The disclosure relates to the field of portable assay devices.
It is known to measure properties of either the liquid or the solid part of a suspension for monitoring health. For example, a blood sample may be used either to measure levels of specific biomarkers in the plasma, or to measure neutrophil levels (part of a white blood cell count). The biomarkers in the plasma may be measured using a lateral flow test. Measurement of neutrophil levels may be conducted using centrifugation as described by Oh H., Siano B., Diamond S. (2008). Neutrophil Isolation Protocol. JoVE. 17. http://www.jove.com/index/Details.stp?ID=745, doi: 10.3791/745.
Conventionally, these known techniques require the action of a trained professional to prepare the sample and to then undertake the desired test. Measurement of both liquid and solid parts of the suspension would require two samples to be processed. Often, the sample is provided by a patient at to a medical centre with a significant time delay between the point in time when the sample is provided and when the sample is processed and results are available.
Against this background, there is provided an assay device configured to separate a suspension into a filtrate and a residue for testing at least one of the filtrate and the residue. The device comprises a filter aperture for a filter membrane for receiving the suspension and separating the suspension into the filtrate and the residue. The device further comprises a filtrate receiving portion for receiving the filtrate. The device further comprises a residue receiving portion for receiving the residue. The device further comprises a first buffer container configured to contain a first buffer liquid. The device further comprises a liquid release member configured to create an outlet of the first buffer container. The device further comprises a filter arm comprising the filter. The device further comprises a user actuated switch configured to be movable from a first set position to a second set position, the user actuated switch comprising a transition structure configured to guide the filter arm. The assay device is configured such that at the first set position the filter aperture is aligned with the filtrate receiving portion. The assay device is further configured such that at the second set position the filter aperture is aligned with the first buffer container and with the residue receiving portion. The assay device is further configured such that during a first transition from the first set position to the second set position the filter arm is moved such that the filter aperture is aligned with the residue receiving portion; and the liquid release member and the first buffer container are brought together such that the liquid release member creates the outlet of the first buffer container.
In this way, a user may separate a suspension into a filtrate and residue in order to test at least one of the filtrate and residue, by simple mechanical actuation of a user actuated switch.
A specific embodiment of the disclosure will now be described, by way of example only, with reference to the accompanying drawings in which:
An assay device according to an embodiment of the present disclosure is configured to separate a suspension into a filtrate and a residue, for testing at least one of the filtrate and the residue.
The assay device comprises a filter aperture for a filter membrane, wherein the filter membrane is used to separate the suspension into the filtrate and the residue. The assay device further comprises a filtrate receiving portion for receiving the filtrate that has passed through the filter aperture. The assay device also comprises a residue receiving portion that may receive the residue that is left on the filter membrane. The residue receiving portion may receive the residue still on the filter membrane, or the residue may be transferred from the filter membrane to the residue receiving portion. The residue may undergo further processing prior to being transferred to the residue receiving portion. A filter arm comprises the filter aperture.
The assay device comprises a first buffer container (also referred to as a processing buffer container) configured to contain a first buffer liquid (also referred to as a processing buffer liquid). A liquid release member is configured to create an outlet in the first buffer container such that the first buffer liquid is released and passes through the filter aperture.
The assay device further comprises a user actuated switch configured to be movable from a first set position to a second set position. The user actuated switch comprises a transition structure configured to guide the filter arm. At the first set position the filter aperture is aligned with the filtrate receiving portion. At the second set position the filter aperture is aligned with the first buffer container and with the residue receiving portion. During a first transition from the first set position to the second set position the filter arm is moved such that the filter aperture is aligned with the residue receiving portion, and the liquid release member and the first buffer container are brought together such that the liquid release member creates the outlet of the first buffer container.
In use, the assay device may begin with the user actuated switch in the first set position. The user deposits the suspension onto a filter membrane that is in the filter aperture. At the first set position, the filter aperture is aligned with the filtrate receiving portion such that when the suspension is deposited on the filter membrane, any filtrate that passes through the filter membrane is received by the filtrate receiving portion. The user moves the user actuated switch from the first set position to the second set position, and during this first transition the filter arm is moved such that the filter aperture is aligned with the residue receiving portion. The liquid release member and the first buffer container are brought together such that the liquid release member creates the outlet of the first buffer container. The first buffer liquid washes through the filter membrane onto the residue receiving portion. The first buffer liquid may process the residue such that a residue component can pass through the filter membrane. The first buffer liquid may also wash the residue component through the filter membrane.
