Electrochemical Biosensors in Point-of-Care Devices: Recent Advances and Future Trends

A Review on Potential Electrochemical Point-of-Care Tests Targeting Pandemic Infectious Disease Detection: COVID-19 as a Reference

Fast and accurate point-of-care testing (POCT) of infectious diseases is crucial for diminishing the pandemic miseries. To fight the pandemic coronavirus disease 2019 (COVID-19), numerous interesting electrochemical point-of-care (POC) tests have been evolved to rapidly identify the causal organism SARS-CoV-2 virus, its nucleic acid and antigens, and antibodies of the patients. Many of those electrochemical biosensors are impressive in terms of miniaturization, mass production, ease of use, and speed of test, and they could be recommended for future applications in pandemic-like circumstances. On the other hand, self-diagnosis, sensitivity, specificity, surface chemistry, electrochemical components, device configuration, portability, small analyzers, and other features of the tests can yet be improved. Therefore, this report reviews the developmental trend of electrochemical POC tests (i.e., test platforms and features) reported for the rapid diagnosis of COVID-19 and correlates any significant advancements with relevant references. POCTs incorporating microfluidic/plastic chips, paper devices, nanomaterial-aided platforms, smartphone integration, self-diagnosis, and epidemiological reporting attributes are also surfed to help with future pandemic preparedness. This review especially screens the low-cost and easily affordable setups so that management of pandemic disease becomes faster and easier. Overall, the review is a wide-ranging package for finding appropriate strategies of electrochemical POCT targeting pandemic infectious disease detection.

Fundamentals of Biosensors and Detection Methods

Biosensors have a great impact on our society to enhance the life quality, playing an important role in the development of Point-of-Care (POC) technologies for rapid diagnostics, and monitoring of disease progression. COVID-19 rapid antigen tests, home pregnancy tests, and glucose monitoring sensors represent three examples of successful biosensor POC devices. Biosensors have extensively been used in applications related to the control of diseases, food quality and safety, and environment quality. They can provide great specificity and portability at significantly reduced costs. In this chapter are described the fundamentals of biosensors including the working principles, general configurations, performance factors, and their classifications according to the type of bioreceptors and transducers. It is also briefly illustrated the general strategies applied to immobilize biorecognition elements on the transducer surface for the construction of biosensors. Moreover, the principal detection methods used in biosensors are described, giving special emphasis on optical, electrochemical, and mass-based methods. Finally, the challenges for biosensing in real applications are addressed at the end of this chapter.

Biosensors for Klebsiella pneumoniae with Molecularly Imprinted Polymer (MIP) Technique

Nosocomial infection is one of the most important problems that occurs in hospitals, as it directly affects susceptible patients or patients with immune deficiency. Klebsiella pneumoniae (K. pneumoniae) is the most common cause of nosocomial infections in hospitals. K. pneumoniae can cause various diseases such as pneumonia, urinary tract infections, septicemias, and soft tissue infections, and it has also become highly resistant to antibiotics. The principal routes for the transmission of K. pneumoniae are via the gastrointestinal tract and the hands of hospital personnel via healthcare workers, patients, hospital equipment, and interventional procedures. These bacteria can spread rapidly in the hospital environment and tend to cause nosocomial outbreaks. In this research, we developed a MIP-based electrochemical biosensor to detect K. pneumoniae. Quantitative detection was performed using an electrochemical technique to measure the changes in electrical signals in different concentrations of K. pneumoniae ranging from 10 to 10⁵ CFU/mL. Our MIP-based K. pneumoniae sensor was found to achieve a high linear response, with an R² value of 0.9919. A sensitivity test was also performed on bacteria with a similar structure to that of K. pneumoniae. The sensitivity results show that the MIP-based K. pneumoniae biosensor with a gold electrode was the most sensitive, with a 7.51 (% relative current/log concentration) when compared with the MIP sensor applied with Pseudomonas aeruginosa and Enterococcus faecalis, where the sensitivity was 2.634 and 2.226, respectively. Our sensor was also able to achieve a limit of detection (LOD) of 0.012 CFU/mL and limit of quantitation (LOQ) of 1.61 CFU/mL.

Toward Next-Generation Mobile Diagnostics: Near-Field Communication-Powered Electrochemiluminescent Detection

Mobile phones have been used in combination with point of care (PoC) devices for over a decade now. However, their use seems restricted to the detection of sensing events using the video and camera functions. In contrast, the complementary ability to use mobile phones to power such PoC devices has been largely unexplored. This work demonstrates the proof-of-principle that a smartphone can be used to both power and analyze an electrochemiluminescence (ECL) detection system. A printed device is presented featuring an electrochemical cell connected in series to a rectenna that is able to use the Near Field Communication (NFC, 13.56 MHz) signal to provide the energy needed to generate ECL from Ru(bpy)₃²⁺/tri-n-propylamine. The emitted light, the intensity of which is directly proportional to the concentration of the ruthenium complex, can then be captured by the mobile phone camera and analyzed. This work presents the fabrication and the electrical and electrochemical characterization of the device. Effective voltages ranging from 0.90 to 4.50 V have been recorded, depending on the coupling between emitter and receiver, which translate into working electrode potentials ranging from 0.76 up to 1.79 V vs Ag. Detection and quantification limits of 0.64 and 1.52 μM, respectively, have been achieved for Ru(bpy)₃²⁺, and linear ranges up to 0.1 mM (red channel) and no less than 1.0 mM (green channel) have been found.

