Literature DB >> 20113352

Development and evaluation of loop-mediated isothermal amplification (LAMP) for the rapid diagnosis of Penicillium marneffei in archived tissue samples.

Jiufeng Sun1, Xiqing Li, Hanxiang Zeng, Zhi Xie, Changming Lu, Liyan Xi, Gert S de Hoog.   

Abstract

Penicillium marneffei is the etiologic agent of a severe systemic disease in immunocompromised hosts in Southeast Asia. In the present study, a novel method, known as loop-mediated isothermal amplification (LAMP), is described for the rapid and specific detection of the species, using a primer set derived from the internal transcribed spacer (ITS) region of the rRNA gene. Amplification products can be detected macroscopically by visual inspection in vials using SYBR Green I as well as by electrophoresis on agarose gel. The LAMP assay resulted in specific amplification of P. marneffei ITS using pure cultures after a 1-h reaction at 65 degrees C in a water bath; no cross-reactivity with other fungi including other biverticillate penicillia was observed. The detectable DNA limit was two copies. In addition, specific amplification was achieved using paraffin wax-embedded tissue samples from patients with penicilliosis marneffei and tissue samples from bamboo rats. The method provides a powerful tool for rapid diagnostics in the clinical lab, and has potential for use in ecological studies.

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Year:  2010        PMID: 20113352      PMCID: PMC7110349          DOI: 10.1111/j.1574-695X.2010.00647.x

Source DB:  PubMed          Journal:  FEMS Immunol Med Microbiol        ISSN: 0928-8244


Introduction

Penicillium marneffei is the agent of a life-threatening systemic mycosis known as penicilliosis marneffei, occurring in patients infected with HIV in Southeast Asia (Supparatpinyo ; Wong ; Liyan ) and now recognized as an AIDS-defining disease (Lee, 2008). Cases were particularly frequent in endemic zones of northern Thailand (Watanabe ), but the disease has also been observed in China (Fisher ). Since the first reported Chinese case in 1985 (Wei, 1985), there has been a drastic increase in the incidence of the infection, concomitant with the emergence of the AIDS pandemic. More than 100 cases of AIDS with penicilliosis marneffei were reported between 2003 and 2006 in a single hospital in Guangzhou (Linghua Li & Weiping, 2008). Clinical diagnosis may be hampered by the fact that major manifestations of the mycosis in HIV-infected patients are not specific for P. marneffei. As a result, many patients do not receive timely and appropriate antifungal treatment, and their prognosis is poor. Traditionally, penicilliosis marneffei is diagnosed by a microscopic observation of fungal fission yeast cells in alveolar macrophages and by culturing the etiologic agent. These procedures may be time-consuming (Ukarapol ; Mo ), and there is a need for experimental diagnostic methods. Serological diagnosis (Panichakul ) is tedious because it requires paired, acute- and convalescent-phase sera, and the results may be influenced by contamination or cross-reaction. Several molecular methods have been proposed, such as nested or semi-nested PCR (LoBuglio & Taylor, 1995; Vanittanakom ; Prariyachatigul ), PCR-enzyme immunoassays (Lindsley ) and PCR hybridization (Vanittanakom ). All have been developed on the basis of cultured material, and require a fully equipped molecular laboratory. Thus, there is still a need for a rapid and simple technique that is able to deliver an unambiguous identification within a single day. Loop-mediated isothermal amplification (LAMP) was introduced for the detection of hepatitis B virus DNA by Notomi (2000). This novel technique is able to amplify DNA with high specificity, efficiency and rapidity under isothermal conditions. The assay is based on the use of Bst DNA polymerase, performing autocycling strand displacement DNA synthesis using a set of four or six specially designed primers that recognize six or eight distinct sequences on the target DNA. The cycling reactions result in the accumulation of 109- to 1010-fold amplification of the target in less than an hour. Amplification products can be detected easily by visual assessment of turbidity in Eppendorf vials or by electrophoresis. The sensitivity of LAMP does not appear to be affected by the presence of nontarget DNA in samples, and there is no interference by known PCR inhibitors such as blood, serum, plasma or heparin (Notomi ; Enosawa ; Poon ). These properties of high specificity, selectivity, simplicity and speed made LAMP attractive for the diagnosis of bacteria (Iwamoto ; Yoshida ; Aoi ), viruses (Poon ; Hagiwara ; Cai ) and parasites (Ikadai ; Iseki ). However, very few papers have appeared on the use of LAMP with fungi (Endo ; Ohori ; Inacio ). We recently developed a protocol for LAMP detection for Fonsecaea agents of chromoblastomycosis (Sun, 2009). In the present study, we introduce LAMP diagnostics for P. marneffei in paraffin wax-embedded human tissue and in bamboo rat tissue samples.

