Transcript Document
FilmArray™ - Nested Multiplex PCR for Multi-pathogen Screening Beth Lingenfelter Regulatory Affairs Manager Kirk Ririe CEO, FilmArray Inventor Mark Poritz, PhD Senior Scientist Film Array Program Lead Todd Ritter Corporate Development Officer Marshall McCarty Director QA/RA 1 Meeting Objectives and Agenda Objectives Start a dialogue about FilmArray Obtain input for product design Gain insights concerning regulatory issues Agenda Introductions and background– Beth Lingenfelter Principle of operation – Kirk Ririe Test system evaluation data – Kirk Ririe Controls – Mark Poritz Questions – OIVD? 2 Idaho Technology Inc – A PCR company 1990 – 1995 Rapid Air Thermocyclers 1996 – ITI launches LightCycler 1997 – Roche licenses LC from ITI 1999 – R.A.P.I.D., military version of LC 2003 – Awarded JBAIDS contract 2005 – Cleared JBAIDS Anthrax Detection Kit 2007 – Submitted JBAIDS Plague and Tularemia Detection Kits 3 How does it work? Nested Multiplex PCR (nmPCR) High-sensitivity assays for large panels of biological agents. Chemical Circuits in a Pouch – Closed system for complex chemistry Bead Beating to liberate nucleic acids Magnetic bead nucleic acid extraction Reverse transcription for RNA targets Nested Multiplex PCR High Resolution DNA melting curve analysis Instrument Automation 4 Nested PCR Pathogen Genome RNA or DNA Outer primers, Reverse transcription, 1st Stage PCR 200bp Dilution Step, Inner primers, 2nd Stage PCR 90bp 5 Nested Multiplex PCR Primary Multiplex RT-PCR 1F 2nd Stage PCR 1R 2F LCGreen or Taqman 2R 3F 3R 4F 4R 5F 5R 6F 6R Dilute 100 fold Between 1st & 2nd stage reactions 6 Robust Multiplex PCR 1 - 5000 x LOD C. burnetti 2 - 5000 x LOD C. burnetti + 0.1x LOD B. anthracis (100 ul of a 100 CFU/ml BA sample) 7 20 Organism Pool 20 Organism Mixture Results Organism Subtype Adenovirus Phylo group1 Phylo group2 Phylo group3 Phylo group4 Bocavirus Coronavirus SARS Coronavirus 229E Coronavirus NL63 Coronavirus OC43 Coronavirus HKU1 Pan Influenza A H3N2 H5N1 Pan Influenza B Human Metapneumov Phylo group1 Human Phylo group2 Rhinovirus Phylo group3 Phylo group4 Parainfluenza 1 2 virus 3 4 RSV pertussis Bordatella pneumoniae Clymidia Mycoplasma pneumoniae Gene Hexon Hexon Hexon Hexon NP NS NG Pol NG Pol NG Pol NG Pol NG Pol Matrix HA NA HA NA HA NG PL 5' UTR 5' UTR 5' UTR 5' UTR HN FG FG FG MG Toxin gyrB GyrB Average of Replicate CP Infectious Units TCID50/ CFU or µl of NPA per Run 12.9 14.2 6.84E+02 14.5 19.8 0.74µl NPA NA 13.9 12.4 21.6 23.6 7.8 9.2 1.22E+02 0.74µl NPA 1.88E+05 NA 11.5 12.2 13.0 11.8 24.7 27.3 24.4 22.5 24.5 24.2 12.0 15.5 12.4 19.8 12.9 12.7 17.6 23.1 2.16E+04 NA 6.84E+03 0.74µl NPA 7.43E+02 1.22E+05 6.84E+03 1.22E+06 1.17E+01 1.22E+04 1.49E+03 81.49E+03 1.54E+03 Chemical Circuit-boards Freeze dried reagents for sample preparation and nested multiplex PCR (nmPCR) (A) Reagents delivered into working blisters pneumatically (B) 1st Stage PCR (Blisters F and G) High-density array of 120, 1 ul 2nd stage nmPCR reactions (I) 9 Instrument Automation – Electro-pneumatic Integration Silicone bladders inflate over blisters to move liquids Air Channels Valve Pistons close channels to select flow path All components integrated in a single core module Window - 2nd Pneumatic Bladders Stage PCR 10 Prototype FilmArray™ Instrument Fully automated 1 hour to result System weight 14 lbs + laptop Five prototype systems in operation 11 The Instrument Generates a Complex Data Set 12 MetaAnalysis Summary 13 Analysis for each organism 14 Analyze the results for each assay 15 System Evaluation Data Demonstration for US Air Force EOS program, Lackland AFB, San Antonio, TX URI pre-clinical test Primary Children’s Medical Center (PCMC) Salt Lake City, UT IRB approved protocol 16 Lackland AFB Demo – Jul 07 3 Pre-production FilmArray™ Instruments Pooled ATCC samples and frozen de-identified clinical specimens 17 Lackland Results Blinded test demonstrated very reproducible Drop Page Fields Here multiplex results across three instruments Friday Mix 2, 3 runs SpyoRpob.02 SpnePly.01 RSVMG.01 PIV3FG.01 PIV2FG.02 PIV1HN.01 MpneTox.02 MpneGyrb.01 FluBHA.01 FluAN2.06 FluAN1.11 FluAH3.04 FluAH1.09 2.31E+04 2.16E+05 4.61E+06 6.92E+04 Drop More Series Fields CoVOC43NG.07 Staphylococcus aureus HSV-1 Neisseria mucosa Hemophilus influenzae Average of Cp 30 25 20 15 10 5 0 CoV229EPL.01 Influenza A H3N2 Influenza B Adenovirus B & E Coronavirus 229E M. pneumoniae S. pyogenes Strep. pneumoniae CEID/TCID/cfu /run 2.16E+05 6.84E+04 6.84E+03 1.22E+03 1.54E+04 7.54E+07 6.15E+03 AdHex-iF1R2 Organism Assay 18 PCMC Test System Evaluation 100 frozen samples tested at ITI, (collected February-March 2007) 50 Samples tested at PCMC (October – November 2007) Triplicate results are compared to DFA, discordant results are being followed up with sequencing Viruses 17 Organisms Tested FilmArray Bacteria Assays 3 36 DFA Viruses 8 19 Detection Rates for FilmArray and DFA Percent Results/ Sample 60 50 40 FilmArray 30 DFA 20 10 0 Negative Single Dual Triple 20 0 Mycoplasma pneumoniae Coronavirus SARS Coronavirus NL63 Coronavirus HKU1 Coronavirus 229E Coronavirus 0C43 Chlamydia pneumoniae Bordatella pertussis Bocavirus Human Rhinovirus Parainfluenza Virus 4 Parainfluenza Virus 3 Parainfluenza Virus 2 Parainfluenza Virus 1 Respiratory Syncytial Virus Influenza B Influenza A Human Metapneumovirus Adenovirus PCMC Study Results To-date Organisms ID'd in 143 Samples 35 30 25 20 FilmArray 15 DFA 10 5 21 Triple Infection Bocavirus – black PIV2 – blue Human Rhinovirus - green Bocavirus – black, PIV2 – blue, Human Rhinovirus - green 22 23