Sensitivity24 Nov 2020 19:46
I have spent that afternoon trying to get a grasp of the numbers. The problem is the mixing of PFU’s/ml, pg/ml and then virons/ml.
The LFT is going to be at least 10x less sensitive than the ELISA from what has been presented – ELISA LOD 5pg/ml (buffer) 40pg/ml saliva, LFT <300pg/ml (buffer??). This seems reasonable as the linked enzyme in ELISA amplifies the signal.
If you look at the Avacta presentation of 7th Sept (6.5 min) they show the data of Wyllie et al with a detection limit of the ELISA around 3k copies/ml (they use also virus particles/ml synonymously in the legends) , so one assumes that we are looking at 30-50k virus particles LOD for the LFT.
What I then struggle with is the use of PFU by Porton, they are looking for sensitivity of >50% at 102 pfu/mL, (see Table2)
UK evaluation_PHE Porton Down University of Oxford_final.pdf
At first I assumed one PFU was one viron, but I now do not think this is the case.
The text below Table 2 –
‘We also analysed the association between viral antigen detection and viral load as part of Phase 3a evaluations with clinical samples which were placed in viral transport medium allowing direct comparison of viral load and antigen tests (Fig1). This shows that samples with a CT <25.5 (calculated as a viral load> 100,000 RNA copies/ ml) had a 90% or greater chance of being detected’.
Now a CT<25.5 in their table is equivalent to 100 PFU. So does this mean 1 PFU =1000 virons -which I do not understand (other than only 1 in 1000 virons is viable/capable of forming a plaque in their assay) !
If this is the case, then they are looking for 10>5 virons which Avacta should be well within the range of. This seems reasonable and is agreement with what was said in the presentation - ‘in clinical range’.
I also thought that I would look at it form a protein view. The S1 protein is 76 Kd, this is 1.262 10>-7 pg. there are approx. 100 spikes per viron, each is a trimer, so each viron has 0.000037 pg S1 protein. In this case you would need 10>7 virons/ml to get 300pg/ml S1 which is too high (in all senses…).
(apologies for the 10 > X cannot do powers in text only)
Has anyone got any ideas about this?