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Vignesh V, Castro-Dominguez B, James TD, Gamble-Turner JM, Lightman S, Reis NM. Advancements in Cortisol Detection: From Conventional Methods to Next-Generation Technologies for Enhanced Hormone Monitoring. ACS Sens 2024; 9:1666-1681. [PMID: 38551608 PMCID: PMC11059103 DOI: 10.1021/acssensors.3c01912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/22/2024] [Accepted: 03/08/2024] [Indexed: 05/02/2024]
Abstract
The hormone cortisol, released as the end-product of the hypothalamic-pituitary-adrenal (HPA) axis, has a well-characterized circadian rhythm that enables an allostatic response to external stressors. When the pattern of secretion is disrupted, cortisol levels are chronically elevated, contributing to diseases such as heart attacks, strokes, mental health disorders, and diabetes. The diagnosis of chronic stress and stress related disorders depends upon accurate measurement of cortisol levels; currently, it is quantified using mass spectroscopy or immunoassay, in specialized laboratories with trained personnel. However, these methods are time-consuming, expensive and are unable to capture the dynamic biorhythm of the hormone. This critical review traces the path of cortisol detection from traditional laboratory-based methods to decentralised cortisol monitoring biosensors. A complete picture of cortisol biology and pathophysiology is provided, and the importance of precision medicine style monitoring of cortisol is highlighted. Antibody-based immunoassays still dominate the pipeline of development of point-of-care biosensors; new capture molecules such as aptamers and molecularly imprinted polymers (MIPs) combined with technologies such as microfluidics, wearable electronics, and quantum dots offer improvements to limit of detection (LoD), specificity, and a shift toward rapid or continuous measurements. While a variety of different sensors and devices have been proposed, there still exists a need to produce quantitative tests for cortisol ─ using either rapid or continuous monitoring devices that can enable a personalized medicine approach to stress management. This can be addressed by synergistic combinations of technologies that can leverage low sample volumes, relevant limit of detection and rapid testing time, to better account for cortisol's shifting biorhythm. Trends in cortisol diagnostics toward rapid and continuous monitoring of hormones are highlighted, along with insights into choice of sample matrix.
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Affiliation(s)
- Visesh Vignesh
- Department
of Chemical Engineering and Centre for Bioengineering and Biomedical
Technologies (CBio) University of Bath, BA2 7AY Bath, U.K.
| | - Bernardo Castro-Dominguez
- Department
of Chemical and Engineering and Digital Manufacturing and Design University
of Bath, BA2 7AY Bath, U.K.
| | - Tony D. James
- Department
of Chemistry, University of Bath, BA2 7AY Bath, U.K.
| | | | - Stafford Lightman
- Translational
Health Sciences, Bristol Medical School, University of Bristol, BS1 3NY Bristol, U.K.
| | - Nuno M. Reis
- Department
of Chemical Engineering and Centre for Bioengineering and Biomedical
Technologies (CBio) University of Bath, BA2 7AY Bath, U.K.
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2
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Mishra A, Agrawal M, Ali A, Garg P. Uninterrupted real-time cerebral stress level monitoring using wearable biosensors: A review. Biotechnol Appl Biochem 2023; 70:1895-1914. [PMID: 37455443 DOI: 10.1002/bab.2491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023]
Abstract
Stress is the major unseen bug for the health of humans with the increasing workaholic era. Long periods of avoidance are the main precursor for chronic disorders that are quite tough to treat. As precaution is better than cure, stress detection and monitoring are vital. Although there are ways to measure stress clinically, there is still a constant need and demand for methods that measure stress personally and in an ex vitro manner for the convenience of the user. The concept of continuous stress monitoring has been introduced to tackle the issue of unseen stress accumulating in the body simultaneously with being user-friendly and reliable. Stress biosensors nowadays provide real-time, noninvasive, and continuous monitoring of stress. These biosensors are innovative anthropogenic creations that are a combination of biomarkers and indicators like heart rate variation, electrodermal activity, skin temperature, galvanic skin response, and electroencephalograph of stress in the body along with machine learning algorithms and techniques. The collaboration of biological markers, artificial intelligence techniques, and data science tools makes stress biosensors a hot topic for research. These attributes have made continuous stress detection a possibility with ease. The advancement in stress biosensing technologies has made a great impact on the lives of human beings so far. This article focuses on the comprehensive study of stress-indicating biomarkers and the techniques along with principles of the biosensors used for continuous stress detection. The precise overview of wearable stress monitoring systems is also sectioned to pave a pathway for possible future research studies.
