Non-invasive diagnosis of oral cancer: The role of electro-analytical methods and nanomaterials

Nano-diagnostics as an emerging platform for oral cancer detection: Current and emerging trends

Globally, oral cancer kills an estimated 150,000 individuals per year, with 300,000 new cases being diagnosed annually. The high incidence rate of oral cancer among the South-Asian and American populations is majorly due to overuse of tobacco, alcohol, and poor dental hygiene. Additionally, socio-economic issues and lack of general awareness delay the primary screening of the disease. The availability of early screening techniques for oral cancer can help in carving out a niche for accurate disease prognosis and also its prevention. However, conventional diagnostic approaches and therapeutics are still far from optimal. Thus, enhancing the analytical performance of diagnostic platforms in terms of specificity and precision can help in understanding the disease progression paradigm. Fabrication of efficient nanoprobes that are sensitive, noninvasive, cost-effective, and less labor-intensive can reduce the global cancer burden. Recent advances in optical, electrochemical, and spectroscopy-based nano biosensors that employ noble and superparamagnetic nanoparticles, have been proven to be extremely efficient. Further, these sensitive nanoprobes can also be employed for predicting disease relapse after chemotherapy, when the majority of the biomarker load is eliminated. Herein, we provide the readers with a brief summary of conventional and new-age oral cancer detection techniques. A comprehensive understanding of the inherent challenges associated with conventional oral cancer detection techniques is discussed. We also elaborate on how nanoparticles have shown tremendous promise and effectiveness in radically transforming the approach toward oral cancer detection. This article is categorized under: Diagnostic Tools > Biosensing Diagnostic Tools > Diagnostic Nanodevices Diagnostic Tools > In Vitro Nanoparticle-Based Sensing.

Electrochemical immunoplatform to assist in the diagnosis of oral cancer through the determination of CYFRA 21.1 biomarker in human saliva samples: Preparation of a novel portable biosensor toward non-invasive diagnosis of oral cancer

In this study, a novel, low-cost, and flexible paper-based electrochemical immunosensor was developed for the bioanalysis of Cyfra 21.1 biomarker in human saliva samples by using stabilization of synthesis Ag nano-ink on the surface of paper using pen-on-paper technology. The employed electrochemical techniques for the evaluation of immunoplatform performance were differential pulse voltammetry and chronoamperometry. Also, the prepared immunosensor showed great ability in the determination of Cyfra21.1 in human saliva specimens. Under the optimized conditions, the obtained linear range was from 0.0025 to 10 ng/mL, and the obtained LLOQ was 0.0025 ng/mL. The developed immunosensor is easy to prepare, sensitive, cost-effective, portable, and simple. So proposed immunoplatform can be an accomplished biodevice in clinical laboratories. The proposed paper-based immunosensor could be a hopefully new and cheap tool for the diagnosis of other biomarkers. Also, the prepared immunosensor showed great ability in the determination of Cyfra21.1 biomarker in human saliva specimens.

Proteomic approaches to assist in diagnosis and prognosis of oral cancer

Introduction: Oral squamous cell carcinoma (OSCC) ranks among the top 10 leading causes of cancer worldwide, with 5-year survival rate of about 50%, high lymph node metastasis, and relapse rates. The OSCC diagnosis, prognosis, and treatment are mostly based on the clinical TNM classification. There is an urgent need for the discovery of biomarkers and therapeutic targets to assist in the clinical decision-making process.Areas covered: We summarize proteomic studies of the OSCC tumor, immune microenvironment, potential liquid biopsy sites, and post-translational modifications trying to retrieve information in the discovery and verification or (pre)validation phases. The search strategy was based on the combination of MeSH terms and expert refinement.Expert opinion: Untargeted combined with targeted proteomics are strategies that provide reliable and reproducible quantitation of proteins and are the methods of choice of many groups worldwide. Undoubtedly, proteomics has been contributing to the understanding of OSCC progression and uncovers potential candidates as biomarker or therapeutic targets. Nevertheless, none of these targets are available in the clinical practice yet. The scientific community needs to overcome the limitations by investing in robust experimental designs to strengthen the value of the findings, leveraging the translation of knowledge, and further supporting clinical decisions.

