Recent progress on the sensitive detection of cardiovascular disease markers by electrochemical-based biosensors

Insights into the prospects of nanobiomaterials in the treatment of cardiac arrhythmia

Cardiac arrhythmia, a disorder of abnormal electrical activity of the heart that disturbs the rhythm of the heart, thereby affecting its normal function, is one of the leading causes of death from heart disease worldwide and causes millions of deaths each year. Currently, treatments for arrhythmia include drug therapy, radiofrequency ablation, cardiovascular implantable electronic devices (CIEDs), including pacemakers, defibrillators, and cardiac resynchronization therapy (CRT). However, these traditional treatments have several limitations, such as the side effects of medication, the risks of device implantation, and the complications of invasive surgery. Nanotechnology and nanomaterials provide safer, effective and crucial treatments to improve the quality of life of patients with cardiac arrhythmia. The large specific surface area, controlled physical and chemical properties, and good biocompatibility of nanobiomaterials make them promising for a wide range of applications, such as cardiovascular drug delivery, tissue engineering, and the diagnosis and therapeutic treatment of diseases. However, issues related to the genotoxicity, cytotoxicity and immunogenicity of nanomaterials remain and require careful consideration. In this review, we first provide a brief overview of cardiac electrophysiology, arrhythmia and current treatments for arrhythmia and discuss the potential applications of nanobiomaterials before focusing on the promising applications of nanobiomaterials in drug delivery and cardiac tissue repair. An in-depth study of the application of nanobiomaterials is expected to provide safer and more effective therapeutic options for patients with cardiac arrhythmia, thereby improving their quality of life.

Rapid-Test Kit for Cardiac Troponin I: A Reliable Enzyme-Linked-Immuno-Substrate-Assay-Based Biosensor for Daily-Use Naked-Eye Detection and Pharmacokinetic Studies for Myocardial Infarction in Cardiovascular Disease

Myocardial infarction (MI) is a severe cardiovascular event that can lead to death. Cardiac troponin I (cTnI) is an MI biomarker in the circulation system; however, methods for detecting cTnI protein require substantial time, tedious operations, an expensive reader for translating signals, and a lot of reagents. This study aims to create a cTnI protein test kit with results easily distinguished by color differences, explicitly focusing on the resolution between different concentrations that eyes can discern. These results will aid in creating a commercial, portable, convenient, daily-use rapid-test kit. This study proposes a cTnI biosensor that the naked eye can perceive, performs diagnoses based on pattern color, does not require a reader machine, is easy to operate, and is portable. Our device shortens diagnosis time, has a 0.32-200 ng/mL quantitative analysis range in the human serum matrix, achieves a 0.32 ng/mL limit of detection, and exhibits many advantages compared to a traditional cTnI ELISA plate.

2D-Bio-FETs for sensitive detection of cardiovascular diseases

The biosensing industry has seen exponential growth in the past decade. Impact of biosensors in the current scenario cannot be overlooked. Cardiovascular diseases (CvDs) have been recognized as one of the major causes for millions of deaths globally. This mortality can be minimized by early and accurate detection/diagnosis of CvDs with the help of biosensing devices. This also presents a global market opportunity for the development of biosensors for CvDs. A vast variety of biosensing methods and devices have been developed for this problem. Most of commercially available platforms for CvD detection rely on optical (fluorometric and colorimetric analysis) techniques using serum biomarkers since optical testing is the gold standard in medical diagnosis. Field effect transistors-based biosensors, termed as Bio-FETs, are the upcoming devices for blood or serum analyte detection due to excellent sensitivity, low operational voltage, handheld device structure and simple chip-based operation. Further, the discovery of two dimensional (2D) materials and their integration with conventional FETs has improved the overvoltage problem, sensitivity and strict operating conditions as compared to conventional FETs. Graphene-FETs based biosensing devices have been proven as promising candidates due to their attractive properties. Despite the severe threat of CvDs which has further increased in post-covid era, the Bio-FET sensor studies in literature are still rare. In this review, we aim to provide a comprehensive view of all the multidisciplinary concepts related to 2D-BioFETs for CvDs. A critical review of the different platforms has been covered with detailed discussions of related studies to provide a clear concept and present status of 2D-BioFETs based CvD biosensors.

Advancements in electrochemical biosensing of cardiovascular disease biomarkers

Cardiovascular diseases (CVDs) stand as a predominant global health concern, introducing vast socioeconomic challenges. In addressing this pressing dilemma, enhanced diagnostic modalities have become paramount, positioning electrochemical biosensing as an instrumental innovation. This comprehensive review navigates the multifaceted terrain of CVDs, elucidating their defining characteristics, clinical manifestations, therapeutic avenues, and intrinsic risk factors. Notable emphasis is placed on pivotal diagnostic tools, spotlighting cardiac biomarkers distinguished by their unmatched clinical precision in terms of relevance, sensitivity, and specificity. Highlighting the broader repercussions of CVDs, there emerges an accentuated need for refined diagnostic strategies. Such an exploration segues into a profound analysis of electrochemical biosensing, encapsulating its foundational principles, diverse classifications, and integral components, notably recognition molecules and transducers. Contemporary advancements in biosensing technologies are brought to the fore, emphasizing pioneering electrode architectures, cutting-edge signal amplification processes, and the synergistic integration of biosensors with microfluidic platforms. At the core of this discourse is the demonstrated proficiency of biosensors in detecting cardiovascular anomalies, underpinned by empirical case studies, systematic evaluations, and clinical insights. As the narrative unfolds, it addresses an array of inherent challenges, spanning intricate technicalities, real-world applicability constraints, and regulatory considerations, finally, by casting an anticipatory gaze upon the future of electrochemical biosensing, heralding a new era of diagnostic tools primed to revolutionize cardiovascular healthcare.