Materials and methods

Strains and biopsy specimens

Forty strains of P. marneffei isolated from human patients and 46 reference strains used in this study are listed in Table 1. All isolates were cultured on Sabouraud's glucose agar plates at 25 °C for 1 week; Escherichia coli was cultured in flasks shaken at 250 r.p.m. with Luria–Bertani at 37 °C overnight. About 0.5 g of mycelium or conidia, or precipitate of E. coli, respectively, were harvested for DNA extraction.
Table 1

Sampling data of the isolates used in this study

SpeciesAccession no.GenBankSource
Penicillium marneffei CBS101038Assam, India
CBS555.90TAustralia
CBS388.87Vietnam
CBS122.89Indonesia
CBS440.88USA
SUMS0266FJ009553Bamboo rat spleen, Jiangxi, China
SUMS0267FJ009551Bamboo rat spleen, Jiangxi, China
SUMS0264FJ009566Bamboo rat kidney, Jiangxi, China
SUMS0268FJ009565Bamboo rat spleen, Jiangxi, China
SUMS0272FJ009555Bamboo rat lung, Jiangxi, China
SUMS0344FJ009554Bamboo rat spleen, Shaoguan, China
SUMS0345FJ009559Bamboo rat kidney, Shaoguan, China
SUMS0346FJ009560Bamboo rat lung, Shaoguan, China
SUMS0347FJ009564Bamboo rat liver, Fujian, China
SUMS0348FJ009563Bamboo rat lung, Fujian, China
SUMS0349FJ009552Bamboo rat liver, Shaoguan, China
SUMS0350FJ009557Bamboo rat lung, Shaoguan, China
SUMS0351FJ009562Bamboo rat lung, Shaoguan, China
SUMS0352FJ009558Bamboo rat spleen, Shaoguan, China
SUMS0353FJ009561Bamboo rat lung, Shaoguan, China
SUMS0354FJ009556Bamboo rat lung, Shaoguan, China
IFM47289AB298957Chiba University, Japan
IFM47288AB298956Chiba University, Japan
IFM47287AB298955Chiba University, Japan
IFM47286AB298954Chiba University, Japan
IFM47285AB298953Chiba University, Japan
SUMS0152AB353913Human blood and bone marrow, Guangdong, China
SUMS0112AB353909Human, Jiangxi, China
SUMS0165AB353908Human blood, Guangdong, China
SUMS0186AB353917Human face and blood, Guangdong, China
SUMS0178AB353916Human blood, Guangdong, China
SUMS0174AB353915Human neck, Guangdong, China
SUMS0164AB353914Human face, Guangdong, China
SUMS0096AB353912Human dialysate, Guangdong, China
SUMS0050AB353911Animal, Guangxi, China
SUMS0051AB353910Human, Guangxi, China
SUMS0111AB353919Human, Guangdong, China
SUMS0187AB353918Human blood, Guangdong, China
SUMS0107AB353907Human legs, Guangdong, China
SUMS0047AB353906Human legs, Guangdong, China
Aspergillus fumigatus SUMS0106FJ011537Human, Shanghai, China
SUMS0317FJ011543
A. flavus SUMS0060FJ011539Human sputum, Guangdong, China
SUMS0062FJ011545Human lung, Guangdong, China
A. niger SUMS0061FJ011541Human acoustic meatus, Guangdong, China
SUMS0037FJ011542Human, Guangdong, China
A. terreus SUMS0191FJ011538Human acoustic meatus, Guangdong, China
SUMS0113FJ011536Human sputum, Guangdong, China
Penicillium griseofulvum SUMS0392FJ011548Human face, Guangzhou, China
Paecilomyces variotii SUMS0303FJ011547Human, Guangzhou, China
Penicillium janthinellum IFM40620IAM 7018
P. chrysogenum IFM5338MTU7003
P. purpurogenum IFM40627IAM7095
P. citrinum IFM40616IAM7003
P. duclauxii CBS187.89NRRL 2020
P. verruculosum CBS101366Soil, Hong Kong
P. minioluteum CBS442.89Soil, Lyngby, Denmark
P. crustosum IFM47479IFO31913 silk-worm foods
P. funiculosum IFM57310-11CBS235.94, ATCC11797 MD
P. pinohilum IFM57309-L1CBS631.66, IMI114933, ATCC36839
Talaromyces flavus IFM42233F-S-1
T. trachyspermus IFM42251M-2143
T. stipitatus IFM42240NHL 6092
T. thermophis IFM52998ATCC10518, CBS236.58, IMI48593
T. derxii CBS413.89Cultivated soil, Okayama Prefecture, Kurashiki City, Higashitomii, Japan
T. intermedius CBS152.65Alluvial pasture and swamp soil, Nottingham, Attenborough, UK
Blastomyces dermatitidis IFM40753From Jyunntenndo University
Coccidioides immitis IFM45811Patient, San Jose, AZ
Paracoccidioides brasiliensis IFM41620Patient, E. Burger
Sporathrix schenckii SUMS0382FJ011549Human, Guangzhou, China
SUMS0383FJ011550Human, Guangzhou, China
Fonsecaea pedrosoi CBS272.37TBrazil
F. monophora CBS269.37TAY857511South America
Histoplasmo capsulatum SUMS0035AB353921
H. duboisii IFM5417MTU 16024, TIMM0738, IP638
H. farciminosum IFM41335CDC B-22, L. Ajiello
Cryptococcus neoformans SUMS0167AB436650Human cerebrospinal fluid, Guangzhou, China
SUMS0042AB436636Human cerebrospinal fluid, Guangzhou, China
Candida albicans ATCC90028AB049119Unknown
C. tropicalis SUMS0125FJ011533Human blood, Guangzhou, China
C. parapsilosis ATCC22019AB105209Unknown
C. krusei ATCC6258AB105208Unknown
C. guilliermondii ATCC6260AF022717Unknown
C. glabrata ATCC2001AF134719Unknown
C. dubliniensis SUMS0393FJ011546Human sputum, Guangzhou, China
Escherichia coli ATCC25922DQ360844Shangdong, China

