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

Wearable soft electrochemical microfluidic device integrated with iontophoresis for sweat biosensing

A soft and flexible wearable sweat epidermal microfluidic device capable of simultaneously stimulating, collecting, and electrochemically analyzing sweat is demonstrated. The device represents the first system integrating an iontophoretic pilocarpine delivery system around the inlet channels of epidermal polydimethylsiloxane (PDMS) microfluidic device for sweat collection and analysis. The freshly generated sweat is naturally pumped into the fluidic inlet without the need of exercising. Soft skin-mounted systems, incorporating non-invasive, on-demand sweat sampling/analysis interfaces for tracking target biomarkers, are in urgent need. Existing skin conformal microfluidic-based sensors for continuous monitoring of target sweat biomarkers rely on assays during intense physical exercising. This work demonstrates the first example of combining sweat stimulation, through transdermal pilocarpine delivery, with sample collection through a microfluidic channel for real-time electrochemical monitoring of sweat glucose, in a fully integrated soft and flexible multiplexed device which eliminates the need of exercising. The on-body operational performance and layout of the device were optimized considering the fluid dynamics and evaluated for detecting sweat glucose in several volunteers. Furthermore, the microfluidic monitoring device was integrated with a real-time wireless data transmission system using a flexible electronic board PCB conformal with the body. The new microfluidic platform paves the way to real-time non-invasive monitoring of biomarkers in stimulated sweat samples for diverse healthcare and wellness applications.

Kinetic changes in sweat lactate following fatigue during constant workload exercise

It is useful to investigate various physiological responses induced by fatigue in athletes. Moreover, wearable noninvasive sensors, including sweat sensors, are compatible with fatigue evaluation because of their ease of use, and ability to measure repeatedly and continual data. This cross-sectional study aimed to clarify how sweat lactate elimination curves obtained during constant workload exercise changed following fatigue. Seventeen recreationally trained males (average age, 20.6 ± 0.8 years) completed two consecutive constant workload exercise tests (at 25% peak power) with rest intervals; the participants were encouraged to perform Test 1 until exhaustion and Test 2 only for 10 min. Subjective fatigue (numerical rating scale with face rating scale), sweat lactate, and sweat rate were measured for 10 min in each test. Subjective fatigue was compared using the Wilcoxon signed-rank test and time to each constant value between Tests 1 and 2 was compared using paired t-test. Subjective fatigue significantly increased during Test 2 compared with that during Test 1. After Test 1, the sweat lactate elimination curve demonstrated a leftward shift, as proved by the significantly sooner observation of the peak and constant values of sweat lactate (2, 3, and 4 μA) (p < 0.01). Our preliminary results suggest that the sweat lactate elimination curve is different in the fatigue state. Further research may provide insight in the application of this curve to the evaluation for fatigue.

Advances in Medical Wearable Biosensors: Design, Fabrication and Materials Strategies in Healthcare Monitoring

In the past decade, wearable biosensors have radically changed our outlook on contemporary medical healthcare monitoring systems. These smart, multiplexed devices allow us to quantify dynamic biological signals in real time through highly sensitive, miniaturized sensing platforms, thereby decentralizing the concept of regular clinical check-ups and diagnosis towards more versatile, remote, and personalized healthcare monitoring. This paradigm shift in healthcare delivery can be attributed to the development of nanomaterials and improvements made to non-invasive biosignal detection systems alongside integrated approaches for multifaceted data acquisition and interpretation. The discovery of new biomarkers and the use of bioaffinity recognition elements like aptamers and peptide arrays combined with the use of newly developed, flexible, and conductive materials that interact with skin surfaces has led to the widespread application of biosensors in the biomedical field. This review focuses on the recent advances made in wearable technology for remote healthcare monitoring. It classifies their development and application in terms of electrochemical, mechanical, and optical modes of transduction and type of material used and discusses the shortcomings accompanying their large-scale fabrication and commercialization. A brief note on the most widely used materials and their improvements in wearable sensor development is outlined along with instructions for the future of medical wearables.

Printed microfluidic sweat sensing platform for cortisol and glucose detection

Wearable sweat biosensors offer compelling opportunities for improved personal health monitoring and non-invasive measurements of key biomarkers. Inexpensive device fabrication methods are necessary for scalable manufacturing of portable, disposable, and flexible sweat sensors. Furthermore, real-time sweat assessment must be analyzed to validate measurement reliability at various sweating rates. Here, we demonstrate a "smart bandage" microfluidic platform for cortisol detection and continuous glucose monitoring integrated with a synthetic skin. The low-cost, laser-cut microfluidic device is composed of an adhesive-based microchannel and solution-processed electrochemical sensors fabricated from inkjet-printed graphene and silver solutions. An antibody-derived cortisol sensor achieved a limit of detection of 10 pM and included a low-voltage electrowetting valve, validating the microfluidic sensor design under typical physiological conditions. To understand effects of perspiration rate on sensor performance, a synthetic skin was developed using soft lithography to mimic human sweat pores and sweating rates. The enzymatic glucose sensor exhibited a range of 0.2 to 1.0 mM, a limit of detection of 10 μM, and reproducible response curves at flow rates of 2.0 μL min^-1 and higher when integrated with the synthetic skin, validating its relevance for human health monitoring. These results demonstrate the potential of using printed microfluidic sweat sensors as a low-cost, real-time, multi-diagnostic device for human health monitoring.

