WO2010001924A1 - 結核菌におけるイソニアジド感受性を検出するための方法および試験片 - Google Patents
結核菌におけるイソニアジド感受性を検出するための方法および試験片 Download PDFInfo
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- WO2010001924A1 WO2010001924A1 PCT/JP2009/062034 JP2009062034W WO2010001924A1 WO 2010001924 A1 WO2010001924 A1 WO 2010001924A1 JP 2009062034 W JP2009062034 W JP 2009062034W WO 2010001924 A1 WO2010001924 A1 WO 2010001924A1
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- 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
- C12Q1/6888—Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes for detection or identification of organisms
- C12Q1/689—Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes for detection or identification of organisms for bacteria
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- 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
- G01N33/53—Immunoassay; Biospecific binding assay; Materials therefor
- G01N33/569—Immunoassay; Biospecific binding assay; Materials therefor for microorganisms, e.g. protozoa, bacteria, viruses
- G01N33/56911—Bacteria
- G01N33/5695—Mycobacteria
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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
- C12Q2600/00—Oligonucleotides characterized by their use
- C12Q2600/156—Polymorphic or mutational markers
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- 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
- G01N2333/195—Assays involving biological materials from specific organisms or of a specific nature from bacteria
- G01N2333/35—Assays involving biological materials from specific organisms or of a specific nature from bacteria from Mycobacteriaceae (F)
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2800/00—Detection or diagnosis of diseases
- G01N2800/44—Multiple drug resistance
Definitions
- the present invention relates to a method and a test piece for detecting sensitivity to isoniazid in Mycobacterium tuberculosis.
- tuberculosis is basically a medical therapy centered on chemotherapy, and surgical therapy is considered when it is impossible to achieve the purpose of treatment with medical therapy.
- drugs for treating tuberculosis used in medical therapy many kinds of drugs such as isoniazid (INH), rifampicin (RFP), streptomycin (SM), ethambutol (EB), pyrazinamide (PZA) and the like are known.
- IH isoniazid
- RFP rifampicin
- SM streptomycin
- EB ethambutol
- PZA pyrazinamide
- a drug is administered to a patient, there is a problem that a resistant bacterium that has acquired resistance to the administered drug is generated due to the mutation.
- the currently developed DNA microarray kit “Oligo® Array” (Nisshinbo Co., Ltd.) is a kit that can detect gene mutations involved in resistance to 5 drugs of INH, RFP, SM, kanamycin (KM), and EB. .
- Isoniazid is the most representative drug in the treatment of tuberculosis.
- Many of the INH resistant bacteria have mutations in the katG gene or the inhA gene.
- Various methods for detecting these mutations have been studied (for example, Patent Documents 2 and 3).
- Patent Documents 2 and 3 about 80% of INH-resistant bacteria are detected as resistant bacteria because of known mutations in the katG gene or inhA gene, but the remaining about 20% of INH-resistant bacteria cannot be detected. Therefore, INH is also administered to tuberculosis patients who have such undetectable INH-resistant bacteria.
- JP 2001-103981 A Japanese Patent No. 3579049 Japanese National Patent Publication No. 9-501823
- An object of the present invention is to provide a new means for more reliably detecting the INH sensitivity of M. tuberculosis, that is, whether or not M. tuberculosis is an INH-resistant bacterium.
- the present inventors have newly found that the fabG1 gene is also an isoniazid-susceptible gene, and that the fabG1 gene has a mutation, and that this mutation can make a tuberculosis bacterium into an INH-resistant bacterium.
- the present invention provides a method for detecting isoniazid susceptibility in Mycobacterium tuberculosis, the method comprising: A step of obtaining a FabG1 gene of Mycobacterium tuberculosis in a specimen, and a step of detecting a mutation involved in isoniazid resistance in the obtained fabG1 gene.
- the mutation is a mutation from base G to A or T at position 609 of the base sequence set forth in SEQ ID NO: 1 in the sequence listing, or a complementary sequence thereof.
- the present invention also provides a test strip for detecting sensitivity to isoniazid in Mycobacterium tuberculosis, wherein the test strip has at least one probe immobilized thereon.
- the at least one probe consists of an oligonucleotide capable of hybridizing with a region of a base sequence having a mutation in the FabG1 gene of Mycobacterium tuberculosis, or the mutation in a region of the base sequence having a mutation in the FabG1 gene of Mycobacterium tuberculosis It consists of an oligonucleotide that cannot hybridize with a region of a base sequence having, but can hybridize with a region of a wild type base sequence corresponding to the region.
- the mutation in the fabG1 gene is a mutation from base G at position 609 to A or T in the base sequence set forth in SEQ ID NO: 1 in the sequence listing, or a complementary sequence thereof.
- the oligonucleotide capable of hybridizing with the wild-type base sequence region comprises the base sequence set forth in SEQ ID NO: 3 in the sequence listing or a complementary sequence thereof.
