1
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Lebel P, Elledge S, Wiener DM, Jeyakumar I, Phelps M, Jacobsen A, Huynh E, Charlton C, Puccinelli R, Mondal P, Saha S, Tato CM, Gómez-Sjöberg R. A handheld luminometer with sub-attomole limit of detection for distributed applications in global health. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002766. [PMID: 38381748 PMCID: PMC10881016 DOI: 10.1371/journal.pgph.0002766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/08/2023] [Indexed: 02/23/2024]
Abstract
Luminescence is ubiquitous in biology research and medicine. Conceptually simple, the detection of luminescence nonetheless faces technical challenges because relevant signals can exhibit exceptionally low radiant power densities. Although low light detection is well-established in centralized laboratory settings, the cost, size, and environmental requirements of high-performance benchtop luminometers are not compatible with geographically-distributed global health studies or resource-constrained settings. Here we present the design and application of a ~$700 US handheld, battery-powered luminometer with performance on par with high-end benchtop instruments. By pairing robust and inexpensive Silicon Photomultiplier (SiPM) sensors with a low-profile shutter system, our design compensates for sensor non-idealities and thermal drift, achieving a limit of detection of 1.6E-19 moles of firefly luciferase. Using these devices, we performed two pilot cross-sectional serology studies to assess sars-cov-2 antibody levels: a cohort in the United States, as well as a field study in Bangladesh. Results from both studies were consistent with previous work and demonstrate the device's suitability for distributed applications in global health.
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Affiliation(s)
- Paul Lebel
- Chan Zuckerberg Biohub San Francisco, San Francisco, California, United States of America
| | - Susanna Elledge
- University of California, San Francisco, California, United States of America
| | - Diane M. Wiener
- Chan Zuckerberg Biohub San Francisco, San Francisco, California, United States of America
| | - Ilakkiyan Jeyakumar
- Chan Zuckerberg Biohub San Francisco, San Francisco, California, United States of America
| | - Maíra Phelps
- Chan Zuckerberg Biohub San Francisco, San Francisco, California, United States of America
| | - Axel Jacobsen
- Chan Zuckerberg Biohub San Francisco, San Francisco, California, United States of America
| | - Emily Huynh
- Chan Zuckerberg Biohub San Francisco, San Francisco, California, United States of America
| | - Chris Charlton
- Chan Zuckerberg Biohub San Francisco, San Francisco, California, United States of America
| | - Robert Puccinelli
- University of California, Berkeley, California, United States of America
| | | | - Senjuti Saha
- Child Health Research Foundation, Dhaka, Bangladesh
| | - Cristina M. Tato
- Chan Zuckerberg Biohub San Francisco, San Francisco, California, United States of America
| | - Rafael Gómez-Sjöberg
- Chan Zuckerberg Biohub San Francisco, San Francisco, California, United States of America
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2
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van Aalen EA, de Vries IR, Hanckmann ETL, Stevens JRF, Romagnoli TR, Derijks LJJ, Broeren MAC, Merkx M. Point-of-care therapeutic drug monitoring of tumour necrosis factor-α inhibitors using a single step immunoassay. SENSORS & DIAGNOSTICS 2023; 2:1492-1500. [PMID: 38013761 PMCID: PMC10633107 DOI: 10.1039/d3sd00131h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/04/2023] [Indexed: 11/29/2023]
Abstract
Therapeutic drug monitoring (TDM) of tumor necrosis factor-α (TNFα)-inhibitors adalimumab and infliximab is important to establish optimal drug dose and maximize treatment efficacy. Currently, TDM is primarily performed with ELISA techniques in clinical laboratories, resulting in a long sample-to-result workflow. Point-of-care (POC) detection of these therapeutic antibodies could significantly decrease turnaround times and allow for user-friendly home-testing. Here, we adapted the recently developed bioluminescent dRAPPID (dimeric Ratiometric Plug-and-Play Immunodiagnostics) sensor platform to allow POC TDM of infliximab and adalimumab. We applied the two best performing dRAPPID sensors, with limit-of-detections of 1 pM and 17 pM, to measure the infliximab and adalimumab levels in 49 and 40 patient serum samples, respectively. The analytical performance of dRAPPID was benchmarked with commercial ELISAs and yielded Pearson's correlation coefficients of 0.93 and 0.94 for infliximab and adalimumab, respectively. Furthermore, a dedicated bioluminescence reader was fabricated and used as a readout device for the TDM dRAPPID sensors. Subsequently, infliximab and adalimumab patient serum samples were measured with the TDM dRAPPID sensors and bioluminescence reader, yielding Pearson's correlation coefficients of 0.97 and 0.86 for infliximab and adalimumab, respectively, and small proportional differences with ELISA (slope was 0.97 ± 0.09 and 0.96 ± 0.20, respectively). The adalimumab and infliximab dRAPPID sensors, in combination with the dedicated bioluminescence reader, allow for ease-of-use TDM with a fast turnaround time and show potential for POC TDM outside of clinical laboratories.
