Abstract:
All neoplastic cells express one or more members of a unique family of cell surface ubiquinone (NADH) oxidase proteins with protein disulfide-thiol interchange activity (ECTO-NOX proteins) that are characteristically inhibited by quinone site inhibitors with anti-cancer activity. Cancers of different cellular or tissue origins express different tNOX cancer isoforms or combinations of isoforms and shed these proteins into the circulation. Herein are disclosed methods both for cancer detection and diagnosis of particular origin, based on the patterns and molecular weights of the isoforms which allow the identification of the cell type and or tissue of origin of the neoplasm. Relative tNOX amounts are proportional to tumor burden and provide a reliable measure of response to therapy and disease progression.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims benefit of U.S. Provisional Application 60/824,398 and U.S. Provisional Application 60/824,333, both filed Sep. 1, 2006, and both incorporated by reference herein to the extent there is no inconsistency with the present disclosure. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    The field of this invention is the area of protein biochemistry, in particular, as related to the diagnosis of neoplastic and diseased cells, as specifically related to particular isoforms of a cell surface marker characteristic of neoplasia in general and with specific patterns of protein expression indicative of specific types of cancer. Detection of the particular isoforms is by use of specific antibodies. 
         [0003]    There is a unique, growth-related family of cell surface hydroquinone or NADH oxidases with protein disulfide-thiol interchange activity referred to as ECTO-NOX proteins (for cell surface NADH oxidases) (1,2). One member of the ECTO-NOX family, designated tNOX (for tumor associated) is specific to the surfaces of cancer cells and the sera of cancer patients (3, 4). The presence of the tNOX protein has been demonstrated for several human tumor tissues (mammary carcinoma, prostate cancer, neuroblastoma, colon carcinoma and melanoma) (5), and serum analysis suggest a much broader association with human cancer (6, 7). 
         [0004]    NOX proteins are ectoproteins anchored in the outer leaflet of the plasma membrane (8). As is characteristic of other examples of ectoproteins (sialyl and galactosyl transferase, dipeptidylamino peptidase IV, etc.), the NOX proteins are shed. They appear in soluble form in conditioned media of cultured cells (5) and in patient sera (6, 7). The serum form of tNOX from cancer patients exhibits the same degree of drug responsiveness as does the membrane-associated form. Drug-responsive tNOX activities are seen in sera of a variety of human cancer patients, including patients with leukemia, lymphomas or solid tumors (prostate, breast, colon, lung, pancreas, ovarian, liver) (6, 7). An extreme stability and protease resistance of the tNOX protein (9) may help explain its ability to accumulate in sera of cancer patients to readily detectable levels. In contrast, no drug-responsive NOX activities have been found in the sera of healthy volunteers (6, 7) or in the sera of patients with disorders other than neoplasia. 
         [0005]    While the basis for the cancer specificity of cell surface tNOX has not been determined, the concept is strongly supported by several lines of evidence. A drug responsive tNOX activity has been rigorously determined to be absent from plasma membranes of non-transformed human and animal cells and tissues (3). The tNOX proteins lack a transmembrane binding domain (10) and are released from the cell surface by brief treatment at low pH (9). A drug-responsive tNOX activity has not been detected in sera from healthy volunteers or patients with diseases other than cancer (6, 7). Several tNOX antisera have identified the immunoreactive band at 34kDa (the processed molecular weight of one of the cell surface forms of tNOX) with Western blot analysis or immunoprecipitation when using transformed cells and tissues or sera of cancer patients as antigen source (5,10,11). The immunoreactive band at 34kDa is absent with western blot analysis or immunoprecipitation when using transformed cells and tissues or sera from healthy volunteers or patents with disorders other than cancer (5,10,11). These antisera include a monoclonal antibody (5), single-chain variable region fragment (scFv) which reacts with the cell surface NADH oxidase from normal and neoplastic cells, polyclonal antisera made in response to expressed tNOX (11) and polyclonal peptide antisera to the conserved adenine nucleotide binding region of tNOX (11). 
         [0006]    tNOX cDNA has been cloned (GenBank Accession No. AF207881; 11; U.S. Patent Publication 2003-0207340 A1). The derived molecular weight from the open reading frame was 70.1 kDa. Functional motifs include a quinone binding site, an adenine nucleotide binding site, and a CXXXXC cysteine pair as a potential protein disulfide-thiol interchange site based on site-directed mutagenesis (11). Based on available genomic information (12) the tNOX gene is located on chromosome X, and it is comprised of multiple exons (thirteen). It is known that there are a number of splice variant mRNAs and proteins expressed. 
         [0007]    The hybridoma cell line which produces the tumor NADH oxidase-specific monoclonal antibody MAB 12.1 was deposited with the American Type Culture Collection, Manassas, Va., 20108 on Apr. 4, 2002, under the terms of the Budapest Treaty. This deposit is identified by Accession No. ATCC PTA-4206. The deposit will be maintained with restriction in the ATCC depository for a period of 30 years from the deposit date, or 5 years after the most recent request, or for the effective life of the patent, which ever is longer, and will be replaced if the deposit becomes non-viable during that period. This monoclonal antibody is described in U.S. Pat. No. 7,053,188, issued May 30, 2006, which is incorporated by reference herein. 
         [0008]    Because cancer poses a significant threat to human health and because cancer results in significant economic costs, there is a long-felt need in the art for an effective, economical and technically simple system in which to assay for the presence of cancer. 
       BRIEF SUMMARY OF THE INVENTION 
       [0009]    The present invention provides a method for the analysis of a biological sample for the presence of particular isoforms of the pan-cancer antigen known as tNOX (for tumor-specific NADH oxidase). The present method entails 2-dimensional gel electrophoresis and immunoblotting using an antibody specific for the pan-cancer tNOX antigen and the various isoforms which characterize particular types of cancers. As specifically exemplified, about 4-6 mg protein are loaded for analysis. 
         [0010]    The present invention provides a method for the detection of particular cancer-specific serum or plasma tNOX isoforms as indicators of the presence of cancer and of the cell type or tissue of cancer origin (breast, ovarian prostate, etc). tNOX isoforms are identified on the basis of their molecular mass and isoelectric point with detection using a tNOX-specific monoclonal antibody (MAB) (U.S. Pat. No. US 7,053,188), using single chain variable region (ScFv) fragment which recognizes all cell surface NOX proteins (both age-related, normal cell and neoplasia specific NADH oxidase) or using polyclonal sera raised against tNOX. The ECTO-NOX proteins are first enriched and concentrated from a biological sample, desirably a serum sample, by binding to nickel-agarose and then eluting. After release of the proteins from the nickel-agarose by vortexing, the proteins are separated in the first dimension by isoelectric focusing and in the second dimension by polyacrylamide gel electrophoresis. As specifically exemplified herein, the isoelectric focusing step is over a pH range from 3 to 10, and size separation is over a 10% polyacrylamide gel. Most of the cancer-specific tNOX isoforms exhibit isoelectric points in a very narrow range between pH 4.4 and 5.4 but differ in molecular weight from 34 to 136 kDa. In the 2D gel system specifically exemplified, the cancer-specific isoforms are located in Quadrants I (relatively high molecular weight material) and IV (lower molecular weight material, notably the 34 and 43 kDa isoforms). IgG heavy chains (Quadrant II and IgG light chains (Quadrant III) cross react with the ScFv antibody and serve as loading controls. The absence of all tNOX isoforms indicates the absence of cancer; the presence of a tNOX isoform indicates the presence of cancer. The particular molecular weight present in a serum sample or a particular combination of isoforms provides an indication of the cell type or tissue of origin of the cancer. The method not only determines cancer presence, but also the method of the present invention provides diagnostic information concerning the tissue of origin. At present there are no other pan cancer (all forms of human cancer) tests with these particular capabilities. 
         [0011]    The present invention provides a method for determining neoplasia in a mammal, including a human, said method comprising the steps of detecting cancer presence, in a biological sample. The present invention further provides additional information for assessment of neoplasia, including a measure of tumor burden, for example in serum, plasma, urine, saliva or in biopsy material. 