Bioactive Metal-Organic Frameworks as a Distinctive Platform to Diagnosis and Treat Vascular Diseases

Vascular diseases (VDs) pose the leading threat worldwide due to high morbidity and mortality. The detection of VDs is commonly dependent on individual signs, which limits the accuracy and timeliness of therapies, especially for asymptomatic patients in clinical management. Therefore, more effective early diagnosis and lesion-targeted treatments remain a pressing clinical need. Metal-organic frameworks (MOFs) are porous crystalline materials formed by the coordination of inorganic metal ions and organic ligands. Due to their unique high specific surface area, structural flexibility, and functional versatility, MOFs are recognized as highly promising candidates for diagnostic and therapeutic applications in the field of VDs. In this review, the potential of MOFs to act as biosensors, contrast agents, artificial nanozymes, and multifunctional therapeutic agents in the diagnosis and treatment of VDs from the clinical perspective, highlighting the integration between clinical methods with MOFs is generalized. At the same time, multidisciplinary cooperation from chemistry, physics, biology, and medicine to promote the substantial commercial transformation of MOFs in tackling VDs is called for.

Electrochemical and Plasmonic Detection of Myocardial Infarction Using Microfluidic Biochip Incorporated with Mesoporous Nanoscaffolds

This paper reports a microfluidic device for the electrochemical and plasmonic detection of cardiac myoglobin (cMb) and cardiac troponin I (cTnI) with noticeable limits of detection (LoD) as low as a few picograms per milliliter (pg/mL) ranges, achieved in a short detection time. The device features two working electrodes, each with a mesoporous Ni3V2O8 nanoscaffold grafted with reduced graphene oxide (rGO) that improves the interaction of diffusing analyte molecules with the sensing surface by providing a high surface area and reaction kinetics. Electrochemical studies reveal sensitivities as high as 9.68 μA ng/mL and a LoD of 2.0 pg/mL for cTnI, and 8.98 μA ng/mL and 4.7 pg/mL for cMb. Additionally, the surface plasmon resonance (SPR) studies demonstrate a low-level LoD of 8.8 pg/mL for cMb and 7.3 pg/mL for cTnI. The dual-modality sensor enables dynamic tracking of kinetic antigen-antibody interactions during sensing, self-verification through providing signals of two modes, and reduced false readout. This study demonstrates the complementary nature of the electrochemical and SPR modes in biosensing, with the electrochemical mode being highly sensitive and the SPR mode providing superior tracking of molecular recognition behaviors. The presented sensor represents a significant innovation in cardiovascular disease management and can be applied to monitor other clinically important biomolecules.

Advancements in magnetic nanoparticle-based biosensors for point-of-care testing

The significance of point-of-care testing (POCT) in early clinical diagnosis and personalized patient care is increasingly recognized as a crucial tool in reducing disease outbreaks and improving patient survival rates. Within the realm of POCT, biosensors utilizing magnetic nanoparticles (MNPs) have emerged as a subject of substantial interest. This review aims to provide a comprehensive evaluation of the current landscape of POCT, emphasizing its growing significance within clinical practice. Subsequently, the current status of the combination of MNPs in the Biological detection has been presented. Furthermore, it delves into the specific domain of MNP-based biosensors, assessing their potential impact on POCT. By combining existing research and spotlighting pivotal discoveries, this review enhances our comprehension of the advancements and promising prospects offered by MNP-based biosensors in the context of POCT. It seeks to facilitate informed decision-making among healthcare professionals and researchers while also promoting further exploration in this promising field of study.

Molecular imprinting technology for biomedical applications

Molecularly imprinted polymers (MIPs), a type of biomimetic material, have attracted considerable interest owing to their cost-effectiveness, good physiochemical stability, favourable specificity and selectivity for target analytes, and widely used for various biological applications. It was demonstrated that MIPs with significant selectivity towards protein-based targets could be applied in medicine, diagnostics, proteomics, environmental analysis, sensors, various in vivo and/or in vitro applications, drug delivery systems, etc. This review provides an overview of MIPs dedicated to biomedical applications and insights into perspectives on the application of MIPs in newly emerging areas of biotechnology. Many different protocols applied for the synthesis of MIPs are overviewed in this review. The templates used for molecular imprinting vary from the minor glycosylated glycan-based structures, amino acids, and proteins to whole bacteria, which are also overviewed in this review. Economic, environmental, rapid preparation, stability, and reproducibility have been highlighted as significant advantages of MIPs. Particularly, some specialized MIPs, in addition to molecular recognition properties, can have high catalytic activity, which in some cases could be compared with other bio-catalytic systems. Therefore, such MIPs belong to the class of so-called 'artificial enzymes'. The discussion provided in this manuscript furnishes a comparative analysis of different approaches developed, underlining their relative advantages and disadvantages highlighting trends and possible future directions of MIP technology.

A large population-based study on the prevalence of electrocardiographic abnormalities: A result of Mashhad stroke and heart atherosclerotic disorder cohort study

BACKGROUND

Twelve-lead electrocardiogram (ECG) is a common and inexpensive tool for the diagnostic workup of patients with suspected cardiovascular disease, both in clinical and epidemiological settings. The present study was designed to evaluate ECG abnormalities in Mashhad population.

METHODS

ECGs were taken as part of MASHAD cohort study (phase1) and were coded according to the Minnesota coding criteria. Data were analyzed using SPSS.

RESULTS

Total 9035 ECGs were available for final analysis including 3615 (40.0%) male and 5420 (60.0%) female. Among ECG abnormalities precordial Q wave, major T-wave abnormalities, inferior Q wave, sinus bradycardia, and left axis deviation were the most prevalent abnormalities. The frequency of precordial and inferior Q wave, inferior QS pattern, major and minor ST abnormalities, major and minor T abnormalities, Wolff-Parkinson-White and Brugada pattern, sinus bradycardia, sinus tachycardia, left axis deviation, ST elevation, and tall T wave were significantly different between two genders. Moreover, the frequency of Q wave in precordial and aVL leads, QS pattern in precordial and inferior leads, major and minor T-wave abnormalities, Wolff-Parkinson-White, atrial fibrillation, sinus bradycardia, left axis deviation, and ST elevation were significantly different in different age groups. A comparison of the heart rate, P-wave duration, and QRS duration between men and women indicated that there was a significant difference.

CONCLUSIONS

Our finding indicated that the prevalence ECG abnormalities are different between men and women and also it varied in different age groups.

