Super-sensitive time-resolved fluoroimmunoassay for thyroid-stimulating hormone utilizing europium(III) nanoparticle labels achieved by protein corona stabilization, short binding time, and serum preprocessing
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Abstract
Thyrotropin or thyroid-stimulating hormone (TSH) is used as a marker for thyroid function. More precise and more sensitive immunoassays are needed to facilitate continuous monitoring of thyroid dysfunctions and to assess the efficacy of the selected therapy and dosage of medication. Moreover, most thyroid diseases are autoimmune diseases making TSH assays very prone to immunoassay interferences due to autoantibodies in the sample matrix. We have developed a super-sensitive TSH immunoassay utilizing nanoparticle labels with a detection limit of 60 nU L−1 in preprocessed serum samples by reducing nonspecific binding. The developed preprocessing step by affinity purification removed interfering compounds and improved the recovery of spiked TSH from serum. The sensitivity enhancement was achieved by stabilization of the protein corona of the nanoparticle bioconjugates and a spot-coated configuration of the active solid-phase that reduced sedimentation of the nanoparticle bioconjugates and their contact time with antibody-coated solid phase, thus making use of the higher association rate of specific binding due to high avidity nanoparticle bioconjugates.
We were able to decrease the lowest limit of detection and increase sensitivity of TSH immunoassay using Eu(III)-nanoparticles. The improvement was achieved by decreasing binding time of nanoparticle bioconjugates by small capture area and fast circular rotation. Also, we applied a step to stabilize protein corona of the nanoparticles and a serum-preprocessing step with a structurally related antibody.
Keywords
Sandwich-type immunoassay Time-resolved fluoroimmunoassay Nanoparticle bioconjugate Immunoassay interference Nanoparticle protein coronaAbbreviations
- HAB
Human autoantibody
- HAMA
Human anti-mouse antibody
- LLD
Lowest limit of detection
- TSH
Thyroid-stimulating hormone
Introduction
Eu-doped nanoparticles can be manufactured to afford high colloidal stability; good protection of Eu-chelates from solvent; very low self-quenching owing to long Stoke’s shift of the Eu-chelates; density that is close to water’s density to reduce sedimentation; and a dense coating of carboxyl groups on their surface for efficient bioconjugation [1]. Most importantly the Eu-doped nanoparticles facilitate sensitive time-resolved low background detection of Eu-emission and are thus perfect label candidates for assays that require high sensitivity. However, while the nanoparticle-based assay concepts have high signal output, their applicability has been limited because of assay matrix-related interference and relatively high level of nonspecific binding observed in the assays [1, 2, 3]. Matrix effects in an immunoassay usually refer to interference arising from the sample matrix (e.g., whole blood, serum, or saliva) that contains the analyte. Previously, we have used a systematic approach to characterize different aspects of a sandwich-type non-competitive immunoassay utilizing nanoparticle bioconjugates as labels [4]. We have developed a rational basis for development of immunoassays using nanoparticles as labels [5, 6, 7] and now expand this work to describe assay matrix-derived interactions [8].
Matrix-related interferences like high nonspecific binding and cross-reactivity of antibodies, autoantibodies (HAB), human anti-mouse antibodies (HAMA), and polyanions (heparin) often hamper precise measurements in clinical samples, e.g., in serum [9, 10]. In most assays, serum samples are preprocessed from whole blood by removing the blood cells and clotting factors, but they still contain a variety of factors that prevent reaching the lowest limit of detection (LLD) that can be obtained with artificial buffer samples. Binding of a nanoparticle bioconjugate is defined by nanoparticle material and the bioconjugate layer, but also by their biomolecule corona [11]. The biomolecule corona of a nanoparticle describes a loosely bound dynamic layer of non-covalently associated proteins and other biomolecules that in part mediate nanoparticle interactions [12]. TSH and thyroid hormone assays are especially prone to HAB interference, as both Graves’ and Hashimoto’s diseases are autoimmune disorders, implying the prevalence of autoantibodies to the hormones or their respective receptors. Thus, optimization of TSH assay conditions is of particular interest. There are a number of sample preprocessing strategies for various immunoassays, but none that would directly focus on removing nanoparticle corona-forming proteins.