- the test piece further comprises an oligonucleotide that can hybridize with a region of a base sequence having a mutation of the furA gene of Mycobacterium tuberculosis, or of a base sequence having a mutation of the furA gene of Mycobacterium tuberculosis.
- a probe composed of an oligonucleotide that cannot hybridize with the region of the base sequence having the mutation but can hybridize with a region composed of the wild-type base sequence corresponding to the region of the furA gene is fixed. .
- the mutation of the furA gene is a mutation from base C to T at position 41 of the base sequence set forth in SEQ ID NO: 8 in the sequence listing, or a complementary sequence thereof.
- the oligonucleotide capable of hybridizing with the region of the wild type base sequence of the furA gene consists of the base sequence set forth in SEQ ID NO: 10 of the sequence listing or a complementary sequence thereof.
- the present invention also provides a kit for detecting isoniazid sensitivity in Mycobacterium tuberculosis, comprising any of the above test pieces.
- the present invention further provides a method for detecting isoniazid sensitivity in Mycobacterium tuberculosis, the method comprising: Obtaining a FabG1 gene of Mycobacterium tuberculosis in a specimen; The step of bringing the obtained fabG1 gene into contact with any one of the above test pieces to bind to the probe fixed to the test piece, and the step of developing the color of the fabG1 gene bound to the probe.
- the method comprises Obtaining a furA gene of Mycobacterium tuberculosis in the sample, The method further includes the step of bringing the obtained furA gene into contact with any one of the above test pieces to bind to the probe fixed to the test piece, and the step of causing the furA gene bound to the probe to develop color.
- INH-resistant bacteria that have not been identified as INH-resistant bacteria can be accurately identified as INH-resistant bacteria. Therefore, by combining with a method for detecting a mutation in the existing katG gene or inhA gene, about 90% of INH-resistant bacteria can be identified as INH-resistant bacteria. Thus, INH sensitivity can be detected more reliably. As a result, an appropriate treatment can be provided for tuberculosis patients carrying isoniazid-resistant tuberculosis bacteria.
- the isoniazid (INH) susceptibility gene of Mycobacterium tuberculosis refers to a gene related to the action of the drug for treating tuberculosis isoniazid (INH).
- INH resistant bacterium a mutation occurs in this wild type INH susceptibility gene, and drug resistance to the action of INH is acquired.
- substitution, insertion and / or deletion occurs in the constituent amino acid sequence, resulting in a decrease in enzyme activity and a structural change in the drug binding site. The effect of is suppressed.
- INH resistance of Mycobacterium tuberculosis can be caused by mutation of various genes related to the action of INH such as katG gene and inhA gene. Such mutations are disclosed in, for example, Patent Documents 1 to 3. Any one of these mutations can be an INH-resistant tuberculosis bacterium.
- the fabG1 gene has a mutation, and it has been newly found that this mutation can make tuberculosis bacteria become INH resistant bacteria.
- the fabG1 gene is the first gene of the fabG1-inhA operon and encodes mycolic acid synthase (Non-Patent Documents 1 to 3).
- the mutation of the fabG1 gene is a mutation from base G to A or T at position 609 of the base sequence shown in SEQ ID NO: 1 in the sequence listing and a base C to T or A mutation in its complementary sequence. is there.
- these mutations are collectively expressed as “mutation from base G at position 609 to A or T, or a mutation of its complementary sequence”.
- This mutation is a silent mutation of leucine (Leu) at position 203 of FabG1 (SEQ ID NO: 2 in the sequence listing) encoded by the fabG1 gene.
- tubercle bacilli can become INH-resistant bacteria also by mutation of the furA gene.
- the above-mentioned katG gene encoding catalase-peroxidase constitutes the furA-katG operon starting with furA, and there is a report that the furA gene is a negative transcriptional gene of this operon (Non-patent Document 4).
- the furA gene regulates katG expression and is therefore involved in INH resistance.
- the function of the furA gene is only confirmed by deleting the entire furA gene, and there is no description of mutations in the furA gene.
- examples of the mutation of the furA gene include a mutation from base C to T at position 41 in the base sequence shown in SEQ ID NO: 8 in the sequence listing and a base G to A mutation in its complementary sequence.
- these mutations are collectively expressed as “mutation from base C to T at position 41 of the base sequence, or mutation of its complementary sequence”.
- alanine (Ala) at position 14 of FurA (SEQ ID NO: 9 in the sequence listing) encoded by the furA gene is mutated to valine (Val).
- Methods for detecting the above mutations on the fabG1 gene and the furA gene include Nollau et al., Clin. Chem., 43, 1114-1120 (1997), “Laboratory protocol for mutation detection” (Landegren, U. et al. , Oxford University Press (1996)), and “PCR” 2nd edition (Newton et al., BIOS Scientific Publishers Limited (1997)) can be used.
- PCR fragment sequencing method single-stranded conformation polymorphism method (SSCP method: Orita, M. et al., Proc. Natl. Acad. Sci.
