Electrochemical Paper-Based Biosensor Devices for Rapid Detection of Biomarkers

Recent Advances in the Fabrication and Application of Electrochemical Paper-Based Analytical Devices

In response to growing environmental concerns, the scientific community is increasingly incorporating green chemistry principles into modern analytical techniques. Electrochemical paper-based analytical devices (ePADs) have emerged as a sustainable and efficient alternative to conventional analytical devices, offering robust applications in point-of-care testing, personalized healthcare, environmental monitoring, and food safety. ePADs align with green chemistry by minimizing reagent use, reducing energy consumption, and being disposable, making them ideal for eco-friendly and cost-effective analyses. Their user-friendly interface, alongside sensitive and selective detection capabilities, has driven their popularity in recent years. This review traces the evolution of ePADs from simple designs to complex multilayered structures that optimize analyte flow and improve detection. It also delves into innovative electrode fabrication methods, assessing key advantages, limitations, and modification strategies for enhanced sensitivity. Application-focused sections explore recent advancements in using ePADs for detecting diseases, monitoring environmental hazards like heavy metals and bacterial contamination, and screening contaminants in food. The integration of cutting-edge technologies, such as wearable wireless devices and the Internet of Things (IoT), further positions ePADs at the forefront of point-of-care testing (POCT). Finally, the review identifies key research gaps and proposes future directions for the field.

Applications of chemically modified screen-printed electrodes in food analysis and quality monitoring: a review

Food analysis and food quality monitoring are vital aspects of the food industry, ensuring the safety and authenticity of various food products, from packaged goods to fast food. In this comprehensive review, we explore the applications of chemically modified Screen-Printed Electrodes (SPEs) in these critical domains. SPEs have become extremely useful devices for ensuring food safety and quality assessment because of their adaptability, affordability, and convenience of use. The Introduction opens the evaluation, that covers a wide spectrum of foods, encompassing packaged, junk food, and food quality concerns. This sets the stage for a detailed exploration of chemically modified SPEs, including their nature, types, utilization, and the advantages they offer in the context of food analysis. Subsequently, the review delves into the multitude applications of SPEs in food analysis, ranging from the detection of microorganisms such as bacteria and fungi, which are significant indicators of food spoilage and safety, to the identification of pesticide residues, food colorants, chemicals, toxins, and antibiotics. Furthermore, chemically modified SPEs have proven to be invaluable in the quantification of metal ions and vitamins in various food matrices, shedding light on nutritional content and quality.

Metal-organic framework (MOF)-based biosensors for miRNA detection

MicroRNAs (miRNAs) play several crucial roles in the physiological and pathological processes of the human body. They are considered as important biomarkers for the diagnosis of various disorders. Thus, rapid, sensitive, selective, and affordable detection of miRNAs is of great importance. However, the small size, low abundance, and highly similar sequences of miRNAs impose major challenges to their accurate detection in biological samples. In recent years, metal-organic frameworks (MOFs) have been applied as promising sensing materials for the fabrication of different biosensors due to their distinctive characteristics, such as high porosity and surface area, tunable pores, outstanding adsorption affinities, and ease of functionalization. In this review, the applications of MOFs and MOF-derived materials in the fabrication of fluorescence, electrochemical, chemiluminescence, electrochemiluminescent, and photoelectrochemical biosensors for the detection of miRNAs and their detection principle and analytical performance are discussed. This paper attempts to provide readers with a comprehensive knowledge of the fabrication and sensing mechanisms of miRNA detection platforms.

Paper-based sensors: affordable, versatile, and emerging analyte detection platforms

Paper-based sensors, often referred to as paper-based analytical devices (PADs), stand as a transformative technology in the field of analytical chemistry. They offer an affordable, versatile, and accessible solution for diverse analyte detection. These sensors harness the unique properties of paper substrates to provide a cost-effective and adaptable platform for rapid analyte detection, spanning chemical species, biomolecules, and pathogens. This review highlights the key attributes that make paper-based sensors an attractive choice for analyte detection. PADs demonstrate their versatility by accommodating a wide range of analytes, from ions and gases to proteins, nucleic acids, and more, with customizable designs for specific applications. Their user-friendly operation and minimal infrastructure requirements suit point-of-care diagnostics, environmental monitoring, food safety, and more. This review also explores various fabrication methods such as inkjet printing, wax printing, screen printing, dip coating, and photolithography. Incorporating nanomaterials and biorecognition elements promises even more sophisticated and sensitive applications.

