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The method for determining the level of circulating autoantibodies in biological fluids

The method for determining the level of circulating autoantibodies in biological fluids
IPC classes for russian patent The method for determining the level of circulating autoantibodies in biological fluids (RU 2240561):
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(57) Abstract:

The invention relates to medicine, in particular to immunology, and can be used for the diagnosis of autoimmune process. The essence of the method lies in the fact that they are carrying out the determination of the level of circulating autoantibodies in biological fluids by identifying interacting proteins with autoantibodies, subsequent identification and determination of the level of circulating autoantibodies using the labeled conjugate, the conjugate use of anti-IgE antibodies, complementary Epsilon-chains of immunoglobulin E, conjugated labeled for later identification. The technical result is to develop a method that provides high sensitivity and specificity. 1 PL.

The invention relates to medicine, in particular to immunology, and can be used for the diagnosis of autoimmune process and the subsequent impact on the pathogenesis of due to the possibility of ascertaining the presence or absence of atopic mechanism among other mechanisms of auto-aggression aimed at the body of the target.

From such different approaches are changing and therapeutic tactics. If the speech Inostrannye antigens prevent patient contact with them, destroying them and Vice versa, if we are talking about autoimmune process, the goal of the physician is to defend antigen, because it is a necessary organ.

Currently, for the detection of autoantibodies use different sensitivity and specificity of methods that do not allow for verification of atopic mechanism from other mechanisms of auto-aggression (see EN 2173464 C1, 10.09.2001).

The closest analogue to the claimed method is a method of determining the level of antibodies, which carried out the identification of interacting proteins with autoantibodies, identification and determination of the level of circulating antibodies is carried out using the labeled conjugate company Amersham (biotinylated human anti-IgG and avidin-peroxidase) method enzyme-linked immunosorbent assay (see OfP L. L. et al. Immune response to some intracellular antigens in patients with dilated cardiomyopathy (http://www.rql.kiev.ua/cardio j/2000/3/ryabenko.htm. 1999).

The method allows to solve the problem on determination of autoantibodies, where the conjugate was used in the conjugates of the antibody classes, which is considered a classic autoimmune syndromes, n is determining the level of antigen-specific IgE.

The aim of the present invention is to develop neinvazivnoe way to verify atopic component of autoaggression on the affected target organ. The developed method is implemented by determining the level of antigen-specific IgE and allows you to actually influence the course of the autoimmune process. This is achieved in that for determining the level of circulating autoantibodies in biological fluids carry out the identification of interacting proteins with autoantibodies using conjugate, chaste which use labeled for later identification of antibodies, complementary Epsilon-chains of immunoglobulin E production cnrri, St. Petersburg, Russia. The methods for generating antibodies are presented in the publication Bohn A, Konig W. Generation of murine monoclonal anti-DNP-IgE, IgM and IgG1 antibodies: biochemical and biological characterization // Immunology. 1982 Oct; 47(2):297-3H.

The method is as follows.

Spend the detection of circulating antibodies of IgE class in biological fluids (blood, lymph, saliva, cerebrospinal fluid, semen, bile, urine, bleed and have exudate, edema fluid, eye camera and others) using pre-labeled for later identification of antibodies, complementary Epsilon-chains of IgE. For the label can be used fluorescence in ultraviolet light dye, isotope detected radiometry and so on, depending on the method used to determine the level of antibodies.

At the first stage of the research is specific binding proteins (proteins of the target organs of autoimmune process) with autoantibodies class IgE circulating in the study of biological fluid. Encounter complexes antigen-antibody, which is then detected using the above identified conjugate, afinno interacting with antibodies of class IgE, acting in this case as antigen. Removing the reaction is carried out using sensitive instruments, allowing to quantitatively identify the labeled conjugate and, consequently, the desired antibodies of IgE defined antigenspecific.

Examples of specific implementation method

Example 1

1. Patient 72 years. Hospitalized for the period from 19.11. on 9.01.02 with the diagnosis of Chronic viral hepatitis b, Nveav(+), HB SOG (+). The aggravation. Ischemic heart disease. General atherosclerosis. Diffuse non-toxic goiter. Autres". During supervision was observed vasovist as in the dynamics of the health of the patient, and the nature of the flow of the main Hepatology syndromes. So, it is main biochemical marker of cytolysis syndrome - the activity of the enzyme Alat first systematically increased from 1102 e/l 20.11 to 1111 e/l 23.11, then as has steadily declined to 397 u/l 04.12 (norm - 11-40 u/l).

Bilirubinemia biochemical marker of the syndrome of jaundice in the dynamics of the first phase showed a rise with a slight decrease in the concentration of bilirubin (also 23-24.11). In General, however, the rate increased from 20.11 (376 μmol/l) to 3.12 (510 µmol/l), and then gradually decreased to 199 μmol/l 04.01.

It is difficult to specify the factor that influenced the change in the trends in the dynamics of cytolysis and transient decline in the concentration of bilirubin 23 - 24.11. The nature of the phenomenon of phase transitions in the dynamics of health and jaundice syndrome is obvious: it is 03.12 patient was conducted repeated plasmapheresis procedure. Such a relief effect of this therapy on the patient's condition is indirectly confirmed by antibody-dependent mechanism for the development of her disease. The proof of this we find in these immunological studies.