- PCR-sequence-specific oligonucleotide probes can be used.
- a probe that is completely complementary to one allele sequence of about 10 to about 30 bases including a mutation site is prepared, DNA containing the mutation site is amplified by the PCR method, and then hybridization is performed. This is a method for discriminating gene polymorphism based on the presence of hybridization.
- an oligonucleotide probe that can bind (hybridize) to a region having a mutation in the FabG1 gene of Mycobacterium tuberculosis (hereinafter referred to as “fabG1 mutant probe”)
- fabG1 mutant probe an oligonucleotide that cannot hybridize with the region of the base sequence having the mutation but can hybridize with the region consisting of the wild-type base sequence corresponding to the region
- a probe hereinafter sometimes referred to as “fabG1 wild-type probe”.
- an oligonucleotide probe that can bind (hybridize) to a region having a mutation in the furA gene of Mycobacterium tuberculosis (hereinafter sometimes referred to as “furA mutation probe”), and a region having a mutation in this furA gene
- furA mutation probe an oligonucleotide probe that cannot hybridize to a region having a base sequence having a mutation, but can hybridize to a region consisting of a wild-type base sequence corresponding to the region (hereinafter referred to as “furA wild-type probe”) ).
- each probe depends on the temperature at the time of binding (hybridization), but is generally 10 to 30 nucleotides, preferably 12 to 26 nucleotides.
- the mutation probe is capable of binding (hybridizing) to a region having the above mutations of the furA gene or the fabG1 gene.
- the base sequence other than the mutation is a wild type. If this region is wild type, the mutant probe cannot bind to this region.
- the wild-type probe can bind (hybridize) to any region corresponding to the region having the mutation in the wild-type furA gene or the fabG1 gene.
- Each of the above probes can be obtained using standard programs and primer analysis software such as Primer Express (Perkin Elmer) and can be synthesized using standard methods such as automated oligonucleotide synthesizers. .
- each probe may be modified at either the 5 'or 3' end, for example, in order to fix it to the test piece.
- Each probe may be provided in any form as long as detection is possible, may be in the form of a solution, or may be fixed to a carrier. In order to facilitate detection, it is preferably fixed to a test piece.
- At least one probe is fixed to the test piece for detecting isoniazid sensitivity in Mycobacterium tuberculosis according to the present invention.
- At least one probe immobilized is the fabG1 mutant probe or the fabG1 wild type probe. More preferably, the fabG1 mutant probe and the fabG1 wild-type probe are immobilized at different positions on the test strip.
- the fabG1 gene has a mutation, the fabG1 gene binds to the fabG1 mutant probe but does not bind to the furA wild type probe.
- there is no mutation it binds to the fabG1 wild type probe. Therefore, in the case of INH sensitivity, it binds only to the fabG1 wild type probe, and in the case of INH resistance, it binds to the fabG1 mutant probe without binding to the fabG1 wild type probe.
- control or marker for confirming color development may be fixed to the test piece of the present invention.
- the test piece for detecting sensitivity to isoniazid in Mycobacterium tuberculosis is the furA mutant probe or the furA wild type probe. It is preferable that the furA mutant probe and the furA wild type probe are immobilized at different positions on the test piece.
- the furA gene has a mutation, the furA gene binds to the furA mutant probe but does not bind to the furA wild type probe.
- the furA wild type probe when there is no mutation, it binds to the furA wild type probe. Therefore, in the case of INH sensitivity, it binds only to the furA wild type probe, and in the case of INH resistance, it binds to the furA mutant probe without binding to the furA wild type probe.
- a known probe capable of detecting INH sensitivity or INH resistance other than the fabG1 gene and the furA gene may be immobilized on the test piece of the present invention.
- the test piece of the present invention can be prepared by physically or chemically fixing the probe on the surface of the carrier.
- the carrier include organic materials such as vinyl polymer, nylon, polyester, polyethylene, polypropylene, polystyrene, polyethylene terephthalate, and nitrocellulose; inorganic materials such as glass and silica; metal materials such as gold and silver, and the like.
- An organic material is preferable in terms of easy molding processability, and polyesters such as polyethylene terephthalate are more preferable.
- These carriers are preferably white in order to make the color development easily visible in the detection by the color development method.
- the probes are arranged on the carrier at regular intervals for each type.
- various known methods are used. For example, there is a method of coating the carrier surface with a polycationic polymer such as polylysine. According to this method, the efficiency of immobilization can be increased by electrostatic interaction with a probe that is a polyanion.
- an irrelevant base sequence such as a polythymine chain
- various probes can be immobilized relatively easily by discharging a solution containing a polythymine-added oligonucleotide probe from a dispenser onto a nitrocellulose membrane and irradiating with ultraviolet rays.
- each probe is placed in a dispenser equipped with a 24-gauge needle, and is applied at a coating speed of 2.5 to 8.5 mm / sec while discharging an amount of 0.5 to 1.0 ⁇ L / min.
