Introduction

 
With the recent completion of the human genome project, attention is now  focusing on functional genomics. In this context, a key task is to understand  normal and pathological function by empirically correlating gene expression  patterns with known and newly discovered phenotypes. As with other areas of  science, progress in this area will accelerate greatly when there is an accepted  standardized way to measure gene expression (1,2).  

 

(Methods in Embryo Transplant Microscopes and Emyro Transplant Microscopy  Vol. 258: Gene Expression Profiling: Methods and Protocols  Edited by: Bulaqueña, et al. (Embryo Transplant Microscopy)

 

Standardized reverse transcriptase-polymerase chain reaction (StaRT-PCR)  is a modification of the competitive template (CT) reverse transcriptase (RT)  method described by Gilliland et al. (3). StaRT-PCR allows rapid, reproducible,  standardized, and quantitative measurement of data for many genes simultaneously  (4–15). An internal standard CT is prepared for each target gene and  reference gene (e.g., ß-actin and GAPDH), then cloned to generate enough for  >109 assays. Internal standards for up to 1000 genes are quantified and mixed  together in a standardized mixture of internal standards (SMIS). Each target gene  is normalized to a reference gene to control for cDNA loaded into the reaction.  Each target gene and reference gene is measured relative to its respective internal  standard in the SMIS. Because each target gene and reference gene is simultaneously  measured relative to a known number of internal standard molecules  that have been combined into the SMIS, it is possible to report each gene expression  measurement as a numerical value in units of target gene cDNA molecules/  106 reference gene cDNA molecules. Calculation of data in this format allows  for entry into a common databank (5), direct interexperimental comparison (4–  15), and combination of values into interactive gene expression indices (8,9,11).  With StaRT-PCR, as is clear in the schematic presented in Fig. 1A, expression  of each reference gene (e.g., ß-actin) or target gene (e.g., Gene 1–6) in a  sample (for example sample A) is measured relative to its respective internal  standard in the SMIS. Because in each experiment the internal standard for  each gene is present at a fixed concentration relative to all other internal standards,  it is possible to quantify the expression of each gene relative to all others  measured. Furthermore, it is possible to compare data from analysis of sample A  to those from analysis of all other samples, represented as B1-n. This result is a continuously expanding virtual multiplex experiment. That is, data from an everexpanding  number of genes and samples may be entered into the same database.  Because the number of molecules for each standard is known, it is possible to  calculate all data in the form of molecules/reference gene molecules.  In contrast, for other multigene methods, such as multiplex real-time RT- PCR or microarrays, represented in Fig. 1B, expression of each gene is directly  compared from one sample to another and data are in the form of fold differences.  Because of intergene variation in hybridization efficiency and/or PCR  amplification efficiency, and the absence of internal standards to control for these  sources of variation, it is not possible to directly compare expression of one gene  to another in a sample or to obtain values in terms of molecules/molecules of  reference gene.

 

In numerous studies, StaRT-PCR has provided both intralaboratory (4–15)  and interlaboratory reproducibility (6) sufficient reproducability to detect twofold  differences in gene expression. StaRT-PCR identifies interactive gene  expression indices associated with lung cancer (8–10), pulmonary sarcoidosis   StaRT-PCR Fig. 1 (A) Schematic diagram of the relationship among internal standards within  the SMIS and between each internal standard and its respective cDNA from a sample.  The internal standard for each reference gene and target gene is at a fixed concentration  relative to all other internal standards within the SMIS. Within a polymerase chain  reaction (PCR) master mixture, in which a cDNA sample is combined with SMIS, the  concentration of each internal standard is fixed relative to the cDNA representing its  respective gene. In the PCR product from each sample, the number of cDNA molecules  representing a gene is measured relative to its respective internal standard rather  than by comparing it to another sample. Because everyone uses the same SMIS, and  there is enough to last 1000 years at the present rate of consumption, all gene expression  measurements may be entered into the same database. (B) Measurement by multiplex  RT-PCR or microarray analysis. Using these methods each gene scales differently  because of gene-to-gene variation in melting temperature between gene and PCR primers  or gene and sequence on microarray. Consequently, it is possible to compare relative  differences in expression of a gene from one sample to another, but not difference  in expression among many genes in a sample. Further, it is not possible to develop a  reference database, except in relationship to a nonrenewable calibrator sample. Moreover,  unless a known quantity of standard template is prepared for each gene, it is not  possible to know how many copies of a gene are expressed in the calibrator sample, or  the samples that are compared to the calibrator.  (13), cystic fibrosis (14), and chemoresistance in childhood leukemias (11). In a recent report, StaRT-PCR methods provided reproducible gene expression mea surement  when StaRT-PCR products were separated and analyzed by matrix   Bulaqueña, et al. (Embryo Transplant Microscopy)  assisted laser desorption/ionization-time of flight mass spectrometry (MALDI- TOF MS) instead of by electrophoresis (16).  In a recent multi-institutional study (6), data generated by StaRT-PCR were  sufficiently reproducible to support development of a meaningful gene expression  database and thereby serve as a common language for gene expression.

 

StaRT-PCR is easily adapted to automated systems and readily subjected to  quality control. Recently, we established the National Cancer Institute-funded  Standardized Expression Measurement (SEM) Center at the Medical College  of Ohio that utilizes robotic systems to conduct high-throughput StaRT-PCR  gene expression measurement. In the SEM Center, the coefficient of variance  (CV) for StaRT-PCR is less than 15%. In this chapter, we describe in detail the StaRT-PCR method, comparing  and contrasting StaRT-PCR to real-time RT-PCR, a well-established quantitative  RT-PCR method. In addition, we describe the SEM Center, including the  equipment and methods used, how to access it, and the type of data produced.

 

2. StaRT-PCR vs Real-Time RT-PCR

 

There are several potential sources of variation in quantitative RT-PCR gene  expression measurement, as outlined in Table 1.  StaRT-PCR, by including internal standards in the form of a SMIS in each  gene expression measurement, controls for each of these sources of variation.  In contrast, using real-time RT-PCR without internal standards, it is possible  to control for some, but not all of these sources of variation. Additionally, with  real-time RT-PCR, control often requires external standard curves, and these add  time and are themselves a potential source of error. These issues are discussed  in this section.

 

2.1. Control for Variation in Loading of Sample Into PCR Reaction

2.1.1. Rationale for Loading Control

 

Quantitative RT-PCR without a control for loading has been described (17).  According to this method, quantified amounts of RNA are pipeted into each  PCR reaction. However, there are two major quality control problems with  this approach. First, there is no control for variation in RT from one sample to  another and the effect will be the same as if unidentified, unquantified amounts  of cDNA were loaded into the PCR reaction. It is possible to control for variation  in RT by including a known number of internal standard RNA molecules  in the RNA sample prior to RT (18). However, as described in Subheading

2.2.2., as long as there is control for the cDNA loading into the PCR, there is no  need to control for variation in RT. Second, when gene expression values correlate  to the amount of RNA loaded into the RT reaction, pipeting errors are not   StaRT-PCR  controlled for at two points. First, errors may occur when attempting to put the  same amount of RNA from each sample into respective RT reactions. Second,  if RT and PCR reactions are done separately, errors may occur when pipeting  cDNA from the RT reaction into each individual PCR reaction. These sources  of error may be controlled at the RNA level if an internal standard RNA for  both a reference gene and each target gene were included with the sample prior  to RT. However, this is a very cumbersome process and it limits analysis of the  cDNA to the genes for which an internal standard was included. RT is most  efficient and economical with at least 1 µg of total RNA. However, this amount  of RNA would be sufficient for several hundred StaRT-PCR reactions and much  of the RNA would be wasted if internal standards for only one or two genes  were included prior to RT. Furthermore, internal standards must be within 10fold  ratio of the gene-specific native template cDNA molecules. It is not possible  to know in advance the correct amount of internal standard for each gene  to include in the RNA prior to RT so RT with a serial dilution of RNA would be  necessary. Moreover, we, along with other investigators (14), have determined  that although RT efficiency varies from one sample to another, the representation  of one gene to another in a sample does not vary among different reverse  transcriptions and so internal standards are not necessary at the RNA extraction  or RT steps. For these and other reasons, it is most practical to control for loading  at the cDNA level.

