Lateral flow immunoassay with upconverting nanoparticle‐based detection for indirect measurement of interferon response by the level of MxA

Rational design of MIPs for the detection of Myxovirus resistance protein A (MxA), a biomarker for viral infection

Accurate diagnosis is crucial for effective patient care and the containment of antimicrobial resistance outbreaks. The intricate challenge of distinguishing bacterial from viral infections, coupled with limited diagnostic tools and overlapping symptoms has driven the utilization of molecular imprinting techniques. This study focuses on developing cost-effective, chemically stable antibody analogs for the interferon-induced protein myxovirus resistance protein A (MxA). MxA is an intracellular, cytoplasmic GTPase having activity against a wide range of viruses and serves as a distinctive biomarker for viral infections. We utilized computational design to guide the polymer assembly, centering on epitope imprinting to target MxA-specific regions crucial for interaction. Molecular docking calculations, alongside a pioneering multi-monomer simultaneous docking (MMSD) protocol, efficiently elucidate cooperativity during pre-polymerization. Monomer binding affinity scores, such as for APTMS, exhibited notable increase, ranging from -3.11 to -13.03 kcal/mol across various MMSD combinations compared to a maximum of -2.78 kcal/mol in single monomer docking, highlighting the capacity of MMSD in elucidating crucial monomer-monomer interactions. This computational approach provides a theoretical alternative to labor-intensive experimental optimization, streamlining the development process for synthetic receptors. Simulations reveal unique interactions enhancing MIP-peptide complementarity, yielding optimized receptors selectively binding to MxA epitopes. The obtained MIPs demonstrated a maximum adsorption capacity of approximately 12 mg/g and captured 1.6 times more epitope and 2.6 times more epitope containing MxA protein than corresponding NIPs. A proof-of-concept study demonstrates MxA protein binding to synthetic receptors, highlighting the potential of MIPs, analogous to antibodies, in overcoming current diagnostic challenges for precise detection of viral infection.

Extensive acute and sustained changes to neutrophil proteomes post-SARS-CoV-2 infection

BACKGROUND

Neutrophils are important in the pathophysiology of coronavirus disease 2019 (COVID-19), but the molecular changes contributing to altered neutrophil phenotypes following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not fully understood. We used quantitative mass spectrometry-based proteomics to explore neutrophil phenotypes immediately following acute SARS-CoV-2 infection and during recovery.

METHODS

Prospective observational study of hospitalised patients with PCR-confirmed SARS-CoV-2 infection (May to December 2020). Patients were enrolled within 96 h of admission, with longitudinal sampling up to 29 days. Control groups comprised non-COVID-19 acute lower respiratory tract infection (LRTI) and age-matched noninfected controls. Neutrophils were isolated from peripheral blood and analysed using mass spectrometry. COVID-19 severity and recovery were defined using the World Health Organization ordinal scale.

RESULTS

Neutrophil proteomes from 84 COVID-19 patients were compared to those from 91 LRTI and 42 control participants. 5800 neutrophil proteins were identified, with >1700 proteins significantly changed in neutrophils from COVID-19 patients compared to noninfected controls. Neutrophils from COVID-19 patients initially all demonstrated a strong interferon signature, but this signature rapidly declined in patients with severe disease. Severe disease was associated with increased abundance of proteins involved in metabolism, immunosuppression and pattern recognition, while delayed recovery from COVID-19 was associated with decreased granule components and reduced abundance of metabolic proteins, chemokine and leukotriene receptors, integrins and inhibitory receptors.

CONCLUSIONS

SARS-CoV-2 infection results in the sustained presence of circulating neutrophils with distinct proteomes suggesting altered metabolic and immunosuppressive profiles and altered capacities to respond to migratory signals and cues from other immune cells, pathogens or cytokines.