         [0012]    Also within the scope of the present invention are particular isoforms of tNOX associated with specific (primary) cancers: tNOX proteins with apparent molecular weights of about 64, 66 and/or 68 kDa are associated with breast cancer; two tNOX proteins of about 40.5 and 52 kDa are associated with small cell lung cancer; tNOX proteins of about 40.5, 52 and 80 kDa characterize ovarian cancer; two tNOX isoforms of about 75 kDa designated 75α and 75β are associated with prostate cancer; a tNOX protein of about 94 kDa is associated with cervical cancer; tNOX proteins of about 43 and 52 kDa are characteristic of colon cancer; and a tNOX isoform of about 54 kDa is associated with non small cell lung cancer. Where a patient is suspected of having cancer, a biological sample, advantageously a serum sample can be prepared, and the 2D gel electrophoresis/immunological analysis of the present invention can be undertaken. Positive results are indicative of the presence of cancer, and the detection of characteristic proteins allow a presumption as to the primary incidence of cancer in that patient according to the association of particular protein(s) with particular cancer origins, as set forth above. 
         [0013]    The methods of the present invention can also be applied to evaluate response to therapy, with decreasing amounts of NOX isoform(s) reflecting successful treatment, as well as early detection of recurrent disease (reflected increased or reappearance of tNOX-specific isoforms. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS  
         [0014]      FIG. 1  provides the results of analytical 2-D gel electrophoresis of ECTO-NOX enriched serum proteins from a preparation of sera pooled from cancer patients (breast, ovarian, lung and colon) concentrated by nickel agarose precipitation, followed by immunoblots analysis. Separation in the first dimension was by isoelectric focusing and in the second dimension by SDS-PAGE (using ampholytes over the pH range of 3 to 10 and 10% polyacrylamide gel). For interpretative purposes, the gel is divided into quadrants I-IV with unreactive albumin (albumin) at the center. Detection was with recombinant anti-tNOX single chain variable region (scFv) antibody (MAB 12.1 scFv) carrying an S-tag followed by alkaline phosphatase-liked anti S (Novagen cat. # 69598-3 or equivalent product) with Western Blue NBT substrate (Promega, Madison, Wis; Cat. No. S3841 or equivalent product). Reactive proteins appear reddish blue. 
           [0015]      FIG. 2  shows the results of generalized analytical 2-D gel map of tNOX isoforms located in quadrant I identified using the diagnostic system of  FIG. 1 . 
           [0016]      FIG. 3  shows the results of generalized analytical 2-D gel map of putative tNOX isoforms located in quadrant IV identified using the diagnostic system of  FIG. 1 . 
           [0017]      FIG. 4  shows the results of analytical 2-D gel electrophoresis and immunoblotting using a tNOX-specific antibody; over quadrant IV from the 2-D gel of serum from a patient with ovarian cancer. The 40.5, 52 and approximately 80 kDa ovarian cancer tNOX isoforms are marked by arrows. 
           [0018]      FIG. 5  shows the results of analytical 2-D gel electrophoresis and immunoblotting using a tNOX-specific antibody; as in  FIG. 1  except it shows only quadrants I and IV from the same 2-D gel of serum from a patient with small cell lung cancer. These sera contain both 40.5 kDa and 52 kDa tNOX isoforms (arrows), typical of sera from patients with this cancer. 
           [0019]      FIG. 6  provides the results of analytical 2-D gel electrophoresis and immunoblotting using tNOX-specific antibody. This figure is as in  FIG. 1  except it shows only quadrant I and quadrant IV from the 2-D gel of serum from a patient with non-small cell lung cancer. This serum contains a 54 kDa tNOX isoform characteristic of non-small cell lung cancer (arrow). 
           [0020]      FIG. 7  provides the results of analytical 2-D gel electrophoresis and immunoblotting using tNOX-specific antibody. This figure is as in  FIG. 1  except it shows only quadrant I and quadrant IV from the 2-D gel of serum from a patient with breast cancer. This serum contains a 68 kDa tNOX isoform, one of the isoforms characteristic of breast cancer (arrow). 
           [0021]      FIG. 8  provides the results of analytical 2-D gel electrophoresis and immunoblotting using tNOX-specific antibody. This figure is as in  FIG. 1  except it shows only quadrant I from the 2-D gel of serum from a patient with prostate cancer. Plasma and serum from prostate cancer patients contain a characteristic 75 kDa tNOX isoforms (arrows) of isoelectric points of pH 5.8 (a) and pH 5.2 (β) respectively. 
           [0022]      FIG. 9  provides the results of analytical 2-D gel electrophoresis and immunoblotting using tNOX-specific antibody. This figure is as in  FIG. 1  except it shows only quadrant I of a 2-D gel of serum from a cervical cancer patient. These sera contain a 94 kDa tNOX isoform characteristic of cervical cancer (arrow). 
           [0023]      FIG. 10  provides the results of analytical 2-D gel electrophoresis and immunoblotting using tNOX-specific antibody. This figure is as in  FIG. 1  except it shows only quadrant I of a 2-D gel of serum from a colon cancer patient. This serum contains tNOX isoforms of 52 and 43 kDa, characteristic of colon cancer (arrows). 
           [0024]      FIG. 11  provides the results of analytical 2-D gel electrophoresis and immunoblotting using tNOX-specific antibody. This figure is as in  FIG. 1  except it shows only quadrant I and quadrant IV from the 2-D gel of serum from a patient with an unknown primary cancer. This serum contains tNOX isoforms of 40.5, 52 and ca. 80 kDa. The diagnosis based on this analysis is that the primary cancer is of ovarian origin. 
           [0025]      FIG. 12  shows results of analytical 2-D gel electrophoresis and immunoblotting using tNOX-specific antibody of sera from a patient with Non-Hodgkins lymphoma illustrating the 43 kDa tNOX isoform of low isoelectric point characteristic of hematological cancers. 
           [0026]      FIG. 13  provides the results of analytical 2-D gel electrophoresis and immunoblotting using tNOX-specific antibody. This figure is as in  FIG. 1  except it shows only quadrant I and quadrant IV from the 2-D gel of pooled sera from more than 25 random patients with disorders other than cancer, or sera and plasma from healthy volunteers. Both quadrants I and IV are devoid of tNOX isoforms. 
           [0027]      FIG. 14  summarizes the particular tNOX isoforms characteristic of commonly occurring cancers. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0028]    The cancer diagnostic system of the present invention utilizes two-dimensional polyacrylamide gel electrophoretic techniques for the separation of proteins in human sera to generate cancer-specific isoform patterns and compositions indicative of cancer presence, tumor type, disease severity and therapeutic response. The protocol is designed for the detection of at least 20 cancer-specific tNOX isoforms which are resolved to indicate cancer presence and disease severity. This specification illustrates the process of the isoform-resolving two-dimensional gel electrophoresis protocol and subsequent immunoanalysis to detect tNOX isoforms which reflect particular cancers. 
         [0029]    Two-dimensional gel electrophoresis separates by displacement in two dimensions oriented at right angles to one another and immunoblotting identifies the tNOX isoforms. In the first dimension isoforms are separated according to charge (pI) by isoelectric focusing (IEF). The isoforms are then separated according to size (Mr) by SDS-PAGE in a second dimension. The isoforms are then blotted onto a nitrocellulose membrane for further analysis using a pan-cancer specific antibody preparation. 
         [0030]    Rabbits were immunized and sera were prepared against a 33.5 kDa component of culture medium conditioned by the growth of HeLa cells that exhibited an antitumor sulfonylurea-(Morré et al. (1995) Biochim. Biophys. Acta 1240:11-17) and capsaicin-inhibited (Morré et al. (1995) Proc. Natl. Acad. Sci. USA 92:1831-1835) NADH oxidase activity and was capable of binding ( 3 H)-LY181984. These antisera cross-reacted on Western blots with the 34 kDa tNOX protein from HeLa cells and with the 68 kDa and 136 kDa multimeric bands of the material from FPLC separations enriched in capsaicin-inhibitable NADH oxidase activity. No reactivity was observed with preimmune sera. 
         [0031]    Antibodies specific for the plasma membrane tNOX and the shed forms in urine and serum of cancer patients and animals with neoplastic disorders are useful, for example, as probes for screening DNA expression libraries or for detecting or diagnosing a neoplastic disorder in a sample from a human or animal. The antibodies (or second antibodies which are specific for the antibody which recognizes tNOX) can be bound to a substance which provides a cofactor, inhibitor, fluorescent agent, chemiluminescent agent, magnetic particle or other detectable signal. Suitable labels include but are not limited to radionuclides, enzymes, substrates, magnetic particles and the like. United States Patents describing the use of such detectable moieties (labels) include, but are not limited to, U.S. Pat. Nos. 3,817,837; 3,850,752; 3,939,350; 3,996,345; 4,277,437; 4,275,149; 4,331,647; 4,348,376; 4,361,544; 5,444,744; 4,460,561; 4,624,846; 4,366,241, 5,716,595; among others. For use in therapeutic regimens, the antibody of the present invention can be coupled to a therapeutic radionuclide, a chemotherapeutic agent, a ribonucleolytic agent or a toxin. See, among others, U.S. Pat. Nos. 5,541,297, 6,395,276.The invention may be further understood by the following non-limiting examples. 
         [0032]    Sample preparation is carried out as follows. 
         [0033]    Serum tNOX Protein Concentration and Enrichment
       1. Add 40 μl of Nickel Agarose Beads to a 0.5 ml Microfuge Tube
           a. Shake beads to disrupt pellet and bring fully into solution   b. Cut about 2 mm off tip before using   
           2. Wash Beads
           a. Add 400 μl of deionized distilled-H 2 O to fill tubes   b. Vortex tubes, fully mixing beads for 2-3 seconds   c. Centrifuge tubes at 1,000 g for 30 seconds   d. Place tubes vertically in holder allowing beads to settle   e. Discard water/ethanol supernatant   
           3. Add 400 μl of Serum to Beads   4. Vortex Tubes for 2-3 Seconds to Fully Disrupt Pellet   5. Incubate Tubes on Horizontal Side at 4° C. on Shaker Overnight       
 
