Methods and compositions for pertussis diagnosis
11851479 ยท 2023-12-26
Assignee
Inventors
Cpc classification
International classification
A61K39/00
HUMAN NECESSITIES
G01N33/543
PHYSICS
Abstract
Compositions and methods for the detection and diagnosis of Bordetella pertussis are disclosed. Provided are antibodies, or antigen binding fragment thereof, specific for tracheal colonization factor A (TcfA). Also provided are compositions comprising an anti-TcfA antibody of the instant invention and a carrier; and methods for inhibiting, treating, and/or preventing pertussis and/or a B. pertussis infection in a subject in need thereof are provided, comprising administering an anti-TcfA antibody of the instant invention to the subject.
Claims
1. An isolated antibody or antigen binding fragment thereof immunologically specific for tracheal colonization factor A (TcfA), wherein said antibody or fragment thereof comprises all six complementarity determining regions from 14D12, 23F8, 18B2, 20F4, 14G11, 13E11, 10B1, 7E11, or 3E6.
2. The antibody or fragment thereof of claim 1, wherein said antibody or fragment thereof comprises a) a heavy chain comprising NYAMS (SEQ ID NO: 24), SISSGGSYIYYSDSVKG (SEQ ID NO: 25), and GAHGNFDY (SEQ ID NO: 26) and a light chain comprising RTSETVDYDGDSYMN (SEQ ID NO: 27), GASNVES (SEQ ID NO: 28), and QQNRKLPYT (SEQ ID NO: 29); b) a heavy chain comprising DYGMH (SEQ ID NO: 36), YISSGSRTIYYADTVKG (SEQ ID NO: 37), and LGYGYDWYFDV (SEQ ID NO: 38) and a light chain comprising KSSQSLLDSDGRTYLN (SEQ ID NO: 39), LVSKLDS (SEQ ID NO: 40), and WQGTHFPQT (SEQ ID NO: 41); c) a heavy chain comprising NYWIG (SEQ ID NO: 48), DIYPGGVYTNYNENFKG (SEQ ID NO: 49), and GGKYGNFFAMDY (SEQ ID NO: 50) and a light chain comprising RSSKSLLYKDGKTYLN (SEQ ID NO: 51), LMSTRAS (SEQ ID NO: 52), and QQLVEYPFT (SEQ ID NO: 53); d) a heavy chain comprising NYGMN (SEQ ID NO: 60), WINTYTGEPTYADDFKG (SEQ ID NO: 61), and AATGYFDY (SEQ ID NO: 62) and a light chain comprising KSSQSLLYSSNQKNYLA (SEQ ID NO: 63), WASTRES (SEQ ID NO: 64), and QQYYNEYT (SEQ ID NO: 65); e) a heavy chain comprising DYYMS (SEQ ID NO: 72), FIRNKANGYTTEYSASVKG (SEQ ID NO: 73), and YRRDYYGSLNYYTMDY (SEQ ID NO: 74) and a light chain comprising RASENIYSYLA (SEQ ID NO: 75), NAKTLAE (SEQ ID NO: 76), and QNHYGIPLT (SEQ ID NO: 77); f) a heavy chain comprising DYGMH (SEQ ID NO: 84), YISSGSSTIYYADTVKG (SEQ ID NO: 85), and PRSGRYFDY (SEQ ID NO: 86) and a light chain comprising KSSQSLLDSNGNTYLH (SEQ ID NO: 87), LVSKLDS (SEQ ID NO: 88), and LQGTHFPYT (SEQ ID NO: 89); g) a heavy chain comprising DTYIH (SEQ ID NO: 96), RIDPANGNTIYASKFQG (SEQ ID NO: 97), and MDY (SEQ ID NO: 98) and a light chain comprising KSSQSLLHSNGKTYLN (SEQ ID NO: 99), LVSKLDS (SEQ ID NO: 100), and LQATHFPHT (SEQ ID NO: 101); h) a heavy chain comprising DTYIH (SEQ ID NO: 108), RIDPANGNIIYASKFQG (SEQ ID NO: 109), and MDY (SEQ ID NO: 110) and a light chain comprising KSSQSLLHSNGKTYLN (SEQ ID NO: 111), LVSKLDS (SEQ ID NO: 112), and LQATHFPHT (SEQ ID NO: 113); or i) a heavy chain comprising DYYMS (SEQ ID NO: 120), FIRNKAKGYTTDYSASVKG (SEQ ID NO: 121), and NYDYSMDY (SEQ ID NO: 122) and a light chain comprising RASDNIHKYLA (SEQ ID NO: 123), NAKTLAD (SEQ ID NO: 124), and QHFWSTPLT (SEQ ID NO: 125).
3. The antibody or fragment thereof of claim 1, wherein said antibody or fragment thereof comprises a) a heavy chain comprising: EVMLVESGGALVKPGGSLKLSCAASGITFSNYAMSWIRQTPEKRLEWV ASISSGGSYIYYSDSVKGRFTISRDNARNTLNLQMSSLRSEDTAMYYCVRGAHGNFDYWGQG TTLTVSS (SEQ ID NO: 22) and a light chain comprising: DIVLTQSPASLAVSLGQRATISCRTSETVDYDGDSYMNWYQQKSGQP PKLLISGASNVESGVPARFSGSGSGTDFSLNIHPVEEDDITMYFCQQNRKLPYTFGSGTKLE MK (SEQ ID NO: 23); b) a heavy chain comprising: EVQLVESGGGLVKPGGSRKLSCAASGFTFSDYGMHWVRQAPEKGLEWV AYISSGSRTIYYADTVKGRFTISRDNAKNTLFLQMTSLRSEDTAMYYCARLGYGYDWYFDVW GTGTTVTVSS (SEQ ID NO: 34) and a light chain comprising: DVVMTQTPLTLSVTIGQPASISCKSSQSLLDSDGRTYLNWLLQRPGQS PKRLIYLVSKLDSGVPDRFTGSGSGTDFTLKISRVEAEDLGIYYCWQGTHFPQTFGGGTKLE IK (SEQ ID NO: 35); c) a heavy chain comprising: QVQLQQSGAELVRPGTSVKMSCKAAGYTFTNYWIGWVKQRPGHGLEWIGDI YPGGVYTNYNENFKGKATLTADTSSSTAHMQLSSLTSEDSAIYYCVRGGKYGNFFAMDYWGQ GTSVTVSS (SEQ ID NO: 46) and a light chain comprising: DIVITQDELSNPVTSGESVSISCRSSKSLLYKDGKTYLNWFLQRPGQ SPQLLIYLMSTRASGVSDRFSGSGSGTDFTLEISRVKAEDVGVYYCQQLVEYPFTFGSGTKL EIK (SEQ ID NO: 47); d) a heavy chain comprising: QIQLVQSGPELKKPGETVKISCKASGYTFTNYGMNWVKQAPGKGLKWM GWINTYTGEPTYADDFKGRFAFSLETSATTAYLQINNLKNEDTATYFCARAATGYFDYWGQG TTLTVSS (SEQ ID NO: 58) and a light chain comprising: DIVMSQSPSSLAVSAGEKVTMSCKSSQSLLYSSNQKNYLAWYQQKPG QSPKLLIYWASTRESGVPDRFTGSGSGTDFTLTISSVKAEDLAVYYCQQYYNEYTFGGGTKL EIK (SEQ ID NO: 59); e) a heavy chain comprising: EVKLVESGGGLVQPGGSLSLSCAASGFTFTDYYMSWVRQPPGKALEWL GFIRNKANGYTTEYSASVKGRFTISRDNSQSILYLQMNALRAEDSATYYCARYRRDYYGSLN YYTMD YWGQGTSVTVSS (SEQ ID NO: 70) and a light chain comprising: DIQMTQSPASLSASVGETVTITCRASENIYSYLAWYQQKQGKSPQLL VYNAKTLAEGVPSRFSGSGSGTQFSLKINSLQPEDFGSYYCQNHYGIPLTFGAGTKLELK (SEQ ID NO: 71); f) a heavy chain comprising: EVQLVESGGGLVKPGGSRKLSCAASGFTFSDYGMHWVRQAPEKGLEWV