Electrochemical immunosensor AuNPs/NG-PANI/ITO-PET for the determination of BDNF in depressed mice serum

A novel electrochemical immunosensor was developed for highly sensitive detection of brain-derived neurotrophic factor (BDNF), a well-known depression marker. The immunosensor was fabricated by modifying indium tin oxide-coated polyethylene terephthalate (ITO-PET) with N-doped graphene-polyaniline (NG-PANI) and gold nanoparticles (AuNPs) to enhance the conductivity and protein loading capacity. Subsequently, BDNF was immobilized onto the electrode surface via gold-sulfur bonds, followed by the attachment of biotinylated antibody (Biotin-Ab) and horseradish peroxidase-avidin (HRP-Avidin) to create the final immunosensor (HRP-Avidin-Biotin-Ab-BDNF-AuNPs/NG-PANI/ITO-PET). The proposed immunosensor exhibited a linear range of determination (0.781-400 pg/mL) with a low limit of detection (LOD) of 0.261 pg/mL (S/N = 3) and excellent reproducibility (RSD = 1.4%) and stability (92.7%, RSD = 3.1%). Additionally, the immunosensor demonstrated good anti-interference performance and good recovery (98.1-107%). To evaluate the practical utility of the immunosensor, BDNF levels were quantified in the serum of mice with depression induced by chronic unpredictable mild stress (CUMS). The results indicated that the serum BDNF levels were significantly decreased in the depression model group compared with the control group, highlighting the potential of this immunosensor for clinical detection of BDNF in depression diagnosis and treatment.

Recent advancements of nanomodified electrodes - Towards point-of-care detection of cardiac biomarkers

The increasing number of deaths from cardiovascular diseases has become a substantial concern in both developed and underdeveloped countries. Rapid and on-site monitoring of this disease is urgently important to control, prevent and make awareness of public health. Recently, a lot of focus has been placed on nanomaterials and modify these nanomaterials have been explored to detect cardiac biomarkers. By implementing biosensors that are modified with novel recognition elements and more stable nanomaterials, the use of electrochemistry for point-of-care devices is more realistic every day. This review focuses on the current state of nanomaterials conjugated biorecognition elements (enzyme integrated with nanomaterials, antibody conjugated nanomaterials and aptamer conjugated nanomaterials) for electrochemical cardiovascular disease detection. Specifically, a lot of attention has been given to the trends toward more stable biosensors that have increased the potential to be used as point-of-care devices for the detection of cardiac biomarkers due to their high stability and specificity. Moreover, the recent progress on biomolecule-free electrochemical nanosensors for cardiovascular disease detection has been considered. At last, the possibility and drawbacks of some of these techniques for point-of-care cardiac device development in the future have been discussed.

Recent Advances in Impedimetric Biosensors Focusing on Myocardial Infarction Diagnosis

Acute myocardial infarction is the most common cardiovascular disease and 85% of cardiovascular disease-related deaths are associated with it. The variation in the cardiac troponin concentration is considered as the most significant judge index for acute myocardial infarction diagnosis. Here, a comprehensive insights is given about the impedimetric methods as powerful electrochemical biosensing platforms for cardiac troponin evaluation. Focusing on nano materials, various impedimetric techniques including faradaic and non-faradaic techniques and different transducer modification techniques are addressed. The steps taken by each of the studied platforms to solve the existing problems are discussed and their advantages and drawbacks are highlighted. A glance at the provided table is given a mind into the features of each impedimetric sensors and their comparison are provided.

A Robust Framework Combining Image Processing and Deep Learning Hybrid Model to Classify Cardiovascular Diseases Using a Limited Number of Paper-Based Complex ECG Images

Heart disease can be life-threatening if not detected and treated at an early stage. The electrocardiogram (ECG) plays a vital role in classifying cardiovascular diseases, and often physicians and medical researchers examine paper-based ECG images for cardiac diagnosis. An automated heart disease prediction system might help to classify heart diseases accurately at an early stage. This study aims to classify cardiac diseases into five classes with paper-based ECG images using a deep learning approach with the highest possible accuracy and the lowest possible time complexity. This research consists of two approaches. In the first approach, five deep learning models, InceptionV3, ResNet50, MobileNetV2, VGG19, and DenseNet201, are employed. In the second approach, an integrated deep learning model (InRes-106) is introduced, combining InceptionV3 and ResNet50. This model is developed as a deep convolutional neural network capable of extracting hidden and high-level features from images. An ablation study is conducted on the proposed model altering several components and hyperparameters, improving the performance even further. Before training the model, several image pre-processing techniques are employed to remove artifacts and enhance the image quality. Our proposed hybrid InRes-106 model performed best with a testing accuracy of 98.34%. The InceptionV3 model acquired a testing accuracy of 90.56%, the ResNet50 89.63%, the DenseNet201 88.94%, the VGG19 87.87%, and the MobileNetV2 achieved 80.56% testing accuracy. The model is trained with a k-fold cross-validation technique with different k values to evaluate the robustness further. Although the dataset contains a limited number of complex ECG images, our proposed approach, based on various image pre-processing techniques, model fine-tuning, and ablation studies, can effectively diagnose cardiac diseases.

Development of molecularly imprinted polymer based phase boundaries for sensors design (review)

Achievements in polymer chemistry enables to design artificial phase boundaries modified by imprints of selected molecules and some larger structures. These structures seem very useful for the design of new materials suitable for affinity chromatography and sensors. In this review, we are overviewing the synthesis of molecularly imprinted polymers (MIPs) and the applicability of these MIPs in the design of affinity sensors. Such MIP-based layers or particles can be used as analyte-recognizing parts for sensors and in some cases they can replace very expensive compounds (e.g.: antibodies, receptors etc.), which are recognizing analyte. Many different polymers can be used for the formation of MIPs, but conducing polymers shows the most attractive capabilities for molecular-imprinting by various chemical compounds. Therefore, the application of conducting polymers (e.g.: polypyrrole, polyaniline, polythiophene, poly(3,4-ethylenedioxythiophene), and ortho-phenylenediamine) seems very promising. Polypyrrole is one of the most suitable for the development of MIP-based structures with molecular imprints by analytes of various molecular weights. Overoxiation of polypyrrole enables to increase the selectivity of polypyrrole-based MIPs. Methods used for the synthesis of conducting polymer based MIPs are overviewed. Some methods, which are applied for the transduction of analytical signal, are discussed, and challenges and new trends in MIP-technology are foreseen.

