Detection of low-abundance biomarker lipocalin 1 for diabetic retinopathy using optoelectrokinetic bead-based immunosensing

Structure, Functions, and Implications of Selected Lipocalins in Human Disease

The lipocalin proteins are a large family of small extracellular proteins that demonstrate significant heterogeneity in sequence similarity and have highly conserved crystal structures. They have a variety of functions, including acting as carrier proteins, transporting retinol, participating in olfaction, and synthesizing prostaglandins. Importantly, they also play a critical role in human diseases, including cancer. Additionally, they are involved in regulating cellular homeostasis and immune response and dispensing various compounds. This comprehensive review provides information on the lipocalin family, including their structure, functions, and implications in various diseases. It focuses on selective important human lipocalin proteins, such as lipocalin 2 (LCN2), retinol binding protein 4 (RBP4), prostaglandin D2 synthase (PTGDS), and α1-microglobulin (A1M).

Photonic crystal enhanced immunofluorescence biosensor integrated with a lateral flow microchip: Toward rapid tear-based diabetic retinopathy screening

Diabetic retinopathy (DR) has accounted for major loss of vision in chronic diabetes. Although clinical statistics have shown that early screening can procrastinate or improve the deterioration of the disease, the screening rate remains low worldwide because of the great inconvenience of conventional ophthalmoscopic examination. Instead, tear fluid that contains rich proteins caused by direct contact with eyeballs is an ideal substitute to monitor vision health. Herein, an immunofluorescence biosensor enhanced by a photonic crystal (PhC) is presented to handle the trace proteins suspended in the tear fluid. The PhC was constructed by self-assembled nanoparticles with a thin layer of gold coated on top of it. Then, the PC substrate was conjugated with antibodies and placed in a microchannel. When the capillary-driven tear sample flew over the PC substrate, the immunoassay enabled the formation of a sandwich antibody-antigen-antibody configuration for PhC-enhanced immunofluorescence. The use of PhC resulted in a concentration enhancement of more than tenfold compared to non-PhC, while achieving an equivalent signal intensity. The limit of detection for the target biomarker, lipocalin-1 (LCN-1), reached nearly 3 μg/ml, and the turnaround time of each detection was 15 min. Finally, a preclinical evaluation was conducted using ten tear samples. A clear trend was observed, showing that the concentrations of LCN-1 were at least twofold higher in individuals with chronic diabetes or DR than in healthy individuals. This trend was consistent with their medical conditions. The results provided a direct proof-of-concept for the proposed PhC biosensor in rapid tear-based DR screening.

Genome-wide identification and comparative analysis of lipocalin families in Lepidoptera with an emphasis on Bombyx mori

Lipocalins exhibit functional diversity, including roles in retinol transport, invertebrate cryptic coloration, and stress response. However, genome-wide identification and characterization of lipocalin in the insect lineage have not been thoroughly explored. Here, we found that a lineage-specific expansion of the lipocalin genes in Lepidoptera occurred in large part due to tandem duplication events and several lipocalin genes involving insect coloration were expanded more via tandem duplication in butterflies. A comparative analysis of conserved motifs showed both conservation and divergence of lepidopteran lipocalin family protein structures during evolution. We observe dynamic changes in tissue expression preference of paralogs in Bombyx mori, suggesting differential contribution of paralogs to specific organ functions during evolution. Subcellular localization experiments revealed that lipocalins localize to the cytoplasm, nuclear membrane, or nucleus in BmN cells. Moreover, several lipocalin genes exhibited divergent responses to abiotic and biotic stresses, and 1 lipocalin gene was upregulated by 300 fold in B. mori. These results suggest that lipocalins act as signaling components in defense responses by mediating crosstalk between abiotic and biotic stress responses. This study deepens our understanding of the comprehensive characteristics of lipocalins in insects.