Osmotically Enabled Wearable Patch for Sweat Harvesting and Lactate Quantification

Lactate is an essential biomarker for determining the health of the muscles and oxidative stress levels in the human body. However, most of the currently available sweat lactate monitoring devices require external power, cannot measure lactate under low sweat rates (such as in humans at rest), and do not provide adequate information about the relationship between sweat and blood lactate levels. Here, we discuss the on-skin operation of our recently developed wearable sweat sampling patch. The patch combines osmosis (using hydrogel discs) and capillary action (using paper microfluidic channel) for long-term sweat withdrawal and management. When subjects are at rest, the hydrogel disc can withdraw fluid from the skin via osmosis and deliver it to the paper. The lactate amount in the fluid is determined using a colorimetric assay. During active sweating (e.g., exercise), the paper can harvest sweat even in the absence of the hydrogel patch. The captured fluid contains lactate, which we quantify using a colorimetric assay. The measurements show the that the total number of moles of lactate in sweat is correlated to sweat rate. Lactate concentrations in sweat and blood correlate well only during high-intensity exercise. Hence, sweat appears to be a suitable biofluid for lactate quantification. Overall, this wearable patch holds the potential of providing a comprehensive analysis of sweat lactate trends in the human body.

Super-Hydrophilic Zwitterionic Polymer Surface Modification Facilitates Liquid Transportation of Microfluidic Sweat Sensors

The transportation of sweat in an epidermal sweat sensor is critical for the monitoring of biochemical compositions of human sweat. However, it is still a challenge to engineer microfluidic devices with super-wetting channels for such epidermal sweat sensors. Herein, a zwitterionic poly (2-methacryloyloxyethyl phosphorylcholine) (PMPC) modified microfluidic device with super-wetting and good liquid transport ability via an azo coupling reaction of PMPC onto the surface of polydimethylsiloxane microfluidic devices is reported. The obtained PMPC-modified microfluidic device can be integrated with flexible electrochemical sensor to measure the ion compositions of human sweat in real-time. The super-hydrophilic zwitterionic polymer surface modification can greatly facilitate the transportation of body fluids in microfluidic sensors for the detection of various biomarkers. Such microfluidic sensors have great potential for next-generation personalized healthcare.

Robust Nanozyme-Enzyme Nanosheets-Based Lactate Biosensor for Diagnosing Bacterial Infection in Olive Flounder (Paralichthys olivaceus)

Bacterial infections in fish farms increase mass mortality and rapid detection of infection can help prevent its widespread. Lactate is an important biomarker for early diagnosis of bacterial infections in farmed olive flounder (Paralichthys olivaceus). To determine the lactate levels, we designed a disposable amperometric biosensor based on Prussian blue nanozyme and lactate oxidase (LOX) entrapped in copolymer-reduced graphene oxide (P-rGO) on screen-printed carbon electrodes. Because LOX is inherently unstable, P-rGO nanosheets were utilized as a base matrix to immobilize it. After optimization in terms of enzyme loading, operating potential, and pH, the biosensor displayed maximum current responses within 5 s at the applied potential of -0.1 V vs. internal Ag/AgCl. The biosensor had Langmuir-type response in the lactate concentration range from 10 µM to 1.6 mM, a dynamic linear response range of 10-100 µM, a sensitivity of 15.9 µA mM-1 cm-2, and a lower detection limit of 3.1 µM (S/N = 3). Additionally, the biosensor featured high reproducibility, good selectivity, and stability till four weeks. Its practical applicability was tested in olive flounder infected by Streptococcus parauberis against the uninfected control. The results were satisfactory compared to those of a standard colorimetric assay kit, validating our method.

Can Wearable Sweat Lactate Sensors Contribute to Sports Physiology?