Recent advances in point-of-care diagnostics for oral cancer

Early-stage diagnosis is a crucial step in reducing the mortality rate in oral cancer cases. Point-of-care (POC) devices for oral cancer diagnosis hold great future potential in improving the survival rates as well as the quality of life of oral cancer patients. The conventional oral examination followed by needle biopsy and histopathological analysis have limited diagnostic accuracy. Besides, it involves patient discomfort and is not feasible in resource-limited settings. POC detection of biomarkers and diagnostic adjuncts has emerged as non- or minimally invasive tools for the diagnosis of oral cancer at an early stage. Various biosensors have been developed for the rapid detection of oral cancer biomarkers at the point-of-care. Several optical imaging methods have also been employed as adjuncts to detect alterations in oral tissue indicative of malignancy. This review summarizes the different POC platforms developed for the detection of oral cancer biomarkers, along with various POC imaging and cytological adjuncts that aid in oral cancer diagnosis, especially in low resource settings. Various immunosensors and nucleic acid biosensors developed to detect oral cancer biomarkers are summarized with examples. The different imaging methods used to detect oral tissue malignancy are also discussed herein. Additionally, the currently available commercial devices used as adjuncts in the POC detection of oral cancer are emphasized along with their characteristics. Finally, we discuss the limitations and challenges that persist in translating the developed POC techniques in the clinical settings for oral cancer diagnosis, along with future perspectives.

A Review: Electrochemical Biosensors for Oral Cancer

Oral cancer poses a serious threat worldwide owing to its soaring case-fatality rate and its metastatic characteristics of spreading to the other parts of the body. Despite the recent breakthroughs in biomedical sciences, the detection of oral cancer at an early stage is still challenging. Conventional diagnosis in clinics and optical techniques to detect oral cancer in the initial stages are quite complicated as well as not completely accurate. To enhance the survival rate of oral cancer patients, it is important to investigate the novel methodologies that can provide faster, simpler, non-invasive, and yet ultraprecise detection of the onset of oral cancer. In this review, we demonstrate the promising aspects of an electrochemical biosensor as an ideal tool for oral cancer detection. We discuss the cutting-edge methodologies utilizing various electrochemical biosensors targeting the different kinds of biomarkers. In particular, we emphasize on electrochemical biosensors working at the molecular levels, which can be classified into mainly three types: DNA biosensors, RNA biosensors and protein biosensors according to the types of the analytes. Furthermore, we focus on the significant electrochemical methods including cyclic voltammetry (CV), differential pulse voltammetry (DPV) and electrochemical impedance spectroscopy (EIS) to analyze the oral cancer biomarkers (such as IL-6, IL-8, CYFRA 21-1, CD 59 and CIP2A) present in body fluids including saliva and serum, using non-invasive manner. Hence, this review provides essential insights into the development of pioneering electrochemical biosensors for the detection of oral cancer at an early stage.

Facile incorporation of DNA-templated quantum dots for sensitive electrochemical detection of the oral cancer biomarker interleukin-8

