Complete validation of a continuous and blood-correlated sweat biosensing device with integrated sweat stimulation

Non-enzymatic electrochemical sensors for point-of-care testing: Current status, challenges, and future prospects

Current electrochemical sensors in point-of-care (POC) testing devices rely mainly on enzyme-based sensors owing to superior sensitivity and selectivity. Nevertheless, the poor stability, high reagent cost, complex fabrication methods and requirement of specific operational conditions make their adaptability in real-world applications unfavorable. Non-enzymatic electrochemical sensors are thus developed as they are more robust and cost-effective strategies. The advancement in material science and nanotechnology enables the development of novel non-enzymatic electrodes with favorable analytical performance. However, the developments are yet far from being adopted as viable products. This review therefore aims to gain insight into the field and evaluate the current progress and challenges to eventually propose future research directions. Here, fabrication strategies based on traditional and emerging technology are discussed in the light of analytical performance and cost-effectiveness. Moreover, the discussion is given on the pros and cons of non-enzymatic sensors when they are employed with various kinds of sample matrices, i.e., clinical and non-clinical samples, which must be taken into consideration for sensor development. Furthermore, molecular imprinting technology in tackling the selectivity issue is introduced and current progress is provided. Finally, the promising strategies from literature for solving the remaining challenges are included which could facilitate further development of robust POC testing devices based non-enzymatic sensors. We believe that once researchers and technology developers have reached the point where most problems are solved, the non-enzymatic sensors are going to be the robust choice for POC testing in clinical diagnostic, ensuring food safety, monitoring contaminants in environment, and bioprocess control.

The LOD paradox: When lower isn't always better in biosensor research and development

Biosensor research has long focused on achieving the lowest possible Limits of Detection (LOD), driving significant advances in sensitivity and opening up new possibilities in analysis. However, this intense focus on low LODs may not always meet the practical needs or suit the actual uses of these devices. While technological improvements are impressive, they can sometimes overlook important factors such as detection range, ease of use, and market readiness, which are vital for biosensors to be effective in real-world applications. This review advocates for a balanced approach to biosensor development, emphasizing the need to align technological advancements with practical utility. We delve into various applications, including the detection of cancer biomarkers, pathology-related biomarkers, and illicit drugs, illustrating the critical role of LOD within these contexts. By considering clinical needs and broader design aspects like cost-effectiveness, sustainability, and regulatory compliance, we argue that integrating technical progress with practicality will enhance the impact of biosensors. Such an approach ensures that biosensors are not only technically sound but also widely useable and beneficial in real-world applications. Addressing the diverse analytical parameters alongside user expectations and market demands will likely maximize the real-world impact of biosensors.

A physiological perspective of the relevance of sweat biomarkers and their detection by wearable microfluidic technology: A review

The great majority of published microfluidic wearable platforms for sweat sensing focus on the development of the technology to fabricate the device, the integration of sensing materials and actuators and the fluidics of sweat within the device. However, very few papers have discussed the physiological relevance of the metabolites measured using these novel approaches. In fact, some of the analytes present in sweat, which serve as biomarkers in blood, do not show a correlation with blood levels. This discrepancy can be attributed to factors such as contamination during measurements, the metabolism of sweat glands, or challenges in obtaining significant samples. The objective of this review is to present a critical and meaningful insight into the real applicability and potential use of wearable technology for improving health and sport performance. It also discusses the current limitations and future challenges of microfluidics, aiming to provide accurate information about the actual needs in this field. This work is expected to contribute to the future development of more suitable wearable microfluidic technology for health and sports science monitoring, using sweat as the biofluid for analysis.

An in silico design method of a peptide bioreceptor for cortisol using molecular modelling techniques

Cortisol is established as a reliable biomarker for stress prompting intensified research in developing wearable sensors to detect it via eccrine sweat. Since cortisol is present in sweat in trace quantities, typically 8-140 ng/mL, developing such biosensors necessitates the design of bioreceptors with appropriate sensitivity and selectivity. In this work, we present a systematic biomimetic methodology and a semi-automated high-throughput screening tool which enables rapid selection of bioreceptors as compared to ab initio design of peptides via computational peptidology. Candidate proteins from databases are selected via molecular docking and ranked according to their binding affinities by conducting automated AutoDock Vina scoring simulations. These candidate proteins are then validated via full atomistic steered molecular dynamics computations including umbrella sampling to estimate the potential of mean force using GROMACS version 2022.6. These explicit molecular dynamic calculations are carried out in an eccrine sweat environment taking into consideration the protein dynamics and solvent effects. Subsequently, we present a candidate baseline peptide bioreceptor selected as a contiguous sequence of amino acids from the selected protein binding pocket favourably interacting with the target ligand (i.e., cortisol) from the active binding site of the proteins and maintaining its tertiary structure. A unique cysteine residue introduced at the N-terminus allows orientation-specific surface immobilization of the peptide onto the gold electrodes and to ensure exposure of the binding site. Comparative binding affinity simulations of this peptide with the target ligand along with commonly interfering species e.g., progesterone, testosterone and glucose are also presented to demonstrate the validity of this proposed peptide as a candidate baseline bioreceptor for future cortisol biosensor development.

Diving into Sweat: Advances, Challenges, and Future Directions in Wearable Sweat Sensing

Sweat analysis has advanced from diagnosing cystic fibrosis and testing for illicit drugs to noninvasive monitoring of health biomarkers. This article introduces the rapid development of wearable and flexible sweat sensors, highlighting key milestones and various sensing strategies for real-time monitoring of analytes. We discuss challenges such as developing high-performance nanomaterial-based biosensors, ensuring continuous sweat production and sampling, achieving high sweat/blood correlation, and biocompatibility. The potential of machine learning to enhance these sensors for personalized healthcare is presented, enabling real-time tracking and prediction of physiological changes and disease onset. Leveraging advancements in flexible electronics, nanomaterials, biosensing, and data analytics, wearable sweat biosensors promise to revolutionize disease management, prevention, and prediction, promoting healthier lifestyles and transforming medical practices globally.