- each probe When applied on the nitrocellulose membrane at regular intervals, each probe is applied as a stripe having a width of about 1 to 2 mm arranged at regular intervals.
- the probe is fixed on the carrier by irradiating the carrier coated with the stripe of the probe with ultraviolet rays. Furthermore, if necessary, if a thin cut is made so as to cross these stripes, a large number of test pieces in which the probes are arranged in sequence can be obtained at a time.
- the carrier surface is a metal material such as gold
- the surface of the carrier is treated with a thiol having an amino group such as 2-aminoethanethiol or a disulfide compound, thereby causing electrostatic interaction with the probe that is a polyanion. It is also known that the efficiency of immobilization is improved.
- a method for chemically immobilizing a probe by introducing a functional group various known methods are used.
- the carrier material is an inorganic material such as glass or silicon
- a functional group capable of silane coupling reaction such as trimethoxysilyl group or triethoxysilyl group.
- the test piece is obtained by immersing the carrier in a solution containing the probe modified in this manner for 24 to 48 hours, removing it, and washing it.
- an inorganic material carrier such as glass or silicon
- a silane coupling agent having an amino group such as aminoethoxysilane
- the surface of the carrier is aminated, and then a probe having an carboxylic acid introduced at the terminal and an aminocup
- the carrier material is a metal material such as gold or silver
- the end of the probe is modified with a functional group capable of binding to a metal such as a thiol group or a disulfide group, and the carrier is added to a solution containing the modified probe. It can be fixed by immersing for ⁇ 48 hours, taking out and then washing.
- the “specimen” may generally be a specimen necessary for the tubercle bacillus test.
- bodily fluids such as sputum, throat swab, gastric fluid, bronchoalveolar lavage fluid, intratracheal aspirate, throat wipes and / or tissue biopsy, and cultures obtained from these cultures It is done.
- Sample pretreatment Extraction of DNA from the specimen can be performed by a known method. Examples thereof include a phenol extraction method, a guanidine thiocinate extraction method, and a vanadyl ribonucleoside complex extraction method.
- a target gene is obtained from the obtained DNA.
- a target gene is amplified by the PCR method, for example, it is carried out in the following steps: (1) Heat treatment of double-stranded genomic DNA under a reaction condition of about 92 to 95 ° C. for about 30 seconds to 1 minute Step of denaturation to make a double strand; (2) PCR reaction is started by binding at least two kinds of amplification primers to each of the single-stranded DNA at about 50 to 65 ° C. for about 20 seconds to 1 minute. An annealing step for producing a double-stranded portion to be a point; (3) a strand extension step in which a DNA polymerase is reacted at about 70 to 75 ° C. under reaction conditions for about 20 seconds to 5 minutes; and (1) to (3 Step) is repeated 20 to 40 times by a conventional method.
- a sequence upstream from the sequence site containing the mutation site and a sequence downstream from the site so that the fabG1 gene containing the mutation site can be amplified.
- oligonucleotides having the same or complementary base sequence examples include oligonucleotides having SEQ ID NO: 6 (ggctacatcg acaccgatat gacc) and SEQ ID NO: 7 (gcgtccttgt gttgtgtcag tgg) in the sequence listing or an oligonucleotide having a complementary sequence thereof.
- a primer pair used to amplify the furA gene by PCR a sequence upstream from the sequence site containing the mutation site and a sequence downstream from the site so that the furA gene containing the mutation site can be amplified.
- oligonucleotides having the same or complementary base sequence examples include the oligonucleotides of SEQ ID NO: 13 (gccatcccac gatccagcgg) and SEQ ID NO: 14 (gtcgggcagc gcaaaacgca c) of the sequence listing or oligonucleotides having complementary sequences thereof.
- the nucleic acid may be further amplified by the Nested PCR method (Japanese Patent Publication No. 6-81600) before the PCR reaction.
- a primer in the Nested PCR method a sequence outside the primer used in the PCR reaction can be selected.
- the oligonucleotide of SEQ ID NO: 4 (gtcgaaggca aacgtgaccg cg) and SEQ ID NO: 5 (gtccagcagt cctgtcatgt g) in the sequence listing or an oligonucleotide having a complementary sequence thereof can be mentioned.
- the above probe and primer sequences can be obtained using standard programs and primer analysis software such as Primer Express (Perkin Elmer) and synthesized using standard methods such as automated oligonucleotide synthesizers. can do.
- the INH sensitivity of Mycobacterium tuberculosis can be detected by the PCR-SSOP method. More simply, the detection can be performed by comparing the position of the fixed probe with the position of the spot detected by the PCR-SSOP method. For example, when using a test strip to which the above probe is immobilized, hybridization in the PCR-SSOP method is preferably performed at a temperature of about 60 to 65 ° C. in that nonspecific binding reaction is unlikely to occur. If the position of the detected spot is the position of the fabG1 wild-type probe, M.