The Footprint of Kynurenine Pathway in Cardiovascular Diseases

Kynurenine pathway is the main route of tryptophan metabolism and produces several metabolites with various biologic properties. It has been uncovered that several cardiovascular diseases are associated with the overactivation of kynurenine pathway and kynurenine and its metabolites have diagnostic and prognostic value in cardiovascular diseases. Furthermore, it was found that several kynurenine metabolites can differently affect cardiovascular health. For instance, preclinical studies have shown that kynurenine, xanthurenic acid and cis-WOOH decrease blood pressure; kynurenine and 3-hydroxyanthranilic acid prevent atherosclerosis; kynurenic acid supplementation and kynurenine 3-monooxygenase (KMO) inhibition improve the outcome of stroke. Indoleamine 2,3-dioxygenase (IDO) overactivity and increased kynurenine levels improve cardiac and vascular transplantation outcomes, whereas exacerbating the outcome of myocardial ischemia, post-ischemic myocardial remodeling, and abdominal aorta aneurysm. IDO inhibition and KMO inhibition are also protective against viral myocarditis. In addition, dysregulation of kynurenine pathway is observed in several conditions such as senescence, depression, diabetes, chronic kidney disease (CKD), cirrhosis, and cancer closely connected to cardiovascular dysfunction. It is worth defining the exact effect of each metabolite of kynurenine pathway on cardiovascular health. This narrative review is the first review that separately discusses the involvement of kynurenine pathway in different cardiovascular diseases and dissects the underlying molecular mechanisms.

Biosensors Based on Bio-Functionalized Semiconducting Metal Oxides

Immobilization of biomaterials is a very important task in the development of biofuel cells and biosensors. Some semiconducting metal-oxide-based supporting materials can be used in these bioelectronics-based devices. In this article, we are reviewing some functionalization methods that are applied for the immobilization of biomaterials. The most significant attention is paid to the immobilization of biomolecules on the surface of semiconducting metal oxides. The improvement of biomaterials immobilization on metal oxides and analytical performance of biosensors by coatings based on conducting polymers, self-assembled monolayers and lipid membranes is discussed.

Gold Nanoparticles Based Optical Biosensors for Cancer Biomarker Proteins: A Review of the Current Practices

Cancer prognosis depends on the early detection of the disease. Gold nanoparticles (AuNPs) have attracted much importance in biomedical research due to their distinctive optical properties. The AuNPs are easy to fabricate, biocompatible, surface controlled, stable, and have surface plasmonic properties. The AuNPs based optical biosensors can intensely improve the sensitivity, specificity, resolution, penetration depth, contrast, and speed of these devices. The key optical features of the AuNPs based biosensors include localized surface plasmon resonance (LSPR), SERS, and luminescence. AuNPs based biomarkers have the potential to sense the protein biomarkers at a low detection level. In this review, the fabrication techniques of the AuNPs have been reviewed. The optical biosensors based on LSPR, SERS, and luminescence are also evaluated. The application of these biosensors for cancer protein detection is discussed. Distinct examples of cancer research that have a substantial impact on both scientific and clinical research are presented.

A Comprehensive Review of Metal-Organic Framework: Synthesis, Characterization, and Investigation of Their Application in Electrochemical Biosensors for Biomedical Analysis

Many studies have addressed electrochemical biosensors because of their simple synthesis process, adjustability, simplification, manipulation of materials' compositions and features, and wide ranges of detection of different kinds of biomedical analytes. Performant electrochemical biosensors can be achieved by selecting materials that enable faster electron transfer, larger surface areas, very good electrocatalytic activities, and numerous sites for bioconjugation. Several studies have been conducted on the metal-organic frameworks (MOFs) as electrode modifiers for electrochemical biosensing applications because of their respective acceptable properties and effectiveness. Nonetheless, researchers face challenges in designing and preparing MOFs that exhibit higher stability, sensitivity, and selectivity to detect biomedical analytes. The present review explains the synthesis and description of MOFs, and their relative uses as biosensors in the healthcare sector by dealing with the biosensors for drugs, biomolecules, as well as biomarkers with smaller molecular weight, proteins, and infectious disease.

Electrochemically Deposited Molecularly Imprinted Polymer-Based Sensors

This review is dedicated to the development of molecularly imprinted polymers (MIPs) and the application of MIPs in sensor design. MIP-based biological recognition parts can replace receptors or antibodies, which are rather expensive. Conducting polymers show unique properties that are applicable in sensor design. Therefore, MIP-based conducting polymers, including polypyrrole, polythiophene, poly(3,4-ethylenedioxythiophene), polyaniline and ortho-phenylenediamine are frequently applied in sensor design. Some other materials that can be molecularly imprinted are also overviewed in this review. Among many imprintable materials conducting polymer, polypyrrole is one of the most suitable for molecular imprinting of various targets ranging from small organics up to rather large proteins. Some attention in this review is dedicated to overview methods applied to design MIP-based sensing structures. Some attention is dedicated to the physicochemical methods applied for the transduction of analytical signals. Expected new trends and horizons in the application of MIP-based structures are also discussed.

A voyage from 3D to 4D printing in nanomedicine and healthcare: part II

Recent advancements in biomedical tissue engineering are gaining wide interest. Implementing biology of living cells and organisms using technological solutions such as incorporating 4D printing and bioprinting for tissue regeneration/tissue repair, organ regeneration, early diagnosis of deadly diseases (particularly cancer, cardiac disorders and tuberculosis) has successfully opened a new generation of biomedical research. The present review primarily addresses the clinical application of 4D printing and bioprinting techniques for applications such as early detection of diseases and drug delivery. Notably, this review continues the discussion from part I regarding published informative data, in vitro and in vivo findings, commercial biosensors for early disease diagnosis, drug delivery and current challenges in 4D printing/bioprinting.

Molybdenum Disulfide-Based Nanoprobes: Preparation and Sensing Application

The use of nanoprobes in sensors is a popular way to amplify their analytical performance. Coupled with two-dimensional nanomaterials, nanoprobes have been widely used to construct fluorescence, electrochemical, electrochemiluminescence (ECL), colorimetric, surface enhanced Raman scattering (SERS) and surface plasmon resonance (SPR) sensors for target molecules' detection due to their extraordinary signal amplification effect. The MoS₂ nanosheet is an emerging layered nanomaterial with excellent chemical and physical properties, which has been considered as an ideal supporting substrate to design nanoprobes for the construction of sensors. Herein, the development and application of molybdenum disulfide (MoS₂)-based nanoprobes is reviewed. First, the preparation principle of MoS₂-based nanoprobes was introduced. Second, the sensing application of MoS₂-based nanoprobes was summarized. Finally, the prospect and challenge of MoS₂-based nanoprobes in future were discussed.

