Reliable clinical serum analysis with reusable electrochemical sensor: Toward point-of-care measurement of the antipsychotic medication clozapine

Domain-Limited Sub-Nanometer Co Nanoclusters in Defective Nitrogen Doped Carbon Structures for Non-Invasive Drug Monitoring

In this work, sub-nanometer Co clusters anchored on porous nitrogen-doped carbon (C─N─Co NCs) are successfully prepared by high-temperature annealing and pre-fabricated template strategies for non-invasive sensing of clozapine (CLZ) as an efficient substrate adsorption and electrocatalyst. The introduction of Co sub-nanoclusters (Co NCs) provides enhanced electrochemical performance and better substrate adsorption potential compared to porous and nitrogen-doped carbon structures. Combined with ab initio calculations, it is found that the favorable CLZ catalytic performance with C─N─Co NCs is mainly attributed to possessing a more stable CLZ adsorption structure and lower conversion barriers of CLZ to oxidized state CLZ. An electrochemical sensor for CLZ detection is conceptualized with a wide operating range and high sensitivity, with monitoring capabilities validated in a variety of body fluid environments. Based on the developed CLZ sensing system, the CLZ correlation between blood and saliva and the accuracy of the sensor are investigated by the gold standard method and the rat model of drug administration, paving the way for non-invasive drug monitoring. This work provides new insights into the development of efficient electrocatalysts to enable drug therapy and administration monitoring in personalized healthcare systems.

Electrochemical sensing of dual biomolecules in live cells and whole blood samples: A flexible gold wire-modified copper-organic framework-based hybrid composite

For clinical research, the precise measurement of hydrogen peroxide (H₂O₂) and glucose (Glu) is of paramount importance, due to their imbalanced concentrations in blood glucose, and reactive oxygen species (ROS) play a huge role in COVID-19 viral disease. It is critical to construct and develop a simple, rapid, flexible, long-term, and sensitive detection of H₂O₂ and glucose. In this paper, we have developed a unique morphological structure of MOF(Cu) on a single-walled carbon nanotube-modified gold wire (swnt@gw). Highly designed frameworks with nanotube composites enhance electron rate-transfer behavior while extending conductance and electroactive surface area.The composite sensing system delivers wide linear-range concentrations, low detection limit, and interference-free performance in co-existence with other biomolecules and metal ions. Endogenous quantitative tracking of H₂O₂ was performed in macrophage live-cells with the help of a strong stimulator lipopolysaccharide.The composite device was effectively utilized for the measurement of H₂O₂ and glucose in turbid samples of whole blood and milk samples without a pretreatment process. The practical results of biofluids showed favorable voltammetric results and acceptance recovery percentage levels between 97.49 and 98.88%. Finally, a flexible MOF-based hybrid system may provide a suitable detection platform in the construction of electro-biosensors and hold potential promise for clinical-sensory applications.

Application of nickel-doped graphene nanotubes to modified GCE as a sensitive electrochemical sensor for the antipsychotic drug clozapine in spiked human blood serum samples

Clozapine (CLZ) is one of the most vital medications for managing schizophrenia, and the timely measurement of CLZ levels has been recognized as an obstacle to the wider use of CLZ. Herein, for the first time, nickel-doped graphene nanotubes (Ni@GRNT) were used to construct an electrochemical CLZ sensor by drop coating Ni@GRNT suspension on a glassy carbon electrode. The Ni@GRNT was synthesized and characterized using X‐ray diffraction, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. The electrochemical behavior and influence of different physicochemical factors of sensing electrodes were investigated by using cyclic voltammetry, EIS technique, and differential pulse voltammetry techniques. Also, the catalytic rate constant (kcat) and the transfer coefficient (α) were calculated. The modified electrode illustrated satisfactory linear range, detection limit (LOD), reusability, and reproducibility results. At optimal experimental conditions, measurements can be performed at a broad linear dynamic range of 0.3 nmol L−1–60.0 μmol L−1 CLZ and with a LOD of 0.1 nmol L−1. The sensitivity value was estimated to be 3.06 μA µmol L−1 cm−2. Ultimately, this platform was successfully used for CLZ sensing in spiked human blood serum and tablet samples with an accuracy of > 93%.

