CMB2000 Essential Biomedical Research Skills Flashcards
What is PCR
Polymerase Chain Reaction
What does DNA replication require?
-Template DNA
-40 or more proteins
-Helicase
-Primase
-Polymerases
-Nuclease
-Ligase
-ssDNA binding proteins
-Sliding clamps
What are the advantages of PCR?
-Sensitive (can amplify as little as one molecule)
-Specific (cam amplify a unique target sequence)
-Cheap
-Rapid
-Robust (DNA is very stable)
What’s required for PCR?
-Template dsDNA
-2 primers (small ssDNA)
-Polymerase (copies the template)
-dNTPs
-Magnesium (cofactor for DNA polymerase enzyme)
-Buffer (maintains pH and provide necessary salt)
What is the function of the sliding clamp in DNA replication?
The clamp protein binds DNA polymerase and prevents this enzyme from dissociating from the template DNA strand.
Describe the primers used in PCR?
-One for template and for complementary strand
-Single stranded DNA
-Length of 18-24 bp
-40-60%G/C content
-Start and end with G/C pairs
-Melting temp of 50-60C
What must primer pairs not have to prevent primer dimers?
Complementary regions to each other
Why is Magnesium required in PCR?
Magnesium acts to enhance the enzymatic activity (specifically of DNA polymerase) thereby supporting DNA application
What makes up the buffer found in PCR?
-pH of 8-9.5
-Tris HCl
-Potassium ions (KCl) promotes annealing
What are the 3 stages of PCR?
-Denaturation
-Annealing
-Elongation
What is Nancy520 an example of?
An Intercalating agent, which aids in detection of DNA.
How may we detect PCR products?
Run products on agarose gel, using intercalating dye to stain DNA to determine size and yield.
Give some key steps involved in cloning
-Bioinformatics searching
-Design primers
-PCR
-Choose plasmid and insert
-Transform into competent E Coli
-Select correct colonies
Give some uses of PCR in biotechnology
-Cloning
-Manipulating DNA
-Knock out genes
-Fuse host proteins
What must our template DNA for PCR be?
-Clean and pure
-Contaminent free
-High concentration
Describe reverse transcriptase PCR
-Convert RNA to cDNA, using reverse transcriptase (a retroviral enzyme) that converts RNA to DNA
-Amplify DNA by PCR (including qPCR)
How does qPCR/Real time PCR work?
-Using a fluorescent report in the PCR reaction
-Couples amplification of the sequence with quantification of the concentration of DNA
How does qPCR using SYBR green work?
Fluorescent that binds to groove of dsDNA
How does qPCR using TAQman work?
Fluorescent that uses probes with fluorescent reporter and quencher
In qPCR, if there is a time to reach the cycle threshold, what does this signify?
more cDNA in the sample
What may we use as reference genes in qPCR?
-House keeping genes
-As these have a constant level of expression, which is not affected by experimental factors
Why do we use reference genes in qPCR?
-Essential to support validity of qPCR
-Confirms RNA extraction was good and efficient
Give some common uses of PCR in diagnosis.
-Genotyping the patient
-Genotyping the pathogen
-Phenotyping the disease
Why may we use PCR to genotype a patient?
-Diagnose genetic traits
-Detection of carriers of genetic traits
-Tissue matching (HLA typing)
-Pharmacogenetics
Why may we use PCR to genotype a pathogen?
Diagnose a strain of infecting pathogen
Why may we use PCR to phenotype a disease?
-Measuring disease progression
-Measuring disease severity
What types of PCR are used when genotyping a patient?
PCR-RFLP or ARMS-PCR
What is PCR-RFLP?
PCR-Restriction Fragment Length Polymorphism
What is ARMS-PCR?
Amplification Refractory Mutation System-PCR
How does PCR-RFLP work?
-Works when diseased alleles carry a site for a specific restriction endonuclease, but healthy does not
-When looking at bands, healthy and diseased can be differentiated
How may you identify diseased or healthy in PCR-RFLP banding?
