JP2011523037A - 血清中のBLyS/APRILヘテロ三量体レベルおよび診断方法における使用 - Google Patents
血清中のBLyS/APRILヘテロ三量体レベルおよび診断方法における使用 Download PDFInfo
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Abstract
Description
本発明のこれらの側面およびその他の側面は、以下に詳述された本発明の詳細を読むことよって当業者に明らかとなるであろう。
本明細書中の「ヘテロ三量体(HT)」という用語は、3個のリガンドサブユニットの多量体を包含し、各リガンドサブユニットはBLySまたはAPRILであり、少なくとも1個のサブユニットはBLySであり、少なくとも1個のサブユニットはAPRILである。したがって、「HT」には、BLySが2個およびAPRILが1個である分子、並びにAPRILが2個およびBLySが1個である分子が含まれる。
本発明は、APRILおよびBLySポリペプチドの分離測定を通じたHTポリペプチドの検出を提供する。「APRILポリペプチド」という用語には、公知のAPRILポリペプチド(例えば、公的に入手可能なGenBank受入番号AF046888)のオープンリーディングフレーム(ORF)によってコードされるアミノ酸配列が含まれ、その具体例としては、完全長の天然ポリペプチドおよびそのフラグメント、特に生物学的に活性なフラグメントおよび/または機能ドメインに対応するフラグメント、例えば、生物学的活性を有する領域またはドメイン等、その抗原フラグメントが挙げられるとともに、対象となるポリペプチドがその他のタンパク質またはその部分に融合したものが挙げられる。APRILポリペプチドのアミノ酸配列は公知である(例えば、Hahne 等, J. Exp. Med. 188:1185-90, 1998 参照)。本発明のAPRILポリペプチドは、様々な供給源、例えばヒト組織またはその他の供給源から単離することができるし、組換え法および/または合成法によって調製することもできる。APRILポリペプチドにおける多型は、一般的には、参照配列と比較して規定される。
以下の項で詳述した複数の使用に加え、上述したように、APRIL核酸組成物は全部または一部のAPRILポリペプチドの調製に使用される。ポリヌクレオチド(例えばcDNAまたは完全長遺伝子)は、部分的または完全な遺伝子産物を発現させるために使用される。対象となるポリヌクレオチドを含む構築物は、合成により作製することができる。また、多数のオリゴデオキシリボヌクレオチドからの遺伝子および完全なプラスミドの1段階アセンブリは、例えば、Stemmer 等, Gene (Amsterdam) (1995) 164(1):49-53に記載されている。この方法において、アセンブリPCR(多数のオリゴデオキシリボヌクレオチド(oligo)からの長いDNA配列の合成)が記載されている。この方法は、DNAシャッフリング(Stemmer, Nature (1994) 370:389-391)に基づくものであり、DNAリガーゼに依存せず、その代わりにDNAポリメラーゼに依存しており、アセンブリ工程において次第に長いDNAフラグメントが構築される。適当なポリヌクレオチド構築物は、Sambrook 等, Molecular Cloning: A Laboratory Manual, 2nd Ed., (1989) Cold Spring Harbor Press, Cold Spring Harbor, N.Y.等に記載された標準的な組換えDNA技術を用いて、米国保健社会福祉省の組換えDNA研究に関する米国国立衛生研究所(NIH)ガイドラインに記載された現行の規制の下で精製される。
本発明はさらに、APRILおよびBLySポリペプチドに対して特異的な抗体、特に単離された抗体の使用を包含する。本発明の抗体は、以下に詳述されるように、様々な診断アッセイに有用である。例えば、抗体は、生体サンプル中のHTレベルを検出および/または測定するために用いることができる。
