Analytical techniques for the detection of glycated haemoglobin underlining the sensors

Structural changes in hemoglobin and glycation

Hemoglobin (Hb) is a hemeprotein found inside erythrocytes and is crucial in transporting oxygen and carbon dioxide in our bodies. In erythrocytes (Ery), the main energy source is glucose metabolized through glycolysis. However, a fraction of Hb can undergo glycation, in which a free amine group from the protein spontaneously binds to the carbonyl of glucose in the bloodstream, resulting in the formation of glycated hemoglobin (HbA1c), widely used as a marker for diabetes. Glycation leads to structural and conformational changes, compromising the function of proteins, and is intensified in the event of hyperglycemia. The main changes in Hb include structural alterations to the heme group, compromising its main function (oxygen transport). In addition, amyloid aggregates can form, which are strongly related to diabetic complications and neurodegenerative diseases. Therefore, this chapter discusses in vitro protocols for producing glycated Hb, as well as the main techniques and biophysical assays used to assess changes in the protein's structure before and after the glycation process. This more complete understanding of the effects of glycation on Hb is fundamental for understanding the complications associated with hyperglycemia and for developing more effective prevention and treatment strategies.

Emerging biosensor probes for glycated hemoglobin (HbA1c) detection

Glycated hemoglobin (HbA1c), originating from the non-enzymatic glycosylation of βVal1 residues in hemoglobin (Hb), is an essential biomarker indicating average blood glucose levels over a period of 2 to 3 months without external environmental disturbances, thereby serving as the gold standard in the management of diabetes instead of blood glucose testing. The emergence of HbA1c biosensors presents affordable, readily available options for glycemic monitoring, offering significant benefits to small-scale laboratories and clinics. Utilizing nanomaterials coupled with high-specificity probes as integral components for recognition, labeling, and signal transduction, these sensors demonstrate exceptional sensitivity and selectivity in HbA1c detection. This review mainly focuses on the emerging probes and strategies integral to HbA1c sensor development. We discussed the advantages and limitations of various probes in sensor construction as well as recent advances in diverse sensing strategies for HbA1c measurement and their potential clinical applications, highlighting the critical gaps in current technologies and future needs in this evolving field.

Chitosan and sodium alginate nanocarrier system: Controlling the release of rapeseed-derived peptides and improving their therapeutic efficiency of anti-diabetes

Rapeseed-derived peptides (RPPs) can maintain the homeostasis of human blood glucose by inhibiting Dipeptidyl Peptidase-IV (DPP-IV) and activating the calcium-sensing receptor (CaSR). However, these peptides are susceptible to hydrolysis in the gastrointestinal tract. To enhance the therapeutic potential of these peptides, we developed a chitosan/sodium alginate-based nanocarrier to encapsulate two RPP variants, rapeseed-derived cruciferin peptide (RCPP) and rapeseed-derived napin peptide (RNPP). A convenient three-channel device was employed to prepare chitosan (CS)/sodium alginate (ALG)-RPPs nanoparticles (CS/ALG-RPPs) at a ratio of 1:3:1 for CS, ALG, and RPPs. CS/ALG-RPPs possessed optimal encapsulation efficiencies of 90.7 % (CS/ALG-RNPP) and 91.4 % (CS/ALG-RCPP), with loading capacities of 15.38 % (CS/ALG-RNPP) and 16.63 % (CS/ALG-RCPP) at the specified ratios. The electrostatic association between CS and ALG was corroborated by zeta potential and near infrared analysis. 13C NMR analysis verified successful RPPs loading, with CS/ALG-RNPP displaying superior stability. Pharmacokinetics showed that both nanoparticles were sustained release and transported irregularly (0.43 < n < 0.85). Compared with the control group, CS/ALG-RPPs exhibited significantly increased glucose tolerance, serum GLP-1 (Glucagon-like peptide 1) content, and CaSR expression which play pivotal roles in glucose homeostasis (*p < 0.05). These findings proposed that CS/ALG-RPPs hold promise in achieving sustained release within the intestinal epithelium, thereby augmenting the therapeutic efficacy of targeted peptides.

Rapid detection of glycosylated hemoglobin levels by a microchip liquid chromatography system in gradient elution mode

BACKGROUND

The determination of glycosylated hemoglobin (HbA1c) is crucial for diabetes diagnosis and can provide more substantial results than the simple measurement of glycemia. While there is a lack of simple methods for the determination of HbA1c using a point-of-care test (POCT) compared to glycemia measurement. In particular, high-performance liquid chromatography (HPLC) is considered the current gold standard for determining HbA1c levels. However, commercial HPLC systems usually have some sort of disadvantages such as bulky size, high-cost and need for qualified operators. Therefore, there is an urgent demand to develop a portable, and fast HbA1c detection system consuming fewer reagents.