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Affiliation(s)
- Eva A van Aalen
- Laboratory of Chemical Biology, Department of Biomedical Engineering, Eindhoven University of Technology P.O. Box 513 5600 MB Eindhoven The Netherlands +31 40 247 4728
- Institute for Complex Molecular Systems, Eindhoven University of Technology P.O. Box 513 5600 MB Eindhoven The Netherlands
| | - Ivar R de Vries
- Department of Electrical Engineering, Eindhoven University of Technology P.O. Box 513 5600 MB Eindhoven The Netherlands
| | - Eva T L Hanckmann
- Laboratory of Chemical Biology, Department of Biomedical Engineering, Eindhoven University of Technology P.O. Box 513 5600 MB Eindhoven The Netherlands +31 40 247 4728
- Institute for Complex Molecular Systems, Eindhoven University of Technology P.O. Box 513 5600 MB Eindhoven The Netherlands
| | - Jeannot R F Stevens
- Laboratory of Chemical Biology, Department of Biomedical Engineering, Eindhoven University of Technology P.O. Box 513 5600 MB Eindhoven The Netherlands +31 40 247 4728
- Institute for Complex Molecular Systems, Eindhoven University of Technology P.O. Box 513 5600 MB Eindhoven The Netherlands
| | - Thomas R Romagnoli
- Laboratory of Chemical Biology, Department of Biomedical Engineering, Eindhoven University of Technology P.O. Box 513 5600 MB Eindhoven The Netherlands +31 40 247 4728
- Institute for Complex Molecular Systems, Eindhoven University of Technology P.O. Box 513 5600 MB Eindhoven The Netherlands
| | - Luc J J Derijks
- Department of Clinical Pharmacy and Pharmacology, Máxima Medical Center P.O. Box 7777 5500 MB Veldhoven The Netherlands
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center P.O. Box 5800 6202 AZ Maastricht The Netherlands
| | - Maarten A C Broeren
- Laboratory of Clinical Chemistry and Haematology, Máxima Medical Center P.O. Box 7777 5500 MB Veldhoven The Netherlands
| | - Maarten Merkx
- Laboratory of Chemical Biology, Department of Biomedical Engineering, Eindhoven University of Technology P.O. Box 513 5600 MB Eindhoven The Netherlands +31 40 247 4728
- Institute for Complex Molecular Systems, Eindhoven University of Technology P.O. Box 513 5600 MB Eindhoven The Netherlands
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3
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Li Z, Zhai W, Wang L, Liu J, Li C, Xu L. Preparation and characterization of a homogeneous immunoassay for point-of-care testing (POCT) of procalcitonin (PCT). ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2023; 15:5002-5009. [PMID: 37728429 DOI: 10.1039/d3ay00890h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Procalcitonin (PCT) has been recognized as a specific and early marker for microbial infection and sepsis. Sensitive measuring interaction-triggered luminescence experiment (SMILE), a homogeneous immunoassay method, was established for point-of-care testing (POCT) of PCT. SMILE is achieved through the principle of double antibody sandwich, where two antibodies immobilized on the surface of polystyrene microspheres (donor and acceptor beads) bind to the PCT antigen. The donor bead contains phthalocyanine dye (luminol chemiluminescent substance) and the acceptor bead contains dimethylthiophene derivatives and Eu chelates. Therefore, singlet oxygen can be transferred when the distance between donor and acceptor beads is within 200 nm, generating detectable luminescent signals. Scanning electron microscopy (SEM) was used to detect the diameter and polymer dispersity index (PDI) of microspheres before and after binding with antibodies to characterize the immobilization of antibodies. The reaction conditions for antibody immobilization including pH, mass ratio and reaction time have also been optimized. The limit of quantitation (LOQ) of the SMILE method (0.01 ng mL-1) was lower than that of the LFI method (0.1 ng mL-1), the working range (0.01-500 ng mL-1) was wider than that of the LFI method (0.1-50 ng mL-1), and the assay time (10 min) was shorter than that of the LFI method (15 min). So, SMILE is more suitable for POCT of PCT compared with lateral flow immunochromatography (LFI), which is the most used measuring method, due to its advantages of simple operation, saving time, convenience, wide detection range, and high sensitivity and accuracy.
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Affiliation(s)
- Zhaoying Li
- Graduate School, Tianjin Medical University, Tianjin, 300070, China.
- Tianjin Chest Hospital, Tianjin, 300222, China
| | | | - Lu Wang
- Graduate School, Tianjin Medical University, Tianjin, 300070, China.
- School of Pharmacy, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Jiyang Liu
- Epsilon Biotechnology Corporation, Zhejiang, 311199, China
| | - Chunjie Li
- Tianjin Chest Hospital, Tianjin, 300222, China
| | - Liang Xu
- Graduate School, Tianjin Medical University, Tianjin, 300070, China.
- Tianjin Medical College, Tianjin, 300222, China
- School of Pharmacy, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
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4
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Oliayi M, Emamzadeh R, Rastegar M, Nazari M. Tri-part NanoLuc as a new split technology with potential applications in chemical biology: a mini-review. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2023; 15:3924-3931. [PMID: 37545367 DOI: 10.1039/d3ay00512g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
For several decades, researchers have been using protein-fragment complementation assay (PCA) approaches for biosensing to study protein-protein interaction for a variety of aims, including viral infection, cellular apoptosis, G protein coupled receptor (GPCR) signaling, drug and substrate screening, and protein aggregation and protein editing by CRISPR/Cas9. As a reporter, NanoLuc (NLuc), a smaller and the brightest engineered luciferase derived from deep-sea shrimp Oplophorus gracilirostris, has been found to have many benefits over other luminescent enzymes in PCA. Inspired by the split green fluorescent protein (GFP) and its β-barrel structure, two split NLuc consisting of peptide fragments have been reported including the binary and ternary NLuc systems. NanoBiT® (large fragment + peptide) has been used extensively. In contrast, tripart split NLuc (large fragment + 2 peptides) has been applied and hardly used, while it has some advantages over NanoBiT in some studies. Nevertheless, tripart NLuc has some drawbacks and challenges to overcome but has several potential characteristics to become a multifunctional and powerful tool. In this review, several aspects of tripart NLuc are studied and a brief comparison with NanoBiT® is given.
