Modular point-of-care devices and uses thereof
Abstract
Point-of-care methods have proven to be extremely useful in disease and treatment monitoring (eg, glycemic system in the treatment of diabetes, measurement of prothrombin time in anticoagulant therapy with warfarin). By measuring multiple markers, it may be possible to better monitor and control treatments such as complex diseases (such as cancer) and multidrug therapies for cancer. The present invention provides devices and systems used in Point of Care. The method and device of the present invention are intended to automatically detect an analysis target in a body fluid. The components of the device are modular, allowing flexibility and robustness of use in the methods disclosed in various medical applications.

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Projected expiry 2 October 2028.
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78 claims: 9 independent, 69 dependent
- 1体液試料中における解析対象の自動検出カートリッジであって、 前記解析対象の存在または不在を示す検出可能なシグナルをもたらす化学反応を実行するように構成されるアドレス可能なアッセイユニットのアレイと、 前記アッセイユニットのアレイの個々のアドレス可能なアッセイユニットに対応するように個々のアドレス可能な試薬ユニットがアドレスされ、前記カートリッジ上において組み立てられる前に前記対応する個々のアッセイユニットを基準として較正されるように前記個々の試薬ユニットが構成されるアドレス可能な試薬ユニットのアレイとを含むカートリッジ。
- 2体液試料中における解析対象の自動検出カートリッジであって、 前記体液試料を受け入れるように構成される試料収集ユニットと、 前記試料収集ユニットから試料の一部を受け入れ、前記試料中における前記解析対象の存在を示す検出可能なシグナルをもたらす化学反応を実行するように構成されるアッセイユニットのアレイと、 前記化学反応を実行するための試薬を収容する試薬ユニットのアレイと、 を含み、前記化学反応を実行するための試薬が前記アッセイユニット内の前記試料の一部と接触するように、前記アッセイユニットのアレイの個々のアッセイユニットおよび前記試薬ユニットのアレイの個々の試薬ユニットが流体連絡へと移動可能であるように構成されるカートリッジ。
- 3前記体液試料を受け入れるように構成される試料収集ユニットをさらに含む、請求項1に記載のデバイス。
- 4前記個々の試薬ユニットが、移動可能なアッセイユニットを受け入れるように構成される、請求項1または2に記載のデバイス。
- 5前記個々のアッセイユニットがアッセイチップを含む、請求項1または2に記載のデバイス。
- 6前記個々のアッセイユニットが、イムノアッセイを実行するように構成される、請求項1または2に記載のデバイス。
- 7前記体液試料が血液試料である、請求項1または2に記載のデバイス。
- 8前記試料収集ユニットが、容量約20マイクロリットル以下の前記体液試料を受け入れるように構成される、請求項2または3に記載のデバイス。
- 9前記試料収集ユニットが、1滴の血液である容量の前記体液試料を受け入れるように構成される、請求項2または3に記載のデバイス。
- 10化学反応を実行して前記解析対象を検出するために前記体液試料の一部を取り出すように構成される前処理ユニットをさらに含む、請求項1または2に記載のデバイス。
- 11前記体液試料が全血試料であり、前記一部が血漿である、請求項10に記載のデバイス。
- 12体液試料中における解析対象の自動検出システムであって、 a.請求項1または2に記載のデバイスと、 b.前記解析対象の存在または不在を示す検出可能なシグナルを検出するための検出アセンブリーとを含むシステム。
- 13前記個々のアッセイユニットを第1の位置から第2の位置へと移動させるように構成されるプログラム可能な機械デバイスをさらに含む、請求項12に記載のシステム。
- 14流体移送デバイスをさらに含む、請求項12に記載のシステム。
- 15前記流体移送デバイスがピペットである、請求項14に記載のシステム。
- 16前記流体移送デバイスが自動式である、請求項14に記載のシステム。
- 17検出される前記解析対象に基づくプロトコールを送信するための通信アセンブリーをさらに含む、請求項12に記載のシステム。
- 18個々のアッセイユニットを受け入れるように構成される加熱ブロックをさらに含む、請求項12に記載のシステム。
- 19磁性ブロックをさらに含む、請求項12に記載のシステム。
- 20体液試料中における複数種の解析対象の自動検出システムであって、 前記体液試料を収容するように構成される試料収集ユニット、 検出される前記複数種の解析対象の個々の解析対象を示すシグナルをもたらす化学反応を実行するように個々のアッセイユニットが構成されるアッセイユニットのアレイ、および 個々の試薬ユニットが試薬を収容する試薬ユニットのアレイを含む流体デバイスと、 前記個々のアッセイユニットに係合するように個々のヘッドが構成される複数のヘッドを含み、前記試料収集ユニットからの前記体液試料および前記個々の試薬ユニットからの前記試薬の、前記個々のアッセイユニットへの流体移送を方向づけるように構成されるプログラム可能なプロセッサーを含む流体移送デバイスとを含むシステム。
- 21前記複数種の解析対象が前記システムで検出可能となるように、流体移送を方向づけるプロセッサーの構成により、前記アッセイユニットのアレイ内における前記体液試料のある希釈度を達成し、検出される前記複数種の解析対象を示すシグナルを検出可能な範囲内に収める、請求項20に記載のシステム。
- 22前記体液試料が、少なくとも2桁分異なる濃度で存在する少なくとも2種の解析対象を含む、請求項21に記載のシステム。
- 23前記体液試料が、少なくとも5桁分異なる濃度で存在する少なくとも2種の解析対象を含む、請求項21に記載のシステム。
- 24前記体液試料の前記希釈度により、前記少なくとも2種の解析対象を示すシグナルを前記検出可能な範囲内に収める、請求項22に記載のシステム。
- 25前記検出可能な範囲のシグナル強度を検出するように構成される検出器をさらに含む、請求項21に記載のシステム。
- 26前記検出器が光電子増倍管である、請求項25に記載のシステム。
- 27前記検出可能な範囲が毎秒約1000~約100万カウントである、請求項26に記載のシステム。
- 28前記体液試料が約20ul未満である、請求項20に記載のシステム。
- 29前記体液試料が1滴の血液である、請求項20に記載のシステム。
- 30前記個々のヘッドが前記個々のアッセイユニットに接着するように構成される、請求項20に記載のシステム。
- 31前記個々のアッセイユニットがイムノアッセイ反応サイトを提供する、請求項20に記載のシステム。
- 32前記個々のアッセイユニットがピペットチップである、請求項20に記載のシステム。
- 33前記流体移送デバイスがピペットである、請求項20に記載のシステム。
- 34前記ピペットが空気置換式ピペットである、請求項33に記載のシステム。
- 35前記流体移送デバイスが、プログラム可能なプロセッサーと連絡しているモーターをさらに含む、請求項20に記載のシステム。
- 36前記モーターが、前記プログラム可能なプロセッサーからのプロトコールに基づき、前記複数のヘッドを移動させ、場合によって、前記プログラム可能なプロセッサーが外部デバイスから送信されたプロトコールに応答する、請求項35に記載のシステム。
- 37全血試料の血漿部分中における解析対象の自動検出システムであって、 a.前記全血試料を自動的に受け入れ処理して前記血漿部分をもたらすように構成され、前記目的の解析対象の存在または不在を示す検出可能なシグナルがオンボードで前記血漿部分から発生するデバイスと、 b.前記解析対象の存在または不在を示す前記検出可能なシグナルを検出するための検出アセンブリーとを含むシステム。
- 38体液試料中における解析対象を検出する方法であって、 a.請求項1または2に記載のデバイスに血液試料を供給するステップと、 b.前記試料を少なくとも1つのアッセイユニット内で反応させるステップと、 c.前記体液試料中において収集された前記解析対象から発生する前記検出可能なシグナルを検出するステップとを含む方法。
- 39前記体液試料が血液であり、前記方法が前記血液から血漿を取り出すステップをさらに含む、請求項38に記載の方法。
- 40体液試料中における解析対象の自動検出カートリッジのオンデマンドアセンブリー法であって、デバイスがハウジングを含み、前記ハウジングが、前記解析対象の存在または不在を示す検出可能なシグナルをもたらす化学反応を実行するように個々のアッセイユニットが構成されるアドレス可能なアッセイユニットのアレイ、および前記個々のアッセイユニットに対応するように個々の試薬ユニットがアドレスされるアドレス可能な試薬ユニットのアレイを含み、 (i)エンドユーザーによりオーダーされた目的の解析対象を検出する化学反応を実行するように個々のアッセイユニットが構成されるアドレス可能なアッセイユニットのアレイを、検出される前記解析対象に従って前記ハウジング内に配置するステップと、 (ii)個々の試薬ユニットが前記個々のアッセイユニットに対応する試薬ユニットのアレイを、検出される前記解析対象に従って前記ハウジング内に配置するステップと、 (iii)(i)および(ii)のアレイを前記デバイスの前記ハウジング内に固定するステップとを含む方法。
- 41検出される解析対象を選択するステップをさらに含む、請求項40に記載の方法。
- 42前記カートリッジをシーリングするステップをさらに含む、請求項40に記載の方法。
- 43検出される前記解析対象を示す読み取り可能なラベルにより前記カートリッジをラベルするステップをさらに含む、請求項40に記載の方法。
- 44前記読み取り可能なラベルがバーコードまたはRFIDである、請求項43に記載の方法。
- 45体液試料中における複数種の解析対象の自動検出法であって、 a.前記体液試料を収容するように構成される試料収集ユニット、検出される前記複数種の解析対象の個々の解析対象を示すシグナルをもたらす化学反応を実行するように個々のアッセイユニットが構成されるアッセイユニットのアレイ、および個々の試薬ユニットが試薬を収容する試薬ユニットのアレイを含む流体デバイスに前記体液試料を供給するステップと、 b.流体移送デバイスを用いて前記個々のアッセイユニットを係合するステップと、 c.前記流体移送デバイスを用いて前記体液試料を前記試料収集ユニットから前記個々のアッセイユニットへと移送するステップと、 d.前記試薬を前記個々の試薬ユニットから前記個々のアッセイユニットへと移送し、これにより、前記試薬を前記体液試料と反応させて、検出される前記複数種の解析対象の前記個々の解析対象を示す前記シグナルをもたらすステップとを含む方法。
- 46前記流体移送デバイスが、前記個々のアッセイユニットを係合するように個々のヘッドが構成される複数のヘッドを含み、前記流体移送デバイスが、前記試料収集ユニットからの前記体液試料および前記個々の試薬ユニットからの前記試薬の、前記個々のアッセイユニットへの流体移送を方向づけるように構成されるプログラム可能なプロセッサーを含む、請求項45に記載の方法。
- 47命令を前記プログラム可能なプロセッサーに下すステップをさらに含む、請求項46に記載の方法。
- 48前記命令が、前記体液試料を前記個々のアッセイユニットへと移送する前記ステップを方向づける、請求項47に記載の方法。
- 49前記体液試料を移送する前記ステップにより、前記個々のアッセイユニット内における前記体液試料のある希釈度を達成し、検出される前記複数種の解析対象の前記個々の解析対象を示す前記シグナルを検出可能な範囲内に収める、請求項45に記載の方法。
- 50前記体液試料が、少なくとも2桁分異なる濃度で存在する少なくとも2種の個々の解析対象を含む、請求項45に記載の方法。
- 51前記体液試料が、少なくとも5桁分異なる濃度で存在する少なくとも2種の個々の解析対象を含む、請求項45に記載の方法。
- 52前記体液試料の前記希釈度により、前記少なくとも2種の個々の解析対象を示すシグナルを前記検出可能な範囲内に収める、請求項50に記載の方法。
- 53前記検出可能な範囲が、光電子倍増管で検出され、毎秒約1000~約100万カウントである、請求項45に記載の方法。
- 54前記体液試料が、約20ul未満である、請求項45に記載の方法。
- 55前記体液試料が1滴の血液である、請求項45に記載の方法。
- 56前記個々の試薬ユニット内における前記試薬がイムノアッセイ用の酵素基質である、請求項45に記載の方法。
- 57検出される複数種の解析対象の個々の解析対象を示すシグナルをもたらす反応が完了した後で、前記個々の試薬ユニットから前記試薬を移送するステップを反復し、これにより、前記個々の解析対象を示す第2のシグナルをもたらす第2の反応を創出するステップをさらに含む、請求項56に記載の方法。
- 58前記個々の解析対象を示す前記シグナルの強度および前記第2のシグナルの第2の強度を平均して、前記個々の解析対象を示す前記シグナルの最終強度を計算する、請求項57に記載の方法。
- 59生物学的流体試料の容量を測定する方法であって、 a.前記試料中における公知の量の対照解析対象を試薬と反応させて、前記対照解析対象の量を示す検出可能なシグナルをもたらすステップと、 b.前記検出可能なシグナルを、予測される検出可能なシグナルと比較するステップであって、前記予測されるシグナルが前記試料の予測容量を示し、前記比較が、測定される前記試料の前記容量の測定値を与えるステップとを含む方法。
- 60前記対照解析対象が通常、前記試料中において、検出可能な量では存在しない、請求項59に記載の方法。
- 61前記試料の前記容量の前記測定値が、前記試料の前記予測容量の約50%以内である場合に、前記試料の前記容量を検証するステップをさらに含む、請求項59に記載の方法。
- 62a.標的解析対象を含有する体液試料を、前記標的解析対象を示す検出可能なシグナルをもたらす試薬と反応させるステップと、 b.前記標的解析対象を示す前記検出可能なシグナルおよび前記液体試料の前記容量の前記測定値に基づき、前記体液試料中における標的解析対象の量を測定するステップとをさらに含む、請求項59に記載の方法。
- 63液体試料と体液試料とが同じ試料である、請求項59に記載の方法。
- 64前記対照解析対象が前記体液試料中における前記標的解析対象と反応しない、請求項59に記載の方法。
- 65前記液体試料と前記体液試料とが異なる液体試料である、請求項59に記載の方法。
- 66前記対照解析対象が、アルブミン、フルオレセイン、IgG、プロテインC、フルオレセイン標識アルブミン、フルオレセイン標識IgG、抗フルオレセイン、抗ジゴキシゲニン、ジゴキシゲニン標識アルブミン、ジゴキシゲニン標識IgG、ビオチン化タンパク質、および非ヒトIgGからなる群から選択される、請求項59に記載の方法。
- 67請求項12または19に記載のシステムにおいて実施される、請求項59に記載の方法。
- 68血液試料から血漿を取り出す方法であって、 a.試料収集ユニット内における磁化可能粒子の存在下で血液試料を混合するステップであって、前記磁化可能粒子が、前記血液試料の非血漿部分に結合する抗体捕捉表面を含むステップと、 b.血漿収集領域の上方から前記混合された血液試料へと磁場を適用し、前記血漿収集領域の上部で前記血液試料の前記非血漿部分を懸濁させるステップとを含む方法。
- 69前記試料収集ユニットが毛細管である、請求項68に記載の方法。
- 70前記血液試料が約20マイクロリットル未満である、請求項68に記載の方法。
- 71前記取り出される血漿が約10マイクロリットル未満である、請求項68に記載の方法。
- 72前記血液試料が希釈されない、請求項68に記載の方法。
- 73前記混合するステップが、固体表面に結合しない抗体の存在下で行われる、請求項68に記載の方法。
- 74前記混合するステップが、シリンジ動作により混合するステップを含む、請求項68に記載の方法。
- 75請求項12または19に記載のシステムにおいて実施される、請求項68に記載の方法。
- 76自動イムノアッセイを用いて全血試料の血漿部分中に存在する解析対象を検出する方法であって、 a.全血試料をオンボードで自動的に受け入れ処理して前記血漿部分をもたらすように構成され、目的の解析対象の存在または不在を示す検出可能なシグナルがオンボードで前記血漿部分から発生するデバイスに前記全血試料を供給するステップと、 b.前記体液試料中における前記解析対象の存在または不在を示す前記シグナルを検出するステップと、 c.(b)の結果をエンドユーザーに送信するステップとを含む方法。
- 77前記イムノアッセイがELISAである、請求項76に記載の方法。
- 78前記結果が無線で送信される、請求項76に記載の方法。
Independent claims78
246 paragraphs, as filed
This application claims the interests of US Provisional Patent Application No. 60 / 997,460 filed on October 2, 2007. US Provisional Patent Application No. 60 / 997,460 is incorporated herein by reference in its entirety.
The discovery of vast numbers of disease biomarkers and the establishment of micromedical systems are developing new means of disease prediction, diagnosis, and treatment monitoring in point-of-care situations. The Point of Care system can quickly communicate test results to healthcare professionals, other healthcare professionals, and patients. Early diagnosis of the disease or progression of the disease allows healthcare professionals to initiate or modify treatment in a timely manner.
Multiple biomarker measurements can provide additional insight into the patient's condition. For example, when monitoring the effect of a drug, three or more biomarkers can be measured in parallel. Multiple separation-based assays are typically performed using microtitration plates and other similar devices. A microtitration plate (eg, a 384-well microtitration plate) allows multiple assays to be performed in parallel.
For point-of-care (POC) devices, the number of assays that can be performed in parallel is often limited by the size of the device and the volume of sample analyzed. For many POC devices, the number of assays performed is about 2-10. A POC device capable of performing multiple assays on small samples is desirable.
The drawback of many multiple POC assay devices is the high manufacturing cost of the device components. If the device is disposable, the high cost of the components can make the manufacture of POC devices impractical. In addition, in the case of a multi-POC device with all required reagents mounted on the device body, if any one of these reagents exhibits instability, it will be manufactured even if all other reagents are still available. It may be necessary to dispose of the entire device lot.
While customers are interested in customizing POC devices to a particular set to analyze, manufacturers of multiple POC assay systems often face the need to mix and match device assays and reagents. Multiple POC assays suitable for each customer can be extremely expensive, difficult to calibrate, and difficult to maintain quality control.
The POC method has proven to be extremely useful in disease and treatment monitoring (eg, glycemic system in the treatment of diabetes, measurement of prothrombin time in anticoagulant therapy with warfarin). By measuring multiple markers, it may be possible to better monitor and control treatments such as complex diseases (such as cancer) and multidrug therapies for cancer.