Graphical abstract

Electrochemical behaviour of cellulose/reduced graphene oxide/carbon fiber paper electrodes towards the highly sensitive detection of amitrole

Amitrole is a non-selective triazole herbicide that is widespread used to control a variety of weeds in agriculture, but it may pollute the environment and do harm to organisms. Thus, it is of critical significance to enlist a low-cost, sensitive, stable and renewable method to detect amitrole. In this paper, electrochemical experiments were carried out using carbon fibers/reduced graphene oxide/cellulose paper electrodes, which demonstrated good electrocatalytic performance for amitrole detection. The electrochemical process of amitrole on the surface of the reduced paper electrode was a quasi-reversible reaction controlled by diffusion. Cyclic voltammetry and the amperometric i-t curve method were used for amitrole determination at a micro molar level and higher-concentration range with the following characteristics: linear range 5 × 10^-6 mol L^-1 to 3 × 10^-5 mol L^-1, detection limit 2.44 × 10^-7 mol L^-1. In addition, the relative standard deviation of repeatability is 3.74% and of stability is 4.68%. The reduced paper electrode with high sensitivity, low detection limit, good stability and repeatability provides novel ideas for on-site amitrole detection in food and agriculture.

Perspective-Electrochemical Sensors for Neurotransmitters and Psychiatrics: Steps toward Physiological Mental Health Monitoring

Therapeutic monitoring of neurotransmitters (NTs) and psychiatric medications is essential for the diagnosis and treatment of mental illness. However, in-vivo monitoring of NTs in humans as well as continuous physiological monitoring of psychiatrics have yet to be realized. In pursuit of this goal, there has been a plethora of work to develop electrochemical sensors for both in-vivo NT monitoring as well as in-vitro detection of psychiatric medications. We review these sensors here while discussing next steps needed to achieve concurrent, continuous physiological monitoring of NTs and psychiatric medications as part of a closed-loop feedback system that guides medication administration.

Electrogenetic Signal Transmission and Propagation in Coculture to Guide Production of a Small Molecule, Tyrosine

There are many strategies to actuate and control genetic circuits, including providing stimuli like exogenous chemical inducers, light, magnetic fields, and even applied voltage, that are orthogonal to metabolic activity. Their use enables actuation of gene expression for the production of small molecules and proteins in many contexts. Additionally, there are a growing number of reports wherein cocultures, consortia, or even complex microbiomes are employed for the production of biologics, taking advantage of an expanded array of biological function. Combining stimuli-responsive engineered cell populations enhances design space but increases complexity. In this work, we co-opt nature's redox networks and electrogenetically route control signals into a consortium of microbial cells engineered to produce a model small molecule, tyrosine. In particular, we show how electronically programmed short-lived signals (i.e., hydrogen peroxide) can be transformed by one population and propagated into sustained longer-distance signals that, in turn, guide tyrosine production in a second population building on bacterial quorum sensing that coordinates their collective behavior. Two design methodologies are demonstrated. First, we use electrogenetics to transform redox signals into the quorum sensing autoinducer, AI-1, that, in turn, induces a tyrosine biosynthesis pathway transformed into a second population. Second, we use the electrogenetically stimulated AI-1 to actuate expression of ptsH, boosting the growth rate of tyrosine-producing cells, augmenting both their number and metabolic activity. In both cases, we show how signal propagation within the coculture helps to ensure tyrosine production. We suggest that this work lays a foundation for employing electrochemical stimuli and engineered cocultures for production of molecular products in biomanufacturing environments.

Lab-in-a-pencil graphite: A 3D-printed microfluidic sensing platform for real-time measurement of antipsychotic clozapine level

A novel lab-in-a-pencil graphite microfluidic sensing electrode (μFSE) was fabricated for real-time flow injection measurement of the antipsychotic drug clozapine (Clz). A simple, low-cost, and reusable μFSE was obtained by using 3D printing of a microfluidic chamber integrated with a flat pencil graphite without the need to utilize complex technologies. The μFSE has tubular geometry with 800 μm diameter, where the solution continuously flows in the holes of flat pencil graphite electrodes. Under optimized conditions, this device offers fast and effective Clz detection with good analytical features. A linear calibration curve in the range of 0.5 to 10 μM Clz was obtained with good sensitivity (0.01275 μA μM^-1) and detection limit (24 nM). Finally, we demonstrate the applicability of our lab-fabricated microfluidic electrochemical device by monitoring Clz in serum samples at low concentrations.