-If healthy, there is only 1 band
-If homozygous for the diseased allele there are 2 bands
-If heterozygous with the diseased allele there are 3 bands
Give some disadvantages of PCR-RFLP
-Only possible if the site contains a known RE site
-Some RE are expensive
-Only possible if a single nucleotide variation
-Can be time consuming
Give some advantages of PCR-RFLP
-Cheap
-Easy design
-Applied to microindels and SNPs
-Simple resources with commonly used techniques
How does ARMS PCR work?
-One PCR comprises allele specific primer at 5’ end and a common primer at 3’ end
-If the presence of an amplified mutant is detected by agarose gel electrophoresis, it suggests that the target sequence contains the mutant allele
Give some advantages of using PCR over other methods of microbial diagnosis.
-Sensitive (can detect single copy of genome)
-Specific (Can identify strain)
-Quick, taking only a few hours
-No need for culture
-Detects DNA/RNA so not reliant on immune response
What may we use to phenotype a disease using PCR?
-Quantitative PCR
-Measures abundance of DNA or RNA in a sample
Why should we make competent cells instead of buying them?
-Saves money
-Ensures we don’t run out
What OD600nm should we grow competent cells to?
0.3, which is mid exponential growth
When forming competent cells, what may we plate them on?
Agar containing Xgal and ampicillin
Why do we use “double selection” ie plating competent cells on Amp+Xgal
-Ampicillin selects for bacteria that have taken up the plasmid (need resistance to survive)
-Xgal shows white colonies for the bacteria that have an insert as the lacZ gene no longer works and the lacZ makes the colonies blue
What is Xgal?
-When cleaved by βgalacotosidase creates an intensely blue product which is insoluble
-So when LacZ is functional blue product is formed.
Why do we use calcium chloride when forming competent cells?
-Disrupts cell membrane to allow plasmid uptake
-Aids binding of DNA to the surface of the cell, which can then enter the cell after a short heat shock
How can we ensure the proper orientation of the insert in PCR?
Using 2 different restriction enzymes
What is the percentage of agarose used in agarose gel electrophoresis?
1.5%
In Agarose gel electrophoresis, what is agarose dissolved in?
TAE
What is a clinical study?
Involves research using human volunteers (also called participants) that is intended to add to medical knowledge. These can be interventional and observational
Give some examples of types of experimental studies
-Randomised control trials
-Non randomised control trials
Give some examples of types of observational studies
-Cohort studies
-Case control studies
-Cross sectional studies
-Ecological studies
Describe the characteristics of a randomised control trial.
-Units are randomised to one of two or more groups
-Experimental group has the intervention being tested
-Comparison group has an alternative intervention
OR
-Control group has a placebo
Describe the characteristics of a cohort study.
-A defined group is followed over time
-Cohort includes people with similar characteristics
What is the difference between a prospective and a retrospective cohort study?
A ‘prospective’ cohort study recruits participants before any intervention and follows them into the future. A ‘retrospective’ cohort study identifies subjects from past records describing the interventions received and follows them from the time of those records.
What are case-control studies?
-An observational study to find out the possible cause of a disease or condition
-Done by comparing a group of patients who have the disease or condition with a group of controls.
What are cross-sectional studies?
-A snapshot observation of a set of people at 1 time
-Aimed to describe a variable
Describe ecological studies
Ecological studies are used to understand the relationship between outcome and exposure at a population level, where ‘population’ represents a group of individuals with a shared characteristic
Give the phases of a clinical trial
-Laboratory studies
-Phase I
-Phase II
-Phase III
-Phase IV
Give the goals of preclinical (laboratory) phase of research?
-Model the desired biological effect of a drug
-Predict treatment outcome in patients (EFFICACY)
-Identify and characterise toxicities associated with a drug (SAFETY)
Give the goals of Phase I of research?
Study the drug to learn about safety and side effects
Give the goals of Phase III of research?
-Gathering information about safety and effectiveness
-Focusing on determination of dosage
Give the goals of Phase II of research?
