$$\rightleftharpoonup{xx}$$
$$\longleftharp{xx}$$,
$$\longrightharp{xx}$$,
LAM-PCR results in amplification of vector genome junctions with a defined fragment size for each junction. The size of individual PCR fragments depends on the distance between the location of the known DNA in the genome and the closest restriction enzyme recognition site. This allows visualizing the diversity of amplified junctions in analyzed samples by gel electrophoresis, e.g., if only single (monoclonal), several (oligoclonal), or multiple (polyclonal) bands are present on the gel. The results of LAM-PCR are best viewed by high resolution electrophoresis gels (Figure 2A) but can also be visualized on 2% agarose gels (Figure 2B). nrLAM-PCR results in PCR fragments of various length for each individual junction. Thus monoclonal, oligoclonal or polyclonal samples appear as a smear by electrophoresis and cannot be distinguished visually. Visualizing the nrLAM-PCR product on 2% agarose gel is sufficient to determine success of the protocol (Figure 2C). After sequencing the recovered genomic DNA can be aligned to the respective host genome to identify exact positions of the location of the vector (Figure 3A). Annotation of the genome allows to analyze the IS repertoire for different vector specific features like preference for integration into gene coding regions (Figure 3B) or close to transcription start sites (Figure 3C).

Figure 1. Schematic outline of LAM-PCR and nrLAM-PCR. A) Both methods start with an initial preamplification of vector genome junctions using biotinylated primers hybridizing close to the end of the known DNA sequence (here long terminal repeat (LTR) of a retroviral vector). Preamplification results in biotinylated ssDNA of different size for identical or different vector genome junctions. Biotinylated ssDNA is captured on magnetic particles. B) For LAM PCR, enzymatic reaction steps composed of dsDNA synthesis, restriction digest and ligation of a known linker DNA generate products of different sizes with known sequences on both ends of the product. Due to restriction length polymorphism each amplified junction has a characteristic length. After denaturation the LAM-PCR product is amplified by nested PCR with linker and vector specific primers. C) For nrLAM a ssDNA linker sequence is directly ligated to the unknown end of the preamplified ssDNA from A) allowing exponential amplification by nested PCR with linker and vector specific primers. This figure has been modified from 2,12. Please click here to view a larger version of this figure.

Figure 2. Representative results of LAM- PCR and nrLAM-PCR. A, B) LAM-PCR analysis of isolated DNA from peripheral blood of gene therapy treated patients. The number of bands on the gel corresponds to the number of IS present in the sample. High-resolution gels (B) are better suited to visualize clonality of analyzed samples than 2% agarose gels (A). C) nrLAM-PCR analysis of lentiviral vector transduced single cell clones or bulk cells. Independent of the number of amplified insertion sites a smear is seen on the gel after electrophoresis. M, 100 bp ladder; MC, monoclonal; OC, oligoclonal; PC, polyclonal. This figure has been modified from 2,9.

