GM hybridoma cell, monoclonal antibody, kit and preparation method and use thereof
10428139 ยท 2019-10-01
Assignee
Inventors
- Chunlong Liu (Tianjin, CN)
- Jie Peng (Tianjin, CN)
- Zhou Zhang (Tianjin, CN)
- Shuanzhu Zhai (Tianjin, CN)
- Ning Li (Tianjin, CN)
- Yan SU (TIANJIN, CN)
- Zeqi ZHOU (TIANJIN, CN)
Cpc classification
C07K16/14
CHEMISTRY; METALLURGY
C07K16/44
CHEMISTRY; METALLURGY
International classification
C07K16/00
CHEMISTRY; METALLURGY
C07K16/14
CHEMISTRY; METALLURGY
Abstract
The present invention provides a hybridoma cell under the accession number CGMCC No. 13827. The hybridoma cell is capable of producing a monoclonal antibody against Aspergillus galactomannan antigen and a kit is prepared using the same. The kit provided by the present invention can specifically bind to the GM antigen, has both sensitivity and specificity of more than 95%, a detection limit of 0.85 ng/mL compared to 1 ng/mL of the existing product, and high compliance rate between the detection result and the reference reagent, and can provide more accurate and reliable detection results, so that IA can be detected early in the course of the disease and the patients can receive treatment in timely and effective manner, thereby improving the survival rate of patients. Moreover, the kit has simple and convenient operation, rapid and sensitive detection, which provides an effective tool for the quantitative detection of Aspergillus GM antigen.
Claims
1. A hybridoma cell or a passage cell thereof having an accession number of CGMCC No. 13827.
2. A monoclonal antibody or a specific antigen-binding fragment thereof, wherein the monoclonal antibody is produced by the hybridoma cell of claim 1, and the specific antigen-binding fragment is capable of specifically binding to Aspergillus galactomannan antigen.
3. The monoclonal antibody or specific antigen-binding fragment thereof of claim 2, wherein the specific antigen-binding fragment is selected from the group consisting of (Fab)2, Fab, Fv, scFv, diabody, linear antibody or multispecific antibody.
4. A detection kit comprising the monoclonal antibody or specific antigen-binding fragment thereof of claim 2.
5. The detection kit of claim 4, wherein the specific antigen-binding fragment is selected from the group consisting of (Fab).sub.2, Fab, Fv, scFv, diabody, linear antibody or multispecific antibody.
6. The kit of claim 4, further comprising one or more of a buffer of a coating solution, a blocking solution, and a sample treatment solution.
7. The kit of claim 6, wherein the buffer of the coating solution is selected from the group consisting of 0.1 mol/L Tris-HCl, 0.1 mol/L PBS, 0.05 mol/L CBS, 0.1 mol/L CBS, 0.2 mol/L CBS, and normal saline; the blocking solution is selected from the group consisting of 2% newborn calf serum, 5% newborn calf serum and 8% newborn calf serum; and the sample treatment solution is selected from the group consisting of 0.03 mol/L EDTA, 0.1 mol/L EDTA, 0.12 mol/L EDTA, 0.05 mol/L proteinase K, 0.1 mol/L proteinase K, 0.2 mol/L proteinase K, 5% DMSO, 15% DMSO and 30% DMSO.
8. The kit of claim 6, wherein the sample treatment solution is 0.12 mol/L EDTA.
9. The kit of claim 6, wherein the buffer of the coating solution is 0.1 mol/L Tris-HCl with a pH of 6.0-9.0.
10. The kit of claim 6, wherein the blocking solution is 8% newborn calf serum.
11. The kit of claim 4, further comprising a galactomannan antigen-coated solid phase carrier and a galactomannan antigen standard.
12. The kit of claim 4, wherein the monoclonal antibody is an enzyme-labeled monoclonal antibody.
13. The kit of claim 4, wherein the monoclonal antibody is a monoclonal antibody not labeled with an enzyme, and the kit further comprises an enzyme-labeled secondary antibody, and the enzyme-labeled secondary antibody can bind to the monoclonal antibody.
14. A preparation method of the monoclonal antibody or specific antigen-binding fragment thereof of claim 2, including a step of culturing a hybridoma cell or passage cell thereof having an accession number of CGMCC No. 13827.
15. The preparation method of claim 14, wherein the specific antigen-binding fragment is selected from the group consisting of (Fab).sub.2, Fab, Fv, scFv, diabody, linear antibody or multispecific antibody.
16. A method for detecting Aspergillus infection, comprising a step of detecting GM antigen with the monoclonal antibody or specific antigen-binding fragment thereof of claim 2 by competitive ELISA.
17. The method of claim 16, wherein the specific antigen-binding fragment is selected from the group consisting of (Fab).sub.2, Fab, Fv, scFv, diabody, linear antibody or multispecific antibody.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1)
(2)
(3)
DETAILED DESCRIPTION OF THE INVENTION
Example 1 Preparation of Aspergillus Galactomannan (GM) Antigen
(4) The GM antigen was prepared using Aspergillus, and the Aspergillus strain used in the present invention was purchased from the American Type Culture Collection (ATCC) under the accession number ATCC 1022.
(5) Aspergillus was cultured in a solid medium until the medium was covered with green spores. The hyphae were removed by filtration. The cells and spores were inactivated. After centrifugation, the spores were collected and washed, and crushed and filtered to remove spore fragments. The filtrate was subjected to alcohol precipitation and washing to obtain a crude GM antigen extract. The crude GM antigen extract was decolorized and ultrafiltered to obtain a GM antigen.
