DK2256132T3 - Fremgangsmåde til påvisning af probnp med et monoklonalt antistof - Google Patents

Fremgangsmåde til påvisning af probnp med et monoklonalt antistof Download PDF

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Publication number
DK2256132T3
DK2256132T3 DK10172014.2T DK10172014T DK2256132T3 DK 2256132 T3 DK2256132 T3 DK 2256132T3 DK 10172014 T DK10172014 T DK 10172014T DK 2256132 T3 DK2256132 T3 DK 2256132T3
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Denmark
Prior art keywords
probnp
antibody
native
native probnp
mab
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DK10172014.2T
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English (en)
Inventor
Volker Klemt
Anneliese Borgya
Andreas Gallusser
Michael Grol
Christoph Seidel
Klaus Hallermayer
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Roche Diagnostics Gmbh
Hoffmann La Roche
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Application filed by Roche Diagnostics Gmbh, Hoffmann La Roche filed Critical Roche Diagnostics Gmbh
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Publication of DK2256132T3 publication Critical patent/DK2256132T3/da

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    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K16/00Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
    • C07K16/18Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/26Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against hormones ; against hormone releasing or inhibiting factors
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K14/00Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • C07K14/435Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • C07K14/575Hormones
    • C07K14/58Atrial natriuretic factor complex; Atriopeptin; Atrial natriuretic peptide [ANP]; Cardionatrin; Cardiodilatin
    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12NMICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N5/00Undifferentiated human, animal or plant cells, e.g. cell lines; Tissues; Cultivation or maintenance thereof; Culture media therefor
    • C12N5/10Cells modified by introduction of foreign genetic material
    • C12N5/12Fused cells, e.g. hybridomas
    • C12N5/16Animal cells
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/53Immunoassay; Biospecific binding assay; Materials therefor
    • G01N33/531Production of immunochemical test materials
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/68Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00Medicinal preparations containing antigens or antibodies
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K2317/00Immunoglobulins specific features
    • C07K2317/10Immunoglobulins specific features characterized by their source of isolation or production
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K2317/00Immunoglobulins specific features
    • C07K2317/30Immunoglobulins specific features characterized by aspects of specificity or valency
    • C07K2317/34Identification of a linear epitope shorter than 20 amino acid residues or of a conformational epitope defined by amino acid residues
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S435/00Chemistry: molecular biology and microbiology
    • Y10S435/975Kit
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S436/00Chemistry: analytical and immunological testing
    • Y10S436/811Test for named disease, body condition or organ function

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  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Organic Chemistry (AREA)
  • Engineering & Computer Science (AREA)
  • Immunology (AREA)
  • Molecular Biology (AREA)
  • Biochemistry (AREA)
  • General Health & Medical Sciences (AREA)
  • Genetics & Genomics (AREA)
  • Medicinal Chemistry (AREA)
  • Biomedical Technology (AREA)
  • Proteomics, Peptides & Aminoacids (AREA)
  • Endocrinology (AREA)
  • Biophysics (AREA)
  • Urology & Nephrology (AREA)
  • Hematology (AREA)
  • Zoology (AREA)
  • Biotechnology (AREA)
  • Microbiology (AREA)
  • Cell Biology (AREA)
  • Physics & Mathematics (AREA)
  • Toxicology (AREA)
  • Wood Science & Technology (AREA)
  • Pathology (AREA)
  • Cardiology (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Food Science & Technology (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Analytical Chemistry (AREA)
  • General Physics & Mathematics (AREA)
  • General Engineering & Computer Science (AREA)
  • Peptides Or Proteins (AREA)
  • Preparation Of Compounds By Using Micro-Organisms (AREA)
  • Micro-Organisms Or Cultivation Processes Thereof (AREA)

Claims (7)

