A C-reactive protein immunosensor based on platinum nanowire / titania nanotube composite sensitized electrochemiluminescence

Smartphone-enabled flow injection amperometric glucose monitoring based on a screen-printed carbon electrode modified with PEDOT@PB and a GOx@PPtNPs@MWCNTs nanocomposite

This study presents a modified screen-printed carbon electrode (SPCE) to determine glucose in a custom-built flow injection system. The biosensor was constructed by immobilizing glucose oxidase on porous platinum nanoparticles decorated on multi-walled carbon nanotubes (GOx@PPtNPs@MWCTNs). The fabrication of the biosensor was completed by coating the GOx@PPtNPs@MWCTNs nanocomposite on an SPCE modified with a nanocomposite of poly(3,4-ethylenedioxythiophene) and Prussian blue (GOx@PPtNPs@MWCTNs/PEDOT@PB/SPCE). The fabricated electrode accurately measured hydrogen peroxide (H2O2), the byproduct of the GOx-catalyzed oxidation of glucose, and was then applied as a glucose biosensor. The glucose response was amperometrically determined from the PB-mediated reduction of H2O2 at an applied potential of -0.10 V in a flow injection system. Under optimal conditions, the developed biosensor produced a linear range from 2.50 μM to 1.250 mM, a limit of detection of 2.50 μM, operational stability over 500 sample injections, and good selectivity. The proposed biosensor determined glucose in human plasma samples, achieving recoveries and results that agreed with the hexokinase-spectrophotometric method (P > 0.05). Combining the proposed biosensor with the custom-built sample feed, a portable potentiostat and a smartphone, enabled on-site glucose monitoring.

Ultrasensitive electrochemical immunosensor for the detection of C-reactive protein antigen

Cardiovascular disease is one of the leading causes of premature death worldwide, and the determination of C-reactive protein (CRP) from human serum is of vital importance for the diagnosis of the disease. For this study, we have developed an electrochemical immunosensor based on onion-like carbon@polyacrylonitrile (OLC-PAN) for the detection of CRP antigens. This was accomplished by immobilizing CRP antibodies on a modified glassy carbon electrode (GCE). Several electrochemical techniques such as cyclic voltammetry (CV), square wave voltammetry (SWV), and electrochemical impedance spectroscopy (EIS) were employed to evaluate the electrochemical detection of the CRP antigen. This ultrasensitive method for CRP antigen detection exhibited a very good logarithmic plot from -4.52 to -12.05 g mL-1 and a limit of detection (LOD) of 0.9 fg mL-1. The high selectivity, sensitivity, and stability of the developed electrochemical immunosensor would facilitate miniaturization for point-of-care applications and the efficient diagnosis of cardiovascular diseases.

Advances in heart failure monitoring: Biosensors targeting molecular markers in peripheral bio-fluids

Cardiovascular diseases (CVDs), especially chronic heart failure, threaten many patients' lives worldwide. Because of its slow course and complex causes, its clinical screening, diagnosis, and prognosis are essential challenges. Clinical biomarkers and biosensor technologies can rapidly screen and diagnose. Multiple types of biomarkers are employed for screening purposes, precise diagnosis, and treatment follow-up. This article provides an up-to-date overview of the biomarkers associated with the six main heart failure etiology pathways. Plasma natriuretic peptides (BNP and NT-proBNP) and cardiac troponins (cTnT, cTnl) are still analyzed as gold-standard markers for heart failure. Other complementary biomarkers include growth differentiation factor 15 (GDF-15), circulating Galactose Lectin 3 (Gal-3), soluble interleukin (sST2), C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α). For these biomarkers, the electrochemical biosensors have exhibited sufficient sensitivity, detection limit, and specificity. This review systematically summarizes the latest molecular biomarkers and sensors for heart failure, which will provide comprehensive and cutting-edge authoritative scientific information for biomedical and electronic-sensing researchers in the field of heart failure, as well as patients. In addition, our proposed future outlook may provide new research ideas for researchers.