本発明はさらに、生体サンプル中のHT mRNAの存在および/またはレベルを検出する方法、並びに、生体サンプル中のHTポリペプチドの存在および/またはレベルを検出する方法を提供する。
HTタンパク質レベルに対する薬剤(例えば、薬物、化合物)の影響(例えば、転写活性化の調節)のモニタリングは、基本的な薬物のスクリーニングだけではなく、臨床試験にも適用することができる。例えば、本明細書に記載されるスクリーニングアッセイによって決定された薬剤の、HTタンパク質レベルを低減させる効果が、低減したHT遺伝子発現またはタンパク質レベルを示す被験者の臨床試験においてモニタリングされ得る。そのような臨床試験において、HT遺伝子の発現または活性、および、好ましくは、例えばHTタンパク質レベルに関連する疾患に関与するその他の遺伝子の発現または活性を、特定の細胞(本発明の場合にはB細胞)の表現型の「出力(read out)」またはマーカーとして用いることができる。
本発明は、血清中の増大したHTレベルと関連する症状を有すると臨床的に診断された個体を処置する方法を提供する。この方法は、一般的には、生体サンプルを分析してHTレベルを測定すること、およびそのレベルを健常対照のHTレベルと比較することを含む。次いで、増大したHTレベルと関連する自己免疫疾患等の症状を有すると臨床的に診断された個体に最も効果的な処置計画が選択され、次いで、患者が状況に応じて処置される。本発明はさらに、患者が増大したHTレベルと関連する症状に対する薬物処置に応答する可能性を予測する方法を提供する。この方法は、患者のHT遺伝子の発現を決定することを含み、この方法において、SLE等の自己免疫疾患と関連する増大したHTレベルの存在は、患者がその疾患に対する薬物処置に応答する可能性の予兆である。
以下は、本明細書で開示されたHT測定アッセイの使用が、その処置の助けとなり得る自己免疫疾患の非限定的な例示である。B細胞関連自己免疫疾患、例えば、関節炎(関節リウマチ、若年性関節リウマチ、変形性関節症、乾癬性関節炎)、乾癬、アトピー性皮膚炎等の皮膚炎;慢性自己免疫性蕁麻疹、多発性筋炎/皮膚筋炎、中毒性表皮剥離症、全身性強皮症および硬化症、炎症性大腸炎(IBD)に関連する応答(クローン病、潰瘍性大腸炎)、呼吸窮迫症候群、成人呼吸窮迫症候群(ARDS)、髄膜炎、アレルギー性鼻炎、脳炎、ブドウ膜炎、大腸炎、糸球体腎炎、アレルギー症状、湿疹、喘息、T細胞の浸潤および慢性炎症反応を伴う症状、アテローム性動脈硬化症、自己免疫性心筋炎、白血球接着不全症、全身性エリテマトーデス(SLE)、ループス(例えば、腎炎、非腎性、円板状、脱毛症)、若年型糖尿病、多発性硬化症、アレルギー性脳脊髄炎、サイトカインおよびTリンパ球によって媒介される急性および遅延型過敏症に関連する免疫応答、結核、サルコイドーシス、肉芽腫症(例えばウェゲナー肉芽腫症)、無顆粒球症、血管炎(例えばANCA)、再生不良性貧血、クームス陽性貧血、ダイアモンドブラックファン貧血、免疫溶血性貧血(例えば自己免疫性溶血性貧血(AIHA))、悪性貧血、赤芽球癆(PRCA)、第VIII因子欠乏症、血友病A、自己免疫性好中球減少症、汎血球減少症、白血球減少症、白血球漏出を伴う疾患、CNS炎症性疾患、多臓器不全症候群、重症筋無力症、抗原−抗体複合体が媒介する疾患、抗糸球体基底膜抗体病、抗リン脂質抗体症候群、アレルギー性神経炎、ベーチェット病、キャッスルマン症候群、グッドパスチャー症候群、Lambert-Eaton筋無力症候群、レイノー症候群、シェーグレン症候群、スティーブンス−ジョンソン症候群、固形臓器移植片拒絶反応(例えば高パネル反応性抗体力価のための前処理、組織におけるIgA沈着等)、移植片対宿主病(GVHD)、水疱性類天疱瘡、天疱瘡(例えば、尋常性天疱瘡、落葉状天疱瘡)、自己免疫性多腺性内分泌障害、ライター病、スティフマン症候群、巨細胞性動脈炎、免疫複合体性腎炎、IgA腎症、IgM多発