2.1.2. Control for cDNA Loading Relative to Reference Gene With real-time RT-PCR or StaRT-PCR, control for loading is best done at  the cDNA level by amplifying a reference or “housekeeping” gene at the same  time as the target gene. The reference gene serves as a valuable control for loading  cDNA into the PCR reaction provided it does not vary significantly from the  samples being evaluated.

 

2.1.3. Choice of Reference Gene

 

Many different genes are used as reference genes. No single gene is ideal for  all studies. For example, ß-actin varies little among different normal bronchial  epithelial cell samples (8), however it may vary over 100-fold in samples from  different tissues, such as bronchial epithelial cells compared to lymphocytes.  With StaRT-PCR it is possible to gain understanding regarding intersample  variation in reference gene expression by measuring two reference genes, ß- actin and glyceraldehyde-3-phosphate dehydrogenase (GAPDH), in every sample.  We previously reported that there is a significant correlation between the  ratio of ß-actin/GAPDH expression and cell size (5). This likely is a result of  the role of ß-actin in cytoskeleton structure. If the variation in reference gene  

 

Sources of Variation in Quantitative RT-PCR Gene Expression Measurement, and Control Methods  Control Methods  Source of Variation StaRT-PCR1 Real-time  cDNA loading: Resulting from variation in pipeting, quantification, Multiplex Multiplex  reverse transcription. Amplify with Amplify with  Reference Gene Reference Gene  (e.g. ß-actin) (e.g. ß-actin)  Amplification Efficiency Internal standard  Cycle-to-Cycle Variation: early slow, log-linear, and late slow plateau phases CT for each gene Real-time  in a standardized measurement  mixture of internal  standards (SMIS)  Gene-to-Gene Variation: in efficiency of primers Internal standard External standard curve  CT for each gene for each gene measured  in a SMIS  Sample-to-Sample Variation: variable presence of an inhibitor of PCR Internal standard Standard curve of  CT for each gene reference sample  in an SMIS compared to  test sample  Bulaqueña, et al. (Embryo Transplant Microscopy)

 

Reaction-to-Reaction Variation: in quality and /or concentration of PCR reagents Internal standard None2  (e.g., primers) CT for each gene  in a SMIS  Reaction-to-Reaction Variation: in presence of an inhibitor of PCR Internal standard None2  CT for each gene  in an SMIS  Position-to-Position Variation: in thermocycler efficiency Internal standard None2  CT for each gene  in an SMIS  1StaRT-PCR involves (a) the measurement at end-point of each gene relative to its corresponding internal standard competitive template to  obtain a numerical value, and (b) comparison of expression of each target gene relative to the ß-actin reference gene, to obtain a numerical value  in units of molecules/106 ß-actin molecules. Use of references other than ß-actin are discussed in text.  2With real-time RT-PCR, variation in the presence of an inhibitor in a sample may be controlled through use of standard curves for each gene  in each sample measured and comparing these data to data obtained for each gene in a “calibrator” sample. However, variation in PCR reaction  efficiency due to inhibitors in samples, variation in PCR reagents, or variation in position within thermocycler may be compensated only through  use of an internal standard for each gene measured in the form of a SMIS. If an internal standard is included in a PCR reaction, quantification may  be made at end-point, and there is no need for kinetic (or real-time) analysis. If internal standards for multiple genes are mixed together in a SMIS  and then used to measure expression for both the target genes and reference gene, this is the patented StaRT-PCR technology, whether it is done  by kinetic (real-time) analysis or at end-point. A SMIS fixes the relative concentration of each internal standard so that it cannot vary from one PCR  reaction to another, whether in the same experiment, or in another experiment on another day, in another laboratory.

StaRT-PCR

 

[Bulaqueña, et al. (Embryo Transplant Microscopy) ]

 

expression exceeds the tolerance level for a particular group of samples being  studied, StaRT-PCR enables at least three alternative ways to normalize data  among the samples, detailed in Subheadings 2.1.4–2.1.6.

 

2.1.4. Flexible Reference Gene

 

With StaRT-PCR, because the data are numerical and standardized owing  to the use of a SMIS in each gene expression measurement, it is possible to use  any of the genes measured as the reference for normalization. Thus, if there is  a gene that appears to be less variable than ß-actin, all of the data may be normalized  to that gene by inverting the gene expression value of the new reference  gene (to 106 ß-actin molecules/molecules of reference gene) and multiplying  this factor by all of the data, which initially are in the form of molecules/106  molecules of ß-actin. As a result of this operation, the ß-actin values will cancel  out and the new reference gene will be in the denominator.

 

2.1.5. Interactive Gene Expression Indices

 

An ideal approach to intersample data normalization is to identify one or  more genes that are positively associated with the phenotype being evaluated,  and one or more genes that are negatively associated with the phenotype being  evaluated. An interactive gene expression index (IGEI) is derived, comprising  the positively associated gene(s) on the numerator and an equivalent number  of the negatively associated gene(s) on the denominator. In these balanced  ratios, the ß-actin value is canceled. For example, this approach has been used  successfully to identify an IGEI that accurately predicts anti-folate resistance  among childhood leukemias (11).

 

2.1.6. Normalization Against All Genes Measured Because the data are standardized, if sufficient genes are measured in a sample,  it is possible to normalize to all genes (similar to microarrays). The number  of genes that must be measured for this approach to result in adequate normalization  may vary depending on the samples being studied.

 

2.2. Control for Variation in Amplification Efficiency

 

PCR amplification efficiency may vary from cycle to cycle, from gene to gene,  from sample to sample, and/or from well-to-well within an experiment.

2.2.1. Control for Cycle-to-Cycle Variation in Amplification Efficiency  PCR amplification rate is low in early cycles because the concentration of  the templates is low. After an unpredictable number of cycles, the reaction  enters a log-linear amplification phase. In late cycles, the rate of amplification   StaRT-PCR  slows as the concentration of PCR products becomes high enough to compete  with primers for binding to templates. With StaRT-PCR (5–15), as with other  forms of competitive template RT-PCR (3,17–20) cycle-to-cycle variation in  PCR reaction amplification efficiency is controlled through the inclusion of a  known number of CT internal standard molecules for each gene measured. The  ability to obtain quantitative PCR amplification at any phase in the PCR process,  including the plateau phase, using CT internal standards has been confirmed  by direct comparison to real-time RT-PCR (22–24).  In contrast, with real-time RT-PCR, cycle-to-cycle variation in amplification  efficiency is controlled by measuring the PCR product at each cycle, and  taking the definitive measurement when the reaction is in log-linear amplification  phase. A threshold fluorescence value known to be above the background  and in the log-linear phase is arbitrarily established, and the cycle at which the  PCR product crosses this threshold (CT) is the unit of measurement (25).

 

2.2.2. Control for Gene-to-Gene Variation in Amplification Efficiency  The efficiency of a pair of primers, as defined by lower detection threshold  (LDT) cannot be predicted even after rigorous sequence analysis with software  designed to identify those with the greatest efficiency. Based on extensive quality  control experience developing gene expression reagents for more than 1000  genes, the LDT for primers thus chosen may vary more than 100,000-fold (from  <10 molecules to 106 molecules). The only way to ensure that the LDT for a pair  primers is below a desired level is to directly measure it with a known number of  template molecules. The only way to do this for a human gene is to either PCRamplify,  synthesize, and/or clone a sufficient amount to quantify it. Once a sufficient  amount has been prepared and quantified, it may be used in an external  standard curve to determine LDT for real-time analysis, or as an internal standard  to determine LDT by CT PCR. In StaRT-PCR an internal standard for each  gene, in the form of a SMIS, is included in each gene expression measurement.