- tuberculosis has no mutation, that is, is sensitive to INH, while the position of the detected spot is the position of the fabG1 mutant probe. It can be judged that M. tuberculosis is INH resistant. Further, if the detected spot position is the position of the furA wild type probe, it is determined that the tubercle bacillus is INH-sensitive. On the other hand, if the detected spot position is the position of the furA mutant probe, the tuberculosis bacteria is determined. Can be determined to be INH resistant.
- a primer pair in which a labeling substance such as a radioisotope, a fluorescent substance, or a chemiluminescent substance is modified.
- a labeling substance such as a radioisotope, a fluorescent substance, or a chemiluminescent substance is modified.
- NBT nitroblue tetrazolium
- BCIP 5-bromo-4-chloro-3-indolylphosphatase p-toluidinyl salt
- the method is preferred. Specifically, it is performed as follows.
- a gene having biotin at the end is amplified using a primer pair in which biotin is modified at the 3 'end or 5' end of the primer.
- the amplified gene and the probe fixed to the test piece are bound to the probe by hybridization, and further contacted with alkaline phosphatase-labeled streptavidin to bind to biotin present at the end of the gene bound to the probe.
- NBT / BCIP is added and reacted with alkaline phosphatase to develop color at a position where alkaline phosphatase bound to the probe is present. This color development is visible.
- the detection kit of the present invention includes the above-described test piece.
- any reagent suitable for detecting Mycobacterium tuberculosis isoniazid sensitivity may be included.
- a reagent for extracting the above DNA, a reagent for gene amplification, a reagent for detecting the binding of the gene to the probe, and the like can be mentioned.
- a kit for carrying out the PCR-SSOP method is exemplified.
- the reagent for DNA extraction that can be included in the kit of the present invention is a reagent used in any of the above-described methods.
- a primer pair for amplifying the fabG1 gene by PCR can also be included in the kit of the present invention.
- the primer pair includes the same or complementary nucleotide sequence including a sequence upstream from the sequence site including the mutation site and a sequence downstream from the site so that the fabG1 gene including any mutation site can be amplified.
- examples of a preferable primer pair for amplifying the fabG1 gene include the oligonucleotides of SEQ ID NOs: 6 and 7 in the above sequence listing or an oligonucleotide having a complementary sequence thereof.
- the oligonucleotides of SEQ ID NOs: 13 and 14 in the above sequence listing or oligonucleotides having complementary sequences thereof can be mentioned.
- the primer pair in the Nested PCR method for improving the measurement sensitivity include, for the fabG1 gene, the oligonucleotides of SEQ ID NOs: 4 and 5 in the above sequence listing or an oligonucleotide having a complementary sequence thereof.
- the oligonucleotides of SEQ ID NOs: 11 and 12 in the above sequence listing or oligonucleotides having complementary sequences thereof can be mentioned.
- the primer pair is preferably modified with a radioisotope, a fluorescent substance, a chemiluminescent substance or the like in order to facilitate detection in the PCR-SSOP method.
- gene amplification may include known techniques such as the LAMP method and the ICAN method.
- any of these methods may be used, and the present invention also includes a kit containing any reagent used in these methods.
- kit of the present invention may contain reagents for detection.
- reagents for detection For example, when the NBT / BCIP color development method is employed, streptavidin-modified alkaline phosphatase, NBT, and BCIP are exemplified.
- Example 1 Gene analysis of Mycobacterium tuberculosis of INH-resistant Mycobacterium tuberculosis of INH-resistant Mycobacterium tuberculosis
- 92 samples determined to be INH-resistant Mycobacterium tuberculosis were obtained by confirming growth in an INH-containing solution (MGIT 960: Nihon Becton Dickinson Co., Ltd.) or INH-containing agar medium (Ogawa Medium, 7H10), Genomic DNA was extracted from these 92 samples by the phenol extraction method and purified.
- fabG1 gene was amplified using the primer pairs shown below. PCR reaction conditions were 94 ° C. and 30 seconds for the denaturation process, 55 ° C. and 20 seconds for the annealing process, and 72 ° C. and 20 seconds for the chain extension process, and amplification was performed in 30 cycles of this process.
- fabG1 primer 2 gcgtccttgt gtgtgtgtcag tgg SEQ ID NO: 7.
- furA gene was amplified using the primer pairs shown below. PCR reaction conditions were 94 ° C. and 30 seconds for the denaturation process, 55 ° C. and 20 seconds for the annealing process, and 72 ° C. and 20 seconds for the chain extension process, and amplification was performed in 30 cycles of this process.
- furA primer 1 gccatcccac gatccagcgg SEQ ID NO: 13
- furA primer 2 gtcgggcagc gcaaaacgca c SEQ ID NO: 14
- a primer that binds to the furA-katG operon 129 bases upstream from the furA initiation codon (gctcatcgga acatacgaag: SEQ ID NO: 15) and a primer that binds 50 bases downstream from the katG stop codon (gtgctgcggc gggttgtggt tgatcggcgg) PCR was performed using SEQ ID NO: 16), and the entire nucleotide sequence was determined by DNA sequencing. Mutations not reported in published papers were designated as new mutations.
