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Nucleic Acid-Based Lateral Flow Biosensor for Salmonella Typhi and Salmonella Paratyphi: A Detection in Stool Samples of Suspected Carriers. Diagnostics (Basel) 2021; 11:diagnostics11040700. [PMID: 33919817 PMCID: PMC8070779 DOI: 10.3390/diagnostics11040700] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/11/2021] [Accepted: 04/11/2021] [Indexed: 11/17/2022] Open
Abstract
A multiplex rapid detection system, based on a PCR-lateral flow biosensor (mPCR-LFB) was developed to identify Salmonella Typhi and Salmonella Paratyphi A from suspected carriers. The lower detection limit for S. Typhi and S. Paratyphi A was 0.16 and 0.08 ng DNA equivalent to 10 and 102 CFU/mL, respectively. Lateral flow biosensor was used for visual detection of mPCR amplicons (stgA, SPAint, ompC, internal amplification control) by labeling forward primers with fluorescein-isothiocyanate (FITC), Texas Red, dinitrophenol (DNP) and digoxigenin (DIG) and reverse primers with biotin. Binding of streptavidin-colloidal gold conjugate with the amplicons resulted in formation of a red color dots on the strip after 15-20 min of sample exposure. The nucleic acid lateral flow analysis of the mPCR-LFB was better in sensitivity and more rapid than the conventional agarose gel electrophoresis. Moreover, the mPCR-LFB showed 100% sensitivity and specificity when evaluated with stools spiked with 100 isolates of Salmonella genus and other bacteria. A prospective cohort study on stool samples of 1176 food handlers in outbreak areas (suspected carriers) resulted in 23 (2%) positive for S. Typhi. The developed assay has potential to be used for rapid detection of typhoid carriers in surveillance program.
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Alam N, Tong L, He Z, Tang R, Ahsan L, Ni Y. Improving the sensitivity of cellulose fiber-based lateral flow assay by incorporating a water-dissolvable polyvinyl alcohol dam. CELLULOSE (LONDON, ENGLAND) 2021; 28:8641-8651. [PMID: 34305338 PMCID: PMC8286161 DOI: 10.1007/s10570-021-04083-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/12/2021] [Indexed: 05/09/2023]
Abstract
UNLABELLED Lateral flow assay (LFA) is an important point-of-care (POC) test platform due to the associated portability, on-site testing, and low cost for diagnosis of pathogen infections and disease biomarkers. However, compared to high-end analyzers in hospitals, LFA devices, in particular, paper- based LFA tests, fall short in accuracy. This study focuses on two ways to improve LFAs: (1) using cellulose fibers, rather than glass fibers for a sample pad, and (2) incorporating a one-step simple, facile, and low cost PVA dam into the LFA. Both strategies (cellulose fiber as a sample pad and water dissolvable PVA dam) contributed to delaying the controlled biomolecule's flow through the nitrocellulose membrane's capillary channels resulting in increased bio-recognition time, thus contributing to the enhancement of LFA sensitivity. PVA modified cellulose fiber-based LFA demonstrated 10 times higher sensitivity than the cellulose fiber-based unmodified LFA, whereas 2 times enhancement was obtained in the cellulose fiber-based sample pad LFA compared to the glass fiber-based sample pad LFA. Ultimately, 20 times increase in sensitivity was achieved in the modified LFA device. This study shows that PVA and eco-friendly cellulose fibers could be incorporated into other paper based POC testing devices for future development. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10570-021-04083-3.