性神経障害またはIgM媒介神経障害、特発性血小板減少性紫斑病(ITP)、血栓性血小板減少性紫斑病(TTP)、自己免疫性血小板減少症、精巣および卵巣の自己免疫疾患(例えば、自己免疫性精巣炎および卵巣炎)、原発性甲状腺機能低下症;自己免疫性内分泌疾患(例えば自己免疫性甲状腺炎)、慢性甲状腺炎(橋本甲状腺炎)、亜急性甲状腺炎、特発性甲状腺機能低下症、アジソン病、グレーブス病、多腺性自己免疫症候群(または多腺性内分泌障害症候群)、インスリン依存性糖尿病(IDDM)とも呼ばれるI型糖尿病およびシーハン症候群;自己免疫性肝炎、リンパ球様間質性肺炎(HIV)、閉塞性細気管支炎(非移植)vsNSIP、ギラン−バレー症候群、大血管の血管炎(例えば、リウマチ性多発筋痛および巨細胞性(高安)動脈炎)、中血管の血管炎(例えば、川崎病および結節性多発動脈炎)、強直性脊椎炎、ベルジェ病(IgA腎症)、急速進行性糸球体腎炎、原発性胆汁性肝硬変症、セリアック病(グルテン性腸症)、クリオグロブリン血症、ALS、および冠動脈疾患。
自己免疫疾患に罹患する患者において高いHTレベルが観察される場合、このことは、患者がBLySおよび/またはAPRILの阻害に対して好ましい応答を示す可能性を示唆する。したがって、本発明はまた、上昇したHTレベルを有する患者における自己免疫疾患の処置に用いられるBLySおよび/またはAPRILアンタゴニストを含む。以下は、そのような患者を処置するために用いることができるBLySおよび/またはAPRILアンタゴニストの代表例である。BLySおよび/またはAPRILアンタゴニストとして機能する目的において、いずれかのTNFRファミリー受容体の細胞外ドメインは、一般的にBLySに結合する能力を維持する膜貫通または細胞質ドメインを本質的に含まないポリペプチドである。具体的には、TACIの細胞外ドメインは、TACIポリペプチド配列(配列番号2)の1−154アミノ酸を含み得る。さらに、ECDは、この配列のフラグメントまたは変異体、例えば、von Bulow 等(前出), WO 98/39361, WO 00/40716, WO 01/85782, WO 01/87979, および WO 01/81417に記載されるようなTACIのECD形態であり得る。特に、これらのECD形態は、配列番号2のアミノ酸1−106、配列番号2のアミノ酸1−142、配列番号2のアミノ酸30−154、配列番号2のアミノ酸30−106、配列番号2のアミノ酸30−110、配列番号2のアミノ酸30−119、配列番号2のアミノ酸1−166、配列番号2のアミノ酸1−165、配列番号2のアミノ酸1−114、配列番号2のアミノ酸1−119、配列番号2のアミノ酸1−120、および配列番号2のアミノ酸1−126を含み得る。さらに、TACIのECDは、システインリッチドメインを1つだけ有するそれらの分子を含み得る。
本発明の方法では、その他の免疫抑制薬を単独であるいはBLySおよび/またはAPRIL阻害剤と組み合わせて使用することが意図される。その他の免疫抑制薬としては、例えば、特に限定されるわけではないが、カルシニューリン阻害剤(例えばシクロスポリンAまたはFK506)、ステロイド(例えばメチルプレドニゾンまたはプレドニゾン)等の免疫抑制薬、または免疫細胞の成長を阻止する免疫抑制薬(例えばラパマイシン)、抗CD40経路阻害剤(例えば、抗CD40抗体、抗CD40リガンド抗体およびCD40経路の小分子阻害剤)、移植サルベージ経路阻害剤(例えばミコフェノール酸モフェチル(MMF))、IL−2受容体アンタゴニスト(例えばホフマン ラ ロッシュ社のZeonpax.COPYRGT.およびノバルティス社のSimulet)またはそのアナログ、シクロホスファミド、サリドマイド、アザチオプリン、モノクローナル抗体(例えば、ダクリズマブ(抗インターロイキン(IL)−2)、インフリキシマブ(抗腫瘍壊死因子)、MEDI−205(抗CD2))、abx−cb1(抗CD147)、およびポリクローナル抗体(例えば、抗胸腺細胞グロブリン)が挙げられる。
