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      A Simple and Multiplex Loop-Mediated Isothermal Amplification (LAMP) Assay for Rapid Detection of SARS-CoV

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          Abstract

          The current diagnosis of severe acute respiratory syndrome-associated coronavirus (SARS-CoV) relies on laboratory-based tests since its clinical features are nonspecific, unlike other respiratory pathogens. Therefore, the development of a rapid and simple method for on-site detection of SARS-CoV is crucial for the identification and prevention of future SARS outbreaks. In this study, a simple colorimetric and multiplex loop-mediated isothermal amplification (LAMP) assay was developed to rapid screening of severe acute respiratory syndrome-associated coronavirus (SARS-CoV). It can be visually detected based on color change and monitored in real-time with fluorescent signals. The performance of this assay, based on six primers targeting open reading frame (ORF1b) and nucleocapsid (N) genes located in different regions of the SARS-CoV, was compared with real-time RT-PCR assay using various concentrations of target genes. The detection limit of the LAMP assay was comparable to that of real-time RT-PCR assay and therefore a few target RNA to 10 4-10 5 copies could be detected within a short period of time (20–25 min). In addition, we established a multiplex real-time LAMP assay to simultaneously detect two target regions within the SARS-CoV genome. Two target sequences were amplified by specific primers in the same reaction tube and revealed that it was able to detect down to 10 5 copies. The standard curve had a linear relationship with similar amplification efficiencies. The LAMP assay results in shorter “sample-to-answer” time than conventional PCR method. Therefore, it is suitable not only for diagnosis of clinical test, but also for surveillance of SARS virus in developing countries.

          Electronic Supplementary Material

          Supplementary material is available for this article at 10.1007/s13206-019-3404-3 and is accessible for authorized users.

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          Most cited references25

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          A worldwide outbreak of severe acute respiratory syndrome (SARS) has been associated with exposures originating from a single ill health care worker from Guangdong Province, China. We conducted studies to identify the etiologic agent of this outbreak. We received clinical specimens from patients in seven countries and tested them, using virus-isolation techniques, electron-microscopical and histologic studies, and molecular and serologic assays, in an attempt to identify a wide range of potential pathogens. None of the previously described respiratory pathogens were consistently identified. However, a novel coronavirus was isolated from patients who met the case definition of SARS. Cytopathological features were noted in Vero E6 cells inoculated with a throat-swab specimen. Electron-microscopical examination revealed ultrastructural features characteristic of coronaviruses. Immunohistochemical and immunofluorescence staining revealed reactivity with group I coronavirus polyclonal antibodies. Consensus coronavirus primers designed to amplify a fragment of the polymerase gene by reverse transcription-polymerase chain reaction (RT-PCR) were used to obtain a sequence that clearly identified the isolate as a unique coronavirus only distantly related to previously sequenced coronaviruses. With specific diagnostic RT-PCR primers we identified several identical nucleotide sequences in 12 patients from several locations, a finding consistent with a point-source outbreak. Indirect fluorescence antibody tests and enzyme-linked immunosorbent assays made with the new isolate have been used to demonstrate a virus-specific serologic response. This virus may never before have circulated in the U.S. population. A novel coronavirus is associated with this outbreak, and the evidence indicates that this virus has an etiologic role in SARS. Because of the death of Dr. Carlo Urbani, we propose that our first isolate be named the Urbani strain of SARS-associated coronavirus. Copyright 2003 Massachusetts Medical Society
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            Middle East respiratory syndrome coronavirus: another zoonotic betacoronavirus causing SARS-like disease.

