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Lista MJ, Matos PM, Maguire TJA, Poulton K, Ortiz-Zapater E, Page R, Sertkaya H, Ortega-Prieto AM, Scourfield E, O’Byrne AM, Bouton C, Dickenson RE, Ficarelli M, Jimenez-Guardeño JM, Howard M, Betancor G, Galao RP, Pickering S, Signell AW, Wilson H, Cliff P, Kia Ik MT, Patel A, MacMahon E, Cunningham E, Doores K, Agromayor M, Martin-Serrano J, Perucha E, Mischo HE, Shankar-Hari M, Batra R, Edgeworth J, Zuckerman M, Malim MH, Neil S, Martinez-Nunez RT. Resilient SARS-CoV-2 diagnostics workflows including viral heat inactivation. PLoS One 2021; 16:e0256813. [PMID: 34525109 PMCID: PMC8443028 DOI: 10.1371/journal.pone.0256813] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/17/2021] [Indexed: 12/23/2022] Open
Abstract
There is a worldwide need for reagents to perform SARS-CoV-2 detection. Some laboratories have implemented kit-free protocols, but many others do not have the capacity to develop these and/or perform manual processing. We provide multiple workflows for SARS-CoV-2 nucleic acid detection in clinical samples by comparing several commercially available RNA extraction methods: QIAamp Viral RNA Mini Kit (QIAgen), RNAdvance Blood/Viral (Beckman) and Mag-Bind Viral DNA/RNA 96 Kit (Omega Bio-tek). We also compared One-step RT-qPCR reagents: TaqMan Fast Virus 1-Step Master Mix (FastVirus, ThermoFisher Scientific), qPCRBIO Probe 1-Step Go Lo-ROX (PCR Biosystems) and Luna® Universal Probe One-Step RT-qPCR Kit (Luna, NEB). We used primer-probes that detect viral N (EUA CDC) and RdRP. RNA extraction methods provided similar results, with Beckman performing better with our primer-probe combinations. Luna proved most sensitive although overall the three reagents did not show significant differences. N detection was more reliable than that of RdRP, particularly in samples with low viral titres. Importantly, we demonstrated that heat treatment of nasopharyngeal swabs at 70°C for 10 or 30 min, or 90°C for 10 or 30 min (both original variant and B 1.1.7) inactivated SARS-CoV-2 employing plaque assays, and had minimal impact on the sensitivity of the qPCR in clinical samples. These findings make SARS-CoV-2 testing portable in settings that do not have CL-3 facilities. In summary, we provide several testing pipelines that can be easily implemented in other laboratories and have made all our protocols and SOPs freely available at https://osf.io/uebvj/.
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Affiliation(s)
- Maria Jose Lista
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Pedro M. Matos
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Thomas J. A. Maguire
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Inflammation Biology, School of Immunology and Microbial Sciences, Asthma UK Centre in Allergic Mechanisms of Asthma, King’s College London, London, United Kingdom
| | - Kate Poulton
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Elena Ortiz-Zapater
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Randall Centre for Cell & Molecular Biophysics, King’s College London, London, United Kingdom
- Peter Gorer Department of Immunobiology, King’s College London, London, United Kingdom
| | - Robert Page
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- King’s Health Partners Integrated Cancer Centre, School of Cancer and Pharmaceutical Sciences, Guy’s Hospital, King’s College London, London, United Kingdom
| | - Helin Sertkaya
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Ana M. Ortega-Prieto
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Edward Scourfield
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Aoife M. O’Byrne
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Centre for Inflammation Biology and Cancer Immunology (CIBCI), Centre for Rheumatic Diseases (CRD–EULAR Centre of Excellence), King’s College London, London, United Kingdom
| | - Clement Bouton
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Ruth E. Dickenson
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Mattia Ficarelli
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Jose M. Jimenez-Guardeño
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Mark Howard
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Peter Gorer Department of Immunobiology, King’s College London, London, United Kingdom
| | - Gilberto Betancor
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Rui Pedro Galao
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Suzanne Pickering
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Adrian W. Signell
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Harry Wilson
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Penelope Cliff
- Viapath pathology laboratories at St Thomas’ Hospital, London, United Kingdom
| | - Mark Tan Kia Ik
- Centre for Infectious Diseases Research, St Thomas’ Hospital, London, United Kingdom
| | - Amita Patel
- Centre for Infectious Diseases Research, St Thomas’ Hospital, London, United Kingdom
| | - Eithne MacMahon
- Centre for Infectious Diseases Research, St Thomas’ Hospital, London, United Kingdom
| | - Emma Cunningham
- Centre for Infectious Diseases Research, St Thomas’ Hospital, London, United Kingdom
| | - Katie Doores
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Monica Agromayor
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Juan Martin-Serrano
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Esperanza Perucha
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Centre for Inflammation Biology and Cancer Immunology (CIBCI), Centre for Rheumatic Diseases (CRD–EULAR Centre of Excellence), King’s College London, London, United Kingdom
| | - Hannah E. Mischo
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Manu Shankar-Hari
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Rahul Batra
- Centre for Infectious Diseases Research, St Thomas’ Hospital, London, United Kingdom
| | - Jonathan Edgeworth
- Centre for Infectious Diseases Research, St Thomas’ Hospital, London, United Kingdom
| | - Mark Zuckerman
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- South London Specialist Virology Centre, King’s College Hospital, London, United Kingdom
| | - Michael H. Malim
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Stuart Neil
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Rocio Teresa Martinez-Nunez
- King’s College London Diagnostics Team at Guy’s Campus, London, United Kingdom
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