本発明で用いられるBLyS結合抗体等のBLySおよび/またはAPRILアンタゴニストの治療製剤は、所望の精製度を有する抗体を製剤学的に許容し得る任意の担体、賦形剤、安定剤(Remitgtorz's Pharmaceutical Science 16th edition, Osol, A. Ed. (1980))と混合し、凍結乾燥製剤または水溶液の形態で調製され、保存される。許容し得る担体、賦形剤または安定剤は、用いられる用量および濃度において受容者に無毒であり、例えば、リン酸緩衝液、クエン酸緩衝液およびその他の有機酸緩衝液等の緩衝液;アスコルビン酸およびメチオニン等の抗酸化物質;保存剤(例えば、オクタデシルジメチルベンジルアンモニウムクロリド;塩化ヘキサメトニウム;塩化ベンザルコニウム、塩化ベンゼトニウム;フェノール、ブチルまたはベンジルアルコール;メチルまたはプロピルパラベ等のアルキルパラベン;カテコール;レゾルシノール;シクロヘキサノール;3−ペンタノール;およびm−クレゾール);低分子量(約10残基未満)ポリペプチド;血清アルブミン、ゼラチンまたはイムノグロブリン等のタンパク質;ポリビニルピロリドン等の親水性ポリマー;グリシン、グルタミン、アスパラギン、ヒスチジン、アルギニンまたはリジン等のアミノ酸;グルコース、マンノースまたはデキストリン等の単糖類、二糖類およびその他の糖類;EDTA等のキレート剤;スクロース、マンニトール、トレハロースまたはソルビトール等の糖類;ナトリウム等の塩形成対イオン;金属複合体(例えば、Zn−タンパク質複合体);および/またはTWEEN、PLURONICSTMまたはポリエチレングリコール(PEG)等の非イオン性界面活性剤が挙げられる。
in vivo投与に用いられる製剤は滅菌の必要がある。滅菌は、滅菌濾過膜による濾過によって容易に実現される。
試薬:
ビーズに結合した抗APRIL抗体(例えば、BioRad xMap bead 106(Hercules,CA)に結合したZGEN抗APRIL抗体E9617)(クローン319.6.8.5))
ビオチン化抗BLyS抗体(ビオチン化ZGEN 抗BLyS抗体E4731(クローン258.2.1.9.1.3))
ストレプトアビジン−PE(Jackson ImmunoResearch. Labs,Inc(West Grove,PA)#016−110−084)
マルチスクリーンプレート(Millipore(Billerica,MA),MABVN1250)
ELISA B(ELISA C+1%BSA+NaAz)
APRIL/BLySヘテロ三量体 LOT A1642F 標準品(25ng/mL),QC1(7.5ng/mL),およびQC2(500pg/mL)(2APRILサブユニット,1BLySサブユニット)
サンプル
ヒトAB血清(BLySおよびAPRILが低含有量であることについて予めスクリーニングされている)
攪拌器
2)プレートのブロック:ELSA B100μLを全てのウェルに加え、吸引しながら10分間攪拌する。
3)ビーズを30秒間ボルテックスし、30秒間超音波処理する。
a.添加するビーズ容量の決定:25μL/ウェルのELISA B中の5K ビーズ/ウェル
b.1つのプレート全てに2.5mL+5E5ビーズ
4)全てのウェルについて、1ウェルあたりビーズ混合物25μLを加える。
5)標準品の希釈:A1642F標準品(25ng/mL)をELISA Bで希釈し(1:3で6回)、7段階の希釈系列(25000,8333,2778,926,309,103および34pg/mL)を調製する。
6)A1に25000pg/mL標準品を、B1に8333pg/mL標準品を、25μL加える。
7)A2にQC1を25μL加え、B2にQC2を25μL加える。
8)血清25μLを全ての標準品、バックグラウンドおよびQCウェルに加える。
9)ELISA B 25μLを全てのサンプルウェルおよびバックグラウンドウェルに加える。
10)血清サンプル25μLを各サンプルウェルに加える。*,**
