Provided herein are quality control substances for use with microscopy-based urine sediment analyzers and methods of using the same.
Microscopy-based urine sediment analyzers evaluate urine samples for the presence of various analytes based on the morphologies of those analytes. To ensure that the sediment analyzers are properly detecting analytes based upon their morphologies, quality controls are required. The current sediment urinalysis quality control (QC) materials, however, do not serve as adequate controls for all common analytes.
Provided herein are quality control substances for use with a microscopy-based urine sediment analyzer, the quality control substance comprising a urine matrix and a cancer cell, an algae cell, a yeast cell, egg white, or any combination thereof.
Methods of detecting the presence of an analyte in a urine sample from a subject are also disclosed herein. The methods comprise analyzing any of the quality control substances disclosed herein with a microscopy-based urine sediment analyzer to determine a morphology of components within the quality control substance and comparing the morphology of the components within the quality control substance to a morphology of analytes within the urine sample, wherein a matching morphology between the analyte and the quality control substance indicates the presence of the analyte in the urine sample.
Also provided are quality control substances for use in identifying the presence of one or more analytes in a urine sample from a subject and the use of a cancer cell, an algae cell, a yeast cell, egg white, or any combination thereof in the manufacture of a quality control substance for use with a microscopy-based urine analyzer.
The summary, as well as the following detailed description, is further understood when read in conjunction with the appended drawings. For the purpose of illustrating the disclosed quality control substances and methods, there are shown in the drawings exemplary embodiments of the quality control substances and methods; however, the quality control substances and methods are not limited to the specific embodiments disclosed. In the drawings:
The disclosed quality control substances and methods may be understood more readily by reference to the following detailed description taken in connection with the accompanying figures, which form a part of this disclosure. It is to be understood that the disclosed quality control substances and methods are not limited to the specific quality control substances and methods described and/or shown herein, and that the terminology used herein is for the purpose of describing particular embodiments by way of example only and is not intended to be limiting of the claimed quality control substances and methods.
Unless specifically stated otherwise, any description as to a possible mechanism or mode of action or reason for improvement is meant to be illustrative only, and the disclosed quality control substances and methods are not to be constrained by the correctness or incorrectness of any such suggested mechanism or mode of action or reason for improvement.
Throughout this text, the descriptions refer to quality control substances and methods of using said quality control substances. Where the disclosure describes or claims a feature or embodiment associated with a quality control substance, such a feature or embodiment is equally applicable to the methods of using said quality control substance. Likewise, where the disclosure describes or claims a feature or embodiment associated with a method of using a quality control substance, such a feature or embodiment is equally applicable to the quality control substance.
It is to be appreciated that certain features of the disclosed quality control substances and methods which are, for clarity, described herein in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the disclosed quality control substances and methods that are, for brevity, described in the context of a single embodiment, may also be provided separately or in any subcombination.
Any reference to “one embodiment” or “an embodiment” means that a particular element, feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. The appearances of the phrase “in one embodiment” in various places in the specification are not necessarily referring to the same embodiment.
Unless expressly stated to the contrary, “or” refers to an inclusive “or” and not to an exclusive “or.” For example, a condition A or B is satisfied by anyone of the following: A is true (or present) and B is false (or not present), A is false (or not present) and B is true (or present), and both A and B are true (or present). An inclusive “or” may be understood as being the equivalent to: at least one of condition A or B.
As used herein, the singular forms “a,” “an,” and “the” include the plural.
Various terms relating to aspects of the description are used throughout the specification and claims. Such terms are to be given their ordinary meaning in the art unless otherwise indicated. Other specifically defined terms are to be construed in a manner consistent with the definitions provided herein.
The term “comprising” is intended to include examples encompassed by the terms “consisting essentially of” and “consisting of”; similarly, the term “consisting essentially of” is intended to include examples encompassed by the term “consisting of.”
The term “negative urine” refers to a urine specimen that exhibits negative results with sediment analysis.
As used herein, the term “urine matrix” refers to urine that is stabilized with an anti-microbial agent such as, for example, with the use of a BD Vacutainer® UA Preservative Tube (BD Diagnostics, Catalog #364992). The difference between native and preserved urine is the presence of a preservative chemical in preserved urine.
The following abbreviations are used throughout the disclosure: bacteria (BAC); crystal (CRY); non-squamous epithelial cells (NEC); pathological cast (PAT); quality control (QC); red blood cell (RBC); urinalysis (UA); white blood cell (WBC); yeast (YEA).
Current commercial QC materials have only some of the sediment analytes found in urine (such as red blood cells (RBC), white blood cells (WBC), and crystal (CRY)). These QC materials, however, do not contain the controls to analyze bacteria (BAC), yeast (YEA), pathological cast (PAT), or non-squamous epithelial cells (NEC). Because the presence of BAC, YEA, PAT, and/or NEC, even in small quantities, can be indicative of pathological conditions, it is important to check that the analyzer is properly detecting these analytes. The instant disclosure provides quality control substances for detection of these analytes.
