초록 ▼

The invention provides among other things methods and kits based on assaying for cardiac troponin autoantibodies, either in conjunction with an assay for cardiac troponin and/or as an independent indicator of cardiac pathology, such as myocarditis, cardiomyopathy, and/or ischemic heart disease. Assa

The invention provides among other things methods and kits based on assaying for cardiac troponin autoantibodies, either in conjunction with an assay for cardiac troponin and/or as an independent indicator of cardiac pathology, such as myocarditis, cardiomyopathy, and/or ischemic heart disease. Assay methods of the invention can be employed among other things to identify cardiac pathology, or risk thereof, in subjects who have an autoimmune disease or who are related to an individual with an autoimmune disease. In particular embodiments, the invention also provides a method of determining whether a subject having, or at risk for, a cardiac pathology is a candidate for immunosuppressive therapy or immunoabsorption therapy. The invention also provides kits and kit components that are useful for performing the methods of the invention.

대표청구항 ▼

1. A method of determining the reliability of a cardiac troponin antigen assay in a biological sample from a subject, the method comprising assaying the biological sample from the subject for an autoantibody reactive with the cardiac troponin antigen being assayed, to allow detection of an elevated

1. A method of determining the reliability of a cardiac troponin antigen assay in a biological sample from a subject, the method comprising assaying the biological sample from the subject for an autoantibody reactive with the cardiac troponin antigen being assayed, to allow detection of an elevated level of the cardiac troponin-reactive autoantibody against the cardiac troponin antigen in the biological sample in comparison to a predetermined normal control sample having normal values of cardiac troponin-reactive autoantibody against the cardiac troponin antigen, wherein assaying comprises (a) contacting the biological sample with a cardiac troponin antigen, under conditions sufficient for binding of the cardiac troponin antigen to any corresponding cardiac troponin-reactive autoantibody present in the sample;(b) contacting the biological sample with a labeled cardiac troponin-reactive antibody under conditions sufficient for the labeled cardiac troponin-reactive antibody to compete with said cardiac troponin-reactive autoantibody for specific binding to the cardiac troponin antigen; and(c) detecting the level of complex(es) comprising the cardiac troponin antigen bound to the labeled cardiac troponin-reactive antibody, wherein the level of said complex(es) is negatively correlated with the level of the corresponding cardiac troponin-reactive autoantibody present in the sample; and wherein: detecting an elevated level of cardiac troponin-reactive autoantibody in the biological sample in comparison to the predetermined normal control sample provides indication that the biological sample is scored as one in which the cardiac troponin antigen assay is not reliable, anddetecting a level of cardiac troponin-reactive autoantibody that is not elevated in the biological sample in comparison to the predetermined normal control sample provides indication that the biological sample is scored as one in which the cardiac troponin antigen assay is reliable. 2. The method of claim 1, wherein the biological sample is obtained from a human. 3. The method of claim 1, wherein the cardiac troponin antigen assayed comprises a cardiac troponin antigen selected from the group consisting of a cardiac troponin I, cardiac troponin T, and cardiac troponin C, and complexes thereof. 4. The method of claim 1, wherein the autoantibody is reactive with a cardiac troponin antigen comprising a cardiac troponin antigen selected from the group consisting of a cardiac troponin I, cardiac troponin T, and cardiac troponin C, and complexes thereof. 5. The method of claim 1, wherein the method is carried out before, or simultaneously with, the cardiac troponin antigen assay. 6. The method of claim 1, wherein the method is carried out in the absence of the cardiac troponin antigen assay. 7. The method of claim 1, wherein the sample is determined to have an elevated level of cardiac troponin-reactive autoantibody, and the sample is assessed for one or more additional indicators of cardiac pathology selected from the group consisting of myoglobin, CK-MB, BNP, CRP, Troponin-I, Troponin-T, blood oxygen level, cardiac imaging, and electrocardiography. 8. The method of claim 1, wherein the contacting of claim 1(a) and the contacting of claim 1(b) are carried out simultaneously. 9. The method of claim 1, wherein the contacting of claim 1(a) and the contacting of claim 1(b) are carried out sequentially, in any order. 10. The method of claim 1, wherein the cardiac troponin antigen is affixed to a solid phase, binding of the cardiac troponin antigen to labeled cardiac troponin-reactive antibody or to the corresponding cardiac troponin-reactive autoantibody present in the sample forms a solid phase-affixed complex, and said detecting comprises detecting a signal from the solid phase-affixed complex. 11. The method of claim 10, wherein the solid phase comprises a microparticle. 12. The method of claim 10, wherein the solid phase comprises an electrode. 13. The method of claim 1, wherein the label comprises a direct label. 14. The method of claim 13, wherein the direct label comprises an acridinium-9-carboxamide. 15. The method of claim 1, wherein the label comprises an indirect label. 16. The method of claim 1, wherein the detecting of (c) comprises contacting the label with an indicator reagent. 17. A test kit for use in assaying a biological sample from a human for an autoantibody reactive with a cardiac troponin antigen, the test kit comprising a humanized monoclonal antibody, wherein the humanized monoclonal antibody is specific for a cardiac Troponin-I or Troponin-T, wherein the test kit additionally comprises a solid phase and a capture agent affixed to the solid phase, wherein the capture agent is selected from the group consisting of a cardiac troponin antigen and a human-specific antibody which binds to the cardiac troponin-reactive autoantibody against the cardiac troponin antigen, and wherein, if the capture agent comprises a cardiac troponin antigen, the kit additionally comprises a human-specific antibody which binds to the cardiac troponin-reactive autoantibody against the cardiac troponin antigen. 18. The test kit of claim 17, wherein the test kit additionally comprises a labeled detection agent, wherein if the capture agent comprises a cardiac troponin antigen, the detection agent comprises the human-specific antibody; andif the capture agent comprises a human-specific antibody, the detection agent comprises a cardiac troponin antigen. 19. The test kit of claim 18, wherein at least the label comprises a direct label. 20. The test kit of claim 19, wherein the direct label comprises an acridinium-9-carboxamide. 21. The test kit of claim 18, wherein the label comprises an indirect label. 22. The test kit of claim 18, additionally comprising an indicator reagent that interacts with at least one label to produce a detectable signal. 23. The test kit of claim 17, wherein the solid phase comprises a microplate. 24. The test kit of claim 17, wherein the solid phase comprises a microparticle. 25. The test kit of claim 17, wherein the solid phase comprises an electrode. 26. A test kit for use in assaying a biological sample from a human for an autoantibody reactive with a cardiac troponin antigen, the test kit comprising a humanized monoclonal antibody, wherein the humanized monoclonal antibody is specific for a cardiac Troponin-I or Troponin T, wherein the test kit additionally comprises a labeled non-human monoclonal antibody, wherein the non-human monoclonal antibody is specific for a cardiac Troponin-I or Troponin-T, and a human-specific antibody which binds to the cardiac troponin-reactive autoantibody against the cardiac troponin antigen.