dg molecular hiv 2013 (2)

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Diagnostic molecular in virusologie

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Page 1: Dg Molecular HIV 2013 (2)

Diagnostic molecular in virusologie

Page 2: Dg Molecular HIV 2013 (2)

Diagnosticul molecular in virusologie

AMPLIFICAREA TINTEI–PCR–NASBA (nucleic acid sequenced based amplification)

AMPLIFICAREA SEMNALULUI–B-DNA (branched DNA)

Page 3: Dg Molecular HIV 2013 (2)

PCRPOLYMERASE

CHAIN REACTION

Metoda utilizata pentru detectia ADN-ului de orice tip.

-se bazeaza pe obtinerea unui numar mare de catene tinta prin repetatea unui nr. n de cicluri, ce contin in principal 3 etape:

- denaturarea

- aditia primerilor la capetele secventei tinta

- extensia primerilor

Page 4: Dg Molecular HIV 2013 (2)

PCR Amplifies a Targeted Sequence

Target Sequence

DNA StrandDouble HelixDNA StrandSupercoiled

DNA Strand

Chromosome

Page 5: Dg Molecular HIV 2013 (2)
Page 6: Dg Molecular HIV 2013 (2)

PCR – 1- Denaturare

Secventa tinta

Page 7: Dg Molecular HIV 2013 (2)

PCR- 2 – CUPLAREA PRIMERILOR LA CAPETELE SECVENTEI TINTA

Target Sequence

Target Sequence

Primer 1Primer 2

Biotin

Biotin

5’

3’

5’

5’

3’

5’

3’

3’

Page 8: Dg Molecular HIV 2013 (2)

PCR -3 – Elongarea primerilor sub actiunea Taq Polimerazei

Secventa tinta

Primer 1

Primer 2

Biotina

Biotina

5’

3’

5’

5’

3’

5’

3’

3’

ADN Polimeraza Taq

Secventa tinta

Page 9: Dg Molecular HIV 2013 (2)

End of the 1st PCR Cycle - Results in Two Copies of Target Sequence

Target Sequence

Target Sequence

Biotin

Biotin

Page 10: Dg Molecular HIV 2013 (2)

Target Amplification

No. of No. Amplicon Cycles Copies of Target

1 2

2 4

3 8

4 16

5 32

6 64

20 1,048,576

30 1,073,741,822

1 cycle = 2 Amplicon

2 cycle = 4 Amplicon

3 cycle = 8 Amplicon

4 cycle = 16 Amplicon

5 cycle = 32 Amplicon

6 cycle = 64 Amplicon

7 cycle = 128 Amplicon

Page 11: Dg Molecular HIV 2013 (2)

PCR: Master Mix

Mg2+

Mn2+

dNTP

Target DNA

Taq DNAPolymerase

Primers •forward primer •reverse primer

Page 12: Dg Molecular HIV 2013 (2)

RT- PCR

Reverstranscriere + PCR

Page 13: Dg Molecular HIV 2013 (2)

Reverse Transcription - Step 1 – Aditia Primer la secventa tinta ARN

Target RNA Sequence

Primer

Biotin

5’

3’

5’

3’

Page 14: Dg Molecular HIV 2013 (2)

Reverse Transcription - Step 2 – Reverstranscriptaze Catalizeaza extensia Primerului prin incorporarea nucleotidelor

complementare

Target RNA Sequence

PrimerBiotin

5’

3’

5’

3’

rTth DNA Polymerase

Page 15: Dg Molecular HIV 2013 (2)

End of Reverse Transcription - Step 3 – Rezulta sinteza ADNcomplementar (cDNA)

pe secventa tinta ARN

Target RNA Sequence

cDNA

Biotin

Page 16: Dg Molecular HIV 2013 (2)

Basic Lab Setup

Unidirectional Unidirectional workflow!workflow!