(6) The solid medium is selected from the group consisting of PDA medium, Sabouraud medium or czapek's medium; preferably is PDA medium. Specific steps are as follows:
(7) 1. Preparation of Crude GM
(8) 2.0 L of PDA solid medium was prepared, the composition of which was 600 g of supernatant of boiled potato, 80.0 g of D-glucose, and 30.0 g of agar powder. Aspergillus strain was cultured in the medium at 25 C. for 3 days until the medium was covered with green spores. The spores were rinsed with sterile normal saline. The obtained spore suspension was filtered through 8 layers of sterile gauze 3 times to remove hyphae. Formaldehyde was added to the spore suspension to a final concentration of 3.7%, and the mixture was allowed to stand at 4 C. for 24 h to inactivate the cells and spores. The spores were collected by centrifugation at 12,000 g for 30 min at 4 C., and washed 6 times with sterile normal saline to remove formaldehyde which may be present. The spores frozen with liquid nitrogen were repeatedly ground. Then sterile normal saline was added thereto. Then the spores were broken with an ultrasonic cell disruptor. The resulting fluid containing the broken spores was filtered through a qualitative filter paper, and the filtrate was filtered through a 0.45 m filter membrane to remove spore fragments. The resulting filtrate was transferred to a clean container, and 2.5 times by volume of absolute ethanol was added thereto. The mixture was allowed to stand at 4 C. overnight, and then centrifuged at 12,000 g for 30 min at 4 C. The resulting precipitate was dissolved in deionized water, and 2.5 times by volume of absolute ethanol was added thereto. The mixture was allowed to stand for 2 hours, and then centrifuged to separate the precipitate. The resulting precipitate was washed 3 times with absolute ethanol, and centrifuged at 12,000 g for 30 min at 4 C. The supernatant was discarded, and a crude GM was obtained.
(9) 2. Decolorization of Crude GM by Adsorption With Activated Carbon. The Specific Steps are as Follows
(10) GM was dissolved in 200 mL of deionized water. 3.0 g of activated carbon powder was slowly added thereto while stirring. The mixture was decolorized at 4 C. for 4 hours. After the claybank color of the solution was faded, it was filtered with a Buchner funnel repeatedly until the solution was clarified to obtain a GM extract from which the pigment was removed.
(11) 3. Purification of GM by Ultrafiltration. The Specific Steps are as Follows
(12) The GM extract was suction filtered at room temperature to remove activated carbon particles. The resulting filtrate was filtered through a 0.22 m filter membrane. The resulting filtrate was transferred to a 10 KD centrifugal ultrafiltration tube, and centrifuged at 4000 g for 20 min to obtain a high-purity GM.
(13) 4. Purification of GM, and Detection of Polysaccharide, Protein and Nucleic Acid Content of the Obtained GM Sample
(14) 1) The polysaccharide content of the pure GM antigen obtained above was determined by the Dubois-sulfuric acid phenol method. The detection results are shown in Table 1-1, Table 1-2, and
(15) TABLE-US-00001 TABLE 1-1 Polysaccharide content in pure GM antigen Polysaccharide content Sample name (mg/mL) OD485 Standard 0 0.118 1.25 0.257 2.5 0.495 5 0.837 7.5 1.155 10 1.532 Detected 2.203 0.425 sample
(16) TABLE-US-00002 TABLE 1-2 Polysaccharide content in pure GM antigen Polysaccharide Volume (mL) content (mg) Detected 0.04 0.088 sample All samples 100 220
(17) It can be seen from the detection results that 220 mg of pure Aspergillus fumigatus galactomannan antigen can be finally obtained from 2 L of Aspergillus fumigatus culture medium by the preparation method.
(18) 2) The pure GM antigen sample obtained by the preparation method was subjected to ultraviolet absorption detection. The samples were detected at the wavelength of UV 260 nm, UV 280 nm, and UV 320 nm, respectively. The results are shown in Table 2 below. As can be seen from the detection results, the total content of nucleic acids and proteins did not exceed 4% of the total mass of the sample.
(19) TABLE-US-00003 TABLE 2 DNA and protein content in pure GM antigen Detection items Concentration Content (%) DNA 3.641 g/mL 0.16 Protein 74.583 g/mL 3.27 Polysaccharide 2.203 mg/mL 96.57
(20) 5. Purification of GM, and HPLC Detection of the Obtained GM Sample
(21) The purified sample of the GM antigen obtained by the preparation method was subjected to HPLC detection. The detector was a refractive index detector. The detection results are shown in
(22) 6. Purification of GM Antigen by the Preparation Method, and Identification of the Antigen of the Obtained Pure GM Antigen Sample by Aspergillus fumigatus Antigen Detection Kit of Bio-Rad Laboratories
(23) At present, the GM antigen is generally detected by the Aspergillus fumigatus antigen detection kit of Bio-Rad Laboratories in the world. The GM antigen sample was detected with this kit at a sample concentration of 1 ng/mL. The detection results are shown in Table 3 below. As can be seen from the results, the GM antigen was positive and the OD value was greater than the positive control, indicating that the galactomannan antigen of Aspergillus fumigatus can be obtained by the method of the present invention.
(24) TABLE-US-00004 TABLE 3 Detection results of antigen identification using Bio-Rad Aspergillus fumigatus antigen detection kit Sample OD450 OD450 mean Blank control 0.045 0.046 0.046 0.046 Negative quality control 0.083 0.076 0.087 0.082 Positive quality control 0.972 0.951 0.936 0.953 Cut off quality control 0.408 0.389 0.419 0.405 Detected sample 1.352 1.408 1.315 1.358
Example 2 GM Antigen Modification
(25) It is well known that the molecular size of a substance may affect its immunogenicity. The molecular weight of an effective immunogen is mostly above 10 kD. The larger the molecular weight, the stronger the immunogenicity. This may be because a macromolecular substance is easy to form a colloid in an aqueous solution, which stays in the body for a long time, has a great chance of contact with the immune cells, and is beneficial to stimulate the body to generate an immune response. In addition, the macromolecular substance has a relatively complex chemical structure, and thus has relatively many types and numbers of effective antigen genes.
(26) The GM antigen obtained in Example 1 had a small molecular weight and poor immunogenicity, and needed to be coupled with a related macromolecular substance to enhance its immunogenicity. The macromolecule substance is one or more of latex microspheres, KLH (keyhole limpet hemocyanin), BSA (bovine serum albumin), and GST. A part of the coupling requires the addition of a crosslinking agent to promote the improvement of the crosslinking rate, and the obtained antigen polypeptide fragment can be used to immunize an animal.
(27) In this example, the aminated latex microspheres were taken as an example. The specific coupling method is as follows:
(28) 1. 1 mL of microspheres (100 mg/mL) was washed twice with 10 mL of a washing/coupling buffer;
(29) 2. the microspheres were resuspended in 10 mL of glutaraldehyde solution (glutaraldehyde dissolved in the washing/coupling buffer at a concentration of 10%) to ensure sufficient suspension;
(30) 3. the mixture was reacted at room temperature (18-25 C.) for 1-2 h, and continuously stirred;
(31) 4. the microspheres were washed twice with the coupling buffer, and resuspended in 5 mL of the coupling buffer to ensure sufficient suspension;
(32) 5. an antigen was dissolved in 5 mL of the coupling buffer and mixed with the suspended microspheres;
(33) 6. the mixture was reacted at room temperature for 2-4 h, and continuously stirred;
(34) 7. the microspheres were washed, resuspended in 10 mL of a stop solution, gently stirred for 30 min, washed, resuspended in a storage buffer at a suitable concentration (usually 10 mg/mL); and
(35) 8. the microspheres were stored at 4 C. for use.