AYISSGSSTIYYADTVKGRFTISRDNAKNTLFLQMTSLRSEDTAMYYCARPRSGRYFDYWGQ GTTLTVSS (SEQ ID NO: 82) and a light chain comprising: DVMMTQTPLTLSVTIGQPASISCKSSQSLLDSNGNTYLHWLLQRPGQS PKILIYLVSKLDSGVPDRFSGSGSGTDFTLKISRVEAEDLGVYYCLQGTHFPYTFGGGTKLE IK (SEQ ID NO: 83); g) a heavy chain comprising: EVQLQQSGAELVKPGASVKLSCTASGFNIKDTYIHWVKQRPEQGLEWI GRIDPANGNTIYASKFQGKAPITAVISSNTAYMQFSSLTSGDTAVYYCTAMDYWGQGTSVTV SS (SEQ ID NO: 94) and a light chain comprising: DVVMTQTPLTLSVTIGQPASISCKSSQSLLHSNGKTYLNWLLQRPGQS PKLLIYLVSKLDSGVPDRFSGSGSGTDFTLKISRVEAEDLGVYYCLQATHFPHTFGSGTKLE IK (SEQ ID NO: 95); h) a heavy chain comprising: EVQLQQSGAELVKPGASVKLSCTASGFNIKDTYIHWVKQRPEQGLEWI GRIDPANGNIIYASKFQGEATITADTSSNTAYMQLSSLTSGDTAVYYCSAMDYWGQGTSVTV SS (SEQ ID NO: 106) and a light chain comprising: DVVMTQTPLTLSLTIGQPASISCKSSQSLLHSNGKTYLNWLLQRPGQS PKLLIYLVSKLDSGVPDRFSGSGSGTDFTLKISRVEAEDLGVYYCLQATHFPHTFGSGTKLE IK (SEQ ID NO: 107); or i) a heavy chain comprising: EVKLVESGGGLVQPGGSLRLSCATSGFTFTDYYMSWVRQPPGKALEWM GFIRNKAKGYTTDYSASVKGRFTISRDDSQSILYLQMNTLRPEDSATYYCARNYDYSMDYWG QGTSVTVSS (SEQ ID NO: 118) and a light chain comprising: DIQLTQSPASLSASVGETVTITCRASDNIHKYLAWYQQKQGKSPQRL VYNAKTLADGVPSRFNGSGSGTQYSLKINSLQPEDFGIYYCQHFWSTPLTFGAGTKLELK (SEQ ID NO: 119).
4. The antibody or fragment thereof of claim 1 conjugated to at least one detectable agent.
5. The antibody or fragment thereof of claim 4, wherein said detectable agent is a gold nanoparticle.
6. A composition comprising an antibody or fragment thereof of claim 1 and a carrier.
7. A method of detecting Bordetella pertussis in a sample, said method comprising contacting the sample with at least one antibody or fragment thereof of claim 1.
8. The method of claim 7, wherein said sample is a biological sample obtained from a subject.
9. The method of claim 8, wherein said biological sample is a nasopharyngeal swab, aspirate, or wash.
10. A methods for inhibiting, treating, and/or preventing pertussis and/or a B. pertussis infection in a subject in need thereof, said method comprising administering an antibody or fragment thereof of claim 1 to the subject.
11. An immunoassay comprising at least one antibody or fragment thereof of claim 1.
12. A method of detecting Bordetella pertussis in a sample, said method comprising analyzing the sample with an immunoassay of claim 11.
13. A lateral flow immunoassay test strip, wherein said lateral flow immunoassay test strip comprises a test site comprising one or more anti-TcfA antibodies of claim 4 and a conjugation pad comprising one or more anti-TcfA antibodies of claim 1 conjugated to a detectable agent.
14. The immunoassay of claim 13, wherein the conjugated antibody specifically binds amino acids 139-150 or amino acids 151-156 of TcfA.
15. The immunoassay of claim 14, wherein the conjugated antibody specifically binds amino acids 139-150 of TcfA.
16. The immunoassay of claim 13, wherein the test site antibody specifically binds amino acids 289-324 of TcfA.
17. The immunoassay of claim 13, wherein the test site antibody specifically binds amino acids 289-294 of TcfA.
18. The immunoassay of claim 13, wherein the test site antibody specifically binds amino acids 292-300 of TcfA.
19. The immunoassay of claim 13, wherein the test site antibody specifically binds amino acids 322-330 of TcfA.
20. The immunoassay of claim 13, wherein the conjugated antibody specifically binds amino acids 289-324 of TcfA.
21. The immunoassay of claim 20, wherein the test site antibody specifically binds amino acids 139-150 of TcfA.
22. The immunoassay of claim 13, wherein the conjugated antibody specifically binds the same epitope as 10B1 and said test site comprises antibodies which bind the same epitope as 14D12 and antibodies which bind the same epitope as 13E11.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF THE INVENTION
(12) Herein, a point-of-care, lateral flow immunoassay (LFI) diagnostic for early pertussis that enables immediate treatment initiation (e.g., during the patient's initial clinic visit) is provided. This point-of-care assay for detection of early pertussis will improve patient care and public health. It is well established that disease severity and duration can be reduced with pertussis if patients receive antibiotic treatment early (Tiwari, et al. (2005) MMWR Recomm. Rep., 54(RR-14):1-16; von Konig, C. H. (2005) Pediatr. Infect. Dis. J., 24(5 Suppl):S66-8; Mattoo, et al. (2005) Clin. Microbiol. Rev., 18(2):326-82; Hewlet, et al. (2005) N. Engl. J. Med., 352(12):1215-22). For infants, early diagnosis would also save lives. Currently, infants require more doctor visits to reach a pertussis diagnosis than do older patients (Lee, et al. (2000) Arch. Fam. Med., 9(10):989-96). Infants also have the highest risk of mortality and severe neurological complications (Tanaka, et al. (2003) JAMA 290(22):2968-75). For infants, early diagnosis would enable not only earlier treatment with antibiotics, but also key supportive care for dehydration and malnutrition (Crowcroft, et al. (2006) Lancet 367(9526):1926-36; Hewlet, et al. (2005) N. Engl. J. Med., 352(12):1215-22).