Recent studies reveal a great value of interleukin-8 (IL-8), a pro-inflammatory cytokine, as a potent biomarker for early diagnosis of oral cancer. Herein, a new electrochemical method is proposed to detect IL-8 by facilely incorporating DNA-templated quantum dots (QDs). In principle, target IL-8 is first treated with the reducing agent tris(2-carboxyethyl)phosphine (TCEP) to yield active thiols and then captured by antibody-functionalized magnetic beads (MBs). Thereafter, via the Michael addition reaction between the active thiol and maleimide group, a maleimide-modified DNA probe is linked to the surface of MBs, which can initiate a process of rolling circle amplification. In this way, long-range DNA strands are generated on the MB surface, subsequently recruiting DNA-templated CdTe/CdS QDs (DNA-QDs) to act as electrochemical reporters. By tracing the responses of DNA-QDs, the method allows IL-8 detection in a linear range from 5 to 5000 fg/mL with a detection limit of 3.36 fg/mL. The selectivity, reproducibility, and applicability in complex serum samples are also demonstrated to be favorable, indicating that the method may have a great potential in the future. More importantly, the use of TCEP treatment in the method not only provides a facile way to incorporate DNA-QDs, avoiding the complicated and time-consuming preparation process of antibody-DNA conjugates or functional nanomaterials; but also makes the method capable of being extended to detect other protein biomarkers in view of widespread presence of disulfides, which may hold a broad potential to facilitate efficient biosensing designs.

Advanced electronic skin devices for healthcare applications

Electronic skin, a kind of flexible electronic device and system inspired by human skin, has emerged as a promising candidate for wearable personal healthcare applications. Wearable electronic devices with skin-like properties will provide platforms for continuous and real-time monitoring of human physiological signals such as tissue pressure, body motion, temperature, metabolites, electrolyte balance, and disease-related biomarkers. Transdermal drug delivery devices can also be integrated into electronic skin to enhance its non-invasive, real-time dynamic therapy functions. This review summarizes the recent progress in electronic skin devices for applications in human health monitoring and therapy systems as well as several potential mass production technologies such as inkjet printing and 3D printing. The opportunities and challenges in broadening the applications of electronic skin devices in practical healthcare are also discussed.

Bioassay of saliva proteins: The best alternative for conventional methods in non-invasive diagnosis of cancer

Non-invasive diagnosis of cancer is often the key to effective treatment and patient survival. Saliva as a multi-constituent oral fluid comprises various disease signaling biomarkers, holds great potential for early-stage cancer diagnostics with cost-effective and easy collection, storage, transport and processing. Therefore, detection of biomarkers and proteins in the saliva samples is highly demand. The current review was performed using reliable internet database (mainly PubMed) to provide an overview of the most recent developments on non-invasive diagnosis of cancers in saliva and highlights main challenges and future prospects in sensing of the salivary biomarkers. The conventional detection methods of cancer biomarkers in saliva is discussed in the paper, however, the main focus is on non-invasive diagnosis of cancers in saliva using immunosensing (electrochemical, optical, piezoelectric), DNA based sensors, aptasensors and peptide based bio-assays The reviewed literature revealed that non-invasive cancer detection methods using the mentioned biosensors and without any processing of saliva sample offers a quick, sensitive, specific and cost effective analytical tool. Besides, salivary based detection methods can be used for simultaneous detection of panels of disease specific biomarkers in a real time manner or as home testing kits in near future.

Ultrasensitive immunoassay of carcinoma antigen 125 in untreated human plasma samples using gold nanoparticles with flower like morphology: A new platform in early stage diagnosis of ovarian cancer and efficient management

