Cardiovascular biomarkers in body fluids: progress and prospects in optical sensors

Nanosensors and Microsensors for Body Fluid Monitoring: Various Analyte Detection and Construction Solutions

This review provides a comprehensive overview of the recent advancements in nanosensors and microsensors for body fluid monitoring. The principles behind sensor technologies, their applications in healthcare, and the types of body fluids that they analyze are described in the scope of this paper. Additionally, this review discusses emerging trends, challenges, and future perspectives in this field. The first two sections explore various body fluids and their diagnostic significance and discuss the fundamentals and classification of nanosensors and microsensors. The main aim of this paper is to highlight recent advancements in nanosensors for body fluid monitoring and to examine the role of microsensors in healthcare diagnostics. Innovative solutions such as microfluidic-based sensors, lab-on-a-chip systems, MEMS-based sensors, and wearable and implantable sensors are discussed in this section. Various construction solutions for microsensors and nanosensors have also been compiled and compared based on their target analytes, which are widely present in body fluids. The following sections review technologies and trends, including AI integration and flexible sensors, and discuss challenges and future perspectives in the development and application of sensors. The conclusion includes a summary of key findings and the future outlook for nanosensors and microsensors in personalized medicine.

Advancements in Bio-Integrated Flexible Electronics for Hemodynamic Monitoring in Cardiovascular Healthcare

Cardiovascular diseases (CVDs) remain the leading cause of global mortality, highlighting the urgent need for effective monitoring and prevention strategies. The rapid advancement of flexible sensing technology and the development of conformal sensors have attracted significant attention due to their potential for continuous, real-time assessment of cardiovascular health over extended periods. This review outlines recent advancements in bio-integrated flexible electronics designed for hemodynamic monitoring and broader CVD healthcare applications. It introduces key physiological indicators relevant to hemodynamics, including heart rate, blood pressure, blood flow velocity, and cardiac output. Next, it discusses flexible bio-integrated electronics engineering strategies, such as working principles and configuration designs. Various non-invasive and invasive bio-integrated devices for monitoring these hemodynamic indicators are then presented. Additionally, the review highlights the role of artificial intelligence algorithms and their practical applications in bio-integrated electronics for hemodynamic detection. Finally, it proposes future directions and addresses potential challenges in the field.

Optimized Microfluidic Biosensor for Sensitive C-Reactive Protein Detection

Lateral flow immunoassays (LFIAs) were integrated into microfluidic chips and tested to enhance point-of-care testing (POCT), with the aim of improving sensitivity and expanding the range of CRP detection. The microfluidic approach improves upon traditional methods by precisely controlling fluid speed, thus enhancing sensitivity and accuracy in CRP measurements. The microfluidic approach also enables a one-step detection system, eliminating the need for buffer solution steps and reducing the nitrocellulose (NC) pad area to just the detection test line. This approach minimizes the non-specific binding of conjugated antibodies to unwanted areas of the NC pad, eliminating the need to block those areas, which enhances the sensitivity of detection. The gold nanoparticle method detects CRP in the high-sensitivity range of 1-10 μg/mL, which is suitable for chronic disease monitoring. To broaden the CRP detection range, including infection levels beyond 10 μg/mL, fluorescent labels were introduced, extending the measuring range from 1 to 70 μg/mL. Experimental results demonstrate that integrating microfluidic technology significantly enhances operational efficiency by precisely controlling the flow rate and optimizing the mixing efficiency while reducing fabrication resources by eliminating the need for separate pads, making these methods suitable for resource-limited settings. Microfluidics also provides greater control over fluid dynamics compared to traditional LFIA methods, which contributes to enhanced detection sensitivity even with lower sample volumes and no buffer solution, helping to enhance the usability of POCT. These findings highlight the potential to develop accessible, accurate, and cost-effective diagnostic tools essential for timely medical interventions at the POC.