11)プレートを密閉し、ホイルで覆う。600RPM、室温(RT)で60分間攪拌器に設置する。
12)吸引する。プレートをELISA B 2×100μLで洗浄する。
13)1μg/mLの抗体E4731−ビオチンを25μL/ウェル加える。
14)プレートを密閉し、ホイルで覆う。600RPMで60分間、攪拌器に設置する。
15)洗浄および吸引を行うことなく、ELISA Bで希釈したSA−PE(1:100)を25μL/ウェル加える。
16)プレートを密閉し、ホイルで覆う。600RPMで30分間、攪拌器に設置する。
17)吸引する。プレートをELISA B 2×100μLで洗浄する。
18)ELISA Bを110μL/ウェル加える。600RPMで5分間混合する。
19)ルミネックス100を実行する。
ZymoZipper N末端三量化ドメインは、組換えBLyS/APRILヘテロ三量体(rHT)の産生を可能とし、これを標準品として用いて、実施例1に記載したようなビーズを用いたイムノアッセイを開発し、ヒト血清中の天然HTを定量化した。このアッセイを、BLySおよびAPRIL特異的ELISAとともに用いて、健常対照(HC;n=79)、全身性エリテマトーデス患者(SLE;n=30)および関節リウマチ患者(RA;n=29)に由来する血清中のこれら3つのリガンドを測定した(図1および2参照)。TACIをNFκB/ルシフェラーゼリポーター遺伝子とともにトランスフェクトしたJurkat細胞を用いた4時間のシグナリングアッセイおよび4日間の初代ヒトB細胞増殖アッセイにおいて、rHTの生物活性を、rBLySおよびrAPRILの生物活性と比較した。
凍結したアフェレーシス処理(apheresed)末梢血単核細胞(PBMC)1×108個を含有するバイアルを、37℃の水浴中ですばやく解凍し、50mL試験管中のB細胞培地25mL(RPMI−1640培地,10%加熱不活性化ウシ胎仔血清,5% L−グルタミン,5%ペニシリン/ストレプトマイシン(Pen/Strep))に再懸濁した。トリパンブルー(GIBCO BRL,Gaithersburg,MD)を用いて細胞の生存率を検査した。次いで、抗CD19でコーティングしたマイクロビーズ(Miltenyi Biotech)を用いた陽性選別によってCD19+ B細胞を単離した。次いで、MACS LSカラム(Miltenyi Biotech)によって被覆細胞を単離した。得られたB細胞を最終濃度1.6×10細胞/mLでB細胞培地中に再懸濁し、96ウェル U底プレート(Falcon,VWR,Seattle,WA)に100μL/ウェルでプレーティングした。HTおよびホモ三量体リガンドを調製し、1000ng/mlから0ng/mlまでの3倍希釈系列の細胞に加えた。最終容量は200μL/ウェルであった。
TACI in vivo バイオアッセイでは、2つのプラスミドがトランスフェクトされたJurkat細胞株(ヒト急性T細胞リンパ球,KZ142,クローン#24)を用いる。まず、NF−κβ/AP−1プロモーターおよびネオマイシン耐性遺伝子の制御下にルシフェラーゼレポーター遺伝子を含有するプラスミドを、細胞株にトランスフェクトした。G418選択の後、適当なクローンを選択した。次いで、この細胞株に、CMVプロモーターおよびピューロマイシン耐性遺伝子の制御下に完全長TACI cDNAを含有するプラスミド(TACI/pZP7P)をトランスフェクトした。ピューロマイシンを用いてクローンを選択し、TACIモノクローナル抗体を用いたフローサイトメトリーによってTACI発現を評価し、アッセイに適切な細胞株を選択した。
Claims (42)
- 個体の増大したBLyS/APRILヘテロ三量体(HT)レベルを検出する方法であって、
(a)生体サンプル中の第一のHTレベルを測定すること、
(b)前記レベルを、健常個体の生体サンプル中の第二のHTレベルと比較すること、および
(c)前記第一のレベルが前記第二のレベルと比較して増大しているか否かを決定すること
を含み、