- a primer that binds 200 bases upstream from the fabG1 initiation codon (ttcgtagggc gtcaatacac: SEQ ID NO: 17) and a primer that binds 40 bases downstream from the inhA stop codon (ccgaacgaca gcagcaggac: PCR was performed using SEQ ID NO: 18), and the entire nucleotide sequence was determined by DNA sequencing. Mutations not reported in published papers were designated as new mutations.
- INH-resistant bacteria having known mutations were 67 specimens out of 92 specimens, but considering the mutations of the fabG1 gene and furA gene, 83 specimens out of 92 specimens (90.2%) A resistant bacterium can be easily determined to be INH resistant. Therefore, more reliable and simple detection is possible.
- Probe design The following two probes (probe 1 and 2: a fabG1 wild type probe and a furA wild type probe, respectively) were designed as probes that can detect the INH sensitivity of Mycobacterium tuberculosis. All of these are wild-type probes that do not bind when there is a mutation but only bind (hybridize) with a wild-type gene.
- each of the wild type probes (probes 1 and 2) added with polythymine was placed in a dispenser equipped with a 24 gauge needle, and 2 mm was applied at a coating speed of 2.5 mm / second while discharging an amount of 0.7 ⁇ L / min. It was applied in a vertical direction at intervals of 2 mm on a nitrocellulose film (length 75 mm ⁇ width 150 mm: Whatman) so as to form a stripe having a width of 1 mm.
- the probes were immobilized by irradiating these nitrocellulose membranes with ultraviolet rays of 312 nm for 2 minutes.
- the nitrocellulose membrane was cut so as to include all the stripes, thereby preparing a test piece of 5 mm ⁇ 150 mm.
- INH-resistant bacteria that could not be determined for INH sensitivity so far. Therefore, by combining with a method for detecting a mutation in the existing katG gene or inhA gene, about 90% of INH resistant bacteria can be easily identified as INH resistant bacteria without culturing, and isoniazid Can be easily diagnosed as being incurable. As a result, appropriate treatment can be provided to such patients. Therefore, unnecessary drug administration and testing can be prevented, the burden on the patient can be reduced, and unnecessary medical expenses can be reduced.
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Abstract
Description
検体中の結核菌のfabG1遺伝子を取得する工程、および
該取得したfabG1遺伝子について、イソニアジド耐性に関与する変異を検出する工程
を含む。
該少なくとも1つのプローブが、結核菌のfabG1遺伝子の変異を有する塩基配列の領域とハイブリダイズし得るオリゴヌクレオチドからなるか、あるいは該結核菌のfabG1遺伝子の変異を有する塩基配列の領域において、該変異を有する塩基配列の領域とはハイブリダイズし得ないが、該領域に対応する野生型塩基配列からなる領域とハイブリダイズし得るオリゴヌクレオチドからなる。
検体中の結核菌のfabG1遺伝子を取得する工程、
該取得したfabG1遺伝子を上記のいずれかの試験片と接触させて、該試験片に固定されたプローブに結合させる工程、および
該プローブに結合したfabG1遺伝子を発色させる工程
