/-2 ℃;

(3) And (3) termination detection: adding stop buffer, centrifuging (200 g,10 min), sucking the supernatant, and re-suspending the cells;

(4) Labeling the antibody: diluting the fluorescent-labeled antibody with a staining reagent diluent, adding the fluorescent-labeled antibody, and incubating for a period of time t2 (preferably t2 is 25-40 min) in the dark;

(5) Lysing erythrocytes: adding a red blood cell lysate, lysing red blood cells, adding a washing solution for washing, centrifuging, and collecting cell precipitates, wherein the cell precipitates are cell populations containing basophils;

(6) Cell pellet was resuspended by addition of wash solutionAnd subjecting the resuspended cells to flow cytometry to determine target basophils, said target basophils being CD203c ⁺ CD123 ⁺ CD45 ⁺ SS ^low A type cell;

(7) Determination of CD63 in the target basophils ⁺ Cell number and/or ratio of (a); and

(8) CD63 for negative control group, positive control group and activation test group ⁺ Is compared to determine qualitatively and/or quantitatively the degree of activation of basophils in the sample to be tested.

In another preferred embodiment, the method comprises the steps of:

(2) Grouping and stimulating: taking a flow tube, and dividing the flow tube into 4 tubes, namely a negative control tube, a positive control tube a, a positive control tube b and a test tube; adding heparin anticoagulation into each tube, diluting the positive control product a, the positive control product b and the allergen to 0.1-10 mug/mL by using a stimulating buffer solution, adding the stimulating buffer solution, the diluted positive control product a, the diluted positive control product b and the allergen into a negative control tube, a positive control tube a, a positive control tube b and a test tube respectively, and stimulating for a period of time t1 (preferably t1 is 15-30 min) at 37+/-2 ℃;

(6) Adding a washing solution to resuspend the cell pellet and performing flow cytometry on the resuspended cells to determine the target basophils, said target Target basophil was CD203c ⁺ CD123 ⁺ CD45 ⁺ SS ^low A type cell;

(8) CD63 for negative control group, positive control group a, positive control group b and activation test group ⁺ Is compared to determine qualitatively and/or quantitatively the degree of activation of basophils in the sample to be tested.

In another preferred embodiment, in step (d), the test is considered quality control qualified if the first SI value of the positive control group is not less than 2 and the absolute percentage of activated basophils is not less than 5%; and if the second SI value of the activation test group is not less than 2 and the absolute percentage of activated basophils is not less than 5%, a positive test result is given, i.e. basophils are activated or activatable.

In another preferred embodiment, in step (d), the positive control group comprises an anti-human IgE antibody positive control group and an fMLP positive control group; if the first SI value in any positive control group is more than or equal to 2 and the absolute activated basophil percentage is more than or equal to 5%, the test is considered to be qualified in quality control; and if the second SI value of the activation test group is not less than 2 and the absolute percentage of activated basophils is not less than 5%, a positive test result is given, i.e. basophils are activated or activatable.

In another preferred embodiment, in the activation test group, the absolute activated basophil percentage=activated basophil percentage after stimulation in the activation test group-activated basophil percentage in the negative control group.

In another preferred example, in the positive control group, the absolute activated basophil percentage=the positive control group activated basophil percentage-the negative control group activated basophil percentage.

In another preferred embodiment, the activated basophils comprise CD63 ⁺ Basophils.

In another preferred embodiment, the method is non-diagnostic and non-therapeutic.

In a third aspect of the invention there is provided the use of a combination of reagents for use in the detection of basophil activation according to the first aspect of the invention for the preparation of a detection kit for use in

(a) Diagnosis of allergic diseases or identification of allergens;

(b) For analysis of allergy severity;

(c) Screening for allergic disease or susceptibility thereto; and/or

(d) Monitoring the efficacy of allergic diseases.

In another preferred example, the allergic diseases include allergic asthma, rhinitis, dermatitis and other various diseases associated with allergy.

In another preferred embodiment, the kit further comprises a description describing the method according to the second aspect of the invention.

It is understood that within the scope of the present invention, the above-described technical features of the present invention and technical features specifically described below (e.g., in the examples) may be combined with each other to constitute new or preferred technical solutions. And are limited to a space, and are not described in detail herein.

