JP6192177B2 - Use of S100A9 as a biomarker for inflammatory bowel disease - Google Patents

Use of S100A9 as a biomarker for inflammatory bowel disease Download PDF

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JP6192177B2
JP6192177B2 JP2015105096A JP2015105096A JP6192177B2 JP 6192177 B2 JP6192177 B2 JP 6192177B2 JP 2015105096 A JP2015105096 A JP 2015105096A JP 2015105096 A JP2015105096 A JP 2015105096A JP 6192177 B2 JP6192177 B2 JP 6192177B2
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俊介 関屋
俊介 関屋
村田 誠
誠 村田
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本発明は、炎症性腸疾患のバイオマーカーとしてのS100A9の使用に関するものである。   The present invention relates to the use of S100A9 as a biomarker for inflammatory bowel disease.

S100ファミリーに属するS100A8およびA9の複合体であるカルプロテクチンは、分子量36,000のタンパク質である。糞便中のカルプロテクチンを測定することにより、炎症性腸炎疾患(IBD)の診断に利用できることから(非特許文献1)、既に糞便中のカルプロテクチン測定キットが海外で製造発売されている(Eurospital社、Immundiagnostik AG社など)。   Calprotectin, which is a complex of S100A8 and A9 belonging to the S100 family, is a protein having a molecular weight of 36,000. Since fecal calprotectin can be used for diagnosis of inflammatory enteritis disease (IBD) by measuring fecal calprotectin (Non-patent Document 1), fecal calprotectin measurement kits have already been manufactured and released overseas ( Eurospital, Immundiagnostik AG, etc.).

しかしながら、カルプロテクチンは、IBDの診断に利用できるものの、必ずしも臨床状態を反映しているとは言い難い面があった。たとえば、実施例に示すように、IBDの1つである潰瘍性大腸炎(UC)のモデルラット糞便中のカルプロテクチンは炎症状態を反映していない。 However, although calprotectin can be used for the diagnosis of IBD, it has been difficult to say that it necessarily reflects the clinical state. For example, as shown in the Examples, calprotectin in model rat feces of ulcerative colitis (UC), one of the IBDs, does not reflect an inflammatory condition.

British Medical Journal, 2010;341:c3369British Medical Journal, 2010; 341: c3369 第41回日本毒性学会学術年会 セッションID:P−136 2014年7月2日〜4日(木村恵人 日精バイリス株式会社)で報告された「デキストラン硫酸ナトリウム誘発マウス潰瘍性大腸炎モデルの検討」The 41th Annual Meeting of the Japanese Society of Toxicology Session ID: P-136 “Examination of Dextran Sulfate Sodium-Induced Mouse Ulcerative Colitis Model Reported July 2-4, 2014 (Keto Kimura Nissei Baylis Co., Ltd.) "

一般に、IBDを研究するモデル系においては、主に便の状態を観察してスコア化するDisease Activity Index(DAI)によって病態の程度が評価されており(非特許文献2)、この手法は生体内の炎症状態を反映する良い方法ではあるものの、便状態を主観的に判断するため、判定する人によりDAIスコアに差が生じやすいことが問題とされていた。 In general, in a model system for studying IBD, the degree of pathological condition is evaluated mainly by a disease activity index (DAI) that observes and scores the state of stool (Non-Patent Document 2). Although it is a good method to reflect the inflammatory state, it has been a problem that the DAI score tends to be different depending on the person making the judgment because the stool state is subjectively judged.

一方、従来、上述したように、カルプロテクチンとIBDとの関係に関しては明示されているものの、カルプロテクチンの構成成分であるS100A9タンパク質とIBDとの関連性は十分に検討されていない。 On the other hand, conventionally, as described above, although the relationship between calprotectin and IBD has been clarified, the relationship between S100A9 protein, which is a component of calprotectin, and IBD has not been sufficiently studied.

本発明者は、IBDを研究するモデル系において、DAIスコアに代わり得るバイオマーカーを見いだすべく鋭意検討を重ねた結果、S100A9タンパク質が、病態をスコア化したDAIスコアよりも早期に、かつ客観的に腸の状態を反映することを見いだし、本発明を完成させた。   As a result of intensive studies to find a biomarker that can replace the DAI score in a model system for studying IBD, the present inventor has objectively and objectively found that the S100A9 protein is earlier than the DAI score scored for the disease state. The present invention has been completed by finding that it reflects the state of the intestines.