Carbon Electrodes with Gold Nanoparticles for the Electrochemical Detection of miRNA 21-5p

Extracellular vesicles are involved in many physiological and pathological activities. They transport miRNAs to recipient cells during their role in intercellular communication, making them emerging biomarkers of many diseases. Interest in exosomal miRNAs has grown after they have shown numerous advantages as biomarkers for diagnosis, prognosis, and evaluation of cancer treatment. This work describes the development of a biosensor for the detection of 21-5p miRNA in human serum using screen-printed carbon electrodes modified with gold nanoparticles fabricated in situ, an innovative approach to avoid the use of more expensive gold substrates that provide better analytical outputs. The several variables involved in the assembly of the biosensor were optimized by univariant mode. Under the best conditions, the biosensor showed a linear response from 0.010 fM to 10 pM, with a limit of detection (LOD) of 4.31 aM. The sensitivity was 0.3718 relative Ω per decade concentration in buffered saline solutions, and the standard deviation of the blank is 2.94 Ω. A linear response was also obtained when human serum samples were tested with miRNA 21-5p. Interference from similar miRNA and miss-match miRNA sequences was evaluated and good selectivity for miRNA 21-5p was observed. Overall, the device proposed is an alternative approach to gold substrates, which typically result in more sensitive systems and lower LODs, which compares favorably to current gold-based biosensors for the targeted miRNA. This design may be further extended to other nucleic acids.

Label-free detection of HPV mRNA with an artificial chaperone-enhanced MNAzyme (ACEzyme)-based electrochemical sensor

Nucleic acid biosensors for point-of-care (POC) diagnostic applications are highly desirable. The ability to detect DNA and RNA in a simple, rapid, affordable and portable format leads to a range of important applications for early screening in the field of disease monitoring and management. Herein, we report the development of an isothermal, label-free electrochemical biosensor that was designed on the basis of target-driven MNAzyme cleavage activity. Hybridization with HPV mRNA, a model nucleic acid target, activated MNAzyme and initiated the cleavage of immobilized hairpin substrates, leading to changes in the electrochemical signal. Under optimal conditions, a detection limit of 2.6 pM was obtained with an incubation time of 60 min. Furthermore, an artificial chaperone-enhanced MNAzyme (ACEzyme) system was integrated to an electrochemical biosensor for the first time. The analytical performance of the biosensor was enhanced, and the detection time was significantly reduced by the addition of PLL-g-Dex, which exhibits nucleic acid chaperone-like activity. A detection limit of 0.88 pM was obtained with a threefold decrease in incubation time without prior amplification. The proposed biosensing platform shows the advantages of simple fabrication and operation, good selectivity in the presence of single-base mismatch, and excellent versatility in a complex mixture of total RNA. We believe that this isothermal, label-free, and protein-free nucleic acid analysis platform could provide foundations for the further development of a universal nucleic acid biosensing platform for clinical application.

Development of an Aptamer-Based Electrochemical Microfluidic Device for Viral Vaccine Quantitation

Global deployment of vaccines poses significant challenges in the distribution and use of the accompanying immunoassays, one of the standard methods for quality control of vaccines, particularly when establishing assays in countries worldwide to support testing/release upon importation. This work describes our effort toward developing an integrated, portable device to carry out affinity assays for viral particles quantification in viral vaccines by incorporating (i) aptamers, (ii) microfluidic devices, and (iii) electrochemical detection. We generated and characterized more than eight aptamers against multiple membrane proteins of cytomegalovirus (CMV), which we used as a model system and designed and fabricated electrochemical microfluidic devices to measure CMV concentrations in a candidate vaccine under development. The aptamer-based assays provided a half maximal effective concentration, EC₅₀, of 12 U/mL, comparable to that of an ELISA using a pair of antibodies (EC₅₀ 60 U/mL). The device measured relative CMV concentrations accurately (within ±10% bias) and precisely (11%, percent relative standard deviation). This work represents the critical first steps toward developing simple, affordable, and robust affinity assays for global deployment without the need for sensitive equipment and extensive analyst training.

Harmful Microalgae Detection: Biosensors versus Some Conventional Methods

In the last decade, there has been a steady stream of information on the methods and techniques available for detecting harmful algae species. The conventional approaches to identify harmful algal bloom (HAB), such as microscopy and molecular biological methods are mainly laboratory-based and require long assay times, skilled manpower, and pre-enrichment of samples involving various pre-experimental preparations. As an alternative, biosensors with a simple and rapid detection strategy could be an improvement over conventional methods for the detection of toxic algae species. Moreover, recent biosensors that involve the use of nanomaterials to detect HAB are showing further enhanced detection limits with a broader linear range. The improvement is attributed to nanomaterials' high surface area to volume ratio, excellent biological compatibility with biomolecules, and being capable of amplifying the electrochemical signal. Hence, this review presents the potential usage of biosensors over conventional methods to detect HABs. The methods reported for the detection of harmful algae species, ranging from conventional detection methods to current biosensor approaches will be discussed, along with their respective advantages and drawbacks to indicate the future prospects of biosensor technology for HAB event management.

A Review on Flexible Electrochemical Biosensors to Monitor Alcohol in Sweat

The continued focus on improving the quality of human life has encouraged the development of increasingly efficient, durable, and cost-effective products in healthcare. Over the last decade, there has been substantial development in the field of technical and interactive textiles that combine expertise in electronics, biology, chemistry, and physics. Most recently, the creation of textile biosensors capable of quantifying biometric data in biological fluids is being studied, to detect a specific disease or the physical condition of an individual. The ultimate goal is to provide access to medical diagnosis anytime and anywhere. Presently, alcohol is considered the most commonly used addictive substance worldwide, being one of the main causes of death in road accidents. Thus, it is important to think of solutions capable of minimizing this public health problem. Alcohol biosensors constitute an excellent tool to aid at improving road safety. Hence, this review explores concepts about alcohol biomarkers, the composition of human sweat and the correlation between alcohol and blood. Different components and requirements of a biosensor are reviewed, along with the electrochemical techniques to evaluate its performance, in addition to construction techniques of textile-based biosensors. Special attention is given to the determination of biomarkers that must be low cost and fast, so the use of biomimetic materials to recognize and detect the target analyte is turning into an attractive option to improve electrochemical behavior.