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Affiliation(s)
- Anuja Mishra
- Department of Biotechnology, Institute of Applied Science & Humanities, GLA University, Mathura, Uttar Pradesh, India
| | - Mukti Agrawal
- Department of Biotechnology, Institute of Applied Science & Humanities, GLA University, Mathura, Uttar Pradesh, India
| | - Aaliya Ali
- School of Applied Sciences and Biotechnology, Shoolini University, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University, Solan, Himachal Pradesh, India
| | - Prakrati Garg
- School of Applied Sciences and Biotechnology, Shoolini University, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University, Solan, Himachal Pradesh, India
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3
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Bryan AE, Krutko M, Westphal J, Sheth M, Esfandiari L, Harris GM. Ultrasound-Activated Piezoelectric Polyvinylidene Fluoride-Trifluoroethylene Scaffolds for Tissue Engineering Applications. Mil Med 2023; 188:61-66. [PMID: 37948229 DOI: 10.1093/milmed/usad018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/09/2023] [Accepted: 01/17/2023] [Indexed: 11/12/2023] Open
Abstract
Severe peripheral nervous system (PNS) injuries have limited options for therapeutic solutions to regain functional recovery. This can be attributed in part to the lack of regeneration pathways promoted by recapitulating chemical, physical, and electrical cues to direct nerve guidance. To address this, we examined ultrasonic stimulation of a piezoelectric polyvinylidene fluoride-triflouroethylene (PVDF-TrFE) scaffold as a potentially clinically relevant therapy for PNS regeneration. Owing to the piezoelectric modality of PVDF-TrFE, we hypothesize that ultrasound stimulation will activate the scaffold to electrically stimulate cells in response to the mechanical deformation mediated by sound waves. Biocompatible PVDF-TrFE scaffolds were fabricated to be used as an ultrasound-activated, piezoelectric biomaterial to enhance cellular activity for PNS applications. NIH-3T3 fibroblasts were cultured on PVDF-TrFE nanofibers and stimulated with low-, medium-, or high-powered ultrasound. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assays were performed on fibroblasts to measure the metabolic activity of the cells following stimulation. MTT assays showed that ultrasound-stimulated fibroblasts on PVDF-TrFE scaffolds had increased metabolic activity as power was increased, whereas on plain polystyrene, an opposite trend was observed where cells had a decreased metabolic activity with ascending levels of ultrasound power. Ultrasound-stimulated PVDF-TrFE nanofibers hold exciting potential as a therapy for PNS injuries by promoting increased metabolic activity and proliferation. The ability to noninvasively stimulate implantable piezoelectric nanofibers to promote mechanical and electrical stimulation for nerve repair offers a promising benefit to severe trauma patients.
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Affiliation(s)
- Andrew E Bryan
- Department of Chemical and Environmental Engineering, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Maksym Krutko
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Jennifer Westphal
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Maulee Sheth
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Leyla Esfandiari
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221, USA
- Department of Electrical Engineering and Computer Science, University of Cincinnati, Cincinnati, OH 45221, USA
- Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Greg M Harris
- Department of Chemical and Environmental Engineering, University of Cincinnati, Cincinnati, OH 45221, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221, USA
- Neuroscience Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
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Yuan X, Ouaskioud O, Yin X, Li C, Ma P, Yang Y, Yang PF, Xie L, Ren L. Epidermal Wearable Biosensors for the Continuous Monitoring of Biomarkers of Chronic Disease in Interstitial Fluid. MICROMACHINES 2023; 14:1452. [PMID: 37512763 PMCID: PMC10385734 DOI: 10.3390/mi14071452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
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.