(13) Early diagnosis can change the course of an outbreak because patients are most infectious from the start of nonspecific symptoms until three weeks after paroxysmal cough onset (Tiwari, et al. (2005) MMWR Recomm. Rep., 54(RR-14):1-16). Antibiotic treatment eliminates culturable bacteria from the nasopharynx (Bergquist, et al. (1987) Pediatr. Infect. Dis. J., 6(5):458-61), which decreases the patients' infectious period and limits transmission (Wirsing von Konig, et al. (1998) Eur. J. Pediatr., 157(5):391-4). Moreover, once patients are diagnosed, their close contacts can receive prophylactic antibiotics (Tiwari, et al. (2005) MMWR Recomm. Rep., 54(RR-14):1-16; von Konig, C. H. (2005) Pediatr. Infect. Dis. J., 24(5 Suppl):S66-8). Thus, early diagnosis would reduce the size of pertussis outbreaks.
(14) Minimizing outbreak size through early diagnosis would also reduce the economic burden of pertussis. More than $17 billion were spent on pertussis costs (direct and indirect) from 2001-2010 in the U.S. (Purdy, et al. (2004) Clin. Infect. Dis., 39(1):20-8). Preventing infant cases is particularly important because 70% of infants with pertussis become hospitalized (Tanaka, et al. (2003) JAMA 290(22):2968-75) and each infant hospital stay costs an average of $10,000, excluding outpatient direct and societal indirect costs (O'Brien, et al. (2005) BMC Infect. Dis., 5:57).
(15) In accordance with one aspect of the instant invention, anti-tracheal colonization factor A (TcfA) antibodies and fragments thereof are provided. The anti-TcfA antibodies may be monoclonal or polyclonal. In a particular embodiment, the antibody or fragment thereof is immunologically specific for TcfA of Bordetella pertussis (e.g., Tohama I strain). Amino acid and nucleotide sequences of TcfA are provided in GenBank Accession No. NP_879974 and Gene ID: 2666888.
(16) In a particular embodiment, the anti-TcfA antibody or fragment thereof is immunologically specific for amino acids 288-304 or 292-300 of TcfA. In a particular embodiment, the anti-TcfA antibody is 14D12 (as depicted in
(17) In a particular embodiment, the anti-TcfA antibody or fragment thereof is immunologically specific for amino acids 288-304 or 292-300 of TcfA. In a particular embodiment, the anti-TcfA antibody is 23F8 (as depicted in
(18) In a particular embodiment, the anti-TcfA antibody or fragment thereof is immunologically specific for amino acids 337-345 of TcfA. In a particular embodiment, the anti-TcfA antibody is 18B2 (as depicted in
(19) In a particular embodiment, the anti-TcfA antibody or fragment thereof is immunologically specific for amino acids 305-323 or 307-315 of TcfA. In a particular embodiment, the anti-TcfA antibody is 20F4 (as depicted in
(20) In a particular embodiment, the anti-TcfA antibody or fragment thereof is immunologically specific for amino acids 305-323 or 313-321 of TcfA. In a particular embodiment, the anti-TcfA antibody is 14G11 (as depicted in
(21) In a particular embodiment, the anti-TcfA antibody or fragment thereof is immunologically specific for amino acids 288-323, 229-240, 289-300, and/or 304-312 of TcfA. In a particular embodiment, the anti-TcfA antibody is 13E11 (as depicted in
(22) In a particular embodiment, the anti-TcfA antibody or fragment thereof is immunologically specific for amino acids 140-160 or 139-150 of TcfA. In a particular embodiment, the anti-TcfA antibody is 10B1 (as depicted in
(23) In a particular embodiment, the anti-TcfA antibody or fragment thereof is immunologically specific for amino acids 140-160 or 139-150 of TcfA. In a particular embodiment, the anti-TcfA antibody is 7E11 (as depicted in
(24) In a particular embodiment, the anti-TcfA antibody or fragment thereof is immunologically specific for amino acids 140-160 or 151-156 of TcfA. In a particular embodiment, the anti-TcfA antibody is 3E6 (as depicted in
(25) In another embodiment, the anti-TcfA antibody or fragment thereof comprise an amino acid sequence having at least 90%, 95%, 97%, 99%, or 100% homology or identity with any of the sequences provided above (e.g., any of SEQ ID NOs: 115 and 117-125).
(26) Compositions comprising an anti-TcfA antibody or fragment thereof and a carrier such as a pharmaceutically acceptable carrier are also encompassed by the instant invention. In a particular embodiment, the composition comprises at least one anti-TcfA antibody or antibody fragment and at least one carrier (e.g., a pharmaceutically acceptable carrier).
(27) Nucleic acid molecules encoding an anti-TcfA antibody or fragment thereof are encompassed by the instant invention. Examples of nucleic acid molecules encoding anti-TcfA antibodies are provided in
(28) The antibody may be a synthetic or modified antibody (e.g., a recombinantly generated antibody; a chimeric antibody; a bispecific antibody; a humanized antibody; a camelid antibody; and the like). In a particular embodiment of the instant invention, the antibody is a monoclonal antibody.
(29) The antibodies of the instant invention may be an antibody fragment. In a particular embodiment, the antibody fragment is an antigen binding fragment of the antibody. Antibody fragments include, without limitation, immunoglobulin fragments including, without limitation: single domain (Dab; e.g., single variable light or heavy chain domain), Fab, Fab, F(ab).sub.2, and F(v); and fusions (e.g., via a linker) of these immunoglobulin fragments including, without limitation: scFv, scFv.sub.2, scFv-Fc, minibody, diabody, triabody, and tetrabody. The antibody may also be a protein (e.g., a fusion protein) comprising at least one antibody or antibody fragment.
(30) The antibodies of the instant invention may be further modified. For example, the antibodies may be humanized. In a particular embodiment, the antibodies (or a portion thereof) are inserted into the backbone of an antibody or antibody fragment construct (e.g., an antibody framework), particularly a human construct/framework. For example, the variable light domain and/or variable heavy domain of the antibodies of the instant invention or the CDRs contained therein may be inserted into another antibody construct or framework, particularly human. Methods for recombinantly producing antibodies are well-known in the art. Indeed, commercial vectors for certain antibody and antibody fragment constructs are available.
(31) The antibodies of the instant invention may also be conjugated/linked to other components. For example, the antibodies may be operably linked (e.g., covalently linked, optionally, through a linker) to at least one detectable agent, or imaging agent, contrast agent. Detectable agents include, without limitation, colloidal gold or gold nanoparticles, fluorescent probe, colored latex particles, colored cellulose nanobeads, horseradish peroxidase, and europium (Eu) nanoparticles. The antibodies of the instant invention may also comprise at least one purification tag (e.g., a His-tag). In a particular embodiment, the antibodies of the instant invention are conjugated to biotin or streptavidin (or analog thereof).
