Hemolysis-free blood plasma separation

Sample-to-answer lateral flow assay with integrated plasma separation and NT-proBNP detection

Through enabling whole blood detection in point-of-care testing (POCT), sedimentation-based plasma separation promises to enhance the functionality and extend the application range of lateral flow assays (LFAs). To streamline the entire process from the introduction of the blood sample to the generation of quantitative immune-fluorescence results, we combined a simple plasma separation technique, an immunoreaction, and a micropump-driven external suction control system in a polymer channel-based LFA. Our primary objective was to eliminate the reliance on sample-absorbing separation membranes, the use of active separation forces commonly found in POCT, and ultimately allowing finger prick testing. Combining the principle of agglutination of red blood cells with an on-device sedimentation-based separation, our device allows for the efficient and fast separation of plasma from a 25-µL blood volume within a mere 10 min and overcomes limitations such as clogging, analyte adsorption, and blood pre-dilution. To simplify this process, we stored the agglutination agent in a dried state on the test and incorporated a filter trench to initiate sedimentation-based separation. The separated plasma was then moved to the integrated mixing area, initiating the immunoreaction by rehydration of probe-specific fluorophore-conjugated antibodies. The biotinylated immune complex was subsequently trapped in the streptavidin-rich detection zone and quantitatively analyzed using a fluorescence microscope. Normalized to the centrifugation-based separation, our device demonstrated high separation efficiency of 96% and a yield of 7.23 µL (= 72%). Furthermore, we elaborate on its user-friendly nature and demonstrate its proof-of-concept through an all-dried ready-to-go NT-proBNP lateral flow immunoassay with clinical blood samples.

Pronounced effect of lamination on plasma separation from whole blood by microfluidic paper-based analytical devices

Many diseases are detected through blood tests. Currently, most blood tests are done on plasma instead of whole blood because of the interference of blood cells on detection results. Here, we developed a laminated microfluidic paper-based analytical device (L-μPAD) for the separation of plasma from whole blood without using plasma separation membrane (PSM). A lateral flow design consisting of a circular sampling zone and rectangular detection zone was patterned on the paper substrate using laser printing technology. The μPAD was then laminated after impregnation with KCl solution. Lamination and electrolyte addition represented synergistic effects on the separation by controlling the pore size of the paper. In addition, by preventing evaporation on one hand and squeezing paper pores on the other hand, lamination caused longer movement of the separated plasma, the longest plasma path reported so far. The separation process was monitored using colorimetric reagent bromocresol green and scanning electron microscopy. The process of separation was completed in less than 90s without significant hemolysis and the separated plasma was far from the interfering effect of red blood cells. We used the device for the determination of serum albumin. However, it represents the potential for point-of-care testing in multi-assay experiments too.

Intensity-Based Camera Setup for Refractometric and Biomolecular Sensing with a Photonic Crystal Microfluidic Chip

Label-free sensing is a promising approach for point-of-care testing devices. Among optical transducers, photonic crystal slabs (PCSs) have positioned themselves as an inexpensive yet versatile platform for label-free biosensing. A spectral resonance shift is observed upon biomolecular binding to the functionalized surface. Commonly, a PCS is read out by a spectrometer. Alternatively, the spectral shift may be translated into an intensity change by tailoring the system response. Intensity-based camera setups (IBCS) are of interest as they mitigate the need for postprocessing, enable spatial sampling, and have moderate hardware requirements. However, they exhibit modest performance compared with spectrometric approaches. Here, we show an increase of the sensitivity and limit of detection (LOD) of an IBCS by employing a sharp-edged cut-off filter to optimize the system response. We report an increase of the LOD from (7.1 ± 1.3) × 10^-4 RIU to (3.2 ± 0.7) × 10^-5 RIU. We discuss the influence of the region of interest (ROI) size on the achievable LOD. We fabricated a biochip by combining a microfluidic and a PCS and demonstrated autonomous transport. We analyzed the performance via refractive index steps and the biosensing ability via diluted glutathione S-transferase (GST) antibodies (1:250). In addition, we illustrate the speed of detection and demonstrate the advantage of the additional spatial information by detecting streptavidin (2.9 µg/mL). Finally, we present the detection of immunoglobulin G (IgG) from whole blood as a possible basis for point-of-care devices.

