# Patent

## Title
Methods and compositions for diagnosing autoimmune insulin dependent

## Abstract

A method for diagnosing hepatic carcinoma, which is characterized by enzyme-immunologically measuring the amount of collagenase inhibitor present in sera, plasmas of synovial fluids by way of a sandwich assay wherein two different monoclonal antibodies which specifically bind to different antigenic determinants of the collagenase inhibitor are used, and comparing the measured amount with that for normal subjects.

## Background
The present invention relates to a method of the diagnosis for hepatic carcinoma by way of quantitation of collagenase inhibitor. More particularly the invention relates to a method for carrying out the diagnosis of hepatic carcinoma, by means of a sandwich enzyme immunoassay for human collagenase inhibitor using monoclonal antibodies to bovine collagenase inhibitor (tissue inhibitors of metalloproteinases: TIMP), on the basis of the fact that the amount of collagenase inhibitor in sera, plasmas or synovial fluids from patients with hepatic carcinoma is clearly higher than the amount of collagenase inhibitor in sera, plasmas or synovial fluids, respectively, from normal subjects. The enzyme immunoassay mentioned above is used to mean a method for determining collagenase inhibitor which is characterized in that there are used two different monoclonal antibodies which specifically bind to different antigenic determinants of collagenase inhibitor as an antibody to be bound to a solid phase support and an antibody to be labeled with an enzyme.

Collagenase inhibitor has been known to exist in human's and other animals' bones, skins, dental pulps, amniotic fluids, bloods and synovial fluids as well as in cultures of joint chondrocytes, synovial cells, fibroblasts derived from varied tissues and fibrosarcomatous cells. As means for determining the amount of collagenase inhibitor, methods have heretofore been known which are based on measurement of its biological activity. As described by Eisen et al. in J. Lab. Clin. Med. 75, 258-263 (1973) and also by Cawston et al. in Arthritis and Rheumatism 27, 285-290 (1984), however, it is impossible, with the heretofore known methods of determination, to assay sera, plasmas or synovial fluids for collagenase inhibitor activity since there exist in such fluids proteins, such as .alpha..sub.2 -macroglobulin, which interfere disturbingly with the measurement. Hayakawa, Iwata et al. have already developed a sandwich enzyme immunoassay (EIA) using monoclonal antibodies to bovine collagenase inhibitor, a method which enables specific quantitation of collagenase inhibitor with very small volumes of samples in a precise, straightforward and rapid manner (Japanese Patent Application No. Sho 62-42781). The present inventors have discovered that the level of collagenase inhibitor present in human sera, plasmas or synovial fluids apparently increases in association with affliction with hepatic carcinoma, and found that it is possible to make a diagnosis of hepatic carcinoma by determining, by the enzyme immunoassay mentioned above, the amount of collagenase inhibitor present in sera, plasmas or synovial fluids.

FIG. 1 shows Western blotting patterns of bovine dental pulp collagenase inhibitor subjected to SDS-PAGE, obtained with different monoclonal antibodies;

FIG. 2 shows a standard curve for bovine dental pulp collagenase inhibitor, prepared with a solid phase 7-23G9 antibody-conjugate Fab'(7-6C1)-POD assay system;

FIG. 3 shows immunologically stained patterns obtained by subjecting human serum collagenase inhibitor to SDS-PAGE and then to Western blotting;

FIG. 4 shows a standard curve for human serum collagenase inhibitor, prepared with a solid phase 7-23G9 antibody-conjugate Fab'(7-6C1)-POD assay system;

FIG. 5 shows SDS-PAGE patterns of collagenase inhibitor purified from human sera;

FIG. 6 shows a standard curve prepared by sandwich assay for purified human serum collagenase inhibitor; and

FIG. 7 shows Western blotting patterns obtained when the eluted fraction obtained upon application of human sera onto an affinity column with IgG(7-23G9) antibody bound was subjected to SDS-PAGE followed by application of Fab'(7-6C1)-POD conjugate.

The present invention has been accomplished on the basis of the findings as mentioned above, and provides a method for diagnosing whether the subject is afflicted with hepatic carcinoma, which comprises carrying out an enzyme immunoassay by the sandwich method, with the aid of two different monoclonal antibodies that specifically bind to different antigenic determinants of bovine collagenase inhibitor as antibodies to be bound to a solid phase support and to be labeled with an enzyme, to measure the amount of human collagenase inhibitor present in the subject's sera, plasmas or synovial fluids, and comparing the measured amount with that for normal subjects.

The present inventors immunized Balb/c mice by intraperitoneal administration thereto of a solution containing collagenase inhibitor purified from culture media obtained by cultivating bovine dental pulps, and spleen cells were then removed from the mice. The spleen cells were mixed with 8-azaguanine-resistant myeloma cells NS-1  in a ratio of 5:1, and they were allowed to fuse together in 50% polyethyleneglycol 4000 to obtain hybridomas. The hybridomas were dispensed in a 96-well microwell made of polystyrene so that 6.0.times.10.sup.5 cells exist in each well and then cultivated in HAT culture medium. The culture medium in each well was checked by a solid phase-antibody binding test (ELISA) for production of antibodies against bovine dental pulp collagenase inhibitor, and hybridomas in those wells that were positive in the test were cloned by means of the limiting dilution method. As a result, there were obtained seventeen monoclones capable of producing monoclonal antibody to bovine dental pulp collagenase inhibitor. Each of the monoclones was intraperitoneally administered to Balb/c mice to obtain ascites containing monoclonal antibody. From the ascites were purified monoclonal antibodies through salting-out fractionation with ammonium sulfate, ion exchange chromatography by DEAE-Sephacel, gel filtration on Sephacryl S-300 Superfine, etc. The thus purified seventeen monoclonal antibodies were all found to specifically cross-react with bovine collagenase inhibitor, and four out of them, i.e. IgG (clone 7-6C1), IgG (clone 7 -19F6), IgG (clone 7-21B12) and IgG (clone 7-23G9), were revealed by Western blotting to react also with human collagenase inhibitor. A very small amount (1.5 pg) of human collagenase inhibitor could be quantitated in a specific and precise manner by carrying out a sandwich EIA with two out of four such monoclonal antibodies: IgG (clone 7-23G9) as the solid phase antibody, and IgG (clone 7-6C1) as the labeled antibody in the form of Fab' (clone 7-6C1)-POD prepared therefrom. The hybridomas FERM BP-3468 and FERM BP-3469, which produce monoclonal antibodies 7-6C1 and 7-23G9, respectively, have been deposited under the terms of the Budapest Treaty on Jul. 1, 1991 at the Fermentation Research Institute, Agency of Industrial Science and Technology, Tomoo Suzuki, Director General, 1-3, Higashi 1-chome, Tsukuba-shi, Ibaraki-ken, 305, Japan. This sandwich method was used to measure the amount of collagenase inhibitor in fifty samples of serum from normal subjects to find that 184.+-.30 ng of collagenase inhibitor was present in one ml of serum. On the other hand, the mean amounts of collagenase inhibitor present in one hundred samples of serum from patients with hepatocellular carcinoma and three such samples from those with metastatic liver carcinoma were 486.+-.316 ng and 1172.+-.712 ng per ml of serum, respectively, and these levels are apparently high as compared to those found in sera from normal subjects. In contrast, the mean amounts of collagenase inhibitor present in forty-six samples of serum from patients with liver cirrhosis, in forty-five such samples from those with chronic active hepatitis and in twenty-six such samples from those with chronic inactive hepatitis were 228.+-.163 ng, 233.+-.88 ng and 166.+-.73 ng per ml of serum, respectively, and therefore showed no significant difference as compared to those found in sera from normal subjects. It has thus been found, in the light of specifically high serum collagenase inhibitor levels for patients with hepatic carcinoma as compared to those for patients with other liver disorders, that it is possible, by quantitating collagenase inhibitor in a patient's serum, to diagnose whether the patient is afflicted with hepatic carcinoma. Moreover, whereas the amount of collagenase inhibitor present in twenty-six samples of plasma from normal subjects was 64.+-.10 ng per ml of plasma, that present in eight such samples from patients with hepatocellular carcinoma was 583.+-.447 ng per ml of plasma, thus being clearly high as compared to the plasma level for normal subjects.

