Method for diagnosing a molecular phenotype of a patient suffering from an illness accompanied by chronic inflammation
Chronic inflammation is an increasing medical problem area of high socioeconomic significance. The invention relates to a method and a kit for diagnosing a molecular phenotype of a patient suffering from an illness accompanied by chronic inflammation, and to a medicament for treating such a patient. To that end, the gene expression of GATA-3 and/or Tbet in a biological isolate of the patient is measured and used for association with a molecular phenotype of the illness.
1. A method for diagnosing and treating chronic inflammation in a patient suffering from an illness accompanied by chronic inflammation characterized by a dominance of T-cells of the Th1 subtype with increased expression of Tbet and Interferon gamma and/or increased Interferon gamma release, in combination with a relative absence of Th2-driven inflammatory features such as GATA-3 expression, expression and/or release of IL-4, IL-5 and IL-13 and accumulation of eosinophil granulocytes by identifying a molecular phenotype of the patient wherein the molecular phenotype is selected from the group consisting of the subgroups “Th1 high” and “Th1 low” and the gene expression of GATA-3 and/or Tbet is measured in a biological isolate of the patient and used for the assignment to a molecular phenotype of the illness wherein a therapeutic agent for downregulating Tbet expression is administered when the patient has a molecular phenotype of Th1 high and a therapeutic agent for downregulating the effects of GATA 3 is administered when the patient has a molecular phenotype of Th1 low.
2. The method according to claim 1 , characterized in that
the expression level of GATA-3 and/or Tbet is determined via the protein or mRNA quantity, wherein the protein quantity is quantitatively determined with the help of an immunoassay, preferably an ELISA test, a radioimmunoassay, an electrochemiluminescence immunoassay, a CLIA (chemoluminescence-linked immunosorbent assay), an FLIA (fluorescence-linked immunosorbent assay) or a multiplex-assay; and/or
the expression level of GATA-3 and/or Tbet is determined via the protein or mRNA quantity, wherein the mRNA quantity is quantitatively determined in particular with the help of a PCR or a micro-array chip.
3. The method according to claim 1 , characterized in that an assignment of the patient to a molecular phenotype of the subgroup “Th1 high” occurs when at least one of the following conditions is fulfilled:
the Tbet gene expression in the biological isolate is higher than a defined reference value,
the ratio of Tbet:GATA-3 gene expression in the biological isolate is higher than a defined reference value.
4. The method according to claim 1 , characterized in that an assignment of the patient to a molecular phenotype of the subgroup “Th1 low” occurs when at least one of the following conditions is fulfilled:
the Tbet gene expression in the biological isolate is lower than a defined reference value,
the ratio of Tbet:GATA-3 gene expression in the biological isolate is lower than a defined reference value.
5. The method according to claim 1 , characterized in that along with the determination of the gene expression of GATA-3 and/or Tbet a determination of the serum IgE level and/or the number of eosinophilic granulocytes occurs and/or the Fe NO value is determined.