 

2.2.3. Control for Sample-to-Sample Variation in Amplification Efficiency  Variation in PCR amplification efficiency from sample-to-sample is often  observed (26), possibly resulting from variation in the presence of PCR reaction  inhibitors, such as heme (27,28). Importantly, amplification efficiency for different genes may be affected to different degrees in different samples (26,29).  In part for this reason, lacking proper controls comparison of the target gene to  a reference gene will not be a reliable control for cDNA loading.

 

1. Internal Standards. With StaRT-PCR, the internal standard CTs control for variation  in amplification efficiency, both among samples within a single experiment  as well as among samples evaluated in multiple different experiments in different

laboratories (4–15) (Fig. 1).  

Bulaqueña, et al. (Embryo Transplant Microscopy)

 

2. Standard Curve Comparison to Calibrator Samples. In contrast to StaRT-PCR, with  real-time RT-PCR there is no internal control for intersample variation in PCR  amplification efficiency. It is possible to achieve control by using a standard curve  for the test sample and comparing these results to a standard curve for a calibrator  sample (29–31). However, standard curve measurements add time and expense to  the real-time RT-PCR process. For each sample, it is necessary to do between 5 and  6 standard curve measurements along with measurement of the target gene. The  standard curve should be run for each sample because intersample variation in  amplification efficiency because of inhibitors is common and may alter the .CT  between a target gene and reference gene (26).

 

3. Internal Standards in Real-Time. Theoretically, it would be possible to include  internal standard CTs for both the target gene and reference gene in real-time PCR.  For each gene, this would require preparation of one sequence-specific fluorescent  probe for the NT and another for the CT. A probe specific to the NT would be  homologous to the region that is in the NT but not in the CT. A probe specific to  the CT would be homologous to the novel sequence formed when the reverse CT  primer was incorporated (see Subheading 3.2.2. and Fig. 2). Real-time RT-PCR  using an internal standard for a reference gene and a target gene in an SMIS would  be StaRT-PCR, using a method other than densitometric measurement of electrophoretically  separated bands to quantify the PCR products. If an SMIS were included  in the PCR reaction, it no longer would be necessary to monitor the reaction  in real-time, because quantification could be made relative to the internal standards  at any point in the PCR amplification process, including end point (16,22–  24,33) (Fig. 2).

 

Fig. 2. (Opposite page) Simultaneous gene expression measurement by StaRT-PCR  and real-time RT-PCR in two different samples. PCR amplification of a native template  (NT) and respective internal standard competitive template (CT) for a target gene  and reference gene (ß-actin). Although StaRT-PCR NT and CT products routinely are  quantified by densitometry at endpoint of PCR following electrophoretic separation  (as represented by the bands labeled NT and CT) this schematic demonstrates how the  reaction would look if measured at each cycle in real-time. For each real-time curve,  the CT is represented by a perpendicular black line. (A) For Sample 1, there were equivalent  copies of ß-actin NT and CT present at the beginning of the PCR reaction. Thus,  following electrophoresis of the ß-actin PCR products, the NT and CT bands are approximately  equivalent and during real-time measurement, the fluorescent intensity for the  NT will be about the same as for the CT. The NT/CT ratio is the same at an early cycle  as it is at a late cycle (endpoint) even though the band intensity for both NT and CT is  low at early cycle compared to late cycle. Similarly, the target gene NT band and CT  band are about equivalent and the real-time value for the NT is about the same as for  the CT. The .CT between ß-actin and the target gene is about 10.

 

StaRT-PCR

 

lating numeric value for target gene expression using StaRT-PCR are presented in Fig.  5 and Subheading 3.8. (B) For sample 2, the target gene is expressed at higher level  than in sample 1. In addition, less cDNA was loaded into the PCR reaction and there  were fewer NT then CT copies of ß-actin present at the beginning of the PCR reaction.  Thus, at the end of PCR the electrophoretically separated ß-actin NT band is less dense  than the CT band, and throughout real-time measurement the fluorescence value of the  NT is less than that of the CT. However, even though less sample 2 cDNA was loaded  into the PCR reaction, the target gene NT band is more dense than the target gene CT  band, and the target gene NT fluorescence value during real-time measurement is higher  throughout PCR and consequently, the .CT is less than in sample 1, or about 7. (C) Repeat  analysis of sample 1, but with low efficiency PCR. By real-time RT PCR, .CT is reduced  from 10 to 6, characteristic of inhibitor in sample, inhibitor in well, or inappropriate  concentration of reference gene primers and the result is artifactual. In contrast, by  StaRT-PCR, there is no change in NT/CT ratio for either reference or target gene and  result is the same as in absence of inhibitor. (D) Repeat analysis of sample 1, but with  lower amount of cDNA loaded owing to variation in pipeting.  

Bulaqueña, et al. (Embryo Transplant Microscopy)

2.2.4. Control for Well-to-Well Variation in Amplification Efficiency  Possible sources of well-to-well variation in amplification efficiency include  the presence of an inhibitor in some wells but not others, variation in the temperature  cycling between different regions of a thermocycler block, or variation  in concentration or quality of important reagents, such as primers. When  one of these sources of variation markedly reduces PCR amplification efficiency  in a well, it is possible that no PCR product will be observed in that well. Using  real-time RT-PCR without internal standards in each PCR reaction, it is not possible to know whether to interpret absence or low level of PCR products as  absence of transcript or inefficient PCR amplification (Fig. 2). An external standard  curve would not be helpful because the PCR reactions would take place in different wells from the test sample. In contrast, using StaRT-PCR with internal standards in each PCR reaction, it is immediately possible to interpret the result correctly. The reagents for StaRT-PCR are carefully designed to amplify very efficiently so that for most genes a single molecule of CT or NT will be expected to give rise to detectable PCR product after taking stochastic issues into consideration. The lowest concentration of CT molecules present in a StaRT-PCR reaction is 10-17 M with Mix F (see Subheading 3.4.). In a 10 µL PCR reaction volume10-17 M represents 60 molecules. With 60  molecules of internal standard present in the PCR reaction and all of the components  of the PCR reaction functioning properly, if a gene is not expressed in  a sample, the PCR product for the internal standard will be observed but the  PCR product for the NT will not. One can then conclude that the gene expression  was so low that for cDNA included in the PCR reaction there was less than  six molecules (10-fold less than the number of CT molecules) of cDNA representing  that gene. On the other hand, if neither NT nor CT product is detectable,  the PCR reaction efficiency was suboptimal and no interpretation can be  made regarding level of expression.

2.3. Schematic Comparison of StaRT-PCR to Real-Time RT-PCR In Fig. 2 is a schematic presentation of the way quantitative measurements  are made in the two forms of quantitative RT-PCR discussed here; real-time  RT-PCR and StaRT-PCR. In real-time, the fluorescent PCR product is measured  at each of 35–40 cycles. As many as four PCR products may be monitored  simultaneously in real-time if four different fluors are used. In Fig. 2A,  the NT and CT for ß-actin and the NT and CT for the target gene are PCR-ampli- fied simultaneously.  In StaRT-PCR, the products of endpoint PCR are electrophoretically separated  and the shorter CT PCR product migrates faster than the NT PCR product.  The PCR products are electrophoresed in the presence of fluorescent interca