Example 3 Preparation of Anti-GM Antigen Monoclonal Antibody
(36) Preparation of Anti-GM Antigen Monoclonal Antibody
(37) 1 Animal Immunity
(38) Animals were immunized with GM antigen. Wherein, the immunization may be performed by subcutaneous injection, footpad injection, intrasplenic injection, intravenous injection or intraperitoneal injection, etc.; and the animals may be selected from rats, mice, guinea pigs, rabbits, chickens, sheep, horses, pigs or donkeys, etc. In this example, rabbits were used as animals for immunization. The specific steps are as follows:
(39) The GM antigen and a Freund's complete adjuvant were mixed in an equal volume to a suitable volume, fully emulsified, and then injected into New Zealand white rabbits by subcutaneous multiple-point injection at an immunizing dose controlled at 0.01-0.1 mg per rabbit. Three days before immunization, ear blood was taken, and serum was separated as a negative control. The immunization was performed once every 2 weeks after the initial immunization, and the method was the same as the first time. The serum titer of the rabbit after immunization was measured.
(40) 2. Cell Fusion
(41) An immune spleen cell refers to a B lymphoblast in an immune state in the spleen: plasmablast. Generally, the spleen 3 days after the last booster immunization is used to prepare a cell suspension. Since the proportion of B lymphocytes is large at this time, the success rate of cell fusion is relatively high.
(42) First, the spleen was taken, and myeloma cells were activated. The myeloma cells were fused with spleen cells at a ratio of 1:10. The PEG fusion method was employed.
(43) 3. Screening and Cloning of Hybridoma Cells
(44) After cell fusion, there are two parental cells and three randomly fused cells in the medium. In order to obtain hybridoma cells capable of secreting the target antibody, it is necessary to separate the successfully fused hybridoma cells from a large number of cells. Since B lymphocytes cannot survive in vitro for a long time, only myeloma cells and their own fused cells need to be removed. Therefore, it is necessary to culture the fused cells through a HAT medium to selectively retain the hybridoma cells.
(45) On the 5th day after fusion, the growth of the cells could be observed. On the 10th to 14th day, the cell culture supernatant could be detected by indirect ELISA, and the positive hybridoma cells could be screened for cloning culture. The positive hybridoma cells were cloned and cultured by limiting dilution method. The positive hybridoma cells with the strongest titer of the detection results were expanded to a cell positive rate of 100%, and the cells were for further use. The titer of the culture supernatant of the hybridoma cells was measured by ELISA. The monoclonal hybridoma cells expanded in the culture were frozen in liquid nitrogen. The hybridoma cells were deposited with the China General Microbiological Culture Collection Center under the accession number of CGMCC No. 13827.
(46) 4. Preparation of Ascites
(47) New Zealand white rabbits were injected intraperitoneally with 0.5 mL of paraffin oil. After 2 weeks, the hybridoma cells were collected and suspended in normal saline. 1 to 510.sup.6 cells were suspended per 1 mL of normal saline. Then, each rabbit was intraperitoneally injected with 0.5 mL of the cell suspension and injected with a mixture of equal amounts of paraffin and Freund's incomplete adjuvant. After about 7-10 days, after the ascites was obviously produced, the rabbits were sacrificed, their abdominal cavities were cut open to suck and collect the ascites. The ascites was centrifuged at 12000 r/min for 15 min, added with an appropriate amount of a preservative, and stored at 4 C.
(48) 5. Purification of Monoclonal Antibody
(49) Preliminary purification with saturated ammonium sulfate salting-out method:
(50) 2 mL of ascites sample was added with an equal volume of normal saline, followed by 4 mL of saturated ammonium sulfate solution, and the mixture was precipitated overnight at 4 C.;
(51) the above mixture was centrifuged at 10000 g for 10 min at a low temperature, the supernatant was discarded, the precipitate was dissolved in 2 mL of PBS, and 1 mL of saturated ammonium sulfate solution was slowly added dropwise thereto, and the mixture was allowed to stand at 4 C. for 1 hour;
(52) the above mixture was centrifuged at 10000 g for 10 min at a low temperature, the supernatant was discarded, the precipitate was dissolved in 1 mL of PBS and dialyzed with a PBS solution overnight at 4 C.
(53) Further purification with affinity chromatography:
(54) the column was washed with 5-10 bed volumes of elution buffer;
(55) the column was washed with 5-10 bed volumes of coupling buffer;
(56) the sample which was initially purified with saturated ammonium sulfate salting-out method was loaded;
(57) the column was washed with 5-10 bed volumes of coupling buffer; and
(58) the column was eluted with 2-5 bed volumes of elution buffer to obtain an anti-GM antigen monoclonal antibody.
(59) Wherein, the elution buffer is selected from the group consisting of 0.1 mol/L glycine buffer, PB buffer, citric acid-phosphate buffer, citric acid-sodium citrate buffer or acetic acid-sodium acetate buffer, pH 3.0; and the coupling buffer is selected from the group consisting of PBS buffer, Tris-HCl buffer, and acetic acid-sodium acetate buffer, preferably is PBS buffer.
(60) Preparation of Aspergillus Galactomannan (GM) Antigen Immunoassay Kit
(61) The specific preparation method is as follows:
(62) I. Preparation of GM Antigen-Coated ELISA Plate
(63) 1. Preparation of GM Antigen Coating Solution
(64) The GM antigen is diluted to 100 ng/mL-10 g/mL with a buffer solution. The buffer solution is selected from the group consisting of: 0.1 mol/L Tris-HCl buffer with a pH of 6.0-9.0, 0.1 mol/L PBS buffer with a pH of 6.0-9.0, 0.05-0.2 mol/L CBS buffer with a pH of 6.0-9.0, or normal saline.
(65) 2. Preparation of Blocking Solution
(66) 2%-8% of newborn calf serum is added to a buffer solution to prepare a blocking solution. The buffer solution is selected from the group consisting of: 0.1 mol/L Tris-HCl buffer with a pH of 6.0-9.0, 0.1 mol/L PBS buffer with a pH of 6.0-9.0, 0.05-0.2 mol/L CBS buffer with a pH of 6.0-9.0, or normal saline.
