The instant application contains a Sequence Listing which has been submitted electronically in XML format and is hereby incorporated by reference in its entirety. Said XML copy, created on Mar. 15, 2023, is named 1448-0221US01 SL.xml and is 16,449 bytes in size.
In Dec. 2019, a previously unknown betacoronavirus was identified in Wuhan, China and discovered to cause, sometimes life-threatening, pneumonia-like symptoms. Over the next few months, the novel coronavirus, named SARS-CoV-2, continued to spread around the world, sickening millions of people with COVID-19 and causing hundreds of thousands of deaths.
Since then, the world has continued to look for improved methods to contain the spread of the virus. Although there is universal agreement on the critical value of widespread, distributed molecular testing for SARS-CoV-2 in the global response to the COVID-19 pandemic, such testing is not currently achievable using complicated and expensive molecular technologies. The current FDA EUA-approved point-of-care COVID-19 molecular tests are either too expensive and insensitive or too slow and complex for large-scale use. There is an urgent need for an affordable, fast, and simple-to-use molecular test, to ascertain the infection status of up to tens of millions of people per week, in a manner that avoids chaotic and socially dense queues at limited testing sites.
What is needed is a highly sensitive and reliable gold standard test that can be made available in an affordable and rapid manner to locations around the country and world, and which could be developed and offered in the near future. Such a test would be useful for a large number of viruses (including SARS-CoV-2, flu, and others), bacteria, and infectious-disease targets.
Aspects described herein provide a first method of detecting a nucleic acid in a single reaction chamber by (a) obtaining a patient specimen suspected of comprising a first nucleic acid, (b) forming a crude lysate from the patient specimen, (c) forming a reaction mixture by combining the crude lysate with infrared absorbing materials, a detecting nucleic acid, and at least one reporter molecule in the single reaction chamber, (d) heating the reaction mixture to at least 35° C. by irradiating the reaction mixture with infrared light, and (e) detecting a presence of the at least one reporter molecule, wherein a presence of the at least one reporter molecule indicates the patient specimen contains the first nucleic acid, and wherein steps (b) through (d) occur in the single reaction chamber.
Aspects described herein provide a second method for detecting a presence or absence of a plurality of different molecules within a reaction container comprising (a) illuminating contents of the reaction container using infrared light until a temperature within the reaction container reaches a denaturing temperature; (b) allowing the heated contents of the reaction container to cool until a temperature within the reaction container reaches an annealing temperature; (c) illuminating the contents of the reaction container with excitation light; (d) obtaining, while the contents of the reaction container are being illuminated with the excitation light, a respective measured spectrum of light that is being emitted by the contents of the reaction container; (e) deconvolving the respective measured spectrum into a plurality of respective individual spectra, each of which corresponds to a respective one of the different molecules; and (f) outputting data corresponding to each of the respective individual spectra. Steps (a) through (f) are repeated at least 10 times.
Aspects described herein provide a first apparatus for detecting a presence or absence of a plurality of different molecules within a reaction container. The first apparatus comprises an infrared light source aimed to illuminate contents of the reaction container; an excitation light source positioned to illuminate contents of the reaction container; and a spectrometer positioned to detect emission light emanating from the reaction container during times when the excitation light source is illuminating the contents of the reaction container. The first apparatus also comprises a controller programmed to, for each of N cycles, (a) control the infrared light source so that the temperature within the reaction container cycles between a denaturing temperature and an annealing temperature, (b) obtain, from the spectrometer, a respective measured spectrum in response to the excitation light, (c) deconvolve the respective measured spectrum into a plurality of respective individual spectra, each of which corresponds to a respective one of the different molecules, and (d) output data corresponding to each of the respective individual spectra, wherein N is an integer greater than or equal to 10.
Further aspects provide a second apparatus for detecting the presence or absence of a nucleic acid within a reaction container. The reaction container has a longitudinal axis. The second apparatus has a support structure shaped and dimensioned to hold the reaction container so that contents of the reaction container occupy a region in space; an infrared light source aimed in a first direction so as to illuminate at least a first portion of the region in space; an infrared thermometer aimed in a second direction so as to obtain temperature readings from at least a second portion of the region in space; a first-wavelength light source aimed in a third direction so as to illuminate at least a third portion of the region in space; and a light detector aimed in a fourth direction, wherein the light detector detects second-wavelength light arriving from the third portion of the region in space. The first and second wavelengths are selected such that when reporter molecules are illuminated by first-wavelength light, the reporter molecules will fluoresce at the second wavelength.
Further aspects provide a third apparatus for detecting the presence or absence of a nucleic acid within a reaction container. The third apparatus comprises a support structure shaped and dimensioned to hold the reaction container so that contents of the reaction container occupy a first region in space; a support structure shaped and dimensioned to hold a reference tube so that contents of the reference tube occupy a second region in space; an infrared light source aimed to impart equal amounts of infrared radiation on the reaction container and the reference tube; a thermometer positioned to measure the temperature of material within the reference tube and generate an output indicative of the measured temperature; a first-wavelength light source aimed in a first direction so as to illuminate at least a first portion of the first region in space; and a light detector aimed in a second direction, wherein the light detector detects second-wavelength light arriving from the first portion of the first region in space. The first and second wavelengths are selected such that when reporter molecules are illuminated by first-wavelength light, the reporter molecules will fluoresce at the second wavelength.
For widespread use, current point-of-care molecular tests are either too expensive and insensitive or too expensive, slow, and complex. There is an urgent need for an affordable, fast, and simple-to-use molecular tests, in a manner that avoids chaotic and socially dense queues at limited testing sites.
Methods and apparatus described herein perform highly sensitive and reliable nucleic acid detection (e.g., reverse transcriptase polymerase chain reaction or RT-PCR) in a fast, lower cost, and integrated way. In some instances, the apparatus and method requires only a single step from a user perspective, and the result can be generated using an app in less than ten minutes. In some instances, the exemplary apparatus and system uses photothermal amplification based on the rapid absorption of infrared light by gold nanoparticles (Au-NPs).