Quantitative Point of Care Tests for Timely Diagnosis of Early-Onset Preeclampsia with High Sensitivity and Specificity

Preeclampsia is a heterogeneous and multiorgan cardiovascular disorder of pregnancy. Here, we report the development of a novel strip-based lateral flow assay (LFA) using lanthanide-doped upconversion nanoparticles conjugated to antibodies targeting two different biomarkers for detection of preeclampsia. We first measured circulating plasma FKBPL and CD44 protein concentrations from individuals with early-onset preeclampsia (EOPE), using ELISA. We confirmed that the CD44/FKBPL ratio is reduced in EOPE with a good diagnostic potential. Using our rapid LFA prototypes, we achieved an improved lower limit of detection: 10 pg ml-1 for FKBPL and 15 pg ml-1 for CD44, which is more than one order lower than the standard ELISA method. Using clinical samples, a cut-off value of 1.24 for CD44/FKBPL ratio provided positive predictive value of 100 % and the negative predictive value of 91 %. Our LFA shows promise as a rapid and highly sensitive point-of-care test for preeclampsia.

Fluorescent detection of emerging virus based on nanoparticles: From synthesis to application

The spread of COVID-19 has caused huge economic losses and irreversible social impact. Therefore, to successfully prevent the spread of the virus and solve public health problems, it is urgent to develop detection methods with high sensitivity and accuracy. However, existing detection methods are time-consuming, rely on instruments, and require skilled operators, making rapid detection challenging to implement. Biosensors based on fluorescent nanoparticles have attracted interest in the field of detection because of their advantages, such as high sensitivity, low detection limit, and simple result readout. In this review, we systematically describe the synthesis, intrinsic advantages, and applications of organic dye-doped fluorescent nanoparticles, metal nanoclusters, up-conversion particles, quantum dots, carbon dots, and others for virus detection. Furthermore, future research initiatives are highlighted, including green production of fluorescent nanoparticles with high quantum yield, speedy signal reading by integrating with intelligent information, and error reduction by coupling with numerous fluorescent nanoparticles.

Oral fluid-based lateral flow point-of-care assays for pertussis serology

Introduction. Current serological diagnosis of pertussis is usually performed by ELISA, which is typically performed in larger diagnostic or reference laboratories, requires trained staff, and due to sample batching may have longer turnaround times.Hypothesis and Aim. A rapid point-of-care (POC) assay for pertussis serology would aid in both the diagnosis and surveillance of the disease.Methodology. A quantitative lateral flow (LF)-based immunoassay with fluorescent Eu-nanoparticle reporters was developed for the detection of anti-pertussis toxin (PT) and adenylate cyclase toxin (ACT) antibodies from oral fluid samples (N=100), from suspected pertussis cases with respiratory symptoms.Results. LF assay results were compared to those obtained with anti-PT IgG oral fluid ELISA. For an ELISA cut-off value of 50 arbitrary units, the overall agreement between the assays was 91/100 (91 %), the sensitivity was 63/70 (90 %) and the specificity was 28/30 (93 %). No ACT-specific antibodies were detected from oral fluid samples; however, the signal readout positively correlated to those patients with high anti-PT IgG antibodies.Conclusion. The developed LF assay was a specific, sensitive and rapid test for serological diagnosis of pertussis with anti-PT antibodies and is a suitable POC test using oral fluid samples.

Whole blood based point-of-care assay for the detection of anti-pertussis toxin IgG antibodies

Current serological diagnosis of pertussis is usually done by ELISA to determine serum specific anti-pertussis toxin (PT) IgG antibodies. However, the ELISAs are often central-laboratory based, require trained staff, and have long turnaround times. A rapid point-of-care (POC) assay for pertussis serology would aid in both diagnosis and surveillance of the disease. In this study, a quantitative lateral flow assay (LFA) with fluorescent Eu-nanoparticle reporters was used for the detection of anti-PT antibodies from whole blood. The assay was evaluated by testing overall 141 samples including 25 before and 116 one month after acellular pertussis booster vaccination. LFA results were compared to those obtained with standardized anti-PT IgG ELISAs with paired serum samples. Correlation between the assays was high (Pearson R = 0.832), and the achieved analytical sensitivity of the LFA was 29 IU/mL, which would be sufficient for clinically relevant cutoffs for determining recent infections. The paired samples, collected pre- and post-booster, demonstrated a significant increase in anti-PT IgG antibodies similar to that detected by ELISA. The developed LFA opens up several alternatives for a suitable POC test also in middle- and low-income countries.

