Evaluation of SARS-CoV-2 RNA quantification by RT-LAMP compared to RT-qPCR.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a global pandemic caused by a novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The viral load of SARS-CoV-2 is associated with mortality in COVID-19 patients. Measurement of viral load requires the use of reverse transcription quantitative PCR (RT-qPCR), which in turn requires advanced equipment and techniques. In this study, we aimed to evaluate the viral load measurement using reverse transcription loop-mediated isothermal amplification (RT-LAMP), which is a simpler procedure compared to RT-qPCR. MATERIALS AND METHODS: RNA was extracted by using the QIAamp Viral RNA Mini Kit. The RT-LAMP assay was performed by using the Loopamp® 2019-SARS-CoV-2 detection reagent kit and 10-fold serial dilutions of known viral load RT-LAMP were used to measure Tt, which is the time until the turbidity exceeds the threshold. Based on the relationship between viral load and Tt, the linearity and detection sensitivity of the calibration curve were evaluated. In addition, 117 clinical specimens were measured, and RT-qPCR and RT-LAMP assay results were compared. RESULTS: The dilution linearity of the calibration curve was maintained at five orders of magnitude 1.0× 106 to 1.0 × 101 copies/µL, and was confirmed to be detectable down to 1.0 × 100 copies/µL. The limit of quantification of RNA extracted from clinical specimens using RT-LAMP correlated well with that obtained using RT-qPCR (r2 = 0.930). CONCLUSION: The findings indicate that RT-LAMP is an effective method to determine the viral load of SARS-CoV-2.

Periocular injection of candesartan-PLGA microparticles inhibits laser-induced experimental choroidal neovascularization.

PURPOSE: Microparticle technology enables local administration of medication. The purpose of this study was to examine the inhibitory effect of locally administered candesartan (CAN)-encapsulated microparticles on experimental choroidal neovascularization (CNV). METHODS: Laser photocoagulation was used to induce CNV in Brown Norway rats. The rats were pretreated with subconjunctival injections of CAN (5.0 mg/eye) or phosphate buffer saline for 3 days before photocoagulation. The volume of CNV was evaluated 7 days after laser injury using the lectin staining technique. The infiltration of macrophages within the CNV lesion was determined using immunofluorescent staining with an anti-CD68 antibody. mRNA levels of MCP-1, IL1-ß and VEGF in the retinal pigment epithelium/choroid complex were determined using quantitative PCR (q-PCR). RESULTS: CNV volume was significantly suppressed by the treatment with CAN compared with that in vehicle-treated eyes (P<0.05, two-tailed Student's t-test). Subconjunctival injections of CAN decreased the numbers of CD68+ cells in the CNV lesion. The increased mRNA levels of MCP-1, IL1-ß, and VEGF induced by photocoagulation was significantly suppressed following the local administration of CAN (P<0.05, two-tailed Student's t-test). CONCLUSION: Local administration of CAN inhibited experimentally induced CNV possibly through anti-inflammatory effects.

Multi-imaging of Cytokinin and Abscisic Acid on the Roots of Rice (Oryza sativa) Using Matrix-Assisted Laser Desorption/Ionization Mass Spectrometry.

Plant hormones act as important signaling molecules that regulate responses to abiotic stress as well as plant growth and development. Because their concentrations of hormones control the physiological responses in the target tissue, it is important to know the distributions and concentrations in the tissues. However, it is difficult to determine the hormone concentration on the plant tissue as a result of the limitations of conventional methods. Here, we report the first multi-imaging of two plant hormones, one of cytokinin [i.e., trans-zeatin (tZ)] and abscisic acid (ABA) using a new technology, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) imaging. Protonated signals of tZ (m/z 220.1) and ABA (m/z 265.3) were chosen on longitudinal sections of rice roots for MS imaging. tZ was broadly distributed about 40 mm behind the root apex but was barely detectable at the apex, whereas ABA was mainly detected at the root apex. Multi-imaging using MALDI-TOF-MS enabled the visualization of the localization and quantification of plant hormones. Thus, this tool is applicable to a wide range of plant species growing under various environmental conditions.

[Upcoming Challenges of Next-Generation Clinical Laboratory Tests with Mass Spectrometric Technique -Chairman's Introductory Remarks -].

