Disposable electrochemical immunosensor for cortisol determination in human saliva

Ultrasensitive electrochemical sensor for detection of salivary cortisol in stress conditions

A natural stress response induces elevated cortisol levels in biological fluids, such as saliva. While current sensor technologies can detect cortisol in real time, their sensitivity and reliability for human subjects have not been assured. This is due to relatively low concentrations of salivary cortisol, which fluctuate throughout the day and vary significantly between individuals. To address these challenges, we present an improved electrochemical biosensor leveraging graphene's exceptional conductivity and physicochemical properties. A 1-pyrenebutyric acid N-hydroxysuccinimide ester (PBASE-NHS)-modified commercial graphene foam (GF) electrode is presented to realize an ultra-sensitive biosensor for cortisol detection directly in human saliva. The biosensor fabrication process entails the attachment of anti-cortisol monoclonal antibodies (mAb-cort) onto a PBASE-NHS/GF electrode through noncovalent immobilization on the vertically stratified graphene foam electrode surface. This unique immobilization strategy preserves graphene's structural integrity and electrical conductivity while facilitating antibody immobilization. The binding of cortisol to immobilized mAb-cort is read out via differential pulse voltammetry using ferri/ferro redox reactions. The immunosensor demonstrates an exceptional dynamic range of 1.0 fg mL-1 to 10,000 pg mL-1 (R2 = 0.9914) with a detection limit of 0.24 fg mL-1 (n = 3) for cortisol. Furthermore, we have established the reliability of cortisol sensors in monitoring human saliva. We have also performed multiple modes of validation, one against the established enzyme-linked immunosorbent assay (ELISA) and a second by a third-party service Salimetric on 16 student volunteers exposed to different stress levels, showing excellent correlation (r = 0.9961). These findings suggest the potential for using mAb-cort/PBASE-NHS/GF-based cortisol electrodes for monitoring salivary cortisol in the general population.

Tip-Enhanced Sub-Femtomolar Steroid Immunosensing via Micropyramidal Flexible Conducting Polymer Electrodes for At-Home Monitoring of Salivary Sex Hormones

Noninvasive testing and continuous monitoring of ultralow-concentration hormones in biofluids have attracted increasing interest for health management and personalized medicine, in which saliva could fulfill the demand. Steroid sex hormones such as progesterone (P4) and β-estradiol (E2) are crucial for female wellness and reproduction; however, their concentrations in saliva can vary down to sub-pM and constantly fluctuate over several orders of magnitude. This remains a major obstacle toward user-friendly and reliable monitoring at home with low-cost flexible biosensors. Herein we introduce a 3D micropyramidal electrode architecture to address such challenges and achieve an ultrasensitive flexible electrochemical immunosensor with sub-fM-level detection capability of salivary sex hormones within a few minutes. This is enabled by micropyramidal electrode arrays consisting of a poly(3,4-ethylenedioxythiophene):poly(4-styrenesulfonate) (PEDOT:PSS) thin film as the coating layer and electrochemically decorated gold nanoparticles (AuNPs) to improve the antibody immobilization. The enhanced mass transport around the 3D tips provided by the micropyramidal architecture is discovered to improve the detection limit by 3 orders of magnitude, pushing it to as low as ∼100 aM for P4 and ∼20 aM for E2, along with a wide linear range up to μM. Accordingly, these hormones down to sub-fM in >1000-fold-diluted saliva samples can be accurately measured by the printed soft immunosensors, thus allowing at-home testing through simple saliva dilution to minimize the interfering substances instead of centrifugation. Finally, monitoring of the female ovarian hormone cycle of both P4 and E2 is successfully demonstrated based on the centrifuge-free saliva testing during a period of 4 weeks. This ultrasensitive and soft 3D microarchitected electrode design is believed to provide a universal platform for a diverse variety of applications spanning from accurate clinical diagnostics and counselling and in vivo detection of bioactive species to environmental and food quality tracing.

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.