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Affiliation(s)
- Mina Oliayi
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran.
| | - Rahman Emamzadeh
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran.
| | - Mojgan Rastegar
- Department of Biochemistry and Medical Genetics, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
| | - Mahboobeh Nazari
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
- Nanobiotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.
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5
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Lopez DM, Maltby CJ, Warming H, Divecha N, Vargas-Caballero M, Coldwell MJ, Deinhardt K. A luminescence-based reporter to study tau secretion reveals overlapping mechanisms for the release of healthy and pathological tau. Front Neurosci 2023; 17:1196007. [PMID: 37342467 PMCID: PMC10277490 DOI: 10.3389/fnins.2023.1196007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023] Open
Abstract
In Alzheimer's disease, tau pathology is thought to spread via a prion-like manner along connected neuronal networks. For this to occur, the usually cytosolic tau protein must be secreted via an unconventional mechanism prior to uptake into the connected neuron. While secretion of healthy and pathological tau has been documented, it remains under-investigated whether this occurs via overlapping or distinct processes. Here, we established a sensitive bioluminescence-based assay to assess mechanisms underlying the secretion of pseudohyperphosphorylated and wild-type tau in cultured murine hippocampal neurons. We found that under basal conditions, both wild-type and mutant tau are secreted, with mutant tau being more robustly secreted. Pharmacological stimulation of neuronal activity led to a modest increase of wild-type and mutant tau secretion, whereas inhibition of activity had no effect. Interestingly, inhibition of heparin sulfate proteoglycan (HSPG) biosynthesis drastically decreased secretion of both wild-type and mutant tau without affecting cell viability. This shows that native and pathological tau share release mechanisms; both activity-dependent and non-activity-dependent secretion of tau is facilitated by HSPGs.
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6
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Lyu Y, An L, Zeng H, Zheng F, Guo J, Zhang P, Yang H, Li H. First-passage time analysis of diffusion-controlled reactions in single-molecule detection. Talanta 2023; 260:124569. [PMID: 37116360 DOI: 10.1016/j.talanta.2023.124569] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/21/2023] [Accepted: 04/16/2023] [Indexed: 04/30/2023]
Abstract
Single-molecule detection (SMD) aims to achieve the ultimate limit-of-detection (LOD) in biosensing. This method detects a countable number of targeted analyte molecules in solution, where the dynamics of molecule diffusion, capturing, identification and delivery greatly impact the SMD's efficiency and accuracy. In this study, we adopt the first-passage time method to investigate the diffusion-controlled reaction process in SMD. We analyze the influence of detection conditions on incubation time and the expected coefficient of variation (CV) under three SMD molecule capturing strategies, including solid-phase capturing (one-dimensional solid-liquid interface fixation), liquid-phase magnetic bead (MB) capturing, and liquid-phase direct fluorescence pair labeling. We find that inside a finite-sized reaction chamber, a finite average reaction time exists in all three capturing strategies, while the liquid-phase strategies are in general more efficient than the solid-phase approaches. CV can be estimated by averaging first-passage time solely in all three strategies, and the CV reduction is achievable given an extended reaction time. To further enable zeptomolar detection, extra treatments, such as adopting liquid-phase fluorescence pairs with high diffusion rates to label the molecule, or designing specific sensing devices with large effective sensing areas would be required. This framework provides solid theoretical support to guide the design of SMD sensing strategies and sensor structures to achieve desired measurement time and CV.
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Affiliation(s)
- Yingkai Lyu
- National Innovation Center for Advanced Medical Devices, Shenzhen, China; Bionic Sensing and Intelligence Center, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Lixiang An
- National Innovation Center for Advanced Medical Devices, Shenzhen, China
| | - Huaiyang Zeng
- National Innovation Center for Advanced Medical Devices, Shenzhen, China; Bionic Sensing and Intelligence Center, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Feng Zheng
- National Innovation Center for Advanced Medical Devices, Shenzhen, China
| | - Jiajia Guo
- Bionic Sensing and Intelligence Center, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Pengcheng Zhang
- Bionic Sensing and Intelligence Center, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Hui Yang
- Bionic Sensing and Intelligence Center, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Hao Li
- National Innovation Center for Advanced Medical Devices, Shenzhen, China.
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7
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Rani AQ, Zhu B, Ueda H, Kitaguchi T. Recent progress in homogeneous immunosensors based on fluorescence or bioluminescence using antibody engineering. Analyst 2023; 148:1422-1429. [PMID: 36916979 DOI: 10.1039/d2an01913b] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Homogeneous immunosensors integrate the advantages of both biosensors and immunoassays; they include speed, high sensitivity, and accuracy. They have been developed rapidly in the past few years and offer a cost-effective alternative technology with rapidity, sensitivity, and user-friendliness, which has been applied in a wide variety of applications. This review introduces the current directions of immunosensor development, focusing on fluorescent and bioluminescent immunosensors and highlighting the advantages, improvements, and key approaches to overcome the limitations of each.
