WO2001011371A2 - Diagnosis of inflammation measuring il-8 in urine - Google Patents
Diagnosis of inflammation measuring il-8 in urine Download PDFInfo
- Publication number
- WO2001011371A2 WO2001011371A2 PCT/GB2000/002971 GB0002971W WO0111371A2 WO 2001011371 A2 WO2001011371 A2 WO 2001011371A2 GB 0002971 W GB0002971 W GB 0002971W WO 0111371 A2 WO0111371 A2 WO 0111371A2
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- WIPO (PCT)
- Prior art keywords
- level
- mammal
- interleukin
- diagnosis
- urine
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Classifications
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- 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
- G01N33/6863—Cytokines, i.e. immune system proteins modifying a biological response such as cell growth proliferation or differentiation, e.g. TNF, CNF, GM-CSF, lymphotoxin, MIF or their receptors
- G01N33/6869—Interleukin
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2333/00—Assays involving biological materials from specific organisms or of a specific nature
- G01N2333/435—Assays involving biological materials from specific organisms or of a specific nature from animals; from humans
- G01N2333/52—Assays involving cytokines
- G01N2333/54—Interleukins [IL]
Definitions
- This invention relates to a method and apparatus for diagnosis of medical conditions and in particular to a method and apparatus for non-invasive testing for the diagnosis of inflammatory conditions.
- Inflammatory conditions can be chronic, such as chronic inflammatory bowel disease, chronic arthritis, or acute, such as appendicitis, colecystitis or acute surgical inflammatory conditions. Diagnosis of any inflammatory condition requires a number of very unpleasant and invasive tests. These tests are expensive and can only be performed in hospital by specialists.
- Inflammatory conditions are characterised by the accumulation of inflammatory cells including neutrophils in the inflamed tissue.
- Neutrophils play a major part in acute mucosa inflammation. For example, in active inflammatory bowel disease neutrophil turnover has been shown to be greatly increased. Neutrophils have a potent ability to produce toxic mediators such as reactive oxygen and nitrogen intermediates. Neutrophils also have a potent ability to produce cytokines .
- Interleukin 8 is a member of the ⁇ chemokine family of chemotactic cytokines. It is a potent chemo-attractant and activator of neutrophils. It is present in a wide variety of diseased states. Neutrophils are prominent producers of IL-8 in actively inflamed tissue. That is, tissue damage results from inflammatory cell infiltration. Inflammatory cell infiltration is facilitated by a number of mediators. The chief mediator is IL-8. Thus, patients with active disease have elevated tissue level of IL-8.
- a method of diagnosis of a medical condition of a mammal comprising detection of the level of Interleukin-8 (IL-8) in excreted urine of the mammal.
- IL-8 Interleukin-8
- the level of IL-8 in the excreted urine provides a direct indicator of the level of IL-8 in the mammal, and this can be used to diagnose, or be used in the diagnosis of, a medical condition of the mammal.
- Preferably said method is applicable in the diagnosis of inflammatory conditions.
- Such conditions include at least ulcerative colitis, Crohn's disease, arthritis, cholecystitis, appendicitis, urinary tract infections, etc.
- Said method may have application in the diagnosis of chronic inflammatory conditions, acute inflammatory conditions, and indeed non-specific inflammations and infections.
- IL-8 Interleukin-8
- an apparatus for measuring the level of IL-8 in excreted urine is provided.
- said apparatus comprises means for immunoassay such as enzyme linked immunosorbent assay (ELISA) .
- ELISA enzyme linked immunosorbent assay
- said apparatus is provided in kit form.
- Said apparatus may also be adapted for use in the laboratory.
- Said apparatus may be adapted for use by a patient.
- a method of detecting the level of IL-8 in the excreted urine of a mammal uses measuring means or apparatus as hereinbefore defined, preferably an ELISA assay, wherein urine is added to the means or apparatus and a detection means determines either the or a relative level of IL-8, possibly in comparison with a standard level.
- a method of diagnosis of a mammal comprising the steps of obtaining a sample of urine excreted by the mammal; testing the level of IL-8 in the urine; and comparing the level obtained against a standard level to determine whether it is significantly abnormal.
- said method includes the step of testing the level of IL-8 using immunoassay. More preferably said method includes the step of testing the level of IL-8 using enzyme linked immunoassay.
- the present invention i.e. the measurement of IL-8 in urine, can also be used to complement or as a replacement for measuring blood parameters of inflammation like acute phase substances, e.g. C- reactive protein, but with the advantage of being a non-invasive test.
