JP7331168B2 - 多発性骨髄腫におけるmタンパク質反応の臨床評価 - Google Patents
多発性骨髄腫におけるmタンパク質反応の臨床評価 Download PDFInfo
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Description
アミノ酸配列YSFSNYWIS(配列番号18)のHCDR1、
アミノ酸配列WMGIIDPASSKTRYSPSFQG(配列番号19)のHCDR2、
アミノ酸配列SRGAGMDY(配列番号20)のHCDR3
を含む可変重鎖、および
アミノ酸配列TGSSSNIGAGYDVH(配列番号21)のLCDR1、
アミノ酸配列LLIYADNNRPS(配列番号22)のLCDR2、
アミノ酸配列GSYDESSNSM(配列番号23)のLCDR3
を含む可変軽鎖を含む。
a)前記患者から血液サンプルを得ること、
b)血液サンプルを抗イディオタイプ抗体と共にインキュベートすること、
c)免疫固定電気泳動(IFE)を実行すること、および
d)IFEの結果を報告すること。
用語「抗イディオタイプ」は、抗体の可変領域に結合するタンパク質またはペプチドを記述する。抗イディオタイプタンパク質は、抗体であり得る。例えば、抗体MOR09292は、MOR202の可変領域に結合する。
臨床的な関心のほとんどは、血清タンパク質スペクトルのガンマ領域に集中する。なぜなら、免疫グロブリンがこの領域に泳動されるからである。免疫グロブリンは多くの場合、電気泳動スペクトルの至る所で見出され得る点に留意する必要がある。C反応性タンパク質(CRP)が、ベータ成分とガンマ成分との間の領域内に位置決めされる。
1)電気泳動によるタンパク質の分離。
2)電気泳動にかけたタンパク質の免疫固定(免疫沈降)-適切な電気泳動の泳動トラックを、個々の抗血清で覆う。抗血清は、ゲル中に拡散して、対応する抗原を、存在する場合には析出させる。参照トラック中のタンパク質を、固定剤で固定する。
3)析出しなかった、可溶性のタンパク質を、ブロッティングおよび洗浄によってゲルから除去する。抗原-抗体複合体の析出を、ゲルマトリックス内にトラップする。
4)析出したタンパク質を、染色(例えばアシッドバイオレット染色)によって視覚化する。
Sebiaの半自動化アガロースゲル電気泳動系HydrasysおよびHydrasys2を用いて、かつSebiaのMaxikit Hydragel 9IFを用いて、免疫固定を実行した。キットは、免疫固定電気泳動によるヒト血清中の免疫グロブリンの検出用に設計されており、必要な試薬および材料を全て、すなわち、アガロースゲル、緩衝ストリップ(buffered strips)、希釈剤、アシッドバイオレット染色剤、抗血清(例えば、IgG、IgA、IgM、カッパおよびラムダ)、固定溶液、およびアプリケータを含有する。
a)Mタンパク質濃度前処理と比較して、少なくとも≧40%の血清Mタンパク質レベルの引下げ、および
b)残されたMタンパク質スパイクの少なくとも1つが、薬物抗体MOR202の特性(すなわち、IFEにおけるIgG/ラムダポジティブ染色)と同じである。
臨床研究MOR202C101の範囲内でのIFE反射アッセイの使用および結果についてのケーススタディ
多発性骨髄腫患者をMOR202で処置する第1の臨床研究(MOR202C101)の範囲内で、血清Mタンパク質レベルの≧86%の引下げが観察された後に、IFE反射アッセイを患者19007に施した。当該患者について、同定したMタンパク質スパイクを、IFEによって、IgG/ラムダポジティブとして記述した。これは、MOR202について知られているのと同じ分子特性である。SPEを実行して、1または2g/Lの潜在的Mタンパク質の残留濃度を、2106年1月12日および2016年2月19日に検出した。IFE反射アッセイは、このアッセイシグナルが専ら、MOR202干渉によって引き起こされるので、Mタンパク質は関係しないことを実証し得た(表1の要約ラボ結果を参照)。当該結果は、新たに確立されたIFE反射アッセイが、Mタンパク質、従って疾患関連アッセイシグナルとMOR202処置関連アッセイシグナルを明確に識別し得る方法を実証している。
一態様が、アルブミンに融合した抗イディオタイプ抗体である。一実施形態において、アルブミンは、配列番号6のアミノ酸配列を有するヒトアルブミンである。一実施形態において、ヒトアルブミンは、ヒトアルブミンのフラグメントまたはヒトアルブミンの部分配列である。
以下のアミノ酸配列を含む可変軽鎖ドメイン
アミノ酸配列YSFSNYWIS(配列番号18)のHCDR1、
アミノ酸配列WMGIIDPASSKTRYSPSFQG(配列番号19)のHCDR2、
アミノ酸配列SRGAGMDY(配列番号20)のHCDR3
を含む可変重鎖、および
アミノ酸配列TGSSSNIGAGYDVH(配列番号21)のLCDR1、
アミノ酸配列LLIYADNNRPS(配列番号22)のLCDR2、
アミノ酸配列GSYDESSNSM(配列番号23)のLCDR3
を含む可変軽鎖を含む。
e)前記患者から血液サンプルを得ること、
f)血液サンプルを抗イディオタイプ抗体と共にインキュベートすること、
g)免疫固定電気泳動(IFE)を実行すること、および
h)IFEの結果を報告すること。
アミノ酸配列YSFSNYWIS(配列番号18)のHCDR1、
アミノ酸配列WMGIIDPASSKTRYSPSFQG(配列番号19)のHCDR2、
アミノ酸配列SRGAGMDY(配列番号20)のHCDR3
を含む可変重鎖、および
アミノ酸配列TGSSSNIGAGYDVH(配列番号21)のLCDR1、
アミノ酸配列LLIYADNNRPS(配列番号22)のLCDR2、
アミノ酸配列GSYDESSNSM(配列番号23)のLCDR3
を含む可変軽鎖を含む。
Claims (2)
- 抗イディオタイプ抗体であって、
配列番号7のアミノ酸配列を含む可変重鎖ドメイン、および、配列番号8のアミノ酸配列を含む可変軽鎖ドメインを有する抗CD38抗体に特異的であり、
前記抗イディオタイプ抗体は、
配列番号18のアミノ酸配列のHCDR1、
配列番号19のアミノ酸配列のHCDR2、
配列番号20のアミノ酸配列のHCDR3
を含む可変重鎖、および
配列番号21のアミノ酸配列のLCDR1、
配列番号22のアミノ酸配列のLCDR2、
配列番号23のアミノ酸配列のLCDR3
を含む可変軽鎖を含む
ことを特徴とする抗イディオタイプ抗体。 - 多発性骨髄腫または他の免疫グロブリン血症の治療を受けている患者から得られた血液サンプルの、総Mタンパク質レベルについての評価における、請求項1に記載の抗イディオタイプ抗体の使用であって、前記使用は、
a)前記患者から得られた血液サンプルを、抗イディオタイプ抗体と共にインキュベートするステップと、
b)免疫固定電気泳動(IFE)を実行するステップと、
c)前記IFEの結果を報告するステップと
を含み、
前記患者は、配列番号7のアミノ酸配列を含む可変重鎖ドメイン、および、配列番号8のアミノ酸配列を含む可変軽鎖ドメインを有する抗CD38抗体による治療を受けていることを特徴とする使用。
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