<p> Thus, the need for alternative designs for POC devices remains unmet. The desired design provides a modular capture surface and assay incubation element. In addition, modular capture surfaces and assay incubation elements need to be incorporated into POC disposable products suitable for just-in-time (JIT) manufacturing. It is desirable to supply customizable POC devices at a practical cost for users and manufacturers. The present invention addresses these needs and also provides related advantages.</p>
<p> In some embodiments, with an array of addressable assay units configured to perform an automated detection cartridge of an analysis target in a body fluid sample that carries out a chemical reaction that results in a detectable signal indicating the presence or absence of the analysis target. , Individual addressable reagent units are addressed to correspond to individual addressable assay units in the assay unit array and calibrated relative to the corresponding individual assay units before assembly on the cartridge. A cartridge containing an array of addressable reagent units, each of which comprises an individual reagent unit, is disclosed. The device may further include a sample collection unit configured to receive body fluid samples.</p><p> In another aspect, an automatic detection cartridge for analysis in a body fluid sample, a sample collection unit configured to accept the body fluid sample, and a sample collection unit that receives a portion of the sample and analyzes the sample. To carry out a chemical reaction, including an array of assay units configured to carry out a chemical reaction that results in a detectable signal of presence, and an array of reagent units containing reagents to carry out the chemical reaction. Cartridges configured to allow individual assay units in the assay unit array and individual reagent units in the assay unit array to move into fluid communication so that the assay unit contacts the body fluid sample in the assay unit. Will be disclosed.</p><p> Individual reagent units can be configured to accept mobile assay units. In some embodiments, the individual assay unit comprises an assay chip. In some embodiments, individual assay units are configured to perform an immunoassay.</p><p> The body fluid sample can be a blood sample. In some cases, the sample collection unit is configured to accept body fluid samples with capacities of approximately 50, 20, 10, 5, or 3 microliters or less. In some cases, the sample collection unit is configured to receive an equal volume of fluid sample as a drop of blood.</p><p> The device described herein may include a pretreatment unit configured to take a portion of a body fluid sample to perform a chemical reaction and detect an analysis target, where the pretreatment unit is a sample. It can be configured to remove plasma from the whole blood sample received in the collection unit.</p><p> In some embodiments, the present specification is an automatic detection system for an analysis target in a body fluid sample for detecting the device described herein and a detectable signal indicating the presence or absence of the analysis target. The system including the detection assembly is described. The system may further include programmable mechanical devices configured to move individual assay units from a first position to a second position. In some cases, the system includes a fluid transfer device. The fluid transfer device can be a pipette and can be automatic. The system may also include a communication assembly for sending a protocol based on the analyzed object to be detected. Optionally, the system herein includes a heating block configured to accept individual assay units, and may also include, for example, a magnetic block that can be used to separate red blood cells from a sample.</p><p> In another aspect, it is an automatic detection system for a plurality of types of analysis targets in a body fluid sample, a sample collection unit configured to contain the body fluid sample, and individual analysis targets of the plurality of types of analysis targets to be detected. A fluid device containing an array of assay units in which the individual assay units are configured to perform a chemical reaction that results in a signal indicating, and an array of reagent units in which the individual reagent units contain reagents, and the individual assay units. Includes multiple heads, each of which is configured to engage, and is configured to direct fluid transfer of body fluid samples from the sample collection unit and reagents from the individual assay units to the individual assay units. A system including a fluid transfer device including a programmable processor is disclosed. In some embodiments, the fluid sample in the assay unit array is detected with some dilution by configuring the processor to direct the fluid transfer so that the plurality of analysis objects can be detected by the system. Keep signals indicating multiple types of analysis targets within the detectable range.</p><p> In some cases, fluid samples include at least two analysis subjects that are present at at least 2, 5, 10, 15, 50, or 100 orders of magnitude different concentrations. By diluting the body fluid sample to some extent, signals indicating at least two types of analysis targets can be kept within a detectable range.</p><p> The system herein may further include a detector configured to detect a detectable range of signal intensities. An exemplary detector is a photomultiplier tube, and the detectable range of the detector can be from about 200 to about 10 million counts.</p><p> In some embodiments, the individual heads of the fluid transfer device are configured to adhere to the individual assay units. Individual assay units may provide immunoassay reaction sites. In some cases, the individual assay unit is a pipette tip. The fluid transfer device can be a pipette, such as an air replacement pipette. The fluid transfer device may also include a motor in contact with the programmable processor, which is capable of moving the plurality of heads based on a protocol from the programmable processor.</p><p> In another embodiment, the present specification is an automatic detection system for a plurality of types of analysis targets in a plasma portion of a whole blood sample, which is configured to automatically accept and process the whole blood sample to produce the plasma portion. A system that includes a device in which a detectable signal indicating the presence or absence of an analysis target is generated from the plasma portion onboard and a detection assembly for detecting a detectable signal indicating the presence or absence of an analysis target. Is explained.</p><p> In some embodiments, herein is a method of detecting an analysis target in a body fluid sample, the step of feeding a blood sample to the device described herein, and the sample in at least one assay unit. A method is provided that includes a step of reacting and a step of detecting the detectable signal generated from the analysis target collected in the body fluid sample. The body fluid sample can be blood, and this method can include the step of removing plasma from the blood.</p><p> In the embodiments provided herein, an on-demand assembly method of an automatic detection cartridge to be analyzed in a body fluid sample, wherein the device includes a housing, the housing being detectable to indicate the presence or absence of the analysis target. An array of addressable assay units in which individual assay units are configured to perform chemical reactions that result in different signals, and addressable reagent units in which individual reagent units are addressed to correspond to individual assay units. The method comprising an array of is (i) an array of addressable assay units in which individual assay units are configured to perform a chemical reaction that detects the target of analysis ordered by said end user. (Ii) Each reagent unit places an array of reagent units corresponding to each assay unit in the housing according to the analysis target to be detected, and (iii). Includes steps (i) and fixing the array of (ii) within the housing of the device. This method may include the step of selecting the analysis target to be detected. In some embodiments, the method comprises the step of sealing the cartridge. In certain embodiments, the method comprises labeling the cartridge with a readable label indicating the analysis target to be detected, eg, by barcode or RFID.</p><p> In one aspect, it is an automatic detection method for a plurality of types of analysis targets in a body fluid sample, wherein a sample collection unit configured to accommodate the body fluid sample and individual analysis targets of the plurality of types of analysis targets to be detected are detected. A step of feeding a fluid sample to a fluid device containing an array of assay units in which individual assay units are configured to perform a chemical reaction that results in a signal indicating, and an array of assay units in which the individual reagent units contain reagents. And the step of engaging individual assay units with a fluid transfer device, the step of transferring a body fluid sample from a sample collection unit to an individual assay unit using a fluid transfer device, and the step of transferring reagents from individual assay units. A method of transferring to an individual assay unit, which causes the reagent to react with a body fluid sample, to provide a signal indicating the individual analysis target of multiple detected analysis targets is provided.</p><p> In certain embodiments, the fluid transfer device comprises a plurality of heads in which individual heads are configured to engage individual assay units, said fluid transfer device being a body fluid sample from a sample collection unit and individual reagents. Includes a programmable processor configured to direct fluid transfer of reagents from units to individual assay units. The method may further include giving instructions to the programmable processor that can direct the steps of transferring the fluid sample to the individual assay units.</p><p> In certain embodiments, the step of transferring the body fluid sample dilutes the body fluid sample to some extent within the individual assay units so that signals indicating the individual analysis targets of the multiple types of analysis targets to be detected are within a detectable range. Fit. A body fluid sample may contain at least two individual analysis objects that are present at a concentration that differs by at least 2, 5, 10, 15, 50, or 100 orders of magnitude. In some cases, a degree of dilution with respect to the body fluid sample will result in at least two signals indicating individual analysis targets within the detectable range. In certain embodiments, the detectable range is about 10 to about 1 million counts per second using a photomultiplier tube.</p><p> In certain embodiments, the reagents within the individual reagent units are enzyme substrates for immunoassays, and this method is performed after the reaction has been completed that yields a signal indicating the individual analysis target of the multiple species of analysis to be detected. The steps of transferring reagents from individual reagent units may be repeated, which may further include the step of creating a second reaction that results in a second signal indicating the individual analysis target. The final intensity of the signal indicating the individual analysis target can be calculated by averaging the intensity of the signal indicating the individual analysis target and the second intensity of the second signal.</p><p> In some embodiments, the present specification is a method of measuring the volume of a liquid sample in which a known amount of a control analysis object in the liquid sample is reacted with a reagent to provide a detectable signal indicating the control analysis object. The step and the step of comparing the detectable signal with the predicted detectable signal, wherein the predicted signal indicates the predicted volume of the liquid sample, and the comparison is said to the said liquid sample to be measured. A method including a step of giving a measured value of capacitance is described. In some cases, the control analysis target is usually not present in the liquid sample in a detectable amount. The method may include verifying the volume of the liquid sample when the measured volume of the sample is within about 50% of the predicted volume of the liquid sample. In certain embodiments, the method involves reacting a body fluid sample containing a target analysis target with a reagent that provides a detectable signal indicating the target analysis target, and the intensity and intensity of the detectable signal indicating the target analysis target. A step of measuring the amount of the target analysis target in the body fluid sample using the measured value of the volume of the liquid sample is further included. The liquid sample and the body fluid sample can be the same sample, and the control analysis target does not react with the target analysis target in the body fluid sample. In some cases, the liquid sample and the body fluid sample are different liquid samples. Control analysis targets may be, for example, fluorescein-labeled albumin, fluorescein-labeled IgG, anti-fluorescein, anti-digoxigenin, digoxigenin-labeled albumin, digoxigenin-labeled IgG, biotinylated protein, non-human IgG.</p><p> In another aspect, herein is a method of removing plasma from a blood sample, a step of mixing the blood sample in the presence of magnetizable particles in a sample collection unit, wherein the magnetizable particles are the blood sample. A step involving an antibody capture surface that binds to the non-plasma portion of the blood sample and a step of applying a magnetic field from above the plasma collection region to the mixed blood sample to suspend the non-plasma portion of the blood sample above the plasma collection region. Methods including and are provided. In some cases, the sampling unit is a capillary. Blood samples can be less than about 20 microliters and plasma removed can be less than about 10 microliters. In some cases, the blood sample is not diluted. Optionally, the mixing step is performed in the presence of an antibody that does not bind to the solid surface. The mixing step may include mixing by syringe operation.</p><p> In yet another embodiment, the present specification is a method of detecting an analysis target present in a plasma portion of a whole blood sample using an automatic immunoassay, in which the whole blood sample is automatically accepted and processed onboard. A step of feeding a whole blood sample to a device that is configured to provide a plasma moiety and a detectable signal indicating the presence or absence of the subject to be analyzed is generated from the plasma moiety onboard, and an analysis target in the body fluid sample. A method is provided that includes the step of detecting the signal indicating the presence or absence of the blood plasma and the step of transmitting the result of (b) to the end user. The immunoassay can be an ELISA. In some cases, the results are transmitted wirelessly.</p><p> In some embodiments, the methods described herein are performed within the system described herein.</p><p> Built-in by reference All publications and patent applications referred to herein are by reference to the same extent as if it were assumed that each individual publication or patent application was specifically and individually indicated to be incorporated by reference. Incorporated herein.</p><p> Many novel features of the present invention are detailed in the appended claims. A better understanding of the features and advantages of the present invention is obtained by reference to the following detailed description showing specific embodiments, wherein a number of principles of the present invention are utilized, the accompanying drawings are shown below. It's a street.</p>
<figref num="1">FIG. 5 illustrates an exemplary device of the invention, including an assay unit, reagent unit, and other modular components of the device.</figref><figref num="2">FIG. 5 shows two side cross-sectional views of an exemplary device of FIG. 1, including an assay unit, a reagent unit, and a cavity in the housing of the device shaped to house a sample chip.</figref><figref num="3A">FIG. 5 shows an exemplary assay unit containing a small chip or tube shape.</figref><figref num="3B">It is a figure which shows the example of the sample chip described in this specification.</figref><figref num="4">It is a figure which shows two examples of the reagent unit containing a cup.</figref><figref num="5">It is a figure which shows the example of the system which includes a device and a fluid moving device.</figref><figref num="6">FIG. 5 illustrates an exemplary system of the invention, including a heating block and a detector for temperature control.</figref><figref num="7">FIG. 5 illustrates an exemplary system in which a patient transports blood to a device and then the device is inserted into a reader.</figref><figref num="8">It is a figure which shows the process flow of constructing the system for evaluating a patient's medical condition.</figref><figref num="9">FIG. 5 shows an example of a plasma separation method in which a whole blood sample is attracted to a sample chip, a magnetic reagent is mixed, suspended with the sample, and then a magnetic field is applied to the whole blood sample and the magnetic reagent mixture. The separated blood plasma sample can then be dispensed into the wells of the device.</figref><figref num="10">FIG. 5 illustrates an exemplary method of control assay described herein, including a known amount of control analysis subject.</figref><figref num="11">It is a figure which shows the contamination in the chip when a thin film, for example, a liquid is discharged and another liquid is sucked.</figref><figref num="12">It is a figure which shows the calibration curve which associates the assay unit and the reagent unit for performing an assay for VEGFR2.</figref><figref num="13">It is a figure which shows the calibration curve which correlates the result for the assay unit and the reagent unit for performing an assay for PlGF in a system, which is measured using a illuminometer.</figref><figref num="14">It is a figure which shows the CRP concentration plotted against the assay signal (photon count), and the data fitted to the 5 polynomial function to generate the calibration function.</figref><figref num="15">It is a diagram showing that the fitting is achieved between the model and the parameters Smax, C0.5 and D described herein.</figref><figref num="16">It is a figure which displays the data concerning the dilution used to achieve the final concentration of an assay chip.</figref><figref num="17">Referenced assay response (B / Bmax) is log-referenced concentration (C / C0.5) for relative dilutions: 1: 1 (solid line), 5: 1 (dashed line), and 25: 1 (dotted line). ) Is plotted against.</figref><figref num="18">It is a figure which shows the example similar to FIG. 17 with different standardized concentrations.</figref><figref num="19">It is a figure which shows the example similar to FIG. 17 with different standardized concentrations.</figref><figref num="20">FIG. 5 shows the assay response for a control analysis subject after step: removal of detected antibody, assay wash, and addition of substrate, read with a spectrophotometer for 0.5 seconds.</figref><figref num="21">It is a figure which shows the result of the assay which evaluates by measuring the photon generated over about 10 seconds in the system of this specification.</figref>
Embodiments and aspects of the invention described herein relate to devices, systems, and methods for automatic detection of objects to be analyzed in body fluid samples. The present invention can detect and / or quantify the subject of analysis associated with a particular biological process, physiological condition, disorder or stage of the disorder, or the effect of a biological agent or therapeutic agent. The embodiments and examples of the invention described herein are not intended to limit the scope of the invention.
device In aspects of the invention, the device for automatic detection of an analysis target in a body fluid sample is an array of addressable assay units configured to perform a chemical reaction that results in a detectable signal indicating the presence or absence of the analysis target. And corresponds to one or more addressable assay units in the device so that individual reagent units can be calibrated relative to the corresponding assay unit (s) before being assembled on the device. Includes an array of addressable reagent units, each of which is addressed as such.
In another aspect of the invention, the device for automatic detection of an assay target in a body fluid sample comprises an array of assay units configured to carry out a chemical reaction that results in a detectable signal indicating the presence of the subject to be analyzed, and chemistry. At least one of the assay units and reagents so that the reagents for performing the chemical reaction automatically contact the body fluid sample in the assay unit, including an array of reagent units containing the reagents for performing the reaction. At least one of the units is movable relative to each other within the device.
In an embodiment of the device of the invention, an array of assay units or reagent units can be addressed according to the chemical reactions performed by the assay units configured. In another embodiment, at least one of the assay units and at least one of the reagent units are relative to each other in the device so that the reagents for performing the chemical reaction automatically contact the body fluid sample in the assay unit. It is movable.
In one embodiment, the device of the invention is body-integrated and includes all reagents, liquid phase and solid phase reagents required to perform multiple assays in parallel. If desired, the device is configured to perform at least 2, 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 100, 200, 500, 1000 or more assays. Will be done. If desired, one or more control assays performed in parallel can also be mounted within the device.
The assay can be a quantitative immunoassay and can be performed in a short time. Other types of assays, including but not limited to the measurement of nucleic acid sequences and the measurement of metabolites such as cholesterol, can also be performed with the devices of the invention. In some embodiments, the assay is completed within 1 hour, preferably less than 30, 15, 10, or 5 minutes. In other embodiments, the assay is performed in less than 5 minutes. The assay detection time can be adjusted according to the type of assay performed by the device of the invention. For example, if high sensitivity is required, the assay can be incubated for more than an hour or more than a day. In some examples, long-term assays may be more practical in other POC applications, such as home use, than in clinical POC situations.
Any body fluid suspected of containing the subject of interest can be used with the systems or devices of the invention. Commonly used body fluids include, but are not limited to, blood, serum, saliva, urine, gastric and digestive juices, tears, feces, semen, vaginal fluid, interstitial fluid derived from neoplastic tissue, and cerebrospinal fluid. ..
Body fluids are taken from the patient and fed to the device in various forms including, but not limited to, lansing, injection, or pipetting. The terms subject and patient as used herein are used interchangeably herein to refer to vertebrates, preferably mammals, more preferably humans. Mammals include, but are not limited to, mice, monkeys, humans, domestic animals, competition animals, and pets. In certain embodiments, the skin is punctured with a lancet and a sample is taken using, for example, gravity, capillary action, suction, or vacuum force. The lancet can be part of the device, part of the system, or even a single component. If desired, the lancet can be actuated by a variety of mechanical, electrical, electromechanical, or any other known actuating mechanism, or any combination of such methods. In another embodiment that does not require an active mechanism, the patient may simply supply fluid to the device, for example with a saliva sample. The collected body fluid can be placed in a sample collection unit within the device. In yet another embodiment, the device comprises at least one microneedle that punctures the skin.
The volume of body fluid used by the device is generally less than about 500 microliters, typically about 1-100 microliters. If desired, use the device to detect 1-50 microliters, 1-40 microliters, 1-30 microliters, 1-10 microliters, or 1-3 microliters of sample to detect the subject of analysis. Can be used.
In certain embodiments, the volume of body fluid used to detect the subject of analysis using the device or system is one drop of body fluid. For example, a drop of blood from a punctured finger can supply a fluid sample analyzed by the device, system, or method described herein.
Body fluid samples can be collected from the subject and delivered to the device of the invention described herein below.
In certain embodiments, the assay unit and reagent unit array is configured to be a set of mix-and-match components. The assay unit may include at least one capture surface capable of reacting with an analysis object derived from a body fluid sample. The assay unit can be a tubular chip with a capture surface inside it. Examples of chips of the present invention are described herein. The reagent unit typically holds the liquid or solid reagents needed to perform the assay to detect a given analysis target. Each individual assay unit and reagent unit can be individually configured depending on the assay function. When assembling the device, the unit can be assembled in the just-in-time manner used in integrated cartridges.
Both liquid and solid components can be made individually and then examined for performance and stored. In certain embodiments, device assembly is performed on-demand at the site of manufacture. The device can be modular and consists of a comprehensive housing for all assays, an assay unit such as a chip, and a reagent unit such as a variety of fragile or instrument-operated containers containing liquid reagents. Can contain elements. In some cases, the assembled device is then inspected to confirm calibration (the relationship of system response to known levels of analysis). Assay devices can be assembled from a library of on-demand pre-manufactured and calibrated elements. In some embodiments, the fluid pathway within the device can be simple, eliminating the potential for air bubbles and an effective method of cleaning overlabeled reagents in reagent overassays such as ELISA. I will provide a.
The housing for the device of the present invention can be made from polystyrene or another plastic that can be molded or machined and may have a defined location for the assay unit and reagent unit. In certain embodiments, the housing has a means for the suction tip or assay unit to remove excess liquid. The means for absorption may be a porous membrane such as cellulose acetate, or a hygroscopic material piece such as filter paper .
In some embodiments, at least one component of the device can be constructed from a polymeric material. Non-limiting examples of polymeric materials include polystyrene, polycarbonate, polypropylene, polydimethylsiloxane (PDMS), polyurethane, polyvinyl chloride (PVC), polysulfone, polymethylmethacrylate (PMMA), acryliconitrile-butadiene-styrene (ABS), And including glass.
The device or component of the device can be manufactured by a variety of methods including, but not limited to, stamping, injection molding, embossing, casting, blow molding, machining, welding, ultrasonic welding, and thermal bonding. .. In certain embodiments, the device is manufactured by injection molding, thermal bonding, and ultrasonic welding. The component of the device is natural for thermal bonding, ultrasonic welding, friction bonding (pressure welding), adhesives, or certain substrates, such as glass or semi-rigid and non-rigid polymer substrates, between the two components. Can be fixed to each other by bonding.
An exemplary device described herein is shown in FIG. The device 100 may also be referred to herein as the cartridge 100. The device 100 includes a housing 130 having a place for accommodating the assay unit 121 and the reagent units 103, 122, 124, 125. In the exemplary embodiment of FIG. 1, assay unit 121 occupies the central row of housing 130 of device 100. Assay unit 121 may optionally include at least one calibration unit 126. In some examples herein, the assay unit 121 is similar to a pipette tip, which is referred to as the assay tip 121, and the calibration unit 126 is referred to as the calibration tip 126, wherein the assay unit 121 is a device described herein. It can be any wide range of shapes and sizes accommodated by 100. Assay Unit 121 and Calibration Unit 126 are exemplary assay units 121 and are described in more detail herein. The assay unit 121 in FIG. 1 includes a capture surface and is capable of performing chemical reactions such as nucleic acid assays and immunoassays. The assay unit 121 can be assembled into a housing according to the assay that the user wishes to perform on the instruction or sample.
As shown in FIG. 1, the housing of the device 100 may include a sample collection unit 110 configured to contain the sample. Samples such as blood samples can be placed in the sample collection unit 110. The sample tip 111 (eg, a pipette tip attached to a fluid transfer device described in more detail herein) may occupy another part of the housing 130. When performing an assay, the sample chip 111 can dispense the sample into a pretreatment reagent unit or pretreatment unit 103, 104, 105, 106, 107, or assay unit 121. The exemplary pretreatment units 103, 104, 105, 106, 107 include a mixing unit 107, a diluent unit or a diluent unit 103, 104, and if the sample is a blood sample, a plasma removal unit or a plasma collection unit 105, Including, but not limited to 106. The pretreatment units 103, 104, 105, 106, 107 may be of the same type or may be different types of units. As will be apparent to those skilled in the art who have knowledge of the present disclosure, device 100 may incorporate other pretreatment units 103, 104, 105, 106, 107 necessary to carry out a chemical reaction. Units 103, 104, 105, 106, 107 may accommodate varying amounts of reagents or diluents flexibly according to whatever is required to perform the assay on the cartridge 100.
The assay unit 121 can often be manufactured separately from the housing 130 and then inserted into the housing 130 by the pick-and-place method. The assay unit 121 may fit snugly into housing 130 or loosely into housing 130. In some embodiments, the housing 130 is manufactured such that it holds the reagent units 103, 122, 124, 125, and / or the assay unit 121 snugly in place, eg, during shipment or operation of the cartridge. Will be done. Reagent units 103, 122, 124, 125 containing a conjugate reagent 122 (eg, used in an immunoassay), a wash reagent 125 (eg, washing the conjugate from a capture surface), and a substrate 124 (eg, an enzyme substrate). Is shown in Fig. 1. Other embodiments of the components in the device 100 and the example of FIG. 1 are described herein. Reagent units 103, 122, 124, 125 are manufactured separately from housing 130, filled, and placed within housing 130. Thus, the cartridge 100 can be constructed modularly, thus increasing the flexibility of the cartridge 100 used in various assays. Reagents within reagent units 103, 122, 124, 125 can be selected according to the assay performed. Illustrative reagents and assays are described herein.
A device such as the example shown in FIG. 1 may also include other features that may be required to carry out a chemical reaction. For example, if the assay unit 121 is the assay chip 121 described herein, the device is oversampled from the assay chip 121 or sample chip 111, eg, after fluid transfer by the system described herein. Alternatively, it may include a tip touch-off pad 112 that removes excess reagents. Housing 130 may also include units or regions 101, 102 within device 100 that contain used chips or units, for example, to avoid cross-contamination of sample chip 111 or assay unit 121. In FIG. 1, device 100 includes a sample chip 111 for transferring a sample between units of device 100. The device 100 shown in FIG. 1 also includes a pretreatment chip 113 for transferring the pretreated sample within the unit of the device 100 to another unit of the device 100 to carry out a chemical reaction. For example, as described, the sample chip 111 can be used to remove a blood sample from the sample collection unit 110 and transfer the blood sample to the pretreatment units 103, 104, 105, 106, 107. Red blood cells are removed from the blood samples in the pretreatment units 103, 104, 105, 106, 107, and then plasma is collected from the pretreatment units 103, 104, 105, 106, 107 using the pretreatment chip 113 to obtain the plasma. It can be transferred to another pretreatment unit (eg, diluent unit) 103, 104, 105, 106, 107, and / or at least one assay unit 121. In certain embodiments, the sample chip 111 is a sample collection unit 110. In another embodiment, the sample collection unit 110 resembles a well and is configured to contain a sample accepted by the user.