A Novel Cortisol Immunosensor Based on a Hafnium Oxide/Silicon Structure for Heart Failure Diagnosis

Assessing cortisol levels in human bodies has become essential to diagnose heart failure (HF). In this work, we propose a salivary cortisol detection strategy as part of an easily integrable lab-on-a-chip for detection of HF biomarkers. Our developed capacitive immunosensor based on hafnium oxide (HfO2)/silicon structure showed good linearity between increasing cortisol concentration and the charge-transfer resistance/capacitance. Moreover, the developed biosensor was demonstrated to be highly selective toward cortisol compared to other HF biomarkers such as tumor necrosis factor (TNF-α) and N-terminal pro-brain natriuretic peptide (NT-proBNP). The precision of our developed biosensor was evaluated, and the difference between the determined cortisol concentration in saliva and its expected one is <18%.

Advances on Hormones and Steroids Determination: A Review of Voltammetric Methods since 2000

This article presents advances in the electrochemical determination of hormones and steroids since 2000. A wide spectrum of techniques and working electrodes have been involved in the reported measurements in order to obtain the lowest possible limits of detection. The voltammetric and polarographic techniques, due to their sensitivity and easiness, could be used as alternatives to other, more complicated, analytical assays. Still, growing interest in designing a new construction of the working electrodes enables us to prepare new measurement procedures and obtain lower limits of detection. A brief description of the measured compounds has been presented, along with a comparison of the obtained results.

Hosseini I, Lu Y, Yedire SG, Mahshid SS, Tabatabaiefar MA, Liang C, Mahshid S. A Versatile Biomimic Nanotemplating Fluidic Assay for Multiplex Quantitative Monitoring of Viral Respiratory Infections and Immune Responses in Saliva and Blood

The last pandemic exposed critical gaps in monitoring and mitigating the spread of viral respiratory infections at the point-of-need. A cost-effective multiplexed fluidic device (NFluidEX), as a home-test kit analogous to a glucometer, that uses saliva and blood for parallel quantitative detection of viral infection and body's immune response in an automated manner within 11 min is proposed. The technology integrates a versatile biomimetic receptor based on molecularly imprinted polymers in a core-shell structure with nano gold electrodes, a multiplexed fluidic-impedimetric readout, built-in saliva collection/preparation, and smartphone-enabled data acquisition and interpretation. NFluidEX is validated with Influenza A H1N1 and SARS-CoV-2 (original strain and variants of concern), and achieves low detection limit in saliva and blood for the viral proteins and the anti-receptor binding domain (RBD) Immunoglobulin G (IgG) and Immunoglobulin M (IgM), respectively. It is demonstrated that nanoprotrusions of gold electrodes are essential for the fine templating of antibodies and spike proteins during molecular imprinting, and differentiation of IgG and IgM in whole blood. In the clinical setting, NFluidEX achieves 100% sensitivity and 100% specificity by testing 44 COVID-positive and 25 COVID-negative saliva and blood samples on par with the real-time quantitative polymerase chain reaction (p < 0.001, 95% confidence) and the enzyme-linked immunosorbent assay.

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.

Tunable and Sensitive Detection of Cortisol Using Anisotropic Phosphorene with a Surface Plasmon Resonance Technique: Numerical Investigation

Tunable and ultrasensitive surface plasmon resonance (SPR) sensors are highly desirable for monitoring stress hormones such as cortisol, a steroid hormone formed in the human body’s adrenal glands. This paper describes the detection of cortisol using a bimetallic SPR sensor based on a highly anisotropic two-dimensional material, i.e., phosphorene. Thicknesses of bi-metal layers, such as copper (Cu) and nickel (Ni), are optimized to achieve strong SPR excitation. The proposed sensor is rotated in-plane with a rotation angle (φ) around the z-axis to obtain the phosphorene anisotropic behavior. The performance parameters of the sensor are demonstrated in terms of higher sensitivity (347.78 °/RIU), maximum angular figure of merit (FOM* = 1780.3), and finer limit of detection (0.026 ng/mL). Furthermore, a significant penetration depth (203 nm) is achieved for the proposed sensor. The obtained results of the above parameters indicate that the proposed sensor outperforms the previously reported papers in the literature on cortisol detection using the SPR technique.

Effects of Nature-Based Intervention in Occupational Health Care on Stress – A Finnish Pilot Study Comparing Stress Evaluation Methods

Purpose

To assess methodology and its limitations for measuring effects of nature-based intervention (NBI).

