Point-of-care immunotesting: Approaching the analytical performance of central laboratory methods

Polymer thin film-embedded metal oxide-modified electrochemical paper-based sensor for glycine detection

This work describes the design and selectivity of a simple electrochemical paper-based analytical sensor (ePAS) for the detection of an amino acid (glycine) using Whatman No. 1 filter paper as the substrate material. A simple wax fabrication method was used to create hydrophobic and hydrophilic channels to control the sample flow. For electrochemical analysis, the carbon and silver ink electrodes were printed on a paper. The working and counter electrodes were made from carbon ink, and the reference and connective pads were made of silver/silver chloride ink. A sensing material composed of methoxy poly(ethylene glycol)-block-poly(l-glutamic acid) and cadmium oxide quantum dots was utilized for the detection of glycine. The proposed ePAS exhibited potential electrocatalytic activity toward the oxidation of glycine. The electrochemical studies showed a higher sensitivity for glycine in a basic medium in a potential window of -0.4 to +0.6 V. The detection limit for glycine under optimized conditions achieved with this sensor was 75.8 μM, while the limit of quantification was 229.7 μM. The sensor showed high sensitivity and reproducibility for up to 25 cycles and directly quantified the amino acids in the samples. The sensor could be reused, making it more economical and environmentally friendly.

Point-of-Care Diagnostics Using Self-heating Elements from Smart Food Packaging: Moving Towards Instrument-Free Nucleic Acid-Based Detection

Compromising between accuracy and rapidity is an important issue in analytics and diagnostics, often preventing timely and appropriate reactions to disease. This issue is particularly critical for infectious diseases, where reliable and rapid diagnosis is crucial for effective treatment and easier containment, thereby reducing economic and societal impacts. Diagnostic technologies are vital in disease modeling, tracking, treatment decision making, and epidemic containment. At the point-of-care level in modern healthcare, accurate diagnostics, especially those involving genetic-level analysis and nucleic acid amplification techniques, are still needed. However, implementing these techniques in remote or non-laboratory settings poses challenges because of the need for trained personnel and specialized equipment, as all nucleic acid-based diagnostic techniques, such as polymerase chain reaction and isothermal nucleic acid amplification, require temperature cycling or elevated and stabilized temperatures. However, in smart food packaging, there are approved and commercially available methods that use temperature regulation to enable autonomous heat generation without external sources, such as chemical heaters with phase change materials. These approaches could be applied in diagnostics, facilitating point-of-care, electricity-free molecular diagnostics, especially with nucleic acid-based detection methods such as isothermal nucleic acid amplification. In this review, we explore the potential interplay between self-heating elements, isothermal nucleic acid amplification techniques, and phase change materials. This paves the way for the development of truly portable, electricity-free, point-of-care diagnostic tools, particularly advantageous for on-site detection in resource-limited remote settings and for home use.

Cutting-edge 3D printing in immunosensor design for early cancer detection

Cancer is a major cause of death globally, and early detection is a key to improving outcomes. Traditional diagnostic methods have limitations such as being invasive and lacking sensitivity. Immunosensors, which detect cancer biomarkers using antibodies, offer a solution with high sensitivity and selectivity. When combined with 3D printing, these immunosensors can be customized to detect specific cancer markers, creating rapid, cost-effective, and scalable diagnostic tools. The article reviews the principles behind immunosensors, different 3D fabrication methods such as Fused Deposition Modeling (FDM) and Stereolithography (SLA), and discusses how functionalization strategies, such as surface modifications, can enhance the sensitivity of these devices. The integration of 3D printing allows for the creation of complex sensor structures, offering advantages such as customization, rapid prototyping, and multi-material printing. These advancements make immunosensors arrays highly promising for early cancer detection, tumor profiling, and personalized medicine. The article also explores challenges like scalability, material biocompatibility, and the need for clinical validation. Future perspectives suggest the potential of integrating nanomaterials, multiplexed detection, and wearable technology to further improve the performance and accessibility of these diagnostic tools.

An integrated electronic tag-based vertical flow assay (e-VFA) with micro-sieve and AlGaN/GaN HEMT sensors for multi-target detection in actual saliva

Vertical flow assay (VFA) is an effective point-of-care (POC) diagnostic tool for widespread application. Nevertheless, the lack of multi-target detection and multi-signal readout capability still remains a challenge. Herein, a brand new VFA scheme for multi-target saliva detection based on electronic tags was proposed, where AlGaN/GaN HEMT sensors modified with different bio-receptors as electronic tags endowed the VFA with multi-target detection capability. In addition, the use of electronic tags instead of optical tags allowed the VFA to simultaneously carry out direct multi-target readouts, which ensure effective POC diagnostics for saliva analysis. Moreover, by integrating a hydrophilically optimized micro-sieve, impurities like sticky filaments, epidermal cells and other large-scale charged particles in saliva were effectively screened, which enabled the direct detection of saliva using AlGaN/GaN HEMT sensors. Glucose, urea, and cortisol were selected to verify the feasibility of the multi-target e-VFA scheme, and the results showed that the limit of detection (LOD) was as low as 100 aM. The linear response was demonstrated in the dynamic range of 100 aM to 100 μM, and the specificity, long-term stability and validity of the actual saliva test were also verified. These results demonstrated that the as-proposed e-VFA has potential for application in saliva detection for simultaneous multi-target detection, and it is expected to achieve the real-time detection of more biological targets in saliva.