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Affiliation(s)
- Nur Alam
- Department of Chemical Engineering, University of New Brunswick, Fredericton, NB E3B 5A3 Canada
| | - Li Tong
- Department of Chemical Engineering, University of New Brunswick, Fredericton, NB E3B 5A3 Canada
| | - Zhibin He
- Department of Chemical Engineering, University of New Brunswick, Fredericton, NB E3B 5A3 Canada
| | - Ruihua Tang
- Department of Chemical Engineering, University of New Brunswick, Fredericton, NB E3B 5A3 Canada
- College of Bioresources Chemical and Materials Engineering, Shaanxi University of Science & Technology, Xi’an, 710021 People’s Republic of China
| | - Laboni Ahsan
- Labaid Ltd (Diagonestic and Reference Lab), Dhanmondi, Dhaka, Bangladesh
| | - Yonghao Ni
- Department of Chemical Engineering, University of New Brunswick, Fredericton, NB E3B 5A3 Canada
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Meyer Sauteur PM, Stevens MJA, Paioni P, Wüthrich D, Egli A, Stephan R, Berger C, Bloemberg GV. Siblings with typhoid fever: An investigation of intrafamilial transmission, clonality, and antibiotic susceptibility. Travel Med Infect Dis 2019; 34:101498. [PMID: 31580900 DOI: 10.1016/j.tmaid.2019.101498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/27/2019] [Accepted: 09/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Typhoid fever usually manifests as an acute disease. However, asymptomatic carriage with Salmonella Typhi may occur. This study investigated a family setting of severe typhoid fever in Switzerland months after return from Bangladesh. METHOD Standard microbiological procedures were performed. Testing for S. Typhi IgM antibodies was done using a novel immunochromographic lateral flow assay. Whole genome sequencing (WGS) followed by comparative core genome multilocus sequence typing (cgMLST) was performed on the S. Typhi isolates. RESULTS Four months after returning from a visit to Bangladesh sibling 1 (9 months) was diagnosed with a S. Typhi meningitis and sibling 3 (8 years) was identified as asymptomatic S. Typhi carrier. Sibling 2 (2 years) was retrospectively diagnosed with typhoid fever by IgM serology at the time point of admission to the hospital. Parents were asymptomatic and culture-negative. WGS analysis of family S. Typhi isolates showed clonality and strongest homology with S. Typhi strains occurring in Bangladesh. The S. Typhi strain showed resistance against fluoroquinolones. A 4-week course of ceftriaxone resulted in full recovery of sibling 1. S. Typhi was eradicated from sibling 3 following azithromycin treatment for 14 days. CONCLUSION S. Typhi, acquired from a visit to Bangladesh, was most likely transmitted within the family from one brother as asymptomatic shedder to his 9-month-old brother who manifested S. Typhi meningitis as a very rare and life-threatening presentation of typhoid fever. S. Typhi infection should be considered even in case of uncommon manifestations and irrespective of the interval between disease presentation and travel to an endemic area.
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Affiliation(s)
- Patrick M Meyer Sauteur
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Switzerland
| | - Marc J A Stevens
- Institute for Food Safety and Hygiene, University of Zurich, Switzerland
| | - Paolo Paioni
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Switzerland
| | - Daniel Wüthrich
- Clinical Bacteriology & Mycology, University Hospital Basel, Basel, Switzerland; Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland; Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Adrian Egli
- Clinical Bacteriology & Mycology, University Hospital Basel, Basel, Switzerland; Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Roger Stephan
- Swiss National Center for Enteropathogenic Bacteria and Listeria (NENT), Institute for Food Safety and Hygiene, University of Zurich, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Switzerland
| | - Guido V Bloemberg
- Swiss National Center for Enteropathogenic Bacteria and Listeria (NENT), Institute for Food Safety and Hygiene, University of Zurich, Switzerland.