従来、IBDモデルを用いた評価は、DAIスコアを中心とした主観的な方法が採用されていたが、糞便中S100A9を測定することによって、DAIスコアよりも客観的、かつ早期に腸の炎症状態を反映する結果を得ることができる。   Conventionally, the subjective method centered on the DAI score has been adopted for the evaluation using the IBD model. By measuring S100A9 in the stool, the inflamed state of the intestine is objective and earlier than the DAI score. Can be obtained.

また、すでにカルプロテクチンとIBDの関係は報告されているが、実施例に示すように必ずしも糞便中カルプロテクチンが病態を反映していない。一方で糞便中S100A9をマーカーとして用いた場合には、より病態に即した結果を得ることができる。 Moreover, although the relationship between calprotectin and IBD has already been reported, as shown in the Examples, fecal calprotectin does not necessarily reflect the disease state. On the other hand, when S100A9 in stool is used as a marker, a result more suited to the disease state can be obtained.

以上より、糞便中S100A9は従来法よりも、客観的で早期に病態に合った結果を得ることのできる有用なマーカーである。さらに、IBDの寛解状態の判断は、医師により異なるが、多くは内視鏡検査によるため患者への負担が大きい。しかしながら、代替法として糞便中S100A9を測定することにより、非侵襲的かつ簡易に腸の状態を調べることが可能となる。 As described above, fecal S100A9 is a useful marker that can obtain a result that is more objective and suits the disease state earlier than the conventional method. Furthermore, although the judgment of the remission state of IBD differs depending on the doctor, many are based on endoscopy, so the burden on the patient is large. However, by measuring stool S100A9 as an alternative method, it becomes possible to examine the state of the intestine non-invasively and easily.

図1は、ラットの体重変化を示したものである。表の縦軸が体重(g)、横軸がDayである。ダイヤ印がDSS投与群、四角印がコントロール群の平均値を表している。FIG. 1 shows changes in body weight of rats. The vertical axis of the table is body weight (g), and the horizontal axis is Day. The diamond mark represents the average value of the DSS administration group, and the square mark represents the average value of the control group. 図2は、DAIスコアの変化を示したものである。表の縦軸がDAIスコア、横軸がDayである。ダイヤ印がDSS投与群、四角印がコントロール群の平均値を示す。*P<0.05 **P<0.01(Mann−Whitney Rank Sum Test)FIG. 2 shows changes in the DAI score. The vertical axis of the table is the DAI score, and the horizontal axis is Day. A diamond mark shows the average value of the DSS administration group, and a square mark shows the average value of the control group. * P <0.05 ** P <0.01 (Mann-Whitney Rank Sum Test) 図3は、腸の平均比重を比較したものである。縦軸が比重であり、左グラフがDSS投与群、右グラフがコントロール群の平均値を示した。**P<0.01(Mann−Whitney Rank Sum Test)FIG. 3 compares the average specific gravity of the intestines. The vertical axis is specific gravity, the left graph shows the average value of the DSS administration group, and the right graph shows the average value of the control group. ** P <0.01 (Mann-Whitney Rank Sum Test) 図4は、便中のS100A9濃度の変化を示したものである。表の縦軸が便1mg中のS100A9量、横軸がDayである。ダイヤ印がDSS投与群、四角印がコントロール群の平均値を示す。**P<0.01(Mann−Whitney Rank Sum Test)FIG. 4 shows changes in the S100A9 concentration in the stool. The vertical axis of the table is the amount of S100A9 in 1 mg of stool, and the horizontal axis is Day. A diamond mark shows the average value of the DSS administration group, and a square mark shows the average value of the control group. ** P <0.01 (Mann-Whitney Rank Sum Test) 図5は、便中のカルプロテクチン濃度の変化を示したものである。縦軸が便中のカルプロテクチン濃度、横軸がDayである。ダイヤ印がDSS投与群での平均値を示した。コントロール群は検出限界以下のため図中には示していない。FIG. 5 shows the change in calprotectin concentration in feces. The vertical axis is calprotectin concentration in feces, and the horizontal axis is Day. A diamond mark represents an average value in the DSS administration group. The control group is not shown in the figure because it is below the detection limit.