Lateral flow assay: a promising rapid point-of-care testing tool for infections and non-communicable diseases

The point-of-care testing (POCT) approach has established itself as having remarkable importance in diagnosing various infectious and non-communicable diseases (NCDs). The POCT approach has succeeded in meeting the current demand for having diagnostic strategies that can provide fast, sensitive, and highly accurate test results without involving complicated procedures. This has been accomplished by introducing rapid bioanalytical tools or biosensors such as lateral flow assays (LFAs). The production cost of these tools is very low, allowing developing countries with limited resources to utilize them or produce them on their own. Thus, their use has grown in various fields in recent years. More importantly, LFAs have created the possibility for a new era of incorporating nanotechnology in disease diagnosis and have already attained significant commercial success worldwide, making POCT an essential approach not just for now but also for the future. In this review, we have provided an overview of POCT and its evolution into the most promising rapid diagnostic approach. We also elaborate on LFAs with a special focus on nucleic acid LFAs.

A Novel ELISA for the Quantification of Serum Levels of 2 Glycosylated Variants of Apolipoprotein J: Biomarkers for Myocardial Ischemia

BACKGROUND

Previous studies have pointed out a potential role of ApoJ-Glyc as a biomarker of cardiac ischemia. The aim of this study was to validate the analytical performance of 2 novel ELISAs against 2 different glycosylated ApoJ variants, ApoJ-GlycA2 and ApoJ-GlycA6.

METHODS

The analytical measuring range, limit of blank (LoB), lower limit of quantification (LoQ), precision, accuracy, recovery, cross-reactivity, and stability were evaluated in serum samples.

RESULTS

The analytical measuring range was 500-16 000 ng/mL for ApoJ-GlycA2 and 125-4000 ng/mL for ApoJ-GlycA6, with a LoB of 455 ng/mL and 121 ng/mL for ApoJ-GlycA2 and ApoJ-GlycA6, respectively. The LoQ was 500 ng/mL for ApoJ-GlycA2 and 125 ng/mL for ApoJ-GlycA6. The assay performance fulfills the acceptance criteria established in the European Medicines Agency Guideline on bioanalytical method validation. Specifically, the calibration range variability is <15% for ApoJ-GlycA2 and ApoJ-GlycA6; the accuracy is <15% for ApoJ-GlycA2 and ApoJ-GlycA6; the between- and within-run precision is <15% for ApoJ-GlycA6 and ≤20% for ApoJ-GlycA2; and the total allowable error is <30% for ApoJ-GlycA2 and ApoJ-GlycA6. Cross-reactivity studies revealed the absence of cross-reactivity with endogenous components of the matrix (using ApoJ-depleted serum), with nonglycosylated ApoJ and with transferrin (as a high abundant N-glycosylated serum protein). Both ApoJ-GlycA2 and ApoJ-GlycA6 measurements were stable after storage of serum samples at -80°C for 24 months.

CONCLUSIONS

The newly developed ELISAs to quantify ApoJ-GlycA2 and ApoJ-GlycA6 serum levels showed an acceptable analytical performance according to European Medicines Agency guidelines on bioanalytical method validation in terms of precision, accuracy, recovery, cross-reactivity, and stability.

Organic Light-Emitting Diode Based Fluorescence-Linked Immunosorbent Assay for SARS-CoV-2 Antibody Detection

Immunodiagnostics have been widely used in the detection of disease biomarkers. The conventional immunological tests in central laboratories require expensive equipment and, for non-specialists, the tests are technically demanding and time-consuming, which has prevented their use by the public. Thus, point-of-care tests (POCT), such as lateral flow immunoassays, are being, or have been, developed as more convenient and low-cost methods for immunodiagnostics. However, the sensitivity of such tests is often a concern. Here, a fluorescence-linked immunosorbent assay (FLISA) using organic light-emitting diodes (OLEDs) as excitation light sources was investigated as a way forward for the development of compact and sensitive POCTs. Phycoerythrin (PE) was selected as the fluorescent dye, and OLEDs were designed with different emission spectra. The leakage light of different OLEDs for exciting PE was then investigated to reduce the background noise and improve the sensitivity of the system. Finally, as proof-of-principle that OLED-based technology can be successfully further developed for POCT, antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in human serum was detected by OLED-FLISA.

Microfluidic devices: The application in TME modeling and the potential in immunotherapy optimization

With continued advances in cancer research, the crucial role of the tumor microenvironment (TME) in regulating tumor progression and influencing immunotherapy outcomes has been realized over the years. A series of studies devoted to enhancing the response to immunotherapies through exploring efficient predictive biomarkers and new combination approaches. The microfluidic technology not only promoted the development of multi-omics analyses but also enabled the recapitulation of TME in vitro microfluidic system, which made these devices attractive across studies for optimization of immunotherapy. Here, we reviewed the application of microfluidic systems in modeling TME and the potential of these devices in predicting and monitoring immunotherapy effects.

The Future of Biomarkers in Veterinary Medicine: Emerging Approaches and Associated Challenges

Simple Summary

In this review we seek to outline the role of new technologies in biomarker discovery, particularly within the veterinary field and with an emphasis on ‘omics’, as well as to examine why many biomarkers-despite much excitement-have not yet made it to clinical practice. Further we emphasise the critical need for close collaboration between clinicians, researchers and funding bodies and the need to set clear goals for biomarker requirements and realistic application in the clinical setting, ensuring that biomarker type, method of detection and clinical utility are compatible, and adequate funding, time and sample size are available for all phases of development.

Abstract

New biomarkers promise to transform veterinary practice through rapid diagnosis of diseases, effective monitoring of animal health and improved welfare and production efficiency. However, the road from biomarker discovery to translation is not always straightforward. This review focuses on molecular biomarkers under development in the veterinary field, introduces the emerging technological approaches transforming this space and the role of ‘omics platforms in novel biomarker discovery. The vast majority of veterinary biomarkers are at preliminary stages of development and not yet ready to be deployed into clinical translation. Hence, we examine the major challenges encountered in the process of biomarker development from discovery, through validation and translation to clinical practice, including the hurdles specific to veterinary practice and to each of the ‘omics platforms–transcriptomics, proteomics, lipidomics and metabolomics. Finally, recommendations are made for the planning and execution of biomarker studies with a view to assisting the success of novel biomarkers in reaching their full potential.

