Bio


Wei Gu, MD, PhD, is a physician, engineer, and scientist whose research focus is methylation classification within the area of molecular pathology. He has pioneered technologies in cell-free DNA 'liquid biopsy' testing, CRISPR diagnostics, clinical metagenomic sequencing, non-invasive prenatal testing, and COVID diagnostics. Dr. Gu has received awards from the Burroughs Wellcome Career Award and the National Cancer Institute. As a physician, he is a board-certified molecular and clinical pathologist and maintains a clinical practice at Stanford Healthcare.

Clinical Focus


  • Molecular Pathology
  • Anatomic and Clinical Pathology

Academic Appointments


  • Assistant Professor - University Medical Line, Pathology
  • Member, Bio-X

Honors & Awards


  • Career Awards for Medical Scientists (CAMS), Burroughs Wellcome (2018)
  • Career Development Award (K08), National Cancer Institute (2017)
  • Laurence Marton Research Award, UCSF (2016)
  • Julius R. Krevans Award for Clinical Excellence, UCSF (2015)
  • Medical Scientist Training Program Scholarship, Stanford University (2005-2014)
  • Terumo Scholarship, Terumo (2004-2005)
  • Winner (Undergraduate), National Collegiate Inventors Competition, US Patent Office (2004)
  • Clifton S. Goddin Scholarship, University of Michigan (2004)
  • Regents Award & Engineering Scholarships, University of Michigan (2001, 2003-2005)

Professional Education


  • Board Certification: American Board of Pathology, Molecular Genetic Pathology (2018)
  • Fellowship: UCSF Pathology Fellowships (2018) CA
  • Board Certification: American Board of Pathology, Clinical Pathology (2017)
  • Residency: UCSF Pathology Residency (2017) CA
  • Medical Education: Stanford University School of Medicine (2014) CA
  • PhD, Stanford University Schools of Medicine and Engineering, Bioengineering (2014)
  • BSE, University of Michigan, Chemical Engineering (2005)

Current Research and Scholarly Interests


Overall Interests: Our lab is dedicated to innovating in molecular diagnostics. We develop cutting-edge tools designed to convert nucleic acids into actionable clinical insights. We have been at the forefront of several breakthrough technologies in cell-free DNA 'liquid biopsy' testing, CRISPR diagnostics, clinical metagenomic sequencing, non-invasive prenatal testing, and COVID diagnostics. We have extensively studied cell-free nucleic acids from minimally invasive biopsies that contain terabytes of epigenetic and genetic data. Our goal is to maximize the diagnostic potential from this rich data through less invasive sampling, providing earlier, actionable information for patients. These biomarkers have already proven to be useful in fetal, transplant, microbial, and cancer diagnostics. However, there is still much to learn about utilizing this unique dataset in the context of human disease.

Current Interests: Our research team recently invented a methylation sequencing profiler that enriches genomewide by up to 18-fold (97%+ of reads have unbiased CpG data), and we are leveraging it to focus on: tumor classification, early cancer detection, early cancer prognostication, enhancing minimally invasive biopsies classification and prognostication, and tools to advance the diagnostic resolution of hard-to-diagnose clinical cases. The profiler is scaled and allows us to generate methylation profiles from thousands of FFPE and cfDNA specimens, beyond what is usually available or affordable. We then use advanced computational techniques related to methylation classification, bulk deconvolution, markers of prognostication, and new approaches in these areas.

Stanford Advisees


All Publications


  • Liquid Biopsy Based on Cell-Free DNA and RNA. Annual review of biomedical engineering Loy, C., Ahmann, L., De Vlaminck, I., Gu, W. 2024

    Abstract

    This review delves into the rapidly evolving landscape of liquid biopsy technologies based on cell-free DNA (cfDNA) and cell-free RNA (cfRNA) and their increasingly prominent role in precision medicine. With the advent of high-throughput DNA sequencing, the use of cfDNA and cfRNA has revolutionized noninvasive clinical testing. Here, we explore the physical characteristics of cfDNA and cfRNA, present an overview of the essential engineering tools used by the field, and highlight clinical applications, including noninvasive prenatal testing, cancer testing, organ transplantation surveillance, and infectious disease testing. Finally, we discuss emerging technologies and the broadening scope of liquid biopsies to new areas of diagnostic medicine. Expected final online publication date for the Annual Review of Biomedical Engineering, Volume 26 is May 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

