Paper based point of care immunosensor for the impedimetric detection of cardiac troponin I biomarker

Electrochemical and Plasmonic Detection of Myocardial Infarction Using Microfluidic Biochip Incorporated with Mesoporous Nanoscaffolds

This paper reports a microfluidic device for the electrochemical and plasmonic detection of cardiac myoglobin (cMb) and cardiac troponin I (cTnI) with noticeable limits of detection (LoD) as low as a few picograms per milliliter (pg/mL) ranges, achieved in a short detection time. The device features two working electrodes, each with a mesoporous Ni3V2O8 nanoscaffold grafted with reduced graphene oxide (rGO) that improves the interaction of diffusing analyte molecules with the sensing surface by providing a high surface area and reaction kinetics. Electrochemical studies reveal sensitivities as high as 9.68 μA ng/mL and a LoD of 2.0 pg/mL for cTnI, and 8.98 μA ng/mL and 4.7 pg/mL for cMb. Additionally, the surface plasmon resonance (SPR) studies demonstrate a low-level LoD of 8.8 pg/mL for cMb and 7.3 pg/mL for cTnI. The dual-modality sensor enables dynamic tracking of kinetic antigen-antibody interactions during sensing, self-verification through providing signals of two modes, and reduced false readout. This study demonstrates the complementary nature of the electrochemical and SPR modes in biosensing, with the electrochemical mode being highly sensitive and the SPR mode providing superior tracking of molecular recognition behaviors. The presented sensor represents a significant innovation in cardiovascular disease management and can be applied to monitor other clinically important biomolecules.

Clinical relevance and advances in detection of translational biomarker cardiac troponin

Cardiovascular diseases (CVD) are a range of diseases, pointing the functional hindrances in the heart and blood vessels of the human system that contributes to 48.6 % of the world's adult death rate. The diagnosis of CVD relies upon the Electro Cardio Gram (ECG) and detection of muscle markers such as troponins. Among the cardiac trio, Cardiac Troponin I (cTnI) weighing 23 KiloDalton (kDa) is a sorted biomarker for CVD. cTnI remains high in the blood after 1-2 weeks of myocardial damage. Testing of cTnI in CVD patients aids in diagnosis and risk stratification of the disease. Different determination systems including optical, electrochemical, and acoustic have been put forward for monitoring the cTnI which are Point of Care (POC) that promotes simple and sensitive detection of cTnI. The modern era has paved way to high-sensitivity Troponin I (hscTnI) devices that can detect up to 0.01 ng/ml in human blood/plasma/serum. Yet, the practice of hscTnI is impracticable due to cost inefficiency. Development of new hscTnI devices with minimal investment and maximal detection range will meet the global requirement. This review gives an over view on different detection systems of cardiac troponin I which stands as a translational detection molecule for CVDs.

Kirigami tripod-based electrode for the development of highly stretchable dengue aptasensor

Kirigami is one of the interesting paper art forms and the modified sub-class of origami. Kirigami paper art is widely employed in a variety of applications, and it is currently being used in biosensors because of its outstanding advantages. This is the first study on the use of a Kirigami-based aptasensor for DENV (Dengue virus)-antigen detection. In this study, the kirigami approach has been utilized to develop a stretchable, movable, and flexible sensor. The constructed stretchable-kirigami electrode helps in adjusting the connection of electrodes without disturbing the electrochemical cell zone during the experiment. To increase the sensitivity of this biosensor we have synthesized Ag-NPs (Silver nanoparticles) via chemical methods and characterized their results with the help of TEM & UV-Vis Spectroscopy. Different electrochemical approaches were used to validate the sensor response i.e., CV (Cyclic voltammetry) and LSV (Linear sweep voltammetry), which exhibited great detection capability towards dengue virus with the range of 0.1 µg/ml to 1000 µg/ml along with a detection limit of 0.1 µg/ml and showing no reactivity to the chikungunya virus antigen, making it more specific to the DENV antigen. Serum (healthy-human) was also successfully applied to validate the results of the constructed aptasensor. Integration of the Kirigami approach form with the electrochemical aptasensor that utilizes a 3-E setup (three-electrode setup) which is referred to as a tripod and collectively called Kirigami-tripod-based aptasensor. Thus, the developed integrated platform improves the sensors capabilities in terms of cost efficiency, high stretchability, and sensitivity.