Aspects described herein are faster, more accurate, and less expensive that previous point-of-care molecular diagnostic tests. In addition, they avoid contamination from direct contact with thermocouples, and integrate reagents and sample preparation into a single reaction chamber. In some instances, the methods and apparatus can be used for rapid diagnosis of SARS-CoV-2, but the methods and apparatus can be used for any point-of-care molecular nucleic acid testing by using primer sets designed to detect other target molecules.
In one aspect, the method and apparatus utilizes 1) single-step sample preparation using a temperature-release mechanism for reagents rather than mechanical switches, 2) ultrafast light-controlled thermocycling (both photothermal control and contactless measurements with closed-loop software feedback control), and 3) an industry-level secure and scalable software platform (both in mobile app that controls the instrument, and connection to a cloud server).
Reagents used in the apparatus can be provided, for example, in a capsule having a temperature-sensitive seal (e.g., containing Mastermix and enzymes for PCR). In this aspect, reagents can be added directly to a swab collection medium without complicated mechanical components to eliminate the need for mechanical components to add sample processing reagents.
Fast thermocycling can be performed using an infrared thermometer for temperature feedback with real-time fluorescence readout of the amplified products. In some instances, a “temperature control” tube can be used to control thermal cycling. Instead of using a thermometer (contact or contactless) on the PCR tube itself, temperature measurements can be made using a “temperature control” tube that is positioned equidistant from the focal point of the IR LED+Lens as compared to the main PCR tube as described herein. The temperature control can be calibrated such that the temperature in the reference tube matches or coordinates to that of the PCR tube.
Aspects described herein provide a first method of detecting a nucleic acid in a single reaction chamber by (a) obtaining a patient specimen suspected of comprising a first nucleic acid, (b) forming a crude lysate from the patient specimen, (c) forming a reaction mixture by combining the crude lysate with infrared absorbing materials, a detecting nucleic acid, and at least one reporter molecule in the single reaction chamber, (d) heating the reaction mixture to at least 35° C. by irradiating the reaction mixture with infrared light, and (e) detecting a presence of the at least one reporter molecule, wherein a presence of the at least one reporter molecule indicates the patient specimen contains the first nucleic acid, and wherein steps (b) through (d) occur in the single reaction chamber. In some instances, the at least one reporter molecule comprises at least two reporter molecules.
In some instances, the infrared-absorbing material comprises gold nanoparticles. The term “infrared-absorbing material” refers to a gas, liquid, or solid that is capable of substantially absorbing infrared radiation It is understood that other suitable infrared-absorbing materials can be used including, but not limited to, metallic nanofilms.
The term “nanoparticles” refers to a particle of matter that is between about 1 and 500 nanometers in diameter.
The term “nucleic acid” includes deoxyribonucleic acid (“DNA”), ribonucleic acid (“RNA”), and variants of DNA and RNA including, but not limited to, miRNA, mRNA, cDNA, etc.
The term “crude lysate” refers to an unfiltered mixture of a patient specimen and reagents used in a process for detecting a nucleic acid where the reagents can disrupt or lyse cell membranes or tissue from a patient specimen or sample. No RNA extraction step is applied to a crude lysate for “cleaning up” the lysed mixture. For example, the virus is lysed (e.g. by temperature), and the DNA polymerase acts directly on the crude lysate mixture.
The term “reporter molecule” refers to a molecule that is detectable and measurable and can be used to monitor the presence of or level of expression of molecule of interest (e.g., nucleic acid, protein). As used herein, a reporter molecule can refer to a nucleic acid that is labelled with a detectable moiety (e.g., fluorescent moiety, radiolabel, etc.) to indicate the presence of a nucleic acid of interest. In some instances, more than one reporter molecule can be detected.
In some instances, the first nucleic acid is amplified using one of the polymerase chain reaction (PCR) or isothermal amplification. The term “PCR” refers to a method amplifying nucleic acid by a cyclical, multi-step process of heating double-stranded nucleic acid until the two strands separate, binding or annealing a complementary nucleic acid to a region of nucleic acid to be amplified, and extending the annealed nucleic acid strand to form two double-stranded nucleic acid molecules, and cooling the nucleic acid.
In some instances, the isothermal amplification comprises loop-mediated isothermal amplification (LAMP).
The term “isothermal amplification” refers to a nucleic acid amplification technique that can be carried out without the need for thermocycling and with enzymes to operate at one constant temperature. Loop-mediated isothermal amplification (LAMP) is one example of an isothermal amplification technique.
In some instances, the heating of the reaction mixture denatures the first nucleic acid at a denaturing temperature. The term “denature” refers to separation of two complementary nucleic acid strands.
In some instances, the reaction mixture is cooled to an annealing temperature after and the detecting nucleic acid can anneal to the first nucleic acid, forming an annealed nucleic acid. The term “annealing temperature” refers to a temperature at which two complementary nucleic acid strands can bind to each other.
In some instances, a temperature within the reaction chamber cycles between a denaturing temperature and an annealing temperature at least 10 times. The term “cycle” refers to a repetition of the temperature adjustment between the denaturing and annealing temperatures such that a target nucleic acid can be amplified in an amount sufficient to be detected.
In some instances, nucleotides are added to or part of the reaction mixture, and an annealed nucleic acid can be extended along a complementary strand with the nucleotides.
In some instances, the first nucleic acid is ribonucleic acid (RNA). In some instances, the RNA is derived from a virus (e.g., SARS-CoV-2).
In some instances, the RNA is reverse transcribed prior to the heating of the reaction mixture. The term “reverse transcribed” refers to synthesis of DNA from RNA to form cDNA (complementary DNA).