Innovative Wearable Sweat Sensor Array for Real-Time Volatile Organic Compound Detection in Noninvasive Diabetes Monitoring

Wearable sweat sensors are reshaping healthcare monitoring, providing real-time data on hydration and electrolyte levels with user-friendly, noninvasive devices. This paper introduces a highly portable two-channel microfluidic device for simultaneous sweat sampling and the real-time detection of volatile organic compound (VOC) biomarkers. This innovative wearable microfluidic system is tailored for monitoring diabetes through the continuous and noninvasive tracking of acetone and ammonia VOCs, and it seamlessly integrates with smartphones for easy data management. The core of this system lies in the utilization of carbon polymer dots (CPDs) and carbon dots (CDs) derived from monomers such as catechol, resorcinol, o-phenylenediamine, urea, and citric acid. These dots are seamlessly integrated into hydrogels made from gelatin and poly(vinyl alcohol), resulting in an advanced solid-state fluorometric sensor coating on a cellulose paper substrate. These sensors exhibit exceptional performance, offering linear detection ranges of 0.05-0.15 ppm for acetone and 0.25-0.37 ppm for ammonia, with notably low detection limits of 0.01 and 0.08 ppm, respectively. Rigorous optimization of operational parameters, encompassing the temperature, sample volume, and assay time, has been undertaken to maximize device performance. Furthermore, these sensors demonstrate impressive selectivity, effectively discerning between biologically similar substances and other potential compounds commonly present in sweat. As this field matures, the prospect of cost-effective, continuous, personalized health monitoring through wearable VOC sensors holds significant potential for overcoming barriers to comprehensive medical care in underserved regions. This highlights the transformative capacity of wearable VOC sweat sensing in ensuring equitable access to advanced healthcare diagnostics, particularly in remote or geographically isolated areas.

Wearable Electrochemical Sensor for Sweat-Based Potassium Ion and Glucose Detection in Exercise Health Monitoring

The increasing prevalence of wearable devices has sparked a growing interest in real-time health monitoring and physiological parameter tracking. This study focuses on the development of a cost-effective sweat analysis device, utilizing microfluidic technology and selective electrochemical electrodes for non-invasive monitoring of glucose and potassium ions. The device, through real-time monitoring of glucose and potassium ion levels in sweat during physical activity, issues a warning signal when reaching experimentally set thresholds (K+ concentration at 7.5 mM, glucose concentrations at 60 μM and 120 μM). This alerts users to potential dehydration and hypoglycemic conditions. Through the integration of microfluidic devices and precise electrochemical analysis techniques, the device enables accurate and real-time monitoring of glucose and potassium ions in sweat. This advancement in wearable technology holds significant potential for personalized health management and preventive care, promoting overall well-being, and optimizing performance during physical activities.

Nature-Inspired Superhydrophilic Biosponge as Structural Beneficial Platform for Sweating Analysis Patch

Perspiration plays a pivotal role not only in thermoregulation but also in reflecting the body's internal state and its response to external stimuli. The up-to-date skin-based wearable platforms have facilitated the monitoring and simultaneous analysis of sweat, offering valuable physiological insights. Unlike conventional passive sweating, dynamic normal perspiration, which occurs during various activities and rest periods, necessitates a more reliable method of collection to accurately capture its real-time fluctuations. An innovative microfluidic patch incorporating a hierarchical superhydrophilic biosponge, poise to significantly improve the efficiency capture of dynamic sweat is introduced. The seamlessly integrated biosponge microchannel showcases exceptional absorption capabilities, efficiently capturing non-sensitive sweat exuding from the skin surface, mitigating sample loss and minimizing sweat volatilization. Furthermore, the incorporation of sweat-rate sensors alongside a suite of functional electrochemical sensors endows the patch of uninterrupted monitoring and analysis of dynamic sweat during various activities, stress events, high-energy intake, and other scenarios.

Label-Free Classification of L-Histidine Vs Artificial Human Sweat Using Laser Scribed Electrodes and a Multi-Layer Perceptron Neural Network

A challenge in wearable technology lies in the realtime monitoring of molecular biomarkers associated with human health. Electrochemical sensors are one of the most useful tools for this purpose and are commonly used in health monitoring devices. Electrochemical biosensing is particularly convenient when used in user-friendly, low-cost devices for testing noninvasive body fluids such as sweat and saliva. However, achieving high selectivity and specificity in measurements depends on the complexity of the biomarker and the stability of the biomarker capture molecule. In this study, laser-scribed electrodes (LSEs) were manufactured using a CO2 laser cutter on Polyimide for the label-free classification of sweat components. Cyclic voltammetry experiments were performed on artificial human sweat and the sweat component L-Histidine. The resulting voltammogram data served as input to train a Multi-Layer Perceptron Neural Network (MLP-NN) algorithm capable of classifying L-Histidine and artificial sweat.

An ethyl cellulose novel biodegradable flexible substrate material for sustainable screen-printing

We introduce an innovative solution to reduce plastic dependence in flexible electronics: a biodegradable, water-resistant, and flexible cellulose-based substrate for crafting electrochemical printed platforms. This sustainable material based on ethyl cellulose (EC) serves as an eco-friendly alternative to PET in screen printing, boasting superior water resistance compared to other biodegradable options. Our study evaluates the performance of carbon-based screen-printed electrodes (SPEs) fabricated on conventional PET, recycled PET (r-PET), and (EC)-based materials. Electrochemical characterization reveals that EC-SPEs exhibit comparable analytical performance to both P-SPEs and rP-SPEs, as evidenced by similar limits of detection (LOD), limits of quantification (LOQ), and reproducibility values for all the analytes tested (ferro-ferricyanide, hexaammineruthenium chloride, uric acid, and hydroquinone). This finding underscores the potential of our cellulose-based substrate to match the performance of conventional PET-based electrodes. Moreover, the scalability and low-energy requirements of our fabrication process highlight the potential of this material to revolutionize eco-conscious manufacturing. By offering a sustainable alternative without compromising performance, our cellulose-based substrate paves the way for greener practices in flexible electronics production.

Fundamental Study of a Wristwatch Sweat Lactic Acid Monitor

A lactic acid (LA) monitoring system aimed at sweat monitoring was fabricated and tested. The sweat LA monitoring system uses a continuous flow of phosphate buffer saline, instead of chambers or cells, for collecting and storing sweat fluid excreted at the skin surface. To facilitate the use of the sweat LA monitoring system by subjects when exercising, the fluid control system, including the sweat sampling device, was designed to be unaffected by body movements or muscle deformation. An advantage of our system is that the skin surface condition is constantly refreshed by continuous flow. A real sample test was carried out during stationary bike exercise, which showed that LA secretion increased by approximately 10 μg/cm2/min compared to the baseline levels before exercise. The LA levels recovered to baseline levels after exercise due to the effect of continuous flow. This indicates that the wristwatch sweat LA monitor has the potential to enable a detailed understanding of the LA distribution at the skin surface.