Pillar-structured 3D inlets fabricated by dose-modulated e-beam lithography and nanoimprinting for DNA analysis in passive, clogging-free, nanofluidic devices

We present the fabrication of three-dimensional inlets with gradually decreasing widths and depths and with nanopillars on the slope, all defined in just one lithography step. In addition, as an application, we show how these micro- and nanostructures can be used for micro- and nanofluidics and lab-on-a-chip devices to facilitate the flow and analyze single molecules of DNA. For the fabrication of 3D inlets in a single layer process, dose-modulated electron beam lithography was used, producing depths between 750 nm and 50 nm along a 30 μm long inlet, which is additionally structured with nanometer-scale pillars randomly distributed on top, as a result of incomplete exposure and underdevelopment of the resist. The fabrication conditions affect the slope of the inlet, the nanopillar density and coverage. The key parameters are the dose used for the electron beam exposure and the development conditions, like the developer's dilution, stirring and development time. The 3D inlets with nanostructured pillars were integrated into fluidic devices, acting as a transition between micro and nanofluidic structures for pre-stretching and unfolding DNA molecules, avoiding the intrusion of folded molecules and clogging the analysis channel. After patterning these structures in silicon, they can be replicated in polymer by UV nanoimprinting. We show here how the inlets with pillars slow down the molecules before they enter the nanochannels, resulting in a 3-fold decrease in speed, which would translate to an improvement in the resolution for DNA optical mapping.

CunO/Au heterostructure dendrimer anchored on Cu foam as dual functional catalytic nanozyme for glucose sensing by enzyme mimic cascade reaction

Multifunctional catalytic performance plays a crucial role in bio-applications through the diversity and durability of artificial nanozymes. An effective synergy with sufficient accessible active sites and high specific surface area is a challenge for composite catalysts, especially to avoid uncontrollable aggregation and structural instability. Here, we fabricated a Cu_nO/Au heterostructure dendrimer on copper foam (Cu_nO/Au HD/CF) as dual functional catalytic nanozyme to achieve enzyme mimic cascade reactions for efficient colorimetric analysis. A highly porous CF skeleton-based CuO nanowire array (CuO NWA) with a large specific surface area supported an efficient load capacity to assemble sufficient Cu_nO/Au HD by electrodeposition. The bimetallic Au-Cu nanozyme successfully achieved an oxidase-like and peroxidase-like cascade catalysis by a target-responsive sensing mechanism. Due to the confirmed catalytic performance of selectivity, anti-interference ability, and reproducibility, a Cu_nO/Au HD/CF-based quantitative analytical method was developed for glucose detection with a wide linear range and considerable detection limit of 8.4 μM. The robust nonenzymatic catalytic strategy for colorimetric detection not only confirmed the dual functional catalytic activity of Cu_nO/Au HD/CF, but also showed great potential for applications in clinical diagnostics and biochemical analysis.

Sensor System Based on a Piezoelectric Resonator with a Lateral Electric Field for Virus Diagnostics

A sensor system based on a piezoelectric resonator with a lateral electric field in the frequency range 6-7 MHz of the electric field for virus detection is described. Through use of the transmissible virus causing gastroenteritis in pigs and specific antibodies, the possibility of detecting the virus in suspension in real time was determined. It was found that the frequency dependence of the real and imaginary parts of the electrical impedance of such a resonator loaded with a virus suspension changes significantly after the addition of specific antibodies to the suspension. No changes are observed if the antibodies are not specific. Thus, the results obtained illustrate the possibility of detecting viruses in situ, directly in the liquid phase, if the change in the real or imaginary parts of the electrical impedance after the addition of antibodies is used as an analytical signal. The possibility of virus detection in the presence of foreign viral particles has been illustrated.

Laser-patterned paper-based flow-through filters and lateral flow immunoassays to enable the detection of C-reactive protein

We report the use of a laser-based fabrication process in the creation of paper-based flow-through filters that when combined with a traditional lateral flow immunoassay provide an alternative pathway for the detection of a pre-determined analyte over a wide concentration range. The laser-patterned approach was used to create polymeric structures that alter the porosity of the paper to produce porous flow-through filters, with controllable levels of porosity. When located on the top of the front end of a lateral flow immunoassay the flow-through filters were shown to block particles (of known sizes of 200 nm, 500 nm, 1000 nm and 3000 nm) that exceed the effective pore size of the filter while allowing smaller particles to flow through onto a lateral flow immunoassay. The analyte detection is based on the use of a size-exclusive filter that retains a complex (∼3 μm in size) formed by the binding of the target analyte with two antibodies each of which is tagged with different-sized labels (40 nm Au-nanoparticles and 3 μm latex beads), and which is larger than the effective pore size of the filter. This method was tested for the detection of C-reactive protein in a broad concentration range from 10 ng/ml to 100,000 ng/ml with a limit-of-detection found at 13 ng/ml and unlike other reported methods used for analyte detection, with this technique we are able to counter the Hook effect which is a limiting factor in many lateral flow immunoassays.

A sample-to-answer electrochemical biosensor system for biomarker detection

Biomarker detection is critical for the diagnosis and treatment of numerous diseases. Typically, target biomarkers in blood samples are measured through tests conducted at centralized laboratories. Testing at central laboratories increases wait times for results, in turn increasing healthcare costs and negatively impacting patient outcomes. Alternatively, point-of-care platforms enable the rapid measurement of biomarkers, expand testing location capabilities and mitigate manual processing steps through integration and automation. However, many of these systems focus on sample detection rather than the equally important sample preparation. Here we present a fully integrated and automated sample-to-answer electrochemical biosensing platform which incorporates each aspect of the biomarker testing workflow from blood collection to sample preparation to assay operation and readout. The system combines a commercial microneedle blood sampling device with membrane-based plasma filtration upstream of a bead-based electrochemical immunoassay. We characterize the high separation efficiency (>99%) and low non-specific binding of the whole blood-to-plasma filtration membrane under a range of operating conditions. We demonstrate a full sample-to-answer workflow through the analysis of interlukin-6-spiked blood samples.

