CRISPR-Cas-mediated Multianalyte Synthetic Urine Biomarker Test for Portable Diagnostics

Summary

This protocol describes a CRISPR-Cas-mediated, multianalyte synthetic urine biomarker test that enables point-of-care cancer diagnostics through the ex vivo analysis of tumor-associated protease activities.

Abstract

Creating synthetic biomarkers for the development of precision diagnostics has enabled detection of disease through pathways beyond those used for traditional biofluid measurements. Synthetic biomarkers generally make use of reporters that provide readable signals in the biofluid to reflect the biochemical alterations in the local disease microenvironment during disease incidence and progression. The pharmacokinetic concentration of the reporters and biochemical amplification of the disease signal are paramount to achieving high sensitivity and specificity in a diagnostic test. Here, a cancer diagnostic platform is built using one format of synthetic biomarkers: activity-based nanosensors carrying chemically stabilized DNA reporters that can be liberated by aberrant proteolytic signatures in the tumor microenvironment. Synthetic DNA as a disease reporter affords multiplexing capability through its use as a barcode, allowing for the readout of multiple proteolytic signatures at once. DNA reporters released into the urine are detected using CRISPR nucleases via hybridization with CRISPR RNAs, which in turn produce a fluorescent or colorimetric signal upon enzyme activation. In this protocol, DNA-barcoded, activity-based nanosensors are constructed and their application is exemplified in a preclinical mouse model of metastatic colorectal cancer. This system is highly modifiable according to disease biology and generates multiple disease signals simultaneously, affording a comprehensive understanding of the disease characteristics through a minimally invasive process requiring only nanosensor administration, urine collection, and a paper test which enables point-of-care diagnostics.

Introduction

Despite the significant effort to identify tumor biomarkers such as shed proteins and DNA, the cancer diagnostic field has been strained by their low abundance or rapid degradation in circulation¹. As a complementary strategy, bioengineered synthetic biomarkers that selectively respond to disease features to generate amplified signals represent new avenues towards accurate and accessible diagnostics^2,3. To aid detection, these synthetic biomarkers harness tumor-dependent activation mechanisms such as enzymatic amplification to produce analytes with improved signal-to-noise ratio

Protocol

All animal studies are approved by the Institutional Animal Care and Use Committee (IACUC) at the authors' institution. Standard animal care facilities including housing chambers, sterile hoods, anesthetization, and ethical endpoint euthanization are required to properly carry out these experiments. All experiments are conducted in compliance with institutional and national guidelines and supervised by the veterinarian staff at the institution. Female BALB/c mice, used for the experiments, are obtained from a commercial source (see Table of Materials) and ranged in age from 6 to 8 weeks at the start of the study. Sequences for custom-synthesized D....

Results

Nominating protease-activated peptide substrates
To design sensors which will reflect changes in the proteolytic activity of the tissue, protease activity in the tissue is first characterized using a library of peptide probes¹³ (Figure 1). Fresh and frozen tissue samples can provide substantial information about the proteolytic activity of the tumor microenvironment by combining tissue samples with FRET probes designed to detect substrate cleava.......

Discussion

Presented here is a highly customizable platform for multiplexed cancer detection with a portable urine test that assesses disease-associated proteolytic activity using a minimally invasive injected sensor. When activated by tumor proteases, peptide substrate cleavage is amplified via DNA barcode release into the urine. The synthetic DNA reporters in a urine sample can be read out by a secondary CRISPR-Cas-mediated enzymatic amplification using fluorometric detection or a simple paper-based test. DNA barcoding i.......

Materials

Name	Company	Catalog Number	Comments
10x NEB Buffer 2.1	New England Biolabs	B6002SVIAL
20-mer phosphorothioated DNA reporters with 3’-DBCO group	IDT		Custom DNA
Agilent 1100 High Performance Liquid Chromatography system with Vydac 214TP510 C4 column	Agilent		HPLC
ÄKTA fast protein liquid chromatography (FPLC)	GE Healthcare		FPLC
Amicon ultracentrifuge tubes (MWCO = 10 kDa)	EMD millipore		Various volumes available
Azide-terminated PAPs with C-terminus cysteine	CPC Scientific		Custom peptide
crRNAs	IDT		See Supplementary Table 1
Cryogenic transmission electron microscopy	JEM-2100F	JEOL	cyroTEM
Cysteine terminated DNA-peptide conjugates	CPC Scientific		Custom peptide
Dynamic light scattering (DLS)			DLS
EnGen LbaCas12a (Cpf1), 100 µM	New England Biolabs	M0653T
Experimental animals	Taconic Biosciences	BALB/cAnNTac	6–8 weeks of age
gentleMACS C tubes	Miltenyi Biotec	130-093-237	tissue homogenization
HybriDetect Universal Lateral Flow Assay Kit	Miltenyi Biotec	MGHD 1
Matrix-assisted laser desorption/ionization–time of flight (MALDI–TOF) mass spectrometry	Bruker		Microflex MALDI–TOF
MC26-Fluc cell line			Kenneth K. Tanabe Laboratory, Massachusetts General Hospital
multivalent PEG (40 kDA, 8-arm) with maleimide-reactive group	JenKem	A10020-1 / 8ARM(TP)-MAL-40K,1 g
Python, Version 3.9			https://www.python.org/
Quant-iT OliGreen ssDNA Assay Kit and Quant-iT OliGreen ssDNA Reagent	Invitrogen	O11492	ssDNA assay kit
ssDNA FAM-T10-Quencher and  FAM-T10-Biotin reporter substrates	IDT		Custom DNA
Superdex 200 Increase 10/300 GL column	GE Healthcare	GE28-9909-44	For FPLC
Tecan Infinite Pro M200 plate reader	Tecan
ThermoFisher Pierce BCA Protein Assay Kit	ThermoFisher Scientific	23225