Prospects and advancements in C-reactive protein detection

Preparation and Characterization of C-Reactive Protein Dual-Particle Latex-Enhanced Immunoturbidimetric Reagents

Objective and Impact Statement: This study aims to couple C-reactive protein (CRP) antibodies onto latex spheres of 2 different sizes to enhance the accuracy and sensitivity of CRP detection. Furthermore, it seeks to establish a robust methodological framework crucial for advancing the development of latex-enhanced immunoturbidimetric detection reagents. Introduction: CRP, an acute-phase protein, rapidly elevates in response to infections or tissue damage. Double-particle latex-enhanced immunoturbidimetry offers important advantages for accurately measuring CRP levels. Methods: CRP antibodies were coupled with 2 sizes of polystyrene latex spheres. Coupling rates were evaluated to determine optimal conditions. Particle sizes suitable for CRP detection, as well as coupling and mixing ratios, were optimized using automated biochemical analysis. Transmission electron microscopy and nanoparticle size analysis were employed to characterize the morphology and size changes of CRP antibodies and coupled latex spheres before and after immune reaction. Results: Optimization identified 168- and 80-nm latex sphere sizes, with CRP antibody coupling rates of 92% and 91%, respectively. The optimal ratios were 10:1.5 for large latex spheres to polyclonal antibodies and 5:1.5 for small latex spheres to monoclonal antibodies. A 1:8 mixing ratio of large to small latex spheres was effective. Transmission electron microscopy confirmed uniform sizes postcoupling, maintaining dispersion with no morphological changes. CRP reacted with the double-particle latex reagent, forming immune complexes that exhibited agglutination. Mixed latex spheres showed varied agglutination states with CRP concentration, altering solution absorbance. Conclusion: This study validates the efficacy of the dual-particle-size CRP antibody latex reagent, highlighting its potential for future immunoturbidimetric analysis applications.

Effects of minimally invasive non-surgical therapy on C-reactive protein, lipoprotein-associated phospholipase A2, and clinical outcomes in periodontitis patients: A 1-year randomized, controlled clinical trial

BACKGROUND

Growing evidence suggests the type of periodontal treatment could differentially influence the reduction of key cardiovascular risk mediators in periodontitis patients. This randomized, controlled clinical trial compared the impact of minimally invasive non-surgical therapy (MINST) with quadrant-wise subgingival instrumentation (Q-SI) on C-reactive protein (CRP) together with lipoprotein-associated phospholipase A2 (Lp-PLA2) levels, and clinical periodontal outcomes in patients with periodontitis. Moreover, it was evaluated if baseline CRP levels impacted the efficacy of non-surgical periodontal therapy protocols.

METHODS

Forty-two periodontitis patients were enrolled and randomly treated by means of MINST (n = 21) or Q-SI (n = 21). The outcomes assessed were serum CRP and Lp-PLA2, and periodontal parameters (probing depth [PD], clinical attachment level [CAL], full-mouth bleeding score [FMBS]), at baseline and at follow-ups at 1, 3, and 6 months and at 1 year after treatment.

RESULTS

At 1 year, MINST significantly reduced, among others, mean PD (p = 0.007), mean CAL (p = 0.007), the number of pockets >4 mm (p = 0.011) and ≥6 mm (p = 0.005), and FMBS (p = 0.048) compared to Q-SI. Generalized multivariate analysis evidenced that high baseline CRP (p = 0.039) and FMBS (p = 0.046) levels, together with MINST treatment (p = 0.007) were significant predictors of PD reduction at 1-year follow-up. Moreover, the Jonckheere-Terpstra test showed that patients with high baseline CRP levels gained more benefits from MINST treatment at 1-year follow-up than they did from Q-SI.

CONCLUSION

Patients receiving MINST showed a greater reduction in CRP levels than patients with Q-SI after 1 year of follow-up. Moreover, patients with high baseline levels of CRP and Lp-PLA2 gained more benefits from the MINST approach at 1-year follow-up.