In an embodiment, the filter arm may rest on the transition structure. Moving the user actuated switch moves the transition structure, which in turn guides the filter arm. In an embodiment, the transition structure may comprise a plurality of levels such that moving the transition structure guides the filter arm up or down between the plurality of levels.
In an embodiment, the assay device further comprises a second buffer container (also referred to as a filtering buffer container) configured to contain a second buffer liquid (also referred to as a filtering buffer liquid). The residue receiving portion is configured to receive the residue and the processing buffer liquid through the filter aperture. The filtrate receiving portion may be configured to receive the filtrate and the filtering buffer liquid through the filter aperture. The user actuated switch may be configured to be movable from a third set position to the first set position and from the first set position to the second set position. At the third set position the filter aperture may be aligned with the filtrate receiving portion. At the first set position the filter aperture may be aligned with the filtrate receiving portion and with the filtering buffer container. The liquid release member may be further configured to create an outlet of the filtering buffer container. In use, the assay device may begin with the user actuated switch in the third set position. The user deposits the suspension onto a filter membrane that is in the filter aperture. During a transition from the third set position to the first set position the liquid release member and the filtering buffer container may be brought together such that the liquid release member creates the outlet of the filtering buffer container. The filtering buffer liquid may pass through the filter aperture and be received by the filtrate receiving portion. At the second set position the filter aperture may be aligned with the residue receiving portion and with the processing buffer container. In a transition from the first set position to the second set position the filter arm is moved such that the filter aperture is aligned with the residue receiving portion, and the liquid release member and the processing buffer container are brought together such that the liquid release member creates the outlet of the processing buffer container.
The assay device may be configured such that the filtering buffer liquid washes the filtrate through the filter membrane and onto the filtrate receiving portion. The assay device may be configured such that the processing buffer may process the residue to form a residue component that may pass through the filter membrane. The assay device may be further configured such that the processing buffer washes the residue component through the filter membrane.
In an embodiment, the user actuated switch may be further configured to be movable to a fourth set position, wherein at the fourth set position the filter aperture is aligned with the residue receiving portion and not with the first buffer container (processing buffer container). The assay device may comprise a third buffer container (also referred to as the chasing buffer container) configured to contain a third buffer liquid (also referred to as the chasing buffer liquid), and wherein in the fourth set position the filter aperture is aligned with the residue receiving outlet and the chasing buffer container. The fourth set position may be after the second set position, such that the user actuated switch is configured to be movable from the first set position to the second set position, and from the second set position to the fourth set position. During the transition from the second set position to the fourth set position the liquid release member and the chasing buffer container may be brought together such that the liquid release member creates the outlet of the chasing buffer container. At the fourth set position, the chasing buffer liquid may pass through the filter aperture and be received by the residue receiving portion.
In an embodiment, the assay device may comprise the processing buffer container (wherein the user actuated switch is configured to be movable from the first set position to the second position). In an embodiment, the assay device may comprise the filtering buffer container and the processing buffer container (wherein the user actuated switch is configured to be movable from the third set position to the first set position and from the first set position to the second position). In an embodiment, the assay device may comprise the processing buffer container and the chasing buffer container (wherein the user actuated switch is configured to be movable from the first set position to the second position and from the second set position to the fourth set position). In an embodiment, the assay device may comprise the filtering buffer, the processing buffer container and the chasing buffer container (wherein the user actuated switch is configured to be movable from the third set position to the first set position, from the first set position to the second position and from the second set position to the fourth set position).
In an embodiment the user actuated switch may comprise a dial. The dial may be configured to be rotated from the first set position to the second set position. The dial may be configured to be rotated from the third set position to the first set position and from the first set position to the second set position. The dial may be configured to be rotated from the third set position to the first set position, from the first set position to the second set position, and from the second set position to the fourth set position. The dial may be configured to be rotated from the first set position to the second set position and from the second set position to the fourth set position. The transition structure may be configured to be rotated by rotating the dial.
In another embodiment the user actuated switch may comprise a slider, wherein the slider is configured to be moved from the first set position to the second set position. The slider may be configured to be moved from the third set position to the first set position and from the first set position to the second set position. The slider may be configured to be moved from the first set position to the second set position and from the second set position to the fourth set position. The slider may be configured to be moved from the third set position to the first set position, from the first set position to the second set position, and from the second set position to the fourth set position. The slider may be configured to be moved in one dimension. For example, the slider may be configured to move from the third set position to the first set position and in the same one dimension from the first set position to the second set position. Alternatively, the slider may be configured to be moved in a plurality of dimensions. For example, the slider may be configured to be movable in one dimension from the third set position to the first set position and in a different one dimension from the first set position to the second set position.