In some instances, the reverse transcribing of the RNA occurs in about 1 to 5 minutes. In some instances, the heating step occurs in about 1 to 30 seconds. In some instances, the cooling step occurs in about 2 to 30 seconds. In some instances, the annealing and extending of the detecting nucleic acid occurs in about 1 to 60 seconds. In some instances, the detecting of the presence of the reporter molecule occurs in about 1 to 30 seconds.
Some instances further comprise filtering the crude lysate in the single reaction chamber.
Aspects described herein provide a second method for detecting a presence or absence of a plurality of different molecules within a reaction container comprising (a) illuminating contents of the reaction container using infrared light until a temperature within the reaction container reaches a denaturing temperature; (b) allowing the heated contents of the reaction container to cool until a temperature within the reaction container reaches an annealing temperature; (c) illuminating the contents of the reaction container with excitation light; (d) obtaining, while the contents of the reaction container are being illuminated with the excitation light, a respective measured spectrum of light that is being emitted by the contents of the reaction container; (e) deconvolving the respective measured spectrum into a plurality of respective individual spectra, each of which corresponds to a respective one of the different molecules; and (f) outputting data corresponding to each of the respective individual spectra. Steps (a) through (f) are repeated at least 10 times.
In some instances of the second method, step (g) comprises repeating steps (a) through (f) at least 40 times.
In some instances of the second method, the plurality of different molecules comprises at least three different molecules. In some instances of the second method, the plurality of different molecules comprises FAM, SUN, and ROX. In some instances of the second method, the plurality of different molecules comprises at least two molecules selected from the group consisting of FAM, SUN, HEX, and ROX. In some instances of the second method, each of the plurality of different molecules comprises a fluorescent dye having an excitation wavelength between 480 and 600 nm and an emission wavelength between 500 and 625 nm. In some instances of the second method, the reaction container contains gold nanoparticles dispersed in a liquid.
In some instances of the second method, step (a) comprises illuminating contents of the reaction container using infrared light for a first fixed interval of time; and step (b) comprises allowing the heated contents of the reaction container to cool for a second fixed interval of time.
Aspects described herein provide a first apparatus for detecting a presence or absence of a plurality of different molecules within a reaction container (40). The first apparatus comprises an infrared light source (50) aimed to illuminate contents of the reaction container; an excitation light source (95) positioned to illuminate contents of the reaction container; and a spectrometer (75) positioned to detect emission light emanating from the reaction container during times when the excitation light source is illuminating the contents of the reaction container. The first apparatus also comprises a controller programmed to, for each of N cycles, (a) control the infrared light source so that the temperature within the reaction container cycles between a denaturing temperature and an annealing temperature, (b) obtain, from the spectrometer, a respective measured spectrum in response to the excitation light, (c) deconvolve the respective measured spectrum into a plurality of respective individual spectra, each of which corresponds to a respective one of the different molecules, and (d) output data corresponding to each of the respective individual spectra, wherein N is an integer greater than or equal to 10.
In some embodiments of the first apparatus, N is greater than or equal to 40. In some embodiments of the first apparatus, at least one optical fiber (130) is used to route emission light from the reaction container to the spectrometer. In some embodiments of the first apparatus, the plurality of different molecules comprises at least three different molecules. In some embodiments of the first apparatus, the plurality of different molecules comprises FAM, SUN, and ROX. In some embodiments of the first apparatus, the plurality of different molecules comprises at least two molecules selected from the group consisting of FAM, SUN, HEX, and ROX. In some embodiments of the first apparatus, each of the plurality of different molecules comprises a fluorescent dye having an excitation wavelength between 480 and 600 nm and an emission wavelength between 500 and 625 nm.
Some embodiments of the first apparatus further comprise the reaction container (40), wherein the reaction container contains gold nanoparticles dispersed in a liquid. Some embodiments of the first apparatus further comprise the reaction container (40), wherein the reaction container contains nanoparticles dispersed in a liquid, where the nanoparticles are efficient absorbers of infrared light.
In some embodiments of the first apparatus, the control of the infrared light source comprises open-loop control based on time.
Further aspects provide a second apparatus for detecting the presence or absence of a nucleic acid within a reaction container (40). The reaction container has a longitudinal axis. The second apparatus comprises a support structure (45) shaped and dimensioned to hold the reaction container (40) so that contents of the reaction container (40) occupy a region in space; an infrared light source (50) aimed in a first direction so as to illuminate at least a first portion of the region in space; an infrared thermometer (55) aimed in a second direction so as to obtain temperature readings from at least a second portion of the region in space; a first-wavelength light source (60) aimed in a third direction so as to illuminate at least a third portion of the region in space; and a light detector (70) aimed in a fourth direction, wherein the light detector detects second-wavelength light arriving from the third portion of the region in space. The first and second wavelengths are selected such that when reporter molecules are illuminated by first-wavelength light, the reporter molecules will fluoresce at the second wavelength.
Some embodiments of the second apparatus further comprise a controller programmed to control the infrared light source based on a signal from the infrared thermometer so that the temperature within the reaction container (40) cycles between a denaturing temperature and an annealing temperature at least 10 times.
In some embodiments of the second apparatus, the second direction is substantially perpendicular to the first direction. In some embodiments of the second apparatus, the third direction is substantially perpendicular to the fourth direction.
In some embodiments of the second apparatus, the longitudinal axis of the reaction container (40) and the first direction are offset by 40-50°. In some embodiments of the second apparatus, the longitudinal axis of the reaction container (40) and the first direction are offset by 25-70°.
In some embodiments of the second apparatus, the second direction is substantially perpendicular to the first direction, the third direction is substantially perpendicular to the fourth direction, and the longitudinal axis of the reaction container and the first direction are offset by 40-50°.
Some embodiments of the second apparatus further comprise a fan (80) aimed in a fifth direction to blow at the region in space. The fifth direction can be substantially perpendicular to the first direction. The fifth direction can also be substantially perpendicular to the second direction.
