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Yerlikaya S, Broger T, Isaacs C, Bell D, Holtgrewe L, Gupta-Wright A, Nahid P, Cattamanchi A, Denkinger CM. Blazing the trail for innovative tuberculosis diagnostics. Infection 2024; 52:29-42. [PMID: 38032537 PMCID: PMC10811035 DOI: 10.1007/s15010-023-02135-3] [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: 08/21/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023]
Abstract
The COVID-19 pandemic brought diagnostics into the spotlight in an unprecedented way not only for case management but also for population health, surveillance, and monitoring. The industry saw notable levels of investment and accelerated research which sparked a wave of innovation. Simple non-invasive sampling methods such as nasal swabs have become widely used in settings ranging from tertiary hospitals to the community. Self-testing has also been adopted as standard practice using not only conventional lateral flow tests but novel and affordable point-of-care molecular diagnostics. The use of new technologies, including artificial intelligence-based diagnostics, have rapidly expanded in the clinical setting. The capacity for next-generation sequencing and acceptance of digital health has significantly increased. However, 4 years after the pandemic started, the market for SARS-CoV-2 tests is saturated, and developers may benefit from leveraging their innovations for other diseases; tuberculosis (TB) is a worthwhile portfolio expansion for diagnostics developers given the extremely high disease burden, supportive environment from not-for-profit initiatives and governments, and the urgent need to overcome the long-standing dearth of innovation in the TB diagnostics field. In exchange, the current challenges in TB detection may be resolved by adopting enhanced swab-based molecular methods, instrument-based, higher sensitivity antigen detection technologies, and/or artificial intelligence-based digital health technologies developed for COVID-19. The aim of this article is to review how such innovative approaches for COVID-19 diagnosis can be applied to TB to have a comparable impact.
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Affiliation(s)
- Seda Yerlikaya
- Division of Infectious Diseases and Tropical Medicine, Heidelberg University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany.
| | - Tobias Broger
- Division of Infectious Diseases and Tropical Medicine, Heidelberg University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | | | - David Bell
- Independent Consultant, Lake Jackson, TX, USA
| | - Lydia Holtgrewe
- Division of Infectious Diseases and Tropical Medicine, Heidelberg University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Ankur Gupta-Wright
- Division of Infectious Diseases and Tropical Medicine, Heidelberg University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Institute for Global Health, University College London, London, UK
| | - Payam Nahid
- UCSF Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA
| | - Adithya Cattamanchi
- UCSF Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA
- Division of Pulmonary Diseases and Critical Care Medicine, University of California Irvine, Irvine, CA, USA
| | - Claudia M Denkinger
- Division of Infectious Diseases and Tropical Medicine, Heidelberg University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- German Centre for Infection Research, Partner Site Heidelberg University Hospital, Heidelberg, Germany
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2
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Qiu G, Zhang X, deMello AJ, Yao M, Cao J, Wang J. On-site airborne pathogen detection for infection risk mitigation. Chem Soc Rev 2023; 52:8531-8579. [PMID: 37882143 PMCID: PMC10712221 DOI: 10.1039/d3cs00417a] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Indexed: 10/27/2023]
Abstract
Human-infecting pathogens that transmit through the air pose a significant threat to public health. As a prominent instance, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that caused the COVID-19 pandemic has affected the world in an unprecedented manner over the past few years. Despite the dissipating pandemic gloom, the lessons we have learned in dealing with pathogen-laden aerosols should be thoroughly reviewed because the airborne transmission risk may have been grossly underestimated. From a bioanalytical chemistry perspective, on-site airborne pathogen detection can be an effective non-pharmaceutic intervention (NPI) strategy, with on-site airborne pathogen detection and early-stage infection risk evaluation reducing the spread of disease and enabling life-saving decisions to be made. In light of this, we summarize the recent advances in highly efficient pathogen-laden aerosol sampling approaches, bioanalytical sensing technologies, and the prospects for airborne pathogen exposure measurement and evidence-based transmission interventions. We also discuss open challenges facing general bioaerosols detection, such as handling complex aerosol samples, improving sensitivity for airborne pathogen quantification, and establishing a risk assessment system with high spatiotemporal resolution for mitigating airborne transmission risks. This review provides a multidisciplinary outlook for future opportunities to improve the on-site airborne pathogen detection techniques, thereby enhancing the preparedness for more on-site bioaerosols measurement scenarios, such as monitoring high-risk pathogens on airplanes, weaponized pathogen aerosols, influenza variants at the workplace, and pollutant correlated with sick building syndromes.
