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| <h1 id="IntroVaccine">Preface</h1> | | <h1 id="IntroVaccine">Preface</h1> |
| <h3>How Neoantigen-based Cancer Immunotherapy Works</h3> | | <h3>How Neoantigen-based Cancer Immunotherapy Works</h3> |
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| <p class="lead">Cells become cancerous because of changes in their genetic makeup. These same changes can result in proteins that are differentially expressed on the cancerous cells but not human cells. These are called <i>neoantigens</i>, and refer to new cancer antigens that can signal the immune system to attack the cancer and eliminate it.</p> | | <p class="lead">Cells become cancerous because of changes in their genetic makeup. These same changes can result in proteins that are differentially expressed on the cancerous cells but not human cells. These are called <i>neoantigens</i>, and refer to new cancer antigens that can signal the immune system to attack the cancer and eliminate it.</p> |
| <p class="lead">A patient is diagnosed with a cancer tumor. A biopsy of the tumor and a biopsy of healthy tissue are acquired to perform whole exome sequencing on both biopsies. A bioinformatic tool (such as CAPOEIRA’s <a href="https://2018.igem.org/Team:EPFL/Software"><span style="color:blue">Ginga</span></a>) processes the whole exome sequences of both the healthy and tumor biopsies used to identify neoantigens. | | <p class="lead">A patient is diagnosed with a cancer tumor. A biopsy of the tumor and a biopsy of healthy tissue are acquired to perform whole exome sequencing on both biopsies. A bioinformatic tool (such as CAPOEIRA’s <a href="https://2018.igem.org/Team:EPFL/Software"><span style="color:blue">Ginga</span></a>) processes the whole exome sequences of both the healthy and tumor biopsies used to identify neoantigens. |
− | A specific neoantigen that is differentially expressed on tumor cells and not healthy cells is supplied to the patient through a vaccine formulation. Dendritic cells of the patient uptake the neoantigen from the vaccine formulation. Alongside the neoantigen, the vaccine formulation supplies an adjuvant that activates the dendritic cell to uptake foreign material, and perceive them as danger signals.</p> | + | A specific neoantigen that is differentially expressed on tumor cells and not healthy cells is supplied to the patient through a vaccine formulation. Dendritic cells of the patient uptake the neoantigen from the vaccine formulation. Alongside the neoantigen, the vaccine formulation supplies an adjuvant that activates the dendritic cell to uptake foreign material, and perceive them as danger signals.</p> |
| <p class="lead">The dendritic cell then processes the neoantigen and cross-presents it on MHC-1 complexes on its surface, where naïve CD8+ T cells can recognize it. Once the naïve CD8+ cells recognize the neoantigen, they mature into cytotoxic CD8+ T cells that specifically attack cells expressing this neoantigen; in this case, the tumor cells.</p> | | <p class="lead">The dendritic cell then processes the neoantigen and cross-presents it on MHC-1 complexes on its surface, where naïve CD8+ T cells can recognize it. Once the naïve CD8+ cells recognize the neoantigen, they mature into cytotoxic CD8+ T cells that specifically attack cells expressing this neoantigen; in this case, the tumor cells.</p> |
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| <h3>Rising Importance of Cancer Vaccination</h3> | | <h3>Rising Importance of Cancer Vaccination</h3> |
| <p class="lead">The immunogenicity of neoantigens leading to T-cell activation has long been demonstrated in patients (<a href="#Wolfel1995"><span style="color:blue">Wolfel <i>et al.</i>, 1995</span></a>). In fact, preclinical and clinical data has already shown that neoantigen specific cytotoxic T lymphocytes (CTLs) constitute the most potent T-cell populations for tumor rejection (<a href="#Wolfel1995"><span style="color:blue">Wolfel <i>et al.</i>, 1995</span></a>; <a href="#Matsushita2012"><span style="color:blue">Matsushita <i>et al.</i>, 2012</span></a>). | | <p class="lead">The immunogenicity of neoantigens leading to T-cell activation has long been demonstrated in patients (<a href="#Wolfel1995"><span style="color:blue">Wolfel <i>et al.</i>, 1995</span></a>). In fact, preclinical and clinical data has already shown that neoantigen specific cytotoxic T lymphocytes (CTLs) constitute the most potent T-cell populations for tumor rejection (<a href="#Wolfel1995"><span style="color:blue">Wolfel <i>et al.</i>, 1995</span></a>; <a href="#Matsushita2012"><span style="color:blue">Matsushita <i>et al.</i>, 2012</span></a>). |
− | Still, the natural production of neoantigen-specific CTLs by a patient’s immune system is scarce because of low clonal frequency and ineffective presentation of neoantigens (<a href="#Alexandrov2013"><span style="color:blue">Alexandrov <i>et al.</i>, 2013</span></a>; <a href="#Zhu2017"><span style="color:blue">Zhu <i>et al.</i>, 2017</span></a>). Therefore, cancer vaccines or adjuvant cancer therapies (ACT) are crucial to potentiate immunity against neoantigens for cancer treatment. Hence, a large number of strategies have been progressed for the creation, formulation and delivery of various cancer vaccines; for example, whole tumor cell lysate, nucleotide (mRNA/ DNA), protein or peptide-based vaccines, dendritic cell (DC) based vaccines, viral vectors and biomaterial-assisted vaccines.</p> | + | Still, the natural production of neoantigen-specific CTLs by a patient’s immune system is scarce because of low clonal frequency and ineffective presentation of neoantigens (<a href="#Alexandrov2013"><span style="color:blue">Alexandrov <i>et al.</i>, 2013</span></a>; <a href="#Zhu2017"><span style="color:blue">Zhu <i>et al.</i>, 2017</span></a>). Therefore, cancer vaccines or adjuvant cancer therapies (ACT) are crucial to potentiate immunity against neoantigens for cancer treatment. Hence, a large number of strategies have been progressed for the creation, formulation and delivery of various cancer vaccines; for example, whole tumor cell lysate, nucleotide (mRNA/ DNA), protein or peptide-based vaccines, dendritic cell (DC) based vaccines, viral vectors and biomaterial-assisted vaccines.</p> |
| <p class="lead">However, it remains challenging to develop a universal and effective delivery strategy to target neoantigen-based vaccines to professional antigen-presenting cells (APCs) for eliciting robust and potent T-cell responses against cancer.</p> | | <p class="lead">However, it remains challenging to develop a universal and effective delivery strategy to target neoantigen-based vaccines to professional antigen-presenting cells (APCs) for eliciting robust and potent T-cell responses against cancer.</p> |