Drawings

FIG. 1 shows an example of a procedure for screening blood for basophils using flow cytometry in the present invention. Circled CD123c ⁺ CD203c ⁺ CD45 ⁺ SS ^low The cell population is basophils.

Fig. 2 shows the number of basophils and the CD63 detection results of the negative control group, the positive control group (anti-human IgE antibody) and the recombinant dust mite allergen component Der f 2-stimulated group, wherein fig. 2A is the negative control group, fig. 2B is the positive control group, and fig. 2C is the recombinant allergen component Der f 2-stimulated group.

FIG. 3 shows a negative control group, a positive control group (anti-human IgE antibody) and a recombinant dust mite allergen fraction Der f2 stimulated group, incubated with heparin anticoagulated whole blood of dust mite allergen-specific IgE positive patients, fluorescent antibody labeling, flow cytometry, respectively Analysis of basophils CD63 by surgery ⁺ Comparison of cell ratios.

Fig. 4 shows the basophil numbers and CD63 detection results of the negative control group, the positive control group a (anti-human IgE antibody), the positive control group B (fMLP), and the dust mite allergen crude extract-stimulated group, wherein fig. 4A is the negative control group, fig. 4B is the positive control group a (anti-human IgE antibody), fig. 4C is the positive control group B (fMLP), and fig. 4D is the dust mite allergen crude extract-stimulated group.

FIG. 5 shows a negative control group, a positive control group a (anti-human IgE antibody), a positive control group b (fMLP) and a dust mite allergen crude extract stimulated group, respectively incubated with heparin anticoagulated whole blood of dust mite allergen-specific IgE positive patients, fluorescent antibody-labeled, flow cytometry analysis of basophils CD63 ⁺ Comparison of cell ratios.

Detailed Description

The inventor of the present invention has conducted extensive and intensive studies and has developed a method for detecting activation of basophils and a corresponding detection reagent for the first time through a large number of screening. In particular, the inventors have found CD63 in a specific class of target basophil populations ⁺ Positive cells can be used as detection indexes for in vitro detection of allergic diseases or susceptibility thereof. In particular, when using flow cytometry for said CD203c ⁺ CD123 ⁺ CD45 ⁺ SS ^low When the expression level of the cell surface activation marker molecules of the basophil group is detected, according to the positive judgment standard of basophil activation, namely the Stimulation Index (SI) is more than or equal to 2 and the absolute activation basophil percentage is more than or equal to 5 percent, the activation state of the basophil under allergen stimulation can be estimated, the method has higher specificity and sensitivity for diagnosis of allergy, has better consistency with the gold standard (in vivo excitation test) for diagnosis of allergic diseases, and has better diagnosis effect than in-vitro allergen specific IgE detection (sIgE). The detection result can better reflect the in-vivo state, has important value for the severity prediction of allergic symptoms, the curative effect monitoring of desensitization treatment and the prognosis judgment, and completes the invention on the basis.

Terminology

In order that the present disclosure may be more readily understood, certain terms are first defined. As used in this application, each of the following terms shall have the meanings given below, unless expressly specified otherwise herein.

As used herein, the term "target basophil" or "target basophil of the invention" are used interchangeably to refer to having CD203c ⁺ CD123 ⁺ CD45 ⁺ SS ^low Characteristic basophils.

Basophils

As used herein, the term "basophil" generally refers to one of the leukocytes, which originates from bone marrow hematopoietic multipotent stem cells, which, after differentiation and maturation in the bone marrow, enter the blood stream. Basophils and mast cells are effector cells that cause allergic diseases. IgE combined with allergen is activated by bridging basophils and mast cell membrane receptors, and effector cells release particles synthesized in advance in cytoplasm once activated, and the particles are rich in release inflammatory mediators, cytokines, chemokines and the like, are active factors which lead to telangiectasia, increased vascular permeability, smooth muscle contraction and gland secretion and cause local or systemic allergic reaction symptoms, including allergic rhinitis, asthma, conjunctivitis, eczema, food allergy, drug allergy and the like, so that the activation of basophils can better reflect allergic conditions.

Basophils are effector cells in blood, and in the present invention, the gating method for detecting basophils in blood by flow cytometry is defined as CD203c ⁺ CD123 ⁺ CD45 ⁺ SS ^low A population of cells.