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Affiliation(s)
- Guangyu Qiu
- Institute of Medical Robotics, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.
- Institute of Environmental Engineering, ETH Zürich, Zürich 8093, Switzerland
- Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Xiaole Zhang
- Institute of Environmental Engineering, ETH Zürich, Zürich 8093, Switzerland
- Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Andrew J deMello
- Institute for Chemical and Bioengineering, Department of Chemistry and Applied Biosciences, ETH Zürich, Vladimir-Prelog-Weg1, Zürich, Switzerland
| | - Maosheng Yao
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, China
| | - Junji Cao
- Institute of Atmospheric Physics, Chinese Academy of Science, China
| | - Jing Wang
- Institute of Environmental Engineering, ETH Zürich, Zürich 8093, Switzerland
- Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
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3
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Thibon C, Vecellio L, Belkhir L, Dubus JC, Robert A, Kabamba B, Reychler G. There Is a Risk of Spread During a Nebulization Session in a Patient with COVID-19. J Aerosol Med Pulm Drug Deliv 2023; 36:268-274. [PMID: 37610849 DOI: 10.1089/jamp.2023.0010] [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] [Indexed: 08/25/2023] Open
Abstract
Introduction: A hypothetical risk of SARS-CoV-2 airborne transmission through nebulization was suggested based on a potential environmental contamination by the fugitive aerosol emitted in the environment during the procedure. The aim of this study was to verify this risk from the fugitive aerosol emitted by COVID-19 patients during one nebulization session. Methods: In this cohort study, COVID-19 patients treated with nebulization were recruited at their admission to the hospital. Patients had to perform a nebulization session while a BioSampler® and a pump were used to vacuum the fugitive aerosol and collect it for SARS-CoV-2 RNA detection. Results: Ten consecutive patients hospitalized with COVID-19 were recruited. The median viral load was 6.5 × 106 copies/mL. Two out of the 10 samples from the fugitive aerosol collected were positive to SARS-CoV-2. Conclusion: The risk of fugitive aerosol contamination with SARS-CoV-2 during nebulization has now been verified.
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Affiliation(s)
- Christophe Thibon
- Secteur de Kinésithérapie et Ergothérapie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
- Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Laurent Vecellio
- PST A, Université de Tours, Tours, France
- Group Aerosoltherapy GAT of the French Language Respiratory Society-Société de Pneumologie de Langue Française SPLF, Paris, France
| | - Leila Belkhir
- Department of Internal Medicine, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Jean-Christophe Dubus
- Group Aerosoltherapy GAT of the French Language Respiratory Society-Société de Pneumologie de Langue Française SPLF, Paris, France
- Unité de Pneumologie Pédiatrique, Centre Hospitalo-Universitaire (CHU) Timone-Enfants, Marseille, France
- Aix Marseille Université, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Annie Robert
- Pole épidémiologie et biostatistique, Institut de recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Benoît Kabamba
- Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
- Department of Microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Gregory Reychler
- Secteur de Kinésithérapie et Ergothérapie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
- Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Group Aerosoltherapy GAT of the French Language Respiratory Society-Société de Pneumologie de Langue Française SPLF, Paris, France
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4
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Ghumra D, Shetty N, McBrearty KR, Puthussery JV, Sumlin BJ, Gardiner WD, Doherty BM, Magrecki JP, Brody DL, Esparza TJ, O’Halloran JA, Presti RM, Bricker TL, Boon ACM, Yuede CM, Cirrito JR, Chakrabarty RK. Rapid Direct Detection of SARS-CoV-2 Aerosols in Exhaled Breath at the Point of Care. ACS Sens 2023; 8:3023-3031. [PMID: 37498298 PMCID: PMC10463275 DOI: 10.1021/acssensors.3c00512] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023]
Abstract
Airborne transmission via virus-laden aerosols is a dominant route for the transmission of respiratory diseases, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Direct, non-invasive screening of respiratory virus aerosols in patients has been a long-standing technical challenge. Here, we introduce a point-of-care testing platform that directly detects SARS-CoV-2 aerosols in as little as two exhaled breaths of patients and provides results in under 60 s. It integrates a hand-held breath aerosol collector and a llama-derived, SARS-CoV-2 spike-protein specific nanobody bound to an ultrasensitive micro-immunoelectrode biosensor, which detects the oxidation of tyrosine amino acids present in SARS-CoV-2 viral particles. Laboratory and clinical trial results were within 20% of those obtained using standard testing methods. Importantly, the electrochemical biosensor directly detects the virus itself, as opposed to a surrogate or signature of the virus, and is sensitive to as little as 10 viral particles in a sample. Our platform holds the potential to be adapted for multiplexed detection of different respiratory viruses. It provides a rapid and non-invasive alternative to conventional viral diagnostics.
