Fiber-Optic Bio-sniffer (Biochemical Gas Sensor) Using Reverse Reaction of Alcohol Dehydrogenase for Exhaled Acetaldehyde

Femtosecond Laser Ionization Mass Spectrometry for Online Analysis of Human Exhaled Breath

A variety of organic compounds in human exhaled breath were measured online by mass spectrometry using the fifth (206 nm) and fourth (257 nm) harmonic emissions of a femtosecond ytterbium (Yb) laser as the ionization source. Molecular ions were enhanced significantly by means of resonance-enhanced, two-color, two-photon ionization, which was useful for discrimination of analytes against the background. The limit of detection was 0.15 ppm for acetone in air. The concentration of acetone in exhaled breath was determined for three subjects to average 0.31 ppm, which lies within the range of normal healthy subjects and is appreciably lower than the range for patients with diabetes mellitus. Many other constituents, which could be assigned to acetaldehyde, ethanol, isoprene, phenol, octane, ethyl butanoate, indole, octanol, etc., were observed in the exhaled air. Therefore, the present approach shows potential for use in the online analysis of diabetes mellitus and also for the diagnosis of various diseases, such as COVID-19 and cancers.

Molecular design and architectonics towards film-based fluorescent sensing

The past few decades have witnessed encouraging progress in the development of high-performance film-based fluorescent sensors (FFSs) for detecting explosives, illicit drugs, chemical warfare agents (CWAs), and hazardous volatile organic chemicals (VOCs), among others. Several FFSs have transitioned from laboratory research to real-world applications, demonstrating their practical relevance. At the heart of FFS technology lies the sensing films, which play a crucial role in determining the analytes and the resulting signals. The selection of sensing fluorophores and the fabrication strategies employed in film construction are key factors that influence the fluorescence properties, active-layer structures, and overall sensing behaviors of these films. This review examines the progress and innovations in the research field of FFSs over the past two decades, focusing on advancements in fluorophore design and active-layer structural engineering. It underscores popular sensing fluorophore scaffolds and the dynamics of excited state processes. Additionally, it delves into six distinct categories of film fabrication technologies and strategies, providing insights into their advantages and limitations. This review further addresses important considerations such as photostability and substrate effects. Concluding with an overview of the field's challenges and prospects, it sheds light on the potential for further development in this burgeoning area.

Emerging trends in metal oxide-based electronic noses for healthcare applications: a review

An electronic nose (E-nose) is a technology fundamentally inspired by the human nose, designed to detect, recognize, and differentiate specific odors or volatile components in complex and chaotic environments. Comprising an array of sensors with meticulously designed nanostructured architectures, E-noses translate the chemical information captured by these sensors into useful metrics using complex pattern recognition algorithms. E-noses can significantly enhance the quality of life by offering preventive point-of-care devices for medical diagnostics through breath analysis, and by monitoring and tracking hazardous and toxic gases in the environment. They are increasingly being used in defense and surveillance, medical diagnostics, agriculture, environmental monitoring, and product validation and authentication. The major challenge in developing a reliable E-nose involves miniaturization and low power consumption. Various sensing materials are employed to address these issues. This review presents the key advancements over the last decade in E-nose technology, specifically focusing on chemiresistive metal oxide sensing materials. It discusses their sensing mechanisms, integration into portable E-noses, and various data analysis techniques. Additionally, we review the primary metal oxide-based E-noses for disease detection through breath analysis. Finally, we address the major challenges and issues in developing and implementing a portable metal oxide-based E-nose.

Biosensor development for low-level acetaldehyde gas detection using mesoporous carbon electrode printed on a porous polyimide film

Acetaldehyde, which is an intermediate product of alcohol metabolism, is known to induce symptoms, including alcohol flushing, vomiting, and headaches in humans. Therefore, real-time monitoring of acetaldehyde levels is crucial to mitigating these health issues. However, current methods for detecting low-concentration gases necessitate the use of complex measurement equipment. In this study, we developed a low-cost, low-detection-limit, enzyme-based electrochemical biosensor for acetaldehyde gas detection that does not require sophisticated equipment. The sensor was constructed by screen-printing electrodes onto a porous polyimide film, using grafted MgO-templated carbon (GMgOC) as working electrode material, carbon for the counter electrode, and silver/silver chloride for the reference electrode. Pyrroloquinoline-quinone-dependent aldehyde dehydrogenase was immobilized on the working electrode, and a chamber was attached to the electrode chip and filled with 1-methoxy-5-methylphenazinium methyl sulfate solution. The sensor can be used to measure acetaldehyde gas concentrations from 0.02 to 0.1 ppm, making it suitable for monitoring human skin gas. This low detection limit was achieved by delivering the analyte through the porous polyimide film on which the electrodes were printed and accumulating acetaldehyde in the mesoporous GMgOC of the working electrode. This mechanism suggests that this sensor design can be adapted to develop other low-detection limit gas sensors, such as those for screening skin gas biomarkers.

