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DK3004388T3 - Påvisning og kvantificering af cellefrit dna fra donor i kredsløbet hos organtransplantatmodtagere - Google Patents

Påvisning og kvantificering af cellefrit dna fra donor i kredsløbet hos organtransplantatmodtagere Download PDF

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DK3004388T3
DK3004388T3 DK14804474.6T DK14804474T DK3004388T3 DK 3004388 T3 DK3004388 T3 DK 3004388T3 DK 14804474 T DK14804474 T DK 14804474T DK 3004388 T3 DK3004388 T3 DK 3004388T3
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snp
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DK3004388T4 (da
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Ekkehard Schutz
Julia Beck
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Chronix Biomedical
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Claims (13)

1. Fremgangsmåde til evaluering af integriteten af et transplantat hos en modtager, hvilken fremgangsmåde omfatter monitorering af niveauet af graft-cellefrit DNA (cfDNA) ved vurdering af mængden af en donor-SNP-allel i en cfDNA-prøve opnået fra blod fra en patient, hvor SNP-allellen er forhåndsvalgt som havende en mindre allelfrekvens (MAF) på mindst 0,4, og endvidere hvor donor-SNP-allellen er til stede hos donoren og modtageren er homozygotisk for en alternativ allel for denne SNP, hvor SNP-allellen identificeres uden anvendelse af en separat prøve fra en donor.
2. Fremgangsmåde ifølge krav 1, hvor kvantificering af niveauet af donor-SNP-allellen i cfDNA-prøven omfatter bestemmelse af kopiantal af donor-SNP-allellen i cfDNA-prøven eller bestemmelse af procentsatsen af donor-SNP-allellen i cfDNA-prøven.
3. Fremgangsmåde ifølge krav 1 eller 2, hvor (i) det transplanterede materiale er et marginalt organ; (ii) cfDNA-prøven er fra en blodprøve opnået ti dage eller længere efter transplantation; et år eller længere efter transplantation; eller inden for syv dage efter transplantation; (iii) donorvævet er en lever, et hjerte eller en nyre; og/eller (iv) fremgangsmåden endvidere omfatter påvisning af donorspecifikke antistoffer i modtagerens blod.
4. Fremgangsmåde til påvisning af en SNP fra en donor for at monitorere transplantatintegritet hos en modtager, der modtager væv fra donoren, hvilken fremgangsmåde omfatter: (a) identificering af, at en SNP med en mindre allelfrekvens på 0,4 eller højere er homozygotisk hos modtageren; (b) amplificering af cellefrit (cfDNA) fra en serum- eller plasmaprøve opnået fra modtageren mindst 5 dage efter transplantation af materialet fra donoren; (c) udførelse af en kvantitativ PCR-reaktion for de SNP’er, der er identificeret i (a), fir at påvise tilstedeværelsen af den alternative allel for én eller flere af SNP’erne; og (d) udvælgelse af en SNP, hvor den alternative SNP er til stede i det amplificerede cfDNA for at monitorere patientens transplantatintegritet.
5. Fremgangsmåde ifølge krav 4, hvor (i) trin (a) udføres ved anvendelse af DNA isoleret fra perifere blodleukocytter opnået fra patienten eller ved anvendelse af cfDNA’et fra trin (b); (ii) SNP’en med en mindre allelfrekvens på 0,4 eller højere er en SNP ifølge tabel 1; og/eller (iii) SNP’en valgt i (d) er homozygotisk hos donoren.
6. Fremgangsmåde til påvisning af en SNP fra en donor for at monitorere transplantatintegritet hos en modtager, der modtager væv fra donoren, hvilken fremgangsmåde omfatter: (a) identificering af, at en SNP med en mindre allelfrekvens på 0,4 eller højere er homozygotisk hos modtageren; (b) amplificering af cellefrit (cfDNA) fra en blodprøve opnået fra modtageren 24 timer eller mindre efter transplantation af et graftmateriale fra donoren; (c) identificering af en SNP med en mindre allelfrekvens på 0,4 eller højere som homozygotisk hos donoren ved anvendelse af cfDNA’et fra trin (b); (d) udførelse af en kvantitativ PCR-reaktion for de SNP’er, der er identificeret i (a), for at påvise tilstedeværelsen af den alternative allel for én eller flere af SNP’erne hos donoren, og (e) udvælgelse af en SNP, hvor den alternative SNP er homozygotisk hos donoren.
7. Fremgangsmåde ifølge krav 6, hvor (i) trin (a) udføres ved anvendelse af DNA isoleret fra perifere blodleukocytter opnået fra patienten; og/eller (ii) SNP’en med en mindre allelfrekvens på 0,4 eller højere er en SNP ifølge tabel 1.
8. Fremgangsmåde ifølge et hvilket som helst af kravene 4 til 7, der endvidere omfatter opnåelse af en cfDNA-prøve fra modtageren efter transplantation af donorvæv; and kvantificering af niveauet af donor-SNP-allellen i cfDNA-prøven, eventuelt hvor (i) kvantificeringstrinnet omfatter bestemmelse af kopiantal af donor-SNP-allellen i cfDNA-prøven eller bestemmelse af procentsatsen af donor-SNP-allellen i cfDNA-prøven; (ii) det transplanterede materiale er et marginalt organ; (iii) cfDNA-prøven er fra en blodprøve opnået ti dage eller længere efter transplantation; eller et år eller længere efter transplantation; eventuelt hvor fremgangsmåden endvidere omfatter justering af en administrationsplan eller dosering eller af et immunsuppressivt lægemiddel; (iv) cfDNA-prøven er fra en blodprøve opnået inden for syv dage efter transplantation; (v) donorvævet er en lever, et hjerte eller en nyre; og/eller (vi) fremgangsmåden endvidere omfatter påvisning af donorspecifikke antistoffer i modtagerens blod.
9. Anvendelse af fremgangsmåden ifølge kravene 1 til 3 eller 8 til: påvisning af reperfusionsskade på donorvæv hos en transplantatmodtager; påvisning af skade på donorlevervæv forårsaget af en hepatitis virus hos en transplantatmodtager, påvisning af kronisk graftnefropati eller påvisning af graftvaskulopati; bestemmelse af den minimale virksomme dosis af et immunsuppressivt lægemiddel; og/eller påvisning af transplantatskade fra donorspecifikke antistoffer eller en kronisk transplantatslæsion.
10. Fremgangsmåde til monitorering af integriteten af et transplantat hos en transplantatmodtager, hvilken fremgangsmåde omfatter kvantificering, i en cfDNA-prøve opnået fra transplantatmodtageren af mængden af en donor-SNP-allel til en SNP valgt i et hvilket som helst af kravene 1 til 6.
11. Fremgangsmåde ifølge krav 10, hvor (i) transplantatet er et marginalt organ; (ii) transplantatet monitoreres for at påvise reperfusionsskade; (iii) transplantatet monitoreres for at bestemme den laveste virksomme dosis af et immunsuppressivt lægemiddel; (iv) transplantatet monitoreres for at påvise skade på transplantatet fra donorspecifikke antistoffer eller (v) transplantatet er en lever, nyre eller et hjerte.
12. Fremgangsmåde ifølge et hvilket som helst af kravene 1 til 3, hvor SNP’en vælges ved anvendelse afen fremgangsmåde ifølge et hvilket som helst af kravene 4 til 8.
13. Fremgangsmåde ifølge et hvilket som helst af kravene 4 til 7, hvor den kvantitative PCR er realtids-PCR.
DK14804474.6T 2013-05-29 2014-05-29 Påvisning og kvantificering af cellefrit dna fra donor i kredsløbet hos organtransplantatmodtagere DK3004388T4 (da)

