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Background: In real-time PCR assays, the most accurate way to identify false-negative results, e.g., those caused by PCR inhibitors, is to add to samples an internal control that will be coamplified with the target (e.g., pathogen) DNA. Current internal control procedures, however, which usually involve the introduction of a DNA fragment, are complex, time-consuming, and expensive.
Methods: Single-stranded oligonucleotides, which contain little more than primer and probe binding sites, were used as internal controls in real-time PCR assays. Mismatches were included in the probe-binding region of the internal control oligonucleotide (ICO) to prevent probe-control hybridization during the fluorescence acquisition step of the PCR. Amplified ICOs were detected by melting point analysis. ICOs could be added directly to the sample material before DNA extraction.
Results: To demonstrate the feasibility of the new approach, we designed ICOs for the LightCycler hybridization probe assays for Mycobacterium tuberculosis complex, hepatitis B virus, herpes simplex virus, and varicella zoster virus. In each case, the controls did not interfere with detection of the pathogen, but were clearly detectable during a subsequent melting point analysis.
Conclusions: A single-stranded oligonucleotide that mimics the target region of the pathogen but is clearly distinguishable from the target during melting point analysis can serve as a simple, cost-effective internal control for real-time amplification assays. Such control oligonucleotides are easy to design and inexpensive. A costly second probe system is not necessary. Moreover, the internally controlled assay uses only one fluorescence detection channel of the instrument, leaving the second channel free for multiplex applications.
© 2004 American Association for Clinical Chemistry
Real-time nucleic acid amplification is a convenient, fast, and safe way to detect pathogens. Such techniques have replaced traditional amplification methods in many clinical settings. However, just like other amplification methods, real-time amplification must be able to differentiate a true negative result from a false negative caused by amplification inhibitors.
This is an important assay requirement because there are many potential sources of amplification inhibition. For example, if they are not removed during nucleic acid purification, many substances present in clinical samples (e.g., hemoglobin) can inhibit amplification (1, 2). In addition, certain compounds used to extract nucleic acids from sample material, e.g., ethanol or detergents such as sodium dodecyl sulfate, are potent amplification inhibitors.
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