Some embodiments of the second apparatus further comprise the reaction container (40), wherein the reaction container (40) contains gold nanoparticles dispersed in a liquid. Some embodiments of the second apparatus further comprise the reaction container (40), wherein the reaction container (40) contains nanoparticles dispersed in a liquid, and where the nanoparticles are efficient absorbers of infrared light.
In some embodiments of the second apparatus, the light detector also detects third-wavelength light arriving from the third portion of the region in space, wherein the third wavelength is different from the second wavelength.
Further aspects provide a third apparatus for detecting the presence or absence of a nucleic acid within a reaction container. The third apparatus comprises a support structure shaped and dimensioned to hold the reaction container so that contents of the reaction container occupy a first region in space; a support structure shaped and dimensioned to hold a reference tube so that contents of the reference tube occupy a second region in space; an infrared light source aimed to impart equal amounts of infrared radiation on the reaction container and the reference tube; a thermometer positioned to measure the temperature of material within the reference tube and generate an output indicative of the measured temperature; a first-wavelength light source aimed in a first direction so as to illuminate at least a first portion of the first region in space; and a light detector aimed in a second direction , wherein the light detector detects second-wavelength light arriving from the first portion of the first region in space. The first and second wavelengths are selected such that when reporter molecules are illuminated by first-wavelength light, the reporter molecules will fluoresce at the second wavelength.
Some embodiments of the third apparatus further comprise a controller. The controller can be programmed to control the infrared light source based on the output generated by the thermometer so that the temperature within the reference tube cycles between a denaturing temperature and an annealing temperature at least 10 times.
Some embodiments of the third apparatus further comprise a fan aimed to blow equal amounts of air on the reaction container and the reference tube.
I some embodiments of the third apparatus, the light detector also detects third-wavelength light arriving from the first portion of the first region in space, wherein the third wavelength is different from the second wavelength.
The exemplary instrument shown in
In the illustrated example, each instrument can run one test at a time. Optionally, multiple copies of the instrument may be used to enable multiple tests to be run in parallel within a benchtop space to achieve faster processing of multiple samples. Unlike high-throughput testing machines, tests are not processed in batches which lengthens the sample-to-result times, as testing of every specimen waits until the last specimen collected to initiate a single run. Instead, each test is processed in its own individual machine in real time, to maximize the fastest possible speed at which every individual can get their test result.
This high degree of scalability (across locations, speed, and throughput) also allows people to be tested frequently, facilitating, for example, same-day status changes to quarantine or back to work.
The aspects described herein also have the advantage of increased accuracy compared to other systems (as described below). For every percentage reduction in sensitivity, a COVID-19 patient that receives a false negative test not only poses a health risk to themselves and their neighbors, but also would result in testing re-visits for additional testing, hence placing a greater burden on national testing capacity.
Whereas RT-PCR has remained the gold standard for molecular testing since the 1980's, standard isothermal methods still lack the sensitivity, reliability and versatility among practical, commercially used nucleic-acid diagnostic techniques. The current point-of-care COVID-19 isothermal amplification devices face unresolved questions regarding low sensitivity.
More recently, CRISPR techniques are based on Cas enzymes, have been used. CRISPR techniques have demonstrated limited enzyme efficiency parameters at very low numbers of targets. Currently, CRISPR-based techniques are confined to a lab setting, and take over 40 minutes to generate a result. In addition, results using these systems have not yet been validated and proven for any diagnostic targets in a commercial, clinical, or a challenging point-of-care environment. In contrast, PCR methods have remained the gold standard for decades in terms of performance, and validated through use in numerous laboratories.
Optionally the exemplary apparatus described herein can be connected wirelessly (e.g. via Bluetooth) to a smart tablet or smartphone running an app that communicates with the instrument. Use of this or a similar connectivity system can enable a tight coupling between distributed, low-cost COVID-19 testing and cloud-based analysis of health data (including low-latency alerting of contacts, if desired) while maintaining data security and individual privacy, built to defense industry-security and performance standards.
After about 5 minutes, a high-positive result will be shown on the smart device; after about 12 minutes, a final result (positive or negative) is recorded on the app and sent to the cloud.
In the current COVID-19 pandemic, challenges exist with respect to low availability of disposable cartridges. In the FDA-authorized point-of-care RT-PCR systems, sample preparation is performed by complex cartridges, placing pressure on the supply chain and increasing the likelihood of quality assurance challenges.
The present apparatus and methods described herein utilize a sample preparation procedure that does not require complex cartridges. In this exemplary single-step, single reaction chamber approach for sample preparation (
After stirring for 10 seconds, the tube is closed and placed into the instrument, and the user hits “start” on a mobile app (
SARS-CoV-2 genomic RNA (BEI resources) was successfully amplified with TaqPath One-Step RT-PCR master mix, which contains both the reverse transcriptase and DNA polymerase (
PCR instrumentation required to ramp up and down the temperature in a controlled manner can be limited by complexity, size, and cost. Standard thermal cycling, for example, uses a Peltier heating device, which requires a relatively large amount of power and time, and takes at least 40 minutes to complete the PCR cycles.
The apparatus and methods described herein replace the convective heating approach of a relatively large and expensive Peltier component with a photothermal process driven by compact optical components, and which drive thermocycling at 5 to 10 times faster than the conventional Peltier methods. In this exemplary setup (depicted in the left panel of
A modification of the RT-PCR test used the N1 primer and probe set to target the SARS-CoV-2 nucleocapsid gene. In this exemplary light-controlled setup for thermocycling, the one-step TaqPath RT-PCR kit (combined reverse transcriptase and DNA polymerase) was used in the reaction mixture with gold nanoparticles to achieve the thermocycling of the PCR step. Across triplicates, this optical setup achieved well-controlled thermocycling (
In this experiment, short hold times were programmed (95° C. for 1 second, and 60° C. at 2 seconds), and achieved a precision of less than 3% in total cycling over 40 cycles. This exemplary RT-PCR setup successfully amplified and detected the SARS-CoV-2 nucleocapsid gene within a positive control plasmid (IDT), using the gold-standard CDC primer sequences (https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-per-panel-primer-probes.html), at 2 copies/μL (
The apparatus 100 detects the presence or absence of a nucleic acid within a reaction container 40, and this apparatus 100 may be used to implement the methods described herein. The reaction container 40 has a longitudinal axis. In some preferred embodiments, a thin-walled PCR tube is used as the reaction container 40. But in alternative embodiments, any of a variety of alternative reaction containers may be used. The apparatus 100 includes a support structure 45 that is shaped and dimensioned to hold the reaction container 40 so that contents of the reaction container 40 occupy a region in space.