            The source of the severe acute respiratory syndrome (SARS) epidemic was traced to wildlife market civets and ultimately to bats. Subsequent hunting for novel coronaviruses (CoVs) led to the discovery of two additional human and over 40 animal CoVs, including the prototype lineage C betacoronaviruses, Tylonycteris bat CoV HKU4 and Pipistrellus bat CoV HKU5; these are phylogenetically closely related to the Middle East respiratory syndrome (MERS) CoV, which has affected more than 1,000 patients with over 35% fatality since its emergence in 2012. All primary cases of MERS are epidemiologically linked to the Middle East. Some of these patients had contacted camels which shed virus and/or had positive serology. Most secondary cases are related to health care-associated clusters. The disease is especially severe in elderly men with comorbidities. Clinical severity may be related to MERS-CoV's ability to infect a broad range of cells with DPP4 expression, evade the host innate immune response, and induce cytokine dysregulation. Reverse transcription-PCR on respiratory and/or extrapulmonary specimens rapidly establishes diagnosis. Supportive treatment with extracorporeal membrane oxygenation and dialysis is often required in patients with organ failure. Antivirals with potent in vitro activities include neutralizing monoclonal antibodies, antiviral peptides, interferons, mycophenolic acid, and lopinavir. They should be evaluated in suitable animal models before clinical trials. Developing an effective camel MERS-CoV vaccine and implementing appropriate infection control measures may control the continuing epidemic.
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              The loop-mediated isothermal amplification (LAMP) is a novel nucleic acid amplification method that uses only one type of enzyme. One of the characteristics of the LAMP method is its ability to synthesize extremely large amount of DNA. Accordingly, a large amount of by-product, pyrophosphate ion, is produced, yielding white precipitate of magnesium pyrophosphate in the reaction mixture. Judging the presence or absence of this white precipitate allows easy distinction of whether nucleic acid was amplified by the LAMP method. Since an increase in the turbidity of the reaction mixture according to the production of precipitate correlates with the amount of DNA synthesized, real-time monitoring of the LAMP reaction was achieved by real-time measurement of turbidity. Copyright 2001 Academic Press.
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                Author and article information

                Contributors
                minhee.kang@samsung.com
                minikang@skku.edu
                Journal
                Biochip J
                Biochip J
                Biochip Journal
                The Korean BioChip Society (KBCS) (Seoul )
                1976-0280
                2092-7843
                11 November 2019
                2019
                : 13
                : 4
                : 341-351
                Affiliations
                [1 ]GRID grid.264381.a, ISNI 0000 0001 2181 989X, Biomedical Engineering Research Center, Smart Healthcare Research Institute, Samsung Medical Center, , Sungkyunkwan University School of Medicine, ; Seoul, Republic of Korea
                [2 ]GRID grid.264381.a, ISNI 0000 0001 2181 989X, Department of Medical Device Management and Research, SAIHST, , Sungkyunkwan University, ; Seoul, Republic of Korea
                [3 ]GRID grid.414964.a, ISNI 0000 0001 0640 5613, Center for Infection Prevention and Control, , Samsung Medical Center, ; Seoul, Republic of Korea
                [4 ]Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Republic of Korea
                [5 ]GRID grid.264381.a, ISNI 0000 0001 2181 989X, Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, , Sungkyunkwan University School of Medicine, ; Seoul, Republic of Korea
                [6 ]GRID grid.31501.36, ISNI 0000 0004 0470 5905, Department of Microbiology and Immunology, , Seoul National University College of Medicine, ; Seoul, South Korea
                [7 ]GRID grid.412484.f, ISNI 0000 0001 0302 820X, Institute of Endemic Diseases, , Seoul National University Medical Research Center, ; Seoul, South Korea
                Author information
                http://orcid.org/0000-0003-0330-7828
                http://orcid.org/0000-0001-9267-101X
                Article
                3404
                10.1007/s13206-019-3404-3
                7097549
                32226589
                fbfd8f26-954d-4db5-90e6-10ebf256ea50
                © The Korean BioChip Society and Springer 2019

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 15 July 2019
                : 23 August 2019
                Categories
                Original Article
                Custom metadata
                © The Korean BioChip Society and Springer-Verlag GmbH Germany, part of Springer Nature 2019

                sars-cov,loop-mediated isothermal amplification,colorimetric detection,point-of-care test

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