Nanopore Sequencing: Real-Time RNA for Point-of-Care Diagnostics


Traditional RNA sequencing (RNA-seq) methods, while powerful, often suffer from delays associated with library preparation and complex instrumentation. This hinders real-time analysis, crucial for applications like rapid diagnostics and personalized medicine. Nanopore sequencing technology offers a promising alternative, enabling near real-time RNA sequencing with potential for point-of-care deployment.

Recent Advancements in Nanopore Sequencing for RNA Analysis

Nanopore sequencing utilizes biological nanopores – protein channels embedded in membranes – to detect single molecules as they translocate through the pore. Specific modifications cater this technology for RNA analysis:

  • Direct RNA Sequencing: Oxford Nanopore's direct RNA sequencing (DRS) eliminates the need for reverse transcription, significantly reducing processing times. DRS employs enzymatic modifications to polyadenylate RNA molecules, enabling their procession through the pore.
  • Sequencing Kits Optimized for RNA: Advancements in nanopore sequencing kits have improved accuracy and read lengths for RNA molecules. Kits like the Rapid RNA Sequencing Kit (SQK-RNA002) leverage proprietary enzymes to enhance RNA stability and minimize degradation during sequencing.
  • Basecalling Algorithms for RNA: Specialized basecalling algorithms like EcuraRNA are being developed to improve the accuracy of RNA sequence determination from nanopore data.

Envisioned strategies for nanopore-based RNA-seq. Left: while a single-stranded RNA stretch is translocated through a hemolysin pore in a membrane, each ribobase could be detected by measuring current changes between the cis ( − ) and trans (+) compartment divided by the lipid bilayer. Right: single-stranded RNA is cleaved by polynucleotide phosphorylase (PNPase) and each released ribobase could be read separately by measuring the current between the cis ( − ) and trans (+) compartment. Nanopore drawing is reproduced from (169) by permission from Macmillan Publishers Ltd on behalf of Scientific Reports, copyright 2013. RNA exosequencing principle is adapted with permission from (167) and copyright 2013 American Chemical Society.

Real-Time RNA Sequencing and its Potential Impact

These advancements pave the way for real-time RNA sequencing with nanopores. Key advantages include:

  • Rapid Results: Nanopore sequencing offers significantly faster turnaround times compared to traditional RNA-seq methods. Studies have demonstrated RNA sequencing completion in under 7 hours for SARS-CoV-2 positive samples.
  • Point-of-Care Diagnostics: The portability and relatively lower infrastructure requirements of nanopore sequencers make them ideal for decentralized settings. This facilitates real-time diagnosis of infectious diseases and personalized medicine applications at the point of care.
  • Actionable Insights: Rapid access to RNA sequencing data allows for dynamic treatment decisions based on the patient's specific molecular profile.

Direct RNA sequencing library preparation steps using Oxford Nanopore Technologies. (A) Schematic representation of a nanopore embedded in the membrane of the flowcell. (B) Overview of the main library preparation steps in ONT direct RNA sequencing.

Future Directions and Challenges

Despite the exciting possibilities, certain challenges remain:

  • Error Rates: Nanopore sequencing currently exhibits higher error rates compared to traditional methods. Continued development of basecalling algorithms and enzymatic processes is crucial for enhancing accuracy.
  • Data Analysis Pipelines: Efficient bioinformatics pipelines specifically designed for nanopore RNA-seq data are needed to facilitate real-time analysis and interpretation.


Nanopore sequencing technology holds immense promise for revolutionizing real-time RNA sequencing. Its potential applications in rapid diagnostics and personalized medicine are significant. Continued advancements in basecalling algorithms, error correction methods, and data analysis pipelines will be instrumental in realizing the full potential of this transformative technology.

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Nanopore Sequencing: Real-Time RNA for Point-of-Care Diagnostics
Gen store May 23, 2024
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