The apparatus 100 also includes an infrared light source 50 aimed in a first direction so as to illuminate at least a first portion of the region in space (i.e., the interior of the reaction container 40). When the reaction container 40 contains an infrared absorbing material (e.g., gold nanoparticles) suspended in a fluid (e.g., PCR mastermix), illuminating the interior of the reaction container 40 with infrared light causes the contents of the reaction container 40 to heat up. In the
The apparatus 100 also includes an infrared thermometer 55 aimed in a second direction so as to obtain temperature readings from at least a second portion of the region in space (i.e., the interior of the reaction container 40). Preferably, the second portion of the region in space coincides with the first portion of the region in space. But there may be some offset between those two regions. The infrared thermometer 55 may be aimed at the exact same spot within the interior of the reaction container 40 as the IR LED. Alternatively, the infrared thermometer could be aimed at a different spot within the interior of the reaction container 40. Any of a variety of approaches for implementing the infrared thermometer may be used, (e.g., Pyrometer Optris CS LT with CF lens and USB programming—https://www.optris.com/product-configurator-cs-lt). In the
The apparatus 100 also includes a first-wavelength (excitation) light source 60 is aimed in a third direction so as to illuminate at least a third portion of the region in space. In the
The apparatus 100 also includes a light detector 70 aimed in a fourth direction. This light detector 70 detects second-wavelength (emission) light arriving from the third portion of the region in space. The purpose of this light detector 70 is to detect fluorescent emmission light arriving from the portion of the reaction container 40 that is being illuminated by the excitation light from the first wavelength light source 60. In some embodiments, a photodiode may serve as the light detector 70. In some embodiments, the light detector 70 may be implemented using a collimating lens attached to a fiber optic cable that leads to a spectrophotometer. The first and second wavelengths are selected such that when reporter molecules are illuminated by first-wavelength light, the reporter molecules will fluoresce at the second wavelength. In the
In some embodiments, the light detector 70 responds to more than one wavelength (e.g., by using a spectrometer as the light detector 70). For example, in addition to responding to second-wavelength light, the light detector 70 may respond to third-wavelength light (where the third wavelength is different from the second wavelength) and optionally additional wavelengths of light. These embodiments may be used to detect emission light at different wavelengths (e.g., second-wavelength light and third-wavelength light) from different reporter molecules. In these embodiments, deconvolution may be used to separate out the contribution of each of the detected wavelengths (e.g., as described below).
Optionally, a fan 80 (e.g., a 12 V rotary fan) is aimed to blow at the region in space (i.e. to blow at the reaction container 40) to speed up cooling of the contents of the reaction container 40. The fan 80 may be aimed in a fifth direction that is both (a) substantially perpendicular to the first direction and (b) substantially perpendicular to the second direction.
When a reaction container 40 is positioned at the region in space and the reaction container 40 is filled with a liquid in which gold nanoparticles (or another infrared-absorbing material) are dispersed, the contents of the reaction container 40 can be heated by activating the infrared light source 50, and the temperature within that reaction container 40 can be measured by monitoring signals received from the infrared thermometer 55.
A controller (not shown) controls the apparatus 100. In some embodiments, this controller is programmed to control the infrared light source 50 based on a signal from the infrared thermometer 55 so that the temperature within the reaction container 40 cycles between a denaturing temperature and an annealing temperature at least 10 times. The controller can implement a closed-loop feedback control system for IR-controlled heating and cooling by controlling the infrared light source 50 based on signals received from the infrared thermometer 55.
In some embodiments, temperature control and measurements can be run on LabView, and fed into a PID (proportional-integral-derivative) algorithm for IR heating and passive cooling or fan-assisted cooling. This control can be transferred e.g., via Bluetooth to a mobile app (e.g. Science Translational Medicine, doi: 10.1126/scitranslmed.aaa0056).
Current measurements indicate a limit of detection within an order of magnitude of the plate reader measurements shown previously in the amplification results. Optical alignment and electronics optimization can be performed to close this small gap.
In the
The controller determines the temperature inside the reaction container by using the output of the thermometer to measure the temperature in the reference tube, and then making an assumption that the temperature in the reaction container is the same as the temperature in the reference tube. When a fan is used for cooling in these embodiments, the fan should be aimed to blow equal amounts of air on both the reaction container and the reference tube.
A prototype apparatus can be constructed as follows. Infrared LED is positioned underneath a lens and set to directly shine onto the PCR tube. The LED/lens setup is attached to a heat sink and fan to prevent overheating.
The PCR tube was placed at a 45° angle and held in place using a breadboard and brackets (ThorLabs) and a metal adapter (machined in house). An additional fan was positioned perpendicular to the LED and used to cool the sample. K-type thermocouples (Omega) were used to measure temperature.
A 3D-printed ‘thermocouple guide’ was used to position the thermocouple in the PCR tube. A program written in LabView was used to measure temperature, and provide a feedback loop for thermocycling. The program used a PID algorithm to improve temperature holds. For amplification experiments, a thermocycling protocol of 20 seconds at 95° C. followed by 35-40 cycles of 95° C. for 1 second and 60° C. for 2 seconds was used.