Nanomaterial and interface advances in immunoassay biosensors

Biosensors have been used for a remarkable array of applications, including infectious diseases, environmental monitoring, cancer diagnosis, food safety, and numerous others. In particular, the global COVID-19 pandemic has exposed a need for rapid tests, so the type of biosensor that has gained considerable interest recently are immunoassays, which are used for rapid diagnostics. The performance of paper-based lateral flow and dipstick immunoassays is influenced by the physical properties of the nanoparticles (NPs), NP-antibody conjugates, and paper substrate. Many materials innovations have enhanced diagnostics by increasing sensitivity or enabling unique readouts. However, negative side effects can arise at the interface between the biological sample and biomolecules and the NP or paper substrate, such as non-specific adsorption and protein denaturation. In this Perspective, we discuss the immunoassay components and highlight chemistry and materials innovations that can improve sensitivity. We also explore the range of bio-interface issues that can present challenges for immunoassays.

Blood myxovirus resistance protein-1 measurement in the diagnostic work-up of suspected COVID-19 infection in the emergency department

INTRODUCTION

Myxovirus resistance protein 1 (MxA) is a biomarker that is elevated in patients with viral infections. The goal of this study was to evaluate the diagnostic value of MxA in diagnosing COVID-19 infections in the emergency department (ED) patients.

METHODS

This was a single-center prospective observational cohort study including patients with a suspected COVID-19 infection. The primary outcome of this study was a confirmed COVID-19 infection by RT-PCR test. MxA was assessed using an enzyme immunoassay on whole blood and receiver operating chart and area under the curve (AUC) analysis was conducted. Sensitivity, specificity, negative predictive value, and positive predictive value of MxA on diagnosing COVID-19 at the optimal cut-off of MxA was determined.

RESULTS

In 2021, 100 patients were included. Of these patients, 77 patients had COVID-19 infection and 23 were non-COVID-19. Median MxA level was significantly higher (p < .001) in COVID-19 patients compared to non-COVID-19 patients, respectively 1933 and 0.1 ng/ml. The AUC of MxA on a confirmed COVID-19 infection was 0.941 (95% CI: 0.867-1.000). The optimal cut-off point of MxA was 252 ng/ml. At this cut-off point, the sensitivity of MxA on a confirmed COVID-19 infection was 94% (95% CI: 85%-98%) and the specificity was 91% (95% CI: 72%-99%).

CONCLUSION

MxA accurately distinguishes COVID-19 infections from bacterial infections and noninfectious diagnoses in the ED in patients with a suspected COVID-19 infection. If the results can be validated, MxA could improve the diagnostic workup and patient flow in the ED.

PMVEMA-coated upconverting nanoparticles for upconversion-linked immunoassay of cardiac troponin

Surface engineering of upconverting nanoparticles (UCNPs) is crucial for their bioanalytical applications. Here, an antibody specific to cardiac troponin I (cTnI), an important biomarker for acute myocardial infection, was covalently immobilized on the surface of UCNPs to prepare a label for the detection of cTnI biomarker in an upconversion-linked immunoassay (ULISA). Core-shell UCNPs (NaYF₄:Yb,Tm@NaYF₄) were first coated with poly(methyl vinyl ether-alt-maleic acid) (PMVEMA) and then conjugated to antibodies. The morphology (size and uniformity), hydrodynamic diameter, chemical composition, and amount of coating on the of UCNPs, as well as their upconversion luminescence, colloidal stability, and leaching of Y³⁺ ions into the surrounding media, were determined. The developed ULISA allowed reaching a limit of detection (LOD) of 0.13 ng/ml and 0.25 ng/ml of cTnI in plasma and serum, respectively, which represents 12- and 2-fold improvement to conventional enzyme-linked immunosorbent based on the same immunoreagents.

Multiple sclerosis and immune system biomarkers: Novel comparison in glatiramer acetate and interferon beta-1a-treated patient groups

BACKGROUND

Multiple sclerosis (MS) is a chronic, demyelinating disease of the central nervous system (CNS). T cells and B lymphocytes are involved in the development of this disease.

METHODS

The following biomarkers were determined in peripheral blood in 28 patients treated with glatiramer acetate (GA) and 21 patients treated with interferon beta 1-a (IFN): IL-10, BAFF, Mx1, IgG, IgG1, IgG2, IgG3 and IgG4 (at baseline and after 6 months of treatment). All participants had confirmed MS diagnosis.

OBJECTIVES

The primary objective is to assess a percentual change of biomarkers after 6 months since the first-line treatment initiation with GA or IFN. The secondary objective is to explore correlations between the baseline biomarkers' values (levels).