Surface chemistry applications and development of immunosensors using electrochemical impedance spectroscopy: A comprehensive review

Immunosensors are promising alternatives as detection platforms for the current gold standards methods. Electrochemical immunosensors have already proven their capability for the sensitive, selective, detection of target biomarkers specific to COVID-19, varying cancers or Alzheimer's disease, etc. Among the electrochemical techniques, electrochemical impedance spectroscopy (EIS) is a highly sensitive technique which examines the impedance of an electrochemical cell over a range of frequencies. There are several important critical requirements for the construction of successful impedimetric immunosensor. The applied surface chemistry and immobilisation protocol have impact on the electroanalytical performance of the developed immunosensors. In this Review, we summarise the building blocks of immunosensors based on EIS, including self-assembly monolayers, nanomaterials, polymers, immobilisation protocols and antibody orientation.

Controlling Fluorescent Readout in Paper-based Analytical Devices

Paper is an ideal candidate for the development of new disposable diagnostic devices because it is a low-cost material, allows transport of the liquid on the device by capillary action, and is environmentally friendly. Today, colorimetric analysis is most often used as a detection method for rapid tests (test strips or lateral flow devices) but usually gives only qualitative results and is limited by a relatively high detection threshold. Here, we describe studies using fluorescence as a readout tool for paper-based diagnostics. We study how the optical readout is affected by light transmission, scattering, and fluorescence as a function of paper characteristics such as thickness (grammage), water content, autofluorescence, and paper type/composition. We show that paper-based fluorescence analysis allows better optical readout compared to that of nitrocellulose, which is currently the material of choice in colorimetric assays. To reduce the loss of analyte molecules (e.g., proteins) due to adsorption to the paper surface, we coat the paper fibers with a protein-repellent hydrogel. For this purpose, we use hydrophilic copolymers consisting of N,N-dimethyl acrylamide and a benzophenone-based cross-linker, which are photochemically transformed into a fiber-attached polymer hydrogel on the paper fiber surfaces in situ. We show that the combination of fluorescence detection and the use of a protein-repellent coating enables sensitive paper-based analysis. Finally, the success of the strategy is demonstrated by using a simple LFD application as an example.

Paper-Based All-in-One Origami Nanobiosensor for Point-of-Care Detection of Cardiac Protein Markers in Whole Blood

Rapid and accurate diagnosis of cardiovascular diseases (CVDs) at the earliest stage is of paramount importance to improve the treatment outcomes and avoid irreversible damage to a patient's cardiovascular system. Microfluidic paper-based devices (μPADs) represent a promising platform for rapid CVD diagnosis at the point of care (POC). This paper presents an electrochemical μPAD (E-μPAD) with an all-in-one origami design for rapid and POC testing of cardiac protein markers in whole blood. Based on the label-free, electrochemical impedance spectroscopy (EIS) immunoassay, the E-μPAD integrates all essential components on a single chip, including three electrochemical cells, a plasma separation membrane, and a buffer absorption pad, enabling easy and streamlined operations for multiplexed detection of three cardiac protein markers [cardiac troponin I (cTnI), brain natriuretic peptide (BNP)-32, and D-Dimer] on a finger-prick whole blood sample within 46 min. Superior analytical performance is achieved through sensitive EIS measurement on carbon electrodes decorated with semiconductor zinc oxide nanowires (ZnO NWs). Using spiked human plasma samples, ultralow limits of detection (LODs) of E-μPAD are achieved at 4.6 pg/mL (190 fM) for cTnI, 1.2 pg/mL (40 fM) for BNP-32, and 146 pg/mL (730 fM) for D-Dimer. Real human blood samples spiked with purified proteins are also tested, and the device's analytical performance was proven to be comparable to commercial ELISA kits. The all-in-one E-μPAD will allow rapid and sensitive testing of cardiac protein markers through easy operations, which holds great potential for on-site screening of acute CVDs in nonlaboratory settings such as emergency rooms, doctor's offices, or patient homes.

An impedimetric immunosensor based on chitosan-Au nanoparticles-reduced graphene oxide nanosheet composite modified PG electrode for detection of brain natriuretic peptide

An ultrasensitive impedimetric immunosensor was developed to detect brain natriuretic peptide (BNP) for early diagnosis of heart failure. To construct this immunosensor, anti-BNP antibodies were immobilized covalently onto nanocomposite of chitosan-Au nanoparticles and reduced graphene oxide nanosheets (CHIT-Au@rGONs) electrodeposited onto pencil graphite electrode. This approach impedes charge transfer resistance (Rct) value proportionally to the BNP captured by antigen-antibody interactions. The observed Rct values by this immunosensor, were correlated with linear concentrations of BNP in the range, 1 × 10-2 to 1 × 103 pg/mL, with a limit of detection of 12 pg/mL and limit of quantification of 36.3 pg/mL. The immunosensor detected BNP in spiked human sera. The analytic recovery of added BNP in human sera was 97.04%. The present method was fairly consistent with commercial approach. The working electrode was stored for 2 months in cold. BSA-IgG had no interference in the electrode activity showing its high specificity for BNP. This novel approach provided a new POC-diagnostics, as direct sample measurements are easier and more efficient by this immunosensor compared to existing immunosensors.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13205-023-03704-x.