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Arora P, Thorlund K, Brenner DR, Andrews JR. Comparative accuracy of typhoid diagnostic tools: A Bayesian latent-class network analysis. PLoS Negl Trop Dis 2019; 13:e0007303. [PMID: 31067228 PMCID: PMC6527309 DOI: 10.1371/journal.pntd.0007303] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 05/20/2019] [Accepted: 03/13/2019] [Indexed: 11/19/2022] Open
Abstract
Background Typhoid fevers are infections caused by the bacteria Salmonella enterica serovar Typhi (Salmonella Typhi) and Paratyphi A, B and C (Salmonella Paratyphi). Approximately 17.8 million incident cases of typhoid fever occur annually, and incidence is highest in children. The accuracy of current diagnostic tests of typhoid fever is poorly understood. We aimed to determine the comparative accuracy of available tests for the pediatric population. Methods We first conducted a systematic literature review to identify studies that compared diagnostic tests for typhoid fever in children (aged ≤15 years) to blood culture results. We applied a Bayesian latent-class extension to a network meta-analysis model. We modelled known diagnostic properties of bone marrow culture and the relationship between bone marrow and blood culture as informative priors in a Bayesian framework. We tested sensitivities for the proportion of negative blood samples that were false as well as bone marrow sensitivity and specificity. Results We found 510 comparisons from 196 studies and 57 specific to the pediatric population. IgM-based tests outperformed their IgG-based counterparts for ELISA and Typhidot tests. The lateral flow IgG test performed comparatively well with 92% sensitivity (72% to 98% across scenario analyses) and 94% specificity. The most sensitive test of those investigated for the South Asian pediatric population was the Reverse Passive Hemagglutination Assay with 99% sensitivity (98% - 100% across scenario analyses). Adding a Widal slide test to other typhoid diagnostics did not substantially improve diagnostic performance beyond the single test alone, however, a lateral flow-based IgG rapid test combined with the typhoid/paratyphoid (TPT) assay yielded improvements in sensitivity without substantial declines in specificity and was the best performing combination test in this setting. Conclusion In the pediatric population, lateral-flow IgG, TPT and Reverse Passive Hemagglutination tests had high diagnostic accuracy compared to other diagnostics. Combinations of tests may provide a feasible option to increase diagnostic sensitivity. South Asia has the most informed set of data on typhoid diagnostic testing accuracy, and the evidence base in other important regions needs to be expanded. Typhoid fever is an infection caused by the bacterium Salmonella Typhi. Typhoid fever is rare in developed countries but remains high in the developing world. Effective treatment is available but accurate diagnosis of typhoid fever is challenging as typhoid fever can be difficult to distinguish from other infections. Bone marrow culture is the most accurate diagnostic test for typhoid fever however is invasive and not feasible in many settings. New vaccines for typhoid and the need for improved estimates of burden increases the demand for improved understanding of diagnostic accuracy. Comparing the diagnostic accuracy of tests for typhoid fever is challenging as head-to-head studies are few. We applied newly developed methods for comparative evaluation of diagnostic tests for typhoid fever in children using statistical approaches that allowed for the proper incorporation of uncertainty and comparison of tests that had not been compared directly. The lateral-flow IgG, TPT and Reverse Passive Hemagglutination tests all had good diagnostic accuracy compared to other diagnostics. Combinations of tests may provide a feasible option to increase diagnostic sensitivity. Finally, while South Asia has the most informed set of data on typhoid diagnostic testing accuracy, the evidence base in other important regions needs to be expanded.
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Affiliation(s)
- Paul Arora
- Dalla Lana School of Public Health, Division of Epidemiology, University of Toronto, Ontario, Canada
- * E-mail:
| | - Kristian Thorlund
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Darren R. Brenner
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jason R. Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, California, United States of America
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Yahaya M, Zakaria N, Noordin R, Razak K. The Effect of Nitrocellulose Membrane Pore Size of Lateral Flow Immunoassay on Sensitivity for Detection of Shigella sp. in Milk Sample. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.matpr.2019.06.384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Phaneuf CR, Mangadu B, Tran HM, Light YK, Sinha A, Charbonier FW, Eckles TP, Singh AK, Koh CY. Integrated LAMP and immunoassay platform for diarrheal disease detection. Biosens Bioelectron 2018; 120:93-101. [PMID: 30172236 PMCID: PMC6145809 DOI: 10.1016/j.bios.2018.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/01/2018] [Accepted: 08/06/2018] [Indexed: 01/15/2023]
Abstract
The challenges of diagnosing infectious disease, especially in the developing world, and the shortcomings of available instrumentation have exposed the need for portable, easy-to-use diagnostic tools capable of detecting the wide range of causative microbes while operating in low resource settings. We present a centrifugal microfluidic platform that combines ultrasensitive immunoassay and isothermal amplification-based screening for the orthogonal detection of both protein and nucleic acid targets at the point-of-care. A disposable disc with automatic aliquoting inlets is paired with a non-contact heating system and precise rotary control system to yield an easy-to-use, field-deployable platform with versatile screening capabilities. The detection of three enterotoxins (cholera toxin, Staphylococcal enterotoxin B, and Shiga-like toxin 1) and three enteric bacteria (C. jejuni, E. coli, and S. typhimurium) were performed independently and shown to be highly sensitive (limit of detection = 1.35-5.50 ng/mL for immunoassays and 1-30 cells for isothermal amplification), highly exclusive in the presence of non-specific targets, and capable of handling a complex sample matrix like stool. The full panel of toxins and bacteria were reliably detected simultaneously on a single disc at clinically relevant sample concentrations in less than an hour. The ability of our technology to detect multiple analyte types in parallel at the point-of-care can serve a variety of needs, from routine patient care to outbreak triage, in a variety of settings to reduce disease impact and expedite effective treatment.