Emerging Applications of Electrochemical Impedance Spectroscopy in Tear Film Analysis

Human tear film, with a flow rate of 1-3 µL/min, is a rich bodily fluid that transmits a variety of metabolites and hormones containing proteins, lipids and electrolytes that provide clues about ocular and systemic diseases. Analysis of disease biomarkers such as proteins, mRNA, enzymes and cytokines in the tear film, collected by noninvasive methods, can provide significant results for sustaining a predictive, preventive and personalized medicine regarding various diseases such as glaucoma, diabetic retinopathy, keratoconus, dry eye, cancer, Alzheimer's disease, Parkinson's disease and COVID-19. Electrochemical impedance spectroscopy (EIS) offers a powerful technique for analyzing these biomarkers. EIS detects electrical equivalent circuit parameters related to biorecognition of receptor-analyte interactions on the electrode surface. This method is advantageous as it performs a label-free detection and allows the detection of non-electroactive compounds that cannot be detected by direct electron transfer, such as hormones and some proteins. Here, we review the opportunities regarding the integration of EIS into tear fluid sampling approaches.

Diabetic retinopathy: Involved cells, biomarkers, and treatments

Diabetic retinopathy (DR), a leading cause of vision loss and blindness worldwide, is caused by retinal neurovascular unit dysfunction, and its cellular pathology involves at least nine kinds of retinal cells, including photoreceptors, horizontal and bipolar cells, amacrine cells, retinal ganglion cells, glial cells (Müller cells, astrocytes, and microglia), endothelial cells, pericytes, and retinal pigment epithelial cells. Its mechanism is complicated and involves loss of cells, inflammatory factor production, neovascularization, and BRB impairment. However, the mechanism has not been completely elucidated. Drug treatment for DR has been gradually advancing recently. Research on potential drug targets relies upon clear information on pathogenesis and effective biomarkers. Therefore, we reviewed the recent literature on the cellular pathology and the diagnostic and prognostic biomarkers of DR in terms of blood, protein, and clinical and preclinical drug therapy (including synthesized molecules and natural molecules). This review may provide a theoretical basis for further DR research.

Lab-on-a-chip technologies for minimally invasive molecular sensing of diabetic retinopathy

Diabetic retinopathy (DR) is the most common diabetic eye disease and the worldwide leading cause of vision loss in working-age adults. It progresses from mild to severe non-proliferative or proliferative DR based on several pathological features including the magnitude of blood-retinal barrier breakdown and neovascularization. Available pharmacological and retinal laser photocoagulation interventions are mostly applied in the advanced stages of DR and are inefficient in halting disease progression in a significantly high percentage of patients. Yet, recent evidence has shown that some therapies could potentially limit DR progression if applied at early stages, highlighting the importance of early disease diagnostics. In the past few decades, different imaging modalities have proved their utility for examining retinal and optic nerve changes in patients with retinal diseases. However, imaging based-methodologies solely rely on morphological examination of the retinal vascularization and are not suitable for recurrent and personalized patient evaluation. This raises the need for new technologies to enable accurate and early diagnosis of DR. In this review, we critically discuss the potential clinical benefit of minimally-invasive molecular biomarker identification and profiling of diabetic patients who are at risk of developing DR. We provide a comparative overview of conventional and recently developed lab-on-a-chip technologies for quantitative assessment of potential DR molecular biomarkers and discuss their advantages, current limitations and challenges for future practical implementation and continuous patient monitoring at the point-of-care.

Identification of tear-based protein and non-protein biomarkers: Its application in diagnosis of human diseases using biosensors

Discovery of robust, selective and specific biomarkers are important for early diagnosis and monitor progression of human diseases. Eye being a common target for several human diseases, vision impediment and complications are often associated with systemic and ocular diseases. Tears are bodily fluids that are closest to eye and are rich in protein content and other metabolites. As a biomarker repository, it advantages over other bodily fluids due to the ability to collect it non-invasively. In this review, we highlight some recent advancements in identification of tear-based protein biomarkers like lacryglobin and cystatin SA for cancer; interleukin-6 and immunoglobulin-A antibody for COVID-19; tau, amyloid-β-42 and lysozyme-C for Alzheimer's disease; peroxiredoxin-6 and α-synuclein for Parkinson's disease; kallikrein, angiotensin converting enzyme and lipocalin-1 for glaucoma; lactotransferrin and lipophilin-A for diabetic retinopathy and zinc-alpha-2 glycoprotein-1, prolactin and calcium binding protein-A4 for eye thyroid disease. We also discussed identification of tear based non-protein biomarkers like lysophospholipids and acetylcarnitine for glaucoma, 8-hydroxy-2'-deoxyquanosine and malondialdehyde for thyroid eye disease. We elucidate technological advancement in developing tear-based biosensors for diagnosis and monitoring diseases such as diabetes, diabetic retinopathy and Alzheimer's disease. Altogether, the study of tears as potential biomarkers for early diagnosis of human diseases is promising.