Adaptive time modulation technique for multiplexed on-chip particle detection across scales

Integrated optofluidic biosensors have demonstrated ultrasensitivity down to single particle detection and attomolar target concentrations. However, a wide dynamic range is highly desirable in practice and can usually only be achieved by using multiple detection modalities or sacrificing linearity. Here, we demonstrate an analysis technique that uses temporal excitation at two different time scales to simultaneously enable digital and analog detection of fluorescent targets. We demonstrated the seamless detection of nanobeads across eight orders of magnitude from attomolar to nanomolar concentration. Furthermore, a combination of spectrally varying modulation frequencies and a closed-loop feedback system that provides rapid adjustment of excitation laser powers enables multiplex analysis in the presence of vastly different concentrations. We demonstrated this ability to detect across scales via an analysis of a mixture of fluorescent nanobeads at femtomolar and picomolar concentrations. This technique advances the performance and versatility of integrated biosensors, especially toward point-of-use applications.

Advancement in Paper-Based Electrochemical Biosensing and Emerging Diagnostic Methods

The utilization of electrochemical detection techniques in paper-based analytical devices (PADs) has revolutionized point-of-care (POC) testing, enabling the precise and discerning measurement of a diverse array of (bio)chemical analytes. The application of electrochemical sensing and paper as a suitable substrate for point-of-care testing platforms has led to the emergence of electrochemical paper-based analytical devices (ePADs). The inherent advantages of these modified paper-based analytical devices have gained significant recognition in the POC field. In response, electrochemical biosensors assembled from paper-based materials have shown great promise for enhancing sensitivity and improving their range of use. In addition, paper-based platforms have numerous advantageous characteristics, including the self-sufficient conveyance of liquids, reduced resistance, minimal fabrication cost, and environmental friendliness. This study seeks to provide a concise summary of the present state and uses of ePADs with insightful commentary on their practicality in the field. Future developments in ePADs biosensors include developing novel paper-based systems, improving system performance with a novel biocatalyst, and combining the biosensor system with other cutting-edge tools such as machine learning and 3D printing.

An Accessible Yarn-Based Sensor for In-Field Detection of Succinylcholine Poisoning

Succinylcholine (SUX) is a clinical anesthetic that induces temporary paralysis and is degraded by endogenous enzymes within the body. In high doses and without respiratory support, it results in rapid and untraceable death by asphyxiation. A potentiometric thread-based method was developed for the in-field and rapid detection of SUX for forensic use. We fabricated the first solid-contact SUX ion-selective electrodes from cotton yarn, a carbon black ink, and a polymeric ion-selective membrane. The electrodes could selectively measure SUX in a linear range of 1 mM to 4.3 μM in urine, with a Nernstian slope of 27.6 mV/decade. Our compact and portable yarn-based SUX sensors achieved 94.1% recovery at low concentrations, demonstrating feasibility in real-world applications. While other challenges remain, the development of a thread-based ion-selective electrode for SUX detection shows that it is possible to detect this poison in urine and paves the way for other low-cost, rapid forensic diagnostic devices.

A Review on Microfluidics-Based Impedance Biosensors

Electrical impedance biosensors are powerful and continuously being developed for various biological sensing applications. In this line, the sensitivity of impedance biosensors embedded with microfluidic technologies, such as sheath flow focusing, dielectrophoretic focusing, and interdigitated electrode arrays, can still be greatly improved. In particular, reagent consumption reduction and analysis time-shortening features can highly increase the analytical capabilities of such biosensors. Moreover, the reliability and efficiency of analyses are benefited by microfluidics-enabled automation. Through the use of mature microfluidic technology, complicated biological processes can be shrunk and integrated into a single microfluidic system (e.g., lab-on-a-chip or micro-total analysis systems). By incorporating electrical impedance biosensors, hand-held and bench-top microfluidic systems can be easily developed and operated by personnel without professional training. Furthermore, the impedance spectrum provides broad information regarding cell size, membrane capacitance, cytoplasmic conductivity, and cytoplasmic permittivity without the need for fluorescent labeling, magnetic modifications, or other cellular treatments. In this review article, a comprehensive summary of microfluidics-based impedance biosensors is presented. The structure of this article is based on the different substrate material categorizations. Moreover, the development trend of microfluidics-based impedance biosensors is discussed, along with difficulties and challenges that may be encountered in the future.

