Wearable Microneedle-Based Array Patches for Continuous Electrochemical Monitoring and Drug Delivery: Toward a Closed-Loop System for Methotrexate Treatment

Tailoring Design of Microneedles for Drug Delivery and Biosensing

Microneedles (MNs) are emerging as versatile tools for both therapeutic drug delivery and diagnostic monitoring. Unlike hypodermic needles, MNs achieve these applications with minimal or no pain and customizable designs, making them suitable for personalized medicine. Understanding the key design parameters and the challenges during contact with biofluids is crucial to optimizing their use across applications. This review summarizes the current fabrication techniques and design considerations tailored to meet the distinct requirements for drug delivery and biosensing applications. We further underscore the current state of theranostic MNs that integrate drug delivery and biosensing and propose future directions for advancing MNs toward clinical use.

Trends in ready-to-use portable electrochemical sensing devices for healthcare diagnosis

Compared with previous decades, healthcare has emerged as a key global concern in light of the recurrent outbreak of pandemics. The initial stage in the provision of healthcare involves the process of diagnosis. Countries worldwide advocate for healthcare research due to its efficacy and capacity to assist diverse populations. Enhanced levels of healthcare management can be attained by the implementation of rapid diagnostic procedures and cognitive data analysis. Therefore, there is a constant need for smart therapeutics, analytical tools, and diagnostic systems to improve health and well-being. The past decade witnessed enormous growth in the sensing detection systems integrated into smartphones with printed electrodes and wearable patches for the screening of various healthcare diagnostics biomarkers and therapeutic drugs. This review focuses on the expansion of point-of-care technologies and their incorporation into a broader array of portable devices, a critical aspect in the context of decentralized societies and their healthcare systems. Discussions are broadly focused on the different sensing platforms such as solid electrodes, screen-printed electrodes, and paper-based sensing strategies for the detection of various biomarkers and therapeutic drugs. We also discuss the next-generation healthcare wearable sensing device importance and future research possibilities. Finally, the portable electrochemical sensing devices and their future perspective developments towards healthcare diagnosis are critically summarized.

Microneedles as a Promising Technology for Disease Monitoring and Drug Delivery: A Review

The delivery of molecules, such as DNA, RNA, peptides, and certain hydrophilic drugs, across the epidermal barrier poses a significant obstacle. Microneedle technology has emerged as a prominent area of focus in biomedical research because of its ability to deliver a wide range of biomolecules, vaccines, medicines, and other substances through the skin. Microneedles (MNs) form microchannels by disrupting the skin's structure, which compromises its barrier function, and facilitating the easy penetration of drugs into the skin. These devices enhance the administration of many therapeutic substances to the skin, enhancing their stability. Transcutaneous delivery of medications using a microneedle patch offers advantages over conventional drug administration methods. Microneedles containing active substances can be stimulated by different internal and external factors to result in the regulated release of the substances. To achieve efficient drug administration to the desired location, it is necessary to consider the design of needles with appropriate optimized characteristics. The choice of materials for developing and manufacturing these devices is vital in determining the pharmacodynamics and pharmacokinetics of drug delivery. This article provides the most recent update and overview of the numerous microneedle systems that utilize different activators to stimulate the release of active components from the microneedles. Further, it discusses the materials utilized for producing microneedles and the design strategies important in managing the release of drugs. An explanation of the commonly employed fabrication techniques in biomedical applications and electronics, particularly for integrated microneedle drug delivery systems, is discussed. To successfully implement microneedle technology in clinical settings, it is essential to comprehensively assess several factors, such as biocompatibility, drug stability, safety, and production cost. Finally, an in-depth review of these criteria and the difficulties and potential future direction of microneedles in delivering drugs and monitoring diseases is explored.