(67) 3. ELISA Plate Coating
(68) The prepared GM antigen coating solution is added into the well of an ELISA plate, 50-150 L (preferably 100 L) per well. The ELISA plate is coated at 12-18 C. (preferably 15 C.) for 6-8 h (preferably 7 h). The prepared blocking solution is added into the well of the ELISA plate, 50-150 L (preferably 100 L) per well, which is placed in an incubator at 12-18 C. (preferably 15 C.) for 2-4 h (preferably 3 h). The ELISA plate is taken out from the incubator. After discarding the blocking solution, the ELISA plate is incubated at a constant temperature of 20-25 C. (preferably 22 C.) for 2-4 h (preferably 3 h).
(69) The ELISA plate may be modified prior to coating. The method includes placing the ELISA plate on a medical purification operation table equipped with an ultraviolet lamp, fixing the vertical distance between the ultraviolet lamp and the ELISA plate base, and selecting the different time periods to perform ultraviolet treatment on the ELISA plate.
(70) II. Preparation of Standards (Establishment of Quantitative Standard Curve)
(71) The standard is prepared by diluting GM antigen with 0.1 mol/L PBS. The concentrations of GM antigen are 5 ng/mL, 2.5 ng/mL, 1 ng/mL, 0.5 ng/mL, and 0.25 ng/mL, respectively.
(72) III. Preparation of Anti-GM Antigen Monoclonal Antibody Solution
(73) The anti-GM antigen monoclonal antibody solution is prepared by diluting the anti-GM antigen monoclonal antibody with an enzyme conjugate stabilizer at a ratio of 1:20000-1:40000 (preferably 1:30000).
(74) The enzyme conjugate stabilizer is an agent capable of maintaining the stability between the antibody and the enzyme conjugate, and is capable of maintaining the activity of the antibody and the enzyme. Preferably, it may be an HRP enzyme conjugate stabilizer. The enzyme conjugate stabilizer in the present invention may be a commercially available product.
(75) IV. Preparation of Enzyme-Labeled Secondary Antibody Solution
(76) The enzyme-labeled secondary antibody solution is prepared by diluting a horseradish peroxidase (HRP)-labeled goat anti-rabbit secondary antibody with a HRP enzyme conjugate stabilizer at a ratio of 1:5000-1:20000 (preferably 1:10000).
(77) V. Sample Treatment Solution
(78) The sample treatment solution is a protein degeneration solution, preferably one or more selected from the following protein degeneration solutions: 0.05-0.2 mg/mL proteinase K, 0.03-0.18 mol/L EDTA (ethylene diamine tetraacetic acid) solution with a pH of 2-10, 5-30% DMSO (dimethyl sulfoxide) solution, and 1-8 mol/L urea with a pH of 7.0-8.0.
(79) VI. Concentrated Wash Solution (200.01 M PBS)
(80) The concentrated wash solution is a Tween-20-containing PBS solution (abbreviated as PBST solution), wherein the PBST solution may contain a biological liquid preservative such as ProClin300. In this example, the concentrated wash liquid was selected as follows:
(81) in parts by weight, 160.0 parts of sodium chloride, 4.0 parts of potassium chloride, 31.6 parts of disodium hydrogen phosphate dodecahydrate, 2.8 parts of potassium dihydrogen phosphate, 0.2 part of Tween-20, 2 parts of ProClin300, and 1000 parts of ultrapure water, which were uniformly mixed.
(82) VII. Sample Diluent
(83) The sample diluent may be a CBS dilution containing 5-15% dried skim milk, BSA or bovine serum. In this example, a CBS dilution containing 10% dried skim milk was selected.
(84) VIII. Substrate Solution
(85) The substrate solution may be OPD (o-phenylenediamine), OT (o-toluidine), ABTS (2,2-azino-bis(3-ethylbenzothiazole-6-sulfonic acid)) or p-NPP (p-nitrophenyl phosphate), preferably tetramethylbenzidine (3,3,5,5-Tetramethylbenzidine, TMB).
(86) IX. Stop Solution
(87) The stop solution may be a 1-10 mol/L sulfuric acid solution, preferably a 2 mol/L sulfuric acid solution, which is prepared by diluting concentrated sulfuric acid with ultrapure water in a ratio of 1:8.
(88) The present application tested various conditions in the above preparation methods. Wherein, in Examples 4-9, the effects of different GM antigen coating solutions on the detection repeatability of the kit were investigated; in Examples 10-11, the effects of different blocking solutions on the detection repeatability of the kit were investigated; and in Examples 12-18, the effects of different sample treatment solutions on the detection repeatability and recovery rate of the kit were investigated. The specific examples are shown in Table 4 below.
(89) TABLE-US-00005 TABLE 4 Types and concentrations of coating solution, blocking solution and sample treatment solution in each of the examples Final Buffer in the coating concentration of Sample treatment Examples solution GM antigen Blocking solution solution Example 4 0.1 mol/L Tris-HCl 100 ng/mL 2% newborn calf 0.03 mol/L EDTA serum Example 5 0.1 mol/L PBS 100 ng/mL 2% newborn calf 0.03 mol/L EDTA serum Example 6 0.05 mol/L CBS 100 ng/mL 2% newborn calf 0.03 mol/L EDTA serum Example 7 0.1 mol/L CBS 100 ng/mL 2% newborn calf 0.03 mol/L EDTA serum Example 8 0.2 mol/L CBS 100 ng/mL 2% newborn calf 0.03 mol/L EDTA serum Example 9 Normal saline 100 ng/mL 2% newborn calf 0.03 mol/L EDTA serum Example 10 0.1 mol/L Tris-HCl 5 g/mL 8% newborn calf 0.1 mol/L EDTA serum Example 11 0.1 mol/L Tris-HCl 5 g/mL 5% newborn calf 0.1 mol/L EDTA serum Example 12 0.1 mol/L Tris-HCl 10 g/mL 8% newborn calf 0.12 mol/L EDTA serum Example 13 0.1 mol/L Tris-HCl 10 g/mL 8% newborn calf 0.05 mol/L Proteinase K serum Example 14 0.1 mol/L Tris-HCl 10 g/mL 8% newborn calf 0.1 mol/L Proteinase K serum Example 15 0.1 mol/L Tris-HCl 10 g/mL 8% newborn calf 0.2 mol/L Proteinase K serum Example 16 0.1 mol/L Tris-HCl 10 g/mL 8% newborn calf 5% DMSO serum Example 17 0.1 mol/L Tris-HCl 10 g/mL 8% newborn calf 15% DMSO serum Example 18 0.1 mol/L Tris-HCl 10 g/mL 8% newborn calf 30% DMSO serum
Example 19 Preparation of Enzyme-Labeled Anti-GM Antigen Monoclonal Antibody Solution
(90) The horseradish peroxidase-labeled anti-GM antigen monoclonal antibody was diluted with a HRP enzyme conjugate stabilizer at a ratio of 1:20000.