1
1. Antistof, som specifikt binder sig til nativt proBNP, hvor antistoffet, som specifikt binder sig til nativt proBNP, er et monoklonalt antistof, som binder sig til syntetiske peptider bestående af aminosyrerne henholdsvis 39 til 46, 40 til 47, 41 til 48 og 42 til 49 fra NT-proBNP og med hensyn til værdierne for proBNP som bestemt i patientprøver ved anvendelse af antistoffet korrelerer med en r-værdi på mindst r=0,95 eller derover med værdierne for proBNP som bestemt i prøverne ved anvendelse af det monoklonale antistof MAB 1.21.3 produceret af den hybridomcellelinje, som er deponeret under DSM ACC 2650 hos DSMZ, og hvor r-værdien bestemmes ved hjælp af lineær regressionsanalyse.
2. Fremgangsmåde til specifik påvisning af nativt proBNP in vitro, hvilken fremgangsmåde omfatter trinene etablering af kontakt mellem en prøve, som mistænkes for eller vides at indeholde proBNP, og et antistof mod nativt proBNP ifølge krav 1 under betingelser, som muliggør dannelse af et antistof mod nativt proBNP-nativt proBNP-kompleks og påvisning af det dannede kompleks.
3. Fremgangsmåde ifølge krav 2, hvor påvisningen gennemføres ved hjælp af et kompetitivt immunassay.
4. Fremgangsmåde ifølge krav 2, hvor påvisningen gennemføres ved hjælp af et sandwich-immunassay, hvor der også anvendes et andet antistof mod proBNP, og hvor det andet antistof mod proBNP og antistoffet mod nativt proBNP begge binder sig til nativt proBNP og således danner et andet anti-proBNP-antistof-nativt proBNP-anti-nativt proBNP-antistof-kompleks.
5. Fremgangsmåde ifølge krav 4, hvor det andet antistof er valgt fra gruppen bestående af henholdsvis MAB 17.3.1, MAB 18.4.34 og MAB 18.29.23, der er produceret af de hybridomcellelinjer, som er deponeret hos DSM under henholdsvis DSM ACC 2591, DSM ACC 2592 og DSM ACC 2593. 2
6. Fremgangsmåde til at skelne NYHA-klasserne O og I fra klasserne II, III og IV in vitro, hvilken fremgangsmåde omfatter specifik påvisning af nativt proBNP ved anvendelse af et antistof ifølge krav 1 og korrelering af niveauet af nativt proBNP med hjerteinsufficiens.
7. Kit til måling af nativt proBNP, hvilket kit omfatter et antistof ifølge krav 1 og hjælpereagenser til påvisning af nativt proBNP.
DK10172014.2T 2003-05-12 2004-05-12 Fremgangsmåde til påvisning af probnp med et monoklonalt antistof DK2256132T3 (da)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
EP03010591 2003-05-12
EP04732282A EP1625164B1 (en) 2003-05-12 2004-05-12 Method of detecting probnp with a monoclonal antibody binding to the amino acids 42-46

Publications (1)

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DK2256132T3 true DK2256132T3 (da) 2015-07-13

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ID=33427054

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Application Number Title Priority Date Filing Date
DK04732282.1T DK1625164T3 (da) 2003-05-12 2004-05-12 Fremgangsmåde til at påvise proBNP med et monoklonalt antistof, som binder til aminosyrerne 42-46
DK04732278.9T DK1625163T3 (da) 2003-05-12 2004-05-12 Fremgangsmåde til at påvise proBNP med en monoklonal antistofbinding til aminosyrerne 38-43
DK10172014.2T DK2256132T3 (da) 2003-05-12 2004-05-12 Fremgangsmåde til påvisning af probnp med et monoklonalt antistof

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DK04732282.1T DK1625164T3 (da) 2003-05-12 2004-05-12 Fremgangsmåde til at påvise proBNP med et monoklonalt antistof, som binder til aminosyrerne 42-46
DK04732278.9T DK1625163T3 (da) 2003-05-12 2004-05-12 Fremgangsmåde til at påvise proBNP med en monoklonal antistofbinding til aminosyrerne 38-43

Country Status (15)