Facile open-well immunofluorescence enhancement with coplanar-electrodes-enabled optoelectrokinetics and magnetic particles

Electrokinetic manipulation has been proven powerful in enhancing the sensing capability of general-purpose biochips. However, the close-form configuration of biochips and the required use of low electric conductivity limit their practicability. In this study, an open-well microfluidic system facilitated with coplanar-electrodes-enabled optoelectrokinetic concentration and magnetic particles were therefore developed to overcome these challenges. The open side achieves optoelectrokinetic manipulation for biosignal enhancement, enabling free manual operations. Magnetic particles were employed in immunoassays to facilitate the rapid onsite separation of targets. A common cytokine biomarker found in many diseases, that is, tumor necrosis factor alpha (TNF-α), was used for assessing the immunosensing system. In addition to the benefits inherited from the immunoassays, the fluorescent signal enhanced by the optoelectrokinetic technique also featured rapid enhancement in 1 min and a limit of detection of as low as 2.9 pg/mL. The open-well architecture allowed the entire immunosensing process to be completed on site without frequent off-site washing. For a practical test, the TNF-α in human tear fluids was measured by the developed device and validated with a standard enzyme-linked immunosorbent assay (ELISA). The data show consistency in terms of trend. The developed open-well optoelectrokinetic device provides an insight into future facile clinical diagnoses. By simply modifying the surface linkers on the magnetic particles, the technique can be further extended to more other trace biomarker detections.

Mixing during Trapping Enabled a Continuous-Flow Microfluidic Smartphone Immunoassay Using Acoustic Streaming

Smartphone-enabled microfluidic chemiluminescence immunoassay is a promising portable system for point-of-care (POC) biosensing applications. However, due to the rather faint emitted light in such a limited sample volume, it is still difficult to reach the clinically accepted range when the smartphone serves as a standalone detector. Besides, the multiple separation and washing steps during sample preparation hinder the immunoassay's applications for POC usage. Herein, we proposed a novel acoustic streaming tweezers-enabled microfluidic immunoassay, where the probe particles' purification, reaction, and sensing were simply achieved on the same chip at continuous-flow conditions. The dedicatedly designed high-speed microscale vortexes not only enable dynamic trapping and washing of the probe particles on-demand but also enhance the capture efficiency of the heterogeneous particle-based immunoassay through active mixing during trapping. The enriched probe particles and enhanced biomarker capture capability increase the local chemiluminescent light intensity and enable direct capture of the immunobinding signal by a regular smartphone camera. The system was tested for prostate-specific antigen (PSA) sensing both in buffer and serum, where a limit of detection of 0.2 ng/mL and a large dynamic response range from 0.3 to 10 ng/mL using only 10 μL of sample were achieved in a total assay time of less than 15 min. With the advantages of on-chip integration of sample preparation and detection and high sensing performance, the developed POC platform could be applied for many on-site diagnosis applications.

Fluorescent aptasensor based on G-quadruplex-assisted structural transformation for the detection of biomarker lipocalin 1