-Focus of effectiveness
-Obtain data on efficacy in those with a certain condition or disease
Give the goals of Phase IV of research?
-Post marketing monitoring stage
-Monitering polypharmacy
What things should you consider when setting up and running a clinical trial?
-Consent
-Controls
-Randomisation
-Blinding
-Sample size
-Statistics
-Ethics
What is ethics?
Moral principles that govern a person’s behaviour or the conducting of an activity
What is bias?
Systematic errors that encourage one outcome over others.
What is randomisation?
Randomisation its the process by which treatments are assigned to participants by chance rather than by choice
Give some types of randomisation
-Simple randomisation
-Block randomisation
-Stratified randomisation
What is simple randomisation?
-Randomisation based on a single sequence of random assignments
-Maintaining complete randomness of a subject to a particular group.
What is block randomisation?
-Designed to randomise subjects into groups that result in equal sample sizes.
-Once block size is determined, all possible balanced combinations of assignment must be calculated.
-Blocks are then randomly chosen to determine assignment.
What is stratified randomisation?
-Ensures key characteristics are evenly distributed between different groups
-Divide into groups based on key characteristics (eg group A male group B female)
-Randomise within each strata to different treatment groups
-This ensures each treatment group has a similar mix of participants
What is blinding?
Studies are designed to prevent members of the research team and study participants from influencing the results.
What is the difference between single and double blinded studies?
Single - Only the researcher knows the allocation
Double - Neither the participants nor researcher knows the allocation
Why do double blinding?
Prevents the research team from
-Influencing patient management
-Influencing withdrawing patient from trial
-Decide to adjust drug dose or therapy intensity
What is the placebo effect?
The placebo effect is when a person’s physical or mental health appears to improve after taking a placebo treatment
What is a hypothesis?
A proposed assumption for a phenomenon that may or may not be true
What is the issue with having a sample with too few participants?
-Real effect may be missed as it will be indistinguishable from chance variation
-If the study does not yield useful results, time and money may have been wasted
What is the issue with having a sample with too many participants?
-Smaller trials could reach firm conclusions so no need for participants beyond this
-Cost implications
What are the different types of end points in a study?
-True endpoint
-Surrogate endpoint
What is the true endpoint of a study?
A clinical meaningful endpoint that directly measure patients eg how a patient feels, functions or survives
What is the surrogate endpoint of a study?
A measurement of a specific outcome used in place of another as a predictor to tell if a treatment works. Usually occurs before a true endpoint and yields conclusions about the effect of treatment.
What is the dissemination of results?
Getting the findings of your research to the people who can make use of them, to maximise the benefit of the research.
What are some of the principles that make up the Nuremberg code for ethical research?
-Voluntary consent
-Research is for the good of society
-Based on previous knowledge to justify the experiment
-Avoids unnecessary physical and mental suffering
-Conducted by qualified persons
-Subjects can withdraw
What does the Helsinki declaration do?
Guide doctors operating in the dual role of researcher and clinician.
What is a human participant in research?
-A living human being
-Human beings who have recently died (including body parts)
-Foetus
-Embryo
How can Human participants be involved in research?
-Directly through physical presence
-Indirectly through stored human tissue/body fluids or use of human data
What is informed consent?
The act of providing information to a potential research participant to enable them to
-Understand their involvement in a study
-Understand the researcher’s responsibilities
How would you describe the multi stepped process that is gaining informed consent?
1 - Giving of information
2 - Discussion, clarification and review
3 - Obtaining written/verbal consent
4 - Ongoing revalidation of consent
What does the common law dictate a child as?
Below the age of 18 years old
How do we gain informed consent from children?
Under 16 years, it is often best practice to gain the child’s assent and legal guardian provides informed consent.
What laws dictate the ability to gather informed consent from vulnerable adults?
-Mental Capacity Act 2007
-Medicines for Human Use (clinical trials) Regulations 2004
-Common Law
Describe the Human Tissue Act 2004
Framework for the regulation of storage and use of human tissue from the living, and the removal, storage and use of tissue and organs from the deceased for specified purposes.