本発明は、炎症性腸疾患のバイオマーカーとしてのS100A9の使用に関するものである。   The present invention relates to the use of S100A9 as a biomarker for inflammatory bowel disease.

S100A9を測定する試料としては、ヒトを含む動物の糞便試料を用いることができる。糞便試料は、便中のヘモグロビン測定時と同様の処理に付せばよく、たとえば、市販の便潜血検査用の採便容器を用いて糞便試料を採取し、適当な緩衝液、たとえば、リン酸緩衝液に懸濁後、遠心分離等によって固液分離し、上清を試料として使用する。   As a sample for measuring S100A9, a fecal sample of an animal including a human can be used. The stool sample may be subjected to the same treatment as when measuring hemoglobin in the stool. For example, a stool sample is collected using a commercially available stool sample for occult blood test, and an appropriate buffer solution such as phosphate is used. After suspending in a buffer solution, solid-liquid separation is performed by centrifugation or the like, and the supernatant is used as a sample.

試料を採取する対象の炎症性腸疾患としては、潰瘍性大腸炎、クローン病などの大腸、小腸、直腸などの腸に関連した炎症性疾患であれば、すべて対象とすることができる。 The target inflammatory bowel disease from which a sample is collected may be any inflammatory disease related to the intestine such as ulcerative colitis, Crohn's disease, etc., such as the large intestine, small intestine, and rectum.

S100A9を測定するには、既にS100A9に対する抗体が市販(SIGMA−ALDRICH, SAB1404348, Monoclonal Anti−S100A9 antibody produced in mouse)されていることから、それらを利用して、又は常法によりS100A9に対する抗体を取得し、ELISA等の公知の方法(CircuLex, CY−8062, CircuLex S100A9/MRP14 ELISA kit、Proteomics Clinical Applications. 2012;6:170−81)により測定することが可能である。 In order to measure S100A9, since antibodies against S100A9 are already commercially available (SIGMA-ALDRICH, SAB1404348, Monoclonal Anti-S100A9 antibody produced in mouse), an antibody against S100A9 is obtained by using them or by a conventional method. In addition, it can be measured by a known method such as ELISA (CircuLex, CY-8062, CircuLex S100A9 / MRP14 ELISA kit, Proteomics Clinical Applications. 2012; 6: 170-81).

以下、実施例をあげて具体的に説明するが、本発明はこれらによって何ら限定されるものではない。   Hereinafter, although an example is given and explained concretely, the present invention is not limited at all by these.

(実施例)
デキストラン硫酸ナトリウム(DSS)誘発ラットUC潰瘍性大腸炎モデルにおいて、便中のS100A9を測定することにより、既存のDAIスコアよりも客観的かつ早期に大腸の炎症を検出することが可能か検討した。
(Example)
In the dextran sodium sulfate (DSS) -induced rat UC ulcerative colitis model, it was investigated whether the inflammation of the large intestine could be detected objectively and earlier than the existing DAI score by measuring S100A9 in the stool.

(1)手順:
(モデル作製)
薬物はDSS(MP Biomedicals,LLC CAT NO.160110 M.W.=36,000−50,000)を使用した。実験には、6週齢のSDラット(オス)を用い、DSS投与群7匹、コントロール群6匹に分けた。ラットは、一週間馴化後、投与群(D群)には3%(w/v)DSS水溶液、コントロール群(C群)には純水を11日間自由飲水させた。
(1) Procedure:
(Model creation)
The drug used was DSS (MP Biomedicals, LLC CAT NO. 160110 MW = 36,000-50,000). In the experiment, 6-week-old SD rats (male) were used and divided into 7 DSS administration groups and 6 control groups. After acclimation for one week, the rats were allowed to drink freely for 3 days with 3% (w / v) DSS aqueous solution in the administration group (Group D) and pure water in the control group (Group C).