Gas-Phase Biosensors (Bio-Sniffers) for Measurement of 2-Nonenal, the Causative Volatile Molecule of Human Aging-Related Body Odor

The molecule 2-nonenal is renowned as the origin of unpleasant human aging-related body odor that can potentially indicate age-related metabolic changes. Most 2-nonenal measurements rely on chromatographic analytical systems, which pose challenges in terms of daily usage and the ability to track changes in concentration over time. In this study, we have developed liquid- and gas-phase biosensors (bio-sniffers) with the aim of enabling facile and continuous measurement of trans-2-nonenal vapor. Initially, we compared two types of nicotinamide adenine dinucleotide (phosphate) [NAD(P)]-dependent enzymes that have the catalytic ability of trans-2-nonenal: aldehyde dehydrogenase (ALDH) and enone reductase 1 (ER1). The developed sensor quantified the trans-2-nonanal concentration by measuring fluorescence (excitation: 340 nm, emission: 490 nm) emitted from NAD(P)H that was generated or consumed by ALDH or ER1. The ALDH biosensor reacted to a variety of aldehydes including trans-2-nonenal, whereas the ER1 biosensor showed high selectivity. In contrast, the ALDH bio-sniffer showed quantitative characteristics for trans-2-nonenal vapor at a concentration range of 0.4-7.5 ppm (with a theoretical limit of detection (LOD) and limit of quantification (LOQ) of 0.23 and 0.26 ppm, respectively), including a reported concentration (0.85-4.35 ppm), whereas the ER1 bio-sniffer detected only 0.4 and 0.8 ppm. Based on these findings, headspace gas of skin-wiped alcohol-absorbed cotton collected from study participants in their 20s and 50s was measured by the ALDH bio-sniffer. Consequently, age-related differences in signals were observed, suggesting the potential for measuring trans-2-nonenal vapor.

Odorant-responsive biological receptors and electronic noses for volatile organic compounds with aldehyde for human health and diseases: A perspective review

Volatile organic compounds (VOCs) are gaseous chemicals found in ambient air and exhaled breath. In particular, highly reactive aldehydes are frequently found in polluted air and have been linked to various diseases. Thus, extensive studies have been carried out to elucidate disease-specific aldehydes released from the body to develop potential biomarkers for diagnostic purposes. Mammals possess innate sensory systems, such as receptors and ion channels, to detect these VOCs and maintain physiological homeostasis. Recently, electronic biosensors such as the electronic nose have been developed for disease diagnosis. This review aims to present an overview of natural sensory receptors that can detect reactive aldehydes, as well as electronic noses that have the potential to diagnose certain diseases. In this regard, this review focuses on eight aldehydes that are well-defined as biomarkers in human health and disease. It offers insights into the biological aspects and technological advances in detecting aldehyde-containing VOCs. Therefore, this review will aid in understanding the role of aldehyde-containing VOCs in human health and disease and the technological advances for improved diagnosis.

On-chip mid-infrared optical sensing with GeSbSe waveguides and resonators

We fabricated single mode Ge₂₈Sb₁₂Se₆₀ waveguides and resonators using e-beam lithography and achieved a propagation loss of 3.88 dB/cm at 3.66 µm. We compared BCl₃ and CHF₃ etch chemistries and determined CHF₃ produced 1.5 dB/cm higher propagation losses at 3.6 µm due to C-H bond absorption. We use fabricated waveguides to detect an aromatic aldehyde dissolved in a non-polar solvent with a limit of detection of 1.09 µmol/mL. We then reduce this detection limit to 0.25 µmol/mL using the enhancement produced by a chalcogenide ring resonator.

