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Three POCT Molecular Applications: A View Into Future Development

Kiechle, Frederick L. MD, PhD

Point of Care: The Journal of Near-Patient Testing & Technology: September 2015 - Volume 14 - Issue 3 - p 95–98
doi: 10.1097/POC.0000000000000052
Review Articles

Molecular diagnostic tests consist of 3 processes: extraction/purification of nucleic acid, amplification of specific target region, and finally detection of amplified products. For Point of Care Testing applications, these 3 steps need to be miniaturized using microfluidics to reduce reagent volumes and associated costs. Extraction may be eliminated if Polymerase Chain Reaction enhancers are added and if mutated/modified DNA polymerase are used, which are resistant to polymerase inhibitors. Numerous proof of concept devices have been reported for molecular diagnostic assays, and some are Food and Drug Administration cleared. This review focuses on 3 specific applications: (1) multiplex Polymerase Chain Reaction identification of 4 Plasmodium species that causes malaria; (2) CYP2C19 variant detection that alters the prodrug clopidogrel's conversion to an active anticoagulant; and (3) next-generation sequencing using nanopores embedded in biological or nonbiological substrates to sequence DNA. These clinical applications provide the potential of added clinical value with faster turnaround time and increased sensitivity and specificity. This technology will rapidly provide a final diagnosis and a subsequent appropriate treatment decision.

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From the Department of Clinical Pathology, Memorial Healthcare System, Pathology Consultants of South Broward, LLP, Hollywood, FL.

Reprints: Frederick L. Kiechle, MD, PhD, Department of Pathology, Memorial Regional Hospital, 3501 Johnson St, Hollywood, FL 33021. E-mail: fkiechle@mhs.net.

The author declares no conflict of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Website (www.poctjournal.com).

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