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Journal of Clinical Microbiology, June 2003, p. 2734-2736, Vol. 41, No. 6
0095-1137/03/$08.00+0 DOI: 10.1128/JCM.41.6.2734-2736.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Division of Molecular and Cellular Biology, Department of Clinical Veterinary Science, University of Bristol, Langford, Bristol BS40 5DU, United Kingdom
Received 1 March 2002/ Accepted 1 November 2002
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We have previously reported the detection of C. felis by real-time PCR using a molecular beacon (3). This type of assay has considerable advantages over conventional nested PCR for the detection of pathogens. Importantly, the reaction is performed in a sealed tube, which dramatically reduces the risk of amplicon carryover and, hence, the chance of false-positive results. Also, the starting copy number can easily and accurately be quantified, allowing the efficacy of treatment regimens to be determined.
In this paper, we report the use of three-way real-time multiplex PCR to simultaneously detect C. felis, FHV, and feline 28S ribosomal DNA (rDNA). By detecting both pathogens in the same tube at the same time, the assay is fast and efficient and allows a rapid throughput of samples.
Sequence data for the feline 28S rDNA gene were obtained using conserved primers from human, rat, and mouse 28S rDNA gene sequences and deposited in the GenBank database under the accession number AF353617. This sequence was used to design real-time PCR primers and probe.
Real-time PCR primers and probes were designed using MacVector 6.5 (Oxford Molecular, Oxford, United Kingdom) (Table 1). Molecular beacons and fluorescently quenched (FQ) probes were designed to have annealing temperatures 10°C higher than those of their primer pairs. The mfold program (http://bioinfo.math.rpi.edu/
mfold/dna/) was used to ensure that minimal secondary structure formed in the region of the primers or probe at the annealing temperature. This program was also used to calculate the melting temperature of the stem-loop in the molecular beacon and to ensure that the fluorophore and quencher were adjacent in the folded beacon.
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TABLE 1. PCR primers and probes used in the multiplex real-time PCR assay
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Real-time PCR was performed using an iCycler (Bio-Rad Laboratories Ltd., Hemel Hempstead, United Kingdom) with optical upgrade system. The PCR mixture consisted of 12.5 µl of Platinum Q PCR SuperMix-UDG (Life Technologies Ltd.), 150 nM each of the 28S rDNA forward and reverse primers (see Table 1 for primer and probe sequences), 100 nM each of the FHV forward and reverse primers, 100 nM each of the C. felis forward and reverse primers, 200 nM 28S rDNA molecular beacon, 100 nM herpesvirus FQ probe, 100 nM C. felis FQ probe, 6 mM MgCl2, 1.25 U of Platinum Taq DNA polymerase (Life Technologies Ltd.) (to give 2 U of Taq per 25-µl reaction mixture), 5 µl of genomic DNA, and water to 25 µl. After an initial incubation at 50°C for 3 min to allow uracil DNA glycosylase (UDG) to digest any amplicon carryover and a subsequent incubation at 95°C for 2 min to inactivate the UDG and activate the Platinum Taq, 45 cycles of PCR, with 1 cycle consisting of 10 s at 95°C and 30 s at 60°C, were performed. Fluorescence was detected at 530-, 575-, and 620-nm wavelengths at each annealing step (60°C). All reactions were run in triplicate.
Reproducible results were obtained only when the concentration of Taq DNA polymerase was increased from 0.75 to 2 U and the MgCl2 concentration was increased from 3 to 6 mM per multiplex reaction mixture. It was also found that titration of the primer concentrations was essential to limit PCR product formation from the FHV assay, which was very efficient.
Figure 1 shows the linearity and reproducibility of the three-way multiplex real-time PCR assay. It can be seen that the linearity ranges from 103 for the 28S rDNA PCR to 106 for the herpesvirus PCR. This difference is due to the starting copy number, since the threshold cycle (Ct) values for the undiluted sample were 13.4 for the herpesvirus PCR and 28.8 for the 28S rDNA PCR, indicating that there was considerably more FHV template than feline genomic DNA in the initial sample. The correlation coefficient ranges from 0.996 to 1.000, indicating that the assays are highly reproducible. The slope of each line indicates the efficiency of the reaction, giving efficiencies of 102% for FHV, 92% for C. felis, and 85% for 28S rDNA. These efficiencies are acceptable for quantifying differences of the order of magnitude. The formation of primer dimers or the secondary structures of the PCR products, which were not predicted by the mfold program, are possible factors that could affect efficiency.
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FIG. 1. Dilution curves for each component of the three-way PCR. Genomic DNA was isolated from a mixture of FHV-infected feline cells and C. felis and was serially diluted in 10-fold steps. After multiplex PCR, the threshold cycle was plotted against the log10 of the dilution. Dilution curves for FHV (a), C. felis (b), and feline 28S rDNA (c) are shown. Each point represents the average ± standard deviation for three PCRs.
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Of 538 ocular swab samples submitted over a 4-month period to the Diagnostic Service, University of Bristol, Langford, Bristol, United Kingdom, 123 were positive for FHV, 97 were positive for C. felis, and 16 were positive for both FHV and C. felis using the real-time PCR assay described in this paper. In a parallel study comparing FHV isolation and real-time PCR, 11 samples were found to be positive by virus isolation, while 58 were positive by real-time PCR, including the 11 positive by virus isolation. All samples negative by real-time PCR were negative by virus isolation. Overall, the Ct values of the samples where FHV was isolated were significantly lower (P < 0.0001) than the Ct values of samples where virus could not be isolated, indicating that the real-time PCR assay is more sensitive than virus isolation. No such comparison could be done for C. felis, since isolation was never undertaken on the samples used for real-time PCR. We have, however, tested six C. felis field isolates grown in tissue culture using the multiplex PCR, and all were positive.
Of 538 samples, 9 were negative for 28S rDNA by the real-time PCR assay. Of these nine samples, four showed a signal for either FHV or C. felis, although the Ct value was always greater than 35. One possible explanation is that some samples contained very low numbers of feline cells and therefore little 28S rDNA but also contained measurable numbers of pathogen. This could arise from the swabbing technique used to take the sample. Additionally, the less-than-optimal efficiency of the 28S rDNA assay may reduce its sensitivity. Overall, only 1.67% of samples in this study showed no 28S rDNA signal. It is suggested that in such cases, new samples should be taken from the cats for diagnostic testing to reduce the number of false-negative results for the pathogens being tested.
The inclusion of 28S rDNA as an internal control in the multiplex real-time PCR assay enables samples containing different amounts of DNA to be normalized to allow quantification. This allows direct comparison between pre- and posttreatment samples to allow measurement of treatment efficacy.
Other multiplex PCR assays have been reported for FHV, C. felis, and feline calicivirus, but these methods rely on conventional PCR (8), which does not enable accurate quantification of starting template and is time-consuming because of the need to run PCR products on gels. The use of hybridization probes increases specificity, since they will not bind to nonspecific PCR product. The inclusion of the 28S rDNA positive control ensures that samples negative for FHV or C. felis are truly negative by confirming that amplifiable DNA was present on the swab sample. The assay is fast and efficient, allowing 96 samples to undergo three-way real-time PCR within 90 min. This type of assay is especially suited to epidemiological studies, as it allows large numbers of samples to be assayed quickly at a relatively low cost and with minimum hands-on time.
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