    View details for DOI 10.1146/annurev-bioeng-110222-111259

    View details for PubMedID 38346275

  • Detection of Neoplasms by Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid. JAMA neurology Gu, W., Rauschecker, A. M., Hsu, E., Zorn, K. C., Sucu, Y., Federman, S., Gopez, A., Arevalo, S., Sample, H. A., Talevich, E., Nguyen, E. D., Gottschall, M., Nourbakhsh, B., Gold, C. A., Cree, B. A., Douglas, V. C., Richie, M. B., Shah, M. P., Josephson, S. A., Gelfand, J. M., Miller, S., Wang, L., Tihan, T., DeRisi, J. L., Chiu, C. Y., Wilson, M. R. 2021

    Abstract

    Importance: Cerebrospinal fluid (CSF) cytologic testing and flow cytometry are insensitive for diagnosing neoplasms of the central nervous system (CNS). Such clinical phenotypes can mimic infectious and autoimmune causes of meningoencephalitis.Objective: To ascertain whether CSF metagenomic next-generation sequencing (mNGS) can identify aneuploidy, a hallmark of malignant neoplasms, in difficult-to-diagnose cases of CNS malignant neoplasm.Design, Setting, and Participants: Two case-control studies were performed at the University of California, San Francisco (UCSF). The first study used CSF specimens collected at the UCSF Clinical Laboratories between July 1, 2017, and December 31, 2019, and evaluated test performance in specimens from patients with a CNS malignant neoplasm (positive controls) or without (negative controls). The results were compared with those from CSF cytologic testing and/or flow cytometry. The second study evaluated patients who were enrolled in an ongoing prospective study between April 1, 2014, and July 31, 2019, with presentations that were suggestive of neuroinflammatory disease but who were ultimately diagnosed with a CNS malignant neoplasm. Cases of individuals whose tumors could have been detected earlier without additional invasive testing are discussed.Main Outcomes and Measures: The primary outcome measures were the sensitivity and specificity of aneuploidy detection by CSF mNGS. Secondary subset analyses included a comparison of CSF and tumor tissue chromosomal abnormalities and the identification of neuroimaging characteristics that were associated with test performance.Results: Across both studies, 130 participants were included (median [interquartile range] age, 57.5 [43.3-68.0] years; 72 men [55.4%]). The test performance study used 125 residual laboratory CSF specimens from 47 patients with a CNS malignant neoplasm and 56 patients with other neurological diseases. The neuroinflammatory disease study enrolled 12 patients and 17 matched control participants. The sensitivity of the CSF mNGS assay was 75% (95% CI, 63%-85%), and the specificity was 100% (95% CI, 96%-100%). Aneuploidy was detected in 64% (95% CI, 41%-83%) of the patients in the test performance study with nondiagnostic cytologic testing and/or flow cytometry, and in 55% (95% CI, 23%-83%) of patients in the neuroinflammatory disease study who were ultimately diagnosed with a CNS malignant neoplasm. Of the patients in whom aneuploidy was detected, 38 (90.5%) had multiple copy number variations with tumor fractions ranging from 31% to 49%.Conclusions and Relevance: This case-control study showed that CSF mNGS, which has low specimen volume requirements, does not require the preservation of cell integrity, and was orginally developed to diagnose neurologic infections, can also detect genetic evidence of a CNS malignant neoplasm in patients in whom CSF cytologic testing and/or flow cytometry yielded negative results with a low risk of false-positive results.

    View details for DOI 10.1001/jamaneurol.2021.3088

    View details for PubMedID 34515766

  • Detection of cryptogenic malignancies from metagenomic whole genome sequencing of body fluids. Genome medicine Gu, W., Talevich, E., Hsu, E., Qi, Z., Urisman, A., Federman, S., Gopez, A., Arevalo, S., Gottschall, M., Liao, L., Tung, J., Chen, L., Lim, H., Ho, C., Kasowski, M., Oak, J., Holmes, B. J., Yeh, I., Yu, J., Wang, L., Miller, S., DeRisi, J. L., Prakash, S., Simko, J., Chiu, C. Y. 2021; 13 (1): 98