       Protein Purification 
       [0046]    1. Centrifuge tubes (above) at 1,000 g for 30 seconds 
         [0047]    2. Discard supernatant 
         [0048]    3. Wash beads 3x with deionized distilled-H 2 0 as described above 
         [0000]    First-Dimension (Isoelectric focusing, IEF) is carried out as follows. 
       Strip Re-hydration 
       [0049]    1. Prepare/thaw re-hydration solution
       a. Add 1% dithiothreitol (DTT) to solution immediately before use (0.014 g/1.4 ml)       
 
         [0051]    2. Add 150 μl of re-hydration solution to agarose bound sample 
         [0052]    3. Vortex tubes for 75 minutes 
         [0053]    4. Remove Immobiline DryStrips (Amersham Pharmacia Biotech) from freezer and allow strips to equilibrate to room temperature for 5 minutes (but not more than 10 min prior to use).
       5. Label plastic back of strips with black felt tip pen.   6. Centrifuge sample at 1,000 g for 1 minute to pellet beads.   7. Place tubes in holder vertically and allow pellet to completely settle.   8. Load 125 μl of sample (supernatant) to level tray per 7 cm DryStrip.   9. Place DryStrips gel-side down over sample   10. Insure sample is evenly spread throughout strip by carefully lifting strip in and out of sample a few times if needed.   11. If samples are concentrated in one region of the strip, redistribute sample by pipetting.   12. Remove air bubbles by gently pressing down on DryStrip with pipette tip.   13. Place lid on tray, and place tray in plastic bag with wet paper towels.   14. Seal bag.   15. Allow sample to re-hydrate overnight (between 12-24 hours) at room temperature on level surface allowing strips to absorb samples.       
 
         [0065]    Alternative Sample Preparation.
       1. Prepare/thaw re-hydration solution
           a. Add 1% Dithiothreitol (DTT) to solution before use (0.014 g/ 1.4 ml) (contacting with reducing agent)   
           2. Add 135 μl of re-hydration solution per microfuge tube   3. Add 15 μl of sera per microfuge tube   4. Vortex tubes for 15 min   5. Remove Immobiline DryStrips (Amersham Pharmacia Biotech) from freezer and allow strips to equilibrate to RT for 5 minutes (but not more than 10 min.)   6. Label plastic back of strips   7. Load 125 of sample to level tray per 7 cm. DryStrip.   8. Place DryStrips gel-side down over sample   9. Insure sample is evenly spread throughout strip by carefully lifting strip in and out of sample a few times if needed.   10. If samples are concentrated in one region of the strip, redistribute sample by pipetting.   11. Remove air bubbles by gently pressing down on DryStrip with pipette tip.   12. Place lid on tray, and place tray in plastic bag w/wet paper towels.   13. Seal bag.   14. Allow sample to re-hydrate overnight at RT on level surface allowing strips to absorb samples.
           a. Between 12-24 hours   
           15. Continue to Isoelectric focusing of strips.       
 
         [0083]    Isoelectric Focusing of Strips
       1. Turn on IPGphor 3 (Amersham)   2. Remove strips from tray and carefully remove excess sample from strips by blotting both sides with a tissue.   3. Place strips on manifold focusing tray (Amersham) as follows
           a. Gel side up   b. Positive (acidic) end towards back   c. Strips are aligned   d. Between metal strips (so electrodes fit and touch metal strip)   
           4. Employ 2 paper wicks (Amersham Pharmacia, #80-6499-14) per strip   5. Wet wicks with 150 μl distilled water per wick.   6. Place wicks over anodic and cathodic ends of gel (approx. 0.3 cm).   7. Place electrodes on wicks, but away from gel (be sure prong is on metal plate), and lock in place.   8. Cover strips, filling entire lane with DryStrip Cover Fluid (Amersham Pharmacia, #17-1335-01)   9. Close apparatus   10. IEF run with IPGphor 3 (Amersham) at a maximum amperage of 50 μAmps at 20° C. As needed, pause run and replace wicks, continuing the run until dye front disappears.       
 
         [0000]    
       
         
               
               
               
               
             
               
               
               
               
               
               
             
               
               
               
               
             
           
               
                   
                   
               
               
                   
                 Step 
                 Voltage 
                 Time/Vhrs 
               
               
                   
                   
               
             
             
               
                   
               
             
          
           
               
                   
                 7 cm Strip pH 3-10 
                 1- 
                  250 V 
                 15 
                 min. 
               
               
                   
                   
                 Stp. 
               
               
                   
                   
                 2- 
                  500 V 
                 15 
                 min. 
               
               
                   
                   
                 Stp. 
               
               
                   
                   
                 3- 
                 1000 V 
                 30 
                 min. 
               
               
                   
                   
                 Stp. 
               
               
                   
                   
                 4- 
                 4000 V 
                 2 
                 hrs. 
               
               
                   
                   
                 Grd. 
               
               
                   
                   
                 5- 
                 4000 V 
                 25,000 
                 Vhrs. 
               
               
                   
                   
                 Stp. 
               
             
          
           
               
                   
                 6- 
                  500 V 
                 Hold 
               
               
                   
                 Stp. 
               
               
                   
                   
               
             
          
         
       
     
         [0098]    Second-Dimension (SDS-PAGE) is carried out as follows. 
         [0099]    Preparation of the SDS-PAGE Gel
       1. Prior to use, wash and scrub plates very well in soap and hot water.   2. Rinse in distilled water   3. Leave the plates to air dry or wipe with methanol-soaked tissues.   4. Assemble plates in Protean-plus Multi-Gel Casting Chamber   5. Ensure screws are fully tightened.   6. Degas gel solution prior to addition of APS and TEMED   7. Carefully pour degassed gel solution through gel plates to prevent formation of air bubbles.   8. Stop pouring when gel is about 3 cm from top of glass plates.   9. Gently overlay gels with distilled water.   10. Cover with plastic wrap.   11. Allow gels to polymerize for at least one hour       
 
         [0111]    Equilibration of IEF Strips
       1. Remove strips from tray and place on Whatman filter paper to   remove excess oil.   2. Blot both sides of strips with tissue to remove excess oil.   3. Place strips in equilibration plate (Bio-Rad) gel side up; freeze or equilibrate. If frozen, the plates are wrapped in plastic wrap and stored at −80° C. Then, the strips are thawed prior to equilibration (strips are clear when thawed).
           a. Equilibrate: Cover strips with equilibration buffer, about 1.5 ml per strip.   
           4. Shake 25 minutes at room temperature       
 
         [0118]    Loading and Running Second-Dimension Gel
       1. Prepare markers by adding 10 μl of standards on Whatman 3MM chromatography paper cut to approximately 3 cm×0.5 cm.   2. Decant Equilibration Buffer.   3. Cover strips in SDS Running Buffer to rinse away excess Equilibration Buffer.   4. Remove Equilibration Buffer from strips.   5. Repeat steps 3 and 4.   6. Carefully place strips gel side out on back plate of second dimensional gel.   7. Overlay strips with 1% low melting agarose, at room temperature, ensure no air bubbles have formed under the gel.   8. Insert marker next to gel strip&#39;s basic end, ensuring marker is flush to gel strip       
 
         [0127]    Agarose must be cool enough to not disrupt marker
       9. Allow agarose to solidify   10. Continue for each strip to be loaded in second dimension   11. Place gels in Dodeca tank, hinged side down   12. After all gels have been put in tank, ensure gels are covered entirely by SDS Second dimension electrophoresis is at 13° C., 250 volts for 1 hour 35 minutes.       
 
