Structural switching electrochemical DNA aptasensor for the rapid diagnosis of tuberculous meningitis.

Background: Tuberculous meningitis (TBM) is the most devastating manifestation of extra-pulmonary tuberculosis. About 33% of TBM patients die due to very late diagnosis of the disease. Conventional diagnostic methods based on signs and symptoms, cerebrospinal fluid (CSF) smear microscopy or liquid culture suffer from either poor sensitivity or long turnaround time (up to 8 weeks). Therefore, in order to manage the disease efficiently, there is an urgent and unmet need for a rapid and reliable diagnostic test.
Methods: In the current study, to address the diagnostic challenge of TBM, a highly rapid and sensitive structural switching electrochemical aptasensor was developed by combining the electrochemical property of methylene blue (MB) with the molecular recognition ability of a ssDNA aptamer. To demonstrate the clinical diagnostic utility of the developed aptasensor, a blinded study was performed on 81 archived CSF specimens using differential pulse voltammetry.
Results: The electrochemical aptasensor developed in the current study can detect as low as 10 pg HspX in CSF background and yields a highly discriminatory response ( P <0.0001) for TBM and not-TBM categories with ~95% sensitivity and ~97.5% specificity and has the ability to deliver sample-to-answer in ≤30 minutes.
Conclusion: In summary, we demonstrate a new aptamer-based electrochemical biosensing strategy by exploiting the target-induced structural switching of H63 SL-2 M6 aptamer and electroactivity of aptamer-tagged MB for the detection of HspX in CSF samples for the diagnosis of TBM. Further, the clinical utility of this sensor could be extended for the diagnosis of other forms of tuberculosis in the near future.
Competing Interests: Disclosure The aptamer used in this study is a proprietary reagent and is deposited in the Indian Patent Office as part of Indian Patent application number 201611001550; the patent was transferred to a Translational Health Science and Technology Institute (THSTI) spinoff, AptaBharat Innovation Pvt. Ltd. (ABIPL), for further development of aptamer-based diagnostics. RD is employed by AptaBharat Innovation Pvt. Ltd (ABIPL) and TKS is employed by THSTI. TKS is also the founder of THSTI spinoff, ABIPL and owns 87% stakes in ABIPL. The authors report no other conflicts of interest in this work.