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Technical Aspects of Quantitative Competitive PCR

Article in BioTechniques · September 1996


DOI: 10.2144/96212rv01 · Source: PubMed

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Review
Technical Aspects of
Quantitative Competitive PCR
BioTechniques 21:268-279 (August 1996)

Klaus Zimmermann and ences 16–18, 21, 31, 32 and 84). This plates, different PCR strategies and
Josef W. Mannhalter assay is based on competitive co-ampli- modes of detecting PCR products.
Immuno AG fication of a specific target sequence to-
gether with known concentrations of an
Vienna, Austria internal standard in one reaction tube. CONSTRUCTION OF INTERNAL
The internal standard has to share primer STANDARDS FOR
recognition sites with the spe-cific COMPETITIVE PCR
template, both specific template and
INTRODUCTION internal standard must be PCR-am- Generation and testing of suitable
plified with the same efficiency and it internal standards and the choice of
The polymerase chain reaction must be possible to analyze the PCR- primer pairs are among the most
(PCR), first described by Saiki et al. amplified products of specific template crucial and time-consuming aspects of
(79), is a highly sensitive and specific and internal standard separately. Quan- setting up a competitive PCR protocol.
methodology for detection of nucleic titation is then performed by comparing The simplest way to choose suitable
acids and a useful tool for quantitation the PCR signal of the specific template pri-mers is to use, as far as possible,
of the amount of specific nucleic acids with the PCR signals obtained with primers already widely used and/or
present in a sample. The simplest ap- known concentrations of the competitor well described. If new primers have to
proach to quantitation of PCR and re- (the internal standard). Ever since this be designed, computer programs in
verse transcription PCR (RT-PCR) method was first described (6,38,99), it combination with sequence data bases
products (reviewed by References 17, has been widely used for quantitation of may be helpful tools.
21, 31 and 32) is measurement of the cellular RNA and DNA as well as vi-ral General concepts of PCR primer de-
amount of amplification product in the and bacterial nucleic acids. Exam-ples sign have been reviewed by Dieffen-
exponential phase by reference to the reported on include the quantita-tion of bach et al. (26). Since different primer
dilution series of an external standard. cytokine expression (6,38,52,91, 99,103) pairs for the same gene can exhibit up to
However, accurate quantitation with this and of viral nucleic acids such as 1000-fold differences in sensitivity (44),
type of PCR is hampered by a number of hepatitis B (46), hepatitis C (9,40,53, special emphasis should be placed on
variabilities that can occur during 58,75,78,106), human cytomegalovirus testing the specificity and efficiency of
sample preparation or in the course of (35), herpes simplex virus (74) or hu- primer pairs in advance before inter-nal
the reaction, and minor varia-tions in man immunodeficiency virus type 1 standards are generated. Once the
reaction conditions are greatly (HIV-1) (3,5,36,51,62,70,71,81,88,92) appropriate primer pair has been select-
magnified during the amplification and quantitation of bacteria, especially ed, various strategies for the construc-
process. These variabilities may partly of slow-growing species such as my- tion of internal standards may be used.
be overcome by normalizing the amount cobacteria (55). Furthermore, the utili-ty Internal standards for competitive
of PCR products of the specific template of competitive PCR or RT-PCR has PCR or RT-PCR are DNA or RNA
with respect to an internal ref-erence been demonstrated in the quantitation of fragments sharing the primer recogni-
template such as the cellular gene b- mitochondrial DNA (100) or mRNA tion sequences with the specific target
globin (20) amplified in the same expression (29,69) and assessment of yet yielding PCR products that are dis-
reaction tube. hereditary deficiencies (e.g., Reference tinguishable from the wild-type tem-
Alternatively, limiting dilution 43) or leukemias (22,93). plate. The easiest way to distinguish
using a nested primer methodology Considering the hundreds of pub- between wild-type template and inter-
(57,90) can be used in combination lished papers on the use of competitive nal standard is by differences in the size
with Pois-son statistics for evaluation PCR, it is not surprising that a great va- of the two products. This can be
of the results. riety of protocols exist. In the present achieved, for example, by constructing
The most precise quantitation of article, we shall review this methodolo- standards having the same sequence as
DNA and RNA can, however, be ob- gy, concentrating in particular on tech- the specific target but containing a dele-
tained by competitive PCR and com- nical aspects of competitive PCR, such tion or an insertion. The simplest con-
petitive RT-PCR (reviewed in Refer- as the construction of competitive tem- struction procedure is to use a compos-