前記増大したHTレベルが自己免疫疾患と関連している前記方法。 - 前記自己免疫疾患が、関節リウマチ、若年性関節リウマチ、全身性エリテマトーデス(SLE)、ループス腎炎(LN)、ウェゲナー病、炎症性大腸炎、特発性血小板減少性紫斑病(ITP)、血栓性血小板減少性紫斑病(TTP)、自己免疫性血小板減少症、多発性硬化症、乾癬、IgA腎症、IgM多発性神経障害、重症筋無力症、血管炎、糖尿病、レイノー症候群、シェーグレン症候群および糸球体腎炎からなる群より選択される請求項1記載の方法。
- 前記自己免疫疾患がSLEである請求項1記載の方法。
- 測定においてルミネックス イムノアッセイを用いる請求項3記載の方法。
- 自己免疫疾患であると臨床的に診断された個体を処置する方法であって、
自己免疫疾患であると臨床的に診断された個体に由来する生体サンプルを、上昇したBLyS/APRILヘテロ三量体(HT)レベルの存在または不存在について分析すること、および
増大したHTレベルと関連する疾患に罹患していると臨床的に診断された個体に最も効果的な処置計画を選択すること
を含み、
前記上昇したAPRILタンパク質レベルの存在が自己免疫疾患の臨床診断と関連している前記方法。 - 前記処置計画がHTアンタゴニストの投与を含む請求項5記載の方法。
- 前記HTアンタゴニストがBLySアンタゴニストでもある請求項5記載の方法。
- 前記HTアンタゴニストがAPRILアンタゴニストでもある請求項5記載の方法。
- 前記自己免疫疾患が、関節リウマチ、若年性関節リウマチ、全身性エリテマトーデス(SLE)、ループス腎炎(LN)、ウェゲナー病、炎症性大腸炎、特発性血小板減少性紫斑病(ITP)、血栓性血小板減少性紫斑病(TTP)、自己免疫性血小板減少症、多発性硬化症、乾癬、IgA腎症、IgM多発性神経障害、重症筋無力症、血管炎、糖尿病、レイノー症候群、シェーグレン症候群および糸球体腎炎からなる群より選択される請求項5記載の方法。
- 前記自己免疫疾患がSLEである請求項5記載の方法。
- 前記分析においてルミネックス イムノアッセイを用いる請求項5記載の方法。
- 患者が自己免疫疾患に対する薬物処置に応答する可能性を予測する方法であって、
生体サンプル中のBLyS/APRILヘテロ三量体(HT)レベルを決定することを含み、
上昇したHTレベルの存在が、前記患者が前記疾患に対する薬物処置に応答する可能性の予兆である前記方法。 - 前記自己免疫疾患が、関節リウマチ、若年性関節リウマチ、全身性エリテマトーデス(SLE)、ループス腎炎(LN)、ウェゲナー病、炎症性大腸炎、特発性血小板減少性紫斑病(ITP)、血栓性血小板減少性紫斑病(TTP)、自己免疫性血小板減少症、多発性硬化症、乾癬、IgA腎症、IgM多発性神経障害、重症筋無力症、血管炎、糖尿病、レイノー症候群、シェーグレン症候群および糸球体腎炎からなる群より選択される請求項12記載の方法。
- 前記自己免疫疾患がRAである請求項12記載の方法。
- 前記決定がルミネックス イムノアッセイを用いて行われる請求項12記載の方法。
- 前記薬物処置がHTアンタゴニストの投与を含む請求項12記載の方法。
- 前記HTアンタゴニストがBLySアンタゴニストでもある請求項16記載の方法。
- 前記HTアンタゴニストがAPRILアンタゴニストでもある請求項16記載の方法。
- 個体の血清中の増大したBLyS/APRILヘテロ三量体(HT)レベルを検出するin vitro方法であって、
(a)前記個体に由来する試験生体サンプル中のHTレベルを測定すること、
(b)前記レベルを、健常対照に由来するサンプル中のHTレベルと比較すること、および
(c)前記試験生体サンプル中のHTレベルが前記対照サンプル中のレベルと比較して増大しているか否かを決定すること
を含み、