- acute phase substances e.g. C- reactive protein
- Fig 1 is a graphic representation of urinary levels of IL-8 in a control group
- Fig 2 is a graphic comparison of urinary levels of IL-8 in patients with inactive and active ulcerative colitis
- Fig 3 is a graphic comparison of urinary levels of IL-8 in patients with inactive and active Crohn's disease
- Fig 4 is a graphic comparison of urinary levels of IL-8 in patients with active and inactive rheumatoid arthritis
- Fig 5 is a graphic comparison of urinary levels of IL-8 in patients with cholecystitis and a control group
- Fig 6 is a graphic comparison of urinary levels of IL-8 in patients with appendicitis and a control group
- Fig 7 is a graphic comparison of urinary levels of IL-8 in patients with urinary tract infection and a control group
- Fig 8 is a graphic comparison of urinary levels of IL-8 in patients with non-specific inflammation and a control group
- Fig 9 is a graphic comparison of urinary levels of IL-8 in children with an active inflammation/infection and a control group.
- Fig 10 is a graphic comparison of urinary levels of IL-8 in children with a viral illness and a control group.
- IBS Irritable Bowel Syndrome
- Clinical assessment included the frequency of diarrhoea stools, bleeding, pain, urgency, haemoglobin, ESR and CRP levels.
- the urine specimens of the above group were tested for the level of IL-8 present using enzyme linked immunosorbent assay (ELISA) .
- ELISA enzyme linked immunosorbent assay
- the results of the assay were then statistically analyzed.
- the statistical analysis included multiple group comparisons using the Kruskall Wallis test, and, where appropriate, comparison between two groups using the Mann-Whitney test and 95% confidence intervals.
- Sub-Groups (by condition) Ulcerative colitis Patients with Active disease Median IL-8 level 104.3 pg/ml Interquartile range 16.1 to 196.0 pg/ml.
- Control versus Active disease P 0.001 95% confidence interval: 15.9, 126.6.
- Control versus Inactive disease P 0.13 95% confidence interval: -1.2, 20.5.
- Active ulcerative colitis versus Inactive ulcerative colitis P 0.002 95% confidence interval: 37.5, 127.9.
- Urinary Interleukin-8 Levels in Active and Inactive Rheumatoid Arthritis A total of 43 patients were studied. Twenty-one had active arthritis, including 4 men and 17 women, with a median age of 62 years. Twenty-two patients had inactive arthritis, including 9 men and 13 women, with a median age of 56 years.
- Interleukin-8 levels in both groups are shown in Figure 4 , and the raw data are presented in the Table 2. Patients with active arthritis have higher levels compared with those with inactive disease.
- Urinary tract infection Nonspecific inflammation/ infection (diverticulitis, gastroenteritis) . Similar results were found in children with active inflammatory processes (with the exception of viral illness causing upper respiratory tract infection) . This is because IL-8 is likely to rise in conditions characterised by neutrophilic and macrophage infiltration.
- the level of IL-8 in excreted urine is a measure of systemic inflammation. That is, flare-ups in patients known to have e.g. chronic inflammatory bowel disease can be simply and non-invasively diagnosed by determining the level of urinary IL-8 for comparison with the normal level of IL-8 for inactive inflammatory disease, or with IL-8 levels in healthy patients.
- This test is comparatively inexpensive, painless and may overt unnecessary invasive testing or perhaps even unnecessary surgical intervention.
- Non-invasive testing methods are particularly attractive for use on paediatric patients. Children presenting with any kind of medical condition are usually easily distressed and non-invasive testing ensures that their distress can also be kept to a minimum.
- this method of diagnosis has application in chronic inflammatory conditions.
- examples of such conditions are chronic bowel disease and chronic arthritis.
- this method of diagnosis has application in acute inflammatory conditions where the level of IL-8 can be compared with the expected level in healthy patients.
- acute inflammatory conditions where the level of IL-8 can be compared with the expected level in healthy patients.
- examples of such conditions are acute surgical inflammation, appendicitis, colecystitis, pancreatitis and non-specific abdominal pain.
- This method of diagnosis has wide application particularly in paediatric patients for both inflammatory and non-inflammatory conditions. That is, this method of diagnosis can be used in place of blood tests, barium meals, radioisotope tests, endoscopy or colonoscopy, at least in the first instance.
- the level of IL-8 indicating the presence of active disease or acute inflammation obviously differs in adults and in paediatric patients.
- results of a test measuring the level of IL-8 in urine are quickly and cheaply obtained using enzyme linked immunosorbent assay.
- the results have application as a diagnostic tool, or as an adjective aid to diagnosis.
- This test is also of use in the self management of chronic inflammatory conditions. That is, an apparatus for measurement of the urinary level of IL- 8 will be provided in kit form analogous to a pregnancy test. This will allow patients with known chronic inflammatory conditions to monitor the need for medical intervention. That is, patients diagnosed with chronic inflammatory conditions can confirm a suspicion that their disease may have become active simply by testing a sample of their urine to check if the IL-8 level is significantly high.