Engineering the Functional Expansion of Microneedles

Microneedles (MNs), composed of an array of micro-sized needles and a supporting base, have transcended their initial use to replace hypodermic needles in drug delivery and fluid collection, advancing toward multifunctional platforms. In this review, four major areas are summarized in interdisciplinary engineering approaches combined with MNs technology. First, electronics engineering, the most extensively researched field, enables applications in biomonitoring, electrical stimulation, and closed-loop theranostics through the generation, transmission, and transformation of electrical signals. Second, in electromagnetic engineering, the responsiveness of electromagnetic induction offers prospects for remote and programmable therapeutic applications. Third, photonic engineering endows MNs with novel functionalities, such as waveguiding and photonic manipulation to enhance optical therapeutic capabilities and facilitate the visualization of disease progression and treatment processes. Lastly, it reviewed the role of mechanical engineering in conferring shape adaptability and programmable motion features necessary for various MNs applications. This review focuses on the functionalities that emerge from the intersection of MNs with complementary engineering technologies, aiming to inspire further research and innovation in microneedle technology for biomedical applications.

I-Motif DNA Based Fluorescent Ratiometric Microneedle Sensing Patch for Sensitive Response of Small pH Variations in Interstitial Fluid

Detection of slight pH changes in skin interstitial fluid (ISF) is crucial yet challenging for studying pathological processes and understanding personal health conditions. In this work, we construct an i-motif DNA based fluorescent ratiometric microneedle sensing patch (IFR-pH MN patch) strategy that enables minimally invasive, high-resolution, and sensitive transdermal monitoring of small pH variations in ISF. The IFR-pH MN patch with advanced integration of both ISF sampling and pH sensing was fabricated from the cross-linking of gelatin methacryloyl and methacrylated hyaluronic acid, wrapping with pH-sensitive hairpin-containing i-motif DNA based fluorescent ratiometric probes in the matrix. Because it is mechanically robust for skin penetration and has high swelling ability, the IFR-pH MN patch could be quickly extracted as sufficient liquid from agarose gel (∼56.4 μL in 10 min). Benefiting from conformation changes of the hairpin-containing i-motif DNA under pH variation and ratiometric fluorescence signal readout, the IFR-pH MN patch could quantitate pH over a small range between pH 6.2 and 6.9 with an accuracy of 0.2 pH units in the mimic skin model. Furthermore, in vivo testing on wound and tumor mouse models indicated the ability of the biocompatible IFR-pH MN patch to penetrate the skin for obtaining transdermal pH values, demonstrating the potential applications in monitoring and intervention of pathological states.

Advancements in microneedle technology: current status and next-generation innovations

Microneedle technology is a pivotal component of third-generation transdermal drug delivery systems featuring tiny needles that create temporary microscopic channels in the stratum corneum which facilitate drug penetration in the dermis. This review offers a detailed examination of the current types of microneedles, including solid, coated, dissolving, hollow, and swelling microneedles, along with their preparation techniques as well as their benefits and challenges. Use of 3D printing technology is especially gaining significant attention due to its ability to achieve the high dimensional accuracy required for precise fabrication. Additionally, its customisability presents significant potential for exploring new designs and creating personalised microneedles products. Furthermore, this review explores next generation microneedles, especially stimuli-responsive microneedle, bioinspired microneedle and microneedles combined with other transdermal technology like sonophoresis, electroporation and iontophoresis. Regulatory aspects, characterisation techniques, safety considerations, and cost factors have also been addressed which are crucial for translation from lab to the market.

Iontophoresis and electroporation-assisted microneedles: advancements and therapeutic potentials in transdermal drug delivery

Transdermal drug delivery (TDD) using electrically assisted microneedle (MN) systems has emerged as a promising alternative to traditional drug administration routes. This review explores recent advancements in this technology across various therapeutic applications. Integrating iontophoresis (IP) and electroporation (EP) with MN technology has shown significant potential in improving treatment outcomes for various conditions. Studies demonstrate their effectiveness in enhancing vaccine and DNA delivery, improving diabetes management, and increasing efficacy in dermatological applications. The technology has also exhibited promise in delivering nonsteroidal anti-inflammatory drugs (NSAIDs), treating multiple sclerosis, and advancing obesity and cancer therapy. These systems offer improved drug permeation, targeted delivery, and enhanced therapeutic effects. While challenges remain, including safety concerns and technological limitations, ongoing research focuses on optimizing these systems for broader clinical applications. The future of electrically assisted MN technologies in TDD appears promising, with potential advancements in personalized medicine, smart monitoring systems, and expanded therapeutic applications.

