Sensitive determination of NT-proBNP for diagnosing abdominal aortic aneurysms incidence on interdigitated electrode sensor

Biosensors for natriuretic peptides in cardiovascular diseases. A review

Heart failure (HF) is a complex clinical syndrome associated with high rates of morbidity and mortality. Over the years, it has been crucial to find accurate biomarkers capable of doing a precise monitor of HF and provide an early diagnosis. Of these, it has been established an important role of natriuretic peptides in HF assessment. Moreover, the development of biosensors has been garnering interest as new diagnostic medical tools. In this review we first provide a general overview of HF, its pathogenesis, and diagnostic features. We then discuss the role of natriuretic peptides in heart failure by characterizing them and point out their potential as biomarkers. Finally, we adress the evolution of biosensors development and the available natriuretic peptides biosensors for disease monitoring.

Selection, alkaline phosphatase fusion, and application of single-chain variable fragment (scFv) specific to NT-proBNP as electrochemical immunosensor for heart failure

Heart failure has a high global prevalence, with symptoms such as breathlessness, fatigue, and swelling. Early detection is crucial, as the condition worsens over time and can be fatal. This study identified the single-chain variable fragment (scFv) that specifically binds to the heart failure biomarker N-terminal pro B-type natriuretic peptide (NT-proBNP) using biopanning techniques for the development of an alternative diagnostic tool. Ten clones were identified that bound to the target peptide, with two clones (scFv-16 and scFv-36) selected for further analysis. Soluble scFv-16 and scFv-36 were produced and fused with alkaline phosphatase (AP) for potential applications. The binding efficiency and specificity levels of scFv to natriuretic peptides were evaluated using surface plasmon resonance (SPR) analysis. The values of the dissociation constant (KD) for NT-proBNP of scFv-16, scFv-36, scFv-16-AP, and scFv-36-AP were in the range 3.72 × 10-7-3.42 × 10-8 M with high specificity. All constructed scFvs had specificity to NT-proBNP, while not binding to A-type (ANP) and C-type (CNP) natriuretic peptides. When AP was combined, the scFv had a slightly higher yield of expression. The enzyme activity of scFv-36-AP was observed first by the absorption at 405 nm at a minimum of 44 nM and then by the naked eye at a minimum of 88 nM. Additionally, the potential application of NT-proBNP binding scFv was preliminarily investigated using an electrochemical technique to directly detect NT-proBNP in phosphate buffer saline. The results revealed the limit of detection at 69.09 pg/mL, which was less than the cutoff value (150 pg/mL) to discharge patients or healthy people. These findings provided promising biomolecules for the development of a reliable and sensitive diagnostic tool for heart failure.

LSPR-Based Aptasensor for Rapid Urinary Detection of NT-proBNP

N-terminal pro-brain natriuretic peptide (NT-proBNP) is a myocardial stress biomarker that can be found in serum or plasma, saliva, and urine in the context of cardiovascular disease. In this study, we developed a rapid (~25 min) and straightforward localized surface plasmon resonance (LSPR)-based assay for detecting NT-proBNP in urine. The assay employs citrate-capped gold nanoparticles (AuNPs) and an aptamer specific for NT-proBNP, which initially interacts with NT-proBNP. The remaining unbound aptamer then interacts with the AuNPs, and the addition of NaCl induces the aggregation of the unprotected AuNPs, resulting in a decrease in absorbance at the LSPR band (A₅₂₁) and an increase in absorbance at 750 nm (A₇₅₀). The concentration of NT-proBNP showed a linear correlation with the aggregation ratio (A₅₂₁/A₇₅₀), and the assay demonstrated a limit of detection (LOD) of 0.303 µg·L^-1 and a detection range of 0.566-8 µg·L^-1. However, the presence of sulfur-containing proteins in saliva and fetal bovine serum hindered the detection of NT-proBNP in these biofluids. Nevertheless, the assay successfully detected NT-proBNP in diluted urine with an LOD of 0.417 µg·L^-1 and a detection range of 0.589-6 µg·L^-1. The observed values in urine samples from preterm infants with cardiovascular disease fell within this range, indicating the potential clinical relevance of the assay. The recovery percentages ranged from 92.3 to 116.3%. Overall, our findings suggest that the LSPR-based assay for NT-proBNP detection in urine can be a valuable tool for the diagnosis and treatment of cardiovascular disease.

One-step impedimetric NT-proBNP aptasensor targeting cardiac insufficiency in artificial saliva

Currently, sensitive and accurate approaches for diagnosis, rapid assessment, and cardiac biomarker monitoring in patients with heart failure are needed. In this context, the advantages of aptamers over traditional antibodies have been employed to fabricate a single-step impedimetric N-terminal pro b-type natriuretic peptide (NT-proBNP)-modified gold microelectrode array. The development of an electrochemical aptasensing platform was based on the coimmobilization of alkanethiol self-assembled monolayers and amine-terminated aptamer that specifically recognized cardiac NT-proBNP protein resulting in charge electron transfer. Electroimpedimetric signals of the sensor were observed to be linear to the NT-proBNP concentrations in the range of 5.0 × 10^-3 to 1.0 pg mL^-1 (R² = 0.9624), while achieving a low detection limit of 5.0 × 10^-3 pg mL^-1. Clinically relevant detection levels for NT-proBNP were achieved in a simple, rapid, and label-free measurement using artificial saliva, which was highlighted to be specific, regenerative, and selective over potential interferers occurring during the processes of cardiac insufficiency, Therefore, the novel NT-proBNP aptasensor is a promising point-of-care tool exhibiting safe, non-invasive, affordable, and non-prescription home use accessible to overcome the limitations associated with conventional ELISA and previous aptasensing.

Electroanalytical point-of-care detection of gold standard and emerging cardiac biomarkers for stratification and monitoring in intensive care medicine - a review

Determination of specific cardiac biomarkers (CBs) during the diagnosis and management of adverse cardiovascular events such as acute myocardial infarction (AMI) has become commonplace in emergency department (ED), cardiology and many other ward settings. Cardiac troponins (cTnT and cTnI) and natriuretic peptides (BNP and NT-pro-BNP) are the preferred biomarkers in clinical practice for the diagnostic workup of AMI, acute coronary syndrome (ACS) and other types of myocardial ischaemia and heart failure (HF), while the roles and possible clinical applications of several other potential biomarkers continue to be evaluated and are the subject of several comprehensive reviews. The requirement for rapid, repeated testing of a small number of CBs in ED and cardiology patients has led to the development of point-of-care (PoC) technology to circumvent the need for remote and lengthy testing procedures in the hospital pathology laboratories. Electroanalytical sensing platforms have the potential to meet these requirements. This review aims firstly to reflect on the potential benefits of rapid CB testing in critically ill patients, a very distinct cohort of patients with deranged baseline levels of CBs. We summarise their source and clinical relevance and are the first to report the required analytical ranges for such technology to be of value in this patient cohort. Secondly, we review the current electrochemical approaches, including its sub-variants such as photoelectrochemical and electrochemiluminescence, for the determination  of important CBs highlighting the various strategies used, namely the use of micro- and nanomaterials, to maximise the sensitivities and selectivities of such approaches. Finally, we consider the challenges that must be overcome to allow for the commercialisation of this technology and transition into intensive care medicine.