CBS, Centraalbureau voor Schimmelcultures, Baarn, the Netherlands; SUMS, Sun Yat-Sen University Medical Science, Guangzhou, China; IFM, Research Center for Pathogenic Fungi and Microbial Toxicoses, Chiba University, Chiba, Japan; ATCC, American type culture collection, Rockville, MD; TType strain; IAM, Institute of Applied Microbiology, University of Tokyo, Tokyo, Japan; MTU, Department of Bacteriology, Faculty of Medicine, University of Tokyo, Tokyo, Japan; IFO, Institute for Fermentation, Osaka, Japan; IMI, CAB International Mycological Institute, Kew, UK; NHL, National Collection of Pathogenic Fungi, Mycological Reference Laboratory, Central Public Health Laboratory, London, UK; TIMM, Research Center for Medical Mycology, Teikyo University, Hachioji, Tokyo, Japan; IP, Unite de Mycologie, Institut Pasteur, Paris, France; CDC, Communicable Disease Centers, United States Public Health Services, Atlanta, GA; NRRL, Northern Regional Research Laboratory, Peoria, IL.

Sampling data of the isolates used in this study CBS, Centraalbureau voor Schimmelcultures, Baarn, the Netherlands; SUMS, Sun Yat-Sen University Medical Science, Guangzhou, China; IFM, Research Center for Pathogenic Fungi and Microbial Toxicoses, Chiba University, Chiba, Japan; ATCC, American type culture collection, Rockville, MD; TType strain; IAM, Institute of Applied Microbiology, University of Tokyo, Tokyo, Japan; MTU, Department of Bacteriology, Faculty of Medicine, University of Tokyo, Tokyo, Japan; IFO, Institute for Fermentation, Osaka, Japan; IMI, CAB International Mycological Institute, Kew, UK; NHL, National Collection of Pathogenic Fungi, Mycological Reference Laboratory, Central Public Health Laboratory, London, UK; TIMM, Research Center for Medical Mycology, Teikyo University, Hachioji, Tokyo, Japan; IP, Unite de Mycologie, Institut Pasteur, Paris, France; CDC, Communicable Disease Centers, United States Public Health Services, Atlanta, GA; NRRL, Northern Regional Research Laboratory, Peoria, IL. Twenty-three tissue samples from 23 patients (Zeng ) were selected. These included 12 samples from patients with proven penicilliosis marneffei, three from chromoblastomycosis, three from sporotrichosis, one from histoplasmosis, one from cryptococcosis, one from candidiasis, one from pulmonary aspergillosis and one from visually healthy human skin. Cases from human patients were confirmed by routine and molecular identification methods. Penicillium marneffei was also isolated from 10 of 11 bamboo rat tissue samples; one (bamboo rat liver) was used as a negative control. The time that elapsed after paraffin embedding of the tissue samples ranged between one day and 13 years. About 10-µg sectioned paraffin material was used for DNA extraction.