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Affiliation(s)
- Xichen Yuan
- Key Laboratory of Flexible Electronics of Zhejiang Province, Ningbo Institute of Northwestern Polytechnical University, Ningbo 315103, China
- MOE Key Laboratory of Micro and Nano Systems for Aerospace, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Oumaima Ouaskioud
- Key Laboratory of Flexible Electronics of Zhejiang Province, Ningbo Institute of Northwestern Polytechnical University, Ningbo 315103, China
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Xu Yin
- MOE Key Laboratory of Micro and Nano Systems for Aerospace, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Chen Li
- Key Laboratory of Flexible Electronics of Zhejiang Province, Ningbo Institute of Northwestern Polytechnical University, Ningbo 315103, China
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Pengyi Ma
- Key Laboratory of Flexible Electronics of Zhejiang Province, Ningbo Institute of Northwestern Polytechnical University, Ningbo 315103, China
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Yang Yang
- Ministry of Education Key Laboratory of Low-Grade Energy Utilization Technologies and Systems, Chongqing University, Chongqing 400030, China
| | - Peng-Fei Yang
- Key Laboratory of Flexible Electronics of Zhejiang Province, Ningbo Institute of Northwestern Polytechnical University, Ningbo 315103, China
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Li Xie
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Li Ren
- Key Laboratory of Flexible Electronics of Zhejiang Province, Ningbo Institute of Northwestern Polytechnical University, Ningbo 315103, China
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
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5
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Zheng H, Pu Z, Wu H, Li C, Zhang X, Li D. Reverse iontophoresis with the development of flexible electronics: A review. Biosens Bioelectron 2023; 223:115036. [PMID: 36580817 DOI: 10.1016/j.bios.2022.115036] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022]
Abstract
Skin-centric diagnosis techniques, such as epidermal physiological parameter monitoring, have developed rapidly in recent years. The analysis of interstitial fluid (ISF), a body liquid with abundant physiological information, is a promising method to obtain health status because ISF is easily assessed by implanted or percutaneous measurements. Reverse iontophoresis extracts ISF by applying an electric field onto the skin, and it is a promising method to noninvasively obtain ISF, which, in turn, enables noninvasive epidermal physiological parameter monitoring. However, the development of reverse iontophoresis was relatively slow around the 2010s due to the rigidity and low biocompatibility of the applied devices. With the rapid development of flexible electronic technology in recent years, new progress has been made in the field of reverse iontophoresis, especially in the field of blood glucose monitoring and drug monitoring. This review summarizes the recent advances and discusses the challenges and opportunities of reverse iontophoresis.
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Affiliation(s)
- Hao Zheng
- State Key Laboratory of Precision Measuring Technology and Instruments, Tianjin University, Tianjin, 300072, China
| | - Zhihua Pu
- State Key Laboratory of Precision Measuring Technology and Instruments, Tianjin University, Tianjin, 300072, China.
| | - Hao Wu
- State Key Laboratory of Precision Measuring Technology and Instruments, Tianjin University, Tianjin, 300072, China
| | - Chengcheng Li
- State Key Laboratory of Precision Measuring Technology and Instruments, Tianjin University, Tianjin, 300072, China
| | - Xingguo Zhang
- State Key Laboratory of Precision Measuring Technology and Instruments, Tianjin University, Tianjin, 300072, China
| | - Dachao Li
- State Key Laboratory of Precision Measuring Technology and Instruments, Tianjin University, Tianjin, 300072, China.