268 BioTechniques Vol. 21, No. 2 (1996)


ite primer containing two specific tar-get
sequences at a predetermined dis-tance
from each other (thus resulting in a
deletion) and a second primer specific sequences.
for the opposite strand (14,33,48, 61,77). A basically different approach to the
The amplification of wild-type templates construction of competitive internal
with such primers results in a PCR standards is to use a nonspecific spacer
product that is shorter than the wild-type gene or spacer DNA. These competi-
template and can thus easily be tors have nucleotide sequences totally
identified (e.g., after electrophoretic or different from the wild type, except for
HPLC separation). Alternatively, wild-type primer sequences attached to
elongated internal standards can be their 5¢ ends. Such approaches have
constructed using a “looped oligo” been used for quantitation of cyto-
method by amplifying cDNA with a chrome P450 by using the glutathione
primer containing a non-templated nu- transferase m gene as the spacer se-
cleotide insertion between template se- quence for an internal standard (96) or
quences (80). for quantitation of glycerinaldehyde 3-
When deletions or insertions in the phosphate dehydrogenase with an in-
center of the internal standard are de- ternal standard based on the v-erb B
sired, a splice overlap extension PCR oncogene (85). Nonspecific spacer se-
can be used (39,72,82,92). First, two quences are also frequently used to
parts of a gene or different genes are construct multicompetitor standards
amplified in separate PCRs. Since the containing priming sites for various
downstream primer of the first template genes of interest. Such multicompetitor
and the upstream primer of the second standards can be constructed by direct-
template are designed to contain com- ly linking together several primer sites
plementary sequences, the two parts of and then attaching them to a spacer se-
the gene or the different genes can be quence (4,7,52,86,99).
linked together by subsequently ampli- Finally, generation of competitive
fying the two different PCR products in standards by amplification of multiple
one reaction tube. In similar approach- DNA fragments from cellular material
es, internal standards can also be con- in a PCR with low-stringency anneal-
structed by PCR amplification of a ing conditions has been described
mixture of religated PCR products (34,94). This procedure results in a va-
(1,37). Finally, if the sequence of the riety of different-sized PCR products,
specific template contains one or two the most suitable of which is purified
internal restriction sites, these sites can and used as internal standard in a quan-
be used to obtain a construct with an in- titative competitive PCR assay.
sertion or a deletion (3,11,70,72,104). The competitive templates con-
Differences between wild type and structed in one of the ways described
standard can also be obtained by above are usually loaded on a gel, sepa-
incor-poration of restriction sites rated, excised and extracted. They can
(2,6,35,38, 59,68,88). Following PCR, then be used directly in a competitive
the stan-dards containing such PCR assay (14,48,85), but more often,
restriction sites are digested with the they are cloned into plasmids, prefer-
respective restric-tion enzyme. Since ably by the help of additionally intro-
the digested prod-ucts are smaller in duced restriction sites (e.g., References
size, they can easily be distinguished 9, 61, 72, 104 and 110).
from the wild-type template and can Cloning of competitive standards
be analyzed separ-ately. into plasmids usually involves enzy-
Exchange of nucleotides in specific matic reactions such as digestion with
templates is another way to construct specific restriction enzymes, generation
competitive internal standards (54,75, of blunt ends and ligation (e.g., Refer-
78,106). After competitive PCR, the ences 61, 70, 88 and 92). In addition to
wild-type fragment and competitive in- these conventional strategies, other
ternal standards containing nucleotide simpler procedures have been devel-
exchanges can be identified following oped. Should a plasmid containing the
differential hybridization with probes wild-type sequence be available, this
specific for wild-type and competitor plasmid can be used directly as an in-
ternal standard after introducing a dele-
tion into the wild-type sequence as
described by Zarlenga et al. (108). Fur-