Simple Bioparticle Filtration Device Based on an Ultralow-Fouling Zwitterionic Polyurethane Membrane for Rapid Large-Volume Separation of Plasma and Viruses from Whole Blood

Plasma separation from whole blood is oftent required as an essential first step when performing blood tests with a viral assay. However, developing a point-of-care plasma extraction device with a large output and high virus recovery remains a significant obstacle to the success of on-site viral load tests. Here, we report a portable, easy-to-use, cost-efficient, membrane-filtration-based plasma separation device that enables rapid large-volume plasma extraction from whole blood, designed for point-of-care virus assays. The plasma separation is realized by a low-fouling zwitterionic polyurethane-modified cellulose acetate (PCBU-CA) membrane. The zwitterionic coating on the cellulose acetate membrane can decrease surface protein adsorption by 60% and increase plasma permeation by 46% compared with a pristine membrane. The PCBU-CA membrane, with its ultralow-fouling properties, enables rapid plasma separation. The device can yield a total of 1.33 mL plasma from 10 mL whole blood in 10 min. The extracted plasma is cell-free and exhibits a low hemoglobin level. In addition, our device demonstrated a 57.8% T7 phage recovery in the separated plasma. The results of real-time polymerase chain reaction analysis confirmed that the nucleic acid amplification curve of the plasma extracted by our device is comparable to that obtained by centrifugation. With its high plasma yield and good phage recovery, our plasma separation device provides an excellent replacement for traditional plasma separation protocols for point-of-care virus assays and a broad spectrum of clinical tests.

Hemolysis prediction in bio-microfluidic applications using resolved CFD-DEM simulations

BACKGROUND AND OBJECTIVE

Hemolysis, namely hemoglobin leakage from red blood cells (RBCs), is one of the major sources of incorrect results in clinical tests, especially when passive microfluidics is involved. This is due to small characteristic dimensions which could cause strong RBCs deformation. Prediction of hemolysis is essential in the design and optimization of lab-on-a-chip devices for cell sorting and plasma separation. The aim of this work is to provide a numerical simulation tool this purpose applicable to real-scale bio-microfluidic devices with affordable computational cost.

METHODS

Blood is modelled as a suspension of biological cells, mainly RBCs, in liquid plasma assumed as a Newtonian, incompressible carrier fluid. Therefore, the physics of cells and carrier fluid is coupled by means of an immersed boundary concept known as resolved CFD-DEM. In this approach, the Navier-Stokes equations are numerically solved through a finite volume method with an additional penalty term to account for the presence of RBCs. RBCs' positions and velocities are updated by solving Newton and Euler equations for conservation of linear and angular momentum. To model the RBCs deformation, a reduced-order model is employed, where each RBC is represented by a clump of overlapping rigid spheres connected by fictional numerical bonds, whose properties are tuned to reproduce the ones of RBCs viscoelastic membrane. This coupled approach allows access to cell-level information and facilitates the usage of strain-based hemolysis models.

RESULTS

Different micro-channel geometries and blood hematocrits are simulated, to explore the influence of these factors on RBCs damage. Statistical analysis is performed to extract relevant biophysical quantities from numerical simulations such as hemolysis index distribution at the channel exit. Finally, the effect of carrier fluid viscosity is studied in relation to cell-cell interactions.

CONCLUSIONS

Simulation results show that hemolysis occurrence is almost independent of the hematocrit values in the microchannel, implying the possibility to speed up calculation using low hematocrit values. Nevertheless, using whole blood viscosity for the carrier fluid overestimates the value of the hemolysis index by almost one order of magnitude.