(便の回収)
毎朝D群、C群の便を回収した。回収方法は、飼育カゴの大きさに合うバットにネット(穴の大きさ4×5mm)をはり、便と尿を分けた。便は、Day0からDay10の期間で回収した。回収時間は、午前8時から12時までとした。
(Collection of stool)
Every morning, stool from Group D and Group C was collected. The collection method was to separate the stool and urine by applying a net (hole size 4 × 5 mm) to a bat that fits the size of the cage. The stool was collected during the period from Day 0 to Day 10. The collection time was from 8:00 am to 12:00.

(DAIスコア判定)
便の状態を観察して下痢、血便の状態をスコア化し、足し合わせた値をDAIスコアとした。判定基準は、下痢スコアが正常便で0、軟便で1、下痢便で2、水様便で3とし、血便スコアは正常便で0、茶色の便で1、赤茶けた色の便で2、血便で3とした。有意差検定は、Sigma Plot 12を用いてMann−Whitney Rank Sum Testを実施し、P値が0.05より小さいとき、有意差があるとした。
(DAI score determination)
The state of stool was observed to score the state of diarrhea and bloody stool, and the combined value was taken as the DAI score. The criteria are 0 for normal stool, 1 for soft stool, 2 for diarrheal stool, 3 for watery stool, 0 for normal stool, 1 for brown stool, 2 for reddish stool, It was set to 3 by bloody stool. The significance test was performed using Mann-Whitney Rank Sum Test using Sigma Plot 12, and it was determined that there was a significant difference when the P value was less than 0.05.

(サンプル処理)
回収した便は、あらかじめ重量を測定した1.5mLチューブに入れ、再度重量を測定し、便のみの重さを記録した。500μLの検体希釈液を加えて、氷上で15分間静置した。ホモジナイザーペッスルを使用して、便を懸濁した。その際にペッスルを500μLの検体希釈液で洗い、液量を計1,000μLとした。次に12,000g 4℃ 5分間遠心し、上清を回収した。得られた上清は、測定まで−80℃で保存した。
(Sample processing)
The collected stool was placed in a 1.5 mL tube that had been weighed in advance, the weight was measured again, and the weight of only the stool was recorded. 500 μL of the sample diluent was added and allowed to stand on ice for 15 minutes. The stool was suspended using a homogenizer pestle. At that time, the pestle was washed with 500 μL of the sample diluent, and the total volume was 1,000 μL. Next, the supernatant was collected by centrifugation at 12,000 g at 4 ° C. for 5 minutes. The obtained supernatant was stored at −80 ° C. until measurement.

便中S100A9濃度の測定 ELISA)
ラットS100A9測定ELISAキットを用いて便中のS100A9量を測定した。凍結していた便から抽出した上清を解凍し、適宜検体希釈液で希釈した。スタンダードと希釈したサンプルを抗体固相プレートに100μl/wellでアプライし、室温2時間静置した。洗浄液を用いてウェルを洗い、酵素標識抗体を100μl/wellでアプライし、室温1時間静置した。再び洗浄操作を行い、発色液を100μl/wellでアプライし、室温20分間反応後、反応停止液を100μl/wellを加えた。操作終了後、プレートリーダーを用いて450nmの吸光度を測定した。サンプルの濃度計算は、PLATE manager V4を用いた。
(Measurement ELISA of S100A9 concentration in stool )
The amount of S100A9 in stool was measured using a rat S100A9 measurement ELISA kit. The supernatant extracted from the frozen stool was thawed and appropriately diluted with a sample diluent. Standards and diluted samples were applied to an antibody solid phase plate at 100 μl / well and allowed to stand at room temperature for 2 hours. The wells were washed with a washing solution, enzyme-labeled antibody was applied at 100 μl / well, and allowed to stand at room temperature for 1 hour. The washing operation was performed again, and the coloring solution was applied at 100 μl / well. After reacting for 20 minutes at room temperature, 100 μl / well of the reaction stop solution was added. After completion of the operation, absorbance at 450 nm was measured using a plate reader. For the concentration calculation of the sample, PLATE manager V4 was used.

