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Hällqvist J, Lane D, Shapanis A, Davis K, Heywood WE, Doykov I, Śpiewak J, Ghansah N, Keevil B, Gupta P, Jukes-Jones R, Singh R, Foley D, Vissers JPC, Pattison R, Ferries S, Wardle R, Bartlett A, Calton LJ, Anderson L, Razavi M, Pearson T, Pope M, Yip R, Ng LL, Nicholas BI, Bailey A, Noel D, Dalton RN, Heales S, Hopley C, Pitt AR, Barran P, Jones DJL, Mills K, Skipp P, Carling RS. Operation Moonshot: rapid translation of a SARS-CoV-2 targeted peptide immunoaffinity liquid chromatography-tandem mass spectrometry test from research into routine clinical use. Clin Chem Lab Med 2023; 61:302-310. [PMID: 36395058 DOI: 10.1515/cclm-2022-1000] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES During 2020, the UK's Department of Health and Social Care (DHSC) established the Moonshot programme to fund various diagnostic approaches for the detection of SARS-CoV-2, the pathogen behind the COVID-19 pandemic. Mass spectrometry was one of the technologies proposed to increase testing capacity. METHODS Moonshot funded a multi-phase development programme, bringing together experts from academia, industry and the NHS to develop a state-of-the-art targeted protein assay utilising enrichment and liquid chromatography tandem mass spectrometry (LC-MS/MS) to capture and detect low levels of tryptic peptides derived from SARS-CoV-2 virus. The assay relies on detection of target peptides, ADETQALPQRK (ADE) and AYNVTQAFGR (AYN), derived from the nucleocapsid protein of SARS-CoV-2, measurement of which allowed the specific, sensitive, and robust detection of the virus from nasopharyngeal (NP) swabs. The diagnostic sensitivity and specificity of LC-MS/MS was compared with reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) via a prospective study. RESULTS Analysis of NP swabs (n=361) with a median RT-qPCR quantification cycle (Cq) of 27 (range 16.7-39.1) demonstrated diagnostic sensitivity of 92.4% (87.4-95.5), specificity of 97.4% (94.0-98.9) and near total concordance with RT-qPCR (Cohen's Kappa 0.90). Excluding Cq>32 samples, sensitivity was 97.9% (94.1-99.3), specificity 97.4% (94.0-98.9) and Cohen's Kappa 0.95. CONCLUSIONS This unique collaboration between academia, industry and the NHS enabled development, translation, and validation of a SARS-CoV-2 method in NP swabs to be achieved in 5 months. This pilot provides a model and pipeline for future accelerated development and implementation of LC-MS/MS protein/peptide assays into the routine clinical laboratory.
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Affiliation(s)
- Jenny Hällqvist
- University College London Translational Mass Spectrometry Research Group Unit, London, UK
- UCL Queen Square Institute of Neurology, London, UK
| | - Dan Lane
- The Department of Chemical Pathology and Metabolic Diseases, Leicester Royal Infirmary, Leicester, UK
- Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Andrew Shapanis
- Centre for Proteomic Research, University of Southampton, Southampton, UK
- Biological Sciences, University of Southampton, Southampton, UK
| | - Kayleigh Davis
- Biochemical Sciences, Synnovis, Guys & St Thomas' NHSFT, London, UK
| | - Wendy E Heywood
- University College London Translational Mass Spectrometry Research Group Unit, London, UK
| | - Ivan Doykov
- University College London Translational Mass Spectrometry Research Group Unit, London, UK
| | - Justyna Śpiewak
- University College London Translational Mass Spectrometry Research Group Unit, London, UK
| | - Nana Ghansah
- Neurometabolic Unit, National Hospital, London, UK
| | - Brian Keevil
- Department of Biochemistry, Manchester University NHS Trust, Manchester, UK
| | - Pankaj Gupta
- The Department of Chemical Pathology and Metabolic Diseases, Leicester Royal Infirmary, Leicester, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Rebekah Jukes-Jones
- The Department of Chemical Pathology and Metabolic Diseases, Leicester Royal Infirmary, Leicester, UK
- van Geest MS-OMICS Facility, University of Leicester, Leicester, UK
| | - Raj Singh
- van Geest MS-OMICS Facility, University of Leicester, Leicester, UK
| | - Dominic Foley
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | | | - Rebecca Pattison
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | - Samantha Ferries
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | - Robert Wardle
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | - Amy Bartlett
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | - Lisa J Calton
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | - Leigh Anderson
- SISCAPA Assay Technologies, Inc., Washington, DC, USA
- SISCAPA Assay Technologies, Inc., Victoria, BC, Canada
| | - Morteza Razavi
- SISCAPA Assay Technologies, Inc., Washington, DC, USA
- SISCAPA Assay Technologies, Inc., Victoria, BC, Canada
| | - Terry Pearson
- SISCAPA Assay Technologies, Inc., Washington, DC, USA
- SISCAPA Assay Technologies, Inc., Victoria, BC, Canada
| | - Matt Pope
- SISCAPA Assay Technologies, Inc., Washington, DC, USA
- SISCAPA Assay Technologies, Inc., Victoria, BC, Canada
| | - Richard Yip
- SISCAPA Assay Technologies, Inc., Washington, DC, USA
- SISCAPA Assay Technologies, Inc., Victoria, BC, Canada
| | - Leong L Ng