The phenomenon of increased collagenase inhibitor level in serum or plasma is also observable not only with patients with hepatic carcinoma but also with those with rheumatoid arthritis. Consequently, by performing the measurement of serum collagenase inhibitor in combination with liver function tests such as ZTT (zinc sulfate turbidity test), GOT (glutamic oxaloacetic transaminase), GPT (glutamic-pyruvic transaminase), ALP (alkaline phosphatase), LDH (lactate dehydrogenase), .gamma.-GTP (.gamma.-glutamyl transpeptidase), PH (prolyl hydroxylase) and AFP (.alpha.-fetoprotein), it is possible to diagnose whether the subject is afflicted with hepatic carcinoma.

In the above mentioned enzyme immunoassay employed according to the method of the present invention, a variety of materials in any usage forms which well adsorb passively antigens or antibodies may be chosen for use as solid supports, e.g. polystyrenes, polycarbonates, polypropylenes or polyvinyls in such forms as balls, microplates, sticks or test tubes. As the antibody to be labeled with an enzyme, there may be used an IgG fraction obtainable by the fractionation of a material containing antibodies with ammonium sulfate followed by purification on an anion exchange gel such as DEAE-Sephacel, as well as FAb' that specifically reacts with an antigen molecule and that is obtainable by its digestion with pepsin followed by reduction.

The method of the invention is, as mentioned above, for diagnosing whether the subject is afflicted with hepatic carcinoma by carrying out the quantitative determination of human collagenase inhibitor on the basis of an enzyme immunoassay with the aid of a combination of two monoclonal antibodies that specifically bind to different antigenic determinants of the collagenase inhibitor as antibodies to be bound to a solid phase support and to be labeled with an enzyme, followed by comparing the result with values for normal subjects.

The present invention will now be illustrated in more detail by way of the following examples, but it is to be noted that this invention is not limited thereto.

In accordance with the procedure described by the present inventors in J. Biochem. 96, 395-404 (1984), collagenase inhibitor was purified from culture media obtained by cultivated in Eagle's MEM medium (supplied by Nissui Seiyaku) of root pulps from bovine unerupted wisdom teeth, using columns of Con A-Sepharose, Ultrogel AcA 44 and DE-52 cellulose. When examined by sodium dodecyl sulfatepolyacrylamide gel electrophoresis (SDS-PAGE) according to the method described by Laemmli et al. in J. Mol. Biol. 80, 579-599 (1973), the purified inhibitor showed a single band having a molecular weight of about 32,000 dalton (D).

Two 6-week-old female Balb/c mice were initially immunized intraperitoneally with 48 .mu.g in 0.4 ml emulsion of purified bovine collagenase inhibitor described above in (a) in Freund's complete adjuvant. The mice then received, after 30 days, a booster injection of 84 .mu.g of the bovine collagenase inhibitor dissolved in saline. As the final immunization, the mice received, after 58 days, an additional booster injection by intraperitoneal administration of 95 .mu.l/500 .mu.l of the inhibitor in saline. On the 3rd day after the final immunization the spleen was extirpated and the spleen cells were prepared.

RPMI 1640 culture medium: RPMI No. 1640 (Difco Laboratories) supplemented with sodium bicarbonate (12 mM), sodium pyruvate (1 mM), L-glutamine (2 mM), penicillin G potassium (50 U/ml), streptomycin sulfate (50 .mu.g/ml) and amikacin sulfate (100 .mu.g/ml), adjusted to pH 7.2 with dry ice and filtered through a 0.2 .mu.m Toyo membrane filter for sterilization.

NS-1 culture medium: the above RPMI 1640 culture medium supplemented with 15% (v/v) fetal bovine serum (M.A. Bioproducts) filter-sterilized.

PEG 4,000 solution: Serum-free RPMI 1640 culture medium, containing 50% (w/w) polyethylene glycol 4,000 (PEG 4,000, Merck & Co., Inc.).

Utilizing an 8-azaguanine-resistant myeloma cell line, NS-1 (P3-NS1-1), cell fusion was effected according to a slightly modified method of Oi et al. described in "Selected Methods in Cellular Immunology" (ed. B. B. Mishell and S. M. Shiigi, W. H. Freeman and Company, (1980), pp. 351-372). viability 100%) were fused in a ratio of 5 to 1 with myeloma cells (cell viability 100%). Thus, the splenocytes and the myeloma cells were separately washed in RPMI 1640 culture medium, then suspended in the same medium and mixed together for fusion in the ratio described above. 40 ml of the RPMI 1640 culture medium was put into a 50 ml conical styrene resin test tube (Iwaki Glass), and centrifuged at 400 xg for 10 min., and the supernatant was discarded completely by suction. To the precipitated cells was added dropwise over 1 min. 1.3 ml of the PEG 4,000 solution warmed at 37.degree. C. with gentle stirring. The cells were resuspended and dispersed by stirring for another minute. To the suspension was then added dropwise over 1 min. 1.3 ml of RPMI 1640 culture medium warmed at 37.degree. C. After repeating the same operation once more, the cells were dispersed, by adding 9 ml of the same culture medium dropwise over 2 to 3 min. under continuous agitation. The dispersion was centrifuged at 400 xg for 10 min., and the supernatant was discarded completely by suction. To the precipitated cells was added rapidly 12.9 ml of NS-1 culture medium warmed at 37.degree. C., and big cell clumps were then dispersed by pipetting carefully with a 10 ml pipette. The dispersion was diluted with 26 ml of the same culture medium, and distributed into 96-well microwell made of polystyrene (Iwaki Glass) so that 6.0.times.10.sup.5 cells/0.1 ml exist in each well. As a preliminary treatment, the 96-well microwells had been treated with 0.2 ml of NS-1 culture medium overnight at 37.degree. C. in a CO.sub.2 incubator, and the culture medium had been removed therefrom by suction on actual use. After loaded with the cells, the microwells were subjected to cultivation at 37.degree. C. in 7% CO.sub.2 /93% air under 100% humidity. culture medium:

HAT selection medium: the NS-1 culture medium mentioned above in (c) supplemented with hypoxanthine (100 .mu.M), aminopterin (0.4 .mu.M) and thymidine (16 .mu.M).

