This protocol permits the naked-eye identification of point mutated DNA in a 200-fold excess of wild type DNA molecules, by exploiting gold nanoparticles and paramagnetic microparticles.
The protocol describes a naked-eye colorimetric test for the detection of somatic point mutations in an excess of wild type DNA. The future foreseen application of the method is the identification of rare mutations in circulating cell-free DNA from liquid biopsies, with a relevance in cancer diagnostics and stratification of oncological patients for personalized therapy. As a proof of concept, the test has been designed to detect the BRAFV600E mutation in the BRAF gene, which is important to identify the sub-group of melanoma patients that can benefit from targeted therapies with BRAF inhibitors. However, this colorimetric test can be easily generalized to other somatic mutations of clinical relevance due to the use of universal detection probes, thus providing strong potential in oncological diagnostics.
The test detects 0.5% of BRAFV600E in an excess of BRAFWT DNA, which matches the sensitivity of some commercial instrumental assays. Such sensitivity is clinically relevant for diagnostic purposes, allowing the early identification of drug-sensitive patients. In contrast to commercial assays based on real-time PCR, this test requires minimal instrumentation and processing, as it can be performed on DNA amplified with a standard PCR (or isothermal techniques) and provides a naked-eye readout with a one-tube reaction of a few steps in only one hour. At present, the test has been used only on synthetic DNA samples. However, the latter have been designed to mimic a real sample amplified from circulating cell-free DNA, to favor the translation of the test to clinical diagnostics.
The purpose of the method is to detect underrepresented point mutations in a DNA sample with a minimally instrumented methodology and a naked-eye readout. The final aim is to have a proof-of-principle assay, suitable for future applications in rapid tests for the detection of somatic mutations in circulating cell-free DNA (ccf-DNA) (e.g., from blood biopsy samples) for the early diagnostics and monitoring of cancer1. Cancer-related somatic mutations represent an important cancer biomarker2 and are present in a minor (yet very variable)3 fraction of ccf-DNA, making their identification challenging4. We chose, as a model target, the oncogenic mutation BRAFV600E that causes the constitutive activation of BRAF kinase. This mutation is present in 80% of all BRAF mutated cancers5 and is generally represented in only <1% of circulating tumor DNA6. Identifying patients carrying this mutation is important as it is predictive of the therapeutic response to BRAF inhibitors. Therefore, several methods7,8,9,10 to assess the BRAF mutation status have been developed, with sensitivities ranging from 0.01% to 2%.
The main advantage of this method over the state-of-the-art methods is that its detection is instrument-free (naked-eye), as opposed to instrumental detection of fluorescent molecules by real-time PCR. Another advantage is its efficiency in discriminating one single mutated DNA molecule in an excess of 200 wild type DNA molecules. This discrimination factor of 0.5% is superior11 or matches12 that of some laboratory-based or commercially available kits, based on an instrumental detection and it is, thus, relevant for clinical diagnostic applications. On the other hand, as a laboratory prototype test, the method relies on the manual control of temperature-sensitive steps. However, the number of steps and the total duration of the assay is limited, making its future implementation in automated microfluidic systems conceivable.
This proof-of-concept method has been developed using synthetic DNA molecules. For its efficient translation to the clinics, it should be validated by using real-world samples amplified from patients' blood biopsies. We note that the future application field of the method is not intended to be the direct analysis of unprocessed complex biological matrices, such as bodily fluids. From the latter, DNA needs to be extracted with standard methodologies, and then amplified and purified. Consequently, the starting material for the analysis will always be purified and amplified DNA, which is reasonably comparable, in terms of possible interfering substances, to a synthetic DNA sample, such as that used for the development of this method.
1. Synthesis of gold nanoparticle probes
2. Colorimetric discrimination of BRAFV600E rare mutation
This method was used for the detection of BRAFV600E mutation in an excess of BRAFwt synthetic DNA. Figure 1 shows the details of the detection strategy. The assay gives a colorimetric YES/NO result17,18 where red corresponds to a positive result (YES) and yellow to a negative one (NO).