Analysis of Personalized Cardiovascular Drug Therapy: From Monitoring Technologies to Data Integration and Future Perspectives

Cardiovascular diseases have long been a major challenge to human health, and the treatment differences caused by individual variability remain unresolved. In recent years, personalized cardiovascular drug therapy has attracted widespread attention. This paper reviews the strategies for achieving personalized cardiovascular drug therapy through traditional dynamic monitoring and multidimensional data integration and analysis. It focuses on key technologies for dynamic monitoring, dynamic monitoring based on individual differences, and multidimensional data integration and analysis. By systematically reviewing the relevant literature, the main challenges in current research and the proposed potential directions for future studies were summarized.

Distinctive blood and salivary proteomics signatures in Qatari individuals at high risk for cardiovascular disease

Cardiovascular disease (CVD) remains a leading cause of global morbidity and mortality. Timely diagnosis is important in reducing both short and long-term health complications. Saliva has emerged as a potential source for biomarker discovery, offering a non-invasive tool for early detection of individuals at elevated risk for CVD, yet large-scale extensive proteomic analysis using saliva for a comprehensive biomarker discovery remains limited. In an effort to develop a diagnostic tool using saliva samples, our study aims to assess the salivary and plasma proteomes in subjects with high risk of developing CVD using a large-scale proteomic approach. Leveraging on the SOMAscan platform, we analyzed 1,317 proteins in saliva and plasma collected from subjects at a high risk of CVD (HR-CVD) and compared the profiles to subjects with low risk of CVD (LR-CVD). Our analysis revealed significant differences in the plasma and salivary proteins between the two groups. Pathway enrichment analysis of the differentially detected proteins revealed that the immune system activation and extracellular matrix remodeling are the most enriched pathways in the CVD-HR group. Comparing proteomic signatures between plasma and saliva, we found approximately 42 and 17 differentially expressed proteins associated with CVD-HR uniquely expressed in plasma and saliva respectively. Additionally, we identified eight common CVD-risk biomarkers shared between both plasma and saliva, demonstrating promising diagnostic tools for identifying individuals at high risk of developing CVD. In conclusion, saliva proteomics holds a significant promise to identify subjects with a high risk to develop CVD. Further studies are needed to validate our findings.

Advancing personalized medicine: Integrating statistical algorithms with omics and nano-omics for enhanced diagnostic accuracy and treatment efficacy

Medical laboratory services enable precise measurement of thousands of biomolecules and have become an inseparable part of high-quality healthcare services, exerting a profound influence on global health outcomes. The integration of omics technologies into laboratory medicine has transformed healthcare, enabling personalized treatments and interventions based on individuals' distinct genetic and metabolic profiles. Interpreting laboratory data relies on reliable reference values. Presently, population-derived references are used for individuals, risking misinterpretation due to population heterogeneity, and leading to medical errors. Thus, personalized references are crucial for precise interpretation of individual laboratory results, and the interpretation of omics data should be based on individualized reference values. We reviewed recent advancements in personalized laboratory medicine, focusing on personalized omics, and discussed strategies for implementing personalized statistical approaches in omics technologies to improve global health and concluded that personalized statistical algorithms for interpretation of omics data have great potential to enhance global health. Finally, we demonstrated that the convergence of nanotechnology and omics sciences is transforming personalized laboratory medicine by providing unparalleled diagnostic precision and innovative therapeutic strategies.

2D-Bio-FETs for sensitive detection of cardiovascular diseases

The biosensing industry has seen exponential growth in the past decade. Impact of biosensors in the current scenario cannot be overlooked. Cardiovascular diseases (CvDs) have been recognized as one of the major causes for millions of deaths globally. This mortality can be minimized by early and accurate detection/diagnosis of CvDs with the help of biosensing devices. This also presents a global market opportunity for the development of biosensors for CvDs. A vast variety of biosensing methods and devices have been developed for this problem. Most of commercially available platforms for CvD detection rely on optical (fluorometric and colorimetric analysis) techniques using serum biomarkers since optical testing is the gold standard in medical diagnosis. Field effect transistors-based biosensors, termed as Bio-FETs, are the upcoming devices for blood or serum analyte detection due to excellent sensitivity, low operational voltage, handheld device structure and simple chip-based operation. Further, the discovery of two dimensional (2D) materials and their integration with conventional FETs has improved the overvoltage problem, sensitivity and strict operating conditions as compared to conventional FETs. Graphene-FETs based biosensing devices have been proven as promising candidates due to their attractive properties. Despite the severe threat of CvDs which has further increased in post-covid era, the Bio-FET sensor studies in literature are still rare. In this review, we aim to provide a comprehensive view of all the multidisciplinary concepts related to 2D-BioFETs for CvDs. A critical review of the different platforms has been covered with detailed discussions of related studies to provide a clear concept and present status of 2D-BioFETs based CvD biosensors.