Kirigami tripod-based electrode for the development of highly stretchable dengue aptasensor

Kirigami is one of the interesting paper art forms and the modified sub-class of origami. Kirigami paper art is widely employed in a variety of applications, and it is currently being used in biosensors because of its outstanding advantages. This is the first study on the use of a Kirigami-based aptasensor for DENV (Dengue virus)-antigen detection. In this study, the kirigami approach has been utilized to develop a stretchable, movable, and flexible sensor. The constructed stretchable-kirigami electrode helps in adjusting the connection of electrodes without disturbing the electrochemical cell zone during the experiment. To increase the sensitivity of this biosensor we have synthesized Ag-NPs (Silver nanoparticles) via chemical methods and characterized their results with the help of TEM & UV-Vis Spectroscopy. Different electrochemical approaches were used to validate the sensor response i.e., CV (Cyclic voltammetry) and LSV (Linear sweep voltammetry), which exhibited great detection capability towards dengue virus with the range of 0.1 µg/ml to 1000 µg/ml along with a detection limit of 0.1 µg/ml and showing no reactivity to the chikungunya virus antigen, making it more specific to the DENV antigen. Serum (healthy-human) was also successfully applied to validate the results of the constructed aptasensor. Integration of the Kirigami approach form with the electrochemical aptasensor that utilizes a 3-E setup (three-electrode setup) which is referred to as a tripod and collectively called Kirigami-tripod-based aptasensor. Thus, the developed integrated platform improves the sensors capabilities in terms of cost efficiency, high stretchability, and sensitivity.

Advances and Challenges in Nanomaterial-Based Electrochemical Immunosensors for Small Cell Lung Cancer Biomarker Neuron-Specific Enolase

Early and rapid detection of neuron-specific enolase (NSE) is highly significant, as it is putative biomarker for small-cell lung cancer as well as COVID-19. Electrochemical techniques have attracted substantial attention for the early detection of cancer biomarkers due to the important properties of simplicity, high sensitivity, specificity, low cost, and point-of-care detection. This work reviews the clinically relevant labeled and label-free electrochemical immunosensors developed so far for the analysis of NSE. The prevailing role of nanostructured materials as electrode matrices is thoroughly discussed. Subsequently, the key performances of various immunoassays are critically evaluated in terms of limit of detection, linear ranges, and incubation time for clinical translation. Electrochemical techniques coupled with screen-printed electrodes developing market level commercialization of NSE sensors is also discussed. Finally, the review concludes with the current challenges associated with available methods and provides a future outlook toward commercialization opportunities for easy detection of NSE.

Paper as smart support for bioreceptor immobilization in electrochemical paper-based devices

The use of paper as a smart support in the field of electrochemical sensors has been largely improved over the last 15 years, driven by its outstanding features such as foldability and porosity, which enable the design of reagent and equipment-free multi-analysis devices. Furthermore, the easy surface engineering of paper has been used to immobilize different bioreceptors, through physical adsorption, covalent bonding, and electrochemical polymerization, boosting the fine customization of the analytical performances of paper-based biosensors. In this review, we focused on the strategies to engineer the surface of the paper for the immobilization of (bio)recognition elements (eg., enzymes, antibodies, DNA, molecularly imprinted polymers) with the overriding goal to develop accurate and reliable paper-based electrochemical biosensors. Furthermore, we highlighted how to take advantage of paper for designing smart configurations by integrating different analytical processes in an eco-designed analytical tool, starting from the immobilization of the (bio)receptor and the reagents, through a designed sample flow along the device, until the analyte detection.

Sample-to-answer sensing technologies for nucleic acid preparation and detection in the field

Efficient sample preparation and accurate disease diagnosis under field conditions are of great importance for the early intervention of diseases in humans, animals, and plants. However, in-field preparation of high-quality nucleic acids from various specimens for downstream analyses, such as amplification and sequencing, is challenging. Thus, developing and adapting sample lysis and nucleic acid extraction protocols suitable for portable formats have drawn significant attention. Similarly, various nucleic acid amplification techniques and detection methods have also been explored. Combining these functions in an integrated platform has resulted in emergent sample-to-answer sensing systems that allow effective disease detection and analyses outside a laboratory. Such devices have a vast potential to improve healthcare in resource-limited settings, low-cost and distributed surveillance of diseases in food and agriculture industries, environmental monitoring, and defense against biological warfare and terrorism. This paper reviews recent advances in portable sample preparation technologies and facile detection methods that have been / or could be adopted into novel sample-to-answer devices. In addition, recent developments and challenges of commercial kits and devices targeting on-site diagnosis of various plant diseases are discussed.

Paper-Based All-in-One Origami Nanobiosensor for Point-of-Care Detection of Cardiac Protein Markers in Whole Blood