RESULTS

We present a novel microchip that integrates a micromixer, passive injector, packed column and detection cell. The integrated microchip, in which all the microstructures were formed in the CNC machining center through micro-milling, is small in size (30 mm × 70 mm × 10 mm), and can withstand 1600 psi of liquid pressure. The integrated design is beneficial to reduce the band broadening caused by dead volume. Based on the microchip, a microchip liquid chromatography (LC) system was built and applied to the analysis of HbA1c. The separation conditions of HbA1c in blood calibrator samples were optimized using the microchip LC system. Samples containing four levels of HbA1c were completely separated within 2 min in optimal gradient conditions, with an inaccuracy (<3.2 %), a coefficient of variation (c.v. < 2.1 %) and a correlation coefficient (R2 = 0.993), indicating excellent separation efficiency and reproducibility.

SIGNIFICANCE

The POCT of HbA1c is critical for diabetes diagnosis. The microchip chromatography system was developed for HbA1c determination, which contains an integrated microchip and works under a gradient elution. It surpasses existing chip technology in terms of separation performance and detection speed, providing a competitive advantage for POCT of HbA1c. It is considered one important step for realizing efficient portable systems for timely and accurate diabetes diagnosis.

Towards detection of structurally-diverse glycated epitopes in native proteins: Single-chain antibody directed to non-A1c epitope in human haemoglobin

Over 500 million people worldwide are affected by diabetes mellitus, a chronic disease that leads to high blood glucose levels and causes severe side effects. The predominant biological marker for diagnosis of diabetes is glycated haemoglobin (GHb). In human blood the predominant reducing sugar, glucose, irreversibly conjugates onto accessible amine groups within Hb. Most methods for diagnosis and monitoring of diabetes selectively detect N-terminal glycation at Val-1 on the β-globin chain, but not glycation at other sites. Detection of other glycated epitopes of GHb has the potential to provide new information on the extent, duration and timing of elevated glucose, facilitating personalised diagnosis and intelligent diabetic control. In this work, a new anti-GHb Fab antibody (Fab-1) specific for haemoglobin A1c (HbA1c) with nanomolar affinity was discovered via epitope-directed immunisation and phage display. A single chain variable fragment (scFv) antibody derived from Fab-1 retained affinity and specificity for HbA1c, and affinity was enhanced tenfold upon addition of an enhanced green fluorescent protein tag. Both the scFv and Fab-1 recognised an epitope within HbA1c that was distinct from β-Val-1, and our data suggest that this epitope may include glycation at Lys-66 in the β-globin chain. To our knowledge, this is the first report of an scFv/Fab anti-glycated epitope antibody that recognises a non-A1c epitope in GHb, and confirms that fructosamine attached to different, discrete glycation sites within the same protein can be resolved from one another by immunoassay.

Aptamer-Based Targeting of Cancer: A Powerful Tool for Diagnostic and Therapeutic Aims

Cancer is known as one of the most significant causes of death worldwide, and, in spite of novel therapeutic methods, continues to cause a considerable number of deaths. Targeted molecular diagnosis and therapy using aptamers with high affinity have become popular techniques for pathological angiogenesis and cancer therapy scientists. In this paper, several aptamer-based diagnostic and therapeutic techniques such as aptamer-nanomaterial conjugation, aptamer-drug conjugation (physically or covalently), and biosensors, which have been successfully designed for biomarkers, were critically reviewed. The results demonstrated that aptamers can potentially be incorporated with targeted delivery systems and biosensors for the detection of biomarkers expressed by cancer cells. Aptamer-based therapeutic and diagnostic methods, representing the main field of medical sciences, possess high potential for use in cancer therapy, pathological angiogenesis, and improvement of community health. The clinical use of aptamers is limited due to target impurities, inaccuracy in the systematic evolution of ligands via exponential enrichment (SELEX)stage process, and in vitro synthesis, making them unreliable and leading to lower selectivity for in vivo targets. Moreover, size, behavior, probable toxicity, low distribution, and the unpredictable behavior of nanomaterials in in vivo media make their usage in clinical assays critical. This review is helpful for the implementation of aptamer-based therapies which are effective and applicable for clinical use and the design of future studies.