Heavy metal exposure and metabolomics analysis: an emerging frontier in environmental health

Exposure to heavy metals in various populations can lead to extensive damage to different organs, as these metals infiltrate and bioaccumulate in the human body, causing metabolic disruptions in various organs. To comprehensively understand the metal homeostasis, inter-organ "traffic," and extensive metabolic alterations resulting from heavy metal exposure, employing complementary analytical methods is crucial. Metabolomics is pivotal in unraveling the intricacies of disease vulnerability by furnishing thorough understandings of metabolic changes linked to different metabolic diseases. This field offers exciting prospects for enhancing the disease prevention, early detection, and tailoring treatment approaches to individual needs. This article consolidates the existing knowledge on disease-linked metabolic pathways affected by the exposure of diverse heavy metals providing concise overview of the underlying impact mechanisms. The main aim is to investigate the connection between the altered metabolic pathways and long-term complex health conditions induced by heavy metals such as diabetes mellitus, cardiovascular diseases, renal disorders, inflammation, neurodegenerative diseases, reproductive risks, and organ damage. Further exploration of common pathways may unveil the shared targets for treating associated pathological conditions. In this article, the role of metabolomics in disease susceptibility is emphasized that metabolomics is expected to be routinely utilized for the diagnosis and monitoring of diseases and practical value of biomarkers derived from metabolomics, as well as determining their appropriate integration into extensive clinical settings.

Advancements in Cerebrospinal Fluid Biosensors: Bridging the Gap from Early Diagnosis to the Detection of Rare Diseases

Cerebrospinal fluid (CSF) is a body fluid that can be used for the diagnosis of various diseases. However, CSF collection requires an invasive and painful procedure called a lumbar puncture (LP). This procedure is applied to any patient with a known risk of central nervous system (CNS) damage or neurodegenerative disease, regardless of their age range. Hence, this can be a very painful procedure, especially in infants and elderly patients. On the other hand, the detection of disease biomarkers in CSF makes diagnoses as accurate as possible. This review aims to explore novel electrochemical biosensing platforms that have impacted biomedical science. Biosensors have emerged as techniques to accelerate the detection of known biomarkers in body fluids such as CSF. Biosensors can be designed and modified in various ways and shapes according to their ultimate applications to detect and quantify biomarkers of interest. This process can also significantly influence the detection and diagnosis of CSF. Hence, it is important to understand the role of this technology in the rapidly progressing field of biomedical science.

Biodegradable, Biocompatible, and Implantable Multifunctional Sensing Platform for Cardiac Monitoring

Cardiac monitoring after heart surgeries is crucial for health maintenance and detecting postoperative complications early. However, current methods like rigid implants have limitations, as they require performing second complex surgeries for removal, increasing infection and inflammation risks, thus prompting research for improved sensing monitoring technologies. Herein, we introduce a nanosensor platform that is biodegradable, biocompatible, and integrated with multifunctions, suitable for use as implants for cardiac monitoring. The device has two electrochemical biosensors for sensing lactic acid and pH as well as a pressure sensor and a chemiresistor array for detecting volatile organic compounds. Its biocompatibility with myocytes has been tested in vitro, and its biodegradability and sensing function have been proven with ex vivo experiments using a three-dimensional (3D)-printed heart model and 3D-printed cardiac tissue patches. Moreover, an artificial intelligence-based predictive model was designed to fuse sensor data for more precise health assessment, making it a suitable candidate for clinical use. This sensing platform promises impactful applications in the realm of cardiac patient care, laying the foundation for advanced life-saving developments.