Recent Advances in Impedimetric Biosensors Focusing on Myocardial Infarction Diagnosis

Acute myocardial infarction is the most common cardiovascular disease and 85% of cardiovascular disease-related deaths are associated with it. The variation in the cardiac troponin concentration is considered as the most significant judge index for acute myocardial infarction diagnosis. Here, a comprehensive insights is given about the impedimetric methods as powerful electrochemical biosensing platforms for cardiac troponin evaluation. Focusing on nano materials, various impedimetric techniques including faradaic and non-faradaic techniques and different transducer modification techniques are addressed. The steps taken by each of the studied platforms to solve the existing problems are discussed and their advantages and drawbacks are highlighted. A glance at the provided table is given a mind into the features of each impedimetric sensors and their comparison are provided.

Electrochemical Aptasensor Developed Using Two-Electrode Setup and Three-Electrode Setup: Comprising Their Current Range in Context of Dengue Virus Determination

We present, for the very first time, the fabrication and electrochemical characterization of a paper-based experimental platform for dengue virus analysis. The paper-based device incorporates a screen-printing technology with the help of black carbon conductive ink. The paper-based device utilizes two styles of electrode setups, i.e., the two-electrode system and three-electrode system, and both setups effectively detected the dengue virus with an LOD of 0.1 µg/mL; however, these paper electrodes exhibit various current ranges, and the created sensor was encompassed and compared in this research based on current response. It is observed that the three-electrode system has a substantially higher current range, ranging from 55.53 µA to 322.21 µA, as compared to the two-electrode system, which has a current range of 0.85 µA to 4.54 µA. According to this study, the three-electrode system displayed a good range of current amplification that is roughly 50 times higher than the two-electrode system, which had a weak current response. As a result, the three-electrode method has emerged as a viable option for the very sensitive detection of the dengue virus, as well as for the diagnosis of other diseases.

Label-Free Physical Techniques and Methodologies for Proteins Detection in Microfluidic Biosensor Structures

Proteins in biological fluids (blood, urine, cerebrospinal fluid) are important biomarkers of various pathological conditions. Protein biomarkers detection and quantification have been proven to be an indispensable diagnostic tool in clinical practice. There is a growing tendency towards using portable diagnostic biosensor devices for point-of-care (POC) analysis based on microfluidic technology as an alternative to conventional laboratory protein assays. In contrast to universally accepted analytical methods involving protein labeling, label-free approaches often allow the development of biosensors with minimal requirements for sample preparation by omitting expensive labelling reagents. The aim of the present work is to review the variety of physical label-free techniques of protein detection and characterization which are suitable for application in micro-fluidic structures and analyze the technological and material aspects of label-free biosensors that implement these methods. The most widely used optical and impedance spectroscopy techniques: absorption, fluorescence, surface plasmon resonance, Raman scattering, and interferometry, as well as new trends in photonics are reviewed. The challenges of materials selection, surfaces tailoring in microfluidic structures, and enhancement of the sensitivity and miniaturization of biosensor systems are discussed. The review provides an overview for current advances and future trends in microfluidics integrated technologies for label-free protein biomarkers detection and discusses existing challenges and a way towards novel solutions.

Recent Progress in Electrochemical Immunosensors

Biosensors used for medical diagnosis work by analyzing physiological fluids. Antibodies have been frequently used as molecular recognition molecules for the specific binding of target analytes from complex biological solutions. Electrochemistry has been introduced for the measurement of quantitative signals from transducer-bound analytes for many reasons, including good sensitivity. Recently, numerous electrochemical immunosensors have been developed and various strategies have been proposed to detect biomarkers. In this paper, the recent progress in electrochemical immunosensors is reviewed. In particular, we focused on the immobilization methods using antibodies for voltammetric, amperometric, impedimetric, and electrochemiluminescent immunosensors.

