CN1275885A - 测定包括化学治疗剂在内的活性剂精确效力的方法 - Google Patents

测定包括化学治疗剂在内的活性剂精确效力的方法 Download PDF

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CN1275885A
CN1275885A CN97196143A CN97196143A CN1275885A CN 1275885 A CN1275885 A CN 1275885A CN 97196143 A CN97196143 A CN 97196143A CN 97196143 A CN97196143 A CN 97196143A CN 1275885 A CN1275885 A CN 1275885A
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P·L·科恩布里斯
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    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
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    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
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    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/5005Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving human or animal cells
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    • GPHYSICS
    • G01MEASURING; TESTING
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Abstract

一种用来为具体患者筛选多个候选治疗剂或化学治疗剂的效力的改进系统,其中,先获取患者的组织样品,培育并使其分别暴露在多种处理剂和/或治疗剂下,以便客观地确定对特定患者的最佳治疗剂。具体的方法革新,如组织样品制备方法,使得该方法在实践和理论上均适用。对于初始组织培养单层制备来说,特别重要的组织样品制备方法是初步制备组织样品的粘合性多细胞颗粒,而不是酶解离的细胞悬液或制备液。通过使均匀的细胞样品受各种活性剂(及其各种浓度)的作用,就可确定治疗特定患者最为有效的试剂和浓度。