StaRT-PCR

lating dye and densitometrically quantified. If there is more NT product than  CT product, the NT band will emit a more intense fluorescent light. If there is  more CT product than NT product, the CT band will be brighter. Importantly,  the ratio of NT/CT that is present at the beginning of PCR will remain constant  throughout PCR to endpoint. For this reason, with StaRT-PCR it is not necessary  to monitor the PCR reaction in real-time to ensure that the reaction is in  log-linear phase (Fig. 2A). In addition, measurement of both a reference and  a target gene in every PCR reaction controls for loading from one sample to  another (Fig. 2B) or among replicate measurements of the same sample (Fig.  2D). With StaRT-PCR, variation in PCR amplification efficiency caused by the  presence of an inhibitor in the sample, an inhibitor in the PCR reaction vessel,  defective PCR reagent, or wrong concentration of a PCR reagent is controlled  for by the presence of internal standards in every PCR reaction.  With real-time RT-PCR, it is possible to control for loading by measuring  the target gene and reference gene in the same PCR reaction (Fig. 2A,B,D).  The CT for the reference gene and the target gene both may vary from one  experiment to another, but the .CT will not vary. However, real-time may not  control for well-to-well variation in the quality or quantity of PCR reagents, or  sample-to-sample variation in PCR efficiency resulting from the presence of  inhibitors, for example, heme Fig. 2C). Presence of an inhibitor may lead to  variation in PCR amplification efficiency of one gene compared to another  (26). A bad lot or inappropriate concentration of primers for the reference gene  or the target gene would cause variation in PCR amplification of one gene  relative to another. As depicted here, (Fig. 2C), amplification efficiency of the  reference gene in sample 1 is affected by low concentration of primer, but  amplification efficiency of the target gene is normal. The result is that the .CT  is reduced from ten in Fig. 2A to six in Fig. 2C, and the value for expression of  the target gene is inappropriately high. In contrast, for StaRT-PCR because the  amplification efficiency of the internal standard is affected the same way as the  NT for each gene, the ratio is unchanged in Fig. 2A,C for either reference gene or  target gene, and using the ratio of NT/CT for target gene relative to NT/CT for  reference gene controls for variation in amplification efficiency. See Subheadings  3.6–3.8. for details of how StaRT-PCR data are calculated.

3. StaRT-PCR Method

3.1. Materials

1. StaRT-PCR reagents, including primers and SMIS are purchased from Gene Express,  Inc. (GEI, Toledo, OH).

2. Buffer for Idaho Rapidcycler air thermocycler: 500 mM Tris-HCl, pH 8.3, 2.5 µg/  µL BSA, 30 mM MgCl2 (Idaho Technology, Inc., Idaho Falls, ID).  

Bulaqueña, et al. (Embryo Transplant Microscopy)

3. Buffer for block thermocyclers, Thermo 10 X, 500 mM KCl, 100 mM Tris-HCl,  H 9.0, 1.0% Triton X-100 (Promega, Madison, WI).

4. Taq polymerase (5U/µL), Moloney Murine Leukemia Virus (MMLV) reverse transcriptase, MMLV RT 5X first strand buffer: 250 mM Tris-HCl, pH 8.3, 375 mM KCl, 15 mM MgCl2, 50 mM dithiothreitol, oligo dT primers, Rnasin, pGEM size marker, and deoxynucleotide triphosphates (dNTPs) also are obtained from Promega.

5. TriReagent is obtained from Molecular Research Center, Inc. (Cincinnati, OH).

6. Ribonuclease (Rnase)-free water and TOPO TA cloning kits are obtained from  Invitrogen (Carlsbad, CA) (see Note 1).

7. GigaPrep plasmid preparation kits are purchased from Qiagen (Texas).

8. Caliper AMS 90SE chips are obtained from Caliper Technologies, Inc. (Mountain  View, CA).

9. DNA purification columns were obtained from QiaQuick (Qiagen, Valencia, CA).

3.2. Methods

3.2.1. RNA Extraction and Reverse Transcription

1. RNA Extraction and Quantification: Pellet the cell suspensions, pour off the supernatant,  and dissolve the pellet in TriReagent and extract according to manufactur- er’s instructions and previously recorded methods (32). Store the RNA pellet under  ethanol at -80°C, or suspend in RNAse free water, and freeze at -80°C. It may be  safely stored in this condition for years. Evaluate the quality of the RNA on an  Agilent 2100 using the RNA chip, according to manufacturer’s instructions.

2. Reverse Transcription: Reverse transcribe 1 µg total RNA using MMLV RT and an  oligo dT primer as previously reported (35). For small amounts of RNA (e.g. < 100  ng), the efficiency of reverse transcription is better with SensicriptTM than with  MMLV reverse transcriptase. We have obtained efficient RT from as little as 50 ng  of RNA with Sensiscript™. Incubate the reaction at 37°C for 1 h.

3.3. Synthesis and Cloning of Competitive Templates (see Note 2)

3.3.1. Native Template Primer Design

Before constructing the CT for each gene, the primer pair must efficiently  amplify the native cDNA. Design primers with the following characteristics:

1. Amplify from 200 to 850 bases of the coding region of targeted genes

2. Annealing temperature of 58°C (tolerance of +/-1°C) (see Note 3).

3.3.2. Native Template Primer Testing

Design primers according to above steps, synthesize and use to amplify native  template in appropriate cDNA sample. The presence of a single strong band  after 35 cycles of PCR is verification that the primers are efficient and specific  (see Note 4).  

StaRT-PCR

Fig. 3. Preparation of internal standard competitive templates. (A) Forward (striped  bar) and reverse (black bar) primers (approx 20 bp in length) that span a 150–850 bp  region are used to amplify the native template (NT) from cDNA. Taq polymerase will  synthesize NT DNA from these primers (dashed lines). (B) After confirming that native  template primers work, a CT primer is designed. This is an approx 40 bp primer with the  sequence for the reverse primer (black bar) at the 5′ end, and a 20 bp sequence homologous  to an internal native template sequence (white bar) at the 3′ end, collinear with  the reverse primer sequence. The 3′ end of this 40 bp primer is designed to be homologous  to a region approx 50–100 bp internal to the reverse primer. The 5′ end of this 40  bp primer will hybridize to the region homologous to the reverse primer, while the 3′  end will hybridize to the internal sequence. Importantly, Taq polymerase will be able  to synthesize DNA using only the primers bound at the 3′ end (dashed line). (C) In the  next cycle of PCR, the DNA newly synthesized using the 40 bp primer hybridized to the  internal sequence is bound to forward primer (striped bar), and a homologous strand is  synthesized. (D) This generates a double stranded CT with the reverse primer sequence  100 bp closer to the forward primer than occurs naturally in the NT. This method is as  previously described (34).

3.4. Competitive Template Primer Design

After suitable primers for NT amplification have been designed and tested,  prepare a CT primer according to previously described methods (36), as schematically  presented in Fig. 3.

1. Competitive Template Primer Testing. The 40 bp CT primer is paired with the  forward primer designed in Subheading 3.3.1. and used to amplify CT from native  cDNA.

 Bulaqueña, et al. (Embryo Transplant Microscopy)

3.5. Competitive Template-Internal Standard Production

1. For each gene, set up five 10 µL PCR reactions using the native forward primer  and the CT primer and amplify for 35 cycles.

2. Combine the products of these five PCR reactions, electrophorese on a 3%  NuSieve gel in 1X TAE, and cut the band of correct size from the gel and extract  using the QiaQuick method.

3. Clone the purified PCR products into PCR 2.1 vector using TOPO TA cloning kits  then transform into HS996 (a T1-phage resistant variant of DH10B).

4. After cloning, transformation, and plating on LB plates containing X-Gal, IPTG,  and carbenicillin, pick three isolated white colonies. Prepare plasmid minipreps,  performEcoRI digestion and electrophorese on 3% SeaKem agarose. For those  clones documented to have an insert by EcoRI digestion, confirm the insert to be  the desired one by sequencing the same undigested plasmid preparation using vector  specific primers. Only those clones with homology to the correct gene sequence  and that have 100% match for the primer sequences proceed to large-scale CT  preparation and are included in the standard mixes. Those that pass this quality  control assessment then continued to the next steps.