Smartphone-based mobile biosensors for the point-of-care testing of human metabolites

Rapid, accurate, portable and quantitative profiling of metabolic biomarkers is of great importance for disease diagnosis and prognosis. The recent development in the optical and electric biosensors based on the smartphone is promising for profiling of metabolites with advantages of rapid, reliability, accuracy, low-cost and multi-analytes analysis capability. In this review, we introduced the optical biosensing platforms including colorimetric, fluorescent and chemiluminescent sensing, and electrochemical biosensing platforms including wired and wireless communication. Challenges and future perspectives desired for reliable, accurate, cost-effective, and multi-functions smartphone-based biosensing systems were also discussed. We envision that such smartphone-based biosensing platforms will allow daily and comprehensive metabolites monitoring in the future, thus unlocking the potential to transform clinical diagnostics into non-clinical self-testing. We also believed that this progress report will encourage future research to develop advanced, integrated and multi-functional smartphone-based Point-of-Care testing (POCT) biosensors for the monitoring and diagnosis as well as personalized treatments of a spectrum of metabolic-disorder related diseases.

Current and Future Perspective of Devices and Diagnostics for Opioid and OIRD

OIRD (opioid-induced respiratory depression) remains a significant public health concern due to clinically indicated and illicit opioid use. Respiratory depression is the sine qua non of opioid toxicity, and early detection is critical for reversal using pharmacologic and non-pharmacologic interventions. In addition to respiratory monitoring devices such as pulse oximetry, capnography, and contactless monitoring systems, novel implantable sensors and detection systems such as optical detection and electrochemical detection techniques are being developed to identify the presence of opioids both in vivo and within the environment. These new technologies will not only monitor for signs and symptoms of OIRD but also serve as a mechanism to alert and assist first responders and lay rescuers. The current opioid epidemic brings to the forefront the need for additional accessible means of detection and diagnosis. Rigorous evaluation of safety, efficacy, and acceptability will be necessary for both new and established technologies to have an impact on morbidity and mortality associated with opioid toxicity. Here, we summarized existing and advanced technologies for opioid detection and OIRD management with a focus on recent advancements in wearable and implantable opioid detection. We expect that this review will serve as a complete informative reference for the researchers and healthcare professionals working on the subject and allied fields.

Emerging biosensing and transducing techniques for potential applications in point-of-care diagnostics

With the deepening of our understanding in life science, molecular biology, nanotechnology, optics, electrochemistry and other areas, an increasing number of biosensor design strategies have emerged in recent years, capable of providing potential practical applications for point-of-care (POC) diagnosis in various human diseases. Compared to conventional biosensors, the latest POC biosensor research aims at improving sensor precision, cost-effectiveness and time-consumption, as well as the development of versatile detection strategies to achieve multiplexed analyte detection in a single device and enable rapid diagnosis and high-throughput screening. In this review, various intriguing strategies in the recognition and transduction of POC (from 2018 to 2021) are described in light of recent advances in CRISPR technology, electrochemical biosensing, and optical- or spectra-based biosensing. From the perspective of promoting emerging bioanalytical tools into practical POC detecting and diagnostic applications, we have summarized key advances made in this field in recent years and presented our own perspectives on future POC development and challenges.

Zwitterionic Polymer Electroplating Facilitates the Preparation of Electrode Surfaces for Biosensing

Surface chemistry critically affects the diagnostic performance of biosensors. An ideal sensor surface should be resistant to nonspecific protein adsorption, yet be conducive to analytical responses. Here a new polymeric material, zwitterionic polypyrrole (ZiPPy), is reported to produce optimal surface condition for biosensing electrodes. ZiPPy combines two unique advantages: the zwitterionic function that efficiently hydrates electrode surface, hindering nonspecific binding of hydrophobic proteins; and the pyrrole backbone, which enables rapid (<7 min), controlled deposition of ZiPPy through electropolymerization. ZiPPy-coated electrodes show lower electrochemical impedance and less nonspecific protein adsorption (low fouling), outperforming bare and polypyrrole-coated electrodes. Moreover, affinity ligands for target biomarkers can be immobilized together with ZiPPy in a single-step electropolymerization. ZiPPy-coated electrodes are developed with specificity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The prepared sensor detects SARS-CoV-2 antibodies in human saliva down to 50 ng mL-1 , without the need for sample purification or secondary labeling.

An Overview for the Nanoparticles-Based Quantitative Lateral Flow Assay

The development of the lateral flow assay (LFA) has received much attention in both academia and industry because of their broad applications to food safety, environmental monitoring, clinical diagnosis, and so forth. The user friendliness, low cost, and easy operation are the most attractive advantages of the LFA. In recent years, quantitative detection has become another focus of LFA development. Here, the most recent studies of quantitative LFAs are reviewed. First, the principles and corresponding formats of quantitative LFAs are introduced. In the biomaterial and nanomaterial sections, the detection, capture, and signal amplification biomolecules and the optical, fluorescent, luminescent, and magnetic labels used in LFAs are described. The invention of dedicated strip readers has drawn further interest in exploiting the better performance of LFAs. Therefore, next, the development of dedicated reader devices is described and the usefulness and specifications of these devices for LFAs are discussed. Finally, the applications of LFAs in the detection of metal ions, biotoxins, pathogenic microorganisms, veterinary drugs, and pesticides in the fields of food safety and environmental health and the detection of nucleic acids, biomarkers, and viruses in clinical analyses are summarized.

Electrochemical Sensor for Methamphetamine Detection Using Laser-Induced Porous Graphene Electrode

A 3D porous graphene structure was directly induced by CO₂ laser from the surface of Kapton tape (carbon source) supported by polyethylene terephthalate (PET) laminating film. A highly flexible laser-induced porous graphene (LI-PGr) electrode was then fabricated via a facile one-step method without reagent and solvent in a procedure that required no stencil mask. The method makes pattern design easy, and production cost-effective and scalable. We investigated the performance of the LI-PGr electrode for the detection of methamphetamine (MA) on household surfaces and in biological fluids. The material properties and morphology of LI-PGr were analysed by scanning electron microscopy (SEM), energy dispersive x-ray (EDX) and Raman spectroscopy. The LI-PGr electrode was used as the detector in a portable electrochemical sensor, which exhibited a linear range from 1.00 to 30.0 µg mL⁻¹ and a detection limit of 0.31 µg mL⁻¹. Reproducibility was good (relative standard deviation of 2.50% at 10.0 µg mL⁻¹; n = 10) and anti-interference was excellent. The sensor showed good precision and successfully determined MA on household surfaces and in saliva samples.