Provided herein are quality control substances for use with a microscopy-based urine sediment analyzer, the quality control substance comprising:
a urine matrix; and
a cancer cell, an algae cell, a yeast cell, egg white, or any combination thereof.
Cancer cells can be included in the quality control substance to serve as a morphological control for non-squamous epithelial cells present in a urine sample. Suitable cancers cells will have a similar morphology to the non-squamous epithelial cells including a round shape with smooth and defined perimeters, a size in the range of 30-40 micrometer, and granulated cytoplasm and a dark-round nucleus. Suitable cancer cells include SKBR-3 cells or H-1975 cells. SKBR-3 cells are human breast cancer cells and can include ATCC® HTB-30® cells. H-1975 cells are human lung cancer cells and can include ATCC® CRL-5908™ cells. In some embodiments, the quality control substance comprises SKBR-3 cells. In some embodiments, the quality control substance comprises H-1975 cells. In some embodiments, the quality control substance comprises both SKBR-3 and H-1975 cells. SKBR-3 cells can be grown in McCoy's 5A medium with 10% FBS (Fetal bovine serum) and H-1975 cells can be grown in DMEM (Dulbecco's Modified Eagle's Medium). After collecting a sufficient number of cells, the cells can be washed with PBS (phosphate buffer saline) to remove the growth media. The H-1975 cells can then be fixed by incubating the cells at 2-8° C. for 24 hours in 2% formaldehyde in PBS. SKBR-3 cells can be fixed by incubating the cells at 2-8° C. for 24 hours in 2% formaldehyde in PBS. Cells obtained by the above mentioned methods and fixed with glutaraldehyde, or other common cell preservatives (including diazolidinyl urea or imidazolidinyl urea) can be used as a morphological control for non-squamous epithelial cells.
Algae cells can be included in the quality control substance to serve as a morphological control for pathological cast present in a urine sample. Suitable algae cells have a similar morphology to the pathological cast including a cylindrical shape and a granulated interior. Suitable algae cells can comprise, for example, diatom (such as that from Nile Biological Inc.). Diatoms are eukaryotic algae, which, under microscope, appear to have a two parallel edges with granular interior. Such distinct morphological aspect mimics the cylindrical shape and granularity of pathological casts. The diatom algae can be obtained in water suspension. The suspension can be mixed by inverting the container and added (approximately 0.5 mL) to 3 mL negative urine.
Yeast cells can be included in the quality control substance to serve as a morphological control for yeast present in a urine sample. Exemplary yeast include a naturally occurring yeast present in urine or Saccharomyces cerevisiae. In some embodiments, yeast cells (Candida albican) can be isolated from the urine of a control subject (i.e. not the subject whose urine is being analyzed) and added to the quality control substance. In some embodiments, Saccharomyces cerevisiae can be added to the quality control substance. Yeast cells grown in urine medium containing a sucrose solution are correctly recognized as yeast by the sediment analyzers. The yeast cells grown in urine or PBS without sucrose solution, however, are both correctly recognized as yeast and also incorrectly recognized as RBC by the sediment analyzers. (Table 7). Thus, in some embodiments, the yeast cells are present in a solution comprising a sucrose solution or are obtained from a sucrose solution.
Egg white can be included in the quality control substance to serve as morphological control for mucus in urine sample. Egg white is a protein solution with a small quantity of carbohydrate and sodium salt. The egg white mucoid material (approximately 1 mL) can be added into negative urine (3 mL) to create a sample with a positive mucus result.
In some embodiments, the quality control substance can comprise a cancer cell and an algae cell. In some embodiments, the quality control substance can comprise a cancer cell and a yeast cell. In some embodiments, the quality control substance can comprise an algae cell and a yeast cell. In some embodiments, the quality control substance can comprise a cancer cell and egg white. In some embodiments, the quality control substance can comprise an algae cell and egg white. In some embodiments, the quality control substance can comprise a yeast cell and egg white. In some embodiments, the quality control substance can comprise a cancer cell, an algae cell, and egg white. In some embodiments, the quality control substance can comprise an algae cell, a yeast cell, and egg white. In some embodiments, the quality control substance can comprise a cancer cell, an algae cell, and a yeast cell. In some embodiments, the quality control substance can comprise a cancer cell, an algae cell, a yeast cell, and egg white.
The disclosed quality control substances can further comprise a crystal, a bacterial cell, a sperm cell, a white blood cell, a red blood cell, a hyaline cast, or any combination thereof.
