User:Shawndouglas/sandbox/sublevel1
As the pandemic has progressed and test manufacturers have become more experienced with SARS-CoV-2 test development, multiplex testing has become an option. The multiplex assay—an immunoassay test able to measure multiple analytes in a single test—is certainly not new in itself. In 1989, R. Ekins developed the ambient analyte theory, which stated that miniaturizing an immunoassay can lead to an improved limit of detection (LOD). That work influenced the future development of microarray multiplex technology principles.[1] By 2013, development of multiplex protein immunoassays was becoming increasingly prominent.[1]
As of September 2021, eighteen "multi-analyte" in vitro molecular diagnostic tests are shown as receiving EUAs by the FDA, four of them even authorized for CLIA waived testing.[2] Common additional targets for analysis among the various kits include influenza A, influenza B, and respiratory syncytial virus (RSV).[2] However, several multiplex test kits cover an even broader array of respiratory-affecting organism types and subtypes such as adenovirus and a few other coronavirus types, to name a few. Kits include the ePlex Respiratory Pathogen Panel 2[3], the NxTAG Respiratory Pathogen Panel + SARS-CoV-2[4], the QIAstat-Dx Respiratory SARS-CoV-2 Panel[5], and the BioFire Respiratory Panel 2.1-EZ.[6] (Of the four, the BioFire panel is approved for CLIA waived testing.[2]) Adding multiplex testing of SARS-CoV-2 plus other organisms to your laboratory will largely revolve around your lab's CLIA status and assessment of the available options.
Multiplexing provides a variety of benefits for laboratories and patients. In their 2015 paper on ELISA and multiplex technologies, Tighe et al find that multiplexed immunoassays have the potential to decrease diagnosis times and reduce assay costs. "At the same time, such multiplexing offers more comprehensive analysis whether for research purposes, differential diagnoses, or monitoring of therapeutic interventions."[1] They also note the potential for improved health surveillance of patients, catching early-onset diseases by looking for informative biomarkers.[1] From the perspective of diagnosing infections of SARS-CoV-2 or influenza, the CDC adds that multiplexing helps preserve testing supplies that may be in short supply, conduct more tests in a given time period, and paint a clearer picture of both viruses and their prevalence in a given population.[7]
References
- ↑ 1.0 1.1 1.2 1.3 Tighe, Patrick J.; Ryder, Richard R.; Todd, Ian; Fairclough, Lucy C. (1 April 2015). "ELISA in the multiplex era: Potentials and pitfalls" (in en). PROTEOMICS – Clinical Applications 9 (3-4): 406–422. doi:10.1002/prca.201400130. ISSN 1862-8346. PMC PMC6680274. PMID 25644123. https://onlinelibrary.wiley.com/doi/10.1002/prca.201400130.
- ↑ 2.0 2.1 2.2 "In Vitro Diagnostics EUAs - Molecular Diagnostic Tests for SARS-CoV-2". U.S. Food and Drug Administration. 7 September 2021. https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/in-vitro-diagnostics-euas-molecular-diagnostic-tests-sars-cov-2. Retrieved 07 September 2021.
- ↑ Hinton, D.M. (7 October 2020). "ePlex Respiratory Pathogen Panel 2 (ePlex RP2 Panel)" (PDF). U.S. Food and Drug Administration. https://www.fda.gov/media/142902/download. Retrieved 19 September 2021.
- ↑ Hinton, D.M. (3 March 2021). "NxTAG Respiratory Pathogen Panel + SARS-CoV-2" (PDF). U.S. Food and Drug Administration. https://www.fda.gov/media/146492/download. Retrieved 19 September 2021.
- ↑ Hinton, D.M. (29 July 2021). "QIAstat-Dx Respiratory SARS-CoV-2 Panel" (PDF). U.S. Food and Drug Administration. https://www.fda.gov/media/136569/download. Retrieved 19 September 2021.
- ↑ Hinton, D.M. (30 August 2021). "BioFire Respiratory Panel 2.1-EZ (RP2.1-EZ)" (PDF). U.S. Food and Drug Administration. https://www.fda.gov/media/142693/download. Retrieved 19 September 2021.
- ↑ Centers for Disease Control and Prevention (13 July 2021). "CDC’s Influenza SARS-CoV-2 Multiplex Assay and Required Supplies". Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/lab/multiplex.html. Retrieved 19 September 2021.