A Highly Sensitive Graphene-based Field Effect Transistor for the Detection of Myoglobin

Biomedical applications adapt Nano technology-based transistors as a key component in the biosensors for diagnosing life threatening diseases like Covid-19, Acute myocardial infarction (AMI), etc. The proposed work introduces a new biosensor, based on Graphene Field Effect Transistor (GFET), which is used in the diagnosis of Myoglobin (Mb) in human blood. Graphene-based biosensors are faster, more precise, stronger, and more trustworthy. A GFET is created in this study for the detection of myoglobin biomarker at various low concentrations. Because graphene is sensitive to a variety of biomarker materials, it can be employed as a gate material. When constructed Graphene FET is applied to myoglobin antigens, it has a significant response. The detection level for myoglobin is roughly 30 fg/ml, which is quite high. The electrical behavior of the GFET-based biosensor in detecting myoglobin marker is ideal for Lab-on-Chip platforms and Cardiac Point-of-Care Diagnosis.

Nanomaterial-based aptasensors as an efficient substitute for cardiovascular disease diagnosis: Future of smart biosensors

As a major cause of deaths in developed countries, cardiovascular disease (CVD) has been a big burden for human health systems. Its early and rapid detection is crucial to efficiently apply appropriate on time therapy and to ultimately reduce the associated mortality rate. Aptamers, known as single-stranded DNA/RNA or oligonucleotides containing receptors and/or catalytic properties, have been widely employed in biodetection platforms due to their beneficial properties. Like antibodies, aptamers have served as artificial target receptors in affinity biosensors. Currently, advanced biosensors with improved sensitivity and specificity are fabricated by the synergistic combination of aptamers and diverse nanomaterials. Herein, we review the current development and applications of nanomaterial-based aptasensors for the recognition of CVD biomarkers with special emphasis on electrochemical and optical technologies. The performance of aptasensors has been assessed further in terms of key quality assurance metrics along with discussions on recent technologies developed for the amplification of signals with enhanced portability.

Troponin I as a Biomarker for Early Detection of Acute Myocardial Infarction

Acute myocardial infarction (AMI) as the main cause of death among cardiovascular diseases is defined as a deficiency of oxygen that generates irreversible tissue necrosis in the heart muscle. For diagnostic measurements, the evaluation of cardiac markers concentration like cardiac triponin I (cTnI) in plasma or saliva thought the use of biosensors has become one of the most commonly applied strategies for prognosis of AMI. Inside this diagnostic devices, electrochemical (ECL) ones have been highly encourage to improve sensing capabilities by using different materials and configurations. In this review, the authors presents a summary of studies that involves cTnI detection using ECL biosensors modified with nanomaterials and related mechanisms.

Development of a Point-of-Care System Based on White Light Reflectance Spectroscopy: Application in CRP Determination

The development of methods and miniaturized systems for fast and reliable quantitative determinations at the Point-of-Care is a top challenge and priority in diagnostics. In this work, a compact bench-top system, based on White Light Reflectance Spectroscopy, is introduced and evaluated in an application with high clinical interest, namely the determination of C-Reactive protein (CRP) in human blood samples. The system encompassed all the necessary electronic and optical components for the performance of the assay, while the dedicated software provided the sequence and duration of assay steps, the reagents flow rate, the real-time monitoring of sensor response, and data processing to deliver in short time and accurately the CPR concentration in the sample. The CRP assay included two steps, the first comprising the binding of sample CRP onto the chip immobilized capture antibody and the second the reaction of the surface immunosorbed CRP molecules with the detection antibody. The assay duration was 12 min and the dynamic range was from 0.05 to 200 μg/mL, covering both normal values and acute inflammation incidents. There was an excellent agreement between CRP values determined in human plasma samples using the developed device with those received for the same samples by a standard diagnostic laboratory method.

Carbon nanomaterials for cardiovascular theranostics: Promises and challenges

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Heart attack and stroke cause irreversible tissue damage. The currently available treatment options are limited to "damage-control" rather than tissue repair. The recent advances in nanomaterials have offered novel approaches to restore tissue function after injury. In particular, carbon nanomaterials (CNMs) have shown significant promise to bridge the gap in clinical translation of biomaterial based therapies. This family of carbon allotropes (including graphenes, carbon nanotubes and fullerenes) have unique physiochemical properties, including exceptional mechanical strength, electrical conductivity, chemical behaviour, thermal stability and optical properties. These intrinsic properties make CNMs ideal materials for use in cardiovascular theranostics. This review is focused on recent efforts in the diagnosis and treatment of heart diseases using graphenes and carbon nanotubes. The first section introduces currently available derivatives of graphenes and carbon nanotubes and discusses some of the key characteristics of these materials. The second section covers their application in drug delivery, biosensors, tissue engineering and immunomodulation with a focus on cardiovascular applications. The final section discusses current shortcomings and limitations of CNMs in cardiovascular applications and reviews ongoing efforts to address these concerns and to bring CNMs from bench to bedside.

Evaluation of PAMAM Dendrimers (G3, G4, and G5) in the Construction of a SPR-based Immunosensor for Cardiac Troponin T

An immunosensor was developed using a SAM of an alkanethiol associated with PAMAM(G4) dendrimers based on surface plasmon resonance (SPR) to enhance the sensitivity for troponin T detection in blood samples. The feasibility of using three-dimensional platforms based on dendrimers for the development of immunosensors was demonstrated by evaluating three different generations of these dendrimers (G3, G4, and G5) to detect troponin T. The results showed the efficiency of these 3D platforms in anchoring biomolecules, amplifying the detection of troponin T. The sandwich assay showed good performance for troponin T detection, using secondary monoclonal antibodies, in the concentration range of 5 - 300 ng mL^-1 (0.14 - 8.67 nmol L^-1), R² = 0.991, with the LOD of 3.6 ng mL^-1. The sandwich assay's applicability was demonstrated by evaluating a secondary polyclonal antibody's performance in the concentration range of 3 - 30 ng mL^-1, R² = 0.998, with the LOD of 0.98 ng mL^-1. The immunosensor was applied to determine troponin T in blood plasma samples from healthy patients, with an average recovery of 88 to 104%. The performance of the SPR-based immunosensor indicates reliable results and is expected to contribute to the rapid diagnosis of heart attack, with reduced costs.