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- van Geest MS-OMICS Facility, University of Leicester, Leicester, UK
| | | | - Alistair Bailey
- Centre for Proteomic Research, University of Southampton, Southampton, UK
| | - Dan Noel
- Biological Sciences, University of Southampton, Southampton, UK
| | - R Neil Dalton
- WellChild Laboratory, Evelina London Children's Hospital, London, UK
| | - Simon Heales
- Neurometabolic Unit, National Hospital, London, UK
| | | | - Andrew R Pitt
- Manchester Institute of Biotechnology, University of Manchester, Manchester, UK
| | - Perdita Barran
- Manchester Institute of Biotechnology, University of Manchester, Manchester, UK
| | - Donald J L Jones
- van Geest MS-OMICS Facility, University of Leicester, Leicester, UK
| | - Kevin Mills
- University College London Translational Mass Spectrometry Research Group Unit, London, UK
| | - Paul Skipp
- Centre for Proteomic Research, University of Southampton, Southampton, UK
- Biological Sciences, University of Southampton, Southampton, UK
| | - Rachel S Carling
- Biochemical Sciences, Synnovis, Guys & St Thomas' NHSFT, London, UK
- GKT School Medical Education, Kings College London, London, UK
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Doykov ID, Heywood WE, Nikolaenko V, Śpiewak J, Hällqvist J, Clayton PT, Mills P, Warnock DG, Nowak A, Mills K. Rapid, proteomic urine assay for monitoring progressive organ disease in Fabry disease. J Med Genet 2019; 57:38-47. [PMID: 31519711 DOI: 10.1136/jmedgenet-2019-106030] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 07/04/2019] [Accepted: 07/24/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Fabry disease is a progressive multisystemic disease, which affects the kidney and cardiovascular systems. Various treatments exist but decisions on how and when to treat are contentious. The current marker for monitoring treatment is plasma globotriaosylsphingosine (lyso-Gb3), but it is not informative about the underlying and developing disease pathology. METHODS We have created a urine proteomic assay containing a panel of biomarkers designed to measure disease-related pathology which include the inflammatory system, lysosome, heart, kidney, endothelium and cardiovascular system. Using a targeted proteomic-based approach, a series of 40 proteins for organ systems affected in Fabry disease were multiplexed into a single 10 min multiple reaction monitoring Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) assay and using only 1 mL of urine. RESULTS Six urinary proteins were elevated in the early-stage/asymptomatic Fabry group compared with controls including albumin, uromodulin, α1-antitrypsin, glycogen phosphorylase brain form, endothelial protein receptor C and intracellular adhesion molecule 1. Albumin demonstrated an increase in urine and could indicate presymptomatic disease. The only protein elevated in the early-stage/asymptomatic patients that continued to increase with progressive multiorgan involvement was glycogen phosphorylase brain form. Podocalyxin, fibroblast growth factor 23, cubulin and Alpha-1-Microglobulin/Bikunin Precursor (AMBP) were elevated only in disease groups involving kidney disease. Nephrin, a podocyte-specific protein, was elevated in all symptomatic groups. Prosaposin was increased in all symptomatic groups and showed greater specificity (p<0.025-0.0002) according to disease severity. CONCLUSION This work indicates that protein biomarkers could be helpful and used in conjunction with plasma lyso-Gb3 for monitoring of therapy or disease progression in patients with Fabry disease.
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Affiliation(s)
- Ivan D Doykov
- Centre for Inborn Errors of Metabolism, UCL Institute of Child Health Library, London, UK
| | - Wendy E Heywood
- Centre for Inborn Errors of Metabolism, UCL Institute of Child Health Library, London, UK.,NIHR Great Ormond Street Biomedical Research Centre, Great Ormond Street Hospital and UCL Great Ormond Street Institute of Child Health, London, UK
| | - Valeria Nikolaenko
- Centre for Inborn Errors of Metabolism, UCL Institute of Child Health Library, London, UK.,NIHR Great Ormond Street Biomedical Research Centre, Great Ormond Street Hospital and UCL Great Ormond Street Institute of Child Health, London, UK
| | - Justyna Śpiewak
- Centre for Inborn Errors of Metabolism, UCL Institute of Child Health Library, London, UK
| | - Jenny Hällqvist
- Centre for Inborn Errors of Metabolism, UCL Institute of Child Health Library, London, UK
| | - Peter Theodore Clayton
- Centre for Inborn Errors of Metabolism, UCL Institute of Child Health Library, London, UK
| | - Philippa Mills
- Centre for Inborn Errors of Metabolism, UCL Institute of Child Health Library, London, UK
| | - David G Warnock
- Division of Nephrology, Department of Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Albina Nowak
- Department of Endocrinology and Clinical Nutrition, University Hospital Zurich and University of Zurich, Raemistrasse, Zurich, Switzerland
| | - Kevin Mills
- Centre for Inborn Errors of Metabolism, UCL Institute of Child Health Library, London, UK .,NIHR Great Ormond Street Biomedical Research Centre, Great Ormond Street Hospital and UCL Great Ormond Street Institute of Child Health, London, UK
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