Point-of-care diagnostics

即时诊断
  • 文章类型: Journal Article
    本系统综述和荟萃分析对纸基微流控装置进行了全面评估,专注于它们在免疫测定中的应用。这些设备正在成为民主化诊断技术的创新解决方案,尤其是在资源有限的环境中。我们的评论巩固了各种研究的发现,概述了基于纸张的微流体技术的进展,包括设计复杂性和操作功效。低成本等关键优势,便携性,突出了易用性。
    这篇综述根据这些诊断工具的设计和操作细微差别对文献进行了分类,探索各种方法,制造技术,检测方法,和应用,特别是在蛋白质科学。荟萃分析延伸到这些技术的不同应用,提供一个框架来分类和分层他们在诊断中的用途。
    值得注意的发现包括对性能指标的关键分析,如敏感性和特异性。审查解决了挑战,包括需要进一步验证和优化更广泛的临床应用。关于验证过程的重要讨论,包括交叉验证和严格的控制测试,提供以确保微流体装置的鲁棒性。这项研究为支撑这些技术的计算策略提供了新的见解,并为未来的研究提供了全面的路线图。有可能扩大整个蛋白质科学世界的影响。
    UNASSIGNED: This systematic review and meta-analysis present a comprehensive evaluation of paper-based microfluidic devices, focusing on their applications in immunoassays. These devices are emerging as innovative solutions to democratize access to diagnostic technologies, especially in resource-limited settings. Our review consolidates findings from diverse studies to outline advancements in paper-based microfluidic technology, including design intricacies and operational efficacy. Key advantages such as low cost, portability, and ease of use are highlighted.
    UNASSIGNED: The review categorizes literature based on the design and operational nuances of these diagnostic tools, exploring various methodologies, fabrication techniques, detection methods, and applications, particularly in protein science. The meta-analysis extends to the diverse applications of these technologies, providing a framework for classifying and stratifying their uses in diagnostics.
    UNASSIGNED: Notable findings include a critical analysis of performance metrics, such as sensitivity and specificity. The review addresses challenges, including the need for further validation and optimization for broader clinical applications. A critical discussion on the validation processes, including cross-validation and rigorous control testing, is provided to ensure the robustness of microfluidic devices. This study offers novel insights into the computational strategies underpinning these technologies and serves as a comprehensive roadmap for future research, potentially broadening the impact across the protein science universe.
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  • 文章类型: Journal Article
    新型冠状病毒SARS-CoV-2于2019年底首次分离;它已经传播到所有大陆,感染了超过7亿人,到目前为止,在全球范围内造成了700多万人死亡。病毒的高传播性和具有改变的致病性和对治疗剂和疫苗的潜在抗性的新型毒株的出现是病毒研究和治疗中的主要挑战。正在进行的筛查工作旨在识别新病例,以监测病毒的传播,并帮助确定与新变种出现有关的危险。鉴于其敏感性和特异性,核酸扩增试验(NAAT)如RT-qPCR是SARS-CoV-2检测的金标准。然而,由于高成本,复杂性,以及在低资源和定点护理(POC)环境中的不可用,现有的RT-qPCR检测方法无法满足全球检测需求.另一种NAAT,基于RT-LAMP的SARS-CoV-2检测提供了可扩展的,低成本,和快速测试能力。我们开发了一种基于RT-LAMP的自动化微流控芯片,该芯片结合了RNA分离,净化,和扩增步骤在同一设备上,并能够在40分钟内从唾液和鼻咽样品中目视检测SARS-CoV-2。整个化验是在一个独特设计的内部执行的,廉价的一次性微流控芯片,其中分析组件和试剂已被优化以提供精确和定性的结果,并且可以有效地部署在POC设置中。此外,这项技术可以很容易地适应其他新出现的病毒。
    The novel coronavirus SARS-CoV-2 was first isolated in late 2019; it has spread to all continents, infected over 700 million people, and caused over 7 million deaths worldwide to date. The high transmissibility of the virus and the emergence of novel strains with altered pathogenicity and potential resistance to therapeutics and vaccines are major challenges in the study and treatment of the virus. Ongoing screening efforts aim to identify new cases to monitor the spread of the virus and help determine the danger connected to the emergence of new variants. Given its sensitivity and specificity, nucleic acid amplification tests (NAATs) such as RT-qPCR are the gold standard for SARS-CoV-2 detection. However, due to high costs, complexity, and unavailability in low-resource and point-of-care (POC) settings, the available RT-qPCR assays cannot match global testing demands. An alternative NAAT, RT-LAMP-based SARS-CoV-2 detection offers scalable, low-cost, and rapid testing capabilities. We have developed an automated RT-LAMP-based microfluidic chip that combines the RNA isolation, purification, and amplification steps on the same device and enables the visual detection of SARS-CoV-2 within 40 min from saliva and nasopharyngeal samples. The entire assay is executed inside a uniquely designed, inexpensive disposable microfluidic chip, where assay components and reagents have been optimized to provide precise and qualitative results and can be effectively deployed in POC settings. Furthermore, this technology could be easily adapted for other novel emerging viruses.