A Smartphone-Based Detection Method of Colloidal Gold Immunochromatographic Strip

The outbreak of the new coronavirus (SARS-CoV-2) infection has become a global public health crisis. Antigen detection strips (colloidal gold) can be widely used in novel coronavirus clinical screening and can even be extended to home self-testing, which provides a practical and effective way for people to obtain health status information away from the crowd. In this paper, a colloidal gold detection system without complex devices is proposed, which is based on smartphone usage along with a mobile-phone software embedded with normalization algorithms and a special designed background paper. The basic principle of the device relies on image processing. First, the data of the green channel of the image captured by a smartphone are selected to be processed. Second, the calibration curves are established using standard black and white card, and the calibration values under different detection environments are obtained by calibration curves. Finally, to verify the validity of the proposed method, various standard solutions with different concentrations are tested. Results show that this method can eliminate the influence of different environments on the test results, the test results in different detection environments have good stability and the variation coefficients are less than 5%. It fully proves that the detection system designed in this paper can detect the result of colloidal gold immunochromatographic strip in time, conveniently and accurately in different environments.

Quantitative particle agglutination assay for point-of-care testing using mobile holographic imaging and deep learning

Particle agglutination assays are widely adopted immunological tests that are based on antigen-antibody interactions. Antibody-coated microscopic particles are mixed with a test sample that potentially contains the target antigen, as a result of which the particles form clusters, with a size that is a function of the antigen concentration and the reaction time. Here, we present a quantitative particle agglutination assay that combines mobile lens-free microscopy and deep learning for rapidly measuring the concentration of a target analyte; as its proof-of-concept, we demonstrate high-sensitivity C-reactive protein (hs-CRP) testing using human serum samples. A dual-channel capillary lateral flow device is designed to host the agglutination reaction using 4 μL of serum sample with a material cost of 1.79 cents per test. A mobile lens-free microscope records time-lapsed inline holograms of the lateral flow device, monitoring the agglutination process over 3 min. These captured holograms are processed, and at each frame the number and area of the particle clusters are automatically extracted and fed into shallow neural networks to predict the CRP concentration. 189 measurements using 88 unique patient serum samples were utilized to train, validate and blindly test our platform, which matched the corresponding ground truth concentrations in the hs-CRP range (0-10 μg mL^-1) with an R² value of 0.912. This computational sensing platform was also able to successfully differentiate very high CRP concentrations (e.g., >10-500 μg mL^-1) from the hs-CRP range. This mobile, cost-effective and quantitative particle agglutination assay can be useful for various point-of-care sensing needs and global health related applications.

A Pencil-Drawn Electronic Tongue for Environmental Applications

We report on the development of a simple and cost-effective potentiometric sensor array that is based on manual “drawing” on the polymeric support with the pencils composed of graphite and different types of zeolites. The sensor array demonstrates distinct sensitivity towards a variety of inorganic ions in aqueous media. This multisensor system has been successfully applied to quantitative analysis of 100 real-life surface waters sampled in Mahananda and Hooghly rivers in the West Bengal state (India). Partial least squares regression has been utilized to relate responses of the sensors to the values of different water quality parameters. It has been found that the developed sensor array, or electronic tongue, is capable of quantifying total hardness, total alkalinity, and calcium content in the samples, with the mean relative errors below 18%.

Diagnosing point-of-care diagnostics for neglected tropical diseases

Inadequate and nonintegrated diagnostics are the Achilles' heel of global efforts to monitor, control, and eradicate neglected tropical diseases (NTDs). While treatment is often available, NTDs are endemic among marginalized populations, due to the unavailability or inadequacy of diagnostic tests that cause empirical misdiagnoses. The need of the hour is early diagnosis at the point-of-care (PoC) of NTD patients. Here, we review the status quo of PoC diagnostic tests and practices for all of the 24 NTDs identified in the World Health Organization's (WHO) 2021-2030 roadmap, based on their different diagnostic requirements. We discuss the capabilities and shortcomings of current diagnostic tests, identify diagnostic needs, and formulate prerequisites of relevant PoC tests. Next to technical requirements, we stress the importance of availability and awareness programs for establishing PoC tests that fit endemic resource-limited settings. Better understanding of NTD diagnostics will pave the path for setting realistic goals for healthcare in areas with minimal resources, thereby alleviating the global healthcare burden.

Numerical Modeling for Sensitive and Rapid Molecular Detection by Membrane-Based Immunosensors

Rapid, simple, and sensitive point-of-care testing (POCT) has attracted attention in recent years due to its excellent potential for early disease diagnosis and health monitoring. The flow-through biosensor design is a candidate for POCT that utilizes the small-sized pores of a porous membrane as a recognition space where it emits a signal comparable to that of a conventional enzyme-linked immunosorbent assay within 35 min of detection time. In this paper, we present a numerical model for this immunosensing technology to systematically design an improved recognition system. The model considers mass transfer into the pore (convection and diffusion), the kinetics between the immobilized receptor and the target molecule, and the flow conditions, successfully leading to a bottleneck step (capture of secondary antibody) in sandwich-type detection. Our simulation results also show that this problem can be solved by adopting both appropriate receptors and analytical conditions. Eventually, the requirements to achieve the sensitivity required for POCT were fulfilled, which will allow for further development of immunosensing devices for disease detection.

