The polymerase chain reaction (PCR) is a biochemical technology in molecular biology, to amplify a single or a few copies of a piece of DNA (Target), generating thousands to millions of copies of this particular DNA sequence
DNA polymerase from the hyperthermophilic organisms Thermus aquaticus, commonly used because it is thermally tolerant (survives the melting T of DNA denaturation) → the process is more specific since higher temperatures result in less mismatch and more specific replication
RT-PCR is used to convert RNA into complementary DNA (cDNA) and then amplify this cDNA for analysis. It is a variation of the standard PCR (Polymerase Chain Reaction) technique that is primarily used to amplify and analyze DNA.
Using fluorescent dyes such as SYBR Green or fluorescent-containing DNA probes such as TaqMan, we can measure the amount of amplified product as the amplification progresses. Special thermal cyclers are used to monitor the amount of product during the amplification.
Specific probe that binds to a sequence of interest. Upon synthesis of complementary DNA strand, the probe is cleaved separating the reporter from the quencher, resulting in a fluorescent signal.
The number of cycles required for the fluorescent signal to cross the threshold (ie exceeds background level). Ct levels are inversely proportional to the amount of target nucleic acid in the sample (ie the lower the Ct level the greater the amount of target nucleic acid in the sample).
Reference genes or House Keeping genes, such as actin, are used in qPCR to account for variations in the starting material, reverse transcription efficiency, and qPCR efficiency, to ensure that any changes in the quantification of the gene of interest are due to biological differences and not technical variations.
Case 1: Detection of infectious pathogens using PCR
Diagnosis of a viral respiratory infection in a patient presenting with fever, cough, and respiratory distress. Respiratory samples (nasopharyngeal swab or sputum) are collected from the patient for analysis. Nucleic acid extraction is performed to isolate the viral RNA from the respiratory samples. Polymerase chain reaction (PCR) is performed to amplify specific regions of the viral genome using primers designed to target conserved regions of the virus. If the viral nucleic acid was successfully amplified, the patient is diagnosed with viral respiratory infection.
Case 2: Early Detection of Breast Cancer using PCR
Fine needle aspiration (FNA) biopsy of suspicious breast lesion previously identified on imaging. Polymerase chain reaction (PCR) is performed targeting specific biomarkers associated with breast cancer such as HER2/neu, estrogen and progesterone receptors. Amplification of the HER2/neu gene and overexpression of estrogen and progesterone receptors indicates the patient is diagnosed with hormone dependent breast cancer, which is useful information for treatment decision.