JCM Accepts, published online ahead of print on 22 January 2014 J. Clin. Microbiol. doi:10.1128/JCM.03453-13 Copyright © 2014, American Society for Microbiology. All Rights Reserved. 1 Comparative Assessment of Automated Nucleic Acid Sample Extraction Equipment for 2 Biothreat Agents 3 4 5 Warren Vincent Kalinaa, Christina Elizabeth Douglasa, Susan Rajnik Coynea, 6 Timothy Devin Minoguea# 7 8 Diagnostic Systems Division, United States Army Medical Research Institute of Infectious 9 Disease, Fort Detrick, MD 21702a 10 11 12 Running Head: Agent Extraction Equipment Comparison 13 14 15 #Address correspondence to Timothy D. Minogue, [email protected] 16 17 18 19 20 21 22 23 24 1 25 Abstract: 26 Magnetic beads offer superior impurity removal and nucleic acid selection over older extraction 27 methods. 28 extraction performance of biothreat agents in blood or buffer was evaluated. All instruments 29 showed excellent performance in blood; however, the easyMAG® had best precision and 30 versatility. The easyMAG®, MagNA Pure, EZ1 Advanced-XL, and Arrows’ nucleic acid 31 32 Keywords: Magnetic separation, Bacillus anthracis spores, Y. pestis, Vaccinia Virus, and 33 Venezuelan Equine Encephalitis Virus 34 35 36 37 38 39 40 41 42 43 44 45 46 47 2 48 49 In the early days of molecular biology, nucleic acids were extracted from large laboratory 50 grown agent preparations that yielded sparse product [1]. After the discovery of DNAses, 51 RNAses, and chaotropic salts, purification procedures were generated that yielded consistent, 52 measurable nucleic acid product [2-4]. Several current clinical diagnostic extraction procedures 53 separate nucleic acid by magnetic beads which harmonizes older methods with user-friendly and 54 precise techniques [4, 5]. Such methods have become automated whereby extraction instruments 55 use magnets and silica-coated magnetic beads to bind nucleic acid through electrostatic 56 interactions while impurities are washed away with buffers [6, 7]. 57 Numerous high-throughput, magnetic separation, extraction technologies offer maximal 58 recovery, purity, and minimal operator involvement but use different beads, protocols, or 59 reagents. Material and process disparities potentially affect agent extraction efficiency in 60 specific matrices [8-10]. Few studies have compared the performance of automated nucleic acid 61 extraction platforms using clinical specimens that contain biothreat agents [10, 11]. These facts 62 warranted an analysis of instrument effects on agent-specific detection by real-time PCR. 63 Therefore, extraction performance was evaluated for Bacillus anthracis, Yesinia pestis, Vaccinia, 64 and Venezuelan Equine Encephalitis (VEE) virus in blood and buffer on the easyMAG® 65 (bioMérieux, Durham, NC), MagNA Pure Compact (Roche Diagnostics, Indianapolis, IN), EZ1 66 Advanced XL (Qiagen, Valencia, CA), and Nordiag Arrow (Autogen, Holliston, MA). 67 Yersinia pestis (Colorado92) (ANG-YERS078), VEE 1A/B Trinidad Donkey Strain 68 (ANG-VEETRIN), Vaccina Lister (ANG-VAVIEL), and Bacillus anthracis Ames (ANG- 69 BACI008) were obtained inactivated from the U.S. Department of Defense Critical Reagent 70 Program (Fort Detrick, MD)[12]. Inactivation was previously shown to not affect agent-specific 3 71 real-time PCR assays and other extraction procedures [13]. All agents were serially diluted 8 72 times from titers (CFU or PFU/mL) of 1×105 to 7.8×102. Eight replicates were prepared for each 73 dilution in either Dulbecco’s phosphate buffered saline (DPBS) (Life Technologies, Grand 74 Island, NY) or single donor EDTA whole blood (Bioreclamation, Westbury, NY) which was 75 duplicated for each instrument with all samples diluted on the same day prior to storage at -80°C. 76 Varying instrument throughputs necessitated sample arrangement with minimal 2 dilution 77 replicates per run. Agents were extracted from blood and buffer with kits or settings 78 recommended by the applicable instrument’s vendor (Table 1). Dilution linearity, precision, instrument effects on limit of detection (LOD) and matrix 79 80 were measured by real-time PCR after extraction. Intra and inter-assay precision, defined as 81 variation between replicates within a run and between separate runs respectively, were calculated 82 as %CV. Primers for B. anthracis PA, Y. pestis PIM, VEEV nsp4, and Vaccinia E9L genes were 83 used in real-time PCR assays as previously described on a Lightcycler 480 (Roche Diagnostics, 84 Indianapolis, IN) [13, 14]. Real-time PCR Cq values between instruments and matrices were 85 evaluated by t-tests, one-way-analysis-of-variance, and probit regression in GraphPad Prism® 86 [15]. 