COVID-19: A review and considerations for the resumption of activities in an IVF laboratory and clinic in Brazil

COVID-19 has caused radical effects on the daily lives of millions of people. The causal agent of the current pandemic is SARS-CoV-2, a virus that causes symptoms related to the respiratory system, leading to severe complications. In the in vitro fertilization (IVF) universe, there are several protocols for infection control and laboratory safety. Some professional associations have issued guidelines recommending measures involving patient flow and IVF practices. This study presents a review and considerations for the resumption of activities in IVF laboratories and clinics in Brazil during the COVID-19 pandemic, according to the guidelines and statements from professional organizations and societies in reproductive medicine.

A novel microfluidic system for the sensitive and cost-effective detection of okadaic acid in mussels

Okadaic acid (OA) is produced by marine dinoflagellates and it can be easily accumulated in shellfish, causing intoxications when consumed by humans. Consequently, there is a need for sensitive, reliable and cost-effective methods to detect OA in real samples. In this work, we developed a novel and affordable microfluidic system to detect OA based on the protein phosphatase 1 inhibition colorimetric assay. This enzyme was immobilized in a microfluidic chamber by physisorption in an alumina sol-gel. The results show good enzyme stability over time when maintained at 4 °C. The developed system was sensitive for OA standard solutions, presenting a limit of detection (LOD) of 11.6 nM over a large linear range (43.4 to 3095.8 nM). Our method revealed an LOD as low as 0.2 μg kg-1 and a linear range between 1.47 and 506 μg kg-1 for extracted mussel matrix, detecting OA concentrations in contaminated mussels much lower than the regulated limit (160 μg kg-1). The enzyme stability and reusability along with the simplicity and low cost associated with microfluidics systems make this method very interesting from a commercial point of view.

3D-Printed Immunosensor Arrays for Cancer Diagnostics

Detecting cancer at an early stage of disease progression promises better treatment outcomes and longer lifespans for cancer survivors. Research has been directed towards the development of accessible and highly sensitive cancer diagnostic tools, many of which rely on protein biomarkers and biomarker panels which are overexpressed in body fluids and associated with different types of cancer. Protein biomarker detection for point-of-care (POC) use requires the development of sensitive, noninvasive liquid biopsy cancer diagnostics that overcome the limitations and low sensitivities associated with current dependence upon imaging and invasive biopsies. Among many endeavors to produce user-friendly, semi-automated, and sensitive protein biomarker sensors, 3D printing is rapidly becoming an important contemporary tool for achieving these goals. Supported by the widely available selection of affordable desktop 3D printers and diverse printing options, 3D printing is becoming a standard tool for developing low-cost immunosensors that can also be used to make final commercial products. In the last few years, 3D printing platforms have been used to produce complex sensor devices with high resolution, tailored towards researchers’ and clinicians’ needs and limited only by their imagination. Unlike traditional subtractive manufacturing, 3D printing, also known as additive manufacturing, has drastically reduced the time of sensor and sensor array development while offering excellent sensitivity at a fraction of the cost of conventional technologies such as photolithography. In this review, we offer a comprehensive description of 3D printing techniques commonly used to develop immunosensors, arrays, and microfluidic arrays. In addition, recent applications utilizing 3D printing in immunosensors integrated with different signal transduction strategies are described. These applications include electrochemical, chemiluminescent (CL), and electrochemiluminescent (ECL) 3D-printed immunosensors. Finally, we discuss current challenges and limitations associated with available 3D printing technology and future directions of this field.

White blood cell counting at point-of-care testing: A review

White blood cells, which are also called leukocytes, are found in the immune system that are involved in protecting the body against infections and foreign invaders. Conventional methods of leukocyte analysis provide valuable and accurate information to medical specialists. Analyzing and diagnosing of a disease requires a combination of multiple biomarkers, in some cases, however, such as personal health care, this will occupy some medical resources and causes unnecessary consumption. Traditional method (such as flow cytometer) for WBC counting is time and labor consuming. Compared to gold standard (flow-based fraction/micropore filtration) or improved filtration methods for WBC counting, this is still a lengthy and time consuming process and can lead to membrane fouling due to the rapid accumulation of biological materials. Therefore, the analysis of WBC counts requires more compact and efficient equipment. The microfluidic technologies, powered by different field (force, thermal, acoustic, optical, magnetic) and other methods for leukocyte counting and analysis, are much cost-efficient and can be used in in-home or in resource-limited areas to achieve Point-of-Care (POC). In this review, we highlight the mainstream devices that have been commercialized and extensively employed for patients for WBC counting, Next, we present some recent development with regards to leucocyte counting (mainly microfluidic technologies) and comment on their relative merits. We aim to focus and discuss the possibility of achieving POC and help researchers to tackle individual challenges accordingly. Finally, we offer some technologies in addition to previous detection devices, such as image recognition technology and cloud computing, which we believe have great potential to further promote real-time detection and improve medical diagnosis.

A novel split mode TFBAR device for quantitative measurements of prostate specific antigen in a small sample of whole blood

Easy monitoring of prostate specific antigen (PSA) directly from blood samples would present a significant improvement as compared to conventional diagnostic methods. In this work, a split mode thin film bulk acoustic resonator (TFBAR) device was employed for the first time for label-free measurements of PSA concentrations in the whole blood and without sample pre-treatment. The surface of the sensor was covalently modified with anti-PSA antibodies and demonstrated a very high sensitivity of 101 kHz mL ng^-1 and low limit of detection (LOD) of 0.34 ng mL^-1 in model spiked solutions. It has previously been widely believed that significant pre-processing of blood samples would be required for TFBAR biosensors. Importantly, this work demonstrates that this is not the case, and TFBAR technology provides a cost-effective means for point-of-care (POC) diagnostics and monitoring of PSA in hospitals and in doctors' offices. Additionally, the accuracy of the developed biosensor, with respect to a commercial auto analyser (Beckman Coulter Access), was evaluated to analyse clinical samples, giving well-matched results between the two methods, thus showing a practical application in quantitative monitoring of PSA levels in the whole blood with very good signal recovery.