Assay units 121 and reagent units 103, 122, 124, 125 shown in FIG. 1 may be addressable to indicate the location of the units on cartridge 100. For example, the column of cartridge 100 shown in FIG. 1 can accommodate an assay unit 121 that performs an assay configured to detect C-reactive protein, and the column can be used for assays within the same column. It is possible to accommodate the corresponding reagent units 103, 122, 124, 125, and the units are addressed to correspond to each other. For example, the address can be entered and stored in a computer system and the cartridge 100 can be labeled with a bar code or the like. When used by scanning the barcode on the cartridge 100, the computer system sends the address of a unit, such as the unit described herein, to the system, transfers the fluid according to the address entered in the computer, and reacts. Can be executed. The address can be part of a protocol sent to activate the system. The address can be of any configuration and can be changed if it is necessary to change the protocol in which the assay is performed, which typically results in an assay protocol or not available in prior art POC devices. Modifications to the assay steps can be provided to cartridge users. In some embodiments, the housing 130 and the units consist of an array of 6x8 units, as shown in FIG. The layout of the units can be of any format, for example a rectangular array or a random layout. The cartridge 100 may include, for example, any number of units from 1 to about 500. In some embodiments, the cartridge 100 has 5-100 units. In the case of the example shown in FIG. 1, the cartridge 100 has 48 units.
Two side fracture views of the exemplary device 200 of FIG. 1 are shown in FIGS. 2A and 2B. The cavity can be shaped to accommodate the assay unit (eg, assay chip) 201 in the device housing 220 that is perpendicular to those protrusions towards the top of the device 200 (horizontal to the housing). is there. As shown in FIG. 2, the cavity can also be shaped to accommodate the reagent units 210, 212 or the sample collection unit or sample collection chip 202. Housing 220 may have features that accurately capture and secure the units. Such features can also be designed to be activated by a mechanism that moves the chip, such as pickup and drop-off. In another embodiment, the sample collection unit includes a bendable element that is used to protect the small collection tube at the time of shipment and hold the plunger device in place within the capillary. FIG. 2A also shows two exemplary embodiments of reagent units 210, 212 described herein. The bottom of the housing 220 is configured to collect waste liquid, eg, used cleaning reagents that are sent back to the bottom through the holes in the housing 220. Housing 220 may include an absorbent pad that collects waste fluid. The assay unit 201 and sample unit 202 can be placed so as to fit into the cavity of the housing 220 of the device 200 and extend beyond the internal support structure. As shown in FIG. 2, the reagent units 210 and 212 fit snugly into the housing and do not extend beyond the internal support structure. The area in which the housing 220 and the assay unit 201 and the reagent units 210, 212 can be held and placed can take various patterns.
In some embodiments, each chip comprises a single assay and is capable of pairing with or corresponding to a suitable reagent, such as the reagent required to perform a specified assay. is there. Some chips may include a control assay unit and have a known amount of analysis target that binds to their capture surface during the manufacturing process or when performing the assay. For control assay units, the unit is configured to perform a control assay for comparison. The control assay unit may include, for example, a capture surface in a solid or liquid state and an object to be analyzed.
In many embodiments, the device retains all reagents and liquids required by the assay. For example, in the case of an immunogenic ELISA assay, the reagents in the device may include a sample diluent, a detection conjugate (eg, three enzyme-labeled antibodies), a wash solution, and an enzyme substrate. Additional reagents can be supplied as needed.
In some embodiments, reagents can be loaded within the device to pretreat the sample. Examples of pretreatment reagents include, but are not limited to, leukocyte-dissolving reagents, reagents, enzymes, and cleaning agents that dissociate the analysis target from binding factors in the sample. The pretreatment reagent can also be added to the diluent contained within the device.
Individual reagent units can be configured to accept mobile assay units. In some embodiments, the individual assay unit comprises an open-ended, hollow cylindrical element that includes a capture surface and a reaction cuvette. As used herein, a cylindrical assay unit can be referred to as an assay chip. In some embodiments, individual assay units are configured to perform an immunoassay. Assay unit 301 with a small chip or tubular formation is shown in FIG. 3A. Optionally, the tip 301 is configured to provide an internal cylindrical capture surface 311 and protrusions 321 that can be engaged with the housing of the device. In some cases, the protrusions 321 and the tip 301 are configured to engage the system described herein, or a mechanism that moves the tip 301, such as, for example, a fluid transfer device. The assay chip 301 shown in FIG. 3A may include an opening 331 at the bottom of the chip. The opening 331 can be used to transfer fluids or reagents to and from assay unit 301. In certain embodiments, the assay unit 301 described is, or is similar to, a pipette tip with an improvement in which the assay unit 301 comprises a capture surface 311 configured to detect an analysis target in a sample.
The chip 301 can be manufactured by an injection molding process. In certain embodiments, the chip 301 is made of clear polystyrene used by the chemiluminescent assay. As shown in FIG. 3A, the exemplary tip 301 may engage the housing and, for example, engage the taper element of the fluid transfer device and / or pipetting device to form a pressure airtight seal. There is. The exemplary chip 301, also shown in FIG. 3A, includes a smaller cylindrical portion. In many embodiments, the assay capture surface is housed within a smaller cylindrical portion. The assay capture surface can be any region within the chip 301 or outside the chip 301. The surface of the chip 301 can have many shapes, including but not limited to tubular, spherical, and conical. In chemiluminescent or fluorescence-based assays, chip 301 can be used as a convenient means of presenting assay products to assay optics.
FIG. 3B shows an exemplary sample collection unit 302 containing a sample chip 302. The sample chip 302 shown in FIG. 3B can also be separated from the sample collection unit 302 and used to transfer the sample from the sample collection unit to another unit on the device described herein. The sample chip shown in FIG. 3B includes a protrusion 322 as described herein connecting the chip 302 to the device housing and fluid transfer device. The sample chip 302 also includes an opening 332 to allow the transfer of fluid or sample into and from the sample chip. In some embodiments, the sample chip 302 has the same shape as the assay chip 301. In other embodiments (such as those shown in FIGS. 3A and 3B), the sample chip 302 has a different shape than the assay chip 301.
In certain embodiments, one function of the chip is to allow the sample and liquid reagents to come into contact with the capture surface of the assay unit. Movement can be done by a variety of means including, but not limited to, capillarity, aspiration, and controlled delivery. The small size of the chip allows for rapid control of the temperature required for a chemical reaction. Heat conduction and / or heat retention can be performed simply by placing the chip inside a temperature control block.
In some embodiments, the chip can accommodate approximately 1-40 microliters of fluid. In a further embodiment, the chip can accommodate about 5-25 microliters of fluid. In certain embodiments, the chip contains 20 microliters of fluid. In some cases, the chip may contain up to 1 microliter of fluid. In other cases, the chip can accommodate up to 100 microliters.
If desired, the end of the chip can be sucked onto an absorbent material (eg, mounted on a disposable cartridge) prior to introduction of the next assay component to avoid contamination with small samples and / or reagents. it can. Any liquid drawn into the target chip due to physical force should be held in any desired position, even if held vertically, with little risk of liquid leakage. Can be done.
The assay unit (eg, assay chip) can be coated with assay capture reagents prior to use using the same fluid engineering methods as in the assay (eg, controlled capillaries or mechanical aspiration).
The capture surface (also referred to herein as the reaction site) can be formed by an antibody that binds to the assay unit, or by another capture reagent that covalently binds to it, or by adsorption to it. The surface can then be dried and kept dry until used in the assay. In certain embodiments, there are reaction sites for measuring each analysis target.
In certain embodiments, the assay unit is fluidly communicated with the reagent unit and / or the sample collection unit so that the reagent or sample can interact with the reaction site where the bound probe can detect the target of analysis in the body fluid sample. Can be moved to. The reaction site can then give a signal indicating the presence or concentration of the analysis object of interest, which can then be detected by the detection device described herein.
In some embodiments, the location and composition of the reaction site is an important element in the assay device. Most, if not all, disposable immunoassay devices are configured with a capture surface as an integral part of the device.
In one embodiment, the molded plastic assay unit is commercially available or can be made by injection molding in the correct shape and size. For example, the characteristic size can be 0.05 to 3 mm in diameter and 3 to 30 mm in length. The unit can be coated with a capture reagent using a method similar to that used to coat the microtitration plate, but in a large container, with the coating reagent added, using a sieve, cage, etc. It is advantageous because the units can be processed in bulk by processing and collecting the pieces and cleaning as needed.
The assay unit may provide a rigid support on which the reactants can be immobilized. Assay units are also selected to provide suitable properties for interaction with light. For example, the assay unit is functional glass, Si, Ge, GaAs, GaP, SiO<sub>2</sub>, SiN<sub>4</sub>Made from materials such as modified silicon, or (poly) tetrafluoroethylene, (poly) vinylidene difluoride, polystyrene, polycarbonate, polypropylene, PMMA, ABS, or any one of a wide variety of gels or polymers such as combinations thereof. can do. In certain embodiments, the assay unit comprises polystyrene. Other suitable materials can also be used in accordance with the present invention. A transparent reaction site can be advantageous. In addition, if there is a light-transmitting window that allows light to reach the photodetector, the surface may be advantageous to be opaque and / or preferably light-scattering. is there.
The reactant immobilized on the capture surface can be any substance useful for detecting the subject of analysis in the body fluid sample. For example, such reactants include, but are not limited to, hybridization probes, antibodies, cell membrane receptors, monoclonal antibodies, and antisera that react with a particular subject of analysis. Various commercially available reactants can be used, such as polyclonal and monoclonal antibody hosts specifically developed for a particular analysis target.
Those skilled in the art will appreciate that there are many methods of immobilizing the various reactants on the support on which the reaction can occur. Immobilization can be covalent or non-covalent, via linker moieties, or tethering them to immobilization moieties. Non-limiting exemplary binding moieties for attaching proteinaceous molecules such as nucleic acid molecules or antibodies to solid supports include streptavidin or avidin / biotin bonds, carbamate bonds, ester bonds, amide bonds, thiol ester bonds, (N)-Contains functionalized thiourea bonds, functionalized maleimide bonds, amino bonds, disulfide bonds, amide bonds, hydrazone bonds, and others. In addition, a silyl moiety can be attached to a nucleic acid directly attached to a substrate such as glass using a method known in the art. Surface immobilization can also be achieved with a poly-L resynthesizer that provides an intercharge bond to the surface.
The assay unit can be dried after the final step of incorporating the capture surface. For example, the drying step can be performed by passive exposure to dry air, or by the use of a vacuum manifold and / or the application of clean dry air through the manifold.
In many embodiments, the assay unit is designed to allow the unit to be manufactured in large quantities and in rapid manufacturing processes. For example, the chip can be mounted in a large array for batch coating of capture surfaces within or on the chip. In another example, the inserts can also be placed on a mobile belt or rotary table for continuous machining. In yet another example, a large array of inserts can be connected to vacuum and / or pressure manifolds for simple machining.
In certain embodiments, the assay unit can be operably linked to a fluid transfer device. The fluid transfer device can operate under automatic control without human intervention. In the assay unit containing the tip, control of the installation altitude of the disposable liquid tip relies on a taper-fitting fixture on the tip for the liquid dispenser. The fluid transfer device can engage the chip. In some cases, it is known that the immersion length of the chip in the transferred liquid must minimize the contact of the liquid with the outside of the chip, which can be uncontrollable. Rigid fasteners can be formed on the bottom of the tapered connection that engages the nozzle of the dispenser to bond or bond the tip to the fluid transfer device. An airtight seal can be made by an o-shaped ring on the way to the taper or on the flat bottom of the nozzle. By separating the chip sealing function from the control of the chip altitude, both can be adjusted individually. Modular and fluid transfer devices allow many assays to be performed in parallel.
The reagent unit of the device may hold the reagents needed to carry out a given chemical reaction to detect a given subject of analysis. Liquid reagents can be dispersed in small capsules that can be made from a variety of materials, including but not limited to plastics such as polystyrene, polyethylene, or polypropylene. In some embodiments, the reagent unit is a cylindrical cup. Two examples 401, 402 of reagent units containing cups are shown in Figures 4A and 4B. If desired, units 401, 402 fit snugly into the cavity within the housing of the device. The units 401 and 402 can be sealed on the open surface to prevent the reagents 411 and 412 from overflowing into the main body. In some embodiments, the seal is an arminized plastic and the cup can be sealed by thermal bonding. The unit can be of any shape as needed to accommodate the reagents. For example, the cylindrical reagent unit 401 is shown in FIG. 4A, which houses the liquid reagent 411. The differently shaped reagent units 402 shown in FIG. 4B also contain the liquid reagent 412. Both exemplary reagent units 401, 402 include some optional modifications near the top surface that allow the units 401, 402 to fit snugly into the housing of the device described herein.
In many embodiments of the invention, the reagent unit is modular. Reagent units can be designed to allow the units to be manufactured in large quantities and in rapid manufacturing processes. For example, many reagent units can be simultaneously filled and sealed in large scale processes. Reagent units can be packed according to the type of assay performed by the device. For example, if one user wants an assay different from another, the reagent unit can be manufactured according to each user's request without having to manufacture the entire device. In another example, the reagent unit can also be placed on a mobile belt or rotary table for continuous processing.
In another embodiment, the reagent unit can be housed directly in a cavity within the housing of the device. In the case of this embodiment, a seal can be made in the housing area surrounding the unit.
Reagents according to the present invention include wash buffers, enzyme substrates, dilution buffers, conjugates, enzyme-labeled conjugates, DNA amplification agents, sample diluents, wash solutions, cleaners, polymers, chelating agents, albumin binding reagents, enzyme inhibitors. It includes, but is not limited to, sample pretreatment reagents containing additives such as agents, enzymes, anticoagulants, hemagglutinin agents, antibodies, or other substances necessary to perform the assay on the device. The enzyme-labeled conjugate can be an enzyme-labeled polyclonal antibody or monoclonal antibody that can provide a detectable signal upon reaction with a suitable substrate. Non-limiting examples of such enzymes are alkaline phosphatase and horseradish peroxidase. In some embodiments, the reagent comprises an immunoassay reagent. In general, reagents, especially those that are relatively unstable when mixed with a liquid, are individually encapsulated in a defined area (eg, reagent unit) within the device.
In some embodiments, the reagent unit contains from about 5 microliters to about 1 milliliter of liquid. In some embodiments, the unit can accommodate approximately 20-200 microliters of liquid. In a further embodiment, the reagent unit contains 100 microliters of fluid. In certain embodiments, the reagent unit contains approximately 40 microliters of fluid. The volume of liquid in the reagent unit can vary depending on the assay performed or the type of fluid sample supplied. In some embodiments, the volume of reagent does not have to be predetermined, but must be greater than the known minimum amount. In some embodiments, the reagents are initially kept dry and dissolved at the beginning of the assay performed on the device.
In certain embodiments, reagent units can be filled with siphons, funnels, pipettes, syringes, needles, or combinations thereof. The reagent unit can be filled with liquid using a filling channel and a vacuum suction channel. Reagent units can be filled individually or as part of the bulk manufacturing process.
In certain embodiments, the individual reagent units include different reagents as a means of isolating the reagents from each other. The reagent unit can also be used to contain the wash solution or substrate. In addition, the reagent unit can also be used to contain the luminescent substrate. In another embodiment, a plurality of types of reagents can be contained in a reagent unit.
In some cases, device configuration allows for the ability to pre-calibrate the assay and reagent units prior to assembling the disposable product of the device of interest.
system In some embodiments, the system of the invention comprises a device comprising an assay unit and a reagent unit containing reagents (both liquid phase and solid phase reagents). In some embodiments, the entire device, assay unit, reagent unit, or at least one combination thereof is disposable. In the system of the present invention, the detection of the analysis target by the device is performed by the measuring instrument. In most embodiments, the instrument, device, and method provide an automatic detection system. The auto-discovery system can be automated based on a prescribed protocol or a protocol given to the system by the user.
In some embodiments, an automated detection system for an analysis target in a body fluid sample comprises a device or cartridge and a detection assembly or detector that detects a detectable signal indicating the presence or absence of the analysis target.
In certain embodiments, the user applies a sample (eg, a measured or unmeasured blood sample) to the device and inserts the device into the instrument. All subsequent steps are automatic and programmed by modifying the instrument operation according to the instrument (wired), user, remote user or system, or identifier (eg, barcode or RFID on the device).
Examples of different functions that can be performed using the systems of the invention are sample dilution, removal of a portion of the sample (eg, red blood cells (RBC)), reaction of the sample within the assay unit, liquid to the sample and assay unit. It includes, but is not limited to, addition of reagents, cleaning of reagents from samples and assay units, and storage of liquids during and after use of the device. Reagents can be placed in reagent units on the device body or in reagent units assembled on the device.
The automated system can detect a particular analysis target in a biological sample (eg, blood) by an enzyme-linked immunosorbent assay (ELISA). The system is suitable for multiplexing and is particularly suitable for detecting objects of interest present in a small amount of whole blood sample (eg, 20 microliters or less). The system can also detect the analysis target in different diluents of a single sample, which allows the difference in sensitivity to be examined on the same device, if desired. All reagents, supplies, and waste can be contained on the system's devices.
In use, the sample from the subject is applied to the assembled device and the device is inserted into the instrument. In certain embodiments, the instrument can initiate processing of the sample by a combination of removal of red blood cells (blood sample), dilution of the sample, and transfer of the sample to the assay unit. In embodiments involving multiple assays, multiple assay units are used to transfer a portion of the sample to individual assay units in series or in parallel. The assay can then be performed by controlling the chain of incubation and application of reagents to the capture surface.
An exemplary fluid transfer device consists of any component that is required to perform and / or read the assay. Examples of components include pumps that accurately draw and deliver known fluid volumes from device wells or units, at least one movement stage that improves the accuracy and accuracy of movement within the system, and detection of analysis targets within the assay unit. Includes, but is not limited to, detectors that regulate the temperature environment for assay incubation. In one embodiment of the invention, a measuring instrument controls the temperature of the device. In a further embodiment, the temperature is in the range of about 30-40 degrees Celsius. In some embodiments, temperature control by the system may include active cooling. In some cases, the temperature range is about 0-100 degrees Celsius. For example, in the case of nucleic acid assays, temperatures up to 100 degrees Celsius can be achieved. In certain embodiments, the temperature range is about 15-50 degrees Celsius. The temperature control unit of the system may include a thermoelectric device such as a Peltier device.
The cartridges, devices, and systems described herein can provide many features not used in existing POC or integrated analysis systems. For example, many POC cartridges rely on closed fluid systems or fluid loops that operate small amounts of liquid in an efficient manner. The cartridge and fluid devices described herein may allow fluid movement between units of the cartridge. For example, reagents can be held in the unit, samples can be held in the sample collection unit, diluents can be held in the diluent unit, and capture surfaces can be placed in the assay unit, in which case, in one state of the cartridge, Neither unit is in fluid communication with the other unit. With the fluid transfer devices or systems described herein, under certain conditions, the units do not need to be fluid contacted with each other. Units can be made movable relative to each other in order to fluidize several units. For example, the fluid transfer device may include a head that engages the assay unit and moves the assay unit to fluidly communicate with the reagent unit.
The devices and systems herein may provide an effective means for high-throughput, real-time detection of analyzed objects present in body fluids derived from the object. Detection methods can be used in a wide variety of situations, including the identification and quantification of analysis targets associated with a particular biological process, physiological condition, disorder or stage of the disorder. Thus, the system is extensive in, for example, drug screening, disease diagnosis, phylogenetic classification, relative and forensic identification, disease onset and recurrence, individual response to population-based treatment, and treatment monitoring. Has usefulness. The device and system also improves preclinical and clinical stages of therapeutic drug development, improves patient compliance, monitors prescription drug-related ADRs, develops personalized medicine, from central laboratories to home, It is also particularly useful for outsourcing blood tests on a prescription basis and for monitoring therapeutic agents after regulatory approval. Devices and systems can provide flexible systems for personalized medicine. As described, the system can be used to perform a wide variety of assays by modifying or replacing devices according to protocols or instructions to the system's programmable processors. The systems and devices herein provide many of the features of a laboratory environment in a desktop or smaller sized automated instrument.
In some embodiments, the patient can be supplied with a plurality of devices used to detect various analysis targets. Subjects can use different fluid devices, for example, on different days of the week. In some embodiments, software on an external device that associates an identifier with a protocol may include, for example, the process of comparing the date on which a fluid device is used based on clinical trials to the present day. In another embodiment, the patient is provided with different reagent units and assay units that can be compatiblely fitted into the housing of the device. As described in yet another embodiment, the patient does not need a new device each day of the examination, but rather programs the system or by downloading new instructions from an external device, such as a server. Can be reprogrammed. For example, if the two days of the week are not the same, then by an external device, suitable for the device and / or system suitable for the subject using either of the methods described herein or known in the art. Notifications can be sent wirelessly to inform you of various commands. This example is for illustration purposes only and can be easily extended, for example, to notify the subject that the fluid device will not be used at the exact time of day.
For example, the cartridge shown in FIG. 1 can include various assay and reagent units. The assay unit may include a capture surface according to the analyzed object to be detected. The assay unit can then be assembled with the residue of the device in a just-in-time fashion. For many prior art POC devices, a capture surface is essential to the device, and if the capture surface is improper or improperly formed, the entire device will be defective. When using the devices described herein, the capture surface and / or assay unit can be individually quality controlled and the reagent unit and housing of the device can be individually customized.
The reagent unit can be filled with various reagents by the same just-in-time method. This provides customizable device flexibility. In addition, reagent units can be filled with different volumes of reagents without compromising device stability or chemical reactions performed within the device. By linking with a system with a fluid transfer device as described, the devices and units described herein provide flexibility in the method and protocol of the assay performed. For example, a similar device batch containing the same reagents can be donated to a patient pool for clinical trials. During a clinical trial, the user confirms that the assay can be optimized by varying the dilution ratio of the sample and the amount of reagents supplied to the assay unit. As described herein, the assay can be modified or optimized by simply modifying the instructions to the programmable processor of the fluid transfer device. For example, in a cartridge batch in a patient pool, the cartridge may be filled with excess diluent. The new protocol requires a 4-fold diluent from the previous protocol. The methods and systems described herein allow the central server to modify the protocol to perform the method by the device and send it to all systems without the need to supply a new device to the patient pool. In other words, the POC devices and systems described herein can provide a great deal of flexibility for standard laboratory practices where excess reagents and excess samples are often used.