Many medical researchers and technologists have measured proteins, hormones, lipids, carbohydrates, and nucleotides in body fluids using conventional analytical techniques. After the 1990s, -omics devices includ- ing soft ionization mass spectrometry produced by Prof. John B Fenn and Dr. Koichi Tanaka en'abled us to more easily detect and identify new bioactive molecules in body fluids for the rapid and differential diagnosis of diseases. Especially, the MS techniques are leading to new breakthroughs in the fields of microorganism identification and pathological diagnosis. In this symposium, upcoming challenges of the modern MS techniques, such as electrospray ionization- and matrix-assisted laser desorption ionization-MS, in clinical tests for discovering biomarkers are being presented for the rapid diagnoses of infectious diseases and amyloidosis, and rapid detections of hormones and lipids in clinical samples by 4 speakers. [Review].

[Rapid Identification of Infectious Microorganisms in Clinical Samples by MALDI-TOF MS Analysis].

Matrix-laser desorption ionization time-of flight/mass spectrometry (MALDI-TOF MS) is a powerful tool for the detection of target molecules in body fluids. Recently, the MALDI-TOF MS technique was applied for the rapid detection of protein profiles in cultured strains, and has rapid, simple, and universal advantages over the conventional technique. MALDI mass patterns were compared with the unique ribosomal 16S protein profiles of standard microorganism strains in a commercial database. Although this present MS technique has already been adopted as a routine method for the identification of general bacteria in the clinical laboratory field, there are still many problems to overcome regarding current challenges, necessitating the identification of more valuable species of microorganism. As the first step, we have begun the standardization of sample preparation to identify species causing infectious diseases by MALDI-TOF MS. In this special issue, we summarize the challenges in the modified preparation of clinical samples, such as blood, urine, and sputum, in our laboratory to rapidly diagnose severe infectious disease, and describe the current trends in clinical microbiology.

Time-course mass spectrometry imaging for depicting drug incorporation into hair.

In order to investigate the incorporation of drugs into hair, matrix-assisted laser desorption/ionization-time-of-flight tandem mass spectrometry (MS/MS) imaging was performed on the longitudinal sections of single scalp hair shafts sampled from volunteers after a single oral administration of methoxyphenamine (MOP), a noncontrolled analogue of methamphetamine. Hair specimens were collected by plucking out with the roots intact, and these specimens were prepped by an optimized procedure based on freeze-sectioning to detect the drug inside the hair shaft and hair root. Time-course changes in the imaging results, with confirmatory quantitative liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis for each 1-mm segment of single hair strands, revealed a substantial concentration of the drug first onto the hair bulbs after ingestion, while only a small portion appeared to be incorporated into the hair matrix, forming a 2-3 mm distinctive drug band with tailing. Comparable amount of the drug also appeared to be incorporated into the keratinized hair shaft in the upper dermis zone, forming another distinct drug band of about 2 mm, which both moved toward the distal side, following the strand's growth rate. These findings provide forensically crucial information: there are two major drug incorporation sites, at least for MOP, which cause overlap of the recordings and deteriorates its chronological resolution down to about 11 days or perhaps longer.

Lung Nocardia elegans infection diagnosed on matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS).

A 73-year-old man with adultonset Still's disease developed a high fever, coughing, dyspnea and bloody sputum and was therefore admitted to our hospital. Thoracic X-ray and CT scans revealed oval lesions in the bilateral lungs. A bacterial isolate from the sputum was identified to be Nocardia elegans (N. elegans) on comparative 16S rRNA gene sequencing and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS). The patient recovered following treatment with imipenem/cilastatin and amikacin. To the best of our knowledge, this is the first case of nocardiosis caused by N. elegans identified on MALDI-TOF MS.

Quantitative mass barcode-like image of nicotine in single longitudinally sliced hair sections from long-term smokers by matrix-assisted laser desorption time-of-flight mass spectrometry imaging.

The matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometric technique (IMS) offered a new breakthrough perspective in the analysis of drug abuse in forensic science; however, it only produced barcode-like images, semi-quantitative analysis. In order to develop intermittent monitoring by this IMS for forensic and medical sciences, it is important to quantitatively measure the contents of longitudinally sliced hair sections. We developed quantitative imaging mass spectrometry (QIMS) of nicotine (NC) in longitudinally sliced hairs by MALDI-IMS with the selected reaction monitoring mode using a labeled NC ((13)C3-NC) standard for the serially chronological monitoring and traceability of NC intake in heavy smokers. The calibration curve of NC/(13)C3-NC was virtually a linear equation at ranges from 1 to 50 ng/mL, the slope was 0.020, and the intercept was almost 0.023 and the R(2) was 0.9965. The limit of quantitation of NC was calculated as 1.6 ng/mg hair (an average weight of the hair would be assumed 0.06 mg/cm) by QIMS. Moreover, NC concentrations in two separate heavy smokers (n = 3) were 8.5 ± 1.2 and 34.5 ± 2.8 ng/mg hair, respectively, and covariations were ∼10% using a single hair. Quantitative mass barcode-like image of sliced section of hair allowed for the quantitative assessment of NC concentrations in long-term smokers similar to drugs and medicines during drug histories.