Harvesting and manipulating sweat and interstitial fluid in microfluidic devices

Microfluidic devices began to be used to facilitate sweat and interstitial fluid (ISF) sensing in the mid-2010s. Since then, numerous prototypes involving microfluidics have been developed in different form factors for sensing biomarkers found in these fluids under in vitro, ex vivo, and in vivo (on-body) settings. These devices transport and manipulate biofluids using microfluidic channels composed of silicone, polymer, paper, or fiber. Fluid flow transport and sample management can be achieved by controlling the flow rate, surface morphology of the channel, and rate of fluid evaporation. Although many devices have been developed for estimating sweat rate, electrolyte, and metabolite levels, only a handful have been able to proceed beyond laboratory testing and reach the stage of clinical trials and commercialization. To further this technology, this review reports on the utilization of microfluidics towards sweat and ISF management and transport. The review is distinguished from other recent reviews by focusing on microfluidic principles of sweat and ISF generation, transport, extraction, and management. Challenges and prospects are highlighted, with a discussion on how to transition such prototypes towards personalized healthcare monitoring systems.

Triboelectric Nanogenerator Enabled Sweat Extraction and Power Activation for Sweat Monitoring

Wearable sweat sensors can detect and monitor various substances in sweat, providing valuable information for healthcare monitoring and clinical diagnostics. Recent advances in flexible electronic technologies have enabled the development of wearable sweat sensors that can measure sweat rate and biochemical substances in real time, although several challenges remain, such as power management and sweat extraction issues. Here, a passive sweat extraction strategy as well as a self‐powered monitoring system (SEMS) is reported to be designed for sedentary individuals, i.e., elders. The SEMS system comprises a wearable triboelectric nanogenerator (TENG) for sweat extraction, a sweat‐activated battery (SAB) as the integrated power source, carbachol‐loaded iontophoresis electrodes for sweat extraction, microfluidics with biosensors for detecting physiological information in sweat, and near field communication (NFC)‐based wireless microelectronics for data communication, processing, and collection. By tapping the TENG, sedentary people can passively extract sweat based on the iontophoresis process, allowing the sensors to detect biological information in sweat. The good flexibility of the SEMS device enables real‐time and non‐invasive detection of sweat analytes in a wearable format. This system offers a new strategy of sweat collection and analysis for the elderly group, and therefore can help to understand human physiology and personalize health monitoring deeply.

Measuring the Salt Content of Sweat inside a Sweat-Absorbing Skin Adhesive

Biofluids contain a wealth of different biomarkers, and their concentrations are indicative of the state of the body. As one of those biofluids, sweat is easily accessible, and its composition can, for example, be related to particular diseases or sports performance. Due to the relatively low sweat flow rates, however, adequate sampling is paramount. Here, we aim to explore the potential use of sweat-absorbing skin adhesives as a sweat sampling system for wearable sensors with a simple construction. Upon absorption of sweat, the electrochemical properties of the skin adhesive are determined by the composition of sweat and the amount of sweat within the skin adhesive (i.e., hydration). Through the incorporation of two polarizable electrodes within the skin adhesive, its electrical properties can be monitored using impedance spectroscopy. Here, the double layer capacitance is used as an indicator of hydration, while the conductance depends on both the ion concentration and hydration (the mobility of ions). By evaluating the conductance as a function of hydration, the ion concentration within an electrolyte solution can be estimated. We demonstrate the concept based on a simple model sensor patch, which is exposed to electrolyte solutions containing various concentrations of NaCl and an artificial sweat solution. Finally, we show that ion concentrations in human sweat can be estimated when the model sensor patch is worn during exercise.

Wearing the Lab: Advances and Challenges in Skin-Interfaced Systems for Continuous Biochemical Sensing

Continuous, on-demand, and, most importantly, contextual data regarding individual biomarker concentrations exemplify the holy grail for personalized health and performance monitoring. This is well-illustrated for continuous glucose monitoring, which has drastically improved outcomes and quality of life for diabetic patients over the past 2 decades. Recent advances in wearable biosensing technologies (biorecognition elements, transduction mechanisms, materials, and integration schemes) have begun to make monitoring of other clinically relevant analytes a reality via minimally invasive skin-interfaced devices. However, several challenges concerning sensitivity, specificity, calibration, sensor longevity, and overall device lifetime must be addressed before these systems can be made commercially viable. In this chapter, a logical framework for developing a wearable skin-interfaced device for a desired application is proposed with careful consideration of the feasibility of monitoring certain analytes in sweat and interstitial fluid and the current development of the tools available to do so. Specifically, we focus on recent advancements in the engineering of biorecognition elements, the development of more robust signal transduction mechanisms, and novel integration schemes that allow for continuous quantitative analysis. Furthermore, we highlight the most compelling and promising prospects in the field of wearable biosensing and the challenges that remain in translating these technologies into useful products for disease management and for optimizing human performance.

Access and Management of Sweat for Non-Invasive Biomarker Monitoring: A Comprehensive Review

Sweat is an important biofluid presents in the body since it regulates the internal body temperature, and it is relatively easy to access on the skin unlike other biofluids and contains several biomarkers that are also present in the blood. Although sweat sensing devices have recently displayed tremendous progress, most of the emerging devices primarily focus on the sensor development, integration with electronics, wearability, and data from in vitro studies and short-term on-body trials during exercise. To further the advances in sweat sensing technology, this review aims to present a comprehensive report on the approaches to access and manage sweat from the skin toward improved sweat collection and sensing. It is begun by delineating the sweat secretion mechanism through the skin, and the historical perspective of sweat, followed by a detailed discussion on the mechanisms governing sweat generation and management on the skin. It is concluded by presenting the advanced applications of sweat sensing, supported by a discussion of robust, extended-operation epidermal wearable devices aiming to strengthen personalized healthcare monitoring systems.

Recent Advances in Skin-Interfaced Wearable Sweat Sensors: Opportunities for Equitable Personalized Medicine and Global Health Diagnostics

Recent advances in skin-interfaced wearable sweat sensors enable the noninvasive, real-time monitoring of biochemical signals associated with health and wellness. These wearable platforms leverage microfluidic channels, biochemical sensors, and flexible electronics to enable the continuous analysis of sweat-based biomarkers such as electrolytes, metabolites, and hormones. As this field continues to mature, the potential of low-cost, continuous personalized health monitoring enabled by such wearable sensors holds significant promise for addressing some of the formidable obstacles to delivering comprehensive medical care in under-resourced settings. This Perspective highlights the transformative potential of wearable sweat sensing for providing equitable access to cutting-edge healthcare diagnostics, especially in remote or geographically isolated areas. It examines the current understanding of sweat composition as well as recent innovations in microfluidic device architectures and sensing strategies by showcasing emerging applications and opportunities for innovation. It concludes with a discussion on expanding the utility of wearable sweat sensors for clinically relevant health applications and opportunities for enabling equitable access to innovation to address existing health disparities.