In embodiments, the transition structure may comprise a plurality of levels. The plurality of levels of the transition structure may be connected via a plurality of ramps. The transition structure may be configured to guide the filter arm along the plurality of levels and between the plurality of levels, in response to movement of the user actuated switch between the set positions. The filter arm further may comprise a first contact point configured to rest on the transition structure.
In an embodiment the plurality of levels may comprise concentric arcs. Each of the plurality of levels may comprise one or more arcs.
The assay device may further comprise a sample receiving arm comprising the filtrate receiving portion and the residue receiving portion. The transition structure may be configured to guide the sample receiving arm in response to movement of the user actuated switch. The sample receiving arm may further comprise a contact aperture and a second contact point configured to rest on the transition structure, wherein the filter arm rests on the sample receiving arm and wherein the first contact point is configured to pass through the contact aperture and rest on the transition structure. In this way, the sample receiving arm and filter arm may both be guided by the transition structure, but may rest on the same or different levels.
The plurality of levels comprise a first level, a second level below the first level and a third level below the second level. In an embodiment, during the transition from the third set position to the first set position the first contact point may move from the third level to the second level, and the second contact may move from the second level to the first level. In another embodiment, during the first transition the first contact point may move from the second level to the third level and then to the second level, and the second contact point may move from the first level to the second level and then to the first level. The liquid release member may create the outlet of the filtering buffer container when the first contact point moves from the third level to the second level.
In an embodiment, during the transition from the first set position to the second set position the first contact point may move from the second level to the third level, and the second contact point may move from the first level to the second level. The first contact point may then move from the third level to the second level and the second contact point may remain at the second level, such that the upper arm is lifted relative to the lower arm and the upper arm rotates relative to the lower arm such that the filter aperture is aligned with the residue receiving portion. The liquid release member may create the outlet of the processing buffer container when the first contact point moves from the third level to the second level.
In an embodiment, during the transition from the second set position to the fourth set position the first contact point may move from the second level to the third level and the second contact point may remain at the second level. The first contact point may then move from the third level to the second level and the second contact point may move from the second level to the first level. The liquid release member may create the outlet of the chasing buffer container when the first contact point moves from the third level to the second level.
In other embodiments, the transition structure may be configured to rotate the filter arm in response to movement of the user actuated switch between set positions. The user actuated switch may comprise a dial, wherein the dial and the filter arm rotate about the same axis. The assay device may comprise a filtering buffer container and a processing buffer container. In an example the filtering buffer container may be configured to contain a chase buffer and the processing buffer container may be configured to contain a lysis buffer. The dial may be configured to be rotated from the third set position to the first set position and from the first set position to the second set position. As described above, at the third set position the filter aperture may be aligned with the filtrate receiving portion. At the first set position the filter aperture may be aligned with the filtrate receiving portion, and the filtering buffer container may be aligned with the filtrate receiving portion. At the second set position the filter aperture may be aligned with the residue receiving portion and the processing buffer container may be aligned with the residue receiving portion.
In use, the assay device may begin with the user actuated switch in the third set position. The user deposits the suspension onto a filter membrane that is in the filter aperture. During a transition from the third set position to the first set position the filtering buffer container may be moved to be aligned with the filtrate receiving portion, the liquid release member and filtering buffer container may be brought together such that the liquid release member creates the outlet of the filtering buffer container. The filtering buffer liquid may pass through the filter aperture and be received by the filtrate receiving portion. During the transition from the third set position to the first set position the processing buffer container may be moved to be aligned with the residue receiving portion. At the second set position the filter aperture may be aligned with the residue receiving portion and with the processing buffer container. In a transition from the first set position to the second set position the filter arm may be moved such that the filter aperture is aligned with the residue receiving portion, and the liquid release member and the processing buffer container may be brought together such that the liquid release member creates the outlet of the processing buffer container.
The dial may be configured to rotate the filter buffer container and the processing buffer container about the same axis of rotation as the dial and the filter arm.