Patients and Methods

Participants were 11 middle-aged female health care workers with lowered capacity to work. NBI included six group appointments in six months study period. Heart rate variability (HRV) and self-reported pain and work exhaustion were measured pre-post study period. Salivary α-amylase samples were collected immediately before and after three individual interventions. Salivary cortisol samples were collected on the same three interventions, on three consecutive days starting from the day of intervention, to assess (a) month effect (pre-post study period) and (b) day effect (intervention day vs non-intervention day).

Results

Individual interventions resulted in increase in α-amylase activity. However, the average fold increase decreased from the 3.05 ± 1.20 of the first intervention to 1.91 ± 1.00 and 1.46 ± 0.77 in the second and third intervention, respectively (p < 0.001). Cortisol concentrations were lower on intervention days vs non-intervention days, the difference being indicative (p = 0.050). Pain and work exhaustion decreased during the study period, as well as HRV, although any of these changes was not statistically significant.

Conclusion

For a large-scale study, it would be ideal to select assays for both major pathways: hypothalamic-pituitary-adrenal axis can be measured by cortisol, whereas response via autonomic nervous system can be measured by HRV, when roles of sympathetic and parasympathetic nervous systems can be pinpointed separately. Salivary α-amylase can be used when continuous monitoring is not possible. Psychological well-being of participants should be surveyed, as well as their activities and moods on sampling days recorded.

COVID-19 diagnosis by SARS-CoV-2 Spike protein detection in saliva using an ultrasensitive magneto-assay based on disposable electrochemical sensor

The outbreak of the COVID-19 pandemic, caused by Severe Acute Respiratory Syndrome of Coronavirus 2 (SARS-CoV-2), has fueled the search for diagnostic tests aiming at the control and reduction of the viral transmission. The main technique used for diagnosing the Coronavirus disease (COVID-19) is the reverse transcription-polymerase chain reaction (RT-PCR) technique. However, considering the high number of cases and the underlying limitations of the RT-PCR technique, especially with regard to accessibility and cost of the test, one does not need to overemphasize the need to develop new and less expensive testing techniques that can aid the early diagnosis of the disease. With that in mind, we developed an ultrasensitive magneto-assay using magnetic beads and gold nanoparticles conjugated to human angiotensin-converting enzyme 2 (ACE2) peptide (Gln²⁴-Gln⁴²) for the capturing and detection of SARS-CoV-2 Spike protein in human saliva. The technique applied involved the use of a disposable electrochemical device containing eight screen-printed carbon electrodes which allow the simultaneous analysis of eight samples. The magneto-assay exhibited an ultralow limit of detection of 0.35 ag mL^-1 for the detection of SARS-CoV-2 Spike protein in saliva. The magneto-assay was tested in saliva samples from healthy and SARS-CoV-2-infected individuals. In terms of efficiency, the proposed technique - which presented a sensitivity of 100.0% and specificity of 93.7% for SARS-CoV-2 Spike protein-exhibited great similarity with the RT-PCR technique. The results obtained point to the application potential of this simple, low-cost magneto-assay for saliva-based point-of-care COVID-19 diagnosis.

COVID-19 diagnosis by SARS-CoV-2 Spike protein detection in saliva using an ultrasensitive magneto-assay based on disposable electrochemical sensor

The outbreak of the COVID-19 pandemic, caused by Severe Acute Respiratory Syndrome of Coronavirus 2 (SARS-CoV-2), has fueled the search for diagnostic tests aiming at the control and reduction of the viral transmission. The main technique used for diagnosing the Coronavirus disease (COVID-19) is the reverse transcription-polymerase chain reaction (RT-PCR) technique. However, considering the high number of cases and the underlying limitations of the RT-PCR technique, especially with regard to accessibility and cost of the test, one does not need to overemphasize the need to develop new and less expensive testing techniques that can aid the early diagnosis of the disease. With that in mind, we developed an ultrasensitive magneto-assay using magnetic beads and gold nanoparticles conjugated to human angiotensin-converting enzyme 2 (ACE2) peptide (Gln²⁴-Gln⁴²) for the capturing and detection of SARS-CoV-2 Spike protein in human saliva. The technique applied involved the use of a disposable electrochemical device containing eight screen-printed carbon electrodes which allow the simultaneous analysis of eight samples. The magneto-assay exhibited an ultralow limit of detection of 0.35 ag mL^-1 for the detection of SARS-CoV-2 Spike protein in saliva. The magneto-assay was tested in saliva samples from healthy and SARS-CoV-2-infected individuals. In terms of efficiency, the proposed technique - which presented a sensitivity of 100.0% and specificity of 93.7% for SARS-CoV-2 Spike protein-exhibited great similarity with the RT-PCR technique. The results obtained point to the application potential of this simple, low-cost magneto-assay for saliva-based point-of-care COVID-19 diagnosis.

