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Luo Y, Joung HA, Esparza S, Rao J, Garner O, Ozcan A. Quantitative particle agglutination assay for point-of-care testing using mobile holographic imaging and deep learning. LAB ON A CHIP 2021; 21:3550-3558. [PMID: 34292287 DOI: 10.1039/d1lc00467k] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Particle agglutination assays are widely adopted immunological tests that are based on antigen-antibody interactions. Antibody-coated microscopic particles are mixed with a test sample that potentially contains the target antigen, as a result of which the particles form clusters, with a size that is a function of the antigen concentration and the reaction time. Here, we present a quantitative particle agglutination assay that combines mobile lens-free microscopy and deep learning for rapidly measuring the concentration of a target analyte; as its proof-of-concept, we demonstrate high-sensitivity C-reactive protein (hs-CRP) testing using human serum samples. A dual-channel capillary lateral flow device is designed to host the agglutination reaction using 4 μL of serum sample with a material cost of 1.79 cents per test. A mobile lens-free microscope records time-lapsed inline holograms of the lateral flow device, monitoring the agglutination process over 3 min. These captured holograms are processed, and at each frame the number and area of the particle clusters are automatically extracted and fed into shallow neural networks to predict the CRP concentration. 189 measurements using 88 unique patient serum samples were utilized to train, validate and blindly test our platform, which matched the corresponding ground truth concentrations in the hs-CRP range (0-10 μg mL-1) with an R2 value of 0.912. This computational sensing platform was also able to successfully differentiate very high CRP concentrations (e.g., >10-500 μg mL-1) from the hs-CRP range. This mobile, cost-effective and quantitative particle agglutination assay can be useful for various point-of-care sensing needs and global health related applications.
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Affiliation(s)
- Yi Luo
- Electrical & Computer Engineering Department, University of California, Los Angeles, California 90095, USA.
- California NanoSystems Institute (CNSI), University of California, Los Angeles, California 90095, USA
- Bioengineering Department, University of California, Los Angeles, California 90095, USA
| | - Hyou-Arm Joung
- Electrical & Computer Engineering Department, University of California, Los Angeles, California 90095, USA.
- California NanoSystems Institute (CNSI), University of California, Los Angeles, California 90095, USA
- Bioengineering Department, University of California, Los Angeles, California 90095, USA
| | - Sarah Esparza
- Bioengineering Department, University of California, Los Angeles, California 90095, USA
| | - Jingyou Rao
- Computer Science Department, University of California, Los Angeles, California 90095, USA
| | - Omai Garner
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, California 90095, USA
| | - Aydogan Ozcan
- Electrical & Computer Engineering Department, University of California, Los Angeles, California 90095, USA.
- California NanoSystems Institute (CNSI), University of California, Los Angeles, California 90095, USA
- Bioengineering Department, University of California, Los Angeles, California 90095, USA
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Keppler-Noreuil KM, Lozier J, Oden N, Taneja A, Burton-Akright J, Sapp JC, Biesecker LG. Thrombosis risk factors in PIK3CA-related overgrowth spectrum and Proteus syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2019; 181:571-581. [PMID: 31490637 DOI: 10.1002/ajmg.c.31735] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/27/2019] [Accepted: 07/30/2019] [Indexed: 01/19/2023]
Abstract
Increased risk of thromboembolism has been recognized in individuals with mosaic overgrowth disorders, Proteus syndrome (PS) and PIK3CA-related overgrowth spectrum (PROS), including Klippel-Trenaunay syndrome and CLOVES syndrome. PS and PROS have distinct, yet overlapping clinical findings and are caused by somatic pathogenic variants in the PI3K/AKT gene signaling pathway. PS is caused by a single somatic activating AKT1 c.49G > A p.E17K variant while PROS can be caused one of multiple variants in PIK3CA. The role of prothrombotic factors, endothelial cell adhesion molecules, and vascular malformations in both PS and PROS have not been previously investigated. A pilot study of prospective clinical and laboratory evaluations with the purposes of identifying potential risk factors for thrombosis was conducted. Doppler ultrasounds and magnetic resonance angiogram/ venography (MRA/MRV) scans identified vascular malformations in PS and PROS that were not appreciated on physical examination. Abnormal D-dimers (0.60-2.0 mcg/ml) occurred in half of individuals, many having vascular malformations, but no thromboses. Soluble vascular endothelial markers, including thrombomodulin, soluble vascular adhesion molecule (sVCAM), soluble intercellular adhesion molecule (sICAM), E-selectin, and P-selectin were significantly higher in PS and PROS compared to controls. However, no single attribute was identified that explained the risk of thrombosis. Predisposition to thrombosis is likely multifactorial with risk factors including chronic stasis within vascular malformations, stasis from impaired mobility (e.g., following surgery), decreased anticoagulant proteins, and effects of AKT1 and PIK3CA variants on vascular endothelium. Based on our findings, we propose clinical recommendations for surveillance of thrombosis in PS and PROS.