Ultrafine Bi-Sn nanoparticles decorated on carbon aerogels for electrochemical simultaneous determination of dopamine (neurotransmitter) and clozapine (antipsychotic drug)

This present study describes the synthesis of ultrafine Bi-Sn nanoparticles decorated on carbon aerogels (Bi-Sn NP/CAG) as a nanocomposite for the electrochemical simultaneous determination of dopamine (DA) and clozapine (CLZ). The typical characterization techniques, such as XRD, Raman, BET, FT-IR, TGA, XPS, and FE-SEM/TEM, showed useful insights into the crystal phase and morphology of Bi-Sn NP/CAG. Integrated Bi-Sn NP/CAG built into a cost-effective screen printed carbon electrode (SPCE) offers a high electrochemical surface area (ECSA) compared to unmodified, Bi-Sn, and CAG/SPCEs, such that it favourably allowed the binding of DA and CLZ molecules onto the surface at the Bi-Sn/CAG, which was demonstrated by cyclic and differential pulse voltammetry techniques. As a result, the DA and CLZ sensing exhibited low detection limits (DL, 4.6 and 97.6 nM (S/N = 3)), and sensitivity (3.402 and 0.4 μA μM-1 cm-2) over a wide linear range (0.02-97.59 and 0.5-2092 μM), respectively. To go a step further, the Bi-Sn NP/CAG/SPCE was applied for the simultaneous determination of DA and CLZ which featured lower DL (23.1 and 31.3 nM (S/N = 3)), and sensitivity (0.4979 and 0.04 μA μM-1 cm-2) over a wide linear range (2-182 and 10-910 μM), respectively. The selectivity for DA and CLZ in the presence of a 10-fold concentration of their potentially interfering active species was demonstrated. Finally, this sensing methodology enables the rapid electrochemical determination of the amount of DA and CLZ in a rat brain region serum sample with successful recovery outcomes.

Smart materials for point-of-care testing: From sample extraction to analyte sensing and readout signal generator

The last decade has seen a surge of technical developments in the field on point-of-care testing (POCT). While these developments are extremely diverse, the common aim is to implement improved methods for quick, reliable and inexpensive diagnosis of patients within the clinical setting. While examples of successful introduction and use of POCT techniques are growing, further developments are still necessary to create POCT devices with better portability, usability and performance. Advances in smart materials emerge as potentially valuable know-hows to provide a competitive edge to the development of next generation POCT devices. This review describes the key advantages of adopting smart material-based technologies at different analytical stages of a POCT platform. Under these analytical stages which involves sample pre-treatment, analyte sensing and readout signal generator, several concepts and approaches from contemporary research work in using smart material-based technologies will be the major focus in this review. Lastly, challenges and potential outlook in implementing materials technologies from the application point of view for POCT will be discussed.

A redox-based electrogenetic CRISPR system to connect with and control biological information networks

Electronic information can be transmitted to cells directly from microelectronics via electrode-activated redox mediators. These transmissions are decoded by redox-responsive promoters which enable user-specified control over biological function. Here, we build on this redox communication modality by establishing an electronic eCRISPR conduit of information exchange. This system acts as a biological signal processor, amplifying signal reception and filtering biological noise. We electronically amplify bacterial quorum sensing (QS) signaling by activating LasI, the autoinducer-1 synthase. Similarly, we filter out unintended noise by inhibiting the native SoxRS-mediated oxidative stress response regulon. We then construct an eCRISPR based redox conduit in both E. coli and Salmonella enterica. Finally, we display eCRISPR based information processing that allows transmission of spatiotemporal redox commands which are then decoded by gelatin-encapsulated E. coli. We anticipate that redox communication channels will enable biohybrid microelectronic devices that could transform our abilities to electronically interpret and control biological function.

A Furosemide Excretion Stress Test Predicts Mortality in Mice After Sepsis and Outperforms the Furosemide Stress Test During Vasopressin Administration

Supplemental Digital Content is available in the text.

Objectives:

The furosemide stress test measures the volume of urine produced after a furosemide challenge. Furosemide stress test has previously demonstrated sensitive and specific prediction of progression to Kidney Disease: Improving Global Outcomes guideline defined acute kidney injury stage III in the ICU. Furosemide is actively excreted into the nephron lumen where it inhibits the sodium-potassium-chloride cotransporter, causing diuresis. We hypothesize that furosemide excretion is a more direct measure of tubule health than diuresis.