CD203c is mainly expressed on the surface of basophils, CD123 on the surface of monocytes, neutrophils, basophils, eosinophils and the like, and as shown in FIG. 1A, a scatter diagram is drawn with the fluorescence intensity of CD203c as the X axis and the fluorescence intensity of CD123 as the Y axis, and CD203c is circled ⁺ CD123 ⁺ And (3) cell population, which can obtain basophils, a small part of neutrophils and other cells.

CD45 is a leukocyte common antigen, and side scattered light (SS) reflects internal information such as nuclei and particles. Circled CD203c ⁺ CD123 ⁺ After the cell population, a scatter diagram is drawn by taking the fluorescence intensity of CD45 as an X axis and the size of SS as a Y axis, as shown in FIG. 1B, the cells are obviously clustered according to the fluorescence intensity of CD45 and SS, and basophils are weaker than other white blood cells, namely SS, the SS is lower ^low (cell populations with low side scatter in white blood cells). CD203c ⁺ CD123 ⁺ CD45 circled in cell populations ⁺ SS ^low Cell populations, defined as basophils.

Reagent combination for basophil activation detection

The invention provides a reagent combination for detecting activation of basophils. Typically, the reagent combinations of the present invention comprise: a first antibody against human CD203c, a second antibody against human CD123, a third antibody against human CD45, a fourth antibody against human CD63, a positive control, and an allergen. Preferably, the reagent combination of the present invention further comprises: stimulation buffer and/or termination buffer.

In the present invention, typical positive controls are selected from the group consisting of: anti-human IgE antibodies, fMLP, or a combination thereof; wherein the human IgE is IgE from allergic patients (such as allergen specific IgE (sIgE), or serum total IgE), fMLP is a chemotactic peptide/chemokine N-formylmethylsulfonyl-phenyl-phenylalanine (i.e., CHO-Met-Ile-Phe), N-formylmethylsulfonyl-leucyl-phenylalanine. Preferably, the positive control comprises anti-human IgE antibody and fMLP, which are positive control a and positive control b respectively.

Preferably, in the reagent combination of the present invention, the first antibody, the second antibody, the third antibody, and the fourth antibody carry different fluorescent labels.

Method for detecting activation of basophils

The invention also provides an in vitro detection method for basophil activation.

Typically, the method of the invention comprises the steps of:

(a) Providing a sample to be detected, wherein the sample is anticoagulated whole blood, the anticoagulated whole blood is divided into n parts, and n is a positive integer (such as 3-6 parts) more than or equal to 3;

The inventors have unexpectedly found that the basophils of interest of the present invention (i.e., CD203 c) were first selected by flow cytometry by screening and optimization ⁺ CD123 ⁺ CD45 ⁺ SS ^low Type cells), and then the detection result of basophil activation can be obtained more accurately, rapidly and reliably in vitro by data analysis among the negative control group, the positive control group and the activation test group.

In the invention, the positive control group can be provided with 1 group (anti-human IgE antibody positive control group or fMLP positive control group) or 2 groups (anti-human IgE antibody positive control group and fMLP positive control group), and can realize the detection effect with high specificity and high sensitivity. Further, when 2 positive controls are provided simultaneously, not only IgE-mediated basophil activation but also non-IgE-mediated basophil activation can be covered additionally, thereby avoiding the detection inefficiency that may be present in a small percentage of the population that is non-responsive to anti-human IgE stimulation. Therefore, when large-scale population detection is performed, the positive control group may preferably be set to 2 groups. When the positive control group is set to 2 groups, the detection method as shown in example 4 of the present application is preferably used.

In the detection method, the test group can be provided with a plurality of parallel test groups at the same time to respectively detect different allergen types or components, thereby realizing the test of the activation level of the alkalophilic granulocytes of a plurality of allergens in the same system. Compared with the limitation of specific IgE detection types, the detection method can detect various allergens at the same time, and improves the diagnosis efficiency of allergic diseases.

It is to be understood that the detection method of the present invention has a high correlation with allergy diagnosis, and that the allergen suitable for use in the present invention is not particularly limited, and that any type of allergen can stimulate activation of basophils, so that whether a subject is allergic, the specific allergen of the subject, the severity of allergy of the subject, and the like can be identified by the detection method of the present invention. According to different classification criteria, allergens can be classified as food allergens, pharmaceutical allergens; can also be divided into inhaled allergens, infused allergens, applied/contacted allergens, oral/oral allergens; or a transdermal or transdermal allergen, etc. Various types of allergens are suitable for detection/diagnosis using the detection reagent combination/detection method of the present invention.