Page 17: Dg Molecular HIV 2013 (2)

Safety Gloves, Laboratory Coat Safety Glasses

Page 18: Dg Molecular HIV 2013 (2)

Biohazard Container

0.5% sodium hypochlorite, ethanol,

Page 19: Dg Molecular HIV 2013 (2)

Biological Safety Hood

Page 20: Dg Molecular HIV 2013 (2)

Vortex Mixer

Page 21: Dg Molecular HIV 2013 (2)

Centrifuge and/or Microcentrifuge (min. RCF 12,500 x g), some tests require a refrigerated, high speed centrifuge (min. RCF 24,000 x g)

Page 22: Dg Molecular HIV 2013 (2)

Dry-heat Temperature Block

Incubator (37 C ± 2 C)0

Page 23: Dg Molecular HIV 2013 (2)

•Screw-cap tube racks (to hold Master Mix tubes)

Dedicated Pipettor and Screw-cap Tube Rack, Multichannel Pipettor and Tips

Page 24: Dg Molecular HIV 2013 (2)

PCR System consumables (tubes, base, tray and retainer).

Page 25: Dg Molecular HIV 2013 (2)

Analyser Consumables/partsD-cups

A-rings, A-ring Holder

Page 26: Dg Molecular HIV 2013 (2)

Thermal CyclerPCR System 9600 or System 2400

Page 27: Dg Molecular HIV 2013 (2)

COBAS AMPLICOR™ Analyser

Page 28: Dg Molecular HIV 2013 (2)

DETECTIA AMPLICONULUI

• Electroforeza in gel de agar, colorare cu bromura de ethidiu si comparare cu markeri de GM cunoscuta

• Hibridizare cu sonde moleculare marcate complementare si apoi detectie (+/- spectrofotometrica)

Page 29: Dg Molecular HIV 2013 (2)
Page 30: Dg Molecular HIV 2013 (2)

Detectie

spectrofotometrica Add Stop Solution and Measure Absorbance

CaptureProbe

Microwell Plate

Addition of Substrate

Tetramethylbenzidine(TMB) Substrate

Biotin

BSA

AMPLICON

BSA

AMPLICON

HydrogenPeroxide

Avidin-horseradish peroxidase (Av-HRP conjugate)

Hibridizare

Page 31: Dg Molecular HIV 2013 (2)

Diagnostic molecular in infectia HIV

Page 32: Dg Molecular HIV 2013 (2)

DIAGNOSTIC SEROLOGICTESTE DE TRIAJ- sensibilitate inaltaELISATESTE RAPIDE

TESTE DE CONFIRMARE- specificitate inaltaWESTERN BLOTRADIOIMUNOPRECIPITAREA (RIPA)IMUNOFLUORESCENTA INDIRECTA

DETECTIA VIRUSULUI SAU A PRODUSELOR VIRALE

IZOLARE VIRALADETECTIA ANTIGENEMIEI p24DETECTIA ACIDULUI NUCLEIC VIRAL(ARN HIV PLASMATIC SAU ADN HIV PROVIRAL LIMFOCITAR)

Page 33: Dg Molecular HIV 2013 (2)

Utilizarea metodelor moleculare in infectia HIV

• Fereastra serologica

• Nou-nascuti din mame seropozitive HIV

• Initierea si monitorizarea terapiei antiretrovirale

• iv>5-10.000 corelat cu nr. CD4 si status clinic• iv>30-50.000 indiferent de nr. CD4 si status clinic• Monitorizarea: reducerea iv sub 50 copii ARN

HIV/ml la 24 sapt

Page 34: Dg Molecular HIV 2013 (2)

Precizati tipul de reactie reprezentata mai sus si principiul tehnicii.

In ce viroze aceasta tehnica este de electie?

Page 35: Dg Molecular HIV 2013 (2)

• MC, 25 ani . Se apreciaza ca se gaseste in fereastra serologica pentru infectia HIV. Ce semnifica aceasta notiune si ce etapa urmeaza in diagnostic.

Page 36: Dg Molecular HIV 2013 (2)

Nou nascut din mama seropozitiva HIV.

Care este testul de electie folosit pentru diagnosticul infectiei, precizand si etapele sale.

Page 37: Dg Molecular HIV 2013 (2)

• CE TEHNICA ESTE UTILIZATA IN ETAPA DE CONFIRMARE A INFECTIEI HIV? CE CRITERII TREBUIE OBLIGATORIU INDEPLINITE PENTRU A SPUNE CA TESTUL ESTE POZITIV? CUM SE PROCEDEAZA IN CAZUL UNUI TEST INDETERMINAT? MENTIONATI PRINCIPALELE CAI DE TRANSMITERE ALE INFECTIEI HIV.