Vol. 21, No. 2 (1996) BioTechniques 269


Review
thermore, PCR products can be engi- plification efficiencies is an analysis After linearization of the vector, large
neered to contain terminal sequences of known amounts of wild-type amounts of RNA are transcribed (61,70).
identical to sequences of the two ends of template and competitive internal The RNA is then purified by DNase I
a linearized vector. These two DNAs standard in a PCR protocol that uses digestion, extraction and pre-cipitation.
can be co-transfected simply into E coli, fluorescently or radioactively labeled Subsequently, quality and copy number
which results in incorporation of the primers. After various numbers of of the competitive RNA standard
insert into the vector (49,67). Final-ly, cycles, the PCR products are separated (compared to the copy number of
PCR products and linearized plas-mid and quantitated by measuring their contaminating residual DNA) should be
can also be ligated together in a PCR by radioactivity or fluorescence (19,81). determined both spectrophotometri-cally
overlap extension of comple-mentary When controlling for amplification and by gel electrophoresis (61). Several
ends (50,83). Following denat-uration, efficiencies of wild-type and internal researchers have described an interesting
heterologous re-annealing and standard templates, it is also important shortcut to this common methodology
cyclization, a recombinant plasmid is to keep in mind that possible differ- for synthesizing competi-tive internal
formed that is then used to transform ences may become more pronounced standard RNA. They used a composite
competent E. coli. when the amplification reaction is driven primer to construct a re-combinant
It must furthermore be ensured that to the post-exponential (plateau) phase competitor cDNA carrying the T7 RNA
the concentration of the internal stan- (6,60). To ensure proper quanti-tation, it polymerase recognition sequence at its
dard is determined accurately. It is thus has therefore been suggested that the 5¢ end (39,77,96). After amplification
advisable not only to quantitate the amplification efficiencies of wild-type with this composite primer and a second
competitive plasmid to be used as an and internal standard PCR products be specific primer, the resulting PCR
internal standard spectrophotometrical- measured during the expo-nential, post- product is used di-rectly for transcription
ly, but also to check its quantity and exponential and plateau phases (10,19). by T7 RNA polymerase.
quality electrophoretically. In addition, In general, it can be concluded that
the concentration of internal standards differences in sequences of wild type
should be checked by PCR in combina- and standard as well as small differences PCR AND RT-PCR
tion with end-point dilution, taking into in size do not sub-stantially affect
consideration the Poisson distribution of amplification efficien-cy. However, as Extraction of Nucleic Acids
positive samples (61). an inverse exponential relationship To ensure proper performance of the
between template size and amplification quantitative competitive PCR assay, the
ANALYSIS OF COMPARABLE efficiency has been ob-served (60), it is methods used for preparing the nucleic
AMPLIFICATION OF WILD- obviously important to keep the size acids to be quantitated must be chosen
TYPE AND INTERNAL difference between wild type and with care and, if necessary, optimized.
STANDARD TEMPLATES standard as small as possible (60,61). This is especially essential for prepara-
tion of RNA. DNA preparation, on the
A prerequisite for the proper perfor- Another problem to be dealt with other hand, can follow more straight-
mance of quantitative competitive PCR concerns the possible formation of forward procedures. With respect to
is a comparable amplification efficien- het-eroduplexes, which can occur DNA quantitation, it has been shown
cy of competitive internal standard and when wild-type and internal standard that crude cell lysates can be used with
wild-type templates, and it is especially tem-plates differ in only one or a few the same reproducibility as purified
important to carefully control for this bases (either small differences in size DNA (88,110). Furthermore, the use of
when setting up a new PCR-based or small diversities in the nucleotide crude cell lysates entails less labor and
quantitation procedure. The easiest se-quences) (6,60,70). Since heterodu- avoids the loss of specific sample, which
mode of control is to repeatedly quanti- plexes would interfere with may occur during DNA purifica-tion. If,
fy several known amounts of specific subsequent quantitation procedures, for one reason or another,the use of
wild-type template with the help of the great care should be taken to avoid purified DNA for quantitation appears
newly constructed internal standard. If their forma-tion (2,24,42). preferable, loss of specific sample or
these analyses result in the calculated All of the above-mentioned consid- DNA degradation should be controlled
copy numbers, comparable amplifica- erations are equally important for the for, e.g., by quantitating a control gene
tion efficiencies between standard and construction and analysis of internal in a second competitive PCR, as
wild-type template can be assumed, and standards to be used for quantitation of described by Deng et al. (25).
the newly constructed internal stan-dard DNA by competitive PCR or of RNA by Before quantitation of RNA, it is es-
can be safely used for quantita-tion. If competitive RT-PCR. However, for the pecially important to optimize RNA ex-
the results of such quantitation construction of RNA standards, ad- traction procedures and to perform
experiments point to minor differences ditional precautions have to be taken. careful quality control of the extracted
in amplification efficiency between wild For synthesis of competitive internal RNA. Genomic DNA can either be
type and standard, this may be standard RNA, the competitive DNA eliminated by digestion with DNase I,
compensated for by using a correction constructs are placed in plasmid vectors or, more elegantly, RT-PCR primers
factor (60). Another frequently used under the control of an RNA poly- spanning one or more introns (38) can
procedure for the determination of am- merase promoter (e.g., T7, SP6 or T3). be designed. The simplest means of