Rapid and accurate diagnosis of cardiovascular diseases (CVDs) at the earliest stage is of paramount importance to improve the treatment outcomes and avoid irreversible damage to a patient's cardiovascular system. Microfluidic paper-based devices (μPADs) represent a promising platform for rapid CVD diagnosis at the point of care (POC). This paper presents an electrochemical μPAD (E-μPAD) with an all-in-one origami design for rapid and POC testing of cardiac protein markers in whole blood. Based on the label-free, electrochemical impedance spectroscopy (EIS) immunoassay, the E-μPAD integrates all essential components on a single chip, including three electrochemical cells, a plasma separation membrane, and a buffer absorption pad, enabling easy and streamlined operations for multiplexed detection of three cardiac protein markers [cardiac troponin I (cTnI), brain natriuretic peptide (BNP)-32, and D-Dimer] on a finger-prick whole blood sample within 46 min. Superior analytical performance is achieved through sensitive EIS measurement on carbon electrodes decorated with semiconductor zinc oxide nanowires (ZnO NWs). Using spiked human plasma samples, ultralow limits of detection (LODs) of E-μPAD are achieved at 4.6 pg/mL (190 fM) for cTnI, 1.2 pg/mL (40 fM) for BNP-32, and 146 pg/mL (730 fM) for D-Dimer. Real human blood samples spiked with purified proteins are also tested, and the device's analytical performance was proven to be comparable to commercial ELISA kits. The all-in-one E-μPAD will allow rapid and sensitive testing of cardiac protein markers through easy operations, which holds great potential for on-site screening of acute CVDs in nonlaboratory settings such as emergency rooms, doctor's offices, or patient homes.

Engineering a Point-of-Care Paper-Microfluidic Electrochemical Device Applied to the Multiplexed Quantitative Detection of Biomarkers in Sputum

Health initiatives worldwide demand affordable point-of-care devices to aid in the reduction of morbidity and mortality rates of high-incidence infectious and noncommunicable diseases. However, the production of robust and reliable easy-to-use diagnostic platforms showing the ability to quantitatively measure several biomarkers in physiological fluids and that could in turn be decentralized to reach any relevant environment remains a challenge. Here, we show the particular combination of paper-microfluidic technology, electrochemical transduction, and magnetic nanoparticle-based immunoassay approaches to produce a unique, compact, and easily deployable multiplex device to simultaneously measure interleukin-8, tumor necrosis factor-α, and myeloperoxidase biomarkers in sputum, developed with the aim of facilitating the timely detection of acute exacerbations of chronic obstructive pulmonary disease. The device incorporates an on-chip electrochemical cell array and a multichannel paper component, engineered to be easily aligned into a polymeric cartridge and exchanged if necessary. Calibration curves at clinically relevant biomarker concentration ranges are produced in buffer and artificial sputum. The analysis of sputum samples of healthy individuals and acutely exacerbated patients produces statistically significant biomarker concentration differences between the two studied groups. The device can be mass-produced at a low cost, being an easily adaptable platform for measuring other disease-related target biomarkers.

Large-scale nano-biosensing technologies

Nanoscale technologies have brought significant advancements to modern diagnostics, enabling unprecedented bio-chemical sensitivities that are key to disease monitoring. At the same time, miniaturized biosensors and their integration across large areas enabled tessellating these into high-density biosensing panels, a key capability for the development of high throughput monitoring: multiple patients as well as multiple analytes per patient. This review provides a critical overview of various nanoscale biosensing technologies and their ability to unlock high testing throughput without compromising detection resilience. We report on the challenges and opportunities each technology presents along this direction and present a detailed analysis on the prospects of both commercially available and emerging biosensing technologies.

Recent progress of microfluidic chips in immunoassay

Microfluidic chip technology is a technology platform that integrates basic operation units such as processing, separation, reaction and detection into microchannel chip to realize low consumption, fast and efficient analysis of samples. It has the characteristics of small volume need of samples and reagents, fast analysis, low cost, automation, portability, high throughout, and good compatibility with other techniques. In this review, the concept, preparation materials and fabrication technology of microfluidic chip are described. The applications of microfluidic chip in immunoassay, including fluorescent, chemiluminescent, surface-enhanced Raman spectroscopy (SERS), and electrochemical immunoassay are reviewed. Look into the future, the development of microfluidic chips lies in point-of-care testing and high throughput equipment, and there are still some challenges in the design and the integration of microfluidic chips, as well as the analysis of actual sample by microfluidic chips.

Electrochemical biosensors based on saliva electrolytes for rapid detection and diagnosis

In recent years, electrochemical biosensors (ECBSs) have shown significant potential for real-time disease diagnosis and in situ physical condition monitoring. As a multi-constituent oral fluid comprising various disease signaling biomarkers, saliva has drawn much attention in the field of point-of-care (POC) testing. In particular, during the outbreak of the COVID-19 pandemic, ECBSs which hold the simplicity of a single-step assay compared with the multi-step assay of traditional testing methods are expected to relieve the human and economic burden caused by the massive and long-term sample testing process. Noteworthily, ECBSs for the detection of SARS-CoV-2 in saliva have already been developed and may replace current testing methods. Furthermore, the detection scope has expanded from routine indices such as sugar and uric acid to abnormal biomarkers for early-stage disease detection and drug level monitoring, which further facilitated the evolution of ECBSs in the last 5 years. This review is divided into several main sections. First, we discussed the latest advancements and representative research on ECBSs for saliva testing. Then, we focused on a novel kind of ECBS, organic electrochemical transistors (OECTs), which hold great advantages of high sensitivity and signal-to-noise ratio and on-site detection. Finally, application of ECBSs with integrated portable platforms in oral cavities, which lead to powerful auxiliary testing means for telemedicine, has also been discussed.