Perspective-The Feasibility of Continuous Protein Monitoring in Interstitial Fluid

Real-time continuous monitoring of proteins in-vivo holds great potential for personalized medical applications. Unfortunately, a prominent knowledge gap exists in the fundamental biology regarding protein transfer and correlation between interstitial fluid and blood. Additionally, technological sensing will require affinity-based platforms that cannot be robustly protected in-vivo and will therefore be challenged in sensitivity, longevity, and fouling over multi-day to week timelines. Here we use electrochemical aptamer sensors as a model system to discuss further research necessary to achieve continuous protein sensing.

Skin-Interfaced Wearable Sweat Sensors for Precision Medicine

Wearable sensors hold great potential in empowering personalized health monitoring, predictive analytics, and timely intervention toward personalized healthcare. Advances in flexible electronics, materials science, and electrochemistry have spurred the development of wearable sweat sensors that enable the continuous and noninvasive screening of analytes indicative of health status. Existing major challenges in wearable sensors include: improving the sweat extraction and sweat sensing capabilities, improving the form factor of the wearable device for minimal discomfort and reliable measurements when worn, and understanding the clinical value of sweat analytes toward biomarker discovery. This review provides a comprehensive review of wearable sweat sensors and outlines state-of-the-art technologies and research that strive to bridge these gaps. The physiology of sweat, materials, biosensing mechanisms and advances, and approaches for sweat induction and sampling are introduced. Additionally, design considerations for the system-level development of wearable sweat sensing devices, spanning from strategies for prolonged sweat extraction to efficient powering of wearables, are discussed. Furthermore, the applications, data analytics, commercialization efforts, challenges, and prospects of wearable sweat sensors for precision medicine are discussed.

Wearable Smart Bandage-Based Bio-Sensors

Bandage is a well-established industry, whereas wearable electronics is an emerging industry. This review presents the bandage as the base of wearable bioelectronics. It begins with introducing a detailed background to bandages and the development of bandage-based smart sensors, which is followed by a sequential discussion of the technical characteristics of the existing bandages, a more practical methodology for future applications, and manufacturing processes of bandage-based wearable biosensors. The review then elaborates on the advantages of basing the next generation of wearables, such as acceptance by the customers and system approvals, and disposal.

Conformational-switch biosensors as novel tools to support continuous, real-time molecular monitoring in lab-on-a-chip devices

Recent years have seen continued expansion of the functionality of lab on a chip (LOC) devices. Indeed LOCs now provide scientists and developers with useful and versatile platforms across a myriad of chemical and biological applications. The field still fails, however, to integrate an often important element of bench-top analytics: real-time molecular measurements that can be used to "guide" a chemical response. Here we describe the analytical techniques that could provide LOCs with such real-time molecular monitoring capabilities. It appears to us that, among the approaches that are general (i.e., that are independent of the reactive or optical properties of their targets), sensing strategies relying on binding-induced conformational change of bioreceptors are most likely to succeed in such applications.

Epidermal Wearable Biosensors for Monitoring Biomarkers of Chronic Disease in Sweat

Biological information detection technology is mainly used for the detection of physiological and biochemical parameters closely related to human tissues and organ lesions, such as biomarkers. This technology has important value in the clinical diagnosis and treatment of chronic diseases in their early stages. Wearable biosensors can be integrated with the Internet of Things and Big Data to realize the detection, transmission, storage, and comprehensive analysis of human physiological and biochemical information. This technology has extremely wide applications and considerable market prospects in frontier fields including personal health monitoring, chronic disease diagnosis and management, and home medical care. In this review, we systematically summarized the sweat biomarkers, introduced the sweat extraction and collection methods, and discussed the application and development of epidermal wearable biosensors for monitoring biomarkers in sweat in preclinical research in recent years. In addition, the current challenges and development prospects in this field were discussed.

Wearable and flexible electrochemical sensors for sweat analysis: a review

Flexible wearable sweat sensors allow continuous, real-time, noninvasive detection of sweat analytes, provide insight into human physiology at the molecular level, and have received significant attention for their promising applications in personalized health monitoring. Electrochemical sensors are the best choice for wearable sweat sensors due to their high performance, low cost, miniaturization, and wide applicability. Recent developments in soft microfluidics, multiplexed biosensing, energy harvesting devices, and materials have advanced the compatibility of wearable electrochemical sweat-sensing platforms. In this review, we summarize the potential of sweat for medical detection and methods for sweat stimulation and collection. This paper provides an overview of the components of wearable sweat sensors and recent developments in materials and power supply technologies and highlights some typical sensing platforms for different types of analytes. Finally, the paper ends with a discussion of the challenges and a view of the prospective development of this exciting field.

Development of an insilico model of eccrine sweat using molecular modelling techniques

Eccrine sweat is an ideal surrogate diagnostic biofluid for physiological and metabolic biomarkers for wearable biosensor design. Its periodic and non-invasive availability for candidate analytes such as glucose and cortisol along with limited correlation with blood plasma is of significant research interest. An insilico model of eccrine sweat can assist in the development of such wearable biosensors. In this regard, molecular modelling can be employed to observe the most fundamental interactions. Here, we determine a suitable molecular model for building eccrine sweat. The basic components of sweat are water and sodium chloride, in which glucose and other analytes are present in trace quantities. Given the wide range of water models available in the molecular dynamics space, in this study, we first validate the water models. We use three compounds to represent the base to build bulk sweat fluid and validate the force fields. We compare the self-diffusivity of water, glucose, sodium, and chloride ions as well as bulk viscosity values and present the results which are > 90% accurate as compared with the available literature. This validated insilico eccrine sweat model can serve as an aid to expedite the development de novo biosensors by addition of other analytes of interest e.g. cortisol, uric acid etc., simulate various temperatures and salt concentrations, expand search space for screening candidate target receptors by their binding affinity and assess the interference between competing species via simulations.

