title: Preamplification techniques for real-time RT-PCR analyses of endomyocardial biopsies.
abstract: BACKGROUND
  Due to the limited RNA amounts from endomyocardial biopsies (EMBs) and low expression levels of certain genes, gene expression analyses by conventional real-time RT-PCR are restrained in EMBs. We applied two preamplification techniques, the TaqMan(R) PreAmp Master Mix (T-PreAmp) and a multiplex preamplification following a sequence specific reverse transcription (SSRT-PreAmp).
  
  
  RESULTS
  T-PreAmp encompassing 92 gene assays with 14 cycles resulted in a mean improvement of 7.24 +/- 0.33 Ct values. The coefficients for inter- (1.89 +/- 0.48%) and intra-assay variation (0.85 +/- 0.45%) were low for all gene assays tested (<4%). The PreAmp uniformity values related to the reference gene CDKN1B for 91 of the investigated gene assays (except for CD56) were -0.38 +/- 0.33, without significant differences between self-designed and ABI inventoried Taqman(R) gene assays. Only two of the tested Taqman(R) ABI inventoried gene assays (HPRT-ABI and CD56) did not maintain PreAmp uniformity levels between -1.5 and +1.5. In comparison, the SSRT-PreAmp tested on 8 self-designed gene assays yielded higher Ct improvement (9.76 +/- 2.45), however was not as robust regarding the maintenance of PreAmp uniformity related to HPRT-CCM (-3.29 +/- 2.40; p < 0.0001), and demonstrated comparable intra-assay CVs (1.47 +/- 0.74), albeit higher inter-assay CVs (5.38 +/- 2.06; p = 0.01). Comparing EMBs from each 10 patients with dilated cardiomyopathy (DCM) and inflammatory cardiomyopathy (DCMi), T-PreAmp real-time RT-PCR analyses revealed differential regulation regarding 27 (30%) of the investigated 90 genes related to both HPRT-CCM and CDKN1B. Ct values of HPRT and CDKN1B did not differ in equal RNA amounts from explanted DCM and donor hearts.
  
  
  CONCLUSIONS
  In comparison to the SSRT-PreAmp, T-PreAmp enables a relatively simple workflow, and results in a robust PreAmp of multiple target genes (at least 92 gene assays as tested here) by a mean Ct improvement around 7 cycles, and in a lower inter-assay variance in RNA derived from EMBs. Preliminary analyses comparing EMBs from DCM and DCMi patients, revealing differential regulation regarding 30% of the investigated genes, confirm that T-PreAmp is a suitable tool to perform gene expression analyses in EMBs, expanding gene expression investigations with the limited RNA/cDNA amounts derived from EMBs. CDKN1B, in addition to its function as a reference gene for the calculation of PreAmp uniformity, might serve as a suitable housekeeping gene for real-time RT-PCR analyses of myocardial tissues.
authors.affiliation: Department of Cardiology and Pneumonology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, 12200 Berlin, Germany. michel.noutsias@charite.de
authors.forename: Michel
authors.initials: M
authors.lastname: Noutsias
authors.forename: Maria
authors.initials: M
authors.lastname: Rohde
authors.forename: Andrea
authors.initials: A
authors.lastname: Block
authors.forename: Katrin
authors.initials: K
authors.lastname: Klippert
authors.forename: Olga
authors.initials: O
authors.lastname: Lettau
authors.forename: Katja
authors.initials: K
authors.lastname: Blunert
authors.forename: Michael
authors.initials: M
authors.lastname: Hummel
authors.forename: Uwe
authors.initials: U
authors.lastname: Kühl
authors.forename: Hans
authors.initials: H
authors.lastname: Lehmkuhl
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Ursula
authors.initials: U
authors.lastname: Rauch
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Poller
authors.forename: Matthias
authors.initials: M
authors.lastname: Pauschinger
authors.forename: Heinz P
authors.initials: HP
authors.lastname: Schultheiss
authors.forename: Hans D
authors.initials: HD
authors.lastname: Volk
authors.forename: Katja
authors.initials: K
authors.lastname: Kotsch
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000378:metabolism*; D017931:DNA Primers; D005260:Female; D015870:Gene Expression; D006801:Humans; D008297:Male; D009206:Myocardium / Q000378:metabolism*; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*; D048348:Reverse Transcription / Q000235:genetics
chemical_list: D017931:DNA Primers