Development of a Rapid and Sensitive Fluorescence Sensing Method for the Detection of Acetaldehyde in Alcoholic Beverages

Acetaldehyde is regarded as an important flavor compound in alcoholic beverages. With the advantages of rapidity, low cost and high sensitivity, fluorescent probe could be used as a new tool for the detection of acetaldehyde. Here, an effective fluorescence sensing method based on fluorescent probe N1 (FPN1) was established in this study. The function of FPN1 relies on the nucleophile substitution reaction and photoinduced electron transfer (PET), resulting in a fluorescence increase. Remarkably, the pretreatment background removal method (BRM) was successfully applied for removal of the interference of pyruvate and acetal. The linearity range (LR), limit of detection (LOD) and recovery of the fluorescence sensing method with BRM were 0.0053–200 mg/L, 0.0016 mg/L and 94.02–108.12%, respectively, which showed a broader detection range and better performance on sensitivity compared with the traditional quantitation using gas chromatography (GC). Furthermore, successful application of the method in real samples indicated the advantages of low-cost and rapidity for small-scale detection while assuring the accuracy, which provides a new strategy for the detection of acetaldehyde concentration in alcoholic beverages.

Design of an Artificial Opal/Photonic Crystal Interface for Alcohol Intoxication Assessment: Capillary Condensation in Pores and Photonic Materials Work Together

Alcohol intoxication has a dangerous effect on human health and is often associated with a risk of catastrophic injuries and alcohol-related crimes. A demand to address this problem adheres to the design of new sensor systems for the real-time monitoring of exhaled breath. We introduce a new sensor system based on a porous hydrophilic layer of submicron silica particles (SiO₂ SMPs) placed on a one-dimensional photonic crystal made of Ta₂O₅/SiO₂ dielectric layers whose operation relies on detecting changes in the position of surface wave resonance during capillary condensation in pores. To make the active layer of SiO₂ SMPs, we examine the influence of electrostatic interactions of media, particles, and the surface of the crystal influenced by buoyancy, gravity force, and Stokes drag force in the frame of the dip-coating preparation method. We evaluate the sensing performance toward biomarkers such as acetone, ammonia, ethanol, and isopropanol and test sensor system capabilities for alcohol intoxication assessment. We have found this sensor to respond to all tested analytes in a broad range of concentrations. By processing the sensor signals by principal component analysis, we selectively determined the analytes. We demonstrated the excellent performance of our device for alcohol intoxication assessment in real-time.

Detection of trace volatile organic compounds in spiked breath samples: a leap towards breathomics

Breathomics is the future of non-invasive point-of-care devices. The field of breathomics can be split into the isolation of disease-specific volatile organic compounds (VOCs) and their detection. In the present work, an array of five quartz tuning fork (QTF)-based sensors modified by polymer with nanomaterial additive has been utilized. The array has been used to detect samples of human breath spiked with ∼0.5 ppm of known VOCs namely, acetone, acetaldehyde, octane, decane, ethanol, methanol, styrene, propylbenzene, cyclohexanone, butanediol, and isopropyl alcohol which are bio-markers for certain diseases. Polystyrene was used as the base polymer and it was functionalized with 4 different fillers namely, silver nanoparticles-reduced graphene oxide composite, titanium dioxide nanoparticles, zinc ferrite nanoparticles-reduced graphene oxide composite, and cellulose acetate. Each of these fillers enhanced the selectivity of a particular sensor towards a certain VOC compared to the pristine polystyrene-modified sensor. Their interaction with the VOCs in changing the mechanical properties of polymer giving rise to change in the resonant frequency of QTF is used as sensor response for detection. The interaction of functionalized polymers with VOCs was analyzed by FTIR and UV-vis spectroscopy. The collective sensor response of five sensors is used to identify VOCs using an ensemble classifier with 92.8% accuracy of prediction. The accuracy of prediction improved to 96% when isopropyl alcohol, ethanol, and methanol were considered as one class.

Construction of a Turn-off-on Fluorescent System Based On Aggregation Induced Emission of Acetaldehyde Using Carbonized Polymer dots and Tb3