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Affiliation(s)
- Christopher R Phaneuf
- Biotechnology and Bioengineering, Sandia National Laboratories, 7011 East Avenue, Livermore, CA 94550, United States
| | - Betty Mangadu
- Biotechnology and Bioengineering, Sandia National Laboratories, 7011 East Avenue, Livermore, CA 94550, United States
| | - Huu M Tran
- Biotechnology and Bioengineering, Sandia National Laboratories, 7011 East Avenue, Livermore, CA 94550, United States
| | - Yooli K Light
- Systems Biology, Sandia National Laboratories, 7011 East Avenue, Livermore, CA 94550, United States
| | - Anchal Sinha
- Biotechnology and Bioengineering, Sandia National Laboratories, 7011 East Avenue, Livermore, CA 94550, United States
| | - Frank W Charbonier
- Biotechnology and Bioengineering, Sandia National Laboratories, 7011 East Avenue, Livermore, CA 94550, United States
| | - Tyler P Eckles
- Biotechnology and Bioengineering, Sandia National Laboratories, 7011 East Avenue, Livermore, CA 94550, United States
| | - Anup K Singh
- Biotechnology and Bioengineering, Sandia National Laboratories, 7011 East Avenue, Livermore, CA 94550, United States
| | - Chung-Yan Koh
- Biotechnology and Bioengineering, Sandia National Laboratories, 7011 East Avenue, Livermore, CA 94550, United States.
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Sayeed MA, Islam K, Hossain M, Akter NJ, Alam MN, Sultana N, Khanam F, Kelly M, Charles RC, Kováč P, Xu P, Andrews JR, Calderwood SB, Amin J, Ryan ET, Qadri F. Development of a new dipstick (Cholkit) for rapid detection of Vibrio cholerae O1 in acute watery diarrheal stools. PLoS Negl Trop Dis 2018. [PMID: 29538377 PMCID: PMC5862499 DOI: 10.1371/journal.pntd.0006286] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Recognizing cholera cases early, especially in the initial phase of an outbreak and in areas where cholera has not previously circulated, is a high public health priority. Laboratory capacity in such settings is often limited. To address this, we have developed a rapid diagnostic test (RDT) termed Cholkit that is based on an immunochromatographic lateral flow assay for the diagnosis of cholera cases using stool. Cholkit contains a monoclonal antibody (ICL-33) to the O-specific polysaccharide (OSP) component of V. cholerae O1 lipopolysaccharide, and recognizes both Inaba and Ogawa serotypes. We tested the Cholkit dipstick using fresh stool specimens of 76 adults and children presenting with acute watery diarrhea at the icddr,b hospital in Dhaka, Bangladesh. We compared Cholkit’s performance with those of microbial culture, PCR (targeting the rfb and ctxA genes of V. cholerae) and the commercially available RDT, Crystal VC (Span Diagnostics; Surat, India). We found that all stool specimens with a positive culture for V. cholerae O1 (n = 19) were positive by Cholkit as well as Crystal VC. We then used Bayesian latent class modeling to estimate the sensitivity and specificity of each diagnostic assay. The sensitivity of Cholkit, microbiological culture, PCR and Crystal VC was 98% (95% CI: 88–100), 71% (95% CI: 59–81), 74% (95% CI: 59–86) and 98% (95% CI: 88–100), respectively. The specificity for V. cholerae O1 was 97% (95% CI: 89–100), 100%, 97% (95% CI: 93–99) and 98% (95% CI: 92–100), respectively. Of note, two Crystal VC dipsticks were positive for V. cholerae O139 but negative by culture and PCR in this area without known circulating epidemic V. cholerae O139. In conclusion, the Cholkit dipstick is simple to use, requires no dedicated laboratory capacity, and has a sensitivity and specificity for V. cholerae O1 of 98% and 97%, respectively. Cholkit warrants further evaluation in other settings. Cholera is a severely dehydrating diarrheal disease that can lead to death if remains untreated. The