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  • 文章类型: Journal Article
    完全集成的治疗仪在临床应用中受到高度重视,在实时疾病监测和个性化护理方面提供巨大潜力。微针(MNs),作为创新和可穿戴设备,在生物传感和治疗方面拥有重要优势,因此,在诊断和治疗平台的发展中具有重要的前景。令人鼓舞的是,电化学传感技术的进步,微拉诺制造,生物相容性材料推动了基于MNs的闭环系统的势头,增强检测能力,生物相容性,和成本效益。此外,MN芯片与其他生物芯片集成的显着进展标志着增长的前沿。目标分子监测和药物递送领域的成功临床试验预示着上述治疗治疗平台的良好临床转化前景。最后,我们描述了集成诊断和治疗MN系统开发中的挑战和机遇,包括持续监测,智能控制算法,安全,和监管方面的考虑。
    Fully integrated theranostic devices are highly esteemed in clinical applications, offering immense potential in real-time disease monitoring and personalized care. Microneedles (MNs), as innovative and wearable devices, boast important advantages in biosensing and therapy, thus holding significant promise in the advancement of diagnostic and therapeutic platforms. Encouragingly, advancements in electrochemical sensing technology, micronano fabrication, and biocompatible materials are propelling momentum for MNs-based closed-loop systems, enhancing detection capabilities, biocompatibility, and cost-effectiveness. Moreover, the notable progress in integrating MN chips with other biochips signifies a frontier for growth. Successful clinical trials in target molecule monitoring and drug delivery domains herald excellent clinical translational prospects for the aforementioned theranostic platform. Finally, we delineate both challenges and opportunities in the development of integrated diagnostic and therapeutic MN systems, including continuous monitoring, intelligent control algorithms, safety, and regulatory considerations.
