1
|
Schobesberger S, Thumfart H, Selinger F, Schlimp CJ, Zipperle J, Ertl P. Development of a Paper-based Hematocrit Test and a Lateral Flow Assay to Detect Critical Fibrinogen Concentrations Using a Bottom-Up Pyramid Workflow Approach. ACS OMEGA 2024; 9:8533-8542. [PMID: 38405462 PMCID: PMC10882670 DOI: 10.1021/acsomega.3c10045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 02/27/2024]
Abstract
Fibrinogen is a coagulation factor in human blood and the first one to reach critical levels in major bleeding. Hypofibrinogenemia (a too low fibrinogen concentration in blood) poses great challenges to first responders, clinicians, and healthcare providers since it represents a risk factor for exsanguination and massive transfusion requirements. Thus, the rapid assessment of the fibrinogen concentration at the point of care has gained considerable importance in preventing and managing major blood loss. However, in whole blood measurements, hematocrit variations affect the amount (volume fraction) of plasma that passes the detection zone. In an attempt to accurately determine realistic critical levels of fibrinogen (<1.5 mg/mL) in patients needing immediate treatment and medical interventions, we have developed novel diagnostic systems capable of estimating hematocrit and critical fibrinogen concentrations. A lateral flow assay (LFA) for the detection of fibrinogen has been developed by establishing a workflow employing rapid characterization methods to streamline LFA development. The integration of two detection lines enables (i) the identification of fibrinogen (first line) present in the sample and (ii) the determination of the clinically critical fibrinogen concentrations below 1.5 mg/mL (second line). Furthermore, the paper-based separation of blood cells from plasma provides a semiquantitative estimate of the hematocrit by analyzing the fractions. Initial validation of the point-of-care (PoC) hematocrit test revealed good comparability to a standard laboratory method. The developed diagnostic systems have the ability to accelerate decision-making in cases with major bleeding.
Collapse
Affiliation(s)
| | - Helena Thumfart
- Faculty of Technical Chemistry, TU Wien, Getreidemarkt 9, 1060 Vienna, Austria
| | - Florian Selinger
- Faculty of Technical Chemistry, TU Wien, Getreidemarkt 9, 1060 Vienna, Austria
| | - Christoph J Schlimp
- Ludwig-Boltzmann-Institute for Traumatology, The Research Center in Cooperation with AUVA, Donaueschingenstraße 13, 1200 Vienna, Austria
- Department of Anaesthesiology and Intensive Care, AUVA Trauma Center Linz, Garnisonstraße 7, 4010 Linz, Austria
| | - Johannes Zipperle
- Ludwig-Boltzmann-Institute for Traumatology, The Research Center in Cooperation with AUVA, Donaueschingenstraße 13, 1200 Vienna, Austria
| | - Peter Ertl
- Faculty of Technical Chemistry, TU Wien, Getreidemarkt 9, 1060 Vienna, Austria
| |
Collapse
|
2
|
Al-Tamimi M, El-sallaq M, Altarawneh S, Qaqish A, Ayoub M. Development of Novel Paper-Based Assay for Direct Serum Separation. ACS OMEGA 2023; 8:20370-20378. [PMID: 37332822 PMCID: PMC10268636 DOI: 10.1021/acsomega.3c00215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023]
Abstract
Background: Many conventional laboratory tests require serum separation using a clot activator/gel tube, followed by centrifugation in an equipped laboratory. The aim of this study is development of novel, equipment-free, paper-based assay for direct and efficient serum separation. Methods: Fresh blood was directly applied to wax-channeled filter paper treated with clotting activator/s and then observed for serum separation. The purity, efficiency, recovery, reproducibility, and applicability of the assay were validated after optimization. Results: Serum was successfully separated using activated partial thromboplastin time (APTT) reagent and calcium chloride-treated wax-channeled filter paper within 2 min. The assay was optimized using different coagulation activators, paper types, blood collection methods, and incubation conditions. Confirmation of serum separation from cellular components was achieved by direct visualization of the yellow serum band, microscopic imaging of the pure serum band, and absence of blood cells in recovered serum samples. Successful clotting was evaluated by the absence of clotting of recovered serum by prolonged prothrombin time and APTT, absence of fibrin degradation products, and absence of Staphylococcus aureus-induced coagulation. Absence of hemolysis was confirmed by undetectable hemoglobin from recovered serum bands. The applicability of serum separated in paper was tested directly by positive color change on paper using bicinchoninic acid protein reagent, on recovered serum samples treated with Biuret and Bradford reagents in tubes, or measurement of thyroid-stimulating hormone and urea compared to standard serum samples. Serum was separated using the paper-based assay from 40 voluntary donors and from the same donor for 15 days to confirm reproducibility. Dryness of coagulants in paper prevents serum separation that can be re-stored by a re-wetting step. Conclusions: Paper-based serum separation allows for development of sample-to-answer paper-based point-of-care tests or simple and direct blood sampling for routine diagnostic tests.