Efficient Electrochemiluminescence Sensing in Microfluidic Biosensors: A Review

Microfluidic devices are capable of handling 10-9 L to 10-18 L of fluids by incorporating tiny channels with dimensions of ten to hundreds of micrometers, and they can be fabricated using a wide range of materials including glass, silicon, polymers, paper, and cloth for tailored sensing applications. Microfluidic biosensors integrated with detection methods such as electrochemiluminescence (ECL) can be used for the diagnosis and prognosis of diseases. Coupled with ECL, these tandem devices are capable of sensing biomarkers at nanomolar to picomolar concentrations, reproducibly. Measurement at this low level of concentration makes microfluidic electrochemiluminescence (MF-ECL) devices ideal for biomarker detection in the context of early warning systems for diseases such as myocardial infarction, cancer, and others. However, the technology relies on the nature and inherent characteristics of an efficient luminophore. The luminophore typically undergoes a redox process to generate excited species which emit energy in the form of light upon relaxation to lower energy states. Therefore, in biosensor design the efficiency of the luminophore is critical. This review is focused on the integration of microfluidic devices with biosensors and using electrochemiluminescence as a detection method. We highlight the dual role of carbon quantum dots as a luminophore and co-reactant in electrochemiluminescence analysis, drawing on their unique properties that include large specific surface area, easy functionalization, and unique luminescent properties.

Simultaneous detection of C-reactive protein and lipopolysaccharide based on a dual-channel electrochemical biosensor for rapid Gram-typing of bacterial sepsis

Sepsis is a life-threatening multi-organ failure syndrome, with bacterial infections being the most common cause. Rapid Gram-typing is imperative to assist in antibiotic intervention. C-reactive protein (CRP) and lipopolysaccharide (LPS) are effective biomarkers for discerning the Gram type of bacteria but differ by several orders of magnitude in clinical detection, thereby impeding their simultaneous detection. And two independent methods are time-consuming and laborious. In this study, a dual-channel electrochemical biosensor was developed for simultaneous detection of LPS and CRP. Under optimal conditions, linear ranges of LPS (0.5-1000 pg/mL) and CRP (0.1-20 μg/mL) were obtained in line with the clinical evaluation scopes. In simulated sample tests, Gram-positive, Gram-negative, and healthy plasma samples were clearly distinguished by the developed biosensors, and these results were consistent with that of enzyme-linked immunosorbent assay (ELISA). In addition, the results of the plasma samples tested by the electrochemical biosensor matched those derived from blood cultures in the laboratory. Collectively, the electrochemical biosensor was expected to provide the scientific basis for the rapid Gram-typing and point-of-care detection of bacterial sepsis.

The Fabrication of a Probe-Integrated Electrochemiluminescence Aptasensor Based on Double-Layered Nanochannel Array with Opposite Charges for the Sensitive Determination of C-Reactive Protein

The effective and sensitive detection of the important biomarker, C-reactive protein (CRP), is of great significance in clinical diagnosis. The development of a convenient and highly sensitive electrochemiluminescence (ECL) aptasensor with an immobilized emitter probe is highly desirable. In this work, a probe-integrated ECL aptamer sensor was constructed based on a bipolar silica nanochannel film (bp-SNF) modified electrode for the highly sensitive ECL detection of CRP. The bp-SNF, modified on an ITO electrode, consisted of a dual-layered SNF film, including the negatively charged inner SNF (n-SNF) and the outer SNF with a positive charge and amino groups (p-SNF). The ECL emitter, tris(bipyridine) ruthenium (II) (Ru(bpy)32+), was stably immobilized in a nanochannel of bp-SNF using the dual electrostatic interactions with n-SNF attracting and p-SNF repelling. The amino groups on the outer surface of bp-SNF were aldehyde derivatized, allowing for the covalent immobilization of recognitive aptamers (5'-NH2-CGAAGGGGATTCGAGGGGTGATTGCGTGCTCCATTTGGTG-3'), leading to the recognition interface. When CRP bound to the aptamer on the recognition interface, the formed complex increased the interface resistance and reduced the diffusion of the co-reactant tripropylamine (TPA) into the nanochannels, leading to a decrease in the ECL signal. Based on this mechanism, the constructed aptamer sensor could achieve a sensitive ECL detection of CRP ranging from 0.01 to 1000 ng/mL, with a detection limit (DL) of 8.5 pg/mL. The method for constructing this probe-integrated ECL aptamer sensor is simple, and it offers a high probe stability, good selectivity, and high sensitivity.