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6
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Development of an insilico model of eccrine sweat using molecular modelling techniques. Sci Rep 2022; 12:20263. [PMID: 36424428 PMCID: PMC9691721 DOI: 10.1038/s41598-022-24440-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022] Open
Abstract
Eccrine sweat is an ideal surrogate diagnostic biofluid for physiological and metabolic biomarkers for wearable biosensor design. Its periodic and non-invasive availability for candidate analytes such as glucose and cortisol along with limited correlation with blood plasma is of significant research interest. An insilico model of eccrine sweat can assist in the development of such wearable biosensors. In this regard, molecular modelling can be employed to observe the most fundamental interactions. Here, we determine a suitable molecular model for building eccrine sweat. The basic components of sweat are water and sodium chloride, in which glucose and other analytes are present in trace quantities. Given the wide range of water models available in the molecular dynamics space, in this study, we first validate the water models. We use three compounds to represent the base to build bulk sweat fluid and validate the force fields. We compare the self-diffusivity of water, glucose, sodium, and chloride ions as well as bulk viscosity values and present the results which are > 90% accurate as compared with the available literature. This validated insilico eccrine sweat model can serve as an aid to expedite the development de novo biosensors by addition of other analytes of interest e.g. cortisol, uric acid etc., simulate various temperatures and salt concentrations, expand search space for screening candidate target receptors by their binding affinity and assess the interference between competing species via simulations.
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7
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Sessi V, Ibarlucea B, Seichepine F, Klinghammer S, Ibrahim I, Heinzig A, Szabo N, Mikolajick T, Hierlemann A, Frey U, Weber WM, Baraban L, Cuniberti G. Multisite Dopamine Sensing With Femtomolar Resolution Using a CMOS Enabled Aptasensor Chip. Front Neurosci 2022; 16:875656. [PMID: 35720700 PMCID: PMC9204155 DOI: 10.3389/fnins.2022.875656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/12/2022] [Indexed: 12/02/2022] Open
Abstract
Many biomarkers including neurotransmitters are found in external body fluids, such as sweat or saliva, but at lower titration levels than they are present in blood. Efficient detection of such biomarkers thus requires, on the one hand, to use techniques offering high sensitivity, and, on the other hand, to use a miniaturized format to carry out diagnostics in a minimally invasive way. Here, we present the hybrid integration of bottom-up silicon-nanowire Schottky-junction FETs (SiNW SJ-FETs) with complementary-metal–oxide–semiconductor (CMOS) readout and amplification electronics to establish a robust biosensing platform with 32 × 32 aptasensor measurement sites at a 100 μm pitch. The applied hetero-junctions yield a selective biomolecular detection down to femtomolar concentrations. Selective and multi-site detection of dopamine is demonstrated at an outstanding sensitivity of ∼1 V/fM. The integrated platform offers great potential for detecting biomarkers at high dilution levels and could be applied, for example, to diagnosing neurodegenerative diseases or monitoring therapy progress based on patient samples, such as tear liquid, saliva, or eccrine sweat.
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Affiliation(s)
- Violetta Sessi
- Institute of Semiconductor and Microsystems, TU Dresden, Dresden, Germany
- Center for Advancing Electronics Dresden, TU Dresden, Dresden, Germany
| | - Bergoi Ibarlucea
- Center for Advancing Electronics Dresden, TU Dresden, Dresden, Germany
- Max Bergman Center of Biomaterials Dresden and Institute for Materials Science, TU Dresden, Dresden, Germany
- Bergoi Ibarlucea,
| | - Florent Seichepine
- RIKEN Quantitative Biological Center, Kobe, Japan
- Imperial College London, London, United Kingdom
| | - Stephanie Klinghammer
- Center for Advancing Electronics Dresden, TU Dresden, Dresden, Germany
- Max Bergman Center of Biomaterials Dresden and Institute for Materials Science, TU Dresden, Dresden, Germany
| | - Imad Ibrahim
- Institute of Semiconductor and Microsystems, TU Dresden, Dresden, Germany