Description

测定包括化学治疗剂在内的活性剂精确效力的方法
                 发明领域
本发明涉及包括化学治疗剂在内的活性剂的筛选和测试方法,以预测其在打算使用这种试剂来治疗的各患者中的潜在效力。
                   引言
在美国,包括化学治疗剂再内的所有活性剂都应在批准用于医疗前进行效力和安全性的严格测试。评价效力的方法包括对给定治疗方法和/或活性剂用双盲试验(double blind study)在大量试验者中进行细致的研究,然后对获得的数据作统计学整理分析,但是这些结论必定是根据患者总数作为一个整体来作出的。然而,在许多药物学上,尤其在化学治疗领域上,单个患者治疗的结果可能与总结的数据并不相符,这对单个患者是不利的。长期以来认识到需要有这样一种方法,该方法能在对给定的各个患者治疗前测定治疗活性剂(包括但不局限于化学治疗剂)对该患者的治疗潜力。
已有技术测定方法早已存在,该方法是将各类恶性组织暴露在多种活性剂下以评价治疗给药的最佳选择。例如,在Kruczynski,A.等,″Evidence of a directrelationship between the increase in the in vitro passage number of human non-small-cell-lung cancer primocultures and their chemosensitivity,″Anticancer Research,vol.13,no.2,pp.507-513(1993)中,在体内移植物、体外初始培养物(primoculture)和商业上购得的长期生长癌细胞系中,研究了非肺癌小细胞(non-small-cell-lungcancer)的化学敏感性。记录下化学敏感性的增加,并使其与出现问题的细胞的形态变化关联。有时用预期的治疗剂来测试动物模型恶性细胞和/或建立的细胞培养物,例如参见Arnold,J.T.,″Evaluation of chemopreventive agents in differentmechanistic classes using a rat tracheal epithelial cell culture transformation assay,″Cancer Res.,vol.55,no.3,pp.537-543(1995)。
当针对各个患者用真正的患者细胞来进行体外测定方法时,在典型的已有技术方法中,细胞通过获取(活体检查)和胰蛋白酶消化(用胰蛋白酶消化结缔组织)来产生适于变成所需组织培养物形式的细胞悬液。从这些方法获得的体外组织培养细胞收集物通常受到这样的困扰,即它们不能准确地模拟原来的肿瘤或其它活体检查细胞的化学敏感性。而且,标准的克隆和组织培育技术在用于不同患者的测定设置时显得非常复杂和昂贵。因此仍需要一种组织培育方法,该方法能为药物筛选提供细胞培养物,该细胞培养物在简单地制备后能以等价于其体内反应性的方式进行反应,从而能对打算进行这种筛选的特定患者进行药物或化学治疗剂的筛选。
                             发明概述
为了满足这一需求,本发明是用来为具体患者筛选多个候选治疗剂或化学治疗剂的效力的改进系统,其中,先获取患者的组织样品,培育并使其分别暴露在多种处理剂和/或治疗剂下,以客观地确定对患者的培育细胞的最佳处理剂。具体的方法革新,如组织样品制备方法,使得该方法在实践和理论上均适用。对于制备最初的组织培养单层来说,一个特别重要的组织样品制备方法是初步制备组织样品的粘合性多细胞颗粒,而不是酶解离的细胞悬液或制备液。例如对于恶性细胞的培育,认为(不拟受理论束缚)通过将恶性细胞保持在原来组织的多细胞颗粒内,恶性细胞本身的生长比成纤维细胞或其它细胞的过分生长(当悬浮的肿瘤细胞在培养物中生长时很容易发生这种情况)更容易。因此可以形成实用的单层细胞,以便能有意义地筛选多种处理剂和/或试剂。检测细胞的生长以确定开始试验的时间,并测定培育细胞的生长速度;另外对药物加入的次序和时间也进行监控和优化。通过使均匀的细胞样品受各种活性剂(及其各种浓度)的作用,就可确定最有效的试剂。对于有关癌症治疗的测定,考虑采用两阶段评价方法,在该方法中对给定的抗癌试剂的急性细胞毒性和长期抑制效果均可进行研究。
                           发明详述
本发明是用来为具体患者筛选多种候选治疗剂或化学治疗剂的效力的系统,其中,先获取患者的组织样品,并使其分别暴露在多种处理剂和/或治疗剂下,以客观地确定最佳的处剂理或试剂。具体的方法革新,如组织样品制备方法,使得该方法在实践和理论上均适用。对于制备最初的组织培养单层来说,一个特别重要的组织样品制备技术是初步制备组织样品的粘合性多细胞颗粒(外值体),而不是酶解离的细胞悬液或制备液。对细胞生长、药物加入的次序和时间进行监控和优化。
本发明的一个重要应用是筛选出抗恶性细胞(该恶性细胞从患者体内活体检查获得)组织培养制备物的化学治疗剂和其它抗赘生治疗剂。可用本发明系统来筛选的有关抗癌症治疗剂是,放射治疗剂和增强放射致细胞毒性的试剂,以及抗癌症免疫治疗试剂。非恶性综合征的处理剂或治疗剂的筛选方法也包括在本发明范围内,然而,它还包括抗过度增生综合征(如牛皮癣)的试剂,或伤口愈合剂。本发明的效力测定法不仅仅局限于筛选可加速细胞生长(愈合情况)或减缓细胞生长(抗癌症、抗过度增生)的活性剂,因为本发明的组织培育系统也可用于测试增强或抑制细胞内生物化学功能的试剂。例如,在对患者进行治疗之前,可用本发明的测定方法来筛选酶、神经传递介质和其它生物化学物质的形成或阻断。
在治疗患者肿瘤时,在本发明的较佳实例中,采用本领域已知的任何合适的活体检查或外科方法,来从患者体内获得肿瘤活体检查物,即大于100mg的无坏死、无污染组织。活体检查样品制备通常在层流罩超净台(应在使用前至少20分钟前打开)上按照以下步骤进行。在开始制备样品前,用试剂级乙醇擦干净超净台表面。然后在无菌条件下,从运输容器中取出肿瘤,并用消毒剪剪碎。如果获得的样品已经粉碎,则应将各肿瘤部分分成四组。然后用消毒镊子将每一未分组的组织的1/4部分放入3ml消毒生长培养基(标准的F-10培养基,含有17%小牛血清和标准量的青霉素和链霉素)中,并用两把类似剪刀运动方式的消毒手术刀、或机械上等效的手工或自动的相反切齿刀片(incisor blade)来进行有规则的切削。这种交错切割的运动很重要,因为该方法在获得的肿瘤多细胞颗粒上产生了平滑的切割边缘。较佳的(但不是必需的),每个肿瘤颗粒的大小为1mm3。在每个肿瘤的1/4部分被切碎后,用消毒的巴斯德毛细吸管将颗粒种在培育瓶中(每个T-25瓶中有9个外值体,或每个T-75瓶中有20个颗粒)。然后在每个瓶上标上患者代码、外植日期以及任何其它辨别的数据。外值体应均匀地分布在瓶底表面上,先在37℃培养箱中倒置培育5-10分钟,然后加入约5-10ml消毒的生长培养基,以正常的非倒置位置进行进一步培养。此瓶放在35℃、没有CO2的培养箱中。应每天检查瓶中的生长和污染情况。在几个星期后(每周取出并更换5ml生长培养基),外值体会使细胞生长形成单层。对于恶性细胞的培养,认为(不拟受理论束缚)通过将恶性细胞保持在原来组织的多细胞颗粒内,恶性细胞本身的生长比成纤维细胞(或其它不要的细胞)的过度生长(悬浮的肿瘤细胞在培养基中生长时经常产生此情况)更容易。
