Process for diagnosis of neurodegenerative diseases
10900976 ยท 2021-01-26
Assignee
Inventors
Cpc classification
Y02A90/10
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
G16B25/00
PHYSICS
G01N21/6428
PHYSICS
G16H50/20
PHYSICS
G01N33/4833
PHYSICS
A61B5/4088
HUMAN NECESSITIES
G16B99/00
PHYSICS
G01N1/286
PHYSICS
International classification
G01N1/28
PHYSICS
G16B20/00
PHYSICS
Abstract
The invention provides an analytical process for analysing the presence of at least one aggregated conformation prion protein in a sample of body fluid or a sample of tissue and uses the dependency of the amplification of the aggregated conformation on the shear-force intensity applied to the native conformation prion protein, which is also dependent on the specific seed present in the admixture with native conformation prion protein, for specifically analysing for the presence of an aggregated conformation prion protein in the sample. The process of the invention contains the step of determining the content of aggregated conformation prion protein generated in admixture with the sample to be analysed using one shear-force intensity, preferably using least at two different shear-force intensities and the step of comparing data on these contents of generated prion protein having an aggregated conformation with data on the content of aggregated prion protein that is pre-determined, each at the same shear-force intensity for a mixture of the same native conformation prion protein with a reference sample as a seed.
Claims
1. A process for analysis for the presence of neurodegenerative prion-protein aggregation disease-related aggregated conformation prion protein in a biopsied mammalian sample, the disease being one of Idiopathic Parkinson's Disease (IPD), Parkinson's Disease with Dementia (PDD), Dementia with Lewy-Bodies (DLB) or Multiple System Atrophy (MSA), comprising the steps of a) adding alpha-synuclein as a native conformation prion protein to the sample to form a mixture and adding to the mixture at least one luminescent dye that is specific for the aggregated conformation prion protein and measuring the luminescence of the dye, b) subjecting the mixture comprising the sample and alpha-synuclein obtained in step a) to at least one shear-force intensity that is computer-controlled to have a uniform intensity having an intensity range of maximally 20% of one shear-force value for one or a plurality of cycles of shear-force acting and resting; c) following step b), determining via computer and storing the content of aggregated conformation prion protein for each of the shear-force intensities, and d) comparing, with a computer, the content of aggregated conformation prion protein determined in step c) to data in a computer-based databank on the content of aggregated conformation prion protein, which content was determined for alpha-synuclein as a native conformation prion protein subjected to the same shear-force intensity as in step b), wherein the data on the content of aggregated conformation prion protein was determined in alpha-synuclein as a native conformation prion protein in admixture with a reference sample and these data are provided in the computer-based databank which in association with these data contains the neurodegenerative prion-protein aggregation disease diagnosis of one or more of Idiopathic Parkinson's Disease (IPD), Parkinson's Disease with Dementia (PDD), Dementia with Lewy-Bodies (DLB) and Multiple System Atrophy (MSA) for the patient from which the reference sample originates.
2. The process according to claim 1, wherein prior to step b) the mixture is divided into aliquots and in step b) at least two aliquots are subjected to a different shear-force intensity each and in step c) the content of aggregated conformation prion protein is determined for each aliquot and in step d) the content of aggregated conformation prion protein determined in step c) for each aliquot is compared to data on a content of aggregated conformation prion protein.
3. The process according to claim 1, wherein in step b) the mixture is subjected to a succession of at least two different shear-force intensities and the content of aggregated conformation prion protein is determined during or following subjecting the mixture to each one of the shear-force intensities.
4. The process according to claim 1, comprising irradiating the mixture with light having a wavelength for exciting luminescence in the dye and measuring the luminescence of the dye during shear-force acting of step b) or during a resting phase of step b), without moving the volume occupied by the mixture relative a the shear-force generator generating the shear-force in step b).
5. The process according to claim 1, wherein in step b) the rate of formation of aggregated conformation prion protein is determined from the content of aggregated state prion protein determined at the at least one shear-force intensity and the data contain the rate of formation at the same shear-force intensity.
6. The process according to claim 1, wherein the content of aggregated conformation prion protein is determined as the time-resolved content and that the rate of formation of aggregated conformation prion protein is determined by non-linear regression analysis of an approximation on the determined time-resolved content of aggregated conformation prion protein for each of the shear-force intensities.
7. The process according to claim 1, characterized by adding at least one aggregated conformation prion protein to at least one aliquot of the mixture comprising the sample and alpha-synuclein as a native conformation prion protein, wherein the alpha-synuclein in aggregated conformation is produced by subjecting native alpha-synuclein as a native conformation prion protein to a uniform shear-force controlled to an intensity range of maximally 1% of one shear-force intensity.