Wearable chemical sensors for biomarker discovery in the omics era

Biomarkers are crucial biological indicators in medical diagnostics and therapy. However, the process of biomarker discovery and validation is hindered by a lack of standardized protocols for analytical studies, storage and sample collection. Wearable chemical sensors provide a real-time, non-invasive alternative to typical laboratory blood analysis, and are an effective tool for exploring novel biomarkers in alternative body fluids, such as sweat, saliva, tears and interstitial fluid. These devices may enable remote at-home personalized health monitoring and substantially reduce the healthcare costs. This Review introduces criteria, strategies and technologies involved in biomarker discovery using wearable chemical sensors. Electrochemical and optical detection techniques are discussed, along with the materials and system-level considerations for wearable chemical sensors. Lastly, this Review describes how the large sets of temporal data collected by wearable sensors, coupled with modern data analysis approaches, would open the door for discovering new biomarkers towards precision medicine.

A touch-based multimodal and cryptographic bio-human-machine interface

The awareness of the individuals’ biological status is critical for creating interactive environments. Accordingly, we devised a multimodal cryptographic bio-human–machine interface (CB-HMI), which seamlessly translates touch-based entries into encrypted biochemical, biophysical, and biometric indices (i.e., circulating biomarkers levels, heart rate, oxygen saturation level, and fingerprint pattern). As its central component, the CB-HMI features thin hydrogel-coated chemical sensors and a signal interpretation framework to access/interpret biochemical indices, bypassing the challenge of circulating analyte accessibility and the confounding effect of pressing force variability. Upgrading the surrounding objects with CB-HMI, we demonstrated new interactive solutions for driving safety and medication use, where the integrated CB-HMI uniquely enabled one-touch bioauthentication (based on the user’s biological state/identity), prior to rendering the intended services.

The awareness of individuals’ biological status is critical for creating interactive and adaptive environments that can actively assist the users to achieve optimal outcomes. Accordingly, specialized human–machine interfaces—equipped with bioperception and interpretation capabilities—are required. To this end, we devised a multimodal cryptographic bio-human–machine interface (CB-HMI), which seamlessly translates the user’s touch-based entries into encrypted biochemical, biophysical, and biometric indices. As its central component, the CB-HMI features thin hydrogel-coated chemical sensors and inference algorithms to noninvasively and inconspicuously acquire biochemical indices such as circulating molecules that partition onto the skin (here, ethanol and acetaminophen). Additionally, the CB-HMI hosts physical sensors and associated algorithms to simultaneously acquire the user’s heart rate, blood oxygen level, and fingerprint minutiae pattern. Supported by human subject studies, we demonstrated the CB-HMI’s capability in terms of acquiring physiologically relevant readouts of target bioindices, as well as user-identifying and biometrically encrypting/decrypting these indices in situ (leveraging the fingerprint feature). By upgrading the common surrounding objects with the CB-HMI, we created interactive solutions for driving safety and medication use. Specifically, we demonstrated a vehicle-activation system and a medication-dispensing system, where the integrated CB-HMI uniquely enabled user bioauthentication (on the basis of the user’s biological state and identity) prior to rendering the intended services. Harnessing the levels of bioperception achieved by the CB-HMI and other intelligent HMIs, we can equip our surroundings with a comprehensive and deep awareness of individuals’ psychophysiological state and needs.

Validation of the Application of Solid Contact Ion-Selective Electrode for Off-Body Sweat Ion Monitoring

The solid contact ion-selective electrode (ISE) is a promising skin-interfaced monitoring system for sweat ions. Despite a growing number of on-body usages of ISE with fancy new materials and device fabrications, there are very few reports attempting to validate ISE results with a gold standard technique. For this purpose, this work uses inductively coupled plasma-optical emission spectrometry (ICP-OES) as a reference technique to conduct a direct evaluation of the sweat sodium and potassium ion levels obtained by ISE in an off-body approach. Eight healthy male subjects were recruited to collect exercise-induced sweat. It was found that sweat sodium and potassium ions present a rather wide concentration range. The sweat sodium concentration did not vary greatly in an exercise period of half an hour, while the sweat potassium concentration typically decreased with exercise. Mineral drink intake had no clear impact on the sweat sodium level, but increased the sweat potassium level. A paired t-test and mean absolute relative difference (MARD) analysis, a method typically used for evaluating the performance of glucometers, was employed to compare the results of ISE and ICP-OES. The statistical analysis validated the feasibility of ISE for measuring sweat ions, although better accuracy is required. Our data suggests that overweight subjects are likely to possess a higher sweat sodium level.

A One-Dollar, Disposable, Paper-Based Microfluidic Chip for Real-Time Monitoring of Sweat Rate

Collecting sweat and monitoring its rate is important for determining body condition and further sweat analyses, as this provides vital information about physiologic status and fitness level and could become an alternative to invasive blood tests in the future. Presented here is a one-dollar, disposable, paper-based microfluidic chip for real-time monitoring of sweat rate. The chip, pasted on any part of the skin surface, consists of a skin adhesive layer, sweat-proof layer, sweat-sensing layer, and scale layer with a disk-shape from bottom to top. The sweat-sensing layer has an impressed wax micro-channel containing pre-added chromogenic agent to show displacement by sweat, and the sweat volume can be read directly by scale lines without any electronic elements. The diameter and thickness of the complete chip are 25 mm and 0.3 mm, respectively, permitting good flexibility and compactness with the skin surface. Tests of sweat flow rate monitoring on the left forearm, forehead, and nape of the neck of volunteers doing running exercise were conducted. Average sweat rate on left forearm (1156 g·m-2·h-1) was much lower than that on the forehead (1710 g·m-2·h-1) and greater than that on the nape of the neck (998 g·m-2·h-1), in good agreement with rates measured using existing common commercial sweat collectors. The chip, as a very low-cost and convenient wearable device, has wide application prospects in real-time monitoring of sweat loss by body builders, athletes, firefighters, etc., or for further sweat analyses.

