Preservation of cell-free nucleic acids

1. A method comprising:

preparing a blood collection tube including at least, or about, 200 grams per liter of a composition formulated for stabilizing cell-free nucleic acids within a blood sample, the composition including:

a. from about 0.5% to about 20% by weight of a single nuclease inhibitor;

b. from about 50 to about 500 grams per liter of one or more formaldehyde releaser preservative agents; and

c. one or more solvents;

wherein the presence of the one or more formaldehyde releaser preservative agents results in release of at least some formaldehyde and up to, or about, 1% formaldehyde into the composition; and

sending the blood collection tube and composition located therein to a remote location for collection of a blood sample that contains cell-free nucleic acids that are stabilized by the composition.

2. The method of claim 1 , wherein the one or more formaldehyde releaser preservative agents includes diazolidinyl urea, imidazolidinyl urea, or combinations thereof.

3. The method of claim 1 , including sending the blood collection tube to a remote location for isolation of cell-free nucleic acids after the collection of a blood sample.

4. The method of claim 3 , including isolating the cell free nucleic acids from the stabilized blood sample.

5. The method of claim 4 , including testing the isolated cell free nucleic acids, wherein the testing occurs at a remote location from the blood sample collection.

6. The method of claim 5 , wherein the testing includes identification of the presence, absence or severity of a disease state.

7. The method of claim 6 , wherein the disease state is cancer.

8. The method of claim 5 , wherein the testing includes performing one or more of the following: polymerase chain reaction (PCR), reverse transcription polymerase chain reaction (RT-PCR), quantitative real time polymerase chain reaction (Q-PCR), gel electrophoresis, capillary electrophoresis, mass spectrometry, fluorescence detection, ultraviolet spectrometry, DNA hybridization, allele specific polymerase chain reaction, polymerase cycling assembly (PCA), asymmetric polymerase chain reaction, linear after the exponential polymerase chain reaction (LATE-PCR), helicase-dependent amplification (HDA), hot-start polymerase chain reaction, intersequence-specific polymerase chain reaction (ISSR), inverse polymerase chain reaction, ligation mediated polymerase chain reaction, methylation specific polymerase chain reaction (MSP), multiplex polymerase chain reaction, nested polymerase chain reaction, solid phase polymerase chain reaction, or any combination thereof.

9. The method of claim 6 , wherein the testing includes performing polymerase chain reaction (PCR).

10. The method of claim 5 , wherein the method is performed on a single sample or on multiple samples simultaneously in a multi-well plate.

11. The method of claim 4 , wherein the sample is contacted with proteinase K.

12. The method of claim 1 , wherein the single nuclease inhibitor is selected from diethyl pyrocarbonate, ethanol, aurintricarboxylic acid (ATA), formamide, vanadyl-ribonucleoside complexes, macaloid, ethylenediamine tetraacetic acid (EDTA), proteinase K, heparin, hydroxylamine-oxygen-cupric ion, bentonite, ammonium sulfate, dithiothreitol (DTT), beta-mercaptoethanol, cysteine, dithioerythritol, tris (2-carboxyethyl) phosphene hydrochloride, or a divalent cation selected from Mg+ 2 , Mn+ 2 , Zn+ 2 , Fe+ 2 , Ca+ 2 , and Cu+ 2 .

13. The method of claim 1 , wherein the single nuclease inhibitor is ethylenediamine tetraacetic acid.

14. The method of claim 1 , wherein the composition includes one or more protease inhibiting compounds selected from antipain, aprotinin, chymostatin, elastatinal, phenylmethylsulfonyl fluoride (PMSF), APMSF, TLCK, TPCK, leupeptin, soybean trypsin inhibitor, indoleacetic acid (IAA), E-64, pepstatin, VdLPFFVdL, EDTA, 1,10-phenanthroline, phosphoramodon, amastatin, bestatin, diprotin A, diprotin B, alpha-2-macroglobulin, lima bean trypsin inhibitor, pancreatic protease inhibitor, egg white ovostatin, egg white cystatin and any combination thereof.

15. The method of claim 1 , including drawing blood into the blood collection tube including the composition.

16. The method of claim 15 , wherein the blood is contacted with the composition from the time of blood draw until nucleic acids are isolated, screened, and/or tested.

17. The method of claim 1 , wherein the tube is polymeric.

18. A method comprising:

a) preparing a blood collection tube including at least, or about, 200 grams per liter of a composition formulated for stabilizing cell-free nucleic acids within a blood sample, the composition including:

i) from about 0.5% to about 20% by weight one or more nuclease inhibitors;

ii) from about 50 to about 500 grams per liter of one or more preservative agents; and

iii) one or more solvents;

b) drawing blood into the evacuated blood collection tube including the composition;

c) sending the blood collection tube and composition located therein to a remote location for collection of a blood sample that contains cell-free nucleic acids that are stabilized by the composition;

d) isolating the cell free nucleic acids from the stabilized blood sample; and

e) testing the isolated cell free nucleic acids from the stabilized blood sample to identify the presence, absence or severity of a disease state by performing one or more of the following: polymerase chain reaction (PCR), reverse transcription polymerase chain reaction (RT-PCR), quantitative real time polymerase chain reaction (Q-PCR), gel electrophoresis, capillary electrophoresis, mass spectrometry, fluorescence detection, ultraviolet spectrometry, DNA hybridization, allele specific polymerase chain reaction, polymerase cycling assembly (PCA), asymmetric polymerase chain reaction, linear after the exponential polymerase chain reaction (LATE-PCR), helicase-dependent amplification (HDA), hot-start polymerase chain reaction, intersequence-specific polymerase chain reaction (ISSR), inverse polymerase chain reaction, ligation mediated polymerase chain reaction, methylation specific polymerase chain reaction (MSP), multiplex polymerase chain reaction, nested polymerase chain reaction, solid phase polymerase chain reaction, or any combination thereof; and

wherein the collected blood sample is storable for at least, or about 7 days without cell lysis and without cell-free nucleic acid degradation of the blood sample due to DNase and RNase activity after blood collection.

19. The method of claim 18 , wherein the one or more preservative agents includes diazolidinyl urea, imidazolidinyl urea, or combinations thereof.

20. The method of claim 18 , wherein the blood is contacted with the composition from the time of blood draw until nucleic acids are isolated, screened, and/or tested.