In the present invention, representative allergens include, but are not limited to: dust mites, cockroaches, german cockroaches, mugwort, aspergillus fumigatus, dog dander, cat dander, pollen, catkin, insect venom, fungi, shrimp, wheat, rye, barley, oats, corn, peanuts, fish, crabs, eggs, milk, sesame, soybean, common ragweed, quinoa, cocklebur, nuts, mushrooms, seafood, mangoes, kiwi, pineapple, antibiotics, biologicals, or combinations thereof.

The allergen and the component raw materials thereof can be rapidly put into the detection system of the invention for application, and the types and components of the allergen to be detected can be freely matched, so that the flexibility is high. The detection method of the invention does not need complicated research and development and verification processes of specific IgE detection, and can be applied to patients allergic to unusual allergens.

The reagent combinations or kits and detection methods of the present invention are typically useful for one or more applications selected from the group consisting of:

(a) Diagnosis of allergic diseases or identification of allergens;

(b) For analysis of allergy severity;

(c) Screening for allergic disease or susceptibility thereto; and/or

(d) Monitoring the efficacy of allergic diseases.

The main advantages of the invention

1. Compared with in vivo excitation tests, the basophil activation detection method provided by the invention has the advantages that the risk of inducing severe allergic reaction is avoided, the safety is higher, and the pain of patients, especially children, during detection can be relieved.

2. Compared with the allergen sIgE detection method, the basophil activation detection method reduces the detection technical requirements and expands the allergen variety range for screening.

3. Compared with the commercial basophil activation kit, the basophil activation detection method provided by the invention does not need to be imported from abroad, and can reduce the price and cost. Meanwhile, the method is easy in the aspects of operation technology difficulty, result interpretation difficulty and the like, and is more beneficial to developing clinical application.

4. The basophil activation detection method is simpler in door setting method for basophil groups, reduces detection difficulty and complexity, and improves detection efficiency.

5. The basophil activation detection method disclosed by the invention has better consistency with the result of the gold standard (in-vivo excitation test) for diagnosing allergic diseases than the existing method, and reduces the probability of misdiagnosis and missed diagnosis compared with the existing method. For example, in a case where a patient whose allergy is confirmed by clinical diagnosis or whose allergy is highly suspected is detected by the allergen sIgE detection method, the detection result is found to be negative, and it is judged that the patient is a non-allergic patient, and thus there is a phenomenon of missed diagnosis. When the basophil activation detection method is used for detecting the basophil activation, the detection result is positive, and the patient is judged to be allergic, so that missed diagnosis is avoided.

6. The basophil activation detection method has higher specificity, and can distinguish the reaction results when a plurality of allergens exist, so that screening of a plurality of allergen types can be performed in one detection, and the diagnosis efficiency of allergic diseases is improved.

7. The basophil activation detection method has higher sensitivity, can predict the severity of allergic symptoms by the activation degree of basophil, and can also be used for monitoring the curative effect of desensitization treatment.

8. The detection method and the detection system can reflect the in-vivo state of the subject. Almost all common or non-common allergens and components thereof can be rapidly put into use in the detection method and the detection system, and the allergens to be detected and the components thereof can be freely matched according to the conditions of patients, so that the flexibility is high.

9. The basophil activation detection method has strong specificity on allergic patients/allergic high-risk groups, can be used for early diagnosis/classification of patients to be diagnosed, and can effectively identify or classify the patients to be diagnosed as allergic patients/allergic high-risk group types and other non-allergic group types (such as intolerant and non-allergic group).

The invention will be further illustrated with reference to specific examples. It is to be understood that these examples are illustrative of the present invention and are not intended to limit the scope of the present invention. The experimental procedure, in which the specific conditions are not noted in the following examples, is generally followed by conventional conditions, such as, for example, molecular cloning: conditions described in the laboratory Manual (Sambrook et al, new York: cold Spring Harbor Laboratory Press, 1989), or as recommended by the manufacturer. Percentages and parts are weight percentages and parts unless otherwise indicated.

EXAMPLE 1 preparation of stimulation buffer

Hank' balanced salt solution X (HBSS) was mixed with HEPES buffer (15:4 to 25:4 by volume) and NaHCO was added ₃ (final concentration of 0.1-0.25 wt%) and regulating pH to 7.2-7.5, making into stimulation buffer solution, filtering with 0.22 μm, and storing in 4 deg.C refrigerator.