The trends in nanomaterial-based biosensors for detecting critical biomarkers in stroke

Acute ischemic stroke (AIS), is the second global cause of death after cardiovascular diseases, accounts for 80-85% of cerebrovascular disease. Stroke diagnosis could be challenging in the acute phase. Detection of biomarkers for evaluating the prognosis of diseases is essential for improving personalized treatment and decreasing mortality. At the present time, the absence of a broadly existing and rapid diagnostic test is an important limitation in the evaluation and treatment of diseases. The use of a biomarker-based diagnostic attitude has confirmed very valuable in acute coronary syndromes, which has been promoted in acute stroke to help early management decisions. Over the past decade, different detection procedures have developed for the assessment of human cardiac troponins (cTnI). This review emphasizes on summarizing optical, and electrochemical biosensors for the detection of cTnI, brain natriuretic peptide (BNP), and neuron-specific enolase (NSE) as a critical biomarker in stroke.

Recent advances in cardiac biomarkers detection: From commercial devices to emerging technologies

Although cardiac pathologies are the major cause of death in the world, it remains difficult to provide a reliable diagnosis to prevent heart attacks. Rapid patient care and management in emergencies are critical to prevent dramatic consequences. Thus, relevant biomarkers such as cardiac troponin and natriuretic peptides are currently targeted by commercialized Point-Of-Care immunoassays. Key points still to be addressed concern cost, lack of standardization, and poor specificity, which could limit the reliability of the assays. Consequently, alternatives are emerging to address these issues. New probe molecules such as aptamers or molecularly imprinted polymers should allow a reduction in cost of the assays and an increase in reproducibility. In addition, the assay specificity and reliability could be improved by enabling multiplexing through the detection of several molecular targets in a single device.

Engineering strategies for enhancing the performance of electrochemical paper-based analytical devices

Applications of electrochemical detection methods in microfluidic paper-based analytical devices (μPADs) has revolutionized the area of point-of-care (POC) testing towards highly sensitive and selective quantification of various (bio)chemical analytes in a miniaturized, low-coat, rapid, and user-friendly manner. Shortly after the initiation, these relatively new modulations of μPADs, named as electrochemical paper-based analytical devices (ePADs), gained widespread popularity within the POC research community thanks to the inherent advantages of both electrochemical sensing and usage of paper as a suitable substrate for POC testing platforms. Even though general aspects of ePADs such as applications and fabrication techniques, have already been reviewed multiple times in the literature, herein, we intend to provide a critical engineering insight into the area of ePADs by focusing particularly on the practical strategies utilized to enhance their analytical performance (i.e. sensitivity), while maintaining the desired simplicity and efficiency intact. Basically, the discussed strategies are driven by considering the parameters potentially affecting the generated electrochemical signal in the ePADs. Some of these parameters include the type of filter paper, electrode fabrication methods, electrode materials, fluid flow patterns, etc. Besides, the limitations and challenges associated with the development of ePADs are discussed, and further insights and directions for future research in this field are proposed.

Sensors and microarrays in protein biomarker monitoring: an electrochemical perspective spots

The development of clinically applicable portable sensors and multiplex protein biomarker assays is one of the most important goals of laboratory medicine today. Sensing strategies based on electrochemical devices are discussed in this overview, with special emphasis on detection principles derived from voltammetry, electrogenerated chemiluminescence, bipolar electrochemistry and impedance-based measurements. Up-to-date examples of electrochemical methods in biomedical research and development are highlighted here, including critical evaluation and future directions of the analysis, development and validation of new protein biomarkers.

Aptamer-based surface-enhanced resonance Raman scattering assay on a paper fluidic platform for detection of cardiac troponin I

SIGNIFICANCE

Cardiac troponin I (cTnI) is a primary biomarker for diagnosis of myocardial infarction (MI). In contrast to central laboratory tests for cTnI, point-of-care (POC) testing has the advantage of providing results when the patient is first encountered, which helps high-risk patients to be treated more rapidly and low-risk patients to be released in a timely fashion. A paper fluidic platform is good for POC testing because the paper is abundant, low cost, and disposable. However, current cTnI assays on paper platforms use antibodies as the recognition element, which has limitations due to the high cost of production and antibody stability issues at the POC.

AIM

To develop an aptamer-based assay on a paper strip using surface-enhanced resonance Raman spectroscopy (SERRS) for detection of cTnI in the clinically relevant range at the POC.

APPROACH

Gold nanoparticles (AuNPs) were functionalized with a Raman reporter molecule, malachite green isothiocyanate. The functionalized AuNPs were encapsulated in a silica shell and provided a SERRS signal using a handheld Raman system with a 638-nm excitation wavelength. A primary aptamer and a secondary aptamer of cTnI were used in a sandwich assay format to bind the cTnI on a test line of a paper fluidic platform. By measuring the SERRS signal from the test line, the concentration of cTnI was quantitatively determined.