We used TSH as a model analyte to demonstrate advances in immunoassay technology. TSH is a 28-kDa glycoprotein hormone secreted by the pituitary gland. TSH comprises two chemically different subunits, α and β, which are joined by non-covalent bonds. The normal range of TSH in serum is 0.3–5.0 mU L−1 (0.05–0.8 μg L−1), but over 95% of screened normal euthyroid volunteers have TSH levels below 2.5 mU L−1 [13]. Abnormal TSH level can be a sign of thyroid malfunction, and it can be used as a tool to diagnose thyroid diseases and to monitor the effectiveness of therapy. Patients suffering from hypothyroidism have elevated TSH level, and more precise TSH assays allow one to distinguish subclasses of hyperthyroidisms. Over 13 million Americans are believed to be affected by some type of thyroid disease, but thyroid diseases nevertheless remain underdiagnosed because of ineffective screening programs [14]. Furthermore, precise analysis of thyroid function is required during pregnancy, as one to three in 200 pregnancies are affected by thyroid dysfunction caused by the autoimmune disorders Graves’ and Hashimoto’s diseases [15, 16]. These conditions are dangerous and may cause congestive heart failure for the mother, miscarriage, and attention deficit hyperactivity disorder symptoms or impaired cognitive development for the child. The likelihood of adverse effects is increased especially if the thyroid disease develops during the first trimester [16, 17]. Furthermore, there is increasing evidence on thyroid dysfunction being one of the factors triggering or aggravating metabolic syndrome [18, 19]. Slightly elevated TSH levels have been linked to metabolic syndrome, also in euthyroidism; in particular, young females with a TSH in the upper normal range (2.5–4.5 mU L−1) were more likely to be obese, had higher triglyceride levels, and were more likely to be affected by metabolic syndrome.
Good precision and accuracy are often problematic to achieve at the same time, and therefore small changes in trends cannot usually be detected in a number of diagnostic test formats. Hence, more powerful tools are required to quantitatively detect low concentrations of target analyte, small changes in concentrations, and trend reversals due to intervention therapy [19]. In plasma and serum the matrix-related interferences often hamper precise measurements, especially in the case of autoimmune disorders [20]. In this study we demonstrate the effects of our conceptual findings on the TSH immunoassay performance, and especially their potential to reduce matrix interference. Our optimized europium(III) nanoparticle labeling technology in sandwich-type immunoassays is shown to improve the LLD to 60 nU L−1, which equals 450 amol L−1 [21], and is 1/50 of the LLD obtainable by the current market leaders in TSH assays. The assay is based on 96 well-plate format, where Eu(III)-labeled nanoparticles are used as labels and time-resolved fluorescence is used to monitor TSH quantitatively from the surface of a reaction well.
Experimental
Reagents
Europium(III)-chelate-doped Fluoro-Max™, carboxyl-modified, monodisperse, polystyrene nanoparticles with a 92-nm diameter were acquired from Seradyn (Indianapolis, IN). The fluorescent properties of these particles were described previously [22, 23]. The particles are stabile in aqueous suspensions and nanoparticle material protects doped Eu-chelates, thereby facilitating stabile fluorescence [24]. Anti-TSH monoclonal antibodies (clones anti-TSH 5404 SP-1 and anti-TSH 5409 SPTNE-5) were purchased from Medix Biochemica (Kauniainen, Finland). Antibody fragments (anti-prostate specific antigen (PSA) Fab 5A10, Fab anti-TSH 5409, and anti-TSH 5404) were produced at the Department of Biotechnology in the University of Turku [25, 26]. Affinity constants for the antibodies were 9.3 × 108 L mol−1 and 2.2 × 1010 L mol−1 for anti-TSH 5409 and anti-TSH 5404, respectively [27]. KaivogenSA96™ streptavidin-coated microtitration low-fluor plates, KVG buffer [50 mmol L−1 Tris–HCl (pH 7.8), 150 mmol L−1 NaCl, 7.7 mmol L−1 NaN3, 76 μmol L−1 bovine serum albumin, 80 μmol L−1 Tween 40, 3 μmol L−1 bovine γ-globulin, 20 μmol L−1 diethylenetriaminopentaacetic acid] and washing solution (5 mmol L−1 Tris–HCl, pH 7.8 containing 150 mmol L−1 NaCl, 3.5 mmol L−1 Germall II, and 40 μmol L−1 Tween 20) were from Kaivogen Oy (Turku, Finland). N-Hydroxysulfosuccinimide (NHS) was acquired from Fluka (Buchs, Switzerland); bovine serum albumin fraction V (BSA), biotin, and N-(3-dimethylaminopropyl)-N′-ethylcarbodiimide (EDC) were purchased from Sigma (Steinheim, Germany).
