A microfabricated thickness shear mode electroacoustic resonator for the label-free detection of cardiac troponin in serum

A rapid and ultrasensitive cardiac troponin I aptasensor based on an ion-sensitive field-effect transistor with extended gate

Acute myocardial infarction (AMI) is a life-threatening disease with a short course and a high mortality rate. However, it is still a great challenge to achieve the on-site diagnosis of this disease within minutes, meaning there is an urgent need to develop an efficient technology for realizing the rapid diagnosis and early warning of AMI in clinical emergencies. In this study, an ultrasensitive electrochemical aptasensor based on an extended-gate ion-sensitive field-effect transistor (EGISFET) was designed to achieve the quantitative assay of cardiac troponin I (cTnI), which is a highly sensitive and specific biomarker of AMI, within only 5 min. The EGISFET exhibits extremely high detection sensitivity due to its separated structure with a large sensing area and the surface-modified Prussian blue-gold nanoparticles (PB-AuNPs) composite, which serves as a signal magnifier and DNA loading platform for good electrocatalytic ability with a large specific area. Additionally, a target-induced strand-release strategy is proposed to shorten the recognition time of cTnI using a particular DNA strand. Under optimal conditions, the as-prepared aptasensor exhibits a wide linear range of 1-1000 pg/mL, an ultralow detection limit of 0.3 pg/mL, and reliable detection results in real serum samples. It is highly anticipated that this EGISFET-based aptasensor will have broad applications in the early warning and rapid diagnosis of AMI and other acute diseases in emergency treatment.

Clinical relevance and advances in detection of translational biomarker cardiac troponin

Cardiovascular diseases (CVD) are a range of diseases, pointing the functional hindrances in the heart and blood vessels of the human system that contributes to 48.6 % of the world's adult death rate. The diagnosis of CVD relies upon the Electro Cardio Gram (ECG) and detection of muscle markers such as troponins. Among the cardiac trio, Cardiac Troponin I (cTnI) weighing 23 KiloDalton (kDa) is a sorted biomarker for CVD. cTnI remains high in the blood after 1-2 weeks of myocardial damage. Testing of cTnI in CVD patients aids in diagnosis and risk stratification of the disease. Different determination systems including optical, electrochemical, and acoustic have been put forward for monitoring the cTnI which are Point of Care (POC) that promotes simple and sensitive detection of cTnI. The modern era has paved way to high-sensitivity Troponin I (hscTnI) devices that can detect up to 0.01 ng/ml in human blood/plasma/serum. Yet, the practice of hscTnI is impracticable due to cost inefficiency. Development of new hscTnI devices with minimal investment and maximal detection range will meet the global requirement. This review gives an over view on different detection systems of cardiac troponin I which stands as a translational detection molecule for CVDs.

Biosensing Platforms for Cardiac Biomarker Detection

Myocardial infarction (MI) is a cardiovascular disease that occurs when there is an elevated demand for myocardial oxygen as a result of the rupture or erosion of atherosclerotic plaques. Globally, the mortality rates associated with MI are steadily on the rise. Traditional diagnostic biomarkers employed in clinical settings for MI diagnosis have various drawbacks, prompting researchers to investigate fast, precise, and highly sensitive biosensor platforms and technologies. Biosensors are analytical devices that combine biological elements with physicochemical transducers to detect and quantify specific compounds or analytes. These devices play a crucial role in various fields including healthcare, environmental monitoring, food safety, and biotechnology. Biosensors developed for the detection of cardiac biomarkers are typically electrochemical, mass, and optical biosensors. Nanomaterials have emerged as revolutionary components in the field of biosensing, offering unique properties that significantly enhance the sensitivity and specificity of the detection systems. This review provides a comprehensive overview of the advancements and applications of nanomaterial-based biosensing systems. Beginning with an exploration of the fundamental principles governing nanomaterials, we delve into their diverse properties, including but not limited to electrical, optical, magnetic, and thermal characteristics. The integration of these nanomaterials as transducers in biosensors has paved the way for unprecedented developments in analytical techniques. Moreover, the principles and types of biosensors and their applications in cardiovascular disease diagnosis are explained in detail. The current biosensors for cardiac biomarker detection are also discussed, with an elaboration of the pros and cons of existing platforms and concluding with future perspectives.

