A low-cost, portable and easy-operated salivary urea sensor for point-of-care application

A salivary urea sensor based on a microsieve disposable gate AlGaN/GaN high electron mobility transistor

The abundant bio-markers in saliva provide a new option for non-invasive testing. However, due to the presence of impurities in the saliva background, most of the existing saliva testing methods rely on pre-processing, which limits the application of saliva testing as a convenient means of testing in daily life. Herein, a disposable-gate AlGaN/GaN high electron mobility transistor (HEMT) biosensor integrated with a micro-sieve was introduced to solve the problem of signal interference caused by charged impurities in saliva for HEMT based biosensors, where the micro-sieve was utilized as a pre-treatment unit to remove large particles of impurities from saliva through the size effect and thus greatly improving the accuracy of detection. The experimental results showed that the HEMT based biosensor has excellent linearity (R2 = 0.9977) and a high sensitivity of 6.552 μA dec-1 for urea sensing from 1 fM to 100 mM in 0.1× PBS solution. When it comes to artificial saliva detection, compared to the HEMT sensor without the micro-sieve (sensitivity = 3.07432 μA dec-1), the sensitivity of the HEMT sensor integrated with the micro-sieve showed almost no change. Moreover, to verify that urea can be detected in actual saliva, urea is sensed directly in human saliva. The addition of the microsieve module provides a new way for biosensors to detect specific markers in saliva in real time, and the designed HEMT biosensor with the microsieve function has a wide range of application potential in rapid saliva detection.

Study of the reusability and stability of nylon nanofibres as an antibody immobilisation surface

In the case of a biological threat, early, rapid, and specific detection is critical. In addition, ease of handling, use in the field, and low-cost production are important considerations. Immunological devices are able to respond to these needs. In the design of these immunological devices, surface antibody immobilisation is crucial. Nylon nanofibres have been described as a very good option because they allow for an increase in the surface-to-volume ratio, leading to an increase in immunocapture efficiency. In this paper, we want to deepen the study of other key points, such as the reuse and stability of these nanofibres, in order to assess their profitability. On the one hand, the reusability of nanofibres has been studied using different stripping treatments at different pH values on the nylon nanofibres with well-oriented antibodies anchored by protein A/G. Our study shows that stripping with glycine buffer pH 2.5 allows the nanofibres to be reused as long as protein A/G has been previously anchored, leaving both nanofibre and protein A/G unchanged. On the other hand, we investigated the stability of the nylon nanofibres. To achieve this, we analysed any loss of immunocapture ability of well-oriented antibodies anchored both to the nylon nanofibres and to a specialised surface with high protein binding capacity. The nanofibre immunocapture system maintained an unchanged immunocapture ability for a longer time than the specialised planar surface. In conclusion, nylon nanofibres seem to be a very good choice as an antibody immobilisation surface, offering not only higher immunocapture efficiency, but also more cost efficiency as they are reusable and stable.

Saliva Analysis Based on Microfluidics: Focusing the Wide Spectrum of Target Analyte

Saliva is one of the most critical human body fluids that can reflect the state of the human body. The detection of saliva is of great significance for disease diagnosis and health monitoring. Microfluidics, characterized by microscale size and high integration, is an ideal platform for the development of rapid and low-cost disease diagnostic techniques and devices. Microfluidic-based saliva testing methods have aroused considerable interest due to the increasing need for noninvasive testing and frequent or long-term testing. This review briefly described the significance of saliva analysis and generally classified the targets in saliva detection into pathogenic microorganisms, inorganic substances, and organic substances. By using this classification as a benchmark, the state-of-the-art research results on microfluidic detection of various substances in saliva were summarized. This work also put forward the challenges and future development directions of microfluidic detection methods for saliva.