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Affiliation(s)
- Dishit
P. Ghumra
- Center
for Aerosol Science and Engineering, Department of Energy, Environmental
and Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
| | - Nishit Shetty
- Center
for Aerosol Science and Engineering, Department of Energy, Environmental
and Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
| | - Kevin R. McBrearty
- Department
of Neurology, Hope Center for Neurological Disease, Knight Alzheimer’s
Disease Research Center, Washington University, St. Louis, Missouri 63110, United States
| | - Joseph V. Puthussery
- Center
for Aerosol Science and Engineering, Department of Energy, Environmental
and Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
| | - Benjamin J. Sumlin
- Center
for Aerosol Science and Engineering, Department of Energy, Environmental
and Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
| | - Woodrow D. Gardiner
- Department
of Neurology, Hope Center for Neurological Disease, Knight Alzheimer’s
Disease Research Center, Washington University, St. Louis, Missouri 63110, United States
| | - Brookelyn M. Doherty
- Department
of Neurology, Hope Center for Neurological Disease, Knight Alzheimer’s
Disease Research Center, Washington University, St. Louis, Missouri 63110, United States
| | - Jordan P. Magrecki
- Department
of Neurology, Hope Center for Neurological Disease, Knight Alzheimer’s
Disease Research Center, Washington University, St. Louis, Missouri 63110, United States
| | - David L. Brody
- National
Institute of Neurological Disorders and Stroke, Bethesda, Maryland 20892, United States
- Department
of Neurology, Uniformed Services University
of the Health Sciences, Bethesda, Maryland 20814, United States
| | - Thomas J. Esparza
- National
Institute of Neurological Disorders and Stroke, Bethesda, Maryland 20892, United States
| | - Jane A. O’Halloran
- Department
of Medicine, Washington University, St. Louis, Missouri 63110, United States
| | - Rachel M. Presti
- Department
of Medicine, Washington University, St. Louis, Missouri 63110, United States
| | - Traci L. Bricker
- Department
of Medicine, Washington University, St. Louis, Missouri 63110, United States
- Departments
Molecular Microbiology, and Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri 63110, United States
| | - Adrianus C. M. Boon
- Department
of Medicine, Washington University, St. Louis, Missouri 63110, United States
- Departments
Molecular Microbiology, and Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri 63110, United States
| | - Carla M. Yuede
- Department
of Psychiatry, Washington University School
of Medicine, Campus Box
8134, 660 South Euclid Avenue, St. Louis, Missouri 63110, United States
| | - John R. Cirrito
- Department
of Neurology, Hope Center for Neurological Disease, Knight Alzheimer’s
Disease Research Center, Washington University, St. Louis, Missouri 63110, United States
| | - Rajan K. Chakrabarty
- Center
for Aerosol Science and Engineering, Department of Energy, Environmental
and Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
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5
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Seok Y, Mauk MG, Li R, Qian C. Trends of respiratory virus detection in point-of-care testing: A review. Anal Chim Acta 2023; 1264:341283. [PMID: 37230728 DOI: 10.1016/j.aca.2023.341283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023]
Abstract
In resource-limited conditions such as the COVID-19 pandemic, on-site detection of diseases using the Point-of-care testing (POCT) technique is becoming a key factor in overcoming crises and saving lives. For practical POCT in the field, affordable, sensitive, and rapid medical testing should be performed on simple and portable platforms, instead of laboratory facilities. In this review, we introduce recent approaches to the detection of respiratory virus targets, analysis trends, and prospects. Respiratory viruses occur everywhere and are one of the most common and widely spreading infectious diseases in the human global society. Seasonal influenza, avian influenza, coronavirus, and COVID-19 are examples of such diseases. On-site detection and POCT for respiratory viruses are state-of-the-art technologies in this field and are commercially valuable global healthcare topics. Cutting-edge POCT techniques have focused on the detection of respiratory viruses for early diagnosis, prevention, and monitoring to protect against the spread of COVID-19. In particular, we highlight the application of sensing techniques to each platform to reveal the challenges of the development stage. Recent POCT approaches have been summarized in terms of principle, sensitivity, analysis time, and convenience for field applications. Based on the analysis of current states, we also suggest the remaining challenges and prospects for the use of the POCT technique for respiratory virus detection to improve our protection ability and prevent the next pandemic.
