{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T01:02:22Z","timestamp":1781830942943,"version":"3.54.5"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T00:00:00Z","timestamp":1612396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010843","name":"Guangzhou Science, Technology and Innovation Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010843","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>Hand, foot, and mouth disease (HFMD) is a common infectious disease affecting mainly children under 5 years of age. Coxsackievirus A6 (CVA-6), a major causative pathogen of HFMD, has caused outbreaks in recent years. Currently, no effective vaccine or antiviral treatments are available. In this study, one-step reverse-transcription recombinase polymerase amplification (RT-RPA), combined with a disposable lateral flow strip (LFS) assay, was developed to detect CVA-6. This assay can be performed in less than 35 min at 37\u00b0C without expensive instruments, and the result can be observed directly with the naked eye. The sensitivity of the RT-RPA-LFS was 10 copies per reaction, which was comparable to that of the conventional real-time quantitative polymerase chain reaction (qPCR) assays. Moreover, the assay specificity was 100%. The clinical performance of the RT-RPA-LFS assay was evaluated using 142 clinical samples, and the coincidence rate between RT-RPA-LFS and qPCR was 100%. Therefore, our RT-RPA-LFS assay provides a simple and rapid approach for point-of-care CVA-6 diagnosis.<\/jats:p>","DOI":"10.3389\/fmicb.2021.629533","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T04:39:04Z","timestamp":1612413544000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["One-Step Reverse-Transcription Recombinase Polymerase Amplification Using Lateral Flow Strips for the Detection of Coxsackievirus A6"],"prefix":"10.3389","volume":"12","author":[{"given":"Jia","family":"Xie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenli","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changbin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengru","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyong","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"654","DOI":"10.3201\/eid2404.171298","article-title":"Emerging coxsackievirus A6 CAUSING HAND. FOOT AND MOUTH DISEASE, VIETNAm.","volume":"24","author":"Anh","year":"2018","journal-title":"Emerg. Infect. Dis."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1586\/14787210.2015.1058156","article-title":"Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide.","volume":"13","author":"Bian","year":"2015","journal-title":"Expert Rev. Anti. Infect. Ther."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.00135-13","article-title":"Rapid detection of HIV-1 proviral DNA for early infant diagnosis using recombinase polymerase amplification.","volume":"4","author":"Boyle","year":"2013","journal-title":"mBio"},{"key":"B4","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/j.ram.2018.05.003","article-title":"Atypical hand, foot, and mouth disease caused by Coxsackievirus A6 in Argentina in 2015.","volume":"51","author":"Cisterna","year":"2018","journal-title":"Rev. Argent Microbiol."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.snb.2020.128919","article-title":"Point-of-care DNA testing by automatically and sequentially performing extraction, amplification and identification in a closed-type cassette.","volume":"327","author":"Dong","year":"2021","journal-title":"Sens. Actuators. B Chem."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1186\/s12917-020-02341-3","article-title":"Rapid and visual detection of porcine deltacoronavirus by recombinase polymerase amplification combined with a lateral flow dipstick.","volume":"16","author":"Gao","year":"2020","journal-title":"BMC Vet. Res."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/mi10060408","article-title":"Microfluidic-based nucleic acid amplification systems in microbiology.","volume":"10","author":"Gorgannezhad","year":"2019","journal-title":"Micromachines"},{"key":"B8","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1016\/j.jinf.2014.04.001","article-title":"Epidemic characteristics of hand, foot, and mouth disease in southern China, 2013: coxsackievirus A6 has emerged as the predominant causative agent.","volume":"69","author":"Li","year":"2014","journal-title":"J. Infect."},{"key":"B9","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1007\/s12519-018-0189-8","article-title":"Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition).","volume":"14","author":"Li","year":"2018","journal-title":"World J. Pediatr."},{"key":"B10","doi-asserted-by":"publisher","first-page":"3144","DOI":"10.1002\/jmv.26343","article-title":"Risk factors for severe hand, foot, and mouth disease infected with Coxsackievirus A6: a hospital-based case-control study.","volume":"92","author":"Li","year":"2020","journal-title":"J. Med. Virol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1128\/JCM.01114-07","article-title":"Rapid and highly sensitive coxsackievirus a indirect immunofluorescence assay typing kit for enterovirus serotyping.","volume":"46","author":"Lin","year":"2008","journal-title":"J. Clin. Microbiol."},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1186\/s12917-018-1594-x","article-title":"Visual and equipment-free reverse transcription recombinase polymerase amplification method for rapid detection of foot-and-mouth disease virus.","volume":"14","author":"Liu","year":"2018","journal-title":"BMC Vet. Res."