Diabetic retinopathy (DR) is the leading global cause of blindness in the working-age population. Early diagnosis and intervention can effectively reduce the risk for blindness. However, the current diagnostic methods in clinical practice remain constrained by nonquantitative examinations and individual ophthalmologists' experiences. Sensitive, specific and accurate detection of DR-specific biomarkers is an important approach to achieve its early and rapid diagnosis. In this study, a high-affinity aptamer APT12TM that specifically binds to the tear-derived DR biomarker lipocalin 1 was obtained. The aptamer APT12TM can be folded into a stable B-DNA structure, and its strong interaction with LCN 1, including hydrogen bonding and hydrophobic interactions, is an important factor for targeted recognition and high-affinity binding. A G-rich DNA fragment was further assembled at both ends of the aptamer APT12TM, and the B-DNA form was successfully converted into a parallel G-quadruplex. Most importantly, LCN 1 could induce further transformation of the G-quadruplex structure. Therefore, a fluorescent aptasensor based on G-quadruplex-assisted structural transformation was developed through the Thioflavin T mediator. The aptasensor exhibited a broad detection window from 0.25 to 1000 nM LCN 1, with a limit of detection of 0.2 nM. Furthermore, the aptasensor was applied to LCN 1 detection in artificial tear samples and displayed good reproducibility and stability. These results show that the developed aptasensor has significant potential for sensitive, specific and convenient detection of the DR-specific biomarker LCN 1.

Recent Advances in Smart Biomaterials for the Detection and Treatment of Autoimmune Diseases

Autoimmune diseases are a group of debilitating illnesses that are often idiopathic in nature. The steady rise in the prevalence of these conditions warrants new approaches for diagnosis and treatment. Stimuli-responsive biomaterials also known as "smart", "intelligent" or "recognitive" biomaterials are widely studied for their applications in drug delivery, biosensing and tissue engineering due to their ability to produce thermal, optical, chemical, or structural changes upon interacting with the biological environment. This critical analysis highlights studies within the last decade that harness the recognitive capabilities of these biomaterials towards the development of novel detection and treatment options for autoimmune diseases.

Sensitive tear screening of diabetic retinopathy with dual biomarkers enabled using a rapid electrokinetic patterning platform

Bead-based immunosensors have intrigued the scientific community over the past decades due to their rapid and multiplexed capabilities in the detection of various biological targets. Nevertheless, their use in the detection of low-abundance analytes remains a continuing challenge because of their limited number of active enrichment approaches. To this end, our research presents a delicate microbead enrichment technique using an optoelectrokinetic platform, followed by the detection of dual biomarkers for the sensitive screening of an eye disease termed diabetic retinopathy (DR). In this study, microbeads turned fluorescent as their surfaces formed sandwiched immunocomplexes in the presence of target antigens. The tiny fluorescent dots were then concentrated using the optoelectrokinetic platform for the enhancement of their signals. The signal rapidly escalated in 10 s, and the optimal limit of detection was nearly 100 pg mL^-1. For practical DR screening, two biomarkers, lipocalin 1 (LCN1) and vascular endothelial growth factor (VEGF), were used. Approximately 20 μL of analytes were collected from the tear samples of the tested patients. The concentrations of both biomarkers showed escalating trends with the severity of DR. Two concentration thresholds of LCN1 and VEGF that indicate proliferative DR were determined out of 24 clinical samples based on the receiver operating characteristic curves. For verification, a single-blind test was conducted with additional clinical tear samples from five random subjects. The final outcome of this evaluation showed an accuracy of >80%. This non-invasive screening provides a potential means for the early diagnosis of DR and may increase the screening rate among the high-risk diabetic population in the future.

Rare variants and loci for age-related macular degeneration in the Ohio and Indiana Amish

Age-related macular degeneration (AMD) is a leading cause of blindness in the world. While dozens of independent genomic variants are associated with AMD, about one-third of AMD heritability is still unexplained. To identify novel variants and loci for AMD, we analyzed Illumina HumanExome chip data from 87 Amish individuals with early or late AMD, 79 unaffected Amish individuals, and 15 related Amish individuals with unknown AMD affection status. We retained 37,428 polymorphic autosomal variants across 175 samples for association and linkage analyses. After correcting for multiple testing (n = 37,428), we identified four variants significantly associated with AMD: rs200437673 (LCN9, p = 1.50 × 10⁻¹¹), rs151214675 (RTEL1, p = 3.18 × 10⁻⁸), rs140250387 (DLGAP1, p = 4.49 × 10⁻⁷), and rs115333865 (CGRRF1, p = 1.05 × 10⁻⁶). These variants have not been previously associated with AMD and are not in linkage disequilibrium with the 52 known AMD-associated variants reported by the International AMD Genomics Consortium based on physical distance. Genome-wide significant linkage peaks were observed on chromosomes 8q21.11–q21.13 (maximum recessive HLOD = 4.03) and 18q21.2–21.32 (maximum dominant HLOD = 3.87; maximum recessive HLOD = 4.27). These loci do not overlap with loci previously linked to AMD. Through gene ontology enrichment analysis with ClueGO in Cytoscape, we determined that several genes in the 1-HLOD support interval of the chromosome 8 locus are involved in fatty acid binding and triglyceride catabolic processes, and the 1-HLOD support interval of the linkage region on chromosome 18 is enriched in genes that participate in serine-type endopeptidase inhibitor activity and the positive regulation of epithelial to mesenchymal transition. These results nominate novel variants and loci for AMD that require further investigation.