DNA extraction and quality test

Fungal DNA from pure culture was extracted using 6% InStaGeneTMMatrix (Bio-Rad, CA) as described previously (Xi ). Crude DNA of paraffin wax-embedded tissue was extracted from approximately 10-µg sections of paraffin wax-embedded tissue using the QIAamp® FFPE Tissue Kit (Qiagen, Hilden, Germany) according to Zeng (2009). DNA concentrations were measured spectrophotometrically at 260 nm (Shimadzu Corp., Japan). DNA quality was confirmed by successful PCR amplification using universal fungal primers internal transcribed spacer (ITS)4 and ITS5 (Zeng ). PCR was performed as follows: 95 °C for 5 min; 35 cycles of 95 °C for 30 s, 55 °C for 30 s and 72 °C for 1 min, with a final extension at 72 °C for 10 min. Amplicons were detected by electrophoresis (Bio-Rad) on a 2% agarose gel (NuSieve, Rockland, ME).

Design of LAMP primers

Four sets of 24 species-specific primers were designed based on the rRNA gene ITS region of P. marneffeiSUMS0152 (AB353913) (Liu ; Xi ) using primerexplorer v4 software (http://primerexplorer.jp). A set of six species-specific LAMP primers was selected as follows: forward outer primer (F3): CCG AGC GTC ATT TCT GCC, reverse outer (B3): AGT TCA GCG GGT AAC TCC T, forward inner primer (FIP): TCG AGG ACC AGA CGG ACG TCT TTT TCA AGC ACG GCT TGT GTG, reverse inner (BIP): TAT GGG GCT CTG TCA CTC GCT CTT TTA CCT GAT CCG AGG TCA ACC, loop forward (LF): GTT GGT CAC CAC CAT ATT TAC CA and loop reverse (LB): TGC CTT TCG GGC AGG TC.

LAMP reaction

LAMP was performed in 25-µL reaction volumes containing 0.25 µM of F3 and B3 each, 1.0 µM of FIP and BIP each, 0.5 µM of LF and LB each, 1.0 mM dNTPs, 1 M betaine (Sigma), 20 mM Tris-HCl (pH 8.8), 10 mM KCl, 10 mM (NH4)2SO4, 4 mM MgSO4, 0.1% Triton X-100 and 8 U of Bst DNA large fragment polymerase (New England Biolabs), with 2 µL of crude DNA extract as the template. The reaction mixture, except Bst DNA polymerase, was denatured at 95 °C for 5 min and cooled on ice, followed by the addition of 1 µL Bst polymerase and incubation at 65 °C in a water bath for 60 min and final heating at 85 °C for 2 min to terminate the reaction. DNAs of 40 P. marneffei and 46 reference strains were used as templates to evaluate the specificity of the LAMP assay. DNA of strain SUMS0152 was used as a positive control; reaction mixtures without P. marneffei DNA, i.e. healthy human skin DNA, healthy bamboo rat DNA and DNAs from Penicillium purpurogenum, Penicillium funiculosum and other biverticillate penicillia taxonomically close to P. marneffei were used as negative controls. A recombinant plasmid (pT-IT12) was constructed as a template for establishing the detection limit of the LAMP assay. The ITS region of P. marneffei (603 bp) was amplified from SUMS0152 genomic DNA using primers ITS4 and ITS5 and subcloned into the pGEM-T Easy vector (Promega) according to the manufacturer's instructions. Detection limits were evaluated using 10-fold serial dilutions of plasmid pT-IT12. The plasmid DNA (0.32 µg µL−1, equivalent to 8.067 × 1010 copies µL−1) was 10-fold serially diluted and 2 µL of each dilution was used as a template for the LAMP reaction. DNA of P. marneffeiSUMS0152 was used as a positive control; the reaction mixture without DNA was used as a negative control. To evaluate the inhibition of nontarget DNA in the LAMP assay, 2 µL crude DNA extract each of P. marneffei was added to the LAMP-negative samples, and then tested by LAMP again.