Functionalized silica-coated gold nanorods (Au-NRs) were purchased from Nanopartz. Au-NRs had an SPR peak ˜855 (slight variation between batches) and an aspect ratio ˜4.5 nm. The silica coating was 10-nm thick. Amplification with Au-NRs in the mix was tested to demonstrate no inhibition of PCR. For initial compatibility testing, master mix consisting of 5 μL of TaqPath ProAmp MasterMix (ThermoFisher), 0.25 μL Taqman primer/probe mix (40× working concentration, ThermoFisher), 1.75 μL BSA (10 mg/mL in 1× PBS with 0.1% Tween-20), 0.5 μL template DNA (2.5 ng/μL working concentration, IDT) and Au-NRs (final OD 18) and nuclease-free water to a final volume of 10 μL. Standard thermocycling was performed per manufacturer's recommendation in a QuantStudio 3. Fast thermocycling was performed with a 3-minute initial denaturation at 95° C. followed by 40 cycles of 10 seconds at 95° C. and 15 seconds at 60° C.
For experiments involving plasmids, 2019-nCoV N Positive Control plasmid, Hs_RPP30 Positive Control plasmid, and N1 and RP primers and probes were purchased (IDT). The N1 primer/probe set was purchased as part of the 2019-nCoV CDC RUO kit, and the RP primers/probes were purchased individually with the HEX fluorophore instead of the FAM fluorophore (Table 1). RP primers/probes were resuspended in IDTE pH8.0 (IDT) buffer to a working concentration of 6.7 μM for the probe and 1.7 μM for each primer, as indicated in the CDC protocol. For PCR mastermix using plasmids, no BSA was used and 0.375 μL/reaction of primer probe mix was used. Control amplifications were conducted using a ‘fast’ thermocycling protocol which included 20 seconds at 95° C. followed by 35-40 cycles of 95° C. for 1 second and 60° C. for 2 seconds. Negative controls were tested using the same mix and conditions but without template.
Table 2 discloses SEQ ID NOS 1, 2, 7-10, 4, 5, and 11, respectively, in order of appearance.
For experiments involving RT-PCR, genomic RNA from SARS-CoV-2 was purchased (Isolate USA-WA1/2020, BEI Resources). Total control RNA (ThermoFisher) was used as an internal positive control. For reverse transcription and for RT-PCR, a master mix consisting of 2.5 μL TaqPath One-Step RT MasterMix, GC (ThermoFisher), 0.6 primer/probe mix, 1 μL RNA, Au-NRs diluted to a final concentration of OD 18, and RNase-free water to bring the reaction volume up to 10 μL was used. For just reverse transcription, a 15-minute reverse transcription step was performed at 50° C. in the QuantStudio 3. For full RT-PCR, the standard protocol was performed as described in the manufacturer's protocol, as well as a shorter protocol which involved either a 5-, 3-, or 1-minute reverse transcription step followed by 20 seconds at 95° C. and 40 cycles of 1 second at 95° C. and 2 seconds at 60° C. Negative controls were tested with the same mix and conditions but without SARS-CoV-2 RNA and either with and without total control RNA.
For experiments in the prototype (named P1), 10 μL of mix was used with 15-75 μL ChillOut Liquid Wax (Bio-Rad) to prevent evaporation. To test samples for fluorescence, wax was removed and disposed of and the samples were loaded into the plate reader (BioTek) and measured. All samples were normalized to ROX for analysis. For initial experiments on P1, the following thermal cycling protocol was used as controlled in LabView: 5 minutes at 50° C., 20 seconds at 95° C., and 40 cycles of 1 second at 95° C. and 2 seconds at 60° C. For 1-minute RT, the same protocol was used but 1 minute at 50° C. instead of 5 minutes. For ultrafast testing, 1 minute at 50° C. was programmed, followed by 20 seconds at 95° C., followed by a second LabView program which included 40 cycles of 0 seconds at 95° C. and 0 seconds at 60° C. with no PID algorithm involved during the cycles.
De-identified clinical specimens were obtained under a protocol approved by the Columbia University Medical Center IRB (AAAT0100). Saliva specimens were obtained from Mirimus Foundation/SUNY Downstate and stored in −80° C. upon receipt. Mirimus had previously inactivated samples by incubating them at 95° C. for 5 minutes. For initial testing in QuantStudio, some samples were again heated for 5 minutes at 95° C. upon receipt. Samples were diluted 1:2 in 1× TE buffer (10 mM Tris-HCl, 1 mM EDTA) and a master mix containing 5 μL of TaqPath One-Step RT-PCR MasterMix, GC (ThermoFisher), 1 μL N1 primer/probe mix, 1 μL RP primer/probe mix, 3.33 μL Au-NRs (final OD 18), and 9.7 diluted sample was used.
A ‘fast’ RT-PCR step with a 5-minute reverse transcription step was performed as previously described in a QuantStudio 3. For testing of samples using ultrafast thermocycling on P1, samples were maintained at 4° C. upon receipt. Samples were diluted 1:1 in 1× TE buffer and heated for 30 minutes at 95° C. Mastermix was made using 2.5 μL of TaqMan Fast Virus 1-Step Master Mix, 3.1 μL Au-NRs (final OD 18), 0.6 μL N1 primer/probe mix, 0.6 μL RP primer/probe mix, and 3.2 μL diluted and heated sample (or nuclease-free water for NTCs). The ultrafast protocol (i.e. 1 minute at 50° C., 20 seconds at 95° C., and 40 cycles of 0 seconds at 95° C. and 0 seconds at 60° C.) was run and endpoint fluorescence was measured on the plate reader as previously described.
All statistics, including one-way ANOVA followed by Sidak's multiple comparison tests and Student's t-tests were performed in GraphPad Prism 8.
