A general strategy for highly sensitive analysis of genetic biomarkers at single-base resolution with ligase-based isothermally exponential amplification.

Robust, reliable, and sensitively quantitative detection of genetic biomarkers at single-base resolution has the potential to revolutionize medical diagnostics, especially for precision medicine. Here, taking the advantages of the high specificity of ligase reaction and the powerful amplification features of the isothermally exponential amplification, we have demonstrated a novel methodology to sensitively quantify genetic biomarkers at one-base resolution. The methodology is based on the ligase reaction of two stem-loop DNA probes templated by the nucleic acid targets to form a double stem-loop DNA, which subsequently initiates the isothermally exponential amplification reaction with high amplification efficiency. With the proposed method, high sensitivity to determine as low as 0.01 fM DNA or 0.1 fM RNA targets and high specificity to detect single-base changes can be achieved. The new methodology is robust to be performed by using a pair of universal primers under isothermal conditions, which should be employed to quantitatively detect any genetic biomarkers because all DNA/RNA targets can be directly used as the templates to ligate the stem-loop DNA probes with single-base resolution.