EXAMPLE 2 preparation of stop buffer

EDTA was dissolved in PBS and pH was adjusted to prepare 5-20mM EDTA in PBS buffer (pH 7.2-7.5), which was the stop buffer.

Example 3 procedure for the basophil activation method

A negative control group (stimulation with stimulation buffer), a positive control group (stimulation with anti-human IgE antibody + stimulation buffer) and a dust mite allergen Der f2 stimulation group (recombinant dust mite allergen + stimulation buffer) were set and incubated with 100 μl of heparin anticoagulated whole blood of 3 dust mite allergen-specific IgE positive patients and 3 normal controls, respectively, for 20min.

For example, the materials and volumes used for each set of incubations may be as shown in table 1.

TABLE 1

Stop buffer was added to each group, centrifuged at 200g for 10min, and the supernatant was removed. Cell pellet was resuspended, incubated with FITC-anti-human CD63, PE-anti-human CD203c, perCP-cyanine5.5-anti-human CD123 and KO-anti-human CD45 for 30min in the dark, lysed by addition of erythrocyte lysate for 5min, stopped by addition of dilution buffer, centrifuged, the cells resuspended, and basophils detected by flow cytometry (CD 203c ⁺ CD123 ⁺ CD45 ⁺ SS ^low Door set) CD63 ⁺ Cell ratio andcompared with the negative control group, the Stimulation Index (SI) is more than or equal to 2 and activates CD63 ⁺ An absolute difference in cell proportion exceeding 5% is considered positive.

As the results in Table 2 show, the positive control group and the recombinant dust mite allergen component Der f2 stimulated group had basophils CD63, compared to the negative control group ⁺ The cell proportion is remarkably increased, the difference values of the cell proportion and the negative control group are respectively (90.6%, 55.3%, 19.2%) and (88.3%, 48.37% and 71.9%), SI is respectively (146.5, 52.9, 12.3) and (133.8, 39.2 and 110.1), the positive judgment standard is met, and a flow cytometry detection basophil activation method is established (figures 2 and 3).

TABLE 2

* SI values in the table are calculated based on the average fluorescence intensity of the cells; the number or percentage of cells can also be directly used for conversion.

Judgment criteria for basophil activation detection method:

1. identification of basophils: CD203c ⁺ CD123 ⁺ CD45 ⁺ SS ^low ；

2. Detection of CD63 in the groups of basophils ⁺ Calculating the corresponding difference and SI;

3. judging whether the experiment is effective or not: when Z1 is more than or equal to 5% and SI-1 is more than or equal to 2, the experimental detection is considered to be effective, otherwise, the experiment is not effective;

4. judging allergy: when the experiment is judged to be effective, Z2 is more than or equal to 5%, SI-2 is more than or equal to 2, and the risk of allergy is considered to be high, and the clinical symptoms are combined, so that the allergy can be judged; otherwise, it cannot be identified as a high risk of allergy or allergy.

According to the above judgment criteria, it is shown that:

the experimental detection on the case 1, the case 2 and the case 3 is effective, and the result shows that 3 people are allergic patients or allergic high-risk groups, and the expected value is consistent;

the experimental tests for normal control 1, normal control 2, and normal control 3 were effective, and the results showed that none of the 3 persons were allergic patients, or none were allergic high risk population, in agreement with the expected values.

Example 4 procedure for the double positive control basophil activation method

A negative control group (stimulation with stimulation buffer), a positive control group a (stimulation with anti-human IgE antibody + stimulation buffer), a positive control group b (fMLP + stimulation buffer) and a dust mite allergen crude extract stimulation group (dust mite allergen crude extract + stimulation buffer) were set and incubated with 100 μl of heparin anticoagulated whole blood of 3 dust mite allergen-specific IgE positive patients and 3 normal controls, respectively, for 20min.

For example, the materials and volumes used for each set of incubations may be as shown in table 3.

