Melanoma is the most deadly form of skin cancer. Although melanoma has a relatively low death rate compared with other cancers as it is generally easy to see on the skin and can be simply removed, it quickly becomes deadly if the superficial tumor metastasizes to other parts of the body. In metastasis, circulating melanoma cells (CMCs), cells that have broken off from the original tumor site and move through the blood or lymphatic system, can plant themselves elsewhere and create secondary tumors that are subsequently the cause for terminal melanoma. Accordingly, early diagnosis will likely be the cure to cancer, as the treatments have higher chances of success because the cancer has not fully manifested itself yet.
Furthermore, it is predicted that in 2010 over 68,000 Americans will be diagnosed with the disease and over 8,000 melanoma patients will die from the illness. Nevertheless, melanoma can be easily cured if it is detected early and quickly removed from the skin; however, if it metastasizes, the cancer can become lethal. Considering that a 1 mm diameter tumor typically consists of one million cells, larger more visible tumors can generally consist of billions of cells. That said, a patient who is diagnosed from a large tumor will have reduced options and will necessitate more physically demanding treatment than a patient who is diagnosed before secondary tumors can form. Unfortunately, patients must currently wait months to know if the superficial melanoma tumor has spread, because the current methods of diagnosing metastatic cancer are through imaging techniques, which require the presence of a visible metastatic tumor. Consequently, patients are oftentimes diagnosed too late.
Current methods for diagnosing metastatic cancer include lymph node biopsies and imaging techniques. However, lymph node biopsies can produce false negatives if the cancer did not interact with the lymphatic system and cannot be performed numerous times for disease monitoring. That said, circulating tumor cells can be an excellent source of information for diagnosis and monitoring of metastatic melanoma and other pathological diseases if they can be detected in the lymphatic system or blood stream. For that reason, many techniques are being investigated to detect and isolate these cells for both diagnostic and disease monitoring purposes. Some research has already been conducted to find CMCs, including RT-PCR, immunohistochemistry, magnetic cell sorting, fiber optic array scanning technology, and microfilters; however, high false negative rates, labeling, and long procedures limit chances of clinical implementation.
Unfortunately, the current methods used to diagnose metastatic disease are not sensitive to single metastatic cells. Patients must wait until secondary tumors are formed before they can be diagnosed and begin life saving treatment.
The present invention is described in detail below with reference to the attached drawing figures, wherein:
Embodiments of the present invention are directed to a label-free method to detect melanoma in vitro in combination with an isolation method that is simple, has a low margin for error, and effective. Metastatic melanoma cells are detected and then isolated from a patient sample, such as a centrifuged blood sample. Isolation of melanoma cells will aid not only in early diagnosis of the patient but there is a positive correlation between the number of circulating tumor cells present in the blood and the prognosis of the patient. Detection of circulating melanoma cells, cells that have broken off from the original tumor site and move through the blood or lymph system, can be diagnostic and monitoring tools for cancer. Being able to isolate and count melanoma cells could be used for monitoring therapies of cancer patients; high cell counts would indicate a severe prognosis, whereas low cell counts would indicate that the treatment is working well.
Detection of metastatic melanoma in the blood is imperative because it eliminates the waiting game for cancer patients. Using embodiments of the present invention, patients can have a simple blood sample scanned for cancer as often as desired instead of waiting months to see if a tumor is visible on a scan. These months could have been spent providing the patients with life saving therapies, as opposed to waiting to see if the cancer has spread, or monitoring whether current therapies are working.
Embodiments of the present invention decrease potential error involved with a normal flow system and allow for preliminary isolation of metastatic melanoma from the patient sample. In one embodiment, the detector includes a laser, transducer, and oscilloscope.