Application of Shear Horizontal Surface Acoustic Wave (SH-SAW) Immunosensor in Point-of-Care Diagnosis

Point-of-care testing (POCT), also known as on-site or near-patient testing, has been exploding in the last 20 years. A favorable POCT device requires minimal sample handling (e.g., finger-prick samples, but plasma for analysis), minimal sample volume (e.g., one drop of blood), and very fast results. Shear horizontal surface acoustic wave (SH-SAW) biosensors have attracted a lot of attention as one of the effective solutions to complete whole blood measurements in less than 3 min, while providing a low-cost and small-sized device. This review provides an overview of the SH-SAW biosensor system that has been successfully commercialized for medical use. Three unique features of the system are a disposable test cartridge with an SH-SAW sensor chip, a mass-produced bio-coating, and a palm-sized reader. This paper first discusses the characteristics and performance of the SH-SAW sensor system. Subsequently, the method of cross-linking biomaterials and the analysis of SH-SAW real-time signals are investigated, and the detection range and detection limit are presented.

A review of piezoelectric MEMS sensors and actuators for gas detection application

Piezoelectric microelectromechanical system (piezo-MEMS)-based mass sensors including the piezoelectric microcantilevers, surface acoustic waves (SAW), quartz crystal microbalance (QCM), piezoelectric micromachined ultrasonic transducer (PMUT), and film bulk acoustic wave resonators (FBAR) are highlighted as suitable candidates for highly sensitive gas detection application. This paper presents the piezo-MEMS gas sensors' characteristics such as their miniaturized structure, the capability of integration with readout circuit, and fabrication feasibility using multiuser technologies. The development of the piezoelectric MEMS gas sensors is investigated for the application of low-level concentration gas molecules detection. In this work, the various types of gas sensors based on piezoelectricity are investigated extensively including their operating principle, besides their material parameters as well as the critical design parameters, the device structures, and their sensing materials including the polymers, carbon, metal-organic framework, and graphene.

Biosensors for the Rapid Detection of Cardiovascular Biomarkers of Vital Interest: Needs, Analysis and Perspectives

We have previously surveyed a panel of 508 physicians from around the world about which biomarkers would be relevant if obtained in a very short time frame, corresponding to emergency situations (life-threatening or not). The biomarkers that emerged from this study were markers of cardiovascular disease: troponin, D-dimers, and brain natriuretic peptide (BNP). Cardiovascular disease is a group of disorders affecting the heart and blood vessels. At the intersection of medicine, basic research and engineering, biosensors that address the need for rapid biological analysis could find a place of choice in the hospital or primary care ecosystem. Rapid, reliable, and inexpensive analysis with a multi-marker approach, including machine learning analysis for patient risk analysis, could meet the demand of medical teams. The objective of this opinion review, proposed by a multidisciplinary team of experts (physicians, biologists, market access experts, and engineers), is to present cases where a rapid biological response is indeed valuable, to provide a short overview of current biosensor technologies for cardiac biomarkers designed for a short result time, and to discuss existing market access issues.

The Challenges of Developing Biosensors for Clinical Assessment: A Review

Emerging research in biosensors has attracted much attention worldwide, particularly in response to the recent pandemic outbreak of coronavirus disease 2019 (COVID-19). Nevertheless, initiating research in biosensing applied to the diagnosis of diseases is still challenging for researchers, be it in the preferences of biosensor platforms, selection of biomarkers, detection strategies, or other aspects (e.g., cutoff values) to fulfill the clinical purpose. There are two sides to the development of a diagnostic tool: the biosensor development side and the clinical side. From the development side, the research engineers seek the typical characteristics of a biosensor: sensitivity, selectivity, linearity, stability, and reproducibility. On the other side are the physicians that expect a diagnostic tool that provides fast acquisition of patient information to obtain an early diagnosis or an efficient patient stratification, which consequently allows for making assertive and efficient clinical decisions. The development of diagnostic devices always involves assay developer researchers working as pivots to bridge both sides whose role is to find detection strategies suitable to the clinical needs by understanding (1) the intended use of the technology and its basic principle and (2) the preferable type of test: qualitative or quantitative, sample matrix challenges, biomarker(s) threshold (cutoff value), and if the system requires a mono- or multiplex assay format. This review highlights the challenges for the development of biosensors for clinical assessment and its broad application in multidisciplinary fields. This review paper highlights the following biosensor technologies: magnetoresistive (MR)-based, transistor-based, quartz crystal microbalance (QCM), and optical-based biosensors. Its working mechanisms are discussed with their pros and cons. The article also gives an overview of the most critical parameters that are optimized by developing a diagnostic tool.

