The present inventions relate to methods and devices for detection of pathogen protease activities and their applications including diagnostic applications for detection of certain pathogen infections in a patient or animal species. Present invention discloses a method of signal amplification enabled by a protease to be detected and its applications. The present invention further discloses methods for monitoring disease progression after infection of SARS CoV-2 virus and for diagnosis of SARS CoV-2 infection.
No government funds were used in making the inventions herein disclosed.
Pathogens have adapted to live and replicate in their host cells and to transmit from one individual to another. Replication of a pathogen, particularly viruses, in infected human or animal hosts often rely on the nucleic acid and/or protein synthesis machines of the host cells. However, proteins encoded by the genome of a pathogen, particularly a virus, often play essential roles in the survival, replication and transmission of the pathogen. Among these pathogen-encoded proteins are endopeptidases, which are also known as proteases and proteinases.
In order to efficiently use its compact genome, viruses often synthesize the viral proteins as polyproteins, each of which contains more than one functional protein. The polyproteins must be cleaved at precise locations to release the individual proteins. In some cases, the polyproteins are cleaved by a protease of the host cells. In other cases, the viral polyproteins are cleaved by a protease encoded by viral genome itself. This latter class of viruses includes, but is not limited to, human immunodeficiency virus (HIV), human hepatitis C virus (HCV), coronavirus viruses, West Nile virus, Zika virus and dengue viruses.
Because a virus encoded protease cleaves the viral polyprotein at specific cleavage sites, viral proteases have been favorite targets for the development of antiviral drugs. Indeed, many efforts have been devoted to developing inhibitors for these viral proteases as antiviral drugs. Some of these inhibitors have become antiviral drugs. For example, protease inhibitors targeting HIV and HCV proteases are important and effective antiviral drugs. The fact that pharmaceutical drugs inhibiting viral proteases could be developed indicated that these targets are highly specific and therefore excellent target for diagnosis of a viral infection.
Fluorescent assays have been developed and used for screening viral protease inhibitors. For example, a fluorescent assay was used for screening for SARS-CoV-2 3CL enzyme inhibitors (ACS Pharmacol. Transl. Sci. 2020, 3, 5, 1008-1016). Typically, these assays use a synthetic peptide as a substrate, which contains the amino acid sequence of the cleavage site, a fluorescent moiety at one end and a quenching moiety at the other end. The quenching moiety reduces the fluorescence or causes a wavelength shift of the fluorescence. When the peptide substrate is cleaved by a protease, the fluorescence intensity increases and/or the peak wavelength changes. These changes can be measured using a fluorimeter. This type of assays is not very sensitive; but, they are adequate for inhibitor drug screening as a large amount of cloned and purified protease can be used in the screening assay. However, they are not adequately sensitive for diagnostic uses, which require the detection of a minute amount of viral protease in a sample.
Methods herein described are substantially more sensitive and hence suitable for use in diagnosis of a pathogen infection by detecting the protease activity indicative of the presence of the pathogen.
Also described herein are methods in which the protease activity being detected enables signal amplification to further improve the detection sensitivity, referred to herein as protease enabled signal amplification (PESA) technology. In embodiments which use PESA technology, a protease for which its activity is to be detected is fused through a linker containing the specific cleavage site to signal generating moiety in a recombinant protein, wherein both the protease and the signal generating moiety are inactivated in the fusion. A protease that cleaves the cleavage site in the fusion separates and activates both the protease and the signal generation moiety. In addition to the signal generated by the activated signal generation, the activated protease cleaves further fusion proteins, activating even more protease and signal generating moiety, whereby the signal is greatly amplified. In a PESA based assay, signal amplification depends on the presence of the protease in the sample and thus can be used for detection of the protease activity. If the protease activity is indicative of a pathogen or pathogen infection, the assay can be used for detection of pathogen or pathogen infection.
Current methods for diagnosis of acute infection of SARS CoV-2, which causes COVID-19 disease, are not ideal. These methods either detect viral antigen or viral nucleic acids, both of which suffer shortcomings. The antigen assays lack sensitivity, while the nucleic acid-based assays, such as PCR, use expensive equipment, require a specialized facility, and have a long wait time for results. In methods described herein all samples can be pre-screened with coronavirus protease assay, such as the 3CL enzyme assay described in greater detail below, as these assays can be rapid and highly sensitive and require simple equipment and facilities, and only positive samples are further tested with a more specific assays such as PCR.