       Western Blotting and Silver Staining 
       [0132]    Transferring Proteins
       1. Fill Pyrex tray (large enough to fit gel) with transfer buffer   2. Place sponges in Bio-Rad transblot cell, 2 sponges per gel   3. Fill tank with transfer buffer to allow sponges to saturate with transfer buffer   4. Remove gel from Dodeca tank and cut to desired size   5. Soak pre-cut transfer membrane in transfer buffer   6. Assemble transfer cassette as follows
           a. Black side down   b. Sponge soaked in transfer buffer   c. Filter paper   d. Gel   e. Nitrocellulose membrane—once placed on gel do not move membrane   f. Filter paper   g. Sponge   
           7. Ensure all air bubbles have been removed between gel and membrane   8. Place tray in Transblot tank, black side (gel side) of tray to black side of tank   9. Transfer at 4° C. at 100 Volts for 60 minutes.       
 
         [0149]    Silver staining to visualize total protein (optional).
       1. Put 50 ml of Silver Stain-Fix in container add 25 μl 37% Formaldehyde   2. Put gel in solution and allow to shake for 1 hour to fix proteins   3. Carefully remove Silver Stain-Fix
           a. Only touch gels on edges   
           4. Cover gels with 50 ml of Silver Stain-Wash and shake for 20 minutes.   5. Remove Silver Stain-Wash solution   6. Add 50 ml. of Silver Stain-Pretreat and shake by hand for 1 minutes.   7. Carefully remove Silver Stain-Pretreat
           a. Only touch gels on edges   
           8. Carefully rinse gels in distilled water for 20 seconds.
           a. Remove distilled water   b. Repeat rinse two more times   
           9. Cover gels with 50 ml of Silver Stain-impregnate and shake for 20 min.   10. Carefully rinse gels in distilled water for 20 seconds.
           a. Remove distilled water   b. Repeat once   
           11. Cover gels with 50 ml of Silver Stain-Develop
           c. Shake gels and watch for spots to develop   
           12. Carefully rinse gels in distilled water for 20 seconds.
           d. Remove distilled water   e. Repeat rinse two more times   
           13. Cover gels with 50 ml. of Silver Stain-Fix   14. Shake gels to fix proteins for 10 minutes.       
 
         [0173]    Immunological analysis of the blot is carried out as follows. 
       Primary Antibody 
       [0000]    
       
         
           
             1. Remove membrane from transfer 
             2. Stain membrane with Ponceau-S until background is red. 
             3. Remove Ponceau-S (return to bottle for reuse) 
             4. Rinse membrane with water and label. 
             5. Scan membrane 
             6. Wash membrane with TTBS to remove all Ponceau-S 
             7. Add 5% milk (enough to cover membrane) to tray and block for 20 minutes at room temperature 
             8. Prepare primary antibody solution (NTI ScFv MAB 12.1®:TTBS-1:150) in container 
             9. Remove milk 
             10. Rinse to remove excess milk in TTBS 
             11. Place membrane into container with primary antibody solution 
             12. Incubate at 4° C. overnight 
           
         
       
     
       Secondary Antibody 
       [0000]    
       
         
           
             1. Remove Primary antibody 
             2. Wash membrane 3 times
           i. Cover membrane with TTBS   ii. Gently shake at room temperature for 10 minutes.   
         
             3. Prepare secondary antibody solution (NTI Anti S:TTBS-1:5,000) 
             4. Cover membrane with secondary antibody solution 
             5. Incubate at 4° C. for 4 hours. 
           
         
       
     
       Develop and Scan 
       [0000]    
       
         
           
             1. Remove secondary antibody solution 
             2. Wash membrane as above 
             3. Cover membrane with Western Blue (Promega, #S3841) 
             4. Allow to develop 
             5. Stop develop by rinsing in water 
             6. Dry membrane 
           
         
       
     
         [0199]    Solutions used in the foregoing protocols are given below. 
       Solutions for First-Dimension 
     Rehydration Buffer pH 7 (25 mL): 
       [0000]    
       
         7 M Urea (FW 60.06)-10.5 g 
         2 M Thiourea (FW 76.12)-3.8 g 
         2% CHAPS-0.5 g 
         0.5% asb-14-0.125 g 
         0.5% Ampholytes-330 μl (40% Ampholytes) 
         0.5% IPG Buffer-125 μl 
         Bromophenol Blue-3 mg
 
Dissolve Urea &amp; Thiourea in 20 ml of distilled water.
 
         Add CHAPS, AsB-14, Ampholytes, IPG Buffer and Bromophenol Blue 
         Fill to 25 ml with distilled water 
         Aliquot to 1.4 ml and store at −80° C. 
         Add 1% DTT-14 mg (0.014 g) before use 
       
     
       Solutions for Second-Dimension 
     Tris Buffer (1.5 M, pH 8.8) (1000 mL): 
       [0000]    
       
         Tris-base (FW 121.1)-36.33 g 
         Dissolve Tris in about 150 mL distilled water. 
         adjust pH to 8.8 with HCl, and make up to a total volume of 200 ml with distilled water. 
         store at 4° C.  
       
     
       Equilibration Buffer (400 mL): 
       [0000]    
       
         1.5 M Tris-HCL, pH 8.8-26.8 mL 
         Urea (60.06)-144 g 
         Glycerol (100%)-120 mL (150 g) 
         SDS-10 g
 
Bromophenol Blue-Trace (add with pipette tip)
 
         Add water to bring to 400 mL 
         Aliquot and store at −20° C. 
       
     
       2D Acrylamide Gel 
       [0000]    
       
         375 mM Tris-HCl, pH 8.8 
         Acrylamide/Piperazine Diacrylyl (40% T/2.5% C) 
         0.12% (v/v) TEMED 
         0.055% (v/v) ammonium persulfate (APS)
 
%T=Total percent of Acrylamide and Piperazine Diacrylyl in the 2D Acrylamide Gel
 
       
     
       %C =Percentage of the Cross-linker (Piperazine Diacrylyl) 
       [0225]    Formulations for Protean II gels (20×20; 1-mm thick) 
         [0000]    
       
         
               
               
               
               
               
               
               
             
               
               
               
               
               
               
               
             
           
               
                   
               
               
                   
                   
                 Gel Buffer (ml) 
                 40% Acrylamide (ml) w/ 
                   
                 10% APS 
                   
               
               
                 % 
                 Gels 
                 (1.875 M Tris-HCl) 
                 PDA (39:1) 
                 Water (ml) 
                 (ml) 
                 TEMED (μl) 
               
               
                   
               
             
             
               
                   
               
             
          
           
               
                 10 
                 2 
                 30 
                 37.5 
                 82.5 
                 0.825 
                 235 
               
               
                   
                 4 
                 50 
                 62.5 
                 137.5 
                 1.375 
                 340 
               
               
                   
                 6 
                 70 
                 87.5 
                 192.5 
                 1.925 
                 545 
               
               
                   
                 8 
                 90 
                 112.5 
                 247.5 
                 2.5 
                 700 
               
               
                   
                 10 
                 110 
                 137.5 
                 302.5 
                 3.025 
                 855 
               
               
                   
                 12 
                 130 
                 162.5 
                 357.5 
                 3.575 
                 1000 
               
               
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
             
               
             
               
             
               
               
               
             
               
             
               
             
               
               
               
             
               
             
               
             
               
               
               
             
               
             
               
             
               
               
               
             
               
             
           
               
                   
               
             
             
               
                 Gel Buffer 
               
             
          
           
               
                   
                 Reagents 
                 Amount 
               
               
                   
                   
               
               
                   
                 1.875 M Tris 
                 22.7 g 
               
               
                   
                 water 
                 Fill to 100 ml 
               
               
                   
                 adjust pH to 
                 use concentrated 
               
               
                   
                 8.8 
                 HCl 
               
               
                   
                   
               
             
          
           
               
                 Store the buffer at 4° C. for no more than 2 weeks. 
               
             
          
           
               
                 Acrylamide Stock - 40% T/2.5% C. 
               
             
          
           
               
                   
                 Reagents 
                 Amount 
               
               
                   
                   
               
               
                   
                 acrylamide 
                 39 g 
               
               
                   
                 piperazine 
                 1 g 
               
               
                   
                 diacrylamide 
               
               
                   
                 water 
                 Fill to 100 ml 
               
               
                   
                   
               
             
          
           
               
                 Filter (0.45 μm), store at 4° C. for no more than 2 weeks. 
               