Advanced Nanomaterial-Based Biosensors for N-Terminal Pro-Brain Natriuretic Peptide Biomarker Detection: Progress and Future Challenges in Cardiovascular Disease Diagnostics

Cardiovascular diseases (CVDs) represent a significant challenge in global health, demanding advancements in diagnostic modalities. This review delineates the progressive and restrictive facets of nanomaterial-based biosensors in the context of detecting N-terminal pro-B-type natriuretic peptide (NT-proBNP), an indispensable biomarker for CVD prognosis. It scrutinizes the escalation in diagnostic sensitivity and specificity attributable to the incorporation of novel nanomaterials such as graphene derivatives, quantum dots, and metallic nanoparticles, and how these enhancements contribute to reducing detection thresholds and augmenting diagnostic fidelity in heart failure (HF). Despite these technological strides, the review articulates pivotal challenges impeding the clinical translation of these biosensors, including the attainment of clinical-grade sensitivity, the substantial costs associated with synthesizing and functionalizing nanomaterials, and their pragmatic deployment across varied healthcare settings. The necessity for intensified research into the synthesis and functionalization of nanomaterials, strategies to economize production, and amelioration of biosensor durability and ease of use is accentuated. Regulatory hurdles in clinical integration are also contemplated. In summation, the review accentuates the transformative potential of nanomaterial-based biosensors in HF diagnostics and emphasizes critical avenues of research requisite to surmount current impediments and harness the full spectrum of these avant-garde diagnostic instruments.

Protein profile pattern analysis: A multifarious, in vitro diagnosis technique for universal screening

Universal health care is attracting increased attention nowadays, because of the large increase in population all over the world, and a similar increase in life expectancy, leading to an increase in the incidence of non-communicable (various cancers, coronary diseases, neurological and old-age-related diseases) and communicable diseases/pandemics like SARS-COVID 19. This has led to an immediate need for a healthcare technology that should be cost-effective and accessible to all. A technology being considered as a possible one at present is liquid biopsy, which looks for markers in readily available samples like body fluids which can be accessed non- or minimally- invasive manner. Two approaches are being tried now towards this objective. The first involves the identification of suitable, specific markers for each condition, using established methods like various Mass Spectroscopy techniques (Surface-Enhanced Laser Desorption/Ionization Mass Spectroscopy (SELDI-MS), Matrix-Assisted Laser Desorption/Ionization (MALDI-MS), etc., immunoassays (Enzyme-Linked Immunoassay (ELISA), Proximity Extension Assays, etc.) and separation methods like 2-Dimensional Polyacrylamide Gel Electrophoresis (2-D PAGE), Sodium Dodecyl-Sulfate Polyacrylamide Gel Electrophoresis (SDS-PAGE), Capillary Electrophoresis (CE), etc. In the second approach, no attempt is made the identification of specific markers; rather an efficient separation method like High-Performance Liquid Chromatography/ Ultra-High-Performance Liquid Chromatography (HPLC/UPLC) is used to separate the protein markers, and a profile of the protein pattern is recorded, which is analysed by Artificial Intelligence (AI)/Machine Learning (MI) methods to derive characteristic patterns and use them for identifying the disease condition. The present report gives a summary of the current status of these two approaches and compares the two in the use of their suitability for universal healthcare.

Multiwavelength Photoacoustic Breath Analysis Sensor for the Diagnosis of Lung Diseases: COPD and Asthma

Breath analysis is emerging as a universal diagnostic method for clinical applications. The possibility of breath analysis is being explored vigorously using different analytical techniques. We have designed and assembled a multiwavelength UV photoacoustic spectroscopy (PAS) sensor for the said application. To optimize laser wavelength for sample excitation, photoacoustic signals from disease and normal conditions are recorded with different laser excitations (213, 266, 355, and 532 nm) on exhaled breath samples. Principal component analysis (PCA) of the PA signals has shown that 213, 266, and 355 nm laser excitations are suitable for breath analysis, with reliable descriptive statistics obtained for 266 nm laser. The study has, therefore, been extended for breath samples collected from asthma, chronic obstructive pulmonary disease (COPD), and normal subjects, using 266 nm laser excitation. PCA of the PA data shows good classification among asthma, COPD, and normal subjects. Match/No-match study performed with asthma, COPD, and normal calibration set has demonstrated the potential of using this method for diagnostic application. Sensitivity and specificity are observed as 88 and 89%, respectively. The area under the curve of the ROC curve is found to be 0.948, which justifies the diagnostic capability of the device for lung diseases. The same samples were studied using a commercial E-Nose, and the measurement outcome strongly supports the PAS results.