Electrochemiluminescence Aptasensor with Dual Signal Amplification by Silica Nanochannel-Based Confinement Effect on Nanocatalyst and Efficient Emitter Enrichment for Highly Sensitive Detection of C-Reactive Protein

The rapid and sensitive detection of the important biomarker C-reactive protein (CRP) is of great significance for monitoring inflammation and tissue damage. In this work, an electrochemiluminescence (ECL) aptasensor was fabricated based on dual signal amplification for the sensitive detection of CRP in serum samples. The sensor was constructed by modifying a silica nanochannel array film (SNF) on a cost-effective indium tin oxide (ITO) electrode using the Stöber solution growth method. Gold nanoparticles (AuNPs) were grown in situ within the nanochannels using a simple electrodeposition method as a nanocatalyst to enhance the active electrode area as well as the ECL signal. The negatively charged nanochannels also significantly enriched the positively charged ECL emitters, further amplifying the signal. The recognition aptamer was covalently immobilized on the outer surface of SNF after modification with epoxy groups, constructing the aptasensor. In the presence of CRP, the formation of complexes on the recognitive interface led to a decrease in the diffusion of ECL emitters and co-reactants to the supporting electrode, resulting in a reduction in the ECL signal. Based on this mechanism, ECL detection of CRP was achieved with a linear range of 10 pg/mL to 1 μg/mL and a low limit of detection (7.4 pg/mL). The ECL aptasensor developed in this study offers advantages such as simple fabrication and high sensitivity, making promising applications in biomarker detection.

Fabrication of a Disposable Electrochemical Immunosensor Based on Nanochannel Array Modified Electrodes and Gated Electrochemical Signals for Sensitive Determination of C-Reactive Protein

Sensitive determination of C-reactive protein (CRP) is of great significance because it is an early indicator of inflammation in cardiovascular disease and acute myocardial infarction. A disposable electrode with an integrated three-electrode system (working, reference, and counter electrodes) has great potential in the detection of biomarkers. In this work, an electrochemical immunosensing platform was fabricated on disposable and integrated screen-printed carbon electrode (SPCE) by introducing nanochannel arrays and gated electrochemical signals, which can achieve the sensitive detection of CRP in serum. To introduce active reactive groups for the fabrication of immuno-recognitive interface, vertically-ordered mesoporous silica-nanochannel film (VMSF) with rich amino groups (NH₂-VMSF) was rapidly grown by electrochemical assisted self-assembly (EASA). The electrochemically reduced graphene oxide (ErGO) synthesized in situ during the growth of NH₂-VMSF was used as a conductive adhesive glue to achieve stable bonding of the nanochannel array (NH₂-VMSF/ErGO/SPCE). After the amino group on the outer surface of NH₂-VMSF reacted with bifunctional glutaraldehyde (GA/NH₂-VMSF/ErGO/SPCE), the converted aldehyde surface was applied for covalent immobilization of the recognitive antibody (Ab) followed with the blocking of the non-specific sites. The fabricated immunosensor, Ab/GA/NH₂-VMSF/ErGO/SPCE, enables sensitive detection of CRP in the range from 10 pg/mL to 100 ng/mL with low limit of detection (LOD, 8 pg/mL, S/N = 3). The immunosensor possessed high selectivity and can realize reliable determination of CRP in human serum.