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Lista MJ, Matos PM, Maguire TJA, Poulton K, Ortiz-Zapater E, Page R, Sertkaya H, Ortega-Prieto AM, O’Byrne AM, Bouton C, Dickenson RE, Ficarelli M, Jimenez-Guardeño JM, Howard M, Betancor G, Galao RP, Pickering S, Signell AW, Wilson H, Cliff P, Ik MTK, Patel A, MacMahon E, Cunningham E, Doores K, Agromayor M, Martin-Serrano J, Perucha E, Mischo HE, Shankar-Hari M, Batra R, Edgeworth J, Zuckerman M, Malim MH, Neil S, Martinez-Nunez RT. Resilient SARS-CoV-2 diagnostics workflows including viral heat inactivation. medRxiv 2021:2020.04.22.20074351. [PMID: 33851184 PMCID: PMC8043481 DOI: 10.1101/2020.04.22.20074351] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There is a worldwide need for reagents to perform SARS-CoV-2 detection. Some laboratories have implemented kit-free protocols, but many others do not have the capacity to develop these and/or perform manual processing. We provide multiple workflows for SARS-CoV-2 nucleic acid detection in clinical samples by comparing several commercially available RNA extraction methods: QIAamp Viral RNA Mini Kit (QIAgen), RNAdvance Blood/Viral (Beckman) and Mag-Bind Viral DNA/RNA 96 Kit (Omega Bio-tek). We also compared One-step RT-qPCR reagents: TaqMan Fast Virus 1-Step Master Mix (FastVirus, ThermoFisher Scientific), qPCRBIO Probe 1-Step Go Lo-ROX (PCR Biosystems) and Luna ® Universal Probe One-Step RT-qPCR Kit (Luna, NEB). We used primer-probes that detect viral N (EUA CDC) and RdRP (PHE guidelines). All RNA extraction methods provided similar results. FastVirus and Luna proved most sensitive. N detection was more reliable than that of RdRP, particularly in samples with low viral titres. Importantly, we demonstrate that treatment of nasopharyngeal swabs with 70 degrees for 10 or 30 min, or 90 degrees for 10 or 30 min (both original variant and B 1.1.7) inactivates SARS-CoV-2 employing plaque assays, and that it has minimal impact on the sensitivity of the qPCR in clinical samples. These findings make SARS-CoV-2 testing portable to settings that do not have CL-3 facilities. In summary, we provide several testing pipelines that can be easily implemented in other laboratories and have made all our protocols and SOPs freely available at https://osf.io/uebvj/ .
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Affiliation(s)
- Maria Jose Lista
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
- All these authors contributed equally to the completion of this work
| | - Pedro M. Matos
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
- All these authors contributed equally to the completion of this work
| | - Thomas J. A. Maguire
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Inflammation Biology, School of Immunology and Microbial Sciences. Asthma UK Centre in Allergic Mechanisms of Asthma. Guy’s Campus, King’s College London SE1 9RT, UK
- All these authors contributed equally to the completion of this work
| | - Kate Poulton
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
- All these authors contributed equally to the completion of this work
| | - Elena Ortiz-Zapater
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Randall Centre for Cell & Molecular Biophysics. Guy’s Campus, King’s College London, SE1 1UL, UK
- Peter Gorer Department of Immunobiology. Guy’s Campus, King’s College London, SE1 9RT, UK
| | - Robert Page
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Inflammation Biology, School of Immunology and Microbial Sciences. Asthma UK Centre in Allergic Mechanisms of Asthma. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Helin Sertkaya
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Ana M. Ortega-Prieto
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Aoife M. O’Byrne
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Centre for Inflammation Biology and Cancer Immunology (CIBCI). Centre for Rheumatic Diseases (CRD – EULAR Centre of Excellence). Guy’s Campus, King’s College London SE1 1UL, UK
| | - Clement Bouton
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Ruth E Dickenson
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Mattia Ficarelli
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Jose M. Jimenez-Guardeño
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Mark Howard
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Peter Gorer Department of Immunobiology. Guy’s Campus, King’s College London, SE1 9RT, UK
| | - Gilberto Betancor
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Rui Pedro Galao
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Suzanne Pickering
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Adrian W Signell
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Harry Wilson
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | | | - Mark Tan Kia Ik
- Centre for Infectious Diseases Research, St Thomas’ Hospital (London, UK)
| | - Amita Patel
- Centre for Infectious Diseases Research, St Thomas’ Hospital (London, UK)
| | - Eithne MacMahon
- Centre for Infectious Diseases Research, St Thomas’ Hospital (London, UK)
| | - Emma Cunningham
- Centre for Infectious Diseases Research, St Thomas’ Hospital (London, UK)
| | - Katie Doores
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Monica Agromayor
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Juan Martin-Serrano
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Esperanza Perucha
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Centre for Inflammation Biology and Cancer Immunology (CIBCI). Centre for Rheumatic Diseases (CRD – EULAR Centre of Excellence). Guy’s Campus, King’s College London SE1 1UL, UK
| | - Hannah E. Mischo
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Manu Shankar-Hari
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Rahul Batra
- Centre for Infectious Diseases Research, St Thomas’ Hospital (London, UK)
| | - Jonathan Edgeworth
- Centre for Infectious Diseases Research, St Thomas’ Hospital (London, UK)
| | - Mark Zuckerman
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Virology. King’s College Hospital (London, UK)
| | - Michael H. Malim
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Stuart Neil
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
| | - Rocio Teresa Martinez-Nunez
- King’s College London Diagnostics Team at Guy’s Campus (London, UK)
- Dept. Infectious Diseases, School of Immunology and Microbial Sciences. Guy’s Campus, King’s College London SE1 9RT, UK