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  • 文章类型: Journal Article
    COVID-19大流行,除了流感病毒和呼吸道合胞病毒(RSV)的同时发生,强调了对呼吸道感染的有效和可靠的多重诊断方法的要求。现有的多重检测技术基于逆转录定量聚合酶链反应(RT-qPCR)和提取纯化试剂盒,对复杂仪器和高成本的需求限制了它们的可扩展性和可用性。在这项研究中,我们开发了一种基于逆转录环介导等温扩增(RT-LAMP)的即时(POC)设备,可以同时检测四种呼吸道病毒(SARS-CoV-2,流感A,乙型流感,和RSV),并在不到30分钟的时间内执行两次控制,同时避免使用RNA提取试剂盒。该系统包括一个带有机械组件的一次性微流体盒,该机械组件可自动化样品处理,具有低成本和便携式光学阅读器和智能手机应用程序来记录和分析荧光图像。使用鼻液中掺入病毒颗粒的拭子验证了作为真正的护理点平台的应用。我们的便携式诊断系统准确检测呼吸道病原体特异性病毒RNA,实现共感染信息的反卷积。使用掺加在化学裂解缓冲液中的病毒颗粒确定每种病毒的检测限。我们的POC设备有可能通过修改引物序列来适应新病原体和多种病毒的检测。这项工作强调了一种用于多种呼吸道病毒诊断的替代方法,该方法非常适合资源有限的环境或家庭中的医疗保健系统。
    The COVID-19 pandemic, in addition to the co-occurrence of influenza virus and respiratory syncytial virus (RSV), has emphasized the requirement for efficient and reliable multiplex diagnostic methods for respiratory infections. While existing multiplex detection techniques are based on reverse transcription quantitative polymerase chain reaction (RT-qPCR) and extraction and purification kits, the need for complex instrumentation and elevated cost limit their scalability and availability. In this study, we have developed a point-of-care (POC) device based on reverse transcription loop-mediated isothermal amplification (RT-LAMP) that can simultaneously detect four respiratory viruses (SARS-CoV-2, Influenza A, Influenza B, and RSV) and perform two controls in less than 30 min, while avoiding the use of the RNA extraction kit. The system includes a disposable microfluidic cartridge with mechanical components that automate sample processing, with a low-cost and portable optical reader and a smartphone app to record and analyze fluorescent images. The application as a real point-of-care platform was validated using swabs spiked with virus particles in nasal fluid. Our portable diagnostic system accurately detects viral RNA specific to respiratory pathogens, enabling deconvolution of coinfection information. The detection limits for each virus were determined using virus particles spiked in chemical lysis buffer. Our POC device has the potential to be adapted for the detection of new pathogens and a wide range of viruses by modifying the primer sequences. This work highlights an alternative approach for multiple respiratory virus diagnostics that is well-suited for healthcare systems in resource-limited settings or at home.
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  • 文章类型: Journal Article
    侧流免疫测定法(LFA)可用于诊断大肠杆菌引起的尿路感染(E。大肠杆菌)在护理点。不幸的是,含有稀浓度大肠杆菌的尿液样本可能会在LFA上产生假阴性结果。我们的实验室首先实施了双水相系统(ATPS),以在将样品应用于LFA之前将样品预浓缩成较小的体积。这是通过操纵顶部相的体积与底部相的体积之比(体积比;VR)和浓缩底部相的生物标志物来实现的,当应用于固定卷中的LFA时,导致灵敏度的相应提高。这项工作是第一个演示,当将整个底部阶段添加到LFA时,无论VR如何,都可以实现相同的LOD。还开发了定制的3D打印设备以减少液体处理步骤。在患者尿液变异性预期的不同VRs中,该诊断工作流程成功检测到合成尿液中大肠杆菌浓度低至2×105菌落形成单位(cfu)mL-1,与没有进行ATPS预浓缩的试验相比,显示出一致的灵敏度提高了10倍.该方法成功地解决了患者样品的可变性,同时保持易于在护理点使用。
    Lateral-flow immunoassays (LFAs) can be used to diagnose urinary tract infections caused by Escherichia coli (E. coli) at the point of care. Unfortunately, urine samples containing dilute concentrations of E. coli can yield false negative results on LFAs. Our laboratory was first to implement aqueous two-phase systems (ATPSs) to preconcentrate samples into smaller volumes prior to their application on LFAs. This is achieved by manipulating the ratio of the volume of the top phase to that of the bottom phase (volume ratio; VR) and concentrating biomarkers in the bottom phase which, when applied to LFAs in fixed volumes, leads to corresponding improvements in sensitivity. This work is the first demonstration that the same LOD can be achieved irrespective of the VR when the entire bottom phase is added to LFAs. A custom 3D-printed device was also developed to decrease liquid handling steps. Across different VRs expected from patient urine variability, this diagnostic workflow successfully detected E. coli concentrations down to 2 × 105 colony-forming units (cfu) mL-1 in synthetic urine, demonstrating consistent 10-fold improvements in sensitivity compared to trials conducted without ATPS preconcentration. This method successfully addresses the variability of patient samples while remaining easy to use at the point of care.