The Fabrication of a Probe-Integrated Electrochemiluminescence Aptasensor Based on Double-Layered Nanochannel Array with Opposite Charges for the Sensitive Determination of C-Reactive Protein

The effective and sensitive detection of the important biomarker, C-reactive protein (CRP), is of great significance in clinical diagnosis. The development of a convenient and highly sensitive electrochemiluminescence (ECL) aptasensor with an immobilized emitter probe is highly desirable. In this work, a probe-integrated ECL aptamer sensor was constructed based on a bipolar silica nanochannel film (bp-SNF) modified electrode for the highly sensitive ECL detection of CRP. The bp-SNF, modified on an ITO electrode, consisted of a dual-layered SNF film, including the negatively charged inner SNF (n-SNF) and the outer SNF with a positive charge and amino groups (p-SNF). The ECL emitter, tris(bipyridine) ruthenium (II) (Ru(bpy)32+), was stably immobilized in a nanochannel of bp-SNF using the dual electrostatic interactions with n-SNF attracting and p-SNF repelling. The amino groups on the outer surface of bp-SNF were aldehyde derivatized, allowing for the covalent immobilization of recognitive aptamers (5'-NH2-CGAAGGGGATTCGAGGGGTGATTGCGTGCTCCATTTGGTG-3'), leading to the recognition interface. When CRP bound to the aptamer on the recognition interface, the formed complex increased the interface resistance and reduced the diffusion of the co-reactant tripropylamine (TPA) into the nanochannels, leading to a decrease in the ECL signal. Based on this mechanism, the constructed aptamer sensor could achieve a sensitive ECL detection of CRP ranging from 0.01 to 1000 ng/mL, with a detection limit (DL) of 8.5 pg/mL. The method for constructing this probe-integrated ECL aptamer sensor is simple, and it offers a high probe stability, good selectivity, and high sensitivity.

Detection of COVID-19-related biomarkers by electrochemical biosensors and potential for diagnosis, prognosis, and prediction of the course of the disease in the context of personalized medicine

As a more efficient and effective way to address disease diagnosis and intervention, cutting-edge technologies, devices, therapeutic approaches, and practices have emerged within the personalized medicine concept depending on the particular patient's biology and the molecular basis of the disease. Personalized medicine is expected to play a pivotal role in assessing disease risk or predicting response to treatment, understanding a person's health status, and, therefore, health care decision-making. This work discusses electrochemical biosensors for monitoring multiparametric biomarkers at different molecular levels and their potential to elucidate the health status of an individual in a personalized manner. In particular, and as an illustration, we discuss several aspects of the infection produced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a current health care concern worldwide. This includes SARS-CoV-2 structure, mechanism of infection, biomarkers, and electrochemical biosensors most commonly explored for diagnostics, prognostics, and potentially assessing the risk of complications in patients in the context of personalized medicine. Finally, some concluding remarks and perspectives hint at the use of electrochemical biosensors in the frame of other cutting-edge converging/emerging technologies toward the inauguration of a new paradigm of personalized medicine.

Fabrication of a Disposable Electrochemical Immunosensor Based on Nanochannel Array Modified Electrodes and Gated Electrochemical Signals for Sensitive Determination of C-Reactive Protein

Sensitive determination of C-reactive protein (CRP) is of great significance because it is an early indicator of inflammation in cardiovascular disease and acute myocardial infarction. A disposable electrode with an integrated three-electrode system (working, reference, and counter electrodes) has great potential in the detection of biomarkers. In this work, an electrochemical immunosensing platform was fabricated on disposable and integrated screen-printed carbon electrode (SPCE) by introducing nanochannel arrays and gated electrochemical signals, which can achieve the sensitive detection of CRP in serum. To introduce active reactive groups for the fabrication of immuno-recognitive interface, vertically-ordered mesoporous silica-nanochannel film (VMSF) with rich amino groups (NH₂-VMSF) was rapidly grown by electrochemical assisted self-assembly (EASA). The electrochemically reduced graphene oxide (ErGO) synthesized in situ during the growth of NH₂-VMSF was used as a conductive adhesive glue to achieve stable bonding of the nanochannel array (NH₂-VMSF/ErGO/SPCE). After the amino group on the outer surface of NH₂-VMSF reacted with bifunctional glutaraldehyde (GA/NH₂-VMSF/ErGO/SPCE), the converted aldehyde surface was applied for covalent immobilization of the recognitive antibody (Ab) followed with the blocking of the non-specific sites. The fabricated immunosensor, Ab/GA/NH₂-VMSF/ErGO/SPCE, enables sensitive detection of CRP in the range from 10 pg/mL to 100 ng/mL with low limit of detection (LOD, 8 pg/mL, S/N = 3). The immunosensor possessed high selectivity and can realize reliable determination of CRP in human serum.

Emerging biomarkers for the detection of cardiovascular diseases

Background

The prevalence of cardiovascular disease (CVD) has been continuously increasing, and this trend is projected to continue. CVD is rapidly becoming a significant public health issue. Every year there is a spike in hospital cases of CVD, a critical health concern in lower- and middle-income countries. Based on identification of novel biomarkers, it would be necessary to study and evaluate the diagnostic requirements or CVD to expedite early detection.