− | <p class="lead">In general, parenterally injected soluble antigens or adjuvants rapidly spread into the systemic circulation making them ineffective due to their small molecular sizes, poor targeting, and rapid draining in lymph nodes (LNs). This ultimately results in a limited immune response (<a href="#Liu2014"><span style="color:blue">Liu <i>et al.</i>, 2014</span></a>; <a href="#Fifis2004"><span style="color:blue">Fifis <i>et al.</i>, 2004</span></a>).</p> | + | <p class="lead">In general, parenterally injected soluble antigens or adjuvants rapidly spread into the systemic circulation making them ineffective due to their small molecular sizes, poor targeting, and rapid draining in lymph nodes (LNs). This ultimately results in a limited immune response (<a href="#Liu2014"><span style="color:blue">Liu <i>et al.</i>, 2014</span></a>; <a href="#Fifis2004"><span style="color:blue">Fifis <i>et al.</i>, 2004</span></a>).</p> |
− | <p class="lead">In addition, even if such soluble tumor neoantigens are acquired by DCs, they would be trapped in endolysosomal compartments and digested into peptides, which are subsequently loaded almost entirely onto MHC class II molecules for presentation to CD4+ helper T-cells solely. However, for achieving an effective immune response, the therapeutic cancer vaccine is expected to elicit robust cytotoxic CD8+ T-cell responses, which is essential for tumor cell destruction (<a href="#Janssen2005"><span style="color:blue">Janssen <i>et al.</i>, 2005</span></a>).</p> | + | <p class="lead">In addition, even if such soluble tumor neoantigens are acquired by DCs, they would be trapped in endolysosomal compartments and digested into peptides, which are subsequently loaded almost entirely onto MHC class II molecules for presentation to CD4+ helper T-cells solely. However, for achieving an effective immune response, the therapeutic cancer vaccine is expected to elicit robust cytotoxic CD8+ T-cell responses, which is essential for tumor cell destruction (<a href="#Janssen2005"><span style="color:blue">Janssen <i>et al.</i>, 2005</span></a>).</p> |
| <p class="lead">Thus, it is also key for cancer vaccines to enable cytosolic delivery of neoantigens for a successful activation of cytotoxic T-cell mediated immunity. Effectively, having a platform for neoantigen delivery is favourable for vaccine delivery as it protects antigen and adjuvant molecules from degradation and clearing, enhances lymphoid organ targeting, and modulates APCs’ functions for better presentation (<a href="#Amigorena2010"><span style="color:blue">Amigorena <i>et al.</i>, 2010</span></a>).</p> | | <p class="lead">Thus, it is also key for cancer vaccines to enable cytosolic delivery of neoantigens for a successful activation of cytotoxic T-cell mediated immunity. Effectively, having a platform for neoantigen delivery is favourable for vaccine delivery as it protects antigen and adjuvant molecules from degradation and clearing, enhances lymphoid organ targeting, and modulates APCs’ functions for better presentation (<a href="#Amigorena2010"><span style="color:blue">Amigorena <i>et al.</i>, 2010</span></a>).</p> |
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| <p class="lead">In 2016, an article was published by Sebyung Kang and colleagues describing the employment of the protein cage nanoparticles, Encapsulin (Encap), as neoantigenic peptide nanocarriers by genetically incorporating the OT-1 peptide of ovalbumin (OVA) protein (used as vaccine for B16-OVA melanoma tumor model) to three different positions of the Encap subunit (<a href="#Choi2016"><span style="color:blue">Choi <i>et al.</i>, 2016</span></a>). This article motivated us to look further into Encapsulin as a strong candidate for the vaccine platform.</p> | | <p class="lead">In 2016, an article was published by Sebyung Kang and colleagues describing the employment of the protein cage nanoparticles, Encapsulin (Encap), as neoantigenic peptide nanocarriers by genetically incorporating the OT-1 peptide of ovalbumin (OVA) protein (used as vaccine for B16-OVA melanoma tumor model) to three different positions of the Encap subunit (<a href="#Choi2016"><span style="color:blue">Choi <i>et al.</i>, 2016</span></a>). This article motivated us to look further into Encapsulin as a strong candidate for the vaccine platform.</p> |
| <p class="lead">In the mentioned study (<a href="#Choi2016"><span style="color:blue">Choi <i>et al.</i>, 2016</span></a>), DCs that were pulsed with constructs of OT1-Encap-C (C-terminal fusion with OT-1 peptide) induced OT-1-specific CD8+ T cell proliferation both in vivo and in vitro. This indicates Encapsulin ability to enhance the uptake of the OT-1 peptides by dendritic cells and the subsequent presentation of these peptides to DC8+ T cells. </p> | | <p class="lead">In the mentioned study (<a href="#Choi2016"><span style="color:blue">Choi <i>et al.</i>, 2016</span></a>), DCs that were pulsed with constructs of OT1-Encap-C (C-terminal fusion with OT-1 peptide) induced OT-1-specific CD8+ T cell proliferation both in vivo and in vitro. This indicates Encapsulin ability to enhance the uptake of the OT-1 peptides by dendritic cells and the subsequent presentation of these peptides to DC8+ T cells. </p> |
− | <p class="lead">OT1-Encap-C presentation to DCs was also able to induce the differentiation of functional effector CD8+ T cells in murine spleen. Finally, OT-1-Encap subcutaneous vaccinations in B16-OVA melanoma tumor bearing mice effectively activated OT-1 peptide specific cytotoxic CD8+ T cells before or even after tumor generation, resulting in significant suppression of tumor growth in prophylactic as well as therapeutic treatments. </p> | + | <p class="lead">OT1-Encap-C presentation to DCs was also able to induce the differentiation of functional effector CD8+ T cells in murine spleen. Finally, OT-1-Encap subcutaneous vaccinations in B16-OVA melanoma tumor bearing mice effectively activated OT-1 peptide specific cytotoxic CD8+ T cells before or even after tumor generation, resulting in significant suppression of tumor growth in prophylactic as well as therapeutic treatments. </p> |
| <p class="lead">Encapsulin was thus chosen as the platform for CAPOEIRA’s vaccine system, for multiple reasons: | | <p class="lead">Encapsulin was thus chosen as the platform for CAPOEIRA’s vaccine system, for multiple reasons: |
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| <li>Such expression systems might help in reducing the cost of generating libraries of peptides by other technologies such as solid-phase peptide synthesis</li> | | <li>Such expression systems might help in reducing the cost of generating libraries of peptides by other technologies such as solid-phase peptide synthesis</li> |
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| <h1 id="EncapsParagraph">Encapsulin</h1> | | <h1 id="EncapsParagraph">Encapsulin</h1> |