Molecularly imprinted electrochemical aptasensor based on functionalized graphene and nitrogen-doped carbon quantum dots for trace cortisol assay

This paper proposes a novel electrochemical aptasensor that integrates molecular imprinting techniques for trace analysis of cortisol. This sensor is based on functionalized graphene and nitrogen-doped carbon quantum dots. The morphology and structure of the modified electrode were characterized by scanning electron microscopy and Raman spectroscopy. The functional monomer aptamer and the template molecule cortisol were adsorbed on the electrode by electrostatic adsorption to construct an imprinted sensing platform. Under the optimal conditions, such as the concentration of template molecule, the ratio of template to functional monomer, the elution and adsorption time, the sensor exhibits linearity and a low detection limit of 10^-12-10^-8 M and 3.3 × 10^-13 M, which is more sensitive than other reported cortisol analysis methods. In addition, this sensor can realize the determination of cortisol in salivary samples with high recovery values, showing great development potential in the field of life sciences.

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.

Impedimetric determination of cortisol using screen-printed electrode with aptamer-modified magnetic beads

A non-invasive aptamer-based electrochemical biosensor using disposable screen-printed graphene electrodes (SPGEs) was developed for simple, rapid, and sensitive determination of cortisol levels. Selective detection of cortisol based on a label-free electrochemical assay was achieved by specific recognition of the cortisol DNA aptamer (CApt). The CApt was modified with streptavidin magnetic beads (MBs) before simple immobilization onto the electrode surface using a neodymium magnet. The electrochemical behavior of the aptamer-based biosensor was assessed by using electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV) (vs Ag/AgCl). The specific binding between cortisol and CApt resulted in a decrease in charge transfer resistance (R_ct) from EIS using [Fe(CN)₆]^3-/4- with increasing cortisol concentration. Under optimal conditions, a linear range from 0.10 to 100 ng/mL with a low detection limit (3SD/slope) of 2.1 pg/mL was obtained. Furthermore, the proposed biosensing system exhibited a satisfactory recovery in the range 97.4-109.2% with 5.7-6.6% RSD in spiked artificial human sweat. Regarding the applications of this tool, the aptamer-based biosensor has potential to be a versatile and point-of-care (POC) device for simple, sensitive, selective, disposable, and low-cost cortisol detection.

Portable electrochemical carbon cloth analysis device for differential pulse anodic stripping voltammetry determination of Pb2

A novel electrochemical carbon cloth (CC) analysis device (eCAD) is proposed for the determination of Pb²⁺ in environmental water samples, which was assembled using a single-step functional CC as both the sensing and the substrate material. The modified CC was characterized by scanning electron microscopy, X-ray photoelectron spectroscopy, Raman spectra, and electrochemical impedance spectroscopy. The increase in electrochemical activity is due to the increased defective extent and excellent electrochemical activity of CC. Under optimum conditions (viz. a pH value of 4.5, deposition time of 160 s), the sensor is capable of determining Pb²⁺ by differential pulse anodic stripping voltammetry (DPASV) at a typical working potential of - 1.0 V (vs. Ag/AgCl). Response is linear from 5.0 × 10^-9 to 3.0 × 10^-6 M Pb²⁺, and the detection limit is 4.8 nM (at S/N = 3). The sensor was successfully applied to the determination of Pb²⁺ in real samples, with apparent recoveries from 96.0 to 102.0% and a relative standard deviation of less than 3.4%. In addition, the integration of the sensor with signal collection components has enabled us to realize on-site analysis of Pb²⁺, which is highlighted as a new generation of electrode platform for the development of a portable analysis device.Graphical abstract.