用上述步骤来形成细胞单层培养物,可以使来自组织样品的恶性细胞的生长最大化,因而优化了随后进行的各种待测试剂化学治疗作用的组织培养测定。然而,真正的恶性细胞生长增强只是本发明的一个方面;本发明的另一重要特征是用来监视一旦形成的单层的生长情况的生长速度监控系统。一旦初始培养及其衍生的次级单层组织培养开始,就对细胞的生长进行监测,以确定开始化学治疗试验的时间并测定培育细胞的生长速度。
对细胞生长的监控这样来进行:不杀死细胞或不对细胞染色,也不从培养瓶中取出任何细胞,对单层细胞进行定期计数。可用肉眼观察或自动的方法,采用或不采用本领域已知的估计方法(例如,计数网格的代表性区域内的数量,再乘以网格数)来进行计数。然后用定期计数获得的数据来确定生长速度是否与同类细胞在患者体内的生长速度平行。例如,如果记录了生长速度周期,则可以为患者制定某些活性剂的剂量。相同的生长速度也可用来评价放射治疗的周期性。应当注意,当单层在中生长时进行生长速度测定时,本发明的方法不需用血细胞计数、流式细胞计数或用显微镜载玻片和染色,也没有这些方法附加的劳力和成本。
细胞单层生长速度的步骤通常是:用相差倒置显微镜检测在37℃培养箱(5%CO2)中培育的培养瓶。将瓶放在相差倒置显微镜下,用10X物镜检测10个网格区域(瓶上固有一个网格区域),其条件是10个区域不应相邻,也不相隔非常远,这样10个区域是整个瓶的代表性取样。记录每个区域被的细胞占据的百分数,对这些百分数取平均值,然后评价细胞培养物中总的铺满百分数(percentconfluency)。当患者样品被分到两个或三个或多个瓶中时,应计算总的患者样品的平均细胞计数值。计算得到的平均铺满百分数应输入工序记录中,以便能汇编这些数据,并绘制时间-生长曲线。可对单层培养物进行照相,以记录细胞形态和培养物生长模式。适用的公式如下:
             细胞占据面积的估计值铺满百分数=       观察区域的总面积
因此,例如,当细胞占据的面积的估计值为30%而总区域的面积为100%时,铺满百分数为30/100,或30。
采纳上述步骤可直接用于非肿瘤细胞,它大致上形成了等价的步骤。
采用培育细胞的活性剂筛选不在原先的培育瓶中进行,而通常在板(如微量滴定板)中进行。用于筛选目的的化学敏感性测定方法的实施取决于将可再现细胞数量输递到一块板和/或一系列板每行中的能力,以及在给定孔中使细胞平均分布的能力。下列步骤确保了细胞能再现地从瓶转移到微量滴定板中,且细胞均匀地分布在每个孔的表面上。
制备微量滴定板的第一步当然是如上所述的制备和检测细胞单层。下列步骤是示范性的,对其所作的变动对于本领域技术人员来说是显然的。从培育瓶中取出细胞,通过离心制备细胞沉淀。然后将从单层获得的细胞沉淀悬浮在5ml生长培养基中,并用涡流搅拌器在锥形试管中混合6-10秒。然后来回振荡试管10次。从锥形试管中心吸取36μl的液滴,滴在96孔板的一个孔中。然后用一新的移液管吸取36μl等份的台盼蓝溶液加入同一孔中,靠移液管的反复抽吸来使两液滴混合。然后将获得的混合物分到血细胞计数计的两个小室中,用标准的光学显微镜检测。在10x放大倍数下,对血细胞计数计的四个象限中的两个进行计数。只对那些没有接受台盼蓝染料的细胞进行计数。对第二个计数小室重复该过程。这样就测得了每个室的平均细胞计数。用本领域已知的方法核定象限计数值,作记录(log),乘以10-4,给出细胞数/毫升,并相应地计算出使其余细胞等份悬浮必需的液体(生长培养基)总量。
在测定了培养基中所需的细胞浓度后,用涡流搅拌机和振荡使来自单层的其余细胞等份悬浮在生长培养基中,并装入本领域已知的Terasaki分装器中。用本领域已知的Terasaki分装技术将制得的细胞悬液按等份转移到微量滴定板上。根据需要可以从一个细胞悬液制得多个培养板。然后根据本领域已知的方法,用消毒的湿棉纱布包裹平板,并放在培养箱中培育。
在制得微量滴定板后,根据下述示范性的步骤使其中的细胞暴露在活性剂下。在本发明测定方法的这部分中,将合适量的特定活性剂转移到如上所述制得的微量滴定板中。通用步骤可作如下改变。解开每个微量滴定板的湿棉纱布,并用显微镜检测细胞的粘附情况。将对照溶液分散在微量滴定板网格中标记行的孔中,在其余行的其余孔中加入合适等份的待测试活性剂。通常是,依次将浓度渐增的待测试活性剂加入培养板中数字逐渐增高的行中。然后将培养板重新包在纱布内,并在37℃、5%CO2的培养箱中培养。在暴露了预定的时间后,解开包布取出培养板,用消毒纱布吸除试剂,用Hank′s Balance Salt Solution洗涤,注入生长培养基,并再次在培养箱中培养预定的时间,然后固定培养板和染色,并进行评价。
固定和染色可根据许多合适的步骤来进行;下面是典型的步骤。从培养箱中取出培养板,倒去培养基,用Hank′s Balance Salt Solution注满培养板。在重复注满倒去后(每次伴随搅拌),注入试剂级乙醇保持2-5分钟。然后倒去乙醇。每个培养板用约5ml Giemsa Stain液进行染色,但是体积并不是关键,注满才是目的。Giemsa染色应放置5分钟±30秒,因为时间长短会影响染色强度。然后倒去Giemsa染色液,将板浸泡在烧杯中的3倍冷自来水中。然后,翻转平板用力振动,并在实验室工作台支架上空气干燥过夜(除去平板盖子)。然后人工或用自动和/或计算机方法对每个孔中的细胞计数,以获得暴露在不同浓度活性剂下时细胞的化学敏感性数据。一种特别适用于细胞计数的计算机操作环境是商业上购得的OPTIMATE编译程序,该编译程序被设计成能执行光学计数功能,该功能非常适用于计算机化细胞计数步骤以及随后的计算。
当测定细胞生长促进剂而不是细胞抑制剂(如化学治疗剂)时,上述步骤没有作明显改变。本发明测定方法使细胞死亡或细胞生长能同样容易地被检测。在任何一种情况下,本发明系统应用的优化包括各种候选活性剂的对比测试,从而根据体外测试结果为患者选择最佳的治疗候选物。上述发明的一个特别有利的实例包括一个两阶段的测定,在测定细胞毒性后再评价药物的长期抑制效果。因此,可以分开评价化学治疗剂的直接化学治疗效果及其较长期的持续效力。
一种或多种活性剂或化学治疗剂的鉴定在本发明的范围内,其目的是为给定患者筛选任何或所有试剂的效力。几乎所有的活性剂均可用本发明的方法来进行筛选;因此这里省略了典型活性剂的一览表。
因此,本发明的精髓包括本发明系统重要特征的简单性:用待测试患者组织的粘合性多细胞颗粒来形成细胞单层;对那些单层的生长进行监控以精确地预测相同细胞在体内的相关生长;可对多种活性剂的不同浓度进行测试,目的不但是确定最合适的试剂,而且是确定用于真实患者治疗时该试剂的最佳浓度(根据计算的细胞生长速度)。也应注意在本发明的内容中,本发明系统允许在组织培养单层(该培养物在快速生长条件下(约几周)在营养培养基中生长)的悬液中进行体外测试,而不是用稀释克隆经过长时间产生的单一细胞子代来测试。在一些情况下,本发明是测定细胞毒性和长期生长抑制作用的两阶段测定法。
尽管本发明已就上述特定材料和方法进行了描述,但应认为,本发明只局限在附加的权利要求提出的范围内。