In some cases where the cartridge unit is separable, the devices and systems provide flexibility in building the systems described herein. For example, the cartridge can be configured to perform eight assays using an array of assay units and an array of reagent units. The cartridge features described herein allow the manufacture of cartridges with up to eight different assays different from previous cartridges, using the same housing, or housing of the same design. This flexibility is difficult to achieve in many current POC device designs because of the closed system and fluid channels, and therefore also the device cannot be modular or easy to assemble as described. Is.
Today, it is necessary to detect multiple types of analysis targets that exist in a wide range of different concentration ranges, for example, one analysis target is in the concentration range of pg / ml and another analysis target is in the concentration range of ug / ml. is there. The system described herein has the ability to simultaneously assay objects for analysis present in the same sample over a wide concentration range. Another advantage of being able to detect the concentrations of different analysis targets that exist in a wide concentration range is the concentration ratio of these analysis targets, as well as the safety and efficacy of multiple drugs administered to the patient. The ability to associate. For example, unforeseen drug-drug interactions can be a common cause of harmful drug action. Simultaneous real-time measurements that measure different analysis targets help avoid the potentially harmful consequences of harmful drug-drug interactions.
It is possible to monitor the concentration of the subject to be analyzed and / or the rate of change of the PD or PK marker concentration over a period of time in a single subject, or the concentration or PD or PK marker, which are the drug concentrations. Performing a trend analysis of or their biotransformer concentrations helps prevent potentially dangerous situations. For example, when glucose is the subject of the analysis of interest, the rate of change in glucose concentration in the sample at a given time point, as well as the rate of change in glucose concentration over a given period of time, is extremely useful, for example, in predicting and avoiding hypoglycemic events. Can be. Such trend analysis provides broad and informative implications for drug administration regimens. When multiple drugs and their metabolites are problematic, it is often desirable to be able to identify trends and take proactive measures.
Therefore, the data generated by the use of this fluid device and system can be used to perform a trend analysis on the concentration of the analysis target in the target.
Eight assays on the same cartridge often require different dilutions or pretreatments. The range of dilution rates can vary considerably between assays. Many current POC devices have a limited range of dilutions, thus limiting the number of assays that can potentially be performed on the POC device. However, the systems and / or cartridges described herein can provide a wide range of dilutions due to their ability to create dilution series of samples. Therefore, a large number of potential assays can be performed on a single cartridge or multiple cartridges without changing the detector or reading instrument depending on the assay.
In one example, the system described herein is configured to perform detection assays for multiple (eg, 5 or more) different target analysis targets. In order to keep the expected concentration of analysis to be within the detection range of the immunoassays described herein and commonly used in the POC field, the sample should be, for example, 3: 1, 8: 1, 10: 1, 100. Each of the five assays must be performed, diluted to 1 and 2200: 1. Since fluid transfer devices are capable of retaining and moving fluids within the device, serial dilutions are performed by the systems described herein to achieve these five different dilutions, five types. Can detect different target analysis targets. As described above, the protocol for performing the assay can also be adjusted without modification of the device or system.
In a laboratory environment with conventional pipetting, it is typical to use a larger volume of sample than is used in a POC environment. For example, in the laboratory, blood samples taken from a patient's arm can be analyzed in volumes in the milliliter range. In a POC environment, the process is fast, easy, and / or minimally invasive, so a small amount of sample (in a volume on the order of the microliter range, such as the volume obtained by fingertip puncture) is analyzed by the POC device. Many devices and users require that it be typical. Due to sample differences, current POC devices may lose the flexibility to perform the assays given in a laboratory environment. For example, when running multiple assays derived from a sample, each assay requires a minimum volume to allow accurate detection of the analysis target, thus imposing certain constraints on the device in a POC environment. Sometimes.
In another example, the systems and / or fluid transfer devices described herein offer a great deal of flexibility. For example, a fluid transfer device can be automated to move an assay unit, assay chip, or empty pipette from one unit of the device to another without fluid communication with each other. In some cases, this can avoid cross-contamination of the device units described. In other cases, this also allows the flexibility to move and contact multiple fluids within the described device according to a protocol or instruction. For example, cartridges containing eight different reagents in eight different reagent units can be addressed and fluid transfer devices can be engaged with them in any order or combination, as instructed by the protocol. Therefore, many different sequences can be performed, depending on any chemical reaction performed on the device. Different assay protocols are possible and can be changed without changing the volume of reagents in the cartridge or the type of reagents in the cartridge and without the need for a second cartridge or second system. it can.
For example, a user orders a cartridge with a particular type of capture surface and a particular reagent to perform an assay to detect an analysis target (eg, C-reactive protein (CRP)) in a sample. The user's originally planned protocol may require two wash steps and three dilution steps. After receiving the device and system, the user decided that the protocol should actually have 5 wash steps and only 1 dilution step. The devices and systems herein may allow flexibility for this change in the protocol without the need to reconfigure the device or system. In this example, all that needs to be sent to the programmable processor of the system or fluid transfer device is a new set of protocols or instructions.
In another example, the system described herein is configured to perform detection assays for five different target analysis subjects, each assay requiring incubation at a different temperature. For many prior art POC devices, incubation of multiple assays at different temperatures is a difficult task because the multiple assays are not modular and the capture surface cannot be moved relative to the heating device. In the case of the system described herein in which individual assay units are configured to carry out chemical reactions, individual assay units can be placed in individual heating units. In some embodiments, the system comprises a plurality of heating units. In some cases, the system includes at least as many heating units as the assay units. Therefore, multiple assays can be performed at multiple temperatures.
The systems and devices described herein may also provide a variety of quality control measures not previously available in many prior art POC devices. For example, due to the modularity of the device, the assay unit and reagent unit can be quality controlled separately from each other and / or from the housing and / or from the system or fluid transfer device. .. Illustrative methods and systems of quality control provided by the systems and devices herein are described.
The system described is capable of performing a variety of assays regardless of the analysis target detected in the body fluid sample. By sending a protocol that relies on device identification from an external device where it can be stored to the reader assembly, it may be possible for the reader assembly to execute a particular protocol on the device. In some embodiments, the device has an identifier (ID) detected or read by the identifier detector described herein. The identifier detector can communicate with the communication assembly via a control device that sends the identifier to an external device. If desired, the external device sends the protocol stored on the external device to the communication assembly based on the identifier. Protocols performed on the system may include instructions that force the control unit of the system to perform protocols including, but not limited to, specific assays performed and detection methods performed. When the assay is performed by the system, a signal is generated in the body fluid sample to indicate what to analyze and is detected by the system's detection assembly. The detected signal is then transmitted to the communication assembly, where it can be transmitted to an external device for processing including, but not limited to, calculating the concentration of the analysis target in the sample.
In some embodiments, the identifier can be a bar code identifier with a series of black and white stripes, which can be read by a well-known identifier detector, such as a bar code reader. The other identifier can be an alphanumeric string, color, protrusion or any other identifier that is placed on the device and can be detected or read by the identifier detector. The identifier detector can also be an LED that emits light that interacts with a light-reflecting identifier and can determine the identification of the device as measured by the identifier detector. In some embodiments, the identifier may include a device for storage or storage and may transmit information to an identification detector. In some embodiments, a combination of techniques can be used. In some embodiments, the detector is calibrated with an antigen such as an LED.
In one example, the device can be fed with a fluid sample and the device can be inserted into the system. In some embodiments, the device is partially manually inserted and then the reader assembly properly and automatically places the device in the system. Any other mechanism known in the art for inserting discs or cartridges into the system can be used. In some embodiments, manual insertion may be required.
In some embodiments, the method of automatically selecting a protocol to be executed on the system is to prepare an identifier detector and a device containing the identifier, to detect the identifier, and to transfer the identifier to an external device. It includes a step of transmitting and a step of selecting a protocol to be executed on the system from a plurality of protocols on the external device associated with the identifier.
In one embodiment, it is an automatic detection system for a plurality of types of analysis targets in a body fluid sample, a sample collection unit configured to accommodate the body fluid sample, and individual analysis targets of the plurality of types of analysis targets to be detected. A fluid device (described herein) comprising an array of assay units in which individual assay units are configured to perform a chemical reaction that results in a signal indicating, and an array of reagent units in which the individual reagent units contain reagents. The system including the device to be used, etc.) is disclosed. The system includes multiple heads configured such that individual heads engage individual assay units, fluid samples from sample collection units and reagents from individual reagent units into individual assay units. It further includes a fluid transfer device, including a programmable processor configured to direct the transfer. For example, each assay unit contains a reagent and is configured to carry out a chemical reaction with that reagent.
In some cases, the analysis of the plurality of types detected by diluting the body fluid sample in the array of the assay unit to some extent by the configuration of the processor that directs the fluid transfer so that the plurality of types of analysis targets can be detected by the system. Keep the signal indicating the target within the detectable range. In one example, a body fluid sample comprises at least two analysis objects present at concentrations that differ by at least 2, 5, 10, 15, 50, or 100 orders of magnitude. In one example, a body fluid sample is a drop of blood. In one embodiment, the concentrations of at least two analysis targets present in the sample differ by up to 10 orders of magnitude (eg, the first analysis target exists at 0.1 pg / mL and the second analysis target is 500 ug / mL. Present in mL). In another example, some protein analysis subjects were found at concentrations above 100 mg / mL, which extend the scope of interest to about 12 digits.
By diluting the body fluid sample to some extent, signals indicating at least two types of analysis targets can be kept within a detectable range. In many cases, the system further includes a detector such as a photomultiplier tube (PMT). For example, in a photomultiplier tube, the detectable range of the detector can be about 100 to about 10 million counts per second. Each count corresponds to a single photon. In some cases, the PMT is not 100% effective and may be slightly below the actual number of photons reaching the detector per unit time, but can still be close to this. In some cases, counts are measured at about 10 intervals, about 1 second each, and the results are averaged. In some cases, when using the PMT as a detector, the range of the assay is 1000-1,000,000 counts per second. In some cases, count rates of at least 100 and up to 10,000,000 per second are measurable. The linear response range of the PMT (eg, where the count rate is directly proportional to the number of photons per unit time) can be about 1000-3,000,000 counts per second. In one example, the assay has a detectable signal at a lower limit of about 200-1000 counts per second and an upper limit of about 10,000-2,000,000 counts per second. In some cases of protein biomarkers, the count rate is directly proportional to the alkaline phosphatase bound to the capture surface and also directly to the concentration to be analyzed. Other exemplary detectors include avalanche photodiodes, avalanche photodiode arrays, CCD arrays, and ultra-low temperature CCD arrays. Many other detectors have a digital output and are generally proportional to the photons reaching the detector. The detectable range of the exemplary detector can be suitable for the detector used.
The individual heads of the fluid transfer device can be configured to adhere to the individual assay units. The fluid transfer device can be a pipette, such as an air replacement pipette. The fluid transfer device can be automatic. For example, a fluid transfer device may further include a motor in contact with a programmable processor, which may move multiple heads based on a protocol from the programmable processor. As described, the individual assay unit can be a pipette tip, eg, a pipette tip with a capture surface or reaction site.
In many cases, for POC devices such as the systems and devices described herein, the dilution factor must be estimated and this must be reasonably accurate. For example, in an environment where a non-expert user operates the system, a means of checking the dilution ratio of the sample is needed.
As described herein, a fluid transfer device can provide accurate assay results with some dilution of the sample. For example, the programmable fluid transfer device can be multi-headed to dilute the sample or serially dilute it, as well as to supply a mixture of sample and diluent. Fluid transfer devices can also result in fluid transfer in POC devices.
As described, the systems and devices herein may enable many features of the flexibility of a laboratory environment in a POC environment. For example, samples can be automatically collected and manipulated in tabletop-sized or smaller devices or systems. A common problem with POC devices is the achievement of different dilution ranges when performing multiple assays that can have significantly different sensitivities or specificities. For example, there can be two types of analysis targets in a sample, one analysis target has a high concentration in the sample and the other analysis target has a very low concentration. As described, the systems and devices herein are capable of diluting samples to significantly different levels to detect both analysis targets. For example, when the analysis target has a high concentration, the sample can be serially diluted to an appropriate detection range and supplied to the capture surface for detection. In the same system or device, samples with low concentrations of analysis may not need to be diluted. Therefore, the assay range of the POC devices and systems described herein can be extended over many current POC devices.
The fluid transfer device can be part of a system that is a benchtop instrument. The fluid transfer device may include multiple heads. In the fluid transfer device of the present invention, any number of heads required to detect a plurality of types of analysis targets in a sample can be assumed. In one example, the fluid transfer device has about eight heads mounted in a straight line at some distance. In certain embodiments, the head has a tapered nozzle that engages by pressure welding with various chips such as the assay unit or sample collection unit described herein. The chips have the feature that after use, they can be automatically removed by the measuring instrument and disposed of in the housing of the device, as described. In certain embodiments, the assay chip is colorless and transparent, and the assay that can be detected by a photodetector, such as a photomultiplier tube, can resemble a cuvette in which it is performed.
In some examples, the system's programmable processor may contain instructions or commands to operate the fluid transfer device in accordance with the instructions to pull the piston out of the closed void (pull liquid) or into the void. It is possible to transfer a liquid sample by pushing the piston into (pushing out the liquid). Both the volume of air moving and the speed of movement can be precisely controlled, for example, by a programmable processor.
Mixing the sample (or reagent) with a diluent (or other reagent) sucks the components to be mixed into a common tube and then repeatedly sucks most of the mixed liquid volume up and down in the chip. It can be achieved by doing. Dissolution of the dried reagent in the tube can be performed in the same manner. Incubation of the liquid sample and reagent with the capture surface to which the capture reagent (eg, antibody) is bound can be achieved by drawing the appropriate liquid into the chip and holding it there for a predetermined period of time. it can. Removal of samples and reagents can be achieved by ejecting the liquid into a reservoir or absorption pad within the described device. Another reagent can then be drawn into the chip according to instructions or protocols from the programmable processor.
In the example shown in FIG. 11, the liquid 1111, which was previously in the chip 1101, may leave a thin film 1113 in the chip 1101 at the time of ejection. Therefore, the system can expel the previously existing liquid 1111 from the chip 1101 by using the action of the head (eg, top) portion of the next liquid 1112. Subsequent liquid portions contaminated with the previously existing liquid 1113 can be retained within the top of chip 1101 which does not continue to interact with the capture surface 1102. The capture surface 1102 can be within the defined area of the chip 1101 so that the previous liquid 1111 does not react with the capture surface 1102, for example, as shown in FIG. 11, the capture surface 1102 is a protrusion on the chip. Occupies a defined portion of the cylindrical portion of chip 1101 that does not extend further. In many cases, the incubation time is short (eg, 10 minutes) and the separation of the contaminated zone of the liquid is relatively large (> 1 mm), so that the contaminated portion of the liquid 1113 or the diffusion of the active ingredient is the capture surface during the incubation. It does not occur quickly enough to react with 1102. For many sensitive assays, it is a requirement to remove one reagent or wash the capture surface (eg, the detection antibody labeled with the assay signal generator). In one example, the fluid transfer device of the system described herein can perform cleaning, for example, by further adding a removal cycle and a suction cycle by fluid transfer using a cleaning reagent. In one example, four wash steps resulted in 10 unbound detection antibodies contacting the capture surface.<sup>6</sup>It is shown to decrease at a good magnification of more than one-third. Any detection antigen (extremely undesirable) non-specifically bound to the capture surface can also be removed during this washing step.
Expansion of the assay range can be achieved by diluting the sample. For POC assay systems, the use of disposable cartridges containing diluents is often the de facto limit to dilution. For example, a small amount of blood sample (eg, about 20 microliters) may be obtained by fingertip puncture and diluted, and if the maximum volume of diluent that can be placed in the tube is 250 microliters, then the dilution for all samples The de facto limit is about 10 times. In the examples herein, the system can increase the maximum dilution factor to about 100 times by aspirating a smaller amount of sample (eg, about 2 microliters). In many assays, such dilution ratios are acceptable, but in the case of assays such as those for CRP (described in the examples herein), the sample needs to be diluted even more. Separation-based Elisa assays can have intrinsic limits on the ability of the capture surface to bind to the analysis subject (eg, about hundreds of ng / ml for a typical protein analysis subject). Some analysis targets are present in the blood at hundreds of micrograms / ml. Even when diluted 100-fold, the concentration to be analyzed can be outside the scope of calibration. In exemplary embodiments of the systems, devices, and fluid transfer devices herein, multiple dilutions are achieved by performing multiple fluid transfers of the diluent into individual assay units or sample collection units. Can be achieved. For example, as described above, when the concentration of the analysis target in the sample is extremely high, the sample can be diluted a plurality of times until the concentration of the analysis target falls within the permissible detection range. The systems and methods herein may provide accurate measurements or estimates of dilution to calculate the original concentration to be analyzed.
In certain embodiments, the system herein allows the liquid sample to be moved and the assay unit to be moved. The system may include a heating block and a detector. To move the liquid sample, the system may provide suction, syringe, or pipette-type movements. In an exemplary embodiment, the fluid transfer device that moves the liquid sample is a pipette and pipette head system. The number of pipette devices required by the system can be adjusted according to the type of analysis to be detected and the number of assays performed. The actions performed by the pipette system can be automatic or manual operation by the user.
FIG. 5 shows an example of the fluid transfer device 520 and system 500 described herein. The fluid transfer device system can use eight different heads 522 to simultaneously move eight different or identical volumes of liquid. For example, a cartridge (or device described herein) 510 comprises eight assay units 501. Each assay unit 501 is configured according to the type of assay performed within the unit 501. Each assay unit 501 may require a volume of sample. The individual heads 522 can be used to distribute the appropriate amount of sample to individual assay units 501. In this example, the individual heads 522 correspond to the individual assay units 501 addressed.
The fluid transfer device mechanism 520 can also be used to dispense reagents from the reagent unit. Different types of reagents include conjugate solutions, cleaning solutions, and substrate solutions. In an automated system, by moving stage 530 on which the device 510 is placed, for the placement of assay unit 501 and head 522, and according to the steps required to complete the assay shown in FIG. The device 510 can be moved. Alternatively, the head 522 and chip 501 or fluid transfer device 520 can be moved relative to the position of device 510.
In some embodiments, the reagent is provided in dry form, which is rehydrated and / or lysed during the assay. Dry forms include lyophilized materials and films coated on the surface.
The system may include a cage or engageer that moves the assay unit or chip. The engager may include a vacuum assembly or an assembly designed to fit snugly within the protrusion of the assay unit tip. For example, the means for moving the chip can be moved in a manner similar to the head of a fluid transfer device. The device can also be moved on the stage according to the position of the engager or cage.
In certain embodiments, the instrument that moves the chip is the same as the instrument that moves a volume of sample, such as the fluid transfer device described herein. For example, the sample collection tip can be fitted into the pipette head according to the protrusions on the collection tip. The collection chip can then be used to distribute the liquid throughout the device and system. After the liquid has been dispensed, the collection tip can be discarded and the pipette head can be fitted into the assay unit according to the protrusions on the assay unit. The assay unit tip can then be moved from reagent unit to reagent unit and the reagent can be dispensed to the assay unit according to the suction or pipette-type motion provided by the pipette head. The pipette head can also perform mixing within a collection tip, assay unit, or reagent unit by suction or pipette operation.
The system may include heating of the assay or assay unit and / or a heating block for controlling assay temperature. The use of heat in the incubation step of the assay reaction can accelerate the reaction and reduce the duration required for the incubation step. The system may include a heating block configured to accept the assay unit of the invention. The heating block can be configured to accept multiple assay units from the devices of the invention. For example, if it is desired to perform eight assays on the device, the heating block can be configured to accommodate eight assay units. In some embodiments, the assay unit can be moved and thermally contacted with the heating block by means of moving the assay unit. The heating can be carried out by a heating means known in the art.
An exemplary system 600 described herein is shown in FIG. The system 600 includes a translational moving stage 630 on which the device 610 (or cartridge in this example) is placed, either manually or automatically or in combination. System 600 also includes a heating block 640 that can be lined up with assay unit 611 of device 610. As shown in FIG. 6, device 610 comprises a chain of eight assay units 611 and correspondingly multiple reagent units 612, and heating block 640 also includes region 641 for simultaneously heating at least eight units. .. Each of the heating regions 641 can be given the same or different temperatures for each individual assay unit 611, depending on the type of assay being performed or the type of analysis being detected. System 600 also includes a detector (such as a photomultiplier tube) 650 for detecting signals from assay unit 611, which represents the detection of the subject to be analyzed in the sample.
In certain embodiments, a sensor is provided that locates the assay unit with respect to the detector when the assay is detected.
In certain embodiments, the detector is a reader assembly that contains a detection assembly that detects the signals produced by at least one assay on the device. The detection assembly can be above the device or in a different orientation with respect to the device, for example, depending on the type of assay performed and the detection mechanism used. The detection assembly can be moved and associated with the assay unit, or the assay unit can be moved and associated with the detection assembly.
In many cases, a photodetector is prepared and used as a detection device. Non-limiting examples include light emitting diodes, photomultiplier tubes (PMTs), photon counting detectors, avalanche photodiodes, or charge-coupled devices (CCDs). In some embodiments, pin diodes can be used. In some embodiments, a pin diode can be coupled to an amplifier to create a detection device with PMT-like sensitivity. Some assays are capable of producing the luminescence described herein. In some embodiments, chemiluminescence is detected. In some embodiments, the detection assembly may include multiple fiber optic cables that are contacted as a bundle for a CCD detector or PMT array. Fiber optic bundles can be constructed from individual fibers or multiple small fibers that are fused together to form a solid bundle. Such robust bundles are commercially available and can be easily coupled with a CCD detector.