HT culture medium: the same composition as the HAT medium mentioned above except that aminopterin is not contained. on the first day), two drops (ca. 0.1 ml) of HAT culture medium were added with a Pasteur pipette. On the 2nd, 3rd, 5th, 8th and 11th days, the half (0.1 ml) of each culture medium was replaced with fresh HAT culture medium. On 14th day, the half of each culture medium was replaced with fresh HT culture medium. Thereafter, replacement of the half of each culture medium by fresh HT culture medium was repeated at 3 to 4 days intervals. Usually, sufficient growth of hybridoma was observed in 2 to 3 weeks. All the wells containing hybridomas grown were tested to see if there were positive wells, using a solid phase-antibody binding test (ELISA) as will be described in the subsequent (e). All the cultures with hybridomas positive in the test above were transferred to a 24-well cell well made of polystyrene (Iwaki Glass) containing 1 ml of the HT culture medium containing 10.sup.7 mouse thymocytes as feeders. The cultures were subjected to cultivation, as described in the preceding (c), at 37.degree. C. in 7% CO.sub.2 for about a week. Once or twice during the cultivation period, 0.5 ml of the supernatant of each well was replaced with  0.5 ml of fresh HT culture medium. At the time sufficient growth of hybridomas was observed, the cultures were checked again for the positivity by the ELISA method, and subjected to a cloning procedure by the limiting dilution method as will be explained in (f) below. The residual culture after cloning was transferred into a 25 cm.sup.2 tissue culture flask made of polystyrene (Iwaki Glass), for the preparation of a frozen sample for storage. inhibitor antibody by means of the solid phase-antibody binding test (ELISA):

The method used for the present example was a slight modification of the method of Rennard et al. described in Anal. Biochem., 104, 205-214, (1980), which is appropriate for the detection of antibody production in hybridomas. Each well of a 96-well microtitration plate (Flow Laboratories, Inc.) was coated with 0.5-1.0 .mu.g of bovine collagenase inhibitor, and the wells remaining uncoated were blocked with 1% bovine serum albumin (BSA). To the wells was added a part of the supernatant from the wells containing hybridomas grown as obtained in (d) above. The incubation was carried out at room temperature for about 1 hr. After the addition of goat anti-mouse immunoglobulin (Cappel Lab.) labeled with horseradish peroxidase as a secondary antibody, further incubation was carried out at room temperature for about 1 hr. The depth of brown color produced upon the addition of H.sub.2 O.sub.2 and o-phenylenediamine as a substrate was assessed qualitatively with naked eyes or determined by measuring the absorbance at 500 nm using a Corona double wave microplate spectrophotometer (MTP-22, Corona Electric).

In order to obtain hybridomas capable of producing monoclonal antibodies it is necessary, after the procedure mentioned above in (d), for cloning to be carried out according to the limiting dilution method, since each well can develop two or more kinds of hybridomas. A cloning culture medium containing in NS-1 culture medium 10.sup.7 cells per ml of mouse thymocytes as feeders was prepared. 5, 1 and 0.5/well of hybridomas were added to 36, 36 and 24 wells of a 96-well microwell, respectively. About 0.1 ml of NS-1 culture medium was further added to each well on the 5th and 12th day. About 14 to 15 days after the cloning when the sufficient growth of hybridoma could be recognized, the culture group in which more than 50% wells were negative for colony formation was subjected to ELISA. When not all of the tested wells were shown to be positive, the colonies in antibody-positive wells were enumerated and out of them 4-6 wells exhibiting the formation of one and single colony were selected for recloning. Finally, 17 hybridoma clones capable of producing monoclonal antibody to bovine collagenase inhibitor were obtained.

Monoclonal antibodies were proliferated in a conventional manner. Thus, they can be obtained from the supernatant of an appropriate culture medium such as NS-1 culture medium in which each of the resultant hybridomas were subjected to cultivation (in vitro proliferation) (The concentration of the monoclonal antibody protein 10-100 .mu.g/ml). If a large amount of antibody is to be produced, on the other hand, an in vivo proliferation is carried out as described below. A carcinogenic excitant, Pristane (2,6,10,14-tetramethylpentadecane, Aldrich Chemical), was administered to animals (Balb/c mice) intraperitoneally in a volume of 0.5 ml per animal, which animals were of the syngenic strain as those providing the splenocytes and the myeloma cells. One to 3 weeks after the administration, 1.times.10.sup.7 cells of each hybridoma were administered intraperitoneally as above, and ascites containing 4-7 mg/ml monoclonal antibody were obtained after 1 to 2 weeks. (h) Isotypes of monoclonal antibodies:

First of all, each of the ascites obtained in (g) above was bound to a microtitration plate coated with bovine collagenase inhibitor according to the above-described ELISA method. After washing with PBS, isotypespecific rabbit anti-mouse Ig antibodies (Zymed Laboratories) were added thereto. After washing with PBS, goat anti-rabbit IgG (H+L) antibody labeled with horseradish peroxidase, was added thereto, and 2,2'-azinodi(3-ethylbenzothiazoline sulfate-6) as a substrate and hydrogen peroxide were then added for detection. The results are shown collectively in Table 1 described hereinafter. Among the resultant monoclonal antibodies against bovine collagenase inhibitor, fifteen antibodies were found to contain immunoglobulin chain .gamma.1/.kappa. and one antibody .gamma.2a/.kappa. and one antibody .gamma.2b/.kappa.. (i) Purification of monoclonal antibody:

Each of the ascites obtained in the foregoing (g) was fractionated with ammonium sulfate (40% saturation) and then loaded on DEAE-Sephacel (Pharmacia) equilibrated with a 40-mM phosphate buffer solution (pH 8.0) containing 0.06-M NaCl to separate an unadsorbed fraction. This IgG fraction was gel-filtered on Sephacryl S-300 Superfine (Pharmacia) column equilibrated with a 50-mM phosphate buffer solution (pH 7.4) containing 0.42-M NaCl, whereby FCS from culture medium and mouse-derived proteins were separated and removed. antibodies conjugates):

The IgG fraction obtained in Example 1(i) was dissolved in a 0.1-M acetate buffer solution, pH 4.2, containing 0.1-M NaCl and the solution was digested with pepsin as follows. Thus, pepsin was added to the fraction to 2% (w/w) based on the IgG therein, and the mixture was subjected to digestion at 37.degree. C. for 24 hrs. The digested product was adjusted to a pH of 7.0 with a 2-M Tris solution thereby to stop the digestion reaction. The product was gel-filtered on a Ultrogel AcA 44 column (supplied by LKB) equilibrated with a 0.1-M phosphate buffer solution (pH 7.0) to obtain F(ab').sub.2 fraction.

The F(ab').sub.2 fraction was dialyzed against a 0.1-M phosphate buffer solution (pH 6.0) containing ethylenediamine tetraacetic acid (EDTA), and aminoethanethiol (MEA) was added to a final concentration of 10-mM to effect reduction at 37.degree. C. for 1.5 hrs. The product was gel-filtered on a Ultrogel AcA 44 column equilibrated with a 0.1-M phosphate buffer solution (pH 6.0) containing 5-mM EDTA to obtain Fab' fraction.