Ultrasensitive electrochemical biosensors for dopamine and cholesterol: recent advances, challenges and strategies

The rapid and accurate determination of the dopamine (neurotransmitter) and cholesterol level in bio-fluids is significant because they are crucial bioanalytes for several lethal diseases, which require early diagnosis. The level of DA in the brain is modulated by the dopamine active transporter (DAT), and is influenced by cholesterol levels in the lipid membrane environment. Accordingly, electrochemical biosensors offer rapid and accurate detection and exhibit unique features such as low detection limits even with reduced volumes of analyte, affordability, simple handling, portability and versatility, making them appropriate to deal with augmented challenges in current clinical and point-of-care diagnostics for the determination of dopamine (DA) and cholesterol. This feature article focuses on the development of ultrasensitive electrochemical biosensors for the detection of cholesterol and DA for real-time and onsite applications that can detect targeted analytes with reduced volumes and sub-picomolar concentrations with quick response times. Furthermore, the development of ultrasensitive biosensors via cost-effective, simple fabrication procedures, displaying high sensitivity, selectivity, reliability and good stability is significant in the impending era of electrochemical biosensing. Herein, we emphasize on recent advanced nanomaterials used for the ultrasensitive detection of DA and cholesterol and discuss in depth their electrochemical activities towards ultrasensitive responses. Key points describing future perspectives and the challenges during detection with their probable solutions are discussed, and the current market is also surveyed. Further, a comprehensive review of the literature indicates that there is room for improvement in the miniaturization of cholesterol and dopamine biosensors for lab-on-chip devices and overcoming the current technical limitations to facilitate full utilization by patients at home.

Combination of Carbon Nanofiber-Based Electrochemical Biosensor and Cotton Fiber: A Device for the Detection of the Middle-East Respiratory Syndrome Coronavirus

The miniaturization of biosensors for point-of-care diagnosis is highly important in infection control. Electrochemical biosensors offer several advantages in diagnosis in terms of cost, disposability, portability, and sensitivity. Here, a miniaturized electrochemical immunosensor combined with cotton fiber for the detection of the Middle-East respiratory syndrome coronavirus (MERS-CoV) is described. Taking advantage of the absorption capability of cotton, the nasal and saliva samples can be collected and directly transferred to the immunosensor surface for detection using a single tool. The immunosensor was fabricated on a disposable screen-printed electrode precoated with carbon nanofibers. The electrodes were functionalized with carboxyphenyl groups that were used for the immobilization of the spike protein of the MERS-CoV. A competitive detection scheme was employed using the antibody for the MERS-CoV spike protein, and the square-wave voltammetry technique was used for measurements. The biosensor tested after the cotton coating of the electrode exhibited excellent performance. The biosensor was capable of detecting the MERS-CoV spike protein within a concentration range from 0.1 pg·mL^-1 to 1 μg·mL^-1 with a limit of detection of 0.07 pg·mL, implying the high sensitivity of the method. The immunosensor did not exhibit any cross-reactivity against proteins from HCoV and Influenza A, indicating the excellent selectivity of this approach. Testing of the biosensor in nasal samples showed very high recovery percentages. This disposable biosensor can be used as a miniaturized device for the collection of samples and detection of the virus using a portable potentiostat connected to a smartphone.

Electrochemical Capillary-Flow Immunoassay for Detecting Anti-SARS-CoV-2 Nucleocapsid Protein Antibodies at the Point of Care

Rapid and inexpensive serological tests for SARS-CoV-2 antibodies are needed to conduct population-level seroprevalence surveillance studies and can improve diagnostic reliability when used in combination with viral tests. Here, we report a novel low-cost electrochemical capillary-flow device to quantify IgG antibodies targeting SARS-CoV-2 nucleocapsid proteins (anti-N antibody) down to 5 ng/mL in low-volume (10 μL) human whole blood samples in under 20 min. No sample preparation is needed as the device integrates a blood-filtration membrane for on-board plasma extraction. The device is made of stacked layers of a hydrophilic polyester and double-sided adhesive films, which create a passive microfluidic circuit that automates the steps of an enzyme-linked immunosorbent assay (ELISA). The sample and reagents are sequentially delivered to a nitrocellulose membrane that is modified with a recombinant SARS-CoV-2 nucleocapsid protein. When present in the sample, anti-N antibodies are captured on the nitrocellulose membrane and detected via chronoamperometry performed on a screen-printed carbon electrode. As a result of this quantitative electrochemical readout, no result interpretation is required, making the device ideal for point-of-care (POC) use by non-trained users. Moreover, we show that the device can be coupled to a near-field communication potentiostat operated from a smartphone, confirming its true POC potential. The novelty of this work resides in the integration of sensitive electrochemical detection with capillary-flow immunoassay, providing accuracy at the point of care. This novel electrochemical capillary-flow device has the potential to aid the diagnosis of infectious diseases at the point of care.

Emerging Biosensors to Detect Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Review

Coronavirus disease (COVID-19) is a global health crisis caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) is the gold standard test for diagnosing COVID-19. Although it is highly accurate, this lab test requires highly-trained personnel and the turn-around time is long. Rapid and inexpensive immuno-diagnostic tests (antigen or antibody test) are available, but these point of care (POC) tests are not as accurate as the RT-PCR test. Biosensors are promising alternatives to these rapid POC tests. Here we review three types of recently developed biosensors for SARS-CoV-2 detection: surface plasmon resonance (SPR)-based, electrochemical and field-effect transistor (FET)-based biosensors. We explain the sensing principles and discuss the advantages and limitations of these sensors. The accuracies of these sensors need to be improved before they could be translated into POC devices for commercial use. We suggest potential biorecognition elements with highly selective target-analyte binding that could be explored to increase the true negative detection rate. To increase the true positive detection rate, we suggest two-dimensional materials and nanomaterials that could be used to modify the sensor surface to increase the sensitivity of the sensor.