    Abstract

    BACKGROUND: Metagenomic next-generation sequencing (mNGS) of body fluids is an emerging approach to identify occult pathogens in undiagnosed patients. We hypothesized that metagenomic testing can be simultaneously used to detect malignant neoplasms in addition to infectious pathogens.METHODS: From two independent studies (n = 205), we used human data generated from a metagenomic sequencing pipeline to simultaneously screen for malignancies by copy number variation (CNV) detection. In the first case-control study, we analyzed body fluid samples (n = 124) from patients with a clinical diagnosis of either malignancy (positive cases, n = 65) or infection (negative controls, n = 59). In a second verification cohort, we analyzed a series of consecutive cases (n = 81) sent to cytology for malignancy workup that included malignant positives (n = 32), negatives (n = 18), or cases with an unclear gold standard (n = 31).RESULTS: The overall CNV test sensitivity across all studies was 87% (55 of 63) in patients with malignancies confirmed by conventional cytology and/or flow cytometry testing and 68% (23 of 34) in patients who were ultimately diagnosed with cancer but negative by conventional testing. Specificity was 100% (95% CI 95-100%) with no false positives detected in 77 negative controls. In one example, a patient hospitalized with an unknown pulmonary illness had non-diagnostic lung biopsies, while CNVs implicating a malignancy were detectable from bronchoalveolar fluid.CONCLUSIONS: Metagenomic sequencing of body fluids can be used to identify undetected malignant neoplasms through copy number variation detection. This study illustrates the potential clinical utility of a single metagenomic test to uncover the cause of undiagnosed acute illnesses due to cancer or infection using the same specimen.

    View details for DOI 10.1186/s13073-021-00912-z

    View details for PubMedID 34074327

  • Cell-Free DNA Tissues-of-Origin by Methylation Profiling Reveals Significant Cell, Tissue and Organ-Specific injury related to COVID-19 Severity. Med (New York, N.Y.) Cheng, A. P., Cheng, M. P., Gu, W., Lenz, J. S., Hsu, E., Schurr, E., Bourque, G., Bourgey, M., Ritz, J., Marty, F. M., Chiu, C. Y., Vinh, D. C., De Vlaminck, I. 2021

    Abstract

    Background: COVID-19 primarily affects the lungs, but evidence of systemic disease with multi-organ involvement is emerging. Here, we developed a blood test to broadly quantify cell, tissue, and organ specific injury due to COVID-19.Methods: Our test leverages genome-wide methylation profiling of circulating cell-free DNA in plasma. We assessed the utility of this test to identify subjects with severe disease in two independent, longitudinal cohorts of hospitalized patients. Cell-free DNA profiling was performed on 104 plasma samples from 33 COVID-19 patients and compared to samples from patients with other viral infections and healthy controls.Findings: We found evidence of injury to the lung and liver and involvement of red blood cell progenitors associated with severe COVID-19. The concentration of cell-free DNA correlated with the WHO ordinal scale for disease progression and was significantly increased in patients requiring intubation.Conclusion: This study points to the utility of cell-free DNA as an analyte to monitor and study COVID-19.

    View details for DOI 10.1016/j.medj.2021.01.001

    View details for PubMedID 33521749

  • Rapid pathogen detection by metagenomic next-generation sequencing of infected body fluids. Nature medicine Gu, W., Deng, X., Lee, M., Sucu, Y. D., Arevalo, S., Stryke, D., Federman, S., Gopez, A., Reyes, K., Zorn, K., Sample, H., Yu, G., Ishpuniani, G., Briggs, B., Chow, E. D., Berger, A., Wilson, M. R., Wang, C., Hsu, E., Miller, S., DeRisi, J. L., Chiu, C. Y. 2020

    Abstract

    We developed a metagenomic next-generation sequencing (mNGS) test using cell-free DNA from body fluids to identify pathogens. The performance of mNGS testing of 182 body fluids from 160 patients with acute illness was evaluated using two sequencing platforms in comparison to microbiological testing using culture, 16S bacterial PCR and/or 28S-internal transcribed ribosomal gene spacer (28S-ITS) fungal PCR. Test sensitivity and specificity of detection were 79 and 91% for bacteria and 91 and 89% for fungi, respectively, by Illumina sequencing; and 75 and 81% for bacteria and 91 and 100% for fungi, respectively, by nanopore sequencing. In a case series of 12 patients with culture/PCR-negative body fluids but for whom an infectious diagnosis was ultimately established, seven (58%) were mNGS positive. Real-time computational analysis enabled pathogen identification by nanopore sequencing in a median 50-min sequencing and 6-h sample-to-answer time. Rapid mNGS testing is a promising tool for diagnosis of unknown infections from body fluids.