Separately from the procedure as mentioned in (1) above, horseradish peroxidase (POD) was labeled with a maleimide compound as follows. Thus, the POD was dissolved in a 0.1-M phosphate buffer solution (pH 7.0) to 10 mg/ml and to the solution was added 25 moles, per mole of the POD, of N-(.epsilon.-maleimidocaproyloxy)succinimide (EMCS) as a solution in dimethylformamide for reaction at 30.degree. C. for 30 min. The product was gel-filtered on a Sephadex G-50 column equilibrated with a 0.1-M phosphate buffer solution (pH 6.0) to obtain maleimide-labeled POD fraction.

The fractions as prepared in (1) and (2) above were admixed so that equimolar amounts of Fab' and maleimide-labeled POD in the respective fractions were mixed. The mixture was then diluted with a 0.1-M phosphate buffer solution (pH 6.0) containing 5-mM EDTA to a final concentration, in respect of both Fab' and maleimide-labeled POD, of 100-.mu.M. After reaction at 4.degree. C. for 20 hrs. was added 10 moles, per mole of Fab', of N-ethylmaleimide to block unreacted thiol groups. The product was gel-filtered on a Ultrogel AcA 44 column equilibrated with a 0.1-M phosphate buffer solution (pH 6.5) to obtain Fab'-POD conjugate fraction, to which 0.1% bovine serum albumin (BSA) and 0.005% thimerosal were added for storage at 4.degree. C.

The bovine dental pulp collagenase inhibitor purified in Example 1(a) was subjected to SDS-PAGE and then to Western blotting, in accordance with the method of Tanabe as described in "Saibo Kogaku"(Cell Technology) 1 & 2, pp. 1061-1068 (1983), using commercially available POD-labeled goat anti-mouse immunoglobulin and the Fab'-POD conjugates obtained in Example 2(a) above, whereby patterns of enzyme antibody staining were obtained. These patterns are shown in FIG. 1. In FIG. 1, A and B show the results obtained when a nitrocellulose membrane was, subsequently to the Western blotting, immunologically stained with Fab' (clone 7-3F1)-POD and Fab' (clone 7-21B12)-POD conjugates obtained in Example 2(a), respectively.

Furthermore, numbers 1 through 16 show the results obtained when a nitrocellulose membrane was, subsequently to the Western blotting, soaked in each of the following monoclonal antibodies (all of IgG type) in solution and then immunologically stained again with POD-labeled goat anti-mouse immunoglobulin (supplied by Cappel Laboratories): 1:       clone 7-3F1    2:    clone 7-4F2 3:       clone 7-5A1    4:    clone 7-6C1 5:       clone 7-7F11   6:    clone 7-8B2 7:       clone 7-9B4    8:    clone 7-10E11 9:       clone 7-11A5   10:   clone 7-12B6 11:      clone 7-15E8   12:   clone 7-18F3 13:      clone 7-19F6   14:   clone 7-20C2 15:      clone 7-21B12  16:   clone 7-23G9. ______________________________________

As it is evident from FIG. 1, all the monoclonal antibodies mentioned above were found to have reactivity with bovine dental pulp collagenase inhibitor.

According to the method of Ishikawa et al. as described in J. Immunoassay 4, 209-327 (1983), monoclonal antibody obtained in Example 1(i) was dissolved in a 0.1-M phosphate buffer solution (pH 7.5) containing 0.1% sodium azide. The monoclonal antibody solution was adjusted to a concentration of 100 .mu.g/ml (A.sub.280 =0.15) and polystyrene balls (6.5 mm in diameter, supplied by Precision Plastic Ball) were soaked therein and allowed to stand at 4.degree. C. for 24 hrs. After removal of the monoclonal antibody solution, the balls were washed five times with a 10-mM phosphate buffer solution (pH 7.0) containing 0.1% BSA, 0.1% NaCl and 0.1% sodium azide (hereinafter referred to Buffer A for short), and then soaked in Buffer A for storage at 4.degree. C.

A solution of purified collagenase inhibitor or a sample solution containing collagenase inhibitor was diluted with Buffer A containing 1% BSA and a 300 .mu.l aliquot of dilution was placed in each test tube. After addition of an antibody-coated ball prepared in (a) above, the test tube was warmed at 30.degree. C. for 1 hr. with shaking (first reaction) and then washed three times with 3 ml portions each of a 10-mM phosphate buffer solution (pH 7.0) containing 0.1-M NaCl. The Fab'-POD conjugate prepared in Example 2(a) was diluted to 20 ng/tube with a 10-mM phosphate buffer solution (pH 7.0) containing 0.1% BSA and 0.1-M NaCl, and then warmed at 30.degree. C. for 1 hr. with shaking (second reaction). After the reaction was complete, washing was carried out in the same manner as upon the completion of the first reaction. 0.3 ml of a substrate for POD dissolved in a 0.1-M acetate buffer solution (pH 5.5), i.e. 0.0134% tetramethylbenzidine (TMBZ) was added. After further addition of 0.1 ml of 0.01% hydrogen peroxide, the mixture was warmed at 30.degree.  C. for 1 hr. with shaking (third reaction), whereafter the reaction was stopped by the addition of 0.6 ml of 1.33N sulfuric acid. The A.sub.450 value of the reaction mixture was measured on a spectrophotometer and the amount of collagenase inhibitor in the sample was determined from a standard curve.

In order to screen for monoclonal antibody combinations with which the quantitation of collagenase inhibitor is possible, Fab'-POD conjugate was prepared from each of the following monoclonal antibodies purified by the method as used in Example 1(i): clone 7-3F1; 7-6C1; 7-19F6 and 7-21B12. Using 1 ng/tube of purified bovine dental pulp collagenase inhibitor was carried out a quantitative sandwich assay, according to the method as used in Example 3(b), with each of the following monoclonal antibodies as solid phase: clone 7-3F1; 7-4F2; 7-5A1; 7-6C1; 7-7F11, 7-8B2; 7-9B4; 7-10E11; 7-11A5; 7-12B6; 7-15E8; 7-18F3; 7-19F6; 7-20C2; 7-21B12 and 7-23G9. The resultant A.sub.450 values are shown in Table 2 below. It is to be noted the A.sub.450 values in Table 2 are those obtained by subtracting values for sandwich assay in which no collagenase inhibitor was added from those for sandwich assay in which 1 ng of sample was added. All the four different Fab'-POD conjugates mentioned above were found to show A.sub.450 values not smaller than 2 for any of the six different antibodies as solid phase: 7-4F2; 7-11A5; 7-12B6; 7-18F3; 7-20C2 and 7-23G9. A quantitative sandwich assay was further carried out by using different amounts of bovine dental pulp collagenase inhibitor added for each of these twenty four combinations. The results obtained when Fab' (clone 7-6C1)-POD conjugate was used in combination with clone 7-23G9 antibody as the solid phase are shown in FIG. 2. As is shown by FIG. 2, linearity was obtained between the amount of bovine dental pulp collagenase inhibitor added and A.sub.450, the determination sensitivities being about 1 pg (32 a mol) per tube. Such linearity was also observed with combinations other than the one mentioned above, it being thereby established that quantitative sandwich assay is possible with any of the combinations.