Construction of a ratiometric fluorescent probe for visual detection of urea in human urine based on carbon dots prepared from Toona sinensis leaves and 5-carboxyfluorescein

In this work, pH-sensitive blue fluorescent carbon dots (CDs) with high fluorescence quantum yield (17.24%) were synthesized by hydrothermal method using Toona sinensis leaves and ethylenediamine (EDA) as raw materials. The CDs can detect urea with a limit of detection (LOD) of 6.700 mmol L^-1. For more sensitive detection of urea, we constructed a ratiometric fluorescent probe (CDs@5-FAM) using CDs and 5-carboxyfluorescein (5-FAM). The CDs@5-FAM probe can rapidly and sensitively detect urea according to the changes of I₅₁₄/I₄₀₅, with LOD as low as 0.014 mmol L^-1. Furthermore, with the help of a smartphone and RGB analysis software, urea's visual intelligent detection was realized using a CDs@5-FAM probe. The method proposed in this paper is consistent with the standard method, which indicates that the pH-sensitive ratiometric fluorescent probe CDs@5-FAM is accurate and reliable for practical application. It provides a new way for rapid and visual detection of urea.

A Room-Temperature Surface Acoustic Wave Ammonia Sensor Based on rGO/DPP2T-TT Composite Films

Surface acoustic wave (SAW) sensors based on reduced graphene oxide/poly (diketopyrrolopyrrolethiophene-thieno [3,2-b]thiophene-thiophene) (rGO/DPP2T-TT) composite sensing films for the detection of ammonia were investigated at room temperature in this study. The rGO/DPP2T-TT composite films were deposited onto ST-X quartz SAW resonators by a drop-casting method. FESEM, EDS, and XRD characterizations showed that the rGO/DPP2T-TT composite film was successfully synthesized and exhibited numerous wrinkles and a rough structure, which are crucial for gas adsorption. The frequency response to 500-1400 ppb ammonia shown by the prepared SAW sensor coated with rGO/DPP2T-TT composite film increased linearly as the ammonia concentration increased. The sensor based on a rGO/DPP2T-TT composite film exhibited a positive frequency shift of 55 Hz/ppm, and its frequency response to 500 ppb ammonia was 35 Hz. The sensors thus show promising potential in detecting sub-ppm concentration levels of NH₃ at room temperature, which opens up possibilities for applications in the noninvasive detection of NH₃ in the breath. As a result, the rGO/DPP2T-TT composite sensor can be a good candidate for in situ medical diagnosis and indoor/outdoor environment monitoring.

State of the Art of Chemosensors in a Biomedical Context

Healthcare is undergoing large transformations, and it is imperative to leverage new technologies to support the advent of personalized medicine and disease prevention. It is now well accepted that the levels of certain biological molecules found in blood and other bodily fluids, as well as in exhaled breath, are an indication of the onset of many human diseases and reflect the health status of the person. Blood, urine, sweat, or saliva biomarkers can therefore serve in early diagnosis of diseases such as cancer, but also in monitoring disease progression, detecting metabolic disfunctions, and predicting response to a given therapy. For most point-of-care sensors, the requirement that patients themselves can use and apply them is crucial not only regarding the diagnostic part, but also at the sample collection level. This has stimulated the development of such diagnostic approaches for the non-invasive analysis of disease-relevant analytes. Considering these timely efforts, this review article focuses on novel, sensitive, and selective sensing systems for the detection of different endogenous target biomarkers in bodily fluids as well as in exhaled breath, which are associated with human diseases.