8. A process for analysis for the presence of neurodegenerative prion-protein aggregation disease-related aggregated conformation prion protein in a biopsied mammalian sample, comprising the steps of a) adding alpha-synuclein as a native conformation prion protein to the sample to form a mixture; b) subjecting the mixture comprising the sample and alpha-synuclein as a native conformation prion protein obtained in step a) to at least one shear-force intensity that is computer-controlled to have a uniform intensity having an intensity range of maximally 20% of one shear-force value for one or a plurality of cycles of shear-force acting and resting; c) following step b), determining via computer and storing the content of aggregated conformation prion protein for each of the shear-force intensities, and d) comparing, with a computer, the content of aggregated conformation prion protein determined in step c) to data in a computer-based databank on the content of aggregated conformation prion protein, which content was determined for alpha-synuclein as a native conformation prion protein subjected to the same shear-force intensity as in step b), wherein the data on the content of aggregated conformation prion protein was determined in alpha-synuclein as a native conformation prion protein in admixture with a reference sample and these data are provided in the computer-based databank which in association with these data contains the neurodegenerative prion-protein aggregation disease diagnosis of one or more of Idiopathic Parkinson's Disease (IPD), Parkinson's Disease with Dementia (PDD), Dementia with Lewy-Bodies (DLB) and Multiple System Atrophy (MSA) for the patient from which the reference sample originates, the method further comprising irradiating the mixture with light having a wavelength that is scattered by the aggregated conformation prion protein and measuring scattered light exiting the admixture during step b), or during a pause of step b), with or without moving the volume occupied by the mixture relative a the shear-force generator generating the shear force in step b).
9. The process according to claim 8, comprising adding to the mixture at least one luminescent dye that is specific for the aggregated conformation prion protein prior to the step of subjecting the mixture to at least two different shear-force intensities and measuring the luminescence of the dye.
Description
(1) The invention is now described in greater detail by way of examples with reference to the figures that show in
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Example: Amplification of Aggregated State Conformation at Different Shear-Force Intensities
(12) As samples, a 1:50 volume portion of brain homogenate was used and mixed with 2 mg/ml alpha-synuclein as the native conformation prion protein. The brain homogenate was prepared by homogenization in cold phosphate-buffered saline (PBS) containing 0.5% Triton X-100 and 1 complete EDTA-free protease inhibitor cocktail (Roche, Cat. No. 11873580001) using 20 strokes with a dounce homogenizer on ice. Brain samples were post-mortem from one healthy control (NEG.) and four different synucleopathy disease patients: Idiopathic Parkinson's Disease (IPD), Parkinson's Disease with Dementia (PDD), Dementia with Lewy-Bodies (DLB), Muliple System Atrophy (MSA). The suspension was clarified by centrifugation at 2000g for 45 s, and the supernatant was used.
(13) As another sample, 360 l human cerebrospinal fluid (CSF), stored at 80 C. were mixed with 40 l cold 10PBS containing 0.5% Triton X-100 and 1 complete EDTA-free protease inhibitor cocktail and clarified by centrifugation at 2000g for 45 s, giving the supernatant as human cerebrospinal fluid extract (CSFE). In this example the CSF sample was post-mortem from the same patient of Parkinson's disease with dementia (PDD) that was used above.
(14) The native conformation prion protein was recombinantly expressed human alpha-synuclein of approx. 5.0 mg/ml water, stored at 80 C. and thawed at 37 C. at very mild agitation. The protein concentration was adjusted to 2.22 mg/ml using sterile-filtered water and 13.5 ml thereof were mixed with 1.5 ml of 10 concentrated PBS to yield 2.0 mg/ml human alpha-synuclein in PBS.
(15) On ice, 15 ml of 2.0 mg/ml human alpha-synuclein in PBS were combined with 300 l brain homogenate supernatant, or alternatively with 300 l CSFE. Of this mixture, twelve identical aliquots of 1.2 ml each were filled into 1.5 ml sealed polypropylene test tubes (SureLock, Eppendorf). Into each test tube, one rotary shearing device having a rotor of 2.00 mm within a tube at a gap width of 0.30 mm was inserted. These assemblies were incubated at 37 C. for 15 min. Shear-force was applied by rotating the rotors with control of the rotating rate to at maximum 1% from the rate set for 5 s with a subsequent resting phase of 295 s for a total of 22 h. The rotating rates used are indicated in
(16) Samples of 20 l were taken from each reaction mixture at time 0 h, 3 h, 6 h, 9 h, 12 h, and at 22 h under shear-force. The amplification of aggregated state conformation was determined by fluorescence spectroscopy of 15 l of the sample taken after mixing with 135 l Thioflavin T stock solution (30 M Thioflavin T in PBS buffer solution) with excitation at 450 nm (bandwidth 10 nm) and detection at 482 nm (bandwidth 20 nm).