A microfluidic device to separate high-quality plasma from undiluted whole blood sample using an enhanced gravitational sedimentation mechanism

The growing interest in lab-on-a-chip systems for plasma separation has led to the presentation of various devices. Trench-based devices benefiting from gravitational sedimentation are efficient structures with air-locking and low speed-drawbacks. The present study introduces a fast, hemolysis-free, highly efficient blood plasma separation microfluidic device. The proposed device is based on gravitational sedimentation combined with dielectrophoresis force to promote the purity of the separated plasma, reduce the separation process time, and overcome the air-locking problem. The effect of geometrical parameters on the separation process is investigated using finite element analysis to attain optimal design specifications. A drop of whole blood (10 μl) is injected into the fabricated chip at four flow rates of 70 nl/s to 100 nl/s. It takes less than 4 min to obtain 2.2 μl plasma from undiluted blood without losing plasma proteins. Additionally, a porous Melt-Blown Polypropylene (MBPP) layer is used to eliminate the air-locking problem, which in previous trench-based microsystems led to time-consuming device preparation steps. Blood samples with various hematocrits (15%-65%) are tested with the applied voltages of 0-20 V_pp through the optimized structure. A purity of 99.98% ± 0.02% (evaluated by hemocytometry) is achieved using optimized dielectrophoresis force by the applied voltage of 20 V_pp, which is more than the previous studies. The UV-Visible spectroscopy results confirm obtaining a non-hemolyzed sample at a flow rate of 70 nl/s. The proposed device achieves a relative increase in the flow rate compared to similar previous studies while maintaining the high quality of the separated plasma. This achievement lies in using the MBPP layer and combining two separation methods.

Instrument-free single-step direct estimation of the plasma glucose level from one drop of blood using smartphone-interfaced analytics on a paper strip

We demonstrated an instrument-free miniaturized adaptation of the laboratory gold standard methodology for the direct estimation of plasma glucose from a drop of whole blood using a low-cost single-user-step paper-strip sensor interfaced with a smartphone. Unlike a majority of the existing glucose meters that use whole blood-based indirect sensing technologies, our direct adaptation of the gold-standard laboratory benchmark could eliminate the possibilities of cross interference with other analytes present in the whole blood by facilitating an in situ plasma separation, capillary flow and colorimetric reaction occurring concomitantly, without incurring additional device complexity or embodiment. The test reagents were dispensed in lyophilized form, and the resulting paper strips were found to be stable over three months stored in a normal freezer, rendering easy adaptability commensurate with the constrained supply chains in extreme resource-poor settings. Quantitative results could be arrived at via a completely-automated mobile-app-based image analytics interface developed using dynamic machine learning, obviating manual interpretation. The tests were demonstrated to be of high efficacy, even when executed by minimally trained frontline personnel having no special skill of drawing precise volume of blood, on deployment at under-resourced community centres having no in-built or accessible healthcare infrastructure. Clinical validation using 220 numbers of human blood samples in a double-blinded manner evidenced sensitivity and specificity of 98.11% and 96.7%, respectively, as compared to the results obtained from a laboratory-benchmarked biochemistry analyser, establishing its efficacy for public health and community disease management in resource-limited settings without any quality compromise of the test outcome.

Towards an Innovative Sensor in Smart Capsule for Aerial Drones for Blood and Blood Component Delivery

Aerial drone technology is currently being investigated worldwide for the delivery of blood components. Although it has been demonstrated to be safe, the delivered medical substances still need to be analyzed at the end of the flight mission to assess the level of haemolysis and pH prior to the use in a patient. This process can last up to 30 min and prevent the time saved using drone delivery. Our study aims to integrating an innovative sensor for the haemolysis and pH detection into the Smart Capsule, an already demonstrated technology capable of managing transfusion transport through drones. In the proposed scenario, the haemolysis is evaluated optically by a minilysis device using LED-photodetector combination. The preliminary validation has been demonstrated for both the thermal stability of the Smart Capsule and the haemolysis detection of the minilysis device prototype. Firstly, the onboard temperature test has shown that the delivery system is capable of maintaining proper temperature, even though the samples have been manipulated to reach a higher temperature before inserting into the Smart Capsule. Then, in the laboratory haemolysis test, the trend of linear regression between the outputs from the spectrophotometer and the minilysis prototype confirmed the concept design of the minilysis device.

