Immunological signatures and parameters predicting therapeutic responses to anti-tnf therapy

Abstract

The invention relates to a method of predicting therapeutic responses to TNF blockers before anti-TNF therapy comprising analyzing immune parameters to selected stimuli in patients before therapy and its use for anti-TNF therapy. The invention relates also to a method of determining a predictive biomarker of response to anti-TNF therapy and to the use of the predictive biomarker obtained by the method.

1 - 17 . (canceled) 
     
     
         18 . A method, comprising:
 a) obtaining a culture of immune cells from a biological sample taken from a patient having a chronic inflammatory disease, wherein the biological sample is collected prior to an anti-TNF therapy;   b) stimulating the culture of immune cells with an agent that stimulates the innate or adaptive immune system;   c) measuring the expression level in the culture of immune cells of at least one cytokine and/or matrix metalloproteinase (MMP); and   d) treating the patient with a TNF blocker.   
     
     
         19 . The method according to  claim 18 , wherein said chronic inflammatory disease is rheumatoid arthritis or a disease of the spondyloarthritis (SpA) group. 
     
     
         20 . The method of  claim 19 , wherein the SpA group disease is selected from psoriatic arthritis, reactive arthritis, arthritis related to inflammatory bowel disease, a subgroup of juvenile chronic arthritis and ankylosing spondylitis. 
     
     
         21 . The method according to  claim 18 , wherein said agent that stimulates the innate or adaptive immune system is chosen from a heat-killed live, attenuated or killed microbe and a Toll-like receptor agonist. 
     
     
         22 . The method of  claim 18 , wherein the culture of immune cells is stimulated with  Helicobacter pylori  or Influenza A virus. 
     
     
         23 . The method of  claim 18 , wherein the cytokine is selected from the group consisting of: IFN-gamma, IL-1 beta, IL-12p70, IL-1ra, IL-17, IL-2, IL-4, MCP1, MIP-1 alpha, MIP-1 beta, TNF-alpha and TNF-beta and the MMP is MMP-9. 
     
     
         24 . The method of  claim 18 , wherein the expression level is measured by measuring mRNA expression level. 
     
     
         25 . The method of  claim 18 , wherein the expression level is measured by measuring protein expression level. 
     
     
         26 . The method of  claim 23 , wherein the expression level of the at least one of IL-1ra, MIP-1beta, and TNF-alpha is increased. 
     
     
         27 . The method of  claim 23 , wherein the expression level of IL-1ra is increased, the expression level of MIP-1beta is increased, and the expression level of TNF-alpha is increased. 
     
     
         28 . The method of  claim 18 , wherein the biological sample taken from a patient is whole blood. 
     
     
         29 . A method, comprising:
 a) obtaining a first culture of immune cells from a biological sample taken from a patient having a chronic inflammatory disease, wherein the biological sample is collected prior to an anti-TNF therapy;   b) stimulating the first culture of immune cells with a first agent that stimulates the innate or adaptive immune system;   c) measuring the expression level in the first culture of immune cells of at least one cytokine and/or matrix metalloproteinase (MMP) in the first culture of immune cells;   d) obtaining a second culture of immune cells from the patient;   e) stimulating the second culture of immune cells with a second agent that stimulates the innate or adaptive immune system;   f) measuring the expression level in the second culture of immune cells of at least one cytokine and/or matrix metalloproteinase (MMP) in the second culture; and   g) treating the patient with a TNF blocker.   
     
     
         30 . The method according to  claim 29 , wherein said chronic inflammatory disease is rheumatoid arthritis or a disease of the spondyloarthritis (SpA) group. 
     
     
         31 . The method of  claim 30 , wherein the SpA group disease is selected from psoriatic arthritis, reactive arthritis, arthritis related to inflammatory bowel disease, a subgroup of juvenile chronic arthritis and ankylosing spondylitis. 
     
     
         32 . The method of  claim 31 , wherein the SpA group disease is ankylosing spondylitis. 
     
     
         33 . The method of  claim 29 , wherein the expression level of IL-1ra, MIP-1beta, and TNF-alpha is measured in the first culture of immune cells and the expression level of IL-1ra, MIP-1beta, and TNF-alpha is measured in the second culture of immune cells. 
     
     
         34 . The method of  claim 29 , wherein the expression level is measured by measuring mRNA expression level. 
     
     
         35 . The method of  claim 29 , wherein the expression level is measured by measuring protein expression level. 
     
     
         36 . The method of  claim 29 , wherein the expression level of the at least one of IL-1ra, MIP-1beta, and TNF-alpha is increased in the first culture of immune cells and in the second culture of immune cells. 
     
     
         37 . The method of  claim 29 , wherein the expression level of IL-1ra is increased, the expression level of MIP-1beta is increased, and the expression level of TNF-alpha is increased in the first culture of immune cells; and wherein the expression level of IL-1ra is increased, the expression level of MIP-1beta is increased, and the expression level of TNF-alpha is increased in the second culture of immune cells. 
     
     
         38 . A method, comprising:
 a) obtaining a culture of immune cells from a biological sample taken from a patient having a chronic inflammatory disease, wherein the biological sample is collected prior to an anti-TNF therapy;   b) stimulating the culture of immune cells with an agent that stimulates the innate or adaptive immune system; and   c) measuring the expression level in the culture of immune cells of IL-1ra, MIP-1beta, and TNF-alpha;   d) wherein the expression level of IL-1ra is increased, the expression level of MIP-1 beta is increased, and the expression level of TNF-alpha is increased; and   e) treating the patient with a TNF blocker.   
     
     
         39 . A method, comprising:
 a) obtaining a first culture of immune cells from a biological sample taken from a patient having a chronic inflammatory disease, wherein the biological sample is collected prior to an anti-TNF therapy;   b) stimulating the first culture of immune cells with a first agent that stimulates the innate or adaptive immune system;   c) measuring the expression level in the first culture of immune cells of IL-1ra, MIP-1 beta, and TNF-alpha;   d) obtaining a second culture of immune cells from the patient;   e) stimulating the second culture of immune cells with a second agent that stimulates the innate or adaptive immune system; and   f) measuring the expression level in the second culture of immune cells of IL-1ra, MIP-1 beta, and TNF-alpha;   wherein the expression level of IL-1ra is increased, the expression level of MIP-1 beta is increased, and the expression level of TNF-alpha is increased in the first   culture of immune cells; and   wherein the expression level of IL-1ra is increased, the expression level of MIP-1 beta is increased, and the expression level of TNF-alpha is increased in the second culture of immune cells; and   g) treating the patient with a TNF blocker.