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Wells PM, Doores KJ, Couvreur S, Nunez RM, Seow J, Graham C, Acors S, Kouphou N, Neil SJD, Tedder RS, Matos PM, Poulton K, Lista MJ, Dickenson RE, Sertkaya H, Maguire TJA, Scourfield EJ, Bowyer RCE, Hart D, O'Byrne A, Steel KJA, Hemmings O, Rosadas C, McClure MO, Capedevilla-Pujol J, Wolf J, Ourselin S, Brown MA, Malim MH, Spector T, Steves CJ. Estimates of the rate of infection and asymptomatic COVID-19 disease in a population sample from SE England. J Infect 2020; 81:931-936. [PMID: 33068628 PMCID: PMC7557299 DOI: 10.1016/j.jinf.2020.10.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/11/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Understanding of the true asymptomatic rate of infection of SARS-CoV-2 is currently limited, as is understanding of the population-based seroprevalence after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. METHODS We undertook enzyme linked immunosorbent assay characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein of 431 unselected general-population participants of the TwinsUK cohort from South-East England, aged 19-86 (median age 48; 85% female). 382 participants completed prospective logging of 14 COVID-19 related symptoms via the COVID Symptom Study App, allowing consideration of serology alongside individual symptoms, and a predictive algorithm for estimated COVID-19 previously modelled on PCR positive individuals from a dataset of over 2 million. FINDINGS We demonstrated a seroprevalence of 12% (51 participants of 431). Of 48 seropositive individuals with full symptom data, nine (19%) were fully asymptomatic, and 16 (27%) were asymptomatic for core COVID-19 symptoms: fever, cough or anosmia. Specificity of anosmia for seropositivity was 95%, compared to 88% for fever cough and anosmia combined. 34 individuals in the cohort were predicted to be Covid-19 positive using the App algorithm, and of those, 18 (52%) were seropositive. INTERPRETATION Seroprevalence amongst adults from London and South-East England was 12%, and 19% of seropositive individuals with prospective symptom logging were fully asymptomatic throughout the study. Anosmia demonstrated the highest symptom specificity for SARS-CoV-2 antibody response. FUNDING NIHR BRC, CDRF, ZOE global LTD, RST-UKRI/MRC.
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Affiliation(s)
- Philippa M Wells
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Simon Couvreur
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Rocio Martinez Nunez
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Sam Acors
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Neophytos Kouphou
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Stuart J D Neil
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | | | - Pedro M Matos
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Kate Poulton
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Maria Jose Lista
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Ruth E Dickenson
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Helin Sertkaya
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Thomas J A Maguire
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Edward J Scourfield
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Ruth C E Bowyer
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Deborah Hart
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Aoife O'Byrne
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Kathryn J A Steel
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Oliver Hemmings
- Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | | | - Myra O McClure
- Department of Infectious Disease, Imperial College London, UK
| | | | | | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Matthew A Brown
- Department of Medical & Molecular Genetics, Guy's and St Thomas' Hospital NHS Trust and King's College London NIHR Biomedical Research Centre, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Tim Spector
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Claire J Steves
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK.
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Molina-Gonzalez SJ, Bhattacharyya T, AlShehri HR, Poulton K, Allen S, Miles MA, Arianitwe M, Tukahebwa EM, Webster B, Russell Stothard J, Bustinduy AL. Application of a recombinase polymerase amplification (RPA) assay and pilot field testing for Giardia duodenalis at Lake Albert, Uganda. Parasit Vectors 2020; 13:289. [PMID: 32505215 PMCID: PMC7275508 DOI: 10.1186/s13071-020-04168-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 06/02/2020] [Indexed: 02/08/2023] Open
Abstract
Background Giardia duodenalis is a gastrointestinal protozoan causing 184 million cases of giardiasis worldwide annually. Detection is by microscopy or coproantigen assays, although sensitivity is often compromised by intermittent shedding of cysts or trophozoites, or operator expertise. Therefore, for enhanced surveillance field-applicable, point-of-care (POC), molecular assays are needed. Our aims were to: (i) optimise the recombinase polymerase amplification (RPA) assay for the isothermal amplification of the G. duodenalis β-giardin gene from trophozoites and cysts, using published primer and probes; and (ii) perform a pilot field validation of RPA at a field station in a resource-poor setting, on DNA extracted from stool samples from schoolchildren in villages around Lake Albert, Uganda. Results were compared to an established laboratory small subunit ribosomal RNA (SSU rDNA) qPCR assay with additional testing using a qPCR targeting the triose phosphate isomerase (tpi) DNA regions that can distinguish G. duodenalis of two different assemblages (A and B), which are human-specific. Results Initial optimisation resulted in the successful amplification of predicted RPA products from G. duodenalis-purified gDNA, producing a double-labelled amplicon detected using lateral flow strips. In the field setting, of 129 stool samples, 49 (37.9%) were positive using the Giardia/Cryptosporidium QuikChek coproantigen test; however, the RPA assay when conducted in the field was positive for a single stool sample. Subsequent molecular screening in the laboratory on a subset (n = 73) of the samples demonstrated better results with 21 (28.8%) RPA positive. The SSU rDNA qPCR assay resulted in 30/129 (23.3%) positive samples; 18 out of 73 (24.7%) were assemblage typed (9 assemblage A; 5 assemblage B; and 4 mixed A+B). Compared with the SSU rDNA qPCR, QuikChek was more sensitive than RPA (85.7 vs 61.9%), but with similar specificities (80.8 vs 84.6%). In comparison to QuikChek, RPA had 46.4% sensitivity and 82.2% specificity. Conclusions To the best of our knowledge, this is the first in-field and comparative laboratory validation of RPA for giardiasis in low resource settings. Further refinement and technology transfer, specifically in relation to stool sample preparation, will be needed to implement this assay in the field, which could assist better detection of asymptomatic Giardia infections.![]()
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Affiliation(s)
- Sandra J Molina-Gonzalez
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.,London Centre for Neglected Tropical Disease Research, London, UK
| | - Tapan Bhattacharyya
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK.