270 BioTechniques Vol. 21, No. 2 (1996)


Review
controlling RNA quality is to both mea- viruses is desired, this can most ele- RT of RNA. Usually, enzymes from
sure optical density and run a denatur- gantly be performed by using virus mu- Moloney murine leukemia virus
ing RNA gel capable of detecting pos- tants as competitors, provided these (MMLV) or avian myeloblastosis virus
sible RNA degradation. It has been mutants differ from the wild type in the (AMV) are used for RT, but the RT-
suggested that extraction efficiency can genome section amplified by the two PCR process can be simplified by the
be estimated by performing a second primers (66). To achieve a meaningful use of Tth DNA polymerase possessing
extraction and determining the mean quantitation, several known concentra- both RT and polymerase activity (64).
RNA loss (61). To ensure comparable tions of competitive internal standard Some authors reported that Tth had a
extraction in a series of samples, house- RNA must be added separately to the lower RT reactivity than RT from
keeping genes are usually quantitated in same concentration of wild-type RNA in MMLV and therefore might not be the
addition, and the copy number of the different vials (70), followed by re-verse most suitable enzyme for detecting low
gene of interest is calculated with re- transcription and PCR amplifica-tion. copy numbers (23). However, if the
spect to the copy number of the house- Before quantitation of RNA using the conditions for Tth are very carefully
keeping gene (7,86). However, it can- nucleic acid sequence-based ampli- optimized, low copy numbers may also
not be taken for granted that the so- fication (NASBAÔ) methodology, ad- be detected with this enzyme (105).
called housekeeping genes will maintain dition of two or more known concentra- To control for the RT step, the sam-
a steady level of expression under all tions of different-sized competitive ple should always be reverse-tran-
circumstances. Expression of RNA standards to the same vial has been scribed in the presence of varying
housekeeping genes is often increased, suggested (97). amounts of competitive internal stan-
especially in activated cells. dard RNA followed by PCR amplifica-
The addition of competitor RNA Reverse Transcription tion. In the scientific literature, several
molecules before extraction is also a After having selected the most ap- protocols do exist in which RNA is first
simple means of controlling extraction propriate method of RNA preparation, reverse-transcribed, and the resulting
efficiency. When detection of RNA great care should be taken to optimize cDNA is then quantitated with compet-
Review
itive DNA templates (e.g., Reference 4). General Considerations for Optimal each other and all of the templates and
However, this does not take into ac- Performance of Quantitative primer pairs used have to be amplified
count the variability of the RT step, and Competitive PCR or RT-PCR with similar efficiency, not more than a
such a procedure is therefore not suit- few different primer-template systems
able when exact quantitation is desired. In theory, a single concentration of can be included in a single assay.
Furthermore, the efficiency of amplifi- competitive internal standard co-ampli- Another important parameter that has
cation between single- or double-stran- fied with the specific template may be to be considered when performing
ded DNA templates may vary (13). sufficient for quantitation, especially if quantitative PCR analyses concerns the
the internal standard/specific template detection limit for specific DNA tem-
Amplification ratio is compared with a calibration plates. With a single round of amplifi-
Polymerase enzymes such as the curve obtained by comparing constant cation, this detection limit has been re-
widely used Taq DNA polymerase or amounts of internal standard with sev- ported to be 10 copies per PCR tube
alternative enzymes such as Dyna- eral known concentrations of wild-type (70). However, problems may arise
ZymeÔ (Finnzymes Oy, Espoo, Fin- template (46,107). However, since it has when a small number of specific copies
land) and Tth usually work very well in been demonstrated that quantitative have to be detected in a high back-
the buffers supplied with the enzyme measurements of PCR-amplified prod- ground of nonspecific cellular DNA. To
when used according to the manufac- ucts are most accurate when ratios of overcome this problem and raise the