Visualization

Amplified products were analyzed by electrophoresis on 1% agarose gels, stained with ethidium bromide and photographed. A 100-bp DNA ladder was used as the molecular weight standard. LAMP reaction products were made visible by the addition of 2.0 µL of 10-fold diluted SYBR Green I (Cambrex Bio Science, Wokingham, UK) to each reaction tube separately; the change in the color of the solution was observed directly by the naked eye or using a UV transilluminator.

Application of LAMP to paraffin wax-embedded tissues

Crude-extracted DNA of 2 µL each from 34 paraffin wax-embedded tissues' samples was used as a template for LAMP assays. The amplified products were analyzed by the naked eye or by electrophoresis.

Results

LAMP assays using a set of six species-specific LAMP primers yielded positive results in all P. marneffei strains, but remained negative in all isolates used for reference, including related biverticillate penicillia (Table 1). Amplification was completed within 1 h isothermally at 65 °C in a water bath. The products of the LAMP reaction could be detected by electrophoresis on 1% agarose gels and showed ladder-like patterns (Fig. 1). The products could also be made visible to the naked eye directly in Eppendorf vials or under UV transillumination after adding SYBR Green I dye. Positive reactions showed bright green fluorescence, whereas negative reactions remained light orange (Fig. 2). The detection limit of P. marneffei DNA by the LAMP assay was found to be two copies by electrophoresis (Fig. 3). The visual sensitivity obtained after adding SYBR Green I correlated with the sensitivity established on agarose gel (Fig. 4).
Figure 1

Agarose gel electrophoresis of LAMP products from tested strains obtained using the primer set designed in this work. Left to right: lane ‘M’, 100-bp DNA marker; lane ‘+’, SUMS0152 positive control; lane ‘−’, negative control without DNA; lanes1–7, CBS101038, CBS555.90, IFM47287, SUMS0266, SUMS0347, SUMS0112, SUMS0051, respectively; lanes 8–53, SUMS0303, SUMS0392, SUMS0106, SUMS0317, SUMS0060, SUMS0062, SUMS0061, SUMS0037, SUMS0191, SUMS0113, SUMS0167, SUMS0042, SUMS0382, SUMS0383, SUMS0035, CBS272.37, CBS269.37, ATCC6260, SUMS0125, ATCC22019, SUMS0393, ATCC90028, ATCC2001, ATCC6258, ATCC25922, IFM40620, IFM5338, IFM40627, IFM40616, IFM47479, IFM57310-11, IFM57309-L1, IFM42233, IFM42251, IFM42240, IFM52998, IFM40753, IFM45811, IFM4162, IFM5417, IFM41335, CBS442.89, CBS101366, CBS187.89, CBS413.89, CBS152.65, respectively.

Figure 2

Visual appearance of LAMP reactions from isolates after addition of SYBR Green I. (a) Positive reaction (tube 1), negative reaction (tube 2) and tube without DNA templates (tube 3). (b) Under UV transillumination, positive reaction (tube 4), negative reaction (tube 5) and tube without DNA templates (tube 6).

Figure 3

Analytical sensitivity of LAMP for detection of the ITS1–5.8S–ITS2 rRNA gene. Left to right: Lane ‘M’, 100-bp DNA ladder; lane ‘+’, SUMS0152 positive control; lane ‘−’, negative control without DNA; lanes 1–12, 2 × 109, 2 × 108, 2 × 107, 2 × 106, 2 × 105, 2 × 104, 2 × 103, 2 × 102, 2 × 101, 2 × 100, 2 × 10−1 and 2 × 10−2 copies per tube, respectively.

Figure 4

Visual sensitivity of LAMP reactions using SYBR Green I. (a) Direct detection by the naked eye, (b) under UV transillumination. Tubes 1–7, 2 × 105, 2 × 104, 2 × 103, 2 × 102, 2 × 101, 2 × 100, 2 × 10−1 copies per tube, respectively; tube 8, negative control without DNA.

