Wearable transdermal colorimetric microneedle patch for Uric acid monitoring based on peroxidase-like polypyrrole nanoparticles

Sensing patches for biomarker identification in skin-derived biofluids

In conventional clinical disease diagnosis and screening based on biomarker detection, most analysis samples are collected from serum, blood. However, these invasive collection methods require specific instruments, professionals, and may lead to infection risks. Additionally, the diagnosis process suffers from untimely results. The identification of skin-related biomarkers plays an unprecedented role in early disease diagnosis. More importantly, these skin-mediated approaches for collecting biomarker-containing biofluid samples are noninvasive or minimally invasive, which is more preferable for point-of-care testing (POCT). Therefore, skin-based biomarker detection patches have been promoted, owing to their unique advantages, such as simple fabrication, desirable transdermal properties and no requirements for professional medical staff. Currently, the skin biomarkers extracted from sweat, interstitial fluid (ISF) and wound exudate, are achieved with wearable sweat patches, transdermal MN patches, and wound patches, respectively. In this review, we detail these three types of skin patches in biofluids collection and diseases-related biomarkers identification. Patch classification and the corresponding manufacturing as well as detection strategies are also summarized. The remaining challenges in clinical applications and current issues in accurate detection are discussed for further advancement of this technology (Scheme 1).

Glucose detection: In-situ colorimetric analysis with double-layer hydrogel microneedle patch based on polyvinyl alcohol and carboxymethyl chitosan

Skin interstitial fluid (ISF) has emerged as a significant reservoir of biomarkers for disease diagnosis and prevention. Microneedle (MN) patches are regarded as an optimal platform for ISF extraction from the skin due to their non-invasive nature. However, challenges such as prolonged sampling durations and complex detection procedures impede timely metabolic analysis. In this investigation, we amalgamated MN technology with immobilized enzyme technology to fabricate a dual-layer MN patch integrating sampling and detection functionalities, thereby enabling in-situ colorimetric detection of hyperglycemia. The tip layer of the patch, comprising polyvinyl alcohol/carboxymethyl chitosan (PVA/CMCS) MN, was synthesized utilizing a chemical crosslinking approach for the first time, with glucose oxidase (GOx) being incorporated. The hydrophilicity of CMCS expedited the extraction process, facilitating the retrieval of approximately 10 mg of ISF within 10 min. The backing layer consisted of an immobilized polyvinyl alcohol-chitosan-horseradish peroxidase (PVA-CS-HRP) hydrogel film loaded with 3,3', 5,5'-tetramethylbenzidine (TMB). Incorporating macromolecular polymer PVA and CS for HRP immobilization addressed the issue of poor stability associated with traditional natural enzymes, thereby enhancing the sensitivity of the reaction system. The in-situ colorimetric sensor facilitated minimally invasive ISF extraction and swift conversion of glucose levels into detectable color changes.

Colorimetric sensing for translational applications: from colorants to mechanisms

Colorimetric sensing offers instant reporting via visible signals. Versus labor-intensive and instrument-dependent detection methods, colorimetric sensors present advantages including short acquisition time, high throughput screening, low cost, portability, and a user-friendly approach. These advantages have driven substantial growth in colorimetric sensors, particularly in point-of-care (POC) diagnostics. Rapid progress in nanotechnology, materials science, microfluidics technology, biomarker discovery, digital technology, and signal pattern analysis has led to a variety of colorimetric reagents and detection mechanisms, which are fundamental to advance colorimetric sensing applications. This review first summarizes the basic components (e.g., color reagents, recognition interactions, and sampling procedures) in the design of a colorimetric sensing system. It then presents the rationale design and typical examples of POC devices, e.g., lateral flow devices, microfluidic paper-based analytical devices, and wearable sensing devices. Two highlighted colorimetric formats are discussed: combinational and activatable systems based on the sensor-array and lock-and-key mechanisms, respectively. Case discussions in colorimetric assays are organized by the analyte identities. Finally, the review presents challenges and perspectives for the design and development of colorimetric detection schemes as well as applications. The goal of this review is to provide a foundational resource for developing colorimetric systems and underscoring the colorants and mechanisms that facilitate the continuing evolution of POC sensors.