Imprinted Fluorescent Cellulose Membranes for the On-Site Detection of Myoglobin in Biological Media

In this work, the conjugation of molecularly imprinted polymers (MIPs) to quantum dots (QDs) was successfully applied in the assembly of an imprinted cellulose membrane [hydroxy ethyl cellulose (HEC)/MIP@QDs] for the specific recognition of the cardiac biomarker myoglobin (Myo) as a sensitive, user-friendly, and portable system with the potential for point-of-care (POC) applications. The concept is to use the MIPs as biorecognition elements, previously prepared on the surface of semiconductor cadmium telluride QDs as detection particles. The fluorescent quenching of the membrane occurred with increasing concentrations of Myo, showing linearity in the interval range of 7.39-291.3 pg/mL in a1000-fold diluted human serum. The best membrane showed a linear response below the cutoff values for myocardial infarction (23 ng/mL), a limit of detection of 3.08 pg/mL, and an imprinting factor of 1.65. The incorporation of the biorecognition element MIPs on the cellulose substrate brings an approach toward a portable and user-friendly device in a sustainable manner. Overall, the imprinted membranes display good stability and selectivity toward Myo when compared with the nonimprinted membranes (HEC/NIP@QDs) and have the potential to be applied as a sensitive system for Myo detection in the presence of other proteins. Moreover, the conjugation of MIPs to QDs increases the sensitivity of the system for an optical label-free detection method, reaching concentration levels with clinical significance.

Electrochemical sensing of blood proteins for mild traumatic brain injury (mTBI) diagnostics and prognostics: towards a point-of-care application

Traumatic Brain Injury (TBI) being one of the principal causes of death and acquired disability in the world imposes a large burden on the global economy. Mild TBI (mTBI) is particularly challenging to assess due to the frequent lack of well-pronounced post-injury symptoms. However, if left untreated mTBI (especially when repetitive) can lead to serious long-term implications such as cognitive and neuropathological disorders. Computer tomography and magnetic resonance imaging commonly used for TBI diagnostics require well-trained personnel, are costly, difficult to adapt for on-site measurements and are not always reliable in identifying small brain lesions. Thus, there is an increasing demand for sensitive point-of-care (POC) testing tools in order to aid mTBI diagnostics and prediction of long-term effects. Biomarker quantification in body fluids is a promising basis for POC measurements, even though establishing a clinically relevant mTBI biomarker panel remains a challenge. Actually, a minimally invasive, rapid and reliable multianalyte detection device would allow the efficient determination of injury biomarker release kinetics and thus support the preclinical evaluation and clinical validation of a proposed biomarker panel for future decentralized in vitro diagnostics. In this respect electrochemical biosensors have recently attracted great attention and the present article provides a critical study on the electrochemical protocols suggested in the literature for detection of mTBI-relevant protein biomarkers. The authors give an overview of the analytical approaches for transduction element functionalization, review recent technological advances and highlight the key challenges remaining in view of an eventual integration of the proposed concepts into POC diagnostic solutions.

An electrochemical biosensor for direct detection of hepatitis C virus

This paper is aimed at the development of a biosensor for direct detection of Hepatitis C virus (HCV) surface antigen: envelope protein (E2). A recombinant LEL fragment of biological cell receptor CD81 and two short synthetic peptides imitating the fragment of LEL sequence of CD81 (linear and loop-like peptides) capable of specific binding to E2 were tested as molecular recognition elements of the biosensor. For this purpose the selected ligands were immobilized to the surface of a screen-printed electrode utilized as an electrochemical sensor platform. The immobilization parameters such as the ligand concentration and the immobilization time were carefully optimized for each ligand. Differential pulse voltammetry used to evaluate quantitatively binding of E2 to the ligands revealed their similar binding affinity towards E2. Thus, the linear peptide was selected as a less expensive and easily prepared ligand for the HCV biosensor preparation. The resulting HCV biosensor demonstrated selectivity towards E2 in the presence of interfering protein, conalbumin. Moreover, it was found that the prepared biosensor effectively detected E2 bound to hepatitis C virus-mimetic particles (HC VMPs) at LOD value of 2.1∙10^-5 mg/mL both in 0.01 M PBS solution (pH 7.4) and in simulated blood plasma.

Nanodiagnostic Attainments and Clinical Perspectives on C-Reactive Protein: Cardiovascular Disease Risks Assessment

Cardiovascular disease (CVD) has become one of the leading causes of morbidity and mortality in both men and women. According to the World Health Organization (WHO), ischemic heart disease is the major issue due to the narrowing of the coronary artery by plaque formation on the artery wall, which causes an inadequate flow of oxygen and blood to the heart and is called 'coronary artery disease'. The CVD death rate increased by up to 15% in 2016 (~17.6 million) compared to the past decade. This tremendous increment urges the development of a suitable biomarker for rapid and early diagnosis. Currently, C-reactive protein (CRP) is considered an outstanding biomarker for quick and accurate outcomes in clinical analyses. Various techniques have also been used to diagnose CVD, including surface plasmon resonance (SPR), colorimetric assay, enzyme-linked immunosorbent assay (ELISA), fluoro-immunoassays, chemiluminescent assays, and electrical measurements. This review discusses such diagnostic strategies and how current, cutting-edge technologies have enabled the development of high-performance detection methodologies. Concluding remarks have been made concerning the clinical significance and the use of nanomaterial in medical diagnostics towards nanotheranostics.