Ovarian cancer, as one of the most life-threatening malignancies among women worldwide, is usually diagnosed at the late stage despite up regulation of molecular markers such as carcinoma antigen 125 (CA 125) at the early stages of the malignancy. CA 125 is the only tumor marker recommended for clinical use in the diagnosis and management of ovarian cancer. The potential role of CA-125 for the early detection of ovarian cancer is controversial and has not yet been adopted for widespread screening efforts in asymptomatic women. Therefore, early detection of CA 125 in human biofluids is highly demanded. In the present study, a novel method was proposed for the fabrication of electrochemical immunosensor based reduced graphene oxide (RGO). Cysteamine capped gold nanoparticle (Cys-AuNPs) were deposited over the surface of ERGO probe using electrophoretic deposition method. These Cys-AuNPs/ERGO probes provide the favorable sites to attach the monoclonal antibody specific to CA 125 antigen. Cyclic voltammetry (CV), and square wave voltammetry (SWV) were applied for the electrochemical recognition of the biolayer. The represented signals demonstrates excellent figure of merits and good capability of the engineered immunosensor towards sensitive detection of CA 125. Quantitative measurements of CA 125 in human plasma samples have been demonstrated, showing the potential of the practical application of this novel immunosensor for the analysis of this biomarker in blood serum samples. This immunosensor has the ability of direct electron transfer as compared to earlier reported electrochemical immunosensors based electrochemical methods. Further, this immunosensor provides a very suitable and convenient alternative to replace the expensive commercially available methods such as immunohistochemistry. The following regression equation between the electrochemical current response and the CA 125 concentration range from 0.1 to 400 U/mL was found. The low limit of quantification for this immunosensor was 0.1 U/mL. To the best of our knowledge, this is the first reported on the direct immobilization of antibody on the surface of Cys-AuNPs/ERGO for fabrication of immunosensors.

Aptamer based assay of plated-derived grow factor in unprocessed human plasma sample and MCF-7 breast cancer cell lysates using gold nanoparticle supported α-cyclodextrin

Platelet-derived growth factor (PDGF), a protein biomarker, is directly involved in many cell transformation processes, such as tumor growth and progression. Elevation platelet-derived growth factor (PDGF-BB) concentration in plasma could indicate the accelerating growth of metastatic breast tumors and angiogenesis. The development of an apta-assay for detection of PDGF-BB in is presented in this work. A highly specific DNA-aptamer, selected to PDGF-BB was immobilized onto a gold nanoparticles supported α-cyclodextrin and electrochemical measurements were performed in a solution containing the phosphate buffer solution with physiological pH. Variety of shapes of gold nanostructures with different sizes from zero-dimensional nanoparticles to spherical structures were prepared by one-step template (α-cyclodextrin)-assistant green electrodeposition method. Fully electrochemical methodology was used to prepare a new transducer on a gold surface which provided a high surface area to immobilize a high amount of the aptamer. The surface morphology of electrode was characterized by high-resolution field emission scanning electron microscope (FE-SEM) and energy dispersive spectroscopy (EDX). The prepared aptasensors represented different electrochemical activities toward the redox processes of PDGF-BB attributing to the size and shape of the gold nanoparticles. The aptasensor was employed for the detection of PDGF using square wave voltammetry (SWV) and Cyclic voltammetry (CV) techniques. Under optimized condition the calibration curve for PDGF-BB was linear in 0.52-1.52nM with low limit of quantification of 0.52nM. Also, under the optimized experimental conditions, the proposed aptasensor of GNPs_-cubic-α-CD-Apt-Au electrode exhibited excellent analytical performance for MCF-7 cells determination, ranging from 328 TO 593 cells mL^-1 with low limit of quantification of 328 cells mL^-1. As a result, the electrochemical aptasensor was able to detect cancer-related targets in unprocessed human plasma samples.

Ensuring food safety using aptamer based assays: Electroanalytical approach

Aptamers, are being increasingly employed as favorable receptors for constructing highly sensitive biosensors, for their remarkable affinities towards certain targets including a wide scope of biological or chemical substances, and their superiority over other biologic receptors. The selectivity and affinity of the aptamers have been integrated with the wise design of the assay, applying suitable modifications, such as nanomaterials on the electrode surface, employing oligonucleotide-specific amplification strategies or, their combinations. After successful performance of the electrochemical aptasensors for biomedical applications, the food sector with its direct implication for human health, which demands rapid and sensitive and economic analytical solutions for determination of health threatening contaminants in all stages of production process, is the next field of research for developing efficient electrochemical aptasensors. The aim of this review is to categorize and introduce food hazards and summarize the recent electrochemical aptasensors that have been developed to address these contaminants.