WO2013031973A1 - 毒素産生性クロストリディウム・ディフィシルの検出方法 - Google Patents
毒素産生性クロストリディウム・ディフィシルの検出方法 Download PDFInfo
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- WO2013031973A1 WO2013031973A1 PCT/JP2012/072219 JP2012072219W WO2013031973A1 WO 2013031973 A1 WO2013031973 A1 WO 2013031973A1 JP 2012072219 W JP2012072219 W JP 2012072219W WO 2013031973 A1 WO2013031973 A1 WO 2013031973A1
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- 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
Definitions
- the present invention relates to an oligonucleotide for detecting toxin-producing Clostridium difficile and a method for detecting toxin-producing Clostridium difficile using the same.
- Clostridium difficile is a spore-forming gram-positive gonococcus that produces exotoxins that are pathogenic to humans.
- C. Cdifficile-related diarrhea (CDAD) caused by this bacterium has become a major problem in recent years (Non-patent Document 1). That is, excessive use of antibiotics or anticancer agents damages the normal intestinal bacterial flora, and as a result, the proliferated C. difficile produces toxins TcdA and TcdB and develops symptoms such as diarrhea.
- C. C difficile is known to go out in the stool of an infected person, reach the person's mouth and mucous membranes through the instruments and hands, etc., and become infected.
- C. difficile The pathogenicity of C. difficile is mainly caused by two toxins TcdA and TcdB belonging to the Large Closridial Toxin (LCTs) family, but each strain of C. difficile produces TcdA-produced TcdB due to the difference in their toxin productivity. It is roughly classified into a type (A + B +), a TcdA non-producing TcdB producing type (A-B +), and a non-toxin producing type (AB-). In addition, the toxin production system of C.
- LCTs Large Closridial Toxin
- tcdA and tcdB and tcdC, tcdR, and tcdE that encode these regulatory factors, and negatively regulates toxin production. It has been reported that deficiency of tcdC enhances the production of toxins TcdA and TcdB.
- Non-Patent Document 2-4 Patent Document 1
- C. difficile has a low number of bacteria in the healthy human intestine
- a detection system with both higher specificity and detection sensitivity for detecting toxin-producing strains in feces using PCR.
- the present invention relates to an oligonucleotide that enables specific and high-sensitivity detection of toxin-producing C. difficile and a method for detecting toxin-producing C. difficile using the same.
- tcdA gene sequence of 20 strains tcdB gene sequence of 22 strains
- tcsL which is a toxin gene of Clostridium sordelii
- tcnA which is a toxin gene of Clostridium novyi
- toxin gene of Clostridium perfringens Toxin-producing C. difficile can be detected with specific and excellent sensitivity by aligning the tcpL base sequences together and amplifying and measuring the tcdA and tcdB genes using the designed specific oligonucleotides. I found.
- the present invention relates to the following 1) to 10).
- a primer pair consisting of an oligonucleotide consisting of the base sequence shown in SEQ ID NO: 1 and an oligonucleotide consisting of the base sequence shown in SEQ ID NO: 2, or a primer pair consisting of a complementary sequence corresponding to the base sequence.
- An oligonucleotide probe consisting of the base sequence shown in SEQ ID NO: 3 or an oligonucleotide probe consisting of a complementary sequence corresponding to the base sequence.
- An oligonucleotide set for real-time PCR comprising the primer pair of 1) above and the oligonucleotide probe of 3) above.
- oligonucleotide probe in which a fluorescent substance is bound to the 5 ′ end of the oligonucleotide and a quencher substance is bound to the 3 ′ end.
- An oligonucleotide set for real-time PCR comprising the primer pair of 5) above and the oligonucleotide probe of 7) above.
- Toxin production comprising the steps of performing PCR using DNA extracted from human feces as a template and using the oligonucleotide set of 4) or 8) above, and measuring the amplification product by measuring fluorescence How to detect sex C. difficile.
- the oligonucleotide set of the above 4) and / or 8) and the primer pair (a) or the primer pair (a) and the oligonucleotide probe (b) shown below A process for performing PCR using each oligonucleotide set for real-time PCR, and a step for measuring an amplification product by measuring fluorescence.
- B an oligonucleotide probe consisting of the base sequence shown in SEQ ID NO: 9 or an oligonucleotide probe consisting of a complementary sequence corresponding to the base sequence, and a fluorescent substance bound to the 5 ′ end of the oligonucleotide; An oligonucleotide probe having a quencher substance bound to the 3 ′ end.
- the toxin-producing C. difficile in stool can be detected specifically and with high sensitivity. Therefore, according to the present invention, it is possible to easily and accurately diagnose toxin-producing C. difficile infections, and the frequency of detection of toxin-producing C. difficile strains in the stool of healthy adults is facilitated. Can be examined. In addition, by measuring the total number of C. difficile bacteria, the abundance ratio of toxin-producing C. difficile or non-toxin producing C. difficile can be calculated for C. difficile in feces.
- the primer pair of the present invention includes (1) a primer pair for amplifying the tcdA gene and (2) a primer pair for amplifying the tcdB gene.
- the primer pair for amplifying the tcdA gene is a first primer which is an oligonucleotide having the base sequence shown in SEQ ID NO: 1 (5'-CAGTCGGATTGCAAGTAATTGACAAT-3 '(tcdA-F)), and SEQ ID NO: 2 comprises a second primer which is an oligonucleotide having the base sequence shown in 2 (5′-AGTAGTATCTACTACCATTAACAGTCTGC-3 ′ (tcdA-R)).
- the first primer can be used as a forward primer in a nucleic acid amplification reaction such as PCR (polymerase chain reaction), and the second primer can be used as a reverse primer combined with the first primer in a nucleic acid amplification reaction.
- TcdA-producing TcdB-producing type A + B +
- TcdA-nonproducing TcdB-producing type A-B +
- non-toxin-producing type AB-
- a primer pair for amplifying the tcdB gene is a third primer which is a primer consisting of the base sequence shown in SEQ ID NO: 4 (5'-TACAAACAGGTGTATTTAGTACAGAAGATGGA-3 '(tcdB-F)), and SEQ ID NO: 5 It consists of the 4th primer which is a primer which consists of a base sequence shown by (5'-CACCTATTTGATTTAGMCCTTTAAAAGC-3 '(tcdB-R)).