Advances in microneedles for transdermal diagnostics and sensing applications

Microneedles, the miniaturized needles, which can pierce the skin with minimal invasiveness open up new possibilities for constructing personalized Point-of-Care (POC) diagnostic platforms. Recent advances in microneedle-based POC diagnostic systems, especially their successful implementation with wearable technologies, enable biochemical detection and physiological recordings in a user-friendly manner. This review presents an overview of the current advances in microneedle-based sensor devices, with emphasis on the biological basis of transdermal sensing, fabrication, and application of different types of microneedles, and a summary of microneedle devices based on various sensing strategies. It concludes with the challenges and future prospects of this swiftly growing field. The aim is to present a critical and thorough analysis of the state-of-the-art development of transdermal diagnostics and sensing devices based on microneedles, and to bridge the gap between microneedle technology and pragmatic applications.

Enhanced Interstitial Fluid Extraction and Rapid Analysis via Vacuum Tube-Integrated Microneedle Array Device

Advancing the development of point-of-care testing (POCT) sensors that utilize interstitial fluid (ISF) presents considerable obstacles in terms of rapid sampling and analysis. Herein, an innovative strategy is introduced that involves the use of a 3D-printed, hollow microneedle array patch (MAP), in tandem with a vacuum tube (VT) connected through a hose, to improve ISF extraction efficiency and facilitate expedited analysis. The employment of negative pressure by the VT allows the MAP device to effectively gather ≈18 µL of ISF from the dermis of a live rabbit ear within a concise period of 5 min. This methodology enables the immediate and minimally invasive measurement of glucose levels within the body, employing personal healthcare meters for quantification. The fusion of the VT and MAP technologies provides for their effortless integration into a comprehensive and mobile system for ISF analysis, accomplished by preloading the hose with custom sensing papers designed to detect specific analytes. Moreover, the design and functionality of this integrated VT-MAP system are intuitively user-friendly, eliminating the requirement for specialized medical expertise. This feature enhances its potential to make a significant impact on the field of decentralized personal healthcare.

Paper-based uric acid assay in whole blood samples by Zn2+ protein precipitation and enzyme-free colorimetric detection

Uric acid (UA) is an important biomarker, as a high concentration in blood can lead to gout and further renal syndrome. Although several point-of-care testing (POCT) devices have been reported to detect UA, there are some limitations such as the requirement for uricase and the complicated pretreatment of serum/plasma samples, which restricts their use at home or in undeveloped areas. In this work, we developed an approach by applying Zn2+ to precipitate proteins and cells in whole blood to avoid interference with the chromogenic reaction. We used carboxymethylcellulose (CMC) to immobilize tetramethylbenzidine (TMB) on a nitrocellulose membrane for colorimetric detection. Using the oxidization properties of H2O2, which turns TMB into oxidized tetramethylbenzidine (TMBox) in the presence of catalyst gold nanoparticles (AuNPs), we successfully constructed an enzyme-free paper-based POCT device using the reduction reaction of UA and TMBox for simple, speedy, and cheap colorimetric detection of UA, achieving a detection time of 8 min, a linear range of 0-150 μg/mL, and an LOD of 25.79 μg/mL. The UA concentration in whole blood samples was further measured and correlated well with the clinical value (R2 = 0.8212). Thus, the proposed assay has the potential for POCT diagnosis, monitoring, and prognosis of diseases related to UA.

Swellable colorimetric microneedles for glucose detection based on glucose oxidase-like gold nanoparticles

BACKGROUND

Regular blood glucose monitoring is very important for diabetic patients. The composition of skin interstitial fluid (ISF) is similar to that of blood, which can be used for daily blood sugar detection and disease care. However, most methods of ISF extraction have complicated steps, may cause skin damage, and can only extract a limited amount of ISF, resulting in low detection efficiency. Therefore, it is very necessary to develop a detection method that can not only extract a large amount of ISF safely, efficiently, and conveniently, but also realize rapid detection of glucose level in ISF.

RESULTS

Here, we developed a gold nanoparticle (AuNP)-based swellable colorimetric MN patch with minimally invasive sampling function and real-time ISF glucose analysis ability. The MN patch could quickly absorb a large amount of skin ISF, and 60.2 mg of ISF was extracted within 10 min in vitro. It was divided into two layers: the tip layer was embedded with AuNPs with glucose oxidase (GOx)-like activity, which catalyzed the oxidation of glucose extracted from ISF and produced hydrogen peroxide (H2O2); horseradish peroxidase (HRP) encapsulated in the backing layer catalyzed the oxidation of 3, 3', 5, 5'-tetramethylbenzidine (TMB) by H2O2 to produce oxTMB, which led to a visible color shift in the backing layer. The ISF glucose level was judged by naked eyes and further quantified by color analysis with Image J software. As a result, the colorimetric MN patch successfully identified the normal blood sugar and hyperglycemia state in vivo.