Electroanalytical point-of-care detection of gold standard and emerging cardiac biomarkers for stratification and monitoring in intensive care medicine - a review

Determination of specific cardiac biomarkers (CBs) during the diagnosis and management of adverse cardiovascular events such as acute myocardial infarction (AMI) has become commonplace in emergency department (ED), cardiology and many other ward settings. Cardiac troponins (cTnT and cTnI) and natriuretic peptides (BNP and NT-pro-BNP) are the preferred biomarkers in clinical practice for the diagnostic workup of AMI, acute coronary syndrome (ACS) and other types of myocardial ischaemia and heart failure (HF), while the roles and possible clinical applications of several other potential biomarkers continue to be evaluated and are the subject of several comprehensive reviews. The requirement for rapid, repeated testing of a small number of CBs in ED and cardiology patients has led to the development of point-of-care (PoC) technology to circumvent the need for remote and lengthy testing procedures in the hospital pathology laboratories. Electroanalytical sensing platforms have the potential to meet these requirements. This review aims firstly to reflect on the potential benefits of rapid CB testing in critically ill patients, a very distinct cohort of patients with deranged baseline levels of CBs. We summarise their source and clinical relevance and are the first to report the required analytical ranges for such technology to be of value in this patient cohort. Secondly, we review the current electrochemical approaches, including its sub-variants such as photoelectrochemical and electrochemiluminescence, for the determination  of important CBs highlighting the various strategies used, namely the use of micro- and nanomaterials, to maximise the sensitivities and selectivities of such approaches. Finally, we consider the challenges that must be overcome to allow for the commercialisation of this technology and transition into intensive care medicine.

Oriented Antibody Covalent Immobilization for Label-Free Impedimetric Detection of C-Reactive Protein via Direct and Sandwich Immunoassays

The detection and monitoring of biological markers as disease indicators in a simple manner is a subject of international interest. In this work, we report two simple and sensitive label-free impedimetric immunoassays for the detection of C-reactive protein (CRP). The gold electrode modified with boronic acid-terminated self-assembled monolayers afforded oriented immobilization of capture glycosylated antibody (antihuman CRP monoclonal antibody, mAb). This antibody-modified surface was able to capture human CRP protein, and the impedance signal showed linear dependence with CRP concentration. We confirmed the immobilization of anti-CRP mAb using surface sensitive X-ray photoelectron spectroscopy (XPS) and electrochemical impedance. The oriented covalent immobilization of mAb was achieved using glycosylated Fc (fragment, crystallizable) region specific to boronic acid. The direct immunoassay exhibited a linear curve for concentration range up to 100 ng ml^-1. The limit of detection (LoD) of 2.9 ng ml^-1, limit of quantification (LoQ) of 9.66 ng ml^-1, and sensitivity of 0.585 kΩ ng^-1 ml cm^-2 were obtained. The sandwich immunoassay was carried out by capturing polyclonal anti-CRP antibody (pAb) onto the CRP antigen immunoreaction. The impedance signal after pAb capture also showed linear dependence with CRP antigen concentration and acted as a CRP antigen detection signal amplifier. The detection of the CRP antigen using sandwich pAb immunoassay improved LoD to 1.2 ng ml^-1, LoQ to 3.97 ng ml^-1, and enhanced the sensitivity to 0.885 kΩ ng^-1 ml cm^-2. The real sample analysis, using newborn calf serum, showed excellent selectivity and % recovery for the human CRP ranging from 91.2 to 96.5%. The method was reproducible to 4.5% for direct immunoassay and 2.3% for sandwich immunoassay.