             
          
           
               
                 10% Ammonium Persulfate (APS) 
               
             
          
           
               
                   
                 Reagents 
                 Amount 
               
               
                   
                   
               
               
                   
                 10% APS 
                 0.1 g 
               
               
                   
                 water 
                 Fill to 1 ml 
               
               
                   
                   
               
             
          
           
               
                 Make 10% Ammonium Persulfate fresh for every use 
               
             
          
           
               
                 10x SDS Running Buffer (4 L): 
               
               
                   
               
             
          
           
               
                   
                 Tris (FW 75.07) 
                 75.69 g 
               
               
                   
                 Glycine (FW 121.14) 
                 360.34 g 
               
               
                   
                 SDS 
                 20 g 
               
               
                   
                 Distilled water 
                 Fill to 4 L 
               
             
          
           
               
                 Store at room temperature 
               
             
          
           
               
                 Agarose Solution (1%): 
               
               
                 Weigh 1.5 g of agarose, add 150 mL SDS Running Buffer - 
               
               
                 heat until it dissolves. 
               
               
                   
               
             
          
           
               
                   
                 1% Low Melt Agarose 
                 1.5 g Low Melt Agarose 
               
               
                   
                 1x SDS Run Buffer 
                 Fill to 150 ml 
               
               
                   
                   
               
             
          
           
               
                 Heat until agarose boils and fully dissolves 
               
               
                 Add 150 μl of 0.05% Bromophenol blue 
               
               
                 Stored at 4° C. 
               
             
          
         
       
     
       Solutions for Blotting and Silver Staining 
       [0226]      
         [0000]    
       
         
               
             
               
               
               
             
               
             
               
               
               
             
               
             
               
               
               
             
               
             
               
               
               
             
               
             
               
               
               
             
               
             
               
               
               
             
               
             
               
               
               
             
               
             
               
               
               
             
               
             
               
               
               
             
               
             
           
               
                   
               
             
             
               
                 Western Transfer Buffer (4 L): 
               
             
          
           
               
                   
                 Trizma base 
                 12.12 g 
               
               
                   
                 Glycine 
                 57.6 g 
               
               
                   
                 Methanol 
                 800 ml 
               
               
                   
                 SDS 
                 3 g 
               
               
                   
                 Water 
                 Fill to 4 L 
               
             
          
           
               
                 Silver Stain-Fix 
               
             
          
           
               
                   
                 50% methanol 
                 500 ml 
               
               
                   
                 12% acetic acid 
                 120 ml 
               
               
                   
                 distilled water 
                 fill to 1 L 
               
             
          
           
               
                 Silver Stain-Ethanol 
               
             
          
           
               
                   
                 50% ethanol 
                 500 ml 
               
               
                   
                 distilled water 
                 fill to 1 L 
               
             
          
           
               
                 Silver Stain-Pretreat 
               
             
          
           
               
                   
                 0.04% Na 2 S 2 O 3 —5H 2 O 
                 0.04 g 
               
               
                   
                 distilled water 
                 fill to 200 ml 
               
             
          
           
               
                 Silver Stain-Impregnate 
               
             
          
           
               
                   
                 0.4% AgNO 3   
                 0.4 g 
               
               
                   
                 0.028% formaldehyde 
                 150 μl 37% formaldehyde 
               
               
                   
                 distilled water 
                 fill to 200 ml 
               
             
          
           
               
                 Silver Stain-Develop 
               
             
          
           
               
                   
                 12% Na 2 CO 3   
                 12 g 
               
               
                   
                 0.019% formaldehyde 
                 100 μl 37% formaldehyde 
               
               
                   
                 2% Pretreat 
                 4 ml 
               
               
                   
                 distilled water 
                 fill to 200 ml 
               
             
          
           
               
                 37% Formaldehyde 
               
             
          
           
               
                   
                 37% formaldehyde 
                 37 ml formaldehyde 
               
               
                   
                 distilled water 
                 fill to 100 ml 
               
             
          
           
               
                 Blocking Buffer (5% milk) 
               
             
          
           
               
                   
                 5% milk 
                 5 g Milk 
               
               
                   
                 0.2% N 3 Na 
                 0.2 g N 3 Na 
               
               
                   
                 distilled water 
                 fill to 100 ml 
               
             
          
           
               
                 10x TTBS (4 L) 
               
             
          
           
               
                   
                 100 mM Trizma 
                 48.4 g 
               
               
                   
                 1.5 M NaCl 
                 350.6 g 
               
               
                   
                 0.5% Tween 20 
                 20 g 
               
               
                   
                   
               
             
          
           
               
                 Add Trizma and NaCl to 3800 ml deionized distilled-H 2 O 
               
               
                 Adjust pH to 8.0 using HCl 
               
               
                 Add Tween 20 
               
               
                 Fill to 4 L with distilled water 
               
             
          
         
       