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Affiliation(s)
- Kim M Keppler-Noreuil
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Jay Lozier
- Department of Laboratory Medicine, Warren Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Neal Oden
- Department of Biostatistics, The EMMES Corporation, Rockville, Maryland
| | - Anjali Taneja
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Jasmine Burton-Akright
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Julie C Sapp
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Leslie G Biesecker
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
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Rodrigues VC, Moraes ML, Soares JC, Soares AC, Sanfelice R, Deffune E, Oliveira ON. Immunosensors Made with Layer-by-Layer Films on Chitosan/Gold Nanoparticle Matrices to Detect D-Dimer as Biomarker for Venous Thromboembolism. BULLETIN OF THE CHEMICAL SOCIETY OF JAPAN 2018. [DOI: 10.1246/bcsj.20180019] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Valquiria C. Rodrigues
- São Carlos Institute of Physics, University of São Paulo, 13560-970 São Carlos-SP, Brazil
| | - Marli L. Moraes
- Federal University of São Paulo, Unifesp, Campus São José dos Campos, SP, Brazil
| | - Juliana C. Soares
- São Carlos Institute of Physics, University of São Paulo, 13560-970 São Carlos-SP, Brazil
| | - Andrey C. Soares
- São Carlos Institute of Physics, University of São Paulo, 13560-970 São Carlos-SP, Brazil
| | - Rafaela Sanfelice
- Department of Chemical Engineering, Federal University of the Triângulo Mineiro, Uberaba-MG, Brazil
| | - Elenice Deffune
- Department of Urology, Medical School, UNESP, Botucatu-SP, Brazil
| | - Osvaldo N. Oliveira
- São Carlos Institute of Physics, University of São Paulo, 13560-970 São Carlos-SP, Brazil
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Keppler-Noreuil KM, Lozier JN, Sapp JC, Biesecker LG. Characterization of thrombosis in patients with Proteus syndrome. Am J Med Genet A 2017. [PMID: 28627093 DOI: 10.1002/ajmg.a.38311] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Patients with overgrowth and complex vascular malformation syndromes, including Proteus syndrome have an increased risk of thromboembolism. Proteus syndrome is a mosaic, progressive overgrowth disorder involving vasculature, skin, and skeleton, and caused by a somatic activating mutation in AKT1. We conducted a comprehensive review of the medical histories and hematologic evaluations of 57 patients with Proteus syndrome to identify potential risk factors for thrombosis. We found that six of ten patients, who were deceased, died secondary to deep venous thrombosis and/or pulmonary embolism. Of the remaining 47 living patients, six had thromboembolic events that all occurred postoperatively and in an affected limb. Eleven of 21 patients had an abnormal hypercoagulable panel including Factor V Leiden heterozygotes, antithrombin III deficiency, positive lupus anticoagulant, or Protein C or S deficiencies. We observed that eight of 17 patients had an abnormal D-dimer level >0.5 mcg/dl, but deep venous thromboses occurred in only four of those with D-dimer >1.0 mcg/dl. We conclude that the predisposition to thrombosis is likely to be multifaceted with risk factors including vascular malformations, immobility, surgery, additional prothrombotic factors, and possible pathophysiologic effects of the somatic AKT1 mutation on platelet function or the vascular endothelium. The D-dimer test is useful as a screen for thromboembolism, although the screening threshold may need to be adjusted for patients with this disorder. We propose developing a registry to collect D-dimer and outcome data to facilitate adjustment of the D-dimer threshold for Proteus syndrome and related disorders, including PIK3CA-Related Overgrowth Spectrum.
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Affiliation(s)
- Kim M Keppler-Noreuil
- Medical Genomics Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Jay N Lozier
- Department of Laboratory Medicine, Warren Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Julie C Sapp
- Medical Genomics Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Leslie G Biesecker
- Medical Genomics Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
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Forgione AM. Managing patients with suspected pulmonary embolism. JAAPA 2006; 19:22-8. [PMID: 16869149 DOI: 10.1097/01720610-200607000-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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