Improving the limit of detection in portable luminescent assay readers through smart optical design

Critical biomarkers of disease are increasingly being detected by point-of-care assays. Chemiluminescence (CL) and electrochemiluminescence (ECL) are often used in such assays due to their convenience and that they do not require light sources or other components that could complicate or add cost to the system. Reports of these assays often include readers built on a cellphone platform or constructed from low-cost components. However, the impact the optical design has on the limit of detection (LOD) in these systems remains unexamined. Here, we report a theoretical rubric to evaluate different optical designs in terms of maximizing the use of photons emitted from a CL or ECL assay to improve the LOD. We demonstrate that the majority of cellphone designs reported in the literature are not optimized, in part due to misunderstandings of the optical tradeoffs in collection systems, and in part due to limitations imposed on the designs arising from the use of a mobile phone with a very small lens aperture. Based on the theoretical rubric, we design a new portable reader built using off-the-shelf condenser optics, and demonstrate a nearly 10× performance enhancement compared to prior reports on an ECL assays running on a portable chip.

An Integrated Portable Multiplex Microchip Device for Fingerprinting Chemical Warfare Agents

The rapid and reliable detection of chemical and biological agents in the field is important for many applications such as national security, environmental monitoring, infectious diseases screening, and so on. Current commercially available devices may suffer from low field deployability, specificity, and reproducibility, as well as a high false alarm rate. This paper reports the development of a portable lab-on-a-chip device that could address these issues. The device integrates a polymer multiplexed microchip system, a contactless conductivity detector, a data acquisition and signal processing system, and a graphic/user interface. The samples are pre-treated by an on-chip capillary electrophoresis system. The separated analytes are detected by conductivity-based microsensors. Extensive studies are carried out to achieve satisfactory reproducibility of the microchip system. Chemical warfare agents soman (GD), sarin (GB), O-ethyl S-[2-diisoproylaminoethyl] methylphsophonothioate (VX), and their degradation products have been tested on the device. It was demonstrated that the device can fingerprint the tested chemical warfare agents. In addition, the detection of ricin and metal ions in water samples was demonstrated. Such a device could be used for the rapid and sensitive on-site detection of both chemical and biological agents in the future.

Use of an electro-optical sensor and phage antibodies for immunodetection of Herbaspirillum

A sheep single-chain antibody-fragment library (Griffin.1, UK) was used to obtain miniantibodies to the lipopolysaccharide of Herbaspirillum seropedicae Z78. Using electro-optical analysis and electron microscopy, we recorded a biospecific interaction of antigenic determinants on the cell surface with phage antibodies against the LPS of H. seropedicae Z78 (mini-Abs_LPS). Control experiments were run to rule out nonspecific binding of the mini-Abs_LPS to cells of Azospirillum brasilense Sp245. Use of the highly specific mini-Abs_LPS enabled the lipopolysaccharide of H. seropedicae Z78 to be detected in a mixture of bacterial cells by electro-optical means (analysis time, ∼5 min). This report is the first to show the possibility of rapid detection of Herbaspirillum on the basis of electro-optical analysis coupled with the use of mini-Abs_LPS. The results are promising for the development of biosensor-based methods to detect potentially human-harmful prokaryotes whose structures either have not been studied or are absent from commercial databases.

Single-point calibration and standard addition assays on calibrant-loaded paper-based analytical devices

This article describes a new, simplified approach for performing quantitative colorimetric assays on paper-based analytical devices that uses calibrant-loaded paper devices to perform external calibration and standard addition calibration using one calibration point. Calibrant-loaded devices consist of sensing areas pre-loaded with a colored product which is produced from the reaction of a standard solution of the analyte with the appropriate colorimetric reagents. When the sample is added into the calibrant-loaded sensing zone the analytical signal (i.e. color intensity) increases proportionally to the concentration of the analyte in the tested sample. The total measured signal corresponds to the sum of the concentration of the analyte in the sample and the standard solution pre-stored in the device and is used to calculate the concentration of the analyte in the sample based on the principles of linear calibration. The applicability of this approach was benchmarked in three colorimetric assays (i.e., for the determination of iron, nickel, and amino acids) that use different reaction chemistries. This work demonstrates a simplified calibration-free approach for assays performed on paper-based analytical devices that requires minimum experimental and computational effort, it can be used for either external or standard addition calibration and can be used to identify and eliminate the presence of interferences in a sample.

Recent advances in immunodiagnostics based on biosensor technologies-from central laboratory to the point of care

Immunological methods are widely applied in medical diagnostics for the detection and quantification of a plethora of analytes. Associated analytical challenges usually require these assays to be performed in a central laboratory. During the last several years, however, the clinical demand for rapid immunodiagnostics to be performed in the immediate proximity of the patient has been constantly increasing. Biosensors constitute one of the key technologies enabling the necessary, yet challenging transition of immunodiagnostic tests from the central laboratory to the point of care. This review is intended to provide insights into the current state of this transition process with a focus on the role of biosensor-based systems. To begin with, an overview on standard immunodiagnostic tests presently employed in the central laboratory and at the point of care is given. The review then moves on to demonstrate how biosensor technologies are reshaping this landscape. Single analyte as well as multiplexed immunosensors applicable to point of care scenarios are presented. A section on the areas of clinical application then creates the bridge to day-to-day diagnostic practice. Finally, the depicted developments are critically weighed and future perspectives discussed in order to give the reader a firm idea on the forthcoming trends to be expected in this diagnostic field.