Conjugations and coatings
Schema and flow diagram of the assay concept. a Sandwich complex. Carboxyl groups on Eu-doped polystyrene nanoparticles are functionalized with EDC-NHS (treatment to generate succinimidyl groups). Then the particles are coated with monoclonal anti-TSH antibodies to form the nanoparticle bioconjugates and unreacted succinimidyl groups are converted back to carboxylic acid through hydrolysis. The solid phase is first coated with streptavidin and blocked with BSA; subsequently, an area of approximately 1 mm2 is functionalized with anti-TSH Fab fragments recognizing a different epitope in TSH than the nanoparticle-conjugated antibodies. b To optimize the assay we needed TSH-free human serum and we produced it by affinity purification of pooled human serum. For the purification we used 2 × 10 min incubation of the serum in anti-TSH-coated microtiter wells, after which we spiked samples with known concentrations of recombinant human TSH. The TSH was added to serum into equal volume of KVG buffer, and 20 μL of this mixture was added to spot-coated wells. After 10 min incubation with fast circular mixing the nanoparticle bioconjugates were added in a volume of 30 μL and incubation was continued for 30 min. Subsequently, unbound nanoparticle bioconjugates were washed away, and wells were read for time-resolved Eu-fluorescence. c To reduce nonspecific binding in a nanoparticle-based immunoassay we used a nonspecific affinity purification step to remove compounds interfering with the assay. First, a sample of female serum low–normal range TSH sample was spiked with 100 μU L−1 of TSH in KVG buffer (Fig. 4) and incubated for 2 × 10 min in anti-PSA Fab-coated wells (women do not have PSA in circulation so nothing specific is removed). A replicate sample was spiked, but left untreated. 20 μL of both samples were transferred to spot-coated wells and assayed like in protocol b. Difference in TSH-assay performance is presented in Fig. 4
The spot-wells were produced by washing streptavidin-coated microtitration wells twice with the washing solution to remove preservatives and loosely bound proteins. To produce fully coated wells 3 × 10−13 mol of biotinylated Fab fragments were incubated in the prewashed wells in 30 μl of KVG buffer for 20 min. In spot-coating 1 × 10−13 mol of biotinylated Fab fragment was incubated in 1 μL of KVG buffer for 10 min. The spot was produced by pipetting a drop of capture antibody solution halfway between the edge and center of the well of a streptavidin-functionalized 96-well plate. The majority of the solid phase is thus left devoid of the capture antibody, and binding of the nanoparticle bioconjugate on it will thus be significantly lower (Fig. 1b) [8].
Immunoassays
Known concentration of TSH was spiked in KVG buffer and incubated for 20 min. Alternatively, the TSH was mixed into affinity purified serum/KVG buffer mixture and incubated for 10–20 min (Fig. 1). In the one-wash assay configuration TSH was spiked into a 1:1 mixture of affinity-purified pooled serum and KVG buffer, and 20 μL of this mixture was then transferred to a reaction well. After 10 min of incubation under fast circular shaking (DELFIA Plateshake 1296-003, with a circular vibrating motion, PerkinElmer), 3 × 107 detector nanoparticle bioconjugates in 30 μL of KVG buffer were added to the reaction wells and incubated for another 30 min under fast circular shaking. Subsequently, the wells were washed six times and aspirated. The time-resolved fluorescence from the nanoparticle–antibody bioconjugates was measured by excitation at 340 nm and detection at 615 nm using time-resolved fluorescence of plate reader Victor2 1420 Multilabel counter (Wallac, PerkinElmer) [8].