Emerging bioanalytical sensors for rapid and close-to-real-time detection of priority abiotic and biotic stressors in aquaculture and culture-based fisheries

Abiotic stresses of various chemical contamination of physical, inorganic, organic and biotoxin origin and biotic stresses of bacterial, viral, parasitic and fungal origins are the significant constraints in achieving higher aquaculture production. Testing and rapid detection of these chemical and microbial contaminants are crucial in identifying and mitigating abiotic and biotic stresses, which has become one of the most challenging aspects in aquaculture and culture-based fisheries. The classical analytical techniques, including titrimetric methods, spectrophotometric, mass spectrometric, spectroscopic, and chromatographic techniques, are tedious and sometimes inaccessible when required. The development of novel and improved bioanalytical methods for rapid, selective and sensitive detection is a wide and dynamic field of research. Biosensors offer precise detection of biotic and abiotic stressors in aquaculture and culture-based fisheries within no time. This review article allows filling the knowledge gap for detection and monitoring of chemical and microbial contaminants of abiotic and biotic origin in aquaculture and culture-based fisheries using nano(bio-) analytical technologies, including nano(bio-)molecular and nano(bio-)sensing techniques.

Paper-based microfluidic devices for food adulterants: Cost-effective technological monitoring systems

Analytical sciences have witnessed emergent techniques for efficient clinical and industrial food adulterants detection. In this review, the contributions made by the paper-based devices are highlighted for efficient and rapid detection of food adulterants and additives, which is the need of the hour and how different categories of techniques have been developed in the past decade for upgrading the performance for point-of-care testing. A simple strategy with an arrangement for detecting specific adulterants followed by the addition of samples to obtain well-defined qualitative or quantitative signals for confirming the presence of target species. The paper-based microfluidics-based technology advances and prospects for food adulterant detection are discussed given the high-demand from the food sectors and serve as a valued technology for food researchers working in interdisciplinary technological frontiers.

Paper-Based Flow Sensor for the Detection of Hyaluronidase via an Enzyme Hydrolysis-Induced Viscosity Change in a Polymer Solution

Hyaluronidase (HAase) is implicated in inflammation, cancer development, and allergic reaction. The detection of HAase is significantly important in clinical diagnosis and medical treatment. Herein, we propose a new principle for the development of equipment-free and label-free paper-based flow sensors based on the enzymatic hydrolysis-induced viscosity change in a stimuli-responsive polymer solution, which increases the water flow distance on the pH indicator paper. The detection of HAase is demonstrated as an example. This facile and versatile method can overcome the potential drawbacks of traditional hydrogel-based sensors, including complex preparation steps, slow response time, or low sensitivity. Moreover, it can also avoid the use of specialized instruments, labeled molecules, or functionalized nanoparticles in the sensors developed using the polymer solutions. Using this strategy, the detection of HAase is achieved with a limit of detection as low as 0.2 U/mL. Also, it works well in human urine. Additionally, the detection of tannic acid, which is an inhibitor of HAase, is also fulfilled. Overall, a simple, efficient, high-throughput, and low-cost detection method is developed for the rapid and quantitative detection of HAase and its inhibitor without the use of labeled molecules, synthetic particles, and specialized instruments. As only minimal reagents of HAase, HA, and paper are used, it is very promising in the development of commercial kits for point-of-care testing.

Design, fabrication and assembly of lab-on-a-chip and its uses

Lab-on-a-chip diagnostic devices can be used as quick tools to identify the onset of diseases at an early stage. An integrated LoC platform usually consists of a set of microfluidic elements, each of which has dedicated functions like fluid mixing, fluid manipulation, and flow control, sample preparation, detection, and a read-out that can perform the conventional laboratory procedures on a miniaturized chip. The lab-on-a-chip device can be developed on a paper or polymeric platform and is usually fabricated using pattern transfer techniques or additive and subtractive manufacturing processes. Thorough knowledge of the physics involved in microfluidic technology is essential for developing miniaturized components required for a stand-alone Point-of-Care LoC device. This chapter discusses different types of lab-on-a-chip devices, the essential principles governing the design of these systems, and different fabrication techniques. The chapter concludes with some of the prominent applications of lab-on-a-chip devices.

Paper and thread as media for the frugal detection of urinary tract infections (UTIs)

Urinary tract infections (UTIs) make up a significant proportion of the global burden of disease in vulnerable groups and tend to substantially impair the quality of life of those affected, making timely detection of UTIs a priority for public health. However, economic and societal barriers drastically reduce accessibility of traditional lab-based testing methods for critical patient groups in low-resource areas, negatively affecting their overall healthcare outcomes. As a result, cellulose-based materials such as paper and thread have garnered significant interest among researchers as substrates for so-called frugal analytical devices which leverage the material's portability and adaptability for facile and reproducible diagnoses of UTIs. Although the field may be only in its infancy, strategies aimed at commercial penetration can appreciably increase access to more healthcare options for at-risk people. In this review, we catalogue recent advances in devices that use cellulose-based materials as the primary housing or medium for UTI detection and chart out trends in the field. We also explore different modalities employed for detection, with particular emphasis on their ability to be ported onto discreet casings such as sanitary products.