Examining the Impact of Sample Thickness Variations on the Hyperspectral Radiometric Responses of Flowing Blood

The hyperspectral reflectance and transmittance of flowing blood samples are employed in a wide range of biomedical applied research initiatives such as the detection and monitoring of hematological abnormalities. The success of these initiatives is tied to the correct interpretation of these radiometric quantities. This, in turn, requires a comprehensive understanding about their sensitivity to variations in the experimental conditions in which they have been obtained. In this paper, we aim to contribute to these efforts by systematically examining the effects of sample thickness variations on these quantities. More specifically, we employed controlled in silico experiments to assess these effects on samples with different biophysical characteristics, notably their hematocrit, hemolysis level and orientation of their constituent cells with respect to the flow direction. To ensure a high degree of fidelity in our experiments, we used a first-principles simulation framework supported by measured data. Our findings unveil distinct spectrally-dependent trends associated with reflectance and transmittance changes elicited by sample thickness variations.

Detection of VEGF165 in Whole Blood by Differential Pulse Voltammetry Based on a Centrifugal Microfluidic Chip

For the rapid and sensitive detection of vascular endothelial growth factor 165 (VEGF₁₆₅) in clinical blood samples, a microfluidic sensing chip that integrates a centrifugal separation pretreatment unit and a composite nanosensing film was proposed in this paper. An efficient sensing strategy and method was established. The blood sample was first separated and extracted by centrifugal force on the centrifugal microfluidic chip within 5 min after injection. The separated plasma can be automatically transferred through the designed microchannels to the detection area integrated electrodes for subsequent differential pulse voltammetric detection. The Au NPs/MCH/Apt2 sensing film was constructed on the surface of the Au working electrode. A sandwich sensing strategy based on "double aptamers" and "nanoprobe" for VEGF₁₆₅ detection was established, by which the synthetic Apt1/PThi/Au NP nanoprobe was applied to capture VEGF₁₆₅ in plasma and bind to the sensing film. By this method, the detection limit of VEGF₁₆₅ in whole blood was 0.67 pg/mL and the linear range was between 1 pg and 10 ng, which met the needs of clinical VEGF₁₆₅ detection. It was illustrated that the proposed methodology based on the centrifugal microfluidic chip had potential application prospects in the development of the point-of-care testing fields.

Integrated Point-of-Care Molecular Diagnostic Devices for Infectious Diseases

The global outbreaks of deadly infectious diseases caused by pathogenic microorganisms have threatened public health worldwide and significantly motivated scientists to satisfy an urgent need for a rapid and accurate detection of pathogens. Traditionally, the culture-based technique is considered as the gold standard for pathogen detection, yet it has a long turnaround time due to the overnight culturing and pathogen isolation. Alternatively, nucleic acid amplification tests provide a relatively shorter turnaround time to identify whether pathogens exist in individuals with high sensitivity and high specificity. In most cases, nucleic acid amplification tests undergo three steps: sample preparation, nucleic acid amplification, and signal transduction. Despite the explosive advancement in nucleic acid amplification and signal transduction technologies, the complex and labor-intensive sample preparation steps remain a bottleneck to create a transformative integrated point-of-care (POC) molecular diagnostic device. Researchers have attempted to simplify and integrate the sample preparations for nucleic acid-based molecular diagnostic devices with innovative progress in integration strategies, engineered materials, reagent storages, and fluid actuation. Therefore, understanding the know-how and obtaining truthful knowledge of existing integrated POC molecular diagnostic devices comprising sample preparations, nucleic acid amplification, and signal transduction can generate innovative solutions to achieve personalized precision medicine and improve global health.In this Account, we discuss the challenges of automated sample preparation solutions integrated with nucleic acid amplification and signal transduction for rapid and precise home diagnostics. Blood, nasal swab, saliva, urine, and stool are emphasized as the most commonly used clinical samples for integrated POC molecular diagnostics of infectious diseases. Even though these five types of samples possess relatively correlated biomarkers due to the human body's circulatory system, each shows unique properties and exclusive advantages for molecular diagnostics in specific situations, which are included in this Account. We examine different integrated POC devices for sample preparation, which includes pathogen isolation and enrichment from the crude sample and nucleic acid purification from isolated pathogens. We present the promising on-chip integration approaches for nucleic acid amplification. We also investigate the on-chip integration methods for reagent storage, which is crucial to simplify the manual operation for end-users. Finally, we present several integrated POC molecular diagnostic devices for infectious diseases. The integrated sample preparation and nucleic acid amplification approach reviewed here can potentially impact the next generation of POC molecular home diagnostic chips, which will significantly impact public health, emergency medicine, and global biosecurity.