Advances and Future Perspective on Detection Technology of Human Norovirus

Human norovirus (HuNoV) is a food-borne pathogen that causes acute gastroenteritis in people of all ages worldwide. However, no approved vaccines and antiviral drugs are available at present. Therefore, the development of accurate and rapid detection technologies is important in controlling the outbreak of HuNoVs. This paper reviewed the research progress on HuNoV detection, including immunological methods, molecular detection and biosensor technology. Immunological methods and molecular detection technologies are still widely used for HuNoV detection. Furthermore, biosensors will become an emerging developmental direction for the rapid detection of HuNoVs because of their high sensitivity, low cost, easy operation and suitability for onsite detection.

Addressing the Theoretical and Experimental Aspects of Low-Dimensional-Materials-Based FET Immunosensors: A Review

Electrochemical immunosensors (EI) have been widely investigated in the last several years. Among them, immunosensors based on low-dimensional materials (LDM) stand out, as they could provide a substantial gain in fabricating point-of-care devices, paving the way for fast, precise, and sensitive diagnosis of numerous severe illnesses. The high surface area available in LDMs makes it possible to immobilize a high density of bioreceptors, improving the sensitivity in biorecognition events between antibodies and antigens. If on the one hand, many works present promising results in using LDMs as a sensing material in EIs, on the other hand, very few of them discuss the fundamental interactions involved at the interfaces. Understanding the fundamental Chemistry and Physics of the interactions between the surface of LDMs and the bioreceptors, and how the operating conditions and biorecognition events affect those interactions, is vital when proposing new devices. Here, we present a review of recent works on EIs, focusing on devices that use LDMs (1D and 2D) as the sensing substrate. To do so, we highlight both experimental and theoretical aspects, bringing to light the fundamental aspects of the main interactions occurring at the interfaces and the operating mechanisms in which the detections are based.

Commercially available rapid diagnostic tests for the detection of high priority pathogens: status and challenges

The ongoing COVID-19 pandemic has shown the importance of having analytical devices that allow a simple, fast, and robust detection of pathogens which cause epidemics and pandemics. The information these devices can collect is crucial for health authorities to make effective decisions to contain the disease's advance. The World Health Organization published a list of primary pathogens that have raised concern as potential causes of future pandemics. Unfortunately, there are no rapid diagnostic tests commercially available and approved by the regulatory bodies to detect most of the pathogens listed by the WHO. This report describes these pathogens, the available detection methods, and highlights areas where more attention is needed to produce rapid diagnostic tests for future pandemic surveillance.

Modern Sensing Approaches for Predicting Toxicological Responses of Food- and Drug-Based Bioactives on Microbiomes of Gut Origin

Recent scientific findings have correlated the gut microbes with homeostasis of human health by delineating their role in pathogen resistance, bioactive metabolization, and immune responses. Foreign materials, like xenobiotics, that induce an altering effect to the human body also influence the gut microbiome to some extent and often limit their use as a result of significant side effects. Investigating the xenobiotic effect of new therapeutic material or edible could be quite painstaking and economically non-viable. Thus, the use of predictive toxicology methods can be an innovative strategy in the food, pharma, and agriculture industries. There are reported in silico, ex vivo, in vitro, and in vivo methods to evaluate such effects but with added drawbacks, such as lower predictability, physiological dissimilarities, and high cost of associated invasive procedures. This review highlights the current and future possibilities with newer modern sensing approaches of economic and time-scale advantages for predicting toxicological responses on gut microbiomes.

Sensitive electrochemical immunosensor using a bienzymatic system consisting of β-galactosidase and glucose dehydrogenase

Bienzymatic systems are often used with electrochemical affinity biosensors to achieve high signal levels and/or low background levels. It is important to select two enzymes whose reactions do not exhibit mutual interference but have similar optimal conditions. Here, we report a sensitive electrochemical immunosensor based on a bienzymatic system consisting of β-galactosidase (Gal, a hydrolase enzyme) and flavin adenine dinucleotide-dependent glucose dehydrogenase (FAD-GDH, a redox enzyme). Both enzymes showed high activities at neutral pH, the reactions catalyzed by them did not exhibit mutual interference, and the electrochemical-enzymatic redox cycling based on FAD-GDH coupled with enzymatic amplification by Gal enabled high signal amplification. Among the three amino-hydroxy-naphthalenes and 4-aminophenol (potential Gal products), 4-amino-1-naphthol showed the highest signal amplification. Glucose, as an electro-inactive, stable reducing agent for redox cycling, helped in achieving low background levels. Our bienzymatic system could detect parathyroid hormone at a detection limit of ∼0.2 pg mL-1, implying that it can be used for highly sensitive electrochemical detection of parathyroid hormone and other biomarkers in human serum.

Emerging point-of-care technologies for anemia detection

Anemia, characterized by low blood hemoglobin level, affects about 25% of the world's population with the heaviest burden borne by women and children. Anemia leads to impaired cognitive development in children, as well as high morbidity and early mortality among sufferers. Anemia can be caused by nutritional deficiencies, oncologic treatments and diseases, and infections such as malaria, as well as inherited hemoglobin or red cell disorders. Effective treatments are available for anemia upon early detection and the treatment method is highly dependent on the cause of anemia. There is a need for point-of-care (POC) screening, early diagnosis, and monitoring of anemia, which is currently not widely accessible due to technical challenges and cost, especially in low- and middle-income countries where anemia is most prevalent. This review first introduces the evolution of anemia detection methods followed by their implementation in current commercially available POC anemia diagnostic devices. Then, emerging POC anemia detection technologies leveraging new methods are reviewed. Finally, we highlight the future trends of integrating anemia detection with the diagnosis of relevant underlying disorders to accurately identify specific root causes and to facilitate personalized treatment and care.