In an embodiment, at least one of the filtrate receiving portion and the residue receiving portion may comprise a lateral flow strip. In the event that the filtrate receiving portion comprises a lateral flow strip, the filtrate travels along the lateral flow strip. If present, the filtering buffer liquid washes the filtrate along the lateral flow strip. In the event that the residue receiving portion comprises a lateral flow strip, either the processing buffer liquid or the chasing buffer liquid washes along the lateral flow strip.
The filtrate receiving portion may comprise a test for the filtrate and the residue receiving portion may comprise a test for the residue. The filtrate receiving portion may direct the filtrate towards a test, and the residue receiving portion may direct the residue towards a test.
Each of the buffer liquids may comprise any liquid. For example, one or more of the buffer liquids may comprise a liquid configured to maintain a particular pH. One or more of the buffer liquids may comprise deionised water. The processing buffer liquid may comprise a lysing solution configured to lyse a component of a cell from the cell and then to wash the component into the residue receiving portion. The buffer liquids may comprise other liquids not mentioned in the examples provided here.
An additional liquid may be supplied externally. For example, the assay device may comprise a first buffer container configured to contain a first buffer liquid, wherein the assay device is configured to receive an additional buffer liquid externally. The additional liquid may be provided by the user, for example via a pipette. A user may add the first buffer liquid to the first buffer container.
The assay device may comprise a plurality of liquid release members. For example, the assay device may comprise a liquid release member for each buffer container.
A first specific embodiment of the disclosure will now be described, by way of example. It will be understood from the preceding description that this disclosure covers both this first specific example, and other examples.
At the third set position (position a), the filter aperture 410 is aligned with the filtrate receiving portion 510, and the sample receiving aperture 320 is aligned with the filter aperture 410. In use, the user deposits the sample in the sample receiving aperture 320 and the sample passes onto the filter membrane held in the filter aperture 410.
With reference to
With reference to
With reference to
At position a, the first contact point 430 (of the filter arm 400) rests on the second level 220 of the transition structure, and the second contact point 560 (of the sample receiving arm 500) rests on the first level 210. During the transition between the position a and position b, both the first contact point 430 and the second contact point 560 drop one level lower (the first contact point 430 to the third level 230 and the second contact point 560 to the second level 220) so that they avoid interference. Both the first contact point 430 and the second contact point 560 are then raised by one level (the first contact point 430 to the second level 220 and the second contact point 560 to the first level 210) so that the liquid release member 420 makes contact with the filtering buffer container 340 and creates an opening in the filtering buffer container 340 (for example by piercing it). The dial 110 continues rotating (with the first and second contact points 430 and 560 remaining at second and first levels 220 and 210 respectively) such that the liquid release member 420 moves across the filtering buffer container 340, increasing the size of the opening and releasing the filtering buffer liquid. At the end of the transition, the dial 110 reaches the position b, with the first contact point 430 resting on the second level 220 and the second contact point 560 resting on the first level 210. The liquid release member 420 rests at the edge of the filtering buffer container 340.
During the transition from position b to position c, both the first contact point 430 and the second contact point 560 drop one level lower (the first contact point 430 to the third level 230 and the second contact point 560 to the second level 220) so that they avoid interference and the liquid release member 420 is released from the filtering buffer container 340. The second contact point 560 remains at the second level 220. The first contact point 430 moves up one level to the second level 220, so that the filter aperture 410 is translated and is aligned with the residue receiving portion 520. The liquid release member 420 then makes contact with the processing buffer container 350 and creates an opening in the processing buffer container 350 (for example by piercing it). The dial 110 continues rotating (with the first and second contact points 430 and 560 remaining at second level 220) such that the liquid release member 420 moves across the processing buffer container 350, increasing the size of the opening and releasing the processing buffer liquid. At the end of the transition, the dial 110 reaches position c, with both the first contact point 430 and the second contact point 560 resting on the second level 220. The liquid release member 420 rests at the edge of the processing buffer container 350. In the above description the processing buffer liquid is released after the filter arm 400 has moved such that the filter aperture 410 is aligned with the residue receiving portion 520. In another embodiment, the processing buffer liquid may be released while the filter arm 400 is moving.
