Differential diagnosis of Plasmodium falciparum and Plasmodium vivax in mixed infection by colorimetric nanogold probes.

Malaria is an infectious disease reported mostly in the tropical region. The most severe human malaria is Plasmodium falciparum since it can cause cerebral malaria. Therefore, the presence of P. falciparum either in single or mixed infection needs accurate diagnosis. In some mixed infections, the presence of P. falciparum may be cryptic which cannot be detected by microscopic examination. The molecular diagnosis is required in these cases. Many methods based on amplification of malaria parasite genes have been developed but most of them need sophisticated instruments. Here, we created a colorimetric method using probe immobilized gold nanoparticles (AuNPs) to detect the malaria parasite gene. Color changes rely on salt-induced aggregation of AuNPs in the presence or absence of DNA hybridization. Color changes could be observed either by a naked eye or UV-vis spectrophotometer. By this approach, single infection by the most common malaria parasite, P. falciparum or P. vivax could be differentially identified. Mixed infection of these two malaria species could also be clearly diagnosed including cases of cryptic P. falciparum. The novel nanogold based molecular malaria diagnosis is sensitive, specific, rapid and cheap ($0.94). The prepared nanogold malaria probes are stable for up to 3 months indicating their filed application in remote areas.

Genotyping of α-thalassemias by the colorimetric nanogold probes.

BACKGROUND: The novel colorimetric nanogold probe was created to genotype subgroups of the mostly found α-thalassemias. They are α-thalassemia 1 (SEA and THAI deletion) and α-thalassemia 2 (3.7-kb and 4.2-kb deletion). METHODS: The genotyping was performed by two-steps hybridizations. First step was hybridization of target DNA with the nanogold mixed probes of either α-thalassemia 1 or α-thalassemia 2. No hybridization in both reactions showing blue color indicated absence of abnormal genes causing these α-thalassemias. Positive reaction showing either red or purple color was further analyzed in second hybridization with the nanogold single probe. Positive of α-thalassemia 1 was genotyped with the single probes of both SEA and THAI deletion while those of α-thalassemia 2 were genotyped with both 3.7-kb and 4.2-kb deletion. RESULTS: Genotypic potency of the nanogold mixed and single probes was evaluated using both known diagnosed and suspected clinical samples. The results by naked eye were consistence with those analyzed by standard agarose gel electrophoresis. CONCLUSIONS: Potency of the colorimetric nanogold α-thalassemia probes was accurate, precise, sensitive, specific, simple, cheap and field applicable. Color reaction was simply visualized by naked eye. This development is an example of colorimetric molecular diagnosis which can be applied in any genetic detection.

Silver quartz crystal microbalance for differential diagnosis of Plasmodium falciparum and Plasmodium vivax in single and mixed infection.

The most severe form of malaria is cerebral malaria caused by Plasmodium falciparum. Standard malaria diagnosis is Giemsa stained peripheral blood smear but false negative findings are always reported. Moreover, mixed infections are underestimated by routine microscopy. Many methods have been developed to overcome these disadvantages and the most specific and sensitive is molecular diagnosis. Specific malaria genes are amplified by polymerase chain reaction (PCR) and many post-PCR methods have been created. We developed a gold fabricated quartz crystal microbalance (QCM) as a post-PCR method of malaria diagnosis. In this work a cheaper silver fabricated QCM was developed to identify both single and mixed infection of P. falciparum and Plasmodium vivax. The biotinylated malaria probe was immobilized on silver surface via specific avidin-biotin interaction. The target DNA fragment of 18s rRNA gene was amplified and hybridized with a QCM immobilized probe. Mass changes due to DNA hybridization were indicated by changes of quartz resonance frequencies. Validation showed that malaria silver QCM had high diagnostic potency. Evaluation of suspected 67 febrile blood samples from malaria endemic area demonstrated that the malaria silver QCM could identify both false negative and misdiagnosis cases of routine microscopy. The analysis cost of malaria silver QCM was $1/sample and analysis time was 30 min after blood collection. The malaria silver QCM is stable at tropical temperature for up to 6 months. Thus, it can be transported to be used in a remote endemic area. Thus, the malaria silver QCM is accurate, precise, rapid, cheap, and field applicable.