SIGNIFICANCE

The colorimetric MN patch combined in-situ colorimetric sensing based on AuNP nanozyme with MN patch, which detected glucose level without blood drawing, increasing patients' compliance and reducing detection steps and time. Compared with the detection methods based on natural nanozymes, our method had better stability and sensitivity to complex environments (extreme pH and high temperature, etc.) in actual detection.

Advances in biomedical systems based on microneedles: design, fabrication, and application

Wearable devices have become prevalent in biomedical studies due to their convenient portability and potential utility in biomarker monitoring for healthcare. Accessing interstitial fluid (ISF) across the skin barrier, microneedle (MN) is a promising minimally invasive wearable technology for transdermal sensing and drug delivery. MN has the potential to overcome the limitations of conventional transdermal drug administration, making it another prospective mode of drug delivery after oral and injectable. Subsequently, combining MN with multiple sensing approaches has led to its extensive application to detect biomarkers in ISF. In this context, employing MN platforms and control schemes to merge diagnostic and therapeutic capabilities into theranostic systems will facilitate on-demand therapy and point-of-care diagnostics, paving the way for future MN technologies. A comprehensive analysis of the growing advances of microneedles in biomedical systems is presented in this review to summarize the latest studies for academics in the field and to offer for reference the issues that need to be addressed in MN application for healthcare. Covering an array of novel studies, we discuss the following main topics: classification of microneedles in the biomedical field, considerations of MN design, current applications of microneedles in diagnosis and therapy, and the regulatory landscape and prospects of microneedles for biomedical applications. This review sheds light on the significance of microneedle-based innovations, presenting an analysis of their potential implications and contributions to the community of wearable healthcare technologies. The review provides a comprehensive understanding of the field's current state and potential, making it a valuable resource for academics and clinicians seeking to harness the full potential of MN applications.

A luminescent MOF-based nonenzymatic probe for colorimetric/photothermal/fluorescence triple-mode assay of uric acid in body fluids

Monitoring the levels of uric acid (UA) in body fluids is of great significance in the clinical diagnosis and therapy of related diseases. Herein, a novel nanocomposite R6G@Fe-MOF based nonenzymatic probe is presented to provide a ratiometric fluorescent, colorimetric, and photothermal triple read-out signal for the visual, sensitive, and convenient assay of UA. The framework structure of the in situ encapsulated R6G@Fe-MOF is found to decompose upon the addition of UA, resulting in the reduction of Fe3+ to Fe2+. This reduction will lead to a rapid increase in fluorescence emission (FL) at 430 nm. Simultaneously, the FL at 573 nm will decrease remarkably due to the inner filter effect (IFE) between UA and R6G@Fe-MOF. Furthermore, the reaction of the generated Fe2+ with potassium ferricyanide (K3 [Fe(CN)6]) can in situ generate Prussian blue (PBNPs) with outstanding color and photothermal properties, which allow for easy colorimetric and photothermal signal readout. The detection limits (LOD) for the colorimetric, fluorometric and photothermal detection are low at 1.68 μM, 0.236 μM, and 1.32 μM respectively. Ultimately, it is successfully employed to determine UA in urine, serum, and saliva, yielding satisfactory results. The constructed R6G@Fe-MOF sensor provides a simple, sensitive, and accurate determination of UA that can be tailored to meet the needs of various applications, and also provides new perspectives for the design and development of versatile sensors for diverse uses.

Conductive and Eco-friendly Biomaterials-based Hydrogels for Noninvasive Epidermal Sensors: A Review

As noninvasive wearable electronic devices, epidermal sensors enable continuous, real-time, and remote monitoring of various human physiological parameters. Conductive biomaterials-based hydrogels as sensor matrix materials have good biocompatibility, biodegradability, and efficient stimulus response capabilities and are widely applied in motion monitoring, healthcare, and human-machine interaction. However, biomass hydrogel-based epidermal sensing devices still need excellent mechanical properties, prolonged stability, multifunctionality, and extensive practicality. Therefore, this paper reviews the common biomass hydrogel materials for epidermal sensing (proteins, polysaccharides, polyphenols, etc.) and the various types of noninvasive sensing devices (strain/pressure sensors, temperature sensors, glucose sensors, electrocardiograms, etc.). Moreover, this review focuses on the strategies of scholars to enhance sensor properties, such as strength, conductivity, stability, adhesion, and self-healing ability. This work will guide the preparation and optimization of high-performance biomaterials-based hydrogel epidermal sensors.