During the transition from position c to position d, the first contact point 430 drops one level lower to the third level 230, such that the liquid release member 420 exits the third buffer container 350. The second contact point 560 remains at the second level 220. Both first and second contact points 430 and 560 then move up one level (to the second and first levels 220 and 210 respectively) so that the liquid release member 420 then makes contact with the chasing buffer container 360 and creates an opening in the chasing buffer container 360 (for example by piercing it). The dial 110 continues rotating (with the first and second contact points 430 and 560 remaining at second level 220 and first level 210 respectively) such that the liquid release member 420 moves across the chasing buffer container 360, increasing the size of the opening and releasing the chasing buffer liquid. At the end of the transition, the dial 110 reaches position d, with the first contact point 430 resting on the second level 220 and the second contact point 560 resting on the first level 210. The liquid release member 420 rests at the edge of the chasing buffer container 360.
In use, at position a the user deposits a suspension into the sample receiving aperture 320. At this position, the sample receiving aperture 320 is aligned with the filter aperture 410 and the filtrate receiving portion 510. The user moves the dial 110 position a to position b, and in doing so the filtering buffer liquid is released. The filtering buffer liquid washes the filtrate through the filter membrane in the filter aperture 410, leaving the washed residue on the filter membrane. The filtering buffer liquid chases the filtrate into the filtrate receiving portion 510. The user then turns the dial 110 from position b to position c. This causes the filter aperture 410 to move to be aligned with the residue receiving portion 520, after which the processing buffer liquid is released from the processing buffer container. The processing buffer liquid breaks down the residue on the filter membrane, releasing a residue component that can pass through the filter membrane. Finally, the user turns the dial from position c to position d, releasing the chasing buffer liquid that chases the residue component into the residue receiving portion.
In an embodiment, the filtrate receiving portion 510 and the residue receiving portion 520 comprise lateral flow strips. The filtering buffer liquid chases the filtrate along the filtrate a first lateral flow strip, and the chasing buffer liquid chases the residue component along a second lateral flow strip. In an example, the suspension may be blood. The first lateral flow strip may test for a sepsis marker (for example lactate or C-reactive protein CRP) in the filtrate (plasma). The processing buffer liquid lyses the white blood cells, releasing proteins (cellular CD16b). The chasing buffer liquid then chases these proteins down the second lateral flow strip, which measures the CD16b (indicative of white blood cell count). The two lateral flow strips may indicate the sepsis marker level or neutrophil level by matching the intensity of the line formed on the lateral flow strip to a key. The lateral flow strips may also show a control line. The two assays will be discussed in more detail later in the description.
The results of the lateral flow tests may be viewed through the apertures 130 on the top 610 of the housing 120, or in another way.
In an alternative embodiment, where the residue does not require both further processing and a chasing buffer, the fourth set position and the chasing buffer liquid may not be required. In this embodiment the assay device may not comprise the chasing buffer container 360. The user may turn the dial 110 from position a to position b, releasing the filtering buffer liquid to chase the filtrate into the filtrate receiving portion 510. The user may then turn the dial position b to position c, moving the filter aperture to the residue receiving portion 520. The processing buffer liquid may be released processing the residue to allow a residue component to pass through the filter membrane and chasing the processed residue component into the residue receiving portion 520.
In an alternative embodiment, the filtrate may not require a filtering buffer liquid (for example, if the viscosity and volume of the filtrate may be such that it travels into the filtrate receiving portion without assistance from a buffer). In this embodiment the assay device may not comprise the filtering buffer container 340. The user may deposit the sample with the dial at position b. The filtrate may pass into the filtrate receiving portion 510. The user may then turn the dial 110 from position b to position c, moving the filter aperture to the residue receiving portion 520. The processing buffer liquid may be released, processing the residue to allow a residue component to pass through the filter membrane. The user may then turn the dial 110 from position c to position d, releasing the chasing buffer. The chasing buffer may wash the processed residue component into the residue receiving portion 520.
Tests may be performed on the filtrate, or the residue, or both. The filtrate receiving portion 510 and the residue receiving portion 520 may each comprise a lateral flow test strip or a lateral flow dummy strip. The filtrate receiving portion 510 may direct the filtrate to microfluidics. The residue receiving portion 520 may direct the residue to microfluidics. The residue may be eluted from the filter membrane, for example into a vessel or onto a device or test strip. Other assays may be used.
The timings of the transitions are controlled by the geometry of the plurality of levels and the ramps of the transition structure 200. This is a factor in achieving precise timings and volumes of released buffer solutions. In the example given above, the lysing buffer may need a certain amount of time in contact with the cells before the chasing buffer is added.