High-Performance Passive Plasma Separation on OSTE Pillar Forest

Plasma separation is of high interest for lateral flow tests using whole blood as sample liquids. Here, we built a passive microfluidic device for plasma separation with high performance. This device was made by blood filtration membrane and off-stoichiometry thiol-ene (OSTE) pillar forest. OSTE pillar forest was fabricated by double replica moldings of a laser-cut polymethylmethacrylate (PMMA) mold, which has a uniform microstructure. This device utilized a filtration membrane to separate plasma from whole blood samples and used hydrophilic OSTE pillar forest as the capillary pump to propel the plasma. The device can be used to separate blood plasma with high purity for later use in lateral flow tests. The device can process 45 μL of whole blood in 72 s and achieves a plasma separation yield as high as 60.0%. The protein recovery rate of separated plasma is 85.5%, which is on par with state-of-the-art technologies. This device can be further developed into lateral flow tests for biomarker detection in whole blood.

Ultralow-Fouling Zwitterionic Polyurethane-Modified Membranes for Rapid Separation of Plasma from Whole Blood

The separation of plasma from blood cells in whole blood is an essential step for many diagnostic and therapeutic applications. However, the current point-of-care plasma separation approaches have not yet satisfied the need for a rapid, high-flux, and low-cost process. Here, we report a portable, low-cost, disposable membrane-based plasma separation device that enables rapid plasma extraction from whole blood. Rapid separation of plasma can be obtained with a simple three-step operation: blood injection, separation, and plasma collection. Our device benefits from the zwitterionic polyurethane-modified cellulose acetate (PCBU-CA) membrane, which can greatly inhibit the surface fouling of blood cells and membrane flux decline. The zwitterionic coating is stable on the membrane surface during blood filtration and leads to a 60% decrease in surface fibrinogen adsorption than a nonmodified membrane surface. The ultralow-blood-fouling properties of the PCBU-CA membrane enable rapid, continuous separation of plasma: within 10 min, the device can yield 0.5-0.7 mL of plasma from 10 mL of whole blood. The extracted plasma is verified as cell-free, exhibits a low hemoglobin level, and has a high protein recovery. Our PCBU-CA membrane provides a pathway for developing a high-efficiency portable plasma separation device that can reduce the time to diagnosis, allow effective patient care, and eventually reduce hospital costs.

Antibody Surface Coverage Drives Matrix Interference in Microfluidic Capillary Immunoassays

The performance of biosensors is often optimized in buffers, which brings inconsistencies during applications with biological samples. Current strategies for minimizing sample (matrix) interference are complex to automate and miniaturize, involving, e.g., sample dilution or recovery of serum/plasma. This study shows the first systematic analysis using hundreds of actual microfluidic immunoassay fluoropolymer strips to understand matrix interference in microflow systems. As many interfering factors are assay-specific, we have explored matrix interference for a range of enzymatic immunoassays, including a direct mIgG/anti-mIgG, a sandwich cancer biomarker PSA, and a sandwich inflammatory cytokine IL-1β. Serum matrix interference was significantly affected by capillary antibody surface coverage, suggesting for the first time that the main cause of the serum matrix effect is low-affinity serum components (e.g., autoantibodies) competing with high-affinity antigens for the immobilized antibody. Additional experiments carried out with different capillary diameters confirmed the importance of antibody surface coverage in managing matrix interference. Building on these findings, we propose a novel analytical approach where antibody surface coverage and sample incubation times are key for eliminating and/or minimizing serum matrix interference, consisting in bioassay optimization carried out in serum instead of buffer, without compromising the performance of the bioassay or adding extra cost or steps. This will help establishing a new route toward faster development of modern point-of-care tests and effective biosensor development.