5. Prepare each quality assured clone in quantities large enough (1.5 L) to allow for  <1 billion assays (approx 2.6mg).

6. Purify plasmids from resultant harvested cells using Qiagen GigaPrep kits.  7. Carefully quantify plasmid yields using a Hoeffer DyNAQuant 210 fluorometer.

8. For each CT that passes all of the defined quality control steps described in step 4,  assess the sensitivity of the cloned CT and primers by performing PCR reactions  on serial dilutions and determine the limiting concentration that still yield a PCR  product. Only those preparations and primers that allow for detection of 60 molecules  or fewer (a product obtained with 10-17M CT in 10 µl PCR reaction volume)  are continued for inclusion into SMIS (see Note 5).

3.6. Preparation of Standardized Mixtures of Internal Standards(SMIS) (see Note 6)

Combine cloned and quantified CTs into SMIS according to modifications  of previously described methods (5,6,36).

1. Mix plasmids from quality assured preparations (see Subheading 3.4.) into SMIS  representing 24 genes.

2. The concentration of the competitive templates in the 24 gene SMIS is 4 × 10-9 M  for ß-actin CT, 4 × 10-10 M for GAPD (CT1), 4 × 10-11 M for GAPD (CT2), and  4 × 10-8 M for each of the other CTs (see Note 7).

3. Linearize each 24 gene SMIS by NotI digestion. Incubate the SMIS with NotI enzyme  at a concentration of 1 unit/µg of plasmid DNA in approx 15 mL of buffer at 37°C  for 12–16 h.

4. Combine four linearized 24-gene SMIS in equal amounts to yield 96-gene CT  mixes with a maximum concentration of 10-9 M for ß-actin, 10-10 M GAPD (CT1),  10-11 M GAPD (CT2), and 10-8 M for the other CTs.  

StaRT-PCR

5. Serially dilute high concentration SMIS with a reference gene CT mixture comprising  ß-actin CT (10-9 M) and two different GAPD CTs, GAPD CT1 (10-10 M),  and GAPD CT2 (10-11 M). This yields six stock SMIS (A–F) with ß-actin, GAPD1  and GAPD2 at constant concentrations of 10-9 M, 10-10 M, and 10-11 M respectively  while the concentration of the other CTs in SMIS A–F respectively are 10-8  M, 10-9 M 10-10 M, 10-11 M, 10-12 M, and 10-13 M.

6. Dilute stock concentration SMIS 1000-fold to working solutions containing ß- actin, GAPD1 and GAPD2 at concentrations of 10-12 M, 10-13 M, and 10-14 M respectively  while the concentration of the other CTs in SMIS A–F respectively are  10-11 M, 10-12 M 10-13 M, 1014 M, 10-15 M, and 10-16 M.

3.7. StaRT-PCR

StaRT-PCR is performed using previously published protocols (5,6). StaRT- PCR is performed using previously published protocols (5,6). First, the cDNA  sample is diluted until 1 µL competes equally with 6 × 105 molecules of ß- actin CT (1 µL of SMIS containing10-12 M ß-actin CT). The NT/CT must be  greater than 1:10 and less than 10:1 for the measurement to be within linear  dynamic range. Typically, this is the amount of cDNA derived from 100 to1000  cells. Next, this amount of cDNA sample is PCR amplified in multiplex with a  SMIS containing internal standards for reference genes and target genes and  gene specific primers from Gene Express, Inc. as described earlier. As with the  reference gene, the target gene NT/CT must be greater than 1:10 and less than  10:1. Because genes are expressed over more than six orders of magnitude, this explains why the target gene CTs in each 96-gene SMIS must be 10-fold  serially diluted relative to the reference gene CTs, in mixes A–F. For each 96gene  SMIS, sufficient amount of A–F mix is prepared for more than 100 billion  assays. Thus, these SMIS are constant and may be used by all labs. This is  schematically represented in Fig. 4. In Fig. 4, genes 6 and 7 are expressed at a  low level in sample A and therefore are measured using SMIS E. In sample B,  genes 6 and 7 are expressed at a higher level and are measured using SMIS C  and D, respectively. All of the values can be compared because all of the SMIS  are standardized and constant. For each experiment, a PCR master mixture is  prepared containing the appropriate amount of cDNA and SMIS for the number  of gene expression assays to be done. Next, the reference gene NT is measured  relative to its CT, and the target gene is measured relative to its CT, and  expression is calculated as target gene molecules/106 ß-actin molecules. Briefly,  StaRT-PCR is done by a) including in each PCR reaction a sample of cDNA  and a known amount of SMIS, and b) multiplex RT-PCR amplifying both the  target gene NT and its respective CT and a reference gene (e.g., ß-actin) NT  and its respective CT for every gene expression measurement (Figs. 1,3). These  four templates may be amplified in the same tube (4,5) or, if the experiment is

Willey et al.

Fig. 4. Relationship among mixes serially 10-fold diluted from each 96-gene SMIS.  As described in text, a serial 10-fold dilution, A–F, of target gene internal standards

relative to reference gene internal standards is prepared for each 96-gene SMIS. This  allows StaRT-PCR measurement of each gene, even though different genes may be  expressed over a range of more than 6 orders of magnitude.  properly designed, the NT and CT pair for the target gene and the NT and CT  pair for the reference gene may be amplified in separate tubes (5).

3.8. Step-by-Step Description of StaRT-PCR Method

1. Balance cDNA with 6 × 105 ß-actin CT molecules (the amount of ß-actin CT in  1 µL of SMIS). After establishing the amount of cDNA in balance with 6 × 105  copies of ß-actin CT, this amount of cDNA is used in all subsequent experiments  (see Note 8).

2. Combine and mix a volume of cDNA sample (diluted to the level that is in balance  with the amount of ß-actin CT in 1 µL of SMIS (6 × 105) molecules, as determined  above) with an equal volume of the appropriate SMIS A–F such that the  target gene NT/CT will be greater than 1/10 and less than 10/1. A 1 µL volume of

each is used for each gene expression assay to be performed (see Note 9). If the  appropriate SMIS is not known for a particular gene in a sample from a particular  type of tissue, expression is measured in both SMIS C and E. This allows measurement  over four orders of magnitude. For the few genes expressed at very high  or low level, it will be necessary to repeat analysis with SMIS A or F. In the SEM  Center, described later, the most appropriate SMIS is selected based on data in the  standardized expression database.

 StaRT-PCR

3. Combine cDNA/SMIS mixture from previous step with other components of the  PCR reaction mixture (buffer, dNTPs, Mg++, Taq polymerase, H2O)

4. Prepare tubes or wells with a primer pair for a single gene. If products are to be  analyzed by PE 310 device (see Subheading 3.4.9.) the primers should be labeled  with appropriate fluor.

5. Place aliquots of this PCR reaction mixture into individual tubes each containing  primers for a single gene (see Note 10).

6. PCR Amplification. Cycle each reaction mixture either in an air thermocycler  (e.g., Rapidcycler (Idaho Technology, Inc., Idaho Falls, ID) or block thermocycler  (e.g., PTC-100 block thermal cycler with heated lid, MJ Research, Inc., Incline  Village, NV; laboratories) for 35 cycles. In either thermocycler, the denaturation  temperature is 94°C, the annealing temperature is 58°C, and the elongation temperature  is 72°C.