A paper-based colorimetric molecular test for SARS-CoV-2 in saliva

Herein, we describe the development of a paper-based device to detect nucleic acids of pathogens of interest in complex samples using loop-mediated isothermal amplification (LAMP) by producing a colorimetric response visible to the human eye. To demonstrate the utility of this device in emerging public health emergencies, we developed and optimized our device to detect SARS-CoV-2 in human saliva without preprocessing. The resulting device was capable of detecting the virus within 60 min and had an analytical sensitivity of 97% and a specificity of 100% with a limit of detection of 200 genomic copies/μL of patient saliva using image analysis. The device consists of a configurable number of reaction zones constructed of Grade 222 chromatography paper separated by 20 mil polystyrene spacers attached to a Melinex® backing via an ARclean® double-sided adhesive. The resulting device is easily configurable to detect multiple targets and has the potential to detect a variety of pathogens simply by changing the LAMP primer sets.

Paper-based field-effect transistor sensors

The present scenario in the world largely demands affordable, fast, recyclable, and flexible electronic devices for bio sensing. Varieties of paper-based devices such as microfluidics paper electrodes, paper diodes, and paper-based transistors etc. have been developed and validated. Most of the fabrication techniques published so far have focused on economic, environment-friendly straightforward methods to develop paper-based field-effect transistors (PFET) sensors, additionally, explored their applications. The synthetic-free, mechanically flexible, biocompatible, and signal amplification capability render PFET based sensors for wearable device makers. Modified organic/inorganic PFETs identify target analytes based on the electrical signal and endow them as perfect transducers. In the field of PFET bio sensing technology, numerous challenges are needed to be discussed to proceed forward in biomedical and other analytical applications. Realizing biologically or chemically modified PFET having an exceptional signal to noise ratio, specificity, with rapid detection ability is challenging. This review recapitulates the fabrication techniques, performances of various PFET sensors, and summarizes the report by concluding remarks including the limitations of the existing PFET based sensors and the future holds in regards to the sustainable nature of PFET.

A new and high-performance microfluidic analytical device based on Fusion 5 paper for the detection of chili pepper anthracnose pathogen Colletotrichum truncatum

A microfluidic analytical device based on wax-patterned Fusion 5 paper was designed and fabricated to facilitate early detection and improve control of anthracnose disease. Here, a rapid, specific, on-site, and low operational cost nucleic acid biosensor (ACT-Ct-PAD) based on the actin gene (ACT) and wax-patterned Fusion 5 paper was used to detect the PCR products of Colletotrichum truncatum (Ct), the main causal agent of chili anthracnose in Asia. The sensor was developed by using DNA conjugated gold nanoparticles (AuNPs-DNA) as a detection probe, which will hybridize to a complementary target sequence. Avidin coated mesoporous silica particles were attached to biotin-tagged DNA sequences forming capture probes, which were immobilized on the test and control zones of the device. The hybridization complex (MSP-dsDNA-AuNPs) produces an intense red color, which provides a platform for colorimetric detection. By targeting an actin gene sequence, the ACT-Ct-PAD device allows the detection of Ct DNA within 15 min. The specificity of the sensor was confirmed by the absence of a positive signal for DNA from non-target Colletotrichum species and two different fungal genera. Our wax-patterned Fusion 5 sensor provides a simple tool for the rapid nucleic acid diagnosis with a detection limit down to 17.42 femtomoles. This method has the potential to be applied for protein assay as well; hence, it has a considerable impact on on-site diagnostics.

Hybrid Technologies Combining Solid-State Sensors and Paper/Fabric Fluidics for Wearable Analytical Devices

The development of diagnostic tools for measuring a wide spectrum of target analytes, from biomarkers to other biochemical parameters in biological fluids, has experienced a significant growth in the last decades, with a good number of such tools entering the market. Recently, a clear focus has been put on miniaturized wearable devices, which offer powerful capabilities for real-time and continuous analysis of biofluids, mainly sweat, and can be used in athletics, consumer wellness, military, and healthcare applications. Sweat is an attractive biofluid in which different biomarkers could be noninvasively measured to provide rapid information about the physical state of an individual. Wearable devices reported so far often provide discrete (single) measurements of the target analytes, most of them in the form of a yes/no qualitative response. However, quantitative biomarker analysis over certain periods of time is highly demanded for many applications such as the practice of sports or the precise control of the patient status in hospital settings. For this, a feasible combination of fluidic elements and sensor architectures has been sought. In this regard, this paper shows a concise overview of analytical tools based on the use of capillary-driven fluidics taking place on paper or fabric devices integrated with solid-state sensors fabricated by thick film technologies. The main advantages and limitations of the current technologies are pointed out together with the progress towards the development of functional devices. Those approaches reported in the last decade are examined in detail.