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| Its crystal structure has been recently solved, and was published in a paper in 2008 (<a href="#Sutter2008"><span style="color:blue">Sutter <i>et al.</i>, 2008</span></a>). The Encapsulin multimer is assembled from 60 identical 31 kDa monomers having a thin and icosahedral T=1 symmetric cage structure, with interior and exterior diameters of 20 and 24 nm, respectively. The multimer automatically assembles from the monomers once expressed, as it leads to a lower energy state. The C-terminus is outward pointing, allowing for easy conjugation of peptides after the C-terminus (<a href="#Moon2014"><span style="color:blue">Moon <i>et al.</i>, 2014</span></a>).</p> | | Its crystal structure has been recently solved, and was published in a paper in 2008 (<a href="#Sutter2008"><span style="color:blue">Sutter <i>et al.</i>, 2008</span></a>). The Encapsulin multimer is assembled from 60 identical 31 kDa monomers having a thin and icosahedral T=1 symmetric cage structure, with interior and exterior diameters of 20 and 24 nm, respectively. The multimer automatically assembles from the monomers once expressed, as it leads to a lower energy state. The C-terminus is outward pointing, allowing for easy conjugation of peptides after the C-terminus (<a href="#Moon2014"><span style="color:blue">Moon <i>et al.</i>, 2014</span></a>).</p> |
| <p class="lead">The Encapsulin monomer was modified by inserting a Hexahistidine linker (GGGGGGHHHHHHGGGGG) between residues 43 and 44 of the WT Encapsulin (<a href="#Moon2014"><span style="color:blue">Moon <i>et al.</i>, 2014</span></a>). This was shown to convey exceptional heat stability and better hydrodynamic properties for the Encapsulin multimer. These properties are crucial to obtain a simpler and more efficient purification of the Encapsulin protein.</p> | | <p class="lead">The Encapsulin monomer was modified by inserting a Hexahistidine linker (GGGGGGHHHHHHGGGGG) between residues 43 and 44 of the WT Encapsulin (<a href="#Moon2014"><span style="color:blue">Moon <i>et al.</i>, 2014</span></a>). This was shown to convey exceptional heat stability and better hydrodynamic properties for the Encapsulin multimer. These properties are crucial to obtain a simpler and more efficient purification of the Encapsulin protein.</p> |
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| <h1 id="OurVaccine">Vaccine Design Project</h1> | | <h1 id="OurVaccine">Vaccine Design Project</h1> |
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| <p class="lead">The insert in between the two BsaI cut sites, consisting of sfGFP with a native promoter and terminator, allows for checking the success of the insertion of the neoantigen after transformation of cells with the Golden Gate product (green colonies do not contain the desired peptide insert, but the original plasmid instead). This cloning strategy was useful in the initial characterization of the system and production of the encapsulin fused with OT-1 peptide. For high-throughput production of encapsulin-neoantigen constructs, different strategies avoiding <i>in vivo</i> could be envisioned. </p> | | <p class="lead">The insert in between the two BsaI cut sites, consisting of sfGFP with a native promoter and terminator, allows for checking the success of the insertion of the neoantigen after transformation of cells with the Golden Gate product (green colonies do not contain the desired peptide insert, but the original plasmid instead). This cloning strategy was useful in the initial characterization of the system and production of the encapsulin fused with OT-1 peptide. For high-throughput production of encapsulin-neoantigen constructs, different strategies avoiding <i>in vivo</i> could be envisioned. </p> |
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| <li>Faster & Easier purification of protein products from cell free expression reactions compared to purification from cells</li> | | <li>Faster & Easier purification of protein products from cell free expression reactions compared to purification from cells</li> |
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− | <h2><i><u>References</u></i></h2> | + | <h2><i><u>References</u></i></h2> |
| <ul> | | <ul> |
| <li id="Alexandrov2013">Alexandrov, Ludmil B., et al. "Signatures of mutational processes in human cancer." <i>Nature</i>, 500.7463 (2013): 415.</li> | | <li id="Alexandrov2013">Alexandrov, Ludmil B., et al. "Signatures of mutational processes in human cancer." <i>Nature</i>, 500.7463 (2013): 415.</li> |
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| <li id="Rollin2013">Rollin, Joseph A., Tsz Kin Tam, and Y-H. Percival Zhang. "New biotechnology paradigm: cell-free biosystems for biomanufacturing." <i>Green chemistry</i>, 15.7 (2013): 1708-1719.</li> | | <li id="Rollin2013">Rollin, Joseph A., Tsz Kin Tam, and Y-H. Percival Zhang. "New biotechnology paradigm: cell-free biosystems for biomanufacturing." <i>Green chemistry</i>, 15.7 (2013): 1708-1719.</li> |
| <li id="Sutter2008">Sutter, Markus, et al. "Structural basis of enzyme encapsulation into a bacterial nanocompartment." <i>Nature structural & molecular biology</i>, 15.9 (2008): 939.</li> | | <li id="Sutter2008">Sutter, Markus, et al. "Structural basis of enzyme encapsulation into a bacterial nanocompartment." <i>Nature structural & molecular biology</i>, 15.9 (2008): 939.</li> |
− | <li id="Tran2014">Tran, Eric, et al. "Cancer immunotherapy based on mutation-specific CD4+ T cells in a patient with epithelial cancer." <i>Science</i>, 344.6184 (2014): 641-645.</li>
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− | <li id="Tran2016">Tran, Eric, et al. "T-cell transfer therapy targeting mutant KRAS in cancer." <i>New England Journal of Medicine</i>, 375.23 (2016): 2255-2262.</li>
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− | <li id="Tran2017">Tran, Eric, Paul F. Robbins, and Steven A. Rosenberg. "'Final common pathway'of human cancer immunotherapy: targeting random somatic mutations." <i>Nature immunology</i>, 18.3 (2017): 255.</li>
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| <li id="Wolfel1995">Wolfel, Thomas, et al. "A p16INK4a-insensitive CDK4 mutant targeted by cytolytic T lymphocytes in a human melanoma." <i>Science</i>, 269.5228 (1995): 1281-1284.</li> | | <li id="Wolfel1995">Wolfel, Thomas, et al. "A p16INK4a-insensitive CDK4 mutant targeted by cytolytic T lymphocytes in a human melanoma." <i>Science</i>, 269.5228 (1995): 1281-1284.</li> |
| <li id="Zhu2017">Zhu, Guizhi, et al. "Efficient nanovaccine delivery in cancer immunotherapy." <i>ACS nano</i>, 11.3 (2017): 2387-2392.</li> | | <li id="Zhu2017">Zhu, Guizhi, et al. "Efficient nanovaccine delivery in cancer immunotherapy." <i>ACS nano</i>, 11.3 (2017): 2387-2392.</li> |
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| <h1 id="IntroFollowup">Introduction</h1> | | <h1 id="IntroFollowup">Introduction</h1> |
| <p class="lead">Through our interviews with health specialists and oncology experts (more information in <a href="https://2018.igem.org/Team:EPFL/Human_Practices"><span style="color:blue">Integrated human practices</span></a>) we assessed the necessity to have a non-invasive treatment companion to determine our vaccine efficacy. Here, we want to provide a proof-of-concept that would allow us to monitor the patient’s response by using the same set of identified neoantigens used for our vaccine. | | <p class="lead">Through our interviews with health specialists and oncology experts (more information in <a href="https://2018.igem.org/Team:EPFL/Human_Practices"><span style="color:blue">Integrated human practices</span></a>) we assessed the necessity to have a non-invasive treatment companion to determine our vaccine efficacy. Here, we want to provide a proof-of-concept that would allow us to monitor the patient’s response by using the same set of identified neoantigens used for our vaccine. |
