發明
中華民國
106133438
I 643955
A群鏈球菌感染之患者的分群方法
義守大學
2018/12/11
A群鏈球菌感染人類會導致咽喉炎、猩紅熱、壞死性肌膜炎或鏈球菌毒素休克症候群,其重症感染如壞死性肌膜炎及鏈球菌毒素休克症候群,與病患體內是否產生中和性抗體有效對抗A群鏈球菌相關,而中和性抗體的含量與疾病的嚴重性成正向相關性,若抗體低則易發展為壞死性肌膜炎或鏈球菌毒素休克症候群等重症。我們將包含:M蛋白片段、纖維結合蛋白(Sfb1)、鏈球菌溶血素S(SagA; SLS)及致熱性外毒素B(SPE B)等A群鏈球菌致病因子的抗原片段,以分子生物技術結合,成功製造基因重組融合蛋白rFSBM,且在動物實驗中證實rFSBM能夠成功誘發免疫反應,使實驗小鼠產生對抗A群鏈球菌之中和性抗體,降低受A群鏈球菌感染小鼠的組織病變及死亡率。我們發現以rFSBM發展的偵測試劑能夠成功結合患者體內對抗A群鏈球菌的中和性抗體,且在壞死性肌膜炎或鏈球菌毒素休克症候群等重症病患血中,此中和性抗體濃度明顯低於咽喉炎及猩紅熱的患者。換言之我們可利用基因重組蛋白rFSBM作為一快速診斷工具,判斷A群鏈球菌感染患者血中對抗M蛋白、Sfb1、SLS及SPE B等致病因子的中和性抗體濃度高低,輔助臨床醫師在收治病患時做出正確有效的判斷及治療方針。 Group A streptococcus (GAS) is an important human pathogen, and it causes a variety of diseases ranging from noninvasive pharyngitis to invasive diseases. Patients with invasive GAS disease had significantly lower serum levels of protective antibodies against GAS cell bound and secreted virulence factors, such as M-protein and streptococcal pyrogenic exotoxins, compared with serum samples from noninvasive cases. A gene encoding for a poly-epitopes recombinant protein (rFSBM) was synthesized, cloned, and expressed. The rFSBM protein contains four different epitopes, including the domains of streptococcal Sfb1, SLS, SPE B, and M protein. Here, we provided an ELISA assay using the rFSBM to identify protective antibodies within serum samples from the GAS infection patients. Results indicated that patients with invasive GAS disease had significantly lower serum levels of antibodies against rFSBM protein compared with serum samples from noninvasive cases.
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