Affinity purification
Serum was isolated from peripheral blood of healthy volunteers (N = 7; 3 male, 4 female) who gave their informed written consent. Affinity purification was performed by incubating pooled human serum in microtiter wells coated with 50 μL of 100 nmol L−1 anti-TSH Mab 5404 (Fig. 1b). Alternatively, the serum was purified with an antibody against prostate specific antigen (PSA) anti-PSA Fab 5A10 (50 μL of 200 nmol L−1) that was, apart from the paratope, structurally similar to the anti-TSH antibodies (Fig. 1c). In this experiment a female donor’s serum was used because of lack of PSA in the circulation. The donors’ (N = 2) TSH was tested to be below 1 mU L−1 2–4 weeks before the serum sample for this study was taken. The incubation lasted 15 min, and the serum was treated twice in a volume of 60 μL. The purified serum was extracted from wells and stored refrigerated or frozen until used. We used regular two-way ANOVA with Sidak’s test for multiple comparisons available in GaphPad Prism to test significance of the observed difference between affinity-purified samples and untreated samples.
Dynamic light scattering measurements
The nanoparticle bioconjugates were vortexed, diluted into KVG buffer, sonicated, vortexed again, after which the dynamic light scattering (DLS) was measured immediately (Zetasizer Nano, Malvern Instruments, Worcestershire, UK). The stabilized samples were diluted, sonicated, vortexed, and allowed to re-equilibrate their protein corona for 24 h, after which the samples were sonicated and vortexed again and DLS was measured.
Results
Stabilization of protein corona on nanoparticle bioconjugates
Concentration-dependent protein corona stabilization. a The nanoparticle bioconjugates were stored in KVG buffer at various concentrations and then used to perform a one-step assay for 100 μU L−1 TSH in KVG buffer assay matrix. Dilution to the assay concentration (2.5 × 106 particles μL−1) was made in a single step. Stabilization of the particle suspension was achieved up to a concentration 100-fold higher than the concentration used in the assay. Mean values of three replicates are presented as bars and standard deviation as error bars. b Main peak of a DLS measurement of nanoparticle bioconjugates diluted into KVG buffer measured immediately after dilution, sonication, and vortexing (black circles, black line represents a mean of 3 replicates) and one measured after dilution, 24 h stabilization, sonication, and vortexing (red squares, deep red line represents a mean of 3 replicates). c Representation of the aggregate peak of the same DLS measurement; while we observed aggregates only in some of the samples, typically the aggregates were fewer and smaller in the stabilized samples. A zero value indicates that the amount of aggregates in the sample fell below the detection limit
Component-by-component investigation of the storage buffer composition at concentration of 1.25 × 108 particles μL−1 and 1 mU L−1 of TSH. Mean values of three replicates are presented as bars and standard deviation as error bars. Impact of the storage buffer composition is measured by testing the assay performance (signal-to-background ratio) with the particles stored in the specified buffer and then diluted into KVG buffer. The best signal-to-background ratio was obtained with particles stored in 50 mmol L−1 Tris–HCl (pH 7.8), 150 mmol L−1 NaCl, 76 μmol L−1 bovine serum albumin, and 80 μmol L−1 Tween 40
Control of association time by solid-phase organization
Comparison of TSH assay signal-to-background ratios in KVG buffer (buffer, gray bars) and in 50% affinity-purified serum (serum, black bars). TSH concentration was 100 μU L−1; mean values of three replicates are presented as bars and standard deviation as error bars. The assay utilized normal (ctrl-NP) and protein corona-stabilized nanoparticle bioconjugates (s-NP) and fully coated (FC) and spot-coated (spot) microtiter wells. The optimized configuration gave 10-fold higher signal-to-background ratio in KVG buffer configuration with fully coated well and control NPs and a 100-fold higher ratio in 50% affinity-purified serum configuration with fully coated well and control NPs