− | We also believe that it is important to be able to detect relapses in early melanoma stages, as the survival rates for patients dramatically drop to 20% in stage IV compared to 99% survival rate in stage I and II (<a href="#Siegel2018"><span style="color:blue">Siegel <i>et al.</i>, 2018</span></a>). </p> | + | We also believe that it is important to be able to detect relapses in early melanoma stages, as the survival rates for patients dramatically drop to 20% in stage IV compared to 99% survival rate in stage I and II (<a href="#Siegel2018"><span style="color:blue">Siegel <i>et al.</i>, 2018</span></a>). </p> |
| <p class="lead">To answer these needs, we envision a new generation of diagnostic tools by which a liquid peripheral blood draw could give an accurate prognosis regarding the elimination of the tumor cells and, by targeting specific biomarkers, be a good predictor of relapse. This requires a detection system that is both highly sensitive and specific since single base pair polymorphisms, barely detectable in the blood, can lead to tumorigenesis.</p> | | <p class="lead">To answer these needs, we envision a new generation of diagnostic tools by which a liquid peripheral blood draw could give an accurate prognosis regarding the elimination of the tumor cells and, by targeting specific biomarkers, be a good predictor of relapse. This requires a detection system that is both highly sensitive and specific since single base pair polymorphisms, barely detectable in the blood, can lead to tumorigenesis.</p> |
| <p class="lead">Our idea is to develop a Cas12a detection system coupled to an amplification step. This detection system is rapid, sensitive and specific enough to reliably detect these biomarkers.</p> | | <p class="lead">Our idea is to develop a Cas12a detection system coupled to an amplification step. This detection system is rapid, sensitive and specific enough to reliably detect these biomarkers.</p> |
| </div> | | </div> |
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− | <img alt="Image" src="https://static.igem.org/mediawiki/2018/6/65/T--EPFL--blood_sample.png" class="img-fluid rounded" width="500" > | + | <img alt="Image" src="https://static.igem.org/mediawiki/2018/8/8e/T--EPFL--bloodsample.png" class="img-fluid rounded" width="500" > |
| <figcaption class="mt-3 text-muted"><b>Figure 1.</b> ctDNA and miRNA in blood</figcaption> | | <figcaption class="mt-3 text-muted"><b>Figure 1.</b> ctDNA and miRNA in blood</figcaption> |
| </figure> | | </figure> |
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| <figure> | | <figure> |
− | <img alt="Image" src="https://static.igem.org/mediawiki/2018/3/32/T--EPFL--ctDNAinblood.png" class="img-fluid rounded" width="500" > | + | <img alt="Image" src="https://static.igem.org/mediawiki/2018/c/c3/T--EPFL--bloodsample3.png" class="img-fluid rounded" width="500" > |
| <figcaption class="mt-3 text-muted"><b>Figure 2.</b> Overview of the release of ctDNA in the blood by necrotic cancer cells. These are, along with some miRNAs, promising biomarkers present in the blood.</figcaption> | | <figcaption class="mt-3 text-muted"><b>Figure 2.</b> Overview of the release of ctDNA in the blood by necrotic cancer cells. These are, along with some miRNAs, promising biomarkers present in the blood.</figcaption> |
| </figure> | | </figure> |
| </center> | | </center> |
| <br> | | <br> |
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| <div class="tab-pane fade" id="miRNA1" role="tabpanel" aria-labelledby="contact-tab"> | | <div class="tab-pane fade" id="miRNA1" role="tabpanel" aria-labelledby="contact-tab"> |
| <br> | | <br> |
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| <p class="lead"><b>MicroRNAs</b> (<b>miRNAs</b>) are short (18-24 nt) non-coding RNA molecules which act as post-transcriptional regulators of gene expression. Over the years, miRNAs have been proved to play a critical role in a variety of different diseases, including cancer (<a href="#Larrea"><span style="color:blue">Larrea <i>et al.</i>, 2016</span></a>). Moreover, miRNAs are remarkably stable in human plasma (<a href="#Mitchell"><span style="color:blue">Mitchell <i>et al.</i>, 2008</span></a>), and several miRNAs circulating in the blood have recently been shown to be dysregulated (either over- or under-expressed) in patients with certain cancers, including melanoma, with respect to healthy subjects (<a href="#Mirzaei"><span style="color:blue">Mirzaei <i>et al.</i>, 2016</span></a>). For these reasons, miRNAs have been proposed as potential prognostic and diagnostic biomarkers for melanoma, which makes them suitable candidates for the follow-up part of our project as well.</p> | | <p class="lead"><b>MicroRNAs</b> (<b>miRNAs</b>) are short (18-24 nt) non-coding RNA molecules which act as post-transcriptional regulators of gene expression. Over the years, miRNAs have been proved to play a critical role in a variety of different diseases, including cancer (<a href="#Larrea"><span style="color:blue">Larrea <i>et al.</i>, 2016</span></a>). Moreover, miRNAs are remarkably stable in human plasma (<a href="#Mitchell"><span style="color:blue">Mitchell <i>et al.</i>, 2008</span></a>), and several miRNAs circulating in the blood have recently been shown to be dysregulated (either over- or under-expressed) in patients with certain cancers, including melanoma, with respect to healthy subjects (<a href="#Mirzaei"><span style="color:blue">Mirzaei <i>et al.</i>, 2016</span></a>). For these reasons, miRNAs have been proposed as potential prognostic and diagnostic biomarkers for melanoma, which makes them suitable candidates for the follow-up part of our project as well.</p> |
| <p class="lead">Previous iGEM teams (e.g. NUDT China 2016 team) have shown promising results with Rolling Circle Amplification of miRNAs by means of dumbbell-shaped probes (details in “Amplification”). Our aim is to investigate whether is possible to combine this dumbbell probe design with a Cas12a system to achieve a sensitive and specific detection assay.</p> | | <p class="lead">Previous iGEM teams (e.g. NUDT China 2016 team) have shown promising results with Rolling Circle Amplification of miRNAs by means of dumbbell-shaped probes (details in “Amplification”). Our aim is to investigate whether is possible to combine this dumbbell probe design with a Cas12a system to achieve a sensitive and specific detection assay.</p> |
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| <h1 id="Cas12a">Cas12a</h1> | | <h1 id="Cas12a">Cas12a</h1> |
| <p class="lead"> | | <p class="lead"> |
| <div id="Cas12"> | | <div id="Cas12"> |