(32) The antibody molecules of the invention may be prepared using a variety of methods known in the art. Polyclonal and monoclonal antibodies may be prepared as described in Current Protocols in Molecular Biology, Ausubel et al. eds. Antibodies may be prepared by chemical cross-linking, hybrid hybridoma techniques and by expression of recombinant antibody fragments expressed in host cells, such as bacteria or yeast cells. In one embodiment of the invention, the antibody molecules are produced by expression of recombinant antibody or antibody fragments in host cells. The nucleic acid molecules encoding the antibody may be inserted into expression vectors and introduced into host cells. The resulting antibody molecules are then isolated and purified from the expression system. The antibodies optionally comprise a purification tag by which the antibody can be purified.
(33) The purity of the antibody molecules of the invention may be assessed using standard methods known to those of skill in the art, including, but not limited to, ELISA, immunohistochemistry, ion-exchange chromatography, affinity chromatography, immobilized metal affinity chromatography (IMAC), size exclusion chromatography, polyacrylamide gel electrophoresis (PAGE), western blotting, surface plasmon resonance and mass spectroscopy.
(34) In accordance with another aspect of the instant invention, immunoassays for detecting B. pertussis are provided. In a particular embodiment, the immunoassay provides a rapid, point of care assay to detect B. pertussis during early disease. The immunoassays use at least one of the anti-TcfA antibodies of the instant invention. In a particular embodiment, the immunoassay can be performed at the point-of-care without the need for expensive equipment or the need for specialized equipment or off-site equipment to analyze the data. In a particular embodiment, the immunoassay is carried out using a sample capture device, such as a lateral flow device, more particularly a lateral flow test strip, that allows detection of the TcfA biomarker. In a particular embodiment, the immunoassay is performed on a lateral flow test strip.
(35) The immunoassay of the instant invention has multiple advantages over existing diagnostics. For example, the immunoassay can be performed at the point of care. Other non-limiting advantages include low cost (e.g., no specialized equipment required), ease of use (e.g., no specialized user expertise required), and rapid results (e.g., less than about 40 minutes, less than about 30 minutes, less than about 20 minutes, or less than about 15 minutes). The immunoassay of the instant invention is also convenient for single samples and there is no need or advantage to batch samples.
(36) Lateral flow immunoassays (LFI or LFIA) are simple tests for rapid detection of the presence or absence of a target analyte in a sample. Generally, lateral flow test strips comprise a matrix or material through which a mobile phase (e.g., a liquid sample) can flow through by capillary action to a test site where a detectable signal is generated to indicate the presence or absence of the target analyte. A lateral flow immunoassay may be used in a vertical or a horizontal orientation or in an orientation between vertical and horizontal.
(37) A test strip is an article of manufacture that includes one or more zones, such as, for example, one or more of the following in any appropriate configurations: sample application area or sample pad, absorbent pad or wicking pad, test site, and conjugation pad. The different zones of the test strip may be made of the same material or different material. In a particular embodiment, the test site comprises nitrocellulose, nylon, polyester or polyester composite, matrix membranes (e.g., FUSION 5 (GE Healthcare Life Sciences, Pittsburgh, Pa.)), glass fiber membranes (e.g., Standard 14 or 17), or PVDF. In a particular embodiment, the test and control lines are on nitrocellulose. In a particular embodiment, the conjugate antibody is on a matrix membrane such as FUSION 5. In a particular embodiment, the sample application area or sample pad is a glass fiber membrane. The different zones may be joined by abutting and/or overlapping. The test strip may further comprise a backing to provide rigidity to the test strip (e.g., a supporting non-interactive material such as polyester).
(38) Generally, the lateral flow immunoassay test strip of the present invention comprises a flow path from an upstream sample application area or sample pad to a test site or capture zone. The test site comprises an area (e.g., a line or stripe) of immobilized anti-TcfA antibodies (e.g., one or more anti-TcfA antibodies (either same or different epitopes)) and, optionally, a control area (e.g., a line or stripe) of immobilized control antibodies (e.g., anti-IgG antibodies, anti-species antibodies (e.g., anti-chicken IgG antibodies (e.g., from donkey or goat)). If the conjugated antibodies are biotin-labeled, then the control area (e.g., a line or stripe) may comprise streptavidin (or analogs thereof) instead of or in conjunction with the control antibodies. Alternatively, if the conjugated antibodies are labeled with streptavidin (or analogs thereof), then the control area (e.g., a line or stripe) may comprise biotin instead of or in conjunction with the control antibodies. When present, the control line is preferably further downstream than the test line. Downstream of the test site is generally an absorbent pad or wicking pad to promote capillary action and movement of the fluid from the sample application area or sample pad. Downstream of the sample application area or sample pad and upstream to the test site is a conjugation pad. The conjugation pad comprises anti-TcfA antibodies (e.g., one or more anti-TcfA antibodies (either same or different epitopes)) conjugated to a detectable agent (e.g., colloidal gold or gold nanoparticles, fluorescent probe, colored latex particles, colored cellulose nanobeads, horseradish peroxidase, and europium (Eu) nanoparticles). In a particular embodiment, the detectable agent generates a direct signal that can be observed by a human (e.g., color from gold colloidal). While other detectable agents require additional steps to produce a signal (e.g., an enzyme to produce detectable product upon reaction with suitable substrate (e.g., horseradish peroxidase); a secondary antibody, etc.), these detectable agents are less preferred.
(39) The assay run length of the lateral flow immunoassay test strip will generally be less than 100 mm in length (e.g., including sample pad, conjugate pad, nitrocellulose, and wicking pad). In a particular embodiment, the assay run length is less than about 80 mm, less than about 70 mm, or less than about 60 mm in length. The test site need only be long enough (e.g., at least about 10 mm) to be able to visualize and differentiate the test line and the control line, when present.
(40) Generally, the anti-TcfA antibody of the conjugation pad binds a different epitope than the anti-TcfA antibody of the test site. In a particular embodiment, the anti-TcfA antibody of the conjugation pad (e.g., the antibody conjugated to a detectable agent such as gold) binds amino acids 140-160 of TcfA. In a particular embodiment, the anti-TcfA antibody of the conjugation pad is 7E11, 10B1, or 3E6 (particularly 10B1) or an anti-TcfA antibody which is a fragment or homolog of 7E11, 10B1, or 3E6 as described hereinabove (e.g., an antibody which binds the same epitope or an antibody comprising all 6 CDRs of 7E11, 10B1, or 3E6). In a particular embodiment, the anti-TcfA antibody of the test site binds amino acids 288-304, amino acids 305-323, and/or amino acids 322-330 of TcfA. In a particular embodiment, the anti-TcfA antibody of the test site is 13E11, 14D12, 23F8, 19F9, 14D9, or 25E3 (particularly 13E11 and/or 14D12) or an anti-TcfA antibody which is a fragment or homolog of 13E11, 14D12, 23F8, 19F9, 14D9, or 25E3 as described hereinabove (e.g., an antibody which binds the same epitope or an antibody comprising all 6 CDRs of 13E11, 14D12, 23F8, 19F9, 14D9, or 25E3). In a particular embodiment, the anti-TcfA antibody of the conjugation pad is 101 or an anti-TcfA antibody which is a fragment or homolog of 10B1 as described hereinabove (e.g., an antibody which binds the same epitope as 101 or an antibody comprising all 6 CDRs of 10B1) and the test site comprises 1) 13E11 or an anti-TcfA antibody which is a fragment or homolog of 13E11 as described hereinabove (e.g., an antibody which binds the same epitope as 13E11 or an antibody comprising all 6 CDRs of 13E11), and 2) 14D12 or an anti-TcfA antibody which is a fragment or homolog of 14D12 as described hereinabove (e.g., an antibody which binds the same epitope as 14D12 or an antibody comprising all 6 CDRs of 14D12).
