DNA sequencing is considered the gold standard for nucleic acid identification and mutation detection. However, sequencing is labor intensive because it requires previous amplification and only a single sequence is analyzed at a time. We developed two novel strategies that substantially improve DNA sequencing. The first allows multiple polymerase chain reaction (PCR) products to be sequenced in a single sequencing reaction and analyzed simultaneously in a single lane or capillary. Simultaneous sequencing by this method, designated "SimulSeq," can provide either simultaneous single-direction sequencing of multiple genes or simultaneous forward and reverse sequencing from a single gene. In the second approach, designated "AmpliSeq," we demonstrate a technique combining PCR amplification and sequencing in a single reaction that is analyzed in a single lane or capillary. We demonstrate combined PCR with short bidirectional sequencing, and combined PCR with unidirectional sequencing. We anticipate that these methods will have utility in research and clinical settings where panels of mutations or large numbers of samples are be analyzed and/or when turnaround time is critical. (Am J Pathol 2002, 161:27-33) DNA sequencing 1 has been the standard against which other types of DNA testing is compared. Major advances in DNA sequencing include the development of automated sequencers, 2 discovery of fluorescent terminator chemistry, 3 and cycle sequencing. 4 These developments have made sequencing easier to perform and therefore more widely used. Currently, sequencing is used to identify microbial drug resistance mutations, 5 cancer predisposition, somatic mutations, 6 and genetic diseases.
7With the cloning and sequencing of the human genome 8,9 and the new era of molecular medicine, one can only expect the use of DNA sequencing to increase.Despite advances in sequencing technology, significant limitations remain. First, most applications require polymerase chain reaction (PCR) amplification of the target sequence, and purification of the product before sequencing. Second, standard Sanger-sequencing reactions are performed with a single primer and therefore yield only a single sequence. These limitations are costly and have somewhat hindered the widespread application of DNA sequencing in clinical and research settings.In this article we report two novel sequencing strategies that directly address these limitations. In the first, we engineered sequencing reactions to permit simultaneous sequencing of multiple PCR products in a single lane. Under normal conditions, multiple sequencing reactions run simultaneously are superimposed on each other because the sequencing products overlap in size. SimulSeq prevents this because of two principles: sequencing products stop when the end of a PCR product is reached, and long oligonucleotide primers can be used to prevent otherwise overlapping short sequencing products. In the second sequencing strategy, we designed conditions and primer modifications to permit combined PCR and sequenc...