| | - Hajri R AlShehri
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.,Ministry of Health, Asir District, Abha, Kingdom of Saudi Arabia
| | - Kate Poulton
- London Centre for Neglected Tropical Disease Research, London, UK.,Natural History Museum Parasites and Vectors Division, Life Sciences Department, London, UK
| | - Stephen Allen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Michael A Miles
- London Centre for Neglected Tropical Disease Research, London, UK.,Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Moses Arianitwe
- Vector Control Division, Ministry of Health, Kampala, Uganda
| | | | - Bonnie Webster
- London Centre for Neglected Tropical Disease Research, London, UK.,Natural History Museum Parasites and Vectors Division, Life Sciences Department, London, UK
| | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Amaya L Bustinduy
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.,London Centre for Neglected Tropical Disease Research, London, UK
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5
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Poulton K, Webster B. Development of a lateral flow recombinase polymerase assay for the diagnosis of Schistosoma mansoni infections. Anal Biochem 2018; 546:65-71. [PMID: 29425749 DOI: 10.1016/j.ab.2018.01.031] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 01/25/2018] [Accepted: 01/30/2018] [Indexed: 12/14/2022]
Abstract
Infection with Schistosoma mansoni causes intestinal schistosomiasis, a major health problem across Africa. The accurate diagnosis of intestinal schistosomiasis is vital to inform surveillance/control programs. Diagnosis mainly relies on microscopic detection of eggs in faecal samples but many factors affect sensitivity. Molecular diagnostics are sensitive and specific but application is limited as necessary infrastructure, financial resources and skilled personnel are often lacking in endemic settings. Recombinase Polymerase Amplification (RPA) is an isothermal DNA amplification/detection technology that is practical in nearly any setting. Here we developed a RPA lateral flow (LF) assay targeting the 28S rDNA region of S. mansoni. The 28S LF-RPA assay's lower limit of detection was 10pg DNA with the lower test parameters permitting sufficient amplification being 6 min and 25°C. Optimal assay parameters were 40-45°C and 10 min with an analytical sensitivity of 102 copies of DNA. Additionally the PCRD3 lateral flow detection cassettes proved more robust and sensitive compared to the Milenia HybriDetect strips. This 28S LF-RPA assay produces quick reproducible results that are easy to interpret, require little infrastructure and is a promising PON test for the field molecular diagnosis of intestinal schistosomiasis.
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Affiliation(s)
- Kate Poulton
- The London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; The Natural History Museum, Cromwell Road, London, UK
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6
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Little AM, Green A, Harvey J, Hemmatpour S, Latham K, Marsh SGE, Poulton K, Sage D. BSHI Guideline: HLA matching and donor selection for haematopoietic progenitor cell transplantation. Int J Immunogenet 2016; 43:263-86. [DOI: 10.1111/iji.12282] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/06/2016] [Accepted: 06/06/2016] [Indexed: 12/29/2022]
Affiliation(s)
- A-M. Little
- Histocompatibility and Immunogenetics Laboratory; Gartnavel General Hospital; Glasgow UK
- Institute of Infection, Immunity and Inflammation; College of Medical, Veterinary and Life Sciences; University of Glasgow; Glasgow UK
| | - A. Green
- Histocompatibility and Immunogenetics Laboratory; NHS Blood and Transplant; Filton UK
| | - J. Harvey
- Histocompatibility and Immunogenetics Laboratory; NHS Blood and Transplant; Filton UK
| | - S. Hemmatpour
- Histocompatibility and Immunogenetics Laboratory; NHS Blood and Transplant; London Tooting UK
| | - K. Latham
- Anthony Nolan Research Institute; Royal Free Hospital; London UK
| | - S. G. E. Marsh
- Anthony Nolan Research Institute; Royal Free Hospital; London UK
- Cancer Institute; University College London; London UK
| | - K. Poulton
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester UK
- British Society for Histocompatibility & Immunogenetics
| | - D. Sage
- Histocompatibility and Immunogenetics Laboratory; NHS Blood and Transplant; London Tooting UK
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7
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Saif MA, Borrill R, Bigger BW, Lee H, Logan A, Poulton K, Hughes S, Turner AJ, Bonney DK, Wynn RF. In vivo T-cell depletion using alemtuzumab in family and unrelated donor transplantation for pediatric non-malignant disease achieves engraftment with low incidence of graft vs. host disease. Pediatr Transplant 2015; 19:211-8. [PMID: 25546609 DOI: 10.1111/petr.12416] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 11/30/2022]
Abstract
In vivo T-cell depletion, using alemtuzumab therapy prior to SCT, can reduce the incidence of GVHD. This treatment has a potential to delay immune reconstitution resulting in increased morbidity due to viral illnesses. We retrospectively analyzed data on all pediatric patients with non-malignant disorders who received alemtuzumab-based conditioning regimens in our center over the last 10 yr (n = 91). Our data show an OS of 91.2%. The incidence of acute (grade 2-4) GVHD was 18.7% and that of chronic GVHD 5.5%. Viremia due to adenovirus, EBV and CMV was seen in 19.8%, 64.8% and 39.6% patients, respectively, with only two deaths attributed to viral infection (adenovirus). Chimerism level at three month was predictive of graft outcome. Nine patients, who had graft failure after first SCT, were salvaged with a second SCT using RIC and same donor (if available). Based on these results, we conclude that the use of in vivo T-cell depletion is safe, achieves good chimerism and does not lead to increased morbidity and mortality due to viral infections. It is associated with a reduced incidence of chronic GVHD.