Molecular diagnosis of α-thalassemias by the colorimetric nanogold.

A new application of gold nanoparticles (AuNPs) as a colorimetric method for gene detection of α-thalassemia 1 (SEA deletion) is reported here for the first time. This technique is based on color changes from salt-induced aggregation of un-hybridized nanogold probes after hybridization with the target DNA. Specific DNA probes were synthesized, thiol modified and conjugated on the surface of AuNPs. The target DNA was amplified and hybridized with the AuNPs-immobilized probe. Salt solution (NaCl) was added to induce aggregation of the un-hybridized nanogold probes. The color changes were visualized either by the naked eye or by UV-vis spectrophotometry at 520 nm. By this nanogold colorimetric method samples carrying normal α-globin genes could be successfully identified from samples carrying α-globin genes causing α-thalassemia 1 (SEA deletion), either as a carrier or disease form. Results demonstrated that the new colorimetric nanogold method is a definite gene diagnosis of α-thalassemia. It is accurate, simple, rapid, specific, sensitive, and cost effective. It is also a promising point-of-care testing (POCT) method for thalassemias and other genetic disorders. The new colorimetric nanogold is a method of choice for areas where access to sophisticated molecular diagnosis is limited.

Biosensor as a molecular malaria differential diagnosis.

BACKGROUND: In malaria diagnosis, specific gene identification is required in cases with subclinical infection or cases with mixed infection. This study applied the biosensor technology based on quartz crystal microbalance (QCM) to differentially diagnose the most common and severe malaria, Plasmodium falciparum and Plasmodium vivax. METHOD: The QCM surface was immobilized with malaria biotinylated probe. Specific DNA fragments of malaria-infected blood were amplified. Hybridization between the amplified products and the immobilized probe resulted in quartz frequency shifts which were measured by an in-house frequency counter. Diagnostic potency and clinical application of the malaria QCM were evaluated. RESULT: The malaria QCM could differentially diagnose blood infected with P. falciparum from that infected with P. vivax (p-value<0.05). No cross reaction with human DNA indicated the QCM specificity. Clinical application was evaluated using 30 suspected samples. Twenty-seven samples showed consistent diagnosis of the QCM with microscopy and rapid diagnosis tests (RDTs). Three samples reported "no malaria found" by microscopy showed P. falciparum infection by both QCM and the RDTs. CONCLUSION: The malaria QCM was developed with high accuracy, specificity, sensitivity, stability and cost-effectiveness. It is field applicable in malaria endemic area and might be a promising point of care testing.

Low cost biosensor-based molecular differential diagnosis of α-thalassemia (Southeast Asia deletion).

BACKGROUND: Thalassemias are genetic hematologic diseases which the homozygous form of α-thalassemia can cause either death in utero or shortly after birth. It is necessary to accurately identify high-risk heterozygous couples. We developed a quartz crystal microbalance (QCM) to identify the abnormal gene causing the commonly found α-thalassemia1, [Southeast Asia (SEA) deletion]. This work is an improved method of our previous study by reducing both production cost and analysis time. METHODS: A silver electrode on the QCM surface was immobilized with a biotinylated probe. The α-globin gene fragment was amplified and hybridized with the probe. Hybridization was indicated by changes of quartz oscillation. Each drying step was improved by using an air pump for 30 min instead of the overnight air dry. The diagnostic potency of the silver QCM was evaluated using 70 suspected samples with microcytic hypochromic erythrocytes. RESULTS: The silver QCM could clearly identify samples with abnormal α-globin genes, either homozygous or heterozygous, from normal samples. Thirteen out of 70 blood samples were identified as carrier of α-thalassemia1 (SEA deletion). Results were consistent with the standard agarose gel electrophoresis. Using silver instead of gold QCM could reduce the production expense 10-fold. An air pump drying the QCM surface could reduce the analysis time from 3 days to 4 h. CONCLUSIONS: The silver thalassemic QCM was specific, sensitive, rapid, cheap and field applicable. It could be used as a one-step definite diagnosis of α-thalassemia1 (SEA deletion) with no need for the preliminary screening test.