JP5261136B2 - 血液分析方法 - Google Patents
血液分析方法 Download PDFInfo
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- JP5261136B2 JP5261136B2 JP2008281987A JP2008281987A JP5261136B2 JP 5261136 B2 JP5261136 B2 JP 5261136B2 JP 2008281987 A JP2008281987 A JP 2008281987A JP 2008281987 A JP2008281987 A JP 2008281987A JP 5261136 B2 JP5261136 B2 JP 5261136B2
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Classifications
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- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
- G01N33/6893—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids related to diseases not provided for elsewhere
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- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12Q—MEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS; COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES
- C12Q1/00—Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions
- C12Q1/68—Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions involving nucleic acids
- C12Q1/6876—Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes
- C12Q1/6883—Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes for diseases caused by alterations of genetic material
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- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/5005—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving human or animal cells
- G01N33/5091—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving human or animal cells for testing the pathological state of an organism
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- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12Q—MEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS; COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES
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- G01N2800/347—Renal failures; Glomerular diseases; Tubulointerstitial diseases, e.g. nephritic syndrome, glomerulonephritis; Renovascular diseases, e.g. renal artery occlusion, nephropathy
Description
(1)1時間除去率(HrURR)
1時間あたりの尿素窒素除去率であり、30%以下が望ましいとされる。27.5%以上で透析処方の変更が必要とされる(第7回に本HDF学会での発表による)。
(2)クレアチニン産生率(%CrG)
人工透析患者は100%以上、糖尿病透析者は90%以上が目標とされる。タンパク摂取や運動を適切に行うことによって筋肉をつけ、クレアチニン産生速度を高くすることが必要とされる。
(3)標準化透析量(Kt/V)
効率的な尿毒素除去は、一層良好な臨床成績を生むと考えられる。尿毒素の体内蓄積に起因する有病率は周知の事実であるが、従来の透析指標であるKt/Vureaは正確なウレアの透析量、すなわち、除去量を表現しない。
この血液分析方法によれば、尿素クリアスペース(CS)または細胞膜クリアランス(Kc)とmRNAもしくはタンパク質プロファイルとの間の相関に基づいてバイオマーカーを予め同定するので、汎用性があり、透析処方および臨床効果の評価に貢献する診断マーカーを与えることができる。
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この血液分析方法によれば、バイオマーカーを診断マーカーとして用いるので、汎用性があり、透析処方および臨床効果の評価に貢献する診断マーカーを与えることができる。