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Affiliation(s)
- M A Saif
- Department of Blood and Marrow Transplant, Royal Manchester Children's Hospital, Manchester, UK
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8
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Hanson V, Adams B, Lord J, Barker A, Poulton K, Lee H. Assessment of the purity of isolated cell populations for lineage-specific chimerism monitoring post haematopoietic stem cell transplantation. ACTA ACUST UNITED AC 2013; 82:269-75. [DOI: 10.1111/tan.12172] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 05/31/2013] [Accepted: 07/02/2013] [Indexed: 11/30/2022]
Affiliation(s)
- V. Hanson
- Transplantation Laboratory, Manchester Royal Infirmary; Central Manchester University Hospitals NHS Trust; Manchester UK
| | - B. Adams
- Transplantation Laboratory, Manchester Royal Infirmary; Central Manchester University Hospitals NHS Trust; Manchester UK
| | - J. Lord
- Transplantation Laboratory, Manchester Royal Infirmary; Central Manchester University Hospitals NHS Trust; Manchester UK
| | - A. Barker
- Transplantation Laboratory, Manchester Royal Infirmary; Central Manchester University Hospitals NHS Trust; Manchester UK
| | - K. Poulton
- Transplantation Laboratory, Manchester Royal Infirmary; Central Manchester University Hospitals NHS Trust; Manchester UK
| | - H. Lee
- Transplantation Laboratory, Manchester Royal Infirmary; Central Manchester University Hospitals NHS Trust; Manchester UK
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9
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Foster L, Tate D, Poulton K. A group-specific sequencing approach to investigate the presence of atypical human leucocyte antigen alleles. Int J Immunogenet 2013; 40:453-9. [PMID: 23724946 DOI: 10.1111/iji.12070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 05/26/2013] [Accepted: 05/15/2013] [Indexed: 11/29/2022]
Abstract
Accurate human leucocyte antigen (HLA) typing results are essential in determining the degree of compatibility between donor and recipient in both solid organ (SO) and hematopoietic stem cell (HSC) transplantation. Current HLA typing methodologies can generate ambiguous results which may need resolving. This group-specific sequencing approach allowed investigation into the presence of the low expressor HLA-A*24:02:01:02L allele and the rare HLA-A*02:64 allele in a SO transplant recipient and a HSC transplant recipient, respectively. Locus-specific amplification of HLA-A was performed. Exons 2 and 3 were sequenced in both directions followed by group-specific sequencing to resolve ambiguities. Hemizygous sequence data of intron 2 generated from the HLA-A*24 allele indicated the presence of the HLA-A*24:02:01:01 allele. HLA-A*02:64 was identified by sequencing the allele in isolation over exons 2 and 3 and allowed confirmation of this allele sequence with the IMGT/HLA database (Accession number AY297166). This approach is cost efficient and can be modified to sequence alleles at other HLA loci. It has also been adapted to characterize the novel HLA-DQB1*06:48 allele (Accession number HE647646) as well as the non-HLA gene, UGT2B17, making it a useful tool to augment existing typing methodologies.