Example 20 Detection Steps of Aspergillus Galactomannan Antigen Immunoassay Kit
(91) Two-Step Method:
(92) a) a sample to be tested is mixed with a sample treatment solution in a volume ratio of 1:1 to 5:1 and boiled for 1-10 min, and then centrifuged to obtain a substance to be detected;
(93) b) a GM antigen standard and the substance to be detected of step a) are separately mixed with an anti-GM antigen monoclonal antibody in an equal volume and incubated for 60 min-120 min;
(94) c) the mixture of step b) is added to a GM antigen-coated ELISA plate and incubated for 60 min-120 min, and the plate is washed after incubation;
(95) d) the ELISA plate of step c) is added with an enzyme-labeled secondary antibody and incubated for 20-60 min, and the plate is washed after incubation; and
(96) e) the ELISA plate of step d) is added with a substrate solution for color development for 10-15 min, and then added with a stop solution followed by determination, the absorbance value at 450 nm is read on a microplate reader, and the antigen is detected by a standard curve. The specific steps are as follows:
(97) I. Treatment of Sample
(98) 1) a sample to be tested and a sample treatment solution are mixed at a volume ratio of 1:3 and then placed in a boiling water bath for 1 min;
(99) 2) the mixture after the water bath treatment is centrifuged at 1,000 g for 1 min; and
(100) 3) the supernatant after centrifugation is used for detection.
(101) II. Detection Steps
(102) 1) a 96-well ELISA plate that has been pre-coated with an antigen is taken;
(103) 2) preparation of working wash solution: a concentrated wash solution is diluted 20 times (1 part of concentrated wash solution (200.01M PBS) is added with 19 parts of sterile deionized water or ultrapure water);
(104) 3) sample mixing: a standard curve group and a sample group to be tested are set, respectively, wherein,
(105) standard curve group: each standard curve point (the concentration of GM antigen standards are 5, 2.5, 1, 0.5, 0.25 ng/mL, respectively), and
(106) sample group to be tested: sample to be tested after treatment,
(107) the two groups of samples are separately mixed with a rabbit-derived anti-GM antigen monoclonal antibody in equal volumes, and the mixtures are separately transferred to the wells of an ELISA plate, 60 L per well, and incubated at 37 C. for 60 min;
(108) 4) washing: the reaction solution was removed by swing, then each well is added with not less than 300 L of wash solution each time, allowed to stand for 40 s and then patted dry, and the above washing operation is repeated 3 times;
(109) 5) addition of enzyme-labeled secondary antibody: after washing, each well is added with 60 L of enzyme-labeled goat anti-rabbit secondary antibody, and incubated at 37 C. for 20 min;
(110) 6) washing: the same as step 4);
(111) 7) color development: after washing, each well is added with 60 L of a substrate solution, and incubated at 37 C. for 15 min, protected from light;
(112) 8) stopping: each well is added with 50 L of a stop solution, and uniformly mixed, the absorbance values are read at OD450 nm; and
(113) 9) calculation of results: the absorbance measurement values of the standard solution and the sample to be tested are respectively input in a computer, and the concentration values of the GM antigen in each sample to be tested are automatically calculated according to the semi-logarithmic standard curve and the equation drawn by a calculation software.
(114) Alternatively, Detection Steps of Aspergillus Galactomannan Antigen Immunoassay Kit (One-Step Method)
(115) a) a sample to be tested is mixed with a sample treatment solution in a volume ratio of 1:1 to 5:1 and boiled for 1-10 min, and then centrifuged to obtain a substance to be detected;
(116) b) a GM antigen standard and the substance to be detected of step a) are separately mixed with an enzyme-labeled anti-GM antigen monoclonal antibody in an equal volume, and added to a GM antigen-coated ELISA plate and simultaneously incubated for 60-120 min, and the plates are washed after incubation; and
(117) c) the ELISA plate of step b) is added with a substrate solution for color development for 10-15 min, and then added with a stop solution followed by determination, the absorbance value at 450 nm is read on a microplate reader, and the antigen is detected by a standard curve. The specific steps are as follows:
(118) 1), and 2) are the same as 1) and 2) of the two-step method;
(119) 3) sample mixing: a standard curve group and a sample group to be tested are set, respectively, wherein,
(120) standard curve group: each standard curve point (the concentration of GM antigen standards are 5, 2.5, 1, 0.5, 0.25 ng/mL, respectively),
(121) sample group to be tested: sample to be tested after treatment,
(122) the two groups of samples are separately mixed with an enzyme-labeled anti-GM antigen monoclonal antibody in equal volumes, and the mixtures are separately transferred to the wells of an ELISA plate, 80 L per well, and incubated at 37 C. for 90 min;
(123) 4) washing: the same as above;
(124) 5) color development: the same as above;
(125) 6) stopping: the same as above; and
(126) 7) calculation of results: the same as above.
Example 21 Clinical Application of Aspergillus Galactomannan Antigen Immunoassay Kit
(127) Using the kit of Example 10, the clinical application of the kit was tested in accordance with the two-step detection steps of Example 20.