In accordance with the method as described by Axen et al. in Nature 214, 1302-1304 (1967) and by Cuatrecasas et al. in Proc. Natl. Acad. Sci. USA, 61, 636-643 (1968), purified monoclonal antibody obtained in Example 1(i) was immobilized as ligand onto a Sepharose 4B support by way of the use of cyanogen bromide. The resultant antibody-Sepharose 4B gel (0.3 ml) was then filled into a glass column and equilibrated, before use, with a 30-mM Tris-HCl buffer solution (pH 8.0) containing 0.1-M NaCl and 5-mM CaCl.sub.2.

Human serum (1 ml) was dialyzed against a 30 mM Tris-HCl buffer solution (pH 8.0) containing 0.1-M NaCl and 5-mM CaCl.sub.2 and then applied onto a clone 7-21B12 antibody-Sepharose 4B column as prepared in accordance with the manner mentioned in (a) above. The column was washed with the same buffer as above to obtain "unadsorbed fraction". It was then washed with a 30-mM Tris-HCl buffer solution (pH 7.5) containing 2-M NaCl and subsequently with a 0.2-M glycine-NaOH buffer solution (pH 10.5) containing 0.5-M NaCl to obtain "washed fraction". Protein adsorbed on the column was finally eluted with a 0.2-M glycine-HCl buffer solution (pH 2.0) to obtain "eluted fraction". The thus obtained eluted fraction was dialyzed against a 30-mM Tris-HCl buffer solution (pH 8.0) containing 0.1-M NaCl and 5-mM CaCl.sub.2, and then subjected again to affinity chromatography on a clone 7-21B12 antibody-Sepharose 4B column to repeat the same procedure as described above, whereby collagenase inhibitor was obtained in the eluted fraction. In order to test whether the monoclonal antibodies against bovine dental pulp collagenase inhibitor react with human serum collagenase inhibitor, the eluted fraction mentioned above was subjected to SDS-PAGE and then to Western blotting. FIG. 3 shows the results obtained when a nitrocellulose membrane was, subsequently to the Western blotting, immunologically stained with Fab'-POD conjugate prepared from each of the following monoclonal antibodies: 1, clone 7-3F1; 2, clone 7-6C1; 3, clone 7-19F6; 4, clone 7-21B12; and 5, clone 7-23G9. As is shown in FIG. 3, collagenase inhibitors with reactivity with monoclonal antibody against bovine dental pulp collagenase inhibitor were found to exist in human serum. On top of that, it has also been found that the molecular weight of each of these collagenase inhibitors was the same as that (32,000D) of bovine dental pulp collagenase inhibitor obtained in Example 1(a). sandwich assay

Screening was performed for the most suitable monoclonal antibody combination for conducting sandwich assay for human collagenase inhibitor. Thus, as shown in Example 3(c), twenty four combinations between four different Fab'-POD conjugates, i.e. Fab'(7-3F1)-POD, Fab'(7-6C1)-POD, Fab'(7-19F6)-POD and Fab'(7-21B12)-POD, and 6 different monoclonal antibodies as solid phase antibodies, i.e. clones 7-4F2, 7-11A5, 7-12B6, 7-18F3, 7-20C2 and 7-23G9, were screened for those with which quantitative determination of human serum collagenase inhibitors treated by column chromatography in the manner as described in Example 4(b) is possible. As a result, when human serum collagenase inhibitor was used as antigen, no A.sub.450 signals were detected for most of the combinations used. It has been found, however, that quantitative sandwich assay is possible with the combination of clone 7-23G9 antibody as the solid phase antibody and Fab'(clone 7-6C1)-POD as the conjugate. A standard curve was prepared by performing the quantitative sandwich assay in accordance with the method as described in Example 3(c) with varied amounts of human serum collagenase inhibitor added, using the combination mentioned above. The results thus obtained are shown in FIG. 4. As is shown by FIG. 4, linearity is attained between the amount of human serum collagenase inhibitor added and A.sub.450, it being thereby found that quantitative determination of human collagenase inhibitor is possible. The determination sensitivity, however, was found to be about 10 pg (320 a mol) per tube, ten times lower than that (i.e. 1 pg per tube) for bovine dental pulp collagenase inhibitor. patients:

Using the monoclonal antibody combination specified in (a) above, ninety-five serum samples from normal subjects, one hundred from patients with hepatocellular carcinoma, and three from those with metastatic liver carcinoma were sandwich-assayed quantitatively for collagenase inhibitor contained therein. The results are shown in Tables 3-1, 3-2 and 3-3, respectively. In this sandwich assay, there was used the human serum collagenase inhibitor purified in Example 4(b) as the antigen for the preparation of the standard curve. This quantitation was performed with the serum samples diluted 1,600 times with Buffer A containing 1% BSA. The values indicated in Tables 3-1 and 3-2 are expressed as means of duplicate experiments. As is seen from Tables 3-2 and 3-3, the mean amounts of collagenase inhibitor present in one ml of serum from patients with hepatocellular carcinoma and from those with metastatic liver carcinoma were as high as 3.22.+-.2.10 .mu.g and 7.81.+-.3.87 .mu.g, respectively, whereas as is seen from Table 3-1 that from normal subjects was 1.59.+-.0.37 .mu.g. Forty-six, forty-five and twenty-six serum samples from patients with liver cirrhosis, with chronic active hepatitis and with chronic inactive hepatitis, respectively, were sandwich-assayed quantitatively and the values obtained with the respective samples are shown in Tables 4-1, 4-2 and 4-3. As a result, the mean amounts of collagenase inhibitor in sera of patients with liver cirrhosis, with chronic active hepatitis and with chronic inactive hepatitis were 1.52.+-.1.08 .mu.g, 1.55.+-.0.58 .mu.g and 1.10.+-.0.48 .mu.g, respectively, all showing no significant difference as compared to the serum collagenase inhibitor level for normal subjects.

As mentioned above, in the eluted fraction finally obtained in Example 4(b) is present collagenase inhibitor with reactivity with monoclonal antibodies against bovine dental pulp collagenase inhibitor (see FIG. 3). A variety of proteins, however, were observed to exist therein, in addition to the collagen inhibitor, which do not react with the monoclonal antibodies mentioned above. Based on this observation, the eluted fraction was gel-filtered on an AcA 44 column equilibrated with a 0.1-M phosphate buffer solution (pH 7.5) for separation of collagenase inhibitor from other proteins thereby to purify human serum collagenase inhibitor. FIG. 5 shows the respective SDS-PAGE patterns for the resultant serum collagenase inhibitor (1), bovine dental pulp collagenase inhibitor (2) as a control and molecular weight markers (3). As is seen in FIG. 5, the molecular weight of human serum collagenase inhibitor was found to be the same as that (i.e. 32,000D) of bovine dental pulp collagenase inhibitor. collagenase inhibitor