Facile open-well immunofluorescence enhancement with coplanar-electrodes-enabled optoelectrokinetics and magnetic particles

Electrokinetic manipulation has been proven powerful in enhancing the sensing capability of general-purpose biochips. However, the close-form configuration of biochips and the required use of low electric conductivity limit their practicability. In this study, an open-well microfluidic system facilitated with coplanar-electrodes-enabled optoelectrokinetic concentration and magnetic particles were therefore developed to overcome these challenges. The open side achieves optoelectrokinetic manipulation for biosignal enhancement, enabling free manual operations. Magnetic particles were employed in immunoassays to facilitate the rapid onsite separation of targets. A common cytokine biomarker found in many diseases, that is, tumor necrosis factor alpha (TNF-α), was used for assessing the immunosensing system. In addition to the benefits inherited from the immunoassays, the fluorescent signal enhanced by the optoelectrokinetic technique also featured rapid enhancement in 1 min and a limit of detection of as low as 2.9 pg/mL. The open-well architecture allowed the entire immunosensing process to be completed on site without frequent off-site washing. For a practical test, the TNF-α in human tear fluids was measured by the developed device and validated with a standard enzyme-linked immunosorbent assay (ELISA). The data show consistency in terms of trend. The developed open-well optoelectrokinetic device provides an insight into future facile clinical diagnoses. By simply modifying the surface linkers on the magnetic particles, the technique can be further extended to more other trace biomarker detections.

Graphene Oxide Nanoparticles Modified Paper Electrode as a Biosensing Platform for Detection of the htrA Gene of O. tsutsugamushi

The unique structural and electrochemical properties of graphene oxide (GO) make it an ideal material for the fabrication of biosensing devices. Therefore, in the present study, graphene oxide nanoparticles modified paper electrodes were used as a low-cost matrix for the development of an amperometric DNA sensor. The graphene oxide was synthesized using the modified hummers method and drop cast on a screen-printed paper electrode (SPPE) to enhance its electrochemical properties. Further, the GO/SPPE electrode was modified with a 5′NH2 labeled ssDNA probe specific to the htrA gene of Orientia tsutsugamushi using carbodiimide cross-linking chemistry. The synthesized GO was characterized using UV-Vis, FTIR, and XRD. The layer-by-layer modification of the paper electrode was monitored via FE-SEM, cyclic voltammetry, and electrochemical impedance spectroscopy (EIS). The sensor response after hybridization with single-stranded genomic DNA (ssGDNA) of O. tsutsugamushi was recorded using differential pulse voltammetry (DPV). Methylene blue (1 mM in PBS buffer, pH 7.2) was used as a hybridization indicator and [Fe(CN)₆]^−3/−4 (2.5 mM in PBS buffer, pH 7.2) as a redox probe during electrochemical measurements. The developed DNA sensor shows excellent sensitivity (1228.4 µA/cm²/ng) and LOD (20 pg/µL) for detection of O. tsutsugamushi GDNA using differential pulse voltammetry (DPV).

Flexible electrochemical biosensors for healthcare monitoring

As the interest in wearable devices has increased recently, increasing biosensor flexibility has begun to attract considerable attention. Among the various types of biosensors, electrochemical biosensors are uniquely suited for the development of such flexible biosensors due to their many advantages, including their fast response, inherent miniaturization, convenient operation, and portability. Therefore, many studies on flexible electrochemical biosensors have been conducted in recent years to achieve non-invasive and real-time monitoring of body fluids such as tears, sweat, and saliva. To achieve this, various substrates, novel nanomaterials, and detection techniques have been utilized to develop conductive flexible platforms that can be applied to create flexible electrochemical biosensors. In this review, we discussed recently reported flexible electrochemical biosensors and divided them into specific categories including materials for flexible substrate, fabrication techniques for flexible biosensor development, and recently developed flexible electrochemical biosensors to externally monitor target molecules, thereby providing a means to noninvasively examine cells and body fluid samples. In conclusion, this review will discuss the materials, methods, recent studies, and perspectives on flexible electrochemical biosensors for healthcare monitoring and wearable biosensing systems.

Synthesis, characterisation and cytotoxicity of gold microwires for ultra-sensitive biosensor development

With the long-term goal of developing an ultra-sensitive microcantilever-based biosensor for versatile biomarker detection, new controlled bioreceptor-analytes systems are being explored to overcome the disadvantages of conventional ones. Gold (Au) microwires have been used as a probe to overcome the tolerance problem that occurs in response to changes in environmental conditions. However, the cytotoxicity of Au microwires is still unclear. Here, we examined the cytotoxicity of Au microwires systems using both commercial and as-synthesised Au microwires. In vitro experiments show that commercial Au microwires with an average quoted length of 5.6 µm are highly toxic against Gram-negative Escherichia coli (E. coli) at 50 µg/mL. However, this toxicity is due to the presence of CTAB surfactant not by the microwires. Conversely, the as-synthesised Au microwires show non-cytotoxicity even at the maximum viable concentration (330 µg/mL). These findings may lead to the development of potentially life-saving cytotoxicity-free biosensors for an early diagnostic of potential diseases.

