Molecularly Imprinted Polymer/Anodic Aluminum Oxide Nanocomposite Sensing Electrode for Low-Concentration Troponin T Detection for Patient Monitoring Applications

Trends in ready-to-use portable electrochemical sensing devices for healthcare diagnosis

Compared with previous decades, healthcare has emerged as a key global concern in light of the recurrent outbreak of pandemics. The initial stage in the provision of healthcare involves the process of diagnosis. Countries worldwide advocate for healthcare research due to its efficacy and capacity to assist diverse populations. Enhanced levels of healthcare management can be attained by the implementation of rapid diagnostic procedures and cognitive data analysis. Therefore, there is a constant need for smart therapeutics, analytical tools, and diagnostic systems to improve health and well-being. The past decade witnessed enormous growth in the sensing detection systems integrated into smartphones with printed electrodes and wearable patches for the screening of various healthcare diagnostics biomarkers and therapeutic drugs. This review focuses on the expansion of point-of-care technologies and their incorporation into a broader array of portable devices, a critical aspect in the context of decentralized societies and their healthcare systems. Discussions are broadly focused on the different sensing platforms such as solid electrodes, screen-printed electrodes, and paper-based sensing strategies for the detection of various biomarkers and therapeutic drugs. We also discuss the next-generation healthcare wearable sensing device importance and future research possibilities. Finally, the portable electrochemical sensing devices and their future perspective developments towards healthcare diagnosis are critically summarized.

Molecularly imprinted polymer sensors for biomarker detection in cardiovascular diseases

Cardiovascular diseases (CVDs) are recognized as a significant threat to global health. The rapid, sensitive, and precise measurement of relevant biomarkers is essential for the timely diagnosis of CVDs. Molecularly imprinted polymers (MIPs), which act as artificial receptor recognition materials, have been extensively utilized in the detection of CVD biomarkers. Their widespread application is due to their cost-effectiveness, physical and chemical stability, straightforward preparation processes, and excellent compatibility with various sensor types. This review introduces the principles of MIP sensors in combination with electrochemical, optical, thermal transfer, and acoustic detection techniques for detecting CVD-related biomarkers. It then discusses methods developed over the past decade for detecting biomarkers of three major CVDs-coronary artery disease (CAD), acute myocardial infarction (AMI), and heart failure (HF)-using MIP sensors. Finally, the review summarizes the potential of MIP sensors in CVD biomarker detection and provides an outlook on future research directions.

Signal amplification in molecular sensing by imprinted polymers

In the field of sensing, the development of sensors with high sensitivity, accuracy, selectivity, sustainability, simplicity, and low cost remains a key focus. Over the past decades, optical and electrochemical sensors based on molecular imprinting techniques have garnered significant attention due to the above advantages. Molecular imprinting technology utilizes molecularly imprinted polymers (MIPs) to mimic the specific recognition capabilities of enzymes or antibodies for target molecules. Recently, MIP-based sensors rooting in signal amplification techniques have been employed to enhance molecular detection level and the quantitative ability for environmental pollutants, biomolecules, therapeutic compounds, bacteria, and viruses. The signal amplification techniques involved in MIP-based sensors mainly cover nucleic acid chain amplification, enzyme-catalyzed cascade, introduction of high-performance nanomaterials, and rapid chemical reactions. The amplified analytical signals are centered around electrochemical, fluorescence, colorimetric, and surface-enhanced Raman techniques, which can effectively realize the determination of some low-abundance targets in biological samples. This review highlights the recent advancements of electrochemical/optical sensors based on molecular imprinting integrated with various signal amplification strategies and their dedication to the study of trace biomolecules. Finally, future research directions on developing multidimensional output signals of MIP-based sensors and introducing multiple signal amplification strategies are proposed.