Advances in Molecularly Imprinted Polymers Based Affinity Sensors (Review)

Recent challenges in biomedical diagnostics show that the development of rapid affinity sensors is very important issue. Therefore, in this review we are aiming to outline the most important directions of affinity sensors where polymer-based semiconducting materials are applied. Progress in formation and development of such materials is overviewed and discussed. Some applicability aspects of conducting polymers in the design of affinity sensors are presented. The main attention is focused on bioanalytical application of conducting polymers such as polypyrrole, polyaniline, polythiophene and poly(3,4-ethylenedioxythiophene) ortho-phenylenediamine. In addition, some other polymers and inorganic materials that are suitable for molecular imprinting technology are also overviewed. Polymerization techniques, which are the most suitable for the development of composite structures suitable for affinity sensors are presented. Analytical signal transduction methods applied in affinity sensors based on polymer-based semiconducting materials are discussed. In this review the most attention is focused on the development and application of molecularly imprinted polymer-based structures, which can replace antibodies, receptors, and many others expensive affinity reagents. The applicability of electrochromic polymers in affinity sensor design is envisaged. Sufficient biocompatibility of some conducting polymers enables to apply them as "stealth coatings" in the future implantable affinity-sensors. Some new perspectives and trends in analytical application of polymer-based semiconducting materials are highlighted.

Charge Transfer and Biocompatibility Aspects in Conducting Polymer-Based Enzymatic Biosensors and Biofuel Cells

Charge transfer (CT) is a very important issue in the design of biosensors and biofuel cells. Some nanomaterials can be applied to facilitate the CT in these bioelectronics-based devices. In this review, we overview some CT mechanisms and/or pathways that are the most frequently established between redox enzymes and electrodes. Facilitation of indirect CT by the application of some nanomaterials is frequently applied in electrochemical enzymatic biosensors and biofuel cells. More sophisticated and still rather rarely observed is direct charge transfer (DCT), which is often addressed as direct electron transfer (DET), therefore, DCT/DET is also targeted and discussed in this review. The application of conducting polymers (CPs) for the immobilization of enzymes and facilitation of charge transfer during the design of biosensors and biofuel cells are overviewed. Significant attention is paid to various ways of synthesis and application of conducting polymers such as polyaniline, polypyrrole, polythiophene poly(3,4-ethylenedioxythiophene). Some DCT/DET mechanisms in CP-based sensors and biosensors are discussed, taking into account that not only charge transfer via electrons, but also charge transfer via holes can play a crucial role in the design of bioelectronics-based devices. Biocompatibility aspects of CPs, which provides important advantages essential for implantable bioelectronics, are discussed.

Conducting Polymers in the Design of Biosensors and Biofuel Cells

Fast and sensitive determination of biologically active compounds is very important in biomedical diagnostics, the food and beverage industry, and environmental analysis. In this review, the most promising directions in analytical application of conducting polymers (CPs) are outlined. Up to now polyaniline, polypyrrole, polythiophene, and poly(3,4-ethylenedioxythiophene) are the most frequently used CPs in the design of sensors and biosensors; therefore, in this review, main attention is paid to these conducting polymers. The most popular polymerization methods applied for the formation of conducting polymer layers are discussed. The applicability of polypyrrole-based functional layers in the design of electrochemical biosensors and biofuel cells is highlighted. Some signal transduction mechanisms in CP-based sensors and biosensors are discussed. Biocompatibility-related aspects of some conducting polymers are overviewed and some insights into the application of CP-based coatings for the design of implantable sensors and biofuel cells are addressed. New trends and perspectives in the development of sensors based on CPs and their composites with other materials are discussed.

Ultrasensitive Detection Platform of Disease Biomarkers Based on Recombinase Polymerase Amplification with H-Sandwich Aptamers

The detection of trace protein biomarkers is essential in the diagnostic field. Protein detection systems ranging from widely used enzyme-linked immunosorbent assays to simple, inexpensive approaches, such as lateral flow immunoassays, play critical roles in medical and drug research. Despite continuous progress, current systems are insufficient for the diagnosis of diseases that require high sensitivity. In this study, we developed a heterogeneous sandwich-type sensing platform based on recombinase polymerase amplification using DNA aptamers specific to the target biomarker. Only the DNA bound to the target in the form of a heterogeneous sandwich was selectively amplified, and the fluorescence signal of an intercalating dye added before the amplification reaction was detected, thereby enabling high specificity and sensitivity. We applied this method for the detection of protein biomarkers for various infectious diseases including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and observed attomolar-level detection of biomarkers and low cross-reactivity between different viruses. We also confirmed detection efficiency of the proposed method using clinical samples. These results demonstrate that the proposed sensing platform can be used to diagnose various diseases requiring high sensitivity, specificity, and accuracy.

An impedimetric biosensor system based on disposable graphite paper electrodes: Detection of ST2 as a potential biomarker for cardiovascular disease in human serum

In present study, we developed a highly sensitive, electrochemical immunosensor based on fullerene C₆₀-modified disposable graphite paper (GP) electrode for determination of Suppression of Tumorigenicity 2 (ST2) in human serum. The synthesis of the ST2 immunosensor was monitored with electrochemical impedance spectroscopy (EIS), cyclic voltammetry (CV) techniques and single frequency impedance (SFI) technique which is utilized for the specific interaction between anti-ST2 and ST2 antigen. Moreover, the morphological alteration of each GP surface was examined by scanning electron microscopy (SEM), SEM-energy dispersive X-ray spectroscopy (EDX) and atomic force microscopy (AFM). All parameters such as fullerene C₆₀ concentration, antibody concentration and antibody incubation time were optimized. Analytical characteristics such as linear determination range, repeatability, reproducibility, regeneration and surface coverage were determined for the immunosensor. The ST2 electrochemical immunosensor had excellent repeatability, reproducibility and a wide detection range (from 0.1 fg mL^-1 to 100 fg mL^-1). The proposed immunosensor also had low limit of detection (LOD) and limit of quantification (LOQ) values of 0.124 fg mL^-1 and 0.414 fg mL^-1, respectively. The proposed immunosensor was applied to real samples to test applicability in clinical practice.

Acute Myocardial Infarction Biosensor: A Review From Bottom Up

Acute myocardial infarction (AMI) is a cardiovascular disease that is produced due to a deficiency of oxygen generating irreversible damage in the heart muscle. In diagnosis, electrocardiogram (ECG) investigation has been the main method but is insufficient, so approaches like the measurement of biomarkers levels in plasma or saliva have become one of the most commonly applied strategies for prognosis of AMI, as some of them are specifically related to a heart attack. Many tests are carrying on to determine biological markers changes, but usually, they present disadvantages related to time consumption and laborious work. To overcome the issues, researchers around the world have been developing different ways to enhance detection through the use of biosensors. These diagnostic devices have a biological sensing element associated to a physicochemical transducer that can be made from different materials and configurations giving place to different kinds of detection: Electrical/Electrochemical, Optical and Mechanical. In this review, the authors presents relevant investigations related to the most important biomarkers and biosensors used for their detection having in mind the nanotechnology participation in the process through the application of nanostructures as a good choice for device configuration.