Briefly, streptavidinated paramagnetic microparticles were coated with biotinylated discriminating probes (DP1) harboring BRAFV600E mutation. The target samples to be analysed (a mixture of BRAFwt and BRAFV600E DNA) were added to microparticles. After a brief incubation, a second detection probe (DP2) was added to the tubes, followed by the addition of the colorimetric AuNP probe. BRAFV600E DNA in the sample binds DP1, then DP2 and the AuNP probe in turn binds, forming a sandwich that results in AuNPs decorating the surface of the paramagnetic microparticles (Figure 2) and conferring to the latter a red color (YES result). On the opposite, if the sample tested does not contain BRAFV600E DNA that binds DP1, the hybridization sandwich does not form and AuNP probes are washed away during the last washing step. The surface of the beads thus maintains its pristine yellow color (NO result). As a positive control, a sample containing only BRAFV600E DNA was used. This sample always returned a red (YES) result (Figure 3, tube A). Samples with different allelic fractions were tested to assess the limit of detection of the assay. As shown in Figure 3, the test could clearly discriminate the presence of BRAFV600E allele down to 1:200 dilution (Figure 3D), which corresponds to a fractional abundance of 0.5% (BRAFV600E/BRAFwt). In each test, a sample containing only the BRAFwt allele is always included as a negative control, and it returns a yellow (NO) result (Figure 3E).
These results demonstrate the detection of BRAFV600E as a proof-of-concept with relevance in the clinics. However, by changing the sequence of the oligonucleotide probes, the assay can be adapted to the detection of any other point mutation of interest. Noticeably, the colorimetric AuNP probes are universal for any target, as they recognize and bind to a universal polyA portion of DP2. Another characteristic of the AuNP probes that is important for the sensitivity of the assay is their 40 nm size. This represent an optimal compromise between the colloidal stability of the nanoparticles and their high extinction coefficient, which enhances the sensitivity of the naked-eye detection. The characterization of AuNPs probes, including size, shape and monodispersity, is shown in Figure 4.
Synthetic DNA targets (ST) | |
ST-BRAFWT | 5’ ATA GGT GAT TTT GGT CTA GCT ACA GTG AA 3’ |
ST-BRAFV600E | 5’ ATA GGT GAT TTT GGT CTA GCT ACA GAG AA 3’ |
Discriminating probes (DP) | |
DP1- BRAFV600E | 5’ /5BiotinTEG//iSp18/ TTC TCT GTA GC 3’ |
DP2 | 5’ TAG ACC AAA ATC ACC TAT AAA AAAAAAAAAAAAAAAAAAAAAAAAAAA 3’ |
Table 1. Sequences of synthetic DNA targets and probes
This table has been modified from Udayan et al.1 with permission from The Royal Society of Chemistry.
Figure 1. Strategy for the colorimetric detection of BRAFV600E rare mutation. Samples containing mixtures of BRAFV600E and BRAFWT allele in different ratios were analyzed by the colorimetric test. The test employed a sandwich hybridization between the target and two probes, the first one linked to the microparticles surface and specific for the mutant allelic variant (DP1), and the second one complementary to a portion of the target (DP2). The latter also included a polyA tail, which is recognized by the polyT of a third probe, conjugated to AuNPs (AuNPs probe), which provides the colorimetric detection. Red result of the sample indicates the presence of the BRAFV600E allele in the sample. This figure has been republished from Udayan et al.1 with permission from The Royal Society of Chemistry. Please click here to view a larger version of this figure.
Figure 2. Characterization of paramagnetic microparticles complexed with AuNPs. (A) Transmission electron microscopy (TEM) images of microparticles complexed with AuNPs. AuNPs are visible as small black spheres on the microparticle's surface. (B) Scanning electron microscopy (SEM) images of microparticles complexed with AuNPs. AuNPs are visible as brilliant dots on the surface of the microparticles. This figure has been republished from Udayan et al.1 with permission from The Royal Society of Chemistry. Please click here to view a larger version of this figure.
Figure 3. Limit of detection of the colorimetric test. Samples containing different ratios of BRAFV600E and BRAFWT allele (B, C, D), positive control (A, containing only BRAFV600E allele) and negative control (E, containing only BRAFWT allele) were tested with the colorimetric assay. Red samples can be clearly discriminated by naked-eye until 1:200 dilution (D). Thus, the assay was sensitive down to a fractional abundance of BRAFV600E of 0.5%. This figure has been republished from Udayan et al.1 with permission from The Royal Society of Chemistry. Please click here to view a larger version of this figure.
Figure 4. AuNPs characterization. (A) UV-vis spectra of 40 nm AuNPs. (B) DLS characterization. (C) Transmission Electron Microscopy representative image of 40 nm AuNPs. (D) Statistics of size distribution of AuNPs as measured by TEM. This figure has been republished from Udayan et al.1 with permission from The Royal Society of Chemistry. Please click here to view a larger version of this figure.