(128) 1. Drawing of Standard Curve
(129) Using the kit of Example 10, according to the detection steps of Example 20, the measured values of the respective standard curve points (5, 2.5, 1, 0.5, and 0.25 ng/mL) were obtained, as shown in Table 5. Using the data in Table 5, a standard curve, as shown in
(130) TABLE-US-00006 TABLE 5 Test standard curve Antigen concentration (ng/mL) OD450 5 0.416 2.5 0.558 1 0.756 0.5 0.906 0.25 1.045
(131) 2. Determination of Reference Value of GM Antigen Immunoassay Kit
(132) The samples, 30 positive samples clinically diagnosed as Aspergillus infection and 200 normal samples, were treated. The OD450 values were measured with the detection steps of Example 20 using the kit of Example 4. The GM antigen concentration values, as shown in Table 6, were calculated according to the standard curve (Table 5,
(133) TABLE-US-00007 TABLE 6 ELISA clinical detection results of reference value of GM antigen immunoassay kit Number of GM concentration Groups cases (
(134) The concentration of the detected GM antigen was calculated according to the results of the standard curve. By detecting 200 normal samples, the concentration value of the antigen in the 95% confidence interval was taken as the Cut-off lower limit:
(135) TABLE-US-00008 TABLE 7 Determination standard reference value of GM antigen immunoassay kit Positive Suspected Negative Antigen 0.65 ng/mL Antigen Antigen concentration concentration 0.85 ng/mL concentration 0.85 ng/mL 0.65 ng/mL
(136) If the detection result of the sample falls within the interval of Suspected, a secondary detection is required.
Example 22 Methodological Study of Kit
(137) Using the kit of Example 10, the methodologies of the kit (sensitivity experiment, specificity experiment, recovery rate experiment, repeatability experiment, and stability test) were studied in accordance with the detection steps of Example 20.
(138) 1. Sensitivity Experiment
(139) 20 clinically diagnosed samples were collected for detection.
(140) Diagnostic sensitivity=number of positive samples detected/total number of positive samples100%. The experimental results are shown in Table 8. As can be seen from the results, the sensitivity of this experiment was above 95%.
(141) TABLE-US-00009 TABLE 8 Sensitivity experiment results Serial Calculated antigen Result number OD450 concentration (g/L) determination 1 0.695 1.33 Positive 2 0.570 2.4 Positive 3 0.625 1.85 Positive 4 0.493 3.45 Positive 5 0.720 1.18 Positive 6 0.593 2.15 Positive 7 0.502 3.31 Positive 8 0.637 1.75 Positive 9 0.576 2.33 Positive 10 0.708 1.25 Positive 11 0.819 0.74 Suspected 12 0.493 3.45 Positive 13 0.634 1.77 Positive 14 0.503 3.3 Positive 15 0.674 1.47 Positive 16 0.627 1.83 Positive 17 0.612 1.97 Positive 18 0.434 4.57 Positive 19 0.494 3.44 Positive 20 0.768 0.94 Positive
(142) 2. Specificity Experiment
(143) 20 healthy human samples were detected.
(144) Specificity=number of negative samples detected/total number of negative samples100%. The experimental results are shown in Table 9. As can be seen from the results, the specificity of this experiment was above 95%, and only one of the samples was detected as a suspected patient, which required a secondary detection.
(145) TABLE-US-00010 TABLE 9 Specificity experiment results Calculated antigen Serial concentration Result number OD450 (g/L) determination 1 0.915 0.47 Negative 2 0.971 0.36 Negative 3 0.919 0.46 Negative 4 0.849 0.64 Negative 5 0.910 0.48 Negative 6 0.989 0.33 Negative 7 0.996 0.32 Negative 8 0.893 0.52 Negative 9 0.938 0.42 Negative 10 1.040 0.26 Negative 11 0.902 0.5 Negative 12 0.977 0.35 Negative 13 0.989 0.33 Negative 14 0.802 0.8 Suspected 15 0.885 0.54 Negative 16 0.954 0.39 Negative 17 0.954 0.39 Negative 18 0.893 0.52 Negative 19 0.906 0.49 Negative 20 0.870 0.58 Negative
(146) 3. Recovery Rate Experiment
(147) Normal human blood was added with Aspergillus galactomannan antigen to a concentration of 2 g/L and 1 g/L, and detected. The ratio of the true value to the expected value was calculated to obtain the recovery rate, as shown in Table 10. The recovery rate between 80-120% was considered acceptable. The experimental results showed that the recovery rate of this experiment was between 80% and 120%, indicating that the recovery rate is good. Moreover, when the concentration of the added antigen was 2 g/L, the recovery rate was between 92% and 102%, which is closer to 100%.
(148) TABLE-US-00011 TABLE 10 Recovery rate experiment results Calculated antigen Recovery OD450 concentration (g/L) rate Concentration of the added 0.627 1.83 92% antigen: 0.621 1.89 95% 2 g/L 0.605 2.03 102% 0.622 1.88 94% 0.615 1.94 97% 0.624 1.86 93% 0.617 1.92 96% Concentration of the added 0.780 0.89 89% antigen: 0.770 0.93 93% 1 g/L 0.747 1.04 104% 0.780 0.89 89% 0.766 0.95 95% 0.785 0.87 87% 0.764 0.96 96%
(149) 4. Repeatability Experiment
(150) 1) Inter-Assay Precision
(151) Criterion of acceptability: The same sample was tested once a day for 11 working days in the different batches of experiments, and its mean M, standard deviation SD and coefficient of variation CV were calculated. A kit with a coefficient of variation of CV25% was considered qualified. The results are shown in Table 11. Conclusion: The inter-assay precision (CV) of this product was 3%, which is far less than 25% and in line with the standard. It proves that the product has an excellent inter-assay precision, very small inter-assay dispersion degree and good repeatability.
(152) TABLE-US-00012 TABLE 11 Inter-assay precision experiment results Inter-assay precision summary Working day Calculated antigen (d) concentration (g/L) 1 1.78 2 1.69 3 1.75 4 1.68 5 1.74 6 1.82 7 1.79 8 1.81 9 1.73 10 1.77 11 1.86 M 1.77 SD 0.0547 CV 3%
(153) 2) Intra-Assay Precision
(154) Criterion of acceptability: The same sample was tested in parallel for 10 sets of data in the same batch of experiments, and its mean M, standard deviation SD and coefficient of variation CV were calculated. A kit with a coefficient of variation of CV15% was considered qualified. The results are shown in Table 12. The product had an intra-assay precision (CV) of 1%, far less than 15%, which not only meets the standards, and passes the verification, but also shows that the intra-assay dispersion degree is very small and the repeatability is very good.