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| <p class="lead">To answer the need for a fast and robust detection method we chose to work with the newly characterized <b>Cas12a</b> (<b>Cpf1</b>) protein. </p> | | <p class="lead">To answer the need for a fast and robust detection method we chose to work with the newly characterized <b>Cas12a</b> (<b>Cpf1</b>) protein. </p> |
| <p class="lead">CRISPR-Cas (clustered regularly interspaced short palindromic repeats–CRISPR-associated) systems are originally inspired by an antiviral defense mechanism used by prokaryotes which work by recognizing and cleaving the foreign DNA/RNA. They have, in the recent years, widely been used as a gene editing tool for their ability to find and cut at a specific site allowing the insertion of a desired sequence. This target sequence is what we call the <i>activator</i>.</p> | | <p class="lead">CRISPR-Cas (clustered regularly interspaced short palindromic repeats–CRISPR-associated) systems are originally inspired by an antiviral defense mechanism used by prokaryotes which work by recognizing and cleaving the foreign DNA/RNA. They have, in the recent years, widely been used as a gene editing tool for their ability to find and cut at a specific site allowing the insertion of a desired sequence. This target sequence is what we call the <i>activator</i>.</p> |
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| It is also worth mentioning that Cas12a proteins retains the capacity to recognize and cleave ssDNA without any PAM sequence.</p> | | It is also worth mentioning that Cas12a proteins retains the capacity to recognize and cleave ssDNA without any PAM sequence.</p> |
| <p class="lead">As a result of its conformational change upon target recognition, Cas12a unleashes a non-specific endonuclease activity (i.e. <i>collateral cleavage</i>) virtually against any single stranded DNA (ssDNA). Each activated Cas12a protein can cleave huge numbers of ssDNA molecules, and this is what makes this system so suitable for detection, as it greatly amplifies the signal. As explained more in detail in “Fluorescent readout”, by coupling this property to a single-stranded FQ reporter, we can hugely increase even very small signals, which means higher sensitivity for this system.</p> | | <p class="lead">As a result of its conformational change upon target recognition, Cas12a unleashes a non-specific endonuclease activity (i.e. <i>collateral cleavage</i>) virtually against any single stranded DNA (ssDNA). Each activated Cas12a protein can cleave huge numbers of ssDNA molecules, and this is what makes this system so suitable for detection, as it greatly amplifies the signal. As explained more in detail in “Fluorescent readout”, by coupling this property to a single-stranded FQ reporter, we can hugely increase even very small signals, which means higher sensitivity for this system.</p> |
− | <p class="lead">In our assays we worked with the purified Lba-Cas12a (type V-A CRISPR) extracted from <i>Lachnospiraceae bacterium ND2006</i> and provided by <a href="#NebCas12a"><span style="color:blue">New England BioLabs</i></span></a>. | + | <p class="lead">In our assays we worked with the purified Lba-Cas12a (type V-A CRISPR) extracted from <i>Lachnospiraceae bacterium ND2006</i> and provided by <a href="#NebCas12a"><span style="color:blue">New England BioLabs</i></span></a>. |
| </p> | | </p> |
| <div class="card"> | | <div class="card"> |
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| <div class="card-body"> | | <div class="card-body"> |
| <p class="lead">The gRNA must contain a 17 to 24bp complementary sequence to the dsDNA of interest. For activating Cas12a and further collateral cleavage, it is crucial that the activator incorporates a T-rich PAM sequence, TTTN, 5’ of the target sequence. Once the protein has recognized the PAM sequence and the gRNA has bound the complementary sequence, the staggered cut will occur around 18 bases 3′ of the PAM and leaves 5′ overhanging ends (<a href="#Zetsche2017"><span style="color:blue">Zetsche <i>et al.</i>, 2017</span></a>).</p> | | <p class="lead">The gRNA must contain a 17 to 24bp complementary sequence to the dsDNA of interest. For activating Cas12a and further collateral cleavage, it is crucial that the activator incorporates a T-rich PAM sequence, TTTN, 5’ of the target sequence. Once the protein has recognized the PAM sequence and the gRNA has bound the complementary sequence, the staggered cut will occur around 18 bases 3′ of the PAM and leaves 5′ overhanging ends (<a href="#Zetsche2017"><span style="color:blue">Zetsche <i>et al.</i>, 2017</span></a>).</p> |
− | <p class="lead">Our gRNAs were transcribed using T7 polymerase starting from a ssDNA with the coding sequence downstream of a T7 promoter. | + | <p class="lead">Our gRNAs were transcribed using T7 polymerase starting from a ssDNA with the coding sequence downstream of a T7 promoter. |
| An appropriate design of the gRNA-coding ssDNA consists of three separate parts in the following order:</p> | | An appropriate design of the gRNA-coding ssDNA consists of three separate parts in the following order:</p> |
| <ul> | | <ul> |
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| <center> | | <center> |
| <figure> | | <figure> |
− | <img alt="Image" src="https://static.igem.org/mediawiki/2018/e/ed/T--EPFL--FluorescentReadout.png" class="img-fluid rounded" width="1000" > | + | <img alt="Image" src="https://static.igem.org/mediawiki/2018/f/f2/T--EPFL--Cas12a.png" class="img-fluid rounded" width="1000" > |
| <figcaption class="mt-3 text-muted"><b>Figure 4.</b> Cas12a assay principles: Activation of Cas12a unleashing the proteins endonuclease activity against ssDNA (here a Fluorophore-Quencher reporter).</figcaption> | | <figcaption class="mt-3 text-muted"><b>Figure 4.</b> Cas12a assay principles: Activation of Cas12a unleashing the proteins endonuclease activity against ssDNA (here a Fluorophore-Quencher reporter).</figcaption> |
| </figure> | | </figure> |
| </center> | | </center> |
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| <hr style="height:2px;border:none;color:#333;background-color:#333;" /> | | <hr style="height:2px;border:none;color:#333;background-color:#333;" /> |
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| <h1 id="SamplePreparation">Sample preparation</h1> | | <h1 id="SamplePreparation">Sample preparation</h1> |
| <p class="lead">A simple blood draw is necessary for both our treatment companion and relapse detection.</p> | | <p class="lead">A simple blood draw is necessary for both our treatment companion and relapse detection.</p> |
| <p class="lead"> | | <p class="lead"> |