One important feature of a COVID-19 virus infection is that a large portion of infected individuals may have mild or no symptoms while some will progress to severe clinical symptoms and even death. It is a challenge to identify those who would progress to having severe clinical symptoms and to monitor disease progress. Methods used to predict the clinical outcome are known as prognostic tests while those used to monitor disease progress or treatment effectiveness are known as monitoring tests. Currently there is no effective prognostic or monitoring test for COVID-19 disease.
Some advantages of COV-19 diagnostic technology are as follows:
For Nucleic Acid assays, the advantages are that they are easy to develop and highly sensitive. However, the sample processing is difficult, they have long turnaround times, their reagents are in short supply and they are susceptible to genetic mutations.
For Antibody/Antigen assays, the advantages are that they are easy to use and suitable for POC use. However, they can be more difficult to develop. Antibody assays rely on antibodies whose appearance can be 10-14 days after infection. They also have a lower specificity and sensitivity when compared to molecular assays and, like molecular assays, are susceptible to genetic mutations.
For Viral Enzyme Activity assays, the advantages are that they are highly sensitive, easy to use (one or two step(s) assay), suitable for large-scale production, and suitable for POC or large-scale batch testing in lab. They are also compatible with a flu assay and detect active infections only. They are also not susceptible to genetic mutations. However, they cannot differentiate between Flu A and Flu B or between COVID-19 and non COVID-19. This limitation can be resolved by subsequent confirmatory testing of positive samples using a molecular assay.
Methods herein described use chemiluminescence or biochemiluminescence to detect protease activity in a sample. So long as the pathogen being detected contains a protease specific for a cleavage site amino acid sequence and such specificity is indicative of the pathogen, an assay can be designed for detection of the pathogen in a specific manner according to the present invention. Various embodiments are set forth illustratively in
In some embodiments, the protease assay is not specific for COVID-19. Instead, it detects Coronaviruses in general. The protease specificity is shared across the Coronaviruses. Therefore, in some embodiments, a second assay is required if the objective is to detect COVID-19 specifically; e.g., RT-PCR. These embodiments allow rapid, inexpensive, and accurate ways to screen patients to identify coronavirus positive individuals for testing by COVID-19 specific assays. This cuts down considerably on the need for RT-PCR tests. It may also serve as a test for Coronavirus infections generally, such as those that cause “common cold”.
Since virus infection of host cells requires the receptor of the host cells and a receptor exists in certain cell types or organs, this phenomenon can be used to monitor infection of certain organs for the purpose of disease progression monitoring. For example, COVID-19 virus (SARS-CoV-2 virus) infection requires cellular receptor ACE2 (Angiotensin Converting Enzyme 2), which abundantly exists in certain organs and cell types. These cell types include, but are not limited to, epithelium cells of the respiratory system, endothelium cells blood vessels, and tubular and glomerular epithelium in kidney. Detection of COVID-19 protease activity in urine may indicate the infection of kidney. Likewise, detection of COVID-19 protease activity in blood specimens (serum or plasma) may indicate infection of endothelium of the vascular system. Thus, the assay described in the present invention can be used to monitor infection of certain organs or tissues to monitor disease progression. This is important for monitoring kidney infection with COVID-19 virus as kidney infection may lead to acute kidney failure, a life-threatening secondary disease.
In an embodiment, as depicted in
In another embodiment, depicted in
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In another embodiment, depicted in
These and other embodiments of inventions herein described can be carried out in a wide variety of ways using methods well known to the art.
A variety of light enabling molecule can be used in methods herein described, including but are not limited to, various types of luciferase, phosphatase, peroxidase, and other catalysts or enzymes that directly or indirectly enable generation of a light signal. As described in embodiments herein, the light signal enabling entities can be modified to contain the specific protease cleavage amino acid sequence and cleavage of the specific site by the protease being detected causes an increase or decrease of the light signal, thereby indicating whether the donor of the sample is infected with the pathogen.