RESULTS

A positive trend was observed in the increase in IL-10 concentration by 30.33 % (IFN) and by 15.65 % (GA). In the IFN group, we observed a statistically significant increase in the BAFF protein concentration by 29.9% (P < 0.001). We found that Mx1 protein levels did not change with the administration of GA, which can be explained by the different mechanisms of action of GA. The serum levels of IgG immunoglobulins and both IgG1 and IgG4 subclasses in both groups of patients were increased. Thus, our data were in accordance with the generally accepted assumption that both IFN and GA are capable of modulating the B cell system.

CONCLUSIONS

Our results suggest that treatment with IFN and GA has a more pronounced influence on the B cell system of MS.

Multiplexed detection of biomarkers in lateral-flow immunoassays

Multiplexed detection of biomarkers, i.e., simultaneous detection of multiple biomarkers in a single assay, can enhance diagnostic precision, improve diagnostic efficiency, reduce diagnostic cost, and alleviate pain of patients.

Detection of resistance protein A (MxA) in paper-based immunoassays with surface enhanced Raman spectroscopy with AuAg nanoshells

Myxovirus protein A (MxA) is a biomarker that can be used to distinguish between viral and bacterial infections. While MxA lateral flow assays (LFAs) have been successfully used for viral vs. bacterial differential diagnosis for children, the clinically relevant level of MxA for adults has been reported to be 100 times lower, which is too low for traditional LFAs. We present results applying the use of surface enhanced Raman spectroscopy (SERS) to detect MxA. AuAg nanoshells (AuAg NSs) were used to enhance the Raman signal of mercaptobenzoic acid (4-MBA), enabling readout by SERS. The AuAg NSs were conjugated to antibodies for the biomarker of interest, resulting in a "nanotag", that could be used in a dipstick immunoassay for detection. We first optimized the nanotag parameters using anti-human IgG/human IgG as a model antibody/antigen system, and then demonstrated detection of MxA using anti-MxA antibodies. We show that SERS readout of immunoassays for MxA can quantify MxA levels at clinically relevant levels for adult viral infection.

An up-converting phosphor technology-based lateral flow assay for point-of-collection detection of morphine and methamphetamine in saliva

Morphine (Mop) and methamphetamine (Met) are highly addictive drugs worldwide. Point-of-collection testing (POCT) for drug-of-abuse screening is important in abuse/rehabilitation clinics and law-enforcement agencies. We established an up-converting phosphor technology-based lateral flow assay (UPT-LFA) as a point-of-collection testing (POCT) method, namely Mop-UPT-LFA and Met-UPT-LFA, for the detection of morphine and methamphetamine without complicated sample pre-treatment, respectively, in saliva. The sensitivities of the Mop-UPT-LFA and the Met-UPT-LFA were 5 and 10 ng mL-1 with accurate quantitation of 5-100 ng mL-1 and 10-250 ng mL-1 for morphine and methamphetamine, respectively, for a detection time of 15 min. In reference to the detection limits of 20 and 25 ng mL-1 for morphine and methamphetamine, respectively, in the Driving Under the Influence of Drugs, Alcohol and Medicines (DRUID) program of the European Union, the percentage test/control (T/C) ratio of the UPT-LFA between 2 and 15 min reached 101% and 86%, and the UPT-LFA produced accurate qualitative results in 2 min for 100 simulated-saliva samples with the exception of a few weakly positive samples. The sample and sample treating buffer were mixed and added to the test strip, and the test was conducted 15 min later. Although we found no significant difference between the UPT-LFA quantitative test and the liquid chromatography tandem mass spectrometry (LC-MS) test, compared with the latter, the UPT-LFA was substantially faster and had higher detection efficiency. The UPT-LFA showed more accurate qualitative results than the LC-MS for 50 simulated-saliva samples. The ease of operation, high sensitivity, and accuracy of the UPT-LFA make it a valid candidate POCT method for drug-of-abuse screening.