    View details for DOI 10.1038/s41591-020-1105-z

    View details for PubMedID 33169017

  • Genomic surveillance reveals multiple introductions of SARS-CoV-2 into Northern California. Science (New York, N.Y.) Deng, X., Gu, W., Federman, S., du Plessis, L., Pybus, O. G., Faria, N. R., Wang, C., Yu, G., Bushnell, B., Pan, C. Y., Guevara, H., Sotomayor-Gonzalez, A., Zorn, K., Gopez, A., Servellita, V., Hsu, E., Miller, S., Bedford, T., Greninger, A. L., Roychoudhury, P., Starita, L. M., Famulare, M., Chu, H. Y., Shendure, J., Jerome, K. R., Anderson, C., Gangavarapu, K., Zeller, M., Spencer, E., Andersen, K. G., MacCannell, D., Paden, C. R., Li, Y., Zhang, J., Tong, S., Armstrong, G., Morrow, S., Willis, M., Matyas, B. T., Mase, S., Kasirye, O., Park, M., Masinde, G., Chan, C., Yu, A. T., Chai, S. J., Villarino, E., Bonin, B., Wadford, D. A., Chiu, C. Y. 2020; 369 (6503): 582-587

    Abstract

    The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally, with >365,000 cases in California as of 17 July 2020. We investigated the genomic epidemiology of SARS-CoV-2 in Northern California from late January to mid-March 2020, using samples from 36 patients spanning nine counties and the Grand Princess cruise ship. Phylogenetic analyses revealed the cryptic introduction of at least seven different SARS-CoV-2 lineages into California, including epidemic WA1 strains associated with Washington state, with lack of a predominant lineage and limited transmission among communities. Lineages associated with outbreak clusters in two counties were defined by a single base substitution in the viral genome. These findings support contact tracing, social distancing, and travel restrictions to contain the spread of SARS-CoV-2 in California and other states.

    View details for DOI 10.1126/science.abb9263

    View details for PubMedID 32513865

    View details for PubMedCentralID PMC7286545

  • Clinical Metagenomic Next-Generation Sequencing for Pathogen Detection. Annual review of pathology Gu, W., Miller, S., Chiu, C. Y. 2019; 14: 319-338

    Abstract

    Nearly all infectious agents contain DNA or RNA genomes, making sequencing an attractive approach for pathogen detection. The cost of high-throughput or next-generation sequencing has been reduced by several orders of magnitude since its advent in 2004, and it has emerged as an enabling technological platform for the detection and taxonomic characterization of microorganisms in clinical samples from patients. This review focuses on the application of untargeted metagenomic next-generation sequencing to the clinical diagnosis of infectious diseases, particularly in areas in which conventional diagnostic approaches have limitations. The review covers ( a) next-generation sequencing technologies and common platforms, ( b) next-generation sequencing assay workflows in the clinical microbiology laboratory, ( c) bioinformatics analysis of metagenomic next-generation sequencing data, ( d) validation and use of metagenomic next-generation sequencing for diagnosing infectious diseases, and ( e) significant case reports and studies in this area. Next-generation sequencing is a new technology that has the promise to enhance our ability to diagnose, interrogate, and track infectious diseases.

    View details for DOI 10.1146/annurev-pathmechdis-012418-012751

    View details for PubMedID 30355154

    View details for PubMedCentralID PMC6345613

  • Non-invasive prenatal measurement of the fetal genome NATURE Fan, H. C., Gu, W., Wang, J., Blumenfeld, Y. J., El-Sayed, Y. Y., Quake, S. R. 2012; 487 (7407): 320-?

    Abstract

    The vast majority of prenatal genetic testing requires invasive sampling. However, this poses a risk to the fetus, so one must make a decision that weighs the desire for genetic information against the risk of an adverse outcome due to hazards of the testing process. These issues are not required to be coupled, and it would be desirable to discover genetic information about the fetus without incurring a health risk. Here we demonstrate that it is possible to non-invasively sequence the entire prenatal genome. Our results show that molecular counting of parental haplotypes in maternal plasma by shotgun sequencing of maternal plasma DNA allows the inherited fetal genome to be deciphered non-invasively. We also applied the counting principle directly to each allele in the fetal exome by performing exome capture on maternal plasma DNA before shotgun sequencing. This approach enables non-invasive exome screening of clinically relevant and deleterious alleles that were paternally inherited or had arisen as de novo germline mutations, and complements the haplotype counting approach to provide a comprehensive view of the fetal genome. Non-invasive determination of the fetal genome may ultimately facilitate the diagnosis of all inherited and de novo genetic disease.