Investigation of Issues for the Accurate and Precise Measurement of an Analyte Using Surface-Enhanced Raman Scattering (SERS)

This paper builds on an earlier examination of the influence of sampling size and analyte surface density on the accuracy and precision of measurements using surface-enhanced Raman scattering (SERS) to read out heterogeneous immunoassays. Quantitation using SERS typically relies on interrogating a small area on the sample surface by using a micrometer-sized laser spot for signal generation. The information obtained using such a small portion of sample is then projected as being representative of the much larger sample, which can compromise the accuracy and precision of the measurement due to undersampling. For a heterogeneous immunoassay interrogated by SERS, quantitation is, therefore, sensitive to the size of the analyzed area and the surface density of the measured analyte. To identify conditions in which sampling error poses a threat to accuracy and precision, a simulation of a SERS immunoassay was developed and compared to experimental results. The simulation randomly distributes adsorbates across the capture surface and then measures the density of adsorbates inside areas of analysis of different sizes. This approach mimics the analysis of a heterogeneous immunoassay when using a Raman microscope with different laser spot sizes. The results of the simulations, which were confirmed experimentally by comparison to an immunoassay of human immunoglobulin G (IgG) show that the accuracy and precision of the measurement improved with larger analysis areas and higher analyte concentrations due to the increased apparent homogeneity of the analyte within the area of analysis. By imposing a threshold on precision (5%), we also begin to establish a framework for the parameters necessary to achieve reliable quantitative measurements (e.g., laser spot size, analyte concentration, and sample volume).

Three-dimensional origami paper-based device for portable immunoassay applications

In this study, we demonstrate a three-dimensional surface-modified origami-paper-based analytical device (3D-soPAD) for immunoassay applications. The platform enables the sequential steps of immunoassays to be easily performed using a folded, sliding paper design featuring multiple pre-stored reagents, allowing us to take advantage of the vertical diffusion of the analyte through the different paper layers. The cellulose substrate is composed of carboxymethyl cellulose modified with N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride and N-hydroxysuccinimide, which provide covalent bonding sites for bio-recognition molecules. After the optimization of the operation parameters, we determined the detection limit of the 3D-soPAD for human immunoglobulin G (HIgG) which can be as low as 0.01 ng mL-1, with a total turnaround time of 7 min. In order to study the long-term storage of the platform, anti-HIgG horseradish peroxidase (aHIgG-HRP) conjugates were stored by freeze-drying in sugar matrices composed of 10% sucrose/10% trehalose (w/w%) on the paper device, retaining 80% of their activity after 75 days of storage at 4 °C. To evaluate the performance of the paper device using real samples, we demonstrated the detection of protein A (a biomarker for Staphylococcus aureus infection) in highly viscous human synovial fluid. These results show that the proposed 3D-soPAD platform can provide sensitive, high-throughput, and on-site prognosis of infection in resource-limited settings.

Improvement in the Reproducibility of a Paper-based Analytical Device (PAD) Using Stable Covalent Binding between Proteins and Cellulose Paper

Paper-based analytical devices (PADs) have been widely used in many fields because they are affordable and portable. For reproducible quantitative analysis, it is crucial to strongly immobilize proteins on PADs. Conventional techniques for immobilizing proteins on PADs are based on physical adsorption, but proteins can be easily removed by weak physical forces. Therefore, it is difficult to ensure the reproducibility of the analytical results of PADs using physical adsorption. To overcome this limitation, in this study, we showed a method of covalent binding of proteins to cellulose paper. This method consists of three steps, which include periodate oxidation of paper, the formation of a Schiff base, and reductive amination. We identified aldehyde and imine groups formed on paper using FT-IR analysis. This covalent bonding approach enhanced the binding force and binding capacity of proteins. We confirmed the activity of an immobilized antibody through a sandwich immunoassay. We expect that this immobilization method will contribute to the commercialization of PADs with high reproducibility and sensitivity.

Rapid Quantitative Fluorescence Detection of Copper Ions with Disposable Microcapsule Arrays Utilizing Functional Nucleic Acid Strategy

In this work, an economical and easy-to-use microcapsule array fabricated by ice printing technique has been realized for ultrasensitive fluorescence quantification of copper ions employing functional nucleic acid strategy. With ice printing, the detection reagents are sealed by polystyrene (PS) film isolation and photopolymer, which guarantees a stable and contamination-free environment for functional nucleic acid reaction. Our microcapsule arrays have shown long-term stability (20 days) under -20 °C storage in frozen form before use. During the Cu²⁺ on-site detection, 1 μL sample is simply injected into the thawy microcapsule by a microliter syringe under room temperature, and after 20 minutes the fluorescence result can be obtained by an LED transilluminator. This method can realize the detection limit to 100 nM (100 fmol/μL) with high specificity.

Recent advances in and potential utilities of paper-based electrochemical sensors: beyond qualitative analysis

Paper based electrochemical sensors (PESs) are simple, low-cost, portable and disposable analytical sensing platforms that can be applied in clinical diagnostics, food quality control and environmental monitoring.

A Proof-of-Concept of Label-Free Biosensing System for Food Allergy Diagnostics in Biophotonic Sensing Cells: Performance Comparison with ImmunoCAP

Food allergy is a common disease worldwide with over 6% of the population (200⁻250 million people) suffering from any food allergy nowadays. The most dramatic increase seems to be happening in children and young people. Therefore, improvements in the diagnosis efficiency of these diseases are needed. Immunoglobulin type E (IgE) biomarker determination in human serum is a typical in vitro test for allergy identification. In this work, we used a novel biosensor based on label-free photonic transducers called BICELLs (Biophotonic Sensing Cells) for IgE detection. These BICELLs have a thin film of nitrocellulose over the sensing surface, they can be vertical optically interrogated, and are suitable for being integrated on a chip. The BICELLs sensing surface sizes used were 100 and 800 µm in diameter. We obtained calibration curves with IgE standards by immobilizating anti-IgE antibodies and identified with standard IgE calibrators in minute sample amounts (3 µL). The results, in similar assay format, were compared with commercially available ImmunoCAP^®. The versatility of the interferometric nitrocellulose-based sensing surface was demonstrated since the limit of detections for BICELLs and ImmunoCAP^® were 0.7 and 0.35 kU/L, respectively.