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Affiliation(s)
- L Foster
- Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK
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10
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Foster L, Tate D, Poulton K. Characterization of the novel HLA-DQB1*06:48 allele by group-specific sequencing. Int J Immunogenet 2012; 40:322-3. [DOI: 10.1111/iji.12004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 09/20/2012] [Indexed: 11/28/2022]
Affiliation(s)
- L. Foster
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - D. Tate
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - K. Poulton
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
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11
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Jervis S, Collins P, Tate D, Foster L, Bowman V, Adhern C, Bloor A, Yin J, Wynn R, Poulton K. Increased severity of acute graft versus host disease as a result of differential expression following a homozygous gene deletion. Int J Immunogenet 2012; 40:116-9. [DOI: 10.1111/j.1744-313x.2012.01138.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 04/23/2012] [Accepted: 05/24/2012] [Indexed: 11/28/2022]
Affiliation(s)
- S. Jervis
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - P. Collins
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - D. Tate
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - L. Foster
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - V. Bowman
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - C. Adhern
- Clinical Trials Department; Manchester Royal Infirmary; Manchester; UK
| | - A. Bloor
- Department of Haematology; The Christie Hospital NHS Foundation Trust; Manchester; UK
| | - J. Yin
- Department of Haematology; Manchester Royal Infirmary; Manchester; UK
| | - R. Wynn
- Blood and Marrow Transplant Unit; Royal Manchester Childrens Hospital; Manchester; UK
| | - K. Poulton
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
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12
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Goodman RS, Ewing J, Evans PC, Craig J, Poulton K, Dyer PA, Marcus RE, Taylor CJ. Donor CD31 genotype and its association with acute graft-versus-host disease in HLA identical sibling stem cell transplantation. Bone Marrow Transplant 2005; 36:151-6. [PMID: 15908974 DOI: 10.1038/sj.bmt.1705013] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
CD31 gene polymorphisms are implicated in the pathogenesis of graft-versus-host disease (GvHD) following haematopoietic stem cell transplantation (HST). We investigated the influence of CD31 genotype on the incidence of GvHD following HST from an human leukocyte antigen (HLA)-identical sibling donor. Donor and recipient CD31 codons 125, 563 and 670 DNA polymorphisms were determined in 85 cases of HLA identical sibling HST from two transplant centres. A correlation between CD31 genotype and acute GvHD was considered significant if observed in patients from both transplant centres independently. A strong correlation was identified between donor CD31 codon 125 genotype and the incidence of acute GvHD. Acute GvHD grades II-IV occurred in 27 of 46 (59%) recipients with a CD31 codon 125 leucine / valine heterozygous donor compared to nine of 39 (23%) recipients with a CD31 codon 125 homozygous donor (P=0.0019, relative-risk 2.45, 95% confidence interval 1.3-4.5). This correlation was significant in patients from both transplant centres (P=0.015 and P=0.019). We suggest that CD31 genotype may influence the function of donor-derived leukocytes and may be informative when there is a choice of comparable donors.
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Affiliation(s)
- R S Goodman
- Tissue Typing Laboratory, Addenbrooke's Cambridge University Teaching Hospital Trust, Cambridge, UK.
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13
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Pandya B, Thomson W, Poulton K, Bruce I, Payne D, Qasim F. Azathioprine toxicity and thiopurine methyltransferase genotype in renal transplant patients. Transplant Proc 2002; 34:1642-5. [PMID: 12176518 DOI: 10.1016/s0041-1345(02)02963-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- B Pandya
- Renal Unit, MINT, Manchester Royal Infirmary, Manchester, United Kingdom
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14
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Villarreal J, Crosdale D, Ollier W, Hajeer A, Thomson W, Ordi J, Balada E, Villardell M, Teh LS, Poulton K. Mannose binding lectin and FcgammaRIIa (CD32) polymorphism in Spanish systemic lupus erythematosus patients. Rheumatology (Oxford) 2001; 40:1009-12. [PMID: 11561111 DOI: 10.1093/rheumatology/40.9.1009] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Mannose binding lectin (MBL) and FcgammaRII (CD32) polymorphisms have both been implicated as candidate susceptibility genes in systemic lupus erythematosus (SLE). The aim of this study was to evaluate the relationship of these polymorphisms with SLE. METHODS We studied a cohort of 125 SLE patients from Barcelona, Spain and 138 geographically matched controls. Sequence-specific primer-polymerase chain reaction (SSP-PCR) amplification was used to determine CD32 and MBL structural polymorphisms. MBL haplotypes were established using sequence-specific oligonucleotide probing techniques. RESULTS Patients carried the MBL codon 54 mutant allele more frequently than controls [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.2-4.0; P=0.007] and the haplotype HY W52 W54 W57 was found to be significantly lower in cases compared with controls (OR 0.6; 95% CI 0.4-0.9; P=0.016). CONCLUSION The MBL gene codon 54 mutant allele appears to be a risk factor for SLE, whilst haplotypes encoding for high levels of MBL are protective against the disease. Differences between controls and patients were not significant when considering the FcgammaRIIa polymorphisms; similar results were observed for renal affectation.
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MESH Headings
- Acute-Phase Proteins/genetics
- Acute-Phase Proteins/metabolism
- Carrier Proteins/genetics
- Carrier Proteins/metabolism
- DNA/analysis
- Gene Frequency
- Haplotypes
- Humans
- Lectins/genetics
- Lectins/metabolism
- Lupus Erythematosus, Cutaneous/genetics
- Lupus Erythematosus, Cutaneous/metabolism
- Lupus Erythematosus, Systemic/complications
- Lupus Erythematosus, Systemic/genetics
- Lupus Erythematosus, Systemic/metabolism
- Lupus Nephritis/genetics
- Lupus Nephritis/metabolism
- Lupus Vasculitis, Central Nervous System/genetics
- Lupus Vasculitis, Central Nervous System/metabolism
- Mannose-Binding Lectins
- Mutation
- Polymerase Chain Reaction
- Polymorphism, Genetic
- Receptors, IgG/genetics
- Receptors, IgG/metabolism
- Spain
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Affiliation(s)
- J Villarreal
- Hospital General Vall d'Hebron, Passieg Vall d'Hebron 119-129, Barcelona, Spain
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16
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Abstract
Hypoxic-ischaemic encephalopathy (HIE) was diagnosed in an infant with acidosis. At 7 weeks of age further investigations revealed abnormal neuroimaging (CT and MRI scans) and a raised plasma and CSF lactate. A skeletal-muscle biopsy at 2 months of age confirmed the diagnosis of cytochrome oxidase deficiency. The course of the patient's disorder has taken that of a static encephalopathy (cerebral palsy). Inborn disorders of the respiratory chain should be considered in the differential diagnosis of HIE.