    View details for DOI 10.1038/nature11251

    View details for Web of Science ID 000306506500033

    View details for PubMedID 22763444

    View details for PubMedCentralID PMC3561905

  • Genome-Wide DNA Methylation Identifies Distinct Subgroups of Vulvovaginal Mesenchymal Neoplasia Neil, A., Howitt, B., Yu, J., Bennett, J., Pinto, A., Quick, C., Neville, G., Nucci, M., Chapel, D., Heilbroner, L., Wang, A., Yao, Y., Ahmann, L., Gu, W., Parra-Herran, C. ELSEVIER SCIENCE INC. 2023: S960-S961
  • CRISPR-Cas12-based detection of SARS-CoV-2. Nature biotechnology Broughton, J. P., Deng, X., Yu, G., Fasching, C. L., Servellita, V., Singh, J., Miao, X., Streithorst, J. A., Granados, A., Sotomayor-Gonzalez, A., Zorn, K., Gopez, A., Hsu, E., Gu, W., Miller, S., Pan, C. Y., Guevara, H., Wadford, D. A., Chen, J. S., Chiu, C. Y. 2020; 38 (7): 870-874

    Abstract

    An outbreak of betacoronavirus severe acute respiratory syndrome (SARS)-CoV-2 began in Wuhan, China in December 2019. COVID-19, the disease associated with SARS-CoV-2 infection, rapidly spread to produce a global pandemic. We report development of a rapid (<40 min), easy-to-implement and accurate CRISPR-Cas12-based lateral flow assay for detection of SARS-CoV-2 from respiratory swab RNA extracts. We validated our method using contrived reference samples and clinical samples from patients in the United States, including 36 patients with COVID-19 infection and 42 patients with other viral respiratory infections. Our CRISPR-based DETECTR assay provides a visual and faster alternative to the US Centers for Disease Control and Prevention SARS-CoV-2 real-time RT-PCR assay, with 95% positive predictive agreement and 100% negative predictive agreement.

    View details for DOI 10.1038/s41587-020-0513-4

    View details for PubMedID 32300245

  • Associations of Early COVID-19 Cases in San Francisco with Domestic and International Travel. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Gu, W., Deng, X., Reyes, K., Hsu, E., Wang, C., Sotomayor-Gonzalez, A., Federman, S., Bushnell, B., Miller, S., Chiu, C. 2020

    Abstract

    In early-to-mid March 2020, 20 of 46 (43%) COVID-19 cases at a tertiary care hospital in San Francisco, California were travel-related. Cases were significantly associated with travel to Europe or New York (odds ratio 32.9). Viral genomes recovered from 9 of 12 (75%) cases co-clustered with lineages circulating in Europe.

    View details for DOI 10.1093/cid/ciaa599

    View details for PubMedID 32436571

    View details for PubMedCentralID PMC7314204

  • Evaluation of SARS-CoV-2 serology assays reveals a range of test performance. Nature biotechnology Whitman, J. D., Hiatt, J. n., Mowery, C. T., Shy, B. R., Yu, R. n., Yamamoto, T. N., Rathore, U. n., Goldgof, G. M., Whitty, C. n., Woo, J. M., Gallman, A. E., Miller, T. E., Levine, A. G., Nguyen, D. N., Bapat, S. P., Balcerek, J. n., Bylsma, S. A., Lyons, A. M., Li, S. n., Wong, A. W., Gillis-Buck, E. M., Steinhart, Z. B., Lee, Y. n., Apathy, R. n., Lipke, M. J., Smith, J. A., Zheng, T. n., Boothby, I. C., Isaza, E. n., Chan, J. n., Acenas, D. D., Lee, J. n., Macrae, T. A., Kyaw, T. S., Wu, D. n., Ng, D. L., Gu, W. n., York, V. A., Eskandarian, H. A., Callaway, P. C., Warrier, L. n., Moreno, M. E., Levan, J. n., Torres, L. n., Farrington, L. A., Loudermilk, R. P., Koshal, K. n., Zorn, K. C., Garcia-Beltran, W. F., Yang, D. n., Astudillo, M. G., Bernstein, B. E., Gelfand, J. A., Ryan, E. T., Charles, R. C., Iafrate, A. J., Lennerz, J. K., Miller, S. n., Chiu, C. Y., Stramer, S. L., Wilson, M. R., Manglik, A. n., Ye, C. J., Krogan, N. J., Anderson, M. S., Cyster, J. G., Ernst, J. D., Wu, A. H., Lynch, K. L., Bern, C. n., Hsu, P. D., Marson, A. n. 2020

