Molecular techniques in diagnostic microbiology

Chapter 4


Molecular techniques in diagnostic microbiology


The development of different nucleic acid amplification technologies has revolutionized the detection and characterization of microbial pathogens. The speed of these techniques has huge advantages over culture-based diagnostic techniques. Other advantages include the ready detection of fastidious, unculturable and/or dangerous pathogens and the ease of strain typing. Organisms that have been inactivated during the processing of vaccines and other biological products can be detected by molecular diagnostics. The polymerase chain reaction (PCR) is the most widely used method of nucleic acid amplification and has the potential to amplify a specific region of DNA millions-fold within a few hours. PCR can be used to identify the microorganism in a sample, from culture or in fixed tissue. PCR requires only small amounts of sample material for the detection of infection. PCR techniques can be adapted to detect actively replicating virus rather than transcriptionally dormant virus. A PCR assay protocol has been developed for virtually all major veterinary pathogens. Probe-based assays such as microarrays that enable the simultaneous detection of a large number of pathogens are being combined with amplification techniques to improve their diagnostic sensitivity.




Polymerase Chain Reaction (PCR)


A diagrammatic representation of the basic PCR procedure is shown in Figure 4.1. PCR is a cyclical process of copying DNA, which involves heating and cooling. Each cycle has three steps, the first of which involves the denaturation of double stranded DNA. The DNA double helix comprises two phosphate sugar (deoxyribose) polymers that are connected by hydrogen bonding between the bases adenine (A), guanine (G), thymine (T) and cytosine (C). Guanine pairs only with cytosine and adenine with thymine. The PCR method separates the two strands of the DNA helix by heating at a temperature of 93 to 94°C. The hydrogen bonds between the paired bases are disrupted giving rise to single stranded DNA.



The second step involves cooling to allow synthetic oligonucleotide primers to anneal to the strands of DNA. The specificity of the reaction is based on these primers which are generally 20 to 25 bases long. They are selected such that they flank the region of DNA to be amplified with one derived from each of the complementary strands. Computer programs are available to assist with the design of primers and avoid primers that self-anneal, that is, form dimers. The annealing temperature varies depending on the sequence of the primers but is usually between 50 and 60°C. When the primers come in contact with a complementary sequence they bind and create a binding site for the enzyme DNA polymerase.


The third step involves heating to allow primer extension. Primer extension is the synthesis of a complimentary strand of DNA using a single stranded template but starting from a double stranded region. In the PCR the primers are arranged so that each primer extension reaction directs the synthesis of DNA towards the other. The DNA polymerase catalyzes the extension of the annealed primers, that is,. it initiates DNA synthesis. It is necessary to use a heat-stable DNA polymerase such as Taq polymerase to withstand the repeated heating during multiple cycles. Extension usually occurs at 72°C as Taq polymerase, which was originally isolated from a bacterium Thermus aquaticus that inhabits hot springs, is most active at this temperature. Extension requires the four deoxynucleotides (dATP, dGTP, dCTP and dTTP) and a specific buffer containing magnesium which is essential for Taq polymerase activity.


The PCR cycle of denaturation, annealing and extension is repeated and the product resulting from the extension of one primer serves as the template for the second primer and vice versa. Initially synthesis goes beyond the sequence complimentary to the other primer but with each cycle of denaturation, annealing and primer extension the target, that is, the region of DNA flanked by the primers, increases almost exponentially. The PCR cycle is repeated 30 to 40 times to produce detectable amounts of PCR product or amplicon. The simplest way to detect the PCR product is to load a fraction of the reaction onto an agarose gel (Fig. 4.2). The product should be visible as a sharp band of expected size. Fluorimeter-based real-time detection systems (see below) are replacing conventional PCR and gel-based detection systems in many veterinary laboratories. Zinc-finger proteins, DNA-binding proteins that directly and specifically detect PCR products, have recently been used to detect microorganisms including Salmonella spp. and influenza A viruses.




PCR instrumentation


The PCR procedure is carried out in a programmable thermal cycler. Thermal cyclers differ in the method of thermoregulation. Most use a heating element in contact with a metal block which holds reaction tubes or microtitre plates. Some have gradient blocks that can operate at a range of temperatures allowing independent PCR reactions that require different annealing temperatures to be carried out simultaneously. Air cyclers do not have a block but heat and cool the air streams circulating around capillaries or tubes containing the PCR reaction mix. Initially air cyclers had faster cycling capacity than block thermocyclers but the latter have become more sophisticated and new fast-blocks have reduced their run times. Portable PCR machines for use in the field have been developed. A new PCR chemistry linear-after-the-exponential (LATE) PCR, has been adapted successfully to these portable machines. Other developments include loop-mediated isothermal amplification (LAMP) technology which does not require a thermocycler but uses a simple thermoblock. The results can be visualized by the naked eye. This type of effective but simpler technology has great potential for use in laboratories in less developed areas.



Reverse transcription PCR


As PCR is based on the amplification of DNA the detection of RNA viruses requires the conversion of their genomic RNA into DNA prior to PCR amplification. This is referred to as reverse transcription PCR (RT-PCR) as it is based on the ability of the RNA-dependent DNA polymerase reverse transcriptase, to generate a complementary strand of DNA (cDNA) using the RNA as a template. The RT-PCR reaction and the subsequent PCR reaction can be carried out in the same tube, that is, a one-step reaction. This type of system is less time-consuming than a two-step reaction where the reverse transcriptase reaction is performed in one tube and the PCR is performed in a second tube. However, a one-step reaction may be less sensitive as neither reaction can be fully optimized. Also, all the cDNA generated in a one-step reaction is used in the PCR while only an aliquot need be used in a two-step reaction and the remainder can be stored for further tests if required.

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Jul 18, 2016 | Posted by in PHARMACOLOGY, TOXICOLOGY & THERAPEUTICS | Comments Off on Molecular techniques in diagnostic microbiology

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