Synthesis and Functions of Resistant Starch

Resistant starch (RS) has become a popular topic of research in recent years. Most scholars believe that there are 5 types of RS. However, accumulating evidence indicates that in addition to starch-lipid complexes, which are the fifth type of RS, complexes containing starch and other substances can also be generated. The physicochemical properties and physiologic functions of these complexes are worth exploring. New physiologic functions of several original RSs are constantly being discovered. Research shows that RS can provide health improvements in many patients with chronic diseases, including diabetes and obesity, and even has potential benefits for kidney disease and colorectal cancer. Moreover, RS can alter the short-chain fatty acids and microorganisms in the gut, positively regulating the body's internal environment. Despite the increase in its market demand, RS production remains limited. Upscaling RS production is thus an urgent requirement. This paper provides detailed insights into the classification, synthesis, and efficacy of RS, serving as a starting point for the future development and applications of RS based on the current status quo.

Trends in Quantification of HbA1c Using Electrochemical and Point-of-Care Analyzers

Glycated hemoglobin (HbA1c), one of the many variants of hemoglobin (Hb), serves as a standard biomarker of diabetes, as it assesses the long-term glycemic status of the individual for the previous 90-120 days. HbA1c levels in blood are stable and do not fluctuate when compared to the random blood glucose levels. The normal level of HbA1c is 4-6.0%, while concentrations > 6.5% denote diabetes. Conventionally, HbA1c is measured using techniques such as chromatography, spectroscopy, immunoassays, capillary electrophoresis, fluorometry, etc., that are time-consuming, expensive, and involve complex procedures and skilled personnel. These limitations have spurred development of sensors incorporating nanostructured materials that can aid in specific and accurate quantification of HbA1c. Various chemical and biological sensing elements with and without nanoparticle interfaces have been explored for HbA1c detection. Attempts are underway to improve the detection speed, increase accuracy, and reduce sample volumes and detection costs through different combinations of nanomaterials, interfaces, capture elements, and measurement techniques. This review elaborates on the recent advances in the realm of electrochemical detection for HbA1c detection. It also discusses the emerging trends and challenges in the fabrication of effective, accurate, and cost-effective point-of-care (PoC) devices for HbA1c and the potential way forward.

Recent Progress on Techniques in the Detection of Aflatoxin B1 in Edible Oil: A Mini Review

Contamination of agricultural products and foods by aflatoxin B1 (AFB1) is becoming a serious global problem, and the presence of AFB1 in edible oil is frequent and has become inevitable, especially in underdeveloped countries and regions. As AFB1 results from a possible degradation of aflatoxins and the interaction of the resulting toxic compound with food components, it could cause chronic disease or severe cancers, increasing morbidity and mortality. Therefore, rapid and reliable detection methods are essential for checking AFB1 occurrence in foodstuffs to ensure food safety. Recently, new biosensor technologies have become a research hotspot due to their characteristics of speed and accuracy. This review describes various technologies such as chromatographic and spectroscopic techniques, ELISA techniques, and biosensing techniques, along with their advantages and weaknesses, for AFB1 control in edible oil and provides new insight into AFB1 detection for future work. Although compared with other technologies, biosensor technology involves the cross integration of multiple technologies, such as spectral technology and new nano materials, and has great potential, some challenges regarding their stability, cost, etc., need further studies.

Advances in Nanomaterial-Based Biosensors for Determination of Glycated Hemoglobin

Diabetes is a major public health burden whose prevalence has been steadily increasing over the past decades. Glycated hemoglobin (HbA1c) is currently the gold standard for diagnostics and monitoring glycemic control in diabetes patients. HbA1c biosensors are often considered to be cost-effective alternatives for smaller testing laboratories or clinics unable to access other reference methods. Many of these sensors deploy nanomaterials as recognition elements, detection labels, and/or transducers for achieving sensitive and selective detection of HbA1c. Nanomaterials have emerged as important sensor components due to their excellent optical and electrical properties, tunable morphologies, and easy integration into multiple sensing platforms. In this review, we discuss the advantages of using nanomaterials to construct HbA1c sensors and various sensing strategies for HbA1c measurements. Key gaps between the current technologies with what is needed moving forward are also summarized.