Main body

The literature review was written using a wide range of sources, such as well-known medical journals, electronic databases, manuscripts, texts, and other writings from the university library. After that, we analysed the specific markers of CVD and compiled a systematic review. A growing body of clinical research aims to identify people who are at risk for cardiovascular disease by looking for biomolecules. A small number of biomarkers have been shown to be useful and reliable in medicine. Biomarkers can be used for a variety of clinical applications, such as predicting heart disease risk, diagnosing disease, or predicting outcomes. As a result of the ability for a single molecule to act as a biomarker, its usefulness in medicine is expected to increase significantly.

Conclusions

Based on assessing the current trends in the application of CVD markers, we discussed and described the requirements for the application of CVD biomarkers in coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other cardiovascular illnesses. Furthermore, the current review focuses on biomarkers for CVD and the procedures that should be considered to establish the comprehensive nature of the expression of biomarkers for cardiovascular illness.

Electrochemical biosensor with electrokinetics-assisted molecular trapping for enhancing C-reactive protein detection

C-Reactive protein (CRP) is an essential biomarker relevant to various disease prognoses. Current biosensors require a significant amount of time for detecting CRP. To address this issue, this work proposes electrokinetic flow-assisted molecule trapping integrated with an impedance biosensor, where a driving signal in terms of a gated sine wave is provided to circularly arranged electrodes which detect proteins. To verify the biosensor's efficacy, protein aggregation on the electrode surface was evaluated through a fluorescence analysis and measurement of the electrochemical impedance spectrum (EIS). The fluorescence analysis with avidin showed that target samples largely accumulated on the electrode surface upon provision of the driving signal. The EIS measurement of CRP accumulation on the electrode surface further confirmed a significant electrokinetic phenomenon at the electrode/electrolyte interface. Even at the low CRP concentration of 10 pg/ml, the proposed device's sensitivity and reliability were as high as 3.92 pg/ml with a signal-to noise ratio (SNR) of ≥3, respectively. In addition, the protein detection time (without considering the preparation time) was minimized to as low as 90 s with the proposed device. This device's advantage is its minimal time consumption, and simple drop-analysis process flow; hence, it was used for monitoring clinical serum samples.

Advances in aptamer-based sensing assays for C-reactive protein

C-reactive protein (CRP), a non-specific acute-phase indicator of inflammation, has been widely recognized for its value in clinical diagnostic applications. With the advancement of testing technologies, there have been many reports on fast, simple, and reliable methods for CRP testing. Among these, the aptamer-based biosensors are the focus and hotspot of research for achieving high-sensitivity analysis of CRP. This review summarizes the progress of in vitro aptamer screening for CRP and the recent advances in aptamer-based CRP sensor applications, thus developing insight for the new CRP aptasensor design strategy.

Serum C-Reactive Protein and Periodontitis: A Systematic Review and Meta-Analysis

Periodontitis has been associated with low-grade inflammation as assessed by C-reactive protein (CRP) levels and its treatment can decrease CRP serum levels. The aim of this systematic review was to critically appraise the evidence comparing CRP serum levels (standard and high-sensitivity [hs]) of otherwise healthy patients suffering from periodontitis when compared to controls. The impact of intensive and non-intensive nonsurgical periodontal treatment (NSPT) on hs-CRP was also investigated. Four electronic databases (Pubmed, The Cochrane Central Register of Controlled Trials [CENTRAL], EMBASE and Web of Science) were searched up to February 2021 and the review was completed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO No. CRD42020167454). Observational and intervention studies that: 1) evaluated CRP and hs-CRP serum levels in patients with and without periodontitis, and; 2) hs- CRP levels after NSPT were included. Following risk of bias appraisal, both qualitative and quantitative analyses were performed. Pooled estimates were rendered through ratio of means (RoM) random-effects meta-analyses. After screening 485 studies, 77 case-control studies and 67 intervention trials were included. Chronic and aggressive periodontitis diagnoses were consistently associated with higher levels of CRP and hs-CRP (p<0.001). Patients with aggressive periodontitis exhibited on average more than 50% higher levels of CRP (RoM [95% confidence interval [CI]]: 1.56 [1.15; 2.12], p=0.0039) than patients with chronic periodontitis. Intensive NSPT induced an immediate increase of hs-CRP followed by a progressive decrease whilst non-intensive NSPT consistently decreased hs-CRP after treatment up to 180 days (p<0.001). These findings provide robust evidence that periodontitis is associated with systemic inflammation as measured by serum CRP levels. Periodontitis treatment induces a short-term acute inflammatory increase when performed in an intensive session, whilst a progressive reduction up to 6 months was demonstrated when performed in multiple visits.