Wearable soft electrochemical microfluidic device integrated with iontophoresis for sweat biosensing

A soft and flexible wearable sweat epidermal microfluidic device capable of simultaneously stimulating, collecting, and electrochemically analyzing sweat is demonstrated. The device represents the first system integrating an iontophoretic pilocarpine delivery system around the inlet channels of epidermal polydimethylsiloxane (PDMS) microfluidic device for sweat collection and analysis. The freshly generated sweat is naturally pumped into the fluidic inlet without the need of exercising. Soft skin-mounted systems, incorporating non-invasive, on-demand sweat sampling/analysis interfaces for tracking target biomarkers, are in urgent need. Existing skin conformal microfluidic-based sensors for continuous monitoring of target sweat biomarkers rely on assays during intense physical exercising. This work demonstrates the first example of combining sweat stimulation, through transdermal pilocarpine delivery, with sample collection through a microfluidic channel for real-time electrochemical monitoring of sweat glucose, in a fully integrated soft and flexible multiplexed device which eliminates the need of exercising. The on-body operational performance and layout of the device were optimized considering the fluid dynamics and evaluated for detecting sweat glucose in several volunteers. Furthermore, the microfluidic monitoring device was integrated with a real-time wireless data transmission system using a flexible electronic board PCB conformal with the body. The new microfluidic platform paves the way to real-time non-invasive monitoring of biomarkers in stimulated sweat samples for diverse healthcare and wellness applications.

Fabrication of a Wearable Flexible Sweat pH Sensor Based on SERS-Active Au/TPU Electrospun Nanofibers

Development of wearable sensing platforms is essential for the advancement of continuous health monitoring and point-of-care testing. Eccrine sweat pH is an analyte that can be noninvasively measured and used to diagnose and aid in monitoring a wide range of physiological conditions. Surface-enhanced Raman scattering (SERS) offers a rapid, optical technique for fingerprinting of biomarkers present in sweat. In this paper, a mechanically flexible, nanofibrous, SERS-active substrate was fabricated by a combination of electrospinning of thermoplastic polyurethane (TPU) and Au sputter coating. This substrate was then investigated for suitability toward wearable sweat pH sensing after functionalization with two commonly used pH-responsive molecules, 4-mercaptobenzoic acid (4-MBA), and 4-mercaptopyridine (4-MPy). The developed SERS pH sensor was found to have good resolution (0.14 pH units for 4-MBA; 0.51 pH units for 4-MPy), with only 1 μL of sweat required for a measurement, and displayed no statistically significant difference in performance after 35 days (p = 0.361). Additionally, the Au/TPU nanofibrous SERS pH sensors showed fast sweat-absorbing ability as well as good repeatability and reversibility. The proposed methodology offers a facile route for the fabrication of SERS substrates which could also be used to measure a wide range of health biomarkers beyond sweat pH.

Energy Autonomous Sweat-Based Wearable Systems

The continuous operation of wearable electronics demands reliable sources of energy, currently met through Li-ion batteries and various energy harvesters. These solutions are being used out of necessity despite potential safety issues and unsustainable environmental impact. Safe and sustainable energy sources can boost the use of wearables systems in diverse applications such as health monitoring, prosthetics, and sports. In this regard, sweat- and sweat-equivalent-based studies have attracted tremendous attention through the demonstration of energy-generating biofuel cells, promising power densities as high as 3.5 mW cm-2 , storage using sweat-electrolyte-based supercapacitors with energy and power densities of 1.36 Wh kg-1 and 329.70 W kg-1 , respectively, and sweat-activated batteries with an impressive energy density of 67 Ah kg-1 . A combination of these energy generating, and storage devices can lead to fully energy-autonomous wearables capable of providing sustainable power in the µW to mW range, which is sufficient to operate both sensing and communication devices. Here, a comprehensive review covering these advances, addressing future challenges and potential solutions related to fully energy-autonomous wearables is presented, with emphasis on sweat-based energy storage and energy generation elements along with sweat-based sensors as applications.

A Conformable, Gas-Permeable, and Transparent Skin-Like Micromesh Architecture for Glucose Monitoring

Monitoring the concentration of useful biomarkers via electronic skins (e-skins) is highly important for the development of wearable health management systems. While some biosensor e-skins with high flexibility, sensitivity, and stability have been developed, little attention has been paid to their long-term comfortability and optical transparency. Here, a conformable, gas permeable, and transparent skin-like Cu₂ O@Ni micromesh structural glucose monitoring patch is reported. With its self-supporting micromesh structure, the skin-like glucose monitoring patch exhibits excellent shape conformability, high gas permeability, and high optical transmittance. The skin-like glucose biosensor achieves real-time monitoring of glucose concentrations with high sensitivity (15 420 µA cm^{- 2} mM^{- 1} ), low detection limit (50 nM), fast response time (＜2 s), high selectivity, and long-term stability. These desirable performance properties arise from the synergistic effects of the self-supporting micromesh configuration, high conductivity of the metallic Ni micromesh, and high electrocatalytic activities of the Cu₂ O toward glucose. This work presents a versatile and efficient strategy for constructing conformable, gas permeable, and transparent biosensor e-skins with excellent practicability towards wearable electronics.

State of Sweat: Emerging Wearable Systems for Real-Time, Noninvasive Sweat Sensing and Analytics

Skin-interfaced wearable systems with integrated colorimetric assays, microfluidic channels, and electrochemical sensors offer powerful capabilities for noninvasive, real-time sweat analysis. This Perspective details recent progress in the development and translation of novel wearable sensors for personalized assessment of sweat dynamics and biomarkers, with precise sampling and real-time analysis. Sensor accuracy, system ruggedness, and large-scale deployment in remote environments represent key opportunity areas, enabling broad deployment in the context of field studies, clinical trials, and recent commercialization. On-body measurements in these contexts show good agreement compared to conventional laboratory-based sweat analysis approaches. These device demonstrations highlight the utility of biochemical sensing platforms for personalized assessment of performance, wellness, and health across a broad range of applications.

Luminescent wearable biosensors based on gold nanocluster networks for "turn-on" detection of Uric acid, glucose and alcohol in sweat

From the difficulty of awareness of abnormal concentrations of biochemical indexes in people's daily life come wearable sensing technologies. Recently, luminescent wearable biosensors are emerging with simple fabrication, easy use, cost-effectivity and reliability. But several challenges should be taken up, such as availability of varied analytes, high sensitivity, stability of enzymes, photostability, low signal noises and recyclability of sensors. Here, the Luminescent Wearable Sweat Tape (LWST) biosensor is developed via embedding multi-component nanoprobes onto microwell-patterned paper substrates of hollowed-out double-side tapes. The nanoprobes consist of responsive luminophores, enzyme-loaded gold nanocluster (AuNCs) nano-networks, which are wrapped by the switch, MnO₂ nanosheets. The responsive luminophores are constructed by 3 substitutable components: enzymes (uricase, GOx and alcohol dehydrogenase) for molecular target recognition, glutathione-protected AuNCs (yellow, red and green) for luminescent signal output and polycations PAH for integration. MnO₂ NSs as the switch can quench the emission of the AuNCs but degraded by the reductive product of incorporated enzymes. Thus, targeting analysts (uric acid, glucose and alcohol) can be dose-dependently detected through "turn-on" luminescence approach. After incorporating the nanoprobes into hollow-out tapes, the formed LWST biosensors can detect uric acid, glucose and alcohol in sweat with the help of a smartphone. Subsequently, we primarily apply them into human daily life scenario, sampling from dine parties, and the positive relationships of analyte intakes and the increase of analytes in sweat are significant with individual difference.