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  • 文章类型: Journal Article
    糖尿病病例的增加已成为医疗保健领域的主要问题,需要开发有效和最低限度的诊断方法。这项研究旨在提供一个全面的检查电化学生物传感器检测糖尿病生物标志物,特别关注碳基电极的利用。
    结合各种碳电极的电化学生物传感器的详细分析,包括丝网印刷碳电极,玻碳电极,和碳糊电极,是presented。强调了碳基电极在生物传感器设计中的优势。该综述涵盖了几种关键的糖尿病生物标志物的检测,如葡萄糖,糖化血红蛋白(HbA1c),糖化人血清白蛋白(GHSA),胰岛素,和新的生物标志物。
    总结了过去十年电化学生物传感器技术的最新进展,强调它们在临床应用中的潜力,特别是在即时护理环境中。在生物传感器中利用碳基电极被证明具有显著的优势,包括增强的灵敏度,选择性,和成本效益。
    这篇综述强调了碳基电极在电化学生物传感器设计中的重要性,并提高了对更具体和个性化糖尿病病例的新型生物标志物检测的认识。该领域的进展突出了这些生物传感器在未来临床应用中的潜力,尤其是在即时诊断中.
    UNASSIGNED: The increase in diabetes cases has become a major concern in the healthcare sector, necessitating the development of efficient and minimal diagnostic methods. This study aims to provide a comprehensive examination of electrochemical biosensors for detecting diabetes mellitus biomarkers, with a special focus on the utilization of carbon-based electrodes.
    UNASSIGNED: A detailed analysis of electrochemical biosensors incorporating various carbon electrodes, including screen-printed carbon electrodes, glassy carbon electrodes, and carbon paste electrodes, is presented. The advantages of carbon-based electrodes in biosensor design are highlighted. The review covers the detection of several key diabetes biomarkers, such as glucose, glycated hemoglobin (HbA1c), glycated human serum albumin (GHSA), insulin, and novel biomarkers.
    UNASSIGNED: Recent developments in electrochemical biosensor technology over the last decade are summarized, emphasizing their potential in clinical applications, particularly in point-of-care settings. The utilization of carbon-based electrodes in biosensors is shown to offer significant advantages, including enhanced sensitivity, selectivity, and cost-effectiveness.
    UNASSIGNED: This review underscores the importance of carbon-based electrodes in the design of electrochemical biosensors and raises awareness for the detection of novel biomarkers for more specific and personalized diabetes mellitus cases. The advancements in this field highlight the potential of these biosensors in future clinical applications, especially in point-of-care diagnostics.
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  • 文章类型: Journal Article
    猪中的甲型流感病毒(IAV-S)是一种人畜共患病原体,在美国的商业猪中几乎普遍存在。猪具有唾液酸受体,其允许人类和禽类病毒共同感染,具有大流行重新组合的潜力。我们旨在开发一种用于猪场IAV-S检测的快速和可靠的测试方法。标记RT-LAMP测定的两个引物用于侧流读出。使用市售的侧流试剂盒来读取扩增子产物。运行时间为45分钟,该测定的检测限与Cq小于35的RT-qPCR相当,灵敏度为83.5%,特异性为89.6%.该测定允许兽医和生产者有限地获得诊断服务,以低设备成本现场执行和检测Matrix基因扩增。从样品采集到检测的时间不到一小时,使这个方法成为一种可访问的,方便,和负担得起的工具,以防止人畜共患疾病的传播。
    Influenza A Virus in swine (IAV-S) is a zoonotic pathogen that is nearly ubiquitous in commercial swine in the USA. Swine possess sialic acid receptors that allow co-infection of human and avian viruses with the potential of pandemic reassortment. We aimed to develop a fast and robust testing method for IAV-S detection on swine farms. Two primers of the RT-LAMP assay were labeled for use in a lateral flow readout. A commercially available lateral flow kit was used to read the amplicon product. With a runtime of ∼ 45 minutes, the limit of detection for the assay is comparable with an RT-qPCR Cq less than 35, with a sensitivity of 83.5 % and a specificity of 89.6 %. This assay allows veterinarians and producers with limited access to diagnostic services to perform and detect Matrix gene amplification on-site with low equipment costs. The time from sample collection to detection is less than one hour, making this method an accessible, convenient, and affordable tool to prevent the spread of zoonotic disease.