Microparticle-based platform for point-of-care immunoassays

There is a need for quantitative and sensitive, yet simple point-of-care immunoassays. We have developed a point-of-care microparticle-based immunoassay platform which combines the performance of a microtiter well-based assay with the usability of a rapid assay. The platform contained a separate reaction and detection chambers and microparticles for the solid-phase. Photoluminescent up-converting nanoparticles (UCNPs) were used as labels. The platform was tested with a cardiac troponin I assay, and a limit of detection of 19.7 ng/L was obtained. This study demonstrates the feasibility of developing point-of-care assays on the new platform for various analytes of interests.

Theoretical and Experimental Comparison of Different Formats of Immunochromatographic Serodiagnostics

In this study, a comparative theoretical and experimental analysis of two immuno-chromatographic serodiagnostics schemes, which differ in the immobilization of immunoreagents and the order of the formation of immune complexes, is performed. Based on the theoretical models, the assays are characterized to determine which scheme has a higher quantity of the detected complex and thus ensures the sensitivity of the analysis. The results show that for the effective detection of low-affinity antibodies, the scheme involving the immobilization of the antigen on gold nanoparticles and the antibody-binding protein on the test strip was more sensitive than the predominantly used scheme, which inverts the immunoreagents’ locations. The theoretical predictions were confirmed by the experimental testing of sera collected from tuberculosis patients.

New Architecture for Reagentless, Protein-Based Electrochemical Biosensors

Here we demonstrate a new class of reagentless, single-step sensors for the detection of proteins and peptides that is the electrochemical analog of fluorescence polarization (fluorescence anisotropy), a versatile optical approach widely employed to this same end. Our electrochemical sensors consist of a redox-reporter-modified protein (the "receptor") site-specifically anchored to an electrode via a short, flexible polypeptide linker. Interaction of the receptor with its binding partner alters the efficiency with which the reporter approaches the electrode surface, thus causing a change in redox current upon voltammetric interrogation. As our first proof-of-principle we employed the bacterial chemotaxis protein CheY as our receptor. Interaction with either of CheY's two binding partners, the P2 domain of the chemotaxis kinase, CheA, or the 16-residue "target region" of the flagellar switch protein, FliM, leads to easily measurable changes in output current that trace Langmuir isotherms within error of those seen in solution. Phosphorylation of the electrode-bound CheY decreases its affinity for CheA-P2 and enhances its affinity for FliM in a manner likewise consistent with its behavior in solution. As expected given the proposed sensor signaling mechanism, the magnitude of the binding-induced signal change depends on the placement of the redox reporter on the receptor. Following these preliminary studies with CheY, we also developed and characterized additional sensors aimed at the detection of specific antibodies using the relevant protein antigens as the receptor. These exhibit excellent detection limits for their targets without the use of reagents or wash steps. This novel, protein-based electrochemical sensing architecture provides a new and potentially promising approach to sensors for the single-step measurement of specific proteins and peptides.

High-sensitivity detection of cardiac troponin I with UV LED excitation for use in point-of-care immunoassay

High-sensitivity cardiac troponin assay development enables determination of biological variation in healthy populations, more accurate interpretation of clinical results and points towards earlier diagnosis and rule-out of acute myocardial infarction. In this paper, we report on preliminary tests of an immunoassay analyzer employing an optimized LED excitation to measure on a standard troponin I and a novel research high-sensitivity troponin I assay. The limit of detection is improved by factor of 5 for standard troponin I and by factor of 3 for a research high-sensitivity troponin I assay, compared to the flash lamp excitation. The obtained limit of detection was 0.22 ng/L measured on plasma with the research high-sensitivity troponin I assay and 1.9 ng/L measured on tris-saline-azide buffer containing bovine serum albumin with the standard troponin I assay. We discuss the optimization of time-resolved detection of lanthanide fluorescence based on the time constants of the system and analyze the background and noise sources in a heterogeneous fluoroimmunoassay. We determine the limiting factors and their impact on the measurement performance. The suggested model can be generally applied to fluoroimmunoassays employing the dry-cup concept.

Surface-enhanced Raman spectroscopy competitive binding biosensor development utilizing surface modification of silver nanocubes and a citrulline aptamer

A point-of-care (PoC) device with the ability to detect biomarkers at low concentrations in bodily fluids would have an enormous potential for medical diagnostics outside the central laboratory. One method to monitor analytes at low concentrations is by using surface-enhanced Raman spectroscopy (SERS). In this preliminary study toward using SERS for PoC biosensing, the surface of colloidal silver (Ag) nanocubes has been modified to test the feasibility of a competitive binding SERS assay utilizing aptamers against citrulline. Specifically, Ag nanocubes were functionalized with mercaptobenzoic acid, as well as a heterobifunctional polyethylene glycol linker that forms an amide bond with the amino acid citrulline. After the functionalization, the nanocubes were characterized by zeta-potential, transmission electron microscopy images, ultraviolet/visible spectroscopy, and by SERS. The citrulline aptamers were developed and tested using backscattering interferometry. The data show that our surface modification method does work and that the functionalized nanoparticles can be detected using SERS down to a 24.5 picomolar level. Last, we used microscale thermophoresis to show that the aptamers bind to citrulline with at least a 50 times stronger affinity than other amino acids. Download PDF SAVE FOR LATER