Advances in heart failure monitoring: Biosensors targeting molecular markers in peripheral bio-fluids

Cardiovascular diseases (CVDs), especially chronic heart failure, threaten many patients' lives worldwide. Because of its slow course and complex causes, its clinical screening, diagnosis, and prognosis are essential challenges. Clinical biomarkers and biosensor technologies can rapidly screen and diagnose. Multiple types of biomarkers are employed for screening purposes, precise diagnosis, and treatment follow-up. This article provides an up-to-date overview of the biomarkers associated with the six main heart failure etiology pathways. Plasma natriuretic peptides (BNP and NT-proBNP) and cardiac troponins (cTnT, cTnl) are still analyzed as gold-standard markers for heart failure. Other complementary biomarkers include growth differentiation factor 15 (GDF-15), circulating Galactose Lectin 3 (Gal-3), soluble interleukin (sST2), C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α). For these biomarkers, the electrochemical biosensors have exhibited sufficient sensitivity, detection limit, and specificity. This review systematically summarizes the latest molecular biomarkers and sensors for heart failure, which will provide comprehensive and cutting-edge authoritative scientific information for biomedical and electronic-sensing researchers in the field of heart failure, as well as patients. In addition, our proposed future outlook may provide new research ideas for researchers.

A MoS2 nanosheet-based CRISPR/Cas12a biosensor for efficient miRNA quantification for acute myocardial infarction

Acute myocardial infarction (AMI) represents the leading cause of cardiovascular death worldwide, and it is thus pivotal to develop effective approaches for the timely detection of AMI markers, especially possessing the characteristics of antibody-free, signal amplification, and manipulation convenience. We herein construct a MoS2 nanosheet-powered CRISPR/Cas12a sensing strategy for sensitive determination of miR-499, a superior AMI biomarker to protein markers. The presence of miR-499 at a trace level is able to induce a significantly enhanced fluorescence signal in a DNA-based molecular engineering platform, which consists of CRISPR/Cas12a enzymatic reactions and MoS2 nanosheet-controllable signal reporting components. The MoS2 nanosheets were characterized by using atomic force microscopy (AFM) and transmission electron microscope (TEM). The detection feasibility was verified by using polyacrylamide gel electrophoresis (PAGE) analysis and fluorescence measurements. The detection limit is determined as 381.78 pM with the linear range from 0.1 ⅹ 10-9 to 13.33 ⅹ 10-9 M in a fast manner (about 30 min). Furthermore, miRNA detection in real human serum is also conducted with desirable recovery rates (89.5 %-97.6 %), which may find potential application for the clinic diagnosis. We describe herein the first example of MoS2 nanosheet-based signal amplified fluorescence sensor for effective detection of AMI-related miRNA.

Electrochemically Synthesized MIP Sensors: Applications in Healthcare Diagnostics

Early-stage detection and diagnosis of diseases is essential to the prompt commencement of treatment regimens, curbing the spread of the disease, and improving human health. Thus, the accurate detection of disease biomarkers through the development of robust, sensitive, and selective diagnostic tools has remained cutting-edge scientific research for decades. Due to their merits of being selective, stable, simple, and having a low preparation cost, molecularly imprinted polymers (MIPs) are increasingly becoming artificial substitutes for natural receptors in the design of state-of-the-art sensing devices. While there are different MIP preparation approaches, electrochemical synthesis presents a unique and outstanding method for chemical sensing applications, allowing the direct formation of the polymer on the transducer as well as simplicity in tuning the film properties, thus accelerating the trend in the design of commercial MIP-based sensors. This review evaluates recent achievements in the applications of electrosynthesized MIP sensors for clinical analysis of disease biomarkers, identifying major trends and highlighting interesting perspectives on the realization of commercial MIP-endowed testing devices for rapid determination of prevailing diseases.

