Electrochemical immunoassay for the detection of stress biomarkers

A Wearable Electrochemical Sensor Based on a Molecularly Imprinted Polymer Integrated with a Copper Benzene-1,3,5-Tricarboxylate Metal-Organic Framework for the On-Body Monitoring of Cortisol in Sweat

Owing to their potential to transform traditional medical diagnostics and health monitoring, wearable biosensors have become an alternative evolutionary technology in the field of medical care. However, it is still necessary to overcome some key technique challenges, such as the selectivity, sensitivity, and stability of biometric identification. Herein, a novel, wearable electrochemical sensor based on a molecularly imprinted polymer (MIP) integrated with a copper benzene-1,3,5-tricarboxylate metal-organic framework (MOF) was designed for the detection of stress through the on-body monitoring of cortisol in sweat. The MOF was used as the substrate for MIP deposition to enhance the stability and sensitivity of the sensor. The sensor consisted of two layers, with a microfluidic layer as the top layer for spontaneous sweating and a modified electrode as the bottom layer for sensing. The sensor measured cortisol levels by detecting the current change that occurred when the target molecules bound to the imprinted cavities, using Prussian blue nanoparticles embedded in the MIP framework as the REDOX probe. The proposed sensor exhibited a linear detection range of 0.01-1000 nM with a detection limit of 0.0027 nM, and favorable specificity over other analogies. This facile anti-body free sensor showed excellent stability, and can be successfully applied for in situ cortisol monitoring.

Wearable and Implantable Cortisol-Sensing Electronics for Stress Monitoring

Cortisol is a steroid hormone that is released from the body in response to stress. Although a moderate level of cortisol secretion can help the body maintain homeostasis, excessive secretion can cause various diseases, such as depression and anxiety. Conventional methods for cortisol measurement undergo procedures that limit continuous monitoring, typically collecting samples of bodily fluids, followed by separate analysis in a laboratory setting that takes several hours. Thus, recent studies demonstrate wearable, miniaturized sensors integrated with electronic modules that enable wireless real-time analysis. Here, the primary focus is on wearable and implantable electronic devices that continuously measure cortisol concentration. Diverse types of cortisol-sensing techniques, such as antibody-, DNA-aptamer-, and molecularly imprinted polymer-based sensors, as well as wearable and implantable devices that aim to continuously monitor cortisol in a minimally invasive fashion are discussed. In addition to the cortisol monitors that directly measure stress levels, other schemes that indirectly measure stress, such as electrophysiological signals and sweat are also summarized. Finally, the challenges and future directions in stress monitoring and management electronics are reviewed.

Electrochemical sensors for cortisol detection: Principles, designs, fabrication, and characterisation

Psychological stress is a major factor contributing to health discrepancies among individuals. Sustained exposure to stress triggers signalling pathways in the brain, which leading to the release of stress hormones in the body. Cortisol, a steroid hormone, is a significant biomarker for stress management due to its responsibility in the body's reply to stress. The release of cortisol in bloodstream prepares the body for a "fight or flight" response by increasing heart rate, blood pressure, metabolism, and suppressing the immune system. Detecting cortisol in biological samples is crucial for understanding its role in stress and personalized healthcare. Traditional techniques for cortisol detection have limitations, prompting researchers to explore alternative strategies. Electrochemical sensing has emerged as a reliable method for point-of-care (POC) cortisol detection. This review focuses on the progress made in electrochemical sensors for cortisol detection, covering their design, principle, and electroanalytical methodologies. The analytical performance of these sensors is also analysed and summarized. Despite significant advancements, the development of electrochemical cortisol sensors faces challenges such as biofouling, sample preparation, sensitivity, flexibility, stability, and recognition layer performance. Therefore, the need to develop more sensitive electrodes and materials is emphasized. Finally, we discussed the potential strategies for electrode design and provides examples of sensing approaches. Moreover, the encounters of translating research into real world applications are addressed.