     
       EXAMPLES 
     Example 1. Pooled Sera 
       [0227]    NOX-Enriched serum proteins (approximately 4-6 mg) from sera pooled from cancer patients (breast, ovarian, lung and colon) were resolved by 2-D gel electrophoresis with detection by recombinant anti-ECTO-NOX antibody (single chain variable region ScFv) carrying an S-tag followed by alkaline phosphatase-linked anti-S with Western Blue NBT alkaline phosphatase substrate yield several proteins present in the cancer sera ( FIG. 1 ) but absent from sera of non-cancer patients or healthy volunteers. The tNOX proteins were enriched and concentrated from the sera by nickel agarose precipitation. This step results in removal of approximately 90% of serum proteins prior to analysis. 
         [0228]    Where sera specific for tNOX or ECTO-NOX are used, typically the dilution is from 1:10 to 1:1000, monoclonal antibody (e.g., 12.1 produced by hybridoma on deposit as ATCC Accession No. PTA-4206) is from 1 ;100-1:10,00, desirably about 1:100, or ascites fluid from growth of the same hybridoma can be from about 1:10 to about 1:1000, desirably about 1:100. 
       Example 2. Analysis of Sera from Patients with Various Cancers 
       [0229]    Results combined from a total of eight different pooled cancer sera were similar to those of  FIG. 1  and the total of the findings are summarized in  FIG. 2  for quadrant I of the 2-D gels. Some additional tNOX proteins were located in quadrant IV and the total of the findings are summarized in  FIG. 3 . 
       Example 3. Analysis of Ovarian Cancer Patient Serum 
       [0230]    2-D gel analysis as in  FIG. 4  when applied to serum from a patient with ovarian cancer yielded ovarian cancer specific tNOX proteins of about 80 and 40.5 kDa in quadrants I and IV ( FIG. 4 ). 
       Example 4. Analysis of Small Cell Lung Cancer Patient Serum 
       [0231]    2-D gel analysis as in  FIG. 5  when applied to sera of a patient with small cell lung cancer contained a 40.5 kDa tNOX protein in quadrant IV and a 52 kDa tNOX protein in quadrant I ( FIG. 5 ). 
       Example 5. Analysis of Non Small Cell Lung Cancer Patient Serum 
       [0232]    2-D gel analysis as in  FIG. 1  when applied to plasma from a patient with non-small cell lung cancer revealed a non-small cell cancer specific tNOX isoform at 54 kDa in quadrant 1 ( FIG. 6 ). 
       Example 6. Analysis of Breast Cancer Patient Serum 
       [0233]    2-D gel analysis as in  FIG. 1  when applied to sera from a patient with breast cancer revealed a breast cancer-specific tNOX protein of 68 kDa in quadrant I ( FIG. 7 ). 
       Example 7. Analysis of Prostate Cancer Patient Serum 
       [0234]    2-D gel analysis as in  FIG. 1  when applied to sera from a patient with prostate cancer revealed prostate cancer-specific tNOX isoforms at 75 kDa ( FIG. 8 ) ) and isoelectric points of pH 5.8 (α) and 5.2 (β). The β-form is most evident with plasma and present infrequently in sera of prostate cancer patients. 
       Example 8. Analysis of Cervical Cancer Patient Serum 
       [0235]    2-D gel analysis as in  FIG. 1  when applied to serum from a patient with cervical cancer revealed a cervical cancer-specific tNOX isoform at 94 kDa ( FIG. 9 ). 
       Example 9. Analysis of Colon Cancer Patient Serum 
       [0236]    2-D gel analysis as in  FIG. 1  when applied to serum from a patient with colon cancer revealed colon cancer-specific tNOX isoforms at 43 and 52 kDa ( FIG. 10 ). 
       Example 10. Cancer Specific Isoforms 
       [0237]    For each kind of cancer there appears to be a tNOX isoform (ovarian, breast, cervical, colon, non-small cell lung, prostate small cell lung) or combination of tNOX isoforms that is specific to the tissue or cell type of origin for the cancer ( FIG. 14 ). 
       Example 11. Analysis of Patient Serum where Cancer of Unknown Origin 
       [0238]    The 2-D gel of  FIG. 11  is from a patient with cancer where the primary tumor was unknown. The presence of 40.5, 52 and ca. 80 kDa tNOX isoforms indicates the primary cancer is ovarian cancer. 
       Example 12. Analysis of Pooled Normal Sera 
       [0239]    In more than 25 randomly selected outpatient sera and sera of healthy volunteers, both quadrants I and IV of the 2-D gels were devoid of tNOX isoforms (FIG.  12 ), confirming previous observations that tNOX proteins are absent from non-cancer patients or sera of healthy volunteers. 
       Example 13.  
       [0240]    The diagnostic strategy of the invention combines one- and two-dimensional polyacrylamide gel electrophoretic separations of human sera to generate cancer specific isoform patterns and compositions indicative of cancer presence, tumor type, disease severity and therapeutic response. At least 20 cancer-specific tNOX isoforms are resolved indicative of cancer presence and disease severity. The system consists of a concentration step where ECTO-NOX proteins are separated from the bulk of the albumin and other serum proteins using a nickel-agarose precipitation. Detection uses a recombinant single chain antibody (scFv) that cross reacts with all known ECTO-NOX isoforms of human origin; this antibody also has an S-tag that reacts with a second antibody I (anti-S). The scFv antibody is described in U.S. Provisional Application 60/824,398, filed Sep. 1, 2006 and below. 
         [0241]    Monoclonal antibody generated against tNOX NADH oxidase tumor cell specific was produced in sp-2 myeloma cells; however, the monoclonal antibody slowed the growth of sp-2 myeloma cells that were used for fusion with spleen cells after 72 h. This phenomenon made it difficult to produce antibody in quantity. To overcome this problem, the coding sequences of the antigen-binding variable region of the heavy chain and the light chain (Fv region) of the antibody cDNA were cloned and linked into one chimeric gene, upstream of the S-tag coding sequence. The Fv portion of an antibody, consisting of variable heavy (V H ) and variable light (V L ) domains, can maintain the binding specificity and affinity of the original antibody (Glockshuber et al. 1990.  Biochemistry  29:1262-1367). 
         [0242]    For a recombinant antibody, cDNAs encoding the variable regions of immunoglobulin heavy chain (V H ) and light chain (V I ), are cloned by using degenerative primers. Mammalian immunoglobulins of light and heavy chain contain conserved regions adjacent to the hypervariable complementary defining regions (CDRs). Degenerate oligoprimer sets allow these regions to be amplified using PCR (Jones et al. 1991.  BiolTechnology  9:88-89; Daugherty et al. 1991.  Nucleic Acids Research  19:2471-2476). Recombinant DNA techniques have facilitated the stabilization of variable fragments by covalently linking the two fragments by a polypeptide linker (Huston et al. 1988.  Proc. Natl. Acad. Sci. USA  85:5879-5883). Either V L  or V H  can provide the NH 2 -terminal domain of the single chain variable fragment (ScFv). The linker should be designed to resist proteolysis and to minimize protein aggregation. Linker length and sequences contribute and control flexibility and interaction with ScFv and antigen. The most widely used linkers have sequences consisting of glycine (Gly) and serine (Ser) residues for flexibility, with charged residues as glutamic acid (Glu) and lysine (Lys) for solubility (Bird et al. 1988.  Science  242:423-426; Huston et al. 1988. supra). 
         [0243]    Total RNA was isolated from the hybridoma cells producing tNOX-specific monoclonal antibodies by the following procedure modified from Chomczynski et al. (1987)  Anal. Biochem.  162:156-159 and Gough (1988)  Anal. Biochem  176:93-95. Cells were harvested from medium and pelleted by centrifugation at 450× g for 10 min. Pellets were gently resuspended with 10 volumes of ice cold PBS and centrifuged again. The supernatant was discarded and cells were resuspended with an equal volume of PBS. Denaturing solution (0.36 ml of 2-mercaptoethanol/50 ml of guanidinium stock solution-4M guanidinium thiocyanate, 25 mM sodium citrate, pH 7.0, 0.5% sarkosyl) 10 ml per 1 g of cell pellet was added prior to use and mixed gently. Sodium acetate (pH 4.0,1 ml of 2M), 10 ml of phenol saturated water and 2 ml of chloroform: isoamyl alcohol (24:1) mixtures were sequentially added after each addition. The solution was mixed thoroughly by inversion. The solution was vigorously shaken for 10 sec, chilled on ice for 15 min and then centrifuged 12,000× g for 30 min. The supernatant was transferred and an equal volume of 2-propanol was added and placed at −20° C. overnight to precipitate the RNA. The RNA was pelleted for 15 min at 12,000× g, and the pellet was resuspended with 2-3ml of denaturing solution and 2 volumes of ethanol. The solution was placed at −20° C. for 2 h, and then centrifuged at 12,000× g for 15 min. The RNA pellet was washed with 70% ethanol and then 100% ethanol. The pellet was resuspended with RNase-free water (DEPC-treated water) after centrifugation at 12,000× g for 5 min. The amount of isolated RNA was measured spectrophotometrically and calculated from the absorbance at 280 nm and 260 nm. 
         [0244]    The poly(A)mRNA isolation kit was purchased from Stratagene. Total RNA was applied to an oligo(dT) cellulose column after heating the total RNA at 65° C. for 5 min. Before applying, the RNA samples were mixed with 500 μl of 10× sample buffer (10 mM Tris-HCl, pH 7.5, 1 mM EDTA, 5 M NaCl). The RNA samples were pushed through the column at a rate of 1 drop every 2 sec. The eluates were pooled and reapplied to the column and purified again. Preheated elution buffer (65° C.) was applied, and mRNA was eluted and collected in 1.5 ml of centrifuge tubes on ice. The amount of mRNA was determined at OD 260  (1 OD unit=40 μg of RNA). The amounts of total RNA and mRNA obtained from 4×10 8  cells were 1328 μg and 28 μg, respectively. 
         [0245]    mRNA (1-2 μg) dissolved in DEPC-treated water was used for cDNA synthesis. mRNA isolated on three different dates was pooled for first-strand cDNA synthesis. The cDNA synthesis kit was purchased from Pharmacia Biotech. mRNA (1.5 μg/5 μl of DEPC-treated water) was heated at 65° C. for 10 min. and cooled immediately on ice. The primed first strand mix containing MuLV reverse transcriptase (11 μl) and appropriate buffers for the reaction were mixed with mRNA sample. DTT solution (1 μl of 0.1 M) and RNase-free water (16 μl) also were added to the solution. The mixture was incubated for 1 h at 37° C. 
         [0246]    Degenerate primers for light chain and heavy chain (Novagen, Madison, Wis.) were used for PCR. PCR synthesis was carried out in 100 μl reaction volumes in 0.5 ml microcentrifuge tubes by using Robocycler (Stratagene, La Jolla, Calif.). All PCR syntheses included 2 μl of sense and anti-sense primers (20 pmoles/μl), 1 μl of first-strand cDNA as a template, 2 μl of 10 mM of dNTPs, 1 μl of Vent polymerase (2 units/μl), 10 μl of 10×PCR buffer (100 mM Tris-HCl, pH 8.8 at 25° C., 500 mM KCl, 15 mM MgCl 2 , 1% Triton X-100), 82 μl of H 2 O. Triton X-100 is t-octylphenoxypolyethoxyethanol. All PCR profiles consisted of 1 min of denaturation at 94° C., 1 min of annealing at 55° C., and 1 min of extension at 72° C. This sequence was repeated 30 times with a 6-min extension at 72° C. in the final cycle. PCR products were purified with QIAEX II gel extraction kit from Qiagen, Valencia, Calif. PCR amplification products for heavy and light chain coding sequences were analyzed by agarose gel electrophoresis and were about 340 base pair (bp) long and 325 bp long, respectively. 
         [0247]    Total RNA or DNA was analyzed by agarose gel electrophoresis (1% agarose gels). Agarose (0.5 g in 50 ml of TAE buffer, 40 mM Tris-acetate, 1 mM EDTA) was heated for 2 min in a microwave to melt and evenly disperse the agarose. The solution was cooled at room temperature, and ethidium bromide (0.5 μg/ml) was added and poured into the apparatus. Each sample was mixed with 6×gel loading buffer (0.25% bromophenol blue, 0.25% xylene cyanol FF, 40% (w/v) sucrose in water). TAE buffer was used as the running buffer. Voltage (10 v/cm) was applied for 60-90 min. 
         [0248]    According to the proper size for heavy and light chain cDNAs, the bands were excised from the gels under UV illumination, and excised gels were placed in 1 ml syringes fitted with 18-gauge needles. Gels were crushed to a 1.5 ml Eppendorf tube. The barrel of each syringe was washed with 200 μl of buffer-saturated phenol (pH 7.9±0.2). The mixture was thoroughly centrifuged and frozen at −70° C. for 10 min. The mixture was centrifuged for 5 min, and the top aqueous phase was transferred to a new tube. The aqueous phase was extracted again with phenol/chloroform (1:1). After centrifuging for 5 min, the top aqueous phase was transferred to a clean tube, and chloroform extraction was performed. Sodium acetate (10 volumes of 3 M) and 2.5 volumes of ice-cold ethanol were added to the top aqueous phase to precipitate DNA at −20° C. overnight. 
         [0249]    Purified heavy and light chain cDNAs were ligated into plasmid pSTBlue-1 vector and transfected into NovaBlue competent cells (Stratagene). Colonies containing heavy and light chain DNAs were screened by blue and white colony selection and confirmed by PCR analysis. Heavy and light chain DNAs were isolated and sequenced using standard techniques. Tables 2A and 2B show the DNA sequences of heavy and light chain DNAs of ScFv. See also SEQ ID NO: 3 and SEQ ID NO: 4. 
         [0250]    PCR amplification and the assembly of single ScFv gene was according to Davis et al. (1991)  Bio/Technology 9:165-169. Plasmid pSTBlue-1 carrying V H  and V L  genes were combined with all four oligonucleotide primers in a single PCR synthesis. Following first PCR synthesis, one tenth of the first PCR product was removed and added to a second PCR reaction mixture containing only the primer a (V H  sense primer) and primer d (V L  Antisense primer). The product of the second PCR synthesis yielded single ScFv gene. The single ScFv gene was ligated to plasmid pT-Adv (Clontech, Palo Alto, Calif.). pT-Adv carrying ScFv gene was used for DNA sequencing. 
         [0251]    The complete ScFv gene was assembled from the V H , V L  and linker genes to yield a single ScFv gene by PCR (Tables 2A and 2B). The DNA sequence encoding the linker was 45 nucleotides long (GGAGGCGGTGGATCGGGCGGTGGCGGCTCGGGTGGCGGCGGCTCT; SEQ ID NO:6), which translates to a peptide of 15 amino acids (GlyGlyGlyGlySerGlyGlyGlyGlySerGlyGlyGlyGlySer; SEQ ID NO:5). Primers for PCR amplification are shown in Tables 2A and 2B. S-peptide was linked to the C-terminus of ScFv[ScFv(S)]. S-peptide binds to S-protein conjugated to alkaline phosphatase for Western blot analysis. The DNA sequence of the S-peptide is AAAGAAACCGCTGCTGCTAAATTCGAACGCCAGCACATGGACAGC (SEQ ID N 0:7) which translates to S-peptide (LysGluThrAlaAlaAlaLysPheGluArgGlnHisMetAspSer; SEQ ID NO:8). 
         [0252]    Recombinant ScFv(S) was expressed in  E. coli . First, oligo nucleotides encoding S-peptide were linked to the 3′ end of the open reading frame (ORF) of ScFv DNA by PCR amplification. Incorporation of S-peptide enables to detect expressed ScFv protein by S-protein conjugated to alkaline phosphatase. The tNOX-specific ScFv(S) coding sequence was then subcloned to plasmid pET-11a, a plasmid designed for protein expression in  E. coli  (Stratagene, Calif.). For PCR amplification, two primers were designed to amplify ORF of ScFv(S) containing endonuclease restriction sites (Ndel and Nhel) and S-peptide residues. Plasmid pET-11a and ORF of ScFv(S) were digested with restriction enzymes Ndel and Nhel and ligated to produce plasmid pET11-ScFv(S).  E. coli  BL21 (DE3) was transformed with pET11-ScFv(S) and grown at 37° C. for 12 h in LB medium containing ampicillin (100 μg/ml). ScFv was expressed by addition of 0.5 mM IPTG and incubation for 4 h. Cells were harvested and lysed using a French Pressure Cell (French Pressure Cell Press, SLM Instruments, Inc.) (three passages at 20,000 psi). Cell extracts were centrifuged at 10,000×g for 20 min. Pellets containing denatured inclusion bodies of ScFv were collected. Renaturation of the inclusion bodies of the ScFv was according to Goldberg et al. (1995) Folding &amp; Design 1:21-27. 
         [0000]    
       