It was the first time to report the aggregation induced emission (AIE) of acetaldehyde (AA) on the surface of carbonized polymer dots (CPDs) with the auxiliary of Tb³⁺. Based on the AIE of AA, a turn-off-on fluorescence method was established for AA detection using the porous CPDs-Tb³⁺ system. The one-pot hydrothermal method was used to obtain CPDs, using milk and polyethyleneimine (PEI) as precursors. In the presence of Tb³⁺, CPDs aggregated immediately and even forming precipitate, and the fluorescence intensity decreased obviously. AA can effectively embed on the surface of CPDs-Tb³⁺ due to the porous structure. AA displayed obviously blue fluorescence with excitation wavelength at 370 nm (emission peak at 460 nm), while there was no fluorescence peak when excited at 460 nm. In the CPDs-Tb³⁺ solution, AA exhibits obvious fluorescence enhancement effect (λ_ex 460 nm, λ_em 545 nm). And then, AA can be determined by the turn-off-on system based on the linear relationship between fluorescence enhancement and the concentration of AA ranging from 0.04 mM to 42.48 mM. The limit of detection (LOD) was 0.02 mM. The turn-off-on system was successfully applied to determine AA in wine samples. The strategy may be exploited to monitor AA in more drinking or foodstuff samples.

Electrocatalytic detection of ethanol and acetaldehyde by aminoxyl radicals: utilizing molecular catalysis for breath analysis

Using molecular catalysis and functional group dependence reactivities of catalysts for breath analysis.

Development of bacterial biosensor for sensitive and selective detection of acetaldehyde

Acetaldehyde is a human carcinogen and widely existed in alcoholic beverages and polluted air. In this study, a simple, fast, convenient and sensitive acetaldehyde biosensor was developed based on an acetaldehyde dehydrogenase (AldDH) bacteria surface display system. The whole-cell catalyst facilitated the dehydrogenation of acetaldehyde, while coenzyme NAD⁺ was reduced and the resultant NADH can be detected spectrometrically at 340 nm. The correct location of AldDH on the bacteria surface was confirmed by the subcellular fraction and immunofluorescence analysis. By comparing the fusion protein expression level and whole-cell activity, the proper display system for anchoring AldDH on the cell surface was obtained. The results of kinetics analysis towards both surface-displayed AldDH and intracellular expressed AldDH demonstrated that the mass-transport resistance was dramatically alleviated by cell-surface display strategy. Under optimal conditions, AldDH-surface display strain with the highest whole-cell activity (3.41 ± 0.3 mU/OD₆₀₀) was applied to spectrophotometry acetaldehyde detection system. An excellent linear relationship between the increases of absorbance at 340 nm and acetaldehyde concentration over the range from 1 μM to 300 μM was reached. The proposed approach offered adequate sensitivity for the detection of acetaldehyde at 0.33 μM. Most importantly, the developed biosensor showed the narrowest substrate specificity towards acetaldehyde, which has been employed for quick determination of acetaldehyde in real samples with good accuracy. The total detection time was within 20 min. The method reported here provided a simple, rapid, and low-cost strategy for the sensitive and selective measurement of acetaldehyde. Therefore, genetically engineered cells may find broad application in biosensors and biocatalysts.

An NAD-Specific 6-Hydroxy-3-Succinoyl-Semialdehyde-Pyridine Dehydrogenase from Nicotine-Degrading Agrobacterium tumefaciens Strain S33

Agrobacterium tumefaciens strain S33 can catabolize nicotine via a hybrid of the pyridine and pyrrolidine pathways. Most of the enzymes involved in this biochemical pathway have been identified and characterized, except for the one catalyzing the oxidation of 6-hydroxy-3-succinoyl-semialdehyde-pyridine to 6-hydroxy-3-succinoylpyridine. Based on a previous genomic and transcriptomic analysis, an open reading frame (ORF) annotated to encode aldehyde dehydrogenase (Ald) in the nicotine-degrading cluster was predicted to be responsible for this step. In this study, we heterologously expressed the enzyme and identified its function by biochemical assay and mass spectrum analysis. It was found that Ald catalyzes the NAD-specific dehydrogenation of 6-hydroxy-3-succinoyl-semialdehyde-pyridine to 6-hydroxy-3-succinoylpyridine. With the nonhydroxylated analog 3-succinoyl-semialdehyde-pyridine (SAP) as a substrate, Ald had a specific activity of 10.05 U/mg at pH 9.0 and apparent K_m values of around 58.68 μM and 0.41 mM for SAP and NAD⁺, respectively. Induction at low temperature and purification and storage in low-salt buffers were helpful to prevent its aggregation and precipitation. Disruption of the ald gene caused a lower growth rate and biomass of strain S33 on nicotine but not on 6-hydroxy-3-succinoylpyridine. Ald has a broad range of substrates, including benzaldehyde, furfural, and acetaldehyde. Recombinant Escherichia coli cells harboring the ald gene can efficiently convert furfural to 2-furoic acid at a specific rate of 0.032 mmol min⁻¹ g dry cells⁻¹, extending the application of Ald in the catalysis of bio-based furan compounds. These findings provide new insights into the biochemical mechanism of the nicotine-degrading hybrid pathway and the possible application of Ald in industrial biocatalysis.