Circulating D-Dimer versus Fibrinogen in the Diagnosis of Peri-Prosthetic Joint Infection: A Meta-Analysis

Background: Circulating D-dimer and fibrinogen are both emerging as promising biomarkers for the diagnosis of peri-prosthetic joint infection (PJI), but their clinical values still remain disputable. This study aims to evaluate and compare the accuracy of circulating D-dimer and fibrinogen in the diagnosis of suspected PJI. Methods: We conducted a comprehensive literature search in PubMed, EMBASE, and the Cochrane Library to retrieve diagnostic accuracy studies in which PJI was investigated with circulating D-dimer or fibrinogen from the time of database inception to August 1, 2019. The pooled sensitivity, specificity, likelihood ratios and diagnostic odds ratio (DOR), summary receiver operating characteristic (sROC) curves, and area under the sROC curve (AUC) were constructed using a meta-analysis framework. Results: Seven eligible studies (1,374 patients) were included in the quantitative analysis. The mean levels of circulating D-dimer and fibrinogen were all significantly higher in patients with PJI. The plasma fibrinogen illustrated relatively higher sensitivity (0.84, 95% confidence interval [CI]: 0.78-0.98) and specificity (0.80, 95% CI: 0.76-0.84) than circulating D-dimer (0.74, 95% CI: 0.69-0.78; 0.66, 95% CI: 0.62-0.69, respectively) for the diagnosis of PJI. The pooled DOR of D-dimer, fibrinogen, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) to diagnose PJI was 7.00 (95% CI, 2.50-19.59), 12.40 (95% CI, 5.85 to 26.28), 10.71 (95% CI, 7.76 to 14.78) and 16.22 (95% CI 11.71-22.46), respectively, while the pooled AUC was 0.84 (95% CI, 0.77-0.90), 0.87 (95% CI, 0.85-0.89), 0.82 (95% CI, 0.78-0.85) and 0.87 (95% CI, 0.86-0.88), respectively. Conclusions: This meta-analysis reveals that it could be concluded that plasma fibrinogen is an excellent biomarker for diagnosing PJI, comparable to serum CRP and ESR, while the diagnostic value of circulating D-dimer is only moderate. Large-scale, prospective studies are still needed to confirm current findings.

Handheld pH meter-assisted immunoassay for C-reactive protein using glucose oxidase-conjugated dendrimer loaded with platinum nanozymes

A simple and feasible pH meter-based immunoassay is reported for detection of C-reactive protein (CRP) using glucose oxidase (GOD)-conjugated dendrimer loaded with platinum nanozyme. Initially, platinum nanozymes were loaded into the dendrimers through an in situ synthetic method. Then, GOD and monoclonal anti-CRP antibody with a high molar ratio were covalently conjugated onto carboxylated dendrimers via typical carbodiimide coupling. The immunoreaction was carried out with a competitive mode in a CRP-coated microplate. Along with formation of immunocomplex, the added glucose was oxidized into gluconic acid and hydrogen peroxide by GOD, and the latter was further decomposed by platinum nanozyme, thus accelerating chemical reaction in the positive direction. The produced gluconic acid changed the pH of detection solution, which was determined using a handheld pH meter. Under optimum conditions, the pH meter-based immunoassay gave a good signal toward target CRP from 0.01 to 100 ng mL-1. The limit of detection was 5.9 pg mL-1. An intermediate precision ≤ 11.2% was acquired with batch-to-batch identification. No nonspecific adsorption was observed during a series of procedures to detect target CRP, and the cross-reaction against other biomarkers was very low. Importantly, our system gave well-matched results for analysis of human serum samples relative to a referenced ELISA kit.Graphical abstract.

Impedimetric Detection of Femtomolar Levels of Interleukin6, Interleukin 8, and Tumor Necrosis Factor Alpha Based on Thermally Modified Nanotubular Titanium Dioxide Arrays