Vibration-enhanced disposable electroanalytical platform for selective analysis of tryptophan in fruits based on molecular imprinting

Although electrochemical detection based on molecular imprinting polymers (MIP) could dramatically improve the selectivity, the procedure is time-consuming because of the essential incubation step. In addition, current MIP electrochemical detections were not suitable for analysis of microliter-level sample solutions, limiting their applications for real samples. This investigation aims at applying vibration to enhance efficiency of MIP electrochemical detection of 20 μL sample solutions. MIP analysis of Tryptophan (Trp) was used as the model with disposable MIP electrodes prepared by electrochemical polymerization of o-phenylenediamine on carbon ink coated on stainless steel sheets. The MIP electrode was integrated in a 3D-printed analytical device for vibration-enhanced electrochemical detection of Trp. Our results showed that this vibration-enhanced strategy could significantly increase electrochemical responses of Trp at the same incubation time. Such improvement might be attributed to the enhanced mass transfer at the surface of the working electrode brought by vibration. It needs to be emphasized that this strategy is suitable for analysis of sample solutions with the volume of microliters, which is superior to normal stirring in MIP electrochemical detection. Our approach could be successfully utilized for differentiation of Trp in different fruits, opening more opportunities for MIP electrochemical detection of real samples. The enhanced efficiency by vibration could pave foundation for extensive practical MIP detection of sample solutions at the level of microliters.

An integrated microfluidic electrochemiluminescence device for point-of-care testing of acute myocardial infarction

Heart-type fatty acid binding protein (H-FABP) is an early biomarker for acute myocardial infarction. The concentration of H-FABP in circulation sharply increases during myocardial injury. Therefore, fast and accurate detection of H-FABP is of vital significance. In this study, we developed an electrochemiluminescence device integrated with microfluidic chip (designed as m-ECL device) for on-site detection of H-FABP. The m-ECL device is consisted of a microfluidic chip that enable easy liquid handling as well as an integrated electronic system for voltage supply and photon detection. A sandwich-type ECL immunoassay strategy was employed for H-FABP detection by using Ru (bpy)₃²⁺ loaded mesoporous silica nanoparticles as ECL probes. This device can directly detect H-FABP in human serum without any pre-treatment, with a wide linear range of 1-100 ng/mL and a low limit of detection of 0.72 ng/mL. The clinical usability of this device was evaluated using clinical serum samples from patients. The results obtained from m-ECL device are well matched with those obtained from ELISA assays. We believe this m-ECL device has extensive application prospects for point-of-care testing of acute myocardial infarction.

Tunable Competitive Absorption-Induced Signal-On Photoelectrochemical Immunoassay for Cardiac Troponin I Based on Z-Scheme Metal-Organic Framework Heterojunctions

Recently emerged Z-scheme heterostructure-based immunoassays have presented new opportunities for photoelectrochemical (PEC) biosensing development. Here, we described a tunable signal-on PEC biosensor for the detection of cardiac troponin I (cTnI), which exploited a competitive absorption effect between Cu(II) ions and a Zr metal-organic framework (Zr-MOF) constructed on TiO2 nanorods (Cu2+@Zr-MOF@TiO2 NRs). Water-stable Zr-MOF was coated onto TiO2 NRs on fluorine-doped tin oxide to form a Z-scheme heterostructure substrate (Zr-MOF@TiO2 NRs), which exhibited a high photoelectric response. Cu2+@Zr-MOF@TiO2 NRs, constructed by loading Cu(II) ions onto the architecture of Zr-MOF by electrostatic interaction, demonstrated a low background signal. After sandwich immunorecognition within a 96-well plate, H2S, generated by confined alkaline phosphatase on zeolitic imidazolate framework-8, was directed to react with Cu(II) ions to form CuS. This resulted in an in situ change in the photoelectrode and an enhanced photoelectric signal. The developed PEC biosensing platform exhibited high sensitivity and selectivity for the cTnI immunoassay with a detection limit of 8.6 pg/mL. The Z-scheme-based competition absorption modulation of photoelectrochemistry provides a new strategy for general PEC biosensing development.

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.