         
               
             
               
               
               
             
           
               
                 TABLE 1A 
               
               
                   
               
               
                 DNA Sequence of Heavy Chain ScFv (V H ), SEQ ID NO: 1 
               
               
                   
               
             
             
               
                   
               
             
          
           
               
                   1 
                 gaggtcaagc tgcaggagtc aggaactgaa gtggtaaagc ctggggcttc 
                   
               
               
                   
               
               
                  51 
                 agtgaagttg tcctgcaagg cttctggcta catcttcaca agttatgata 
               
               
                   
               
               
                 101 
                 tagactgggt gaggcagacg cctgaacagg gacttgagtg gattggatgg 
               
               
                   
               
               
                 151 
                 atttttcctg gagaggggag tactgaatac aatgagaagt tcaagggcag 
               
               
                   
               
               
                 201 
                 ggccacactg agtgtagaca agtcctccag cacagcctat atggagctca 
               
               
                   
               
               
                 251 
                 ctaggctgac atctgaggac tctgctgtct atttctgtgc tagaggggac 
               
               
                   
               
               
                 301 
                 tactataggc gctactttga cttgtggggc caagggacca cggtcaccgt 
               
               
                   
               
               
                 351 
                 ctcctca 
               
               
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
             
           
               
                 TABLE 1B 
               
               
                   
               
               
                 DNA sequence of light chain ScFv (V L ), SEQ ID NO: 2 
               
               
                   
               
             
             
               
                   
               
             
          
           
               
                   1 
                 gaaaatgtgc tcacccagtc tccagcaatc atgtctgcat ctccagggga 
                   
               
               
                   
               
               
                  51 
                 gagggtcacc atgacctgca gtgccagctc aagtatacgt tacatatatt 
               
               
                   
               
               
                 101 
                 ggtaccaaca gaagcctgga tcctccccca gactcctgat ttatgacaca 
               
               
                   
               
               
                 151 
                 tccaacgtgg ctcctggagt cccttttcgc ttcagtggca gtgggtctgg 
               
               
                   
               
               
                 201 
                 gacctcttat tctctcacaa tcaaccgaat ggaggctgag gatgctgcca 
               
               
                   
               
               
                 251 
                 cttattactg ccaggagtgg agtggttatc cgtacacgtt cggagggggg 
               
               
                   
               
               
                 301 
                 accaagctgg agctgaaagc g 
               
               
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
             
           
               
                 TABLE 2A 
               
               
                   
               
               
                 Coding Sequence for ScFv, SEQ ID NO: 3 
               
               
                   
               
             
             
               
                   
               
             
          
           
               
                   1 
                 gaggtcaagc tgcaggagtc aggaactgaa gtggtaaagc ctggggcttc 
                   
               
               
                   
               
               
                  51 
                 agtgaagttg tcctgcaagg cttctggcta catcttcaca agttatgata 
               
               
                   
               
               
                 101 
                 tagactgggt gaggcagacg cctgaacagg gacttgagtg gattggatgg 
               
               
                   
               
               
                 151 
                 atttttcctg gagaggggag tactgaatac aatgagaagt tcaagggcag 
               
               
                   
               
               
                 201 
                 ggccacactg agtgtagaca agtcctccag cacagcctat atggagctca 
               
               
                   
               
               
                 251 
                 ctaggctgac atctgaggac tctgctgtct atttctgtgc tagaggggac 
               
               
                   
               
               
                 301 
                 tactataggc gctactttga cttgtggggc caagggacca cggtcaccgt 
               
               
                   
               
               
                 351 
                 ctcctca gga   ggcggtggat cgggcggtgg cggctcgggt ggcggcggct   
               
               
                   
                                           linker 
               
               
                   
               
               
                 401 
                   ctg aaaatgt gctcacccag tctccagcaa tcatgtctgc atctccaggg 
               
               
                   
               
               
                 451 
                 gagagggtca ccatgacctg cagtgccagc tcaagtatac gttacatata 
               
               
                   
               
               