The protease indicative of a pathogen infection should cleave a specific amino acid sequence and is only present in the pathogen and/or host cells infected with the pathogen. The amino acid sequence of the cleavage site should be specific for the protease to be detected. However, the amino acid sequence may not necessarily be only one amino acid sequence; rather, it can be multiple amino acid sequences, which share similar characteristics among these sequences. The characteristics may be the hydrophobicity or size of the amino acid at certain position. The specific amino acid sequence may be any sequence which can be efficiently cleaved primarily or only by the protease to be detected. The host cellular proteases or other pathogen proteases are either deficient in the sample for detection or cannot efficiently cleave the amino acid sequence.
The sample to be tested should contain the pathogen and/or infected cells or components of the pathogen and/or infected cells.
To still increase the sensitivity of a protease dependent assay, the signal inactivating entity in a fusion protein between the signal enabling molecule and inactivating entity is a protease. When present as a fusion protein, the protease is inactivated as well. Presence of the protease activity in the sample to be detected cleaves the fusion protein at the linker site, leading to activation of both the signal enabling molecule and protease in the fusion protein. The activated signal enabling molecule produces detectable signal, directly or indirectly, indicating the presence of protease activity in the sample. In addition, the released protease from the fusion is also activated and cleaves more fusion protein, which in turn activates more signal enabling molecule and protease, leading to signal amplification. The signal amplification process is illustrated in
An example of this type of embodiment is a fusion protein comprising a signal enabling protein, such as luciferase connected by a protease cleavable sequence to a viral protease, wherein the luciferase and the protease are inactive in the fusion, and regain their activity when the linker is cut.
Herein described are protease assays for research and for clinical diagnosis of an infection of a pathogen. In some embodiments the assays depend on two factors to enable specific and sensitive detection of a pathogen or an infection caused by a pathogen: a pathogen encoded protease capable of only cleaving an amino acid sequence with specific characteristics, and a light signal enabling molecule.
Many pathogens, particularly viruses, produce specific proteases, which can cleave only an amino acid sequence with specific characteristics such as amino acid sequences. The genome of human immunodeficiency virus (HIV), for example, encodes a retropep sin, which cleaves specific sequence in the HIV polyprotein. The genome of HCV encodes a NS3/NS4 serine protease that cleaves four specific sites in the HCV polyproteins.
Specific inhibitors had been identified for these proteases and used as effective antiviral medicines.
Many other viruses also have specific proteases encoded by the viral genomes. Additional examples include, but are not limited to: coronavirus, whose genomes encode encode a papain-like (PL) protease and a 3-chymotrypsin-like (3CL) protease; the dengue virus, whose genome encodes the NS2/NS3 protease; the West Nile Virus, whose genome encodes the NS2/NB3 protease; and the Zika virus, whose genome encodes the NS2B/NS3 protease.
Intense efforts are being directed to developing inhibitors targeting these proteases with the intention that will be useful as antiviral medicines.
In spite of the development of highly successful antivirals targeting these proteases, these pathogen proteases have not been used for diagnosis purposes. There are several advantages of using specific proteases for diagnosis of a pathogen infection. Pathogen proteases appear early in the infection. This means pathogen proteins, including proteases, can be detected before pathogen specific antibodies can be detected. When properly designed, detection of an enzyme activity can be more sensitive than detection of a non-enzyme protein, e.g., an antigen using a pair of antibodies. In addition, because these proteases are unique and specific for their target cleavage amino acid sequences, a homogeneous assay can be designed so that there would be no need for washing, which simplifies the assay and required instrument. Moreover, since the protease activity is essential for the life cycle of a pathogen, it is less susceptible to genetic changes, a frequent problem associated with detection of pathogens, particularly viruses. The fact that pathogen proteases are not commonly used in diagnosis of pathogen infection is primarily due to lack of sensitivity of commonly used protease assays.
Assays disclosed herein overcome these limitations. Assays are described that use light enabling molecule to generate chemiluminescence or biochemiluminescence, resulting in high sensitivity. Light enabling molecules in accordance therefore generally should be a protein or otherwise contain an amino acid sequence, that can be modified by insertion of a protease cleavage site.
In some embodiments, the light enabling molecule is a molecule enabling biochemiluminescence. One requirement of the light enabling molecule is that it can be modified to contain an amino acid sequence with the protease cleavage site without resulting in significant loss of activity. In some embodiments, cleavage of the modified molecule by the protease leads to loss of light enabling activity. In other embodiments, cleavage of the modified molecule does not lead to loss of activity, but rather, leads to loss of the capability of being physically removed from the reaction.