7. Separation and Quantification of NT and CT PCR Products (see Note 11).  a. Agarose gel. Following amplification, load the entire volume of PCR product  (typically 10 µL) into wells of 4% agarose gels (3/1 NuSieve: SeaKem) containing  0.5 µg/mL ethidium bromide. Electrophorese gels for approx 1 h at 225  V in continuously chilled buffer, then visualize and quantify with an image analyzer  (products available from Fotodyne, BioRad).  b. PE Prism 310 Genetic Analyzer CE Device. Amplify PCR products with fluorlabeled  primers. One microliter of each PCR reaction is combined with 9 µL of  formamide and 0.5-0.1 µL of ROX size marker. Heat samples to 94°C for 5  min and flash cooled in an ice slurry. Load samples onto the machine and electrophorese  at 15 kV, 60°C for 35–45 min using POP4 polymer and filter set D.  The injection parameters are 15 kV, 5 sec. Fragment analysis software, GeneScan  (Applied Biosystems, Inc., Foster City, CA) is used to quantify peak heights that  are used to calculate NT/CT ratios. No size correction is performed since each  DNA molecule was tagged with one fluorescent marker from one labeled primer.  c. Agilent 2100 Bioanalyzer Microfluidic CE Device. The DNA 7500 or DNA 1000  LabChip kit may be used. Following amplification, load 1 µL of each 10 µL  PCR reaction into a well of a chip prepared according to protocol supplied by  manufacturer. Run DNA assay, which applies a current to each sample sequentially  to separate NT from CT. DNA is detected by fluorescence of an intercalating  dye in the gel-dye matrix. NT/CT ratios are calculated from area under  curve (AUC) and a size correction is made.  d. Caliper AMS 90 Microfluidic CE Device. Set up the PCR reactions in wells of  a 96- or 384-well microplate. Following amplification, place the microplate in  the Caliper AMS 90. Follow the protocol recommended by the manufacturer.  The AMS 90 removes and electrophoreses a sample from each well sequentially  every 30 sec. The NT and CT PCR products are separated and quantified.  Because detection is through fluorescent intercalating dye, size correction is  necessary.  e. MALDI-TOF separation. A method for separating PCR products recently was  described (16). This method may be applied to analysis of StaRT-PCR products  resulting from amplification of cDNA in the presence of SMIS.  

Willey et al.

Fig. 5. Calculations involved in StaRT-PCR measurement of GST gene expression  relative to ß-actin in an actual bronchial epithelial cell (BEC) sample. The native template  (NT) PCR product was amplified from cDNA specific for the gene being measured, and the competitive template (CT) PCR product was amplified from the internal  standard for each respective gene. A volume of SMIS containing a known number of  internal standard CT molecules for ß-actin (600,000) and GST (6000) were included  at the beginning of the PCR reaction. For each gene the NT and CT will amplify with the  same efficiency. Thus, the ß-actin gene NT/CT PCR product ratio allows determination  of the number of ß-actin NT copies at the beginning of PCR and the target gene NT/CT  ratio allows determination of the number of target gene NT copies at the beginning of  PCR. See text for steps used to calculate gene expression values.

3.9. Steps to Calculate the Numberof NT Molecules Present at the Beginning of PCR for Each Gene  Calculation of gene expression. Values are calculated in units of target gene  cDNA molecules/106 ß-actin cDNA molecules. The steps taken to calculate  gene expression are based on densitometric measurement values for the  electrophoretically  separated NT and CT PCR products such as those presented in  Fig. 5. The calculations below are based on the example in Fig. 5.

1. Correct NT PCR product area under the peak (AUP) to length of CT DNA.

2. Determine ratio of corrected NT AUP relative to CT AUP.

3. Multiply NT/CT value × number of CT molecules at beginning of PCR.

4. Calculation of reference gene (ß-actin) molecules using above protocol.  a. 416/532(ß-actin CT bp/ NT bp) × 42 (NT AUP) = 33 (corrected NT value).  b. Correct ß-actin NT AUP divided by ß-actin CT AUP = 0.37.  c. 0.37 (ß-actin NT/CT) × 600,000 (number of ß-actin CT molecules at beginning  of PCR) = 222,000 NT molecules at beginning of PCR.  

StaRT-PCR

5. Calculation of target gene (GST) molecules using above protocol:  a. 227/359 (GST CT bp/NT bp) × 1.5 (NT AUP) = 0.95 (corrected NT AUP).  b. 0.95 (GST corrected NT AUP) divided by 4.4 (GST CT AUP) = 0.22.  c. 0.22 (GST NT/CT) × 6000 (number of GST CT molecules at beginning of PCR)  = 1290 GST NT molecules at beginning of PCR.

6. Calculation of molecules of GST/106ß-actin molecules

1290 GST NT molecules/222,000 ß-actin NT molecules = 580 GST molecules/106  ß-actin molecules.

4. The Standardized Expression Measurement Center

The SEM Center was recently established at the Medical College of Ohio  through a grant from the National Cancer Institute. The SEM Center is in operation  and available for use at www.geneexpressinc.com.  Currently, microarray technology is the starting point for most large-scale gene  expression profiling investigations. However, owing to limits in lower detection  threshold and sensitivity, and lack of internal standards, microarray technology  is most appropriately applied as a screening tool. For most applications,  data obtained through microarray analysis must be validated by a more sensitive  and quantitative method. Most investigators use a quantitative RT-PCR  method for this purpose.  The purpose of the SEM Center is to provide standardized, reproducible,  gene expression measurement. The SEM Center achieves these goals by using  StaRT-PCR. Further, StaRT-PCR is easily automated and subjected to quality  control, which is critical for analysis of clinical specimens.  The SEM Center function is similar to that of a DNA sequencing service.  Thus, users send their RNA or cDNA samples to the SEM Center for analysis.  Users select a set of genes for measurement and send a requisition listing these  selected genes (available at the SEM Center website) along with the samples.

4.1. Technology Incorporated by the SEM Center

A PE Robotic liquid handler is used to prepare 10 µL PCR reactions in 96well  or 384-well microplates. First, the liquid handler is programmed to distribute  1 µL of primers for the requested genes into wells of the microplates.  Second, for each cDNA a sufficient volume of PCR mixture for the anticipated  number of gene expression measurements is prepared, containing buffer, Taq  polymerase, dNTPs, cDNA and internal standards. The robot then distributes 9  µL of this PCR reaction mixture into each well. Thus, in each well the internal  standard CTs for each gene and cDNA are present in the same ratio, however,  because only one pair of primers is present in each well, only one gene and its  respective internal standard CT are amplified in each well. Following 35 cycles  of PCR, each microplate is transferred to the Caliper AMS 90 for analysis.  

Bulaqueña, et al. (Embryo Transplant Microscopy)

When StaRT-PCR was first developed, products were separated on agarose  gels (4,5). This method is reliable but relatively costly, time consuming, and  labor intensive. Through advances in capillary electrophoresis (CE), alternative  methods for separation of StaRT-PCR products that are faster and less expensive  have become available. We compared separation of StaRT-PCR products on  agarose gel, PE 310 CE, and Agilent 2100 Bioanalyzer mcrofluidic CE (31).  Each of these methods provided the same, reproducible results. Theoretically,  the internal standard mixtures prepared for StaRT-PCR may be used to measure  gene expression coupled with any method capable of quantifying strands  of DNA with different sizes, including HPLC and mass spectrometry. Quantification  of gene expression through analysis of RT-PCR products by MALDI- TOF MS has been recently described (16).  Currently, the Caliper AMS 90 is used for high-throughput separation of  StaRT-PCR products in the SEM Center. This device is capable of 1000 gene  expression assays in eight hours. The SEM Center employs a microfluidic chip  with a sipper that moves from well to well of a microplate, aspirating and then  electrophoretically separating StaRT-PCR products every 30 s. This allows analysis  of a 384-well plate in approx 3 h, which is comparable to the throughput

of the fastest real-time devices.

4.2. Design of High-Throughput StaRT-PCR Experiments

All of the genes that are to be measured in a given sample are measured simultaneously.  Owing to the presence of SMIS in every PCR reaction, gene expression  values for one sample may be compared to gene expression values from another  sample and evaluated at a different time (Fig. 1A).  PCR products (NT and CT) for as many as four genes may be electrophoresed  (separated and quantified) in the same microfluidic channel of the AMS 90SE.  Accomplishing this in the high-throughput SEM Center requires software that  identifies genes that may be electrophoresed simultaneously, based on the length in base pairs (bp) of the NT and CT PCR products. As described in Subheading  3. for each gene, the primers and CTs are designed to amplify PCR products that  range from 150–850 bp. Thus, for every set of genes to be analyzed, the software  must identify which genes may be electrophoresed together.