Blood Plasma Self-Separation Technologies during the Self-Driven Flow in Microfluidic Platforms

Blood plasma is the most commonly used biofluid in disease diagnostic and biomedical analysis due to it contains various biomarkers. The majority of the blood plasma separation is still handled with centrifugation, which is off-chip and time-consuming. Therefore, in the Lab-on-a-chip (LOC) field, an effective microfluidic blood plasma separation platform attracts researchers' attention globally. Blood plasma self-separation technologies are usually divided into two categories: active self-separation and passive self-separation. Passive self-separation technologies, in contrast with active self-separation, only rely on microchannel geometry, microfluidic phenomena and hydrodynamic forces. Passive self-separation devices are driven by the capillary flow, which is generated due to the characteristics of the surface of the channel and its interaction with the fluid. Comparing to the active plasma separation techniques, passive plasma separation methods are more considered in the microfluidic platform, owing to their ease of fabrication, portable, user-friendly features. We propose an extensive review of mechanisms of passive self-separation technologies and enumerate some experimental details and devices to exploit these effects. The performances, limitations and challenges of these technologies and devices are also compared and discussed.

Enhanced Diamagnetic Repulsion of Blood Cells Enables Versatile Plasma Separation for Biomarker Analysis in Blood

A hemolysis-free and highly efficient plasma separation platform enabled by enhanced diamagnetic repulsion of blood cells in undiluted whole blood is reported. Complete removal of blood cells from blood plasma is achieved by supplementing blood with superparamagnetic iron oxide nanoparticles (SPIONs), which turns the blood plasma into a paramagnetic condition, and thus, all blood cells are repelled by magnets. The blood plasma is successfully collected from 4 mL of blood at flow rates up to 100 µL min^-1 without losing plasma proteins, platelets, or exosomes with 83.3±1.64% of plasma volume recovery, which is superior over the conventional microfluidic methods. The theoretical model elucidates the diamagnetic repulsion of blood cells considering hematocrit-dependent viscosity, which allows to determine a range of optimal flow rates to harvest platelet-rich plasma and platelet-free plasma. For clinical validations, it is demonstrated that the method enables the greater recovery of bacterial DNA from the infected blood than centrifugation and the immunoassay in whole blood without prior plasma separation.

Wicking microfluidic approach to separate blood plasma from whole blood to facilitate downstream assays

Separation of blood plasma or serum from blood is essential for accurate analysis. Conventional blood separation requires instrumentation, reagents, and large sample volumes, limiting this process to laboratory environments with trained personnel. Full implementation of effective blood separation and analysis on microliter sample volumes for point of care (POC) diagnostics has proven extremely challenging resulting in a growing market demand, with common challenges such as expensive device fabrication processes or devices being comprised of materials which are not easily disposable. We developed a membrane-based wicking microfluidic device which is made using a simple fabrication process. This device uses a unique 3D flow channel geometry, fabricated in a polycaprolactone-filled glass microfiber membrane, to efficiently separate microliter sample volumes of blood. Colorimetric assay chemistries were integrated to demonstrate utility of these devices in POC diagnostics. The devices are capable of separating both fresh and anticoagulant-treated blood at microscale sample volumes (<15.0 μL). Modifications to the base device are also reported herein which increased sample volume capacity and separation efficiency. Integrated colorimetric assay enabled semi-quantitative detection of conjugated bilirubin in real blood samples (1.0-1.5 mg/dL). These blood separation devices, fabricated on polycaprolactone-filled glass microfiber, enabled effective blood plasma (anticoagulant-treated blood) and serum (fresh blood) separation with microscale sample volumes. Sample volume capacity and separation efficiency are customizable for specific applications and devices can be integrated with downstream assay chemistries to develop complete POC devices that offer blood separation and diagnostics at the same time on a single membrane.