(1)透析前の患者の血液サンプルを採取する。
(2)透析装置を用いて人工透析を行う。
(3)透析後の患者の血液サンプルを採取する。
(4)透析前後の血液サンプルのそれぞれについて、mRNAもしくはタンパク質プロファイルを取得する。
(5)特定のmRNAもしくはタンパク質群をマーカーとして使用し、上記mRNAもしくはタンパク質プロファイルに基づく診断を行う。
(1)患者の状態に合致する透析膜を選択できる。バイオマーカーにより迅速な診断が可能となるため、常に適切な透析膜を選択可能となる。
(2)慢性透析療法患者の原疾患の解明が容易となる。
(3)個体差を反映した診断評価および透析処方を得ることができる。
(4)感染症等の合併症の回避が可能となる。合併症の指標となるバイオマーカーを用いることで、従来の診断マーカーでは抽出できない合併症に関連する評価や適切な透析処方が得られる。
(5)原因同定により適切な治療計画の策定が可能となる。例えば、臨床データと付き合わせたバイオマーカーを用いることで、慢性腎炎、糖尿病由来腎疾患等の原因が判定できる。
(6)患者の栄養状態を把握できる。上記のように、PEM等の栄養状態を示す指標と相関がある遺伝子群をバイオマーカーとして用いることで、栄養状態の向上による病状改善を図ることができる。
(7)臨床データとmRNAもしくはタンパク質プロファイルとの相関の蓄積により、患者の原疾患や病状と、そのような患者における透析(の有無)による治療効果との関係が、明らかになるため、透析の開始時期を適切に判断可能となる。したがって、保存期を長くできる可能性がある。
11 透析器
13 バルブ(血液サンプル採取手段)
Claims (5)
- 人工透析患者から採取された血液に基づいた診断を行うための診断マーカーを提供する血液分析方法において、
尿素クリアスペース(CS)または細胞膜クリアランス(Kc)と遺伝子発現プロファイルとの間の相関に基づいてバイオマーカーを予め同定するステップと、
人工透析患者の透析前後に人工透析患者から採取された前記血液サンプルについて、同定された前記バイオマーカーにより、透析前後における血液の尿素クリアスペース(CS)または細胞膜クリアランス(Kc)を間接的に測定するステップと、
を備えることを特徴とする血液分析方法。 - 前記同定するステップでは、前記バイオマーカーとして、mRNAもしくはタンパク質プロファイルにより、下記遺伝子のうちのいずれかもしくはそれらの組合せを同定することを特徴とする請求項1に記載の血液分析方法。
TNFSF12,MAFB,SLC2A6,POP7,C1orf144,SLC25A6,EIF1,ATP5B,ETFB,FBXW4,TTC9C,NAGA,MYO1G,GSTK1,UBE2S,AP2S1,DNPEP,TGFBI,LSM12,LIPA,RPML2,CITED2,FUCA1,NUP62,OXA1L ,ASB13,NANS,CD68,TSSC4,COMMD4,F8A1,PCGF1,RAD23A,YY1,MRPL43,GPS1,ARL6IP4,ALDOA,FAM54B,NMT1,ATP5J2,VPS11,CLPTM1,NMRAL1,FKSG30,RRAS,COMT,SNHG5,PSMB1,LRRC8D,HDLBP,SCAND1,CSF1R,C20orf4,TPI1,NAPSB,POLDIP2,SNX15,CTSH,TMED1,POLR3K,C22orf9,KLHDC3,LAIR1,PLXNB2,AGPAT3,VPS26B,COMMD9,AP1M1,GSS,EEF1D,MRPL23,ITGB2,C10orf56,ISCA1,PQBP1,SLC22A18,KRT10,C19orf54,COPZ1,WIPI1,SIGLEC10,MGST3,UQCRC1,ASNA1,SCARB2,TSSC1,C1orf85,ADFP,BAK1,ENO1,POLR2E,DUSP3,IGSF2,H1FX,MRPS15,KCMF1,ZBED1,CRTAP,SUSD1,ALKBH7,GHITM,CENTA2,DYM,DPYSL2,NDFIP1,C2orf47,PLEKHF1,C11orf75,ATOX1,PRICKLE4,PEPD,MDH2,SPNS1,JTV1,HNRNPUL1,ENO1L1,ILF3,RPUSD3,ACO2,CENPB,TCF7L2,MAPKAP1,G6PC3,DHPS,RTN1,RABGGTA,CAMTA1,KBRAS2,FARS1,ESD,PTDSS1,C3orf60,HLA-DQB1,NAGPA,XRCC1,NDUFS7,TTLL12,FH,FLAD1,RSU1,ALDH6A1,DCXR,RSL1D1,NUDC,DTD1,CNDP2,TRPV2,ZNF689,H6PD,RNF26,ABHD12,C17orf63,TP53,SUGT1,IDH3B,VDAC2,AIP,C8orf30A,CSNK2A1,HADH2,OCIAD1,TRIM44,PTBP1,SMARCB1,PSMD2,RNF5,EIF3M,NOB1,RALY,GATAD2A,COG2,SCAMP2,MTHFD1,AKR7A2,POLR3E,ECHS1,ACP5,RPL38,CCDC86,NUBP1,AHCYL2,TP53BP1,FTO,NOL5A,BSCL2,LRRC41,SEC31A,SCLY,MAP4,C4orf14,FVT1,FAHD2A,HNRNPD,FAM50B,SRM,LARP1,ZNF777,FARSA,CALR,ZFP64,NUDT19,FGD2,GTPBP3,POLR1C,PCMTD1 - 前記血液サンプルは、血液を透析器により浄化する透析装置を介して採取されることを特徴とする請求項1または2に記載の血液分析方法。
- 前記透析装置は、患者から採取された血液を、前記血液サンプルとして採取する血液サンプル採取手段を備えることを特徴とする請求項3に記載の血液分析方法。
- 前記血液サンプル採取手段は、前記透析器の手前で前記血液サンプルを採取することを特徴とする請求項4に記載の血液分析方法。
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