Assessment of Measurement of Salivary Urea by ATR-FTIR Spectroscopy to Screen for CKD

Stages of CKD are currently defined by eGFR and require measurement of serum creatinine concentrations. Previous studies have shown a good correlation between salivary and serum urea levels and the stage of CKD. However, quantitative salivary urea assays in current clinical use require costly and labor-intensive commercial kits, which restricts the advantage of using saliva and limits wider applicability as a quick and easy means of assessing renal function. Attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy has been shown to provide a potentially straightforward, reagent-free method for the identification of a range of disease-related biomarkers and is in current clinical use for analyses of the chemical composition of kidney stones. We assessed the feasibility of ATR-FTIR spectroscopy as an alternative method to measure salivary urea in patients with different stages of CKD. The ATR-FTIR spectra of dried saliva samples from six healthy controls and 20 patients with CKD (stages 1-5) were analyzed to provide their urea concentrations. The lower limit of detection of salivary urea by the ATR-FTIR spectroscopy method was 1-2 mM, at the lower end of the clinically relevant range. Statistically significant differences in salivary urea concentrations were demonstrated between healthy subjects (4.1±0.5 mM) and patients with CKD stages 3-5 (CKD stage 3, 6.8±0.7 mM; CKD stage 4, 9.1±1 mM; CKD stage 5, 14.8±1.6 mM). These salivary urea concentrations correlated well with serum urea levels in the same patients measured by an automated analyzer (Spearman rank correlation coefficient of 0.71; P<0.001). The ability of the method to detect and stage CKD was assessed from the sensitivity and specificity parameters of a receiver operating characteristics (ROC) curve analysis. This proof-of-concept study demonstrates that quantitation of salivary urea by ATR-FTIR spectroscopy could provide a viable tool for rapid and cost-effective diagnosis of stages 3-5 CKD.

Smartphone-assisted point-of-care colorimetric biosensor for the detection of urea via pH-mediated AgNPs growth

Smartphone-assisted point-of-care (POC) bioassay has brought a giant leap in personal healthcare system and environmental monitoring advancements. In this study, we developed a rapid and reliable colorimetric urea biosensor assisted by a smartphone. We employed hydrolysis of urea into NH₃ by urease, which activates the reduction power of tannic acid, to generate silver nanoparticles for a dramatic colorimetric response. The proposed urea biosensor was validated in a solution to provide high selectivity against various interferents in human urine. It had high sensitivity, with a limit of detection as low as 0.0036 mM, and a high reliability of 99% ± 2.9% via the standard addition method. The urea biosensor was successfully implanted on a paper to facilitate smartphone-assisted POC readout with a limit of detection of 0.58 mM and wide detection range of 500 mM, whereby direct diagnosis of human urine without dilution was realized. Our smartphone-assisted POC colorimetric urea biosensor will pave the way for daily monitoring systems of renal and hepatic dysfunction diseases.

Trend in creatinine determining methods: Conventional methods to molecular‐based methods

Renal failure (RF) disease is ranked as one of the most prevalent diseases with severe morbidity and mortality. Early diagnosis of RF leads to subsequent control of disease to reduce the poor prognosis. The level of sera creatinine is considered as a significant biomarker for kidney biofunction, which is routinely detected by the Jaffe reaction. The normal range for creatinine in the blood may be 0.84‐1.21 mg/dL. Low accuracy, insufficient sensitivity, explosive and toxicity of picric acid, and pseudo‐interaction with nonspecific elements such as ammonium ions in the Jaffe method lead to the development of various techniques for precise detection of creatinine such as spectroscopic, electrochemical, and chromatography approaches and sensors based on enzymes, molecular imprinted polymer and nanoparticles, etc. Based on previously established results, they are trying to construct sensors with high accuracy, optimum sensitivity, acceptable linear/calibration range, and limit of detection, which are small in size and applicable by the patient him/herself (point‐of‐care testing). By comparing the results of research, a molecularly imprinted electrochemiluminescence‐based sensor with linear/calibration range of 5‐1 mMconcentration of creatinine and the detection limit of 0.5 nM has the best detectable resolution with 2 million measurable points. In this paper, we will review the recently developed methods for measuring creatinine concentration and renal biofunction.