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US201361828553P 2013-05-29 2013-05-29
PCT/US2014/040055 WO2014194113A2 (en) 2013-05-29 2014-05-29 Detection and quantification of donor cell-free dna in the circulation of organ transplant recipients

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US (3) US20160115541A1 (da)
EP (1) EP3004388B2 (da)
CY (1) CY1122332T1 (da)
DK (1) DK3004388T4 (da)
ES (1) ES2704682T5 (da)
HR (1) HRP20190209T4 (da)
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EP3004388B2 (en) 2023-05-31
SI3004388T2 (sl) 2023-11-30
ES2704682T5 (es) 2023-11-10
EP3004388B1 (en) 2018-10-31
WO2014194113A3 (en) 2015-01-22
DK3004388T4 (da) 2023-08-28
EP3004388A2 (en) 2016-04-13
WO2014194113A2 (en) 2014-12-04
EP3004388A4 (en) 2017-01-11
US20180346982A1 (en) 2018-12-06
HUE041935T2 (hu) 2019-06-28
HRP20190209T4 (hr) 2023-09-15
CY1122332T1 (el) 2021-01-27
HRP20190209T1 (hr) 2019-04-05
US11155872B2 (en) 2021-10-26
SI3004388T1 (sl) 2019-03-29
PT3004388T (pt) 2019-01-29
LT3004388T (lt) 2019-01-25
US20160115541A1 (en) 2016-04-28
ES2704682T3 (es) 2019-03-19
PL3004388T5 (pl) 2023-10-09
PL3004388T3 (pl) 2019-04-30

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