    Abstract

    Appropriate use and interpretation of serological tests for assessments of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure, infection and potential immunity require accurate data on assay performance. We conducted a head-to-head evaluation of ten point-of-care-style lateral flow assays (LFAs) and two laboratory-based enzyme-linked immunosorbent assays to detect anti-SARS-CoV-2 IgM and IgG antibodies in 5-d time intervals from symptom onset and studied the specificity of each assay in pre-coronavirus disease 2019 specimens. The percent of seropositive individuals increased with time, peaking in the latest time interval tested (>20 d after symptom onset). Test specificity ranged from 84.3% to 100.0% and was predominantly affected by variability in IgM results. LFA specificity could be increased by considering weak bands as negative, but this decreased detection of antibodies (sensitivity) in a subset of SARS-CoV-2 real-time PCR-positive cases. Our results underline the importance of seropositivity threshold determination and reader training for reliable LFA deployment. Although there was no standout serological assay, four tests achieved more than 80% positivity at later time points tested and more than 95% specificity.

    View details for DOI 10.1038/s41587-020-0659-0

    View details for PubMedID 32855547

  • Depletion of Abundant Sequences by Hybridization (DASH): using Cas9 to remove unwanted high-abundance species in sequencing libraries and molecular counting applications GENOME BIOLOGY Gu, W., Crawford, E. D., O'Donovan, B. D., Wilson, M. R., Chow, E. D., Retallack, H., DeRisi, J. L. 2016; 17: 41

    Abstract

    Next-generation sequencing has generated a need for a broadly applicable method to remove unwanted high-abundance species prior to sequencing. We introduce DASH (Depletion of Abundant Sequences by Hybridization). Sequencing libraries are 'DASHed' with recombinant Cas9 protein complexed with a library of guide RNAs targeting unwanted species for cleavage, thus preventing them from consuming sequencing space. We demonstrate a more than 99 % reduction of mitochondrial rRNA in HeLa cells, and enrichment of pathogen sequences in patient samples. We also demonstrate an application of DASH in cancer. This simple method can be adapted for any sample type and increases sequencing yield without additional cost.

    View details for DOI 10.1186/s13059-016-0904-5

    View details for Web of Science ID 000371583600001

    View details for PubMedID 26944702

    View details for PubMedCentralID PMC4778327

  • Brain Tumor Mutations Detected in Cerebral Spinal Fluid CLINICAL CHEMISTRY Pan, W., Gu, W., Nagpal, S., Gephart, M. H., Quake, S. R. 2015; 61 (3): 514-522

    Abstract

    Detecting tumor-derived cell-free DNA (cfDNA) in the blood of brain tumor patients is challenging, presumably owing to the blood-brain barrier. Cerebral spinal fluid (CSF) may serve as an alternative "liquid biopsy" of brain tumors by enabling measurement of circulating DNA within CSF to characterize tumor-specific mutations. Many aspects about the characteristics and detectability of tumor mutations in CSF remain undetermined.We used digital PCR and targeted amplicon sequencing to quantify tumor mutations in the cfDNA of CSF and plasma collected from 7 patients with solid brain tumors. Also, we applied cancer panel sequencing to globally characterize the somatic mutation profile from the CSF of 1 patient with suspected leptomeningeal disease.We detected tumor mutations in CSF samples from 6 of 7 patients with solid brain tumors. The concentration of the tumor mutant alleles varied widely between patients, from <5 to nearly 3000 copies/mL CSF. We identified 7 somatic mutations from the CSF of a patient with leptomeningeal disease by use of cancer panel sequencing, and the result was concordant with genetic testing on the primary tumor biopsy.Tumor mutations were detectable in cfDNA from the CSF of patients with different primary and metastatic brain tumors. We designed 2 strategies to characterize tumor mutations in CSF for potential clinical diagnosis: the targeted detection of known driver mutations to monitor brain metastasis and the global characterization of genomic aberrations to direct personalized cancer care.