The user actuated switch may be configured to operate in one direction only, such that the user can move the switch between the set positions only in the intended order. The assay device may comprise a single use snap. The plurality of levels may comprise notches to prevent backwards travel.
The user actuated switch may comprise a dial (wherein the plurality of levels comprise concentric arcs), a slider (wherein the plurality of levels comprise parallel strips), or other mechanism.
The liquid release member 420 in the example discussed above comprises a spike to pierce the buffer containers. The buffer containers may comprise apertures in the dial 110 containing capsules that are configured to be pierced by the liquid release member. The liquid release member may create an opening in the buffer container by other means, for example by exerting pressure in order to burst the buffer container. With reference to
A second specific embodiment of the disclosure will now be described, by way of example. It will be understood from the preceding description that this disclosure covers both this second specific example, and other examples.
With reference to
With reference to
The assay device 2200 will now be further described in the context of the set positions and transitions between the set positions.
With reference to
The buffer cassette 2540 comprises an aperture 2550. At position a, the aperture 2550 is aligned with the sample receiving aperture 2250, the filter aperture 2420, and the filtrate receiving portion. In use, when a user deposits the sample in the sample receiving aperture 2250 of the dial, the sample passes through the aperture 2550 to the filter aperture 2420. The aperture 2550 may comprise a wall 2551 configured to guide the sample to the filter aperture 2420. The buffer cassette 2540 further comprises a filtering buffer container 2560 (also referred to as the second buffer container), a primary piercer 2570 (also referred to as the second liquid release member) configured to create an outlet of the filtering buffer container 2560, a processing buffer container 2580 (also referred to as the first buffer container) and a secondary piercer 2590 (also referred to as the first liquid release member) configured to create an outlet of the processing buffer container 2580. The primary and secondary piercers 2570 and 2590 may each comprise a spike configured to create an outlet of a buffer container, and may be hingedly connected to the buffer cassette such that the primary and secondary piercers 2570 and 2590 may be configured to be in a raised position or a lowered position, wherein pushing the primary and secondary piercers 2570 and 2590 from the raised position to the lowered position creates an outlet in the filtering and processing buffer containers 2560 and 2580 respectively.
In use, the user actuates the dial to move the dial from the third set position (position a) to the first set position (also referred to as position b). The transition from position a to position b may comprise two stages, although the user may turn the dial from a to b in one continuous motion. The user will turn the dial by 270° during this transition, but we will discuss this as being split into a first stage of 180° and a second stage of 90° (experienced by the user as a continuous 270° turn). With reference to
At position b, the filtering buffer container 2560 is aligned with the filtrate receiving portion and the processing buffer container 2580 is aligned with the residue receiving portion, as in the stage shown in
With reference to
During the transition from position b to position c, the filter arm is rotated such that at position c the filter aperture is aligned with the residue receiving portion (as indicated by arrow 2802 in
With reference to
As described earlier, the first and secondary piercers may be pushed down by an actuating post on the underside of the dial 2210. With reference to
In an embodiment, the filtrate receiving portion and the residue receiving portion comprise lateral flow strips. In an example, the suspension may be blood. The first lateral flow strip may test for a sepsis marker such as lactate or C-reactive protein (CRP) in the filtrate (plasma). The filtering buffer liquid chases the filtrate along the filtrate lateral flow strip. The processing buffer liquid lyses the white blood cells, releasing proteins (cellular CD16b). The processing buffer liquid then chases these proteins down the second lateral flow strip, which measures the CD16b (indicative of white blood cell count). The two lateral flow strips may indicate the sepsis marker level or neutrophil level by matching the intensity of the line formed on the lateral flow strip to a key. The lateral flow strips may also show a control line.
The two assays will be discussed in more detail in the following paragraphs. The description of the assays may apply to both the first and second specific examples of the assay device, and to other examples.
An example of a lateral flow test carried out by an assay device according to embodiments of the present disclosure will now be described.
A lateral flow test may comprise a conjugate pad which may contain detection moieties such as labelled binding reagents; a suitable membrane, such as nitrocellulose, comprising a test capture line and optionally a control capture line; and optionally an absorbent pad. In use, the sample containing unknown concentrations of analyte may travel to the conjugate pad where the analyte binds to the detection moiety and travels up the nitrocellulose membrane towards the capture lines. The test line comprises an immobilised binding reagent specific for the target analyte. If present in the sample, the analyte (bound to the detection moiety) will form a complex with immobilised binding reagent resulting in a visible test line. The control line, if present, comprises an immobilised binding reagent specific for a labelled control reagent. A visible label at the control line confirms that the test has run successfully. The presence and amount of label at the capture line(s) may be determined by eye or using a suitable lateral flow device reader such as the Cube (Optricon, Germany).