- the test could be conducted in hospital laboratories on urinary samples as a matter of routine.
- the urinary level of IL-8 would give doctors confidence that surgical intervention or increased drug therapy is in fact warranted and necessary.
- the method of diagnosis may be contra- indicated in a small number of conditions including renal failure, or where a patient is known to abuse substances such as alcohol or drugs.
- the present invention provides a simple and non- invasive method and apparatus for detecting the level of IL-8 in a mammal, and using the detected level to diagnose, or in the diagnosis of, various medical conditions, particularly but not exclusively inflammatory conditions.
- ELISA plates were passively coated with captures antibody overnight at 4°C.
- mA/b was made up to 1ml (500 ⁇ g/ml) and 40 ⁇ l was added to 5.1 ml PBS pH7.2 (4 ⁇ g/ml) . This was scaled up as necessary. 50 ⁇ l was added per well. The plates were shaken to ensure even coverage of wells.
- the ELISA' s use paired antibodies. Capture antibody was used to coat the plates, then biotinylated detection antibody was used to detect the bound std. This was quantified by subsequently introducing streptavdin peroxidase, then measured peroxidase by a colour reaction. The plates were washed before use. The standard and samples were added to the wells in a total of lOO ⁇ l and it was ensured that the standards were diluted in a similar medium to the samples. The plates were then sealed using the adhesive plate sealers, and were incubated overnight at 4°C. After the first incubation the plates were washed four times with washing buffer. The stock detection antibody was made up to 1ml (50 ⁇ g/ml) .
- the plates were again washed four times by wash buffer, then 200 ⁇ l of substrate was added to each well.
- the substrate was TMB prepared from stable solutions consisting of: A. Urea-hydrogen peroxide 0.3g per 50ml of 50mM sodium acetate buffer pH 6.0 B. Tetramethyl benzidine 2mg/ml in DMF.
- Preservative Polyvinyl pyrollidone 2% BSA 5mg/ml Boehringer preservatives, o.l% of stock EDTAS 5mM
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- Immunology (AREA)
- Molecular Biology (AREA)
- Engineering & Computer Science (AREA)
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- Biomedical Technology (AREA)
- Urology & Nephrology (AREA)
- Hematology (AREA)
- Microbiology (AREA)
- Biotechnology (AREA)
- Proteomics, Peptides & Aminoacids (AREA)
- Food Science & Technology (AREA)
- Medicinal Chemistry (AREA)
- Physics & Mathematics (AREA)
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- General Health & Medical Sciences (AREA)
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Abstract
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Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU64550/00A AU6455000A (en) | 1999-08-07 | 2000-08-07 | Method and apparatus for diagnosis |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GB9918589.4 | 1999-08-07 | ||
GBGB9918589.4A GB9918589D0 (en) | 1999-08-07 | 1999-08-07 | Method and apparatus for diagnosis |
GBGB9925246.2A GB9925246D0 (en) | 1999-08-07 | 1999-10-27 | Method and apparatus for diagnosis |
GB9925246.2 | 1999-10-27 |
Publications (2)
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WO2001011371A2 true WO2001011371A2 (en) | 2001-02-15 |
WO2001011371A3 WO2001011371A3 (en) | 2001-09-07 |
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PCT/GB2000/002971 WO2001011371A2 (en) | 1999-08-07 | 2000-08-07 | Diagnosis of inflammation measuring il-8 in urine |
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AU (1) | AU6455000A (en) |
WO (1) | WO2001011371A2 (en) |
Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2004032711A2 (en) | 2002-10-09 | 2004-04-22 | Dmi Biosciences, Inc. | Diagnosis and monitoring of inflammation, ischemia and appendicitis |
US7560244B2 (en) | 2003-06-04 | 2009-07-14 | Joslin Diabetes Center, Inc. | Method of evaluating a subject for risk or predisposition of reduced renal function over time |
WO2010078403A3 (en) * | 2008-12-30 | 2010-11-25 | Lipella Pharmaceuticals Inc. | Methods and compositions for diagnosing urological disorders |
RU2615353C1 (en) * | 2016-02-24 | 2017-04-04 | федеральное государственное бюджетное образовательное учреждение высшего образования "Северо-Западный государственный медицинский университет имени И.И. Мечникова" Министерства здравоохранения Российской Федерации | Method for determination of degree of activity of exacerbation of chronic obstructive pyelonephritis |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1996041194A1 (en) * | 1995-06-07 | 1996-12-19 | The Children's Medical Center Corporation | Diagnosis, prognosis and monitoring of angiogenesis dependent diseases |