                 501 
                 ttggtaccaa cagaagcctg gatcctcccc cagactcctg atttatgaca 
               
               
                   
               
               
                 551 
                 catccaacgt ggctcctgga gtcccttttc gcttcagtgg cagtgggtct 
               
               
                   
               
               
                 601 
                 gggacctctt attctctcac aatcaaccga atggaggctg aggatgctgc 
               
               
                   
               
               
                 651 
                 cacttattac tgccaggagt ggagtggtta tccgtacacg ttcggagggg 
               
               
                   
               
               
                 701 
                 ggaccaagct ggagctgaaa gcg aaagaaa   ccgctgctgc taaattcgaa   
               
               
                   
               
               
                 751 
                   cgccagcaca tggacagc                  s-peptide 
               
               
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
             
           
               
                 TABLE 2B 
               
               
                   
               
               
                 Amino Acid Sequence for ScFv, SEQ ID NO: 4 
               
               
                   
               
             
             
               
                   
               
             
          
           
               
                   1 
                 EVKLQESGTE VVKPGASVKL SCKASGYIFT SYDIDWVRQT PEQGLEWIGW 
                   
               
               
                   
               
               
                  51 
                 IFPGEGSTEY NEKFKGRATL SVDKSSSTAY MELTRLTSED SAVYFCARGD 
               
               
                   
               
               
                 101 
                 YYRRYFDLWG QGTTVTVSS G   GGGSGGGGSG   GGGS ENVLTQ SPAIMSASPG 
               
               
                   
                                           linker 
               
               
                   
               
               
                 151 
                 ERVTMTCSAS SSIRYIYWYQ QKPGSSPRLL IYDTSNVAPG VPFRFSGSGS 
               
               
                   
               
               
                 201 
                 GTSYSLTINR MEAEDAATYY CQEWSGYPYT FGGGTKLELK A KETAAAKFE   
               
               
                   
               
               
                 251 
                   RQHMDS                                         s-peptide 
               
               
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
             
               
               
               
               
             
               
               
             
               
               
               
               
             
               
               
             
               
               
               
               
             
               
               
             
               
               
               
               
             
           
               
                 TABLE 3 
               
               
                   
               
               
                 Primers for PCR amplification of ScFv(s) gene 
               
               
                   
               
             
             
               
                   
               
             
          
           
               
                 1. Primers for cloning of variable regions of heavy chain and light chain 
                   
               
               
                 of antibody 
               
               
                 (A) Primers for heavy chain (V H ) 
               
             
          
           
               
                 Forward primer: 
                 5′-GGCCCAGCCGGCCGAGGTCAAGCTGCAGGAGTCAGGA- 3′ 
                 (SEQ ID NO: 9) 
                   
               
               
                   
               
               
                 Reverse primer: 
                 5′-CTCGGAACCTGAGGAGACGGTGACCGTGGTCCC- 3′ 
                 (SEQ ID NO: 10) 
               
               
                   
               
             
          
           
               
                 (B) Primers for light chain (V L ) 
                   
               
             
          
           
               
                 Forward primer: 
                 5′-TCCAAAGTCGACGAAAATGTGCTCACCCAGTCTCCA- 3′ 
                 (SEQ ID NO: 11) 
                   
               
               
                   
               
               
                 Reverse primer: 
                 5′-AGCGGCCGCTTTCAGCTCCAGCTTGGTCCCCCC- 3′ 
                 (SEQ ID NO: 12) 
               
               
                   
               
             
          
           
               
                 2. Primers for subcloning of ScFv(s) gene into pET-11a expression vector 
                   
               
               
                 (A) Primers for heavy chain (V H ) and linker amplification 
               
             
          
           
               
                 Forward primer: 
                 5′-GTCAAGCTGCAGGAGTCAGGA- 3′ 
                 (SEQ ID NO: 13) 
                   
               
               
                   
               
               
                 Reverse primer: 
                 5′-AGAGCCGCCGCCACCCGAGCCGCCACCGCCCGATCC 
                 (SEQ ID NO: 14) 
               
               
                   
                 ACCGCCTCCTGAGGAGACGGTGACCGTGGT- 3′ 
               
               
                   
               
             
          
           
               
                 (B) Primers for light chain (V L ), linker and S-tag amplification 
                   
               
             
          
           
               
                 Forward primer: 
                 5′-GGAGGCGGTGGATCGGGCGGTGGCGGCTCGGGTGGC 
                 (SEQ ID NO: 15) 
                   
               
               
                   
                 GGCGGCTCTGAAAATGTGCTCACCCAGTCT- 3′ 
               
               
                   
               
               
                 Reverse primer: 
                 5′-AGTCAGGCTAGCTTAGCTGTCCATGTGCTGGCGTTCG 
                 (SEQ ID NO: 16) 
               
               
                   
                 AATTTAGCAGCAGCGGTTTCTTTCGCTTTCAGCTCCAGCTT- 3′ 
               
               
                   
               
             
          
         
       
     
         [0253]    Standard techniques for cloning, DNA isolation, amplification and purification, for enzymatic reactions involving DNA ligase, DNA polymerase, restriction endonucleases and the like, and various separation techniques are those known and commonly employed by those skilled in the art. A number of standard techniques are described in Sambrook et al. (1989)  Molecular Cloning, Second Edition , Cold Spring Harbor Laboratory, Plainview, N.Y.; Maniatis et al. (1982)  Molecular Cloning , Cold Spring Harbor Laboratory, Plainview, N.Y.; Wu (ed.) (1993)  Meth. Enzymol.  218, Part I; Wu (ed.) (1979)  Meth. Enzymol.  68; Wu et al. (eds.) (1983)  Meth. Enzymol.  100 and 101; Grossman and Moldave (eds.)  Meth. Enzymol.  65; Miller (ed.) (1972)  Experiments in Molecular Genetics , Cold Spring Harbor Laboratory, Cold Spring Harbor, N.Y.; Old and Primrose (1981)  Principles of Gene Manipulation , University of California Press, Berkeley; Schleif and Wensink (1982)  Practical Methods in Molecular Biology ; Glover (ed.) (1985)  DNA Cloning  Vol. I and II, IRL Press, Oxford, UK; Hames and Higgins (eds.) (1985)  Nucleic Acid Hybridization , IRL Press, Oxford, UK; Setlow and Hollaender (1979)  Genetic Engineering: Principles and Methods , Vols. 1-4, Plenum Press, New York; Fitchen, et al. (1993) Annu. Rev. Microbiol. 47:739-764; Tolstoshev, et al. (1993) in  Genomic Research in Molecular Medicine and Virology , Academic Press; and Ausubel et al. (1992)  Current Protocols in Molecular Biology , Greene/Wiley, New York, N.Y. Abbreviations and nomenclature, where employed, are deemed standard in the field and commonly used in professional journals such as those cited herein. Antibody vaccines are described in Dillman R. O. (2001)  Cancer Invest.  19(8):833-841. Durrant L. G. et al. (2001)  Int J. Cancer  1;92(3):414-20 and Bhattacharya-Chatterjee M, (2001)  Curr. Opin. Mol. Ther . Feb;3(1):63-9 describe anti-idiotype antibodies. Many of the procedures useful for practicing the present invention, whether or not described herein in detail, are well known to those skilled in the arts of molecular biology, biochemistry, immunology, and medicine. 
         [0254]    Monoclonal, polyclonal antibodies, peptide-specific antibodies or single chain recombinant antibodies and antigen binding fragments of any of the foregoing, specifically reacting with the tNOX isoform proteins described herein, may be made by methods known in the art. See e.g., Harlow and Lane (1988)  Antibodies: A Laboratory Manual , Cold Spring Harbor Laboratories; and Goding (1986)  Monoclonal Antibodies: Principles and Practice,  2d ed., Academic Press, New York. 
         [0255]    All references cited in the present application are incorporated by reference herein to the extent that there is no inconsistency with the present disclosure. Such references reflect the skill in the arts relevant to the present invention. 
         [0256]    The examples provided herein are for illustrative purposes, and are not intended to limit the scope of the invention as claimed herein. Any variations in the exemplified antibodies, epitopes, purification methods, diagnostic methods, preventative methods, treatment methods, and other methods which occur to the skilled artisan are intended to fall within the scope of the present invention. 
       BIBLIOGRAPHY 
       [0257]    1. Morré, D. J. (1998) in Plasma Membrane Redox Systems and Their Role in Biological Stress and Disease (Asard, H., Bérczi, A. and Caubergs, R. J., Eds) pp.121-156, Kluwer Academic Publishers, Dordrecht, Netherlands. 
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