- Center for Advancing Electronics Dresden, TU Dresden, Dresden, Germany
| | - André Heinzig
- Institute of Semiconductor and Microsystems, TU Dresden, Dresden, Germany
| | | | - Thomas Mikolajick
- Institute of Semiconductor and Microsystems, TU Dresden, Dresden, Germany
- Center for Advancing Electronics Dresden, TU Dresden, Dresden, Germany
- NaMLab gGmbH, Dresden, Germany
| | - Andreas Hierlemann
- Department of Biosystems Science and Engineering, Bio Engineering Laboratory, ETH Zürich, Basel, Switzerland
| | - Urs Frey
- RIKEN Quantitative Biological Center, Kobe, Japan
- Department of Biosystems Science and Engineering, Bio Engineering Laboratory, ETH Zürich, Basel, Switzerland
- MaxWell Biosystems AG, Basel, Switzerland
| | - Walter M. Weber
- Center for Advancing Electronics Dresden, TU Dresden, Dresden, Germany
- NaMLab gGmbH, Dresden, Germany
- Institute of Solid State Electronics, TU Wien, Vienna, Austria
- Walter Weber,
| | - Larysa Baraban
- Center for Advancing Electronics Dresden, TU Dresden, Dresden, Germany
- Max Bergman Center of Biomaterials Dresden and Institute for Materials Science, TU Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf e.V., Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- *Correspondence: Larysa Baraban,
| | - Gianaurelio Cuniberti
- Center for Advancing Electronics Dresden, TU Dresden, Dresden, Germany
- Max Bergman Center of Biomaterials Dresden and Institute for Materials Science, TU Dresden, Dresden, Germany
- Gianaurelio Cuniberti,
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Hoang VC, Shafaat A, Jankovskaja S, Gomes VG, Ruzgas T. Franz cells for facile biosensor evaluation: A case of HRP/SWCNT-based hydrogen peroxide detection via amperometric and wireless modes. Biosens Bioelectron 2021; 191:113420. [PMID: 34182432 DOI: 10.1016/j.bios.2021.113420] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 06/01/2021] [Accepted: 06/05/2021] [Indexed: 12/26/2022]
Abstract
Reducing animal use in biosensor research requires broader use of in vitro methods. In this work, we present a novel application of Franz cells suitable for biosensor development and evaluation in vitro. The work describes how Franz cell can be equipped with electrodes enabling characterization of biosensors in close proximity to skin. As an example of a sensor, hydrogen peroxide biosensor was prepared based on horseradish peroxidase (HRP)/single-walled carbon nanotube (SWCNT)-modified textile. The electrode exhibited lower detection limit of 0.3 μM and sensitivity of 184 μA mM-1 cm-2. The ability of this biosensor to monitor H2O2 penetration through skin and dialysis membranes was evaluated in Franz cell setup in amperometric and wireless modes. The results also show that catalase activity present in skin is a considerable problem for epidermal sensing of H2O2. This work highlights opportunities and obstacles that can be addressed by assessment of biosensors in Franz cell setup before progressing to their testing in animals and humans.
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Affiliation(s)
- Van Chinh Hoang
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, SE-205 06, Malmö, Sweden; Biofilms - Research Center for Biointerfaces, Malmö University, SE-205 06, Malmö, Sweden; The University of Sydney, School of Chemical and Biomolecular Engineering, NSW, 2006, Australia
| | - Atefeh Shafaat
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, SE-205 06, Malmö, Sweden; Biofilms - Research Center for Biointerfaces, Malmö University, SE-205 06, Malmö, Sweden
| | - Skaidre Jankovskaja
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, SE-205 06, Malmö, Sweden; Biofilms - Research Center for Biointerfaces, Malmö University, SE-205 06, Malmö, Sweden
| | - Vincent G Gomes
- The University of Sydney, School of Chemical and Biomolecular Engineering, NSW, 2006, Australia.
| | - Tautgirdas Ruzgas
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, SE-205 06, Malmö, Sweden; Biofilms - Research Center for Biointerfaces, Malmö University, SE-205 06, Malmö, Sweden.
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Jagannath B, Muthukumar S, Prasad S. Electrical double layer modulation of hybrid room temperature ionic liquid/aqueous buffer interface for enhanced sweat based biosensing. Anal Chim Acta 2018. [DOI: 10.1016/j.aca.2018.02.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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