Journal of Microbiology and Biotechnology

The Korean Society for Microbiology and Biotechnology (한국미생물·생명공학회)
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Development of Enzymatic Recombinase Amplification Assays for the Rapid Visual Detection of HPV16/18

  • Ning Ding (Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital) ;
  • Wanwan Qi (Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital) ;
  • Zihan Wu (Centre for Diseases Prevention and Control of Eastern Theater) ;
  • Yaqin Zhang (Department of Infectious Disease, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital) ;
  • Ruowei Xu (Centre for Diseases Prevention and Control of Eastern Theater) ;
  • Qiannan Lin (Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University) ;
  • Jin Zhu (Centre for Diseases Prevention and Control of Eastern Theater) ;
  • Huilin Zhang (Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital)
  • Received : 2023.04.16
  • Accepted : 2023.05.11
  • Published : 2023.08.28
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Abstract

Human papillomavirus (HPV) types 16 and 18 are the major causes of cervical lesions and are associated with 71% of cervical cancer cases globally. However, public health infrastructures to support cervical cancer screening may be unavailable to women in low-resource areas. Therefore, sensitive, convenient, and cost-efficient diagnostic methods are required for the detection of HPV16/18. Here, we designed two novel methods, real-time ERA and ERA-LFD, based on enzymatic recombinase amplification (ERA) for quick point-of-care identification of the HPV E6/E7 genes. The entire detection process could be completed within 25 min at a constant low temperature (35-43℃), and the results of the combined methods could be present as the amplification curves or the bands presented on dipsticks and directly interpreted with the naked eye. The ERA assays evaluated using standard plasmids carrying the E6/E7 genes and clinical samples exhibited excellent specificity, as no cross-reaction with other common HPV types was observed. The detection limits of our ERA assays were 100 and 101 copies/µl for HPV16 and 18 respectively, which were comparable to those of the real-time PCR assay. Assessment of the clinical performance of the ERA assays using 114 cervical tissue samples demonstrated that they are highly consistent with real-time PCR, the gold standard for HPV detection. This study demonstrated that ERA-based assays possess excellent sensitivity, specificity, and repeatability for HPV16 and HPV18 detection with great potential to become robust diagnostic tools in local hospitals and field studies.

Keywords

Acknowledgement

This study is supported by the grants from the Jiangsu Provincial Medical Youth Talent (QNRC2016104, QNRC2016535) and the Science and Technology Support Program of Jiangsu Province (BE2018613).

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