What is inducement in gaining consent?
The provision of an incentive to entice a person to carry out an action
What is GDPR?
-General Data Protection Regulation
-Governs the protection and control of personal data
What qualifies as personal data under GDPR?
Information that relates to an identified or identifiable individual
What are the principles of GDPR?
-Lawfulness fairness and transparency
-Purpose limitation
-Data minimisation
-Accuracy
-Storage limitation
-Integrity and confidentiality
-Accountability principle
What sort of data may be personal?
-Identifiable data
-Confidential information
-Sensitive information
-Coded data
-Linked anonymised
-Unlinked anonymised
-Data that relates to an individual
What are the three divisions of medicines in the Medicines Act 1968?
-Prescription only medicines
-Pharmacy medication
-General medication
What is the role of the UK research ethics committee?
-Ensure the dignity, rights, safety and well being of individuals are protected
-Reducing the risks associated with research
How are participants allocated to UK Research Ethics Committee or University Ethics Committee?
Patient participants -> UK Research Ethics Committee
Non-Patient participants -> University Ethics Committee
What do the UK Research Ethics Committee consider?
-Has the proposal been reviewed for scientific merit?
-Will the health of the research subject be affected
-Is what is planned justified, reasonable and appropriate?
-Are there hazards and if so remedies?
Name some meta ethical theories
-Moral absolutism/dogmatism
-Moral relativism
-Pyrrhonian moral scepticism
Simplify moral absolutism/dogmatism
-Ethics from the pulpit
-“I know that X is right or wrong”
-Anyone who disagrees is wrong
Simplify moral relativism
-Ethics from the restaurant
-The statement that X is right or wrong is synonymous with the statement that someone approves or disapproves of X
Simplify pyrrhonian moral scepticism
I believe that X is right or wrong
What is legalism?
-Excessive conformity to the law
-It is always important to reflect on the law
What must we use when looking at the ethics of a situation
-Use logic
-Use analogies
-Avoiding slippery slope arguments
Describe the subjective aspect to the need for ethics
-People need to justify their behaviour
-People need to explain why their behaviour is (un)acceptable
Describe the objective aspect to the need for ethics
Many things deserve moral consideration
What is an ethical theory?
An account of which principles should be followed, and of how to balance them against each other
What are formal ethical theories?
Formal theories about the sorts of abstract principles and values that should matter (eg happiness, pleasure, health)
What are material ethical theories?
Theories about the concrete things/entities that should matter
Name some formal ethical theories
-Principlism
-Consequentialism
-Deontology
-Virtue ethics
Describe principlism in medicine
4 principles approach, focusing on
-Autonomy
-Beneficence
-Non maleficence
-Justice
What is connected to how we value things?
Our ontologies
What are the two values that contribute to relative moral significance?
-Intrinsic value (value for oneself)
-Instrumental value (value for others)
What are the two ontologies that dominate western philosophy?
-Mechanistic materialism
-Dualism
Describe mechanistic materialism
-Reality is composed of separate entities that act in a machine like fashion
-Mental phenomena (feelings) should be explained entirely in terms of the components that constitute them (neurones)
-So there is no consciousness or free will
Describe dualism
Reality is composed of two fundamentally distinct things - Things with minds and things that lack minds
Describe panexperientalism
Experience is fundamental and ubiquitous throughout nature, and that mentality is not essential to it
What is speciesism?
The practice of treating members of one species as morally more important than members of other species
What are the issues surrounding research involving animals?
-Ethical concerns
-Scientific concerns
-Institutional/professional requirements
-Legal requirements
-Application to medical research
What is the law on using nonhuman animals for biomedical science?
-Animals (scientific procedures) act 1986 (ASPA) demands that some forms of protection should be applied to certain animals
-Applies to scientific procedures which are defined as procedures that cause harm, suffering, pain or distress where this is more than what is caused by the insertion of a needle