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Affiliation(s)
- T A Willis
- Department of Paediatric Neurology, University of Birmingham, UK
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17
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18
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Hajeer AH, Dababneh A, Makki RF, Thomson W, Poulton K, González-Gay MA, García-Porrúa C, Mattey DL, Ollier WE. Different gene loci within the HLA-DR and TNF regions are independently associated with susceptibility and severity in Spanish rheumatoid arthritis patients. Tissue Antigens 2000; 55:319-25. [PMID: 10852383 DOI: 10.1034/j.1399-0039.2000.550405.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The aim of this study was to investigate whether polymorphisms in the tumor necrosis factor (TNF) and HLA-DRB1 gene regions are independently associated with rheumatoid arthritis (RA) in a population from Lugo region of northwestern Spain. RA patients (n=179) attending hospital outpatient clinics in Lugo, northwestern Spain and matched controls (n=145) were recruited. RA susceptibility in this population was predominantly associated with DRB1*0401, while erosive disease was associated with HLA-DRB1*0101 and DRB1*04. The increase in DRB1*04 was accounted for by an increase in DRB1*0404 and *0405 but not *0401 frequencies. In contrast, *0401 frequency was significantly increased in seropositive patients. The rheumatoid arthritis shared epitope (SE) was associated with increased risk for seropositive and erosive disease and this appeared to operate in a dose-dependent manner. Logistic regression analyses revealed that the TNF microsatellite markers TNFc1 and b3 were associated with RA independently of DRB1*04 and the SE. Carriage of a TNF c1 allele provided an increased risk of RA in SE-negative and SE-heterozygous individuals. TNFc1 and TNFb3 were not associated with erosive or seropositive disease. In contrast, TNF a2 was significantly associated with erosive disease which was independent of DRB1*04 and the SE. Further studies will be needed to establish why (TNFc1) polymorphism seemingly associated with low TNFalpha production, is a risk factor for RA.
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Affiliation(s)
- A H Hajeer
- ARC Epidemiology Unit, School of Epidemiology and Health Sciences, Manchester University Medical School, United Kingdom.
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19
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Abstract
BACKGROUND Hyperkinetic disorder or attention-deficit hyperactivity disorder (ADHD) is an important clinical condition. AIMS The research evidence for a genetic contribution to ADHD is reviewed. METHOD Measurement of the phenotype, the extent to which attention deficit and hyperactivity are heritable and molecular genetic findings are discussed. Future research directions are also considered. RESULTS ADHD is a familial disorder. Available adoption evidence suggests genetic influences are important. Twin studies have primarily focused on trait measures which have consistently been found to be highly heritable Molecular genetic studies of clinical disorder so far have suggested the involvement of the dopamine DRD-4 receptor gene and dopamine transporter gene (DAT1). However, these findings await further replication. CONCLUSIONS Advances in psychiatric genetics and current research interest in the genetics of ADHD should improve our understanding of aetiological factors and have an impact on treatment.
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Affiliation(s)
- A Thapar
- Department of Child and Adolescent Psychiatry, University of Manchester, Royal Manchester Children's Hospital, Pendlebury
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20
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Abstract
Ohtahara syndrome is a rare cause of epileptic seizures during the neonatal period. This is believed to be the first report of this syndrome with a specific metabolic defect. Defects in respiratory chain function may be more common than previously assumed in patients with this epilepsy syndrome.
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21
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Affiliation(s)
- T G Barrett
- Department of Clinical Genetics, Birmingham Womens' Hospital NHS Trust, UK
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22
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Hajeer AH, Worthington J, Davies EJ, Hillarby MC, Poulton K, Ollier WE. TNF microsatellite a2, b3 and d2 alleles are associated with systemic lupus erythematosus. Tissue Antigens 1997; 49:222-7. [PMID: 9098928 DOI: 10.1111/j.1399-0039.1997.tb02742.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We have investigated TNF microsatellite polymorphisms in SLE and their association with both HLA class II alleles and disease expression. A total of 91 Caucasoid SLE and 109 matched Caucasoid controls were recruited for this study. TNF microsatellites a, b and d were typed using fluorescent based semi-automated gene scanning. TNF a2, b3 and d2 allele frequencies were significantly increased in the SLE group compared to controls. These alleles were found to be part of an extended HLA-DRB1*0301 haplotype and have previously been associated with high TNF-alpha production. When the SLE group was analyzed according to presentation of certain clinical features, photosensitivity and Raynaud's phenomenon, the frequency of these alleles (TNF a2, b3 and d2) were also significantly increased. No significant increase in the allele frequencies of TNF a2, b3 and d2 was demonstrated in the group of patients with renal involvement. These data suggest that TNF microsatellite alleles are not independent of HLA associations in SLE and may be important in the expression of certain clinical features in SLE.
