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QClamp JAK2 Codon Specific Mutation Detection Kit 1 QClampJAK2 Codon Specific Mutation Detection Kit QClamp™ JAK2 Codon Specific Mutation Detection Kit Instruction Manual Rev. 5.0 For Real-Time PCR Assays #DC -10-0166 (30 samples) #DC-10-0165 (60 samples) Date of Revision: November 21, 2013 DOC-DC1100166_DC1100165 DiaCarta Inc. 3535 Breakwater Ave., Hayward, CA 94545 TEL: (510) 314-8858 FAX: (510) 735-8636 E-MAIL: [email protected] MDSS GmbH Schiffgraben 41 30175 Hannover, Germany

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Page 1: QClamp™ JAK2 Codon Specific Mutation Detection Kit ... · QClamp JAK2 Codon Specific Mutation Detection Kit 1 ... QClamp™ JAK2 Codon Specific Mutation Detection Kit Instruction

QClamp JAK2 Codon Specific Mutation Detection Kit

1

QClamp™ JAK2 Codon Specific Mutation Detection Kit

QClamp™ JAK2 Codon Specific Mutation Detection Kit

Instruction Manual

Rev. 5.0

For Real-Time PCR Assays

#DC -10-0166 (30 samples)

#DC-10-0165 (60 samples)

Date of Revision: November 21, 2013

DOC-DC1100166_DC1100165

DiaCarta Inc.

3535 Breakwater Ave., Hayward, CA 94545

TEL: (510) 314-8858 FAX: (510) 735-8636

E-MAIL: [email protected]

MDSS GmbH

Schiffgraben 41

30175 Hannover,

Germany

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Contents

Components of the QClamp™ JAK2 Mutation Detection Kit .............................................. 3

Storage Requirements ............................................................................................................... 3

Intended Use .............................................................................................................................. 4

JAK2 Mutations and Cancer ................................................................................................... 4

QClamp Technology for Mutation Detection ...................................................................... 5

General Considerations ............................................................................................................ 6

Validated PCR Instruments for QClamp XNA Assays ......................................................... 6

Additional Equipment and Reagents Required .............................................................................. 7

Warnings and Precautions .................................................................................................................... 7

ASSAY PROCEDURE

Sample Preparation ....................................................................................................................... 8

DNA preparation from cells with Qzol reagent

Guidelines for using QZol Reagent on whole blood

Purified DNA sample (non-QZol)

Preparation and aliquoting of PCR mixes and samples ...................................................... 10

Set up mastermixes for assays in 96-well plate, tube strips, or tubes

Dispense master mix, samples, and Clamping Controls

Real-Time PCR Reaction ....................................................................................................... 12

ANALYSIS OF RESULTS

Assessment of Real-Time PCR Results ................................................................................. 13

Clamping Controls (wild-type DNA control)

Judging validity of sample data based on non-XNA mix results

Judging validity of sample data based on Internal Control of HRM Curves

Scoring Detected Mutations ................................................................................................... 15

Assay Performance Characteristics ...................................................................................... 16

Symbols Used in Packaging.................................................................................................... 19

Ordering Information ............................................................................................................. 19

Troubleshooting ...................................................................................................................... 20

References ............................................................................................................................... 22

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KIT COMPONENTS TABLE 1. COMPONENTS OF KITS #DC-10-0166 AND #DC-10-0165

No.

Name of component

Description

Volume

(30 tests)

DC-10-0166

Volume

(60 tests)

DC-10-0165

Storage

1 Non XNA mix #1 Primers only 1 x 200 µl 1 x 400 µl -20°C

2 JAK2 XNA mix #2 Codon 617 XNA and primers 1 x 200 µl 1 x 400 µl -20°C

3 JAK2 XNA 2X premix PCR reaction premix 1 x 0.65 mL 2 x 0.65 mL -20°C

4 Clamping control Wild-type DNA 1 x 50 µl 1 x 100 µl -20°C

5 QZol Solution A Lysis Buffer A 2 x 1.0 ml 4 x 1.0 ml -20 ºC

6 QZol Solution B Lysis Buffer B 2 x 1.0 ml 4 x 1.0 ml -20 ºC

STORAGE REQUIREMENTS

The QClamp™ JAK2 Codon-Specific Mutation Detection Kit should be stored at -20°C.

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INTENDED USE The QClamp™ JAK2 Codon Specific Mutation Detection Kit is used to detect somatic mutations in

codon 617 in the JAK2 tyrosine kinase gene (Table 2) from cell or tissues without DNA extractions.

