Measurement of Differentially Methylated INS DNA Species in Human Serum Samples as a Biomarker of Islet β Cell Death

Summary

Islet β cell death precedes development of type 1 diabetes, and detecting this process may allow for early therapeutic intervention. Here, we provide a detailed description of how to measure differentially methylated INS DNA species in human serum as a biomarker of β cell death.

Abstract

The death of islet β cells is thought to underlie the pathogenesis of virtually all forms of diabetes and to precede the development of frank hyperglycemia, especially in type 1 diabetes. The development of sensitive and reliable biomarkers of β cell death may allow for early therapeutic intervention to prevent or delay the development of diabetes. Recently, several groups including our own have reported that cell-free, differentially methylated DNA encoding preproinsulin (INS) in the circulation is correlated to β cell death in pre-type 1 diabetes and new-onset type 1 diabetes. Here, we present a step-by-step protocol using digital PCR for the measurement of cell-free INS DNA that is differentially methylated at cytosine at position -69 bp (relative to the transcriptional start site). We demonstrate that the assay can distinguish between methylated and unmethylated cytosine at position -69 bp, is linear across several orders of magnitude, provides absolute quantitation of DNA copy numbers, and can be applied to samples of human serum from individuals with new-onset type 1 diabetes and disease-free controls. The protocol described here can be adapted to any DNA species for which detection of differentially methylated cytosines is desired, whether from circulation or from isolated cells and tissues, and can provide absolute quantitation of DNA fragments.

Introduction

Type 1 diabetes (T1D) is an autoimmune disease that is characterized by the destruction of insulin-producing islet β cells by autoreactive T cells¹. The diagnosis of T1D is typically made upon measurement of hyperglycemia (blood glucose > 200 mg/dl) in a lean, young individual, who might present with ketoacidosis as evidence of insulin deficiency. At the time of diagnosis of T1D, there is evidence for substantial loss of β cell function and mass (from 50 - 90%)². In clinical studies, several immune modulatory drugs that were instituted at the time of diagnosis resulted in the stabilization of β cell function (and presumably mas....

Protocol

Ethics Statement: Protocols were approved by the Indiana University Institutional Review Board. Parents of subjects provided written informed consent, and children older than 7 years provided assent for their participation.

1. Serum Processing

NOTE: The assay as described has been rigorously tested using human serum isolated as follows.

1. Collect blood in one red top (no-additive; uncoated) blood collection tube.
2. Let sit at room temperature for 30 min to allow the clot to form.
3. Centrifuge tube at 2,000 x g for 10 min at room temperature. Transfer the supernatant (serum) to a new tube designated for serum storage (polypropyle....

Results

To interpret data appropriately, we use plasmid controls for both the unmethylated and methylated target INS DNA in each digital PCR run. These controls ensure that signals corresponding to methylated and unmethylated DNA are clearly distinguishable. Figure 1 shows the 2-D scatter plots corresponding to droplets for plasmid controls containing bisulfite-converted unmethylated INS DNA (Figure 1A), methylated INS DNA (Figu.......

Discussion

Methylation of cytosines by DNA methyltransferases allows for the epigenetic control of transcription at many genes. The INS gene in humans is almost exclusively expressed in islet β cells, and there appears to be a correlation between the frequency of methylation of cytosines in the INS gene to silencing of its transcription¹¹. As such, most cell types show substantially higher frequencies of methylation of the INS gene at various cytosines compared to β cells¹¹.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Red Top Vacutainer	Beckon Dickinson	366441	no additive, uncoated interior, 10 ml
Cryovial Tube	Simport	T310-3A	polypropylene, screw cap tube, any size
QIAamp DNA Blood Mini Kit	Qiagen	51106
Poly(A)	Sigma	P9403	disloved in TE buffer (10 mM Tris-Cl pH 8.0 + 1 mM EDTA) to 5 µg/µl
Absolute Ethanol (200 Proof)	Fisher Scientific	BP2818-500
DPBS (with CaCl2 and MgCl2)	Sigma	D8662
0.2 ml PCR 8-strip Tubes	MidSci	AVST
8-strip Caps, Dome	MidSci	AVSTC-N
EZ DNA Methylation-Lightning Kit	Zymo	D5031
ddPCR Supermix for Probes (No dUTP)	Biorad	1863024
Buffer Control for Probes	Biorad	1863052
Human Unmethylated/Methylated Primer/Probe mix	Life Technologies	AH21BH1
EcoR1	New England Biolabs	R0101L
twin.tec PCR Plate 96, semi-skirted	Eppendorf	951020346
Pierceable Foil Heat Seal	Biorad	1814040
PX1 PCR Plate Sealer	Biorad	1814000
QX200 AutoDG Droplet Digital PCR System	Biorad	1864101
Automated Droplet Generation Oil for Probes	Biorad	186-4110
DG32 Cartridge for Automated Droplet Generator	Biorad	186-4108
Pipet Tips for Automated Droplet Generator	Biorad	186-4120
Pipet Tip Bins for Automated Droplet Generator	Biorad	186-4125
C1000 Touch Thermal Cycler	Biorad	1851197
QX200 Droplet Reader	Biorad	186-4003
ddPCR Droplet Reader Oil	Biorad	186-3004