Molecular diffusion analysis of dynamic blood flow and plasma separation driven by self-powered microfluidic devices

Integration of microfluidic devices with pressure-driven, self-powered fluid flow propulsion methods has provided a very effective solution for on-chip, droplet blood testing applications. However, precise understanding of the physical process governing fluid dynamics in polydimethylsiloxane (PDMS)-based microfluidic devices remains unclear. Here, we propose a pressure-driven diffusion model using Fick's law and the ideal gas law, the results of which agree well with the experimental fluid dynamics observed in our vacuum pocket-assisted, self-powered microfluidic devices. Notably, this model enables us to precisely tune the flow rate by adjusting two geometrical parameters of the vacuum pocket. By linking the self-powered fluid flow propulsion method to the sedimentation, we also show that direct plasma separation from a drop of whole blood can be achieved using only a simple construction without the need for external power sources, connectors, or a complex operational procedure. Finally, the potential of the vacuum pocket, along with a removable vacuum battery to be integrated with non-PDMS microfluidic devices to drive and control the fluid flow, is demonstrated.

A disc-chip based high-throughput acute toxicity detection system

Acute toxicity assay presents vital significance in modern environmental monitoring, including online detection and in-situ assay for emergency events. Although photobacteria related detection methods were established and verified in the past decades with combination of photomultiplier tube (PMT), the price and size of PMT sensor hampered application of rapid acute toxicity assay and detection system miniaturization, especially in the resource-limited occasions. Wide application of smartphones with great low-light performance cameras could be used in photobacteria-based toxicity assay instead of the PMT methods. Herein a box-type portable detection system had been successfully established, including a disc-chip for detection, detection device, and smartphones with a high-performance camera. The system performed well showing stable temperature and rotation control. Results captured by CMOS-based camera presented a linear relationship with PMT-based detection method. An image progress algorithm was also established and tested by series diluted zinc sulfate solution as a reference substance. The system also performed well for toxicity analysis for real Atmospheric particle matter sample. The system could be used in some environmental monitoring scenarios as an alternative solution.

Ultrahigh throughput beehive-like device for blood plasma separation

We report here a low-cost, rapid-prototyping, and beehive-like multilayer polymer microfluidic device for ultrahigh-throughput blood plasma separation. To understand the device physics and optimize the device structure, the effect of cross-sectional dimension and operational parameter on particle focusing behavior was explored using a single spiral microchannel device. Then, the blood plasma separation performance of the determined channel structure was validated using the blood samples with different hematocrits (HCTs). It was found that a high separation efficiency of 99% could be achieved using the blood sample with an HCT of 0.5% at a high throughput of 1 mL/min. Finally, a multilayer microfluidic device with a novel beehive-like multiplexing channel arrangement was developed for ultrahigh-throughput blood plasma separation. The prototype device could be fabricated within ∼1 hour utilizing the laser cutting and thermal lamination methods. The total processing throughput could reach up to 72 mL/min for 0.5% HCT sample with a plasma separation ratio close to 90%. Our device may hold potentials for the ultrahigh-throughput separation of blood plasma from large volume blood samples for downstream disease diagnosis.

Electrochemical detection of viruses and antibodies: A mini review

Near patient detection of viral infection represents a powerful approach for the control of emerging threats to global health. Moreover, the ability to identify individuals who have contracted the disease and developed antibodies that confer immunity is central to a return to normal daily activities. This review presents some of the recent advances in electrochemical sensors for the detection of viruses and their associated antibody profiles. Given the speed, portability, sensitivity and selectivity achieved using electrochemical detection, these sensor systems hold the promise of transformative change in clinical practice.