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  • 文章类型: Journal Article
    细胞外囊泡(EV)是早期诊断疾病的有前途的工具,和细菌膜囊泡(MV)在健康和环境监测中尤为重要。然而,检测EV或细菌MV对基于EV的诊断的临床转化提出了重大挑战。在这篇评论中,我们对纳米等离子体传感的基础知识进行了全面的讨论,并强调了基于纳米等离子体的光学传感器的最新发展,以有效地识别EV或细菌MV。我们探索为EV或细菌MV检测量身定制的各种纳米等离子体传感器,强调通过金纳米粒子及其多聚体的局部表面等离子体共振的应用。此外,我们重点介绍了基于使用等离子体薄膜和纳米图案化结构的表面等离子体激元极化子的先进EV检测技术。此外,我们评估了表面增强拉曼光谱在识别和分类这些囊泡方面的改进检测能力,等离子体纳米结构的帮助。纳米等离子体传感技术具有显著的精度和灵敏度,使它们成为临床应用中准确检测EV的潜在工具,促进即时分子诊断。最后,我们总结了与纳米等离子体EV或细菌MV传感器相关的挑战,并为这个不断发展的领域提供了潜在的未来方向的见解。
    Extracellular vesicles (EVs) are promising tools for the early diagnosis of diseases, and bacterial membrane vesicles (MVs) are especially important in health and environment monitoring. However, detecting EVs or bacterial MVs presents significant challenges for the clinical translation of EV-based diagnostics. In this Review, we provide a comprehensive discussion on the basics of nanoplasmonic sensing and emphasize recent developments in nanoplasmonics-based optical sensors to effectively identify EVs or bacterial MVs. We explore various nanoplasmonic sensors tailored for EV or bacterial MV detection, emphasizing the application of localized surface plasmon resonance through gold nanoparticles and their multimers. Additionally, we highlight advanced EV detection techniques based on surface plasmon polaritons using plasmonic thin film and nanopatterned structures. Furthermore, we evaluate the improved detection capability of surface-enhanced Raman spectroscopy in identifying and classifying these vesicles, aided by plasmonic nanostructures. Nanoplasmonic sensing techniques have remarkable precision and sensitivity, making them a potential tool for accurate EV detection in clinical applications, facilitating point-of-care molecular diagnostics. Finally, we summarize the challenges associated with nanoplasmonic EV or bacterial MV sensors and offer insights into potential future directions for this evolving field.
