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An important influencing factor of molecular diagnosis- - - -sample stability

Biological samples are important resources for medical research, and their quality largely determines the accuracy and reliability of clinical results. In the process of in vitro diagnostic reagents research, it is necessary to conduct many different types of stability research, among which the sample stability research has the most unique product. This paper will provide a brief overview of the stability of clinical biological samples.


                                                     image.pngSignificance of stability research




The study of the stability of biological samples is often one of the hot topics in the daily life of all analytical researchers. It is also favored by the majority of researchers in the international Forum on biological analysis. Among them, three of the top topics to be discussed and voted are directly related to the stability of biological samples, indicating its importance. Ensuring the stability of samples in biological matrix is the basic premise of biological sample analysis.

Based on this, the national drug regulatory authorities all suggested reanalysis of the actual study samples. According to the In Vitro Diagnostic Reagent Registration Application Data Requirements and Approval Document Format issued by the Market Supervision Administration in 2021, the stability research of in vitro diagnostic reagents should submit at least 3 batches of real-time stability research data of declared products stored under actual storage conditions until the finished product validity period. Specify storage environment conditions (such as temperature, humidity and light) and expiration date [1]. The international basic requirements on the stability of in vitro diagnostic reagents are consistent with those in China. In 1991, the US FDA issued the guiding principle "Shelf Life of Medical Devices" [2], which provided the consideration factors and verification principles for stability research, but did not involve specific verification methods and test items. Clinical and Laboratory Standards Institute, CLSI published the EP25-A Evaluation of Stability of In Vitro Diagnostic Reagents in 2009, It provides guidance for the stability study of quantitative and qualitative in vitro diagnostic reagents [3].

                                            image.pngStorage temperature of the sample

In recent years, biobank has developed rapidly, with dozens of human samples stored. However, each sample bank does not adopt standard and unified cryopreservation technology and methods, which may cause changes in required sample information in the long-term storage process. Therefore, on the basis of exploring the cryopreservation mechanism, the key to ensure the long-term preservation quality of biological samples is to select appropriate cryopreservation agent, rising and cooling rate and other methods to treat the samples, and store them in a reasonable temperature environment.



1


Store at -60-0℃

This temperature is the crystallization temperature of water, which is easy to cause damage to the microstructure of cells and tissues. Generally, this temperature is not used to preserve tissues and cells. In addition, the stability of biomacromolecules in tissue samples may be significantly reduced due to the influence of various factors in cell tissues. Therefore, -60~0℃ is usually not used as the storage temperature in the sample library.



2


Frozen storage at -80℃

-80℃ is the commonly used sample storage temperature, which is also the temperature commonly used ultra-low temperature refrigerator can reach. This temperature is also commonly used to preserve the activity of biomacromolecules in samples due to the ease of operation, storage capacity and cost.

But how long this temperature can be maintained for different biomacromolecular activities is still under investigation. Studies have shown that DNA production, integrity and RNA production can be maintained for up to 7 years without significant changes at -80℃, but RNA integrity will start to decline after 5 years of frozen storage. Therefore, for long-term preservation of RNA activity, it is recommended to use lower temperatures or to extract RNA from a small part of the sample and store it synchronously with the rest of the sample. Proteins, lipids and other biomacromolecules in other samples can also be preserved at -80℃, but the duration is different, and the stability gradually decreases.



3


Frozen storage at -150℃

-150℃ is lower than the glass transformation temperature of water (-136℃), which is the temperature that can be reached by gaseous liquid nitrogen tank and cryogenic refrigerator. In this low temperature range, biological activities of samples are greatly reduced, which is the ideal temperature for preserving cell activity in samples. Cryogenic refrigerator is electric refrigeration without liquid nitrogen, and the stable temperature after filling samples is usually below -140℃. Compared with the use of gas liquid nitrogen tank, its advantage is that it does not need to add liquid nitrogen frequently, and it is easy to maintain. However, the cooling speed of electric refrigeration is lower than that of liquid nitrogen. Once the container is opened to take samples, it is easy to cause a large range of temperature fluctuations, and the temperature recovery time is relatively long. Therefore, it is more suitable for the situation of less opening to take samples. In addition, the electric refrigeration refrigerator must be powered. Liquid nitrogen equipment is recommended to provide backup storage in case of power failure.



4


-196℃ cryogenic storage

-196℃ is the temperature of liquid nitrogen volatilization, only liquid nitrogen liquid phase preservation technology can reach this temperature. sample


                                                    image.pngSample stability



specimen

type

Detection target

Stability condition

Whole blood

Genomic DNA

Stable at room temperature for 24h, stable at 2-8℃ for 72h, long-term storage at -20℃

Genomic RNA

Storage at room temperature is not recommended. Specimens are placed in a container containing nucleic acid stabilizer and transported to the laboratory on ice. Stable storage can be achieved at -20℃

Dried blood tablet

DNA

Room temperature stable for 19 months (Moisture-proof)

plasma

/ serum

Fetal free DNA

The plasma was separated within 8h at 2-8℃ and stably stored at -20℃ or lower

Circulating tumor DNA

Nucleic acid extraction should be completed 4-5h after blood drawing

DNA virus

2-8℃ stable for 1 week, -20℃ stable for more than 1 year

RNA virus

The plasma was separated within 6h at 2-8℃ and stored at -20℃ or lower

organization

DNA/RNA

Fresh tissues should be added to a container containing nucleic acid protectants as soon as possible, placed on ice and transported to the laboratory. Nucleic acids in paraffin-embedded tissues can remain stable at room temperature