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.

On The Application of SiO2/SiC Grating on Ag for High-Performance Fiber Optic Plasmonic Sensing of Cortisol Concentration

This paper reports on high-accuracy simulation of a grating structure based fiber optic plasmonic sensor for salivary cortisol sensing. Gratings of SiO2 and SiC (one at a time) in combination with a thin Ag layer are considered to be in direct contact with analyte medium (solutions containing different concentrations of cortisol) considering that the groove regions are also filled with analyte. The optimization of Ag layer thickness is carried out to achieve maximum power loss (PL) corresponding to cortisol concentration variation. The variation of PL (in dB) spectra with the angle of incidence (α) is the sensing mechanism of the proposed scheme. Sensing performance is extensively analyzed in terms of sensitivity, limit-of-detection (LOD) and figure-of-merit (FOM) that incorporates both the sensitivity and the width of the corresponding PL curves. While the sensitivity and FOM values are significantly large, the results also reveal that in angular interrogation mode (AIM), an average LOD of 9.9 pg/mL and 9.8 pg/mL is obtained for SiO2 and SiC-based sensor designs, respectively. When the intensity interrogation method (IIM) in place of AIM is considered, an average LOD of 22.6 fg/mL and 68.17 fg/mL is obtained for SiO2 and SiC-based sensor designs, respectively. LOD (with IIM, in particular) is considerably better than the present-state-of-art related to cortisol monitoring. Pragmatic model for possible practical implementation of sensor scheme is also discussed. The involvement of optical fiber in the proposed sensor design makes it possible to implement it as a flexible sensor or for wearable solution for cortisol detection via sweat monitoring as well as for measuring cortisol level in aquaculture tanks where concentration levels are much lower than 10 ng/mL.

Electrochemical immunoassay for the detection of stress biomarkers

A rapid electrochemical immunoassay method was developed to detect and measure stress biomarkers (cortisol and cortisone) in two biological samples (Zebrafish whole-body and artificial saliva). This methodology utilizes an immunoassay approach taking advantage of the lock and key mechanism that is related to the antibody-antigen interaction depending on the reliable immobilization of the antibody labelled with ferrocene tags (Ab-Fc) on a modified tin-doped indium oxide (ITO) electrode using electrochemical instrumentation to build a POC platform. The limit of detection (LOD) obtained for this biosensor was 1.03 pg ml⁻¹ for cortisol and 0.68 pg ml⁻¹ for cortisone, respectively. The correlation coefficient was 0.9852 and 0.9841 for cortisol and cortisone, respectively with a linear concentration from (0-50 ng ml⁻¹) which covers the standard levels of stress hormones in both selected biological samples. The incubation time was investigated and 30 min was found to be the optimum incubation time. This time would be acceptable for the POC system as total process time can be determined within 35 min.

Electrochemical Detection and Quantification of Lithium Ions in Authentic Human Saliva Using LiMn2O4-Modified Electrodes

We report an electrochemical sensor for the detection of lithium ions (Li⁺) in authentic human saliva at lithium manganese oxide (LiMn₂O₄)-modified glassy carbon electrodes (LMO-GCEs) and screen-printed electrodes (LMO-SPEs). The sensing strategy is based on an initial galvanostatic delithiation of LMO followed by linear stripping voltammetry (LSV) to detect the reinsertion of Li⁺ in the analyte. The process was investigated using powder X-ray diffraction and voltammetry. LSV measurements reveal a measurable lower limit of 50.0 μM in both LiClO₄ aqueous solutions and synthetic saliva samples, demonstrating the applicability of the proposed analytical method down to low Li⁺ concentrations. Four different samples of authentic human saliva were then analyzed with the established sensing strategy using LMO-SPEs, showing good linearity over a concentration range up to 5.0 mM Li⁺ with high reproducibility (RSD < 7%) and applicability for routine monitoring purposes. The total time needed to analyze a sample is less than 3 min.