Country Link
US (4) US7264939B2 (da)
EP (4) EP1625164B1 (da)
JP (4) JP5128125B2 (da)
KR (2) KR100857752B1 (da)
CN (3) CN100497393C (da)
AT (2) ATE517124T1 (da)
AU (1) AU2004235974B2 (da)
BR (1) BRPI0410261B8 (da)
CA (2) CA2522747C (da)
DK (3) DK1625164T3 (da)
ES (3) ES2369008T3 (da)
HU (1) HUE025169T2 (da)
MX (1) MXPA05011826A (da)
PL (3) PL1625164T3 (da)
WO (2) WO2004099253A1 (da)

Families Citing this family (36)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2843396B1 (fr) * 2002-08-07 2005-04-15 Bio Rad Pasteur Anticorps specifiques pour le diagnostic de l'insuffisance cardiaque
CN100497393C (zh) * 2003-05-12 2009-06-10 霍夫曼-拉罗奇有限公司 用结合脑钠尿肽前体分子氨基酸41-46的单克隆抗体检测脑钠尿肽前体分子的方法
US20070037208A1 (en) * 2003-05-29 2007-02-15 Foote Robert S Method for detecting cardiac ischemia via changes in b-natriuretic peptide levels
DE10355731A1 (de) 2003-11-28 2005-06-30 Roche Diagnostics Gmbh Analytischer Sandwichtest zur Bestimmung von NT-proBNP
ATE364177T1 (de) * 2004-07-07 2007-06-15 Hoffmann La Roche Kombinationen von markern zum nachweis von typ 1 und 2 diabetes
AT500800B1 (de) * 2004-09-08 2008-07-15 Biomedica Medizinprodukte Gmbh Verfahren zur bestimmung von probnp
CN106908603B (zh) 2007-01-25 2019-04-02 霍夫曼-拉罗奇有限公司 Igfbp-7在心力衰竭评估中的用途
KR100836322B1 (ko) * 2007-08-31 2008-06-09 현대자동차주식회사 차량용 흡음재 제작장치 및 방법
US9482677B2 (en) 2008-02-27 2016-11-01 Scios Inc. Method, composition and device for sampling natriuretic peptides in a biological fluid
ES2526928T3 (es) 2008-04-30 2015-01-16 The Governing Council Of The University Of Toronto Uso de SFRP-3 en la evaluación de la insuficiencia cardíaca
CN102549436A (zh) 2009-07-27 2012-07-04 霍夫曼-拉罗奇有限公司 mimecan在评价心力衰竭中的用途
CA2780301A1 (en) * 2009-11-13 2011-05-19 Bg Medicine, Inc. Risk factors and prediction of myocardial infarction
US8778699B2 (en) 2010-08-04 2014-07-15 Idexx Laboratories, Inc. Detection of degradation products of canine NT-proBNP
AU2012262154B2 (en) 2011-05-31 2016-08-04 Idexx Laboratories, Inc. Detection of degradation products of feline NT-proBNP
JP6119607B2 (ja) * 2011-09-20 2017-04-26 コニカミノルタ株式会社 検体希釈用液、それを用いたキットおよび蛍光測定方法
US20140273273A1 (en) 2012-11-01 2014-09-18 Christie Mitchell Ballantyne Biomarkers to improve prediction of heart failure risk
CN103304665A (zh) * 2013-05-21 2013-09-18 上海贝西生物科技有限公司 一种抗氨基末端脑利钠肽前体单克隆抗体及其应用
EP3206032B1 (en) * 2014-10-10 2019-02-27 Akira Matsumori Method for detecting cardiac failure patient, method for discrimination of cardiac disease, test reagent for cardiac failure, test kit for cardiac failure, device for detecting cardiac failure, and program for detecting cardiac failure