(便中S100A9量の計算)
便1mgに含まれるS100A9量(ng)を求めるために、以下の計算式を用いた。有意差検定は、SigmaPlot 12を用いてMann−Whitney Rank Sum Testを実施し、P値が0.05より小さいとき、有意差があるとした。
(Calculation of S100A9 amount in flight)
In order to obtain the amount (ng) of S100A9 contained in 1 mg of stool, the following calculation formula was used. The significance test was conducted using Mann-Whitney Rank Sum Test using SigmaPlot 12, and it was determined that there was a significant difference when the P value was less than 0.05.

Figure 0006192177
Figure 0006192177

(便中カルプロテクチン濃度の測定 ELISA)
便中のカルプロテクチンは、Immundiagnostik AG社のS100A8/S100A9 ELISA Kitを使用し、添付文書に従い測定した。有意差検定は、SigmaPlot 12を用いてMann−Whitney Rank Sum Testを実施し、P値が0.05より小さいとき、有意差があるとした。
(Measurement of fecal calprotectin concentration ELISA)
Calprotectin in the stool was measured according to the package insert using S100A8 / S100A9 ELISA Kit of Immunodiagnostic AG. The significance test was conducted using Mann-Whitney Rank Sum Test using SigmaPlot 12, and it was determined that there was a significant difference when the P value was less than 0.05.

(ラットの解剖、腸の比重計算)
ラットを麻酔下で開腹後、腹部大静脈から全採血した。直腸から結腸まで摘出し、直腸側から走行方向に切り進めた。0.9(w/v)%食塩水で腸表面の内容物を洗い落とし、ペーパータオルの上に3回置き水分を軽く除いた後、腸の長さを測定後、湿重量を測定した。腸の比重は、湿重量(g)を摘出した大腸の長さ(cm)で割り、計算した。有意差検定は、StatView ver5.0を用いてMann−Whitney Rank Sum Testを実施し、P値が0.05より小さいとき、有意差があるとした。
(Anatomy of rat, calculation of specific gravity of intestine)
Rats were laparotomized under anesthesia and then whole blood was collected from the abdominal vena cava. It was removed from the rectum to the colon and cut from the rectum side in the direction of travel. The contents of the intestinal surface were washed off with 0.9 (w / v)% saline, placed on a paper towel three times to lightly remove moisture, and after measuring the length of the intestine, the wet weight was measured. The specific gravity of the intestine was calculated by dividing the wet weight (g) by the length of the excised large intestine (cm). The significance test was performed using Mann-Whitney Rank Sum Test using StatView ver5.0, and when the P value was less than 0.05, it was determined that there was a significant difference.

(2)結果
(体重変化)
StatView ver5.0のMann−Whitney Rank Sum Testを実施したところ、図1に示すように、Day0〜Day10まで有意差は認められなかった。
(2) Results (weight change)
When Mann-Whitney Rank Sum Test of StatView ver5.0 was performed, no significant difference was observed from Day 0 to Day 10, as shown in FIG.

(DAIスコア)
毎朝便を回収する際に便状を観察し、DAIスコア評価を実施した。D群、C群のスコアの平均値を図2に示す。DAIスコアは、Mann−Whitney Rank Sum TestでDay6からD群がC群より有意に高値を示した。D群とC群で有意な差が現われたのはDay6であった。また、D群において便に血が付着し始めた日(血便)の平均はDay6であった。
(DAI score)
When collecting the stool every morning, the feces were observed and the DAI score was evaluated. The average score of the D group and the C group is shown in FIG. The DAI score was significantly higher in Day 6 to Group D than in Group C at Mann-Whitney Rank Sum Test. Day 6 showed a significant difference between Group D and Group C. Moreover, the average of the day (blood stool) on which blood began to adhere to stool in Group D was Day 6.

(腸の比重結果)
図3に示すように、DSS投与群の平均値は0.14g/cm、コントロール群の平均値は0.095g/cmでありMann−Whitney Rank Sum Testを行った結果有意な差が認められた。
(Intestinal specific gravity result)
As shown in FIG. 3, the average value of the DSS administration group was 0.14 g / cm, the average value of the control group was 0.095 g / cm, and a significant difference was observed as a result of the Mann-Whitney Rank Sum Test. .

