How CRISPR could lead to a new low-cost diagnostic tool

The gene-editing technology known as CRISPR could be used as a low-cost diagnostic tool to detect infectious diseases, such as Zika virus or dengue, according to research published Thursday in the journal Science.

Jim Collins, a co-author of the research, said the scientists who developed the new tool, dubbed SHERLOCK for Specific High sensitivity Enzymatic Reporter UnLOCKing, have filed for technology patents and are considering ways they can advance the tool for use in clinical settings. Though, experts note that if approved it would be years before the tool could be used in clinical settings.  

About the tool

While CRISPR—which last year was approved for its first human trial—makes use of a bacterial immune system that can essentially snip away a targeted RNA so a disease-causing gene can repair itself with healthy DNA, SHERLOCK goes a step further by making several cuts to reveal what the researchers call "collateral cleavage" that can be detected using a low-cost device or the even human eye.

A gene-editing first: NIH panel approves human trial of CRISPR

The researchers said SHERLOCK is able to identify unique genetic markers in molecules living in bodily fluid—such as blood, urine, or saliva—to differentiate between viruses, such as Zika or dengue. The researchers also were able to detect and distinguish two notorious antibiotic-resistant strains of bacteria, which, according to STAT News, could help hospitals experiencing a superbug outbreak identify the best treatment for patients' infections.

According to the researchers, SHERLOCK works in a test tube or when placed on glass fiber paper and can be powered using an individual's body heat, making it easily portable and well suited for use in remote areas that do not have access to modern diagnostic tools. Further, the tool is cost-effective.  

The researchers say the tool could cost about 61 cents per test and is easily portable, which could be useful in remote areas that do not have access to modern diagnostic tools.

Stakeholders say SHERLOCK could be a 'first step' toward point-of-care diagnostics

Research co-author Pardis Sabeti of the Broad Institute of the Massachusetts Institute of Technology called SHERLOCK a "game changer" for identifying infectious diseases. For instance, he said the ability to diagnose Zika from urine samples, rather than more invasive blood tests is "exactly what the world needs."

The findings also have caught the eye of several infectious disease experts who were not involved in the research. For example, Scott Weaver, an infectious disease researcher at the University of Texas Medical Branch at Galveston who was not involved with the study, said the research shows that SHERLOCK could be a "significant step on the pathway" to "developing point-of-care, or bedside detection, which doesn't require expensive equipment or even reliable power."

Alex McAdam, a medical microbiologist at Boston Children's Hospital who also was not involved in the research, also called SHERLOCK "a promising method of detecting extremely low concentrations of [genetic material]." However, he stressed there is more work that needs to be done on the technology before it can be used as a diagnostic tool. "It's going to be a long walk from hopeful to clinically useful, and there is a lot to do to demonstrate practicality," he said (Achenbach, "Speaking of Science," Washington Post, 4/13; Begley, STAT News, 4/13).

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