HLA-B27 assay

Chemistry: molecular biology and microbiology – Measuring or testing process involving enzymes or... – Involving antigen-antibody binding – specific binding protein...

Reexamination Certificate

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C435S007100, C435S967000, C435S968000, C436S518000, C436S529000, C436S536000, C436S546000, C436S008000, C436S016000, C436S010000, C436S172000, C436S805000, C436S811000, C530S388700, C530S388750, C530S391300

Reexamination Certificate

active

06613535

ABSTRACT:

FIELD OF THE INVENTION
This invention relates to a method for establishing and using a decision point in flow cytometry wherein the decision point defines a point on the axis of a fluorescence histogram for a fluorescent marker of interest such that if the median channel number of cells stained with that fluorescent marker is greater than the decision point then the sample is said to be “positive” for the fluorescence marker used. The invention more particularly relates to a method for using a fluorescent microparticle as a a control to adjust/monitor the decision point in a flow cytometer. The microparticle having a specified fluorescence which corresponds to the point on the fluorescence histogram when used in conjunction with a fluorescently labelled anti-HLA-B27 monoclonal antibody. When a patient sample is tagged with a fluorescently labelled anti-HLA-B27 antibody, if the median fluorescence channel exceeds the decision point, the patient is said to be “HLA-B27
+
.”
BACKGROUND OF THE INVENTION
Flow cytometry comprises a well known methodology for identifying and distinguishing between different cell types in a non-homogeneous sample. The sample may be drawn from a variety of sources such as blood, lymph, urine, or may be derived from suspensions of cells from solid tissues such as spleen, lymph node or liver. In the flow cytometer, cells are passed substantially one at a time through one or more sensing regions wherein each cell is illuminated by an energy source. The energy source generally comprises means that emits light of a single wavelength in a sensing region such as that provided by a laser (e.g., He/Ne or argon) or a mercury arc lamp with appropriate bandpass filters. Different sensing regions can include energy sources that emit light at different wavelengths.
In series with each sensing region, various light collection means, such as photomultiplier tubes, are used to gather light that is refracted by each cell (generally referred to as forward light scatter), light that is reflected orthogonal to the direction of the flow of the cells through a sensing region (generally referred to as orthogonal or side light scatter) and one or more light collection means to collect fluorescent light that may be emitted from the cell, if it has been tagged with one or more fluorescent markers, as it passes through a sensing region and is illuminated by the energy source. Light scatter is generally correlated with physical characteristics of each cell such as size and granularity.
Flow cytometers further comprise data recording and storage means, such as a computer, wherein separate channels record and store the light scattered and fluorescence emitted by each cell as it passes through a sensing region (i.e., the data collected for each cell comprises a “recorded event”). The recorded events then can be displayed by plotting orthogonal light scatter versus forward light scatter in either real time or by reanalysis of the data after the events have been recorded. U.S. Pat. Nos. 4,599,307 and 4,727,020 describe of the various components that comprise a flow cytometer and also the general principles of its use.
Monoclonal antibodies are particularly useful in flow cytometry when conjugated, directly or indirectly, to fluorescent dyes (generically this combination is referred to as an “immunofluorescent marker”). Monoclonal antibodies have been made against a large number of antigens present on and within cells. Such antibodies are used to identify certain populations of hematopoietic cells as well as subpopulations thereof. An immunofluorescent marker is added to a sample of cells and the sample then is analyzed by means of flow cytometry. The light emitted by the fluorescent dye as it is excited by the energy source is stored and recorded as described above. PCT Appl. No. PCT/CA92/00105 describes the extent to which monoclonal antibodies have been and are being used to identify various cell populations and subpopulations.
When a recorded event includes fluorescent data, the data can be displayed in a fluorescence histogram such as is shown in
FIG. 2
of U.S. Pat. No. 4,727,020. If multiple immunofluorescent markers are used (wherein each dye has an emission spectra that is distinguishable from the other dyes used), the data for a recorded event can be displayed in a multi-dimensional format such as shown in
FIG. 3
of the same patent.
Looking more closely at
FIG. 2
a
in that patent, it can be seen that not all cells express the same amount of fluorescence. This may be due to reaction conditions or may be due to differences between the levels of expression of the antigen on the cell. It also can be seen that there are a large number of cells that have little or no fluorescence intensity. Generally, these cells would be referred to as being “negative” for expression of the immunofluorescent marker while the remaining cells would be referred to as being “positive” for the immunofluorescent marker.
Looking at
FIG. 3
, one can distinguish between cells on the x and y axes that are clearly “positive” (i.e., they are far away from the origin), and cells in the bottom left corner of the figure that are “negative” (i.e., they are close to the origin). For both FIG.
2
and
FIG. 3
, however, it is not immediately apparent from the displays which cells should be characterized definitively as belonging in either class nor is it apparent that one would classify the individual from whom this sample was taken as being positive or negative for the markers used.
Because the level of fluorescence intensity for any given population of tagged cells in a sample is not always clear, many methods have been developed to try to separate “positive” and “negative” cells. U.S. Pat. No. 4,987,086 describes a gating method which can be used to set boundaries or “gates” in a two dimensional display in order to distinguish between such cells. The method makes use of scatter parameters and fluorescent parameters to arrive at a decision point for each fluorescent marker as to the boundary between positive and negative cells.
The information provided by the method described in U.S. Pat. No. 4,987,086, however, relates only to a calculation of the number of cells present in one or more cell populations or subpopulations for the individual sample being examined. It does not give an indication whether a particular sample can be said to be “positive” or “negative” for the a particular marker when that marker is viewed in the context of a population of patients. For example, in certain diseases, the presence or absence of a particular marker may be indicative of a disease state or of susceptibility to such disease. In a sample taken from a patient, there may be individual cells that are “positive” or “negative” on a fluorescence plot of those cells. The plot will have a median fluorescence channel. Unless the channel number for that patient's sample is compared with a decision point derived from a population of patients, the total number of cells which are positive or negative does not make full use of the information present. Thus, merely classifying each cell as positive or negative for a marker is not enough.
SUMMARY OF THE INVENTION
The present invention comprises a method to identify and set a decision point in order to discriminate between a positive and negative sample of cells wherein those cells have been tagged with a fluorescent marker. The decision point comprises a decision point on a fluorescence axis. The decision point is set so that it corresponds to the fluorescence channel at the desired sensitivity and specificity for the fluorescent marker. This is done by analysis of known patient samples. In a preferred embodiment, the desired sensitivity is 100% and the desired specificity is at least 97%. If a patient sample that has been tagged with a fluorescent marker which is specific for the cell marker of interest has a median channel number greater than the decision point, the sample is said to be “positive” for that marker.
The decision point may be set in software used in conjunction

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