Point-of-care CRISPR-based Diagnostics with Premixed and Freeze-dried Reagents

Summary

Here, we present the step-by-step preparation of premixed, lyophilized recombinase-based isothermal amplification and Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-based reactions, which can be used for the detection of nucleic acid biomarkers of infectious disease pathogens or other genetic markers of interest.

Abstract

Molecular diagnostics by Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-based detection have high diagnostic accuracy and attributes that are suitable for use at point-of-care settings such as fast turnaround times for results, convenient simple readouts, and no requirement of complicated instruments. However, the reactions can be cumbersome to perform at the point of care due to their many components and manual handling steps. Herein, we provide a step-by-step, optimized protocol for the robust detection of disease pathogens and genetic markers with recombinase-based isothermal amplification and CRISPR-based reagents, which are premixed and then freeze-dried in easily stored and ready-to-use formats. Premixed, freeze-dried reagents can be rehydrated for immediate use and retain high amplification and detection efficiencies. We also provide a troubleshooting guide for commonly found problems upon preparing and using premixed, freeze-dried reagents for CRISPR-based diagnostics, to make the detection platform more accessible to the wider diagnostic/genetic testing communities.

Introduction

CRISPR-based diagnostics for the detection of nucleic acid biomarkers was first reported in 2017^1,2,3,4, and since then, has been proven as next-generation diagnostics with Food and Drug Administration (FDA)-approved tests, particularly for the detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA, in multiple countries^5,6,7,8. Beyond coronavirus disease 2019 (COVID-19), the technologies hav....

Protocol

1. Preparation of lyophilized RT-RPA premixed reagents

1. Equipment preparation
   1. Prepare a liquid nitrogen dewar or tray for flash-freezing of reactions. Fill the dewar or tray with liquid nitrogen.
   2. Freeze dryer
      1. Check for condensed water in draining tubes and the chamber interior; remove the water if needed.
      2. Clean the chamber interior and the 1.5 mL microcentrifuge tube metal rack with RNase decontamination solution, followed by 70% ethanol.
      .......

Discussion

There are critical steps in this protocol. For area segregation, it is recommended to use separate spaces for nucleic acid extraction, mastermix preparation (pre amplification area), sample addition, and amplicon detection (post amplification area). Each area should be set by using a separate set of tools and equipment. Do not bring tools from one area into another area, especially from the post amplification area into the pre amplification area. Cleaning of working areas is necessary: one should clean working areas, pip.......

Materials

Name	Company	Catalog Number	Comments
Material
Betaine solution	Sigma-Aldrich	B0300-1VL
DEPC-Treated water	Invitrogen	AM9915G
Dithiothreitol (DTT)	Merck	3870-25GM
EpiScript reverse transcriptase	Lucigen	ERT12925K
Gly-Gly-Gly	Sigma-Aldrich	SIA-50239-1G
LwaCas13a	Producing in-house		Strain name:Leptotrichia wadei, Abbreviation: Lwa, Protein name: LwaCas13a
Magnesium chloride solution, 1M	Sigma-Aldrich	M1028-10X1ML
NxGenT7 RNA polymerase	Lucigen	30223-2
Poly(ethylene glycol)	Sigma-Aldrich	81300-1KG
Potassium acetate solution, 5M	Sigma-Aldrich	95843-100ML-F
Riobnucleotide Solution Mix	NEB	N0466L
RNase H	NEB	M0297L
Sucrose	TCI	TCI-S0111-500G
Trehalose Dihydrate	Sigma-Aldrich	SIA-90210-50G
Trizma hydrochloride solution, 1M, pH 7.4	Sigma-Aldrich	T2194-100ML
TwistAmp Basic kit	TwistDx	TABAS03KIT
Equipment
BluPAD Dual LED Blue/White light transilluminator	Bio-Helix	BP001CU
Dry Bath Dual Block	ELITE	4-2-EL-02-220	Model: EL-02
Fluorescence microplate reader	Tecan	30050303	Model: Infinite 200 Pro
Freeze dryer	LABCONCO	794001030	FreeZone Triad Benchtop Freeze Dryer
Microplate 384-well	Greiner	GDE0784076	F-Bottom, small volume, Hibase, Med. Binding, Black
Real-time thermal cycler (CFX Connect Real-Time PCR System)	Bio-Rad	185-5201	Model: CFX Connect Optics Module
Oligonucleotide
s-gene forward RPA primer	IDT		GAAATTAATACGACTCAC TATAGGGAGGTTTCAAAC TTTACTTGCTTTACATAGA
s-gene reverse RPA primer	IDT		TCCTAGGTTGAAGA TAACCCACATAATAAG
n-gene forward RPA primer	IDT		GAAATTAATACGACTC ACTATAGGAACTTCTC CTGCTAGAATGGCTG
n-gene reverse RPA primer	IDT		CAGACATTTTGCTCTC AAGCTGGTTCAATC
LwaCas13a-crRNA for the s gene	Synthego		GAUUUAGACUACCCCAAAAAC GAAGGGGACUAAAACGCAGCA CCAGCUGUCCAACCUGAAGAAG
LwaCas13a-crRNA for the n gene	Synthego		GAUUUAGACUACCCCAAAAACG AAGGGGACUAAAACAAAGCAAG AGCAGCAUCACCGCCAUUGC
FAM-polyU-IABkFQ reporter	IDT		56-FAM/rUrUrUrUrU/3IABkFQ
O-hannah_cytb_F RPA primer	IDT		GAAATTAATACGACTCACTA TAGGGTACGGATGAACCATA CAAAACCTTCACGCAATCG
O-hannah_cytb_R RPA primer	IDT		AAGATCCATAGTAGATTC CTCGTGCGATGTGGATA
synT7crRNA13a_ O_hannah	IDT		GCGCATCCATATTCTTCAT CTGCATTTAGTTTTAGTCC CCTTCGTTTTTGGGGTA GTCTAAATCCCCTATAGT GAGTCGTATTAATTTC