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功能化赫斯勒磁性纳米颗粒辅助定制环介导等温扩增技术快速检测人血液和尿液样本中的毛霉目真菌

Rapid detection of Mucorales in human blood and urine samples by functionalized Heusler magnetic nanoparticle assisted customized loop-mediated isothermal amplification.

作者信息

Roy Rahul, Singh Gagandeep, Dahiya Ujjwal Ranjan, Pandey Mragnayani, Xess Immaculata, Kalyanasundaram Dinesh

机构信息

Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi 110016, India.

Department of Microbiology, All India Institute of Medical Sciences, New Delhi 110029, India.

出版信息

Med Mycol. 2024 Jan 27;62(2). doi: 10.1093/mmy/myae007.

Abstract

Mucormycosis is a rare disease with scarce diagnostic methods for early intervention. Available strategies employing direct microscopy using calcofluor white-KOH, culture, radiologic, and histopathologic testing often are time-intensive and demand intricate protocols. Nucleic Acid Amplification Test holds promise due to its high sensitivity combined with rapid detection. Loop-mediated isothermal amplification (LAMP) based detection offers an ultrasensitive technique that does not require complicated thermocyclers like in polymerase chain reaction, offering a straightforward means for improving diagnoses as a near-point-of-care test. The study introduces a novel magnetic nanoparticle-based LAMP assay for carryover contaminant capture to reduce false positives. Solving the main drawback of LAMP-based diagnosis techniques. The assay targets the cotH gene, which is invariably specific to Mucorales. The assay was tested with various species of Mucorales, and the limit of detections for Rhizopus microsporus, Lichtheimia corymbifera, Rhizopus arrhizus, Rhizopus homothallicus, and Cunninghamella bertholletiae were 1 fg, 1 fg, 0.1 pg, 0.1 pg, and 0.01 ng, respectively. This was followed by a clinical blindfolded study using whole blood and urine samples from 30 patients diagnosed with Mucormycosis. The assay has a high degree of repeatability and had an overall sensitivity of > 83%. Early Mucormycosis detection is crucial, as current lab tests from blood and urine lack sensitivity and take days for confirmation despite rapid progression and severe complications. Our developed technique enables the confirmation of Mucormycosis infection in < 45 min, focusing specifically on the RT-LAMP process. Consequently, this research offers a viable technique for quickly identifying Mucormycosis from isolated DNA of blood and urine samples instead of invasive tissue samples.

摘要

毛霉病是一种罕见疾病,早期干预的诊断方法稀缺。现有的采用荧光增白剂 - 氢氧化钾直接显微镜检查、培养、放射学和组织病理学检测的策略通常耗时较长,且需要复杂的方案。核酸扩增检测因其高灵敏度和快速检测而具有前景。基于环介导等温扩增(LAMP)的检测提供了一种超灵敏技术,它不像聚合酶链反应那样需要复杂的热循环仪,为作为即时检测改善诊断提供了一种直接方法。该研究引入了一种基于磁性纳米颗粒的新型LAMP检测方法,用于捕获残留污染物以减少假阳性。解决了基于LAMP的诊断技术的主要缺点。该检测针对cotH基因,该基因对毛霉目具有特异性。该检测方法用多种毛霉目菌种进行了测试,微小根毛霉、伞枝犁头霉、少根根霉、同宗根霉和伯氏小克银汉霉的检测限分别为1 fg、1 fg、0.1 pg、0.1 pg和0.01 ng。随后进行了一项临床盲法研究,使用了30例被诊断为毛霉病患者的全血和尿液样本。该检测方法具有高度的可重复性,总体灵敏度>83%。早期毛霉病检测至关重要,因为目前血液和尿液的实验室检测缺乏灵敏度,尽管病情进展迅速且有严重并发症,但仍需数天才能确诊。我们开发的技术能够在<45分钟内确认毛霉病感染,特别关注逆转录LAMP过程。因此,本研究提供了一种可行的技术,可从血液和尿液样本的分离DNA而非侵入性组织样本中快速鉴定毛霉病。

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