Having briefly described an overview of embodiments of the present invention, exemplary figures depicting embodiments of the present invention are described in order to provide a general context for various aspects of the present invention. With reference to
With reference to
Referring briefly to
With reference to
First fluid 20 and second fluid 22 are fed into a common fluid tube 30 using a connector 28. Common fluid tube 30 is a common channel for the fluids to flow through. The connector 28 depicted in
First fluid 20 and second fluid 22 essentially take turns entering the common fluid tube 30 due to the immiscibility (e.g., oil and water) and/or gas bubble creation (e.g., air and water) of the two fluids. In one embodiment, the immiscibility is due to the hydrophobicity of the first fluid (such as oil) and the hydrophilicity of the second fluid (such as water soluble fluid). As the first fluid 20 enters common fluid tube 30, second fluid 22 builds up pressure until the first fluid 20 stops flowing and second fluid 22 has its turn to flow. This creates alternating discrete compartments of first fluid 20 and second fluid 22 respectively. By introducing two fluids through a connector, such as a T-junction into a single flow path, a substance is compartmentalized. This is ideal because the exact discrete compartment of a first fluid or second fluid in which the substance to be detected is located can be identified and easily extracted. It will be appreciated that the discrete compartments of the first fluid 20 and second fluid 22 as shown in
In embodiments, first fluid 20 is a separator fluid such as air, gas and/or oil for creating discrete compartments of second fluid 22. Second fluid 22 may include any type of fluid that includes a substance to be detected. In one embodiment, second fluid 22 may be any type of fluid containing a biological material or substance, such as cancer cells (breast cancer, melanoma, prostate cancer and the like), tissue, cells, pathogens, microorganisms (such as malaria), infectious diseases, pigment, non-optically absorbing substances with color inducement (e.g., dyes added to non-colored cancer cells or gold nanoparticles added to cells), compounds, non-biological substances and/or foreign bodies from an individual's biological sample including, but not limited to, blood, saliva, urine, fecal material, serum, plasma, tissue and spinal fluid. In another embodiment, second fluid 22 is a non-biological fluid containing biological or non-biological substances such as detecting lead (substance) in water (second fluid). As will be described in more detail below, in one embodiment second fluid 22 is centrifuged white blood cell solution of an individual which may or may not contain melanoma cells. In one embodiment, whole blood samples are taken from melanoma patients and centrifuged, leaving any melanoma in a white blood cell suspension.
The alternating discrete compartments of first fluid 20 and second fluid 22 flow through common tube 30 into the flow chamber 33 within the detection chamber 38 of detector 32. With reference to
In one embodiment, a photoacoustic detector can detect or determine whether or not a fluid contains substances having pigment such as metastatic melanoma which inherently contains melanin, a small pigmented granule. As an individual discrete component of fluid passes through flow chamber 33, it is irradiated by photoacoustic laser source 34 with a rapid pulse of light. It will be appreciated that the laser light may be directed transversely to the flow or along the axis of the flow using an optical waveguide as described with respect to
In this embodiment, as shown in and discussed in more detail below with respect to
Specific discrete compartment(s) detected to contain the substance being tested for, such as melanoma cell(s), can be extracted. With reference to
The extracted discrete compartment may then be diluted and re-passed through the system 10 and repeated until each separate extraction volume of the second fluid 22 contains a single melanoma cell and no white blood cells. As such, the analysis of samples may be conducted iteratively until a desired concentration of a desired substance is detected and/or isolated. In one embodiment, each iteration of the repeated separation reduces the concentration of undesired particles (such as white blood cells) by a particular factor of dilution. For example, a discrete compartment demonstrating a photoacoustic effect (thus indicating that the discrete compartment contains a melanoma cell) can be diluted and re-passed through the system 10 iteratively until the desired melanoma cell is isolated from other undesired particles. The isolated melanoma cell (or other desired particle) can then be analyzed for particular testing, such as gene expression testing, PCR, and the like.
In embodiments, pigmentation is detected due to photoacoustic thermo-elastic expansion when an absorber is struck with a rapid pulse of light; colorless particles remain acoustically transparent allowing numerous cells to cross the detection beam at a time. Accordingly, a multi-phase flowmetry technique adjunct with photoacoustic detection to detect and capture CMCs in vitro is provided. Capture of the detected melanoma cells not only verifies that melanoma is truly being detected; it will also provide cancer biologists with early stage CMCs to study.
With reference to
The multi-phase flow system 10 allows for a sample of interest to be run across a detector to identify if a certain analytes and/or substances are present in the sample. Millions of cells can flow past the detector at a time due to the photoacoustic transparency of white blood cells. This allows for large volumes to be scanned very quickly for circulating melanoma cells.
The multiple phase flow system utilized in Example 1 comprises cylindrical silicone tubing. However, it will be appreciated that other shapes such as square or rectangular could be used. The multiple phase flow system has an inner flow diameter of the channel of about 1.6 mm in diameter. The multiple phase flow system used ranged from 200-300 μL/min. However, the slugs that formed were only 2-3 microliters and the Capillary and Reynolds number stayed within microfluidic conditions. In addition, high flow rates were used so a large blood volume could be examined quickly.