Electrochemical strategies for the detection of cTnI

Acute myocardial infarction (AMI) is the main cause of death from cardiovascular diseases. Thus, early diagnosis of AMI is essential for the treatment of irreversible damage from myocardial infarction. Traditional electrocardiograms (ECG) cannot meet the specific detection of AMI. Cardiac troponin I (cTnI) is the main biomarker for the diagnosis of myocardial infarction, and the detection of cTnI content has become particularly important. In this review, we introduced and compared the advantages and disadvantages of various cTnI detection methods. We focused on the analysis and comparison of the main indicators and limitations of various cTnI biosensors, including the detection range, detection limit, specificity, repeatability, and stability. In particular, we pay more attention to the application and development of electrochemical biosensors in the diagnosis of cardiovascular diseases based on different biological components. The application of electrochemical microfluidic chips for cTnI was also briefly introduced in this review. Finally, this review also briefly discusses the unresolved challenges of electrochemical detection and the expectations for improvement in the detection of cTnI biosensing in the future.

A handheld testing device for the fast and ultrasensitive recognition of cardiac troponin I via an ion-sensitive field-effect transistor

Cardiac troponin I (cTnI) is an efficient and specific biomarker for the accurate diagnosis of acute myocardial infarction (AMI), one of the diseases with the highest mortality worldwide. Due to the short course and high fatality of this disease, a rapid, accurate and portable device for quantitative detection is urgently needed for early diagnosis and treatment. In this work, we designed a handheld device based on a dual-gate ion-sensitive field-effect transistor (ISFET) for early and accurate warning of AMI through cTnI detection. A one-step enzyme-linked immunosorbent assay strategy was proposed for use in this device to recognize trace cTnI in serum, converting the cTnI concentration to a drain-source current generated by an ultrasensitive ISFET. This portable device exhibited an ultrahigh sensitivity of 132 pA pg^-1·mL^-1, a wide linear range from 1 to 1000 pg/mL that enabled coverage far exceeding the threshold level (280 pg/mL), and a low detection limit of 0.3 pg/mL for the cTnI assay, which was much lower than the current diagnostic cut-off for a healthy control level for AMI (40 pg/mL). In addition, this handheld device showed satisfactory selectivity and reliable results in the analysis of real serum within 20 min, indicating its potential applications in early screening and diagnosis for the clinical evaluation of AMI.

Construction of Bio-Piezoelectric Platforms: From Structures and Synthesis to Applications

Piezoelectric materials, with their unique ability for mechanical-electrical energy conversion, have been widely applied in important fields such as sensing, energy harvesting, wastewater treatment, and catalysis. In recent years, advances in material synthesis and engineering have provided new opportunities for the development of bio-piezoelectric materials with excellent biocompatibility and piezoelectric performance. Bio-piezoelectric materials have attracted interdisciplinary research interest due to recent insights on the impact of piezoelectricity on biological systems and their versatile biomedical applications. This review therefore introduces the development of bio-piezoelectric platforms from a broad perspective and highlights their design and engineering strategies. State-of-the-art biomedical applications in both biosensing and disease treatment will be systematically outlined. The relationships between the properties, structure, and biomedical performance of the bio-piezoelectric materials are examined to provide a deep understanding of the working mechanisms in a physiological environment. Finally, the development trends and challenges are discussed, with the aim to provide new insights for the design and construction of future bio-piezoelectric materials.

Detection of Sub-Nanomolar Concentration of Trypsin by Thickness-Shear Mode Acoustic Biosensor and Spectrophotometry

The determination of protease activity is very important for disease diagnosis, drug development, and quality and safety assurance for dairy products. Therefore, the development of low-cost and sensitive methods for assessing protease activity is crucial. We report two approaches for monitoring protease activity: in a volume and at surface, via colorimetric and acoustic wave-based biosensors operated in the thickness-shear mode (TSM), respectively. The TSM sensor was based on a β-casein substrate immobilized on a piezoelectric quartz crystal transducer. After an enzymatic reaction with trypsin, it cleaved the surface-bound β-casein, which increased the resonant frequency of the crystal. The limit of detection (LOD) was 0.48 ± 0.08 nM. A label-free colorimetric assay for trypsin detection has also been performed using β-casein and 6-mercaptohexanol (MCH) functionalized gold nanoparticles (AuNPs/MCH-β-casein). Due to the trypsin cleavage of β-casein, the gold nanoparticles lost shelter, and MCH increased the attractive force between the modified AuNPs. Consequently, AuNPs aggregated, and the red shift of the absorption spectra was observed. Spectrophotometric assay enabled an LOD of 0.42 ± 0.03 nM. The Michaelis-Menten constant, KM, for reverse enzyme reaction has also been estimated by both methods. This value for the colorimetric assay (0.56 ± 0.10 nM) is lower in comparison with those for the TSM sensor (0.92 ± 0.44 nM). This is likely due to the better access of the trypsin to the β-casein substrate at the surface of AuNPs in comparison with those at the TSM transducer.