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Affiliation(s)
- Abdul Qawee Rani
- Moon Creative Lab Inc., 3-10-5 Kitaaoyama, Minato-ku, Tokyo 107-0061, Japan
| | - Bo Zhu
- Laboratory for Chemistry and Life Science, Institute of Innovative Research, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama 226-8503, Japan.
| | - Hiroshi Ueda
- Laboratory for Chemistry and Life Science, Institute of Innovative Research, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama 226-8503, Japan.
| | - Tetsuya Kitaguchi
- Laboratory for Chemistry and Life Science, Institute of Innovative Research, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama 226-8503, Japan.
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8
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Torio EA, Ressler VT, Kincaid VA, Hurst R, Hall MP, Encell LP, Zimmerman K, Forsyth SK, Rehrauer WM, Accola MA, Hsu CC, Machleidt T, Dart ML. Development of a rapid, simple, and sensitive point-of-care technology platform utilizing ternary NanoLuc. Front Microbiol 2022; 13:970233. [PMID: 36386626 PMCID: PMC9643700 DOI: 10.3389/fmicb.2022.970233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/06/2022] [Indexed: 12/02/2022] Open
Abstract
Point-of-care tests are highly valuable in providing fast results for medical decisions for greater flexibility in patient care. Many diagnostic tests, such as ELISAs, that are commonly used within clinical laboratory settings require trained technicians, laborious workflows, and complex instrumentation hindering their translation into point-of-care applications. Herein, we demonstrate the use of a homogeneous, bioluminescent-based, split reporter platform that enables a simple, sensitive, and rapid method for analyte detection in clinical samples. We developed this point-of-care application using an optimized ternary, split-NanoLuc luciferase reporter system that consists of two small reporter peptides added as appendages to analyte-specific affinity reagents. A bright, stable bioluminescent signal is generated as the affinity reagents bind to the analyte, allowing for proximity-induced complementation between the two reporter peptides and the polypeptide protein, in addition to the furimazine substrate. Through lyophilization of the stabilized reporter system with the formulated substrate, we demonstrate a shelf-stable, all-in-one, add-and-read analyte-detection system for use in complex sample matrices at the point-of-care. We highlight the modularity of this platform using two distinct SARS-CoV-2 model systems: SARS-CoV-2 N-antigen detection for active infections and anti-SARS-CoV-2 antibodies for immunity status detection using chemically conjugated or genetically fused affinity reagents, respectively. This technology provides a simple and standardized method to develop rapid, robust, and sensitive analyte-detection assays with flexible assay formatting making this an ideal platform for research, clinical laboratory, as well as point-of-care applications utilizing a simple handheld luminometer.
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Affiliation(s)
| | | | | | - Robin Hurst
- Promega Corporation, Madison, WI, United States
| | - Mary P Hall
- Promega Corporation, Madison, WI, United States
| | | | | | | | - William M Rehrauer
- Department of Pathology and Laboratory Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- University of Wisconsin Hospital and Clinics, Clinical Laboratories, Madison, WI, United States
| | - Molly A Accola
- University of Wisconsin Hospital and Clinics, Clinical Laboratories, Madison, WI, United States
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9
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Elledge SK, Eigl I, Phelps M, McClinton K, Zhou XX, Leung KK, Tato CM, Wells JA. Using Split Luminescent Biosensors for SARS-CoV-2 Antibody Detection in Serum, Plasma, and Blood Samples. Curr Protoc 2022; 2:e521. [PMID: 36200787 PMCID: PMC9793882 DOI: 10.1002/cpz1.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Antibody detection assays are essential for evaluating immunity of individuals against a given virus, and this has been particularly relevant during the COVID-19 pandemic. Current serology assays either require a laboratory setting and take >1 hr (i.e., enzyme-linked immunosorbent assay [ELISA]) or are rapid but only qualitative in nature and cannot accurately track antibody levels over time (i.e., lateral flow assay [LFA]). Therefore, there is a need for development of a rapid and simple but also quantitative assay that can evaluate antibody levels in patients accurately over time. We have developed an assay that uses a split nanoluciferase fused to the spike or nucleocapsid proteins of the SARS-CoV-2 virus to enable luminescent-based detection of spike- or nucleocapsid-binding antibodies in serum, plasma, and whole blood samples. The resulting approach is simple, rapid, and quantitative and is highly amenable to low-/medium-throughput scale using plate-based assays, high-throughput scale using robotics, and point-of-care applications. In this article, we describe how to perform the assay in a laboratory setting using a plate reader or liquid-handling robotics and in a point-of-care setting using a handheld, battery-powered luminometer. Together, these assays allow antibody detection to be easily performed in multiple settings by simplifying and reducing assay time in a laboratory or clinical environment and by allowing for antibody detection in point-of-care, nonlaboratory settings. © 2022 Wiley Periodicals LLC. Basic Protocol: SARS-CoV-2 antibody detection using the split-luciferase assay on a medium-throughput scale with a laboratory luminometer Alternate Protocol 1: High-throughput-based protocol for SARS-CoV-2 antibody detection using a robotic platform Alternate Protocol 2: Point-of-care-based protocol for SARS-CoV-2 antibody detection using a handheld luminometer Support Protocol: Determining positive/negative cutoffs for test samples and standardizing the assay between days.