を含む。
上記検体中の結核菌のfurA遺伝子を取得する工程、
該取得したfurA遺伝子を上記のいずれかの試験片と接触させて、該試験片に固定されたプローブに結合させる工程、および
該プローブに結合したfurA遺伝子を発色させる工程
をさらに含む。
本発明において、結核菌(Mycobacterium tuberculosis)のイソニアジド(INH)感受性遺伝子とは、結核治療用薬剤イソニアジド(INH)の作用に関連する遺伝子をいう。INH耐性菌では、この野生型のINH感受性遺伝子に変異が生じ、INHの作用に対する薬剤耐性が獲得されている。具体的には、変異を持つINH感受性遺伝子から発現した酵素では、構成するアミノ酸配列において置換、挿入および/または欠落が生じているため、酵素活性の低下や薬剤結合部位の構造変化が生じ、INHの効果が抑制される。
本発明の結核菌におけるイソニアジド感受性を検出するために用いられるプローブとしては、結核菌のfabG1遺伝子の変異を有する領域と結合(ハイブリダイズ)し得るオリゴヌクレオチドプローブ(以下、「fabG1変異プローブ」という場合がある)、ならびにこのfabG1遺伝子の変異を有する領域において、変異を有する塩基配列の領域とはハイブリダイズし得ないが、該領域に対応する野生型塩基配列からなる領域とハイブリダイズし得るオリゴヌクレオチドプローブ(以下、「fabG1野生型プローブ」という場合がある)が挙げられる。
本発明の、結核菌におけるイソニアジド感受性を検出するための試験片には、少なくとも1つのプローブが固定されている。固定されている少なくとも1つのプローブは、上記fabG1変異プローブまたはfabG1野生型プローブである。fabG1変異プローブおよびfabG1野生型プローブは、試験片のそれぞれ異なる位置に固定されることがより好ましい。fabG1遺伝子が変異を有する場合、fabG1遺伝子はfabG1変異プローブと結合するが、furA野生型プローブとは結合しない。一方、変異がない場合には、fabG1野生型プローブと結合する。したがって、INH感受性の場合はfabG1野生型プローブにのみ結合し、INH耐性の場合は、fabG1野生型プローブには結合せずにfabG1変異プローブに結合する。
1.検体
本発明において、「検体」は、通常、結核菌検査に必要な検体であればよい。例えば、喀痰、咽頭ぬぐい液、胃液、気管支肺胞洗浄液、気管内吸引物、喉からの拭取物および/または組織生検物などの体液、ならびにこれらから培養して得られた培養物が挙げられる。
上記検体からのDNAの抽出は、公知の方法で行うことができる。例えば、フェノール抽出法、グアニジンチオシナネート抽出法、バナジルリボヌクレオシド複合抽出法などが挙げられる。
得られたDNAから目的の遺伝子を取得する。PCR法で目的の遺伝子を増幅する場合、例えば、以下の工程で行われる:(1)2本鎖ゲノムDNAを約92~95℃、約30秒~1分間の反応条件で熱処理することにより1本鎖にする変性工程;(2)該1本鎖DNAのそれぞれに約50~65℃を約20秒~1分間の反応条件で、少なくとも2種類の増幅プライマーを結合させることによりPCRの反応開始点となる2本鎖部分を作製するアニール工程;(3)約70~75℃を約20秒~5分間の反応条件でDNAポリメラーゼを用いて反応させる鎖伸張工程;ならびに(1)~(3)の工程を通常の方法により20~40回繰り返す工程。
本発明において、結核菌のINH感受性は、PCR-SSOP法によって検出することができる。より簡便には、固定されたプローブの位置と、PCR-SSOP法において検出されたスポットの位置とを比較することにより検出することもできる。例えば、上記のプローブが固定された試験片を使用する場合、PCR-SSOP法におけるハイブリダイズは、非特異的な結合反応が起きにくい点で、約60~65℃の温度で行うことが好ましい。検出されたスポットの位置が、fabG1野生型プローブの位置であれば、結核菌は変異を有さない、すなわちINH感受性であり、一方、検出されたスポットの位置がfabG1変異プローブの位置であれば、結核菌はINH耐性であると判断することができる。また、検出されたスポットの位置がfurA野生型プローブの位置であれば、結核菌はINH感受性であると判断され、一方、検出されたスポットの位置がfurA変異プローブの位置であれば、結核菌はINH耐性であると判断できる。
本発明の検出用キットは、上記の試験片を含む。好適には、結核菌のイソニアジド感受性を検出するために適切な任意の試薬類を含み得る。例えば、上記のDNAの抽出のための試薬、遺伝子増幅用試薬、プローブへの遺伝子の結合を検出するための試薬などが挙げられる。具体的なキットとして、上記のPCR-SSOP法を実施するためのキットを例示する。
本実施例では、INH含有溶液(MGIT 960:日本ベクトン・ディッキンソン株式会社製)またはINH含有寒天培地(小川培地、7H10)における発育の確認によりINH耐性結核菌と判定された92検体を入手し、これらの92検体からフェノール抽出法によりゲノムDNAを抽出し精製した。
以下に示すプライマー対を用いてfabG1遺伝子を増幅した。PCRの反応条件は、変性過程を94℃、30秒、アニール過程を55℃、20秒、鎖伸長過程を72℃、20秒とし、この工程を30サイクルにより、増幅を行った。
fabG1プライマー1 ggctacatcg acaccgatat gacc (配列番号6)
fabG1プライマー2 gcgtccttgt gttgtgtcag tgg (配列番号7)
以下に示すプライマー対を用いてfurA遺伝子を増幅した。PCRの反応条件は、変性過程を94℃、30秒、アニール過程を55℃、20秒、鎖伸長過程を72℃、20秒とし、この工程を30サイクルにより、増幅を行った。
furAプライマー1 gccatcccac gatccagcgg (配列番号13)
furAプライマー2 gtcgggcagc gcaaaacgca c (配列番号14)
上記92検体について、既知の変異を有するkatG遺伝子およびinhA遺伝子をそれぞれ増幅して、既知の変異の有無を検出した。
1.プローブの設計