Sample preprocessing by affinity purification
Affinity purification increases the sensitivity of the assay. We added (100 μU L−1) of TSH (Sample + 100 μU L−1) into female serum samples with low–normal range TSH (Sample) (approximately 0.4–1 mU L−1). TSH recovery was illustrated by plotting Eu-signal (Sample + 100 μU L−1) – Eu-signal (Sample). The serum samples were not purified (black) or affinity purified (gray) with Fab 5A10 anti-PSA antibodies that beared a resemblance to anti-TSH antibodies, but having no specific antigens in the serum. Addition was done in respect to total well volume, and thus all samples should have given the same Eu-signal. Differences between treated and untreated samples were tested with regular two-way ANOVA with Sidak’s test for multiple comparisons; ns p > 0.05, **p < 0.01, and ***p < 0.001
Super-sensitive TSH assay utilizing nanoparticle bioconjugates
TSH standard curve measured in spiked affinity-purified serum samples by using three replicates of each calibrator. The LLD of the assay was 60 nU L−1 corresponding to 450 aM or 10,000 molecules in sample volume of 20 μL. Background signal was subtracted from the data points presented and the average background signal is set to zero value and LLD at 3 × SD of background
The assay is a one-wash configuration where the undiluted sample is first dispensed into a microtiter well and thereafter tracer nanoparticles are added to the same well without a separation step in between. A single washing step is required before the time-resolved luminescence signal is recorded. The presented assay is relatively easy to perform, total time to conduct the assay is 40 min, and it requires low amounts of sample and reagents, although the affinity purification increases slightly with the amount of antibodies used. We were able to operate the assay with serum volumes of 5–40 μL. Further reduction of sample volume induced a non-linear reduction in measured LLD. There was no kinetic requirement for the incubation period, but we chose to measure the signal when equilibrium was reached for the binding reaction because we wanted the principles presented to be more universally applicable.
Discussion
Our longstanding aim has been to establish general principles for developing sandwich-type immunoassays utilizing Eu-nanoparticle labels [4, 5, 6, 7, 8, 23]. Here we applied those principles, focusing on the matrix-related nonspecific binding and developed a sandwich-type heterogenic immunoassay for TSH that has a lower LLD and higher sensitivity than previously presented assays. The LLD of 60 nU L−1 in our assay is nearly 1/50 of that of the market-leading assay systems: the chemiluminescence microparticle immunoassay (CMIA) 2.5 μU L−1 by Architect i2000 SR (Abbott Diagnostics) or the electrochemiluminescence immunoassay (eCLIA) 5 μU L−1 by Cobas 6000 (Roche Diagnostics). Furthermore, we introduce a concept of stabilization of the protein corona surrounding the nanoparticle bioconjugates that reduced nonspecific binding, especially in clinically relevant matrixes. The presented assay concept will facilitate better recovery of TSH from serum and more precise TSH measurements, and thereby smaller sample volumes. The observed increase in recovery suggests that there are components preventing interaction of nanoparticle label and TSH in the serum matrix. Furthermore, the observed decrease of background signal after the antibody capture-based removal of TSH implies that some of these interacting components cause the increase of nonspecific binding. Although we have not defined the interacting compounds, we suggest that a preprocessing step comprising an affinity purification with an antibody not binding the analyte or matrix filtration (Fig. 5) would increase the performance of many clinical immunoassays and would help to remove both false positives and negatives [20, 37, 38]. We hypothesize that removal of interfering compounds would be especially important in samples where HABs are likely to be present [15]. Furthermore, we propose that the best result of affinity purification is likely to be produced by an antibody resembling the capture antibody that has structural differences only in the hypervariable loops of the paratope.