Initial testing with various concentrations of nanoparticles showed the ability to rapidly thermocycle in buffer (
The effects of using of gold nanoparticles (Au-NPs) on inhibiting amplification during PCR is shown in
To determine which runs failed due to instrument failure, a ‘sample processing control’ (SPC) was added to each run. The addition of the SPC showed that there were priming issues with the plasmid. Thus, amplification was tested using reverse transcribed cDNA from human genomic SARS-CoV-2 RNA, which significantly improved the results compared to using plasmids (
Full RT-PCR was performed using the exemplary P1 apparatus. Initial testing with 5.5E5 copies/mL showed a 100% accuracy rate (
The apparatus was able to successfully detect down to 500 copies/mL (
To further minimize the time needed for amplification, the ability to perform significantly faster reverse transcription than traditional protocols was tested. Comparing 15-minute, 5-minute, 3-minute, and 1-minute reverse transcription, there were no significant difference in Ct value or endpoint amplification (
To even further reduce the time necessary for thermal cycling, the PID algorithm was removed during cycling (maintained during static temperature holds) and the holds at the top and bottom during cycling were removed (see materials and methods for exact times). The 1-minute RT step was also implemented. With these changes, we were able to achieve consistent positive results in an average time of 13.7±2.0 minutes (n=10). Here, the limit of detection was found to be 104 copies/mL (
Saliva samples from validated COVID-19 patients were tested using the exemplary apparatus and method using RT-PCR from crude lysates. Without being bound by theory, it is believed that due to the structure of SARS coronavirus capsids, which are self-assembled particles in which the lipid bilayer is a weak spot, that the virus could be lysed without the need for full RNA extraction. Because of the current shortage of RNA extraction kits, simple methods that avoid purification are advantageous (Vasudevan et al., Digital droplet PCR accurately quantifies SARS-CoV-2 viral load from crude lysate without nucleic acid purification, MedRxiv (https://doi.org/10.1101/2020.09.02.20186023); Lalli et al., Rapid and extraction-free detection of SARS-CoV-2 from saliva with colorimetric LAMP, Version 2. medRxiv. Preprint. 2020 May 11 [revised 2020 Aug 6](doi: 10.1101/2020.05.07.20093542); Lübke et al., Extraction-free SARS-CoV-2 detection by rapid RT-qPCR universal for all primary respiratory materials, Journal of Clinical Virology, Volume 130, September 2020 (https://doi. org/10.1016/j cv.2020.104579).
In one aspect, an additional 95° C. heat step was performed to assist in lysis in combination with dilution in TE buffer. Using the Ct (cycle threshold) value, 6/6 positive results were detected (
The ability to detect SARS-CoV-2 RNA in clinical saliva samples using the ultrafast protocol on the exemplary P1 apparatus was tested. Two saliva samples with known positive cases were prepared and tested on P1. For sample R702-7171, two replicates were conducted, and for sample R702B 7-14, four replicates were conducted. All samples tested positive via endpoint fluorescence with a cutoff threshold of 3.5 (
The exemplary apparatus and methods disclosed herein are capable of ultrafast thermocycling and successful RT-PCR using photothermal amplification down to 500 copies/mL for slightly longer runs (<25 minutes) and down to 104 copies/mL for ultrafast runs (<15 minutes). These results also show the ability to perform RT-PCR from crude lysates from saliva samples and detection of SARS-CoV-2 RNA in saliva samples from clinical patients. In one example, the thermometer is a contactless IR thermometer.
Eight positive saliva specimens were analyzed in duplicate and six negative saliva specimens were analyzed on three different instruments, as shown in
In the
For real-time fluorescent monitoring, three common fluorescent probes (FAM, SUN, and ROX) were excited with a common excitation source and detection source (
This setup uses small components, with a total cost of goods less than $1000 at scale to achieve real-time multispectral fluorescence monitoring alongside plasmonic thermocycling.
The
The
In these embodiments, fast thermocycling, and fast RT-PCR amplification of RNA targets using a streamlined workflow can be achieved without a RNA extraction step using optics-based heating. In one embodiment, a K-type wire thermocouple was inserted in the reaction vessel to measure temperature, and a proportional—integral—derivative (PID) control in a LabView-based thermocycling program was incorporated for precise temperature settings. This embodiment achieved initial temperatures for 2 minutes for reverse transcription and 10 seconds for denaturation of initial DNA template, followed by 45 cycles of rapid thermocycling, in 13 minutes total (
Human RNase P (RP) was amplified as an internal sample processing control for all reactions. This experiment produced a limit of detection (LoD) of 5.9×103 copies/mL (
In the
Potential interference of AuNRs in the reaction vessel with fluorescence during a PCR process was examined. In a PCR reaction, despite some fluorescence quenching at a lowered optical density of AuNRs, fluorescence could still be monitored effectively over the duration of a full qPCR amplification process for amplifying spiked SARS-CoV-2 DNA plasmids in human saliva (
The
[Measured data]=A*[FAMspectrum]+B*[SUNspectrum]+C*[ROXspectrum]+D
where D is a constant offset. A standard algorithm (such as a Linear Least Squares Regression algorithm) is then used to find the best-fit coefficients for each of the cycles (e.g., at the end of each cooling cycle). In alternative embodiments, fluorescent dyes other than FAM, SUN, and ROX may be used (e.g., HEX, or another fluorescent dye having an excitation wavelength between 480 and 600 nm and an emission wavelength between 500 and 625 nm).