The kit is to be used by trained laboratory professionals within a laboratory environment, using, for

example, fresh or formalin-fixed, paraffin-embedded (FFPE) samples of lung and colorectal biopsies

and surgical tissue samples.

TABLE 2. JAK2 MUTATIONS DETECTED BY THE KIT

JAK2 MUTATIONS AND CANCER

Janus kinase 2 (JAK2) is an intracellular tyrosine kinase that associates with the cytoplasmic domains

of multiple cytokine receptors. Ligand binding by the receptor results in conformational changes that

activate JAK2, resulting in phosphorylation of target proteins, including STATs and JAK2 itself. More

than 50% of myeloproliferative neoplasms (MPNs) harbor the activating JAK2 V617F mutation In

addition, a subset of B cell acute lymphoblastic leukemia (B-ALL) with rearrangements of cytokine

receptor–like factor 2 (CRLF2) have activating JAK2 mutations that primarily involve R683. A high

proportion (> 50%) of patients with myeloproliferative disorders (MPD; (polycythemia vera, essential

thrombocythemia, idiopathic myelofibrosis ) carry a dominant gain-of-function V617F mutation in the

JH2 kinase-like domain of JAK2. This mutation leads to deregulation of the kinase activity, and thus to

constitutive tyrosine phosphorylation activity. The V617F mutation seems to occur exclusively in

hematopietic malignancies of the myeloid lineage.

A significant percentage of patients with myeloproliferative disorders carries a dominant gain of

function V617F mutation in JAK2; this mutation seems to lead to deregulation of the kinase activity of

JAK2, and thus to constitutive tyrosine phosphorylation activity, providing hematopoietic cells with a

proliferative and survival advantage.

Reagent Target Exon Codon

JAK2 Mutation 12 617

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QCLAMP™ TECHNOLOGY FOR MUTATION DETECTION

The QClamp™ JAK2 Codon Specific Mutation Detection Kit is based on Xeno-Nucleic Acid

(XNA)-mediated PCR clamping technology. XNA is a synthetic DNA analog in which the

phosphodiester backbone has been replaced by a repeat formed by units of (2-aminoethyl)-glycine.

XNA-mediated PCR clamping relies on the following two unique properties of XNA probes:

First, XNA will hybridize tightly to its complementary DNA target sequence only if the sequence

is a complete match. When there is a mutation in the target gene, and therefore a mismatch is present,

the XNA:DNA duplex is unstable, allowing strand elongation by DNA polymerase.

Second, XNA oligomers are not recognized by DNA polymerases and cannot be utilized as primers

in subsequent real-time PCR reactions. Instead, the XNA oligomer serves as a sequence-selective

clamp to prevent amplification during subsequent PCR reactions.

The assay is sufficiently robust that conventional nucleic acid purification is not required. Tissue or

cells can be simply lysed with the QZol™ reagent provided, then an aliquot of this extract is added

directly to the PCR mixture containing DNA primers and the XNA “clamp”.

FIGURE 1. PRINCIPLE OF THE QCLAMP™ JAK2 CODON-SPECIFIC MUTATION DETECTION KIT

The QClamp XNA oligonucleotide binds the wild-type DNA near the hybridization site of the forward

PCR primer, thus blocking the action of the DNA polymerase. Genetic variations at the QClamp

binding site will prevent tight binding of the QClamp oligonucleotide, permitting the polymerase chain

reaction to produce a detectable amplicon.

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GENERAL CONSIDERATIONS Effective use of real-time PCR tests requires good laboratory practices, including maintenance of

equipment that is dedicated to molecular biology and is compliant with applicable regulations and

relevant standards. Use nuclease-free labware (pipets, pipet tips, reaction vials) and wear gloves when

performing the assay. Use fresh aerosol-resistant pipet tips for all pipetting steps to avoid cross

contamination of the samples and reagents.

Perform the QClamp assay protocol using only material (pipets, tips, etc.) dedicated to this application

in an area where no DNA matrixes (DNA, plasmid, or PCR products) have been introduced. Add

template DNA in a separate area (preferably a separate room) with material (pipets, tips, etc.) dedicated

only to this application. Use extreme caution to prevent DNase contamination that could result in

degradation of the template DNA, or DNA or PCR carryover contamination, which could result in a

false positive signal.

Reagents and instructions supplied in the kit have been tested for optimal performance. All reagents are

formulated specifically for use with this kit. Make no substitutions in order to insure optimal

performance of the kit. Further dilution of the reagents or alteration of incubation times and

temperatures may result in erroneous or discordant data.

VALIDATED REAL-TIME PCR INSTRUMENTS FOR QCLAMP XNA ASSAYS

The following instruments have been validated for use with QClamp XNA assays.