An epidermal patch for the simultaneous monitoring of haemodynamic and metabolic biomarkers

Monitoring the effects of daily activities on the physiological responses of the body calls for wearable devices that can simultaneously track metabolic and haemodynamic parameters. Here we describe a non-invasive skin-worn device for the simultaneous monitoring of blood pressure and heart rate via ultrasonic transducers and of multiple biomarkers via electrochemical sensors. We optimized the integrated device so that it provides mechanical resiliency and flexibility while conforming to curved skin surfaces, and to ensure reliable sensing of glucose in interstitial fluid and of lactate, caffeine and alcohol in sweat, without crosstalk between the individual sensors. In human volunteers, the device captured physiological effects of food intake and exercise, in particular the production of glucose after food digestion, the consumption of glucose via glycolysis, and increases in blood pressure and heart rate compensating for oxygen depletion and lactate generation. Continuous and simultaneous acoustic and electrochemical sensing via integrated wearable devices should enrich the understanding of the body's response to daily activities, and could facilitate the early prediction of abnormal physiological changes.

A review of wearable biosensors for sweat analysis

Recent advances in the skin-interfaced wearable sweat sensors allow a personalized daily diagnosis and prognosis of the diseases in a form of a non-invasive, portable, and continuous monitoring system. Especially, the soft microfluidic system provides robust quantitative analysis platforms that integrate sweat sampling, storing, and various sensing capabilities. This review systematically introduces the sweat collecting mechanism using soft microfluidic valves, including calculation of sweat storage and loss. In terms of sweat analysis, colorimetric (e.g. enzymatic, chemical, or their mixed reactions), electrochemical (e.g. voltammetric, potentiometric, amperometric, or conductometric), and multiplex measurements of sweat contents facilitate diagnosis of diseases via analysis of combined multiple data, such as vital signals (e.g. ECG, EMG, EEG, etc.) and information from the skin (e.g. temperature, GSR, etc.). The integration of wireless communication with the microfluidic systems enables point-of-care health monitoring for disease and specific physiological status.

Integrated non-invasive biochemical and biophysical sensing systems for health and performance monitoring: A systems perspective

Advances in materials, bio-recognition elements, transducers, and microfabrication techniques, as well as progress in electronics, signal processing, and wireless communication have generated a new class of skin-interfaced wearable health monitoring systems for applications in personalized medicine and digital health. In comparison to conventional medical devices, these wearable systems are at the cusp of initiating a new era of longitudinal and noninvasive sensing for the prevention, detection, diagnosis, and treatment of diseases at the molecular level. Herein, we provide a review of recent developments in wearable biochemical and biophysical systems. We survey the sweat sampling and collection methods for biochemical systems, followed by an assessment of biochemical and biophysical sensors deployed in current wearable systems with an emphasis on their hardware specifications. Specifically, we address how sweat collection and sample handling platforms may be a rate limiting technology to realizing the clinical translation of wearable health monitoring systems; moreover, we highlight the importance of achieving both longitudinal sensing and assessment of intrapersonal variation in sweat-blood correlations to have the greatest clinical impact. Lastly, we assess a snapshot of integrated wireless wearable systems with multimodal sensing capabilities, and we conclude with our perspective on the state-of-the-art and the required developments to achieve the next-generation of integrated wearable health and performance monitoring systems.

Recent developments in flow modeling and fluid control for paper-based microfluidic biosensors

Over the last 10 years, researchers have shown that paper is a promising substrate for affordable biosensors. The field of paper-microfluidics has evolved rapidly in that time, with simple colorimetric assays giving way to more complex electrochemical devices that can handle multiple samples at a given time. As paper devices become more complex, the ability to precisely control different fluids simultaneously becomes a challenge. Specifically, automated flow control is a necessary attribute to make paper-based devices more useable in resource-limited settings. Flow control strategies on paper are typically developed experimentally through trial-and-error, with little focus on theory. This is because flow behavior in paper is not well understood and sometimes difficult to predict precisely. Additionally, popular theoretical models are too simplistic, making them unsuitable for complex device designs and application conditions. A better understanding of flow theory would allow devices conceived straight from theoretical models. This could save time and resources by reducing experimental work. In this review, we provide an overview of different theoretical models used to characterize imbibition in paper substrates and document the latest flow control strategies that have been applied to automated fluid control on paper. Additionally, we look at current efforts to commercialize paper-based devices along with challenges facing this industry.

Recent progress, challenges, and opportunities for wearable biochemical sensors for sweat analysis

Sweat is a promising, yet relatively unexplored biofluid containing biochemical information that offers broad insights into the underlying dynamic metabolic activity of the human body. The rich composition of electrolytes, metabolites, hormones, proteins, nucleic acids, micronutrients, and exogenous agents found in sweat dynamically vary in response to the state of health, stress, and diet. Emerging classes of skin-interfaced wearable sensors offer powerful capabilities for the real-time, continuous analysis of sweat produced by the eccrine glands in a manner suitable for use in athletics, consumer wellness, military, and healthcare industries. This perspective examines the rapid and continuous progress of wearable sweat sensors through the most advanced embodiments that address the fundamental challenges currently restricting widespread deployment. It concludes with a discussion of efforts to expand the overall utility of wearable sweat sensors and opportunities for commercialization, in which advances in biochemical sensor technologies will be critically important.