Bone marrow

RNA

Must be placed in RNA stabilizers or quick-frozen in liquid nitrogen immediately after collection and transported on dry ice

Cultured cell

DNA/RNA

37℃ (Maintain cell vitality)

Fine needle

extract

DNA/RNA

37℃ (Maintain cell vitality)

Oral-buccal cells

DNA

It can be stable for about 1 week at room temperature. RNA analysis requires the addition of RNA stabilizers

Pleural effusion

CTC detection

After collection, it was stored at 4℃, and detected within 24h

ascites

CTC detection

After collection, it was stored at 4℃, and detected within 24h

Cerebrospinal fluid

CTC detection

After collection, it was stored at 4℃, and detected within 24h

DNA virus

Store at -20℃ or -70℃

RNA virus

After collection, RNA was extracted 1-4 hours after the specimen was collected; otherwise, red blood cells in the specimen should be removed immediately and stored at low temperature

urine

DNA

Cryopreserved (2-8℃), especially at 25℃ or higher, the urine's low PH and high urea will rapidly denature DNA

Cervical swab

DNA

Store at 2-8℃ for 10d

Semen specimen

DNA

Store at 2-8℃

                                            image.pngTransport conditions of the sample






01

Whole blood/plasma/serum/dry blood tablets

DNA: 24h can be transported to the laboratory at room temperature, 72h can be transported to the laboratory at 2-8℃, 72h and longer transportation needs to be at -20℃.

RNA: Plasma can be separated within 4h, transported to the laboratory within 5 days and stored at 2-8℃, and transported at -20℃ for 5 days or longer.

Dried blood tablets can be transported at room temperature.



02

Alveolar lavage fluid

Within 24h, it can be transported to the laboratory at room temperature. For 72h, it needs to be refrigerated at 2-8℃. For 72h and longer, it needs to use -70℃ or more stringent conditions.



03

Bone marrow

Bone marrow specimens should be transported at 2-8℃ and RNA stabilizers should be added if used for RNA analysis.



04

Oral-buccal cells

At room temperature, nucleic acid can be stable for 1 week, can be transported at room temperature, RNA detection, need to be placed in the RNA stabilizer.



05

Lymphocyte layer

Lymphocytes isolated from blood should be transported in cold storage at 2-8℃, and stored below -70℃ if they cannot be extracted in time.



06

Cerebrospinal fluid

DNA virus testing: Transported at 2-8 degrees Celsius and stored at -20 degrees Celsius or -70 degrees Celsius or lower.

RNA analysis: Cooled immediately on ice and transported to the laboratory on dry ice.



07

Fine needle extraction

DNA virus test: Should be transported at 2-8℃, should be stored at -20℃ or -70℃ or lower temperature conditions.

RNA analysis: Immediately placed on ice to cool or placed in RNA stabilizer for transport.



08

organization

DNA analysis: Fresh tissue should be immediately placed at -20℃ and kept on ice for transport preservation.

RNA analysis: Fresh tissues were immediately frozen with liquid nitrogen for transport and preservation.

The paraffin-embedded tissue can be transported and preserved at room temperature.



09

sputum

It can be transported to the laboratory within 30min at room temperature, otherwise it should be transported at 4-8℃.



10

excrement

Feces collection box and feces collection tube can be used for collection, soybean grain size samples. Nucleic acid was extracted within 4h or stored at -80℃.



11

Cervical and urethral swabs

Transport in the transport medium recommended by the reagent manufacturer.



12

Plant tissue sample

Collect fresh samples with normal body shape and put them in the sample bag for marking; If there is dirt in the sample, it is generally washed, then dried and nucleic acid extracted as soon as possible; Transport and store at room temperature or -20℃[4].


Repeated freeze-thaw should be avoided when samples are stored in stable conditions. Repeated freezing-thawing of samples will accelerate the degradation of biomacromolecules and seriously affect the quality of samples. Before freezing the samples, it is better to pack them into small samples for storage, which can avoid unnecessary repetition.

                                                                    image.png



As an important index to evaluate the performance of in vitro diagnostic reagent maintenance products, sample stability is of great significance to the development, production, transportation, preservation and use of products. Through stability research, product formulation, process and packaging materials can be evaluated and adjusted, the storage period and the storage period after opening of products can be determined, the transportation, storage and storage conditions of products can be defined, and the stability of products after changes can be verified when the storage period and storage conditions of products are changed [5]. Stability studies will be carried out throughout the product development stage, and the results will be the key evidence supporting the post-market storage conditions and expiry dates of the product.


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[1] National Medical Products Administration.Announcement on the announcement of the format of in vitro diagnostic reagent registration application dossier and approval document format[EB/OL].(2021-09-30)[2022-04-25].

[2] FDA. Shelf life of medical devices[S].1991-04-01.

[3] ZHANG Y,WANG Z G. tability testing of in vitro diagnostic reagents[J].J Modern Lab Med,2012,27(2):161-162. (in Chinese)

[4] Li Yan, Li Jinming. Clinical Molecular Diagnostic Analysis before and after analysis [M]. Beijing: Science Press,2017.

[5] ZhangQi Cao Xuefen, li yh. The influence factors of in vitro diagnostic reagent stability study and evaluation requirements [J]. Journal of China biological products, 2022, 35 (5) : 632-636. The DOI: 10.13200 / j.carol carroll nki CJB. 003605.



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