(17) The brain samples originated from patients diagnosed with the following Parkinson syndromes: Idiopathic Parkinson Disease (IPD), ICD-10: G20 Dementia in Parkinson's disease (PDD), ICD-10: G20, F02.3 Multisystem Atrophy (MSA), ICD-10: G90.3: Dementia with Lewybodies (DLB), ICD-10: G31.8, F02.3 Healthy Control (NEG.),
(18) and the CSF sample originated from a patient diagnosed with Dementia in Parkinson's disease (PDD), ICD-10: G20, F02.3
(19) For diagnosis, the ICD-10 codes (available at www.ICD-code.de, at http://apps.who.int/classifications/icd10/browse/2010/en#, at http://www.who.int/classifications/icd/en/, and at http://www.who.int/classifications/icd/en/GRNBOOK.pdf) were used.
(20) In detail, F00 Dementia in Alzheimer's disease: Alzheimer disease (AD) is a primary degenerative cerebral disease of unknown etiology with characteristic neuropathological and neurochemical features. The disorder is usually insidious in onset and develops slowly but steadily over a period of several years. Associated with the deposition of seed of abeta protein, tau protein, and sometimes synuclein protein F00.0*, G30.0*: Dementia in Alzheimer's disease with early onset. Dementia in Alzheimer disease with onset before the age of 65, with a relatively rapid deteriorating course and with marked multiple disorders of the higher cortical functions. Includes: (i) Alzheimer disease, type 2; (ii) Presenile dementia, Alzheimer type; (iii) Primary degenerative dementia of the Alzheimer type, presenile onset. F00.1*, G30.1*: Dementia in Alzheimer's disease with late onset. Dementia in Alzheimer disease with onset after the age of 65, usually in the late 70s or thereafter, with a slow progression, and with memory impairment as the principal feature. Includes (i) Alzheimer disease, type 1; (ii) Primary degenerative dementia of the Alzheimer type, senile onset; (iii) Senile dementia, Alzheimer type. F00.2*, G30.8*: Dementia in Alzheimer's disease, atypical or mixed type. Atypical dementia, Alzheimer type F00.8, G30.9: Dementia in Alzheimer's disease, unspecified
(21) F02 Dementia in other diseases classified elsewhere. Cases of dementia due, or presumed to be due, to causes other than Alzheimer disease or cerebrovascular disease. Onset may be at any time in life. F02.0*, G31.0*: Dementia in Pick's disease (Frontotemporal lobular Dementia, FTD). A progressive dementia, commencing in middle age, characterized by early, slowly progressing changes of character and social deterioration, followed by impairment of intellect, memory, and language functions, with apathy, euphoria and, occasionally, extrapyramidal phenomena. F02.2*, G10*: Dementia in Huntington's disease (HD). A dementia occurring as part of a widespread degeneration of the brain. The disorder is transmitted by a single autosomal dominant gene. Symptoms typically emerge in the third and fourth decade. Progression is slow, leading to death usually within 10 to 15 years. Includes: Dementia in Huntington chorea F02.3*, G20*: Dementia in Parkinson's disease (PDD): dementia developing in the course of established Parkinson disease. No particular distinguishing clinical features have yet been demonstrated. Includes (i) Hemiparkinsonism, (ii) Paralysis agitans, (iii) Parkinsonism or Parkinson disease (NOS (not otherwise specified), idiopathic, primary) F02.3*, G31.82: Lewy body Dementia (DLB), Lewy Body Disease (LBD). A progressive degenerative dementia. Persons with LBD will show markedly fluctuating cognition. Persistent or recurring visual hallucinations with vivid and detailed pictures are often an early diagnostic symptom.
(22) A81 Atypical virus infections of central nervous system. Prion diseases of the central nervous system. A81.0*, F02.1*. Dementia in Creutzfeldt-Jakob disease. A progressive dementia with extensive neurological signs, due to specific neuropathological changes that are presumed to be caused by a transmissible agent. Onset is usually in middle or later life, but may be at any adult age. The course is subacute, leading to death within one to two years. A81.8: Other atypical virus infections of central nervous system: Kuru A81.9: Atypical virus infection of central nervous system, unspecified: Prion disease of central nervous system.
(23) Amyloidosis: 168.0* Cerebral amyloid angiopathy (E85.+) [Possibly to be extended]
(24) Parkinson Syndromes: G20: Idiopathic Parkinson Disease (IPD) G20, F02.3: Dementia in Parkinson's disease (PDD) G90.3: Multisystem Atrophy (MSA) G31.8, F02.3: Dementia with Lewybodies (DLB)
(25) Motor Neuron Disease:
(26) G12.2: Motor neuron disease: includes (i) Familial motor neuron disease and (ii) Amyotrophic Lateral sclerosis (ALS).