87 Inter and intra-assay precision was mostly within tolerance for all instruments except 88 Arrow-extracted buffer samples (Table 2). For all agents in blood and buffer, the easyMAG® 89 had the best overall precision followed by the MagNA Pure, whose B. anthracis inter-assay 90 extraction precision in buffer was appreciably lower. Similarly, the EZ1’s intra and inter-assay 91 precision was good for all agents except Vaccinia in buffer/blood. Lastly, the Arrow failed to 92 extract all agents in buffer, but showed good precision, excluding Vaccinia, for all agents in 93 blood. Incidentally, the easyMAG® uses guanidinium thiocyanate (GuSCN) in lysis and 4 94 washing steps, and the Arrow and EZ1 use guanidinium hydrochloride (GuHCl) during lysis, 95 binding, and washing steps. Comparatively, GuSCN is a stronger chaotropic salt and denaturant 96 than GuHCl that superlatively inactivates nucleases, opens cells to release nucleic acid, induces 97 salt bridge formation, and disrupts H-bonding and subsequently may have resulted in enhanced 98 precision shown here [4]. 99 There was no significant difference in Cq values between instrument sample dilution 100 curves, and each agent failed to produce linear dilution treadlines in blood or buffer (r^2<0.95) 101 (data not shown). Because samples were made in one batch, poor linearity was extraction 102 instrument dependent. 103 Statistical analysis of precision and linearity provided definitive metrics for adjudicating 104 instrument performance; however, detection of organism in a sample for incorporation into the 105 diagnostic pipeline required further consideration, i.e. effects on real-time PCR LOD. Similar to 106 precision and linearity analysis, real-time PCR confirmed better LODs for easyMAG® extracted 107 B. anthracis at 840 CFU in blood whereas the Arrow, MagNA Pure, and EZ1 yielded lower 108 quantities of B. anthracis nucleic acid in blood, and all instruments extracted less material in 109 buffer (Table 2). Yields for Y. pestis, Vaccinia, and VEE were more equivocal than B. anthracis 110 in both matrices (results not shown). Considering all agents, the easyMAG®, MagNA Pure, 111 and EZ1 extracted significantly different amounts of nucleic acid between buffer and blood 112 except VEE on the EZ1 (Figure 1). Incidentally, nucleic acid released from enveloped viruses 113 doesn’t require harsh denaturants, but peptidoglycan and endospores, which are recalcitrant to 114 lysis even in NucliSENS lysis buffer, may account for observational differences between 115 instruments[16]. 5 116 Intuitively blood, teeming with inhibitors, was expected to reduce extraction yields; 117 however, this wasn’t observed thus suggesting GuSCN or GuHCl concentrations in extraction 118 buffers sufficiently inactivate nucleases. Samples in DPBS, extracted with the same reagents 119 used for blood, may be exposed to unnecessary high concentrations of harsh, ionic chaotropic 120 salts that affect silica binding and nucleic acid integrity. Concerning the Arrow’s performance in 121 buffer, chemistry and mechanics may interplay. Buffer sample volumes were observed as not 122 being pipetted accurately by the instrument, thus insinuating liquid retention capacity is 123 calibrated for viscous and not for non-viscous solutions. Of note, our laboratory has used 124 magnetic bead extraction technology to extract the same live and killed agents used in this study 125 without any difference in results (unpublished observation) and therefore had no profound effect 