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Affiliation(s)
- A H Hajeer
- ARC Epidemiology Research Unit, University of Manchester, United Kingdom.
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Abstract
An adult male presented at 28 years of age with muscle weakness and liver dysfunction. His brother had died suddenly 2 years earlier after presenting with Reye's syndrome. Urine organic acid analysis and muscle and cultured fibroblast fatty acid oxidation studies confirmed a diagnosis of ethylmalonic/adipic aciduria-an inherited defect of fatty acid oxidation. The patient responded favourably to treatment with a low fat/high carbohydrate diet supplemented with riboflavin. This case highlights the importance of considering inborn errors of metabolism, in particular fatty acid oxidation defects, in adults with liver disease, muscle disease or Reye's syndrome.
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Affiliation(s)
- E Elias
- Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Birmingham, UK
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24
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Poulton K, Hajeer A, Worthington J, Fryer AA, Strange R, Ollier WER. TNF microsatellite polymorphisms: A comparison of allele freqeuncies in UK and other European populations. Hum Immunol 1996. [DOI: 10.1016/0198-8859(96)85271-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Affiliation(s)
- T G Barrett
- Department of Clinical Genetics, Birmingham Maternity Hospital, UK
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26
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Hemmatpour S, McQuilkin S, Evans P, Poulton K, Howell W. A comparison of serological and DNA-based methods for HLA class I B locus typing in renal transplant matching. Hum Immunol 1994. [DOI: 10.1016/0198-8859(94)91868-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Abstract
There are now many molecular biological techniques available to define HLA class I and class II alleles. Some of these are also applicable to other human polymorphic genes, in particular to those non-HLA genes encoded within the Mhc. The range of techniques available allows laboratories to choose those most suited to their purpose. The routine laboratory supporting solid organ transplants will need to type large numbers of potential recipients over a period of time, probably using PCR-SSOP while donors will be typed singly and rapidly using PCR-SSP with HLA allele compatibility determined by heteroduplex analysis. Laboratories supporting bone marrow transplantation, where time is less pressing, can choose from the whole range of techniques to determine accurately donor recipient Mhc compatibility. For disease studies, techniques defining precise HLA allele sequence polymorphisms are needed and high sample numbers have to be accommodated. When an association is established allele sequencing has to be used. In the near future, the precise role of HLA alleles in transplantation and disease susceptibility is likely to be established unambiguously.
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Affiliation(s)
- P A Dyer
- NW Regional Tissue Typing Laboratory, St. Mary's Hospital, Manchester, UK
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28
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Bundey S, Fielder A, Poulton K. Wolfram syndrome: mitochondrial disorder. Lancet 1993; 342:1059-60. [PMID: 8105296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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29
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Florkowski CM, Rossi ML, Carey MP, Poulton K, Dickson GR, Ferner RE. Rhabdomyolysis and acute renal failure following carbon monoxide poisoning: two case reports with muscle histopathology and enzyme activities. J Toxicol Clin Toxicol 1992; 30:443-54. [PMID: 1512816 DOI: 10.3109/15563659209021558] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Two patients with carbon monoxide poisoning are presented, both of whom suffered rhabdomyolysis complicated by acute renal failure. One patient, an attempted suicide, developed a compartment syndrome of the right thigh that required fasciotomy and recovered after a period of hemofiltration and hemodialysis. Muscle biopsy appearances were consistent with partial muscle infarction. The other patient, rescued from a smoke filled room, exhibited raised creatine kinase but no evidence of muscle swelling. He developed anuric renal failure and adult respiratory distress syndrome and died despite maximum intensive care. Muscle biopsy showed early evidence of muscle necrosis. In both cases there was a marked reduction of enzyme activities in the muscle biopsy consistent with metabolic derangement. Although there was a clinical compartment syndrome in the first case, there was no muscle swelling at the time of biopsy or subsequently in the second case. A direct toxic effect of carbon monoxide may thus have been an important mechanism contributing to the muscle necrosis in the second case, although local ischemia may have been an exacerbating factor in the first case.
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Affiliation(s)
- C M Florkowski
- West Midlands Poisons Unit, Dudley Road Hospital, Birmingham, United Kingdom
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30
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Affiliation(s)
- S Bundey
- Clinical Genetics Unit, Birmingham Maternity Hospital, UK
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31
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Poulton K. Book Review: Muscle Metabolism. Ann Clin Biochem 1991. [DOI: 10.1177/000456329102800524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Carey MP, Poulton K, Hawkins C, Murphy RP. Carnitine palmitoyl transferase deficiency with an atypical presentation and ultrastructural mitochondrial abnormalities. J Neurol Neurosurg Psychiatry 1987; 50:1060-2. [PMID: 3655814 PMCID: PMC1032239 DOI: 10.1136/jnnp.50.8.1060] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A case of carnitine palmitoyl transferase deficiency presenting in a 72 year old woman with the clinical picture of ophthalmoplegia plus other muscle weakness is reported. Histological and ultrastructural examination showed the features of a mitochondrial myopathy.
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Affiliation(s)
- M P Carey
- Department of Pathology, Midland Centre for Neurosurgery and Neurology, Smethwick, UK
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33
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Poulton K. Old people in the community. Two. A measure of independence. Nurs Times 1984; 80:32-5. [PMID: 6237310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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34
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Poulton K. Nursing posts: quantifying the management grades. Nurs Mirror 1982; 155:46-7. [PMID: 6924288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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