TABLE 3 Table 3

Stop buffer was added to each group, centrifuged at 200g for 10min, and the supernatant was removed. Cell pellet was resuspended, incubated with FITC-anti-human CD63, PE-anti-human CD203c, perCP-cyanine5.5-anti-human CD123 and KO-anti-human CD45 for 30min in the dark, lysed by addition of erythrocyte lysate for 5min, stopped by addition of dilution buffer, centrifuged, the cells resuspended, and basophils detected by flow cytometry (CD 203c ⁺ CD123 ⁺ CD45 ⁺ SS ^low Door set) CD63 ⁺ Cell ratio, stimulation Index (SI) 2. Gtoreq.2 and activation of CD63 compared to negative control group ⁺ An absolute difference in cell proportion exceeding 5% is considered positive.

As shown in the results of Table 4, in the dust mite patients, the positive control group a, the positive control group b and the dust mite allergen crude extract stimulated group of basophils CD63 were compared with the negative control group ⁺ The cell ratio is remarkably increased, the difference values of the cell ratio and the negative control group are respectively (22.11%, 54.96%, 51.48%), (45.75%, 39.57%, 8.55%) (37.64%, 26.74%, 70.19%), SI is respectively (16.02, 39.82, 47.08), (67, 21.5, 2.36) and (50.82, 16.64, 91.84), and the positive judgment is metThe standard was broken and a method of detecting basophil activation by flow cytometry with a double positive control was established (fig. 4 and 5).

TABLE 4 Table 4

Judgment criteria for basophil activation detection method:

1. identification of basophils: CD203c ⁺ CD123 ⁺ CD45 ⁺ SS ^low ；

3. judging whether the experiment is effective or not: when any condition of (Z1 (a) is more than or equal to 5 percent, SI-1 (a) is more than or equal to 2 percent and (Z1 (b) is more than or equal to 5 percent, SI-1 (b) is more than or equal to 2 percent is met, the experimental detection is considered to be effective, otherwise, the experiment is ineffective;

According to the above judgment criteria, it is shown that:

Example 5 dust mite allergy sufferers found by basophil activation experiments

The patients, women, 25 years old, had obvious symptoms of facial allergy, were self-described to possible penicillin, blood was collected from the patients (heparin anticoagulation), their basophilic activation level was detected by flow cytometry, negative control group, positive control group a (anti-human IgE antibody), positive control group b (fMLP), test group 3a (dust mite allergen crude extract), test group 3b (milk), test group 3c (egg), test group 3d (penicillin) were set.

The test results showed that the patient was allergic to dust mites (z2= 73.78%, SI-2= 211.25) and not allergic to other allergens.

For further validation, the patient was also rechecked with conventional allergen-specific IgE and skin test. The results showed that the patient had positive dust mite allergen-specific IgE (dust mite: 1.69 KU/L) and negative egg and milk allergens. The skin test results show that dust mites are allergic and allergens such as penicillin are not allergic.

The results show that the detection method can simultaneously detect and identify multiple allergens in parallel in the same detection system. The detection method of the invention can rapidly and largely identify the allergen on the one hand, and has high detection specificity and high sensitivity on the other hand, and the detection result aiming at the patient is completely consistent with the specific IgE and skin test.

EXAMPLE 6 basophil activation experimental Performance analysis

Heparin anticoagulation samples from 61 respiratory patients were collected and tested by the method of example 3 or example 4. Of these, 42 used 1 positive control (anti-human IgE antibody) (method of example 3), 38 used 2 positive controls (anti-human IgE antibody and fMLP) (method of example 4), and at least one positive control indicated a quality control.

The above detection results are shown in table 5, and the results show that:

the procedure of example 3 was used: of the 42 cases, 39 cases were tested as quality control qualified specimens, and the qualification rate was 92.8%. In another 3 cases, the quality control was not acceptable (possibly in anti-IgE stimulation non-responsive patients), and it was not possible to determine whether basophils were activated.

The procedure of example 4 was used: of the 38 test specimens, 37 specimens with qualified test quality control (quality control of two positive controls containing 27 specimens; positive quality control of 7 specimens with anti-human IgE antibodies is disqualified, but positive quality control of fMLP is qualified) have a total qualification rate of 97.37%.

TABLE 5

	Quality control qualification	Quality control failure
			42	39(39+)	3(-)
38	37(27++；3+-；7-+)	1(--)

Wherein "+" indicates that the positive quality control anti-human IgE antibody is positive and the quality control is qualified when a single positive control is adopted;

when two positive controls are adopted, "++", the two positive quality control anti-human IgE antibodies and fMLP are positive, and the quality control is qualified;

"- +" indicates that when two positive controls are used, the anti-human IgE antibody is negative in quality control, fMLP is positive in quality control, and the quality control is qualified;

"+ -" indicates that when two positive controls are used, the anti-human IgE antibody is positive in quality control, fMLP is negative in quality control, and the quality control is qualified;

"-" indicates that the positive quality control anti-human IgE antibody is negative and the quality control is disqualified when a single positive control is adopted;

"-" indicates that both positive quality control anti-human IgE antibodies and fMLP were negative and failed in quality control when two positive controls were used.