- the third primer can be used as a forward primer in the nucleic acid amplification reaction
- the fourth primer can be used as a reverse primer combined with the third primer in the nucleic acid amplification reaction.
- the tcdB gene can be reliably amplified, and TcdB toxin-producing C. difficile, that is, the A + B + type strain and the A-B + type strain can be reliably detected (Table 3). ).
- the oligonucleotide probe of the present invention includes (1) a probe that specifically hybridizes to the tcdA gene and (2) a probe that specifically hybridizes to the tcdB gene.
- the probe that specifically hybridizes to the tcdA gene is an oligonucleotide (first probe) consisting of the base sequence shown in SEQ ID NO: 3 (5′-TTGAGATGATAGCAGTGTCAGGATTG-3 ′ (tcdA-P)) It specifically binds to the amplification range by the primer pair consisting of the first and second primers.
- the probe that specifically hybridizes to the tcdB gene is an oligonucleotide (second probe) consisting of the base sequence shown in SEQ ID NO: 6 (5′-TTTKCCAGTAAAATCAATTGCTTC-3 ′ (tcdB-P)). Yes, it specifically binds to the amplification range by the primer pair consisting of the third and fourth primers.
- Such an oligonucleotide probe has a fluorescent substance such as FAM (carboxyfluorescein) and TET (tetrachlorocarboxyfluorescein) at the 5 ′ end, and a quencher substance such as TAMRA (carboxytetramethylrhodamine) and BHQ-1 (black hole quencher-1) at the 3 ′ end.
- FAM fluorescein
- TET tetrachlorocarboxyfluorescein
- TAMRA carboxytetramethylrhodamine
- BHQ-1 black hole quencher-1
- the modified first probe is an oligonucleotide set for amplifying and measuring the tcdA gene by real-time PCR together with the primer pair consisting of the first and second primers
- the modified second probe is Together with the primer pair consisting of the third and fourth primers
- the tcdB gene can be used as an oligonucleotide set for amplifying and measuring by real-time PCR.
- the oligonucleotide of the present invention includes oligonucleotides composed of complementary sequences corresponding to the respective base sequences in addition to oligonucleotides composed of the base sequences shown in SEQ ID NOs: 1 to 6. That is, a primer pair consisting of a complementary sequence corresponding to the base sequence shown in SEQ ID NO: 1 and SEQ ID NO: 2, an oligonucleotide probe consisting of a complementary sequence corresponding to the base sequence shown in SEQ ID NO: 3, SEQ ID NO: 4 and a sequence A primer pair consisting of a complementary sequence corresponding to the base sequence shown in No. 5 and an oligonucleotide probe consisting of a complementary sequence corresponding to the base sequence shown in SEQ ID No.
- nucleotide sequence shown in SEQ ID NOs: 1 to 6 or a complementary sequence corresponding to the nucleotide sequence comprises a nucleotide sequence in which 1 or 2 bases are deleted, substituted, added or inserted.
- the oligonucleotide having the same function as a primer or probe and the oligonucleotide consisting of the base sequence shown in or a complementary sequence thereof are treated in the same manner as the oligonucleotide of the present invention.
- the oligonucleotide of the present invention can be easily produced by a known chemical synthesis method.
- a nucleic acid amplification reaction is performed using DNA extracted from human feces as a template, and the amplification product is measured to obtain a TcdA toxin-producing C difficile and TcdB toxin-producing C. difficile can be detected, respectively.
- the detection includes determination of the presence or absence of C. difficile and quantification of C. difficile.
- the quantification includes quantification of the number of bacteria.
- the number of TcdA toxin-producing C. difficile and TcdB toxin-producing C. difficile bacteria in feces can be measured.
- C. difficile-specific primers and probes and measuring the total number of C. difficile bacteria, the breakdown of C. difficile in the feces (intestines), that is, C. difficile Toxigenic C. difficile (A + B + type, A-B + type, or A +) against total number of bacteria (sum of A + B +, A-B + and AB-types) The sum of the numbers of B + and A-B + types) or the non-toxin producing C.
- AB-type number can be calculated.
- a primer and probe specific to such C. difficile the following primer pair (a) or (a) a primer pair and (b) an oligonucleotide probe for real-time PCR comprising an oligonucleotide probe: Can be mentioned.
- the primer pair (a) is a fifth primer which is an oligonucleotide having the base sequence (5′-GCAAGTTGAGCGATTTACTTCGGT-3 ′ (CD16SrRNA-F)) shown in SEQ ID NO: 7, and the primer pair shown in SEQ ID NO: 8.
- a sixth primer which is an oligonucleotide having a base sequence (5′-GTACTGGCTCACCTTTGATATTYAAGAG-3 ′ (CD16SrRNA-R)).
- the fifth primer can be used as a forward primer in the nucleic acid amplification reaction
- the sixth primer can be used as a reverse primer combined with the fifth primer in the nucleic acid amplification reaction.
- the oligonucleotide probe (b) is an oligonucleotide (third probe) consisting of the base sequence shown in SEQ ID NO: 9 (5′-TGCCTCTCAAATATATTATCCCGTATTAG-3 ′ (CD16SrRNA-P)). It specifically binds to the amplification range by the primer pair consisting of the primers.
- Such an oligonucleotide probe is a modified oligonucleotide for performing real-time PCR, for example, by modifying the 5 ′ end side with a fluorescent substance such as FAM or TET, and the 3 ′ end with a quencher substance such as TAMRA or BHQ-1.
- nucleotide can be used as a nucleotide (so-called Taqman probe).
- the nucleotide sequence shown in SEQ ID NOs: 7 to 9 or a complementary sequence corresponding to the nucleotide sequence comprises a nucleotide sequence in which 1 or 2 bases are deleted, substituted, added or inserted.
- the oligonucleotide having the same sequence as a primer or probe and the oligonucleotide consisting of the base sequence shown in FIG. 1 or a complementary sequence thereof are treated in the same manner as the oligonucleotides (a) and (b) above.