Gout therapeutics and drug delivery

Gout is a common inflammatory arthritis caused by persistently elevated uric acid levels. With the improvement of people's living standards, the consumption of processed food and the widespread use of drugs that induce elevated uric acid, gout rates are increasing, seriously affecting the human quality of life, and becoming a burden to health systems worldwide. Since the pathological mechanism of gout has been elucidated, there are relatively effective drug treatments in clinical practice. However, due to (bio)pharmaceutical shortcomings of these drugs, such as poor chemical stability and limited ability to target the pathophysiological pathways, traditional drug treatment strategies show low efficacy and safety. In this scenario, drug delivery systems (DDS) design that overcome these drawbacks is urgently called for. In this review, we initially describe the pathological features, the therapeutic targets, and the drugs currently in clinical use and under investigation to treat gout. We also comprehensively summarize recent research efforts utilizing lipid, polymeric and inorganic carriers to develop advanced DDS for improved gout management and therapy.

Progress in optical sensors-based uric acid detection

The escalating number of patients affected by various diseases, such as gout, attributed to abnormal uric acid (UA) concentrations in body fluids, has underscored the need for rapid, efficient, highly sensitive, and stable UA detection methods and sensors. Optical sensors have garnered significant attention due to their simplicity, cost-effectiveness, and resistance to electromagnetic interference. Notably, research efforts have been directed towards UA on-site detection, enabling daily monitoring at home and facilitating rapid disease screening in the community. This review aims to systematically categorize and provide detailed descriptions of the notable achievements and emerging technologies in UA optical sensors over the past five years. The review highlights the advantages of each sensor while also identifying their limitations in on-site applications. Furthermore, recent progress in instrumentation and the application of UA on-site detection in body fluids is discussed, along with the existing challenges and prospects for future development. The review serves as an informative resource, offering technical insights and promising directions for future research in the design and application of on-site optical sensors for UA detection.

Epidermal Wearable Biosensors for the Continuous Monitoring of Biomarkers of Chronic Disease in Interstitial Fluid

Healthcare technology has allowed individuals to monitor and track various physiological and biological parameters. With the growing trend of the use of the internet of things and big data, wearable biosensors have shown great potential in gaining access to the human body, and providing additional functionality to analyze physiological and biochemical information, which has led to a better personalized and more efficient healthcare. In this review, we summarize the biomarkers in interstitial fluid, introduce and explain the extraction methods for interstitial fluid, and discuss the application of epidermal wearable biosensors for the continuous monitoring of markers in clinical biology. In addition, the current needs, development prospects and challenges are briefly discussed.

Recent advancements in the expedition of microneedles: from lab worktops to diagnostic care centers

Microneedle (MN) technology plays a significant role in bioengineering as it allows for minimally invasive exposure to the skin via the non-invasive procedure, increased drug permeability, and improved biological molecule detectability in the epidermal layers, all while improving therapeutic safety and effectiveness. However, MNs have several significant drawbacks, including difficulty scaling up, variability in drug delivery pattern regarding the skin's external environment, blockage of dermal tissues, induction of inflammatory response at the administration site, and limitation of dosing based on the molecular weight of drug and size. Despite these drawbacks, MNs have emerged as a special transdermal theranostics instrument in clinical research to assess physiological parameters. Bioimaging technology relies on microneedles that can measure particular analytes in the extracellular fluid effectively by crossing the stratum corneum, making them "a unique tool in diagnostics detection and therapeutic application inside the body." This review article discusses the recent advances in the applications especially related to the diagnostics and toxicity challenges of microneedles. In addition, this review article discusses the clinical state and commercial accessibility of microneedle technology-based devices in order to provide new information to scientists and researchers.

Microneedle-based transdermal detection and sensing devices

Microneedles have been expected for the construction of next-generation biosensors towards personalization, digitization, and intellectualization due to their metrics of minimal invasiveness, high integration, and favorable biocompatibility. Herein, an overview of state-of-the-art microneedle-based detection and sensing systems is presented. First, the designs of microneedle devices based on extraction mechanisms are concluded, corresponding to different geometries and materials of microneedles. Second, the targets of equipment-assisted microneedle detections are summarized, as well as the objective significance, revealing the current performance and potential scenarios of these microneedles. Third, the trend towards highly integrated sensors is elaborated by emphasizing the sensing principles (colorimetric, fluorometric and electronic manner). Finally, the key challenges to be tackled and the perspectives on future development are discussed.