incidence of case fatality is higher at the beginning of the outbreak. Diagnosis of cholera in the early stage of outbreak is a high public health priority. Although countries facing complex emergencies are more vulnerable to cholera outbreak, laboratory capacity in such settings is usually limited. To address this, here we report the development of a rapid diagnostic test (RDT) termed Cholkit for the diagnosis of cholera cases using stool and the assessment of its performance with those of microbial culture, PCR and Crystal VC assay, a commercially available dipstick using a latent class modeling approach.
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Affiliation(s)
- Md. Abu Sayeed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kamrul Islam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Motaher Hossain
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Md. Nur Alam
- Incepta Pharmaceuticals Ltd, Savar, Dhaka, Bangladesh
| | | | - Farhana Khanam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Meagan Kelly
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Richelle C. Charles
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Pavol Kováč
- National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), Laboratory of Bioorganic Chemistry (LBC), National Institutes of Health, Bethesda, Maryland, United States of America
| | - Peng Xu
- National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), Laboratory of Bioorganic Chemistry (LBC), National Institutes of Health, Bethesda, Maryland, United States of America
| | - Jason R. Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Stephen B. Calderwood
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jakia Amin
- Incepta Pharmaceuticals Ltd, Savar, Dhaka, Bangladesh
| | - Edward T. Ryan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Firdausi Qadri
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- * E-mail:
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Sotnikov DV, Zherdev AV, Dzantiev BB. Theoretical and Experimental Comparison of Different Formats of Immunochromatographic Serodiagnostics. SENSORS 2017; 18:s18010036. [PMID: 29295582 PMCID: PMC5795850 DOI: 10.3390/s18010036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 12/20/2017] [Accepted: 12/22/2017] [Indexed: 11/16/2022]
Abstract
In this study, a comparative theoretical and experimental analysis of two immuno-chromatographic serodiagnostics schemes, which differ in the immobilization of immunoreagents and the order of the formation of immune complexes, is performed. Based on the theoretical models, the assays are characterized to determine which scheme has a higher quantity of the detected complex and thus ensures the sensitivity of the analysis. The results show that for the effective detection of low-affinity antibodies, the scheme involving the immobilization of the antigen on gold nanoparticles and the antibody-binding protein on the test strip was more sensitive than the predominantly used scheme, which inverts the immunoreagents’ locations. The theoretical predictions were confirmed by the experimental testing of sera collected from tuberculosis patients.
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Affiliation(s)
- Dmitriy V Sotnikov
- A.N. Bach Institute of Biochemistry, Research Center of Biotechnology of the Russian Academy of Sciences, Leninsky Prospect 33, Moscow 119071, Russia.
| | - Anatoly V Zherdev
- A.N. Bach Institute of Biochemistry, Research Center of Biotechnology of the Russian Academy of Sciences, Leninsky Prospect 33, Moscow 119071, Russia.
| | - Boris B Dzantiev
- A.N. Bach Institute of Biochemistry, Research Center of Biotechnology of the Russian Academy of Sciences, Leninsky Prospect 33, Moscow 119071, Russia.
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