(155) TABLE-US-00013 TABLE 12 Intra-assay precision experiment results Serial Calculated antigen number 1 2 OD450 concentration (g/L) 1 0.634 0.638 0.636 1.76 2 0.637 0.635 0.636 1.76 3 0.632 0.641 0.637 1.75 4 0.641 0.633 0.637 1.75 5 0.633 0.638 0.636 1.76 6 0.635 0.632 0.634 1.78 7 0.637 0.643 0.640 1.72 8 0.635 0.636 0.636 1.76 9 0.631 0.633 0.632 1.79 10 0.642 0.634 0.638 1.74 M 1.76 SD 0.0184 CV 1%
(156) 5. Stability Experiment
(157) The assembled kit was placed in an environment of 37 C., and used to prepare a standard curve and to detect an antigen solution with known concentration every day for 5 days. The rate of change of the detection value (CV) was less than 20%. The results are shown in Table 13, which proves that the kit is stable. The results showed that the coefficient of variation CV of 5 days was 3.5%, which is much less than 20%, indicating that the kit provided by the present invention has very good stability and makes the detection result more reliable.
(158) TABLE-US-00014 TABLE 13 Stability experiment results 1 2 3 4 5 CV Blank 0.047 0.051 0.058 0.048 0.055 control Antigen 0.25 1.078 1.083 1.036 1.089 1.046 concen- 0.5 0.917 0.925 0.911 0.945 0.916 tration 1 0.764 0.768 0.753 0.766 0.751 in 2.5 0.562 0.569 0.549 0.554 0.537 standard 5 0.436 0.442 0.426 0.433 0.422 curve (g/L) Standard OD450 0.497 0.498 0.472 0.494 0.473 quality Antigen 3.56 3.64 3.86 3.54 3.71 3.5% control concen- point tration (g/L) (g/L)
(159) The kit provided in Example 10 was tested in accordance with the one-step method provided in Example 20, and similar experimental results were also obtained. The kits of other examples were tested in accordance with the two-step or one-step method provided in Example 20, similar experimental results were obtained.
Example 23 Effects of Different GM Antigen Coating Solutions on Detection Reproducibility of Kit
(160) The kits prepared in Examples 4-9 were used to perform an inter-assay precision detection on the same sample to be tested according to the detection steps of Example 20. The same sample was tested once a day for 10 working days to study the effects of different GM antigen coating solutions on the detection reproducibility of the kit. The detection results are shown in Table 14 below.
(161) TABLE-US-00015 TABLE 14 Kit Example Example Example Example Example Example Concentration 4 5 6 7 8 9 GM ng/mL OD450 Antigen 0.25 1.223 1.272 1.245 1.241 1.223 1.205 standard 0.5 1.103 1.078 1.027 1.013 1.056 1.026 1 0.894 0.931 0.907 0.89 0.909 0.916 2.5 0.656 0.742 0.668 0.631 0.72 0.711 5 0.446 0.521 0.441 0.442 0.514 0.513 Sample OD450 0.831 0.890 0.831 0.833 0.877 0.875 to be 0.846 0.901 0.847 0.844 0.840 0.830 tested 0.838 0.867 0.838 0.806 0.871 0.848 0.819 0.897 0.821 0.839 0.859 0.855 0.833 0.897 0.838 0.839 0.863 0.853 0.833 0.880 0.834 0.826 0.859 0.841 0.823 0.888 0.819 0.830 0.869 0.875 0.819 0.873 0.813 0.839 0.844 0.871 0.819 0.907 0.815 0.828 0.852 0.859 0.838 0.897 0.821 0.819 0.855 0.839 Antigen 1.24 1.18 1.21 1.14 1.13 1.09 concentration 1.20 1.13 1.14 1.09 1.29 1.33 ng/mL 1.21 1.3 1.18 1.26 1.16 1.23 1.3 1.15 1.26 1.11 1.22 1.19 1.23 1.15 1.18 1.11 1.2 1.2 1.23 1.23 1.2 1.17 1.22 1.27 1.28 1.19 1.27 1.15 1.17 1.09 1.3 1.27 1.3 1.11 1.3 1.11 1.3 1.1 1.29 1.16 1.26 1.17 1.21 1.15 1.26 1.2 1.24 1.28 CV % 3.27% 5.37% 4.40% 4.45% 4.57% 6.95%
(162) As can be seen from the data in Table 14, the CV values of the results of the samples detected by each kit were less than 7%, indicating that each kit has a small dispersion degree of the detection results of the samples and good repeatability, and can be used for immunodetection of GM antigens; moreover, the CV value of the sample concentration detected by the kit prepared in Example 4 was the minimum, indicating that the coating solution in Example 4 is superior.
Example 24 Effects of Different Blocking Solutions on Detection Repeatability of Kit
(163) The kits prepared in Examples 10-11 were used to perform an inter-assay precision detection on the same sample to be tested according to the detection steps of Example 20. The same sample was tested once a day for 10 working days to study the effects of different blocking solutions on the detection repeatability of the kit. The detection results are shown in Table 15 below.
(164) TABLE-US-00016 TABLE 15 Kit Example 10 Example 11 GM Concentration ng/mL OD450 Antigen 0.25 1.123 1.206 standard 0.5 0.974 1.053 1 0.829 0.913 2.5 0.626 0.689 5 0.502 0.543 Sample to be OD450 0.762 0.861 tested 0.758 0.849 0.773 0.851 0.756 0.846 0.759 0.839 0.762 0.825 0.771 0.833 0.753 0.819 0.773 0.861 0.758 0.849 Antigen concentration 1.38 1.23 ng/mL 1.41 1.3 1.31 1.29 1.42 1.32 1.4 1.36 1.38 1.45 1.32 1.4 1.44 1.49 1.31 1.23 1.41 1.3 CV % 3.49% 6.54%
(165) As can be seen from the data in Table 15, the CV values of the results of the samples detected by each kit were less than 7%, indicating that each kit has a small dispersion degree of the detection results of the samples and good repeatability, and can be used for immunodetection of GM antigens; moreover, the CV value of the sample concentration detected by the kit prepared in Example 10 was the minimum, indicating that the blocking solution in Example 10 is superior.
Example 25 Effects of Different Sample Treatment Solutions on Repeatability and Recovery Rate of Detection of Kit
(166) The kits prepared in Examples 12-18 were used to perform an inter-assay precision and recovery rate detection on the same sample to be tested (the concentration is known as 1.43 ng/mL) according to the detection steps of the two-step method in Example 20. The same sample was tested once a day for 10 working days to study the effects of different sample treatment solutions on the repeatability and recovery rate of detection of the kit. The detection results are shown in Table 16 below.