The assay performance was further improved with of spot-coated configuration of the active solid phase and stabilized protein corona surrounding the nanoparticle bioconjugates. Dilution of the nanoparticle bioconjugates into another buffer or assay matrix causes a change in their protein corona, i.e., proteins loosely adhering to the nanoparticles [12, 33]. Rapid change in the protein corona may cause aggregation of the nanoparticles, as macromolecules in the matrix transiently interact with multiple nanoparticles. These interactions may also mask some of the binding sites, if a dense corona is electrostatically attracted to surround a nanoparticle (Figs. 2 and 3) [8]. These effects can be avoided by incremental dilution of nanoparticles and maintaining adequate concentration of stabilizing compounds (Fig. 3) and allowing time for the protein corona to stabilize before the assay in conducted (Fig. 2). Moreover, we provide evidence that the stabilization effect is independent on nanoparticle concentration and that re-formation of the protein corona can be observed with DLS (Fig. 2). The benefit of spot-coated solid-phase configuration (Figs. 4 and 6) is likely to originate from reduced rolling of nanoparticles on an antibody-coated surface [6] that would potentially increase nonspecific binding by allowing more time for the nanoparticle bioconjugates to adhere via nonspecific bonds. Also, the configuration concentrates the analyte in a confined area promoting efficient multivalent recognition by the nanoparticle. Yet another mechanism through which an improved signal-to-background ratio could be mediated is the decrease in the optimal amount of nanoparticle bioconjugates needed for the assays done in spot-coated wells (see ESM Fig. S1). Our assay concept, however, could not be applied to heparin plasma, most likely because of interactions caused by the polyanions. The ability to perform a washing-free immunoassay in a whole blood sample smaller than 20 μL can be seen as a prerequisite for patient self-testing and point-of-care systems testing for biomarkers in the circulation [39]. While we present a heterogeneous test, the LLD measured is sufficient to design a separation-free or homogenous system that typically performs at an order of magnitude higher LLD or better. We suggest that the principles found in this study are applicable to, e.g., lateral flow-based systems.
The higher the sensitivity of the assay is, the smaller the concentration differences that can be measured. Such a property is of importance when assessing drug response and appropriate dosage, especially in rapidly developing conditions like pregnancy-related thyroid dysfunctions where both too high and too low thyroid hormone concentrations pose a risk for the fetus and the mother [16, 17, 40]. These conditions require exact and repeated measurements to adjust the drug dosage over the course of pregnancy [41], and in some cases treatment needs to be started to promote fertility [40]. Furthermore, thyroid hormones modulate many metabolic pathways relevant to the resting energy expenditure, and hypothyroidism is associated with weight gain and metabolic syndrome [42]. Recognizing trend reversals is essential in the treatment of metabolic syndrome [19, 43].
Conclusions
A super-sensitive time-resolved fluoroimmunoassay for TSH, LLD 60 nU L−1, utilizing europium(III) nanoparticle labels with reduced nonspecific binding was developed. An affinity purification step with an antibody bearing close resemblance to the detecting and capture antibody removed interfering compounds from the sample matrix [8]. Combining these properties with previously found general parameters in sandwich immunoassays [5, 6, 7] facilitated detection of TSH concentrations that were 1/50 of LLD of the current market-leading technologies (Fig. 6) and increased sensitivity [21]. With more accurate diagnostics, intervention therapy can start earlier, and total health care costs can be reduced. However, precision and accuracy are often problematic in a number of test formats, and small changes in trends cannot be detected. There is continuing demand for high-performance clinical tests, and central laboratories still process the majority of diagnostic tests owing to lower unit costs [39, 44].
Notes
Acknowledgements
The authors gratefully acknowledge the Academy of Finland for funding the research under grants #110174, #260599 and The Finnish National Doctoral Programme in Informational and Structural Biology.
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Compliance with ethical standards
Serum was obtained from healthy volunteers who gave their informed written consent. The study was approved by the Ethics Committee of Southwest Finland Hospital District, and was carried out in accordance with the guidelines set for research on human samples by Turku University Hospital and University of Turku.
Conflict of interest statement
The authors declare no conflict of interest.
Supplementary material
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