Advances in Sweat Wearables: Sample Extraction, Real-Time Biosensing, and Flexible Platforms

Point-of-care detection of cytokines in cytokine storm management and beyond: Significance and challenges

Cytokines are signaling molecules between cells in immune system. Cytokine storm, due to the sudden acute increase in levels of pro-inflammatory circulating cytokines, can result in disease severity and major-organ damage. Thus, there is urgent need to develop rapid, sensitive, and specific methods for monitoring of cytokines in biology and medicine. Undoubtedly, point-of-care testing (POCT) will provide clinical significance in disease early diagnosis, management, and prevention. This review aims to summarize and discuss the latest technologies for detection of cytokines with a focus on POCT. The overview of diseases resulting from imbalanced cytokine levels, such as COVID-19, sepsis and other cytokine release syndromes are presented. The clinical cut-off levels of cytokine as biomarkers for different diseases are summarized. The challenges and perspectives on the development of cytokine POCT devices are also proposed and discussed. Cytokine POCT devices are expected to be the ongoing spotlight of disease management and prevention during COVID-19 pandemic and also the post COVID-19 pandemic era.

Hydrogels and Their Role in Biosensing Applications

Hydrogels play an important role in the field of biomedical research and diagnostic medicine. They are emerging as a powerful tool in the context of bioanalytical assays and biosensing. In this context, this review gives an overview of different hydrogels and the role they adopt in a range of applications. Not only are hydrogels beneficial for the immobilization and embedding of biomolecules, but they are also used as responsive material, as wearable devices, or as functional material. In particular, the scientific and technical progress during the last decade is discussed. The newest hydrogel types, their synthesis, and many applications are presented. Advantages and performance improvements are described, along with their limitations.

Touch-Based Fingertip Blood-Free Reliable Glucose Monitoring: Personalized Data Processing for Predicting Blood Glucose Concentrations

Diabetes prevalence has been rising exponentially, increasing the need for reliable noninvasive approaches for glucose monitoring. Different biofluids have been explored recently for replacing current blood finger-stick glucose strips with noninvasive painless sensing devices. While sweat has received considerable attention, there are mixed reports on correlating the sweat results with blood glucose levels. Here, we demonstrate a new rapid and reliable approach that combines a simple touch-based fingertip sweat electrochemical sensor with a new algorithm that addresses for personal variations toward the accurate estimate of blood glucose concentrations. The new painless and simple glucose self-testing protocol leverages the fast sweat rate on the fingertip for rapid assays of natural perspiration, without any sweat stimulation, along with the personalized sweat-response-to-blood concentration translation. A reliable estimate of the blood glucose sensing concentrations can thus be realized through a simple one-time personal precalibration. Such system training leads to a substantially improved accuracy with a Pearson correlation coefficient higher than 0.95, along with an overall mean absolute relative difference of 7.79%, with 100% paired points residing in the A + B region of the Clarke error grid. The speed and simplicity of the touch-based blood-free fingertip sweat assay, and the elimination of periodic blood calibrations, should lead to frequent self-testing of glucose and enhanced patient compliance toward the improved management of diabetes.

Recent progress, challenges, and opportunities for wearable biochemical sensors for sweat analysis

Sweat is a promising, yet relatively unexplored biofluid containing biochemical information that offers broad insights into the underlying dynamic metabolic activity of the human body. The rich composition of electrolytes, metabolites, hormones, proteins, nucleic acids, micronutrients, and exogenous agents found in sweat dynamically vary in response to the state of health, stress, and diet. Emerging classes of skin-interfaced wearable sensors offer powerful capabilities for the real-time, continuous analysis of sweat produced by the eccrine glands in a manner suitable for use in athletics, consumer wellness, military, and healthcare industries. This perspective examines the rapid and continuous progress of wearable sweat sensors through the most advanced embodiments that address the fundamental challenges currently restricting widespread deployment. It concludes with a discussion of efforts to expand the overall utility of wearable sweat sensors and opportunities for commercialization, in which advances in biochemical sensor technologies will be critically important.

Fully Printed Wearable Microfluidic Devices for High-Throughput Sweat Sampling and Multiplexed Electrochemical Analysis

Although the recent advancement in wearable biosensors provides continuous, noninvasive assessment of physiologically relevant chemical markers from human sweat, several bottlenecks still exist for its practical use. There were challenges in developing a multiplexed biosensing system with rapid microfluidic sampling and transport properties, as well as its integration with a portable potentiostat for improved interference-free data collection. Here, we introduce a clean-room free fabrication of wearable microfluidic sensors, using a screen-printed carbon master, for the electrochemical monitoring of sweat biomarkers during exercise activities. The sweat sampling is enhanced by introducing low-dimensional sensing compartments and lowering the hydrophilicity of channel layers via facile silane functionalization. The fluidic channel captures sweat at the inlet and directs the real-time sweat through the active sensing electrodes (within 40 s) for subsequent decoding and selective analyses. For proof of concept, simultaneous amperometric lactate and potentiometric ion sensing (Na⁺, K⁺, and pH) are carried out by a miniature circuit board capable of cross-talk-free signal collection and wireless signal transduction characteristics. All of the sensors demonstrated appreciable sensitivity, selectivity, stability, carryover efficiency, and repeatability. The floating potentiometric circuits eliminate the signal interference from the adjacent amperometric transducers. The fully integrated pumpless microfluidic device is mounted on the epidermis and employed for multiplexed real-time decoding of sweat during stationary biking. The regional variations in sweat composition are analyzed by human trials at the underarm and upperback locations. The presented method offers a large-scale fabrication of inexpensive high-throughput wearable sensors for personalized point-of-care and athletic applications.

Recent Progress in Wearable Biosensors: From Healthcare Monitoring to Sports Analytics

Recent advances in lab-on-a-chip technology establish solid foundations for wearable biosensors. These newly emerging wearable biosensors are capable of non-invasive, continuous monitoring by miniaturization of electronics and integration with microfluidics. The advent of flexible electronics, biochemical sensors, soft microfluidics, and pain-free microneedles have created new generations of wearable biosensors that explore brand-new avenues to interface with the human epidermis for monitoring physiological status. However, these devices are relatively underexplored for sports monitoring and analytics, which may be largely facilitated by the recent emergence of wearable biosensors characterized by real-time, non-invasive, and non-irritating sensing capacities. Here, we present a systematic review of wearable biosensing technologies with a focus on materials and fabrication strategies, sampling modalities, sensing modalities, as well as key analytes and wearable biosensing platforms for healthcare and sports monitoring with an emphasis on sweat and interstitial fluid biosensing. This review concludes with a summary of unresolved challenges and opportunities for future researchers interested in these technologies. With an in-depth understanding of the state-of-the-art wearable biosensing technologies, wearable biosensors for sports analytics would have a significant impact on the rapidly growing field-microfluidics for biosensing.