荷尔蒙皮质醇,作为下丘脑-垂体-肾上腺(HPA)轴的最终产物释放,具有特征良好的昼夜节律,可以对外部压力源产生同种异体反应。当分泌模式被破坏时,皮质醇水平长期升高,导致心脏病等疾病,笔画,精神健康障碍,和糖尿病。慢性应激和应激相关疾病的诊断取决于皮质醇水平的准确测量;目前,它使用质谱或免疫测定进行定量,在有训练有素人员的专业实验室。然而,这些方法很耗时,价格昂贵,无法捕获激素的动态生物节律。这篇重要的评论追溯了皮质醇检测从传统的基于实验室的方法到分散式皮质醇监测生物传感器的路径。提供了皮质醇生物学和病理生理学的完整图片,强调了精准医学方式监测皮质醇的重要性。基于抗体的免疫测定仍然主导着即时生物传感器的开发;新的捕获分子,如适体和分子印迹聚合物(MIP),与微流体等技术相结合,可穿戴电子产品,量子点提供了对检测极限(LoD)的改进,特异性,以及向快速或连续测量的转变。虽然已经提出了各种不同的传感器和设备,目前仍然需要对皮质醇进行定量检测,使用快速或连续的监测设备,这些设备可以实现个性化医疗方法来管理压力。这可以通过可以利用低样本量的技术的协同组合来解决,相关的检测限和快速检测时间,更好地解释皮质醇的生物节律变化。强调了皮质醇诊断朝着激素的快速和连续监测的趋势,以及对样本矩阵选择的见解。
The hormone cortisol, released as the end-product of the hypothalamic-pituitary-adrenal (HPA) axis, has a well-characterized circadian rhythm that enables an allostatic response to external stressors. When the pattern of secretion is disrupted, cortisol levels are chronically elevated, contributing to diseases such as heart attacks, strokes, mental health disorders, and diabetes. The diagnosis of chronic stress and stress related disorders depends upon accurate measurement of cortisol levels; currently, it is quantified using mass spectroscopy or immunoassay, in specialized laboratories with trained personnel. However, these methods are time-consuming, expensive and are unable to capture the dynamic biorhythm of the hormone. This critical review traces the path of cortisol detection from traditional laboratory-based methods to decentralised cortisol monitoring biosensors. A complete picture of cortisol biology and pathophysiology is provided, and the importance of precision medicine style monitoring of cortisol is highlighted. Antibody-based immunoassays still dominate the pipeline of development of point-of-care biosensors; new capture molecules such as aptamers and molecularly imprinted polymers (MIPs) combined with technologies such as microfluidics, wearable electronics, and quantum dots offer improvements to limit of detection (LoD), specificity, and a shift toward
rapid or continuous measurements. While a variety of different sensors and devices have been proposed, there still exists a need to produce quantitative tests for cortisol ─ using either
rapid or continuous monitoring devices that can enable a personalized medicine approach to stress management. This can be addressed by synergistic combinations of technologies that can leverage low sample volumes, relevant limit of detection and
rapid testing time, to better account for cortisol\'s shifting biorhythm. Trends in cortisol diagnostics toward
rapid and continuous monitoring of hormones are highlighted, along with insights into choice of sample matrix.