Significance of the vascular concentration of angiotensin II-receptor blockers on the mechanism of lowering blood pressure in spontaneously hypertensive rats.

To clarify the hypotensive mechanism of angiotensin II receptor-blockers (ARBs), drug concentrations in plasma and vascular tissues were measured using matrix-assisted laser desorption ionization time-of-flight mass spectrometry and imaging mass spectrometry. In spontaneously hypertensive rats, systolic blood pressure (SBP) was measured 2 and 24 h after administration of candesartan cilexetil (0.3, 1, or 3 mg/kg) or azilsartan (0.3, 1, or 3 mg/kg). SBP was similarly lowered 2 h after administration of azilsartan or candesartan cilexetil, but it was significantly lower in the azilsartan-treated group than in the candesartan cilexetil-treated group at 24 h. Angiotensin II-induced vascular contractions were similarly attenuated 2 h after administration of these drugs, and the contractions were significantly lower in the azilsartan-treated group at 24 h. Although plasma concentration was significantly lower in the azilsartan-treated group at 24 h, vascular concentration of azilsartan was significantly greater than that of candesartan. Significant correlations between SBP and vascular concentrations were observed both at 2 and 24 h, while no significant correlation was observed between plasma and vascular concentrations. In conclusion, the mechanism of ARB-induced hypotension is likely to depend on vascular concentrations rather than plasma concentrations.

Topologies of amyloidogenic proteins in Congo red-positive sliced sections of formalin-fixed paraffin embedded tissues by MALDI-MS imaging coupled with on-tissue tryptic digestion.

OBJECTIVES: Matrix-assisted laser desorption time-of flight ionization (MALDI)-imaging MS (IMS) with MSMS analysis using on-tissue tryptic digests is a powerful tool for identification of disease-related proteins in formalin-fixed paraffin-embedded (FFPE) tissue sections. We applied this novel IMS technique, not only to identify tryptic peptides of deposited amyloidogenic proteins but also to clarify topologies of these proteins in amyloidosis tissue sections. METHODS: Sequence determinations of tryptic peptides derived from amyloidogenic proteins were performed using MALDI-MSMS analysis directly from Congo red positive regions in tissue sections with/without procedure for retrieval of epitopes before on-tissue digestion. RESULTS: Tryptic peptides, m/z=1073.5 and 1924.3 were identified with the sequences, from 48th to 56th and 1st to 19th positions of Ig lambda V-III region, respectively. Other peptides, m/z=1365.5 and 1523.5 were with the sequences, from 22nd to 34th and 36th to 48th positions of TTR, respectively. Heat-map images of all four tryptic peptides were overlapped with Congo red positive regions. Immunohistochemistry of FFPE tissue sections was confirmed to only react with anti-λ chain antibody in a case of AL-type amyloidosis or anti-TTR antibody in two cases of TTR-type amyloidosis. CONCLUSION: IMS with MSMS analysis using on-tissue tryptic digestion enables us not only to identify amyloidogenic molecule in a sliced tissue section but also to play a complementary role with the conventional pathological examination.

Quantification of Candesartan in Mouse Plasma by MALDI-TOFMS and in Tissue Sections by MALDI-Imaging Using the Stable-Isotope Dilution Technique.

To determine the contents of candesartan in mouse plasma, and blood vessel and kidney sliced sections and also better understand its pharmacokinetics, we applied matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS) and MALDI-imaging mass spectrometry (IMS) with the selected reaction monitoring (SRM) mode using a labeled-internal standard. The results of fundamental examinations showed that the slope of the resulting curves of candesartan in the plasma from the equation was 0.91 and the y-intercept was 0.02. Both intra- and inter-day accuracies (n=10) and the precision of candesartan in the plasma by MALDI-TOFMS with the SRM mode were in the range of 3.4 to 17.3% and 93.2%, respectively. The detection limit of candesartan in spiked plasma was 0.2 nmol/L. IMS analysis enabled us to clarify distinct spacial time-distribution images in sliced mouse blood vessel and kidney sections although it still needed to improve a protocol of quantification. Typical pharmacokinetic patterns of candesartan were obtained in the plasma and sliced kidney sections, but those in the blood vessel sections gradually increased 24 h after administration. MALDI-TOFMS and IMS with the SRM mode are powerful tools to identify the spacial distribution and traceability of candesartan in sliced blood vessel and tissue sections as well as in the plasma.