Also disclosed are methods of detecting the presence of an analyte in a urine sample from a subject. The disclosed methods comprise analyzing any of the herein disclosed quality control substances with a microscopy-based urine sediment analyzer to determine a morphology of components within the quality control substance and comparing the morphology of the components within the quality control substance to a morphology of analytes within the urine sample, wherein a matching morphology between the analyte and the quality control substance indicates the presence of the analyte in the urine sample.
The disclosed methods can be used to detect the presence of non-squamous epithelial cells within the urine sample. In embodiments wherein the analyte is a non-squamous epithelial cell, the quality control substance can comprise a cancer cell.
The disclosed methods can be used to detect the presence of pathological cast within the urine sample. In embodiments wherein the analyte is a pathological cast, the quality control substance can comprise an algae cell.
The disclosed methods can be used to detect the presence of yeast within the urine sample. In embodiments wherein the analyte is a yeast cell, the quality control substance can comprise a yeast cell.
The disclosed methods can be used to detect the presence of mucus within the urine sample. In embodiments wherein the analyte is mucus, the quality control substance can comprise egg white.
The disclosed methods can be used to detect the presence of: non-squamous epithelial cells and pathological cast; non-squamous epithelial cells and yeast; pathological cast and yeast; non-squamous epithelial cells and mucus; pathological cast and mucus; yeast and mucus; non-squamous epithelial cells, pathological cast, and yeast; non-squamous epithelial cells, pathological cast, and mucus; non-squamous epithelial cells, yeast and mucus; pathological cast, yeast, and mucus; or non-squamous epithelial cells, pathological cast, yeast, and mucus. In embodiments wherein the methods are used to detect a combination of the above analytes, the quality control substances can have a combination of cancer cells (such as SKBR-3 cell or an H-1975 cell), algae cells (such as diatom), yeast cells (such as Candida albican or Saccharomyces cerevisiae), and/or egg whites.
Also provided are quality control substances for use in identifying the presence of one or more analytes in a urine sample from a subject.
The use of a cancer cell, an algae cell, a yeast cell, egg white, or any combination thereof in the manufacture of a quality control substance for use with a microscopy-based urine analyzer are provided herein.
The following examples are provided to further describe some of the embodiments disclosed herein. The examples are intended to illustrate, not to limit, the disclosed embodiments.
RBC positive urine was prepared as follows:
A representative Urised2 image of the sample with targeted RBC concentration 500/μL is shown in
NEC and WBC positive urine samples were created as follows:
The above results indicate that the hybridoma cells are recognized as WBC and NEC by the Urised2.
Preparation of NEC Positive Sample from Human Lung Cancer Epithelial Cells (M1975)
M1975 positive urine was prepared as follows:
The reproducibility of the preparation was tested by separately growing M1975 cells following the above procedure and then adding two different aliquots of cell suspensions (100 μL) in sediment negative urine (5 mL).
Preparation of YEA Positive Sample from Yeast Cells
Yeast positive urine was prepared as follows:
The morphology (round, darker edge) of yeast and red blood cells are very close to each other. Often yeast and red blood cells interfere with each other in microscopy based urinalyses. Similar observations are also found when artificially grown yeast cells are contrived into negative urine sample and analyzed by sediment urinalysis analyzers. Yeast cells grown in the presence of sucrose solution, however, appeared to be detected only as yeast and not falsely detected as red blood cells.
652/μL
Preparation of MUC Positive Sample from Egg White
In general, egg white contains ˜90% water and ˜10% protein as its major components, but also contains a small amount of carbohydrate and sodium salt. The egg white has a thick mucoid appearance. Egg white positive urine was prepared as follows:
Table 8 and
Preparation of Pathological Cast (PAT) Positive Sample from Hydrodictyon Algae
The following procedure was followed to obtain PAT positive urine samples:
The results indicated the presence of PAT (3.08/μL) as shown in
As shown in the above examples, in addition to the similarity in the appearances observed in the microscopy images, the corresponding results from the urine sediment analyzer indicated that the instruments were also recognizing these analogues as urine sediment analytes. The disclosed quality control substances therefore enable better evaluation of the performance of sediment analyzers, which measure pathologically important analytes such as PAT, NEC and YEA.
Those skilled in the art will appreciate that numerous changes and modifications can be made to the preferred embodiments of the quality control substances and methods and that such changes and modifications can be made without departing from the spirit of the disclosed subject matter. It is, therefore, intended that the appended claims cover all such equivalent variations as fall within the true spirit and scope of the invention.
The following list of embodiments is intended to complement, rather than displace or supersede, the previous descriptions.
This application claims priority to U.S. Provisional Application No. 62/550,852, filed Aug. 28, 2017, and U.S. Provisional Application No. 62/608,656, filed Dec. 21, 2017, the disclosure of each of which is hereby incorporated by reference in its entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/US2018/047874 | 8/24/2018 | WO | 00 |
Number | Date | Country | |
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62550852 | Aug 2017 | US | |
62608656 | Dec 2017 | US |