Novel Sensor Approaches of Aflatoxins Determination in Food and Beverage Samples

The rapid quantification of toxins in food and beverage products has become a significant issue in overcoming and preventing many life-threatening diseases. Aflatoxin-contaminated food is one of the reasons for primary liver cancer and induces some tumors and cancer types. Advancements in biosensors technology have brought out different analysis methods. Therefore, the sensing performance has been improved for agricultural and beverage industries or food control processes. Nanomaterials are widely used for the enhancement of sensing performance. The enzymes, molecularly imprinted polymers (MIP), antibodies, and aptamers can be used as biorecognition elements. The transducer part of the biosensor can be selected, such as optical, electrochemical, and mass-based. This review explains the classification of major types of aflatoxins, the importance of nanomaterials, electrochemical, optical biosensors, and QCM and their applications for the determination of aflatoxins.

A Review of Electrochemical Sensors for the Detection of Glycated Hemoglobin

Glycated hemoglobin (HbA1c) is the gold standard for measuring glucose levels in the diagnosis of diabetes due to the excellent stability and reliability of this biomarker. HbA1c is a stable glycated protein formed by the reaction of glucose with hemoglobin (Hb) in red blood cells, which reflects average glucose levels over a period of two to three months without suffering from the disturbance of the outside environment. A number of simple, high-efficiency, and sensitive electrochemical sensors have been developed for the detection of HbA1c. This review aims to highlight current methods and trends in electrochemistry for HbA1c monitoring. The target analytes of electrochemical HbA1c sensors are usually HbA1c or fructosyl valine/fructosyl valine histidine (FV/FVH, the hydrolyzed product of HbA1c). When HbA1c is the target analyte, a sensor works to selectively bind to specific HbA1c regions and then determines the concentration of HbA1c through the quantitative transformation of weak electrical signals such as current, potential, and impedance. When FV/FVH is the target analyte, a sensor is used to indirectly determine HbA1c by detecting FV/FVH when it is hydrolyzed by fructosyl amino acid oxidase (FAO), fructosyl peptide oxidase (FPOX), or a molecularly imprinted catalyst (MIC). Then, a current proportional to the concentration of HbA1c can be produced. In this paper, we review a variety of representative electrochemical HbA1c sensors developed in recent years and elaborate on their operational principles, performance, and promising future clinical applications.

Recent Advancement in Biofluid-Based Glucose Sensors Using Invasive, Minimally Invasive, and Non-Invasive Technologies: A Review

Biosensors have potentially revolutionized the biomedical field. Their portability, cost-effectiveness, and ease of operation have made the market for these biosensors to grow rapidly. Diabetes mellitus is the condition of having high glucose content in the body, and it has become one of the very common conditions that is leading to deaths worldwide. Although it still has no cure or prevention, if monitored and treated with appropriate medication, the complications can be hindered and mitigated. Glucose content in the body can be detected using various biological fluids, namely blood, sweat, urine, interstitial fluids, tears, breath, and saliva. In the past decade, there has been an influx of potential biosensor technologies for continuous glucose level estimation. This literature review provides a comprehensive update on the recent advances in the field of biofluid-based sensors for glucose level detection in terms of methods, methodology and materials used.

Studying protein structure and function by native separation–mass spectrometry

Alterations in protein structure may have profound effects on biological function. Analytical techniques that permit characterization of proteins while maintaining their conformational and functional state are crucial for studying changes in the higher order structure of proteins and for establishing structure-function relationships. Coupling of native protein separations with mass spectrometry is emerging rapidly as a powerful approach to study these aspects in a reliable, fast and straightforward way. This Review presents the available native separation modes for proteins, covers practical considerations on the hyphenation of these separations with mass spectrometry and highlights the involvement of affinity-based separations to simultaneously obtain structural and functional information of proteins. The impact of these approaches is emphasized by selected applications addressing biomedical and biopharmaceutical research questions.

Ferrocene-Labelled Electroactive Aptamer-Based Sensors (Aptasensors) for Glycated Haemoglobin

Glycated haemoglobin (HbA1c) is a diagnostic biomarker for type 2 diabetes. Traditional analytical methods for haemoglobin (Hb) detection rely on chromatography, which requires significant instrumentation and is labour-intensive; consequently, miniaturized devices that can rapidly sense HbA1c are urgently required. With this research, we report on an aptamer-based sensor (aptasensor) for the rapid and selective electrochemical detection of HbA1c. Aptamers that specifically bind HbA1c and Hb were modified with a sulfhydryl and ferrocene group at the 3' and 5'-end, respectively. The modified aptamers were coated through sulfhydryl-gold self-assembly onto screen printed electrodes, producing aptasensors with built in electroactivity. When haemoglobin was added to the electrodes, the current intensity of the ferrocene in the sensor system was reduced in a concentration-dependent manner as determined by differential pulse voltammetry. In addition, electrochemical impedance spectroscopy confirmed selective binding of the analytes to the aptamer-coated electrode. This research offers new insight into the development of portable electrochemical sensors for the detection of HbA1c.