A photoelectrochemical sensor based on Z-Scheme TiO2@Au@CdS and molecularly imprinted polymer for uric acid detection

A novel photoelectrochemical (PEC) sensor based on "Z-scheme" TiO₂@Au@CdS and molecularly imprinted polymer (MIP) was developed for the non-invasive detection of uric acid (UA). The "Z-scheme" material, consisting of an electron-transfer system (Au) and two isolated photochemical systems (CdS, TiO₂), was synthesized by chemical deposition method and it worked as a substrate for electro-polymerization of MIP. Due to the high photoelectric conversion efficiency provided by TiO₂@Au@CdS and specific imprinting effect afforded by MIP, the sensor displayed desirable sensing performance with the merits of sensitivity, selectivity, repeatability, and stability. The linear range for UA detection is from 1 nM to 9 μM with the detection limit of 0.3 nM (S/N = 3). Moreover, the assay was successfully utilized to measure UA in human tears and offered a reliable result. The incorporation of MIP and "Z-scheme" material into a PEC sensor system is expected to provide a promising strategy for detecting other small molecules.

Printable graphene BioFETs for DNA quantification in Lab-on-PCB microsystems

Lab-on-Chip is a technology that aims to transform the Point-of-Care (PoC) diagnostics field; nonetheless a commercial production compatible technology is yet to be established. Lab-on-Printed Circuit Board (Lab-on-PCB) is currently considered as a promising candidate technology for cost-aware but simultaneously high specification applications, requiring multi-component microsystem implementations, due to its inherent compatibility with electronics and the long-standing industrial manufacturing basis. In this work, we demonstrate the first electrolyte gated field-effect transistor (FET) DNA biosensor implemented on commercially fabricated PCB in a planar layout. Graphene ink was drop-casted to form the transistor channel and PNA probes were immobilized on the graphene channel, enabling label-free DNA detection. It is shown that the sensor can selectively detect the complementary DNA sequence, following a fully inkjet-printing compatible manufacturing process. The results demonstrate the potential for the effortless integration of FET sensors into Lab-on-PCB diagnostic platforms, paving the way for even higher sensitivity quantification than the current Lab-on-PCB state-of-the-art of passive electrode electrochemical sensing. The substitution of such biosensors with our presented FET structures, promises further reduction of the time-to-result in microsystems combining sequential DNA amplification and detection modules to few minutes, since much fewer amplification cycles are required even for low-abundance nucleic acid targets.

AMBtalk: A Cardiovascular IoT Device for Ambulance Applications

Acute Coronary Syndrome (ACS) and other heart emergency events require immediate chest pain identification in the ambulance. Specifically, early identification and triage is required so that patients with chest pain can be quickly sent to a hospital with appropriate care facilities for treatment. In the traditional approach, ambulance personnel often use symptom checklists to examine the patient and make a quick decision for the target hospital. However, not every hospital has specialist facilities to handle such emergency cases. If the result of the subsequent cardiac enzyme test performed at the target hospital strongly suggests the occurrence of myocardial infarction, the patient may need to be sent to another hospital with specialist facilities, such as Percutaneous Coronary Intervention. The standard procedure is time consuming, which may result in delayed treatment and reduce patent survival rate. To resolve this issue, we propose AMBtalk (Ambulance Talk) for accurate, early ACS identification in an ambulance. AMBtalk provides real-time connection to hospital resources, which reduces the elapsed time for treatment, and therefore, improves the patient survival rate. The key to success for AMBtalk is the development of the AllCheck^® Internet of Things (IoT) device, which can accurately and quickly provide cardiovascular parameter values for early ACS identification. The interactions between the AllCheck^® IoT device, the emergency medical service center, the ambulance personnel and the hospital are achieved through the AMBtalk IoT server in the cloud network. AllCheck^® outperforms the existing cardiovascular IoT device solutions for ambulance applications. The testing results of the AllCheck^® device show 99% correlation with the results of the hospital reports. Due to its excellent performance in quick ACS identification, the AllCheck^® device was awarded the 17th Taiwan Innovators Award in 2020.

Process-property correlations in laser-induced graphene electrodes for electrochemical sensing

Laser-induced graphene (LIG) has emerged as a promising electrode material for electrochemical point-of-care diagnostics. LIG offers a large specific surface area and excellent electron transfer at low-cost in a binder-free and rapid fabrication process that lends itself well to mass production outside of the cleanroom. Various LIG micromorphologies can be generated when altering the energy input parameters, and it was investigated here which impact this has on their electroanalytical characteristics and performance. Energy input is well controlled by the laser power, scribing speed, and laser pulse density. Once the threshold of required energy input is reached a broad spectrum of conditions leads to LIG with micromorphologies ranging from delicate irregular brush structures obtained at fast, high energy input, to smoother and more wall like albeit still porous materials. Only a fraction of these LIG structures provided high conductance which is required for appropriate electroanalytical performance. Here, it was found that low, frequent energy input provided the best electroanalytical material, i.e., low levels of power and speed in combination with high spatial pulse density. For example, the sensitivity for the reduction of K₃[Fe(CN)₆] was increased almost 2-fold by changing fabrication parameters from 60% power and 100% speed to 1% power and 10% speed. These general findings can be translated to any LIG fabrication process independent of devices used. The simple fabrication process of LIG electrodes, their good electroanalytical performance as demonstrated here with a variety of (bio)analytically relevant molecules including ascorbic acid, dopamine, uric acid, p-nitrophenol, and paracetamol, and possible application to biological samples make them ideal and inexpensive transducers for electrochemical (bio)sensors, with the potential to replace the screen-printed systems currently dominating in on-site sensors used.

