The TINY cancer detection device is promising as a KSHV detector

Its name is an acronym used to express its size, but researchers at Cornell Engineering and Weill Cornell Medicine hope that the impact of their hand cancer detection device in developing countries is anything but minimal.

About half the size of a lunchbox, the tiny isothermal nucleic acid (or TINY) quantification system has shown promise as a sarcoma-associated herpesvirus-associated virus detector. Kaposi in resource-limited areas such as the Sahara. Africa. The first tests resulted in an agreement of about 94% with the traditional methods, the results being generated in a few hours instead of several weeks.

Developed by a team led by mechanical engineering professor David Erickson at Sibley College, and Ethel Cesarman, professor of pathology and laboratory medicine at Weill Cornell Medicine, TINY achieved its goals in the National Institutes' first round of funding of Health. . The team plans extensive testing over the next few years.

The results of the tests performed on the device by the team in 2017 in Uganda are detailed in the document entitled "A wearable device for quantification of nucleic acids powered by sunlight, a flame or electricity", published on September 11th. Nature Biomedical Engineering. Ryan Snodgrass, Ph.D. student at Erickson, and Andrea Gardner, research scientist at Weill Cornell Medicine, are the first two authors.

Kaposi's sarcoma (SK) is a cancer that develops in the lymphatic or blood vessels and usually appears as lesions on the skin, inside the mouth or inside. There are four types of illness. epidemic, or associated with AIDS, SK is the most prevalent in sub-Saharan Africa and defines AIDS. This means that when someone with the HIV virus is diagnosed with SK, they officially have AIDS.

Early detection leads to better results, but this is not always possible in developing countries, where pathological tests can last one to two weeks. "It's hard to diagnose it there," Erickson said. "A number of things resemble KS … and the time it takes for a traditional diagnosis, one to two weeks, makes it difficult."

TINY has demonstrated its ability to generate results in approximately 2.5 hours.

Now in its third generation, TINY performs Loop Isothermal Amplification (LAMP) for quantitation of nucleic acids. This requires heating the sample to 154 degrees, which requires a source of energy.

One of the main advantages of TINY: it can collect and store the heat generated by electricity, the sun or even a bunsen burner, and will work even during a temporary interruption of food, including three during testing in Uganda. The flexibility of TINY's power is important because in many sub-Saharan African countries, health facilities do not have access to reliable electricity.

For the study, the Erickson team collected biopsy samples from 71 patients in Uganda suspected of having SK and tested the samples with TINY as well as by chain reaction by quantitative polymerase (qPCR), the current standard for quantitation of nucleic acids. The agreement between TINY and qPCR was 94% (67 out of 71), and the team showed that all the disagreements stemmed from the limitations of the test and not from TINY's ability.

TINY can not only be transported to remote locations for use at the point of care, but also in clinics and hospitals where electrical energy can be unreliable. "Both applications can allow nucleic acid diagnostics to reach a greater number of [low- and middle-income countries]", concluded the group in its report.

"As a pathologist who knows how difficult it can be to diagnose KS," said Cesarman, "it is very interesting to collaborate with engineers who have invented a great new device that facilitates or removes the diagnosis of KS." more than three hours from the time a biopsy is performed. "

Future work on TINY will include expanding testing to other locations in Africa, South America and the United States, as well as developing a marketing plan. The group filed an application for patent protection with the Cornell Center for Technology Licensing.

Erickson and Cesarman started working on this device about five years ago. "Where we are now," said Erickson, "is beyond the best scenario I could have imagined when I wrote the proposal."

And Snodgrass, who has twice been to Uganda to test TINY, said it was "very rewarding to build a device, take it there and see it used on real patients."