A Comprehensive Study: Traditional and Cutting-Edge Analytical Techniques for the Biomarker Based Detection of the Micronutrients & POC Sensing Directions for Next-Generation Diagnostic

Micronutrient deficiency is wide spread and highly affects morbidity, mortality, and well-being of human beings. Micronutrient deficiency gradually manifests into diseases, which effects pathophysiology directly or indirectly. There is an imprecision in the diagnosis of micronutrient deficiency because of two causes; the selection of the standard biomarker and the diagnostic technique used. In appropriate diagnosis could increase the severity of the disorder. Instead of a single a combination of biomarkers can give more stringent results for micronutrient testing. Several traditional analytical techniques are used for diagnosis but HPLC, ELISA & LCMS/MS are most sensitive and reliable methods used by CLSIA-certified labs. However, these techniques require well-equipped, centralized laboratory facilities. The diagnostic era moves toward the Point of Care Testing (POCT), a boon in emerging diagnostics, breaking all paradigms of traditional analytical techniques. POCT led us toward the development of biosensors, which encompasses many techniques like paper-based sensors, microfluidic chip, wearable devices, and smartphone-assisted diagnostics, which become more popular diagnostic tools. This outlook summarizes the micronutrients like vitamins A, B5, B6, B7, B9, B12 C, D, and E and Minerals like iron, calcium, zinc, magnesium, and sodium; along with its biomarkers, analytical techniques, and point of care innovation in micronutrients.

Microfluidic systems in clinical diagnosis

The use of microfluidic devices is highly attractive in the field of biomedical and clinical assessments, as their portability and fast response time have become crucial in providing opportune therapeutic treatments to patients. The applications of microfluidics in clinical diagnosis and point-of-care devices are continuously growing. The present review article discusses three main fields where miniaturized devices are successfully employed in clinical applications. The quantification of ions, sugars, and small metabolites is examined considering the analysis of bodily fluids samples and the quantification of this type of analytes employing real-time wearable devices. The discussion covers the level of maturity that the devices have reached as well as cost-effectiveness. The analysis of proteins with clinical relevance is presented and organized by the function of the proteins. The last section covers devices that can perform single-cell metabolomic and proteomic assessments. Each section discusses several strategically selected recent reports on microfluidic devices successfully employed for clinical assessments, to provide the reader with a wide overview of the plethora of novel systems and microdevices developed in the last 5 years. In each section, the novel aspects and main contributions of each reviewed report are highlighted. Finally, the conclusions and future outlook section present a summary and speculate on the future direction of the field of miniaturized devices for clinical applications.

Recent advances in polymeric nanostructured ion selective membranes for biomedical applications

Nano structured ion-selective membranes (ISMs) are very attractive materials for a wide range of sensing and ion separation applications. The present review focuses on the design principles of various ISMs; nanostructured and ionophore/ion acceptor doped ISMs, and their use in biomedical engineering. Applications of ISMs in the biomedical field have been well-known for more than half a century in potentiometric analysis of biological fluids and pharmaceutical products. However, the emergence of nanotechnology and sophisticated sensing methods assisted in miniaturising ion-selective electrodes to needle-like sensors that can be designed in the form of implantable or wearable devices (smartwatch, tattoo, sweatband, fabric patch) for health monitoring. This article provides a critical review of recent advances in miniaturization, sensing and construction of new devices over last decade (2011-2021). The designing of tunable ISM with biomimetic artificial ion channels offered intensive opportunities and innovative clinical analysis applications, including precise biosensing, controlled drug delivery and early disease diagnosis. This paper will also address the future perspective on potential applications and challenges in the widespread use of ISM for clinical use. Finally, this review details some recommendations and future directions to improve the accuracy and robustness of ISMs for biomedical applications.

