DEVICES AND METHODS FOR DIAGNOSING, PROGNOSING, OR THERANOSING A CONDITION BY ENRICHING RARE CELLS
The invention encompasses methods and devices for diagnosing, theranosing, or prognosing a condition in a patient by enriching a sample in rare cells. The devices can be a microfluidic device comprising an array of obstacles and one or more binding moieties. The devices and methods can allow for enrichment of cells based on size and affinity, recovery of cells in locations on the microfluidic device, release of cells from the microfluidic device, flow of sample through the microfluidic device, and retention of rare cells from a sample obtained from a patient having a condition.
1 . A microfluidic device comprising:
an array of obstacles including a first subarray of obstacles and a second subarray of obstacles that are fluidly connected and positioned such that a fluid medium introduced to an inlet of the microfluidic device passes sequentially through the first subarray then the second subarray before exiting through an outlet of the microfluidic device;
wherein the first subarray or the second subarray of obstacles is functionalized with one or more sets of one or more binding moieties.
2 . The microfluidic device of claim 1 , wherein the sets of one or more binding moieties includes two or more binding moieties.
3 . The microfluidic device of claim 1 , wherein the first subarray and the second subarray of obstacles are functionalized with one or more sets of one or more binding moieties.
4 . The microfluidic device of claim 1 , further comprising a first set of one or more binding moieties functionalized in a first region of the first subarray and a second set of one or more binding moieties functionalized in a second region of the first subarray.
5 . The microfluidic device of claim 1 , further comprising a first set of one or more binding moieties functionalized in a first region of the second subarray and a second set of one or more binding moieties functionalized in a second region of the second subarray.
6 . The microfluidic device of claim 4 , wherein the first set of one or more binding moieties and the second set of one or more binding moieties include two or more binding moieties.
7 . The microfluidic device of claim 4 , wherein the first region is distinct from the second region.
8 . The microfluidic device of claim 1 , wherein the obstacles are fixed to the microfluidic device.
9 . The microfluidic device of claim 1 , wherein the first subarray has a first average gap length between adjacent obstacles and the second subarray has a second average gap length between adjacent obstacles, wherein the first average gap length is greater than the second average gap length.
10 . The microfluidic device of claim 7 , wherein the second average gap length is less than 8, 10, 12, 15, 17, 20, 24, 29, 35, or 42 microns.
11 . The microfluidic device of claim 1 , wherein a sample obtained from a patient is contacted with the microfluidic device and one or more rare cells are retained by the microfluidic device.
12 . The microfluidic device of claim 11 , wherein 1, 5, or 20% of the one or more rare cells retained by the microfluidic device are retained in the first 30 rows of the second subarray of obstacles.
13 . A method for diagnosing cancer comprising enumerating one or more enriched circulating tumor cells and fragments thereof using a bright field microscope.
14 . The method of claim 13 , wherein the enumerating comprises staining the one or more enriched circulating tumor cells.
15 . The method of claim 13 , wherein the staining includes an indicator for a cancer marker.
16 . The method of claim 15 , wherein the cancer marker is cytokeratin, EGFR, EpCAM, cadherin, mucin, or LAR
17 . The method of claim 15 , wherein the cancer marker is cytokeratin.
18 . The method of claim 14 , wherein the staining includes using a pan-cytokeratin antibody, a biotinylated secondary antibody, an avidin-biotinylated horseradish peroxidase complex, and diaminobenzidine tetrahydrochloride.
19 . The method of claim 18 , wherein the pan-cytokeratin antibody is a mixture of monoclonal antibodies.
20 . The method of claim 14 , wherein the stain includes AE1/AE3 antibodies.
21 - 100 . (canceled)