[Clinical applications of MALDI imaging using sliced sections of formalin-fixed paraffin-embedded tissues and longitudinal sliced hairs].

MALDI-imaging MS (IMS) with MSMS analysis is a new powerful tool for the identification of not only disease-related proteins in formalin-fixed paraffin-embedded (FFPE) tissue sections but also protein/peptides/drugs/medicine in fresh-frozen tissues. IMS is used to reveal the mass profiles and spatial distribution of proteins in tissue sections and/or digested peptides derived from deposited protein in pathologic organs and then MSMS analysis identifies the amino acid sequence of the detected proteins in the tissue section. Moreover, on-tissue digestion combined with the MALDI-IM-TOF-IMS approach allows a proteomics "bottom-up" strategy with clinical samples, especially perioperative isolated tissues and FFPE tissues conserved for a long time in a clinical sample bank. The mass barcode-like image (MBI) on a longitudinal sliced hair by IMS is used in the selected reaction monitoring mode for serially chronological monitoring and traceability every few hours after drug and medicine intake. The advances of quantitative MBI for sliced sections of hair allow a new universal standardized assessment of drugs and medicines throughout the drug history.

MALDI-TOF and MALDI-FTICR imaging mass spectrometry of methamphetamine incorporated into hair.

A new approach is described for imaging mass spectrometry (IMS) of methamphetamine (MA) incorporated into human hair using matrix-assisted laser desorption/ionization (MALDI)-time-of-flight (TOF) and MALDI-Fourier transform ion cyclotron resonance (FTICR). A longitudinal section of a lengthwise manually-cut single human hair shaft from a chronic MA user was directly analyzed by MALDI-TOF-IMS after deposited with α-Cyano-4-hydroxycinnamic acid matrix. A barcode-like image, which was most probably generated with repeated intakes of MA, was for the first time obtained by monitoring MA-specific product ion in the selected reaction monitoring mode. Laser beam scan lengthwise-cut hair shafts gave only poor mass spectra of MA, probably due to the loss of MA and/or the thermal denaturation of hair. The identity of MA detected in hair was further confirmed by MALDI-FTICR mass spectrometry. A combination with ultra-high resolution mass spectrometry by FTICR provided indisputable identification of MA. The MALDI-FTICR-IMS of another hair shaft from the same MA user also provided a barcode-like image by monitoring the protonated molecule of MA with ultra-high resolution. The two barcode-like images exhibited a close resemblance. Thus, MALDI-IMS can offer a new perspective: 'imaging hair analyses for drugs'.

Identification of Autoantibodies for α and γ-Enolase in Serum from a Patient with Melanoma.

Melanoma is one of lethal malignant skin tumors and the sole effective cure for the disease can be achieved by surgical resection of primary tumor and early diagnosis for melanoma is crucial for patients' prognosis. Detection of novel tumor-related antibodies would aid in the diagnosis of early-stage cancer, in the detection of recurrence and in the development of a more effective immunotherapy. In the middle of the exploration of a candidate of biomarker for melanoma by proteomics-base technique, we encountered the coexistence of autoantibodies for α-enolase and γ-enolase in serum derived from a patient with melanoma, who had received the repeated treatments with alkylating agents and interferon ß. Although melanoma is known to be a highly antigenic tumor, it is still unclear why these autoantibodies appeared. To evaluate the usefulness in detecting the circulating α-enolase or γ-enolase autoantibodies in serum from melanoma patients for biomarkers for tumor progression, more studies are needed.

[Proteomic analysis of changes in the serum protein profile by anti-TNF-alpha therapy].

We analyzed the alternation in serum protein by infliximab therapy using proteomics-based technique. More than 50 gel spots were seen to increase or decrease in correlation with clinical improvements of rheumatoid arthritis (RA). Spots of interest were identified by two dimensional electrophoresis and mass spectrometry. Infliximab therapy reduced the inflammatory proteins such as C-reactive protein, serum amyloid protein A, serum amyloid protein P, and alpha1-acid glycoprotein, while the therapy increased Apo A-I, retinol-binding protein, vitamin D-binding protein, and gelsolin. This suggested that infliximab therapy shifted the inflammatory status of serum protein profile of RA patients to normal and modified the extracellular actin-scavenging system as well as vitamin and lipid profile.