(41) In general, a fluid sample (e.g., by dipping or spotting) is applied to the sample application area or sample pad. In a particular embodiment, the sample is a biological sample obtained from a subject. Biological samples obtained from the subject to be used in the immunoassay of the instant invention include, without limitation: nasopharyngeal swabs, aspirates, and washes. The cells in the biological sample may be lysed prior to analysis. The obtained biological sample may be diluted, purified, concentrated, filtered, dissolved, suspended or otherwise manipulated prior to assay to optimize the immunoassay results. In a particular embodiment, the biological sample is diluted in a carrier or buffer (e.g., a dilution and/or extraction buffer). In a particular embodiment, biological sample is diluted in phosphate buffered saline (PBS). In a particular embodiment, biological sample is diluted in PBS comprising a surfactant (e.g., 0.05% to 2.0%, particularly, 0.1%, 0.25%, 0.5%, 0.75%, or 1.0%), such as an anionic surfactant. Examples of surfactants include, without limitation, alkyl sulfates, alkyl ether sulfates, alkyl ether phosphates, ammonium lauryl sulfate, sodium dodecyl sulfate (SDS), sodium lauryl ether sulfate, and sodium myreth sulfate.
(42) The biological sample for testing can be from any subject. The immunoassay will be particularly useful for the rapid diagnosis of infants (e.g., in pediatrician offices, urgent care clinics, small hospital emergency departments, or medical clinics) with early pertussis. Infants have higher bacterial loads than children or adults (Eby, et al., Infect. Immun. (2013) 81(5):1390-8; Nakamura et al. (2011) Clin. Microbiol. Infect. (2011) 17(3):365-70; Tenenbaum et al., Eur. J. Clin. Microbiol. Infect. Dis. (2012) 31(11):3173-82). This higher load can facilitate detection of B. pertussis antigens. Nonetheless, the immunoassay of the instant invention can also be used on older patients (e.g., children and adults).
(43) Methods for detecting B. pertussis are provided using an immunoassay are also encompassed by the instant invention. In a particular embodiment, the method comprises obtaining a sample (e.g., a biological sample (e.g., from a subject)), diluting the sample in a carrier or buffer, and applying the diluted sample to the immunoassay (e.g., LFI). In a particular embodiment, the method further comprises diagnosing a subject as having a B. pertussis infection based on the presence of a positive result from the immunoassay.
(44) The immunoassays of the instant invention may further comprise assays, particularly other point of care assays. In a particular embodiment, the pertussis diagnostic technology of the instant invention is combined or multiplexed with other respiratory diseases or disorders. In a particular embodiment, the immunoassays of the instant invention further comprise an assay for respiratory syncytial virus (RSV). Many RSV-positive infants are also pertussis-positive (generally 8-16%) and most infants with pertussis are co-infected with RSV (approximately 67-74%) (Nuolivirta, et al., Pediatr. Infect. Dis. J. (2010) 29(11):1013-5; Cosnes-Lambe, et al., Eur. J. Pediatr. (2008) 167(9):1017-9). There is no difference in cough symptoms at hospital admission between infants infected only with RSV vs. infants coinfected with RSV and pertussis (Nuolivirta, et al., Pediatr. Infect. Dis. J. (2010) 29(11):1013-5; Crowcroft, et al., Arch. Dis. Child. (2003) 88(9):802-6). But importantly, detecting co-infection is clinically relevant as infants with RSV and B. pertussis co-infections need antibiotics whereas infants infected solely with RSV do not antibiotics (Bronchiolitis AaoPSoDaMo, Pediatrics (2006) 118(4):1774-93). Thus, the instant invention also encompasses immunoassays, particularly LFIs, comprising the anti-TcfA antibodies of the instant invention in a first test line and RSV detecting agents in a second test line (e.g., antibodies against RSV viral fusion protein (see, e.g., QuickVue RSV Test (Quidel, San Diego Calif.)) and/or RSV nucleotprotein (see, e.g., ImmunoCard STAT! RSV (Meidian Biosciences, Cincinnati, Ohio)). These LFIs allow for rapid diagnosis of B. pertussis and/or RSV infections that could otherwise remain undiagnosed and untreated, particularly in infants.
(45) Generally, the immunoassays of the instant invention will be used as a diagnostic for pertussis. Significantly, the immunoassays of the instant invention can also be used to monitor the therapy of a subject with pertussis. For example, after diagnosis with pertussis and administration of an appropriate therapy (e.g., antibiotics), the immunoassays of the instant invention can be used to monitor the amount of B. pertussis and the clearance of the bacteria.
(46) While the present invention has been described with regard to pertussis diagnosis and detecting B. pertussis, the gene for TcfA is also found in B. parapertussis, B. holmesii, and B. bronchiseptica. Notably, B. parapertussis and B. holmesii infect humans and B. bronchiseptica is the causative agent for kennel cough in animals. Thus, in certain embodiments, the anti-TcfA antibodies can also be used to detect the presence of B. parapertussis, B. holmesii, and B. bronchiseptica. Indeed, as seen in Example 2, B. holmesii was detected with one of the five LFIs tested.
(47) In a particular embodiment, the immunoassay of the instant invention is specific for diagnosis and detecting B. pertussis. For example, the immunoassay may be specific for diagnosis and detecting B. pertussis while not significantly detecting B. parapertussis, B. holmesii, and/or B. bronchiseptica.
(48) In accordance with another aspect of the instant invention, compositions and methods for the inhibition, treatment, and/or prevention of pertussis and/or a B. pertussis infection are provided. The methods comprise administering an anti-TcfA antibody or fragment thereof of the instant invention to a subject in need thereof. The anti-TcfA antibodies may be administered in a composition further comprising a pharmaceutically acceptable carrier. The composition may further comprise at least one other therapeutic agent against B. pertussis (e.g., antibiotics). Alternatively, the other therapeutic agent may be contained within a separate composition(s) with at least one pharmaceutically acceptable carrier. The composition(s) comprising at least one anti-TcfA antibody and/or the composition(s) comprising at least one other therapeutic agent may be contained within a kit.