Collapse
Affiliation(s)
- Mohammad Al-Tamimi
- Department
of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
| | - Mariam El-sallaq
- Department
of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
| | - Shahed Altarawneh
- Department
of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
| | - Arwa Qaqish
- Department
of Biology and Biotechnology, Faculty of Science, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
| | - Mai Ayoub
- Department
of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
| |
Collapse
|
3
|
Saidykhan J, Pointon L, Cinti S, May JE, Killard AJ. Development of a paper-based lateral flow prothrombin assay. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2022; 14:3718-3726. [PMID: 36048161 DOI: 10.1039/d2ay00965j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Disorders of haemostasis result in both excessive bleeding and clotting and are a major global cause of morbidity and mortality, particularly in the developing world. A small number of simple tests can be used to screen and monitor for such dysfunctions, one of which is the prothrombin time (PT) test and associated International Normalisation Ratio (INR). PT/INR is routine in hospital laboratories in developed countries, and can also be performed using point-of-care instruments. However, neither of these approaches is appropriate in low-resource settings. Significant interest has grown in paper-based devices to form the basis of simple and low-cost assays that may have the potential for application in such environments. This study describes the development of a simple, low-cost, paper-based lateral flow prothrombin assay. The assay employed wax printing on chromatography paper to define test channels, with deposition of thromboplastin reagent and calcium chloride onto the resulting strips. These were placed in a test housing and measurement of the flow rates of deposited plasma samples were performed in triplicate. The flow dynamics of the assay was optimised according to the type of paper substrate used, the nature and quantity of the thromboplastin reagent, the amount of calcium chloride required, and the volume of sample employed. An optimised assay configuration demonstrated a dynamic range of 6 mm between normal and factor-deficient plasmas. The assay showed good correlation with laboratory-based PT assay (Yumizen G200) in artificial plasmas in the 9.8 to 36 s range (r2 = 0.8112). The assay also demonstrated good dynamic range and correlation in patient plasma samples in comparison with hospital PT, with a range of 9.8 to 45 s (r2 = 0.7209).
Collapse
Affiliation(s)
- Jerro Saidykhan
- Department of Applied Sciences, Centre for Research in Biosciences (CRIB), University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK.
| | - Louise Pointon
- North Bristol NHS Trust, Southmead Hospital, Bristol, BS10 5NB, UK
| | - Stefano Cinti
- Department of Pharmacy, University of Naples "Federico II", Napoli 80131, Italy
| | - Jennifer E May
- Department of Applied Sciences, Centre for Research in Biosciences (CRIB), University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK.
| | - Anthony J Killard
- Department of Applied Sciences, Centre for Research in Biosciences (CRIB), University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK.
| |
Collapse
|
4
|
Sena-Torralba A, Álvarez-Diduk R, Parolo C, Piper A, Merkoçi A. Toward Next Generation Lateral Flow Assays: Integration of Nanomaterials. Chem Rev 2022; 122:14881-14910. [PMID: 36067039 PMCID: PMC9523712 DOI: 10.1021/acs.chemrev.1c01012] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
![]()
Lateral flow assays (LFAs) are currently the most used
point-of-care
sensors for both diagnostic (e.g., pregnancy test, COVID-19 monitoring)
and environmental (e.g., pesticides and bacterial monitoring) applications.
Although the core of LFA technology was developed several decades
ago, in recent years the integration of novel nanomaterials as signal
transducers or receptor immobilization platforms has brought improved
analytical capabilities. In this Review, we present how nanomaterial-based
LFAs can address the inherent challenges of point-of-care (PoC) diagnostics
such as sensitivity enhancement, lowering of detection limits, multiplexing,
and quantification of analytes in complex samples. Specifically, we
highlight the strategies that can synergistically solve the limitations
of current LFAs and that have proven commercial feasibility. Finally,
we discuss the barriers toward commercialization and the next generation
of LFAs.
Collapse
Affiliation(s)
- Amadeo Sena-Torralba
- Nanobioelectronics & Biosensors Group, Institut Català de Nanociència I Nanotecnologia (ICN2), CSIC and The Barcelona Institute of Science and Technology (BIST), Campus UAB, Bellaterra, 08193 Barcelona, Spain.,Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - Ruslan Álvarez-Diduk
- Nanobioelectronics & Biosensors Group, Institut Català de Nanociència I Nanotecnologia (ICN2), CSIC and The Barcelona Institute of Science and Technology (BIST), Campus UAB, Bellaterra, 08193 Barcelona, Spain
| | - Claudio Parolo
- Barcelona Institute for Global Health (ISGlobal) Hospital Clínic-Universitat de Barcelona, Carrer del Rosselló 132, 08036 Barcelona, Spain
| | - Andrew Piper
- Nanobioelectronics & Biosensors Group, Institut Català de Nanociència I Nanotecnologia (ICN2), CSIC and The Barcelona Institute of Science and Technology (BIST), Campus UAB, Bellaterra, 08193 Barcelona, Spain
| | - Arben Merkoçi
- Nanobioelectronics & Biosensors Group, Institut Català de Nanociència I Nanotecnologia (ICN2), CSIC and The Barcelona Institute of Science and Technology (BIST), Campus UAB, Bellaterra, 08193 Barcelona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Pg. Lluís Companys 23, 08010 Barcelona, Spain
| |
Collapse
|