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Affiliation(s)
- Susanna K. Elledge
- Department of Pharmaceutical ChemistryUniversity of CaliforniaSan FranciscoCalifornia
| | - Ian Eigl
- Department of Pharmaceutical ChemistryUniversity of CaliforniaSan FranciscoCalifornia
| | | | | | - Xin X. Zhou
- Cancer BiologyDana Farber Cancer InstituteBostonMassachusetts
| | - Kevin K. Leung
- Department of Pharmaceutical ChemistryUniversity of CaliforniaSan FranciscoCalifornia
| | | | - James A. Wells
- Department of Pharmaceutical ChemistryUniversity of CaliforniaSan FranciscoCalifornia,Chan Zuckerberg BiohubSan FranciscoCalifornia,Department of Cellular and Molecular PharmacologyUniversity of CaliforniaSan FranciscoCalifornia
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10
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Kincaid VA, Wang H, Sondgeroth CA, Torio EA, Ressler VT, Fitzgerald C, Hall MP, Hurst R, Wood MG, Gilden JK, Kirkland TA, Lazar D, Chia-Chang H, Encell LP, Machleidt T, Zhou W, Dart ML. Simple, Rapid Chemical Labeling and Screening of Antibodies with Luminescent Peptides. ACS Chem Biol 2022; 17:2179-2187. [PMID: 35862857 PMCID: PMC9396617 DOI: 10.1021/acschembio.2c00306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
![]()
Sensitive and selective detection assays are essential
for the
accurate measurement of analytes in both clinical and research laboratories.
Immunoassays that rely on nonoverlapping antibodies directed against
the same target analyte (e.g., sandwich enzyme-linked immunosorbent
assays (ELISAs)) are commonly used molecular detection technologies.
Use of split enzyme reporters has simplified the workflow for these
traditionally complex assays. However, identifying functional antibody
pairs for a given target analyte can be cumbersome, as it generally
involves generating and screening panels of antibodies conjugated
to reporters. Accordingly, we sought a faster and easier reporter
conjugation strategy to streamline antibody screening. We describe
here the development of such a method that is based on an optimized
ternary NanoLuc luciferase. This bioluminescence complementation system
is comprised of a reagent-based thermally stable polypeptide (LgTrip)
and two small peptide tags (β9 and β10) with lysine-reactive
handles for direct conjugation onto antibodies. These reagents enable
fast, single-step, wash-free antibody labeling and sensitive functional
screening. Simplicity, speed, and utility of the one-pot labeling
technology are demonstrated in screening antibody pairs for the analyte
interleukin-4. The screen resulted in the rapid development of a sensitive
homogeneous immunoassay for this clinically relevant cytokine.
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Affiliation(s)
| | - Hui Wang
- Promega Biosciences LLC, San Luis Obispo, California 93401, United States
| | | | - Emily A Torio
- Promega Corporation, Madison, Wisconsin 53711, United States
| | | | - Connor Fitzgerald
- Promega Biosciences LLC, San Luis Obispo, California 93401, United States
| | - Mary P Hall
- Promega Corporation, Madison, Wisconsin 53711, United States
| | - Robin Hurst
- Promega Corporation, Madison, Wisconsin 53711, United States
| | - Monika G Wood
- Promega Corporation, Madison, Wisconsin 53711, United States
| | - Julia K Gilden
- Promega Corporation, Madison, Wisconsin 53711, United States
| | - Thomas A Kirkland
- Promega Biosciences LLC, San Luis Obispo, California 93401, United States
| | - Dan Lazar
- Promega Corporation, Madison, Wisconsin 53711, United States
| | - Hsu Chia-Chang
- Promega Corporation, Madison, Wisconsin 53711, United States
| | - Lance P Encell
- Promega Corporation, Madison, Wisconsin 53711, United States
| | | | - Wenhui Zhou
- Promega Biosciences LLC, San Luis Obispo, California 93401, United States
| | - Melanie L Dart
- Promega Corporation, Madison, Wisconsin 53711, United States
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11
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Kinnamon DS, Heggestad JT, Liu J, Chilkoti A. Technologies for Frugal and Sensitive Point-of-Care Immunoassays. ANNUAL REVIEW OF ANALYTICAL CHEMISTRY (PALO ALTO, CALIF.) 2022; 15:123-149. [PMID: 35216530 PMCID: PMC10024863 DOI: 10.1146/annurev-anchem-061020-123817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Immunoassays are a powerful tool for sensitive and quantitative analysis of a wide range of biomolecular analytes in the clinic and in research laboratories. However, enzyme-linked immunosorbent assay (ELISA)-the gold-standard assay-requires significant user intervention, time, and clinical resources, making its deployment at the point-of-care (POC) impractical. Researchers have made great strides toward democratizing access to clinical quality immunoassays at the POC and at an affordable price. In this review, we first summarize the commercially available options that offer high performance, albeit at high cost. Next, we describe strategies for the development of frugal POC assays that repurpose consumer electronics and smartphones for the quantitative detection of analytes. Finally, we discuss innovative assay formats that enable highly sensitive analysis in the field with simple instrumentation.