(便中S100A9量の測定)
便1mg中のS100A9量を算出した結果を図4に示す。図4から明らかなように、D群は経時的に便中のS100A9量が増加しており、C群と比較してDay2において有意に高値を示した。
(Measurement of the amount of S100A9 in the stool)
The result of calculating the amount of S100A9 in 1 mg of stool is shown in FIG. As is apparent from FIG. 4, the amount of S100A9 in the stool increased with time in Group D, and the value was significantly higher in Day 2 than in Group C.

(便中カルプロテクチン濃度の測定)
図5に示すように、D群の便中カルプロテクチン濃度において経時的な変化を確認することはできなかった。もっとも炎症が酷くなっていると考えられたDay10の便においても、便中カルプロテクチン濃度はDay5の濃度と差が認められなかった。また、コントロール群においては、大部分のサンプルにおいて検出限界以下となった。

(Measurement of fecal calprotectin concentration)
As shown in FIG. 5, it was not possible to confirm a change with time in the fecal calprotectin concentration in the D group. Even in Day 10 stool, which was considered to have the most severe inflammation, the fecal calprotectin concentration was not different from the Day 5 concentration. In the control group, most of the samples were below the detection limit.

(3)考察
(実験的潰瘍性大腸炎モデルラットの評価)
D群は、DSSを投与した結果DAIスコアが経時的に上昇することが確認でき、Day6でC群との間に有意な差が認められた。また、D群の血便初確認日の平均は、Day6であった。また、解剖結果よりD群においては腸の比重が大きくなっていることから肥厚を確認できた。以上の結果より、潰瘍性大腸炎(UC)モデルとして適切であると判断した。
(3) Discussion (Evaluation of experimental ulcerative colitis model rats)
In Group D, it was confirmed that the DAI score increased with time as a result of administration of DSS, and a significant difference was observed between Day 6 and Group C. In addition, the average blood stool initial confirmation date of Group D was Day 6. Further, from the anatomical results, thickening could be confirmed because the specific gravity of the intestine was increased in group D. From the above result, it was judged that it was suitable as an ulcerative colitis (UC) model.

(S100A9測定キットの評価)
S100A9測定キットを使用した結果では、D群はDay2においてC群よりも有意な高値を示した。これは、DAIスコアで有意差が現われたDay6よりも早期に腸の炎症を捉えていることを示す。一方、Immundiagnostik AG社のカルプロテクチンキットを使用した結果では経時的変化、かつ炎症を反映した値が得られなかった。
(Evaluation of S100A9 measurement kit)
As a result of using the S100A9 measurement kit, Group D showed a significantly higher value in Day 2 than Group C. This indicates that intestinal inflammation was captured earlier than Day 6 where a significant difference appeared in the DAI score. On the other hand, as a result of using the Calprotectin kit of Immunodiagnostic AG, a value reflecting changes with time and inflammation was not obtained.

以上の結果を踏まえ、糞便中のS100A9を測定することで、潰瘍性大腸炎モデルラットにおける経時的な変化を捉えることができ、病態をスコア化したDAIスコアよりも早期に腸の状態を反映し、炎症性腸疾患のバイオマーカーとして有用であることを確認できた。また、UCモデルラットの評価においては、便中のカルプロテクチンよりS100A9を測定する方が、より病態を反映していることも明らかとなった。 Based on the above results, by measuring S100A9 in stool, changes over time in ulcerative colitis model rats can be captured, reflecting the state of the intestines earlier than the DAI score scored for the disease state. It was confirmed that it is useful as a biomarker for inflammatory bowel disease. Moreover, in the evaluation of UC model rats, it was also clarified that the measurement of S100A9 from calprotectin in stool reflects the pathological condition more.

Claims (1)

DAIスコアで判定されない早期段階の炎症性腸疾患を検出するため、糞便試料中のS100A9を測定することを特徴とする、S100A9のバイオマーカーとしての使用。Use of S100A9 as a biomarker, characterized by measuring S100A9 in a stool sample to detect early stage inflammatory bowel disease that is not determined by a DAI score.
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