-
2000
- 2000-08-07 WO PCT/GB2000/002971 patent/WO2001011371A2/en active Application Filing
- 2000-08-07 AU AU64550/00A patent/AU6455000A/en not_active Abandoned
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1996041194A1 (en) * | 1995-06-07 | 1996-12-19 | The Children's Medical Center Corporation | Diagnosis, prognosis and monitoring of angiogenesis dependent diseases |
Non-Patent Citations (10)
Title |
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BENSON MIKAEL ET AL: "Interleukin (IL)-6 and IL-8 in children with febrile urinary tract infection and asymptomatic bacteriuria." JOURNAL OF INFECTIOUS DISEASES, vol. 174, no. 5, 1996, pages 1080-1084, XP000992537 ISSN: 0022-1899 * |
FLORENT C H: "Inflammatory bowel disease (IBD): Therapeutic actualities." ACTA ENDOSCOPICA, vol. 25, no. 5 SUPPL., 1995, pages 571-574, XP000992520 ISSN: 0240-642X * |
GENDREL D: "Urinary infection and biological markers." ARCHIVES DE PEDIATRIE, vol. 5, no. SUPPL. 3, 1998, pages 269S-273S, XP000992530 ISSN: 0929-693X * |
JACOBSON, S. ET AL.: "Interleukin-6 and Interleukin-8 in Serum and Urine in Patients with Acute Pyelonephritis in Relation to Bacterial-Virulence-Associated Traits and Renal Function" NEPHRON, vol. 67, no. 2, 1994, pages 172-179, XP000992531 * |
MOUTABARRIK ABDELHAKIM ET AL: "Interleukin-8 in patients with glomerulonephritis." JN JOURNAL OF NEPHROLOGY, vol. 8, no. 6, 1995, pages 325-330, XP000992536 ISSN: 1121-8428 * |
STIEMER BEATE ET AL: "Interleukin-8 in urine: A new diagnostic parameter for intra-amniotic infection after premature rupture of the membranes." BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, vol. 104, no. 4, 1997, pages 499-502, XP000992558 ISSN: 0306-5456 * |
TAKAYAMA FUMIO ET AL: "Involvement of interleukin-8 in dialysis-related arthritis." KIDNEY INTERNATIONAL, vol. 53, no. 4, April 1998 (1998-04), pages 1007-1013, XP000992528 ISSN: 0085-2538 * |
TESAR VLADIMIR ET AL: "Cytokines and adhesion molecules in renal vasculitis and lupus nephritis." NEPHROLOGY DIALYSIS TRANSPLANTATION, vol. 13, no. 7, July 1998 (1998-07), pages 1662-1667, XP000992542 ISSN: 0931-0509 * |
TIKHONOV I ET AL: "A study of interleukin-8 and defensins in urine and plasma of patients with pyelonephritis and glomerulonephritis." NEPHROLOGY DIALYSIS TRANSPLANTATION, vol. 12, no. 12, December 1997 (1997-12), pages 2557-2561, XP000992540 ISSN: 0931-0509 * |
YASUMOTO RYOJI ET AL: "Urinary interleukin-6 and interleukin-8 in females with urethral syndrome." ACTA UROLOGICA JAPONICA, vol. 43, no. 4, 1997, pages 267-270, XP000992534 ISSN: 0018-1994 * |
Cited By (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2004032711A2 (en) | 2002-10-09 | 2004-04-22 | Dmi Biosciences, Inc. | Diagnosis and monitoring of inflammation, ischemia and appendicitis |
JP2010071997A (en) * | 2002-10-09 | 2010-04-02 | Dmi Biosciences Inc | Diagnosis and monitoring of inflammation, ischemia, and appendicitis |
EP2386863A1 (en) | 2002-10-09 | 2011-11-16 | DMI Biosciences, Inc. | Diagnosis and monitoring of multiple organ failure |
EP2386862A1 (en) | 2002-10-09 | 2011-11-16 | DMI Biosciences, Inc. | Methods and kits for diagnosing appendicitis |
EP2386864A1 (en) | 2002-10-09 | 2011-11-16 | DMI Biosciences, Inc. | Diagnosis and monitoring of Ischemia |
US7560244B2 (en) | 2003-06-04 | 2009-07-14 | Joslin Diabetes Center, Inc. | Method of evaluating a subject for risk or predisposition of reduced renal function over time |
WO2010078403A3 (en) * | 2008-12-30 | 2010-11-25 | Lipella Pharmaceuticals Inc. | Methods and compositions for diagnosing urological disorders |
RU2615353C1 (en) * | 2016-02-24 | 2017-04-04 | федеральное государственное бюджетное образовательное учреждение высшего образования "Северо-Западный государственный медицинский университет имени И.И. Мечникова" Министерства здравоохранения Российской Федерации | Method for determination of degree of activity of exacerbation of chronic obstructive pyelonephritis |
Also Published As
Publication number | Publication date |
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AU6455000A (en) | 2001-03-05 |
WO2001011371A3 (en) | 2001-09-07 |
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