- Examples of subjects to be examined for the presence or abundance of microorganisms include, for example, conjunctival swab, calculus, plaque, sputum, pharyngeal swab, saliva, nasal discharge, alveolar lavage fluid, pleural effusion, gastric juice, gastric lavage fluid, urine, cervical canal Ecological samples such as mucus, vaginal secretions, skin lesions, feces, blood, ascites, tissue, spinal fluid, joint fluid, affected area wipes, foods, pharmaceuticals, cosmetics, intermediate products of foods / pharmaceuticals / cosmetics, microbial culture Examples include objects that may contain microorganisms such as liquids, plants, soil, activated sludge, and wastewater.
- the sample derived from the subject is not particularly limited as long as it is a sample that can reflect the presence or amount of microorganisms in the subject, and examples thereof include a mixture containing nucleotides and a mixture containing DNA contained in the subject. From the viewpoint of use in the PCR method, a mixture containing DNA contained in the subject is preferable.
- Extraction of DNA from human feces can be performed by the same method as in the case of conventional genomic DNA preparation.
- extraction or separation / purification method can be performed from the whole or a part of the subject as necessary.
- a known method such as filtration, centrifugation, chromatography, etc., for example, “physical crushing with stirring in the presence of glass beads”, “CTAB method”, “phenol”
- CTAB method filtration, centrifugation, chromatography, etc.
- It can be obtained by extraction using a general-purpose method such as the “chloroform method (PC method)”, “magnetic bead method”, “silica column method”, or a combination of these methods, or using a commercially available kit. You can also.
- nucleic acid extracts from feces contain substances that inhibit PCR. It is desirable to obtain highly purified DNA that has been removed as much as possible. For this purpose, it is particularly preferable to use FastDNA SPIN Kit for Feces (MP Biomedicals) that can extract DNA with high concentration and high purity.
- the nucleic acid amplification method is not particularly limited, and a known method using the principle of the PCR method can be mentioned.
- PCR method LAMP (Loop-mediated isothermal AMPlification) method, ICAN (Isothermal and Chimeric primer-initiated Amplification of Nucleic acids) method, RCA (Rolling Circle Amplification) method, LCR (Ligase Chain Reaction) method, SDA (Strand place) Amplification) method and the like.
- a known means capable of specifically recognizing the amplification product can be used.
- a labeled substance such as a radioisotope, a fluorescent substance, or a luminescent substance can be allowed to act on dNTP taken in during the amplification reaction, and this labeled substance can be detected.
- any method for observing the amplification product incorporating the labeled dNTP any method may be used as long as it is a method known in the art for detecting the above-mentioned labeled body.
- the radioactivity can be measured using, for example, a liquid scintillation counter or a ⁇ -counter.
- fluorescence when fluorescence is used as the label, the fluorescence can be detected using a fluorescence microscope, a fluorescence plate reader, or the like.
- a nucleic acid amplification method it is preferable from the viewpoint of rapidity and quantitativeness to use real-time PCR that monitors and analyzes the amount of PCR amplification in real time.
- examples of the real-time PCR include methods usually used in the art, such as TaqMan probe method, intercalator method, and cycling probe method. In the present invention, it is particularly preferable to use the TaqMan probe method.
- the TaqMan probe method is a method in which an oligonucleotide (TaqMan probe) in which the 5 ′ end is modified with a fluorescent substance (FAM, etc.) and the 3 ′ end is modified with a quencher substance (TAMRA, etc.) is added to the PCR reaction system.
- the modified first probe and second probe can be used as TaqMan probes, which specifically hybridize to the template DNA in the annealing step of the PCR reaction. Since a quencher substance exists, the generation of fluorescence is suppressed even when irradiated with excitation light.
- the TaqMan probe hybridized to the template is decomposed by the 5 ′ ⁇ 3 ′ exonuclease activity of Taq DNA polymerase during the extension reaction step, the fluorescent substance is released from the probe, and the inhibition by the quencher substance is released. And emits fluorescence.
- the PCR conditions are not particularly limited, and an optimum condition may be determined for each PCR device. Examples thereof include the following conditions. 1) Thermal denaturation of double-stranded DNA into single-stranded DNA: Heat at about 93 to 95 ° C., usually about 10 seconds to 1 minute. 2) Annealing: Heating is usually performed at about 50 to 60 ° C., usually for about 10 seconds to 1 minute. 3) DNA extension reaction: Heated at about 70 to 74 ° C. for about 30 seconds to 5 minutes. Here, the annealing and the DNA extension reaction can be performed simultaneously without being separated. By carrying out the reactions 1) to 3) usually for about 30 to 50 cycles, the target tcdA gene and tcdB gene can be amplified to a detectable level.
- the concentration of the Taqman probe in the reaction solution is preferably about 100 to 1000 nM from the viewpoint of sensitivity.
- PCR when using an intercalator method in which a reagent that emits fluorescence by binding to double-stranded DNA (fluorescence intercalator) is used in a PCR reaction system, for example, SYBR GreenI, SYBR GreenII, SYBR Gold, PCR may be performed in the presence of a known reagent such as oxazole yellow, thiazole orange, ethidium bromide, pico green, and the fluorescence intensity that increases with amplification of the target sequence may be measured.
- fluorescence intercalator fluorescence intercalator
- Real-time PCR can be performed using an apparatus dedicated to real-time PCR in which a thermal cycler and a spectrofluorometer are integrated, for example, ABI PRISM 7900HT sequence detection system (Applied Biosystems).
- a serially diluted standard DNA solution with a known concentration was used for PCR, and the amount of amplification product of PCR using this initial DNA amount as a template was reached to a certain amount. Plot the number of cycles (threshold cycle; Ct value) on the vertical axis to create a calibration curve.
- Ct value the number of cycles (threshold cycle; Ct value) on the vertical axis.
- a sample having an unknown concentration can also be reacted under the same conditions to obtain a Ct value, and the target DNA amount in the sample can be obtained from this value and a calibration curve.
- Quantification of the number of bacteria can be performed in the same procedure as the measurement of the amount of DNA by calculating the number of bacteria corresponding to the amount of DNA used for preparing a calibration curve.