(49) TcfA has been shown to be required for efficient colonization of the trachea in a mouse model of pertussis (Finn, et al., Mol. Microbiol. (1995) 16(4):625-634). Furthermore, the heterologous expression of TcfA in E. coli enables the engineered E. coli to bind human lung epithelial cells, thereby suggesting a role for TcfA for cellular binding and infection (Gasperini, et al., Mol. Cell Proteomics (2018) 17(2):205-215). Notably, passive immunity has been demonstrated with humanized mouse anti-pertussis toxin mAbs when administered to infected baboons. The anti-pertussis toxin mAbs were capable of blunting the post-infection white blood cell increase and increasing the speed by which B. pertussis bacteria was cleared (Nguyen, et al., Sci. Transl. Med. (2015) 7(316):316ra195). Based on the requirement for TcfA for efficient colonization, blocking TcfA with an antibody of the instant invention will provide therapeutic effects by inhibiting the ability of B. pertussis to bind and infect cells.
(50) The compositions of the present invention can be administered by any suitable route, for example, by injection (e.g., for local or systemic administration), intravenous, oral, pulmonary, nasal or other modes of administration. In a particular embodiment, the compositions are administered orally or by inhalation. The compositions comprising the antibodies of the invention may be conveniently formulated for administration with an acceptable medium such as water, buffered saline, ethanol, polyol (for example, glycerol, propylene glycol, liquid polyethylene glycol and the like), dimethyl sulfoxide (DMSO), oils, detergents, suspending agents or suitable mixtures thereof. Selection of a suitable pharmaceutical preparation depends upon the method of administration chosen. The concentration of the antibodies in the chosen medium may be varied and the medium may be chosen based on the desired route of administration of the pharmaceutical preparation. Except insofar as any conventional media or agent is incompatible with the agents to be administered, its use in the pharmaceutical preparation is contemplated. The pharmaceutical composition of the present invention can be prepared, for example, in liquid form, or can be in dried powder form (e.g., lyophilized).
(51) Pharmaceutical compositions containing agents of the present invention as the active ingredient in intimate admixture with a pharmaceutical carrier can be prepared according to conventional pharmaceutical compounding techniques. The carrier may take a wide variety of forms depending on the form of preparation desired for administration. In preparing the antibody in oral dosage form, any of the usual pharmaceutical media may be employed, such as, for example, water, glycols, oils, alcohols, flavoring agents, preservatives, coloring agents and the like in the case of oral liquid preparations (such as, for example, suspensions, elixirs and solutions); or carriers such as starches, sugars, diluents, granulating agents, lubricants, binders, disintegrating agents and the like in the case of oral solid preparations (such as, for example, powders, capsules and tablets).
(52) A pharmaceutical preparation of the invention may be formulated in dosage unit form for ease of administration and uniformity of dosage. Dosage unit form, as used herein, refers to a physically discrete unit of the pharmaceutical preparation appropriate for the patient undergoing treatment. Each dosage should contain a quantity of active ingredient calculated to produce the desired effect in association with the selected pharmaceutical carrier. Procedures for determining the appropriate dosage unit are well known to those skilled in the art. Dosage units may be proportionately increased or decreased based on the weight of the patient. Appropriate concentrations for alleviation of a particular pathological condition may be determined by dosage concentration curve calculations, as known in the art.
(53) The dose and dosage regimen of the antibodies according to the invention that is suitable for administration to a particular patient may be determined by a physician considering the patient's age, sex, weight, general medical condition, and the specific condition and severity thereof for which the agent is being administered. The physician may also consider the route of administration of the antibodies, the pharmaceutical carrier with which the antibodies may be combined, and the antibodies' biological activity. The appropriate dosage unit for the administration of the agents of the invention may be determined by evaluating the toxicity of the agents in animal models. Appropriate dosage unit may also be determined by assessing the efficacy of the agents in combination with other standard drugs.
(54) The compositions comprising the agents of the instant invention may be administered at appropriate intervals, for example, at least once a day or more until the pathological symptoms are reduced or alleviated, after which the dosage may be reduced to a maintenance level. The appropriate interval in a particular case would normally depend on the condition of the patient.
Definitions
(55) The following definitions are provided to facilitate an understanding of the present invention:
(56) The singular forms a, an, and the include plural referents unless the context clearly dictates otherwise.
(57) Pharmaceutically acceptable indicates approval by a regulatory agency of the Federal or a state government or listed in the U.S. Pharmacopeia or other generally recognized pharmacopeia for use in animals, and more particularly in humans.
(58) A carrier refers to, for example, a diluent, adjuvant, excipient, auxiliary agent or vehicle with which an active agent of the present invention is administered. Pharmaceutically acceptable carriers can be sterile liquids, such as water and oils, including those of petroleum, animal, vegetable or synthetic origin, such as peanut oil, soybean oil, mineral oil, sesame oil and the like. Water or aqueous saline solutions and aqueous dextrose and glycerol solutions are preferably employed as carriers. Suitable pharmaceutical carriers are described, for example, in Remington's Pharmaceutical Sciences by E. W. Martin.
(59) An antibody or antibody molecule is any immunoglobulin, including antibodies and fragments thereof, that binds to a specific antigen. As used herein, antibody or antibody molecule contemplates intact immunoglobulin molecules, immunologically active portions of an immunoglobulin molecule (e.g., antigen-binding fragment), and fusions of immunologically active portions of an immunoglobulin molecule.
(60) As used herein, the term immunologically specific refers to proteins/polypeptides, particularly antibodies, that bind to one or more epitopes of a protein or compound of interest, but which do not substantially recognize and bind other molecules in a sample containing a mixed population of antigenic biological molecules.
(61) As used herein, diagnose refers to detecting and identifying a disease or disorder in a subject. The term may also encompass assessing or evaluating the disease or disorder status (progression, regression, stabilization, response to treatment, etc.) in a patient known to have the disease or disorder.
(62) As used herein, the term prognosis refers to providing information regarding the impact of the presence of a disease or disorder (e.g., as determined by the diagnostic methods of the present invention) on a subject's future health (e.g., expected morbidity or mortality). In other words, the term prognosis refers to providing a prediction of the probable course and outcome of a disease/disorder and/or the likelihood of recovery from the disease/disorder.
(63) As used herein, the term subject refers to an animal, particularly a mammal, particularly a human.
(64) A therapeutically effective amount of a compound or a pharmaceutical composition refers to an amount effective to prevent, inhibit, treat, or lessen the symptoms of a particular disorder or disease. The treatment of a disease or disorder herein may refer to curing, relieving, and/or preventing the disease or disorder, the symptom(s) of it, or the predisposition towards it.
(65) As used herein, the term therapeutic agent refers to a chemical compound or biological molecule including, without limitation, nucleic acids, peptides, proteins, and antibodies that can be used to treat a condition, disease, or disorder or reduce the symptoms of the condition, disease, or disorder.
(66) The term isolated refers to the separation of a compound from other components present during its production or from its natural environment. Isolated is not meant to exclude artificial or synthetic mixtures with other compounds or materials, or the presence of impurities that do not substantially interfere with the fundamental activity, and that may be present, for example, due to incomplete purification, or the addition of stabilizers.