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  • 文章类型: Journal Article
    灵感来自于自然界形成复杂矿物质的非凡能力,研究人员已经解锁了创造具有卓越灵敏度的下一代生物传感器的变革策略,选择性,和生物相容性。通过模仿生物体如何协调矿物质生长,仿生和生物启发材料对生物传感器设计产生了重大影响。与天然材料相比,工程生物材料具有明显的优势,拥有优越的可调性,精确的可控性,以及集成特定功能以增强感测能力的能力。这种非凡的多功能性使各种生物传感平台的建设,包括光学传感器,电化学传感器,磁性生物传感器,和核酸检测平台,用于不同的应用。此外,生物材料促进智能手机辅助生物传感平台的发展,提供用户友好和便携式诊断工具的护理应用。这篇综述全面探讨了天然存在和工程生物矿物和材料在各种生物传感应用中的利用。我们重点介绍了定制其功能以满足特定生物传感需求的制造和设计策略。这种深入的探索强调了生物矿物和材料在彻底改变生物传感方面的变革潜力,为医疗保健的进步铺平道路,环境监测,和其他关键领域。
    Inspired by nature\'s remarkable ability to form intricate minerals, researchers have unlocked transformative strategies for creating next-generation biosensors with exceptional sensitivity, selectivity, and biocompatibility. By mimicking how organisms orchestrate mineral growth, biomimetic and bioinspired materials are significantly impacting biosensor design. Engineered bioinspired materials offer distinct advantages over their natural counterparts, boasting superior tunability, precise controllability, and the ability to integrate specific functionalities for enhanced sensing capabilities. This remarkable versatility enables the construction of various biosensing platforms, including optical sensors, electrochemical sensors, magnetic biosensors, and nucleic acid detection platforms, for diverse applications. Additionally, bioinspired materials facilitate the development of smartphone-assisted biosensing platforms, offering user-friendly and portable diagnostic tools for point-of-care applications. This review comprehensively explores the utilization of naturally occurring and engineered biominerals and materials for diverse biosensing applications. We highlight the fabrication and design strategies that tailor their functionalities to address specific biosensing needs. This in-depth exploration underscores the transformative potential of biominerals and materials in revolutionizing biosensing, paving the way for advancements in healthcare, environmental monitoring, and other critical fields.
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  • 文章类型: Journal Article
    酶联免疫吸附测定(ELISA)因其灵敏度高,是测定蛋白质生物标志物的金标准,特异性,和吞吐量。尽管取得了成功,ELISA和免疫测定格式的不断进步对于应对不断变化的全球挑战和满足不同应用中的新分析需求至关重要。为了扩大免疫测定的能力和应用,我们介绍了一种新型的ELISA样检测方法,我们称之为生物发光细菌联免疫吸附测定(BBLISA).BBLISA是一种无酶测定法,它利用生物发光细菌弧菌和金属纳米颗粒(金纳米颗粒和氧化铱金纳米花)之间的内部过滤效应作为分子吸收剂。用抗体官能化这些纳米颗粒在与分子靶标结合后诱导它们在孔中的积累,形成经典的免疫夹心复合物。由于它们能够吸收细菌发出的光,纳米粒子可以抑制生物发光信号,允许目标的快速定量。为了证明新型免疫测定平台的生物分析特性,作为原则的证明,我们在人血清中检测到两种临床相关的生物标志物(人免疫球蛋白G和SARS-CoV-2核蛋白),实现与经典ELISA相同的灵敏度和精度。我们相信BBLISA可以替代标准ELISA技术,通过将纳米材料与低成本,便携式生物发光平台。
    Enzyme-linked immunosorbent assay (ELISA) is the gold standard technique for measuring protein biomarkers due to its high sensitivity, specificity, and throughput. Despite its success, continuous advancements in ELISA and immunoassay formats are crucial to meet evolving global challenges and to address new analytical needs in diverse applications. To expand the capabilities and applications of immunoassays, we introduce a novel ELISA-like assay that we call Bioluminescent-bacteria-linked immunosorbent assay (BBLISA). BBLISA is an enzyme-free assay that utilizes the inner filter effect between the bioluminescent bacteriaAllivibrio fischeriand metallic nanoparticles (gold nanoparticles and gold iridium oxide nanoflowers) as molecular absorbers. Functionalizing these nanoparticles with antibodies induces their accumulation in wells upon binding to molecular targets, forming the classical immune-sandwich complex. Thanks to their ability to adsorb the light emitted by the bacteria, the nanoparticles can suppress the bioluminescence signal, allowing the rapid quantification of the target. To demonstrate the bioanalytical properties of the novel immunoassay platform, as a proof of principle, we detected two clinically relevant biomarkers (human immunoglobulin G and SARS-CoV-2 nucleoprotein) in human serum, achieving the same sensitivity and precision as the classic ELISA. We believe that BBLISA can be a promising alternative to the standard ELISA techniques, offering potential advancements in biomarker detection and analysis by combining nanomaterials with a low-cost, portable bioluminescent platform.
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