The rise of wearable sensors to measure lactate content in human sweat during sports activities has attracted the attention of physiologists given the potential of these “analytical tools” to provide real-time information. Beyond the assessment of the sensing technology per se, which, in fact, has not rigorously been validated yet in controlled conditions, there are many open questions about the true usefulness of such wearable sensors in real scenarios. On the one hand, the evidence for the origin of sweat lactate (e.g., via the sweat gland, derivation from blood, or other alternative mechanisms), its high concentration (1–25 mM or even higher) compared to levels in the blood, and the possible correlation between different biofluids (particularly blood) is rather contradictory and generates vivid debate in the field. On the other hand, it is important to point out that accurate detection of sweat lactate is highly dependent on the procedure used to collect and/or reach the fluid, and this can likely explain the large discrepancies reported in the literature. In brief, this paper provides our vision of the current state of the field and a thoughtful evaluation of the possible reasons for present controversies, together with an analysis of the impact of wearable sweat lactate sensors in the physiological context. Finally, although there is not yet overwhelming scientific evidence to provide an unequivocal answer to whether wearable sweat lactate sensors can contribute to sports physiology, we still understand the importance to bring this challenging question up-front to create awareness and guidance in the development, validation, and implementation of wearable sensors.

State of Sweat: Emerging Wearable Systems for Real-Time, Noninvasive Sweat Sensing and Analytics

Skin-interfaced wearable systems with integrated colorimetric assays, microfluidic channels, and electrochemical sensors offer powerful capabilities for noninvasive, real-time sweat analysis. This Perspective details recent progress in the development and translation of novel wearable sensors for personalized assessment of sweat dynamics and biomarkers, with precise sampling and real-time analysis. Sensor accuracy, system ruggedness, and large-scale deployment in remote environments represent key opportunity areas, enabling broad deployment in the context of field studies, clinical trials, and recent commercialization. On-body measurements in these contexts show good agreement compared to conventional laboratory-based sweat analysis approaches. These device demonstrations highlight the utility of biochemical sensing platforms for personalized assessment of performance, wellness, and health across a broad range of applications.

Lactate Biosensing for Reliable On-Body Sweat Analysis

Wearable lactate sensors for sweat analysis are highly appealing for both the sports and healthcare fields. Electrochemical biosensing is the approach most widely used for lactate determination, and this technology generally demonstrates a linear range of response far below the expected lactate levels in sweat together with a high influence of pH and temperature. In this work, we present a novel analytical strategy based on the restriction of the lactate flux that reaches the enzyme lactate oxidase, which is immobilized in the biosensor core. This is accomplished by means of an outer plasticized polymeric layer containing the quaternary salt tetradodecylammonium tetrakis(4-chlorophenyl) borate (traditionally known as ETH500). Also, this layer prevents the enzyme from being in direct contact with the sample, and hence, any influence with the pH and temperature is dramatically reduced. An expanded limit of detection in the millimolar range (from 1 to 50 mM) is demonstrated with this new biosensor, in addition to an acceptable response time; appropriate repeatability, reproducibility, and reversibility (variations lower than 5% for the sensitivity); good resiliency; excellent selectivity; low drift; negligible influence of the flow rate; and extraordinary correlation (Pearson coefficient of 0.97) with a standardized method for lactate detection such as ion chromatography (through analysis of 22 sweat samples collected from 6 different subjects performing cycling or running). The developed lactate biosensor is suitable for on-body sweat lactate monitoring via a microfluidic epidermal patch additionally containing pH and temperature sensors. This applicability was demonstrated in three different body locations (forehead, thigh, and back) in a total of five on-body tests while cycling, achieving appropriate performance and validation. Moreover, the epidermal patch for lactate sensing is convenient for the analysis of sweat stimulated by iontophoresis in the subjects’ arm, which is of great potential toward healthcare applications.

PANI-Based Wearable Electrochemical Sensor for pH Sweat Monitoring

Nowadays, we are assisting in the exceptional growth in research relating to the development of wearable devices for sweat analysis. Sweat is a biofluid that contains useful health information and allows a non-invasive, continuous and comfortable collection. For this reason, it is an excellent biofluid for the detection of different analytes. In this work, electrochemical sensors based on polyaniline thin films deposited on the flexible substrate polyethylene terephthalate coated with indium tin oxide were studied. Polyaniline thin films were abstained by the potentiostatic deposition technique, applying a potential of +2 V vs. SCE for 90 s. To improve the sensor performance, the electronic substrate was modified with reduced graphene oxide, obtained at a constant potential of −0.8 V vs. SCE for 200 s, and then polyaniline thin films were electrodeposited on top of the as-deposited substrate. All samples were characterized by XRD, SEM, EDS, static contact angle and FT-IR/ATR analysis to correlate the physical-chemical features with the performance of the sensors. The obtained electrodes were tested as pH sensors in the range from 2 to 8, showing good behavior, with a sensitivity of 62.3 mV/pH, very close to a Nernstian response, and a reproducibility of 3.8%. Interference tests, in the presence of competing ions, aimed to verify the selectivity, were also performed. Finally, a real sweat sample was collected, and the sweat pH was quantified with both the proposed sensor and a commercial pH meter, showing an excellent concordance.