TABLE 3. REAL-TIME INSTRUMENTS TESTED WITH QCLAMP XNA ASSAYS

Company Model

Bio-Rad CFX 96

Roche LightCycler LC96

Roche LightCycler 480 II

ABI ABI 7500

ABI ABI 7900

Qiagen Rotor-Gene Q

Cepheid* SmartCycler

*Cepheid uses a 25 µl reaction volume. If using the Cepheid instrument, or for advice in optimizing

your protocol for other instruments, please contact DiaCarta.

Email: [email protected]

Tel: +1 510 314-8858

www.diacarta.com

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ADDITIONAL EQUIPMENT AND REAGENTS REQUIRED

Real-time PCR instrument capable of SYBR Green dye detection

0.2 ml DNase-free PCR tubes or plates

Pipettes (P-20, P-200, P-1000, P-200 multi-channel)

1.5ml microcentrifuge tubes

15 ml conical tubes

Microcentrifuge

Vortexer

PCR rack

Reagent reservoir

Distilled water

WARNINGS AND PRECAUTIONS

Use extreme caution to prevent contamination of PCR reactions with the Clamping Control.

Minimize exposure of the XNA 2X premix to room temperature for optimal amplification.

Avoid overexposing the XNA 2X premix solution to light for optimal fluorescent signal.

Use of non-recommended reagent volumes may result in a loss of performance and may also

decrease the reliability of the test results.

Use of non-recommended volumes and concentrations of the target DNA sample may result in a

loss of performance and may also decrease the reliability of the test results.

Use of non-recommended consumables with instruments may adversely affect test results.

Do not re-use any remaining reagents after PCR amplification is completed.

Additional validation testing by user may be necessary when using non-recommended instruments.

Additional purification may be required if DNA has been extracted from a paraffin block.

Perform all experiments under proper sterile conditions using aseptic techniques.

Perform all procedures using universal precautions.

Wear personal protective apparel, including disposable gloves, throughout the assay procedure.

Do not eat, drink, smoke, or apply cosmetics in areas where reagents or specimens are handled.

Dispose of hazardous or biologically-contaminated materials according to the practices of your

institution.

Discard all materials in a safe and acceptable manner, in compliance with all legal requirements.

Dissolve reagents completely, then mix thoroughly by vortexing.

If exposure to skin or mucous membranes occurs, immediately wash the area with large amounts of

water. Seek medical advice immediately.

Do not use components beyond the expiration date printed on the kit boxes.

Do not mix reagents from different lots.

Return all components to the appropriate storage condition after preparing the working reagents.

Do not interchange vial or bottle caps, as cross-contamination may occur.

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ASSAY PROCEDURE

Step 1: Sample preparation (30 min) Lyse samples with QZol to release genomic DNA Step 2: Add QClamp Mixture (10min) Add lysates or clamp controls to QClamp mix (2X Premix and XNA Mix)

Step 3: Real-Time PCR Reaction (2 hours)

FIGURE 2. WORKFLOW OF THE QCLAMP JAK2 CODON SPECIFIC MUTATION DETECTION KIT

Use standard pathology methodology to ensure specimen quality during collection, transport and

storage of samples. Alternate methodology for sample handling must be validated by the enduser.

1. SAMPLE PREPARATION QZol™ Reagent is a complete and ready-to-use lysis reagent consisting of QZol Solutions A and B.

QZol releases genomic DNA from solid and liquid samples of animal, plant, yeast, and bacterial origin

into a form which can be used directly in PCR reactions without the need for DNA extraction. In

addition, the special properties of Qzol„s chemistry can help keep DNA in linear format to optimize

hybridization and increase PCR efficiency.

Typical sources of genomic DNA for mutation detection by the kit include samples obtained from

whole blood, purified peripheral blood lymphocytes, polynuclear cells, or granulocytes, fresh or frozen

tissue from surgical procedures and biopsies. QZol has been validated on these sample types, as well as

on cultured cells and cells purified from blood such as peripheral blood lymphocytes, polynuclear cells,

and granulocytes. An extraction procedure for whole blood with the reagent has not yet been validated,

but should work with some optimization depending on coagulant used, etc. Contact DiaCarta at

[email protected] for assistance with genomic DNA protocol optimization.

Other methods for purifying genomic DNA, such as homebrew methods or commercially-available

products, will also work with the kit. Regardless of which approach is used, use the same cellular

fraction and DNA extraction method each time the assay is performed.

DNA preparation from cells with QZol reagent

For softer and moister tissues such as cultured cells or cells purified from blood such as peripheral blood

lymphocytes, polynuclear cells, and granulocytes, modify the protocol to add twice the volume of QZol

reagent as sample volume.