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Affiliation(s)
- David S Kinnamon
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA;
| | - Jacob T Heggestad
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA;
| | - Jason Liu
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA;
| | - Ashutosh Chilkoti
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA;
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12
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Adamson H, Ajayi MO, Gilroy KE, McPherson MJ, Tomlinson DC, Jeuken LJC. Rapid Quantification of C. difficile Glutamate Dehydrogenase and Toxin B (TcdB) with a NanoBiT Split-Luciferase Assay. Anal Chem 2022; 94:8156-8163. [PMID: 35634999 PMCID: PMC9201815 DOI: 10.1021/acs.analchem.1c05206] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
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C. difficile infection (CDI) is a leading healthcare-associated
infection with a high morbidity and mortality and is a financial burden.
No current standalone point-of-care test (POCT) is sufficient for
the identification of true CDI over a disease-free carriage of C. difficile, so one is urgently required to ensure timely,
appropriate treatment. Here, two types of binding proteins, Affimers
and nanobodies, targeting two C. difficile biomarkers,
glutamate dehydrogenase (GDH) and toxin B (TcdB), are combined in
NanoBiT (NanoLuc Binary Technology) split-luciferase assays. The assays
were optimized and their performance controlling parameters were examined.
The 44 fM limit of detection (LoD), 4–5 log range and 1300-fold
signal gain of the TcdB assay in buffer is the best observed for a
NanoBiT assay to date. In the stool sample matrix, the GDH and TcdB
assay sensitivity (LoD = 4.5 and 2 pM, respectively) and time to result
(32 min) are similar to a current, commercial lateral flow POCT, but
the NanoBit assay has no wash steps, detects clinically relevant TcdB
over TcdA, and is quantitative. Development of the assay into a POCT
may drive sensitivity further and offer an urgently needed ultrasensitive
TcdB test for the rapid diagnosis of true CDI. The NanoBiTBiP (NanoBiT
with Binding Proteins) system offers advantages over NanoBiT assays
with antibodies as binding elements in terms of ease of production
and assay performance. We expect this methodology and approach to
be generally applicable to other biomarkers.
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Affiliation(s)
- Hope Adamson
- School of Biomedical Sciences and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Modupe O. Ajayi
- School of Molecular and Cellular Biology and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Kate E. Gilroy
- School of Molecular and Cellular Biology and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Michael J. McPherson
- School of Molecular and Cellular Biology and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Darren C. Tomlinson
- School of Molecular and Cellular Biology and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Lars J. C. Jeuken
- School of Biomedical Sciences and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, United Kingdom
- Leiden Institute of Chemistry, Leiden University, PC Box 9502, 2300 RA, Leiden, The Netherlands
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13
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Liu T, Chen S, Ruan K, Zhang S, He K, Li J, Chen M, Yin J, Sun M, Wang X, Wang Y, Lu Z, Rao H. A handheld multifunctional smartphone platform integrated with 3D printing portable device: On-site evaluation for glutathione and azodicarbonamide with machine learning. JOURNAL OF HAZARDOUS MATERIALS 2022; 426:128091. [PMID: 34952493 DOI: 10.1016/j.jhazmat.2021.128091] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/01/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Azodicarbonamide (ADA) in flour can be easily decomposed to semi-carbazide and biuret, exhibiting strong genotoxicity in vitro and carcinogenicity. Glutathione (GSH) can be conjugated with some ketone-containing compounds and unsaturated aldehydes to form toxic metabolites. Here, a novel ratio fluorescence probe based on blue emitting biomass-derived carbon dots (BCDs) and yellow emitting 2,3-diaminophenazine (OxOPD) was prepared for the bifunctional determination of glutathione (GSH) and ADA. This strategy includes three processes: (1) Ag+ oxidizes o-phenylenediamine (OPD) to produce OxOPD. The peak at 562 nm was enhanced, and the peak at 442 nm was reduced due to fluorescence resonance energy transfer (FRET), (2) glutathione binds Ag+ and inhibits the production of OxOPD, (3) ADA oxidizes GSH to form GSSG, resulting in the release of Ag+ by GSH. Therefore, the newly designed ratio fluorescence probe can be based on the intensity ratio (I442/I562) changes and significant fluorescent color changes to detect GSH and ADA. Moreover, a smartphone WeChat applet and a yolov3-assisted deep learning classification model have been developed to quickly detect GSH and ADA on-site based on an image processing algorithm. These results indicate that smartphone ratiometric fluorescence sensing combined with machine learning has broad prospects for biomedical analysis.
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Affiliation(s)
- Tao Liu
- College of Information Engineering, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China
| | - Suru Chen
- College of Science, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China
| | - Kun Ruan
- College of Information Engineering, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China
| | - Shuxin Zhang
- College of Science, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China
| | - Keqiao He
- College of Science, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China
| | - Jian Li
- College of Science, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China
| | - Maoting Chen
- College of Science, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China
| | - Jiajian Yin
- College of Science, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China
| | - Mengmeng Sun
- College of Science, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China
| | - Xianxiang Wang
- College of Science, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China
| | - Yanying Wang
- College of Science, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China
| | - Zhiwei Lu
- College of Science, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China.
| | - Hanbing Rao
- College of Science, Sichuan Agricultural University, Xin Kang Road, Yucheng District, Ya'an 625014, PR China.