- the number of bacteria in the pure culture solution of the strain used for the preparation of the standard DNA solution is measured, and DNA is extracted from these known numbers of bacteria to be included in the DNA solution after extraction (standard DNA solution)
- standard DNA solution A bacterial value corresponding to the amount of DNA can be obtained. Therefore, since the bacterial value corresponding to the initial DNA amount tested for PCR can be calculated, by creating a calibration curve with the horizontal axis converted to the bacterial value, the target microorganism contained in the sample of unknown concentration The bacterial count can be calculated in the same manner.
- PCR is carried out using a standard DNA solution with a known “DNA amount of the target microorganism” or “number of bacteria of the target microorganism (corresponding to the amount of DNA)” and a DNA sample of an unknown concentration.
- the “number of PCR cycles” (Ct value) when the amount of amplification product is reached the “DNA amount of the target microorganism” or “the number of target microorganisms” in the sample of unknown concentration can be obtained.
- Such a calibration curve is usually created by plotting the number of target microorganisms on the horizontal axis and the Ct value on the vertical axis.
- a known strain such as a reference strain may be used as the microorganism used in preparing the calibration curve.
- the amount of the target microbial DNA in the subject can also be determined, for example, by knowing the hybridization efficiency between the nucleic acid fragment that can specifically hybridize to the target microbial DNA and the subject sample.
- TcdA toxin-producing C. difficile and TcdB toxin-producing C. difficile can be specifically detected (Example 2), and 10 3 or more C. If difficile is present, its DNA can be detected (Example 3), and highly sensitive detection is possible.
- a primer set specific to C. difficile and an oligonucleotide probe and measuring the total number of C. difficile, the breakdown of C. difficile in the feces (intestine) (total number of bacteria) (Existing ratio of toxin-producing and non-toxin-producing C. difficile) to C. difficile, and can contribute to diagnosis, clinical research, etc. of C. difficile infection.
- Example 1 Detection of toxin-producing C. difficile
- DSM 1296T is from Deutsche Sammlung von Mikroorganizmen und Zellkulturen GmbH (DSMZ, Germany), ATCC 43255, 43596, 43598, 700057 are American Type Culture Collection (USA)
- NTCT 13307 and 13366 were purchased from the Health Protection Agency (UK), and CCUG20309, 37780 and 37785 were purchased from the Culture Collection University of Goteborg (Sweden). All Clostridium species except C. difficile were purchased from DSMZ. All strains were cultured for 24 hours at 37 ° C. under anaerobic conditions using modified GAM medium supplemented with 1% glucose (Nissui Pharmaceutical). The number of bacteria in the bacterial solution was measured by the DAPI staining method.
- TaqMan PCR reaction was performed using the ABI7900HT system.
- Takara ExTaq Hot Start Version (Takara) and Ampdirect plus (shimadzu) were used.
- the composition of the reaction solution was 2 ⁇ Ampdirect plus, primer F / R 0.2 ⁇ M, TaqMan probe 0.2 ⁇ M, Rox Reference Dye, ExTaq DNA polymerase 0.4 Units, and template DNA solution 5 ⁇ L, and the total was 20 ⁇ L.
- the Taq enzyme was activated at 95 ° C. for 30 seconds, followed by 50 cycles of 95 ° C., 5 seconds, 56 ° C., 50 seconds.
- Lysing Matrix E Sodium phosphate buffer 825 ⁇ L, and Pre-lysis solution 275 ⁇ L were added to 2.0 ⁇ mL tube containing 200 ⁇ g fecal pellet, and stirred with vortex for 10-15 ⁇ s.
- the supernatant centrifuged at 14,000 ⁇ g for 2 ⁇ min was collected in a 15 mL tube. After adding 1 mL of binding matrix solution and gently mixing, the mixture was incubated at room temperature for 5 minutes. After removing the supernatant centrifuged at 14,000 ⁇ g for 2 ⁇ min, 1 ⁇ mL of Wash buffer-1 was added, and the pellet was gently resuspended by pipetting. About 600 ⁇ L of the suspension was transferred to a SPIN filter tube, and the flow-through centrifuged at 14,000 ⁇ g for 1 ⁇ min was removed.
- Clostridium sordelii tcsL [X82638], Clostridium novyi tcnA [Z48636], and Clostridium perfringens tcpL [AB262081] were also used for alignment.
- the homology between the target toxin gene and other genes is high, and tcdA and tcdB have about 60% homology between both base sequences. It was not possible to find a specific base sequence for the target toxin gene. Therefore, the alignment results were confirmed by visual inspection, and after trial and error, regions that are specific to the target gene and that are considered to be highly conserved among strains were selected, and primers and probes were designed (Table 1). ).
- Primer and probe specificity (2) Among the primer set (J) described in Patent Document 1, the specificity of the primer (sequence 39/40) for amplifying tcdA and the primer tcdA-F / R / P of the present invention were compared. That is, the reactivity of the primer set (sequence 39/40) of Patent Document 1 against C. difficile 10 strains (A + B + type 5 strains, A-B + type 2 strains, AB-type 3 strains) was examined. Using a DNA solution extracted from pure cultured cells, an amount equivalent to 10 5 cells per reaction was subjected to PCR.
- HotStartTaq DNA polymerase (Qiagen Co., Ltd.) was used, and the composition of the reaction solution was 10 ⁇ PCR buffer, primer F / R 0.4 ⁇ M, dNTP 0.25 mM each, Rox Reference Dye, SYBR Green I, Taq DNA polymerase 0.25 Units and template The DNA solution was 5 ⁇ L, and the total was 20 ⁇ L.
- PCR was performed under reaction conditions of 45 cycles of 94 ° C. for 20 seconds, 50 ° C. for 30 seconds, and 74 ° C. for 40 seconds, and the obtained Ct value was within the range of Ct value ⁇ 3.3 of the standard strain (DSM 1296T). If there was “+”, it was judged as “-” if it was 45 or more.
- the reactivity of tcdA-F / R / P obtained in (2) above was also evaluated using the same criteria. These results are shown in Table 4.
- Example 2 Detection of toxin-producing C. difficile (addition recovery test)
- an addition recovery test was performed using three stool samples from which endogenous C. difficile was not detected.
- 10 8 , 10 7 , 10 6 , 10 5 , 10 4 , 10 3 were added per g. The number of added bacteria was adjusted based on the number of bacteria measured in the DAPI count.