The detector may also include a light source such as a bulb or light emitting diode (LED). The light source can illuminate the assay to detect the results. For example, the assay can be a fluorescence assay or an absorbance assay commonly used with nucleic acid assays. The detector may also include an optical element that delivers a light source to the assay, such as a lens or optical fiber.
In some embodiments, the detection system may include a non-photodetector or sensor for detecting a particular parameter of interest. Such sensors can be used for compounds that are oxidized or reduced, such as O<sub>2</sub>, H<sub>2</sub>O<sub>2</sub>, And I<sub>2</sub>, Or in the case of oxidizable / reducible organic compounds, may include temperature, conductivity, potentiometric signals, and current measurement signals.
After manufacturing, the device and system may be shipped to the end user in one piece or in individual form. The device or system of the present invention may be packaged with a user manual or instructions for use. In certain embodiments, the systems of the invention are comprehensive for the types of assays performed on different devices. Since the components of the device can be modular, the user may only need various devices or assay units or reagent units to perform multiple assays in one system and point of care environment. .. In this context, the system can be used repeatedly with multiple devices, for example, it may be necessary to have sensors in both the device and the system to detect such changes at the time of shipment. At the time of shipment, changes in pressure or temperature may affect the performance of many components of the system and are on the device or system so that adjustments can be made during calibration or data processing on the external device. Such sensors placed in can pass these changes, for example, to an external device. For example, if the temperature of a fluid device changes to a certain level at the time of shipment, when the device is inserted into the system by the user, a sensor placed on the device detects this change and sends this information to the system. Can be sent. There may be additional discovery devices in the system that perform these tasks, and such devices may be incorporated into other system components. In some embodiments, the information can be wirelessly transmitted to the system or an external device such as a personal computer or television receiver. Similarly, sensors in the system can detect similar changes. In some embodiments, it may be desirable to have the sensor in place of, or in addition to, the sensor in the system components also in the shipping packaging. is there. For example, perceptible adverse conditions that invalidate an assay cartridge or system can include a violation of cartridge integrity, such as exposure to temperatures above the maximum heat resistant temperature, or moisture permeation.
In certain embodiments, the system comprises a communication assembly capable of wirelessly transmitting and receiving information from an external device. Such wireless communication can be the Bluetooth method or the RTM method. Various communication methods can be used, such as dial-up wired connection with a modem, direct connection of T1, ISDN, or cable lines. In some embodiments, the wireless connection is established using an exemplary wireless network such as a cellular network, satellite network, pager network, GPRS, or a local data transmission system such as Ehternet or Token Ring across a local area network. Will be done. In some embodiments, the information is encrypted before being transmitted across the wireless network. In some embodiments, the communication assembly may include wireless infrared communication components for transmitting and receiving information. The system may include an integrated graphics card that facilitates the display of information.
In some embodiments, the communication assembly may have a storage device or storage device, such as local RAM, where the collected information can be stored, for example. For example, a storage device may be needed when information cannot be transmitted at a given point in time because it is temporarily impossible to connect wirelessly to the network. The information may be associated with the device identifier within the storage device. In some embodiments, the communication assembly may retry transmitting the stored information after a certain length of time.
In some embodiments, the external device communicates with the communication assembly within the reader assembly. External devices may communicate wirelessly or physically with the system, but also with third parties, including but not limited to patients, healthcare professionals, clinicians, laboratory personnel, or other personnel in the healthcare industry. Can communicate.
An exemplary method and system is shown in Figure 7. In the example of FIG. 7, the patient delivers the blood sample to the device described herein and then inserts the device into a reader that can be a desktop system capable of reading the analysis target in the blood sample. .. The reader can be the system described herein. The reader can be a benchtop system or a desktop system and can read a number of different devices as described herein. The reader or system can perform the chemical reaction and detect or read the result of the chemical reaction. In the example of FIG. 7, the reader is automated according to a protocol sent from an external device (eg, a server that includes a user interface). Readers can also send chemical reaction detection results to servers and user interfaces. In an exemplary system, a user (eg, a healthcare professional such as a doctor or researcher) can review and analyze the results and determine or create a protocol used to automate the system. The results can also be saved locally (on the reader) or on the server system. The server can also record patient records, patient diaries, and patient population databases.
FIG. 8 shows the flow of the process of constructing a system for evaluating the treatment status of the subject. The patient enters personal data and / or measurements from the devices, readers, and / or systems described herein in a database that may reside on the described server. The system can be configured to display personal data on the patient station display. In some embodiments, the patient station display is interactive and the patient can modify the input data. The same or different databases contain data from other subjects with similar therapeutic status. Data from other subjects can be historical data from public or private medical institutions. Data from other subjects can also be internal data from clinical trials.
Figure 8 also shows the flow of data from reader-collected data, including data from the subject, to servers that communicate across the public network. The server can also manipulate the data or simply supply the data to the user station. Patient data can also be entered into the server separately from the treatment status related data stored in the database. Figure 8 also shows the display of the user station and the flow of information to the healthcare professional or user. For example, using the exemplary process flow of FIG. 8, a home patient would inject a fluid sample into the cartridge of the invention described herein, and the cartridge would be a system or system described herein. Can be installed on the reader. The patient can see the data from the system on the patient station display and / or change the process flow data or enter new data into it. Data from the patient is then placed in a central computing hub or clinical trial facility over a public network, such as the Internet, in encrypted form, and moved to a server that includes a network interface and processor. obtain. The server can use the treatment status data to manipulate and understand the data from the user and then send the results to the user station over the entire public network described. The user station may be in a treatment facility or laboratory and may have a user station display showing the results of assay and patient data manipulation to healthcare professionals. In the case of this example, the healthcare professional can receive the analysis results of the patient-derived sample from the test administered to the patient at an alternative location, such as the patient's home. Other embodiments and examples of the system and components of the system are described herein.
In some embodiments, the external device can be a computer system, server, or other electronic device capable of storing or processing information. In some embodiments, the external device can be one or more computer systems, servers, or other electronic devices capable of storing or processing information. In some embodiments, the external device may include, for example, a database of patient information such as, but not limited to, treatment records or patient history, clinical trial records, or preclinical trial records. The external device may store a protocol executed on the system that may be sent to the system's communications assembly when it receives an identifier indicating which device has been inserted into the system. In some embodiments, the protocol may depend on the device identifier. In some embodiments, the external device stores multiple protocols for each device. In other embodiments, the patient information on the external device comprises a plurality of protocols. In some cases, the external server stores a mathematical algorithm that processes the photon counts sent by the communication assembly and, in some embodiments, calculates the concentration of the object to be analyzed in the fluid sample.
In some embodiments, the external device may include one or more servers known in the art and commercially available. Such servers can provide load balancing, task management, and backup capabilities when one or more servers or other components of an external device cannot improve server availability. The server can also be implemented on a distributed network of storage units and processor units, as is known in the art, in which case the data processing according to the invention resides on a workstation such as a computer. This eliminates the need for a server.
The server may include a database process and a system process. The database may reside on a server or on another server system that has access to the server. Since the information in the database can contain sensitive information, it is possible to implement a security system that prevents unauthorized users from accessing the database.
One advantage of some of the features described herein is that it sends information from an external device, not only a reader assembly, but also other parties, such as, but not limited to, PDAs or cell phones. Or it can be sent back to other external devices. Such communication can be achieved via the wireless network disclosed herein. In some embodiments, the calculated concentration of analysis or other patient information can be transmitted, for example, to a healthcare professional or patient, but not limited to them.
Therefore, it is possible to perform a trend analysis on the concentration of the analysis target in the target using the data generated by the use of this device and the system.
Another advantage described herein is that the assay results can be communicated almost immediately with any third party who can benefit from obtaining the results. For example, once the concentration to be analyzed is determined on an external device, it can be sent to a patient or healthcare professional who may need to take further action. As described herein, the communication step to a third party can be performed wirelessly, and by transmitting data to the third party's portable device, the third party can have virtually any time. And at the location, the assay results can be notified. Thus, if urgent medical treatment may be required, the patient can be contacted immediately and in a timely manner at any location.
By detecting a device based on an identifier associated with the fluid device after inserting the device into the system, the system allows fluid device-specific protocols to be downloaded and executed from external devices. In some embodiments, the external device may store multiple protocols associated with the system or with a particular patient or patient population. For example, if the identifier is sent to an external device, the software on the external device can receive the identifier. Upon receipt, software on an external device, such as a database, can use the identifier to identify the protocol stored in the database associated with the identifier. For example, if only one protocol is associated with an identifier, the database can select protocols and software on external devices, and then send the protocols to the communication assembly of the system. If a protocol specifically associated with the device can be used, any component of the device of the invention can be used with a single system, thereby targeting a single analysis target of virtually any purpose. It can be detected by the system.
In some embodiments, multiple protocols may be associated with a single identifier. For example, if it is beneficial to detect one analysis target once a week and another analysis target twice a week from the same patient, when the identifier is detected, the software on the external device will use the software on the external device to detect the same day of the week. The protocol on the external device associated with the identifier may also be associated with a different date of the week, so that a particular protocol can be selected.
In some embodiments, the patient can be supplied with a plurality of devices used to detect various analysis objects. For example, subjects can use different devices on different dates of the week. In some embodiments, software on an external device that associates an identifier with a protocol may include, for example, comparing the current date with the date on which the device is used based on clinical trials. For example, if two days of the week are not the same, an external device wirelessly sends a notification to the subject using either method described herein or known in the art and into the system. It is possible to notify the target that there is an inappropriate device and that the appropriate device will be used on that day. This example is merely exemplary and can be easily extended to, for example, notifying the subject that the device has not been used at the correct time on a date.
The system can also use a network method to assess the medical condition of the subject. The information communication system may or may not include a reader that reads the data of interest. For example, when biomarker data is collected by a point-of-care microfluidic device, the device itself or a separate device can read the values assigned to each different biomarker. Another example of a reader is a bar code system that scans within subject data entered in electronic treatment records or physician charts. A further example of a reader consists of an electronic patient record database from which subject data can be obtained directly via a communication network. This method can show the effectiveness of a particular drug in real time, which justifies the reimbursement of treatment.
Non-compliance with medical treatment, including clinical trials, significantly reduces the effectiveness of treatment or clinical trials. Thus, in some embodiments, the systems of the invention can be used to monitor patient compliance and notify the patient or other healthcare professional of such non-compliance. For example, a patient taking a medicinal agent as part of a medical treatment regimen may take a body fluid sample to be assayed as described herein, for example, the concentration of metabolites detected by the system. It may be at higher levels compared to known profiles, indicating that multiple doses of the medicinal agent have been taken. Patients or healthcare professionals will be notified of such non-compliance by any method or wireless method described herein, including but not limited to notification via portable devices such as PDAs or cell phones. can do. Such known profiles can be placed or stored on an external device as described herein.
In certain embodiments, the system can be used to identify a subpopulation of patients for whom treatment is beneficial or detrimental. In this method, its use can be curtailed by assigning over-the-counter drugs of various toxicities that would otherwise be compelled to be taken only to patients for whom it is beneficial.
Method The devices and methods of the present invention provide effective means for real-time detection of analytical objects present in body fluids from the subject. This detection method may be used in a wide variety of situations, including identification and quantification of analysis targets associated with a particular biological process, physiological condition, disorder, stage of disability or stage of treatment. Alternatively, the device and method may be of widespread usefulness in, for example, drug screening, disease diagnosis, phylogenetic classification, parental and forensic identification, disease onset and recurrence, individual response to treatment vs. population criteria, and treatment monitoring. Have. The devices and methods also improve preclinical and clinical stages of therapeutic drug development, improve patient compliance, monitor prescription drug-related ADRs, personalized medicine, from central laboratories to patient residences. Especially useful for outsourcing blood tests. The device may be adopted according to prescription standards and used by pharmaceutical companies to monitor post-regulatory therapeutic agents, or for payers who outsource blood tests from a central laboratory.
Thus, in certain embodiments, the present invention provides a method of detecting an analysis target in a body fluid sample, the method comprising feeding a blood sample to the device or system of the invention and at least one assay of the device. It includes a step of reacting the sample within the unit and a step of detecting a detectable signal generated from the analysis target in the blood sample.
FIG. 1 shows an exemplary embodiment of the device of the invention, comprising at least one assay unit and at least one reagent unit. The assay unit (eg, designed as the sample chip and calibration chip in FIG. 1) can include a capture surface, and the reagent unit can contain items such as conjugates, wash solutions, and substrates. The devices exemplified in FIG. 1 include whole blood sample collection chips, plasma sample collection chips, blood input wells, bead wells or plasma separation wells, chip touch-off or suction pads, dilution wells, diluted plasma sample wells or Includes plasma dilution wells, collection chip disposal area.
In certain embodiments, the method comprises performing an enzyme-linked immunosorbent assay (ELISA). In the examples described in this paragraph, the sample is provided to the sample collection unit of the device described herein. The device is then inserted into the system, where the system detects the type of cartridge or device to be inserted. The system can then communicate with an external device to accept a set of instructions or protocols that allow the system to perform the desired assay (s) of the cartridge. The protocol can be transferred to the programmable processor of the system's fluid transfer device. As an example, a fluid transfer device engages a sample chip in a cartridge, removes a specific amount of sample from the sample collection unit, and transfers the sample to a pretreatment unit that removes red blood cells. The plasma of the sample can then be aspirated into the plasma chip or any assay chip by the fluid transfer device according to the protocol. The plasma-containing chip is then required to run the assay, so a diluent that dilutes the sample can be removed. Many different dilutions can be made by using serial dilutions of the sample. For example, each assay chip or assay unit can contain samples of different dilutions. After aspirating the sample into the assay unit by a fluid transfer device, the assay unit is then incubated with the sample, allowing any existing analysis target to be attached to the capture surface. The incubation described in this example can be in the system or at room temperature for any time, eg, 10 minutes, or in the heating device of the system described herein. The assay unit may engage the reagent unit addressed with the reagent corresponding to the assay performed in each individual assay unit having a capture surface for that assay. In this example, the first reagent is a detection solution of ELISA, eg, a labeled anti-label that is different from the capture surface. Includes detection antibodies such as protein antibodies. The detection solution can then be aspirated and removed from the assay unit, after which the wash solution can be aspirated into the assay unit to remove any excess detection solution. Multiple cleaning steps may be used. The final reagent added is an enzymatic substrate that allows the bound detection solution to cause chemylluminescence. The enzyme substrate is then removed from the assay unit and the assay results are read by the system's detector. At each of the described steps, incubation can be performed as needed, as described herein. In this example, the entire process after installing the cartridge in the system is automated and is done by a protocol or a series of instructions to the programmable system.
One exemplary method initiates the transport of blood samples to blood input wells. The sample can then be removed by the collection chip and inserted into the plasma separation well. Alternatively, the blood can be placed directly in a well containing a blood separator. For example, plasma separation can be performed by the various methods described herein. In this example, plasma separation proceeds with magnetizable beads and antibodies to remove non-plasma blood components. Plasma can then be produced by a plasma collection chip that prevents the sample from being contaminated with a whole blood collection chip. In this example, the plasma collection chip can take a predetermined amount of diluent and dilute the plasma sample. The diluted plasma sample is then dispensed into an assay unit (sample chip) for binding to the capture surface. The assay unit can be incubated to allow a capture reaction. The assay unit can then be used to collect the conjugate and bind it to the reactants in the assay unit. The conjugate can include an entity that enables the detection of the target analysis target by a detector such as an optical detector. Once the conjugate is added to the assay unit, the reaction can be incubated. In an exemplary method using the exemplary device of FIG. 1, the reagent unit containing a wash solution for the conjugate is then assayed to remove any excess conjugate that could interfere with the detection of any analysis target. Accessed by the unit (sample chip). After cleaning and removing excess conjugate, a substrate can be added to the assay unit for detection. In addition, in the example of FIG. 1 and this method, all methods described in this paragraph can be performed using the calibration chip assay unit, except for sample collection and distribution. Detection and measurement using the calibration chip assay unit can be used to calibrate the detection and measurement of the sample-derived analysis target. Other processes and methods similar to those used in this example are described below.
Any body fluid suspected of containing the subject of interest can be used in conjunction with the system or device of the invention. For example, the input well or sample collection unit in the example of FIG. 1 is, but is not limited to, blood, serum, saliva, urine, gastric and digestive juices, tears, excreta, semen, vaginal fluid, tumor tissue fluid extracted from tissue samples. Any type of commonly used body fluid can be collected or included, including the interstitial fluid of origin, as well as cerebrospinal fluid. In certain embodiments, the body fluid is blood and can be obtained by collecting blood in the palm of the hand. In certain embodiments, the body fluid sample is a blood plasma sample.
Body fluids are taken from the patient and may be distributed to the device in a variety of ways, including, but not limited to, lancing, injection, or pipetting. In certain embodiments, the lancet pierces the skin and transports the sample to the device using, for example, gravity, capillarity, suction, or vacuum. The lancet may include a device, part of a reader assembly, or an independent component. If desired, the lancet may be actuated by a variety of mechanical, electrical, electromechanical, or any other known activation mechanism or any combination of such methods. In another embodiment that does not require an activation mechanism, the patient can readily provide body fluids to the device, for example, as can be done with saliva samples. The collected fluid can be placed in the collection well or unit of the device. In some embodiments, there is a user-activated lancet, and a sample collection capillary within the device.
The volume of body fluid used with the methods or devices described herein is generally less than about 500 microliters and may even be about 1-100 microliters. If desired, samples from 1 to 50 microliters, 1 to 40 microliters, 1 to 30 microliters, 1 to 10 microliters, or even 1 to 3 microliters can be used to detect the subject of analysis using the fluid device of interest. Can be used. In one embodiment the sample is 20 microliters.
In certain embodiments, the volume of body fluid used to detect the subject of analysis using a device, system, or method is a drop of fluid. For example, a drop of blood from an injected finger can provide a sample of body fluid that is analyzed using the devices, systems, or methods of the invention.
In some embodiments, the bodily fluid is used directly to detect an analysis target present in the bodily fluid without further treatment. However, if desired, the body fluids may be pretreated prior to analysis using the device. The choice of pretreatment will depend on the type of fluid used and / or the nature of the subject under investigation. For example, if the analysis target is present at low levels in a sample of body fluid, the sample may be concentrated via any conventional means for concentrating the analysis target. Methods of concentrating the subject of analysis include, but are not limited to, drying, evaporation, centrifugation, deposition, precipitation, and amplification. When the analysis target is a nucleic acid, it can be extracted using various lytic enzymes or chemical solutions, or using a nucleic acid-binding resin according to the attached instruction manual provided by the manufacturer. If the subject to be analyzed is a molecule that is present on or within the cell, extraction is not limited to, but is limited to anticoagulants such as EDTA or heparin, denatured surfactants such as SDS or Thesit, sodium deoxylate, This can be done with solubilizers containing non-denaturing surfactants such as Triton X-100 and Tween-20.
In certain embodiments, the subject uses a syringe to collect a sample of body fluid. The sample can be placed in a syringe via a capillary. In certain embodiments where the subject to be analyzed in a blood sample is measured, the subject can take a blood sample in the palm of the hand and bring the outer edge of the glass capillary into contact with the blood, resulting in the drawing of blood by capillarity. Fill the capillary with capacity. In some cases, the capacity used is known. In some embodiments, the sample volume is in the range of about 5-20 microliters, or other volume ranges described herein.
In another embodiment, the method or system is provided to obtain a plasma sample that is practically free of red blood cells from a blood sample. When performing an assay, the analysis target is often contained in blood plasma, and red blood cells can interfere with the reaction.
Often, when measuring blood samples, the target of analysis is in serum or plasma. For clinical purposes, the final reported concentration of multiple blood tests often needs to be associated with the concentration of blood serum or blood plasma in the diluted sample. Often, blood serum or blood plasma is the test medium of choice in the laboratory. Two operations may be required prior to assay, dilution and red blood cell removal. Blood samples vary greatly in the proportion of sample volume occupied by red blood cells (hematocrit values vary from about 20-60%). Moreover, in a point-of-care environment where the assay system is operated by a non-expert, the volume of sample obtained may not be what was intended. If no volume change is observed, it may lead to errors at the reported concentrations to be analyzed.
Although related, in separate embodiments, the present invention provides a method of removing plasma from a blood sample, a step of mixing the blood sample in the presence of magnetizable particles within a sample collection unit, which is magnetizable. A step involving an antibody capture surface in which the particles bind to the non-plasma portion of the blood sample, and applying a magnetic field from above the plasma collection region to the mixed blood sample, squeezing the non-plasma portion of the blood sample above the plasma collection region. Includes the step of suspending and thereby removing plasma from the blood sample.
To process blood samples, the devices or systems of the invention may include magnetic reagents or objects that bind to red blood cells and allow the magnetic removal of red blood cells from plasma. The reagents can be provided in lyophilized form, but may also be present as a liquid dispersant. Reagents composed of magnetizable particles (eg, about 1 micrometer in size) can be coated with red blood cell antigens or antibodies to certain adapter molecules. In some embodiments, the reagent also comprises an unbound antibody against an erythrocyte surface antigen that may be unlabeled or labeled with an adapter moiety (eg, biotin, digoxigenin, or fluorescein). In one embodiment of analyzing a blood sample, the red blood cells in the diluted sample co-aggregate with magnetizable particles assisted by a liquid phase antibody. Alternatively, a lectin that recognizes sugars on the surface of erythrocytes can be used as a coagulation reagent. In some cases, a combination of hemagglutinin agents is used. Alternatively, the device of the invention can include a blood filter, such as a glass fiber pad, to aid in the separation of red blood cells from the sample.