An Integrated Microcurrent Delivery System Facilitates Human Parathyroid Hormone Delivery for Enhancing Osteoanabolic Effect

Human parathyroid hormone (1-34) (PTH) exhibits osteoanabolic and osteocatabolic effects, with shorter plasma exposure times favoring bone formation. Subcutaneous injection (SCI) is the conventional delivery route for PTH but faces low delivery efficiency due to limited passive diffusion and the obstruction of the vascular endothelial barrier, leading to prolonged drug exposure times and reduced osteoanabolic effects. In this work, a microcurrent delivery system (MDS) based on multimicrochannel microneedle arrays (MMAs) is proposed, achieving high efficiency and safety for PTH transdermal delivery. The internal microchannels of the MMAs are fabricated using high-precision 3D printing technology, providing a concentrated and safe electric field that not only accelerates the movement of PTH but also reversibly increases vascular endothelial permeability by regulating the actin cytoskeleton and interendothelial junctions through Ca2+-dependent cAMP signaling, ultimately promoting PTH absorption and shortening exposure times. The MDS enhances the osteoanabolic effect of PTH in an osteoporosis model by inhibiting osteoclast differentiation on the bone surface compared to SCI. Moreover, histopathological analysis of the skin and organs demonstrated the good safety of PTH delivered by MDS in vivo. In addition to PTH, the MDS shows broad prospects for the high-efficiency transdermal delivery of macromolecular drugs.

Microneedle sensors for dermal interstitial fluid analysis

The rapid advancement in personalized healthcare has driven the development of wearable biomedical devices for real-time biomarker monitoring and diagnosis. Traditional invasive blood-based diagnostics are painful and limited to sporadic health snapshots. To address these limitations, microneedle-based sensing platforms have emerged, utilizing interstitial fluid (ISF) as an alternative biofluid for continuous health monitoring in a minimally invasive and painless manner. This review aims to provide a comprehensive overview of microneedle sensor technology, covering microneedle design, fabrication methods, and sensing strategy. Additionally, it explores the integration of monitoring electronics for continuous on-body monitoring. Representative applications of microneedle sensing platforms for both monitoring and therapeutic purposes are introduced, highlighting their potential to revolutionize personalized healthcare. Finally, the review discusses the remaining challenges and future prospects of microneedle technology.

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Wearable and implantable biosensors: mechanisms and applications in closed-loop therapeutic systems

This review article examines the current state of wearable and implantable biosensors, offering an overview of their biosensing mechanisms and applications. We also delve into integrating these biosensors with therapeutic systems, discussing their operational principles and incorporation into closed-loop devices. Biosensing strategies are broadly categorized into chemical sensing for biomarker detection, physical sensing for monitoring physiological conditions such as pressure and temperature, and electrophysiological sensing for capturing bioelectrical activities. The discussion extends to recent developments in drug delivery and electrical stimulation devices to highlight their significant role in closed-loop therapy. By integrating with therapeutic devices, biosensors enable the modulation of treatment regimens based on real-time physiological data. This capability enhances the patient-specificity of medical interventions, an essential aspect of personalized healthcare. Recent innovations in integrating biosensors and therapeutic devices have led to the introduction of closed-loop wearable and implantable systems capable of achieving previously unattainable therapeutic outcomes. These technologies represent a significant leap towards dynamic, adaptive therapies that respond in real-time to patients' physiological states, offering a level of accuracy and effectiveness that is particularly beneficial for managing chronic conditions. This review also addresses the challenges associated with biosensor technologies. We also explore the prospects of these technologies to address their potential to transform disease management with more targeted and personalized treatment solutions.