The system utilized a polyvinylidene fluoride (PVDF) “clip” transducer. The sensor may be any piezoelectric material or other non-piezoelectric sound sensor. It will be appreciated that any material may be used so long as it conducts electrical current. Two brass sheets were cut with a hole in the middle and soldered to a BNC coaxial cable connector. Tape separated the brass sheets and PVDF was placed between the brass covering the holes. The transducer was placed into a Polydimethylsiloxane (PDMS) housing that kept both the transducer and flow chamber stationary. The transducer was fitted into the slit and a PDMS ring was placed above the transducer, exposing the PVDF but covering the brass. The PDMS was used to prevent acoustic reflections from the brass that could interfere with melanoma detection.
Next the flow chamber was placed on top of the PDMS ring such that the chamber was directly aligned with the PVDF element. A frequency-tripled, Q-switched Nd:YAG laser (Continuum) fired at the side of the flow chamber at a right angle from the transducer. The laser pulsed at 532 nm, 20 Hz, and between 5-8 mJ for 5 ns pulse duration.
The flow chamber was connected to two syringe pumps; one syringe contained the cell samples and the other contained air. The air is pumped at 0.2 mL/min and the cell samples are pumped at 0.1 mL/min. The syringe pump that housed the cells was set vertically to ensure the cells did not settle to the bottom, therefore the air needed a higher flow rate to compensate for the increased pressure.
Two-phase flow was created using a T-junction, which combines the two separate phases into one flow path while keeping the phases distinct. The phases chosen for use in Example 2 were both water and oil, and air and water. Air and water produced a water slug could easily be extracted without contaminating the sample with the neighboring phase. However, when using air and water the liquids build up pressure and purge the system. Tween 20 was used in the air/water two-phase flow system to reduce the interfacial tension between the phases. A 2% Tween 20 in PBS buffer was used as the water phase. It will be appreciated that other surfactants, such as 2% Tween 80 may also be used to reduce the tension between the phases.
Biological samples were used to show that the multi-phase system is applicable to a clinical environment. Melanoma cells were cultured at the University of Missouri, and all white blood cell samples were obtained from whole blood donated from lab members. The cell culture and enrichment techniques are described below.
Melanoma Cells Suspended in PBS.
An HS 936 melanoma cell line was cultured for use in photoacoustic experiments. The cells were fixed in ethanol and re-suspended in PBS. Approximately 15 minutes before experiments, the cells were diluted with a phosphate buffered saline (PBS)+2% Tween 20 (Fisher Scientific) solution to the desired cell concentration. The cells were then counted manually using a hemoctyometer.
White Blood Cells Suspended in PBS and Melanoma.
White blood cells suspended in PBS were prepared by first obtaining cancer-free whole blood donated from lab members. The blood was poured into a centrifuge tube that contained Histopaque 1077, a material whose density value is between that of white blood cells and red blood cells, and then centrifuged. The white blood cell layer and the contents adjacent to it were removed and then added to smaller diameter centrifuge tube. This tube was centrifuged again and the white blood cell layer was removed and diluted with PBS.
White blood cell samples spiked with melanoma suspended in PBS were prepared by first obtaining whole blood donated from lab members. The blood was again poured into a centrifuge tube that contained Histopaque 1077. Cultured melanoma cells from the HS 936 line were added into the same centrifuge tube. The centrifugation process and the separation procedure remained the same as the White Blood Cell preparation above. The melanoma cells and white blood cells settle to the same layer after centrifugation due to their similar densities.
This layer was isolated and diluted with PBS.
The photoacoustic multi-phase flow system utilized a PVDF piezoelectric transducer while the laser struck at 90° from the transducer element. The alternative is to introduce laser light along the axis of flow utilizing the optical waveguide nature of the system. A single cell is considered an optical point source and will therefore emit photoacoustic waves radially in all directions equally. The flow chamber was held together with an acrylic ring that had three holes drilled at 90° from each other. Masterflex tubing was fed through the holes and a wire with the same outer diameter as the tubing's inner diameter was suspended through the two opposing holes while a second wire was fed through the third hole to prevent acrylamide from entering the tubing hole.