Recent developments in wearable & non-wearable point-of-care biosensors for cortisol detection

INTRODUCTION

Cortisol is one of the most prominent biomarkers used for the detection of psychological stress and related disorders. It plays an important role in many physiological processes including immunomodulation and fat metabolism. Thus, monitoring of cortisol levels can be used to indicate different pathological conditions including stress disorders. There has been a gradual rise in the development of point of care (PoC) biosensors for continuous cortisol monitoring.

AREAS COVERED

This review discusses recent breakthroughs toward the development of PoC sensors (wearable and non wearable) for cortisol monitoring. Challenges associated with them have also been summarized.

EXPERT OPINION

Electrochemical PoC devices have recently emerged as a powerful tools for continuous monitoring of cortisol that can be utilized for stress management and treatment of related disorders. However, there are many challenges that should be addressed before such devices can be deployed at mass level, such as inter-individual variability, changing the device calibration with the circadian rhythm, interference from other endocrine moieties, etc. [Figure: see text].

Biosensors for saliva biomarkers

The analysis of salivary biomarkers has gained interest and is advantageous for simple, safe, and non-invasive testing in diagnosis as well as treatment. This chapter explores the importance of saliva biomarkers and summarizes recent advances in biosensor fabrication. The identification of diagnostic, prognostic and therapeutic markers in this matrix enables more rapid and frequent testing when combined with the use of biosensor technology. Challenges and future goals are highlighted and examined.

Cortisol Immunosensors: A Literature Review

Cortisol is a steroid hormone that is involved in a broad range of physiological processes in human/animal organisms. Cortisol levels in biological samples are a valuable biomarker, e.g., of stress and stress-related diseases; thus, cortisol determination in biological fluids, such as serum, saliva and urine, is of great clinical value. Although cortisol analysis can be performed with chromatography-based analytical techniques, such as liquid chromatography-tandem mass spectrometry (LC-MS/MS), conventional immunoassays (radioimmunoassays (RIAs), enzyme-linked immunosorbent assays (ELISAs), etc.) are considered the "gold standard" analytical methodology for cortisol, due to their high sensitivity along with a series of practical advantages, such as low-cost instrumentation, an assay protocol that is fast and easy to perform, and high sample throughput. Especially in recent decades, research efforts have focused on the replacement of conventional immunoassays by cortisol immunosensors, which may offer further improvements in the field, such as real-time analysis at the point of care (e.g., continuous cortisol monitoring in sweat through wearable electrochemical sensors). In this review, most of the reported cortisol immunosensors, mainly electrochemical and also optical ones, are presented, focusing on their immunosensing/detection principles. Future prospects are also briefly discussed.

Selective Amplification of Plasmonic Sensor Signal for Cortisol Detection Using Gold Nanoparticles

Herein, gold nanoparticles (AuNP)-modified cortisol-imprinted (AuNP-MIP) plasmonic sensor was developed for signal amplification and real-time cortisol determination in both aqueous and complex solutions. Firstly, the sensor surfaces were modified with 3-(trimethoxylyl)propyl methacrylate and then pre-complex was prepared using the functional monomer N-methacryloyl-L-histidine methyl ester. The monomer solution was made ready for polymerization by adding 2-hydroxyethyl methacrylate to ethylene glycol dimethacrylate. In order to confirm the signal enhancing effect of AuNP, only cortisol-imprinted (MIP) plasmonic sensor was prepared without AuNP. To determine the selectivity efficiency of the imprinting process, the non-imprinted (AuNP-NIP) plasmonic sensor was also prepared without cortisol. The characterization studies of the sensors were performed with atomic force microscopy and contact angle measurements. The kinetic analysis of the AuNP-MIP plasmonic sensor exhibited a high correlation coefficient (R² = 0.97) for a wide range (0.01–100 ppb) with a low detection limit (0.0087 ppb) for cortisol detection. Moreover, the high imprinting efficiency (k′ = 9.67) of the AuNP-MIP plasmonic sensor was determined by comparison with the AuNP-NIP plasmonic sensor. All kinetic results were validated and confirmed by HPLC.