An example of a light signal enabling molecule is a luciferase. Many species of insects and bacteria produce luciferase to generate light, which is believed to be a mating signal in the dark. One example of insect luciferases is the firefly luciferase. Firefly luciferase can be split into two complementary moieties that can still generate light when they are in close proximity, even though they are separate entities and they lose their light-generating activity when they are separated from one another. The two moieties can be held together by a linking amino acid sequence containing a protease cleavage site without causing loss of luciferase activity. Cleavage at the cleavage site by a protease allows the two moieties to separate from one another resulting in loss of the luciferase activity.
Firefly luciferase can also be modified at its N- or C-terminus without causing loss of activity. For example, streptavidin has been fused to the N- or C-terminus of firefly luciferase. These fusion proteins normally contain extra more flexible amino acid sequence between the fused protein and luciferase. Thus, an amino acid sequence containing the protease cleavage site can be inserted between the fusion protein and luciferase. In some embodiments described herein a streptavidin-protease cleavage site-luciferase fusion protein is used for detection of the protease activity in the sample. In this assay format, the luciferase activity can be removed from the reaction using biotinylated magnetic particles unless the protease cleavage site is cleaved by the protease activity in the sample. At least one negative control is assayed along with the sample.
In an embodiment, the sample or negative control is incubated with the streptavidin-protease cleavage site-luciferase fusion protein for a period of time, followed by incubation with biotinylated magnetic particles. After removal of the magnetic particles, the remaining solution is assayed to detect luciferase activity (by adding a solution containing appropriate concentrations of ATP, DTT, CoA, Magnesium salt and luciferin). Increase in light signal in the sample as compared to that in the negative control indicates the presence of protease activity in the sample, which in turn indicates an infection of the host from whom the sample is collected.
Many potent and specific inhibitors of pathogen proteases have been developed as therapeutic drugs or drug candidates. Because a drug or drug candidate is normally highly specific for a protease of a pathogen, it can be used for specific detection of a protease or to improve the specificity of a protease assay. In an assay where a specific protease inhibitor is used, the assay is carried out in two reactions, one of which contains one or more protease inhibitor. If the protease activity is inhibited as indicated by the light signal change, then the protease is present in the sample.
In some embodiments, detection of protease activity in a sample uses a signal amplification method, which depends on the protease activity being detected, to achieve even higher sensitivity. For convenience, this signal amplification method is termed “protease enabled signal amplification”, or PESA. This technology is called PESA technology. An assay based on the PESA technology is called PESA based assay.
The PESA technology is best understood by referring to
The signal enabling molecule in the fusion for a PESA-based assay can be those enabling chemiluminescence or biochemiluminescence as described above. It can also be an entity that produces a product that can be detected by other means. Examples of these signal enabling molecules include, but are not limited to, RNA polymerases such as T7 RNA polymerase, enzymes that can convert ADP or AMP to ATP, sequence specific nucleases, kinases, nonspecific nucleases such as exonucleases, and yet another proteases.
A variety of PESA based assays can be designed.
In some embodiment, the fusion protein is a fusion between the signal enabling molecule at the N terminus and the protease at the C terminus, linked by a linker that contains a protease cleavage site. To lower the possibility of autocleavage by the protease in the fusion protein, another protease cleavage site can be introduced to the C terminus of the protease in the fusion. In still other embodiment, both the N terminus and C terminus of the fusion contain additional protease cleavage sites so that both N and C termini are flanked by additional sequences to further minimize background activity from autocleavage. An example of PESA based assay is provided in Example 4.
Embodiments of inventions herein described include a variety of fusion proteins.
One embodiment in this regard is a fusion protein comprising: (1) a first region of a signal producing polypeptide; (2) a second region of the signal producing polypeptide and (3) a linker polypeptide that connects (1) and (2) and comprises a cleavage site for a site-specific protease,
wherein the signal producing polypeptide is active in the intact fusion protein and is inactivated when the cleavage site is cut by a protease.