4.3. Use of Multiplex StaRT-PCR to Reduce cDNA Consumption

An advantage of quantitative RT-PCR as a tool for measuring gene expression  is that it consumes very small amounts of cDNA. This enables meaningful  analysis of very small-tissue biopsy samples, such as those obtained by fineneedle  aspirate. Despite the low amount of cDNA required in quantitative RT- PCR, high-throughput analysis of many genes simultaneously will consume large  amounts of cDNA for each sample, possibly limiting the analysis of small sam  StaRT-PCR  ples. However, multiplex StaRT-PCR methods recently described (7) may  solve this problem. It should be possible to combine nanotechnology methods  for manipulating small liquid volumes with multiplex StaRT PCR methods to  decrease the PCR reaction volumes to 10–100 nL.

The multiplex StaRT-PCR method involves two rounds of PCR. In the first  round, cDNA, CT mix, and primers for up to 96 genes are amplified for 35  cycles. Next, PCR products from round one are diluted, combined with primers  for one gene, and amplified for an additional 35 cycles. No additional CT or  cDNA is added. Products from round one may be diluted as much as 100,000- old and still be quantified following round two amplification. Thus, using  ultiplex StaRT-PCR, 96 genes may be measured in the same amount of cDNA typically used to measure one gene with uniplex StaRT-PCR. The gene expression  values obtained for multiplex StaRT-PCR are highly correlated with those  obtained by uniplex StaRT-PCR (7).

Multiplex StaRT-PCR works because gene expression measurements are  determined by the ratio of NT/CT for each gene and not by the absolute amount  of NT PCR product. For each gene, NT and CT are amplified with the same primers,  share sequence homology, and amplify with equal efficiencies (7). Therefore,  differences in amplification efficiency will not affect the measured relative  level of expression between genes in different samples even after two rounds  of amplification.

4.4. Other SEM Center Services

The SEM Center provides other services besides gene expression measurement,  and these are listed on the requisition that may be downloaded from www.  geneexpressing.com. Users may submit cDNA or RNA samples. RNA samples  will be assessed for quality on an Agilent 2100 RNA chip. If the RNA quality  is good, it will be reverse transcribed. The amount of cDNA produced will be  quantified by measuring the number of ß-actin molecules in a serially diluted  sample. If sufficient cDNA is present for the requested number of gene expression  measurements, the SEM Center will proceed with the order. If there is  insufficient amount of cDNA, the user will be notified and asked to prioritize  genes to be measured, or send more RNA or cDNA.

4.5. Standardized Gene Expression Database

Users send samples to the SEM Center without any annotating information  and with a requisition that includes an attestation that any primary human  samples were obtained under approved and active IRB protocol. Because no  potentially identifying information is provided, the SEM Center is exempted  from the need to obtain an Institutional Review Board protocol for each set of   Bulaqueña, et al. (Embryo Transplant Microscopy)  samples submitted. As soon as an order is completed, the data are sent by email  and a hard copy sent to the user. Each user is encouraged to send the annotating  information as soon as possible. It is hoped that users will send the annotating  information as soon as a manuscript containing the data is accepted for publication,  or sooner. An annotated standardized gene expression database will be  key for advances in research as well as for developing clinical tests.

5. Notes

1. The quality of the RNase-free water is critical to efficient extraction of intact RNA.  We have found that it is more cost effective to purchase reliable RNase-free water  from commercial sources than it is to prepare our own. Either inadequate DEPC  treatment or inadequate removal of DEPC after treatment can inhibit reverse transcription  and PCR (see Subheading 3.1.6.).

2. Internal standard CTs are constructed by Gene Express, Inc. (GEI, Toledo, OH)  based on previously described methods (5,6,36) (see Subheading 3.3.).

3. Use Primer 3.1 software (Steve Rozen, Helen J. Skaletsky, 1996, 1997) Primer 3.  Code available at http://www-genome.wi.mit.edu/genome_software /other/primer3.  html) to design primers. Designing primers with the same annealing temperature  allows StaRT-PCR reactions to achieve approximately the same amplification efficiency  under identical conditions. If there is variation in amplification efficiency  it does not cause variation in quantitative value because the value is obtained from  the ratio between the NT and CT for the same gene, and amplification efficiency  of the NT and CT for the same gene are affected identically.

Designing primers that amplify different sized products for different genes will  support automation and high-throughput applications, including capillary gel and  microchannel CE. Primer sequences and Genbank accession numbers for genes  designed by GEI are available at www.geneexpressinc.com. (see Subheading 3.3.1.).

4. Primers are tested using reverse transcribed RNA from a variety of tissues or individual  cDNA clones known to represent the gene of interest. Primer pairs that fail  to amplify the target gene in any tissue or individual cDNA clone (less than 10%  of the time) are redesigned and the process repeated (see Subheading 3.3.2.).

5. The number of molecules at different molarities is a multiple of six as a consequence  of Avogadro’s Number (6.02 × 1023 molecules/mole). More than 80% of  the CTs developed have a sensitivity of six molecules or less. Thus, for these genes,  it is possible to measure as few as 10 molecules/ 106 ß-actin molecules. Because  there are approximately 100–1000 ß-actin molecules per cell for most cell types,  this level of sensitivity allows measurement of 1 molecule per 100–1000 cells. At  the other end of the expression spectrum, SMIS A will allow measurement of more  than 107 molecules/106 molecules of ß-actin (103–104 molecules/cell). In our  experience, few genes approach this level of expression, examples include UGB  (Genbank no. U01101) and vimentin (X56134) (unpublished data). Thus, SMIS  A–F should allow measurement of gene expression over the full spectrum observed  in human tissues (see Subheading 3.6.).  

StaRT-PCR

6. The process of identifying primers that lead to high PCR amplification efficiency  for both the NT and CT, preparing large amounts of the CT through cloning,  quantifying the CTs, and mixing the CTs into SMIS, transforms CTs into internal  standards. Thus, CTs are the raw material necessary for development of the much  more valuable product (see Subheading 3.6.).

7. The reason for two different GAPD CTs is that the expression of GAPD relative  to ß-actin may vary as much as 100-fold from one tissue type to another. Having  two different concentrations of GAPD CT relative to ß actin enables comparison  of GAPD to ß-actin in all samples. These comparisons are helpful in determining  intersample variation in expression of reference genes (see Subheading 3.7.).

8. For each cDNA sample, it is necessary to determine the dilution of the test cDNA  that is approximately (within 10-fold range) in balance with 600,000 copies of ß- actin (1 µL of SMIS containing ß-actin CT at 10-12 M). This is approximately the  amount of cDNA derived from 100 to 1000 cells. This amount will ensure that  there is sufficient cDNA to quantify genes expressed at low levels. If the goal is to  have at least 10 transcripts present at the beginning of PCR to avoid stoichiometric  problems, this amount of cDNA will allow quantification of genes expressed  as low as 1 transcript in every 10–100 cells. If less sensitivity is required, less cDNA  may be used. Thus, one could choose to use the amount of cDNA in balance with  60,000 molecules of ß-actin CT. This will not allow measurement of genes expressed  at very low levels, but will be sufficient for analysis of most genes and will reduce  consumption of cDNA 10-fold. This may be useful when analyzing very small  biopsy specimens for diagnostic tests. For each of the SMIS A–F, 1 µl of CT mix  contains 600,000 molecules of ß-actin CT, thus any of the SMIS could be used for  this purpose of balancing cDNA with ß-actin. The standard operating procedure is  to use SMIS F.

