Continuous-flow, microfluidic, qRT-PCR system for RNA virus detection

AbstractOne of the main challenges in the diagnosis of infectious diseases is the need for rapid and accurate detection of the causative pathogen in any setting. Rapid diagnosis is key to avoiding the spread of the disease, to allow proper clinical decisions to be made in terms of patient treatment, and to mitigate the rise of drug-resistant pathogens. In the last decade, significant interest has been devoted to the development of point-of-care reverse transcription polymerase chain reaction (PCR) platforms for the detection of RNA-based viral pathogens. We present the development of a microfluidic, real-time, fluorescence-based, continuous-flow reverse transcription PCR system. The system incorporates a disposable microfluidic chip designed to be produced industrially with cost-effective roll-to-roll embossing methods. The chip has a long microfluidic channel that directs the PCR solution through areas heated to different temperatures. The solution first travels through a reverse transcription zone where RNA is converted to complementary DNA, which is later amplified and detected in real time as it travels through the thermal cycling area. As a proof of concept, the system was tested for Ebola virus detection. Two different master mixes were tested, and the limit of detection of the system was determined, as was the maximum speed at which amplification occurred. Our results and the versatility of our system suggest its promise for the detection of other RNA-based viruses such as Zika virus or chikungunya virus, which constitute global health threats worldwide. Graphical abstractPhotograph of the RT-PCR thermoplastic chip

[1]  Shanavaz Nasarabadi,et al.  On-chip single-copy real-time reverse-transcription PCR in isolated picoliter droplets. , 2007, Analytical chemistry.

[2]  Angelika Niemz,et al.  Point-of-care nucleic acid testing for infectious diseases. , 2011, Trends in biotechnology.

[3]  B. Hewlett,et al.  Distribution and Numbers of Pygmies in Central African Forests , 2016, PloS one.

[4]  Sabine Dittrich,et al.  Target Product Profile for a Diagnostic Assay to Differentiate between Bacterial and Non-Bacterial Infections and Reduce Antimicrobial Overuse in Resource-Limited Settings: An Expert Consensus , 2016, PloS one.

[5]  Theodore K. Christopoulos,et al.  Continuous-flow DNA and RNA amplification chip combined with laser-induced fluorescence detection , 2003 .

[6]  E. Uberbacher,et al.  Ebolavirus comparative genomics , 2015, FEMS microbiology reviews.

[7]  J. Köhler,et al.  Technical Concept of a Flow‐through Microreactor for In‐situ RT‐PCR , 2008 .

[8]  Karan V. I. S. Kaler,et al.  Droplet Microfluidics for Chip-Based Diagnostics , 2014, Sensors.

[9]  Andre Sharon,et al.  RNA isolation from mammalian cells using porous polymer monoliths: an approach for high-throughput automation. , 2010, Analytical chemistry.

[10]  A. J. Kapasi,et al.  Host Biomarkers for Distinguishing Bacterial from Non-Bacterial Causes of Acute Febrile Illness: A Comprehensive Review , 2016, PloS one.

[11]  T. Ksiazek,et al.  High-throughput molecular detection of hemorrhagic fever virus threats with applications for outbreak settings. , 2007, The Journal of infectious diseases.

[12]  A. Sauer-Budge,et al.  Low-cost, real-time, continuous flow PCR system for pathogen detection , 2016, Biomedical microdevices.

[13]  Armando J. Pinho,et al.  Three minimal sequences found in Ebola virus genomes and absent from human DNA , 2015, Bioinform..

[14]  J. Köhler,et al.  Application of an asymmetric helical tube reactor for fast identification of gene transcripts of pathogenic viruses by micro flow-through PCR , 2009, Biomedical microdevices.

[15]  A StJohn,et al.  Existing and Emerging Technologies for Point-of-Care Testing. , 2014 .

[16]  N. Engel,et al.  Point-of-Care Testing for Infectious Diseases: Diversity, Complexity, and Barriers in Low- And Middle-Income Countries , 2012, PLoS medicine.

[17]  K. Ren,et al.  Materials for microfluidic chip fabrication. , 2013, Accounts of chemical research.