− | The analysis of our biomarkers is done directly in the plasma, without the need to isolate them, sparing us precious time, costs and unnecessary contamination that can occur during nucleic acid extraction (<a href="#Abe2003"><span style="color:blue">Abe, 2003</span></a>). The first step for our sample preparation is the isolation of plasma from whole blood. As part of our experiments on ctDNA, we used commercially ordered human plasma for both practical and ethical reasons. The next step is to treat it with PBS then heat it at 95°C for 3 minutes to precipitate proteins. | + | The analysis of our biomarkers is done directly in the plasma, without the need to isolate them, sparing us precious time, costs and unnecessary contamination that can occur during nucleic acid extraction (<a href="#Abe2003"><span style="color:blue">Abe, 2003</span></a>). The first step for our sample preparation is the isolation of plasma from whole blood. As part of our experiments on ctDNA, we used commercially ordered human plasma for both practical and ethical reasons. The next step is to treat it with PBS then heat it at 95°C for 3 minutes to precipitate proteins. |
| </p> | | </p> |
| <p class="lead">Sample preparation for miRNA can theoretically be achieved in a similar way: <a href="#Qiu"><span style="color:blue">Qiu <i>et al.</i>, 2018</span></a> showed that is possible to perform amplification of miRNA directly in serum samples pre-diluted in DEPC-treated water and boiled at 95 °C for 10 minutes. We expect that a similar protocol might be applied also to plasma for miRNA, as measurements of miRNA between plasma and serum have been found to be highly correlated (<a href="#Mitchell"><span style="color:blue">Mitchell <i>et al.</i>, 2008</span></a>).</p> | | <p class="lead">Sample preparation for miRNA can theoretically be achieved in a similar way: <a href="#Qiu"><span style="color:blue">Qiu <i>et al.</i>, 2018</span></a> showed that is possible to perform amplification of miRNA directly in serum samples pre-diluted in DEPC-treated water and boiled at 95 °C for 10 minutes. We expect that a similar protocol might be applied also to plasma for miRNA, as measurements of miRNA between plasma and serum have been found to be highly correlated (<a href="#Mitchell"><span style="color:blue">Mitchell <i>et al.</i>, 2008</span></a>).</p> |
| <p class="lead">Amplification of each biomarker is done afterwards, in order to have enough copies to be able to perform the Cas12a assay effectively.</p> | | <p class="lead">Amplification of each biomarker is done afterwards, in order to have enough copies to be able to perform the Cas12a assay effectively.</p> |
| <hr style="height:2px;border:none;color:#333;background-color:#333;" /> | | <hr style="height:2px;border:none;color:#333;background-color:#333;" /> |
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| <h1 id="Amplification">Amplification</h1> | | <h1 id="Amplification">Amplification</h1> |
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| It is important to note that it is possible to replace this method with an isothermal amplification, like LAMP or RPA, to get this assay closer to point of care.</p> | | It is important to note that it is possible to replace this method with an isothermal amplification, like LAMP or RPA, to get this assay closer to point of care.</p> |
| <p class="lead">One of the limitation of a Cas12a is the need for a PAM sequence near the target we want to detect. Following <a href="#Li2018"><span style="color:blue">Li <i>et al.</i>, 2018</span></a> and to overcome this limitation, we designed primers that would add the PAM sequence by introducing synthetic mutations. This enables us to virtually target any desired sequence regardless of existence of a T-rich PAM sequence near the target.</p> | | <p class="lead">One of the limitation of a Cas12a is the need for a PAM sequence near the target we want to detect. Following <a href="#Li2018"><span style="color:blue">Li <i>et al.</i>, 2018</span></a> and to overcome this limitation, we designed primers that would add the PAM sequence by introducing synthetic mutations. This enables us to virtually target any desired sequence regardless of existence of a T-rich PAM sequence near the target.</p> |
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| <center> | | <center> |
| <figure> | | <figure> |
− | <img alt="Image" src="https://static.igem.org/mediawiki/2018/d/dd/T--EPFL--ctDNAamplification.png" class="img-fluid rounded" width="1000" > | + | <img alt="Image" src="https://static.igem.org/mediawiki/2018/6/65/T--EPFL--amplificationctDNA.png" class="img-fluid rounded" width="1000" > |
| <figcaption class="mt-3 text-muted"><b>Figure 5.</b> Amplification of the target fragment and introduction of the PAM sequence synthetically.</figcaption> | | <figcaption class="mt-3 text-muted"><b>Figure 5.</b> Amplification of the target fragment and introduction of the PAM sequence synthetically.</figcaption> |
| </figure> | | </figure> |
| </center> | | </center> |
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| </div> | | </div> |
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| <div class="tab-pane fade" id="miRNA" role="tabpanel" aria-labelledby="contact-tab"> | | <div class="tab-pane fade" id="miRNA" role="tabpanel" aria-labelledby="contact-tab"> |
| <br> | | <br> |
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| <p class="lead">Although it is the probe - and not directly the miRNA - to be amplified, RCA allows to significantly increase the concentration of the miRNA sequence in solution: indeed, since a large portion of the probe is complementary to the miRNA, the amplicon of the probe will incorporate several copies of the original miRNA. This can theoretically be exploited to increase the sensitivity of an assay for quantification of miRNA. As later explained, while our Amplification step was mostly inspired by <a href="#Qiu"><span style="color:blue">Qiu <i>et al.</i>, 2018</span></a>, we explored a new, ambitious Detection step after RCA based on Cas12a (and not on Cas9 and split reporter proteins). This implied designing new probes with specific characteristics for Cas12a, as explained in the following sections.</p> | | <p class="lead">Although it is the probe - and not directly the miRNA - to be amplified, RCA allows to significantly increase the concentration of the miRNA sequence in solution: indeed, since a large portion of the probe is complementary to the miRNA, the amplicon of the probe will incorporate several copies of the original miRNA. This can theoretically be exploited to increase the sensitivity of an assay for quantification of miRNA. As later explained, while our Amplification step was mostly inspired by <a href="#Qiu"><span style="color:blue">Qiu <i>et al.</i>, 2018</span></a>, we explored a new, ambitious Detection step after RCA based on Cas12a (and not on Cas9 and split reporter proteins). This implied designing new probes with specific characteristics for Cas12a, as explained in the following sections.</p> |
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| <div id="miRNADesignAmpl"> | | <div id="miRNADesignAmpl"> |
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| <table style="undefined;table-layout: fixed; width: 911px"> | | <table style="undefined;table-layout: fixed; width: 911px"> |
| <colgroup> | | <colgroup> |
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| qualitatively the interaction between our probe and let-7a.</p> | | qualitatively the interaction between our probe and let-7a.</p> |