Once the acrylic ring was prepared, Parafilm was stretched across the bottom of the ring and clear acrylamide was poured into the ring, gelling around the tubing and wire. The acrylamide was made from 10 mL of 20% acrylamide solution (Sigma Aldrish), 0.04 g of ammonium persulfate (Sigma Aldrich) and 20 μL of TEMED (Fisher Scientific). After adding the TEMED, the mixture was poured immediately to avoid premature gelling.
After gelling, the wires were removed and the tubing used to hold the optical fiber was pulled out approximately 4 mm. The flow chamber was then ready to be used in the system.
In order to prove that any clinician can successfully operate this system, a blind study was performed to determine if samples that do not contain melanoma can be easily distinguished from samples that do contain melanoma.
Twenty random Boolean values were obtained using a short program made in MATLAB: “0” represented PBS+2% w/v Tween 20 solution, and “1” represented 10 melanoma cells/μL suspended in PBS+2% w/v Tween 20.
Two scientists initially prepared the samples without revealing which samples contained melanoma and which samples did not. Then two different scientists ran the samples through the flow system and were asked to determine which samples had melanoma cells and which did not based on the photoacoustic waves that were seen on the oscilloscope.
The scientists correctly identified all 20 samples, as seen in Table 1. Photoacoustic signals of a baseline and a detected cell sample are shown in
The flow system was prepared using three separate inlets: one syringe pump contained air, one syringe pump contained WBCs in PBS+Tween 20, and one syringe contained cultured melanoma cells in PBS. The WBC+PBS and air formed slugs throughout the system and were used to show that no photoacoustic signals were produced from either air or WBC bubbles. The syringe pump containing white blood cells was stopped and the syringe that contained melanoma was used to manually introduce a melanoma bubble into the flow system in hopes to create photoacoustic waves and then be isolated from the system.
Results
Two-phase flow: Water and oil.
It was observed that two phase flow using oil and air produced uniform, consistent bubbles without any backlogging of the flow system. Water and air.
It was observed that two phase flow using water and air produced inconsistent flow and pressure buildup occasionally purged the flow system.
After 2% Tween 20 was added to the water, consistent and uniform bubbles were produced without undergoing any backlogging.
The system produced a photoacoustic signal from the melanoma bubbles and remained baseline for the WBC and air bubbles as seen in
Although successful bubble formation was achieved using both oil/water and air/water+surfactant, due to the ease of which melanoma cells can be extracted from the flow system, water and air with the addition of a surfactant will be the choice fluids for further studies. The addition of Tween 20 was effective due to its ability to decrease interfacial tension between the two phases allowing water to slide past the air when pressure built up.
The concentration study showed a linear correlation between voltage amplitude and concentration until very low concentrations were investigated. This was expected because the cells do not disseminate homogenously, which is made apparent at low concentrations. Also, as expected the PBS+Tween 20 control did not produce any photoacoustic signals.
The blind study confirmed that this method can be used in a clinical setting to detect melanoma. The melanoma cell capture further proved that the system can effectively isolate detected melanoma cells from the system. In addition, this is a significant step towards both an efficient disease monitoring technique and will enable scientists to study these metastatic cells in hopes of discovering the mechanisms by which they metastasize, survive in the blood and lymphatic systems, and settle in other tissues, so that better therapies for cancer patients and other types of disease can be developed.
The system produced no signals for the PBS baseline, and produced photoacoustic signals from each different concentration of melanoma slugs.
From the foregoing, it will be seen that this invention is one well adapted to attain all the ends and objects hereinabove set forth together with other advantages which are obvious and which are inherent to the structure.
It will be understood that certain features and subcombinations are of utility and may be employed without reference to other features and subcombinations. This is contemplated by and is within the scope of the claims.
Since many possible embodiments may be made of the invention without departing from the scope thereof, it is to be understood that all matter herein set forth or shown in the accompanying drawings is to be interpreted as illustrative and not in a limiting sense.
This application claims priority to U.S. Provisional Application Ser. No. 61/381,809 entitled “MULTIPLE PHASE FLOW SYSTEM FOR DETECTING AND ISOLATING SUBSTANCES,” filed Sep. 10, 2010, the disclosure of which is hereby incorporated by reference as if set forth in its entirety herein.
This invention was made with grant support under Grant No. R21CA139186-0, awarded by the National Institute of Health (NIH). The government has certain rights in this invention.
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