- DNA extraction was performed according to the methods (C) and (D), and TaqMan PCR was performed using the extracted DNA stock solution and 5 ⁇ L of the 2-fold diluted solution, respectively, under the conditions (B).
- 10 8 PBS (-) was added to 10 8 (corresponding to 10 8 per 1 g of stool), and extracted in the same manner as the stool sample.
- a standard curve was prepared by using 5 ⁇ L of a total of 6 points of DNA solution obtained by serially diluting the extracted standard DNA up to 10 5 times to 10 5 times, and used for calculating the number of bacteria in the fecal sample.
- non-toxin-producing C. difficile is the most dominant (the most prevalent in the intestine), and non-toxinous toxin-producing C. difficile can also be detected. That is, by using a combination of CD16SrRNA-F / R / P, tcdA-F / R / P and tcdB-F / R / P, the total number of C. difficile bacteria (A + B + type) was determined by TaqMan PCR. , The total number of A-B + and AB-type bacteria), the number of TcdA-producing C. difficile (A + B +), and the number of TcdB-producing C.
- C. difficile A + B + and A- Since the total number of B + bacteria can be measured, the breakdown of C. difficile in feces (intestine) (total bacteria, ratio of toxin-producing and non-toxin-producing C. difficile to total bacteria) ) Can be accurately grasped and can contribute to diagnosis, clinical research, etc. of C. difficile infection.
Abstract
Description
しかしながら、C. difficileは健常なヒト腸内における菌数レベルが低いため、PCRを用いて糞便中の毒素産生株を検出するためには、より高い特異性及び検出感度の両方を有した検出系の構築が必要であり、この点で、未だ十分であるとは云えなかった。
1)配列番号1に示される塩基配列からなるオリゴヌクレオチド及び配列番号2に示される塩基配列からなるオリゴヌクレオチドからなるプライマーペア、又は当該塩基配列に対応する相補的配列からなるプライマーペア。
2)配列番号3に示される塩基配列からなるオリゴヌクレオチドプローブ、又は当該塩基配列に対応する相補的配列からなるオリゴヌクレオチドプローブ。
3)オリゴヌクレオチドの5’末端に蛍光物質が結合し、3’末端にクエンチャー物質が結合した上記2)のオリゴヌクレオチドプローブ。
4)上記1)のプライマーペアと上記3)のオリゴヌクレオチドプローブとを備えるリアルタイムPCR用のオリゴヌクレオチドセット。
5)配列番号4に示される塩基配列からなるオリゴヌクレオチド及び配列番号5に示される塩基配列からなるオリゴヌクレオチドからなるプライマーペア、又は当該塩基配列に対応する相補的配列からなるプライマーペア。
6)配列番号6に示される塩基配列からなるオリゴヌクレオチドプローブ、又は当該塩基配列に対応する相補的配列からなるオリゴヌクレオチドプローブ。
7)オリゴヌクレオチドの5’末端に蛍光物質が結合し、3’末端にクエンチャー物質が結合した上記6)オリゴヌクレオチドプローブ。
8)上記5)のプライマーペアと上記7)のオリゴヌクレオチドプローブとを備えるリアルタイムPCR用のオリゴヌクレオチドセット。
9)ヒト糞便から抽出したDNAを鋳型として、上記4)又は8)のオリゴヌクレオチドセットを用いてそれぞれPCRを行う工程と、蛍光を測定することにより増幅産物を測定する工程とを含む、毒素産生性C. difficileの検出方法。
10)ヒト糞便から抽出したDNAを鋳型として、上記4)及び/又は8)のオリゴヌクレオチドセット、並びに以下に示す(a)のプライマーペア又は(a)のプライマーペアと(b)のオリゴヌクレオチドプローブとを備えるリアルタイムPCR用のオリゴヌクレオチドセットを用いてそれぞれPCRを行う工程と、蛍光を測定することにより増幅産物を測定する工程とを含む、ヒト糞便中のC. difficileにおける毒素産生性C. difficile及び/又は毒素非産生性C. difficileの存在比率の算出方法。
(a)配列番号7に示される塩基配列からなるオリゴヌクレオチド及び配列番号8に示される塩基配列からなるオリゴヌクレオチドからなるプライマーペア、又は当該塩基配列に対応する相補的配列からなるプライマーペア。
(b)配列番号9に示される塩基配列からなるオリゴヌクレオチドプローブ、又は当該塩基配列に対応する相補的配列からなるオリゴヌクレオチドプローブであって、当該オリゴヌクレオチドの5’末端に蛍光物質が結合し、3’末端にクエンチャー物質が結合したオリゴヌクレオチドプローブ。
当該プライマーペアを用いることにより、tcdB遺伝子を確実に増幅することができ、TcdB毒素産生性C. difficile、すなわちA+B+型株及びA-B+型株を確実に検出することができる(表3)。