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14
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Lopreside A, Montali L, Wang B, Tassoni A, Ferri M, Calabretta MM, Michelini E. Orthogonal paper biosensor for mercury(II) combining bioluminescence and colorimetric smartphone detection. Biosens Bioelectron 2021; 194:113569. [PMID: 34438340 DOI: 10.1016/j.bios.2021.113569] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 01/02/2023]
Abstract
Mercury contamination in the environment has reached alarming levels. Due to its persistence and bioaccumulation, mercury is one of the most widespread toxic heavy metals found in air, water and food. Thus, it is mandatory to monitor mercury and its compounds, and the availability of sensitive and rapid biosensors is highly valuable. We developed a low-cost biosensor for orthogonal detection of mercury(II) integrating three different biorecognition principles on a three-leaf paper: i) a mercury-specific bioluminescent Escherichia coli bioreporter strain expressing NanoLuc luciferase as reporter protein, ii) a purified β-galactosidase (β-gal) enzyme which is irreversibly inhibited by mercury and other metal ions, and iii) an Aliivibrio fischeri bioluminescent strain which is used to quantitatively assess sample toxicity and correct the analytical signal accordingly. Both sensory elements and substrates, Furimazine for the bioluminescent reporter strain and chlorophenol red-β-D-galactopyranoside for colorimetric detection of β-gal, were integrated in the paper sensor to provide a stable all-in-one disposable cartridge which can be easily snapped into a smartphone with a clover-shaped 3D printed housing. This is the first integration of bioluminescence and colorimetric detection on a smartphone-paper sensor, providing a readout within 15 and 60 min for the colorimetric and bioluminescent detection respectively. The biosensor was applied to water samples spiked with different concentrations of mercury, interferents and toxic chemicals providing a limit of detection for Hg(II) at the ppb levels.
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Affiliation(s)
- Antonia Lopreside
- Department of Chemistry "Giacomo Ciamician", University of Bologna, Via Selmi 2, 40126, Bologna, Italy; Center for Applied Biomedical Research (CRBA), Azienda Ospedaliero-Universitaria Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Laura Montali
- Department of Chemistry "Giacomo Ciamician", University of Bologna, Via Selmi 2, 40126, Bologna, Italy; Center for Applied Biomedical Research (CRBA), Azienda Ospedaliero-Universitaria Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Baojun Wang
- Centre for Synthetic and Systems Biology, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom; Hangzhou Innovation Center, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou, 311200, China
| | - Annalisa Tassoni
- Department of Biological, Geological and Environmental Sciences, University of Bologna, Bologna, Italy
| | - Maura Ferri
- Department of Biological, Geological and Environmental Sciences, University of Bologna, Bologna, Italy; Department of Civil, Chemical Environmental and Materials Engineering, University of Bologna, Bologna, Italy
| | - Maria Maddalena Calabretta
- Department of Chemistry "Giacomo Ciamician", University of Bologna, Via Selmi 2, 40126, Bologna, Italy; Center for Applied Biomedical Research (CRBA), Azienda Ospedaliero-Universitaria Policlinico S. Orsola-Malpighi, Bologna, Italy.
| | - Elisa Michelini
- Department of Chemistry "Giacomo Ciamician", University of Bologna, Via Selmi 2, 40126, Bologna, Italy; Center for Applied Biomedical Research (CRBA), Azienda Ospedaliero-Universitaria Policlinico S. Orsola-Malpighi, Bologna, Italy; Health Sciences and Technologies-Interdepartmental Center for Industrial Research (HST-ICIR), University of Bologna, Bologna, Italy.
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15
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A plug-and-play platform of ratiometric bioluminescent sensors for homogeneous immunoassays. Nat Commun 2021; 12:4586. [PMID: 34321486 PMCID: PMC8319308 DOI: 10.1038/s41467-021-24874-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 07/08/2021] [Indexed: 01/07/2023] Open
Abstract
Heterogeneous immunoassays such as ELISA have become indispensable in modern bioanalysis, yet translation into point-of-care assays is hindered by their dependence on external calibration and multiple washing and incubation steps. Here, we introduce RAPPID (Ratiometric Plug-and-Play Immunodiagnostics), a mix-and-measure homogeneous immunoassay platform that combines highly specific antibody-based detection with a ratiometric bioluminescent readout. The concept entails analyte-induced complementation of split NanoLuc luciferase fragments, photoconjugated to an antibody sandwich pair via protein G adapters. Introduction of a calibrator luciferase provides a robust ratiometric signal that allows direct in-sample calibration and quantitative measurements in complex media such as blood plasma. We developed RAPPID sensors that allow low-picomolar detection of several protein biomarkers, anti-drug antibodies, therapeutic antibodies, and both SARS-CoV-2 spike protein and anti-SARS-CoV-2 antibodies. With its easy-to-implement standardized workflow, RAPPID provides an attractive, fast, and low-cost alternative to traditional immunoassays, in an academic setting, in clinical laboratories, and for point-of-care applications. Many current immunoassays require multiple washing, incubation and optimization steps. Here the authors present Ratiometric Plug-and-Play Immunodiagnostics (RAPPID), a generic assay platform that uses ratiometric bioluminescent detection to allow sandwich immunoassays to be performed directly in solution.