    View details for DOI 10.1373/clinchem.2014.235457

    View details for Web of Science ID 000352161300013

    View details for PubMedID 25605683

  • Noninvasive prenatal diagnosis in a fetus at risk for methylmalonic acidemia. Genetics in medicine Gu, W., Koh, W., Blumenfeld, Y. J., El-Sayed, Y. Y., Hudgins, L., Hintz, S. R., Quake, S. R. 2014; 16 (7): 564-567

    Abstract

    Purpose:Prenatal diagnosis of fetal Mendelian disorders can benefit from noninvasive approaches using fetal cell-free DNA in maternal plasma. Detecting metabolic disorders before birth can result in immediate treatment postpartum in order to optimize outcome.Methods:We developed a mathematical model and an experimental methodology to analyze the case of a fetus with a 25% risk of inheriting two known mutations in MUT that cause methylmalonic acidemia. To accomplish this, we measured allelic counts at the mutation sites and the fetal fraction from high minor-allele-frequency single-nucleotide polymorphism positions.Results:By counting linked alleles, the test was able to distinguish 11 positive markers from the negative controls and thereby determine whether or not the mutations carried by the parents were inherited by the fetus. For a homozygous fetus, the Z-score of the mutation site was 5.97, whereas the median Z-score of all the linked alleles was 4.56 when all negative (heterozygous) controls had a Z-score <2.5.Conclusion:The application of this methodology for diagnosing methylmalonic acidemia shows that this is a cost-effective and noninvasive approach to diagnosing known mutations related to Mendelian disorders in the fetus.Genet Med advance online publication 9 January 2014Genetics in Medicine (2014); doi:10.1038/gim.2013.194.

    View details for DOI 10.1038/gim.2013.194

    View details for PubMedID 24406457

  • Noninvasive prenatal diagnosis in a fetus at risk for methylmalonic acidemia GENETICS IN MEDICINE Gu, W., Koh, W., Blumenfeld, Y. J., El-Sayed, Y. Y., Hudgins, L., Hintz, S. R., Quake, S. R. 2014; 16 (7): 564-567
  • Electromechanical properties of pressure-actuated poly(dimethylsiloxane) microfluidic push-down valves ANALYTICAL CHEMISTRY Chen, H., Gu, W., Cellar, N., Kennedy, R., Takayama, S., Meiners, J. 2008; 80 (15): 6110-6113

    Abstract

    Pressure-actuated poly(dimethylsiloxane) (PDMS) valves have been characterized with respect to their electromechanical properties. Measurements of the valve opening and closing times, threshold pressures, and impedance spectra for closed valves can be used to assess the quality of the devices in general, determine their suitability for specialized applications, such as providing electrical isolated fluidic compartments for planar patch clamping, and specify ideal operating conditions. For our particular valve designs, we report valve opening times of the order of 10-100 micros, making them suitable for rapid buffer exchange applications. They can effectively provide reversible electrical isolation between adjacent fluidic compartments with typical resistances of 5 Gohms in the closed state, which meets the gigaohm requirement for patch clamping applications.

    View details for DOI 10.1021/ac800506n

    View details for Web of Science ID 000258096700068

    View details for PubMedID 18576665

    View details for PubMedCentralID PMC2587325

  • A Microfluidic System for Rapid Bacterial Pathogen Detection 7th IEEE Conference on Nanotechnology Mai, J. D., Gaster, R. S., Wu, A., Gu, W., Mach, K. E., Liao, J. C. IEEE. 2007: 1341–1345
  • Handheld recirculation system and customized media for microfluidic cell culture LAB ON A CHIP Futai, N., Gu, W., Song, J. W., Takayama, S. 2006; 6 (1): 149-154

    Abstract

    A palm-sized microfluidic recirculation system and customized media enable simplified long-term culture and imaging of cells. The combination of bare Braille display modules, a leveled monolithic surface for complete chip mounting, and a transparent heater improved portability, mechanical stability and optical accessibility. Modification of basal culture media with Leibovitz's L-15 medium enabled an incubator-free culture of carbonate-dependent cells by eliminating the need for exogenous carbon dioxide. This capability is demonstrated through time-lapse recording of proliferation of C2C12 myoblasts and MC3T3-E1 osteoblasts for over 2 weeks in ambient atmosphere without medium exchange. The method opens up new possibilities for portable cell culture and for long-term continuous visual monitoring of cells.

    View details for DOI 10.1039/b510901a

    View details for Web of Science ID 000235506300020

    View details for PubMedID 16372083

  • Microscale integrated sperm sorter. Methods in molecular biology (Clifton, N.J.) Chung, Y., Zhu, X., Gu, W., Smith, G. D., Takayama, S. 2006; 321: 227-244

    Abstract

    This chapter describes the design and fabrication of a passively driven microfluidic sperm sorter using soft lithographic microfabrication techniques. This self-contained device can separate motile sperm from nonmotile sperm and other cellular debris. The sorting system is small (coin sized) and structurally simple. It comprises two inlets; two outlets; a sorting channel; and arrays of horizontally oriented reservoirs that function as passively driven, constant-flow-rate pumps. Sperm with higher motility are sorted out from the rest of the semen samples based on their ability to swim through interfaces between adjacent laminar streams into separate streamlines, whereas the nonmotile sperm and debris remain in their initial streamlines. The device, which we call a microscale integrated sperm sorter, does not rely on any external power sources or controllers and incorporates all sample loading and sorting functions necessary to prepare high-quality sperm for in vitro fertilization. This self-contained, inexpensive, and portable device may also be useful for developing convenient sperm motility assays that can be used at the point of care or at home.