Another embodiment in this regard is fusion protein comprising: (1) a signal producing polypeptide; (2) a blocking polypeptide that inactivates the signal producing polypeptide in the fusion protein and (3) a linker polypeptide that connects (1) and (2) and comprises a cleavage site for a site specific protease,
wherein the signal producing polypeptide is activated when the linker is cut by a protease.
Another embodiment in this regard is a fusion protein comprising: (1) a signal producing polypeptide; (2) a site specific protease polypeptide and (3) a linker polypeptide that connects (1) and (2) and comprises a cleavage site for a site specific protease, whereby the signal producing polypeptide and the protease polypeptide both are inactive when they are connected by the linker in the fusion, and both are activated when the linker is cut by a protease.
This embodiment is a signal amplification construct. When the initial linker cleavage by a protease releases not only the signal producing polypeptide but also releases the protease which in turn cleaves the linkers in other copies of the fusion protein releasing yet more signal producing polypeptide and protease, resulting in a multiplicative amplification of the signal.
In various related embodiments, the signal producing polypeptide and/or the protease can be flanked by additional linkers in the fusion protein, to facilitate their release and activation.
Additional embodiments in these regards provide polynucleotides encoding the fusion proteins described above, including unmodified and modified RNA and DNA. Such embodiments include cloning vectors, including plasmid, bacteriophage and viral vectors of all kinds, which are known to the art.
Embodiments include cells comprising the aforementioned polynucleotides encoding fusion proteins, particularly cells for producing the fusion proteins.
The Examples below are illustrative of various aspects and embodiments of inventions herein disclosed but are in no ways limitative thereof. A complete understanding the inventions in this application is to have only by reading the entirety of the disclosure, including the claims, of the application and those of priority documents, in the context of the prior art as a whole, with the understanding of a person of skill in the art.
In this example, firefly luciferase is used as the light signal enabling molecule for detection of the protease activity of a coronavirus. In this biochemiluminescence reaction, D-Luciferin is oxidized by luciferase to produce light. This is one of the most efficient light production systems. It can detect as few as 2000 luciferase molecules. It is also less susceptible to interference.
Coronavirus has two proteases targeting unique amino acid sequences with 3CL as the predominant one. Firefly luciferase can be modified by inserting a 3CL cleavage site within the luciferase sequence. The cleavage of the modified luciferase leads to inactivation of the enzyme. Thus, reduction in signal compared to control indicates presence of 3CL enzyme. Additionally, 3CL is present only in infected cells, not the virus. Thus, the assay detects active infection.
The firefly luciferase gene sequence containing the 3CL cleavage site can be expressed in E. coli as a recombinant protein. This recombinant firefly luciferase containing the 3CL cleavage site is named mutant luciferase or mLuc in this example. Construction, cloning and expression of recombinant proteins in E. coli is well known to those skilled in the art. mLuc was constructed, cloned into an appropriate vector and expressed in E. coli according to methods available in the literature, using commercially available reagents.
To test whether the recombinant mutant luciferase (mLuc) with 3CL cleavage site could be properly cleaved with 3CL protease, the recombinant mLuc was mixed with a recombinant COVID-19 viral 3CL enzyme and incubated at 37° C. Aliquots were removed at 0, 5, 10, 15, 20, 25 and 30 minutes after initiating the reaction, and were stopped immediately after removal by heat inactivation in a solution with SDS. The resulting reaction solution were resolved on an SDS-PAGE gel, followed by staining to visualize the proteins on the gel.
As shown in
In this example, mLuc described in Example 1 was used in an assay for detection of coronavirus 3CL activity. This assay consisted of two reagents, Reagent I and Reagent II. Reagent I contained ingredients that enable 3CL cleavage while Reagent II contained ingredients that enable firefly luciferase biochemiluminescent reaction.
A commercially available feline vaccine produced in culture cells was serially diluted and used in the experiments in this example. Since the vaccine contained ingredients from the cells, the samples also contained 3CL enzyme in the sample. The samples were first mixed with Reagent I and incubated at room temperature for 15 minutes along with a negative control, which contained no 3CL enzyme. After incubation, the reactions were mixed with Reagent II and immediately placed in a luminometer to measure the light signal. Relative light units were recorded.
For comparison, the diluted samples were also tested with real time RT-PCR.