Blood for them were seized 21.11 and 5.01, ie, respectively, in the phase of the rise and decline of the main Hepatology syndromes, as well as against the background of deterioration and improvement of subjective well-being of the patient. Level cirkuliruyusiy AU is, omplementary Epsilon-chain immunoglobulin E. the Obtained data showed that in the above-mentioned phases of the pathological process, the level of autoantibodies significantly different. For total antibodies he is in optical density 0,777 and 1,129 for antibodies of class IgE - 1,483; 0,913 respectively. This suggests that the suspect in the pathogenesis of chronic viral liver disease has an autoimmune process, mainly mediated not common for such processes classes of antibodies, and antigen-specific antibodies of the IgE class.

Example 2

The patient 43 years. Hospitalized for the period from 20.05 on 10.06 with the diagnosis of Chronic viral hepatitis b, HBsAg+, cirrhotic stage decompensation. Portal hypertension, edema-ascites syndrome. Hemorrhagic syndrome. Chronic cholecystitis, acute exacerbation”. According to the district specialist (doctor), the present hospitalization is associated with increasing during the week, ascites, weakness, shortness of breath.

Later during hospitalization a state of moderate severity was observed in subjects to 26.05 inclusive; from 27.05 to the day of discharge (10.06) it was assessed as satisfactory or relative who inogo observations it should be noted that the severity of her condition was caused mainly by the manifestations of the syndrome of portal hypertension.

Indeed, bilirubinemia from receipt of patient for hospital observation did not exceed the upper boundary of areas of moderate severity (classification Riga EMC Hepatology center, 1984), and then declined steadily. This dynamic does not fully reflect the dynamics of gravity of the patient.

Even less dynamics of gravity is reflected in the data of biochemistry syndrome cytolysis but the Alat. This parameter is varied around 60 u/l with a wave-like dynamics of being sick.

Meanwhile, the dynamics of clinical manifestations of the syndrome of portal hypertension (weakness, ascites, dyspnea) was the reason for admission and discharge of patients: the disappearance of weakness and shortness of breath, reduction of ascites further stay of the patient at the hospital observation was considered impractical (9.06, examination of the head)”. The patient was discharged 10.06. The district infectious disease specialist who observed the patient prior to admission, also noted a General improvement in her condition. According to the ultrasound examination of abdominal cavity organs from 3.06 is formiruyushchego case Hepatology auto-immune process can affect largely on the severity of the syndrome of portal hypertension. Carried out a determination of the level of circulating autoantibodies radioimmunoassay method using a conjugate that contains antibodies, complementary Epsilon-chain immunoglobulin that is, When the levels of antibodies to the f protein of both General and belong to the class IgE significantly different and are 1,025; 0.94, and 0,185; 0.09, respectively. The data obtained suggest that in this patient in the pathogenesis of chronic viral liver disease has an autoimmune process, along with the generally accepted for such processes classes of antibody-mediated antigen-specific antibodies of the IgE class.

Example 3

Patient 19 years. Were examined and treated the clinic. In October 2002 was observed at the outpatient Department of the city of the EMC Hepatology center with a primary diagnosis of Chronic viral hepatitis C. HBsAg +. HBeAg +. PCR HBV +.” Blood for immunological studies were seized 11.10.02 and 23.10.02. In the anamnesis the patient (December 2001) hospital treatment in the EMC Hepatology center about first identified viral hepatitis with subsequent observation by the district specialist domiciliary and outpatient Department of Hepatology center. Until August At the time of this examination of the patient by palpation was noted faintly marked hepatomegaly (+1 cm).

Analyzing the data of biochemical examination, we came to the obvious conclusion that the patient at the time of observation was uniform growth of abnormal activity indicators characterizing the activity of Hepatology syndromes, such as jaundice syndrome and cytolytic syndrome. The specified uniform growth of biochemical parameters is also faintly marked clinical activity, manifested mild gepatomegalia. That is, clinical, and laboratory data there are grounds to speak about the exacerbation of chronic viral liver disease. Conducted immunological study of biological fluid bile claimed process showed that this aggravation and corresponds, obviously, to a large extent determines its growth intensity autoimmune Hepatology syndrome, manifested by a corresponding fluctuation of the level of antibodies to the f protein of General and circulating antibodies of class IgE, while the optical density is 0,355: 0,525 and 0,155: 0.365, respectively. The obtained data testify that the suspect in the pathogenesis of chronic viral liver disease has an autoimmune process on the AMI of the IgE class.

In the whole of the clinical cases No. 1-3 obvious relevance of the study of the levels of circulating autoantibodies in the serum at different stages and in different leading syndromes study of the disease in different statistical groups of patients (hospitalized and ambulatory patients, patients with newly diagnosed diagnosis and acute exacerbation of previously diagnosed disease, and so on).

Examples show that this method of determining the level of circulating autoantibodies in biological fluids (in particular, in the blood and bile of patients) can be used in the diagnosis of autoimmune process and, in addition, have a real influence on the pathogenesis of. Scientific and practical medicine for decades dealt with IgE-induced effectors anaphylaxis. The transfer of methods developed to combat them, in the field of treatment of an autoimmune component in the pathogenesis of diseases of various etiologies can be a significant aid in effective therapy.

For more extensive testing of the method was also examined 10 specimens of other body fluids, specifically edema fluid of patients who died from chronic virus circulating levels of autoantibodies in biological fluids allow you to bind the level of antibodies of class IgE to the patient's pathological process and to isolate in the pathogenesis of this process atopic mechanism.

The method for determining the level of circulating autoantibodies in biological fluids, including the identification of interacting proteins with autoantibodies and subsequent identification and determination of the level of circulating autoantibodies using the labeled conjugate, characterized in that as the conjugate use of anti-IgE antibodies, complementary Epsilon-chains of immunoglobulin E, conjugated labeled for later identification.

 

 

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