Synthesis and grafting of diazonium tosylates for thermoplastic electrode immunosensors

For electrochemical immunosensors, inexpensive electrodes with fast redox kinetics, and simple stable methods of electrode functionalization are vital. However, many inexpensive and easy to fabricate electrodes suffer from poor redox kinetics, and functionalization can often be difficult and/or unstable. Diazonium tosylates are particularly stable soluble salts that can be useful for electrode functionalization. Recently developed thermoplastic electrodes (TPEs) have been inexpensive, moldable, and highly electroactive carbon composite materials. Herein, the synthesis and grafting of diazonium tosylate salts were optimized for modification of TPEs and used to develop the first TPE immunosensors. With diazonium tosylates, TPEs were amine functionalized either directly through grafting of p-aminophenyl diazonium salt or indirectly through grafting p-nitrophenyl diazonium salt followed by electrochemical reduction to an amine. Diazonium tosylates were synthesized in situ as a paste in 6 min. Once the reaction paste was spread over the electrodes, near monolayer coverage (1.0 ± 0.2 nmol cm-2) was achieved for p-nitrophenyl diazonium salt within 5 min. Amine functionalized electrodes were conjugated to C-reactive protein (CRP) antibodies. Antibody-modified TPEs were applied for the sensitive detection of CRP, a biomarker of cardiovascular disease using electrochemical enzyme-linked immunosorbent assays (ELISA). LODs were determined to be 2 ng mL-1 in buffer, with high selectivity against interfering species for both functionalization methods. The direct p-aminophenyl modification method had the highest sensitivity to CRP and was further tested in spiked serum with an LOD of 10 ng mL-1. This low-cost and robust TPE immunosensor platform can be easily adapted for other analytes and multiplexed detection.

Immunosensor for Assessing the Welfare of Trainee Guide Dogs

Cortisol is a well established biomarker hormone that regulates many processes in the body and is widely referred to as the stress hormone. Cortisol can be used as a stress marker to allow for detection of stress levels in dogs during the training process. This test will indicate if they will handle the stress under the training or if they might be more suitable as an assistant or companion dog. An immunosensor for detection of cortisol was developed using electrochemical impedance spectroscopy (EIS). The sensor was characterized using chemical and topographical techniques. The sensor was calibrated and its sensitivity determined using a cortisol concentration range of 0.0005 to 50 μg/mL. The theoretical limit of detection was found to be 3.57 fg/mL. When the immunosensor was tested on canine saliva samples, cortisol was detected and measured within the relevant physiological ranges in dogs.

Current methods for stress marker detection in saliva

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Introduction of relevant biomarkers in stress conditions.

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Reference ranges of biomarkers in normal conditions.

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Saliva as easy-accessible specimen.

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Review of analytical methods for biomarker determination in saliva.

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Possibilities for design of point-of-care devices.

Stress and stress-related diseases are leading to drastic consequences in private and professional life. Therefore, the need for stress prevention strategies is of personal and economic interest. Especially during the recent period related to covid-19 outbreak and lock-down, an ongoing discussion of increasing stress etiology is reported. Biomarker analysis may help to assist diagnosis and classification of stress-related diseases and therefore support therapeutical decisions. Due to its non-invasive sampling, the analysis of saliva has become highly attractive compared to the detection methods in other specimen. This review article summarizes the status of research, innovative approaches, and trends. Scientific literature published since 2011 was excerpted with concentration on the detection of up to seven promising marker substances. Most often reported cortisol represents the currently best evaluated stress marker, while norepinephrine (noradrenaline) or its metabolite 3-methoxy-4-hydroxyphenylglycol is also a quite commonly considered stress marker. Other complementary stress marker candidates are testosterone, dehydroepiandrosterone (DHEA) and its sulfonated analogue DHEA-S, alpha-amylase, secretory immunoglobulin A, and chromogranin A. Several working groups are researching in the field of stress marker detection to develop reliable, fast, and affordable methods. Analytical methods reported mainly focused on immunological and electrochemical as well as chromatographic methods hyphenated to mass spectrometric detection to yield the required detection limits.