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1. Thaw QZol Solution A and QZol Solution B at room temperature or in a water bath

2. Add anywhere from 200 to 100,000 cells to a microcentrifuge tube, ideally a sample volume of

approximately 50 µl. The sample to reagent volume ratio for these tissue types should be roughly 1:2.

3. Add 100 µl of QZol Solution A to each tube and vortex for 10 seconds.

4. Place sample tubes into a heating block at 95 °C for 20 minutes, removing every 5 minutes to vortex

10 seconds.

5. Remove sample tubes from heating block and add an equivalent volume of QZol Solution B as was

added of QZol Solution A. If 100 µL of Solution A was added earlier, now add 100 µl of Solution B.

6. Vortex each sample for 10 seconds.

7. Spin down the sample preparation tubes for 30 seconds in a microcentrifuge.

8. Collect the supernatant, the QZol lysate, avoiding the pellet, for use in PCR procedure, cool to room

temperature.

Guidelines for using QZol Reagent on Whole Blood

A generalized extraction procedure for QZol Reagent on whole blood has not been established. Whole

blood is a complex tissue and different coagulation reagents produce final products with varying

characteristics. However, a reasonable starting point would be the incubation protocol for cells on a

sample size of 200 µl whole blood along with 400 µl each of Solution A and Solution B. Contact

DiaCarta at [email protected] for assistance with whole blood protocol optimization.

Purified DNA Sample (non-QZol)

The QClamp real-time PCR reaction is optimized for DNA samples containing 5-10 ng of purified

genomic DNA. If you are working with samples consisting of purified DNA, dilute the DNA to a

concentration of 5 ng/μl in 1X TE buffer at pH 8.0. Store samples at +4 to +8 °C for short periods, up to

one week. Store at –20 °C if longer-term storage is required.

2. PREPARATION AND ALIQUOTING OF PCR MIXES AND SAMPLES

Each sample of potentially mutant DNA requires one reaction for each mutation site detected by the kit,

plus an XNA-free control. The XNA-free control insures that the supplied primers and polymerase are

working properly on the sample. The JAK2 Codon-Specific Mutation Detection Kit detects mutation

sites in exon 12, therefore a total of two reactions will be required for each sample.

A set of Clamping Controls must also be run every time the assay is run. Clamping Controls use

wild-type DNA as the sample. Wild-type DNA should have no mutations, therefore the XNA probes

will bind strongly, blocking the polymerase from making amplicons. However, non-XNA mix #1 with

the Clamping Control should make amplicons efficiently, providing another way to monitor

performance of the primers, polymerase, and sample.

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Each kit contains enough material to run five sets (30-sample test kit) or ten sets (60-sample test kit) of

Clamping Controls, or one Clamping Control set for every six samples. Further quantities of JAK2

wild-type genomic reference DNA control can be purchased as a separate item, if desired.

Depending on how many samples will be processed in a given experiment, different strategies are used

for creating master mixes. The most typical application involves testing in 96-well plates, but the assay

can also be run in tube strips or individual tubes.

The QClamp XNA real-time assay protocol uses 20 μl reaction volumes. Each reaction will contain 10

μl 2X Premix, 6 μl of one of each XNA Mix, and 4 μl of sample, for a total of 20μl.

Adjust amounts appropriately for different reaction volumes.

TABLE 4. COMPONENTS OF THE QCLAMP XNA ASSAY REACTION VOLUME

Components Volume

JAK2 XNA 2X Premix 10 μl

XNA Mix (#1, #2) 6 μl

DNA sample or Clamping Control 4 μl

Total volume 20 μl

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Set up mastermixes for assays in 96-well plate, tube strips, or tubes

(This is a suggested method. Other approaches can achieve the final result.)

1. Consecutively label two tubes as M1, and M2.

These will be master mix tubes containing XNA Mixes #1, and #2 respectively, plus the 2X PreMix

(containing polymerase, SYBR Green and appropriate buffers).

Tip: It is good practice to go 10% over when putting master mixes together to insure not running out of

master mix prematurely when aliquotting.

2. Add the appropriate amount of 2X Premix and XNA Mix to its M tube. See table 5 for

appropriate volumes.

TABLE 5. SETTING UP PCR REACTION MASTER MIXES

# samples

(Volume calculated

based on N+2

samples to account

for clamping control

and overage)

Non-XNA Mix #1 (S1) or

JAK2 XNA Mix #2 (S2)

JAK2 XNA 2X

Premix

Total Volume Sample volume

10 72 µl 120 µl 192 µl Add 16 µl to each

tube, then add 4 µl of

sample to the

appropriate tubes.