When blood is mixed with magnetic reagents, coagulation can occur and many, but not all, red blood cells form aggregates mixed with magnetizable particles. The reagent dissociation and mixing process is performed by repeated suction using the tip or collection tip of the invention or a pipette-like tip. Since the plasma can escape from the chip after the magnetizable mass is formed, the mass can be separated from the blood plasma by using a magnet to hold the mass in place. In certain embodiments, the plasma is gravitationally ejected from the chip in a vertical manner and the magnet is held in place. In another embodiment, the plasma escapes from the chip by means of vacuum or pressure and the mass is retained within the chip. Plasma can be placed in the wells of the invention, another collection chip, or an assay unit.
Examples of the plasma separation method of the present invention are shown in FIGS. 9A-9E. In FIG. 9A, the whole blood sample 901 was aspirated into the sample chip 910 described herein, for example in an amount of about 20 microliters. The whole blood sample 901 is then placed in a separation well 920 (eg, a well containing magnetic beads or particles) of an exemplary device. FIG. 9B shows a method of suspending and mixing magnetic reagents (eg, magnetic bead particles and free binding molecules) in a whole blood sample 902 in a separation well. Figure 9C shows a 10 microliter air slag 930 that can be used to prevent loss from the chip 910. The mixed whole blood sample and magnetic reagent 902 are incubated for a few seconds (eg, 60-180 seconds) to allow an agglutination reaction to occur.
FIG. 9D shows the application of magnetic field 940 to whole blood cells and magnetic reagent mixture 902. The magnetic field 940 can be applied by a magnetic collar 942 incorporated with a system known in the art or with any magnetic means. The magnetic field 940 attracts any particles attached to the magnetic reagent. Therefore, the plasma 903 that does not adhere to the magnetic reagent can be separated from the non-plasma portion of the whole blood sample.
FIG. 9E shows how the blood plasma sample 903 separated by the magnetic reagents described herein is dispensed into the wells or units 950 of the devices described herein. The blood plasma sample 903 can also be dispensed into a collection chip or assay unit, as well as any variety of assay devices known to those of skill in the art. In FIG. 9E, the magnetic field 940 is shown to move with a chip 910 that distributes the blood plasma sample 903. In this example, 5-8 microliters of plasma have been removed from a 20 microliter whole blood sample. 1-99% whole blood samples can be plasma separated using the methods of the invention. In certain embodiments, the volume of a 25-60% whole blood sample is plasma that can be separated.
Other exemplary steps of the described method may be completed. To move a whole blood sample to another well or unit, a capillary plasma collection chip (which can be operated by the robotic system of the invention or any other system) collects the whole blood sample by capillary and suction. .. Another step can include dispensing the plasma sample to the diluent, which can then be diluted with the diluent. The diluted blood plasma sample can then be collected by the collection chip in a predetermined volume. The diluted blood plasma sample can then be mixed and dispensed into the wells or units of the device for dispensing into one or more assay units of the device of the invention. The sample can also be dispensed to any other type of device, such as a microliter plate, as will be apparent to those skilled in the art.
The exemplary process shown in FIGS. 9A-9E can be used with other devices and systems other than those disclosed herein. For example, the fluid transfer tip could contain agglomerated masses and the plasma could be placed on a microliter plate. Other devices and systems apparent to those of skill in the art could be utilized to perform the exemplary blood-plasma separations disclosed herein.
Also, body fluid samples can be diluted using a variety of other methods, such as dilutable sample collection devices. The housing of the sampling device can include a tube. In this tube, the two movable seals can contain a certain amount of diluent. In a preferred embodiment, the volume of diluent is predetermined, for example, in the range of about 50 microliters to 1 milliliter, preferably in the range of about 100 microliters to 500 microliters.
In some embodiments, an automated detection method for a plurality of analysis targets in a body fluid sample is provided, a sample collection unit configured to contain the body fluid sample, and a signal indicating the individual analysis target of the plurality of analysis targets to be detected. Includes a step of feeding a fluid sample to a fluid device that includes an array of assay units in which individual assay units are configured to carry out a chemical reaction that results in, and an array of reagent units in which the individual reagent units contain reagents. The method can also include engaging individual assay units with a fluid transfer device. By continuing this method, fluid samples can be transferred from the sample collection unit to the individual assay units using a fluid transfer device, and from each reagent unit to the individual assay units. The reagent can be reacted with the body fluid sample to provide a signal indicating the individual analysis target of the plurality of analysis targets to be detected. In some embodiments, the fluid transfer device comprises a plurality of heads, the individual heads being configured to engage individual assay units, said fluid transfer device being a body fluid sample from a sample collection unit, and. Includes a programmable processor configured to direct fluid transfer of reagents from individual reagent units to individual assay units.
In some cases, the instruction manual is provided to the programmable processor by, for example, the user, subject, or manufacturer. The instruction manual can be provided from an external device such as a personal electronic device or a server. The instruction manual can direct the steps of transferring fluid samples to individual assay units. For example, the step of transferring a body fluid sample affects the degree of dilution of the body fluid sample in each assay so that the signals indicating the individual analysis targets of the multiple analysis targets to be detected are within the detectable range. Can be done. In some examples, the degree of dilution of the fluid sample results in a signal indicating at least two individual analysis targets within the detectable range described herein.
Pattern recognition techniques can be used to determine whether detection of an analysis object or plurality of analysis objects by the methods described herein is within or outside of certain ranges. For example, it is possible to reject detectable signals outside the reportable range. Certain ranges can be achieved during calibration of fluid devices, reagents and assay units. For example, the range is achieved when the device is assembled in a just-in-time fashion.
In some cases, a low dilution result can be rejected as invalid if the detectable signal of the subject to be analyzed that is detected using the low dilution factor or the degree of dilution exceeds the signal by the high dilution factor. In most examples, the concentration of analysis in samples derived from signals from samples with different degrees of dilution decreases with increasing degree of dilution. When this happens, the assay results can be verified. The systems, devices, and methods herein provide the flexibility of quality control standards, eg, the flexibility described as many POC devices cannot provide. Systems, devices, and methods provide many quality control characteristics, as expected in laboratory settings.
In certain embodiments, the sample is diluted in a satisfactory ratio for both high and low sensitivity assays. For example, the dilution ratio of the sample and the diluent may be in the range of about 1: 10,000 to 1: 1. The device can dilute the sample in different locations or ranges. The device can also allow the sample to be subjected to continuous dilution. In a further example, serial dilutions within the device or system can dilute the system up to 10,000,000,000: 1.
In the embodiment, the sample containing the analysis target for detection can be moved from the first position to the second position by suction, syringe, or pipette type action. The sample can be collected on the reaction chip by capillarity or a decrease in air pressure. In some embodiments, the sample is moved to many locations, eg, an array of assay units for the device of the invention, and different wells within the housing of the device of the invention. The process of moving the sample can be automated by the system of the invention described herein.
Also, the assay unit and / or collection chip containing the sample can be moved from the first position to the second position. The process of moving the assay unit or collection chip is automated and can be performed by user-defined protocols.
In certain embodiments, the assay unit is moved to collect reagents from the reagent unit of the invention. In many embodiments, the movement of the assay unit is automated. Reagents can be collected from reagent units into assay units using aspiration, syringe, or pipette-type actions.
Once the sample is added to the assay unit containing the capture surface, all units can be incubated for a time that allows the sample to react with the assay unit's capture surface. The amount of time required to incubate the reaction often depends on the type of assay performed. This process can be automated by the system of the present invention. In certain embodiments, the incubation time is 30 seconds to 60 minutes. In another embodiment the incubation time is 10 minutes.
Also, the assay unit can be incubated at high temperature. In certain embodiments, the assay unit is incubated at a temperature in the range of about 20 ° C to 70 ° C. The assay unit can be inserted into a heating block to raise the temperature of the assay unit and / or the contents of the assay unit.
In certain embodiments of the method of the invention, the conjugate is added to the assay unit after the sample has been added to the unit. The conjugate can contain molecules for labeling the analysis target captured by the capture surface in the assay unit. Examples of conjugates and capture surfaces will be described later. The conjugate may be a reagent contained in the reagent unit. The conjugate can be dispensed into the assay unit by aspiration, syringe, or pipette type action. Once the conjugate has been dispensed into the assay unit, the assay unit can be incubated so that the conjugate can react with the subject of analysis within the assay unit. The incubation time can be determined by the type of assay or the analysis target detected. The incubation temperature may be any temperature suitable for the reaction.
In some embodiments, a method of calibrating a device for automatic detection of an analysis target in a body fluid sample is provided. The device can include an array of addressable assay units and an array of addressable reagent units configured to perform a chemical reaction that results in a detectable signal indicating the presence or absence of an analysis target, respectively. Is addressed to correspond to one or more addressable assay units within said device so that individual reagent units are relative to the corresponding assay unit (s) before the array is integrated into the device. Is calibrated. The device is calibrated by calibrating the assay and reagent units before they are incorporated into the device. The device is then assembled using calibrated components to make the device, and the method and system utilize the device, modular components.
Calibration can be pre-confirmed by measuring the execution of assay reagents such as conjugates before the assay and reagent units are incorporated into the devices of the invention. Calibration information and algorithms can be stored on a server wirelessly linked to the assay system. Calibration can be performed in advance or retroactively by assays performed in repetitive systems at different locations or by using the information obtained when the assay system is used.
In some embodiments, the control material can be used in the device or system to measure or verify the degree of dilution of the fluid sample. Another outcome of solid phase assays, such as ELISA, is the use of solid phase reagents, which are difficult to control quality without disrupting their function. The systems and methods herein provide a method of determining dilution achieved in a POC system using a disposal device that includes automated mixing and / or dilution.
In certain embodiments, the method provides retrospective analysis, for example, by using a server in real time to analyze the data before reporting the results. For example, an assay can be run and a control assay can be run in parallel with the assay. The control assay provides a measurement of the expected dilution of the sample. In some examples, the control assay can verify the dilution of the sample, and therefore the dilution of the sample for the assay performed in the system or for multiple assays can be considered accurate.
The method for measuring the volume of a liquid sample includes a step of reacting a known amount of a control analysis target in a liquid sample with a reagent to obtain a detectable signal indicating the control analysis target, and the intensity of the detectable signal. Where the expected intensity of the signal indicates the expected volume of the liquid sample, the comparison comprises the step of comparing the expected intensity of the detectable signal. A measurement value of the volume of the sample is given. In many examples, the control analysis target is not present in the liquid sample in a detectable amount.
In certain embodiments, the method comprises further verifying the volume of the liquid sample if the measurement of the volume of the sample is within about 50% of the expected volume of the liquid sample.
For example, the device or system-based method described herein presents a body fluid sample containing a target analysis target with a step of reacting a reagent that provides a detectable signal indicating the target analysis target with a target analysis target. The intensity of the detectable signal and the step of measuring the amount of the target analysis target in the body fluid sample using the measured value of the volume of the liquid sample can be further included. The liquid sample and the body fluid sample may be the same sample. In some embodiments, it is provided that the control analysis object does not react with the target analysis object in the body fluid sample and therefore does not interact with the detection of the target analysis object.
In some cases, the liquid sample and the body fluid sample are different liquid samples. For example, water and control liquids such as blood samples. Or another example is a saliva sample and a blood sample.
Control analysis targets are, but are not limited to, fluorescein-labeled albumin, fluorescein-labeled IgG, anti-fluorescein, anti-digoxigenin, digoxigenin-labeled albumin, digoxigenin-labeled IgG, biotinylated protein, and non-human IgG. May be good. Other exemplary control analysis targets may also be apparent to those skilled in the art. In certain embodiments, the control analysis target does not occur in human body fluid samples.
In the POC system described herein configured to detect multiple objects of analysis within a sample, the system can have a capillary for diluting and mixing the liquid. In many examples, an automated system or user can use a control assay to measure the dilution actually achieved and include that dilution in system calibration. For example, the control analysis target cannot be found in the target sample and can be dried in the reagent unit. The amount of dried control analysis target can be known and mixed with the sample in the reagent unit. The concentration to be analyzed can be measured to indicate the volume of the sample and any dilutions made to the sample.
Examples of objects of interest for immunoassays include, but are not limited to, fluorescein-labeled proteins, biotinylated proteins, fluorescein-labeled, Axlexa -labeled, Rhodamine-labeled, Texas Red-labeled. Contains immunoglobulins. For example, labeling can be achieved by having at least two linked haptens per molecule of protein. In some embodiments, 1 to 20 haptens are linked per molecule of protein. In a further embodiment, 4-10 haptens are linked per molecule of protein. Many proteins have a large number of free amino groups to which haptens can be attached. In many cases, the hapten-modified protein is stable and soluble. Also, fluorescein and Texas Haptens such as Red are large enough and stiff enough to produce antibodies with high affinity (eg, haptens are large enough to fill the antibody binding site). In some embodiments, the hapten can be attached to the protein using reagents such as fluorescein isothiocyanate and fluorescein carboxylic acid NHS ester to create a control analysis subject where the portion recognized by the assay system is the hapten. it can.
In some embodiments, the method utilizes a dried control analysis subject. In some examples, the dried control analysis object can avoid diluting the sample and make the control analysis object more stable. The dried control analysis subject can be formulated to dissolve rapidly and / or completely when exposed to a liquid sample. In some embodiments, the control analysis target may be the analysis target for an antibody having a high affinity. In some examples, the control analysis target may be an analysis target that does not cross-react with any endogenous sample component. Further, for example, the analysis object can be inexpensive and / or easy to make. In some embodiments, the control analysis subject is stable beyond the life of the device or system described herein. Exemplary carriers used to make analysis targets with covalently linked haptens include proteins such as, but not limited to, albumin, IgG, and casein. Exemplary polymer carriers used to generate novel analysis targets using covalently linked haptens include, but are not limited to, dextran, polyvinylpyrrolidone. Exemplary excipients used to formulate and stabilize control analysis subjects include, but are not limited to, sucrose, salts, and buffers (such as sodium phosphate and tris chloride).
The control analysis objects and methods described herein can be used in a variety of ways, including the examples described herein. For example, the method can measure the volume of a sample. In some embodiments, the method measures the degree of dilution or dilution of the diluent or sample. Optionally, the method provides a concentration of control analysis target in the sample. Systems or devices described herein for detecting multiple analysis targets validate the measurements of the target analysis target using measurements from the methods herein using control analysis targets. Or can be described. For example, a fluid transfer device with multiple heads may be used to dispense the liquid to multiple assay units, including control units. In some cases, it may be assumed that the amount of liquid distributed to the plurality of units is the same or similar among the individual units. In some embodiments, the methods described herein with control analysis objects can be used to verify that the correct volume of sample is collected or utilized within a device or system. In another embodiment, the method verifies that the correct volume of diluent is provided to the sample. Also, the factor of dilution or the degree of dilution can be verified. In yet another embodiment, the method with control analysis subjects verifies that the correct volume of diluted sample was distributed to multiple units.
FIG. 10 shows an exemplary method of control assay described herein, including a known amount of control analysis subject. The unit 1010 prior to incorporation into the cartridge can be filled with solution 1001 containing a known amount of control analysis target 1002. The liquid in the solution is removed and the unit 1010 can be dried, leaving the control analysis target 1002 in the unit 1010. Unit 1010 can then be inserted into the device and transported for use. If unit 1010 is used and accepts sample or diluent 1003, sample 1003 is transported in the expected volume, mixed with control analysis object 1002 dried in unit 1010, and a control solution with the expected concentration. 1004 can be made. Control solution 1004 can optionally be diluted. In certain embodiments, the control analysis target 1002 can be detected by the same method as a target analysis target in the device. The concentration of the control solution 1004 to be analyzed is measured. Concentration measurements can be used to calculate the volume of sample 1003 added to make control solution 1004. Therefore, the user can compare the measured volume of sample 1003 with the expected volume of sample 1003.
In one example, red blood cells can be removed from the blood sample. However, if some red blood cells remain or the red blood cells are not removed from the blood sample, a method involving a control analysis target can be used to correct for the effects of the red blood cells in the blood sample. Since the hematocrit value can vary significantly (eg, 20-60% of the total volume of the sample), the amount to be analyzed in the fixed or expected blood volume (v) can be a function of the hematocrit value (eg, 20-60% of the total volume of the sample). Here, H is represented as a decimal number). For example, the amount of analysis target with a concentration C in plasma is C.<sup>*</sup>v<sup>*</sup>(1-H). Therefore, the amount of sample with a hematocrit value of 0.3 is 1.4 times the amount of sample with a hematocrit value of 0.5. In an exemplary embodiment, undiluted blood can be dispensed to the device as described and red blood cells can be removed. The control analysis target concentration in the plasma fraction can then be measured to estimate the volume of sample plasma and determine the hematocrit value.
In some embodiments, the unbound conjugate may need to be washed out of the reaction site that interferes with the unbound conjugate as it results in inaccurate detection. The rate-determining step of many immunoassays is the wash step. The minimum carry-over and sensitive compromise relies on the cleaning and removal of unbound conjugates. The cleaning step can be very limited in the microtiter plate format due to the difficulty of removing the cleaning solution from the wells (eg, by automated means). The assay unit devices and systems of the present invention may have many advantages in the way liquids are manipulated. The advantage can be an improvement in the signal-to-noise ratio of the assay.
Removal of the conjugate can be difficult, for example, in the absence of excess lavage fluid, if the conjugate clogs the edge of the assay unit of the device.
Cleaning of the conjugate can be caused by pushing the cleaning solution from above or by pulling up the cleaning solution and expelling a liquid similar to the filling of the sample. The wash can be repeated as many times as necessary.
When a wash buffer is used in the assay, the device can store the wash buffer in a reagent unit, which can have liquid communication with the wash. In certain embodiments, the cleaning reagents can remove unbound reagents from the assay unit by washing up to approximately 99,99.9, or 99.999%. In general, high cleaning efficiencies are preferred, resulting in a high degree of reduction in unwanted background signals. Wash efficiency is typically defined by the ratio of the signal from a given assay to the total amount of signal generated by an assay without a wash step and can be easily determined by routine experimentation. In general, increasing the volume of wash solution and incubation time is preferred, but does not sacrifice signal from a given assay. In some embodiments, the wash is performed for about 10-300 seconds with about 50 μl to about 5000 μl wash buffer, preferably about 50 μl to about 500 μl wash buffer.
In addition, it may be advantageous to use several cycles of a small amount of wash solution that is separated until the wash solution is not used. This sequence is possible for diffuse washes, where the labeled antibody is long dispersed from a protected portion of the assay unit, such as a loosely bound end or surface, into a bulk wash solution and then its It can be removed if the wash solution moves from the reaction site.
In many embodiments, the final step is to dispense the enzymatic substrate and detect the conjugate by optical or electrical means. Examples of substrates are described below.
For example, the reagents in the individual sample units of the devices herein can be enzyme substrates for immunoassays. In another embodiment, the step of transporting substrate reagents from individual sample units can be repeated after the reaction at the capture site. For example, the enzyme substrate is transported to the reaction site and incubated. After measuring the assay signal produced, the substrate used can be removed and replaced with a fresh substrate to remeasure the assay signal. Signals indicating individual analysis targets can be detected from the first and second applications of the substrate using the systems described herein. The second substrate is usually the same as the original substrate. In certain embodiments, the second substrate is transported from the second reagent unit of the device herein to the reaction site. In another embodiment, the second substrate is transported from the same reagent unit as the original substrate to the reaction site. Transporting the second substrate triggers a second reaction, producing a second signal indicating the individual subject to be analyzed. The intensity of the original signal is compared with the second intensity of the second signal to calculate the final intensity of the signal indicating the individual analysis target and whether the assay was performed properly.
In certain embodiments, the intensity of the plurality of signals can be used for quality control of the assay. For example, if the signals differ by 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100% or more, the assay results may be ignored.
In certain embodiments, the methods described herein include a sample to be refilled and / or a detector-conjugate (enzyme-labeled antibody), and / or an enzyme substrate and sample to modify or confirm the assay signal. Or use as an internal control. For example, reuse of the assay chips or units described is provided to verify function and / or add additional samples, or the control material obtains a second signal.
In some cases, the method of refilling the enzyme unit with substrate is made possible by the ability of the system described herein to automatically transfer liquid samples and reagents to the assay unit. Some assays do not require a system to deliver the results immediately or on schedule, and therefore the control methods described provide an opportunity to perhaps increase the reliability of the results. The response observed after repeated additions of the enzyme substrate can be used to verify the initial response or calculate spike recovery.
Experiments show that the reproducibility of results can be maintained by adding a second enzyme substrate to the assay unit. In some embodiments, the control method provides an iterative analysis with an assay unit that gives a significantly lower response than expected.
With any of the control methods described herein, there are a number of possible errors that may be described or requested for the practice of the control method. Exemplary assay errors are, but are not limited to, improper fabrication of assay units or devices, improper aspiration of systems and / or one or more reagents, and proper placement compared to photomultiplier tubes during detection. Assay units that do not, as well as assay units that are flawed in the device or system.
In some embodiments, the invention provides a method of obtaining pharmacological data useful in assessing the efficacy and / or toxicity of a drug from a test animal using a subject fluid device or system.
When using laboratory animals in preclinical drug trials, it is often necessary to kill the test control to extract enough blood to perform an assay to detect the control subject to be analyzed. Is. This has both financial and ethical implications, and it may also be advantageous to be able to draw a certain amount of blood from the test animal so that the animal does not need to be killed. In addition, this also allows the same test animal to be tested at several different time points, thus allowing a more effective assessment of the effect of the drug on a single animal. On average, the total volume of mouse blood is, for example, 6-8 mL of blood per 100 grams of body weight. The advantage of the present invention is that only a small amount of blood is required to perform preclinical studies in mice or other small laboratory animals. In some embodiments, about 1 microliter to about 50 microliters are harvested. In certain embodiments, about 1 microliter to 10 microliters are harvested. In a preferred embodiment, about 5 microliters of blood is collected.