(1)tcdA遺伝子に特異的にハイブリダイズするプローブは、配列番号3に示される塩基配列(5’-TTGAGATGATAGCAGTGTCAGGATTG- 3’(tcdA-P))からなるオリゴヌクレオチド(第1のプローブ)であり、上記第1及び第2のプライマーからなるプライマーペアによる増幅範囲に特異的に結合するものである。また、(2)tcdB遺伝子に特異的にハイブリダイズするプローブは、配列番号6に示される塩基配列(5’-TTTKCCAGTAAAATCAATTGCTTC- 3’(tcdB-P))からなるオリゴヌクレオチド(第2のプローブ)であり、上記第3及び第4のプライマーからなるプライマーペアによる増幅範囲に特異的に結合するものである。
また、配列番号1~6に示される塩基配列や当該塩基配列に対応する相補的配列において1若しくは2個の塩基が欠失、置換、付加又は挿入された塩基配列からなり、配列番号1~6に示される塩基配列又はその相補的配列からなるオリゴヌクレオチドと其々プライマー又はプローブとして同等の機能を有するオリゴヌクレオチドは、本発明のオリゴヌクレオチドと同等に扱われる。
ここで、当該検出には、C. difficileの有無の判定及びC. difficileの定量が包含される。尚、定量には菌数の定量が包含される。
斯かるC. difficileに特異的なプライマー、プローブとしては、以下に示す(a)のプライマーペア又は(a)のプライマーペアと(b)のオリゴヌクレオチドプローブとを備えるリアルタイムPCR用のオリゴヌクレオチドセットが挙げられる。
(a)配列番号7に示される塩基配列からなるオリゴヌクレオチド及び配列番号8に示される塩基配列からなるオリゴヌクレオチドからなるプライマーペア、又は当該塩基配列に対応する相補的配列からなるプライマーペア。
(b)配列番号9に示される塩基配列からなるオリゴヌクレオチドプローブ、又は当該塩基配列に対応する相補的配列からなるオリゴヌクレオチドプローブであって、当該オリゴヌクレオチドの5’末端に蛍光物質が結合し、3’末端にクエンチャー物質が結合したオリゴヌクレオチドプローブ。
(b)のオリゴヌクレオチドプローブは、配列番号9に示される塩基配列(5'-TGCCTCTCAAATATATTATCCCGTATTAG-3'(CD16SrRNA-P))からなるオリゴヌクレオチド(第3のプローブ)であり、上記第5及び第6のプライマーからなるプライマーペアによる増幅範囲に特異的に結合するものである。斯かるオリゴヌクレオチドプローブは、5’末端側をFAM、TET等の蛍光物質、3’末端をTAMRA、BHQ-1等のクエンチャー物質で修飾することにより、例えばリアルタイムPCRを行うための、修飾オリゴヌクレオチド(所謂Taqmanプローブ)として使用できる。
なお、配列番号7~9に示される塩基配列や当該塩基配列に対応する相補的配列において1若しくは2個の塩基が欠失、置換、付加又は挿入された塩基配列からなり、配列番号7~9に示される塩基配列又はその相補的配列からなるオリゴヌクレオチドと其々プライマー又はプローブとして同等の機能を有するオリゴヌクレオチドは、上記(a)及び(b)のオリゴヌクレオチドと同等に扱われる。
PCRによる高い検出感度を得るためには、高濃度なDNAを取得することが望ましく、一方で、糞便からの核酸抽出液中にはPCRを阻害する物質が混在するため、これら阻害物質を可能な限り除去した高純度なDNAを取得することが望ましい。この目的のため、特に、高濃度かつ高純度のDNAが抽出できるFastDNA SPIN Kit for Feces (MP Biomedicals)を用いることが好ましい。
本発明においては、上記のごとく、修飾された第1のプローブと第2のプローブがTaqManプローブとして使用でき、これはPCR反応のアニーリングステップで鋳型DNAに特異的にハイブリダイズするが、プローブ上にクエンチャー物質が存在するため、励起光を照射しても蛍光の発生は抑制される。伸長反応ステップのときに、Taq DNAポリメラーゼのもつ5’→3’エキソヌクレアーゼ活性により、鋳型にハイブリダイズしたTaqManプローブが分解されると、蛍光物質がプローブから遊離し、クエンチャー物質による抑制が解除されて蛍光を発する。
1)2本鎖DNAの1本鎖DNAへの熱変性:通常93~95℃程度で、通常10秒間~1分間程度加熱する。
2)アニーリング:通常50~60℃程度で、通常10秒間~1分間程度加熱する。
3)DNA伸長反応:通常70~74℃程度で、通常30秒間~5分間程度加熱する。
ここで、アニーリングとDNA伸長反応は分けずに同時に行うことも可能である。
上記1)~3)の反応を、通常30~50サイクル程度行うことにより、目的のtcdA遺伝子及びtcdB遺伝子を検出可能な程度に増幅することができる。
また、被検体中における目的微生物DNA量は、例えば、目的微生物DNAに特異的にハイブリダイズしうる核酸断片と被検体試料とのハイブリダイズ効率の知得によっても、求めることができる。
さらに、C. difficileに特異的なプライマーセット、オリゴヌクレオチドプローブを組み合わせて使用し、C. difficileの総菌数を測定することで、糞便中(腸内)におけるC. difficileの内訳(総菌数に対する毒素産生性及び毒素非産生性C. difficileの存在比率)を正確に把握することができ、C. difficile感染症の診断、臨床研究等に貢献できる。
[I]材料及び方法
(A)使用菌株及び培養条件
C. difficile DSM 1296TはDeutsche Sammlung von Mikroorganizmen und Zellkulturen GmbH (DSMZ,Germany)から、ATCC 43255、43596、43598、700057はAmerican Type Culture Collection (USA)から、NTCT 13307、13366はHealth Protection Agency (UK)から、CCUG20309、37780、37785はCulture Collection University of Goteborg (Sweden)からそれぞれ購入した。C. difficile以外のClostridium属菌種はすべて、DSMZから購入した。
すべての菌株は、1% グルコース添加変法GAM培地(日水製薬)を用い、嫌気条件下、37 ℃で24時間培養した。菌液中の菌数測定は、DAPI染色法により行った。
ABI7900HTシステムを用いて、TaqMan PCRを行った。PCRにはTakara ExTaq Hot Start Version (Takara)及びAmpdirect plus (shimadzu)を用いた。反応液組成は2×Ampdirect plus、プライマーF/R 0.2 μM、TaqManプローブ 0.2 μM、Rox Reference Dye、ExTaq DNA polymerase 0.4 Units及び鋳型DNA溶液5 μLであり、total 20 μLとした。95℃, 30秒でTaq酵素を活性化した後、95℃, 5秒、56℃,50秒を50サイクル行った。