turers’ instructions. As has been wild-type and competitive internal sensitivity and specificity of the quanti-
reviewed by Erlich et al. (28), concen- standard templates are equal or similar tative competitive PCR assay, nested
tration of enzyme, primers and nu- (3,73), the performance of quantitative (11,41,42,106) or hemi-nested (62,95,
cleotides, the number of cycles and de- PCR protocols using co-amplification of 110) PCR protocols have been devel-
naturation, annealing and extension one concentration of specific tem-plate oped and successfully used for quan-
times affect the specificity and sensitiv- with several dilutions of internal titation of both DNA and RNA
standard is preferred. templates.
ity of the PCR. Since MgCl2 concentra-
One concentration of specific tem- It is also important not to overesti-
tions and annealing temperature espe-
plate is also compared with only one mate the accuracy of quantitative com-
cially influence the specificity of the
concentration of standard when DNA is petitive PCR. With well-established
reaction, great care should be taken to
quantitated by performing PCR under tests of this type performed by experi-
optimize these parameters. Starting the
reaction at a high temperature (“hot low-stringency conditions (12). With enced scientists, standard deviations
start”) may improve performance of the this method, it is not necessary to con- between 10% and 20% (2,9,24,71,104,
PCR by eliminating undesired hy- struct a competitive internal standard 110) have been reported for the analy-
bridization events (65). and add it to the amplification tube. The sis of replicate portions of the same
Most quantitative competitive PCR standard is generated instead from sample on different occasions. There-
protocols described suggest the use of cellular material co-amplified during the fore, for reliable discrimination of
30–50 PCR cycles, which in most cases low-stringency PCR. However, as the twofold differences in copy numbers
drives the PCR beyond the exponential ratio of cellular material to specific between two samples, it is preferable
phase. From time to time, publications DNA cannot be changed, this method to calculate a mean of replicate
appear (27,78,101) that recommend re- does not allow titration with different determi-nations of the same sample.
stricting quantitative competitive analy- concentrations of competitive standard
sis to the exponential phase of product template and thus does not allow pre-
cise quantitation. DETECTION AND ANALYSIS
accumulation. This exponential phase OF PCR PRODUCTS
would have to be determined carefully Accuracy of quantitative competi-
and might differ not only due to the na- tive RT-PCR can be potentiated by si- For detection and analysis of ampli-
ture of the specific template to be quan- multaneous determination of a gene of fied products, a large variety of proce-
titated, but also with respect to the interest and a reporter gene in one reac- dures are available (reviewed in Refer-
equipment being used; therefore, it tion tube (multiplex PCR) (2,24,27,30). ence 47). It should generally be kept in
would greatly complicate PCR-based The expression of the titrated gene of mind that the detection method chosen
quantitation of nucleic acids and thus be interest is then calculated with refer- should, whenever possible, avoid addi-
a major drawback in routine applica-tion ence to the titrated level of the reporter tional manipulations, which not only
of this technique. However, recent gene. The use of competitive templates take more time, but increase the possi-
studies have addressed this problem with several tandem-arranged internal bility of inaccurate quantitation.
(10,19,63,84) and have shown that standards may be preferable for such an PCR products of different sizes are
amplification of both wild-type and approach (62,76,98), as this may re-duce usually separated by conventional gel
competitive internal standard templates possible errors that could occur when electrophoresis (e.g., References 61,70,
proceeded during the exponential and mixtures of specific template with 110), capillary gel electrophoresis
non-exponential phases up to the pla- several different standards have to be (30,87) or HPLC (24). The easiest and
teau phase with equal efficiency. prepared. However, since the respec-tive most commonly used method is to use
amplifications in a multiplex com- gel electrophoresis for separation of the
petitive PCR should not interfere with PCR products and to visualize the DNA