20 132 µl 220 µl 352 µl

30 172 µl 320 µl 492 µl

40 252 µl 420 µl 672 µl

50 312µl 520 µl 832 µl

60 372 µl 620 µl 992 µl

Table 5 is based on the following calculations to determine the number of microliters of each XNA Mix

and 2X Premix to aliquot to its respective master mix tube, where N = total number of samples. For

sample amounts not indicated in Table 5, the following calculations may be used:

(N + 2) x 6 = Microliters of XNA Mix for each master mix tube of the corresponding number.

(N+2) x 10 = Microliters of 2X Premix in every master mix tube.

(The N+2 calculation is to account for the Clamping Controls and overage.)

Dispense master mix, samples, and Clamping Controls

3. Dispense 16 µl master mix across a 96-well plate or into tubes

Transferring the contents of each master mix tube to a reagent reservoir now enables use of a

multichannel pipettor in dispensing across a plate or into strips.

Alternatively, a repeating pipettor would be useful for an individual tubes assay format.

In the case of 96-well plates, the exact plate layout for the next step can be set to the user‟s preference.

However, take care to remember which wells are for which XNA Mixes, to insure that all potential

detected mutations and XNA minus controls are processed properly.

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A suggested layout involves using a 8-channel pipettor to pipet 16 µl of master mix into the columns on

the plate, that is, to pipet 16 µl of M1 into columns 1, 5, and 9, 16 µl of M2 in columns 2, 6, and 10, and

so on.

6 ul NonXNA Mix #1

6 ul XNA

Mix #2

6 ul Non XNA

Mix #1

6 ul XNA

Mix #2

6 ul NonXNA Mix #1

6 ul XNA Mix

#2

6 ul Non-XNA

Mix #1

6 ul XNA Mix #2

1 2 3 4 5 6 7 8

A

SAMPLE 1

SAMPLE 1

SAMPLE 2

SAMPLE 2

SAMPLE 3 SAMPLE 3 SAMPLE 4 SAMPLE 4

B

SAMPLE 5

SAMPLE 5

SAMPLE 6

SAMPLE 6

SAMPLE 7 SAMPLE 7 SAMPLE 8 SAMPLE 8

C

SAMPLE 9

SAMPLE 9

SAMPLE 10

SAMPLE 10

SAMPLE 11

SAMPLE 11

SAMPLE 12

SAMPLE 12

D

SAMPLE 13

SAMPLE 13

SAMPLE 14

SAMPLE 14

SAMPLE 15

SAMPLE 15

SAMPLE 16

SAMPLE 16

E

SAMPLE 17

SAMPLE 17

SAMPLE 18

SAMPLE 18

SAMPLE 19

SAMPLE 19

SAMPLE 20

SAMPLE 20

F

SAMPLE 21

SAMPLE 21

SAMPLE 22

SAMPLE 22

SAMPLE 23

SAMPLE 23

SAMPLE 24

SAMPLE 24

G

SAMPLE 25

SAMPLE 25

SAMPLE 26

SAMPLE 26

SAMPLE 27

SAMPLE 27

SAMPLE 28

SAMPLE 28

H

SAMPLE 29

SAMPLE 29

SAMPLE 30

SAMPLE 30

CLAMPING CONTROL

CLAMPING CONTROL

10 ul 2X Premix, all wells

FIGURE 3. SUGGESTED PLATE LAYOUT

4A. Dispense 4 µl of sample DNA and Clamping Control DNA into wells

With a plate layout as described in Figure 3, where each column represents a different XNA Mix, use two

pipet tips on an 8-channel pipettor or a repeating pipettor with a single tip to pipet 4 µl of Sample 1 into

each of the first two wells of Row A, then 4 µl of Sample 2 into each of the next two wells in that row, and

so on, until all samples are loaded.

Pipet the clamping controls into the last two wells of Row H.

4B. Dispense 4 µl of sample DNA and Clamping Control DNA into tubes

If pipetting samples into tubes instead of 96-well plates, label tubes as “S” followed by the number of the

mix (1 or 2), a hyphen, then the sample number. For example, if running 15 samples, label tubes as S1-1,

S1-2 …..S1-15. Repeat for S2. Label the single set of Clamping Control reaction tubes as C1and C2.

When all reagents have been loaded, tightly close the PCR tubes or seal the 96-well plate to prevent

evaporation.

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3. REAL-TIME PCR REACTION Set up the real-time PCR instrument to read SYBR Green at 60 °C. Perform real-time PCR using the

cycling conditions described below.