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16
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Calabretta MM, Zangheri M, Calabria D, Lopreside A, Montali L, Marchegiani E, Trozzi I, Guardigli M, Mirasoli M, Michelini E. Paper-Based Immunosensors with Bio-Chemiluminescence Detection. SENSORS (BASEL, SWITZERLAND) 2021; 21:4309. [PMID: 34202483 PMCID: PMC8271422 DOI: 10.3390/s21134309] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/15/2021] [Accepted: 06/21/2021] [Indexed: 12/16/2022]
Abstract
Since the introduction of paper-based analytical devices as potential diagnostic platforms a few decades ago, huge efforts have been made in this field to develop systems suitable for meeting the requirements for the point-of-care (POC) approach. Considerable progress has been achieved in the adaptation of existing analysis methods to a paper-based format, especially considering the chemiluminescent (CL)-immunoassays-based techniques. The implementation of biospecific assays with CL detection and paper-based technology represents an ideal solution for the development of portable analytical devices for on-site applications, since the peculiarities of these features create a unique combination for fitting the POC purposes. Despite this, the scientific production is not paralleled by the diffusion of such devices into everyday life. This review aims to highlight the open issues that are responsible for this discrepancy and to find the aspects that require a focused and targeted research to make these methods really applicable in routine analysis.
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Affiliation(s)
- Maria Maddalena Calabretta
- Department of Chemistry “Giacomo Ciamician”, University of Bologna, 40126 Bologna, Italy; (M.M.C.); (M.Z.); (D.C.); (A.L.); (L.M.); (E.M.); (I.T.); (M.G.)
- Center for Applied Biomedical Research (CRBA), University of Bologna, 40138 Bologna, Italy
| | - Martina Zangheri
- Department of Chemistry “Giacomo Ciamician”, University of Bologna, 40126 Bologna, Italy; (M.M.C.); (M.Z.); (D.C.); (A.L.); (L.M.); (E.M.); (I.T.); (M.G.)
| | - Donato Calabria
- Department of Chemistry “Giacomo Ciamician”, University of Bologna, 40126 Bologna, Italy; (M.M.C.); (M.Z.); (D.C.); (A.L.); (L.M.); (E.M.); (I.T.); (M.G.)
| | - Antonia Lopreside
- Department of Chemistry “Giacomo Ciamician”, University of Bologna, 40126 Bologna, Italy; (M.M.C.); (M.Z.); (D.C.); (A.L.); (L.M.); (E.M.); (I.T.); (M.G.)
- Center for Applied Biomedical Research (CRBA), University of Bologna, 40138 Bologna, Italy
| | - Laura Montali
- Department of Chemistry “Giacomo Ciamician”, University of Bologna, 40126 Bologna, Italy; (M.M.C.); (M.Z.); (D.C.); (A.L.); (L.M.); (E.M.); (I.T.); (M.G.)
- Center for Applied Biomedical Research (CRBA), University of Bologna, 40138 Bologna, Italy
| | - Elisa Marchegiani
- Department of Chemistry “Giacomo Ciamician”, University of Bologna, 40126 Bologna, Italy; (M.M.C.); (M.Z.); (D.C.); (A.L.); (L.M.); (E.M.); (I.T.); (M.G.)
| | - Ilaria Trozzi
- Department of Chemistry “Giacomo Ciamician”, University of Bologna, 40126 Bologna, Italy; (M.M.C.); (M.Z.); (D.C.); (A.L.); (L.M.); (E.M.); (I.T.); (M.G.)
| | - Massimo Guardigli
- Department of Chemistry “Giacomo Ciamician”, University of Bologna, 40126 Bologna, Italy; (M.M.C.); (M.Z.); (D.C.); (A.L.); (L.M.); (E.M.); (I.T.); (M.G.)
- Interdepartmental Centre for Renewable Sources, Environment, Sea and Energy (CIRI FRAME), Alma Mater Studiorum, University of Bologna, 48123 Ravenna, Italy
| | - Mara Mirasoli
- Department of Chemistry “Giacomo Ciamician”, University of Bologna, 40126 Bologna, Italy; (M.M.C.); (M.Z.); (D.C.); (A.L.); (L.M.); (E.M.); (I.T.); (M.G.)
- Interdepartmental Centre for Renewable Sources, Environment, Sea and Energy (CIRI FRAME), Alma Mater Studiorum, University of Bologna, 48123 Ravenna, Italy
- INBB, Istituto Nazionale di Biostrutture e Biosistemi, Via Medaglie d’Oro, 00136 Rome, Italy
| | - Elisa Michelini
- Department of Chemistry “Giacomo Ciamician”, University of Bologna, 40126 Bologna, Italy; (M.M.C.); (M.Z.); (D.C.); (A.L.); (L.M.); (E.M.); (I.T.); (M.G.)
- Center for Applied Biomedical Research (CRBA), University of Bologna, 40138 Bologna, Italy
- INBB, Istituto Nazionale di Biostrutture e Biosistemi, Via Medaglie d’Oro, 00136 Rome, Italy
- Health Sciences and Technologies-Interdepartmental Center for Industrial Research (HST-ICIR), University of Bologna, 40126 Bologna, Italy
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