RNAlaterを用いて調製した10%糞便懸濁液(w/v) 2 mL (200 mg糞便を含む)を遠心分離し、上清1 mLを除去した。リン酸緩衝生理食塩水(PBS(-))1 mLを添加してvortexで撹拌した後、遠心分離した全上清をデカンテーションで除去した。PBS(-) 1 mLを添加してvortexで撹拌した後、遠心分離した全上清を除去した。得られた糞便ペレットはDNA抽出に用いるまで、-80℃で保存した。
培養菌液からのDNA抽出は、松木らの方法( Matsuki, T., K. Watanabe, J. Fujimoto, Y. Kado, T. Takada, K. Matsumoto,and R. Tanaka. 2004. Quantitative PCR with 16S rRNA-gene-targeted species-specific primers for analysis of human intestinal bifidobacteria. Appl.Environ. Microbiol. 70:167-173)に従い行った。
糞便ペレットからのDNA抽出は、FastDNA SPIN Kit for Feces (MP Biomedicals)を用いた。抽出法の詳細を以下に示す。
C. difficileの毒素遺伝子tcdA及びtcdBを標的とし、それぞれに特異的なプライマー及びプローブを以下の手順で設計した。データベースから取得した20菌株のtcdA遺伝子配列(*1)及び22菌株のtcdB遺伝子配列(*2)を用いて、Clustal Xによる相同性検索(アライメント)を行った。TcdA及びTcdBはLarge Clostridial Toxin (LCTs)に分類され、一部の Clostridium属細菌が産生するLCTsと高い相同性を有する。そのため、対照としてClostridium sordeliiのtcsL [X82638] 、Clostridium novyiのtcnA [Z48636]、Clostridium perfringensのtcpL [AB262081]の遺伝子配列を併せてアライメントに用いた。アライメントの結果、標的毒素遺伝子とその他の遺伝子の相同性が高く、また、tcdA及びtcdBは両者の塩基配列間で約60%の相同性があったことから、プライマー作成用ソフトウェアではtcdA及びtcdB各々の標的毒素遺伝子に対する特異的な塩基配列を見出すことはできなかった。そこで、アライメント結果を目視により確認し、試行錯誤のうえ、標的遺伝子に特異的であり、かつ、菌株間で保存性が高いと思われる領域を選択して、プライマー及びプローブを設計した(表1)。
(1)C. difficile菌株の毒素産生性の確認
イムノクロマト法を利用した毒素検出キットKeul-o-test Clostridium difficile Complete (BioGenTechnologies)を用いて、C. difficile 10菌株の毒素産生性を調べた。
BHI液体培地を用いて、各菌株を嫌気条件下、37 ℃で4日間培養した。培養上清をキットのプロトコールに従い供試し、TcdA及びTcdBの毒素産生を特異的なバンドの有無により判定した。その結果、下記表2に示すとおり、いずれも毒素産生性を示すことが確認された。
C. difficile 10菌株(A+B+型5菌株、A-B+型2菌株、A-B-型3菌株)、Clostridium属10菌種、及び腸内菌12菌種を用いて、本発明のプライマー及びプローブセット(tcdA-F/R/P及びtcdB-F/R/P)の特異性を調べた。純培養菌体から抽出したDNA溶液を用い、反応当たり105個相当量を供試して、前記(B)の条件でTaqMan PCRを行い、増幅シグナルの有無を確認した。結果を表3に示す。
前記特許文献1に記載のプライマーセット(J)のうち、tcdAを増幅するためのプライマー(配列39/40)と本願発明の上記プライマーtcdA-F/R/Pとの特異性を比較した。
すなわち、C. difficile 10菌株(A+B+型5菌株、A-B+型2菌株、A-B-型3菌株)に対する、特許文献1のプライマーセット(配列39/40)の反応性を調べた。純培養菌体から抽出したDNA溶液を用い、反応当たり105個相当量をPCRに供試した。PCRにはHotStartTaq DNA polymerase(株式会社キアゲン)を用い、反応液組成は10×PCR buffer、プライマーF/R 0.4 μM、dNTP 0.25 mM each、Rox Reference Dye、SYBR Green I、Taq DNA polymerase 0.25 Units及び鋳型DNA溶液 5 μLであり、total 20 μLとした。94℃で20秒、50℃で30秒、74℃で40秒を45サイクルの反応条件でPCRを行い、得られたCt値が、標準菌株(DSM 1296T)のCt値±3.3の範囲内であれば"+"、45以上であれば"-"と判定した。
上記(2)で得られたtcdA-F/R/Pの反応性についても、同一の判定基準で評価した。これらの結果を表4に示す。
糞便中の毒素産生性C. difficileの検出下限値を検証するため、内在性のC. difficileが検出されない3名の糞便サンプルを用いて、添加回収試験を実施した。
あらかじめ内在性のC. difficileが存在しないことを確認した健常成人3名の糞便サンプルを選択し、TcdA及びTcdBの両方を産生するC. difficile DSM 1296T株の純培養菌体を糞便中に1 g当たり108, 107, 106, 105, 104, 103個となるように添加した。なお、添加菌数はDAPIカウントの測定菌数に基づき調整した。
前記(C)及び(D)の方法に従ってDNA抽出を行い、抽出DNA原液及び2倍希釈液5 μLをそれぞれ用いて、前記(B)の条件でTaqMan PCRを行った。検量線作成用のスタンダードとして、PBS(-) 10 mL当たり108個(糞便1 g当たり108個に対応)となるように添加し、糞便サンプルと同様に抽出した。抽出したスタンダードDNAを105倍まで10倍系列希釈した計6ポイントのDNA溶液5 μL をPCRに供試して検量線を作成し、糞便添加サンプルの菌数算出に用いた。
その結果、tcdA-F/R/P及びtcdB-F/R/Pいずれに関しても、糞便1 g当たり103個を検出可能であった(図2)。斯様に本発明の方法によれば、細菌DNAを標的として高感度な検出が可能であり、毒素産生性C. difficileを特異的かつ高感度(検出下限値:糞便1 gあたり103個)に定量することが可能である。
[I]材料及び方法
(1)CD16SrRNA-F/R/Pの作製
C.difficile総菌数を測定するためのプライマーセットCD16SrRNA-F及びCD16SrRNA-Rを作製し、さらにその増幅範囲に新たにプローブを設計したTaqManプローブCD16SrRNA-Pを設計した(表5)。