Recent advancements in urea biosensors for biomedical applications

The quick progress in health care technology as a recurrent measurement of biochemical factors such as blood components leads to advance development and growth in biosensor technology necessary for effectual patient concern. The review wok of authors present a concise information and brief discussion on the development made in the progress of potentiometric, field effect transistor, graphene, electrochemical, optical, polymeric, nanoparticles and nanocomposites based urea biosensors in the past two decades. The work of authors is also centred on different procedures/methods for detection of urea by using amperometric, potentiometric, conductometric and optical processes, where graphene, polymer etc. are utilised as an immobilised material for the fabrication of biosensors. Further, a comparative revision has been accomplished on various procedures of urea analysis using different materials-based biosensors, and it discloses that electrochemical and potentiometric biosensor is the most promise one among all, in terms of rapid response time, extensive shelf life and resourceful design.

Solution Blowing Spinning Technology towards Green Development of Urea Sensor Nanofibers Immobilized with Hydrazone Probe

Cellulose has been one of the most widespread materials due to its renewability, excellent mechanical properties, biodegradability, high absorption ability, biocompatibility and cheapness. Novel, simple and green colorimetric fibrous film sensor was developed by immobilization of urease enzyme (U) and tricyanofuran hydrazone (TCFH) molecular probe onto cellulose nanofibers (CNF). Cellulose acetate nanofibers (CANF) were firstly prepared from cellulose acetate using the simple, green and low cost solution blowing spinning technology. The produced CANF was exposed to deacetylation to introduce CNF, which was then treated with a mixture of TCFH and urease enzyme to introduce CNF-TCFH-U nanofibrous biosensor. CNF were reinforced with tricyanofuran hyrazone molecular probe and urease enzyme was encapsulated into calcium alginate biopolymer to establish a biocomposite film. This CNF-TCFH-U naked-eye sensor can be applied as a disposable urea detector. CNF demonstrated a large surface area and was utilized as a carrier for TCFH, which is the spectroscopic probe and urease is a catalyst. The biochromic CNF-TCFH-U nanofibrous biosensor responds to an aqueous medium of urea via a visible color signal changing from off-white to dark pink. The morphology of the generated CNF and CNF-TCFH-U nanofibrous films were characterized by different analytical tools, including energy-dispersive X-ray patterns (EDX), polarizing optical microscope (POM), Fourier-transform infrared spectroscopy (FT-IR) and scanning electron microscope (SEM). SEM images of CNF-TCFH-U nanofibers demonstrated diameters between 800 nm and 2.5 μm forming a nonwoven fabric with a homogeneous distribution of TCFH/urease-containing calcium alginate nanoparticles on the surface of CNF. The morphology of the cross-linked calcium alginate nanoparticles was also explored using transmission electron microscopy (TEM) to indicate an average diameter of 56-66 nm. The photophysical performance of the prepared CNF-TCFH-U was also studied by CIE Lab coloration parameters. The nanofibrous film biosensor displayed a relatively rapid response time (5-10 min) and a limit of detection as low as 200 ppm and as high as 1400 ppm. Tricyanofuran hydrazone is a pH-responsive disperse dye comprising a hydrazone detection group. Determination of urea occurs through a proton transfer from the hydrazone group to the generated ammonia from the reaction of urea with urease.

Dynamics of salivary markers of kidney functions in acute and chronic kidney diseases