IMPORTANCE Nicotine is one of the major toxic N-heterocyclic aromatic alkaloids produced in tobacco plants. Manufacturing tobacco and smoking may lead to some environmental and public health problems. Microorganisms can degrade nicotine by various biochemical pathways, but the biochemical mechanism for nicotine degradation has not been fully elucidated. In this study, we identified an aldehyde dehydrogenase responsible for the oxidation of 6-hydroxy-3-succinoyl-semialdehyde-pyridine to 6-hydroxy-3-succinoylpyridine; this was the only uncharacterized enzyme in the hybrid of the pyridine and pyrrolidine pathways in Agrobacterium tumefaciens S33. Similar to the known aldehyde dehydrogenase, the NAD-specific homodimeric enzyme presents a broad substrate range with high activity in alkaline and low-salt-containing buffers. It can catalyze not only the aldehyde from nicotine degradation but also those of benzaldehyde, furfural, and acetaldehyde. It was found that recombinant Escherichia coli cells harboring the ald gene could efficiently convert furfural to valuable 2-furoic acid, demonstrating its potential application for enzymatic catalysis.

Biochemical Methanol Gas Sensor (MeOH Bio-Sniffer) for Non-Invasive Assessment of Intestinal Flora from Breath Methanol

Methanol (MeOH) in exhaled breath has potential for non-invasive assessment of intestinal flora. In this study, we have developed a biochemical gas sensor (bio-sniffer) for MeOH in the gas phase using fluorometry and a cascade reaction with two enzymes, alcohol oxidase (AOD) and formaldehyde dehydrogenase (FALDH). In the cascade reaction, oxidation of MeOH was initially catalyzed by AOD to produce formaldehyde, and then this formaldehyde was successively oxidized via FALDH catalysis together with reduction of oxidized form of β-nicotinamide adenine dinucleotide (NAD+). As a result of the cascade reaction, reduced form of NAD (NADH) was produced, and MeOH vapor was measured by detecting autofluorescence of NADH. In the development of the MeOH bio-sniffer, three conditions were optimized: selecting a suitable FALDH for better discrimination of MeOH from ethanol in the cascade reaction; buffer pH that maximizes the cascade reaction; and materials and methods to prevent leaking of NAD+ solution from an AOD-FALDH membrane. The dynamic range of the constructed MeOH bio-sniffer was 0.32-20 ppm, which encompassed the MeOH concentration in exhaled breath of healthy people. The measurement of exhaled breath of a healthy subject showed a similar sensorgram to the standard MeOH vapor. These results suggest that the MeOH bio-sniffer exploiting the cascade reaction will become a powerful tool for the non-invasive intestinal flora testing.

Exhaled breath biomarker sensing

This goal of this minireview is to introduce the reader to the area of research concerned with exhaled breath analysis for the purpose of detecting abnormal levels of physiologically-relevant chemical markers reflective of respiratory diseases. Two main two groups of sensing methods are reviewed: mass spectrometry and (bio)sensors. The discussion focuses on biosensor applications for EB and EBC analyses, which are presented in detail. The review finishes with conclusions and future perspectives, including recommendations for future near-term and long-term development of EBC biomarker sensing.

Sensitive and selective methanol biosensor using two-enzyme cascade reaction and fluorometry for non-invasive assessment of intestinal bacteria activity

For understanding the status of intestinal flora non-invasively, methanol (MeOH) has been attracting the attention. In this study, we have developed and compared two different liquid-phase methanol biosensors. One, referred to as the AOD electrosensor, utilized alcohol oxidase (AOD) and an oxygen electrode. It electrochemically measured the decrease in oxygen through AOD-catalyzed oxidation of MeOH. The other, referred to as the AOD-FALDH fluorosensor, exploited a cascade reaction of AOD and formaldehyde dehydrogenase (FALDH) in conjunction with a fiber-optic sensor. It measured increase in the fluorescence from reduced form of β-nicotinamide adenine dinucleotide (NADH) that was a final product of the two-enzyme cascade reaction. Due to the cascade reaction, the AOD-FALDH fluorosensor showed 3 times better sensitivity along with 335 times wider dynamic range (494 nM-100 mM) than those of the AOD electrosensor (1.5-300 μM). The selectivity to MeOH was also improved by the cascade reaction with AOD-FALDH as no sensor output was observed from other aliphatic alcohols than MeOH in contrast to the AOD electrosensor. Although the use of FALDH resulted in the increase in the sensor output from aldehydes, such as acetaldehyde and formaldehyde, considering their concentrations in body fluids, the influence on the sensor output is limited. These results indicate that incorporating the cascade reaction into fluorometry enables enhanced biosensing of MeOH that will be useful for assessment of intestinal flora with little burden.