TABLE 6. CYCLING CONDITIONS FOR QCLAMP XNA ASSAYS

One cycle

Pre-denaturation 95 °C 5 minutes

Four-step cycling (40 cycles total)

Denaturation 95 °C 30 seconds

QClamping 70 °C 20 seconds

Primer annealing 58 °C 30 seconds

Extension 60 °C 30 seconds

ANALYSIS OF RESULTS

ASSESSMENT OF REAL-TIME PCR RESULTS

Determine the Cq value for each PCR reaction. Cq is the cycle threshold, the cycle number at which

a signal is detected above background fluorescence. The lower the cycle number at which signal rises

above background, the stronger the PCR reaction it represents (**please see MIQE Guidelines under

References).

Clamping Controls (wild-type DNA control)

The Cq values of the Clamping Controls (tubes C1-C2) should fall in the range given in the table below.

These values are expected because the combination of wild-type DNA with XNA probes in C2 should

block amplification, while the absence of probes in C1 would produce a robust level of amplification.

The assay should be repeated if the values are not within the recommended range.

TABLE 7. ACCEPTABLE CQ RANGES FOR THE CLAMPING CONTROLS

Assay Acceptable Cq Range

Non-XNA mix #1 (C1) 23 ≤ Cq ≤ 30

JAK2 XNA mix #2 (C2) > 34

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Judging validity of sample data based on non-XNA mix results

In considering the Cq values for each sample (S1-S2), note that the Cq values of any non-XNA mix #1

reaction should be in the range of 22-34. The Cq value of non-XNA mix #1 (S1) can serve as an internal

control to indicate the purity and the concentration of DNA. Thus, the validity of the test can be decided

by the Cq value of the non-XNA mix #1 (S1).

TABLE 8. NON-XNA CONTROLS FOR SAMPLE PURITY AND CONCENTRATION

Validity Cq value of

non-XNA mix #1 Descriptions and recommendations

Optimal 23 < Cq < 30 The amplification and amount of DNA sample were

optimal.

Acceptable 30 < Cq < 34 The target gene was amplified at low efficiency. For a more

reliable result, repeat the PCR reaction with more DNA.

Invalid Cq ≤22 Possibility of a false positive is high. Repeat the PCR

reaction with less DNA.

Invalid Cq ≥ 34 The amplification has failed. Check DNA amount and

purity. A new DNA prep may be required.

Judging validity of sample data based on Internal Control of HRM curves

If test sample is negative, please check the HRM melting profile derivative plots ( -dF/dT against

T) to make sure it is true negative.

1. The -dF/dT should be 0.10 or higher

2. If the -dF/dT is less than 0.10, PCR reaction is inhibited, the obtained data must be

discarded and the experiment should be repeated.

Normal PCR reaction HRM profiles:

Sample 1

-dF/dT > 0.3

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Sample 2

-dF/dT > 0.3

-dF/dT = < 0.10 PCR reaction inhibited.

SCORING DETECTED MUTATIONS

After measuring and recording the Cq values for each reactions of each sample and all

Clamping Control reactions, next determine ΔCq values for mutation sites in every sample.

Subtract the Cq of each sample that contained XNA Mix#2 from the Cq of Clamping Control 2

to get that set of ΔCq values.

Mutated samples are defined by conditions where the mutated allele yields Cq < 40, and the

ΔCq relative to the Clamped Control using the same XNA probe > 1.5. For example, if the Cq

of the C2 Clamping Control is 39 and the Cq of sample S1-2 is 35, then the ΔCq = 39 - 35 = 4.0,

or >1.5, so the sample is scored positive for a mutation.

If performing sample replicates, calculate the mean ΔCq for each sample, the standard

deviation (SD), and the mutation threshold (MT) value, where MT = mean ΔCq−2SD.

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ASSAY PERFORMANCE CHARACTERISTICS

Analytical performance

The specific performance characteristics of the QClamp JAK2 Mutation Detection kit were

determined by studies involving JAK2 defined genomic DNA reference samples obtained from

Horizon Diagnostics (Cambridge, England) these are genetically defined JAK2 genomic DNA

that contain heterozygous mutations in the coding sequence of the JAK2 gene at codons described

in Table 2. These single nucleotide polymorphisms in the JAK2 gene are confirmed by droplet

digital PCR (ddPCR) and genomic DNA sequencing. Mutation status of samples are confirmed

by sequencing.