Agarose gel electrophoresis of LAMP products from tested strains obtained using the primer set designed in this work. Left to right: lane ‘M’, 100-bp DNA marker; lane ‘+’, SUMS0152 positive control; lane ‘−’, negative control without DNA; lanes1–7, CBS101038, CBS555.90, IFM47287, SUMS0266, SUMS0347, SUMS0112, SUMS0051, respectively; lanes 8–53, SUMS0303, SUMS0392, SUMS0106, SUMS0317, SUMS0060, SUMS0062, SUMS0061, SUMS0037, SUMS0191, SUMS0113, SUMS0167, SUMS0042, SUMS0382, SUMS0383, SUMS0035, CBS272.37, CBS269.37, ATCC6260, SUMS0125, ATCC22019, SUMS0393, ATCC90028, ATCC2001, ATCC6258, ATCC25922, IFM40620, IFM5338, IFM40627, IFM40616, IFM47479, IFM57310-11, IFM57309-L1, IFM42233, IFM42251, IFM42240, IFM52998, IFM40753, IFM45811, IFM4162, IFM5417, IFM41335, CBS442.89, CBS101366, CBS187.89, CBS413.89, CBS152.65, respectively. Visual appearance of LAMP reactions from isolates after addition of SYBR Green I. (a) Positive reaction (tube 1), negative reaction (tube 2) and tube without DNA templates (tube 3). (b) Under UV transillumination, positive reaction (tube 4), negative reaction (tube 5) and tube without DNA templates (tube 6). Analytical sensitivity of LAMP for detection of the ITS1–5.8S–ITS2 rRNA gene. Left to right: Lane ‘M’, 100-bp DNA ladder; lane ‘+’, SUMS0152 positive control; lane ‘−’, negative control without DNA; lanes 1–12, 2 × 109, 2 × 108, 2 × 107, 2 × 106, 2 × 105, 2 × 104, 2 × 103, 2 × 102, 2 × 101, 2 × 100, 2 × 10−1 and 2 × 10−2 copies per tube, respectively. Visual sensitivity of LAMP reactions using SYBR Green I. (a) Direct detection by the naked eye, (b) under UV transillumination. Tubes 1–7, 2 × 105, 2 × 104, 2 × 103, 2 × 102, 2 × 101, 2 × 100, 2 × 10−1 copies per tube, respectively; tube 8, negative control without DNA. All 12 proven P. marneffei-positive tissue samples and 10 samples of bamboo rat tissue tested positive, whereas samples of unaffected human skin and the remaining tissue samples affected by other fungi and tested for comparison yielded a negative response (Table 2). The correspondence between the LAMP assays and the cultural and molecular results of the same tissue samples proved to be 100%. In the inhibition test, it was found that all LAMP-negative samples became positive after the addition of 2 µL crude DNA extract of P. marneffei.
Table 2

Biopsy specimens used in this study and the results of different detection methods

Detection method
Sample no.SourceCulture and ITS sequencingPASLAMP
Paraffin wax-embedded tissues
    1Human, skin Penicillium marneffei ++
    2Human, skin P. marneffei ++
    3Human, skin P. marneffei +
    4Human, skin P. marneffei +
    5Human, lung P. marneffei ++
    6Human, skin P. marneffei ++
    7Human, lymph node P. marneffei ++
    8Human, skin P. marneffei ++
    9Human, skin P. marneffei ++
    10Human, skin P. marneffei ++
    11Human, skin P. marneffei ++
    12Human, lung P. marneffei ++
    13Human, skin Sporathrix schenckii
    14Human, skin S. schenckii
    15Human, face S. schenckii
    16Human, lung Aspergillus sp.
    17Human, leg Fonsecaea pedrosoi
    18Human, leg F. pedrosoi
    19Human, abdominal skin F. pedrosoi
    20Human, face Cryptococcus neoformans
    21Human, leg Histoplasma capsulatum +
    22Human, skin Candida albicans Candida parapsilosis +
    23Human normal skin
Bamboo rat tissues
    1Bamboo rat, kidney P. marneffei +
    2Bamboo rat, spleen P. marneffei +
    3Bamboo rat, lung P. marneffei +
    4Bamboo rat, liver P. marneffei +
    5Bamboo rat, lung P. marneffei +
    6Bamboo rat, liver P. marneffei +
    7Bamboo rat, lung P. marneffei +
    8Bamboo rat, spleen P. marneffei +
    9Bamboo rat, lung P. marneffei +
    10Bamboo rat, liver P. marneffei +
    11Bamboo rat, lung P. marneffei +
    12Bamboo rat, liver
Biopsy specimens used in this study and the results of different detection methods

