An innovative diagnostic technology for the codon mutation C580Y in kelch13 of Plasmodium falciparum with MinION nanopore sequencer

• Published in: Malaria journal Vol. 17; no. 1; p. 217
• Main Authors: Imai, Kazuo, Tarumoto, Norihito, Runtuwene, Lucky Ronald, Sakai, Jun, Hayashida, Kyoko, Eshita, Yuki, Maeda, Ryuichiro, Tuda, Josef, Ohno, Hideaki, Murakami, Takashi, Maesaki, Shigefumi, Suzuki, Yutaka, Yamagishi, Junya, Maeda, Takuya
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29-05-2018; BioMed Central; BMC
• Subjects: Artemisinin; Artemisinin resistance; Causes of; Detection; Developing countries; DNA; DNA sequencing; Erythrocytes; Evaluation; Gene mutation; Genetic aspects; Haemophilus influenzae; Human diseases; Humans; Indonesia; Laboratories; LAMP; LDCs; Malaria; Malaria, Falciparum - classification; Malaria, Falciparum - parasitology; Methods; MinION; Mutation; Nanopore sequencer; Nanopores; Nucleic Acid Amplification Techniques - methods; Nucleotide sequence; Nucleotides; Parasites; PCR; Plasmids; Plasmodium; Plasmodium falciparum; Plasmodium falciparum - genetics; Plasmodium falciparum - isolation & purification; Plasmodium ovale; Plasmodium vivax; Procedures; Protozoan Proteins - genetics; Public health; Risk factors; Sequencing; Vector-borne diseases; Indonesia; United Kingdom > UK; Southeast Asia; Japan; Artemisinin resistance; Plasmodium falciparum; Malaria; MinION; kelch 13; LAMP; Nanopore sequencer
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/s12936-018-2362-x

The recent spread of artemisinin (ART)-resistant Plasmodium falciparum represents an emerging global threat to public health. In Southeast Asia, the C580Y mutation of kelch13 (k13) is the dominant mutation of ART-resistant P. falciparum. Therefore, a simple method for the detection of C580Y mutation is urgently needed to enable widespread routine surveillance in the field. The aim of this study is to develop a new diagnostic procedure for the C580Y mutation using loop-mediated isothermal amplification (LAMP) combined with the MinION nanopore sequencer.
A LAMP assay for the k13 gene of P. falciparum to detect the C580Y mutation was successfully developed. The detection limit of this procedure was 10 copies of the reference plasmid harboring the k13 gene within 60 min. Thereafter, amplicon sequencing of the LAMP products using the MinION nanopore sequencer was performed to clarify the nucleotide sequences of the gene. The C580Y mutation was identified based on the sequence data collected from MinION reads 30 min after the start of sequencing. Further, clinical evaluation of the LAMP assay in 34 human blood samples collected from patients with P. falciparum malaria in Indonesia revealed a positive detection rate of 100%. All LAMP amplicons of up to 12 specimens were simultaneously sequenced using MinION. The results of sequencing were consistent with those of the conventional PCR and Sanger sequencing protocol. All procedures from DNA extraction to variant calling were completed within 3 h. The C580Y mutation was not found among these 34 P. falciparum isolates in Indonesia.
An innovative method combining LAMP and MinION will enable simple, rapid, and high-sensitivity detection of the C580Y mutation of P. falciparum, even in resource-limited situations in developing countries.