Example 7 comparison of basophil activation results with specific IgE

Heparin anticoagulation was performed on dust mite allergen-specific IgE-positive patients and the level of basophil activation was detected by flow cytometry. Comparison of the results of the detection of dust mite allergen specific IgE and of the activation of basophils in 9 volunteers (including dust mite allergic patients) (from the detected CD 63) ⁺ The cell percentage examples calculate the correlation of the corresponding differences with SI) and the results of the gold standard (intradermal excitation assay) (table 6).

The results show that the method based on allergen-specific IgE is weakly related to the intradermal excitation assay, in contrast to the detection results of the method of the invention, which are more consistent with the gold standard, are far more relevant than the analysis method based on allergen-specific IgE.

TABLE 6

The results show that the in vitro analysis method based on specific target basophils can rapidly and accurately detect the activation of basophils.

Example 8 comparison of basophil activation results with specific IgE (for egg allergic patients)

In this example, cases 1, 2, and 3 (cases 1 to 3 are patients who had a history of intake of eggs in a short period of time (within 2 hours) collected in pediatrics and had skin allergy symptoms and had a high suspicion of egg allergy to hospital pediatric emergency visits), and control 1 and control 2 (not allergic to eggs) were examined by using the basophil activation detection method of the present invention (detection method refer to example 4) and the specific IgE detection method, respectively.

TABLE 7

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The results of the basophil activation test of the present invention are shown in Table 7, and according to the judgment criteria, it is shown that:

the experimental detection of the cases 1, 2 and 3 is effective, and the results show that 3 people are egg allergy patients or egg allergy high risk groups, and the expected results are consistent;

The experimental tests for control 1, control 2 were effective and the results showed that none of the 2 persons were egg allergy sufferers, or none were high risk groups of egg allergy, consistent with the expected results.

TABLE 8

	Egg sIgE (KU/L)
		Case 1	1.32
Case 2	4.02
		Case 3	0.07
Control 1	0.03
		Control 2	0.00

The results of specific IgE detection are shown in Table 8, and according to the judgment standard (sIgE result is more than or equal to 0.35KU/L positive and less than 0.35KU/L negative), the results show that:

the cases 1 and 2 are positive, namely the egg allergy patient or the egg allergy high risk group is consistent with the expected result;

case 3 is negative, namely, the patient is not an egg allergy patient, or is not an egg allergy high risk group, the expected result is not consistent, and the missing diagnosis phenomenon exists;

control 1 and control 2 were negative, i.e. were not patients with egg allergy or were not high risk groups with egg allergy, and were consistent with the expected results.

The results and comparison show that the basophil activation detection method is more accurate than the allergen sIgE detection method, and is beneficial to reducing the missed diagnosis rate.

Example 9 comparison of basophil activation results with specific IgE (for cow milk allergic patients or cow milk intolerant patients)

In this example, the basophil activation test method of the present invention (test method reference example 4) and the specific IgE test method were used to test case 1 (case 1 is a pediatric patient who had a history of milk intake within a short period of time (within 2 hours) and had skin allergy symptoms and had a hospital pediatric emergency visit, which patient was highly suspected of being milk allergy) and control 1, control 2 (control 1, control 2 were pediatric patients whose milk received pediatric income caused gastrointestinal reactions to visit, and were highly suspected of being milk intolerant, not allergy), respectively.

TABLE 9

The results of the basophil activation test of the present invention are shown in Table 9, and according to the judgment criteria, it is shown that:

the experimental detection on the case 1 is effective, and the result shows that the patient is a milk allergy patient or a milk allergy high risk group, and accords with the expected result;

the experimental tests for control 1, control 2 were effective and the results showed that none of the 2 persons were cow's milk allergy sufferers, or none were cow's milk allergy high risk population, consistent with the expected results.