Discussion

LAMP is a powerful innovative gene amplification technique providing a simple and rapid tool for early detection and identification of microbial diseases. Most developments in molecular diagnostics published recently concerned improvements in PCR methodology on DNA extracted from pure cultures or from clinical specimens. This had led to changes in the primer design and reaction temperature (Boehme ; Inacio ) and to integration with hybridization and enzyme-linked immunosorbent assay techniques (Nagamine ; Lee ). In the present study, we further developed and evaluated the LAMP assay, exemplified by the detection and identification of P. marneffei in DNA from pure cultures as well as in paraffin wax-embedded tissues. Compared with any detection method applied thus far, the method is very fast, as it can be carried out within 1 h. It also does not require expensive laboratory equipment, because the method can be carried out isothermally at 65 °C in a water bath. Further, it is simple to use in a routine laboratory, as the results can be observed directly by the naked eye (Fig. 3). In addition, the detection limit is very low. With only two DNA copies, it has a higher sensitivity than the currently applied molecular methods, such as semi-nested PCR (10 pg) (Prariyachatigul ), PCR enzyme immunoassay (3.2 pg) (Lindsley ), PCR hybridization (0.1 pg) (Vanittanakom ) and nested PCR (0.07 pg) (Zeng ). The results of P. marneffei detection by LAMP in 23 paraffin wax-embedded clinical samples and 11 bamboo rat tissues were also highly specific. The etiologic agents of the 23 clinical samples were verified previously using culture and sequencing data. Twelve samples were histopathologically positive; all molecular identifications matched with the clinical diagnoses. Samples from penicilliosis and from the natural bamboo rat host were positive with LAMP, whereas all others, including healthy human skin, proved to be negative. Test results were not inhibited by nontarget DNA. This makes the LAMP technique highly promising for evaluation and application in problematic clinical samples such as blood, urine and sputum. In this study, we have proved with the example of P. marneffei that LAMP is a very efficient method for the quick and sensitive identification of fungal pathogens and opportunists. The method can be applied not only to cultures but also to a variety of clinical samples. This can be of great significance to organisms that cause invasive or disseminated infections that are difficult to cultivate from such samples, such as the zygomycete species. A further application may be for detection without isolation of the fungi in the environment. In summary, in the current study, we proved that the LAMP technique enables specific detection of P. marneffei and excludes related biverticillate penicillia and Talaromyces teleomorphs. Similar results were obtained in Paracoccidioides (Endo ), Candida (Inacio ) and Ochroconis (Ohori ). However, in Fonsecaea, identification was possible only at the generic level (Najafzadeh, 2009). An explanation for this phenomenon may be found in the fact that Penicillium species are relatively distant from each other, with ITS barcoding gaps well over 1%, whereas in Fonsecaea ITS, interspecific differences are a few bases only, species delimitations being based on multilocus analyses.
  38 in total

1.  Real-time quantitative LAMP (loop-mediated isothermal amplification of DNA) as a simple method for monitoring ammonia-oxidizing bacteria.

Authors:  Yoshiteru Aoi; Mariko Hosogai; Satoshi Tsuneda
Journal:  J Biotechnol       Date:  2006-06-21       Impact factor: 3.307

2.  Rapid identification of dimorphic and yeast-like fungal pathogens using specific DNA probes.

Authors:  M D Lindsley; S F Hurst; N J Iqbal; C J Morrison
Journal:  J Clin Microbiol       Date:  2001-10       Impact factor: 5.948

3.  Loop-mediated isothermal amplification for direct detection of Mycobacterium tuberculosis complex, M. avium, and M. intracellulare in sputum samples.

Authors:  Tomotada Iwamoto; Toshiaki Sonobe; Kozaburo Hayashi
Journal:  J Clin Microbiol       Date:  2003-06       Impact factor: 5.948

4.  Loop-mediated isothermal amplification method for rapid detection of the periodontopathic bacteria Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola.

Authors:  Akihiro Yoshida; Shiori Nagashima; Toshihiro Ansai; Masayo Tachibana; Hiroaki Kato; Hajime Watari; Tsugunori Notomi; Tadamichi Takehara
Journal:  J Clin Microbiol       Date:  2005-05       Impact factor: 5.948

5.  Detection of gp43 of Paracoccidioides brasiliensis by the loop-mediated isothermal amplification (LAMP) method.

Authors:  Shigeo Endo; Takashi Komori; Giannina Ricci; Ayako Sano; Koji Yokoyama; Akira Ohori; Katsuhiko Kamei; Marcello Franco; Makoto Miyaji; Kazuko Nishimura
Journal:  FEMS Microbiol Lett       Date:  2004-05-01       Impact factor: 2.742

6.  Development of a multiplex loop-mediated isothermal amplification (mLAMP) method for the simultaneous detection of bovine Babesia parasites.