},{"key":"B13","doi-asserted-by":"publisher","first-page":"298","DOI":"10.3201\/eid2602.190721","article-title":"Neutralizing antibodies against enteroviruses in patients with hand, foot and mouth disease.","volume":"26","author":"Nguyet","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"B14","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1099\/vir.0.81179-0","article-title":"Species-specific RT-PCR amplification of human enteroviruses: a tool for rapid species identification of uncharacterized enteroviruses.","volume":"87","author":"Oberste","year":"2006","journal-title":"J. Gen. Virol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1016\/j.bios.2016.11.063","article-title":"An integrated rotary microfluidic system with DNA extraction, loop-mediated isothermal amplification, and lateral flow strip based detection for point-of-care pathogen diagnostics.","volume":"91","author":"Park","year":"2017","journal-title":"Biosens. Bioelectron."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2014.19.12.20745","article-title":"Atypical hand, foot, and mouth disease associated with coxsackievirus A6 infection, Edinburgh, United Kingdom, January to February 2014.","volume":"19","author":"Sinclair","year":"2014","journal-title":"Euro Surveill"},{"key":"B17","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1016\/S1473-3099(10)70194-8","article-title":"Virology, epidemiology, pathogenesis, and control of enterovirus 71.","volume":"10","author":"Solomon","year":"2010","journal-title":"Lancet Infect. Dis."},{"key":"B18","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.mcp.2018.10.004","article-title":"Reverse transcription recombinase polymerase amplification with lateral flow dipsticks for detection of influenza A virus and subtyping of H1 and H3.","volume":"42","author":"Sun","year":"2018","journal-title":"Mol. Cell Probes"},{"key":"B19","doi-asserted-by":"publisher","first-page":"3591","DOI":"10.1007\/s00216-019-01840-z","article-title":"Visual signal generation for the detection of influenza viruses by duplex recombinase polymerase amplification with lateral flow dipsticks.","volume":"411","author":"Sun","year":"2019","journal-title":"Anal. Bioanal. Chem."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1007\/s00705-015-2340-3","article-title":"Molecular epidemiology of coxsackievirus A6 associated with outbreaks of hand, foot, and mouth disease in Tianjin, China, in 2013.","volume":"160","author":"Tan","year":"2015","journal-title":"Arch. Virol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1128\/JCM.02648-14","article-title":"Early detection of dengue virus by use of reverse transcription-recombinase polymerase amplification.","volume":"53","author":"Teoh","year":"2015","journal-title":"J. Clin. Microbiol."},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1038\/s41426-017-0011-z","article-title":"Epidemiological and serological surveillance of hand-foot-and-mouth disease in Shanghai, China, 2012-2016.","volume":"7","author":"Wang","year":"2018","journal-title":"Emerg. Microbes Infect."},{"key":"B23","doi-asserted-by":"publisher","first-page":"2632","DOI":"10.1007\/s12274-017-1893-z","article-title":"Antarctic thermolabile uracil-DNA-glycosylase-supplemented multiple cross displacement amplification using a label-based nanoparticle lateral flow biosensor for the simultaneous detection of nucleic acid sequences and elimination of carryover contamination.","volume":"11","author":"Wang","year":"2018","journal-title":"Nano Res."},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2020.01015","article-title":"A recombinase polymerase amplification and lateral flow strip combined method That Detects Salmonella enterica serotype typhimurium with no worry of primer-dependent artifacts.","volume":"11","author":"Wu","year":"2020","journal-title":"Front. Microbiol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/s1473-3099(13)70342-6","article-title":"Hand, foot, and mouth disease in China, 2008\u201312: an epidemiological study.","volume":"14","author":"Xing","year":"2014","journal-title":"Lancet Infect. Dis."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1186\/1743-422X-8-508","article-title":"Survey of enterovirus infections from hand, foot and mouth disease outbreak in china, 2009.","volume":"8","author":"Yang","year":"2011","journal-title":"Virol. J."},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2019.104054","article-title":"Clinical features and phylogenetic analysis of severe hand-foot-and-mouth disease caused by Coxsackievirus A6.","volume":"77","author":"Yang","year":"","journal-title":"Infect. Genet. Evol."},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.snb.2020.127903","article-title":"Rapid and visual detection of enterovirus using recombinase polymerase amplification combined with lateral flow strips.","volume":"311","author":"Yang","year":"","journal-title":"Sens. Actuators B Chem."},{"key":"B29","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.jinf.2017.11.005","article-title":"The increasing epidemic of hand, foot, and mouth disease caused by coxsackievirus-A6.","volume":"76","author":"Zeng","year":"2018","journal-title":"J. Infect."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1186\/1743-422X-9-298","article-title":"Rapid and sensitive identification of RNA from the emerging pathogen, coxsackievirus A6.","volume":"9","author":"Zhang","year":"2012","journal-title":"Virol. J."}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2021.629533\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T04:39:06Z","timestamp":1612413546000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2021.629533\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,4]]},"references-count":30,"alternative-id":["10.3389\/fmicb.2021.629533"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2021.629533","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,4]]},"article-number":"629533"}}