[18]  Da Xing,et al.  Fast identification of foodborne pathogenic viruses using continuous-flow reverse transcription-PCR with fluorescence detection , 2011 .

[19]  Peter J. Asiello,et al.  Miniaturized isothermal nucleic acid amplification, a review. , 2011, Lab on a chip.

[20]  S. Sickafoose,et al.  Low-distortion, high-strength bonding of thermoplastic microfluidic devices employing case-II diffusion-mediated permeant activation. , 2007, Lab on a chip.

[21]  Augustine Goba,et al.  Comprehensive panel of real-time TaqMan polymerase chain reaction assays for detection and absolute quantification of filoviruses, arenaviruses, and New World hantaviruses. , 2010, The American journal of tropical medicine and hygiene.

[22]  C. L. Ventola The antibiotic resistance crisis: part 1: causes and threats. , 2015, P & T : a peer-reviewed journal for formulary management.

[23]  Yi-Wei Tang,et al.  Past, present and future molecular diagnosis and characterization of human immunodeficiency virus infections , 2012, Emerging Microbes & Infections.

[24]  Masato Saito,et al.  Rapid detection for primary screening of influenza A virus: microfluidic RT-PCR chip and electrochemical DNA sensor. , 2011, The Analyst.

[25]  Jie Zhou,et al.  Isothermal amplified detection of DNA and RNA. , 2014, Molecular bioSystems.

[26]  Christl A. Donnelly,et al.  The role of rapid diagnostics in managing Ebola epidemics , 2015, Nature.

[27]  Yi Zhang,et al.  Advances in microfluidic PCR for point-of-care infectious disease diagnostics. , 2011, Biotechnology advances.

[28]  Samuel K Sia,et al.  Lab-on-a-chip devices for global health: past studies and future opportunities. , 2007, Lab on a chip.

[29]  Chunsun Zhang,et al.  PCR microfluidic devices for DNA amplification. , 2006, Biotechnology advances.

[30]  Didier Raoult,et al.  The Point-of-Care Laboratory in Clinical Microbiology , 2016, Clinical Microbiology Reviews.

[31]  John A. Bartlett,et al.  Etiology of Severe Non-malaria Febrile Illness in Northern Tanzania: A Prospective Cohort Study , 2013, PLoS neglected tropical diseases.

[32]  Andre Sharon,et al.  Low cost and manufacturable complete microTAS for detecting bacteria. , 2009, Lab on a chip.

[33]  Karan V. I. S. Kaler,et al.  Multiplex, Quantitative, Reverse Transcription PCR Detection of Influenza Viruses Using Droplet Microfluidic Technology , 2014, Micromachines.

[34]  Stuart T. Nichol,et al.  Rapid Diagnosis of Ebola Hemorrhagic Fever by Reverse Transcription-PCR in an Outbreak Setting and Assessment of Patient Viral Load as a Predictor of Outcome , 2004, Journal of Virology.

[35]  M. Bergeron,et al.  Diagnosing infections--current and anticipated technologies for point-of-care diagnostics and home-based testing. , 2010, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[36]  Manfred Weidmann,et al.  Rapid detection protocol for filoviruses. , 2004, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[37]  K. Mohd Hanafiah,et al.  Point-of-care testing and the control of infectious diseases. , 2013, Biomarkers in medicine.

[38]  T. Renné,et al.  A case of severe Ebola virus infection complicated by gram-negative septicemia. , 2014, The New England journal of medicine.

[39]  Andrew St John,et al.  Existing and Emerging Technologies for Point-of-Care Testing. , 2014, The Clinical biochemist. Reviews.

[40]  J. Crump,et al.  Management of adolescents and adults with febrile illness in resource limited areas , 2011, BMJ : British Medical Journal.

[41]  R. Peeling,et al.  Point-of-care tests for diagnosing infections in the developing world. , 2010, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[42]  Syed A Hashsham,et al.  Miniaturized nucleic acid amplification systems for rapid and point-of-care diagnostics: a review. , 2012, Analytica chimica acta.