Design:

We developed a furosemide excretion stress test to evaluate this hypothesis in a murine model of septic-acute kidney injury.

Setting:

Basic science laboratory.

Subjects:

Male and female 8-week old CD-1 mice.

Interventions:

Sepsis was induced by cecal ligation and puncture in male and female mice. Furosemide stress test/furosemide excretion stress test started 42 hours post-cecal ligation and puncture with a 1 mg/kg furosemide bolus and urine was collected for 12 hours. The mice were then euthanized or monitored until 7 days post-cecal ligation and puncture. In another cohort, mice were treated with vasopressin, which decreases urine volume. Furosemide concentration was determined by high performance liquid chromatography.

Measurements and Main Results:

Urine production during the 12-hour collection varied from 0.08 to 2.62 mL. Both urine production (furosemide stress test) and furosemide excretion (furosemide excretion stress test) predicted mortality (area under the receiver operating characteristic curve = 0.925 and 0.916) and time of death (R² = 0.26 and 0.74). Male and female mice demonstrated consistent results. Following vasopressin treatment, furosemide stress test specificity fell to 33% (p = 0.016) but furosemide excretion stress test specificity was maintained.

Conclusions:

The furosemide stress test and furosemide excretion stress test performed similarly in predicting mortality; however, furosemide excretion stress test was superior in predicting time to death and maintained performance when challenged with vasopressin treatment in a mouse sepsis model.

Catechol-Based Capacitor for Redox-Linked Bioelectronics

A common bioelectronics goal is to enable communication between biology and electronics, and success is critically dependent on the communication modality. When a biorelevant modality aligns with instrumentation capabilities, remarkable successes have been observed (e.g., electrodes provide a powerful tool to observe and actuate biology through its ion-based electrical modality). Emerging biological research demonstrates that redox is another biologically relevant modality, and recent research has shown that advanced electrochemical methods enable biodevice communication through this redox modality. Here, we briefly summarize the biological relevance of this redox modality and the use of redox mediators to enable access to this modality through electrochemical measurements. Next, we describe the fabrication of a catechol-chitosan redox capacitor that is redox-active but nonconducting and thus offers a unique set of molecular electronic properties that enhance access to redox-based information. Finally, we cite several recent studies that demonstrate the broad potential for this capacitor to access redox-based biological information. In summary, we envision the redox capacitor will become a vital component in the integrated circuitry of redox-linked bioelectronics.

A Chitosan-Carbon Nanotube-Modified Microelectrode for In Situ Detection of Blood Levels of the Antipsychotic Clozapine in a Finger-Pricked Sample Volume

The antipsychotic clozapine is the most effective medication available for schizophrenia and it is the only antipsychotic with a known efficacious clinical range. However, it is dramatically underutilized due to the inability to test clozapine blood levels in finger-pricked patients' samples. This prevents obtaining immediate blood levels information, resulting in suboptimal treatment. The development of an electrochemical microsensor is presented, which enables, for the first time, clozapine detection in microliters volume whole blood. The sensor is based on a microelectrode modified with micrometer-thick biopolymer chitosan encapsulating carbon nanotubes. The developed sensor detects clozapine oxidation current, in the presence of other electroactive species in the blood, which generate overlapping electrochemical signals. Clozapine detection, characterized in whole blood from healthy volunteers, displays a sensitivity of 32 ± 3.0 µA cm^-2 µmol^-1 L and a limit-of-detection of 0.5 ± 0.03 µmol L^-1 . Finally, the developed sensor displays a reproducible electrochemical signal (0.6% relative standard deviation) and high storage stability (9.8% relative standard deviation after 8 days) in serum samples and high repeatability (9% relative standard deviation for the 5th repetition) in whole blood samples. By enabling the rapid and minimally invasive clozapine detection at the point-of-care, an optimal schizophrenia treatment is provided.