Progress in the Optical Sensing of Cardiac Biomarkers

Biomarkers play key roles in the diagnosis, risk assessment, treatment and supervision of cardiovascular diseases (CVD). Optical biosensors and assays are valuable analytical tools answering the need for fast and reliable measurements of biomarker levels. This review presents a survey of recent literature with a focus on the past 5 years. The data indicate continuing trends towards multiplexed, simpler, cheaper, faster and innovative sensing while newer tendencies concern minimizing the sample volume or using alternative sampling matrices such as saliva for less invasive assays. Utilizing the enzyme-mimicking activity of nanomaterials gained ground in comparison to their more traditional roles as signaling probes, immobilization supports for biomolecules and for signal amplification. The growing use of aptamers as replacements for antibodies prompted emerging applications of DNA amplification and editing techniques. Optical biosensors and assays were tested with larger sets of clinical samples and compared with the current standard methods. The ambitious goals on the horizon for CVD testing include the discovery and determination of relevant biomarkers with the help of artificial intelligence, more stable specific recognition elements for biomarkers and fast, cheap readers and disposable tests to facilitate rapid testing at home. As the field is progressing at an impressive pace, the opportunities for biosensors in the optical sensing of CVD biomarkers remain significant.

Serum protein profile study of myocardial infarction using a LED induced fluorescence based HPLC system

Cardiovascular diseases (CVDs) are the major health conditions for high mortality and morbidity in humans. Delay in the diagnosis of CVDs effect patients long and short-term health condition. In -house assembled UV-light emitting diode (LED) based fluorescence detector for high -performance liquid chromatography (HPLC) (HPLC-LED-IF) system is used to record serum chromatograms of three categories of samples namely, before medicated- myocardial infarction (B-MI), after medicated- MI (A-MI), and normal. The sensitivity and performance of HPLC-LED-IF system is estimated using commercial serum proteins. Statistical analysis tools like, descriptive statistics, principal component analysis (PCA), and Match/ No Match test were applied to visualize the variation in three groups of samples. Statistical analysis of the protein profile data showed fairly good discrimination among the three categories. The receiver operating characteristic (ROC) curve also supported the reliability of the method to diagnose MI.

Triple Enhancement for Sensitive Immunochromatographic Assay: A Case Study for Human Fatty Acid-Binding Protein Detection

The work considers a combination of three enhancing approaches for immunochromatographic assay (ICA) and the integration of their impacts into changes of the limit of detection (LOD). Human fatty acid binding protein (FABP), an early biomarker of acute myocardial infarction, was the target analyte. Starting from the common ICA protocol with an LOD equal to 11.2 ng/mL, three approaches were realized: (1) replacement of spherical gold nanoparticles with gold nanoflowers having a branched surface (20-fold lowering the LOD); (2) enhanced labeling of immune complexes via nanoparticle aggregates (15-fold lowering); (3) in-situ growth of bound nanoparticles by reduction of gold salts (3-fold lowering). Single and combined implementations of these approaches have been studied. It has been shown that the LOD decrease for combined approaches is close to the multiplied contribution of each of them. The final LOD for FABP was 0.05 ng/mL, which is 220 times lower than the LOD for the common ICA protocol. The efficiency of the enhanced ICA with three combined approaches was confirmed by testing human serum samples for FABP presence and content. The development presents a new efficient technique for rapid sensitive detection of FABP for medical diagnostics. Moreover, the demonstrated multiple enhancements could be applied for various demanded analytes.