College of Medicine and Public Health, Flinders University, Adelaide, Australia.
PLoS One. 2023 Apr 21;18(4):e0284538. doi: 10.1371/journal.pone.0284538. eCollection 2023.
qPCR, is widely used for quantifying minimal residual disease (MRD) and is conventionally performed according to guidelines proposed by the EuroMRD consortium. However it often fails when quantifying MRD levels below 10-4. By contrast, HAT-PCR, a recent modification designed to minimise false-positive results, can quantify MRD down to 10-6.
The factors leading to failure of conventional qPCR to quantify low levels of MRD were studied by analysing PCR reagents, protocol and primers and by testing for inhibition by adding primers to a plasmid amplification system. Complementary primers, ending in either G/C or A/T, were used to determine the effect of the 3' end of a primer.
Inhibition of conventional PCR resulted from interaction of primers with genomic DNA leading to exponential amplification of nonspecific amplicons. It was observed with approximately half of the EuroMRD J primers tested. Inhibition by a primer was significantly related to primer Tm and G/C content and was absent when extension at the 3' end was blocked. Nonspecificity and inhibition were decreased or abolished by increasing the annealing temperature and inhibition was decreased by increasing the concentration of polymerase. Primers terminating with G/C produced significantly more nonspecificity and inhibition than primers terminating with A/T. HAT-PCR produced minimal nonspecificity and no inhibition.
Inhibition of the PCR may result from the presence of genomic DNA and resultant exponential amplification of nonspecific amplicons. Factors contributing to the phenomenon include suboptimal annealing temperature, suboptimal primer design, and suboptimal polymerase concentration. Optimisation of these factors, as in HAT-PCR, enables sensitive quantification of MRD. PCR assays are increasingly used for sensitive detection of other rare targets against a background of genomic DNA and such assays may benefit from similar improvement in PCR design.
qPCR 被广泛用于定量检测微小残留病(MRD),并按照 EuroMRD 联合会提出的指南进行常规操作。然而,当定量检测 MRD 水平低于 10-4 时,它经常会失败。相比之下,HAT-PCR 是一种最近设计的方法,旨在最大限度地减少假阳性结果,可以定量检测到 10-6 的 MRD。
通过分析 PCR 试剂、方案和引物,并通过在质粒扩增系统中添加引物来测试抑制作用,研究了常规 qPCR 无法定量检测低水平 MRD 的原因。互补引物以 G/C 或 A/T 结尾,用于确定引物 3' 端的影响。
常规 PCR 的抑制作用源于引物与基因组 DNA 的相互作用,导致非特异性扩增子的指数扩增。在用大约一半的 EuroMRD J 引物进行测试时观察到了这种情况。引物的抑制作用与引物 Tm 和 G/C 含量显著相关,当 3' 端延伸受阻时,抑制作用不存在。通过提高退火温度,可以降低非特异性和抑制作用,通过增加聚合酶的浓度,可以降低抑制作用。以 G/C 结尾的引物比以 A/T 结尾的引物产生更多的非特异性和抑制作用。HAT-PCR 产生的非特异性和抑制作用最小。
PCR 的抑制作用可能是由于存在基因组 DNA,导致非特异性扩增子的指数扩增。导致这种现象的因素包括退火温度不理想、引物设计不理想和聚合酶浓度不理想。优化这些因素,如在 HAT-PCR 中,可以实现 MRD 的敏感定量。PCR 检测越来越多地用于在基因组 DNA 背景下对其他稀有靶标进行敏感检测,此类检测可能受益于 PCR 设计的类似改进。