Reverse Transcriptase-polymerase Chain Reaction Kits Research Articles

A rapid RNA extraction-free lateral flow assay for molecular point-of-care detection of SARS-CoV-2 augmented by chemical probes

The coronavirus disease 2019 (COVID-19) pandemic has highlighted the major shortcoming of healthcare systems globally in their inability to diagnose the disease rapidly and accurately. At present, the molecular approaches for diagnosing COVID-19 primarily use reverse transcriptase polymerase chain reaction (RT-PCR) to create and amplify cDNA from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA. Although molecular tests are reported to be specific, false negatives are quite common. Furthermore, literally all these tests require a step involving RNA isolation which does not make them point-of-care (POC) in the true sense. Here, we report a lateral flow strip-based RNA extraction and amplification-free nucleic acid test (NAT) for rapid diagnosis of positive COVID-19 cases at POC. The assay uses highly specific 6-carboxyfluorescein (6-FAM) and biotin labeled antisense oligonucleotides (ASOs) as probes those are designed to target N-gene sequence of SARS-CoV-2. Additionally, we utilized cysteamine capped gold-nanoparticles (Cyst-AuNPs) to augment the signal further for enhanced sensitivity. Without any large-stationary equipment and highly trained staffers, the entire sample-to-answer approach in our case would take less than 30 min from a patient swab sample collection to final diagnostic result. Moreover, when evaluated with 60 clinical samples and verified with an FDA-approved TaqPath RT-PCR kit for COVID-19 diagnosis, the assay obtained almost 99.99% accuracy and specificity. We anticipate that the newly established low-cost amplification-free detection of SARS-CoV-2 RNA will aid in the development of a platform technology for rapid and POC diagnosis of COVID-19 and other pathogens.

Evaluation of a Visually-Read Rapid Antigen Test Kit (SGA V-Chek) for Detection of SARS-CoV-2 Virus

Although the reverse transcriptase polymerase chain reaction (RT-PCR) method has been accepted as the reference method in the detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA, it requires special laboratory conditions, complicated and expensive laboratory instruments, competent laboratory staff and long testing duration. Antigen testing methods such as enzyme immunoassay, fluorescent antibody and visually-read immunochromatographic rapid antigen detection (RAD) tests eliminated the above mentioned disadvantages of the RT-PCR. The aim of this study was to determine the performance of a RAD test kit (V-Chek, SGA Ltd, Ankara, Turkey). Two paired nasopharyngeal swabs were collected from each patient, and one of them was used for the RAD test, while the other one (different swab) was used to perform the RT-PCR test. SARS CoV-2 Double Gene RT-PCR kit (Bioeksen, Turkey) was used for RNA amplification on the Light Cycler 480 plate-based RT-PCR instrument (Roche, Switzerland). The SARS-CoV-2 double gene RT-PCR kit targeting the SARS-CoV-2 specific N (nucleocapsid) and Orf1ab gene regions was used for RNA amplification. The human RNaseP gene was used for nucleic acid extraction and inhibition control. The shape of the growth curves was examined and the non-sigmoidal curves were recorded as "negative". Sigmoidal curves with cycle threshold (Ct) <38 were evaluated as "positive". The Ct values of all positive results were recorded. V-Chek RAD test kit uses a colloidal gold enhanced double antibody sandwich type antigen test kit. A SARS-CoV-2 positive specimen produces a distinct color band in the test region, formed by the specific antibody-antigen colored conjugate complex. A positive or negative result is indicated by a colored line appearance on the test region. A colored line appears in the control region, independent of the SARS-CoV-2 presence. The result is visually read 10 minutes after the last drop of the sample liquid is dispensed into the sample well. Specificity and sensitivity values were calculated accepting the RT-PCR results as a standard. Agreement between two different techniques was assessed using Cohen's kappa score. 110 patients were enrolled in this study; 34 (30.9 %) of these patients had positive RT-PCR samples, with the mean of Ct values of 25.8 (95% CI= 24.1-27.5), median of Ct values of 26. In our study population, the overall sensitivity was 61.8% (95% CI= 45.4-78.1), and specificity was 100%. Taking RT-PCR as reference, Cohen's kappa score for the antigen test was 0.691. Fisher's exact test was p<0.001. In conclusion, the RAD kit used in the study determined to be useful for the rapid identification of COVID-19 patients. However, a negative result does not eliminate the possibility of COVID-19 infection and should be confirmed by RT-PCR and clinical findings.

Laboratory organisation and management of SARS-CoV-2 infection in Niger, West Africa.