Paper-Based Screen-Printed Electrodes: A New Generation of Low-Cost Electroanalytical Platforms

Screen-printed technology has helped considerably to the development of portable electrochemical sensors since it provides miniaturized but robust and user-friendly electrodes. Moreover, this technology allows to obtain very versatile transducers, not only regarding their design, but also their ease of modification. Therefore, in the last decades, the use of screen-printed electrodes (SPEs) has exponentially increased, with ceramic as the main substrate. However, with the growing interest in the use of cheap and widely available materials as the basis of analytical devices, paper or other low-cost flat materials have become common substrates for SPEs. Thus, in this revision, a comprehensive overview on paper-based SPEs used for analytical proposes is provided. A great variety of designs is reported, together with several examples to illustrate the main applications.

Cultivation of Saccharomyces cerevisiae with Feedback Regulation of Glucose Concentration Controlled by Optical Fiber Glucose Sensor

Glucose belongs among the most important substances in both physiology and industry. Current food and biotechnology praxis emphasizes its on-line continuous monitoring and regulation. These provoke increasing demand for systems, which enable fast detection and regulation of deviations from desired glucose concentration. We demonstrated control of glucose concentration by feedback regulation equipped with in situ optical fiber glucose sensor. The sensitive layer of the sensor comprises oxygen-dependent ruthenium complex and preimmobilized glucose oxidase both entrapped in organic–inorganic polymer ORMOCER^®. The sensor was placed in the laboratory bioreactor (volume 5 L) to demonstrate both regulations: the control of low levels of glucose concentrations (0.4 and 0.1 mM) and maintenance of the glucose concentration (between 2 and 3.5 mM) during stationary phase of cultivation of Saccharomyces cerevisiae. Response times did not exceed 6 min (average 4 min) with average deviation of 4%. Due to these regulation characteristics together with durable and long-lasting (≥2 month) sensitive layer, this feedback regulation system might find applications in various biotechnological processes such as production of low glucose content beverages.

A New Paper-Based Microfluidic Device for Improved Detection of Nitrate in Water

In this paper, we report a simple and inexpensive paper-based microfluidic device for detecting nitrate in water. This device incorporates two recent developments in paper-based technology suitable for nitrate detection and has an optimized microfluidic design. The first technical advancement employed is an innovative fibrous composite material made up of cotton fibers and zinc microparticles that can be incorporated in paper-based devices and results in better nitrate reduction. The second is a detection zone with an immobilized reagent that allows the passage of a larger sample volume. Different acids were tested—citric and phosphoric acids gave better results than hydrochloric acid since this acid evaporates completely without leaving any residue behind on paper. Different microfluidic designs that utilize various fluid control technologies were investigated and a design with a folding detection zone was chosen and optimized to improve the uniformity of the signal produced. The optimized design allowed the device to achieve a limit of detection and quantification of 0.53 ppm and 1.18 ppm, respectively, for nitrate in water. This accounted for more than a 40% improvement on what has been previously realized for the detection of nitrate in water using paper-based technology.

Point-of-care cancer diagnostic devices: From academic research to clinical translation

Early and timely diagnosis of cancer plays a decisive role in appropriate treatment and improves clinical outcomes, improving public health. Significant advances in biosensor technologies are leading to the development of point-of-care (POC) diagnostics, making the testing process faster, easier, cost-effective, and suitable for on-site measurements. Moreover, the incorporation of various nanomaterials into the sensing platforms has yielded POC testing (POCT) platforms with enhanced sensitivity, cost-effectiveness and simplified detection schemes. POC cancer diagnostic devices provide promising platforms for cancer biomarker detection as compared to conventional in vitro diagnostics, which are time-consuming and require sophisticated instrumentation, centralized laboratories, and experienced operators. Current innovative approaches in POC technologies, including biosensors, smartphone interfaces, and lab-on-a-chip (LOC) devices are expected to quickly transform the healthcare landscape. However, only a few cancer POC devices (e.g. lateral flow platforms) have been translated from research laboratories to clinical care, likely due to challenges include sampling procedures, low levels of sensitivity and specificity in clinical samples, system integration and signal readout requirements. In this review, we emphasize recent advances in POC diagnostic devices for cancer biomarker detection and discuss the critical challenges which must be surmounted to facilitate their translation into clinical settings.