Based on amplification in the exemplary system and fluorescence measurements of individual targets, the deconvolution algorithm allowed for deconvolution into individual peaks and simultaneous detection of three nucleic-acid targets with three real-time probes tagged with FAM, SUN, and ROX dyes (
Using endpoint fluorescence detection, the ability of the setup, with integrated plasmonic thermocycling and multispectral fluorescence monitoring, to amplify and detect inactivated SARS-CoV-2 virus particles spiked into human saliva was tested. The N1 target, as indicated by FAM, as well as detection of RNase P, as indicated by ROX, were used as initial targets. Using virus concentrations ranging from ˜18,000 to ˜4,000 copies/mL in human saliva as the positive samples (within the range of SARS-CoV-2 virus exhibited in saliva of most patients), the fluorescence values of runs performed on positive samples were clearly distinguishable from those run on samples without templates (NTCs), with the endpoint fluorescent signals across the spectra being proportional to the amount of starting virus in the sample (
Real-time fluorescence monitoring was enabled by modifying the software to trigger the laser and spectrometer after each cycle. Monitoring the fluorescence of FAM and ROX in human saliva showed the amplitude of the spectra increasing with each cycle over time, indicating performance of real-time RT-PCR (
Inactivated SARS-CoV-2 virus spiked into human saliva on the exemplary real-time plasmonic RT-PCR instrument was tested. This test successfully detected virus concentrations as low as 4425 copies/mL (FIG. 27A) (below the viral load in saliva of most COVID-19 human subjects (Wyllie et al., Saliva or Nasopharyngeal Swab Specimens for Detection of SARS-CoV-2, N Engl J Med 2020; 383:1283-1286)). Ct values (used as a control) for human RP were similar across different concentrations of spiked SARS-CoV-2, which was different from NTC (
The
Finally, for the COVID-19 application, the inventors noted that the extraction-free processing of human saliva specimens as input into plasmonic RT-qPCR could potentially result in a simple workflow when considered more broadly from sample collection to result.
Plasmonic RT-qPCR has multiple advantages for diagnosis of COVID-19 and other infectious diseases compared to previous devices and methods. First, since fluorescence measurements do not require the AuNRs to be removed from the vessel, concerns for biosafety for the user at a POC setting are reduced. Second, early real-time monitoring could give rapid results for strongly positive specimens with low Ct values. Third, Ct values are widely analyzed in clinical diagnostics, while not yet conclusive for COVID-19. There is strongly suggestive evidence that Ct values correlate with severity. For example, patients with severe COVID-19 tend to have a high viral load and a long virus-shedding period, pointing to utility of measuring viral load as an indicator of disease severity and prognosis. Fourth, the ability to monitor and detect more than one viral target in addition to a human control target is of increasing relevance for detecting SARS-CoV-2 variants. Fifth, a demonstration of integrated sample-to-result workflow further highlights the potential of plasmonic thermocycling for real clinical utility. Moreover, because of potential shortage of RNA extraction reagents, extraction-free methods that avoid purification could be advantageous. The apparatus and methods described herein demonstrate that use of plasmonic RT-PCR on clinical specimens from sample collection to result, and provide significant workflow advantages (e.g., use of extraction-free saliva analysis). Overall, the quantitation and multiplexing capabilities of the
The
For initial experiments (
Functionalized silica-coated gold nanorods (Au-NRs) were purchased from Nanopartz. Au-NRs had an SPR peak ˜850 nm (slight variation between batches) and an aspect ratio ˜4.5 nm. A 10 nm silica coating was used to prevent adsorption of proteins during the PCR reaction.
PCR reactions used 10 uL 2× PrimeScript III (TaKaRa, 1× final concentration), 0.57 uL Au-NRs (Nanopartz, final concentration OD of 2), 500 nM forward and reverse primers (IDT) and 125 nM probes (IDT). Spiked RNA (BEI) in 1× TE buffer (10 mM Tris-HCl, 1 mM EDTA) or spiked inactivated virus (BEI) in 1:1 mixtures of donor saliva (Innovative Research) and 1× TE buffer were used to bring the reaction volume up to 20 uL. No template controls (NTC) were tested with the same mix and conditions but without SARS-CoV-2 RNA (
Closed-loop thermal cycling conditions for experiments using purified RNA spiked in buffer (
Thermocycling conditions for experiments that used inactivated virus spiked in donor saliva (
Example 21—Methods of Detection of SARS-CoV-2 RNA from Human Saliva Samples
De-identified clinical specimens were obtained under a protocol approved by the Columbia University Medical Center IRB (AAAT0100). Saliva specimens were obtained from Mirimus Foundation and SUNY Downstate and stored at 4° C. upon receipt. Samples tested in
The results were fully concordant with the reference results from Mirimus Foundation, with the exception of one specimen which tested positive from the vendor but which tested negative (in duplicate) on a Quantstudio instrument, pointing to possible RNA degradation during transportation and storage. A sample was considered positive if N1 and/or RP was detected, negative if N1 was not detected and RP was detected, and indeterminate if neither N1 nor RP was detected. For the Rover instrument, all clinical samples were tested once if positive or negative, and twice if indeterminate. If an indeterminate sample tested either positive or negative upon repeating the run, that result was used. A sample was considered negative if RP was detected but N1 was not detected.
Fluorescent measurements (
All statistics, including one-way ANOVA followed by Sidak's multiple comparison tests, and one-way ANOVA followed by Tukey's multiple comparison tests, were performed using GraphPad Prism 9 software.
While the aspects described herein have been disclosed with reference to certain embodiments, numerous modifications, alterations, and changes to the described aspects are possible without departing from the sphere and scope of the present invention, as defined in the appended claims. Accordingly, it is intended that the present invention not be limited to the described aspects, but that it has the full scope defined by the language of the following claims, and equivalents thereof.
This Application is a continuation of International Application PCT/US2021/032404, filed May 14, 2021, which claims the benefit of U.S. Provisional Application 63/025,420, filed May 15, 2020, and US Provisional Application 63/086,956, filed Oct. 2, 2020, each of which is incorporated herein by reference in its entirety. All references cited herein, including but not limited to patents and patent applications, are incorporated by reference in their entirety.
This invention was made with government support under grant HL143541 awarded by the National Institutes of Health. The government has certain rights in the invention.
Number | Date | Country | |
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63025420 | May 2020 | US | |
63086956 | Oct 2020 | US |
Number | Date | Country | |
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Parent | PCT/US2021/032404 | May 2021 | US |
Child | 17986121 | US |