Update on the human and mouse lipocalin (LCN) gene family, including evidence the mouse Mup cluster is result of an "evolutionary bloom"

Lipocalins (LCNs) are members of a family of evolutionarily conserved genes present in all kingdoms of life. There are 19 LCN-like genes in the human genome, and 45 Lcn-like genes in the mouse genome, which include 22 major urinary protein (Mup) genes. The Mup genes, plus 29 of 30 Mup-ps pseudogenes, are all located together on chromosome (Chr) 4; evidence points to an “evolutionary bloom” that resulted in this Mup cluster in mouse, syntenic to the human Chr 9q32 locus at which a single MUPP pseudogene is located. LCNs play important roles in physiological processes by binding and transporting small hydrophobic molecules —such as steroid hormones, odorants, retinoids, and lipids—in plasma and other body fluids. LCNs are extensively used in clinical practice as biochemical markers. LCN-like proteins (18–40 kDa) have the characteristic eight β-strands creating a barrel structure that houses the binding-site; LCNs are synthesized in the liver as well as various secretory tissues. In rodents, MUPs are involved in communication of information in urine-derived scent marks, serving as signatures of individual identity, or as kairomones (to elicit fear behavior). MUPs also participate in regulation of glucose and lipid metabolism via a mechanism not well understood. Although much has been learned about LCNs and MUPs in recent years, more research is necessary to allow better understanding of their physiological functions, as well as their involvement in clinical disorders.

Noninvasive diagnostic methods for diabetes mellitus from tear fluid

Diabetes mellitus and prolonged hyperglycemia can cause diabetic retinopathy. Diabetic retinopathy arises from damage to retinal vessels and, in its final stages, causes blindness. The early stages are often asymptomatic and although regular screening of diabetic patients is recommended, the beginning of diabetic retinopathy is insufficiently detected. The diagnostic potential of fluorescence spectroscopy, infrared spectroscopy and atomic force microscopy as the untraditional methods for diabetes mellitus was investigated using tear fluid. In our pilot study the structural changes of tear fluid of patients with diabetes mellitus after insulin and oral antidiabetic drug treatment was compared with healthy subjects. The results of analysis, infrared spectroscopy and atomic force microscopy confirmed structural changes in tear fluid of patients in comparison with the tear fluid of healthy subjects. Using new experimental laboratory methods in future could contribute to an improvement in diagnosis of diabetes mellitus and other selected ocular diseases using tear fluid.

In our pilot study we assessed the diagnostic potential of FS, IRS and AFM for diabetes mellitus using tear fluid.

Elimination terminal fixed region screening and high-throughput kinetic determination of aptamer for lipocalin-1 by surface plasmon resonance imaging

A highly efficient method for eliminating terminal fixed region interference of aptamer with real-time monitoring of the SELEX process was described by silver decahedra nanoparticles probe (Ag₁₀-A₁₀-RP(15)) capture and block the terminal fixed region candidates. A microarray chip was developed by immobilization of target protein (lipocalin-1 (LCN-1)) and control proteins (Human serum albumin (HSA), Bovine serum albumin (BSA) and Holo-transferrin) on the biochip surface. The nucleic acid pool was first incubated with target and then captured by hybridization with Ag₁₀-A₁₀-RP(15). The work allows rapid screening of aptamer elimination fixed-region interference, and the kinetic constants of candidate sequences can be quickly determined using SPRi technology. Eventually, ten aptamers with high affinity and specific for LCN-1 after only fifth-round of selection was acquired.