A standard curve was prepared by performing the sandwich assay quantitatively with varied amounts of the purified human serum collagenase inhibitor obtained in Example 6 added, using the monoclonal antibody combination as mentioned in Example 5(a). The results thus obtained are shown in FIG. 6. As is seen from FIG. 6, linearity is attained between the amount of human serum collagenase inhibitor added and A.sub.450, the determination sensitivity being 1.5 pg (48 a mole) per tube. This determination sensitivity was found to be 6.7 times higher than in the case of the standard curve prepared in Example 5(a) and 1.5 times lower than that for bovine dental pulp collagenase inhibitor as described in Example 3(c). inhibitor in human sera or plasmas by sandwich assay with liver disorders:

Using the monoclonal antibody combination as mentioned in Example 7, fifty serum samples from normal subjects, one hundred from patients with hepatocellular carcinoma and three from those with metastatic liver carcinoma were sandwich-assayed quantitatively for collagenase inhibitor contained therein. The results are shown in Tables 5-1, 5-2 and 5-3, respectively. In this sandwich assay there was used the human serum collagenase inhibitor purified in Example 6 as the antigen for preparation of the standard curve. This quantification was performed with the serum samples diluted 1,600 times with Buffer A containing 1% BSA. The values indicated in Tables 5-1, 5-2 and 5-3 are expressed as means of duplicate experiments. As is seen from Tables 5-2 and 5-3, the mean amounts of collagenase inhibitor present in one ml of serum from patients with hepatocellular carcinoma and from those with metastatic liver carcinoma were as high as 484.+-.316 ng and 1171.+-.712 ng, respectively, whereas as is seen from Table 5-1 that from normal subjects was 184.+-.31 ng. Forty-six, forty-five and twenty-six serum samples from patients with liver cirrhosis, with chronic active hepatitis and with chronic inactive hepatitis, respectively, were sandwich-assayed quantitatively and the values obtained with the respective samples are shown in Tables 6-1, 6-2 and 6-3. As shown in these tables, the mean amounts of collagenase inhibitor in sera of patients with liver cirrhosis, with chronic active hepatitis and with chronic inactive hepatitis were 228.+-.163 ng, 233.+-.88 ng and 166.+-.73 ng, respectively, all showing no significant difference as compared to the serum collagenase inhibitor level for normal subjects. patients with liver disorders:

In accordance with the method of Ludlam and Cash as described in Br. J. Haematol. 33, 239-247 (1976), plasma was taken from bloods of normal subjects and of patients with hepatocellular carcinoma. The plasma thus taken is the supernatant obtained from centrifugation at 1,900 x g for 60 min. at 4.degree. C. of cooled blood supplemented with EDTA, prostaglandin E.sub.1 and theophylline, wherein the platelets in the blood are retained in the precipitated fraction without decomposition.

The thus obtained twenty-six plasma samples from normal subjects and eight from patients with hepatocellular carcinoma were sandwich-assayed quantitatively for collagenase inhibitor present therein by the same method as in (a) above. The results are shown in Table 7 below. As is seen from Table 7, the mean amount of collagenase inhibitor present in one ml of plasma from patients with hepatocellular carcinoma was as high as 583.+-.447 ng, whereas that from normal subjects was 64.+-.10 ng. collagenase inhibitor:

As was demonstrated in Example 4(b), the two monoclonal antibodies (clone 7-6C1 and clone 7-23G9) used in the sandwich assay exhibit reactivity with human collagenase inhibitor. A test was performed to establish that these monoclonal antibodies specifically react with collagenase inhibitor in such systems as sera, plasmas and synovial fluids in which different proteins are present dissolved in high concentrations. The sera from normal subjects and from patients with hepatic carcinoma were diluted five times with a 30-mM Tris-HCl buffer solution (pH 8.0) containing 0.1-M NaCl and 5-mM CaCl.sub.2, and then applied onto Sepharose 4B column with immobilized clone 7-23G9 (antibody as the solid phase for the sandwich assay) which is prepared as described in Example 4(a) to obtain the eluted fraction according to the manner as described in Example 4(b). After being subjected to SDS-PAGE followed by Western blotting, the eluted fraction was immunologically stained with Fab'(clone 7-6C1)-POD conjugate, a labeled antibody for the sandwich assay. The results are shown in FIG. 7. As seen from FIG. 7, a single band was shown for all the cases (1: purified human serum collagenase inhibitor; 2: sera from normal subjects; and 3: sera from patients with hepatic carcinoma). It has thus been demonstrated that according to the sandwich assay in the method of diagnosis of the invention collagenase inhibitor is determined extremely specifically.