The Role of Electrochemical Immunosensors in Clinical Analysis

An immunosensor is a kind of affinity biosensor based on interactions between an antigen and specific antigen immobilized on a transducer surface. Immunosensors possess high selectivity and sensitivity due to the specific binding between antibody and corresponding antigen, making them a suitable platform for several applications especially in the medical and bioanalysis fields. Electrochemical immunosensors rely on the measurements of an electrical signal recorded by an electrochemical transducer and can be classed as amperometric, potentiometric, conductometric, or impedimetric depending on the signal type. Among the immunosensors, electrochemical immunosensors have been more perfected due to their simplicity and, especially their ability to be portable, and for in situ or automated detection. This review addresses the potential of immunosensors destined for application in clinical analysis, especially cancer biomarker diagnosis. The emphasis is on the approaches used to fabricate electrochemical immunosensors. A general overview of recent applications of the developed electrochemical immunosensors in the clinical approach is described.

Electrochemical methods for detection of biomarkers of Chronic Obstructive Pulmonary Disease in serum and saliva

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death nowadays, and its underdiagnosis is still a great challenge. More effective diagnosis method is in urgent need since the traditional spirometry has many limitations in the practical application. The electrochemical (EC) detection methods have their unique advantages of high accuracy, short response time and easy integration of the system. In this review, recent works on the EC methods for COPD biomarkers including interleukin 6 (IL-6), interleukin 8 (IL-8) and C-reactive protein (CRP) are summarized. Five types of EC methods are highlighted in this study, as enzyme-labelled immunosensors, nanoparticle-labelled immunosensors, capacitive or impedimetric immunosensors, magnetoimmunosensors, and field effect transistor (FET) immunosensors. To date, EC immunosensors have been exhibiting high analytical performance with a detection limit that can achieve several pg/mL or even lower. The simplicity of EC immunosensors makes them a perfect solution for a future point-of-care device to use in settings for COPD diagnosis and follow-up. Nevertheless, more efforts need to be paid on the simultaneous detection of multiple biomarkers, a demand for the clinical diagnosis, and processes of assay simplification towards achieving one-step detection.

Advances in electrochemical immunosensors

Immunosensors are compact tools on which antibody and antigen interactions are formed. The specific interaction between antibody and antigen is detected by using a transducer and an electrical signal is measured. This specific interaction between these molecules makes immunosensor very attractive for several applications in different fields. Electrochemical immunosensors are successful devices in selective and sensitive detection of several analytes. Electrochemical transducing methods such as voltammetric, potentiometric, conductometric or impedimetric have been utilized in different applications due to their excellent properties such as being low-cost, sensitivity and simplicity. In this chapter, the fundamentals of electrochemical immunosensors are summarized and different applications in food, environmental and clinical analyses are investigated and discussed.

Amperometric sandwich immunoassay for determination of myeloperoxidase by using gold nanoparticles encapsulated in graphitized mesoporous carbon

An ultrasensitive sandwich-type electrochemical immunosensor was developed for the amperometric determination of serum myeloperoxidase (MPO). The method is making use of (a) gold nanoparticles encapsulated in graphitized mesoporous carbons (AuNP@GMC); and (b) horseradish peroxidase (HRP) labeled secondary antibody (HRP@Ab₂) immobilized on AuNP@GMC. MPO capture antibody (Ab₁) was immobilized on the electrode modified with an AuNP-graphene oxide nanocomposite. The sandwich immunoreaction leads to the formation of the complex composed of Ab₁, MPO, and HRP@Ab₂. An amplified electrochemical signal is produced by electrocatalytic reduction of H₂O₂ (at a typical voltage of -0.18 V vs. Ag/AgCl) in the presence of enzymatically oxidized thionine. The peak current of thionine was measured using differential pulse voltammetry. Under optimized steady-state conditions, the reduction peak increases in the 1 to 300 pg.mL^-1 MPO concentration range, and the detection limit is 0.1 pg.mL^-1 (at S/N = 3). Graphical abstract Schematic presentation of AuNP-GO based sandwich-type electrochemical immunoassay for the determination of myeloperoxidase by using gold nanoparticles encapsulated in graphitized mesoporous carbons (AuNP@GMC) as a carrier for horseradish peroxidase (HRP) labeled secondary antibody (HRP@Ab₂).