BackgroundAs the coronavirus disease 2019 (COVID-19) pandemic unfolds, laboratory services have been identified as key to its containment. This article outlines the laboratory organisation and management and control interventions in Niger.InterventionThe capitol city of Niger, Niamey, adopted a ‘National COVID-19 Emergency Preparedness and Response Plan’ to strengthen the preparedness of the country for the detection of severe acute respiratory syndrome coronavirus-2. Laboratory training and diagnostic capacity building were supported by existing active clinical and research laboratories for more rapid and practicable responses. The National Reference Laboratory for Respiratory Viruses located at the Centre de Recherche Médicale et Sanitaire was designated as the reference centre for COVID-19 testing. The national plan for COVID-19 testing is being gradually adopted in other regions of the country in response to the rapidly evolving COVID-19 emergency and to ensure a more rapid turn-around time.Lessons learntAfter the decentralisation of COVID-19 testing to other regions of the country, turn-around times were reduced from 48–72 h to 12–24 h. Reducing turn-around times allowed Niger to reduce the length of patients’ stays in hospitals and isolation facilities. Shortages in testing capacity must be anticipated and addressed. In an effort to reduce risk of shortages and increase availability of reagents and consumables, Niamey diversified real-time reverse transcriptase–polymerase chain reaction kits for severe acute respiratory syndrome coronavirus-2 detection.RecommendationsContinued investment in training programmes and laboratory strategy is needed in order to strengthen Niger’s laboratory capacity against the outbreak.

Evaluation of four commercial real-time RT-PCR kits for the detection of dengue viruses in clinical samples.

BackgroundDengue is the most frequent arthropod-borne viral disease worldwide. Because dengue manifestations are similar to those of many other febrile syndromes, the availability of dengue-specific laboratory tests is useful for the differential diagnosis. Timely and accurate diagnosis of dengue virus (DENV) infection is important for appropriate management of complications, pathophysiological studies, epidemiological investigations and optimization of vector-control measures. Several “in-house” reverse transcriptase-polymerase chain reaction (RT-PCR) methods have been developed to detect, type and/or quantify DENV. Standardized dengue RT-PCR kits with internal controls have been recently introduced, but need clinical evaluation. We assessed the performances of 4 commercial DENV real-time RT-PCR kits.FindingsThe 4 kits were evaluated using a panel of 162 samples positive with an existing in-place hemi-nested RT-PCR used for routine DENV-infection diagnosis in patients with acute-febrile disease. The panel included 46 DENV-1, 37 DENV-2, 33 DENV-3, and 46 DENV-4. Also, 70 negative serum specimens were used to determine specificity. Geno-Sen’s Dengue 1–4 Real-Time RT-PCR kit was the only assay to provide quantification using standards, but lacked sensitivity for DENV-4 detection. The SimplexaTM Dengue RT-PCR assay, with 151 (93.2% [95% confidence interval, 89.3–97.1]) positive samples, had significantly higher sensitivity than the other 3 kits; in a complementary evaluation of 111 consecutive patients’ samples, its performance and genotyping agreed with the hemi-nested gold-standard assay.ConclusionsThe SimplexaTM Dengue RT-PCR’s good performance to detect and genotype DENV1–4 requires further evaluation in multicenter and prospective studies, particularly in settings of clinical diagnosis during dengue outbreaks.

A Comparative Study for the Efficient Detection of Norovirus from Drinking Water by RT-PCR and Real-Time PCR

Noroviruses (NoV), of the family Caliciviridae, are the most important cause of outbreaks of acute gastroenteritis worldwide. Water can be a source of disease outbreaks. Contamination of drinking water takes place almost exclusively through sewage that contains enteric pathogens. In India, no attempt has been made to detect the presence of norovirus in drinking water earlier and the present study is the first attempt in Chennai to identify norovirus from drinking water. In this study, 100 samples were collected and were concentrated for norovirus using granular activated carbon. The main objective of the study is to compare the efficiency of reverse transcriptase-polymerase chain reaction (RT-PCR) with that of real-time polymerase chain reaction. Conventional RT-PCR was performed using the primers NI and E3 and the results were confirmed by agarose gel electrophoresis as well as by slot blot analysis. Real-time PCR assay was performed using SYBR green RT-PCR Kit. Out of the 100 samples, 18% of the samples were positive by conventional RT-PCR, while 20% were positive by real-time PCR reactions. The real-time PCR assays provide rapid, sensitive, and reliable detection of norovirus and proved to be useful for routine monitoring of drinking water samples.

Semiquantitative Analysis of Arabidopsis RNA by Reverse Transcription Followed by Noncompetitive PCR

INTRODUCTIONThis article describes the analysis of Arabidopsis RNA by reverse transcriptase-polymerase chain reaction (RT-PCR). RNA is first reverse-transcribed into cDNA, which is then amplified by PCR. This method is quick and easy. Although RT-PCR can be performed quantitatively, it is often technically challenging to obtain highly accurate results. We recommend the use of an RT-PCR kit; the procedure given here is adapted from a commercial kit protocol. In the PCR step, it is advisable to use oligonucleotide primers that span at least one intron. In this way, amplification of any contaminating genomic DNA is readily detected, because the product derived from genomic DNA will be larger than the cDNA product. Expression levels are determined by comparing against a gene that is expressed fairly uniformly, such as the ubiquitin gene UBQ10.