The first assay analyses the soluble component in the plasma via an enzyme linked assay. Measuring sepsis marker levels (such as lactate levels or CRP levels) in the plasma may be used to test for sepsis. The filtrate receiving portion 510 may comprise a sample pad to which the sample may be added; a conjugate pad which may contain detection moieties such as labelled binding reagents; a suitable membrane, such as nitrocellulose, comprising a test capture line and optionally a control capture line; and optionally an absorbent pad.
The second assay measures the cellular component of the sample. The white blood cells may be lysed and run through an antibody based assay. The residue receiving portion 520 may not comprise a sample pad. The residue receiving portion 520 may comprise a conjugate pad which may contain detection moieties such as labelled binding reagents; a suitable membrane, such as nitrocellulose, comprising a test capture line and optionally a control capture line; and optionally an absorbent pad. The test is for the protein CD16b, which correlates to the neutrophil levels in the blood.
CD16 (a cluster of differentiation molecule found on the surface of certain white blood cells) is an IgG cell surface receptor. It is a type III Fcγ receptor (fragment, crystallisable). In humans it exists in two relatively homologous forms—CD16a and CD16b (also known as FcγRIIIa and FcγRIIIb respectively). CD16a is a transmembrane protein, whereas CD16b is anchored by a glycosyl-phosphatidylinositol (GPI) linker to the plasma membrane (Zhang et al., 2000).
CD16 proteins are expressed on the surface of neutrophils in over 99% of the population. CD16 functions in phagocytosis, degranulation, and oxidative burst. CD16b also specifically functions in removal of soluble immune complexes from blood vasculature. CD16b is expressed on neutrophils and to a far lesser extent on basophils and activated eosinophils, which comprise only 1-5% of all white blood cells.
There is a good positive correlation between the levels of CD16b and neutrophil counts, and so CD16b may be used as a neutrophil cell marker. CD16b may comprise, consist essentially of, or consist of the membrane-anchored form of CD16b (more particularly the glycosylphosphatidylinositol (GPI) anchored form of CD16b) and/or the intracellular form of CD16b. To facilitate the detection of the intracellular form of CD16b, the cell lysis may release the intracellular form of CD16b, or otherwise make it accessible to the detection moiety, such as an anti-CD16b antibody. Cell lysis may, for example, be achieved through the use of a suitable surfactant, which may be ionic or non-ionic, for example Triton x100. As a result of cell lysis, the GPI anchored form of CD16b may be anchored to a cell membrane fraction, or released from the cell membrane.
Both the “GPI anchored form of CD16b” and the “intracellular form of CD16b” may be considered to be a form of CD16b that was not actively shed by a neutrophil, or was not actively shed prior to the sample being taken from the subject. In other words, both the “GPI anchored form of CD16b” and the “intracellular form of CD16b” typically have not been cleaved by a protease such as ADAM17 and therefore typically have an intact stalk region. They may also be referred to as “intact” or “non-truncated” or “non-soluble” CD16b. Preferably, at least a substantial proportion of the soluble form of CD16b is removed from the sample. This should be done prior to lysis, so the earlier step of washing the filtrate through the filter membrane with the filtering buffer liquid may be used to achieve this.
The cells may subsequently be lysed whilst in contact with the filter membrane, for example using a lysis buffer (e.g. containing a surfactant) as the processing buffer liquid. Alternatively, the cells may be eluted from the filter, for example into a vessel or onto a device or test strip.
The CD16b level is indicative of the neutrophil level in the sample. In turn, neutrophil levels below a certain threshold are indicative of neutropenia. Subjects with neutropenia are at an increased risk of neutropenic sepsis. Accordingly, the CD16b level is indicative of neutropenia and may be used to determine the risk of neutropenic sepsis or to diagnose neutropenic sepsis, particularly if the subject has one or more symptoms of infection, such as a temperature of above 38° C. Neutrophil levels above a certain threshold are indicative of sepsis.
Number | Date | Country | Kind |
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2114182.5 | Oct 2021 | GB | national |
Filing Document | Filing Date | Country | Kind |
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PCT/EP2022/077588 | 10/4/2022 | WO |