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Affiliation(s)
- Youngung Seok
- Department of Biotechnology and Bioengineering, Chonnam National University, Gwangju, 61186, Republic of Korea; Department of Mechanical Engineering and Applied Mechanics, School of Engineering and Applied Science, University of Pennsylvania, 216 Towne Building, 220 S. 33rd Street, Philadelphia, PA, 19104, USA.
| | - Michael G Mauk
- Department of Mechanical Engineering and Applied Mechanics, School of Engineering and Applied Science, University of Pennsylvania, 216 Towne Building, 220 S. 33rd Street, Philadelphia, PA, 19104, USA
| | - Ruijie Li
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, 29 Zhongguancun East Road, Haidian District, Beijing, 100190, China
| | - Cheng Qian
- Key Laboratory for Food Microbial Technology of Zhejiang Province, College of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, Zhejiang, 310018, China
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6
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Zhang X, Chen Y, Pan Y, Ma X, Hu G, Li S, Deng Y, Chen Z, Chen H, Wu Y, Jiang Z, Li Z. Research progress of severe acute respiratory syndrome coronavirus 2 on aerosol collection and detection. CHINESE CHEM LETT 2023:108378. [PMID: 37362323 PMCID: PMC10039702 DOI: 10.1016/j.cclet.2023.108378] [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: 12/14/2022] [Revised: 03/02/2023] [Accepted: 03/22/2023] [Indexed: 06/28/2023]
Abstract
The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late 2019 has negatively affected people's lives and productivity. Because the mode of transmission of SARS-CoV-2 is of great concern, this review discusses the sources of virus aerosols and possible transmission routes. First, we discuss virus aerosol collection methods, including natural sedimentation, solid impact, liquid impact, centrifugal, cyclone and electrostatic adsorption methods. Then, we review common virus aerosol detection methods, including virus culture, metabolic detection, nucleic acid-based detection and immunology-based detection methods. Finally, possible solutions for the detection of SARS-CoV-2 aerosols are introduced. Point-of-care testing has long been a focus of attention. In the near future, the development of an instrument that integrates sampling and output results will enable the real-time, automatic monitoring of patients.
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Affiliation(s)
- Xinyu Zhang
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Yuting Chen
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Yueying Pan
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Xinye Ma
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Gui Hu
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Song Li
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Yan Deng
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Zhu Chen
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Hui Chen
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Yanqi Wu
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, 999078, China
- Shenzhen Lemniscare Med Technol Co. Ltd., Shenzhen, 518000, China
| | - Zhihong Jiang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, 999078, China
| | - Zhiyang Li
- Department of Clinical Laboratory, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, China
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7
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Zheng Y, Song X, Fredj Z, Bian S, Sawan M. Challenges and perspectives of multi-virus biosensing techniques: A review. Anal Chim Acta 2023; 1244:340860. [PMID: 36737150 PMCID: PMC9868144 DOI: 10.1016/j.aca.2023.340860] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023]
Abstract
In the context of globalization, individuals have an increased chance of being infected by multiple viruses simultaneously, thereby highlighting the importance of developing multiplexed devices. In addition to sufficient sensitivity and rapid response, multi-virus sensing techniques are expected to offer additional advantages including high throughput, one-time sampling for parallel analysis, and full automation with data visualization. In this paper, we review the optical, electrochemical, and mechanical platforms that enable multi-virus biosensing. The working mechanisms of each platform, including the detection principle, transducer configuration, bio-interface design, and detected signals, are reviewed. The advantages and limitations, as well as the challenges in implementing various detection strategies in real-life scenarios, were evaluated. Future perspectives on multiplexed biosensing techniques are critically discussed. Earlier access to multi-virus biosensors will efficiently serve for immediate pandemic control, such as in emerging SARS-CoV-2 and monkeypox cases.
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Affiliation(s)
- Yuqiao Zheng
- Zhejiang University, Hangzhou, 310058, Zhejiang, China,Research Center for Industries of the Future, Westlake University, Hangzhou, Zhejiang, 310030, China
| | - Xixi Song
- Research Center for Industries of the Future, Westlake University, Hangzhou, Zhejiang, 310030, China
| | - Zina Fredj
- Research Center for Industries of the Future, Westlake University, Hangzhou, Zhejiang, 310030, China
| | - Sumin Bian
- Research Center for Industries of the Future, Westlake University, Hangzhou, Zhejiang, 310030, China.
| | - Mohamad Sawan
- Research Center for Industries of the Future, Westlake University, Hangzhou, Zhejiang, 310030, China.