274 BioTechniques Vol. 21, No. 2 (1996)


bands by ethidium bromide or an
equivalent fluorescent dye (2,7,39,61,
70,77,86,110). The gel materials to be
used are either agaroses specially de- known competitive standard concentra- the use of radioactively or fluores-
signed for separating small DNA frag- tions are then used to generate a dia- cence-labeled dNTPs (27,36,38,48,
ments or polyacrylamide gels. For gram that can be utilized to quantitate 104) or oligonucleotides (3,99). After
quantitation of the respective DNA precisely the amount of wild-type tem- electrophoretic separation, the radioac-
bands, a video image analysis system late. The number of specific template tively labeled bands can be excised from
can be used. The gels can be either copies in the sample is usually calculat- gels and the cpm counted (36,81,
scanned directly on the transilluminator ed by determining the competition 99). However, drying of the gels and di-
(61,70) or scanned after photography equivalence point in a regression plot, as rect autoradiography and scanning (27)
(2,15,77,84,89). In doing so, keep in described by Piatak et al. (70). In brief, or radioimaging of dried gels (3,48,
mind that the amount of incorporated the log10 of the ratio of the signal 109) is simpler and, as this involves
dye and the resulting fluorescent emis- less manipulation, possibly also more
intensity of the competitive internal
sion depends on the length of the nucle- precise. A disadvantage of direct label-
standard over the wild-type fragment,
ic acids. Since the determination of the ing is that it also visualizes all nonspe-
usually multiplied by a correction fac-
equivalence point of the two different cific bands. To avoid this, PCR prod-
fragments is based on molar amounts, a tor, is plotted as a function of the log 10 ucts are separated electrophoretically,
correction factor that takes into account of the concentration of the competitive transferred to a membrane and quanti-
the diverse fluorescence emitted by dif- internal standard template. This yields a tated after hybridization with radioac-
ferent-sized fragments must be used linear plot, and interpolation on the plot tively (92) or nonradioactively labeled
(e.g., Reference 70) to ensure correct for a Y value of 0 gives the numbers of DNA probes. Alternatively, the com-
quantitation. The respective ratios of copies present in the test sample. petitive PCR products can be hy-
unknown wild-type template and A procedure more sensitive than bridized with a labeled oligonucleotide
ethidium bromide staining, which is before separation (liquid hybridization)
also frequently used for quantitation of and autoradiographed after gel elec-
competitive PCR products, is based on trophoresis (66,88).
Review
PCR products generated by using dard and specific template in the pres- quantitation of PCR products (45,102).
fluorescently labeled primers can be ence of biotinylated primers followed by One of the primers used for amplifica-
separated on polyacrylamide gels and capturing of the PCR products on tion is biotinylated to allow capture of
elegantly quantitated using an automat- microplates coated with streptavidin the PCR products by magnetic beads
ed laser fluorescent DNA sequencer (46,56,91). Alternatively, 5¢ aminated coated with streptavidin. The PCR
(19,62,72). This laser-induced fluores- PCR products can be captured onto car- products can be quantitated separately
cence (LIF) is a highly sensitive meth- boxylated wells of microplates (54), or by hybridization with TBR (tris(2,2¢-
odology and in combination with PCR products are captured by probes bipyridine)ruthenium(II) chelate)-la-
computer software offers a means of covalently attached to organosilan sur- beled probes specific for wild-type or
automating post-PCR analysis. LIF can face-activated plates (8). PCR products competitive internal standard tem-plates,
also be applied for quantitation of com- captured in one of the ways described or alternatively TBR-labeled primers are
petitive PCR products following capil- above are hybridized with probes spe- used for direct quantitation of the
lary electrophoresis (30,87). cific for wild-type or internal standard amplified products.
Finally, HPLC has recently been sequences. These probes usually con-
used for separation and quantitative tain radioactive labels or have the ca-
determination of competitive PCR pacity to interact with enzymes. Quan- CONCLUSIONS
products (24). titation is performed by measuring
To achieve more automated quanti- incorporated radioactivity (46) or dig- Competitive PCR and RT-PCR con-
tation, methods that involve capturing oxigenin content (9,54) or by immuno- trolling for tube-to-tube variations in
of PCR products on solid supports enzymatic detection (56,91,106). amplification efficiency by the addition
(e.g., microplates or magnetic beads) Competitive RT-PCR assays have of competitive internal standards are one
followed by quantitation of the cap- also been developed for an automated of the most widely used approach-es for
tured material have been reported. The system that makes use of electrochemi- quantitation of nucleic acids. If the
most frequently used procedure in- luminescence (QPCR System 5000Ô, competitive template is properly chosen
volves amplification of internal stan- Perkin-Elmer, Norwalk, CT, USA) for and constructed, the amplifica-
instruments will also con-tinue to be in symp-tomless patients and in patients
widely used. The future of this with AIDS. J. Virol. 66:7328-7335.
6.Becker-André, M. and K.
procedure, however, lies in routine Hahlbrock.
tion efficiency of specific target and in- diagnostic and clinical applications. 1989. Absolute mRNA quantification using
ternal standard remain equal during the
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