Washing- and Separation-Free Electrochemical Detection of Porphyromonas gingivalis in Saliva for Initial Diagnosis of Periodontitis

Indirect detection of Porphyromonas gingivalis in saliva, based on proteolytic cleavage by an Arg-specific gingipain (Arg-gingipain), has traditionally been used for simple, initial diagnosis of periodontitis. To accurately detect P. gingivalis using a point-of-care format, development of a simple biosensor that can measure the exact concentration of P. gingivalis is required. However, electrochemical detection in saliva is challenging due to the presence of various interfering electroactive species in different concentrations. Here, we report a washing- and separation-free electrochemical biosensor for sensitive detection of P. gingivalis in saliva. Glycine-proline-arginine conjugated with 4-aminophenol (AP) was used as an electrochemical substrate for a trypsin-like Arg-gingipain, and glycylglycine was used to increase the Arg-gingipain activity. The electrochemical signal of AP was increased using electrochemical-chemical (EC) redox cycling involving an electrode, AP, and tris(2-carboxyethyl)phosphine, and the electrochemical charge signal was corrected using the initial charge obtained before a 15 min incubation period. The EC redox cycling combined with the matrix-corrected signal facilitated a high and reproducible signal without requiring washing and separation steps. The proteolytic cleavage of the electrochemical substrate was specific to P. gingivalis. The calculated detection limit for P. gingivalis in artificial saliva was 5 × 10⁵ colony-forming units/mL, and the concentration of P. gingivalis in human saliva could be measured. The developed biosensor can be used as an initial diagnosis method to distinguish between healthy people and patients with periodontal diseases.

Amperometric aptasensor with sandwich-type architecture for troponin I based on carboxyethylsilanetriol-modified graphene oxide coated electrodes

A novel amperometric aptasensor for the specific detection of cardiac troponin I (cTnI) was constructed by using screen-printed carbon electrodes coated with a carboxyethylsilanetriol-modified graphene oxide derivative as transduction element. This novel carboxylic acid-enriched nanomaterial allows easy and high load immobilization of the capture aptamer molecules on the electrode surface. The biosensing interface was assembled by covalent attachment of an amino-functionalized DNA aptamer on the carboxylic acid-enriched electrode surface. The sensing approach relies on the specific recognition of cTnI by the aptamer and further assembly of a sandwich-type architecture with a novel aptamer-peroxidase conjugate as signaling element. The aptasensor was employed to detect the cardiac biomarker in the broad range from 1.0 pg/mL to 1.0 μg/mL with a detection limit of 0.6 pg/mL. This electroanalytical device also showed high specificity, reproducibility and stability, and was useful to quantify cTnI in reconstituted human serum samples.

Flow control in a laminate capillary-driven microfluidic device

Capillary-driven microfluidic devices are of significant interest for on-site analysis because they do not require external pumps and can be made from inexpensive materials. Among capillary-driven devices, those made from paper and polyester film are among the most common and have been used in a wide array of applications. However, since capillary forces are the only driving force, flow is difficult to control, and passive flow control methods such as changing the geometry must be used to accomplish various analytical applications. This study presents several new flow control methods that can be utilized in a laminate capillary-driven microfluidic device to increase available functionality. First, we introduce push and burst valve systems that can stop and start flow. These valves can stop flow for >30 min and be opened by either pressing the channel or inflowing other fluids to the valve region. Next, we propose flow control methods for Y-shaped channels that enable more functions. In one example, we demonstrate the ability to accurately control concentration to create laminar, gradient, and fully mixed flows. In a second example, flow velocity in the main channel is controlled by adjusting the length of the inlet channel. In addition, the flow velocity is constant as the inlet length increases. Finally, the flow velocity in the Y-shaped device as a function of channel height and fluid properties such as viscosity and surface tension was examined. As in previous studies on capillary-driven channels, the flow rate was affected by each parameter. The fluidic control tools presented here will enable new designs and functions for low cost point of need assays across a variety of fields.

The potential application of electrochemical biosensors in the COVID-19 pandemic: A perspective on the rapid diagnostics of SARS-CoV-2

Electrochemical biosensors combine the selectivity of electrochemical signal transducers with the specificity of biomolecular recognition strategies. Although they have been broadly studied in different areas of diagnostics, they are not yet fully commercialized. During the COVID-19 pandemic, electrochemical platforms have shown the potential to address significant limitations of conventional diagnostic platforms, including accuracy, affordability, and portability. The advantages of electrochemical platforms make them a strong candidate for rapid point-of-care detection of SARS-CoV-2 infection by targeting not only viral RNA but antigens and antibodies. Herein, we reviewed advancements in electrochemical biosensing platforms towards the detection of SARS-CoV-2 through studying similar viruses.

Biosensing strategies for the electrochemical detection of viruses and viral diseases - A review

Viruses are the causing agents for many relevant diseases, including influenza, Ebola, HIV/AIDS, and COVID-19. Its rapid replication and high transmissibility can lead to serious consequences not only to the individual but also to collective health, causing deep economic impacts. In this scenario, diagnosis tools are of significant importance, allowing the rapid, precise, and low-cost testing of a substantial number of individuals. Currently, PCR-based techniques are the gold standard for the diagnosis of viral diseases. Although these allow the diagnosis of different illnesses with high precision, they still present significant drawbacks. Their main disadvantages include long periods for obtaining results and the need for specialized professionals and equipment, requiring the tests to be performed in research centers. In this scenario, biosensors have been presented as promising alternatives for the rapid, precise, low-cost, and on-site diagnosis of viral diseases. This critical review article describes the advancements achieved in the last five years regarding electrochemical biosensors for the diagnosis of viral infections. First, genosensors and aptasensors for the detection of virus and the diagnosis of viral diseases are presented in detail regarding probe immobilization approaches, detection methods (label-free and sandwich), and amplification strategies. Following, immunosensors are highlighted, including many different construction strategies such as label-free, sandwich, competitive, and lateral-flow assays. Then, biosensors for the detection of viral-diseases-related biomarkers are presented and discussed, as well as point of care systems and their advantages when compared to traditional techniques. Last, the difficulties of commercializing electrochemical devices are critically discussed in conjunction with future trends such as lab-on-a-chip and flexible sensors.

Graphene: A Disruptive Opportunity for COVID-19 and Future Pandemics?