Analytical accuracy and comparison to reference method

QClamp analytical accuracy is verified and validated through testing of samples with known

mutations. Sample mutation status was verified through sequencing. Three studies were done to

demonstrate concordance in mutation status of samples tested with QClamp Mutation Detection

Kit relative to sequencing. A set of sample were chosen for evaluation based on mutation status. In

a blinded manner, samples were chosen to be tested with QClamp Mutation Detection Kit to be

compared to mutation status returned from sequencing. The results demonstrated that the QClamp

Mutation Detection Kit reported 100% match to sequencing. The results are confirmed by

performance from three different test sites and three different sets of clinical samples.

Cut-off

Along with studies for analytical accuracy, samples were tested to establish cut-off for the assay.

Cut-off for positive mutation has been established at ΔCq > 1.5.

Interfering substances

The objective of this study was to evaluate the impact of potentially interfering substances

on the performance of the QClamp JAK2 Mutation Detection Kit. The impact of each substance

was analyzed by means of spiking experiments at three concentrations on the results of ΔCq and

the mutation status of test samples. Potentially interfering substances tested were paraffin, ethanol,

QZol Solution A, QZol Solution B, Assay Buffer, and Proteinase K at the concentration of 0.1%,

1% and 5%. None of the potentially interfering substances evaluated at the concentrations

expected to be encountered in normal use impacts the ability of the QClamp JAK2 Mutation

Detection Kit to distinguish between mutation-positive and mutation-negative samples.

Multiple freeze/thaw cycles

The effect of 1, 3, 5, and 8 freeze-thaw cycles were tested in QClamp JAK2 Mutation Detection Kit

reagents. There is no effect up to 5 freeze-thaw cycles on the QClamp JAK2 Mutation Detection Kit to

distinguish between mutation positive and mutation negative samples. Caution: Repeated freeze-thaw

cycles may decrease the reliability of test results.

Shelf-Life

6 months after kit is open; 1 year after receiving for unopened kit.

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Repeatability and reproducibility

The precision of QClamp JAK2 Mutation Detection Kit was determined with defined analyte

levels of mutated DNA. To establish lot to lot variation, a reproducibility study of QClamp

Mutation Detection was performed using three different kit lots. Each lot was tested on three

separate dates testing one wild-type and one sample for each mutation with the QClamp JAK2

Mutation Detection Kit. Inter-assay %CV was established using the same lot of reagents tested

by three different users, performed at three different sites, with tests run one-two times a day for

three days. Intra-assay %CV was established through performance of QClamp Mutation

Detection Kit with samples run in triplicate and repeated for three days. All testing was done

using sequence verified samples from Horizon Diagnostics. Reproducibility is demonstrated

based on %CV of Cq values with a rate of 100% correct mutation calls for all assays across

multiple lots and operators for both within and between laboratory experiments.

TABLE 9. REPRODUCIBILITY RESULT SUMMARY %CV

Limit of Detection

To determine the limit of detection (LOD) for the kit, a QClamp assay was run using a

serial dilution of mutant DNA in wild-type background. Mutant samples were sequence verified

by Horizon Diagnostics. Mutant concentrations tested were 50, 10, 5, 1, and 0.1% Results

demonstrate effective clamping of wild type, providing reproducible detection of mutations at

concentrations as low as 0.1%.

Mutant Dilution Study:

ΔCq 0.1% Mutant = 1.65 ΔCq = Cq of negative control – Cq of sample

ΔCq 1.0 % Mutant = 3.0 ΔCq = Cq of negative control – Cq of sample

Intra-assay ≤ 3%

Inter-assay ≤ 5%

Lot to Lot variation ≤ 3%

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Using Roche LC96

Profile of WT DNA Control

Profile of samples and controls

Understanding the Symbols

WT without

QClamping

WT with

Qclamping

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SYMBOLS USED IN PACKAGING

TABLE 10. SYMBOLS USED IN PACKAGING

Symbol Definition

In Vitro diagnostic device

Catalog Number

Manufactured by

Temperature limitation

Batch Code

Use by date

Authorized Representative in the European

Community

CE Mark

2012-11-25 Date format (year-month-day)

2012-11 Date format (year-month)

ORDERING INFORMATION: TABLE 11. ORDERING INFORMATION

QClamp™ JAK2 Codon-Specific Mutation Detection Kit

Product Name Cat.Number Size Reader

Platform JAK2 Mutations

QClamp™ JAK2 Codon Specific

Mutation Detection Kit DC-10-0166

30

samples

Real-time

PCR

Analysis

Mutations in Exon 12

codons 617

QClamp™ JAK2 Codon Specific

Mutation Detection Kit DC-10-0165

60

samples

Real-time

PCR

Analysis

Mutations in Exon 12

codons 617

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TROUBLESHOOTING:

Negative result for Clamping Control with Non-XNA Mix #1

Possible Cause Recommended Solutions

Pipetting error Check pipetting scheme and setup of the reaction. Repeat the PCR run

Inappropriate storage of kit components

Store all kit components at appropriate temperature according to label, also see Kit Components Table (Table 1)

No signal (even in Clamping Controls with Non-XNA Mix #1)

Possible Cause Recommended Solutions

Pipetting error or omitted reagents Check pipetting scheme and the setup of the reaction. Repeat the PCR run

Inhibitory effects of the sample material, caused by insufficient purification

Repeat the RNA preparation.