S-sulfonation of transthyretin is an important trigger step in the formation of transthyretin-related amyloid fibril.

Senile systemic amyloidosis and familial amyloid polyneuropathy are caused by oxidative deposition of conformationally altered transthyretin (TTR). We identified oxidative modification of the 10th cysteine of TTR through S-sulfonation in vitro. Based on mass spectrometric analysis, we determined the spectrophotometric, western blotting, and fluorescent microscopic properties of TTR incubated with and without cysteine-S-sulfonate in acidic (pH 4) and alkaline (pH 8) conditions at 37 degrees. The absorption of the aggregated TTR molecules increased more with incubation time and the concentration of cysteine-S-sulfonate at pH 4 than at pH 8. The Congo red binding to the S-sulfonated TTR at pH 4 was saturated with an apparent Bmax of 2.01 mol per mole of the S-sulfonated TTR and apparent KD of 7.75x10(-6) M. On the other hand, the Bmax of cysteinyl TTR was 1.38, and its KD was 3.52x10(-6) M while the Bmax of reduced TTR was 0.86, and its KD was 2.86x10(-6) M. Moreover, we detected positive amyloid fibril staining using Thioflavin T and Congo red with the S-sulfonated TTR but not with untreated or reduced TTR by microscopic fluorescent analysis. After modification of TTR in vitro, oligomers resisted reduction and denaturation was irreversibly induced, and which contributed differences in the Western blotting patterns obtained with four anti-TTR antibodies. In conclusion, this study showed that the formation of S-sulfonation of TTR through oxidative modifications of the thiol residue on the 10th cysteine of TTR is an important trigger step in the formation of transthyretin-related amyloid fibril.

Proteomics-based identification of a tumor-associated antigen and its corresponding autoantibody in gastric cancer.

Identification of novel tumor-related antigens and autoantibodies will lead to early diagnosis of cancer and the development of more effective immunotherapies. The purpose of this study was to identify novel tumor antigens from the gastric cancer cell lines MkN-1, MkN-45 and KATOIII, and their related autoantibodies in sera of patients with gastric cancer using a proteomics-based approach. Proteins from the gastric cancer cell lines (MkN-1, MkN-45 and KATOIII) were separated by two-dimensional polyacrylamide gel electrophoresis, followed by Western blotting and antibody reaction with sera from patients with gastric cancer, healthy individuals and patients with other cancers. Positive spots were excised from Coomassie blue stained gels and analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/TOF MS). Sera from patients with gastric cancer yielded multiple spots, one of which was identified as the 78 kDa glucose-regulated protein (GRP78) by MALDI-TOF/TOF MS. Western blots against recombinant GRP78 showed reactivity in sera from 17/60 (28.3%) patients with gastric cancer and 0/20 (0.0%) of healthy individuals. Autoantibodies against GRP78 were found in 4/15 (26.7%) and 3/15 (20.0%) patients with esophageal and colon cancer, respectively. We identified for the first time an autoantibody against GRP78 in gastric cancer patients. The proteomic approach implemented in this study offers a powerful tool for identifying novel serum markers that may display clinical usefulness in cancer.

[Oxidative precipitation of transthyretin--a clue to elucidate amyloidosis].

Common precipitation of amyloid proteins occurs in amyloidosis such as dementia and prion diseases. The precipitates are characteristically stained with congo red, although it is not yet known why this occurs. We have found a kind of amyloid protein, transthyretin(TTR), that is S-sulfonated at the residue of cysteine in blood from patients with deficiency of molybdenum cofactor, which is essential to sulfite oxidase. The S-sulfonated TTR was easily stained with congo red, whereas TTR itself was not. Further, the S-sulfonated TTR slowly made fibrils from precipitates, which is well known as a common characteristic in amyloidosis. It seemed an important clue that S-sulfonation is as the starting reaction to induce the precipitation of the protein. We have studied reaction products from TTR and its synthetic octapeptide around the cysteine residue under moderate conditions by mass-spectrometry and estimated the reaction mechanism. Another clue is chinoform(or, clioquinol), which is effective for patients with dementia. The mechanism was assumed that metal ions such as copper and iron involved in oxidative precipitation of the proteins were masked with chinoform. In 1970, Yoshioka, one of the authors, found that in green urine from a patient with SMON disease was identified a chelate compound of chinoform with ferric ion. This finding led to the resolution of SMON disease caused by excess dose of chinoform. In this review, we discuss amyloidosis related with SMON disease.