日本の高齢者施設入居者及び職員102名から採取した糞便のうち、選択培養法によりC. difficileの分離が確認された16検体の糞便DNAを本解析に用いた。
凍結便を融解後、9倍容量の嫌気輸送培地に懸濁した。これを等量の98% エタノールと混和し、室温にて30分間インキュベートした。エタノール処理液0.1 mlをCycloserine cefoxin mannitol agar(CCMA)に塗抹し、本培地を37℃で24時間嫌気培養した。培地上に検出されたコロニーについて、性状及びグラム染色性からC. difficileと推定されるものの数を計測した。
2mLスクリューキャップチューブ中の検量線用菌液200μLまたは大便10倍希釈液に、0.3gのガラスビーズ(φ0.1mm), 300μLのTris-SDS溶液(250mLの200mM Tris-HCl, 80mM EDTA, pH 9.0と50mLの10% SDSを混合して調整する)、500μLのTris-EDTA buffer Saturated Phenolを加える。
サンプルの入ったチューブを振とう破砕機(FastPrep FP120)にセットする。パワーレベル5.0で30秒間激しく振とうし、菌体を破砕する。チューブを取り出し、15,000 rpmで5分間遠心分離する。
上清400μLを、新しい2mLスクリューキャップに移す。400μLのPhenol / Chloroform / Isoamyl alcohol (25:24:1)を加え、FastPrep FP120にセットする。パワーレベル4.0で45秒激しく振とうし、15,000 rpmで5分間遠心分離する。
新しい1.5mLチューブに250μLの上清を移す。25μLの3M酢酸Na (pH 5.4)を加えて混合する。
300μLのIsopropanolを加える。15,000 rpmで5分間遠心分離する。上清をデカンテーションで除く。500μLの70% Ethanol を加え、(撹拌しないでそのまま)再度、15,000 rpmで5分間遠心分離する。上清をデカンテーションで除く。
蓋を外して60℃のヒートブロックインキュベーターで約30分間加温しながら乾燥させる。Tris-EDTA bufferを加え、撹拌して均一に溶解させる。-30℃にて凍結保存する。
実施例1[I](B)と同様の方法で行った。
16検体のうち、8検体から毒素産生株が検出された(表6)。これら8検体のうち、7検体では、TapMan PCR法によるC. difficileの総菌数(CD16SrRNA-F/R/P)、TcdA産生性C. difficileの菌数(tcdA-F/R/P)、及びTcdB産生性C. difficileの菌数(tcdB-F/R/P)が同等であったことから、腸内にA+B+型の毒素産生株が優勢に存在していることがわかる。
毒素産生株が検出された8検体のうちの1検体(S-09)では、C. difficileの総菌数が毒素産生性C. difficileの菌数より対数値で1.5以上と大幅に高かったことから、毒素非産生性C. difficileが最優勢(腸内で最も優勢に存在する)であると判別できる他、最優勢でない毒素産生性C. difficileも検出できることがわかる。
すなわち、CD16SrRNA-F/R/P、tcdA-F/R/P及びtcdB-F/R/Pを組み合わせて使用することで、TaqMan PCR法により、C. difficileの総菌数(A+B+型、A-B+型及びA-B-型の菌数の総和)、TcdA産生性C. difficile(A+B+型)の菌数、及びTcdB産生性C. difficileの菌数(A+B+型及びA-B+型の菌数の総和)を測定することができるため、糞便中(腸内)におけるC. difficileの内訳(総菌数、総菌数に対する毒素産生性及び毒素非産生性C. difficileの比率)を正確に把握することができ、C. difficile感染症の診断、臨床研究等に貢献できる。
Claims (10)
- 配列番号1に示される塩基配列からなるオリゴヌクレオチド及び配列番号2に示される塩基配列からなるオリゴヌクレオチドからなるプライマーペア、又は当該塩基配列に対応する相補的配列からなるプライマーペア。
- 配列番号3に示される塩基配列からなるオリゴヌクレオチドプローブ、又は当該塩基配列に対応する相補的配列からなるオリゴヌクレオチドプローブ。
- オリゴヌクレオチドの5’末端に蛍光物質が結合し、3’末端にクエンチャー物質が結合した請求項2記載のオリゴヌクレオチドプローブ。
- 請求項1記載のプライマーペアと請求項3記載のオリゴヌクレオチドプローブとを備えるリアルタイムPCR用のオリゴヌクレオチドセット。
- 配列番号4に示される塩基配列からなるオリゴヌクレオチド及び配列番号5に示される塩基配列からなるオリゴヌクレオチドからなるプライマーペア、又は当該塩基配列に対応する相補的配列からなるプライマーペア。
- 配列番号6に示される塩基配列からなるオリゴヌクレオチドプローブ、又は当該塩基配列に対応する相補的配列からなるオリゴヌクレオチドプローブ。
- オリゴヌクレオチドの5’末端に蛍光物質が結合し、3’末端にクエンチャー物質が結合した請求項6記載のオリゴヌクレオチドプローブ。
- 請求項5記載のプライマーペアと請求項7記載のオリゴヌクレオチドプローブとを備えるリアルタイムPCR用のオリゴヌクレオチドセット。
- ヒト糞便から抽出したDNAを鋳型として、請求項4及び/又は請求項8記載のオリゴヌクレオチドセットを用いてそれぞれPCRを行う工程と、蛍光を測定することにより増幅産物を測定する工程とを含む、毒素産生性C. difficileの検出方法。
- ヒト糞便から抽出したDNAを鋳型として、請求項4及び/又は請求項8記載のオリゴヌクレオチドセット、並びに以下に示す(a)のプライマーペア又は(a)のプライマーペアと(b)のオリゴヌクレオチドプローブとを備えるリアルタイムPCR用のオリゴヌクレオチドセットを用いてそれぞれPCRを行う工程と、蛍光を測定することにより増幅産物を測定する工程とを含む、ヒト糞便中のC. difficileにおける毒素産生性C. difficile及び/又は毒素非産生性C. difficileの存在比率の算出方法。
(a)配列番号7に示される塩基配列からなるオリゴヌクレオチド及び配列番号8に示される塩基配列からなるオリゴヌクレオチドからなるプライマーペア、又は当該塩基配列に対応する相補的配列からなるプライマーペア。
(b)配列番号9に示される塩基配列からなるオリゴヌクレオチドプローブ、又は当該塩基配列に対応する相補的配列からなるオリゴヌクレオチドプローブであって、当該オリゴヌクレオチドの5’末端に蛍光物質が結合し、3’末端にクエンチャー物質が結合したオリゴヌクレオチドプローブ。
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