Highly Stable Potentiometric (Bio)Sensor for Urea and Urease Activity Determination

There is growing interest for bioanalytical tools that might be designed for a specific user, primarily for research purposes. In this perspective, a new, highly stable potentiometric sensor based on glassy carbon/polyazulene/NH₄⁺-selective membrane was developed and utilized for urease activity determination. Urease–urea interaction studies were carried out and the Michaelis–Menten constant was established for this enzymatic reaction. Biofunctionalization of the ammonium ion-selective sensor with urease lead to urea biosensor with remarkably good potential stability (drift coefficient ~0.9 mV/h) and short response time (t_95% = 36 s). The prepared biosensor showed the Nernstian response (S = 52.4 ± 0.7 mV/dec) in the urea concentration range from 0.01 to 20 mM, stable for the experimental time of 60 days. In addition, some insights into electrical properties of the ion-to-electron transducing layer resulting from impedance spectroscopy measurements are presented. Based on the RCQ equivalent circuits comparison, it can be drawn that the polyazulene (PAz) layer shows the least capacitive behavior, which might result in good time stability of the sensor in respect to response as well as potential E⁰. Both the polyazulene-based solid-contact ion selective electrodes and urea biosensors were successfully used in trial studies for determination of ammonium ion and urea in human saliva samples. The accuracy of ammonium ion and urea levels determination by potentiometric method was confirmed by two reference spectrophotometric methods.

Wearable and Mobile Sensors for Personalized Nutrition

While wearable and mobile chemical sensors have experienced tremendous growth over the past decade, their potential for tracking and guiding nutrition has emerged only over the past three years. Currently, guidelines from doctors and dietitians represent the most common approach for maintaining optimal nutrition status. However, such recommendations rely on population averages and do not take into account individual variability in responding to nutrients. Precision nutrition has recently emerged to address the large heterogeneity in individuals' responses to diet, by tailoring nutrition based on the specific requirements of each person. It aims at preventing and managing diseases by formulating personalized dietary interventions to individuals on the basis of their metabolic profile, background, and environmental exposure. Recent advances in digital nutrition technology, including calories-counting mobile apps and wearable motion tracking devices, lack the ability of monitoring nutrition at the molecular level. The realization of effective precision nutrition requires synergy from different sensor modalities in order to make timely reliable predictions and efficient feedback. This work reviews key opportunities and challenges toward the successful realization of effective wearable and mobile nutrition monitoring platforms. Non-invasive wearable and mobile electrochemical sensors, capable of monitoring temporal chemical variations upon the intake of food and supplements, are excellent candidates to bridge the gap between digital and biochemical analyses for a successful personalized nutrition approach. By providing timely (previously unavailable) dietary information, such wearable and mobile sensors offer the guidance necessary for supporting dietary behavior change toward a managed nutritional balance. Coupling of the rapidly emerging wearable chemical sensing devices-generating enormous dynamic analytical data-with efficient data-fusion and data-mining methods that identify patterns and make predictions is expected to revolutionize dietary decision-making toward effective precision nutrition.

3D-printed manifold integrating solid contact ion-selective electrodes for multiplexed ion concentration measurements in urine

Urinalysis is a simple and non-invasive approach for the diagnosis and monitoring of various health disorders. While urinalysis is predominantly confined to clinical laboratories the non-invasive sample collection makes it applicable in wide range of settings outside of central laboratory confinements. In this respect, 3D printed devices integrating sensors for measuring multiple parameters may be one of the most viable approaches to ensure cost-effectiveness for widespread use. Here we evaluated such a system for the multiplexed determination of sodium, potassium and calcium ions in urine samples with ion-selective electrodes based on state of the art octadecylamine-functionalized multi-walled carbon nanotube (OD-MWCNT) solid contacts. The electrodes were tested in the clinically relevant concentration range, i.e. ca. 10^-4 - 10^-1 mol L^-1 and were proven to have Nernstian responses under flow injection conditions. The applicability of the 3D printed flow manifold was investigated through the analysis of synthetic samples and two certified reference materials. The obtained results confirm the suitability of the proposed system for multiplexed ion analysis in urine.

Development of Flexible Ion-Selective Electrodes for Saliva Sodium Detection

Saliva can be used for health monitoring with non-invasive wearable systems. Such devices, including electrochemical sensors, may provide a safe, fast, and cost-efficient way of detecting target ions. Although salivary ions are known to reflect those in blood, no available clinical device can detect essential ions directly from saliva. Here, we introduce an all-solid-state, flexible film sensor that allows highly accurate detection of sodium levels in saliva, comparable to those in blood. The wireless film sensor system can successfully measure sodium ions from a small volume of infants' saliva (<400 µL), demonstrating its potential as a continuous health monitor. This study includes the structural characterization and error analysis of a carbon/elastomer-based ion-selective electrode and a reference electrode to confirm the signal reliability. The sensor, composed of a pair of the electrodes, shows good sensitivity (58.9 mV/decade) and selectivity (log K = -2.68 for potassium), along with a broad detection range of 5 × 10^-5 ≈ 1 M with a low detection limit of 4.27 × 10^-5 M. The simultaneous comparison between the film sensor and a commercial electrochemical sensor demonstrates the accuracy of the flexible sensor and a positive correlation in saliva-to-blood sodium levels. Collectively, the presented study shows the potential of the wireless ion-selective sensor system for a non-invasive, early disease diagnosis with saliva.