Recent advances in acoustic wave biosensors for the detection of disease-related biomarkers: A review

In the past several decades, acoustic wave biosensors, as an emerging kind of biosensors, have been developed and widely used for the detection of mass, viscosity, conductivity and density. Varieties of applications have been explored such as medical diagnosis, drug screening, environmental monitoring, food analysis and biochemical assay. Among them, the detection of disease-related biomarkers based on acoustic sensors has aroused great research interest all over the world. In this review, the classification and characteristics of acoustic wave biosensors are briefly introduced. Then, some classical studies and recent advances in disease-related biomarker detection utilizing these biosensors are summarized and detailed, respectively. Here, the disease-related biomarkers mainly include antigens, small molecular proteins, cancer cells, viruses and VOCs. Finally, challenges and future trends of these typical acoustic wave biosensors are discussed. Compared with other reviews of acoustic wave sensors, this review highlights the great potential of typical acoustic wave biosensors for early disease screening and diagnosis compared with widely-used medical imaging. Moreover, they are integrated with other technologies for the design of multi-analyte, multi-parameter and intelligent devices, collecting more comprehensive information from biomarkers. This review provides a new perspective on the applications and optimization of acoustic wave biosensors to develop more reliable platforms for disease-related biomarker detection and disease diagnosis.

Engineering inclined orientations of piezoelectric films for integrated acoustofluidics and lab-on-a-chip operated in liquid environments

Different acoustic wave modes are required for effective implementation of biosensing and liquid actuation functions in an acoustic wave-based lab-on-a-chip. For efficient sensing in liquids, shear waves (either a thickness-shear bulk wave or a shear-horizontal surface acoustic wave) can achieve a high sensitivity, without significant loss of acoustic wave energy. On the other hand, longitudinal bulk waves or out-of-plane displacement waves (such as Rayleigh waves) enable efficient sampling functions and liquid manipulation. However, there are significant challenges in developing a lab-on-a-chip to efficiently generate multiple wave modes and perform both these functions on a single piezoelectric substrate, especially when a single crystalline orientation is available. This paper highlights the latest progress in the theories and techniques to deliver both sensing and microfluidic manipulation functions using engineered inclined-angled piezoelectric films, allowing for the simultaneous generation of longitudinal (or Rayleigh) and thickness-shear bulk (or shear-horizontal surface acoustic) waves. Challenges and theoretical constraints for generating various wave modes in the inclined films and techniques to efficiently produce inclined columnar and inclined crystalline piezoelectric films using sputtering deposition methods are presented. Applications of different wave modes in the inclined film-based lab-on-chips with multiple sensing and acoustofluidic functions are also discussed.

Antibody immobilization techniques in mass sensitive immunosensor: enhanced sensitivity through limited mass load

Background:

Biosensors are analytical devices that include a sample-delivery approach between a biological recognition element and a transducer required to convert the physicochemical change produced from the interaction of biological molecules-receptor interaction into signal. The immunosensor is a special type of biosensors that includes an antibody as a biorecognition element to detect analyte as antigens. In mass-sensitive sensors, antigen-antibody interactions can be specified by measuring the frequency change and most commonly knowns are surface acoustic wave, bulk acoustic wave, quartz crystal microbalance and microcantilevers.

Methods:

Different methods for antibody immobilization including functionalization of the transducer surface with specific groups have been reported for antibody immobilization. This stage affects the limit of detection and overall performance. In this review, perspectives on immobilization strategies of mass sensitive immunosensors according to transducer types will be presented. The choice of immobilization methods and their impact on performance in terms of capture molecule loading, orientation and signal improvement is will also be discussed.

Results:

One of the most critical point during configuration of the biorecognition layer is to improve the sensitivity. Therefore, we initially focused on comparisons of the antibody immobilization strategies in the biorecognition layer in terms of mass load level and high sensitivity.

Conclusion:

The lack of significant data on the mass accumulations up to the functionalization and antibody immobilization steps, which are the basis of immusensor production, has been identified. However, mass sensitive immunosensors have the potential to become more common and effective analytical devices for many application areas.