The additional benefit of maintaining the survival of the test animal is evident in preclinical time course studies. For example, when using multiple mice to monitor the level of the analysis target in the body fluid of the test subject for a long period of time, the added variable of using multiple subjects is introduced into the test. However, more accurate and informative preclinical studies can be performed if a single test animal can be used as its own subject for extended periods of time.
In some embodiments, methods are provided for automatically monitoring medical patient compliance with a device or system of interest. This method involves reacting a sample of body fluid with an assay reagent of a device to provide a detectable signal indicating the presence of an analysis target for the sample, and a step of detecting the signal using the device. The signal includes a step of comparing a known profile associated with the medical treatment to determine whether the patient is or is not compliant with the medical treatment, and a step of informing the patient of the compliance or non-compliance. ..
In another embodiment, the systems and methods of the invention provide a means of discovering novel biomarkers and / or enabling them by associating disease and treatment outcomes with trends in such markers.
In another embodiment, the systems and methods of the invention can be used to adjust drug dosages to optimal levels (eg, adaptive doses) for a particular patient, biomarker level trends, and over time. It is possible to identify daily patient information.
In some embodiments, non-compliance may include receiving improper medication of the drug, including unrestricted multiple doses or no medication, or may include improper mixing of the drug. Good. In a preferred embodiment, the patient is notified substantially immediately after the signal is compared to a known profile.
Patients or subjects in clinical trials may forget to take fluid samples for analysis as described herein. In some embodiments, the method of alerting a patient to test a sample of body fluid using the device described herein provides a protocol performed on said device, wherein said protocol. Includes a date and time to test the sample of body fluid, located on an external device associated with the patient; includes informing the patient to test the body fluid at the date and time if the sample was not tested. In some embodiments, the patient may be notified wirelessly as described herein. Treatment prescription compliance can be improved by using prompts on the display and obtaining a response from the patient (eg, via a touch screen).
The device may be provided, for example, at a pharmacy, when the patient obtains a prescription for the drug by any common method. Similarly, a clinical trial subject may be provided with such a device when the clinical trial is initiated. Patient or subject contacts, including unrestricted mobile phones, email addresses, text message addresses, or other means of wireless communication, then enter an external device, eg, in a database, and are described herein. Alternatively, it may be associated with an object. The software of the external device may include a script or other program that can detect if the signal originating from the detection device has not yet been sent to the external device at a given time, for example, the external device may then include. , Can send a warning to inform the patient to take a fluid sample.
In certain embodiments, the system is provided directly to the customer and used in lifestyle and / or exercise management. Relevant lifestyle and exercise data can be entered and parameters indicating muscle damage, anaerobic metabolism (eg, lactate) can be measured. In some embodiments, the system may be small enough to be portable.
In another embodiment, the system is particularly suitable for measuring markers in the blood of small animals such as rats and mice commonly used in preclinical work. Assay systems that require very small volumes of samples, especially those in which only such animals have a small amount of blood, require several samples from a single animal in rapid succession. It is especially useful in time-lapse studies. These considerations can be especially important when several analysis targets require parallel measurements.
In certain embodiments, the system comprises a conventional method for packaging some elements required for multiple complex assays in a form that is safe for shipping. For example, the assay element fits snugly into the housing.
Assay Various assays can be performed on the fluid devices according to the invention to detect the subject of analysis in the sample. A wide variety of labels that can be used to perform subject assays are available in the art. In some embodiments, the label is detectable by spectroscopic, photochemical, biochemical, electrochemical, immunochemical, or other chemical means. For example, useful nucleic acid labels include radioisotopes 32P, 35S, fluorescent dyes, electron density reagents, and enzymes. A wide variety of labels suitable for labeling biological components are known, widely reported in both scientific and patent literature, and generally applicable to the present invention for labeling biological components. is there. Suitable labels include radionuclides, enzymes, substrates, cofactors, inhibitors, fluorescent moieties, chemiluminescent moieties, bioluminescent labels, or coloriluminescent labels. Reagents that characterize the assay include, for example, monoclonal antibodies, polyclonal antibodies, proteins, hybridization probes or other polymers such as affinity matrices, sugars or lipids. Detection is initiated by any of a variety of known methods, including spectrophotometric or optical tracking of radioactive, fluorescent, or luminescent markers, or other methods of tracking molecules based on size, charge, or affinity. be able to. The detectable moiety can be any material with detectable physical or chemical properties. Such detectable labels have been well developed in the fields of gel electrophoresis, column chromatography, solid substrate, spectroscopic techniques and the like, and in general, labels useful in such methods can be applied to the present invention. .. Thus, the label comprises any unrestricted composition detectable by spectroscopic, photochemical, biochemical, immunochemical, hybridization probe based, electrical, photothermal, or other chemical means. ..
In some embodiments, the label is attached directly or indirectly to the detected molecule, such as a product, substrate, or enzyme, according to methods well known in the art. As shown above, a wide variety of labels are used that have sensitivity-dependent label selection, ease of compound conjugation, stability requirements, available instruments, and disposal offerings. .. Non-radioactive labels are often attached by indirect means. In general, the receptor specific for analysis is linked to the signal-generating part. In some cases, the receptor to be analyzed is linked to an adapter molecule (eg, biotin or avidin), and the assay reagent set comprises an adapter and a binding moiety that binds to the subject to be analyzed (eg, biotinylated reagent or avidin). The analysis target binds to a specific receptor at the reaction site. The labeled reagent can form a sandwich complex with the analysis target at the center. In addition, the reagent can compete with the analysis target for the receptor at the reaction site or bind to an empty receptor at the reaction site that is not occupied by the analysis target. The label is attached to a signal system such as an enzyme that is essentially detectable or detectable, a fluorescent compound, a chemiluminescent compound, or a chemiluminescent entity, such as an enzyme having a luminescent substrate. Many ligands and anti-ligands can be used. If the ligand has a natural anti-ligand, such as biotin, thyroxine, digoxigenin, and cortisol, it can be used with a labeled anti-ligand. Alternatively, any hapten or antigenic compound can be used in combination with the antibody.
In some embodiments, the label can also be conjugated directly to the signal-generating compound, for example by conjugating with an enzyme or fluorochrome molecule. Enzymes of interest as labels are primarily hydrolases, especially phosphatases, esterases and glycosidases, or oxidoreductases, especially peroxidases. Fluorescent compounds include fluorescein and its derivatives, rhodamine and its derivatives, dansyl groups, and umbelliferone. Chemiluminescent compounds include dioxetane, acridinium ester, luciferin, and 2,3-dihydrophthalazinedione, such as luminol.
Methods of detecting the label are well known to those of skill in the art. Thus, for example, if the label is radioactive, the detection means may include photographic film, such as in scintillation counting or autoradiography. If the label is fluorescent, the fluorochrome is excited with light of the appropriate wavelength and, for example, by microscopic or visual inspection, through a photographic film, an electron detector such as a digital camera, charge-coupled device (CCD) or It may be detected by detecting fluorescence obtained by using a photomultiplier tube and a phototube, or other detection device. Similarly, enzyme labeling is detected by providing a suitable substrate for the enzyme and detecting the resulting reaction product. Finally, a single colorimetric label is often detected simply by observing the color associated with the label. For example, conjugated gold often looks pink, and various conjugated beads look like beads.
In some embodiments, the detectable signal may be provided by a luminescent source. Emission is a term commonly used to mean the emission of light from a substrate for any reason other than temperature rise. In general, an atom or molecule emits photons of electromagnetic energy (eg, light) the next time it moves from an excited state to a low-energy state (usually the ground state). When the source of excitation is a photon, the luminescence process is called photoluminescence. If the cause of the excitation is an electron, the luminescence process can be called electroluminescence. More specifically, electroluminescence results from the direct injection and removal of electrons to form electron-hole pairs, and the subsequent recombination of electron-hole pairs to emit photons. Luminescence resulting from a chemical reaction is commonly referred to as chemylluminescence. The luminescence produced by an organism is commonly referred to as bioluminescence. When photoluminescence is the result of spin-tolerant transitions (eg, singlet singlet transitions, triplet-triplet transitions), the photoluminescence process is commonly referred to as fluorescence. Fluorescence does not persist after the excitation cause is typically removed as a result of a short-lived excited state that may rapidly relax through such spin-tolerant transitions. When photoluminescence is the result of a spin-forbidden transition (eg, triplet-singlet transition), the photoluminescence process is commonly referred to as phosphorescence. Typically, phosphorescence persists after the cause of excitation has been eliminated as a result of a long-term excited state that may be relaxed only through such spin-forbidden transitions. Luminescence labels may have any one of the above properties.
Suitable chemylluminescence sources include compounds that become electronically excited by a chemical reaction, even if they then emit light that acts as a detectable signal or provides energy to the fluorescent acceptor. Good. A wide variety of families of compounds have been found to provide chemylluminescence under a variety of conditions. One family of compounds is 2,3-dihydro-1,4-phthalazinedione. A frequently used compound is the 5-amino compound, luminol. Other members of the family include 5-amino-6,7,8-trimethoxy- and dimethylamino [ca] benz analogs. These compounds can be made to emit cold light using alkaline hydrogen peroxide or calcium hypochlorite and a base. Another family of compounds is 2,4,5-triphenylimidazole, the common name for the parent compound is loffin. Chemylminecent analogs include para-dimethylamino and -methoxy substituents. Chemilluminescence can also be obtained under basic conditions using oxalate, usually an oxalyl active ester such as p-nitrophenyl and peroxide, such as hydrogen peroxide. Other useful chemylminecent compounds known as well include -N-alkylacrydinium esters and dioxetane. Alternatively, luciferin may be used with luciferase or lucigenin to provide bioluminescence.
The term to be analyzed, as used herein, is not limited to drugs, prodrugs, pharmaceuticals, drug metabolites, biomarkers such as expressed proteins and cell markers, antibodies, serum proteins, cholesterol and other metabolisms. Includes products, polysaccharides, nucleic acids, biological analysis subjects, biomarkers, genes, proteins, or hormones, or any combination thereof. The analysis target can be a combination of a polypeptide, a glycoprotein, a polysaccharide, a lipid, and a nucleic acid.
Of particular interest are biomarkers associated with a particular disease or particular stage of the disease. Such analysis targets are, but are not limited to, autoimmune diseases, obesity, hypertension, diabetes, neurological and / or muscle degenerative diseases, heart disease, endocrine disorders, metabolic disorders, inflammation, cardiovascular disease, septicemia, angiogenesis. , Cancer, Alzheimer's disease, motor complications, and analysis subjects associated with any combination thereof.
It also targets one or more body tissues such as heart, liver, prostate, lungs, kidneys, bone marrow, blood, skin, bladder, brain, muscles, nerves, and various diseases such as various types of cancer ( A biomarker present in varying amounts in selected tissues affected by malignant or non-malignant), autoimmune disease, inflammatory or degenerative disease.
Also, the target is an analysis target showing microorganisms, viruses, or Chlamydiaceae. Exemplary microorganisms include, but are not limited to, bacteria, viruses, fungi and protozoa. In addition, the analysis targets that can be detected by this method include Staphylococcus epidermidis, Escherichia coli, methicillin-resistant Staphylococcus aureus (MSRA), Staphylococcus aureus, Staphylococcus hominis, Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus capitis, Staphylococcus capitis, Staphylococcus capitis. , Staphylococcus simulans, Staphylococcus pneumoniae and Candida albicans, which are selected from a non-limiting group of pathogens.
In addition, the analysis targets that can be detected by this method are various sexually transmitted diseases selected from the following: Gonorrhea (Neisseria gorrhoeae), Treponena pallidum, Chlamyda tracomitis, Nongonococcal urethritis (Ureaplasm urealyticum). , Yeast infection (Candida albicans), chancroid (Haemophilus ducreyi), Trichomonas vaginalis, pudendal herpes (type I and type II HSV), HIV I, HIV II, and hepatitis A, B, C, G , As well as hepatitis caused by TTV.
Further analysis targets that can be detected by this method are, but are not limited to, Pseudomonas aeruginosa, methicillin-resistant Staphlococcus aureus (MSRA), Klebsiella pneumoniae, Haemophilis influenzae, Staphlococcus aureus, Stenotrophomonas maltophilia, Haemophilis parainfluenzae, Escherich. Haemophilis parahaemolyticus, Enterococcus cloacae, Candida albicans, Moraxisella catarrhalis, Streptococcus pneumoniae, Citrobacter freundii, Enterococcus faecium, Klebsella oxytoca, Pseudomonas fluorscens, Neiseria Includes a variety of respiratory pathogens including meningitidis, Streptococcus pyogenes, Pneumocystis carinii, Klebsella pneumoniae Legionella pneumophila, Mycoplasma pneumoniae, and Mycobacterium tuberculosis.
Listed below are further exemplary markers of the invention: theophylline, CRP, CKMB, PSA, myoglobin, CA125, progesterone, TxB2, 6-keto-PGF-1-alpha, and theophylline, estradiol. , Luteinizing hormone, triglyceride, tryptase, low specific gravity lipoprotein cholesterol, high specific gravity lipoprotein cholesterol, cholesterol, IGFR.
Exemplary liver markers include, but are not limited to, LDH, (LD5), (ALT), arginase 1 (liver type), alpha-fetoprotein (AFP), alkaline phosphatase, alanine aminotransferase, lactate dehydrogenase, and bilirubin. Is included.
Exemplary kidney markers include, but are not limited to, TNFa receptor, cysteine C, lipocalinic urinary prostaglandin D, synthase (LPGDS), hepatocellular proliferation factor receptor, polycystine 2, polycystine 1, fibrocystin, uromodulin. , Alanine, aminopeptidase, N-acetyl-BD-glucosaminidase, albumin, and retinol-binding protein (RBP).
Exemplary cardiac markers include, but are not limited to, troponin I (TnI), troponin T (TnT), CK, CKMB, myoglobin, fatty acid binding protein (FABP), CRP, D-dimer, S-100 protein, BNP, NT-proBNP, PAPP-A, myeloperoxidase (MPO), glycogen phosphorylase isoenzyme BB (GPBB), thrombin-activated fibrinolytic inhibitor (TAFI), fibrinogen, ischemic denatured albumin (IMA), cardiotro Includes Fin-1 and MLC-I (myoglobin light chain-I).
Exemplary pancreatic markers include, but are not limited to, amylase, pancreatitis-related protein (PAP-1), and regenerated protein (REG).
Exemplary muscle tissue markers include, but are not limited to, myostatin.
Exemplary blood markers include, but are not limited to, erythropoietin (EPO).
Exemplary bone markers include, but are not limited to, crosslinked N-tellopeptide (NTx) of type I bone collagen, carboxy-terminal crosslinked telopeptide of bone collagen, ricyl-pyridinoline (deoxypyridinoline), pyridinoline, tartrate acid. Salt-tolerant phosphatase, type I procollagen C propeptide, type I procollagen N propeptide, osteocalcin (bone gla-protein), alkaline phosphatase, catepsin K, COMP (chondral oligomeric matrix protein), osteocrine osteoprotegerin (OPG) ), RANKL, sRANK, TRAP5 (TRACP5), osteoblast-specific factor 1 (OSF-1, preiotrophin), soluble cell adhesion molecule, sTfR, sCD4, sCD8, sCD44, and osteoblast-specific factor 2 (OSF-1, preiotrophin) OSF-2, periostin) is included.
In some embodiments, the markers according to the invention are disease specific. Exemplary cancer markers include, but are not limited to, PSA (whole prostate-specific antigen), creatinine, prostatic acid phosphatase, PSA complex, prostate-specific gene-1, CA12-5, carcinoembryonic antigen (CEA), Alpha-fetoprotein (AFP), hCG (human chronic gonadotropin), inhibin, CAA ovary C1824, CA27.29, CA15-3, CAA breast C1924, Her-2, pancreas, CA19-9, carcinoembryonic antigen, CAA pancreas, neurons Specific enolase, angiostatin DcR3 (soluble decoy receptor 3), endostatin, Ep-CAM (MK-I), free immunoglobulin light chain kappa, free immunoglobulin light chain lambda, herstatin, chromoglandin A, adrenome Julin, integrin, epithelial cell proliferation factor receptor, epithelial cell proliferation factor receptor-tyrosine kinase, pro-adrenomedulin N-terminal 20 peptide, vascular endothelial cell proliferation factor, vascular endothelial cell proliferation factor receptor, stem cell factor receptor, Includes c-kit / KDR, KDR, and midkine.
Exemplary infectious conditions include, but are not limited to, viralemia, fungalemia, septicemia, and markers: PMN elastase, PMN elastase / alpha 1-PI complex, surfactor protein D (SP-D), HBVc antigen. , HBVs antigen, anti-HBVc, anti-HIV, T-suppressor cell antigen, T-cell antigen ratio, T-helper cell antigen, anti-HCV, pyrogen, p24 antigen, muramir dipeptide.
Exemplary diabetes markers include, but are not limited to, C-peptide, hemoglobin Alc, glycated albumin, advanced glycation end products (AGEs), 1,5-anhydroglucitol, gastric inhibitory polypeptides, glucose, hemoglobin, ANGPTL3 and 4 is included.
Exemplary inflammatory markers include, but are not limited to, rheumatoid factor (RF), antinuclear antibody (ANA), C-reactive protein (CRP), Clara cell protein (uteroglobin).
Exemplary allergy markers include, but are not limited to, total IgE and specific IgE.
Exemplary autism markers include, but are not limited to, activation of ceruloplasmin, metallothionein, zinc, copper, B6, B12, glutathione, alkaline phosphatase, and apoalkaline phosphatase.
Exemplary coagulopathy markers include, but are not limited to, b-thromboglobulin, platelet factor 4, von Willebrand factor.
In some embodiments, the marker may be treatment-specific. COX inhibitors include, but are not limited to, TxB2 (Cox-1), 6-keto-PGF-1-alpha (Cox2), 11-dehydro-TxB-la (Cox-1).
Other markers of the invention include, but are not limited to, leptin, leptin receptors, and procalcitonin, brain S100 protein, substance P, 8-iso-PGF-2a.
Exemplary aging markers include, but are not limited to, neuron-specific enolase, GFAP, and S100B.
Exemplary nutritional markers include, but are not limited to, prealbumin, albumin, retinol-binding protein (RBP), transferase, acylation-stimulating protein (ASP), adiponetin, aguchi-related protein (AgRP), angioprotein-like protein 4 (ANGPTL4, FIAF), C peptide, AFABP (fat cell fatty acid binding protein, FABP4), acylation stimulating protein (ASP), EFABP (epithelial fatty acid binding protein, FABP5), glycentin, glucagon, glucagon-like peptide-1, glucagon-like Includes Peptide-2, Grelin, Insulin, Leptin, Leptin Receptor, PYY, RELMs, Recystin, and sTfR (Soluble Transfectin Receptor).
Exemplary markers of lipid metabolism include, but are not limited to, apolipoproteins (several), apo-A1, apo-B, apo-C-CII, apo-D, apo-E.
Exemplary coagulation markers include, but are not limited to, factor I: fibrinogen, factor II: prothrombin, factor III: tissue factor, factor IV: calcium, factor V: proaccelerin, factor VI, Factor VII: Proconvertin, Factor VIII: Anti-hemolytic factor, Factor IX: Christmas factor, Factor X: Stuartplauer factor, Factor XI: Plasma thromboplasmin precursor, Factor XII: Hagemann factor, Factor XIII Factors: Factor Stabilizer, Precaricrane, High Molecular Weight Kininogen, Protein C, Protein S, D-Dimeric, Tissue Plasminogen Activator, Plasminogen, a2-Anti-plasmin, Inhibition of Plasminogen Activator Includes Agent 1 (PAIl).
Exemplary monoclonal antibodies include antibodies to EGFR, ErbB2, and IGF1R.
Exemplary tyrosine kinase inhibitors include, but are not limited to, Ab1, Kit, PDGFR, Src, ErbB2, ErbB4, EGFR, EphB, VEGFR1-4, PDGFRb, FLt3, FGFR, PKC, Met, Tie2, RAF, and TrkA. Is included.
Exemplary serine / threonine kinase inhibitors include, but are not limited to, AKT, Aurora A / B / B, CDK, CDK (pan), CDK1-2, VEGFR2, PDGFRb, CDK4 / 6, MEK1-2, mTOR, And PKC-Beta included.
GPCR targets include, but are not limited to, histamine receptor, serotonin receptor, angiotensin receptor, adreno receptor, muscarinic acetylcholine receptor, GnRH receptor, dopamine receptor, prostaglandin receptor, and ADP receptor. included.
In a separate embodiment, a method of monitoring more than one pharmacological parameter useful for assessing the efficacy and / or toxicity of a therapeutic agent is provided. For example, therapeutic agents include any substance that has therapeutic utility and / or potential. Such substances include, but are not limited to, biological or chemical compounds such as simple or complex organic or inorganic molecules, peptides, proteins (eg, antibodies) or polynucleotides (eg, antisense). A large number of compounds can be synthesized, including, for example, polymers such as polypeptides and polynucleotides, and synthetic organic compounds based on various core structures, which can also be included as therapeutic agents. In addition, various natural sources can provide compounds for screening, such as plant or animal extracts. Although not always explicitly stated, this drug is used alone or in combination with another drug that has the same or different biological activity as the drug identified by the screening of the present invention. Should be understood. Also, drugs and methods are intended to be combined with other treatments. For example, small molecule drugs are often measured by mass spectrometry, which can be inaccurate. ELISA (antibody-based) assays can be much more precise and accurate.