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8
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Exhaled breath condensate as bioanalyte: from collection considerations to biomarker sensing. Anal Bioanal Chem 2023; 415:27-34. [PMID: 36396732 PMCID: PMC9672542 DOI: 10.1007/s00216-022-04433-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 11/19/2022]
Abstract
Since the SARS-CoV-2 pandemic, the potential of exhaled breath (EB) to provide valuable information and insight into the health status of a person has been revisited. Mass spectrometry (MS) has gained increasing attention as a powerful analytical tool for clinical diagnostics of exhaled breath aerosols (EBA) and exhaled breath condensates (EBC) due to its high sensitivity and specificity. Although MS will continue to play an important role in biomarker discovery in EB, its use in clinical setting is rather limited. EB analysis is moving toward online sampling with portable, room temperature operable, and inexpensive point-of-care devices capable of real-time measurements. This transition is happening due to the availability of highly performing biosensors and the use of wearable EB collection tools, mostly in the form of face masks. This feature article will outline the last developments in the field, notably the novel ways of EBA and EBC collection and the analytical aspects of the collected samples. The inherit non-invasive character of the sample collection approach might open new doors for efficient ways for a fast, non-invasive, and better diagnosis.
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9
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Raymenants J, Duthoo W, Stakenborg T, Verbruggen B, Verplanken J, Feys J, Van Duppen J, Hanifa R, Marchal E, Lambrechts A, Maes P, André E, Van den Wijngaert N, Peumans P. Exhaled breath SARS-CoV-2 shedding patterns across variants of concern. Int J Infect Dis 2022; 123:25-33. [PMID: 35932968 PMCID: PMC9349369 DOI: 10.1016/j.ijid.2022.07.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES We performed exhaled breath (EB) and nasopharyngeal (NP) quantitative polymerase chain reaction (qPCR) and NP rapid antigen testing (NP RAT) of SARS-CoV-2 infections with different variants. METHODS We included immuno-naïve alpha-infected (n = 11) and partly boosted omicron-infected patients (n = 8) as high-risk contacts. We compared peak NP and EB qPCR cycle time (ct) values between cohorts (Wilcoxon-Mann-Whitney test). Test positivity was compared for three infection phases using Cochran Q test. RESULTS Peak median NP ct was 11.5 (interquartile range [IQR] 10.1-12.1) for alpha and 12.2 (IQR 11.1-15.3) for omicron infections. Peak median EB ct was 25.2 (IQR 24.5-26.9) and 28.3 (IQR 26.4-30.8) for alpha and omicron infections, respectively. Distributions did not differ between cohorts for NP (P = 0.19) or EB (P = 0.09). SARS-CoV-2 shedding peaked on day 1 in EB (confidence interval [CI] 0.0 - 4.5) and day 3 in NP (CI 1.5 - 6.0). EB qPCR positivity equaled NP qPCR positivity on D0-D1 (P = 0.44) and D2-D6 (P = 1.0). It superseded NP RAT positivity on D0-D1 (P = 0.003) and D2-D6 (P = 0.008). It was inferior to both on D7-D10 (P < 0.001). CONCLUSION Peak EB and nasopharynx shedding were comparable across variants. EB qPCR positivity matched NP qPCR and superseded NP RAT in the first week of infection.
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Affiliation(s)
- Joren Raymenants
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000, Leuven, Belgium; Department of general internal medicine, University Hospitals Leuven, 3000, Leuven, Belgium.
| | - Wout Duthoo
- Imec Solutions department, imec, 3001, Leuven, Belgium
| | - Tim Stakenborg
- Life Science Technologies department, imec, 3001, Leuven, Belgium
| | | | - Julien Verplanken
- Enabling Digital Transformations department, imec, 9000, Ghent, Belgium
| | - Jos Feys
- Department of Clinical and Epidemiological Virology (Rega Institute), 3000, Leuven, Belgium
| | - Joost Van Duppen
- Life Science Technologies department, imec, 3001, Leuven, Belgium
| | - Rabea Hanifa
- Life Science Technologies department, imec, 3001, Leuven, Belgium
| | | | | | | | - Emmanuel André
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000, Leuven, Belgium; Department of laboratory medicine, University Hospitals Leuven, 3000, Leuven, Belgium
| | | | - Peter Peumans
- Life Science Technologies department, imec, 3001, Leuven, Belgium
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