Table 10

The results of specific IgE detection are shown in Table 10, and according to the judgment standard (sIgE result is more than or equal to 0.35KU/L positive and less than 0.35KU/L negative), the results show that:

case 1 is negative, namely, is not a cow milk allergy patient, or is not a cow milk allergy high risk group, does not accord with the expected result, and has the phenomenon of missed diagnosis;

control 1, control 2 were negative, i.e. not cow's milk allergy patient, or not cow's milk allergy high risk population, consistent with the expected outcome.

In addition, the basophil activation detection method has strong specificity to allergic patients/allergic high-risk groups, and can effectively screen allergic patients/allergic high-risk groups, for example, two groups of people including milk allergic patients and milk intolerant patients are effectively screened in the embodiment. The allergen sIgE detection method cannot effectively distinguish the two types of patients. Therefore, the basophil activation detection method can be also used for early diagnosis/classification of patients in diagnosis, and can effectively identify or classify allergic patients/allergic high-risk groups and other non-allergic groups.

All documents mentioned in this application are incorporated by reference as if each were individually incorporated by reference. Further, it will be appreciated that various changes and modifications may be made by those skilled in the art after reading the above teachings, and such equivalents are intended to fall within the scope of the claims appended hereto.

Claims

1. A combination of reagents for use in the detection of drug allergen basophil activation, the combination of reagents comprising: a first antibody against human CD203c, a second antibody against human CD123, a third antibody against human CD45, a fourth antibody against human CD63, a positive control, and a drug allergen.

2. The combination of reagents according to claim 1, wherein the combination of reagents further comprises: stimulation buffer and/or termination buffer.

3. The combination of reagents according to claim 1, wherein the combination of reagents further comprises one or more reagents selected from the group consisting of: a staining reagent diluent, a red blood cell lysate and a washing solution.

4. The combination of agents of claim 1, wherein the drug allergen is selected from the group consisting of: a crude drug allergen extract, a purified drug allergen component, a recombinant drug allergen component, or a combination thereof has been discovered.

5. The combination of agents of claim 1, wherein the medicament comprises: anti-infective agents, anesthetics, and adjuvants thereof, neurological agents, psychotropic agents, antineoplastic agents, cardiovascular agents, respiratory agents, digestive agents, urinary system agents, or combinations thereof.

6. The combination of agents of claim 1, wherein the medicament comprises: beta-lactamase drugs (including penicillins, cephalosporins, etc.), neuromuscular blocking agents (NMBAs) drugs (anesthetics) (including succinylcholine, panuronium bromide, tubocurarine, atracurium, vecuronium bromide, rocuronium bromide, mevalonate, etc.), quinolones (including ciprofloxacin, moxifloxacin, levofloxacin, etc.), non-steroidal anti-inflammatory drugs (including aspirin, ibuprofen, diclofenac, phenylbutazone, acetaminophen, indomethacin, naproxen, etc.), iodinated contrast agents (including sodium iodide, diatrizamine, ouabane, iodotomato acid, cholestyramine, etc.), biologicals (including monoclonal antibodies, fusion proteins, cytokines, etc.), or combinations thereof.

7. The reagent combination of claim 1, wherein the positive control is selected from the group consisting of: anti-human IgE antibodies, fMLP, or a combination thereof.

8. An in vitro assay for drug allergen basophil activation comprising the steps of:

(a) Providing a sample to be detected, wherein the sample is anticoagulated whole blood, the anticoagulated whole blood is divided into n parts, and n is a positive integer more than or equal to 3;

wherein, the test conditions of the negative control group, the positive control group and the activation test group are the same, and the difference is that: incubating at least one portion of the anticoagulated whole blood with a positive control in a positive control group; incubating at least one of said anticoagulated whole blood with a drug allergen in an activation test group; in the negative control group, at least one part of the anticoagulated whole blood is incubated in the presence of no positive control and no drug allergen;

9. The method of claim 8, comprising, in step (d), calculating a first SI value for the positive control group and a second SI value for the activation test group, wherein,

or alternatively

10. The use of a combination of reagents for the detection of the activation of the drug allergen basophil according to claim 1, for the preparation of a detection kit for

(a) Diagnosis of allergic diseases or identification of drug allergens;

(b) Analysis of allergy severity for drug allergen sensitization;

(c) Screening for allergic diseases or susceptibility to drug allergen sensitization; and/or

(d) Monitoring the efficacy of allergic diseases sensitized by drug allergens.