(67) As used herein, a biological sample refers to a sample of biological material obtained from a subject, particularly a human subject, including a tissue, a tissue sample, cell(s), and a biological fluid (e.g., blood (e.g., whole blood), serum, plasma, urine, sweat, tears, saliva, mucosal secretions, sputum, CSF).
(68) The following examples are provided to illustrate various embodiments of the present invention. The examples are not intended to limit the invention in any way.
Example 1
(69) A bioinformatics-based strategy was used to identify tracheal colonization factor A (TcfA) as a novel biomarker for B. pertussis infection. Epitope-specific polyclonal antibodies (pAbs) that recognize the cell-associated and secreted isoforms of TcfA were developed. Specifically, polyclonal antibodies were generated against amino acids 140-160, 288-304, or 305-323 of TcfA.
(70) The specificity of the anti-TcfA antibodies was tested. Specifically, the anti-TcfA pAbs were incorporated into immunoassays, particularly in ELISA and LFI formats. Cultures of bacterial species potentially found in the nasopharynx (Bordetella pertussis, Moraxella catarrhalis, Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Haemophilus influenza, and Escherichia coli) were washed from culture plates with phosphate buffered saline (PBS), normalized to an OD.sub.600 of 1.0, and lysed in 1% sodium dodecyl sulfate (SDS) in PBS for 1 hour at 65 C. The lysates were then tested by antigen-capture ELISA with anti-TcfA pAbs. As seen in
(71) Despite demonstrating specificity for B. pertussis, the anti-TcfA pAb-based immunoassay was still able to recognize multiple strains of B. pertussis. Specifically, material from two B. pertussis strainsTohama and 165were tested. Both the Tohama and 165 strains were detected by all anti-TcfA pAb combinations tested by LFI. This result is likely due to the conserved epitopes of the anti-TcfA antibodies. Indeed, the peptide sequences of all 3 of the targeted TcfA epitopes are conserved in >99% (n=436) of clinical isolates from the U.S. and 8 other countries (van Amersfoorth, et al., J. Clin. Microbiol. (2005) 43(6):2837-43; Packard, et al., J. Med. Microbiol. (2004) 53(Pt 5):355-65; van Loo, et al., J. Clin. Microbiol. (2002) 40(6):1994-2001).
(72) TcfA has a cell-associated and a secreted isoform (Finn, et al., Mol. Microbiol. (1995) 16(4):625-34), and the anti-TcfA pAbs described herein are reactive with both isoforms. As seen in
(73) The limit of detection of with one of the anti-TcfA pAbs was tested. Specifically, an LFI was performed with B. pertussis lysates prepared by detergent lysis for 60 minutes at 65 C. with 0.1% SDS in PBS. The lowest serial dilution scored as positive by 3 of 3 blinded reviewers contained material from 1.710.sup.5 colony forming units (CFU) (
Example 2
(74) Although pAbs can be used in commercial LFIs, monoclonal antibodies (mAbs) are preferred for commercialization because of their superior affinity (i.e., better LFI sensitivity), lot-to-lot reproducibility, and their more efficient, reliable, and economic large-scale production. Thus, a library of anti-TcfA mAbs was developed and the mAbs were incorporated into an advanced mAb-based LFI diagnostic to achieve enhanced analytical sensitivity and better commercialization potential.
(75) Generating a library of mAbs against TcfA required an unusually large number of immunization and hybridoma screening strategies. Ultimately, a large library of mAb-secreting hybridomas was generated and the mAbs showed robust reactivity in ELISA with immobilized antigen (recombinant TcfA, endogenous TcfA including formaldehyde-inactivated B. pertussis cells and/or TcfA peptides). Thirty-six mAbs were advanced for large-scale hybridoma culture and mAb purification via Protein A affinity chromatography.
(76) The reactivity of the mAbs was measured by indirect ELISA with plates coated with various antigen (
(77) In order to determine the epitopes recognized by the mAb, purified mAbs were evaluated by indirect ELISA with streptavidin plates loaded with biotinylated peptides. The peptides were 15mers that were offset by 3 amino acids. The minimal overlapping peptide sequence for wells with an OD.sub.450 greater than 0.75 (and in a series of two or more such adjacent wells) was defined as the minimal linear peptide epitope (Table 1). Notably, mAbs 22B7 and 14D9 reacted with a long series of peptides such that the first peptide in the series did not overlap with the last peptide. For these mAbs, the peptide sequence defined by the entire series of reactive wells is provided. In addition, purified mAbs were evaluated by indirect ELISA with plates coated with the TcfA protein fragments. With the exception of amino acids 40-374, all protein fragments were conjugated to bovine serum albumin.
(78) TABLE-US-00001 TABLE 1 Epitopes within TcfA recognized by the mAbs. Protein fragment mAb Minimal linear peptide epitope reactivity 10B1 aa139-150 PGIGKVGGSAPG aa140-160 7E11 aa139-150 PGIGKVGGSAPG aa140-160 7A10 aa148-159 APGPDTSTGSGP aa140-160 9A3 aa148-159 APGPDTSTGSGP aa140-160 7E9 aa148-159 APGPDTSTGSGP aa140-160 3E6 aa151-156 PDTSTG aa140-160 7 A3 aa151-156 PDTSTG aa140-160 15F3 aa151-159 PDTSTGSGP aa140-160 21D6 aa151-159 PDTSTGSGP aa140-160 15A9 aa151-159 PDTSTGSGP aa140-160 14F4 aa151-159 PDTSTGSGP aa140-160 17H2 aa151-159 PDTSTGSGP aa140-160 14G6 aa151-159 PDTSTGSGP aa140-160 15B9 aa151-159 PDTSTGSGP aa140-160 11B5 aa151-159 PDTSTGSGP aa140-160 4A6 aa151-159 PDTSTGSGP aa140-160 13E11 aa229-240; PADGGQDGPPPP; aa288-304, aa289-300; LPERGDDAGPKP; aa305-323 aa304-312 EGGDEGPQP 19D10 aa229-240; PADGGQDGPPPP; aa288-304, aa289-300; LPERGDDAGPKP; aa305-323 aa304-312 EGGDEGPQP 22B7 aa286-321 NAQLPERGDDAGPKPPEGEG aa288-304, GDEGPQPPQGGGEQDA aa305-323 14D9 aa289-324 LPERGDDAGPKPPEGEGG aa288-304, DEGPQPPQGGGEQDAPEV aa305-323 19F9 aa289-294 LPERGD aa288-304 23F8 aa292-300 RGDDAGPKP aa288-304 14D12 aa292-300 RGDDAGPKP aa288-304 20F4 aa307-315 DEGPQPPQG aa305-323 14A8 aa310-315 PQPPQG aa305-323 14G11 aa313-321 PQGGGEQDA aa305-323 25E3 aa322-330 PEVPPVAPA aa40-374 18B2 aa337-345 VYDPGTHTL aa40-374 The sequence identifiers for the provided minimal linear peptide epitope are: aa139-150 (SEQ ID NO: 2); aa148-159 (SEQ ID NO: 3); aa151-156 (SEQ ID NO: 4); aa151-159 (SEQ ID NO: 5); aa229-240 (SEQ ID NO: 6); aa289-300 (SEQ ID NO: 7); aa304-312 (SEQ ID NO: 8); aa286-321 (SEQ ID NO: 9); aa289-324 (SEQ ID NO: 10); aa289-294 (SEQ ID NO: 11); aa292-300 (SEQ ID NO: 12); aa307-315 (SEQ ID NO: 13); aa3 10-315 (SEQ ID NO: 14); aa313-321 (SEQ ID NO: 15); aa322-330 (SEQ ID NO: 16); and aa337-345 (SEQ ID NO: 17).