126 on results presented here. 127 Overall, the easyMAG® had superior precision and extraction yields for most agents 128 with best throughput. However, the EZ1 extracted VEE equivocally regardless of matrix but had 129 lower precision. All instruments extracted material in blood with varying degrees of 130 performance, which was the primary focus of this study. Since the EZ1 has greater versatility for 131 viral samples in different matrices, reasonably good throughput (14 samples/run), and small 132 footprint, such an instrument may be advantageous in clinical labs that frequently process viral 133 samples; however, precision, matrix robustness, throughput, typical agent type, and extraction 134 time should be major instrument considerations. 135 136 137 Acknowledgments: 6 138 This work was supported by the Joint Science & Technology Office for Chemical & Biological 139 Defense under Grant No. CB3901. Opinions, interpretations, conclusions, and recommendation 140 are those of the author and are not necessarily endorsed by the U.S. Army. 141 References: 142 1. Present. Journal of Biomedicine and Biotechnology: p. 10. 143 144 2. 3. Alexander M, Heppel LA, Hurwitz J. 1961. The Purification and Properties of Micrococcal Nuclease. The Journal of Biological Chemistry. 236(11): p. 3014-3019. 147 148 McDonald MR. 1962. 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Detection of 180 biological threat agents by real-time PCR: comparison of assay performance on the 181 R.A.P.I.D., the LightCycler, and the Smart Cycler platforms. Clin Chem. 52(1): p. 141- 182 145. 8 183 15. Lefever S, Hellemans J, Pattyn F, Przybylski DR, Taylor C, Geurts R, Untergasser A, 184 Vandesompele J. 2009. RDML: structured language and reporting guidelines for real- 185 time quantitative PCR data. Nucleic Acids Research. 37(7): p. 2065-2069. 186 16. Wielinga PR, d.H.L., de Groot A, Hamidjaja RA, Bruggeman G, Jordan K, van 187 Rotterdam BJ. 2011. Evaluation of DNA extraction methods for Bacillus anthracis spores 188 spiked to food and feed matrices at biosafety level 3 conditions. Internation Jornal of 189 Food Microbiology. 150(2-3): p. 122-127. 190 191 Figure 1. Percentage of extracted agent dilutions (1×105 to 7.8×102) that were statistically 192 different between blood and buffer for each instrument. The Arrow is not shown because 193 therewas no data for buffer to make comparisons. With the exception of the EZ1 for VEEV, the 194 easyMAG® had similar but overall fewer instances of significantly different data between blood 195 and buffer samples. 196 9 Table 1. Instrument extraction parameters Method (company) Kit Binding Lysis Buffer NucliSens easyMAG® bioMérieux NucliSens magnetic kit NucliSENS Lysis Buffer (GuSCN) EZ1 XL Qiagen EZ1 Virus Mini Kit v2.0 Buffer AL (GuHCl) MagNA Pure Compact Roche Arrow NorDiag Nucleic Acid Kit I GuSCN Unknown Lysisblood/buffer Blood DNA 200 30% GuHCl 30% Perchlorate 50% Ethanol 10 mM TrisHCl pH8.0 None 1 Elution Buffer Used NucliSENS Extraction Buffer 3 +heat Buffer AVE All instruments required sample preparation to be external External Step1 Lysis-blood None Table 2. Performance Results Instrument/Kit Matrix Intra-Best1 Intra-Worst easyMAG® Buffer Blood YP,VV NA BA NA MagNA Pure Buffer Blood Buffer Blood Buffer YP, VEEV BA, YP, VEEV BA, YP, VEEV BA, YP, VEEV None6 Blood BA, YP, VEEV BA VV VV VV BA, YP, VV, VEEV VV EZ1-Advanced XL Arrow %Pass2 Intra 96.6 100 %Pass3 Inter 100 92.9 BA LOD4 1488 840 97.1 99.1 98.7 95.6 55.0 82.1 96.7 76.7 79.5 0.00 4744 2771 10719 8628 ND5 94.4 87.4 1381 1 Agent(s) (YP=Y. pestis, BA=B. anthracis, VV=Vaccina Virus, VEEV=Venqualan Equine Encephalitis Virus) with lowest numbers of intra-assay replicates with %CV<5. Several individual agents had the same pass rate and are shown jointly. 2 Percentage of replicates where intra-assay precision %CV<5 for all agents combined 3 Percentage of replicates where inter-assay precision %CV<2 for all agents combined 4 Expressed as estimated CFU 5 Not Determined 6 For most agents failure exceeded 50%
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