Advanced materials-integrated electrochemical sensors as promising medical diagnostics tools: A review

Electrochemical sensors have increasingly been linked with terms as modern biomedically effective highly selective and sensitive devices, wearable and wireless technology, portable electronics, smart textiles, energy storage, communication and user-friendly operating systems. The work brings the overview of the current advanced materials and their application strategies for improving performance, miniaturization and portability of sensing devices. It provides the extensive information on recently developed (bio)sensing platforms based on voltammetric, amperometric, potentiometric and impedimetric detection modes including portable, non-invasive, wireless, and self-driven miniaturized devices for monitoring human and animal health. Diagnostics of selected free radical precursors, low molecular biomarkers, nucleic acids and protein-based biomarkers, bacteria and viruses of today's interest is demonstrated.

X (metal: Al, Cu, Sn, Ti)-functionalized tunable 2D-MoS2 nanostructure assembled biosensor arrays for qualitative and quantitative analysis of vital neurological drugs

In this work we report for the first time surface functionalization of 2D MoS2 with X (metals: Al, Cu, Sn, Ti) to develop a low-cost, ultra-selective biosensor array based Electronic Tongue (E-Tongue) for the detection of 4 vital neurological drugs in human saliva. The hydrothermally grown surface functionalized X-MoS2 was integrated onto a single 1 × 1 cm aluminium foil and contacts were defined using Cr electrodes. Detailed characterization revealed the formation of 2-H MoS2 and metal-X (Al, Cu, Sn, Ti)-functionalized MoS2 nanoflower like morphology decorated with nanoflake, nanorod, nanocube and nanostick structures, respectively. The response of the sensor array was recorded for aspirin, nicotine, caffeine and tramadol. Principal Component Analysis (PCA) was performed to reduce the dimension of numerous response data sets from all sensors and predict the likely possible response from various neurological drugs towards each sensor. Pattern-recognition analysis confirmed a definite pattern in response to respective functionalization and could efficiently differentiate neurological drugs from one another. Real-time analysis was performed using saliva samples for monitoring the therapeutic neurological drug concentration in the human body. Furthermore, the biosensor array was exposed to respective neurological drugs to study their sensitivity, selectivity, stability, reproducibility and adhesion onto the device. The strategy outlined can be used to develop lab-on-a-chip devices for the real-time detection of numerous bioanalytes in body fluids.

Multisensor Systems and Arrays for Medical Applications Employing Naturally-Occurring Compounds and Materials

The significant improvement of quality of life achieved over the last decades has stimulated the development of new approaches in medicine to take into account the personal needs of each patient. Precision medicine, providing healthcare customization, opens new horizons in the diagnosis, treatment and prevention of numerous diseases. As a consequence, there is a growing demand for novel analytical devices and methods capable of addressing the challenges of precision medicine. For example, various types of sensors or their arrays are highly suitable for simultaneous monitoring of multiple analytes in complex biological media in order to obtain more information about the health status of a patient or to follow the treatment process. Besides, the development of sustainable sensors based on natural chemicals allows reducing their environmental impact. This review is concerned with the application of such analytical platforms in various areas of medicine: analysis of body fluids, wearable sensors, drug manufacturing and screening. The importance and role of naturally-occurring compounds in the development of electrochemical multisensor systems and arrays are discussed.