Microneedles-Based Theranostic Platform: From the Past to the Future

Fully integrated theranostic devices are highly esteemed in clinical applications, offering immense potential in real-time disease monitoring and personalized care. Microneedles (MNs), as innovative and wearable devices, boast important advantages in biosensing and therapy, thus holding significant promise in the advancement of diagnostic and therapeutic platforms. Encouragingly, advancements in electrochemical sensing technology, micronano fabrication, and biocompatible materials are propelling momentum for MNs-based closed-loop systems, enhancing detection capabilities, biocompatibility, and cost-effectiveness. Moreover, the notable progress in integrating MN chips with other biochips signifies a frontier for growth. Successful clinical trials in target molecule monitoring and drug delivery domains herald excellent clinical translational prospects for the aforementioned theranostic platform. Finally, we delineate both challenges and opportunities in the development of integrated diagnostic and therapeutic MN systems, including continuous monitoring, intelligent control algorithms, safety, and regulatory considerations.

Recent advancements in non-invasive wearable electrochemical biosensors for biomarker analysis - A review

A biomarker is a molecular indicator that can be used to identify the presence or severity of a disease. It may be produced due to biochemical or molecular changes in normal biological processes. In some cases, the presence of a biomarker itself is an indication of the disease, while in other cases, the elevated or depleted level of a particular protein or chemical substance aids in identifying a disease. Biomarkers indicate the progression of the disease in response to therapeutic interventions. Identifying these biomarkers can assist in diagnosing the disease early and providing proper therapeutic treatment. In recent years, wearable electrochemical (EC) biosensors have emerged as an important tool for early detection due to their excellent selectivity, low cost, ease of fabrication, and improved sensitivity. There are several challenges in developing a fully integrated wearable sensor, such as device miniaturization, high power consumption, incorporation of a power source, and maintaining the integrity and durability of the biomarker for long-term continuous monitoring. This review covers the recent advancements in the fabrication techniques involved in device development, the types of sensing platforms utilized, different materials used, challenges, and future developments in the field of wearable biosensors.

Harnessing the role of microneedles as sensors: current status and future perspectives

In recent years, microneedles (MNs) have been transformed to serve a wide range of applications in the biomedical field. Their role as sensors in wearable devices has provided an alternative to blood-based monitoring of health and diagnostic methods. Hence, they have become a topic of research interest for several scientists working in the biomedical field. These MNs as sensors offer the continuous monitoring of biomarkers like glucose, nucleic acids, proteins, polysaccharides and electrolyte ions, which can therefore screen for and diagnose disease conditions in humans. The present review focuses on types of MN sensors and their applications. Various clinical trials and bottlenecks of MN R&D are also discussed.

A 3D-printed hollow microneedle-based electrochemical sensing device for in situ plant health monitoring

Plant health monitoring is devised as a new concept to elucidate in situ physiological processes. The need for increased food production to nourish the growing global population is inconsistent with the dramatic impact of climate change, which hinders crop health and exacerbates plant stress. In this context, wearable sensors play a crucial role in assessing plant stress. Herein, we present a low-cost 3D-printed hollow microneedle array (HMA) patch as a sampling device coupled with biosensors based on screen-printing technology, leading to affordable analysis of biomarkers in the plant fluid of a leaf. First, a refinement of the 3D-printing method showed a tip diameter of 25.9 ± 3.7 μm with a side hole diameter on the microneedle of 228.2 ± 18.6 μm using an affordable 3D printer (<500 EUR). Notably, the HMA patch withstanded the forces exerted by thumb pressing (i.e. 20-40 N). Subsequently, the holes of the HMA enabled the fluid extraction tested in vitro and in vivo in plant leaves (i.e. 13.5 ± 1.1 μL). A paper-based sampling strategy adapted to the HMA allowed the collection of plant fluid. Finally, integrating the sampling device onto biosensors facilitated the in situ electrochemical analysis of plant health biomarkers (i.e. H2O2, glucose, and pH) and the electrochemical profiling of plants in five plant species. Overall, this electrochemical platform advances precise and versatile sensors for plant health monitoring. The wearable device can potentially improve precision farming practices, addressing the critical need for sustainable and resilient agriculture in changing environmental conditions.