To
date, medical diagnosis of gout and pseudogout has been performed
by observing the crystals in the joint fluid of patients under a polarized
microscope. Conventional diagnostic methods using a polarized microscope
have disadvantages, such as time-consuming analysis, a high false
negative rate, and difficulty in distinguishing gout with monosodium
urate (MSU) crystals and pseudogout with calcium pyrophosphate dihydrate
(CPPD) crystals in synovial fluids. In this study, a chromogenic assay
for the diagnosis of gout and pseudogout, without the requirement
of a polarized microscope and trained experts, was proposed using
Fv antibodies with specific binding activities to MSU and CPPD crystals.
The IgG VH chain Fv library with randomized complementarity-determining
region 3 (CDR3) region was expressed on the outer membrane of Escherichia coli using autodisplay technology. The
target Fv antibodies with binding activity to MSU and CPPD crystals
were screened from the autodisplayed Fv library on the E. coli outer membrane, and five clones were selected.
On the basis of the binding properties of the screened Fv antibodies,
peptides with the selected clone of amino acid sequences of the CDR3
region (15 residues) were chemically synthesized. The binding properties
of the synthetic peptides with amino acid sequences of CDR3 regions
from the selected clones were analyzed using fluorescence imaging
and flow cytometry, and the affinity constants (K
d) of each peptide for binding to MSU and CPPD crystals
were calculated by fitting based on the isotherm model. A chromogenic
assay configuration for gout and pseudogout was developed using synthetic
peptides. In this chromogenic assay, synthetic peptides labeled with
biotin and streptavidin–horseradish peroxidase (HRP) complex
were used, and crystal detection was possible using a chromogenic
reaction between HRP and a chromogenic substrate (TMB). Finally, gout
and pseudogout were diagnosed by detecting MSU and CPPD crystals in
the synovial fluid in the concentration range of 0–300 μg/mL.