As is apparent from the foregoing description, it is possible, with the method of the present invention, to perform the diagnosis of hepatic carcinoma straightforwardly in a short period of time with high sensitivity. ______________________________________ Clone No.          Subclass/Chain ______________________________________ 7-3F1              IgG1/.kappa. 7-4F2              IgG1/.kappa. 7-5A1              IgG1/.kappa. 7-6C1              IgG1/.kappa. 7-7F11             IgG1/.kappa. 7-8B2              IgG2a/.kappa. 7-9B4              IgG1/.kappa. 7-10E11            IgG1/.kappa. 7-11A5             IgG1/.kappa. 7-12B6             IgG1/.kappa. 7-14E9             IgG1/.kappa. 7-15E8             IgG1/.kappa. 7-18F3             IgG2b/.kappa. 7-19F6             IgG1/.kappa. 7-20C2             IgG1/.kappa. 7-21B12            IgG1/.kappa. 7-23G9             IgG1/.kappa. ______________________________________ __________________________________________________________________________ Solid Phase Fab'-POD Conjugate Antibody IgG1 (7-3F1) IgG1 (7-6C1) IgG1 (7-19F6) IgG1 (7-21B12) __________________________________________________________________________ IgG1 (7-3F1) 0.011  3.989  2.252   2.684 IgG1 (7-4F2) 3.144  4.811  3.354   3.083 IgG1 (7-5A1) 3.257  0.010  0       0 IgG1 (7-6C1) 2.152  0.001  0.011   0 IgG1 (7-7F11) 0.125  0.239  0.102   0.067 IgG2a (7-8B2) 0      3.967  1.064   1.288 IgG1 (7-9B4) 0.196  0.057  0.029   0.020 IgG1 (7-10E11) 0.891  0.007  0.001   0.002 IgG1 (7-11A5) 3.406  4.455  3.288   3.260 IgG1 (7-12B6) 3.604  4.083  2.952   3.077 IgG1 (7-15E8) 0.313  0.781  0.387   1.897 IgG2b (7-18F3) 3.362  4.735  3.114   3.021 IgG1 (7-19F6) 1.066  0      0       0.004 IgG1 (7-20C2) 3.277  4.553  3.355   3.240 IgG1 (7-21B12) 2.107  0.002  0.003   0 IgG1 (7-23G9) 3.622  4.386  3.027   3.092 __________________________________________________________________________ ______________________________________ Sera from normal subjects Collagenase Sample inhibitor No.   (.mu.g/ml) ______________________________________ 1    1.57 2    2.60 3    1.81 4    1.41 5    1.57 6    1.69 7    1.84 8    2.00 9    1.92 10    1.14 11    1.61 12    1.49 13    2.05 14    2.00 15    2.12 16    1.41 17    1.22 18    1.57 19    2.36 20    1.97 21    1.18 22    2.12 23    1.41 24    1.53 25    2.08 26    1.49 27    1.02 28    1.73 29    1.82 30    1.14 31    1.81 32    1.49 33    1.81 34    1.41 35    1.61 36    1.49 37    1.02 38    2.43 39    1.73 40    1.73 41    1.49 42    1.69 43    1.46 44    1.69 45    0.89 46    1.22 47    1.41 48    1.22 49    1.18 50    1.49 51    1.57 52    1.41 53    1.14 54    1.30 55    1.69 56    1.49 57    1.53 58    2.43 59    1.84 60    1.77 61    2.08 62    1.61 63    1.37 64    2.05 65    1.73 66    1.37 67    0.94 68    1.61 69    1.06 70    1.61 71    0.89 72    1.41 73    2.05 74    1.57 75    1.14 76    1.22 77    1.49 78    1.57 79    1.02 80    1.60 81    1.65 82    2.32 83    1.94 84    1.57 85    1.14 86    1.73 87    1.37 88    1.49 89    1.18 90    1.22 91    1.41 92    1.06 93    2.32 94    2.36 95    1.46 Mean 1.59 .+-. 0.37 .mu.g/ml ______________________________________ ______________________________________ Sera from patients with hepatocellular carcinoma Collagenase Sample inhibitor No.   (.mu.g/ml) ______________________________________ 1    3.38 2    2.28 3    2.35 4    4.25 5    4.32 6    4.10 7    1.34 8    4.32 9    0.94 10    7.39 11    3.07 12    3.67 13    13.77 14    3.61 15    4.32 16    4.17 17    2.04 18    1.37 19    1.46 20    1.53 21    5.59 22    1.89 23    1.80 24    2.28 25    2.16 26    7.08 27    1.58 28    4.53 29    3.07 30    5.83 31    2.91 32    11.40 33    3.93 34    4.72 35    2.24 36    2.44 37    1.85 38    5.35 39    3.70 40    1.18 41    2.99 42    4.56 43    1.65 44    1.70 45    1.65 46    1.22 47    1.80 48    1.34 49    1.34 50    1.37 51    1.53 52    4.17 53    2.83 54    2.13 55    4.87 56    5.27 57    7.08 58    8.66 59    4.65 60    2.91 61    4.17 62    1.58 63    4.48 64    5.83 65    2.91 66    3.38 67    4.63 68    1.46 69    1.89 70    4.10 71    1.46 72    2.98 73    2.99 74    1.37 75    1.65 76    2.32 77    1.58 78    5.27 79    2.44 80    2.13 81    1.65 82    2.91 83    2.91 84    6.76 85    0.82 86    2.32 87    1.85 88    2.99 89    2.24 90    2.91 91    2.49 92    2.09 93    1.53 94    2.16 95    3.46 96    1.10 97    1.97 98    1.46 99    3.86 100   3.22 Mean 3.22 .+-. 2.10 .mu.g/ml ______________________________________ ______________________________________ Sera from patients with metastatic liver carcinoma Collagenase Sample inhibitor No.   (.mu.g/ml) ______________________________________ 1     13.01 2     6.69 3     3.72 Mean 7.81 .+-. 3.87 .mu.g/ml ______________________________________ ______________________________________ Sera from patients with liver cirrhosis Collagenase Sample inhibitor No.   (.mu.g/ml) ______________________________________ 1    1.22 2    0.75 3    0.77 4    1.14 5    1.22 6    1.37 7    1.03 8    1.77 9    1.58 10    1.65 11    1.70 12    2.13 13    1.06 14    0.89 15    2.32 16    2.44 17    2.12 18    1.42 19    1.53 20    1.70 21    2.52 22    0.25 23    7.63 24    1.22 25    2.11 26    0.82 27    1.85 28    2.00 29    2.12 30    0.67 31    1.42 32    0.80 33    1.03 34    1.70 35    0.64 36    0.94 37    2.12 38    0.57 39    0.34 40    1.49 41    1.80 42    0.79 43    1.42 44    0.66 45    1.49 46    1.49 Mean 1.52 .+-. 1.07 .mu.g/ml ______________________________________ ______________________________________ Sera from patients with chronic active hepatitis Collagenase Sample inhibitor No.   (.mu.g/ml) ______________________________________ 1    1.42 2    2.59 3    1.41 4    3.38 5    1.37 6    1.03 7    1.77 8    1.61 9    1.42 10    1.89 11    1.85 12    1.80 13    1.65 14    1.22 15    1.85 16    0.97 17    0.76 18    2.04 19    2.09 20    2.16 21    1.89 22    1.65 23    1.25 24    1.77 25    1.65 26    1.92 27    0.86 28    2.91 29    1.37 30    1.15 31    1.30 32    2.24 33    1.10 34    0.76 35    0.72 36    0.72 37    1.97 38    0.91 39    1.06 40    1.97 41    0.91 42    1.77 43    0.91 44    1.85 45    0.91 Mean 1.55 .+-. 0.58 .mu.g/ml ______________________________________ ______________________________________ Sera from patients with chronic inactive hepatitis Collagenase Sample inhibitor No.   (.mu.g/ml) ______________________________________ 1    1.58 2    1.30 3    1.10 4    1.06 5    0.97 6    1.37 7    0.72 8    1.34 9    1.34 10    1.15 11    1.85 12    2.68 13    1.18 14    1.15 15    1.18 16    1.46 17    0.49 18    0.54 19    0.30 20    1.15 21    0.79 22    0.52 23    0.63 24    0.98 25    0.91 26    0.97 Mean 1.10 .+-. 0.48 .mu.g/ml ______________________________________ ______________________________________ Sera from normal subjects Collagenase Sample inhibitor No.   (ng/ml) ______________________________________ 1    123 2    131 3    210 4    161 5    176 6    210 7    200 8    191 9    155 10    210 11    155 12    200 13    170 14    210 15    123 16    139 17    155 18    161 19    176 20    200 21    221 22    200 23    170 24    221 25    150 26    155 27    225 28    185 29    245 30    200 31    210 32    210 33    176 34    165 35    176 36    176 37    185 38    245 39    155 40    210 41    155 42    200 43    236 44    230 45    191 46    165 47    176 48    210 49    165 50    155 Mean 184 .+-. 31 ______________________________________ ______________________________________ Sera from patients with hepatocellular carcinoma Collagenase Sample inhibitor No.   (ng/ml) ______________________________________ 1    507 2    342 3    353 4    638 5    648 6    615 7    201 8    648 9    141 10    1109 11    461 12    551 13    2066 14    542 15    648 16    626 17    306 18    206 19    219 20    230 21    839 22    284 23    270 24    342 25    324 26    1062 27    237 28    680 29    461 30    875 31    437 32    1710 33    590 34    708 35    336 36    366 37    278 38    803 39    555 40    177 41    449 42    684 43    248 44    255 45    248 46    183 47    270 48    201 49    201 50    206 51    230 52    626 53    425 54    320 55    731 56    791 57    1062 58    1299 59    698 60    437 61    626 62    237 63    672 64    875 65    437 66    507 67    694 68    219 69    284 70    615 71    219 72    447 73    449 74    206 75    248 76    348 77    237 78    791 79    366 80    320 81    248 82    437 83    437 84    1014 85    123 86    348 87    278 88    449 89    336 90    437 91    374 92    314 93    230 94    324 95    519 96    165 97    296 98    219 99    579 100   483 Mean 484 .+-. 316 ______________________________________ ______________________________________ Sera from patients with metastatic liver carcinoma Collagenase Sample inhibitor No.   (ng/ml) ______________________________________ 1     1952 2     1004 3      558 Mean 1171 .+-. 712 ______________________________________ ______________________________________ Sera from patients with liver cirrhosis Collagenase Sample inhibitor No.   (ng/ml) ______________________________________ 1    183 2    113 3    116 4    171 5    183 6    206 7    155 8    266 9    237 10    248 11    255 12    320 13    159 14    134 15    348 16    366 17    318 18    213 19    230 20    255 21    378 22     38 23    1145 24    183 25    317 26    123 27    278 28    300 29    318 30    101 31    213 32    120 33    155 34    255 35     96 36    141 37    318 38     86 39     51 40    224 41    270 42    119 43    213 44     99 45    224 46    224 Mean 228 .+-. 163 ______________________________________ ______________________________________ Sera from patients with chronic active hepatitis Collagenase Sample inhibitor No.   (ng/ml) ______________________________________ 1    213 2    389 3    212 4    507 5    206 6    155 7    266 8    242 9    213 10    284 11    278 12    270 13    248 14    183 15    278 16    146 17    114 18    306 19    314 20    324 21    284 22    248 23    188 24    266 25    248 26    288 27    129 28    437 29    206 30    173 31    195 32    336 33    165 34    114 35    108 36    108 37    296 38    137 39    159 40    296 41    137 42    266 43    137 44    278 45    137 Mean 233 .+-. 88 ______________________________________ ______________________________________ Sera from patients with chronic inactive hepatitis Collagenase Sample inhibitor No.   (ng/ml) ______________________________________ 1    237 2    195 3    165 4    159 5    146 6    206 7    108 8    201 9    201 10    173 11    278 12    402 13    177 14    173 15    177 16    219 17     74 18     81 19     45 20    173 21    119 22     78 23     95 24    147 25    137 26    146 Mean 166 .+-. 73 ______________________________________ ______________________________________ Plasmas from     Plasmas from patients with normal subjects  hepatocellular carcinoma Collagenase           Collagenase Sample  inhibitor    Sample   inhibitor No.     (ng/ml)      No.      (ng/ml) ______________________________________ 1      61           1        175 2      78           2        431 3      44           3        1534 4      70           4        943 5      75           5        261 6      84           6        429 7      70           7        366 8      54           8        523 9      49 10      74 11      73 12      64 13      72 14      62 15      67 16      54 17      74 18      51 19      57 20      53 21      60 22      60 23      64 24      56 25      62 26      74 Mean 64 .+-. 10      Mean 583 .+-. 447 ______________________________________