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| <p class="lead">Two main alternatives are suitable in order to test the efficacy of Rolling Circle Amplification (<a href="#Deng"><span style="color:blue">Deng <i>et al.</i>, 2014</span></a>; <a href="#Qiu"><span style="color:blue">Qiu <i>et al.</i>, 2018</span></a>). First of all, the amplicons can be tested by means of an agarose gel to verify the size; nonetheless, this method shows some limitations because of the large size of the amplicons. <!--Indeed, as we also saw from our experiments (link to the <a href="https://2018.igem.org/Team:EPFL/Notebook-Detection"><span style="color:blue">Notebook</span></a>), the size of the amplicons after a 2 hour-RCA is so large that the band is extremely close to the well.--> </p> | | <p class="lead">Two main alternatives are suitable in order to test the efficacy of Rolling Circle Amplification (<a href="#Deng"><span style="color:blue">Deng <i>et al.</i>, 2014</span></a>; <a href="#Qiu"><span style="color:blue">Qiu <i>et al.</i>, 2018</span></a>). First of all, the amplicons can be tested by means of an agarose gel to verify the size; nonetheless, this method shows some limitations because of the large size of the amplicons. <!--Indeed, as we also saw from our experiments (link to the <a href="https://2018.igem.org/Team:EPFL/Notebook-Detection"><span style="color:blue">Notebook</span></a>), the size of the amplicons after a 2 hour-RCA is so large that the band is extremely close to the well.--> </p> |
| <p class="lead">A more valid alternative is instead to perform a real-time fluorescence measurement by means of SYBR Green I.</p> | | <p class="lead">A more valid alternative is instead to perform a real-time fluorescence measurement by means of SYBR Green I.</p> |
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| <br> | | <br> |
| <p class="lead">SYBR green I is an intercalating dye that preferentially binds to minor grooves of double-stranded (dsDNA) (<a href="#Zipper"><span style="color:blue">Zipper <i>et al.</i>, 2004</span></a>). It has also been shown to bind to single-stranded DNA (ssDNA) and RNA (for which instead SYBR Green II is a more suitable option (<a href="#SYBRG"><span style="color:blue">Sigma-Aldrich</span></a>)), but with a significantly lower performance (<a href="#Vitzthum"><span style="color:blue">Vitzthum <i>et al.</i>, 1999</span></a>). </p> | | <p class="lead">SYBR green I is an intercalating dye that preferentially binds to minor grooves of double-stranded (dsDNA) (<a href="#Zipper"><span style="color:blue">Zipper <i>et al.</i>, 2004</span></a>). It has also been shown to bind to single-stranded DNA (ssDNA) and RNA (for which instead SYBR Green II is a more suitable option (<a href="#SYBRG"><span style="color:blue">Sigma-Aldrich</span></a>)), but with a significantly lower performance (<a href="#Vitzthum"><span style="color:blue">Vitzthum <i>et al.</i>, 1999</span></a>). </p> |
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| </div> | | </div> |
| </div> | | </div> |
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| <div class="card"> | | <div class="card"> |
| <a data-toggle="collapse" href="#collapseOne"> | | <a data-toggle="collapse" href="#collapseOne"> |
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| <li>the <u>underlined</u> region is the one complementary to the miRNA (let-7a-5p: <b>UGAGGUAGUAGGUUGUAUAGUU</b>)</li> | | <li>the <u>underlined</u> region is the one complementary to the miRNA (let-7a-5p: <b>UGAGGUAGUAGGUUGUAUAGUU</b>)</li> |
| </ul> | | </ul> |
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| <center> | | <center> |
| <figure> | | <figure> |
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| </figure> | | </figure> |
| </center> | | </center> |
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| <p class="lead">Such probe consists of a double-stranded stem part, a 10 bases-long loop (which from now on we will refer to as "small loop" - on the right in the figure above) and a 16 bases-long loop ("large loop" - on the left). As we can | | <p class="lead">Such probe consists of a double-stranded stem part, a 10 bases-long loop (which from now on we will refer to as "small loop" - on the right in the figure above) and a 16 bases-long loop ("large loop" - on the left). As we can |
| observe, the toehold region of the probe (i.e. the part on the small loop where the miRNA binds) is 7 bases long, in accordance with <a href="#Deng"><span style="color:blue">Deng <i>et al.</i>, 2014</span></a>, who proved it to be the optimal length to achieve both sensitivity and specificity.</p> | | observe, the toehold region of the probe (i.e. the part on the small loop where the miRNA binds) is 7 bases long, in accordance with <a href="#Deng"><span style="color:blue">Deng <i>et al.</i>, 2014</span></a>, who proved it to be the optimal length to achieve both sensitivity and specificity.</p> |
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| sequential copies of this "unitary" sequence.</h6></p> | | sequential copies of this "unitary" sequence.</h6></p> |
| <hr> | | <hr> |
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| </div> | | </div> |
| </div> | | </div> |
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| </center> | | </center> |
| <br> | | <br> |
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| <p class="lead">Below is shown a direct comparison of the interaction between target amplicon and gRNA for Cas 9 and Cas 12a.</p> | | <p class="lead">Below is shown a direct comparison of the interaction between target amplicon and gRNA for Cas 9 and Cas 12a.</p> |
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| <figure> | | <figure> |
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| <p class="lead">From the template above we can therefore conclude that the gRNA for our Cas 12a system, designed as the one for Cas 9 from <a href="#Deng"><span style="color:blue">Deng <i>et al.</i>, 2014</span></a>, has to be: </p> | | <p class="lead">From the template above we can therefore conclude that the gRNA for our Cas 12a system, designed as the one for Cas 9 from <a href="#Deng"><span style="color:blue">Deng <i>et al.</i>, 2014</span></a>, has to be: </p> |
− | <p class="lead">5’-(UAAUUUCUACUAAGUGUAGAU)AACUAU<span style="color:red">|</span>ACAACCUAC<i>UACCUCA</i>-3’ [<b><i>gRNA sequence</i></b>]</p> | + | <p class="lead">5’-(UAAUUUCUACUAAGUGUAGAU)AACUAU<span style="color:red">|</span>ACAACCUAC<i>UACCUCA</i>-3’ [<b><i>gRNA sequence</i></b>]</p> |
| <br> | | <br> |
| <p class="lead">From the specifications for the probe above (10 bases small loop, 16 bases large loop) and from the gRNA sequence, the template amplicon therefore needs to have the following structure:</p> | | <p class="lead">From the specifications for the probe above (10 bases small loop, 16 bases large loop) and from the gRNA sequence, the template amplicon therefore needs to have the following structure:</p> |