EP3360570A1 (en) 2017-02-13 2018-08-15 Roche Diagnostics GmbH Antibodies recognizing genetic variants
ES2948008T3 (es) 2017-10-02 2023-08-25 Otsuka Pharma Co Ltd Método para detectar analito
EP3779438A4 (en) * 2018-04-13 2022-01-26 Kyoritsu Seiyaku Corporation PROCEDURE FOR DETECTING HEART FAILURE, INSTRUMENT FOR DETECTING HEART FAILURE, SANDWICH IMMUNOASSAY PROCEDURE AND ANTIBODY COMBINATION
CN108752480B (zh) * 2018-05-30 2022-03-29 中元汇吉生物技术股份有限公司 一种免疫原组合物、其制备方法及其用途
US12400762B2 (en) 2018-12-11 2025-08-26 Eko.Ai Pte. Ltd. Automatic clinical workflow that recognizes and analyzes 2D and doppler modality echocardiogram images for automated cardiac measurements and diagnosis of cardiac amyloidosis and hypertrophic cardiomyopathy
US11446009B2 (en) 2018-12-11 2022-09-20 Eko.Ai Pte. Ltd. Clinical workflow to diagnose heart disease based on cardiac biomarker measurements and AI recognition of 2D and doppler modality echocardiogram images
US12322100B2 (en) 2018-12-11 2025-06-03 Eko.Ai Pte. Ltd. Automatic clinical workflow that recognizes and analyzes 2D and doppler modality echocardiogram images for automated cardiac measurements and grading of aortic stenosis severity
US12001939B2 (en) 2018-12-11 2024-06-04 Eko.Ai Pte. Ltd. Artificial intelligence (AI)-based guidance for an ultrasound device to improve capture of echo image views
US11931207B2 (en) 2018-12-11 2024-03-19 Eko.Ai Pte. Ltd. Artificial intelligence (AI) recognition of echocardiogram images to enhance a mobile ultrasound device
CN111487222B (zh) * 2019-01-28 2023-11-14 上海乐合生物科技有限公司 一种检测bnp的spr芯片的制备方法
EP4014041A1 (en) 2019-08-13 2022-06-22 Gentian AS Highly sensitive particle enhanced assay for the quantification of nt-probnp
US20230366894A1 (en) * 2020-09-30 2023-11-16 Roche Diagnostics Operations, Inc. Circulating total-nt-probnp (glycosylated and unglycosylated nt-probnp) and its ratio with nt-probnp (unglycosylated nt-probnp) in the assessment of atrial fibrillation
CN112964885B (zh) * 2021-02-20 2022-11-11 广东菲鹏生物有限公司 一种氨基末端脑尿钠肽检测方法和试剂盒
CN112986586A (zh) * 2021-02-20 2021-06-18 广东菲鹏生物有限公司 一种氨基末端脑尿钠肽检测方法和试剂盒
EP4409297B1 (en) 2021-10-01 2025-01-29 Gentian AS Novel method for determining a concentration of n-terminal pro-hormone bnp (nt-probnp) in a sample
JP2025508481A (ja) 2022-03-18 2025-03-26 エフ. ホフマン-ラ ロシュ アーゲー 2型対1型の急性心筋梗塞の早期識別のためのトロポニンマーカーの組合せ
US20250232875A1 (en) 2022-03-18 2025-07-17 Roche Diagnostics Operations, Inc. Cmybpc marker combinations for early discrimination of type 2 versus type 1 acute myocardial infarction
WO2024219421A1 (ja) * 2023-04-19 2024-10-24 栄研化学株式会社 NT-proBNPに対する抗体、これを用いたNT-proBNP検出方法、並びに、NT-proBNP検出に用いるための組成物及びキット