Saliva can be used as an alternative diagnostic fluid enabling easy and non-invasive disease monitoring. Urea and creatinine can be measured in saliva and both were shown to be increased in renal failure. However, the dynamics of these markers during the development of kidney diseases is unknown. We aimed to describe the dynamics of salivary urea and creatinine in various animal models of acute kidney injury (AKI) and chronic kidney disease (CKD) and in patients with different stages AKI or CKD. Ninety Wistar rats underwent bilateral nephrectomy (BNX), ischemia–reperfusion injury (IRI) or glycerol-induced kidney injury to model AKI. CKD was modelled using 5/6 nephrectomy. In the clinical part 57 children aged 12.6 ± 4.9 years with AKI (n = 11) or CKD (n = 46) and 29 healthy controls (aged 10.2 ± 3.7 years) were enrolled. Saliva and blood samples were collected in both, animal experiments and the human study. In animal models of AKI, plasma urea and creatinine were higher than in controls. An increase of salivary urea and creatinine (twofold) was observed in BNX and IRI, but only after 12 h and 24 h, respectively. In glycerol nephropathy and 5/6 nephrectomy, salivary urea increased (by 100% and by 50%), while salivary creatinine did not change during the observation period. Salivary urea and creatinine were significantly higher in all patients compared to controls (threefold) and in both, AKI and CKD they were associated with the severity of renal failure. Plasma and salivary concentrations correlated only in children with renal failure (R = 0.72 for urea; R = 0.93 for creatinine), but not in controls (R = -0.007 for urea; R = 0.02 for creatinine). Our study indicates that during the development of renal impairment saliva could be used for non-invasive monitoring in higher stages of AKI or CKD, rather than for screening of early stages of kidney diseases.

A paper-based device for the colorimetric determination of ammonia and carbon dioxide using thiomalic acid and maltol functionalized silver nanoparticles: application to the enzymatic determination of urea in saliva and blood

A colorimetric assay was developed which has the capability of determining urea in biological samples. It is an origami paper-based sensor consisting of silver nanoparticles that were synthesized by using two different capping agents: thiomalic acid and maltol. The function of the assay relied on hydrolysis of urea to ammonia and carbon dioxide in the presence of urease. The products interacted with nanoparticles which caused aggregation. Interestingly, thiomalic acid capped with silver nanoparticles were selective to ammonia, and the other nanoparticles synthesized by maltol responded to carbon dioxide. These interactions turned the color of nanoparticles from yellow to brown and red, respectively. The resulting colorations were captured by a floatable scanner. A routine image analysis software was utilized to provide the response of the assays. The method was applied to individually determine ammonia, carbon dioxide, and urea. The linear range was 0.06 mg.dL^-1-170.0 mg.dL^-1 for ammonia, 0.08 mg.dL^-1-220.0 mg.dL^-1 for carbon dioxide, and 0.5 mg.dL^-1-200.0 mg.dL^-1 for urea. The respective limits of detection were 0.03 mg.dL^-1, 0.06 mg.dL^-1, and 0.18 mg.dL^-1. No interferences were found in the detremination of urea. The method demonstrates a reliable performance for determination of urea in both saliva and blood samples. Graphical Abstract Schematic representation of paper based colorimetric sensor based on silver nanoparticles for both qualitative and quantitative analyses of urea in biological samples.

The Synergy of Thermally Reduced Graphene Oxide in Amperometric Urea Biosensor: Application for Medical Technologies

Thermally reduced graphene oxide (TRGO) is a graphene-based nanomaterial that has been identified as promising for the development of amperometric biosensors. Urease, in combination with TRGO, allowed us to create a mediator-free amperometric biosensor with the intention of precise detection of urea in clinical trials. Beyond simplicity of the technology, the biosensor exhibited high sensitivity (2.3 ± 0.1 µA cm⁻² mM⁻¹), great operational and storage stabilities (up to seven months), and appropriate reproducibility (relative standard deviation (RSD) about 2%). The analytical recovery of the TRGO-based biosensor in urine of 101 ÷ 104% with RSD of 1.2 ÷ 1.7% and in blood of 92.7 ÷ 96.4%, RSD of 1.0 ÷ 2.5%, confirmed that the biosensor is acceptable and reliable. These properties allowed us to apply the biosensor in the monitoring of urea levels in samples of urine, blood, and spent dialysate collected during hemodialysis. Accuracy of the biosensor was validated by good correlation (R = 0.9898 and R = 0.9982) for dialysate and blood, utilizing approved methods. The advantages of the proposed biosensing technology could benefit the development of point-of-care and non-invasive medical instruments.