(167) TABLE-US-00017 TABLE 16 Kit Example Example Example Example Example Example Example Concentration 12 13 14 15 16 17 18 GM ng/mL OD450 Antigen 0.25 1.068 1.055 1.023 1.052 1.076 1.088 1.063 standard 0.5 0.894 0.909 0.871 0.896 0.913 0.929 0.912 1 0.745 0.743 0.713 0.740 0.728 0.764 0.756 2.5 0.54 0.534 0.493 0.534 0.526 0.555 0.547 5 0.405 0.406 0.374 0.378 0.389 0.412 0.419 Sample OD450 0.676 0.699 0.622 0.663 0.674 0.692 0.705 to be 0.691 0.667 0.614 0.663 0.694 0.725 0.716 tested 0.686 0.681 0.629 0.666 0.679 0.707 0.707 0.692 0.679 0.632 0.655 0.666 0.719 0.694 0.692 0.659 0.634 0.664 0.669 0.703 0.692 0.678 0.701 0.624 0.686 0.686 0.692 0.702 0.681 0.666 0.653 0.661 0.681 0.717 0.732 0.694 0.704 0.631 0.656 0.692 0.717 0.686 0.694 0.678 0.632 0.668 0.676 0.700 0.700 0.694 0.701 0.653 0.669 0.673 0.707 0.734 Antigen 1.5 1.3 1.52 1.41 1.37 1.41 1.28 concentration 1.41 1.5 1.58 1.41 1.26 1.22 1.22 ng/mL 1.44 1.41 1.47 1.39 1.34 1.32 1.27 1.4 1.42 1.45 1.46 1.42 1.25 1.35 1.4 1.56 1.44 1.4 1.4 1.34 1.36 1.49 1.29 1.51 1.27 1.3 1.41 1.3 1.47 1.51 1.32 1.42 1.33 1.26 1.13 1.39 1.27 1.46 1.45 1.27 1.26 1.4 1.39 1.43 1.45 1.38 1.36 1.36 1.31 1.39 1.29 1.32 1.37 1.38 1.32 1.12 Mean value 1.41 1.24 1.46 1.32 1.38 1.3 1.34 CV % 3.23% 7.65% 6.34% 4.38% 3.78% 5.49% 7.18% Recovery rate 100.93% 98.48% 102.91% 97.32% 93.71% 92.19% 88.46%
(168) As can be seen from the data in Table 16, the CV values of the results of the samples detected by each kit were less than 8%, indicating that each kit has a small dispersion degree of the detection results of the samples and good repeatability, and can be used for immunodetection of GM antigens; moreover, the CV value of the sample concentration detected by the kit prepared in Example 12 was the minimum, and the recovery rate was close to 100%, indicating that the treatment solution in Example 12 is superior.
Example 26 Comparison of Detection Results of Sample Between Kit of the Present Invention and Product of Bio-Rad Laboratories
(169) 24 samples were detected with the kit of the present invention (taking the kit provided in Example 12 of the present invention as an example) and the kit of Bio-Rad Laboratories (batch number: 6H0042), respectively. The specific results are shown in Table 17 below.
(170) The determination criterion of the reference value of the kit of the present invention is that: the upper limit of the reference range is 0.85 g/L, and the lower limit is 0.65 g/L. If the sample has a concentration of 0.85 g/L, it is determined to be positive; if the sample has a concentration of <0.65 g/L, it is determined to be negative; and if the sample has a concentration between 0.65 ng/mL and 0.85 ng/mL, it is determined to be a suspected patient. The determination criterion of the kit of Bio-Rad Laboratories is that: if the sample has a I value of 0.5, it is positive, and if the sample has a I value of <0.5, it is negative.
(171) TABLE-US-00018 TABLE 17 Comparative experiment results of the kit of the present invention and kit of Bio-Rad Laboratories Kit of the Kit of Bio-Rad Actual present invention Laboratories results Positive and Positive and Positive and Concentration negative negative negative value results I value results results 1 4.57 + 0.78 + + 2 1.96 + 0.60 + + 3 2.24 + 0.91 + + 4 0.66 0.46 5 1.33 + 0.97 + + 6 0.58 0.41 7 0.81 0.54 + + 8 4.79 + 1.29 + + 9 0.74 0.40 + 10 1.27 + 1.37 + + 11 0.69 0.48 12 1.19 + 3.76 + + 13 1.72 + 2.40 + + 14 0.94 + 0.67 + + 15 0.79 1.33 + + 16 1.27 + 1.79 + + 17 0.58 0.46 18 0.78 0.40 + 19 0.91 + 0.68 + + 20 0.81 0.61 + + 21 0.57 0.40 22 1.05 + 0.64 + + 23 1.20 + 1.51 + + 24 0.66 0.43
(172) As can be seen from Table 17, 1) the kit of Bio-Rad Laboratories is a qualitative test product, which can only provide determination for positive and negative results and cannot provide a specific concentration; 2) when the antigen concentration of the detected sample is between 0.65 ng/mL and 0.85 ng/mL, the results detected by the kit of Bio-Rad Laboratories are highly variable, for example, for the ninth and eighteenth cases in Table 17, the actual results of which are positive, while both the results obtained by the kit of Bio-Rad Laboratories are negative, and the results obtained by the kit provided by the present invention are suspected patients, which need further determination. It can be seen that the kit provided by the present invention has more accurate and reliable detection result than the kit of Bio-Rad Laboratories.
(173) The hybridoma cell under the accession number of CGMCC No. 13827 or the passage cell thereof provided by the present invention has stable performance, and the monoclonal antibody produced therefrom or the specific antigen-binding fragment thereof can specifically bind to the Aspergillus GM antigen. The detection kit prepared using the same has sensitivity and specificity of more than 95%, and very small inter-assay and intra-assay dispersion degrees, good repeatability and high stability; moreover, the detection kits prepared with different buffers of coating solutions, different GM antigen concentrations, different blocking solutions and different sample treatment solutions have small detection degree and good repeatability. The kit provided by the present invention can not only reduce the cost, but also can detect IA quickly and easily, has a detection limit of 0.85 ng/mL compared to 1 ng/mL of the existing product, which can detect IA earlier, and has more accurate and reliable detection results, so that the patient can be treated early, thereby improving the survival rate of the patient.
(174) The above are only the preferred examples of the present invention, and are not intended to limit the present invention. Any modifications, equivalent substitutions, etc., made within the spirit and scope of the present invention, are intended to be included within the scope of the present invention.