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3445816C1 (de) 1984-12-15 1986-06-12 Behringwerke Ag, 3550 Marburg Flaechenfoermiges diagnostisches Mittel
JP2665850B2 (ja) 1991-11-14 1997-10-22 塩野義製薬株式会社 hBNPのC端を認識するモノクロ−ナル抗体
GB9211686D0 (en) 1992-06-03 1992-07-15 Medisinsk Innovation A S Chemical compounds
ES2256952T3 (es) * 1997-09-11 2006-07-16 SHIONOGI & CO., LTD. Inmunoanalisis para bnp.
GB9827348D0 (en) * 1998-12-12 1999-02-03 Univ Leicester Natriuretic peptide
PL204235B1 (pl) * 1999-01-29 2009-12-31 Roche Diagnostics Gmbh Sposób wykrywania natywnego N-końcowego proBNP, zastosowanie tego sposobu, zastosowanie zrekombinowanego N-końcowego proBNP, przeciwciała przeciw zrekombinowanemu N-końcowemu proBNP, linie komórkowe i sposoby wytwarzania przeciwciał poliklonalnych i monoklonalnych
US20030219734A1 (en) 2001-04-13 2003-11-27 Biosite Incorporated Polypeptides related to natriuretic peptides and methods of their identification and use
US20040096919A1 (en) * 2002-11-18 2004-05-20 Michelle Davey Polyclonal-monoclonal ELISA assay for detecting N-terminus proBNP
CN100497393C (zh) * 2003-05-12 2009-06-10 霍夫曼-拉罗奇有限公司 用结合脑钠尿肽前体分子氨基酸41-46的单克隆抗体检测脑钠尿肽前体分子的方法

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JP4834136B2 (ja) 2011-12-14
ES2548327T3 (es) 2015-10-15
EP1625164B1 (en) 2011-07-20
US7811770B2 (en) 2010-10-12
BRPI0410261B8 (pt) 2021-07-27
CA2522378C (en) 2011-03-29
US7264938B2 (en) 2007-09-04
US20070117156A1 (en) 2007-05-24
BRPI0410261B1 (pt) 2020-03-10
ATE522546T1 (de) 2011-09-15
JP5128125B2 (ja) 2013-01-23
ATE517124T1 (de) 2011-08-15
ES2372282T3 (es) 2012-01-18
JP5649631B2 (ja) 2015-01-07
PL1625164T3 (pl) 2011-12-30
PL2256132T3 (pl) 2016-08-31
CN1784425A (zh) 2006-06-07
DK1625163T3 (da) 2011-12-05
DK1625164T3 (da) 2011-10-31
US7264939B2 (en) 2007-09-04
CA2522747C (en) 2012-08-14
JP2007525427A (ja) 2007-09-06
EP2256132A1 (en) 2010-12-01
JP2013018784A (ja) 2013-01-31
ES2369008T3 (es) 2011-11-24
CN101967190A (zh) 2011-02-09
US20070099241A1 (en) 2007-05-03
BRPI0410261A (pt) 2006-05-16
CN100497393C (zh) 2009-06-10
AU2004235974B2 (en) 2008-02-14
EP2949669A1 (en) 2015-12-02
CN1832964A (zh) 2006-09-13
EP2256132B1 (en) 2015-04-01
KR100857752B1 (ko) 2008-09-11
HK1097855A1 (zh) 2007-07-06
KR20080011467A (ko) 2008-02-04
US20060110775A1 (en) 2006-05-25
EP1625163B1 (en) 2011-08-31
JP2010011860A (ja) 2010-01-21
US7807380B2 (en) 2010-10-05
KR20060003905A (ko) 2006-01-11
WO2004099252A1 (en) 2004-11-18
AU2004235974A1 (en) 2004-11-18
EP1625164A1 (en) 2006-02-15
US20060110776A1 (en) 2006-05-25
MXPA05011826A (es) 2006-01-26
PL1625163T3 (pl) 2012-01-31
WO2004099253A1 (en) 2004-11-18
JP4430066B2 (ja) 2010-03-10
HUE025169T2 (en) 2016-02-29
JP2007535470A (ja) 2007-12-06
EP1625163A1 (en) 2006-02-15
CA2522378A1 (en) 2004-11-18
EP1625163B8 (en) 2011-11-02
CA2522747A1 (en) 2004-11-18

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