Paper-based microfluidic aptasensors

For in-situ disease markers detection, point-of-care (POC) diagnosis has great advantages in speed and cost compared with traditional techniques. The rapid diagnosis, prognosis, and surveillance of diseases can significantly reduce disease-related mortality and trauma. Therefore, increasing attention has been paid to the POC diagnosis devices due to their excellent diagnosis speed and portability. Over the past ten years, paper-based microfluidic aptasensors have emerged as a class of critical POC diagnosis devices and various aptasensors have been proposed to detect various disease markers. However, most aptasensors need further improvement before they can actually enter the market and be widely used. There is thus an urgent need to sort out the key points of preparing the aptasensors and the direction that needs to be invested in. This review summarizes the representative articles in the development of paper-based microfluidic aptasensors. These works can be divided into paper-based optical aptasensors and paper-based electrochemical aptasensors according to their output signals. Significant focus is applied to these works according to the following three parts: (1) The ingenious design of device structure; (2) Application and synthesis of nanomaterial; (3) The detection principle of the proposed aptasensor. This is a detailed and comprehensive review of paper-based microfluidic aptasensors. The accomplishments and shortcomings of the current aptasensors are outlined, the development direction and the future prospective are given. It is hoped that the research in this review can provide a reference for further development of more advanced, more effective paper-based microfluidic aptasensors for POC disease markers diagnosis.

Printed Electrodes in Microfluidic Arrays for Cancer Biomarker Protein Detection

Medical diagnostics is trending towards a more personalized future approach in which multiple tests can be digitized into patient records. In cancer diagnostics, patients can be tested for individual protein and genomic biomarkers that detect cancers at very early stages and also be used to monitor cancer progression or remission during therapy. These data can then be incorporated into patient records that could be easily accessed on a cell phone by a health care professional or the patients themselves on demand. Data on protein biomarkers have a large potential to be measured in point-of-care devices, particularly diagnostic panels that could provide a continually updated, personalized record of a disease like cancer. Electrochemical immunoassays have been popular among protein detection methods due to their inherent high sensitivity and ease of coupling with screen-printed and inkjet-printed electrodes. Integrated chips featuring these kinds of electrodes can be built at low cost and designed for ease of automation. Enzyme-linked immunosorbent assay (ELISA) features are adopted in most of these ultrasensitive detection systems, with microfluidics allowing easy manipulation and good fluid dynamics to deliver reagents and detect the desired proteins. Several of these ultrasensitive systems have detected biomarker panels ranging from four to eight proteins, which in many cases when a specific cancer is suspected may be sufficient. However, a grand challenge lies in engineering microfluidic-printed electrode devices for the simultaneous detection of larger protein panels (e.g., 50-100) that could be used to test for many types of cancers, as well as other diseases for truly personalized care.

A Microfluidic Paper-Based Analytical Device for Type-II Pyrethroid Targets in an Environmental Water Sample

A detection method for type-II pyrethroids in an environmental water sample using a microfluidic paper-based analytical device (µPAD) is reported here. The detection approach is based on the formation of cyanide from the hydrolysis of type-II pyrethroids and the colorimetric detection of cyanide on a layer-based µPAD. Parafilm and inexpensive laminating pouches were used to create a hydrophobic barrier for the assay on the µPAD. This detection approach was selective to type-II pyrethroids in water for which an environmental water sample was tested. The calibration curves for cypermethrin, deltamethrin, cyhalothrin, and fenvalerate ranged from 2 to 40 µg/mL without sample preconcentration. The lower concentrations of type-II pyrethroids can be assessed by including a preconcentration step prior to the detection on a µPAD. This detection system provides an alternative platform for fast, semiquantitative testing for pesticide contamination in environmental surface water by allowing for portability, low reagent/sample consumption, and low-cost testing.

Paper-based sorptive phases for microextraction and sensing

The simplification of the analytical procedures, including cost-effective materials and detectors, is a current research trend. In this context, paper has been identified as a useful material thanks to its low price and high availability in different compositions (office, filter, chromatographic). Its porosity, flexibility, and planar geometry permit the design of flow-through devices compatible with most instrumental techniques. This article provides a general overview of the potential of paper, as substrate, on the simplification of analytical chemistry methodologies. The design of paper-based sorptive phases is considered in-depth, and the different functionalization strategies are described. Considering our experience in sample preparation, special attention has been paid to the use of these phases under the classical microextraction-analysis workflow, which usually includes a chromatographic separation of the analytes before their determination. However, the interest of these materials extends beyond this field as they can be easily implemented into spectroscopic and electrochemical sensors. Finally, the direct analysis of paper substrates in mass spectrometry, in the so-called paper-spray technique is also discussed. This review is more focused on presenting ideas rather than the description of specific applications to draw a general picture of the potential of these materials.

Cytokine and Cancer Biomarkers Detection: The Dawn of Electrochemical Paper-Based Biosensor

Although the established ELISA-based sensing platforms have many benefits, the importance of cytokine and cancer biomarkers detection for point-of-care diagnostics has propelled the search for more specific, sensitive, simple, accessible, yet economical sensor. Paper-based biosensor holds promise for future in-situ applications and can provide rapid analysis and data without the need to conduct in a laboratory. Electrochemical detection plays a vital role in interpreting results obtained from qualitative assessment to quantitative determination. In this review, various factors affecting the design of an electrochemical paper-based biosensor are highlighted and discussed in depth. Different detection methods, along with the latest development in utilizing them in cytokine and cancer biomarkers detection, are reviewed. Lastly, the fabrication of portable electrochemical paper-based biosensor is ideal in deliberating positive societal implications in developing countries with limited resources and accessibility to healthcare services.