A wearable patch for continuous analysis of thermoregulatory sweat at rest

The body naturally and continuously secretes sweat for thermoregulation during sedentary and routine activities at rates that can reflect underlying health conditions, including nerve damage, autonomic and metabolic disorders, and chronic stress. However, low secretion rates and evaporation pose challenges for collecting resting thermoregulatory sweat for non-invasive analysis of body physiology. Here we present wearable patches for continuous sweat monitoring at rest, using microfluidics to combat evaporation and enable selective monitoring of secretion rate. We integrate hydrophilic fillers for rapid sweat uptake into the sensing channel, reducing required sweat accumulation time towards real-time measurement. Along with sweat rate sensors, we integrate electrochemical sensors for pH, Cl-, and levodopa monitoring. We demonstrate patch functionality for dynamic sweat analysis related to routine activities, stress events, hypoglycemia-induced sweating, and Parkinson's disease. By enabling sweat analysis compatible with sedentary, routine, and daily activities, these patches enable continuous, autonomous monitoring of body physiology at rest.

Advances in the development paradigm of biosample-based biosensors for early ultrasensitive detection of alzheimer's disease

This review highlights current developments, challenges, and future directions for the use of invasive and noninvasive biosample-based small biosensors for early diagnosis of Alzheimer's disease (AD) with biomarkers to incite a conceptual idea from a broad number of readers in this field. We provide the most promising concept about biosensors on the basis of detection scale (from femto to micro) using invasive and noninvasive biosamples such as cerebrospinal fluid (CSF), blood, urine, sweat, and tear. It also summarizes sensor types and detailed analyzing techniques for ultrasensitive detection of multiple target biomarkers (i.e., amyloid beta (Aβ) peptide, tau protein, Acetylcholine (Ach), microRNA137, etc.) of AD in terms of detection ranges and limit of detections (LODs). As the most significant disadvantage of CSF and blood-based detection of AD is associated with the invasiveness of sample collection which limits future strategy with home-based early screening of AD, we extensively reviewed the future trend of new noninvasive detection techniques (such as optical screening and bio-imaging process). To overcome the limitation of non-invasive biosamples with low concentrations of AD biomarkers, current efforts to enhance the sensitivity of biosensors and discover new types of biomarkers using non-invasive body fluids are presented. We also introduced future trends facing an infection point in early diagnosis of AD with simultaneous emergence of addressable innovative technologies.

Modeling, Fabrication and Integration of Wearable Smart Sensors in a Monitoring Platform for Diabetic Patients

The monitoring of some parameters, such as pressure loads, temperature, and glucose level in sweat on the plantar surface, is one of the most promising approaches for evaluating the health state of the diabetic foot and for preventing the onset of inflammatory events later degenerating in ulcerative lesions. This work presents the results of sensors microfabrication, experimental characterization and FEA-based thermal analysis of a 3D foot-insole model, aimed to advance in the development of a fully custom smart multisensory hardware-software monitoring platform for the diabetic foot. In this system, the simultaneous detection of temperature-, pressure- and sweat-based glucose level by means of full custom microfabricated sensors distributed on eight reading points of a smart insole will be possible, and the unit for data acquisition and wireless transmission will be fully integrated into the platform. Finite element analysis simulations, based on an accurate bioheat transfer model of the metabolic response of the foot tissue, demonstrated that subcutaneous inflamed lesions located up to the muscle layer, and ischemic damage located not below the reticular/fat layer, can be successfully detected. The microfabrication processes and preliminary results of functional characterization of flexible piezoelectric pressure sensors and glucose sensors are presented. Full custom pressure sensors generate an electric charge in the range 0-20 pC, proportional to the applied load in the range 0-4 N, with a figure of merit of 4.7 ± 1 GPa. The disposable glucose sensors exhibit a 0-6 mM (0-108 mg/dL) glucose concentration optimized linear response (for sweat-sensing), with a LOD of 3.27 µM (0.058 mg/dL) and a sensitivity of 21 µA/mM cm2 in the PBS solution. The technical prerequisites and experimental sensing performances were assessed, as preliminary step before future integration into a second prototype, based on a full custom smart insole with enhanced sensing functionalities.

Wearable biochemical sensors for human health monitoring: sensing materials and manufacturing technologies

Wearable biochemical sensors are of great interest nowadays due to their powerful potential in personalized medicine and continuous monitoring of human health. Thus, a great deal of effort has been put into the development of such sensors to enable real-time and non-invasive quantification of various chemical constituents in the human body such as sweat, saliva, and tears. Owing to the advances in materials science and mechanical engineering, wearable biochemical sensors have been developed to probe various biomarkers and have been subsequently considered as wearable electronic devices for practical applications. In this review, we present a broad overview on the recent advances in electrochemical wearable sensors towards various organic components and ions closely linked to human health. With an emphasis on materials and manufacturing technologies of the sensing electrodes, the research status is summarized, and the challenges and opportunities in this growing field are prospected.

A fully screen-printed potentiometric chloride ion sensor employing a hydrogel-based touchpad for simple and non-invasive daily electrolyte analysis

This is the first report demonstrating proof of concept for the passive, non-invasive extraction and in situ potentiometric detection of human sweat chloride ions (Cl^- ions) using a stable printed planar liquid-junction reference electrode-integrated hydrogel-based touch-sensor pad without activities such as exercise to induce perspiration, environmental temperature control, or requiring cholinergic drug administration. The sensor pad was composed entirely of a screen-printed bare Ag/AgCl-based chloride ion-selective electrode and a planar liquid-junction Ag/AgCl reference electrode, which were fully covered by an agarose hydrogel in phosphate-buffered saline (PBS). When human skin contacted the hydrogel pad, sweat Cl^- ions were continuously extracted into the gel, followed by in situ potentiometric detection. The planar liquid-junction Ag/AgCl reference electrode had a polymer-based KCl-saturated inner electrolyte layer to stabilize the potential of the Ag/AgCl electrode even with a substantial change in the chloride ion concentration in the hydrogel pad. We expect this fully screen-printed sensor to achieve the low-cost passive and non-invasive daily monitoring of human Cl^- ions in sweat in the future.

Non-Invasive Electrochemical Biosensors Operating in Human Physiological Fluids

Non-invasive healthcare technologies are an important part of research and development nowadays due to the low cost and convenience offered to both healthcare receivers and providers. This work overviews the recent advances in the field of non-invasive electrochemical biosensors operating in secreted human physiological fluids, viz. tears, sweat, saliva, and urine. Described electrochemical devices are based on different electrochemical techniques, viz. amperometry, coulometry, cyclic voltammetry, and impedance spectroscopy. Challenges that confront researchers in this exciting area and key requirements for biodevices are discussed. It is concluded that the field of non-invasive sensing of biomarkers in bodily fluid is highly convoluted. Nonetheless, if the drawbacks are appropriately addressed, and the pitfalls are adroitly circumvented, the approach will most certainly disrupt current clinical and self-monitoring practices.