Potentiometric Solid-Contact Ion-Selective Electrode for Determination of Thiocyanate in Human Saliva

A new solid-contact potentiometric ion-selective electrode for the determination of SCN- (SCN-ISE) has been described. Synthesized phosphonium derivative of calix[4]arene was used as a charged ionophore. The research included selection of the ion-selective membrane composition, determination of the ISEs metrological parameters and SCN-ISE application for thiocyanate determination in human saliva. Preparation of the ISEs included selection of a plasticizer for the ion-selective membrane composition and type of the electrode material. The study was carried out using ISE with liquid internal electrolyte (LE-ISE) and solid-contact electrodes made of glassy carbon (GC-ISE) and gold rods (Au-ISE). The best parameters were found for GC sensors for which the ion-selective membrane contained chloroparaffin as a plasticizer (S = 59.9 mV/dec, LOD = 1.6 ´ 10-6 M). The study of potentiometric selectivity coefficients has shown that the thiocyanate-selective sensor could be applied in biomedical research for determination of SCN- concentration in human saliva. The accuracy of the SCN- determination was verified by testing 59 samples of volunteers' saliva by potentiometric sensors and UV-Vis spectrophotometry as a reference technique. Moreover, SCN- concentrations in the smokers' and non-smokers' saliva were compared. In order to investigate the influence of various factors (sex, health status, taken medications) on the thiocyanate level in the saliva, more extensive studies on a group of 100 volunteers were carried out. Additionally, for a group of 18 volunteers, individual profiles of SCN- concentration in saliva measured on a daily basis for over a month were collected.

Comparison of Different Commercial Conducting Materials as Ion-to-Electron Transducer Layers in Low-Cost Selective Solid-Contact Electrodes

Simple, robust, sensitive and low-cost all-solid-state ion-selective electrodes (SCISEs) are of interest in different fields, such as medicine, veterinary, water treatment, food control, environmental and pollution monitoring, security, etc. as a replacement for traditional ion-selective electrodes with liquid inner contact. In spite of their potential advantages, SCISEs remain mainly in the research laboratories. With the motivation of developing simple and low-cost SCISEs with possible commercial applications, we report a comparison study of six different commercial conducting materials, namely, polypyrrole-block-polycaprolactone (PPy-b-PCaprol), graphene/poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) ink, poly(3,4-ethylenedioxythiophene):polyethylenglycol (PEDOT:PEG), high conductivity PEDOT:PSS, polyethylenimine (PEI) with PEDOT:PSS for their possible use as ion-to-electron transducer in polyurethane based pH-SCISEs. Among all studied pH-SCISES, PEDOT:PEG based electrodes exhibited the best results in terms of sensitivity, reproducibility and lifetime. Finally, these sensors were tested in different real samples showing good accuracy.

A miniaturized solid-contact potentiometric multisensor platform for determination of ionic profiles in human saliva

This paper describes a miniaturized multisensor platform (MP-ISES) consisting of electrodes: a reference one (RE) and ion-selective electrodes (ISEs) for monitoring Na+, K+, Ca2+, Mg2+, Cl−, and SCN− ions and pH in human saliva. Gold electrode surface was modified by deposition of two layers: electrosynthesized PEDOT:PSS forming an intermediate layer, and ion-selective membrane. The developed ISEs were characterized by a wide linear range and sensitivity consistent with the Nernst model. The entire MP-ISEs are characterized by satisfactory metrological parameters demonstrating their applicability in biomedical research, in particular in measurements concerning determination of ionic profiles of saliva. Saliva samples of 18 volunteers aged from 20 to 26 participating in a month experiment had been daily collected and investigated using the MP-ISEs assigned individually to each person. Personalized profiles of ions (ionograms) in saliva, such as Na+, K+, Ca2+, Mg2+, Cl−, SCN−, and H+, were obtained.

A Fully Integrated Paper-Microfluidic Electrochemical Device for Simultaneous Analysis of Physiologic Blood Ions

A fully integrated paper microfluidic electrochemical device equipped with three different cation permeable films is developed to determine blood ions (Cl-, Na⁺, K⁺, and Ca2+) at a time. These blood ions that are normally dissolved in the real human blood stream are essential for cell metabolisms and homeostasis in the human body. Abnormal concentration of blood ions causes many serious disorders. The optimized microfluidic device working without any external power source can directly and effectively separate human blood components, and subsequently detect a specific blood ion with minimized interference. The measured sensitivity to Cl-, K⁺, Na⁺, and Ca2+ are -47.71, 45.97, 51.06, and 19.46 in mV decade-1, respectively. Potentiometric responses of the microfluidic devices to blood serum samples are in the normal ranges of each cation, and comparable with responses from the commercial blood ion analyzer Abbott i-Stat.