Physiological parameters according to the present invention include, but are not limited to, parameters such as temperature, heart rate / heart pulse, blood pressure, and respiratory rate. Pharmacodynamic parameters include concentrations of biomarkers such as proteins, nucleic acids, cells, and cell markers. Biomarkers may indicate a disease or be the result of the action of a drug. Pharmacokinetic (PK) parameters according to the present invention include, but are not limited to, drug and drug metabolite concentrations. Identifying and quantifying PK parameters in real time from sample volume is highly desirable for proper drug safety and efficacy. If drug and metabolite concentrations are outside the desired range and / or unwanted metabolites are caused by an undesired reaction of the drug, prompt action may be required to ensure patient safety. .. Similarly, if pharmacodynamic (PD) parameters do not fall within the desired range during treatment planning, immediate action may have to be taken as well.
It is possible to monitor the concentration to be analyzed or the rate of change of PD or PK parameters over a period of time in a single subject, or to perform trend analysis on that concentration, PD or PK parameters, they are drugs or them. It can help prevent potential dangerous situations, regardless of their biotransformer concentration. For example, when glucose is the subject of the analysis of interest, the glucose concentration in the sample at a given time, as well as the rate of change in glucose concentration over a given time period, can be very useful, for example, in predicting and avoiding hypoglycemic events. Can be. Such trend analysis has a wide range of beneficial implications in drug prescribing planning. When multiple drugs and their metabolites are involved, the ability to identify trends and take preventative measures is often desired.
In some embodiments, the present invention provides a business method of assisting a clinician in providing personalized medicine. Business methods can include post-prescription monitoring of drug treatment by monitoring biomarker trends over time. The business method is the collection of at least one pharmacological parameter from an individual receiving a drug, said collection step is provided by subjecting a sample of body fluid to a reactant contained in a fluid device, the device. Is provided to the individual and produces a detectable signal indicating the at least one pharmacological parameter; as well as using the at least one pharmacological parameter of the individual of the computer medical record of the individual. Mutual reference by assistance can include the clinician's assistance in providing personalized care.
The devices, systems, and methods described herein are automatic quantification of a patient's pharmacological parameters, as well as a patient's medical record, or subject, which may include a history of the parameters and, for example, monitored parameters. Allows automatic comparison of medical records in different groups of. For example, real-time monitoring of analyzed objects and coupling with external devices capable of storing data as well as performing any type of data processing or algorithm can, for example, combine current patient data with past patient data. Provided is a device that can assist in typical patient treatment that can include steps to compare the data. Therefore, business methods that effectively perform at least some of the patient monitoring currently performed by healthcare professionals are also provided herein.
<p> (Example 1) In this example, the devices, methods, and systems of the invention are used to assay for human VEGFR2. This example shows the types of assays that can be performed at the point of care. The capture surface of the assay unit, which is the VEGFR2 assay in this example, can be coded onto the assay unit according to the assay. The inner surface of the assay unit (made of injection molded polystyrene similar to the example in Figure 3A) was exposed to continuous coating reagents by suction and air release. Each 20 microliter coating reagent was drawn into the assay unit and incubated for 10 minutes at room temperature. The coating reagents used in this example are continuously used, with neutravidin (20 μg / mL) in carbonate-bicarbonate buffer (pH 9) and biotinization in Tris buffered physiological saline (pH 8). A "capture antibody" (monoclonal antibody against VEGFR2, 20 μg / mL), and a "fixed" reagent containing 3% bovine serum albumin in Tris buffered saline. After continuous coating, the assay unit was dried by exposure to dry air and stored dry.</p><p> Samples for analysis are then partitioned into assay units diluted in 50 mM Tris buffered saline (pH 8) containing bovine serum albumin and isotonic sucrose for 20 minutes. In the reagent unit containing the conjugate, a solution of alkaline phosphatase (bovine intestine) -labeled monoclonal antibody against VEGFR2 (which binds to different epitopes of the antibody on the capture surface) at 250 ng / mL in Biostab's stabilizing reagent was added to the assay unit. Supplied for minutes. After the conjugate became bound to the complex to be analyzed bound to the capture surface, the assay unit was washed with the solution contained in the reagent unit (commercially available Assay Designs wash buffer). The assay unit was washed 5 times. The assay unit was then moved, collected, mixed with a different reagent, another reagent contained in a solution of a commercially available luminogenic substrate for alkaline phosphatase (KPL Phosphaglo), and incubated for 10 minutes. The assay response in the assay unit was then detected by the detection assembly of the present invention.</p><p> FIG. 12 shows the VEGFR2 assay response using the method of this example. The x-axis scale indicates VEGFR2 concentration (pg / mL); the y-axis scale indicates relative luminescence (count). The curves were used to calibrate the modular assay unit and reagent unit.</p><p> (Example 2) Assays for human PlGF were performed using the assay and reagent units of the invention and read with commercially available equipment. In parallel, an assay using the same reagents was performed on the prototype reader's prototype disposal cartridge (described below). The concentrations to be analyzed were 0, 4, 80 and 400 pg / mL, respectively. The measurements illustrated in FIG. 13 were used to calibrate the assay and reagent units required to perform an assay on human PlGF.</p><p> (Example 3) Magnetizable beads are BioMag magnetic particles with a diameter of 1.3 μm from Bands Laboratories. The beads are coated with anti-rabbit IgG (according to the manufacturer). The beads are dispersed in Cedar Lane in Tris-buffered sucrose solution (or Tris-buffered saline) containing 3% bovine serum albumin and rabbit anti-human erythrocyte IgG at 1.15 mg / mL at 14 mg / mL. Distribute aliquots (10 μL of this dispersion) to a conical tube and lyophilize before insertion into the slot of the cartridge housing (freeze in liquid N2 and lyophilize at -70 ° C for approximately 24 hours). Rabbit antibodies bind to both erythrocytes and anti-rabbit IgG-coated beads to form coaggregates of beads and erythrocytes.</p><p> The lyophilized magnetizable bead pellets were resuspended by adding 20 μL of whole blood, then aspirating and dispersing in a conical tube at least 8 times (approximately 1.5 minutes).</p><p> Blood was separated by placing the tip (in vertical orientation) in a strong horizontally oriented magnetic field. Typically, 8 μL of red blood cell-free plasma with no hemolysis observed was collected from 20 μl of blood sample (70% yield). The collections analyzed (compared to plasma not exposed to magnetic separation) were close to 100% relative to protein C, VEGF, PlGF, insulin, GlP and GlP-1.</p><p> (Example 4) Continuous dilution of the sample to analyze the subject of analysis can be performed in the system described herein. C-reactive protein (CRP) is an acute marker. Normal levels range from high ng / mL to low μg / ml. In any acute disease process, the human liver produces CRP and blood levels can be increased to hundreds of μg / ml. CRP has a wide dynamic range to be measured (> 10)<sup>5</sup>Therefore, it shows the problem of the conventional POC analysis system.</p><p> A system described herein has been developed that includes a fluid transfer device and a cartridge or device that includes an array of assay and reagent units. The assay chip with the monoclonal anti-CRP bound to the inner surface of the assay chip is subjected to chemical emission of the detection antibody solution (alkaline phosphatase-labeled monoclonal anti-CRP (having epitope specificity different from that on the chip)), washing solution, and KPL. It was laminated on a cartridge with a sex alkaline phosphatase (Phospha GLOTM) substrate.</p><p> To assay CRP, cartridges were loaded with a pre-diluted solution of CRP used undiluted. The cartridge was processed by the system. Subsequently, the CRP solution (10 μL) and the detection antibody (12 μL) were removed from the chip, incubated for 10 minutes at 34 ° C, and then discarded. The chip was washed with 4 aspirations of 20 μL of wash solution, after which 15 μL of substrate was aspirated onto the chip. After 10 minutes at 37 ° C, light emission was measured with the device for 5 seconds. CRP concentrations were plotted against the assay signal (photon count) and the data were fitted to the 5 polynomial functions shown below to yield the calibration function shown in FIG.</p><p> (Example 5) Experiments were then performed with serial dilutions of samples containing high concentrations of analysis to obtain clear assay responses in the systems and devices described herein. A solution of CRP (20 μL) was loaded into the cartridge and serially diluted by device (1:50, 250, 750 and 1500 times, respectively). The diluted solution was then treated as shown in Example 4. A downward response was seen when the diluted CRP concentration exceeded the assay calibration range (300 ng / mL) (shown below; data from two instruments).</p><p> The response shown in FIG. 15 can be modeled using a modification of the Scatchard-coupled isotherm (S / Smax = C / (C + C0.5)). Since this modification is the case in this example, it is estimated that the assay response is directly proportional to the concentration of the detected antibody (data not shown). Any carry-over of CRP in the diluted sample to the next reagent (detection antibody) causes a rapid reaction with a reagent that prevents it from binding to the antigen bound to the solid phase antibody. The decrease in effective concentration decreases in proportion to the CRP carry-over, and the factor (DC)<sub>*</sub>It can be explained using f) / D.</p><p> Therefore, S = Smax<sub>*</sub>(C / (C + C0.5))<sub>*</sub>(DC<sub>*</sub>f) / D, in the equation, S is the assay signal, Smax is the maximum signal (corresponding to zero carryover), C is the concentration to be analyzed, and C0.5 is the concentration for up to half of the signal (carryover). None), D is the detected antibody concentration, and f is the fraction carryover.</p><p> The values used to fit the data were derived by optimizing each of the following four parameters using the technique of minimizing the least squares difference between the data and the model fit. As shown in FIG. 15, a good fit was achieved and the values of the parameters Smax, C0.5 and D (see Table 2) were the maximum signal reached, C0.5 observed and known detections. It is close to the value that can be inferred from the antibody concentration. This model estimated that the degree of carry-over was 0.034% (decimal 3.84E-04).</p><p><tables num="1"><img file="JP2010540971A_D0001.tif" /></tables> The data can then be viewed according to the dilution used to achieve the final concentration in each assay chip, and for each dilution level, the response is that the dilution is accurate and accurate as shown in FIG. Fit for the same response that indicates.</p><p> The models described herein are for computer calculation of the response to any given dilution and for setting an algorithm to ensure that the concentration to be analyzed on any chip is within the calibration range. Can be used. The graphical means representing the data is shown in FIG. 17, where the normalized assay response (B / Bmax) is relative dilution: 1: 1 (solid line), 5: 1 (dashed line), and 25: 1 (dashed line). Dotted line) is plotted against log-referenced concentration (C / C 0.5). 18 and 19 show examples similar to FIG. 17 with different standardized concentrations. A simple pattern recognition algorithm can be used to identify valid data for high concentration samples. For example, for most dose responses, the signal diminishes with dilution. If the signal for any dilution is equal to or greater than the signal for the next higher dilution, the lower dilution result is rejected. In another embodiment, the concentration induced by the use of the calibration function shown in FIG. 4 should correspond to some system inaccuracies using known dilutions. If the calculated concentration for low dilution is lower than the one corresponding to the concentration for high dilution, the low dilution result can be rejected.</p><p> As the assay dosage-response approach approaches maximum, the concentration slope (ΔC / ΔS) vs. signal increases. For assays in which the relative variability (ΔS / S) in the signal is essentially constant (eg, some examples of the systems described), this is a larger variability in the calculated concentration results of high concentrations. It changes to. As provided herein, dilution or serial dilutions are significantly greater (eg,> 10-fold) than the blank (zero analysis subject) signal, but the maximum signal (eg, <0.3).<sub>*</sub>It can provide the concentration accuracy achieved by immunoassay at the signal level, which is not close to Max. Signal). Serial dilution can bring the assay signal within this range.</p><p> Mean values can be obtained from some estimates of the concentrations to be analyzed from different dilutions. Meaning can also be achieved by making repeated measurements at a single dilution level. In some cases, the serial dilution approaches provided by the methods, systems, and devices described herein eliminate errors due to dilution non-linearity, often due to matrix effects from (eg) samples. be able to.</p><p> (Example 6) Fluorescein is a well-known chemistry, and high-affinity antibodies that are specific for its molecule are known. Attaching some fluorescein moieties to a protein such as albumin creates an artificial analysis target that can be measured by ELISA. The examples herein are set up on a microtiter plate to demonstrate the feasibility of such an assay and can be readily transformed into the devices or systems of the invention described herein.</p><p> Anti-fluorescein monoclonal antibody was attached to the wells of a 384-well microtiter plate to create a capture surface. The assay is performed by adding a series of solutions to the wells and, if necessary, incubating at room temperature for 10 minutes at each step. 30 μl of a commercially known concentration of bovine albumin (sample) labeled with fluorescein at a ratio of about 5 fluorescein per molecule was added to the wells. After mechanically removing the sample, 30 μl of alkaline phosphatase-labeled anti-fluorescein (detection antibody) was added at a concentration of 100 ng / ml. After removal of the detection antibody, the wells were washed 3 times with 40 μl of wash solution (diluted 1:20 before use in "Wash Buffer" Catalog # 80-1351 [Assay Dwsigns, Ann Arbor, Michigan]). The Phospah GLO (40 μL) substrate was then added and the assay response was then read on an M5 spectroluminometer for 0.5 seconds. The assay response is shown in Figure 20.</p><p> Fluorescein-labeled albumin (5 μL, various concentrations up to 80 ng / mL) dissolved in Tris buffered saline (buffer) containing bovine albumin at 3 mg / mL is placed in polypropylene tubes and exposed overnight at low humidity. It was dried by. By weighing many tubes before and after drying, complete drying was verified and proper weight loss and near-constant final weight verification were achieved. Subjects were collected by adding and mixing 5 μL of water, 20 μL of human serum and 180 μL of buffer. Control experiments were performed by mixing 5 μL aliquots of the solution under analysis with 20 μL serum and 180 μL buffer.</p><p> Collection of objects to be analyzed was measured using the assays described herein. As shown below, the collection of assay signals (and the subject of analysis) is essentially quantitative at all concentrations. It may be desirable to have accurate (<2% CV in collection) good collection (> 90%). In some cases, the assay dosage-response is linear throughout the range of interest by having a low concentration of analysis subject and excess reagent. For example, a linear assay dosage-response can be achieved by having sufficient capacity for the antigen bound on the capture surface, so that even the highest level of analysis is at the site's moderation. Only a ratio (eg, <30%) is occupied at the end of the binding reaction. As described herein, for assays in the ng / mL range, and for assays with a short incubation time (<about 30 minutes), this condition uses a captive surface coated as described above. Achieved. In another example, sufficient concentration of the detection antibody (eg, <30% of the reagent binds to the surface at maximum antigen level), such that the concentration is not significantly depleted during incubation of the detection antibody, and this concentration It can be satisfied by the use of the detected antibody concentration at about 65-100 ng / mL. In yet another example, a linear assay dosage-response can be achieved by having a signal generation smaller than the linear response of the detector (eg, a PMT with up to about 4 million photons per second). .. As described herein, systems and methods can fall within this scope. In yet another example, a linear assay dosage-response can be achieved by generating a signal high enough to be accurately measured (eg, photon count rates are higher than about 1,000 / sec).</p><p> The assay chips were coated by aspiration of the following series of reagents (as described herein): 20 μL of 5 μg / mL rabbit anti-fluorescein (Molecular Probes # A6413) in carbonate buffer (pH 9), Tris. 20 μl of 3% bovine albumin in buffered saline (pH 8) and 20 μL of fluorescein-labeled 2.5 μg / mL bovine albumin (Sigma-Aldrich) A9771), each was incubated for 10 minutes and the liquid was drained. The chips were then washed 3 times by aspiration of bovine albumin in Tris buffered saline (pH 8) and 3% bovine albumin in Tris buffered saline (pH 8) was incubated. The chips were then dried as described herein. Using these chips, a sample containing goat anti-fluorescein was prepared with the following solution: goat anti-fluorescein (sample) in Tris buffered physiological saline (pH 8) containing 3% BSA, Stabilizyme (commercially available solvent). 20 μl aliquots of alkaline phosphatase-labeled rabbit anti-goat fluorescein (100 ng / mL) in sequence were incubated, washed 4 times with wash buffer, and Phospah GLO alkaline phosphatase chemoluminescence generating substrate was added, each. Assayed by incubating for 10 minutes at room temperature. This assay is performed by Molecular Devices by placing each chip in a custom modified frame that fits the instrument's microtiter plate stage. Evaluation was made by measuring photons generated in the instrument for about 10 seconds using a photomultiplier tube in an M5 illuminometer, and the results are shown in FIG. In this example, FIG. 21 shows a linear response similar to that of FIG.</p><p><tables num="2"><img file="JP2010540971A_D0002.tif" /></tables> (Example 7) This example describes CRP using the assay chips described herein after initial addition of reagents, removal of reaction products, cleaning of the chip, and subsequent reintroduction of some or all components. Show the predictability of the response from the immunoassay. The order of this assay is as follows: Samples in which chips were diluted 500-fold and then 2000-fold by the instrument in the prototype instrument at 34 ° C for 10 minutes, in the following order (1) (CRP 0.3). , 3, 30, 150 and 300 μg / mL), (2) Alkaline phosphatase-labeled rabbit anti-goat IgG [Dab] (5 ng / mL), followed by three washes, and (3) Phospah GLO alkali. Incubated with phosphatase chemoluminescence generating substrate [substrate]. Experiments were performed on several instruments that also read photon generation for 10 seconds after step 3. Final (in-chip) CRP concentrations were 0.15, 0.6, 1.5, 6, 15, 60, 75, 300 and 600 ng / mL, and glow levels ranged from 2,000 to 6,000 counts / 0.5 s. In some experiments, after step (3) of this assay, the reaction product is discarded and variously step 3 (diamonds and solid lines), step 2 + 3 (squares and dashed lines), or step 1 + 2 + 3 (squares and dashed lines). (Triangles and dotted lines) are repeated and the results are shown as the reprocessed assay signal vs. the original assay signal, as shown in FIG.</p><p> The reprocessed assay signal was linearly associated (proportional) to the original assay signal. The addition of the second substrate gives a higher signal than the original signal, and the reprocessed assay with both Dab and substrate introduced, or the assay with all samples, Dab and substrate reintroduced, is the original. It gave a lower signal than the signal. In the examples using this method, to understand whether all steps in the assay sequence are performed as expected according to the expected relationship between the first assay step and the subsequent iterative assay steps. You can find out about quality control.</p><p> For example, as described herein, if the assay steps were not performed properly, the assay results would be rejected as incorrect, or the assay would be appropriate to repeat after the assay results. Can be used as a response.</p><p> Immunoassays for C-reactive protein were performed on the systems described herein. Six equivalent assay chips were incubated with a sample (200 ng / mL CRP), alkaline phosphatase-labeled rabbit anti-goat IgG, then washed and incubated with Phospah GLO alkaline phosphatase chemiluminescent substrate. Incubation was at 34 ° C for 10 minutes. The experiment was performed over 10 seconds on three instruments that also read the photon generation rate. An average read time of about 40,000 counts (photons) /0.5 seconds was detected. In this experiment, the glow levels of chips 1 and 2 of instrument 3 gave distinctly different results as shown in Table 3. The instrument was then used to clean the chips and introduce a new Phospah GLO substrate (suction 2). The result is expressed as the ratio of the glow rate for each chip to the average for each of the 6 chips in each device. After the second suction, chips 1 and 2 gave the other four consistent results of equipment 3, which corrected whether the problem was due to the low signal of chips 1 and 2. Indicated.</p><p><tables num="3"><img file="JP2010540971A_D0003.tif" /></tables></p>
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Numbers
- Publication
- 2010540971
- Publication, DOCDB
- 2010540971
- Publication, EPODOC
- JP2010540971
- Application
- 2010528139
- Application, DOCDB
- 2010528139
- Application, EPODOC
- JP20100528139
Titles2
- Japanese
- モジュール式ポイントオブケアデバイスおよびその使用
- English
- Modular Point of Care Device and Its Use
Classification
- CPC, 83
- B01J19/0046
- G01N35/028
- G01N33/48
- G01N33/5304
- B01L3/5025
- B01J2219/00292
- B01J2219/00283
- B01J2219/00315
- B01J2219/00371
- B01J2219/00369
- B01J2219/00385
- B01J2219/00466
- B01J2219/005
- B01J2219/00495
- B01J2219/00693
- B01J2219/00702
- B01L2200/0689
- B01L2200/141
- B01L2200/148
- B01L2200/04
- B01L2300/0654
- B01L2300/1805
- B01L2300/0829
- B01L2400/043
- B01L3/0262
- B01L3/021
- B01L3/527
- G01N2035/0097
- G01N33/54386
- B01L9/543
- G16H10/40
- Y10T29/49826
- Y10T436/25375
- G01N2333/4737
- A61B10/0038
- A61B10/0045
- A61B10/0051
- A61B10/0058
- A61B10/007
- A61B10/02
- A61B2010/0074
- A61B2010/0077
- G01N2333/71
- G01N33/5302
- G01N2035/103
- G01N35/1065
- B01L3/0275
- G01N33/5091
- G01N33/53
- G01N35/08
- C12M1/266
- C12M1/02
- G01N37/00
- G01N33/50
- G01N35/02
- G01N35/10
- B01L7/5255
- G01N2333/475
- G01N33/54326
- G01N33/5758
- G01N1/38
- G01N33/56966
- A61B5/150755
- A61B5/151
- G01N2333/9129
- B01L7/52
- G01N33/6803
- G01N2800/60
- G01N33/94
- G01N2333/91205
- G01N33/54366
- G01N35/00732
- G01N35/00871
- G01N2035/00237
- G01N2035/00851
- G01N2035/1032
- G01N2800/26
- A61B5/15
- G01N35/1074
- G01N2035/00881
- G01N2035/1034
- G01N2035/1048
- G01N2333/912
- IPC, 6
- G01N35 02
- G01N33 53
- G01N33 553
- G01N33 543
- G01N35 10
- G01N37 00
Designated states4
- Regional, 4
- Zimbabwe
- Turkmenistan
- Türkiye
- Togo