Example 3
(79) Anti-TcfA mAbs were evaluated for performance as a detector mAb (i.e., gold conjugate) and as a capture mAb (i.e., test line) in an LFI while holding all other LFI components constant (e.g., nitrocellulose, conjugate pad, sample pad, wicking pad, blocking buffers, chase buffer). A significant number of LFI mAb pair permutations were identified that effectively detected formaldehyde-inactivated B. pertussis cells (
(80) Several anti-TcfA mAb combinations for LFIs (
(81) TABLE-US-00002 TABLE 2 Pertussis LFI cross-reactivity testing (14D12 and 13E11 test line + 10B1 gold conjugate). LFI Microorganism (3.33 10.sup.7 CFU/mL) Result Acinetobacter baumanni Negative Acinetobacter calcoaceticus Negative Acinetocacter Iwoffii Negative Aspergillus fumigatus Negative Bacillus cereus Negative Bacillus subtilis Negative Bacteroides fragilis Negative Bordetella bronchiseptica (ATCC 19395) Negative Bordetella bronchiseptica (ATCC BAA-588) Negative Bordetella holmesii (F061) Negative Bordetella parapertussis (A747) Negative Bordetella parapertussis (C510) Negative Candida albicans Negative Candida glabrata Negative Citrobacter amalonaticus Negative Citrobacter freundii Negative Citrobacter koseri Negative Cornebacterium diphtheria Negative Enterobacter aerogenes Negative Enterobacter cloacae Negative Enterococcus faecalis (Z346) Negative Enterococcus faecium (Z265) Negative Escherichia coli (O157) Negative Haemophilus influenzae Negative Haemophilus parainfluenzae (ATCC33392) Negative Legionella pneumophila (Philadelphia) Negative Moraxella catarrhalis Negative Morganella morganii (Z098) Negative Mycoplasma pneumonia (M129) Negative Proteus mirabilis (Z050) Negative Proteus vulgaris (Z129) Negative Pseudomonas aeruginosa Negative Staphylococcus epidermidis Negative Stenotrophomonas maltophilia (Z074) Negative Streptococcus agalactiae (Z019) Negative Streptococcus dysgalactiae Positive* Streptococcus mitis Negative Streptococcus mutans (Z072) Negative Streptococcus pneumoniae Negative Streptococcus pyogenes Negative Streptococcus salivarius (Z127) Negative Streptococcus sanguinis (Z089) Negative Testing for S. dysgalactiae was repeated by centrifuging cells to remove traces of growth medium and resuspending cells in extraction buffer at the same CFU/mL concentration; 3 of 3 LFI replicates were negative. S. dysgalactiae testing was also repeated by diluting cells. At a concentration of 8.3 10.sup.6 CFU/mL, 3 of 3 LFI replicates were negative.
(82) The preliminary limit of detection for five of the LFIs with viable B. pertussis cells was 210.sup.5 to 510.sup.5 CFU. Two of the three LFIs with no detectable cross-reactivity had preliminary limits of detection of 210.sup.5 CFU. These two LFIs are: 1) mAb 14D12 as the test line and mAb 7E11 as the gold conjugate; and 2) mAb 25E3 as the test line and mAb 10B1 as the gold conjugate. The sixth LFI (14D12 and 13E11 test line+10B1 gold conjugate) was subjected to detailed limit of detection testing and was determined to have an analytical sensitivity limit of 310.sup.5 CFU/mL (1.810.sup.4 CFU per LFI test) (
Example 4
(83) A library of B. pertussis mAbs has been generated. The mAbs bind viable and formaldehyde-inactivated B. pertussis cells. In addition to use as diagnostic reagents, these mAbs are valuable as therapeutics, prophylactics, and/or research tools (e.g., for fluorescence microscopy on fresh or fixed tissue sections, etc.).
(84) A mAb-based LFI was optimized for sensitive, specific detection of B. pertussis. The LFI comprised 14D12 and 13E11 in the test line and 10B1 as the conjugated antibody. The LFI detected B. pertussis antigen in 20 minutes with a simple protocol, enabling diagnostic use at the point-of-care.
(85) Human infant nasopharyngeal washes contain 710.sup.7 to 810.sup.10 CFU/mL (Eby, et al., Infect. Immun. (2013) 81(5):1390-8; Tenenbaum, et al., Eur. J. Clin. Microbiol. Infect. Dis. (2012) 31(11):3173-82). These CFU/ml values are approximately 200-fold to 260,000-fold greater than the LFI's analytical sensitivity limit (i.e., C95). Indeed, as seen in
(86) The LFI produced strong signal with multiple B. pertussis strains and sample types. As an example,
(87) Nasopharyngeal washes from baboons infected by natural, airborne transmission have greater than or equal to 510.sup.5 CFU/mL from approximately Day 15 to Day 33 post-exposure (Warfel, et al., Proc. Natl. Acad. Sci. (2014) 111(2):787-92). The LFI detected antigen from infected baboon nasopharyngeal washes containing as little as 5.510.sup.4 CFU/mL (3.310.sup.3 CFU per LFI test) (
(88) Specifically, as seen in
(89) As seen in
(90) In addition, the LFI has been tested with human patient samples (nasopharyngeal swabs). The LFI was negative with 2 of 2 patient samples that were diagnosed by RT-PCR as negative for pertussis. The LFI was positive with 1 patient sample that was diagnosed by RT-PCR as being positive for pertussis and with a high bacterial burden. The LFI was negative with 1 patient sample that was diagnosed by RT-PCR as positive for pertussis but with a significantly lower bacterial burden. The 1 positive LFI with the 1 patient who was positive by RT-PCR shows proof of concept for detection of B. pertussis in human nasopharyngeal swab specimens.
(91) Together, the baboon and human results indicate that the LFI can detect infection from two different types of nasopharyngeal specimens: nasopharyngeal washes and nasopharyngeal swabs.
(92) The mAb-based LFI for detection of B. pertussis antigen allows for early, point-of-care diagnosis of pertussis using minimally-invasive nasopharyngeal specimens. The availability of a rapid and simple test for detection of pertussis will increase early diagnosis, as well as facilitate immediate triage, treatment, and outbreak containment.
(93) Several publications and patent documents are cited in the foregoing specification in order to more fully describe the state of the art to which this invention pertains. The disclosure of each of these citations is incorporated by reference herein.
(94) While certain of the preferred embodiments of the present invention have been described and specifically exemplified above, it is not intended that the invention be limited to such embodiments. Various modifications may be made thereto without departing from the scope and spirit of the present invention, as set forth in the following claims.