The test results are shown in Table 1. As expected, the light signal increased as the samples were more diluted, which decreased the concentration of 3CL enzyme in the samples. On the other hand, the light signal of the samples relative to the negative control (the relative activity (RA)), was inversely related to the dilution factors. Based on extrapolation, a dilution of 1:106,739 would have given an RA of 1, which is the cut off value for detecting the coronavirus assay in this example. The extrapolated Ct value at 1:106,739 dilution is equivalent to detection sensitivity of 36 cycles of real time RT-PCR.
The method disclosed in this Example may be used to detect coronavirus infection. A clinical sample such as a throat swab or nasopharyngeal swab can be eluted in a sample buffer compatible with Reagent I. The ingredients in Reagent I may be prepared in, for example, 2× solution. The sample in sample buffer is mixed with 2× concentrated Reagent I in a 1:1 volume ratio. Incubate the reaction at room temperature for 15 minutes, followed by addition of equal volume of 3× Reagent II. The signal can be measured with a luminometer.
In some embodiments, the sample swabs are directly inserted into Reagent I and are left at room temperature for at least 15 minutes. The swabs are then removed from the Reagent I solution. After addition of Reagent II, the light signal is measured with a luminometer.
If the sample from a patient is positive with the assay described in the present invention, the sample proceeds immediately to confirm that positive test with a RT-PCR test to determine whether the sample contains COVID-19 virus. However, if the sample tests negative, there is no need for a RT-PCR test as the test has indicated that the patient is negative of all coronaviruses including COVID-19.
The assay described in Example 2 was used to test the samples containing serially diluted purified COVID-19 virus at concentrations ranging from 0.1 to 105 TCID50/mL. These virus samples were tested along with two positive controls, which contained recombinant 3CL enzyme, and one negative control. The light signal of the samples was compared to that of the negative control to derive the relative activity (RA). No 3CL activity was detected, indicating that coronavirus itself does not contain 3CL enzyme. The data is provided in
Aspects of this example are illustrated in
In this example, firefly luciferase is used as the signal enabling molecule [1] and COVID-19 virus 3CL is used as the protease [6] for detection of COVID-19 virus infection. A recombinant fusion protein is constructed to contain the entire sequence of the firefly luciferase sequence in the N terminus, which is fused with the entire sequence of COVID-19 viral 3CL sequence [6] at the C terminus of the firefly luciferase [1]. Several amino acids in the virus sequence franking the N terminus of 3CL coding sequence is also introduced between the firefly luciferase and 3CL protein sequences as a linker sequence. This linker sequence [4] is derived from the COVID-19 virus pre-protein sequence. In some embodiment, this linker sequence is 4 amino acid sequence of AVLQ, which represents the amino acid sequence of alanine-valine-leucine-glutamine.
Another affinity moiety [10] can be added to the C terminus of 3CL sequence to further reduce background of 3CL enzyme in the recombinant fusion protein. Appropriate affinity moiety can be a His tag consisting of 6-8 amino acid histidine, which can bind to nickel ion. Another example of the affinity moiety is the streptavidin sequence, which can bind to biotin coated to a nanoparticle. A 3CL cleavage sequence needs to be introduced in front of affinity moiety [10] so that it can be cleaved by 3CL enzyme in the sample.
The nucleic acid sequence encoding the recombinant protein sequence can be cloned into an appropriate vector for expression in appropriate cells such as E. coli cells. After purification, the recombinant protein is used in a PESA assay for detection of 3CL activity in a sample. It is expected that there may be background activity due to low level of self-cleavage. A negative control is tested along with samples. The residual signal from the negative control is used the background signal, or commonly referred to as “noise”, to calculate the signal to noise ratio or S/N, which is the signal intensity in the sample divided by the signal intensity of the negative control. Presence of 3CL enzyme in the sample is indicated when the signal to noise or S/N exceeds 1.5, 2.0, 3.0, 4.0 or 5.0 or another threshold value.
This application claims priority of U.S. Provisional Application No. 63/000,045 filed on Mar. 26, 2020 and U.S. Provisional Application No. 63/070,027 filed on Aug. 25, 2020, both of which are herein incorporated by reference in their entireties.
Number | Date | Country | |
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63000045 | Mar 2020 | US | |
63070027 | Aug 2020 | US |