## Claims

1. A screening method to aid in the diagnosis of hepatic carcinoma, comprising: collagenase inhibitor with a first insoluble complex composed of a solid substrate having bound thereto a first monoclonal antibody specific for collagenase inhibitor in order to bind said collagenase inhibitor to said insoluble complex; specific for collagenase inhibitor conjugated to an enzyme so as to form an insoluble ternary complex of said enzyme-conjugated second monoclonal antibody, said collagenase inhibitor, and said solid substrate; ternary complex with a substrate of said enzyme and determining the amount of said enzyme reaction product formed from a standard curve to provide a measure of the amount of collagenase inhibitor; and plasma from normal subjects, wherein an elevation of said amount of collagenase inhibitor is indicative of the presence of hepatic carcinoma.

2. The method of claim 1, wherein said solid substrate is a material selected from the group consisting of polystyrene, polycarbonate, polypropylene, and polyvinyl.

3. The method of claim 1, wherein said solid substrate is in a form selected from the group consisting of a ball, a microplate, a stick, and a test tube.

4. The method of claim 1, wherein said solid substrate is a polystyrene ball.

5. The method of claim 1, wherein said enzyme is horseradish peroxidase.

6. The method of claim 5, wherein said substrate is a substrate for horseradish peroxidase.

7. The method of claim 5, wherein said amount of said collagenase inhibitor is determined by measuring the optical density of the reaction mixture containing said enzyme reaction product formed at 450 nm.

8. The method of claim 1, wherein said standard curve is prepared by measuring the amount of enzyme reaction product formed in reaction mixtures containing varying amounts of human serum collagenase inhibitor.

9. The method of claim 1, wherein said screening further comprises performing liver function tests.

10. The method of claim 11, wherein said liver function tests are selected from the group consisting of the zinc sulfate turbidity test, measurement of glutamic oxaloacetic transaminase, measurement of glutamic-pyruvic transaminase, measurement of alkaline phosphatase, measurement of lactate dehydrogenase, measurement of .gamma.-glutamyl transpeptidase, measurement of prolyl hydroxylase, and measurement of .alpha.-fetoprotein.

11. A screening method to aid in the diagnosis of hepatic carcinoma, comprising: collagenase inhibitor with a first insoluble complex comprised of a solid substrate having bound thereto an antibody produced by hybridoma clone FERM BP-3469 in order to bind said collagenase inhibitor to said insoluble complex; produced by hybridoma clone FERM BP-3468 conjugated to an enzyme so as to form an insoluble ternary complex of said enzyme-conjugated second monoclonal antibody, said collagenase inhibitor, and said solid substrate; ternary complex with a substrate of said enzyme and determining the amount of said enzyme reaction product formed from a standard curve to provide a measure of the amount of collagenase inhibitor; and plasma from normal subjects, wherein an elevation of said amount of collagenase inhibitor is indicative of the presence of hepatic carcinoma.

12. The method of claim 11, wherein said solid substrate is a material selected from the group consisting of polystyrene, polycarbonate, polypropylene, and polyvinyl.

13. The method of claim 11, wherein said solid substrate is in a form selected from the group consisting of a ball, a microplate, a stick, and a test tube.

14. The method of claim 11, wherein said solid substrate is a polystyrene ball.

15. The method of claim 11, wherein said enzyme is horseradish peroxidase.

16. The method of claim 15, wherein said substrate is a substrate for horseradish peroxidase.

17. The method of claim 15, wherein said amount of said collagenase inhibitor is determined by measuring the optical density of the reaction mixture containing said enzyme reaction product formed at 450 nm.

18. The method of claim 11, wherein said standard curve is prepared by measuring the amount of enzyme reaction product formed in reaction mixtures containing varying amounts of human serum collagenase inhibitor.

19. The method of claim 11, wherein said screening further comprises performing liver function tests.

20. The method of claim 19, wherein said liver function tests are selected from the group consisting of the zinc sulfate turbidity test, measurement of glutamic oxaloacetic transaminase, measurement of glutamic-pyruvic transaminase, measurement of alkaline phosphatase, measurement of lactate dehydrogenase, measurement of .gamma.-glutamyl transpeptidase, measurement of prolyl hydroxylase, and measurement of .alpha.-fetoprotein.