A portable and universal upconversion nanoparticle-based lateral flow assay platform for point-of-care testing

Upconversion nanoparticle-based lateral flow assays (UCNP-LFAs) have attracted significant attention in point-of-care testing (POCT) applications, due to the long-term photostability and enhanced signal-to-background noise ratio. The existing UCNP-LFAs generally require peripheral equipment for exciting fluorescent signals and reading out fluorescence results, which are generally bulky and expensive. Herein, we developed a miniaturized and portable UCNP-LFA platform, which is composed of a LFA detection system, an UCNP-LFA reader and a smartphone-assisted UCNP-LFA analyzer. The LFA detection system is based on three types of UCNPs for multiplexed detection. The reader has a dimension of 24.0 cm × 9.4 cm × 5.4 cm (L × W × H) and weight of 0.9 kg. The analyzer based on the custom-designed software of a smartphone (termed as UCNP-LFA analyzer) can get the quantitative analysis results in a real-time manner. We demonstrated the universality of this platform by highly sensitive and quantitative detections of several kinds of targets, including small molecule (ochratoxin A, OTA), heavy metal ion (Hg²⁺), bacteria (salmonella, SE), nucleic acid (hepatitis B virus, HBV) and protein (growth stimulation expressed gene 2, ST-2). Our developed UCNP-LFA platform holds great promise for applications in disease diagnostics, environmental pollution monitoring and food safety at the point of care.

Designing Paper-Based Immunoassays for Biomedical Applications

Paper-based sensors and assays have been highly attractive for numerous biological applications, including rapid diagnostics and assays for disease detection, food safety, and clinical care. In particular, the paper immunoassay has helped drive many applications in global health due to its low cost and simplicity of operation. This review is aimed at examining the fundamentals of the technology, as well as different implementations of paper-based assays and discuss novel strategies for improving their sensitivity, performance, or enabling new capabilities. These innovations can be categorized into using unique nanoparticle materials and structures for detection via different techniques, novel biological species for recognizing biomarkers, or innovative device design and/or architecture.

Fingerstick test quantifying humoral and cellular biomarkers indicative for M. leprae infection

OBJECTIVES

New user-friendly diagnostic tests for detection of individuals infected by Mycobacterium leprae (M. leprae), the causative pathogen of leprosy, can help guide therapeutic and prophylactic treatment, thus positively contributing to clinical outcome and reduction of transmission. To facilitate point-of-care testing without the presence of phlebotomists, the use of fingerstick blood (FSB) rather than whole blood-derived serum is preferred. This study is a first proof-of-principle validating that previously described rapid serum tests detecting antibodies and cytokines can also be used with FSB.

METHODS

Quantitative detection of previously identified biomarkers for leprosy and M. leprae infection, anti-M. leprae PGL-I IgM antibodies (αPGL-I), IP-10 and CRP, was performed with lateral flow (LF) strips utilizing luminescent up-converting reporter particles (UCP) and a portable reader generating unbiased read-outs. Precise amounts of FSB samples were collected using disposable heparinized capillaries. Biomarker levels in paired FSB and serum samples were determined using UCP-LF test strips for leprosy patients and controls in Bangladesh, Brazil, South-Africa and the Netherlands.

RESULTS

Correlations between serum and FSB from the same individuals for αPGL-I, CRP and IP-10 were highly significant (p < .0001) even after FSB samples had been frozen. The αPGL-I FSB test was able to correctly identify all multibacillary leprosy patients presenting a good quantitative correlation with the bacterial index.

CONCLUSIONS

Reader-assisted, quantitative UCP-LF tests for the detection of humoral and cellular biomarkers for M. leprae infection, are compatible with FSB. This allows near-patient testing for M. leprae infection and immunomonitoring of treatment without highly trained staff. On site availability of test-result concedes immediate initiation of appropriate counselling and treatment. Alternatively, the UCP-LF format allows frozen storage of FSB samples compatible with deferred testing in central laboratories.

Microparticle-based platform for point-of-care immunoassays

There is a need for quantitative and sensitive, yet simple point-of-care immunoassays. We have developed a point-of-care microparticle-based immunoassay platform which combines the performance of a microtiter well-based assay with the usability of a rapid assay. The platform contained a separate reaction and detection chambers and microparticles for the solid-phase. Photoluminescent up-converting nanoparticles (UCNPs) were used as labels. The platform was tested with a cardiac troponin I assay, and a limit of detection of 19.7 ng/L was obtained. This study demonstrates the feasibility of developing point-of-care assays on the new platform for various analytes of interests.