Claims (12)

1.一种评价患者细胞化学敏感性的方法,该方法包括下列步骤:
a)收获患者组织、细胞腹水或渗出液的样品;
b)将所述样品分成多细胞颗粒;
c)从所述粘合性多细胞颗粒中长出组织培养单层;
d)将所述单层的细胞接种入分隔的多个部位;和
e)用至少一种活性剂处理所述多个部位,然后评价所述部位中的细胞对至少一种活性剂的化学敏感性。
2.根据权利要求1所述的方法,其中步骤a)还包括步骤
a)制备一个样品,该样品从患者肿瘤组织的样品中获得。
3.根据权利要求1所述的方法,其中所述分隔的多个部位还包括其中含有多个孔的平板。
4.根据权利要求1所述的方法,其中步骤e)还包括步骤
e)用不同浓度的多种活性剂来处理所述多个部位,然后评价单种活性剂在单个浓度下的最优化学敏感性。
5.根据权利要求1所述的方法,其中步骤e)还包括步骤
e)用多种活性剂对所述多个部位处理充分长的时间,以评价所述多种活性剂的至少一种的初始细胞毒性效果和长期抑制效果。
6.根据权利要求1所述的方法,其中根据步骤e)测得的化学敏感性是抗癌敏感性。
7.根据权利要求1所述的方法,其中步骤d)用Terasaki分装器来实现。
8.根据权利要求1所述的方法,其中在步骤d)中,细胞在接种入培养板的多个孔中之前,先制备成悬液。
9.根据权利要求1所述的方法,其中所述活性剂是化学治疗剂。
10.根据权利要求1所述的方法,其中所述活性剂是伤口愈合剂。
11.根据权利要求1所述的方法,其中所述活性剂是放射治疗剂和/或放射治疗致敏剂或改进剂。
12.根据权利要求1所述的方法,其中所述活性剂是免疫治疗剂。
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CN105143883A (zh) * 2013-04-25 2015-12-09 Q吉尔股份有限公司 基于细胞的药物筛选分析方法和其用途
CN116622801A (zh) * 2023-07-24 2023-08-22 安泰康生物技术(北京)有限公司 一种患者来源超微组织培养药物敏感性检测方法

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