Amplification-based quantitative polymerase chain reaction
(qPCR)
provides accurate and sensitive nucleic acid quantification. However,
the requirement of temperature cycling and real-time monitoring limits
its translation to many settings. Quantitative isothermal amplification
methods alleviate the need for thermal cyclers; however, they still
require continuous monitoring of the nucleic acid amplification on
sophisticated readers. Here, we adapted an isothermal recombinase
polymerase amplification (RPA) reaction to develop a semiquantitative
method that relies on the final amplicon yield to estimate the initial
target nucleic acid copy number. To achieve this, we developed a phenomenological
model that captures the essential RPA dynamics. We identified reaction
conditions that constrained the reaction yield corresponding to the
starting DNA template concentration. We validated these predictions
experimentally and showed that the amplicon yields at the end of the
RPA reaction correlated well with the starting DNA concentration while
reducing nonspecific amplification robustly. We demonstrate this approach,
termed quantitative endpoint RPA (qeRPA), to detect DNA over five
log orders with a detection limit of 100 molecules. Using a linear
regression model of the normalized endpoint intensity (NEI) standard
curve, we estimate the viral load from the serum of dengue virus-infected
patients with comparable performance to qPCR. Unlike the conventional
isothermal quantitative methods, qeRPA can be employed for robust
and sensitive nucleic acid estimation at close to room temperature
without real-time monitoring and can be beneficial for field deployment
in resource-limited settings.