RESULTS

The aptamer-based SERRS assay on a paper strip had a detection range of 0.016 to 0.1  ng  /  ml for cTnI, had good selectivity for cTnI compared to three other markers, had good stability over 10 days, and had good performance in the more complex serum sample matrix.

CONCLUSIONS

The aptamer-based SERRS assay on a paper strip has the potential to provide a sensitive, selective, stable, repeatable, and cost-effective platform for the detection of cTnI toward eventual use in diagnosis of MI at the POC.

Biosensing based on surface-enhanced Raman spectroscopy as an emerging/next-generation point-of-care approach for acute myocardial infarction diagnosis

Cardiovascular disease is a major global health issue. In particular, acute myocardial infarction (AMI) requires urgent attention and early diagnosis. The use of point-of-care diagnostics has resulted in the improved management of cardiovascular disease, but a major drawback is that the performance of POC devices does not rival that of central laboratory tests. Recently, many studies and advances have been made in the field of surface-enhanced Raman scattering (SERS), including the development of POC biosensors that utilize this detection method. Here, we present a review of the strengths and limitations of these emerging SERS-based biosensors for AMI diagnosis. The ability of SERS to multiplex sensing against existing POC detection methods are compared and discussed. Furthermore, SERS calibration-free methods that have recently been explored to minimize the inconvenience and eliminate the limitations caused by the limited linear range and interassay differences found in the calibration curves are outlined. In addition, the incorporation of artificial intelligence (AI) in SERS techniques to promote multivariate analysis and enhance diagnostic accuracy are discussed. The future prospects for SERS-based POC devices that include wearable POC SERS devices toward predictive, personalized medicine following the Fourth Industrial Revolution are proposed.

Screen-Printed Electrodes: Promising Paper and Wearable Transducers for (Bio)Sensing

Screen-printing technology has revolutionized many fields, including that of electrochemical biosensing. Due to their current relevance, this review, unlike other papers, discusses the relevant aspects of electrochemical biosensors manufactured using this technology in connection to both paper substrates and wearable formats. The main trends, advances, and opportunities provided by these types of devices, with particular attention to the environmental and biomedical fields, are addressed along with illustrative fundamentals and applications of selected representative approaches from the recent literature. The main challenges and future directions to tackle in this research area are also pointed out.

Nanoscale Technologies in Highly Sensitive Diagnosis of Cardiovascular Diseases

Cardiovascular diseases (CVD) are the leading cause of death and morbidity in the world and are a major contributor to healthcare costs. Although enormous progress has been made in diagnosing CVD, there is an urgent need for more efficient early detection and the development of novel diagnostic tools. Currently, CVD diagnosis relies primarily on clinical symptoms based on molecular imaging (MOI) or biomarkers associated with CVDs. However, sensitivity, specificity, and accuracy of the assay are still challenging for early-stage CVDs. Nanomaterial platform has been identified as a promising candidate for improving the practical usage of diagnostic tools because of their unique physicochemical properties. In this review article, we introduced cardiac biomarkers and imaging techniques that are currently used for CVD diagnosis. We presented the applications of various nanotechnologies on diagnosis within cardiac immunoassays (CIAs) and molecular imaging. We also summarized and compared different cardiac immunoassays based on their sensitivities and working ranges of biomarkers.

Recent Progress of Biomarker Detection Sensors

Early cancer diagnosis and treatment are crucial research fields of human health. One method that has proven efficient is biomarker detection which can provide real-time and accurate biological information for early diagnosis. This review presents several biomarker sensors based on electrochemistry, surface plasmon resonance (SPR), nanowires, other nanostructures, and, most recently, metamaterials which have also shown their mechanisms and prospects in application in recent years. Compared with previous reviews, electrochemistry-based biomarker sensors have been classified into three strategies according to their optimizing methods in this review. This makes it more convenient for researchers to find a specific fabrication method to improve the performance of their sensors. Besides that, as microfabrication technologies have improved and novel materials are explored, some novel biomarker sensors-such as nanowire-based and metamaterial-based biomarker sensors-have also been investigated and summarized in this review, which can exhibit ultrahigh resolution, sensitivity, and limit of detection (LoD) in a more complex detection environment. The purpose of this review is to understand the present by reviewing the past. Researchers can break through bottlenecks of existing biomarker sensors by reviewing previous works and finally meet the various complex detection needs for the early diagnosis of human cancer.