An overview of nanomaterial based biosensors for detection of Aflatoxin B1 toxicity in foods

Aflatoxin B1 (AFB1) is one of the most potent mycotoxin contaminating several foods and feeds. It suppresses immunity and consequently increases mutagenicity, carcinogenicity, teratogenicity, hepatotoxicity, embryonic toxicity and increasing morbidity and mortality. Continuous exposure of AFB1 causes liver damage and thus increases the prevalence of cirrhosis and hepatic cancer. This article was planned to provide understanding of AFB1 toxicity and provides future directions for fabrication of cost effective and user-friendly nanomaterials based analytical devices. In the present article various conventional (chromatographic & spectroscopic), modern (PCR & immunoassays) and nanomaterials based biosensing techniques (electrochemical, optical, piezoelectrical and microfluidic) are discussed alongwith their merits and demerits. Nanomaterials based amperometric biosensors are found to be more stable, selective and cost-effective analytical devices in comparison to other biosensors. But many unresolved issues about their stability, toxicity and metabolic fate needs further studies. In-depth studies are needed for development of advanced nanomaterials integrated biosensors for specific, sensitive and fast monitoring of AFB1 toxicity in foods. Integration of biosensing system with micro array technology for simultaneous and automated detection of multiple AFs in real samples is also needed. Concerted efforts are also required to reduce their possible hazardous consequences of nanomaterials based biosensors.

Glycated Hemoglobin and Methods for Its Point of Care Testing

Glycated hemoglobin (HbA1c) is a product of the spontaneous reaction between hemoglobin and elevated glucose levels in the blood. It is included among the so-called advanced glycation end products, of which is the most important for the clinical diagnosis of diabetes mellitus, and it can serve as an alternative to glycemia measurement. Compared to the diagnosis of diabetes mellitus by glycemia, the HbA1c level is less influenced by a short-term problem with diabetes compensation. Mass spectroscopy and chromatographic techniques are among the standard methods of HbA1c level measurement. Compared to glycemia measurement, there is lack of simple methods for diabetes mellitus diagnosis by means of the HbA1c assay using a point-of-care test. This review article is focused on the surveying of facts about HbA1c and its importance in diabetes mellitus diagnosis, and surveying standard methods and new methods suitable for the HbA1c assay under point-of-care conditions. Various bioassays and biosensors are mentioned and their specifications are discussed.

Effects of resistant starch on glycaemic control: a systematic review and meta-analysis

The effects of resistant starch on glycaemic control are controversial. In this study, a systematic review and meta-analysis of results from nineteen randomised controlled trials (RCT) was performed to illustrate the effects of resistant starch on glycaemic control. A literature search was conducted on PubMed, Scopus and Cochrane electronic databases for related publications from inception to 6 April 2020. Key inclusion criteria were: RCT; resistant starch as intervention substances and reporting glucose- and insulin-related endpoints. Exclusion criteria were: using type I resistant starch or a mixture of resistant starch and other functional food ingredients as intervention; using substances other than digestible starch as controls. The effect of resistant starch on fasting plasma glucose was significant (effect size (ES) –0·09 (95 % CI –0·13, −0·04) mmol/l, P = 0·001) compared with digestible starch. Subgroup analyses revealed that the ES was larger when the dosage of resistant starch was more than 28 g/d (ES –0·16 (95 % CI –0·24, –0·08) mmol/l, P < 0·001) or the intervention period was more than 8 weeks (ES –0·12 (95 % CI –0·18, –0·06) mmol/l, P < 0·001). The effect on homoeostatic model assessment (HOMA)-insulin resistance (IR) was significant (ES –0·33 (95 % CI –0·51, –0·14), P = 0·001). However, the effects on other insulin-related endpoints were not significant, including fasting plasma insulin, four endpoints from the frequently sampled intravenous glucose tolerance test (insulin sensitivity index, acute insulin response, disposition index and glucose effectiveness) and HOMA-β. The current study indicated moderate effects of resistant starch on improving glycaemic control.

Boronate affinity material-based sensors for recognition and detection of glycoproteins

This review comprehensively presents the current overview and development potential of BAMs-based sensors for glycoprotein recognition and detection.