Detection of a novel CBFB/MYH11 variant fusion transcript (K-type) showing partial insertion of exon 6 of CBFB gene using two commercially available multiplex RT-PCR kits

We report on a 20-year-old man with acute myeloid leukemia (AML) showing a distinct novel CBFB/MYH11 variant fusion transcript. Initial results of bone marrow, chromosome, and flow cytometric analyses were not in accordance with the diagnosis of acute myelomonocytic leukemia with eosinophilia (AML-M4Eo) or AML with a CBFB/MYH11 rearrangement. However, results from 2 commercially available multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) tests repeatedly showed an unusual PCR product from his bone marrow specimen. Not only does this case show a partial insertion of exon 6 of the CBFB (ENSG00000067955) gene, but it also involves novel breakpoints within both exon 6 of the CBFB gene and exon 28 (previously exon 7) of the MYH11 (ENSG00000133392) gene, which is regarded as a previously non-reported, new type (K-type) of CBFB/MYH11 fusion transcript. In addition, our study result was in agreement with the recent report of Schnittger et al. that rare fusion transcripts of CBFB/MYH11 are correlated with an atypical cytomorphology and other aberrant characteristics. Therefore, multiplex RT-PCR and sequence analysis of these atypical products should be performed to diagnose atypical AML with CBFB/MYH11 rearrangement, to predict prognosis of these patients as well as to elucidate the molecular mechanism.

Lassa Fever, Nigeria, 2003 and 2004

Lassa Fever, Nigeria, 2003 and 2004

Comparative evaluation of phenobarbital-induced CYP3A and CYP2H1 gene expression by quantitative RT-PCR in Bantam, Bantamized White Leghorn and White Leghorn chicks

The present work was to study induction of cytochrome P450 (CYP)3A and CYP2H1 gene by reverse transcriptase polymerase chain reaction (RT-PCR) and quantitative RTPCR in Bantam, Bantamized White Leghorn and White Leghorn chicks. Out of 18 chicks total 3 from each group (Bantam, Bantamized White Leghorn and White Leghorn) were treated intraperitoneal with phenobarbital at the dose rate of 12 mg/100 g (body weight) while the control group was treated with the saline. Total RNA was extracted from the liver samples using Tri Reagent based method. First strand cDNA was synthesized using one step RT-PCR kit. The PCR was performed and the product was subjected to agarose gel electrophoresis. Quantitative RT-PCR was conducted to quantify gene expression level of CYP3A and CYP2H1 genes. Relative expression ratio of CYP3A and CYP2H1 genes was calculated using relative expression software tool (REST). It was found that CYP3A is up regulated by factor of 1.34, 14.51 and 1.00 in Bantam, Bantamized White Leghorn and White Leghorn chicks, respectively. In Bantam and Bantamized White Leghorn chicks CYP2H1 gene was up regulated by factor 1.50 and 80.87, respectively but down regulated by a factor of 1.97 in White Leghorn chicks. The PCR efficiency ranged from 1.30 to 1.70, 0.86 to 1.70 and 0.91 to 1.58 for CYP3A, CYP2H1 and beta-actin, respectively in Bantam, Bantamized White Leghorn and White Leghorn chicks.

Universal diagnostic RT-PCR protocol for arboviruses

A selected number of PCR protocols were evaluated to determine if they could serve as a universal protocol for detecting and identifying all arboviruses. In this study, four parameters that affect the efficacy of RT-PCR (RNA extraction method, choice of reverse transcriptase, choice of DNA polymerase and thermocycling program) were evaluated in combination. The most optimal combination of those parameters employed use of silica gel membrane spin column, RAV-2 reverse transcriptase, Tth DNA polymerase, and a simple modification of a published thermocycling program. By this modified protocol, viral RNA could be amplified satisfactorily with more than 50 pairs of primers designed for diagnosis of arboviruses representing five families. The sensitivity and specificity obtained by this universal protocol were comparable to those obtained by the original protocol for each primer pair tested; and for some primers, improved sensitivity was observed. It was also found that a simple modification of a suggested protocol of a commercial RT-PCR kit could produce nearly identical results and serve as another universal protocol. With the use of a universal diagnostic reverse transcriptase-polymerase chain reaction (RT-PCR) protocol, simultaneous screening of clinical or biological specimens against a large number of RNA viruses belonging to many families can be performed more efficiently for etiologic determination in the situations complicated by the difficulty of differential diagnosis. Furthermore, such a universal protocol facilitates reducing the cost of PCR-based diagnostic operation and standardizing the qualities of PCR-based diagnosis within an institution or among collaborating institutions. A logical strategy is to conduct diagnosis in two stages by using broadly group-reactive primers in the first stage to narrow the range of possible etiologic agents and using virus-specific primers in the second stage for identification. Before such a strategy is employed, however, more group-reactive primers for a large number of arboviruses, for which no such primers currently exist, must be made available. Furthermore, the best pair or pairs of primers need to be selected for each virus for the second stage of the strategy.