Performance of chitosan polymer as platform during sensors fabrication and sensing applications

Chitosan is an important polymer produced from deacetylation of several sea and insects crusts. Due to its environmental fate and biological biocompatibility, it can be used in several biological and environmental applications. Sensing of biological compounds in human bodies and also in serum, blood, and different body fluids has found an important application instead of direct determination of the body fluids using complicated tools. Sensing process of biological compounds during bio-analysis of the biological systems, especially human fluids lack of several parameters including: high sensitivity, repeatability, speed of analysis and biocompatibility of the used analytical methods, especially in-vivo analysis. That was due to the time between sample handling and sample determination can change various components and concentrations of the bio-compounds. The need for in-situ analysis was directed the researchers for biosensors to overcome the upgrading problems of bio-analysis. Biosensors were the future of this issue. Chitosan can reserve as great platform for fabrication of different sensors to determine the elements, compounds and body bioactive compounds. The presence of different terminal amino and hydroxyl groups within chitosan framework facilitates the immobilization of different biomarkers to be used as sensing elements for the determined compounds. The use of chitosan as sensors platform was enhanced by using chitosan in its nanoforms.

Engineered Nanomaterial Assisted Signal‐amplification Strategies for Enhancing Analytical Performance of Electrochemical Biosensors

The design and development of modern biosensors for sensitive and selective detection of various biomarkers is important in diversified arenas including healthcare, environment, and food industries etc. The requirement of more robust and reliant biosensors lead to the development of various sensing modules. The nanomaterials having specific optical, electrical, and mechanical strength can pave the way towards development of ultrafast, robust, and miniaturized modules for biosensors. It can provide not only the point‐of‐care applicability but also has tremendous commercial as well as industrial justification. In order to improve the performance of the sensor systems, various nanostructure materials have been readily studied and applied for development of novel biosensors. In the last few years, researchers are engaged on harnessing the unique atomic and molecular properties of advance‐engineered materials including carbon nanotubes, graphene nanosheets, metal nanoparticles, metal oxide nanoparticles, and their nano‐conjugates. In view of such recent developments in nanomaterial engineering, the current review has been formulated emphasizing the role of these materials in surface engineering, biomolecule conjugation, and signal amplification for development of various ultrasensitive and robust biosensors having commercial as well as industrial viability. Attention is given on the electrochemical biosensors incorporating various nanomaterials and their conjugates. Importance of nanomaterials in the analytical performance of the various biosensor has also been discussed. To put a perceptive insights on the importance of various nanomaterials, an extended table is incorporated, which includes probe design, analyte, LOD, and dynamic range of various electrochemical biosensors.

Prospects of electrochemical immunosensors for early diagnosis of preeclampsia

Preeclampsia is a vascular multisystem disorder that accounts for varying degree of morbidity and mortality of mother and the fetus. This can be significantly averted if diagnosed at an early (18-20 weeks) stage of gestation, as there is no known way to prevent preeclampsia. In spite of extensive work on biomarker discovery, the existing method for its detection is mostly based on colorimetric immunoassays whose sensitivity is ranging in nanomolar range. Further, it has also been observed that change in the expression of a single biomarker is not sufficient to diagnose this condition. So, for early diagnosis (by 18-20 weeks), an immuno-diagnostic platform with detection limits in picomolar range and beyond along with the ability to do simultaneous detection of multiple analyte would be of great importance. A nano-immunosensors with an electrochemical readout system can be a potential alternative that promises for the ultrasensitive detection of analyte with high specificity as well as suitability for on-site analysis. Coupling the lateral flow technology with immunosensors would make it feasible to detect more than one biomarker simultaneously on a microchip. This review intends to summarize the potential preeclampsia biomarkers, limitations of existing diagnostic methods along with the recent advancements, and prospects to develop electrochemical immunosensors for early clinical diagnosis.

Biomarker detection technologies and future directions

Biomarkers play a vital role in disease detection and treatment follow-up. It is important to note that diseases in the early stage are typically treated with the greatest probability of success. However, due to various technical difficulties in current technologies for the detection of biomarkers, the potential of biomarkers is not explored completely. Therefore, the developments of technologies, which can enable the accurate detection of prostate cancer at an early stage with simple, experimental protocols are highly inevitable. This critical review evaluates the current methods and technologies used in the detection of biomarkers. The aim of this article is to provide a comprehensive review covering the advantages and disadvantages of the biomarker detection methods. Future directions for the development of technologies to achieve highly selective and sensitive detection of biomarkers for point-of-care applications are also commented on.