    View details for PubMedID 16508075

  • Computer-controlled microcirculatory support system for endothelial cell culture and shearing ANALYTICAL CHEMISTRY Song, J. W., Gu, W., Futai, N., Warner, K. A., Nor, J. E., Takayama, S. 2005; 77 (13): 3993-3999

    Abstract

    Endothelial cells (ECs) lining the inner lumen of blood vessels are continuously subjected to hemodynamic shear stress, which is known to modify EC morphology and biological activity. This paper describes a self-contained microcirculatory EC culture system that efficiently studies such effects of shear stress on EC alignment and elongation in vitro. The culture system is composed of elastomeric microfluidic cell shearing chambers interfaced with computer-controlled movement of piezoelectric pins on a refreshable Braille display. The flow rate is varied by design of channels that allow for movement of different volumes of fluid per variable-speed pump stroke. The integrated microfluidic valving and pumping system allowed primary EC seeding and differential shearing in multiple compartments to be performed on a single chip. The microfluidic flows caused ECs to align and elongate significantly in the direction of flow according to their exposed levels of shear stress. This microfluidic system overcomes the small flow rates and the inefficiencies of previously described microfluidic and macroscopic systems respectively to conveniently perform parallel studies of EC response to shear stress.

    View details for DOI 10.1021/ac050131o

    View details for Web of Science ID 000230270800033

    View details for PubMedID 15987102

  • Microfluidics for flow cytometric analysis of cells and particles PHYSIOLOGICAL MEASUREMENT Huh, D., Gu, W., Kamotani, Y., Grotberg, J. B., Takayama, S. 2005; 26 (3): R73-R98

    Abstract

    This review describes recent developments in microfabricated flow cytometers and related microfluidic devices that can detect, analyze, and sort cells or particles. The high-speed analytical capabilities of flow cytometry depend on the cooperative use of microfluidics, optics and electronics. Along with the improvement of other components, replacement of conventional glass capillary-based fluidics with microfluidic sample handling systems operating in microfabricated structures enables volume- and power-efficient, inexpensive and flexible analysis of particulate samples. In this review, we present various efforts that take advantage of novel microscale flow phenomena and microfabrication techniques to build microfluidic cell analysis systems.

    View details for DOI 10.1088/0967-3334/26/3/R02

    View details for Web of Science ID 000229837900002

    View details for PubMedID 15798290

  • Computerized microfluidic cell culture using elastomeric channels and Braille displays PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA Gu, W., Zhu, X. Y., Futai, N., Cho, B. S., Takayama, S. 2004; 101 (45): 15861-15866

    Abstract

    Computer-controlled microfluidics would advance many types of cellular assays and microscale tissue engineering studies wherever spatiotemporal changes in fluidics need to be defined. However, this goal has been elusive because of the limited availability of integrated, programmable pumps and valves. This paper demonstrates how a refreshable Braille display, with its grid of 320 vertically moving pins, can power integrated pumps and valves through localized deformations of channel networks within elastic silicone rubber. The resulting computerized fluidic control is able to switch among: (i) rapid and efficient mixing between streams, (ii) multiple laminar flows with minimal mixing between streams, and (iii) segmented plug-flow of immiscible fluids within the same channel architecture. The same control method is used to precisely seed cells, compartmentalize them into distinct subpopulations through channel reconfiguration, and culture each cell subpopulation for up to 3 weeks under perfusion. These reliable microscale cell cultures showed gradients of cellular behavior from C2C12 myoblasts along channel lengths, as well as differences in cell density of undifferentiated myoblasts and differentiation patterns, both programmable through different flow rates of serum-containing media. This technology will allow future microscale tissue or cell studies to be more accessible, especially for high-throughput, complex, and long-term experiments. The microfluidic actuation method described is versatile and computer programmable, yet simple, well packaged, and portable enough for personal use.

    View details for DOI 10.1073/pnas.0404353101

    View details for Web of Science ID 000225196800009

    View details for PubMedID 15514025

    View details for PubMedCentralID PMC528755