前記増大したHTレベルが自己免疫疾患と関連している前記方法。 - 前記自己免疫疾患が、関節リウマチ、若年性関節リウマチ、全身性エリテマトーデス(SLE)、ループス腎炎(LN)、ウェゲナー病、炎症性大腸炎、特発性血小板減少性紫斑病(ITP)、血栓性血小板減少性紫斑病(TTP)、自己免疫性血小板減少症、多発性硬化症、乾癬、IgA腎症、IgM多発性神経障害、重症筋無力症、血管炎、糖尿病、レイノー症候群、シェーグレン症候群および糸球体腎炎からなる群より選択される請求項19記載の方法。
- 前記自己免疫疾患がSLEである請求項19記載の方法。
- 自己免疫疾患であると臨床的に診断された個体を処置するために最も効果的な処置計画を選択するin vitro方法であって、
自己免疫疾患であると臨床的に診断された個体に由来する生体サンプルを、血清中の上昇したBLyS/APRILヘテロ三量体(HT)レベルの存在または不存在についてin vitroで分析することを含み、
前記上昇したHTレベルの存在が自己免疫疾患の臨床診断と関連している前記方法。 - 前記処置計画がHTアンタゴニストの使用を含む請求項22記載の方法。
- 前記HTアンタゴニストがBLySアンタゴニストでもある請求項23記載の方法。
- 前記HTアンタゴニストがAPRILアンタゴニストでもある請求項25記載の方法。
- 前記自己免疫疾患が、関節リウマチ、若年性関節リウマチ、全身性エリテマトーデス(SLE)、ループス腎炎(LN)、ウェゲナー病、炎症性大腸炎、特発性血小板減少性紫斑病(ITP)、血栓性血小板減少性紫斑病(TTP)、自己免疫性血小板減少症、多発性硬化症、乾癬、IgA腎症、IgM多発性神経障害、重症筋無力症、血管炎、糖尿病、レイノー症候群、シェーグレン症候群および糸球体腎炎からなる群より選択される請求項22記載の方法。
- 前記自己免疫疾患がRAである請求項23記載の方法。
- 前記個体がRAであると新たに診断されている請求項20記載の方法。
- 患者が自己免疫疾患に対する薬物処置に応答する可能性を予測する方法であって、
前記患者に由来するサンプル中のBLyS/APRILヘテロ三量体(HT)レベルを決定することを含み、
上昇したHTレベルの存在が、前記患者が前記疾患に対する薬物処置に応答する可能性の予兆である前記方法。 - 前記免疫疾患が、関節リウマチ、若年性関節リウマチ、全身性エリテマトーデス(SLE)、ループス腎炎(LN)、ウェゲナー病、炎症性大腸炎、特発性血小板減少性紫斑病(ITP)、血栓性血小板減少性紫斑病(TTP)、自己免疫性血小板減少症、多発性硬化症、乾癬、IgA腎症、IgM多発性神経障害、重症筋無力症、血管炎、糖尿病、レイノー症候群、シェーグレン症候群および糸球体腎炎からなる群より選択される請求項29記載の方法。
- 前記自己免疫疾患がSLEである請求項29記載の方法。
- 前記決定がルミネックス イムノアッセイを用いて行われる請求項29記載の方法。
- 前記薬物処置がHTアンタゴニストを含む請求項29記載の方法。
- 前記HTアンタゴニストがBLySアンタゴニストでもある請求項30記載の方法。
- 前記HTアンタゴニストがAPRILアンタゴニストでもある請求項30記載の方法。
- 患者の自己免疫疾患の処置に使用するためのHTアンタゴニストであって、
前記患者において血清中のBLyS/APRILヘテロ三量体(HT)レベルが上昇したレベルにある前記HTアンタゴニスト。 - 前記自己免疫疾患がSLEである請求項36記載のアンタゴニスト。
- 前記HTアンタゴニストがBLySアンタゴニストでもある請求項36記載のアンタゴニスト。
- 前記HTアンタゴニストがAPRILアンタゴニストでもある請求項36記載のアンタゴニスト。
- 前記アンタゴニストが、TACI−IgおよびBCMA−Igからなる群より選択された受容体細胞外ドメイン/Fcドメイン融合タンパク質である請求項36記載のアンタゴニスト。
- 前記受容体細胞外ドメイン/Fcドメイン融合タンパク質がTACI−Igである請求項40記載のアンタゴニスト。
- 前記TACI−Igがアタシセプトである請求項41記載のアンタゴニスト。
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