Figure 3. Representative examples for IS analysis by LAM-PCR and subsequent high-throughput sequencing. IS distribution in two patients from gammaretroviral (blue) or lentiviral (green) clinical gene therapy trials. After sequencing and mapping of LAM-PCR products to the respective genome IS can be evaluated e.g.: A) Genome-wide distribution of IS. B) Difference according to the preference for insertion into gene coding regions between gammaretroviral and lentiviral vectors and C) preference for insertion close to transcription start sites. Please click here to view a larger version of this figure.
| Purpose | Name | Sequence (5'-3') |
| LK-universal | LC1 | GACCCGGGAGATCTGAATTCAGTGGCACAG
CAGTTAGG |
| LK-AATT | LC2 (AATT) | AATTCCTAACTGCTGTGCCACTGAATTCA
GATC |
| LK-CG | LC2 (CG) | CGCCTAACTGCTGTGCCACTGAATTCAGATC |
| LK-TA | LC2 (TA) | TACCTAACTGCTGTGCCACTGAAATCAGATC |
| LK-nrLAM-PCR | ssLC | (P)CCTAACTGCTGTGCCACTGAATTCAGATC
TCCCGGGTddC |
| Preamplification | LTR-I (3'-direction) | (B)AGTAGTGTGTGCCCGTCTGT |
| LTR-I (5'-direction) | (B)TTAGCCAGAGAGCTCCCAGG |
| Exponential amplification I | LTR-II (3'-direction) | (B)GTGTGACTCTGGTAACTAGAG |
| LTR-II (5'-direction) | (B)GATCTGGTCTAACCAGAGAG |
| LC-I | GACCCGGGAGATCTGAATTC |
| Exponential amplification II | LTR-III (3'-direction) | GATCCCTCAGACCCTTTTAGTC |
| LTR-III (5'-direction) | CCCAGTACAAGCAAAAAGCAG |
| LC-II | GATCTGAATTCAGTGGCACAG |
Table 1. Oligonucleotides for LAM- and nrLAM-PCR to amplify lentiviral IS. ssLC is phosphorylated at the 5’-end (P) and has at 3’ didesoxycytidin (ddC) to avoid multimerization of the ssLC during ligation. In general, (nr)LAM-PCR primers should consist of 18-25 nucleotides and should not align to the host genome. Primers for preamplification should be placed as close as possible (≤120 bp) to the 5′ or 3′ end of the vector. Two additional primers for Exponential PCR I and II need to be placed between the primer used for preamplification and the vector end. Primers for preamplification and Exponential PCR I need to be 5’-phosphorylated (P).
| Reagent | Volume (µl) | Concentration | PCR Parameters | Temperature | Time |
| H2O | 43 - x | | Initial denaturation | 95 °C | 5 min |
| Buffer | 5 | 10 x | Denaturation | 95 °C | 45 sec | |
| dNTP | 1 | 10 mM (LAM); 0.5 µM (nrLAM) | Annealing | 60 °C | 45 sec | 2 x 50 Cycles |
| LTR-I | 0.5 | 0.17 µM | Elongation | 72 °C | 60 sec (LAM); 10 sec (nrLAM) |
| Taq Polymerase | 0.5 | 2.5 U/µl | Final Elongation | 72 °C | 5 min (only LAM) |
Table 2. PCR-Conditions for preamplification of vector genome junctions (step 2). Columns 1-3 show the PCR reagents used for amplification of a single DNA sample. Columns 4-6 exemplify the PCR program to preamplify vector genome junctions.
| Reagent | Volume (µl) | Concentration | PCR Parameters | Temperature | Time |
| H2O | 40.5 | | Initial denaturation | 95 °C | 5 min |
| Buffer | 5 | 10 x | Denaturation | 95 °C | 45 sec | |
| dNTP | 1 | 10 mM | Annealing | 60 °C | 45 sec | 35 Cycles |
| LTR-II | 0.5 | 16.7 µM | Elongation | 72 °C | 60 sec (LAM); 5 sec (nrLAM) |
| LC-I | 0.5 | 16.7 µM | Final Elongation | 72 °C | 5 min (only LAM) |
| Taq Polymerase | 0.5 | 2.5 U/µl | | | |
Table 3. PCR-Conditions for exponential Amplification I (step 6). Columns 1-3 show the PCR reagents used for exponential amplification of a single DNA sample. Columns 4-6 exemplify the PCR program used to exponentially amplify one sample after Ligation of linker sequence.
| Reagent | Volume (µl) | Concentration | PCR Parameters | Temperature | Time |
| H2O | 40.5 | | Initial denaturation | 95 °C | 5 min |
| Buffer | 5 | 10 x | Denaturation | 95 °C | 45 sec | |
| dNTP | 1 | 10 mM | Annealing | 60 °C | 45 sec | 35 Cycles |
| LTR-III | 0.5 | 16.7 µM | Elongation | 72 °C | 60 sec (LAM); 5 sec (nrLAM) |
| LC-II | 0.5 | 16.7 µM | Final Elongation | 72 °C | 5 min |
| Taq Polymerase | 0.5 | 2.5 U/µl | | | |
Table 4. PCR-Conditions for exponential Amplification I (step 8). Columns 1-3 show the PCR reagents used for nested exponential amplification of a single sample. Columns 4-6 exemplify the PCR program used for nested exponential amplification of vector genome junctions from one sample.
| Reagent | Volume (µl) | Concentration | PCR Parameters | Temperature | Time |
| H2O | 42.5 - x | | Initial denaturation | 95 °C | 2 min |
| Buffer | 5 | 10 x | Denaturation | 95 °C | 45 sec | |
| dNTP | 1 | 10 mM | Annealing | 58 °C | 45 sec | 12 Cycles |
| Fusionprimer A | 0.5 | 10 µM | Elongation | 72 °C | 60 sec |
| Fusionprimer B | 0.5 | 10 µM | Final Elongation | 72 °C | 5 min |
| Taq Polymerase | 0.5 | 2.5 U/µl | | | |
Table 5. PCR-Conditions for Fusionprimer-PCR (step 9.2). Columns 1-3 show the PCR reagents used for introduction of sequencing adaptors to (nr)LAM-PCR products. Columns 4-6 exemplify the PCR program used for Fusionprimer-PCR.