Transcutaneous Blood VOC Imaging System (Skin-Gas Cam) with Real-Time Bio-Fluorometric Device on Rounded Skin Surface

A skin-gas cam that allows continuous imaging of transcutaneous blood volatile organic compounds (VOCs) emanated from human skin was developed. The skin-gas cam is able to reveal the relationship between the local skin conditions and transcutaneous blood VOCs in the field of volatile metabolomics (volatolomics). A ring-type ultraviolet (UV) light-emitting diode was mounted around a camera lens as an excitation light source, which enabled the simultaneous excitation and imaging of fluorescence. A nicotinamide adenine dinucleotide (NAD)-dependent alcohol dehydrogenase (ADH) was used to detect ethanol as a model sample. When gaseous ethanol was applied to an ADH-immobilized mesh that was wetted with an oxidized NAD solution placed in front of the camera, a reduced form of NAD (NADH) was produced through an ADH-mediated reaction. NADH emits fluorescence by UV excitation, and thus, the concentration distribution of ethanol was visualized by measuring the distribution of the fluorescence light intensity from NADH on the ADH-immobilized mesh surface. In this study, a new gas application method that mimicked the release mechanism of transcutaneous gas for quantification of the transcutaneous gas concentration was evaluated. Also, spatiotemporal changes of transcutaneous ethanol for various body parts were measured. As a result, we revealed a relationship between local skin conditions and VOCs that could not be observed previously. In particular, we demonstrated the facile measurement of transdermal gases from around the ear where capillaries are densely distributed below a thin stratum corneum.

On-line dynamic detection in the column chromatography separation based on an optical fiber surface plasmon resonance sensor

In this design, we introduced a surface plasmon resonance (SPR) fiber-sensing probe into a column chromatography (CC) system to realize on-line dynamic detection in sample separation. The refractive index of the gel around the probe would be adjusted dynamically by the concentration change of the sample during CC separation. To demonstrate the separation and on-line detection process, bovine serum albumin (BSA) and riboflavin-5-phosphate sodium (FMN-Na) are chosen as the analytes in a Sephadex gel filtration chromatography system. The results show that the apparent reversible shift of the SPR spectrum can characterize the separation process. Specifically, the separated BSA with an outflow time of 8 min can cause a resonance wavelength shift of 15.5 nm, and the FMN-Na with an outflow time of 26 min can cause a shift of 8.4 nm. This on-line dynamic detection of SPR spectra has great potential to save time and simplify the analysis process compared to the complex thin layer chromatography detection steps in traditional manual CC.

Prospects and Challenges of Volatile Organic Compound Sensors in Human Healthcare

The chemical signatures of volatile organic compounds (VOCs) in humans can be utilized for point-of-care (POC) diagnosis. Apart from toxic exposure studies, VOCs generated in humans can provide insights into one's healthy and diseased metabolic states, acting as a biomarker for identifying numerous diseases noninvasively. VOC sensors and the technology of e-nose have received significant attention for continuous and selective monitoring of various physiological and pathophysiological conditions of an individual. Noninvasive detection of VOCs is achieved from biomatrices of breath, sweat and saliva. Among these, detection from sweat and saliva can be continuous in real-time. The sensing approaches include optical, chemiresistive and electrochemical techniques. This article provides an overview of such techniques. These, however, have limitations of reliability, precision, selectivity, and stability in continuous monitoring. Such limitations are due to lack of sensor stability and complexity of samples in a multivariate environment, which can lead to false readings. To overcome selectivity barriers, sensor arrays enabling multimodal sensing, have been used with pattern recognition techniques. Stability and precision issues have been addressed through advancements in nanotechnology. The use of various forms of nanomaterial not only enhance sensing performance, but also plays a major role in detection on a miniaturized scale. The rapid growth in medical Internet of Things (IoT) and artificial intelligence paves a pathway for improvements in human theranostics.