Electroanalysis of Tricyclic Psychotropic Drugs using Modified Electrodes

Background:

Tricyclic psychotropic drugs are defined as a tricyclic rings of the dibenzazepine group with the presence of sulfur and nitrogen atoms. They have been prescribed for antidepressive therapy over the years. Due to their medical importance, many analytical methods have been developed for their monitoring. However, benefits of electrochemical techniques such as costeffectiveness, fast, easy operation and non-destructiveness make them appropriate analytical methods for drug assays. Electrochemical determinations of pharmaceuticals require suitable working electrodes. During years, many electrodes are modified by a variety of modifiers and several sensors were developed based on them. In this regard, nanomaterials, due to their remarkable properties, are one of the most important choices.

Objective:

Here, the application of electroanalytical methods in the determination of electroactive tricyclic psychotropic drugs will be reviewed and the nanomaterials which are used for improvements of the working electrodes will be considered.

The Role of Microsystems Integration Towards Point-of-Care Clozapine Treatment Monitoring in Schizophrenia

We present a perspective on microsystems integration aspects for concurrent cellular and molecular sensing in a lab-on-a-chip device. While of interest for a range of applications, very few - narrowly focused - examples of such devices can be found in the literature. Here, we approach the challenge from a systems level, considering sensor integration both in parallel and in series. Our study is specifically geared toward schizophrenia treatment, where concurrent blood monitoring of the antipsychotic clozapine and white blood cells could lead to improved treatment outcomes. We evaluate the critical system components for either design, namely plasma skimming (parallel) and in-blood clozapine detection (series). We find that plasma skimming is infeasible, but for the first time demonstrate direct detection of clozapine in whole blood. With a corresponding series-integrated microsystem, we finally demonstrate downstream white blood cell analysis on the same samples using impedance cytometry. We thus present the first lab-on-a-chip device capable of label- and reagent-free concurrent sensing of cellular and molecular markers.

Point-of-care testing for streptomycin based on aptamer recognizing and digital image colorimetry by smartphone

The rapid detection of antibiotic residual in everyday life is very important for food safety. In order to realize the on-site and visual detection of antibiotic, a POCT method was established by using digital image colorimetry based on smartphone. Streptomycin was taken as the analyte model of antibiotics, streptomycin aptamer preferentially recognized analyte, and the excess aptamer hybridized with the complementary DNA to form the dsDNA. SYBR Green I combined with the dsDNA and then emitted obvious green fluorescence, thus the fluorescence intensity decreased with the increasing of streptomycin concentration. Then a smartphone-based device was constructed as the fluorescence readout. The smartphone camera acquired the images of the fluorescence derived from the samples, and the Touch Color APP installed in smartphone read out the RGB values of the images. There was a linear relationship between the G values and the streptomycin concentrations in the range of 0.1-100µM. The detection limit was 94nM, which was lower than the maximum residue limit defined by World Health Organization. The POCT method was applied for determining streptomycin in chicken and milk samples with recoveries in 94.1-110%. This method had the advantages of good selectivity, simple operation and on-site visualization.

The Binding Effect of Proteins on Medications and Its Impact on Electrochemical Sensing: Antipsychotic Clozapine as a Case Study

Clozapine (CLZ), a dibenzodiazepine, is demonstrated as the optimal antipsychotic for patients suffering from treatment-resistant schizophrenia. Like many other drugs, understanding the concentration of CLZ in a patient's blood is critical for managing the patients' symptoms, side effects, and overall treatment efficacy. To that end, various electrochemical techniques have been adapted due to their capabilities in concentration-dependent sensing. An open question associated with electrochemical CLZ monitoring is whether drug-protein complexes (i.e., CLZ bound to native blood proteins, such as serum albumin (SA) or alpha-1 acid-glycoprotein (AAG)) contribute to electrochemical redox signals. Here, we investigate CLZ-sensing performance using fundamental electrochemical methods with respect to the impact of protein binding. Specifically, we test the activity of bound and free fractions of a mixture of CLZ and either bovine SA or human AAG. Results suggest that bound complexes do not significantly contribute to the electrochemical signal for mixtures of CLZ with AAG or SA. Moreover, the fraction of CLZ bound to protein is relatively constant at 31% (AAG) and 73% (SA) in isolation with varying concentrations of CLZ. Thus, electrochemical sensing can enable direct monitoring of only the unbound CLZ, previously only accessible via equilibrium dialysis. The methods utilized in this work offer potential as a blueprint in developing electrochemical sensors for application to other redox-active medications with high protein binding more generally. This demonstrates that electrochemical sensing can be a new tool in accessing information not easily available previously, useful toward optimizing treatment regimens.