Machine Learning Strategy for Gut Microbiome-Based Diagnostic Screening of Cardiovascular Disease

Cardiovascular disease (CVD) is the number one leading cause for human mortality. Besides genetics and environmental factors, in recent years, gut microbiota has emerged as a new factor influencing CVD. Although cause-effect relationships are not clearly established, the reported associations between alterations in gut microbiota and CVD are prominent. Therefore, we hypothesized that machine learning (ML) could be used for gut microbiome-based diagnostic screening of CVD. To test our hypothesis, fecal 16S ribosomal RNA sequencing data of 478 CVD and 473 non-CVD human subjects collected through the American Gut Project were analyzed using 5 supervised ML algorithms including random forest, support vector machine, decision tree, elastic net, and neural networks. Thirty-nine differential bacterial taxa were identified between the CVD and non-CVD groups. ML modeling using these taxonomic features achieved a testing area under the receiver operating characteristic curve (0.0, perfect antidiscrimination; 0.5, random guessing; 1.0, perfect discrimination) of ≈0.58 (random forest and neural networks). Next, the ML models were trained with the top 500 high-variance features of operational taxonomic units, instead of bacterial taxa, and an improved testing area under the receiver operating characteristic curves of ≈0.65 (random forest) was achieved. Further, by limiting the selection to only the top 25 highly contributing operational taxonomic unit features, the area under the receiver operating characteristic curves was further significantly enhanced to ≈0.70. Overall, our study is the first to identify dysbiosis of gut microbiota in CVD patients as a group and apply this knowledge to develop a gut microbiome-based ML approach for diagnostic screening of CVD.

NiO/SWCNTs coupled with an ionic liquid composite for amplified carbon paste electrode; A feasible approach for improving sensing ability of adrenalone and folic acid in dosage form

Electrochemical sensors have shown great appeal for the simultaneous analysis of pharmaceutical compounds. In this way, the presence study described first electroanalytical sensor for simultaneous determination of adrenalone and folic acid. The two-amplified voltammetric sensor was developed by modifying carbon paste electrode (CPE) with NiO/SWCNTs composite and 1-butyl-3-methylimidazolium methanesulfonate (1B3MIMS) and used for simultaneous determination of adrenalone and folic acid. The NiO/SWCNTs was synthesised by a fast and low-cost precipitation strategy and then characterised by EDS, FESEM and XRD methods. The results confirmed a particle size range of ⁓ 26.93-33.87 nm for NiO nanoparticle decorated at SWCNTs. The cyclic voltammetric investigation showed that oxidation potentials of adrenalone and folic acid depend on changing the pH value. The maximum oxidation current for the simultaneous analysis of two compounds occurred at pH = 7.0. In this condition, the sensor showed linear dynamic range 0.01-400 μM and 0.3-350 μM for determination of adrenalone and folic acid, respectively. The NiO/SWCNTs/1B3MIMS/CPE was then used as an ultrasensitive electroanalytical sensor for determination of adrenalone and folic acid in injection samples with recovery ratio between 98.2-103.66 %.

A new nickel-based co-crystal complex electrocatalyst amplified by NiO dope Pt nanostructure hybrid; a highly sensitive approach for determination of cysteamine in the presence of serotonin

A highly sensitive electrocatalytic sensor was designed and fabricated by the incorporation of NiO dope Pt nanostructure hybrid (NiO–Pt–H) as conductive mediator, bis (1,10 phenanthroline) (1,10-phenanthroline-5,6-dione) nickel(II) hexafluorophosphate (B,1,10,P,1,10, PDNiPF6), and electrocatalyst into carbon paste electrode (CPE) matrix for the determination of cysteamine. The NiO–Pt–H was synthesized by one-pot synthesis strategy and characterized by XRD, elemental mapping analysis (MAP), and FESEM methods. The characterization data, which confirmed good purity and spherical shape with a diameter of ⁓ 30.64 nm for the synthesized NiO–Pt–H. NiO–Pt–H/B,1,10, P,1,10, PDNiPF6/CPE, showed an excellent catalytic activity and was used as a powerful tool for the determination of cysteamine in the presence of serotonin. The NiO–Pt–H/B,1,10, P,1,10, PDNiPF6/CPE was able to solve the overlap problem of the two drug signals and was used for the determination of cysteamine and serotonin in concentration ranges of 0.003–200 µM and 0.5–260 µM with detection limits of 0.5 nM and 0.1 µM, using square wave voltammetric method, respectively. The NiO–Pt–H/B,1,10,P,1,10,PDNiPF6/CPE showed a high-performance ability for the determination of cysteamine and serotonin in the drug and pharmaceutical serum samples with the recovery data of 98.1–103.06%.

Recent Trends in Electrochemical Sensors for Vital Biomedical Markers Using Hybrid Nanostructured Materials

This work provides a succinct insight into the recent developments in electrochemical quantification of vital biomedical markers using hybrid metallic composite nanostructures. After a brief introduction to the biomarkers, five types of crucial biomarkers, which require timely and periodical monitoring, are shortlisted, namely, cancer, cardiac, inflammatory, diabetic and renal biomarkers. This review emphasizes the usage and advantages of hybrid nanostructured materials as the recognition matrices toward the detection of vital biomarkers. Different transduction methods (fluorescence, electrophoresis, chemiluminescence, electrochemiluminescence, surface plasmon resonance, surface-enhanced Raman spectroscopy) reported for the biomarkers are discussed comprehensively to present an overview of the current research works. Recent advancements in the electrochemical (amperometric, voltammetric, and impedimetric) sensor systems constructed with metal nanoparticle-derived hybrid composite nanostructures toward the selective detection of chosen vital biomarkers are specifically analyzed. It describes the challenges involved and the strategies reported for the development of selective, sensitive, and disposable electrochemical biosensors with the details of fabrication, functionalization, and applications of hybrid metallic composite nanostructures.