The graphene revolution, which has taken place during the last 15 years, has represented a paradigm shift for science. The extraordinary properties possessed by this unique material have paved the road to a number of applications in materials science, optoelectronics, energy, and sensing. Graphene-related materials (GRMs) are now produced in large scale and have found niche applications also in the biomedical technologies, defining new standards for drug delivery and biosensing. Such advances position GRMs as novel tools to fight against the current COVID-19 and future pandemics. In this regard, GRMs can play a major role in sensing, as an active component in antiviral surfaces or in virucidal formulations. Herein, the most promising strategies reported in the literature on the use of GRM-based materials against the COVID-19 pandemic and other types of viruses are showcased, with a strong focus on the impact of functionalization, deposition techniques, and integration into devices and surface coatings.

Gold nanostructured laser-scribed graphene: A new electrochemical biosensing platform for potential point-of-care testing of disease biomarkers

Improvements in the laser-scribed graphene (LSG)-based electrodes are critical to overcoming limitations of bare LSG electrodes in terms of sensitivity, direct immobilization of detection probes for biosensor fabrication, and ease of integration with point-of-care (POC) devices. Herein, we introduce a new class of nanostructured gold modified LSG (LSG-AuNS) electrochemical sensing system comprising LSG-AuNS working electrode, LSG reference, and LSG counter electrode. LSG-AuNS electrodes are realized by electrodeposition of gold chloride (HAuCl₄) solution, which gave~2-fold enhancement in sensitivity and electrocatalytic activity compared to bare LSG electrode and commercially available screen-printed gold electrode (SPAuE). We demonstrate LSG-AuNS electrochemical aptasensor for detecting human epidermal growth factor receptor 2 (Her-2) with a limit of detection (LOD) of 0.008 ng/mL and a linear range of 0.1-200 ng/mL. LSG-AuNS-aptasensor can easily detect different concentrations of Her-2 spiked in undiluted human serum. Finally, to show the LSG-AuNS sensor system's potential to develop POC biosensor devices, we integrated LSG-AuNS electrodes with a handheld electrochemical system operated using a custom-developed mobile application.

Introducing polymer conductance in diagnostically relevant transduction

In this work we demonstrate that an impedance derived capacitance method is able to cleanly resolve the resonant conductance characteristics of an electrode-confined polymer film. In decorating the film with receptors, this conductance is thereafter modulated by the capturing of specific targets, demonstrated herein with C-reactive protein. This entirely reagentless and single step marker quantification is relevant to the drive of moving assays to a scaleable format requiring minimal user intervention.

•

Relaxation conductance was used to create a new transducer signal concept.

•

This relaxation conductance transducer signal concept was proved to be valid.

•

Conductive redox polymer was used as sensitive function for the new signal concept.

•

C-reactive protein was successfully detected in suitable low concentrations.

•

This transducer principle is equally applicable to any other target.

Facile strategy for immobilizing horseradish peroxidase on a novel acetate functionalized ionic liquid/MWCNT matrix for electrochemical biosensing

Facile yet simple platforms for the immobilization of biomolecules have always been a substantial requirement for the fabrication of proficient biosensors. In this study, we report a naphthyl substituted acetate functionalized ionic liquid (NpAc-IL) for the covalent anchoring of horseradish peroxidase (HRP), using which the direct electrochemistry of HRP was successfully accomplished and a H₂O₂ biosensor was developed. The naphthyl substitution on the NpAc-IL was utilized for the π-π stacking with the MWCNT modified GCE and the terminal -OCH₃ group of NpAc-IL was used for the covalent attachment with the free -NH₂ group of HRP via amide bond formation. High conducting nature of the newly designed ionic liquid (NpAc-IL), facilitated an improved communication with the deeply buried redox centre of the HRP, while the covalent bonding provided enhanced stability to the fabricated biosensor by stably holding the water soluble HRP enzyme on the electrode surface. Furthermore, incorporation of MWCNT on the sensor setup synergistically enhanced the sensitivity of the developed biosensor. Under optimized conditions, the fabricated biosensor showed an enhanced electrocatalytic reduction of H₂O₂ in the range of 0.01 to 2.07 mM with a limit of detection and sensitivity of 2.7 μM and 55.98 μA mM^-1 cm^-2 respectively. Further, the proposed biosensor was utilized for the sensing of H₂O₂ spiked in real samples. Moreover, the newly fabricated biosensor demonstrated excellent stability with improved sensitivity and selectivity towards H₂O₂ reduction. The superior analytical characteristics are attributed to the facile fabrication strategy using this newly developed acetate functionalized ionic liquid platform.

Engineering Protein Switches for Rapid Diagnostic Tests

Biological signaling pathways are underpinned by protein switches that sense and respond to molecular inputs. Inspired by nature, engineered protein switches have been designed to directly transduce analyte binding into a quantitative signal in a simple, wash-free, homogeneous assay format. As such, they offer great potential to underpin point-of-need diagnostics that are needed across broad sectors to improve access, costs, and speed compared to laboratory assays. Despite this, protein switch assays are not yet in routine diagnostic use, and a number of barriers to uptake must be overcome to realize this potential. Here, we review the opportunities and challenges in engineering protein switches for rapid diagnostic tests. We evaluate how their design, comprising a recognition element, reporter, and switching mechanism, relates to performance and identify areas for improvement to guide further optimization. Recent modular switches that enable new analytes to be targeted without redesign are crucial to ensure robust and efficient development processes. The importance of translational steps toward practical implementation, including integration into a user-friendly device and thorough assay validation, is also discussed.

Recent Developments of Carbon Dots in Biosensing: A Review

Early diagnosis of diseases is of great importance because it increases the chance of a cure and significantly reduces treatment costs. Thus, development of rapid, sensitive, and reliable biosensing techniques is essential for the benefits of human life and health. As such, various nanomaterials have been explored to improve performance of biosensors, among which, carbon dots (CDs) have received enormous attention due to their excellent performance. In this Review, the recent advancements of CD-based biosensors have been carefully summarized. First, biosensors are classified according to their sensing strategies, and the role of CDs in these sensors is elaborated in detail. Next, several typical CD-based biosensors (including CD-only, enzymatic, antigen-antibody, and nucleic acid biosensors) and their applications are fully discussed. Last, advantages, challenges, and perspectives on the future trends of CD-based biosensors are highlighted.