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| <p class="lead">We also wanted to test the case of probes with the amplicon having the PAM sequence not on the large loop, but on the stem instead (i.e. a double-stranded PAM, as usually required in Cas systems, and not single-stranded). We considered in this case three different alternatives:</p> | | <p class="lead">We also wanted to test the case of probes with the amplicon having the PAM sequence not on the large loop, but on the stem instead (i.e. a double-stranded PAM, as usually required in Cas systems, and not single-stranded). We considered in this case three different alternatives:</p> |
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| <ol> | | <ol> |
| <li><p class="lead">Changing 4 bases in the large loop in order for them to be complementary to the PAM sequence, without adding more bases. This leads to a 19 bases-long stem, a 10 bases-long "small" loop and a 8 bases-long "large" loop. The template sequence of the amplicon is the following one:</p> | | <li><p class="lead">Changing 4 bases in the large loop in order for them to be complementary to the PAM sequence, without adding more bases. This leads to a 19 bases-long stem, a 10 bases-long "small" loop and a 8 bases-long "large" loop. The template sequence of the amplicon is the following one:</p> |
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| <p class="lead">Finally, Probe 10 was designed in a way to have a mismatched base in the stem with respect to the let-7a sequence (<mark>highlighted</mark> in both strands below):</p> | | <p class="lead">Finally, Probe 10 was designed in a way to have a mismatched base in the stem with respect to the let-7a sequence (<mark>highlighted</mark> in both strands below):</p> |
| <p class="lead">5'-p<u><span style="color:orange">ACAACCTAC</span><i>TACCTCA</u>AAC</i><span style="color:green">GTAGGTTGTA<mark><span style="color:green">G</span></mark>AGTT</span><i>TAAAGGGAGTCGGCGG</i><u><span style="color:orange">AACT<mark><span style="color:orange">C</span></mark>T</span></u>-3'</p> | | <p class="lead">5'-p<u><span style="color:orange">ACAACCTAC</span><i>TACCTCA</u>AAC</i><span style="color:green">GTAGGTTGTA<mark><span style="color:green">G</span></mark>AGTT</span><i>TAAAGGGAGTCGGCGG</i><u><span style="color:orange">AACT<mark><span style="color:orange">C</span></mark>T</span></u>-3'</p> |
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| </div> | | </div> |
| </div> | | </div> |
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| </p> | | </p> |
| </div> | | </div> |
| <hr style="height:2px;border:none;color:#333;background-color:#333;" /> | | <hr style="height:2px;border:none;color:#333;background-color:#333;" /> |
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| <h1 id="Cas12aAssay">Our detection scheme</h1> | | <h1 id="Cas12aAssay">Our detection scheme</h1> |
− | <p class="lead">We envision a follow-up based on repeated liquid biopsies in order to track the sequences that have been identified using our bioinformatic software, amplified by either PCR, isothermal amplification or RCA, and finally detected directly in the plasma using our Cas12a based system.</p> | + | <p class="lead">We envision a follow-up based on repeated liquid biopsies in order to track the sequences that have been identified using our bioinformatic software, amplified by either PCR, isothermal amplification or RCA, and finally detected directly in the plasma using our Cas12a based system.</p> |
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| <center> | | <center> |
| <figure> | | <figure> |
− | <img alt="Image" src="https://static.igem.org/mediawiki/2018/6/64/T--EPFL--FromBloodTo.png" class="img-fluid rounded" width="800" > | + | <img alt="Image" src="https://static.igem.org/mediawiki/2018/8/85/T--EPFL--DetectionScheme.png" class="img-fluid rounded" width="800" > |
| <figcaption class="mt-3 text-muted"><b>Figure 13.</b> Representation of our detection scheme: from a single drop of blood we collect the plasma in which reside our biomarkers, ctDNA and miRNAs. Depending on the follow-up assay (vaccine monitoring or relapse detection), we will amplify specific target sequences that we will detect afterwards using our Cas12a assay.</figcaption> | | <figcaption class="mt-3 text-muted"><b>Figure 13.</b> Representation of our detection scheme: from a single drop of blood we collect the plasma in which reside our biomarkers, ctDNA and miRNAs. Depending on the follow-up assay (vaccine monitoring or relapse detection), we will amplify specific target sequences that we will detect afterwards using our Cas12a assay.</figcaption> |
| </figure> | | </figure> |
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| <center> | | <center> |
| <figure> | | <figure> |
− | <img alt="Image" src="https://static.igem.org/mediawiki/2018/c/c8/T--EPFL--GraphDetection.png" class="img-fluid rounded" width="800" > | + | <img alt="Image" src="https://static.igem.org/mediawiki/2018/7/7d/T--EPFL--ctDNAconcentration.png" class="img-fluid rounded" width="800" > |
| <figcaption class="mt-3 text-muted"><b>Figure 14.</b> Example of the use of biomarkers as a means of prognosis on the health of a patient with melanoma. In this case, the patient receives our vaccine as a treatment, and we assume that the treatment worked. This would be marked by a decrease in the concentration of ctDNA characteristic of the neoantigens targeted by our vaccine, ideally until their complete eradication. The condition of the patient stabilizes for a certain amount of time but it still ends up in relapse, which is nonetheless promptly marked by an increase of chromosomal rearrangements ctDNA fragments in the blood.</figcaption> | | <figcaption class="mt-3 text-muted"><b>Figure 14.</b> Example of the use of biomarkers as a means of prognosis on the health of a patient with melanoma. In this case, the patient receives our vaccine as a treatment, and we assume that the treatment worked. This would be marked by a decrease in the concentration of ctDNA characteristic of the neoantigens targeted by our vaccine, ideally until their complete eradication. The condition of the patient stabilizes for a certain amount of time but it still ends up in relapse, which is nonetheless promptly marked by an increase of chromosomal rearrangements ctDNA fragments in the blood.</figcaption> |
| </figure> | | </figure> |
| </center> | | </center> |
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| <hr style="height:2px;border:none;color:#333;background-color:#333;" /> | | <hr style="height:2px;border:none;color:#333;background-color:#333;" /> |
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− | <h2><i><u>References</u></i></h2> | + | <h2><i><u>References</u></i></h2> |
| <ul> | | <ul> |
| <li id="Abe2003">Abe, Kenji. "Direct PCR from Serum." <i>PCR Protocols</i>. Humana Press, 2003. 161-166.</li> | | <li id="Abe2003">Abe, Kenji. "Direct PCR from Serum." <i>PCR Protocols</i>. Humana Press, 2003. 161-166.</li> |
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| </article> | | </article> |
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