A common mistake for beginning users of StaRT-PCR is to balance the cDNA  with the ß-actin in the SMIS initially, and then, when the target gene NT and CT  are not in balance, vary the amount of cDNA in the PCR reaction mixture to get  the target gene NT/CT in balance. Instead, keep the amount of cDNA constant and  change the SMIS used. The SMIS have been prepared for measurement of genes  across the full range of gene expression measurement (6 orders of magnitude).  Because the NT/CT ratio must be within 10-fold ratio in order to obtain reliable,  reproducible quantification, six different SMIS have been prepared, containing  10-fold serial dilution of all target gene CTs relative to reference gene CT. If SMIS  D were used to measure a target gene, and the target gene NT was more than 10-fold  greater than the CT, the next step would be to repeat the experiment with the same  amount of cDNA, but using SMIS C, which has a 10-fold higher concentration of  target gene CT (see Subheading 3.8.).

9. The StaRT-PCR method standardizes every gene expression measurement so that  it can be readily compared to all other StaRT-PCR measurements. The procedure  described in this step allows one to compare the NT/CT ratio for the reference gene  to the NT/CT ratio for the target gene in a reliable way that controls for variation  in pipeting. This step commonly is carried out incorrectly by users of StaRT-PCR.  

Bulaqueña, et al. (Embryo Transplant Microscopy)

For example, it is common for users to aliquot SMIS sufficient for a single gene  expression measurement into each separate PCR reaction mixture, and then aliquot  cDNA for a single measurement into each tube. Owing to pipeting errors, this  would be associated with variation in the NT/CT ratio of each target gene relative  to the NT/CT ratio for the reference gene, as well as that for other target genes.

The SMIS (A, B, C, D, E, or F) selected will be the one containing CT at the  concentration most likely, based on previous experience, to be in balance (within  10-fold range) with the gene or genes being assessed (see Subheading 3.8.2.).

10. In Subheading 3.8.5. of this experimental design, the ratio of CT for every gene  in the mixture relative to its corresponding NT in the cDNA is fixed simultaneously.  When aliquots of this mixture are transferred to PCR reaction vessels, although  variations in loading volumes resulting from pipeting errors are unavoidable, there  is no potential for variation in any target gene NT/CT ratio relative to reference  gene NT/CT ratio. In addition, it enables standardized expression measurement.  In order to ensure control for loading in each experiment, the reference gene (ß- actin) is measured along with the target genes for each different master mix utilized.  The choice of which four SMIS to use is based on previous experience. For example,  if among all previous samples a gene has been expressed within a range of  101–103molecules/106 ß-actin molecules, the gene will be measured using SMIS E.  In contrast, if among all previous samples, a gene has been expressed within a range  of 105–107 molecules/106 ß-actin molecules, the gene will be measured using SMIS  B. For the rare samples that express the gene outside of the expected ranges, a fol- low-up analysis with the appropriate CT mix is performed.

11. Electrophoresis may occur in an agarose gel, capillary electrophoresis device (e.g.,  PE 310), or microfluidic CE device (e.g., Agilent 2100 or Calipertech AMS 90  high-throughput system). If an agarose gel is used, electrophoresis is for one hour  at 225 V through agarose gel. If a CE device or microfluidic CE device is used,  electrophoresis is according to the manufacturer’s instructions. Following electrophoresis,  the relative amount of NT and CT is determined by densitometric quantification  of bands that have been stained by an intercalating dye (e.g., ethidium  bromide). Theoretically, the internal standard mixtures prepared for StaRT-PCR  may be used to measure gene expression using any method capable of quantifying  strands of DNA with different sizes and/or sequence, including solid phase  hybridization MALDI-TOF and HPLC (see Subheading 3.8.7.).  The calculation steps presented in Subheading 3.9. have been incorporated  into a spreadsheet. Thus, the user simply enters the raw values for the NT, CT,  and heterodimer PCR products for each gene into the spreadsheet, and the expression  value for the gene in molecules/106 ß-actin molecules is automatically calculated.  Software now in development will automatically enter the peak area values  for each NT and CT PCR product into a spread sheet. The spreadsheet will automatically  calculate expression value or, if the NT/CT ratio is not in balance, will  instruct the robotic liquid handler on how to set up the next experiment.  

StaRT-PCR

Acknowledgments

These studies were funded by NCI grants U01 CA 85147 and R24 CA 95806  and the George Isaac Endowment for Cancer Research. Major contributions to  establishment of the SEM Center have been made by David A. Weaver. JCW,  ELC, KAW, and RJZ have significant equity interest in Gene Express Inc., which  produces and markets StaRT-PCR reagents. EAH and RJZ are employees of  Gene Express Inc.

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GeneCalling

Transcript Profiling Coupled to a Gene Database Query  Bulaqueña, et al.

Summary

We describe the GeneCalling method for the discovery of differentially expressed  genes, both known and novel, from any species including useful sequence information  to determine the potential function of novel genes captured. The method  relies on transcript visualization coupled to a database query to rapidly and quantitatively  identify differentially expressed transcripts. The method has been applied  to a wide variety of disease models in a variety of species, addressing problems  as diverse as identifying novel human cancer gene targets, understanding how  drugs and diet affect animal models of disease, and understanding the basis of  trait differences in related strains of corn.  Key Words: Bioinformatics, cDNA, disease, GeneCalling, mRNA

1. Introduction

The comprehensive discovery of differences in gene expression among  samples is a powerful method of identifying genes associated with diseases,  traits, and biological responses to chemicals. Existing methods for expression  analysis fall into three general classes: transcript sampling by sequencing (1–3),  transcript amplification and imaging (4–8) and hybridization-based approaches  (9–13). Serial analysis of gene expression (SAGE) (2), a cost-effective tran- script-counting technique, is limited by the small amount of sequence information  obtained for each gene. Transcript sequencing following subtractive hybridization  also identifies differentially expressed genes, but is limited to binary  comparisons (3). Transcript imaging approaches such as differential display

From: Methods in Embryo Transplant Microscopes and Emyro Transplant Microscopy  Vol. 258: Gene Expression Profiling: Methods and Protocols  Edited by: R. A. Bulaqueña, et al. (Embryo Transplant Microscopy) © Bulaqueña, et al. (Embryo Transplant Microscopy) Inc., Totowa, NJ

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44 Bulaqueña, et al. (Embryo Transplant Microscopy)

(4), partitioning by type IIS restriction enzymes (6), representational difference  analysis (RDA) (7), and amplified fragment length polymorphism (AFLP)  (8) are rapid, and in theory, are comprehensive because they utilize banding patterns  that are dependent on gene expression. However, each of these approaches  requires a time-consuming cloning and confirmation process for determination  of the identity of differentially expressed gene fragments.  The development of microarrays has revolutionized the capacity of hybridization  techniques (9–13) to identify differences in gene expression. Hybridization  approaches are rapid and immediately provide the identity of differentially  expressed genes of known sequence. However, hybridization methods  are limited by an inability to detect or discover completely novel genes with  no expressed sequence tags (EST) representation, thus making work in most  organisms impossible.  We describe here the GeneCalling® method for the discovery of differentially  expressed genes, both known and novel, from any species and with useful  sequence information to determine the potential function of novel genes  captured (Fig. 1) (14). The method has been applied to a wide variety of disease  models in a wide variety of species, addressing problems as diverse as  identifying novel human cancer gene targets (15,16), understanding how drugs  and diet affect animal models of disease (17,18), and understanding the basis  of trait differences in related strains of corn (19,20).

2. Materials

1. Trizol (BRL, Grand Island NY).

2. Bromochloropropane (Molecular Research Center Inc., Cincinnati, OH).

3. DNAse I (Promega, Madison, WI).

4. Dithiothreitol (DTT) (BRL, Grand Island, NY)

5. RNasin (Promega, Madison, WI).

6. OliGreen (Molecular Probes, Eugene, OR).

7. Oligo(dT) magnetic beads (PerSeptive,