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(28) The results show that in the healthy control (NEG.), no aggregated conformation prion protein was generated. All the samples from the patients diagnosed with Parkinson syndromes resulted in the generation of amplification that was dependent on the shear-force intensity (rotation rate, application time, resting time and cycle number) and dependent on the origin of the sample. The process was highly reproducible in three independent experiments performed on the same brain tissues.
(29) In
(30) In
(31) The results show that the process of the invention differentiates between samples of different pathologies and between subtypes, e.g. specific disease presentation of individual patients.
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(33) The results depicted in
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(35) A comparison of the amplification of aggregated prion protein at single shear-force intensities, i.e. for different rotation rates at the same cycles for a total of 22 h allows to identify similar patterns of amplification, preferably an identification of the unknown sample according to similarities of the amplification pattern generated from a sample of known diagnosis. In this process, the sample of known diagnosis serves as a reference sample. In detail, the samples of
(36) Therefore, it is assumed that the process can differentiate samples according to the progression of accumulation of aggregated prion protein during disease.
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(38) As indicated by the double arrows between the Diagnostic Process and the Reference Seed Library, patient samples can be integrated into the reference samples (Reference Seed Library) once the diagnosis associated with the sample is known.
(39) As generally preferred, the sample to be analysed (Patient Sample) in admixture with the same native conformation prion protein (separated admixtures for each of -Syn, Tau and A) as at least one reference sample of the Reference Seed Library is subjected to the same at least one shear-force intensity (SSA), and amounts of aggregated conformation prion protein are measured. Generally preferred, the sample to be analysed is of the same type as the reference sample, e.g. blood serum, lymph fluid, urine, CSF or a tissue sample.
(40) The amount of aggregated conformation prion protein generated at specific shear-force intensities generated for a sample (Patient sample) is compared to the amount of aggregated conformation prion protein generated at the same shear-force intensities for the same native conformation prion protein (A, Tau, -Syn) each (Computer), allowing the identification (Diagnosis) of the diagnosis associated to the reference sample in the databank (Reference Information Database) by this comparison.
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(42) Further,
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(44) The container 8 provided for receiving a sample 20 is arranged within a housing 7, which preferably at least sectionally is a thermostat T, preferably having form fit to the container 8. Preferably, the thermostat T for each container 8 has a temperature sensor and is independently computer-controlled. The open end of the container 8 is closed by a lid 6 and a seal 5. As shown, the section of housing 7 embracing the section of container 8 between extensions 10e of stator 10 and the bottom of the container 8 opposite its opening is provided with a light source 17 arranged to irradiate the inner volume of the container 8 and an optical detector 14 arranged to receive irradiation exiting the inner volume of the container 8, wherein preferably the beam path of the light source 17 crosses the beam path of the optical detector 14 in the area between the inlet 10i and the bottom of the container 8. The beam path 19 generated by the light source 17 can cross the exiting beam path 11 towards the optical detector 14 e.g. at an angle of 90. Both the light source 17 and the optical detector 14 are coupled to a computer for control of the light source 17 and for receiving measurement signals from the detector 14. In the exiting beam path 11, a wavelength discriminator 13, e.g. an optical filter can be arranged. In the beam path 19 generated by the light source 17, a wavelength discriminator 18, e.g. an optical filter can be arranged. The housing 12 for the detector 14 and/or for the light source 17 has a dataline 16 for transmitting data on irradiation and measurement signals to a computer. Optionally, a control unit 15 for controlling the thermostat T and/or the light source 17 is arranged at the housing 12. Preferably, housing 12 containing the light source 17, optionally provided with a wavelength discriminator 18, and optical detector 14, optionally provided with a wavelength discriminator 13, form an integrated optical unit O. The optical unit O can be mounted releasably to thermostat T and to adjacent lid section L, wherein these elements form a recess for receiving a portion of container 8.
(45) The scale indicated in
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(47) The container 8 can e.g. have a circular, oval or egg-shaped cross-section, and the rotor 9 can be arranged within a part of the cross-section having a smaller or larger diameter.
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REFERENCE NUMERALS
(49) TABLE-US-00001 1 connection 2 drive control unit 3 drive motor 4 coupling 5 seal 6 lid 7 housing 8 container 9 rotor 9a axle 10 stator 10e extensions 10o outlet opening 10i inlet 11 exiting light path 12 housing containing optical detector and light source 13 wavelength discriminator 14 optical detector 15 control unit 16 dataline 17 light source 18 wavelength discriminator 19 beam path from light source 20 sample D drive L lid section T thermostat S sample compartment O optical unit