結核菌のINH感受性を検出し得るプローブとして、以下の2つのプローブ(プローブ1および2:それぞれfabG1野生型プローブおよびfurA野生型プローブ)を設計した。これらはいずれも、変異がある場合には結合せず、野生型の遺伝子とのみ結合(ハイブリダイズ)する野生型プローブである。
プローブ2 gctccggacg gccgacctgc g(配列番号10)
上記プローブ1および2(それぞれ配列番号3および10)のそれぞれの5’末端にターミナルトランスフェラーゼ(Promega社)を用いて、ポリチミンの付加を行った。具体的には、ターミナルトランスフェラーゼ(30unit/μL)を0.4μL、チミジン三リン酸(10pmol/μL)を2μL、オリゴヌクレオチドプローブ(50mM)を2μL、製品添付の反応緩衝液を2μL、および精製水3.6μLを混合して反応溶液を調製し、37℃で4時間反応させた後、10×SSC緩衝液90μLを加えることにより、ポリチミン付加されたオリゴヌクレオチドプローブ1pmol/μLを得た。
Claims (11)
- 結核菌におけるイソニアジド感受性を検出する方法であって、
検体中の結核菌のfabG1遺伝子を取得する工程、および
該取得したfabG1遺伝子について、イソニアジド耐性に関与する変異を検出する工程
を含む、方法。 - 前記変異が、配列表の配列番号1に記載の塩基配列の609位の塩基GからAまたはTへの変異、またはその相補配列の変異である、請求項1に記載の方法。
- 結核菌におけるイソニアジド感受性を検出するための試験片であって、
少なくとも1つのプローブが固定されており、
該少なくとも1つのプローブが、結核菌のfabG1遺伝子の変異を有する塩基配列の領域とハイブリダイズし得るオリゴヌクレオチドからなるか、あるいは該結核菌のfabG1遺伝子の変異を有する塩基配列の領域において、該変異を有する塩基配列の領域とはハイブリダイズし得ないが、該領域に対応する野生型塩基配列からなる領域とハイブリダイズし得るオリゴヌクレオチドからなる、
試験片。 - 前記fabG1遺伝子の変異が、配列表の配列番号1に記載の塩基配列の609位の塩基GからAまたはTへの変異、またはその相補配列の変異である、請求項3に記載の試験片。
- 前記野生型塩基配列の領域とハイブリダイズし得るオリゴヌクレオチドが、配列表の配列番号3に記載の塩基配列またはその相補配列からなる、請求項4に記載の試験片。
- さらに、結核菌のfurA遺伝子の変異を有する塩基配列の領域とハイブリダイズし得るオリゴヌクレオチドからなるか、あるいは該結核菌のfurA遺伝子の変異を有する塩基配列の領域において、該変異を有する塩基配列の領域とはハイブリダイズし得ないが、該furA遺伝子の領域に対応する野生型塩基配列からなる領域とハイブリダイズし得るオリゴヌクレオチドからなるプローブが固定されている、請求項3から5のいずれかの項に記載の試験片。
- 前記furA遺伝子の変異が、配列表の配列番号8に記載の塩基配列の41位の塩基CからTへの変異、またはその相補配列の変異である、請求項6に記載の試験片。
- 前記furA遺伝子の野生型塩基配列の領域とハイブリダイズし得るオリゴヌクレオチドが、配列表の配列番号10に記載の塩基配列またはその相補配列からなる、請求項7に記載の試験片。
- 請求項3から8のいずれかの項に記載の試験片を含む、結核菌におけるイソニアジド感受性の検出用キット。
- 結核菌におけるイソニアジド感受性を検出する方法であって、
検体中の結核菌のfabG1遺伝子を取得する工程、
該取得したfabG1遺伝子を請求項3から8のいずれかの項に記載の試験片と接触させて、該試験片に固定されたプローブに結合させる工程、および
該プローブに結合したfabG1遺伝子を発色させる工程
を含む、方法。 - 請求項10に記載の方法であって、
前記検体中の結核菌のfurA遺伝子を取得する工程、
該取得したfurA遺伝子を請求項6から8のいずれかの項に記載の試験片と接触させて、該試験片に固定されたプローブに結合させる工程、および
該プローブに結合したfurA遺伝子を発色させる工程
をさらに含む、方法。
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EP09773502.1A EP2322659B1 (en) | 2008-07-02 | 2009-07-01 | Method for detecting sensitivity to isoniazid in m. tuberculosis |
BRPI0913658-4A BRPI0913658B1 (pt) | 2008-07-02 | 2009-07-01 | Método, tira de teste e kit para detecção da sensibilidade à isoniazida em mycobacterium tuberculosis |
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JPH09501823A (ja) | 1993-05-13 | 1997-02-25 | アール.,ジュニア ヤコブス,ウィリアム | inhA遺伝子を用いるミコバクテリア感染の検出および処置のための方法および組成物 |
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CN102084006A (zh) | 2011-06-01 |
JP5904432B2 (ja) | 2016-04-13 |
EP2322659A1 (en) | 2011-05-18 |
BRPI0913658A2 (pt) | 2016-05-03 |
EP2322659A4 (en) | 2012-01-04 |
BRPI0913658B1 (pt) | 2019-06-25 |
JPWO2010001924A1 (ja) | 2011-12-22 |
EP2322659B1 (en) | 2013-11-06 |
CN102084006B (zh) | 2014-08-20 |
BRPI0913658A8 (pt) | 2019-05-21 |
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