See manual section “Judging validity of sample data based on

Internal Control of HRM curves”

Fluorescence intensity too low

Possible Cause Recommended Solutions

Inappropriate storage of kit components

Store all kit components at appropriate temperature according to label, also see Kit Components Table (Table 1)

Very low initial amount of target DNA

Increase the amount of sample DNA (Depending on chosen method of DNA preparation, inhibitory effects may occur)

No amplification curve and no PCR product visible on a gel

Possible Cause Recommended Solutions

PCR inhibitors present in the reaction mixture

Re-purify template DNA

Inhibition by excess volume of the RT reaction

Volume of the RT reaction product added to qPCR reaction should not exceed 10% of the total qPCR reaction volume

Pipetting error or missing reagent Repeat the PCR reaction; check the concentrations of template and primers; ensure proper storage conditions of all reagents

Annealing temperature is not optimal

Optimize the annealing temperature in 3°C increments

No amplification curve but PCR product visible on a gel

Possible Cause Recommended Solutions

qPCR instrument settings are incorrect

Check if instrument settings are correct (dye selection, reference dye, filters)

Inactive fluorescence detection Fluorescent detection should be activated and set at extension or annealing/extension step of the thermal cycling protocol

Instrument problems Refer to the instrument manual for troubleshooting

PCR efficiency is >110%

Possible Cause Recommended Solutions

Non-specific products Use melting curve analysis

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PCR efficiency is <90%

Possible Cause Recommended Solutions

PCR inhibitors present in a reaction mixture

Re-purify template DNA

Non-uniform fluorescence intensity

Possible Cause Recommended Solutions

Contamination of the thermal cycler Perform decontamination of your real-time cycler according to the supplier‟s instructions

Poor calibration of the thermal cycler Perform calibration of the real-time cycler according to the supplier‟s instructions

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REFERENCES

1. Levine, R.L., A. Pardanani, A. Tefferi, and D.G. Gilliland. 2007. Role of JAK2 in

the pathogenesis and therapy of myeloproliferative disorders. Nat. Rev. Cancer.

7:673–683. http://dx.doi.org/10.1038/nrc2210

2. Levine, R.L., M. Wadleigh, J. Cools, B.L. Ebert, G. Wernig, B.J. Huntly, T.J.

Boggon, I. Wlodarska, J.J. Clark, S. Moore, et al. 2005. Activating mutation in

the tyrosine kinase JAK2 in polycythemia vera, essential thrombocythemia, and

myeloid metaplasia with myelofibrosis. Cancer Cell. 7:387–397.

http://dx.doi.org/10.1016/j.ccr.2005.03.023

3. Mullighan, C.G., J. Zhang, R.C. Harvey, J.R. Collins-Underwood, B.A. Schulman,

L.A. Phillips, S.K. Tasian, M.L. Loh, X. Su, W. Liu, et al. 2009b. JAK mutations in

high-risk childhood acute lymphoblastic leukemia. Proc. Natl. Acad. Sci. USA.

106:9414–9418. http://dx.doi.org/10.1073/pnas.0811761106

4. Ørum, Henrik., PCR Clamping.. Curr. Issues Mol. Biol. 2000; 2(1), 27-30.

5. Powell et. al., Detection of the hereditary hemochromatosis gene mutation by real-time

fluorescence polymerase chain reaction and peptide nucleic acid clamping. Analytical

Biochemistry 1998; 260: 142–8.

6. Scott, L. M., The JAK2 Exon 12 Mutations: A Comprehensive Review. Am. J.

Hematol. 2011, 86, 668-6766

7. Weigert, O. et. al. Genetic Resistance to JAK2 Enzymatic Inhibitors is overcome

by HSP90 Inhibition. The Journal of Experimental Medicine, January 2012, 209

(2), 259-273.

8. **MIQE Reference: "The MIQE Guidelines: Minimum Information for

Publication of Quantitative Real-Time PCR Experiments". Stephen A. Bustin et.

al., Clin Chem. 55 (4): 611–22 (2009). http://www.clinchem.org/content/55/4/611

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