An inexpensive, easy to prepare, and label-free electrochemical impedance spectroscopy-based biosensor has been developed for the selective detection of human interleukin 6 (IL-6), interleukin 8 (CXCL8, IL-8), and tumor necrosis factor (TNFα)-potential inflammatory cancer biomarkers. We describe a, so far, newly developed and unexplored method to immobilize antibodies onto a titanium dioxide nanotube (TNT) array by physical adsorption. Immobilization of anti-IL-6, anti-IL-8, and anti-TNFα on TNT and the detection of human IL-6, IL-8, and TNFα were examined using electrochemical impedance spectroscopy (EIS). The impedimetric immunosensor demonstrates good selectivity and high sensitivity against human biomarker analytes and can detect IL-6, IL-8, and TNFα at concentrations as low as 5 pg/mL, equivalent to the standard concentration of these proteins in human blood. The calibration curves evidenced that elaborated biosensors are sensitive to three cytokines within 5 ÷ 2500 pg/mL in the 0.01 M phosphate-buffered saline solution (pH 7.4).

Emerging Technologies and Platforms for the Immunodetection of Multiple Biochemical Markers in Osteoarthritis Research and Therapy

Biomarkers, especially biochemical markers, are important in osteoarthritis (OA) research, clinical trials, and drug development and have potential for more extensive use in therapeutic monitoring. However, they have not yet had any significant impact on disease diagnosis and follow-up in a clinical context. Nevertheless, the development of immunoassays for the detection and measurement of biochemical markers in OA research and therapy is an active area of research and development. The evaluation of biochemical markers representing low-grade inflammation or extracellular matrix turnover may permit OA prognosis and expedite the development of personalized treatment tailored to fit particular disease severities. However, currently detection methods have failed to overcome specific hurdles such as low biochemical marker concentrations, patient-specific variation, and limited utility of single biochemical markers for definitive characterization of disease status. These challenges require new and innovative approaches for development of detection and quantification systems that incorporate clinically relevant biochemical marker panels. Emerging platforms and technologies that are already on the way to implementation in routine diagnostics and monitoring of other diseases could potentially serve as good technological and strategic examples for better assessment of OA. State-of-the-art technologies such as advanced multiplex assays, enhanced immunoassays, and biosensors ensure simultaneous screening of a range of biochemical marker targets, the expansion of detection limits, low costs, and rapid analysis. This paper explores the implementation of such technologies in OA research and therapy. Application of novel immunoassay-based technologies may shed light on poorly understood mechanisms in disease pathogenesis and lead to the development of clinically relevant biochemical marker panels. More sensitive and specific biochemical marker immunodetection will complement imaging biomarkers and ensure evidence-based comparisons of intervention efficacy. We discuss the challenges hindering the development, testing, and implementation of new OA biochemical marker assays utilizing emerging multiplexing technologies and biosensors.

Electrochemiluminescent aptamer-sensor for alpha synuclein oligomer based on a metal-organic framework

The alpha synuclein (α-syn) oligomer is one of the biomarkers used for the early diagnosis of Parkinson's disease. In this paper, two electrochemiluminescent (ECL) biosensors with an aptamer as the recognition element for α-syn oligomer detection were prepared. A functionalized indium tin oxide (ITO) glass with metal-organic framework (MOF) materials provides an adequate sensing platform. Here the gold nanoparticles/metal organic frameworks (MOFs) composite (AuNPs@MOFs) using 3-aminopropyltrimethoxysilane as a binding agent, or to connect the MOFs onto the ITO directly via glutaraldehyde, both give a strong ECL emission for luminol, even under weak alkaline conditions. Thereafter, the thiolated or carboxylated aptamer was coalesced onto the MOF material functionalized electrode using an Au-S bond or amide bond via the classic 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide/N-hydroxysuccinimide (EDC-NHS) coupling, respectively. Thus, the ECL emission of the sensors significantly reduced after the specific binding of the α-syn oligomer to the aptamer. The good linear relationship of the ECL sensing signals upon the logarithm of the α-syn oligomer concentration were established, from 2.43 fM to 0.486 pM or 1.39 fM to 0.243 pM, and the limit of detection reached as low as 0.42 or 0.38 fM, for these two sensors. Both of the obtained sensors have the advantages of a high sensitivity, selectivity, and reproducibility and are capable of detecting the target in human serum.