Authors:  Hiroshi Iseki; Andy Alhassan; Naomi Ohta; Oriel M M Thekisoe; Naoaki Yokoyama; Noboru Inoue; Andrew Nambota; Jun Yasuda; Ikuo Igarashi
Journal:  J Microbiol Methods       Date:  2007-10-04       Impact factor: 2.363

7.  Disseminated Penicillium marneffei infection in southeast Asia.

Authors:  K Supparatpinyo; C Khamwan; V Baosoung; K E Nelson; T Sirisanthana
Journal:  Lancet       Date:  1994-07-09       Impact factor: 79.321

8.  Specific identification of Penicillium marneffei by a polymerase chain reaction/hybridization technique.

Authors:  N Vanittanakom; W G Merz; N Sittisombut; C Khamwan; K E Nelson; T Sirisanthana
Journal:  Med Mycol       Date:  1998-06       Impact factor: 4.076

9.  Low effective dispersal of asexual genotypes in heterogeneous landscapes by the endemic pathogen Penicillium marneffei.

Authors:  Matthew C Fisher; William P Hanage; Sybren de Hoog; Elizabeth Johnson; Michael D Smith; Nicholas J White; Nongnuch Vanittanakom
Journal:  PLoS Pathog       Date:  2005-10-28       Impact factor: 6.823

10.  Rapid detection of the severe acute respiratory syndrome (SARS) coronavirus by a loop-mediated isothermal amplification assay.

Authors:  Leo L M Poon; Cynthia S W Leung; Masato Tashiro; Kwok Hung Chan; Bonnie W Y Wong; Kwok Yung Yuen; Yi Guan; Joseph S M Peiris
Journal:  Clin Chem       Date:  2004-03-30       Impact factor: 8.327

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  6 in total

1.  Three isothermal amplification techniques for rapid identification of Cladophialophora carrionii, an agent of human chromoblastomycosis.

Authors:  Shuwen Deng; G Sybren de Hoog; Weihua Pan; Min Chen; A H G Gerrits van den Ende; Liyue Yang; Jiufeng Sun; Mohammad Javad Najafzadeh; Wanqing Liao; Ruoyu Li
Journal:  J Clin Microbiol       Date:  2014-07-09       Impact factor: 5.948

2.  Development of a loop-mediated isothermal amplification method for detection of Histoplasma capsulatum DNA in clinical samples.

Authors:  Christina M Scheel; Yitian Zhou; Raquel C Theodoro; Bethany Abrams; S Arunmozhi Balajee; Anastasia P Litvintseva
Journal:  J Clin Microbiol       Date:  2013-11-27       Impact factor: 5.948

3.  Molecular techniques for pathogen identification and fungus detection in the environment.

Authors:  Clement K M Tsui; James Woodhall; Wen Chen; C André Lévesque; Anna Lau; Cor D Schoen; Christiane Baschien; Mohammad J Najafzadeh; G Sybren de Hoog
Journal:  IMA Fungus       Date:  2011-11-18       Impact factor: 3.515

Review 4.  Accuracy of rapid diagnosis of Talaromyces marneffei: A systematic review and meta-analysis.

Authors:  Chuanyi Ning; Jingzhen Lai; Wudi Wei; Bo Zhou; Jiegang Huang; Junjun Jiang; Bingyu Liang; Yanyan Liao; Ning Zang; Cunwei Cao; Hui Chen; Li Ye; Hao Liang
Journal:  PLoS One       Date:  2018-04-05       Impact factor: 3.240

5.  Detection of Talaromyces marneffei from Fresh Tissue of an Inhalational Murine Pulmonary Model Using Nested PCR.

Authors:  Yinghui Liu; Xiaowen Huang; Xiuwen Yi; Ya He; Eleftherios Mylonakis; Liyan Xi
Journal:  PLoS One       Date:  2016-02-17       Impact factor: 3.240

6.  Detection of influenza viruses by coupling multiplex reverse-transcription loop-mediated isothermal amplification with cascade invasive reaction using nanoparticles as a sensor.

Authors:  Yiyue Ge; Qiang Zhou; Kangchen Zhao; Ying Chi; Bin Liu; Xiaoyan Min; Zhiyang Shi; Bingjie Zou; Lunbiao Cui
Journal:  Int J Nanomedicine       Date:  2017-04-03
  6 in total

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