A Systematic Review on the Advanced Techniques of Wearable Point-of-Care Devices and Their Futuristic Applications

Personalized point-of-care testing (POCT) devices, such as wearable sensors, enable quick access to health monitoring without the use of complex instruments. Wearable sensors are gaining popularity owing to their ability to offer regular and continuous monitoring of physiological data by dynamic, non-invasive assessments of biomarkers in biofluids such as tear, sweat, interstitial fluid and saliva. Current advancements have concentrated on the development of optical and electrochemical wearable sensors as well as advances in non-invasive measurements of biomarkers such as metabolites, hormones and microbes. For enhanced wearability and ease of operation, microfluidic sampling, multiple sensing, and portable systems have been incorporated with materials that are flexible. Although wearable sensors show promise and improved dependability, they still require more knowledge about interaction between the target sample concentrations in blood and non-invasive biofluids. In this review, we have described the importance of wearable sensors for POCT, their design and types of these devices. Following which, we emphasize on the current breakthroughs in the application of wearable sensors in the realm of wearable integrated POCT devices. Lastly, we discuss the present obstacles and forthcoming potentials including the use of Internet of Things (IoT) for offering self-healthcare using wearable POCT.

Microneedle-based interstitial fluid extraction for drug analysis: Advances, challenges, and prospects

Similar to blood, interstitial fluid (ISF) contains exogenous drugs and biomarkers and may therefore substitute blood in drug analysis. However, current ISF extraction techniques require bulky instruments and are both time-consuming and complicated, which has inspired the development of viable alternatives such as those relying on skin or tissue puncturing with microneedles. Currently, microneedles are widely employed for transdermal drug delivery and have been successfully used for ISF extraction by different mechanisms to facilitate subsequent analysis. The integration of microneedles with sensors enables in situ ISF analysis and specific compound monitoring, while the integration of monitoring and delivery functions in wearable devices allows real-time dose modification. Herein, we review the progress in drug analysis based on microneedle-assisted ISF extraction and discuss the related future opportunities and challenges.

A Carbon Paste Electrode Modified by Bentonite and l-Cysteine for Simultaneous Determination of Ascorbic and Uric Acids: Application in Biological Fluids

A novel modification of a paste carbon electrode by Bentonite (Bent) and l-Cysteine (l-Cyst) was carried out for uric acid (UA) and ascorbic acid (AA) detection and quantification. Morphological and compositional characterization of the electrode surface were carried out using electrochemical impedance spectroscopy (EIS), scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopic analysis (EDS). Cyclic voltammetry (CV) and square wave voltammetry (SWV) techniques were used to analyze UA and AA. The obtained sensor shows a good stability, sensibility, selectivity, and regeneration ability. Accordingly, the limit of detection (LOD) is found to be 0.031 μm and 9.6 μm for UA and AA, respectively. A good linearity in the range of 0.1 to 100 μm for UA and 10 to 1000 μm for AA was obtained. The peak-to-peak separation of UA-AA (ΔE_UA-AA ) was determined to be 330 mV. In addition, the sensor is applied successfully to monitor UA and AA in serum samples.

Microfluidic platforms integrated with nano-sensors for point-of-care bioanalysis

Microfluidic technology provides a portable, cost-effective, and versatile tool for point-of-care (POC) bioanalysis because of its associated advantages such as fast analysis, low volumes of reagent consumption, and high portability. Along with microfluidics, the application of nanomaterials in biosensing has attracted lots of attention due to their unique physical and chemical properties for enhanced signal modulation such as signal amplification and signal transduction for POC bioanalysis. Hence, an enormous number of microfluidic devices integrated with nano-sensors have been developed for POC bioanalysis targeting low-resource settings. Herein, we review recent advances in POC bioanalysis on nano-sensor-based microfluidic platforms. We first briefly summarized the different types of cost-effective microfluidic platforms, followed by a concise introduction to nanomaterial-based biosensors. Then, we highlighted the application of microfluidic platforms integrated with nano-sensors for POC bioanalysis. Finally, we discussed the current limitations and perspective trends of the nano-sensor-based microfluidic platforms for POC bioanalysis.