The core aspect of the method is the ability to discriminate a target DNA in the context of an excess of interfering non-target DNA, where target and non-target DNA only differ for one single nucleotide. Thus, the design of the probes and the hybridization conditions are critical to achieve a sensitive discrimination. The assay is designed to use universal colorimetric probes to be adapted to the detection of any point mutations of interest. However, it is possible that some minor optimization of the reaction conditions must be carried out each time a new probe pair is designed for a new mutation.
The only critical step in the method is step 2.17, where magnetic separation must be done at 52 °C. In this step, it is necessary to maintain the temperature of the previous washing step. This is needed because the assay is performed in very small volumes so, if magnetic separation is carried out without temperature control, the temperature will drop down very quickly, causing unspecific binding of non-target molecules to the beads. To ensure that this is not happening, check the color of the negative control, which has to be bright yellow at the end of the assay.
The assay is currently a lab prototype tested on synthetic DNA targets. The translation to the clinics requires the amplification of short portion of genomic DNA containing the target. As the assay needs single stranded DNA, which is readily hybridizable to the probes, it is advisable to amplify the target through a method that yields single strand amplicons. The latter can be obtained either via asymmetric PCR19, or by different isothermal amplification techniques20.
The sensitivity of the assay in detecting BRAFV600E mutation is of ≥0.5%, which is one BRAFV600E copy in 200 interfering BRAFwt copies. This correspond to 500 fmol of the 100 pmol of sample needed for the test, and it is an amount of DNA that can be obtained with a standard PCR. This sensitivity, obtained with a naked-eye readout, is comparable to that obtained with a fluorescence readout by some commercially available rt-PCR assays12, and is clinically relevant6. Moreover, this test does not need a step of allele-specific amplification12.
Given the above, the test could reasonably find future applications in the detection of somatic point mutations in clinical diagnostics.
The authors have nothing to disclose.
The authors gratefully acknowledge Professor Stefano Gustincich (Istituto Italiano di Tecnologia, Genova, IT) for the scientific and financial support. The authors also acknowledge Dr. Maurizio Congedo (Vito Fazzi Hospital, Lecce, IT) and Dr. Paolo Tarantino (Vito Fazzi Hospital, Lecce, IT) for useful scientific discussions. This work was partially supported by the Italian Flagship Project NanoMax.
Bench Top Centrifuge- Allegra X 30 | Beckman Coulter | A99473 | |
DL-Dithiothreitol | Sigma-Aldrich/ Merck KGaA, Darmstadt, Germany | D0632-25G | |
Dynabeads M-280 streptavidin paramagnetic microparticles | Invitrogen | 11205D | |
Hydroxylamine sulfate | Sigma-Aldrich/ Merck KGaA, Darmstadt, Germany | 379913-25G | |
KDS 100 Legacy Syringe Pump | kdScientific | 789100 | |
NanoDrop OneC spectrophotometer | Thermo Fisher Scientific Inc.,Waltham, MA, USA) | ||
Phosphate Buffered Saline | Sigma-Aldrich/ Merck KGaA, Darmstadt, Germany | 806552-500ML | |
Pierce™ TCEP-HCl, No-Weigh™ Format | Thermo Fisher Scientific Inc.,Waltham, MA, USA) | A35349 | |
Polyethylene glycol 600 | Sigma-Aldrich/ Merck KGaA, Darmstadt, Germany | 202401 | |
PTFE 0,22 µm filters, Fluoropore | Millipore | FGLP04700 | |
Quant-iT™ OliGreen™ ssDNA Assay Kit | Thermo Fisher Scientific Inc.,Waltham, MA, USA) | O11492 | |
Sodium citrate dihydrate | Sigma-Aldrich/ Merck KGaA, Darmstadt, Germany | W302600 | |
Synthetic oligonucleotides | Integrated DNA Technologies, Inc. (IDT DNA) | ||
Tetrachloroauric(III) acid | Sigma-Aldrich/ Merck KGaA, Darmstadt, Germany | 520918 | |
Thiolated polyT DNA probes | Integrated DNA Technologies, Inc. (IDT DNA) | ||
Transmission electron microscopy (TEM) | JEOL JEM 1011 microscope | ||
Zetasizer Nano S – Dynamic Light Scattering System | Malvern Panalytical |
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