A simple and rapid method for blood plasma separation driven by capillary force with an application in protein detection

Blood plasma separation is a vital sample pre-treatment procedure for microfluidic devices in blood diagnostics, and it requires reliability and speediness. In this work, we propose a novel and simple method for microvolume blood plasma separation driven by capillary force. Flat-shaped filter membranes combined with hydrophilic narrow capillaries are introduced into devices, in order to reduce the residual volumes of blood plasma. An interference fit is used to ensure no leakage of blood or cells. There is desired trapping efficiency of blood cells in the devices. The method provides high efficiency with a plasma extraction yield of 71.7% within 6 min, using 60 μL of undiluted whole human blood with 45% haematocrit. The influence from structural parameters on the separation kinetics and the dependence of the haematocrit levels on the separation efficiency are also investigated. The total protein detection shows considerable protein recovery of 82.3% in the extracted plasma. Thus, the plasma separation unit with a very simple structure is suitable for integrating into microfluidic devices, presenting promising prospects for clinical diagnostics as well as for point-of-care testing applications.

Screening of multiple hemoprotein-specific aptamers and their applications for the binding, quantification, and extraction of hemoproteins in a microfluidic system

The blood hemoproteins, albumin, γ-globulin, and fibrinogen, serve as biomarkers for a variety of human diseases, including kidney and hepatorenal syndromes. Therefore, there is a need to quickly and accurately measure their concentrations in blood. Herein, nucleic acid aptamers demonstrating high affinity and specificity toward these hemoproteins were selected via systematic evolution of ligands by exponential enrichment, and their ability to capture their protein targets was assessed with sodium dodecyl sulfate-polyacrylamide gel electrophoresis followed by a tetramethyl benzidine assay. The limits of detection for the hemoproteins were all around 10-3 μM, and dissociation constant values of 131, 639, and 29nM were obtained; capture rates were measured to be 66%, 71%, and 61%, which is likely to be suitable for clinical diagnostics. Furthermore, a multi-layer microfluidic disk system featuring hemoprotein-specific aptamers for depleting hemoproteins was demonstrated. It could be a promising approach to use aptamers to replace conventional antibodies.

Three-dimensional microfluidic tape-paper-based sensing device for blood total bilirubin measurement in jaundiced neonates

More than 60% newborns experience hyperbilirubinemia and jaundice within the initial week after birth due to the accumulation of total bilirubin in blood. Left untreated high levels of bilirubin may result in brain impairment. Simple, fast, accurate, low-cost and timely point-of-care (POC) analysis of total bilirubin is an unmet need especially in resource-limited areas. This work introduces a novel sensing device, named a "tape-paper sensor", capable of separating plasma from whole blood and measuring total bilirubin by a colorimetric diazotization method. The tape-paper sensing method overcomes non-homogeneous color distribution caused by the "coffee stain" effect, which improves the accuracy of colorimetric evaluation on paper-based analytical devices. The level of hemolysis in the plasma extracted by the device is evaluated, confirming no interference in the detection of total bilirubin. The accuracy of the tape-paper sensing approach for neonatal blood sample measurement is verified by comparison with the hospital pathology laboratory method. The small volume of samples and reagents, minimal equipment (an office scanner), fast detection (<10 min) and low fabrication cost (∼A$ 0.6) reveal the suitability of the device for POC use and in resource-limited settings. The tape-paper sensor is a low-cost, fast, and user-friendly device for measurement of blood total bilirubin levels in neonatal jaundice diagnostics.

Portable Resource-Independent Blood-Plasma Separator

The centrifuge is the gold standard for lab-based sample processing. While extremely efficient and robust, centrifuges are seldom used in the field due to the high-power requirements, size, and operational complexity. The lack of viable alternatives for remote sample collection has crippled the ability for mobile practitioners in human and animal medicine to reliably collect blood samples from their patients. There is no truly resource-independent solution that is able to perform highly efficient blood-plasma separation. Here, we describe our initial efforts in developing the High Efficiency Rapid Magnetic Erythrocyte Separator (H.E.R.M.E.S) sleeve, an apparatus that uses a magnetic bead-based separation assay in a scaled-up form factor to achieve highly efficient separation of erythrocytes from plasma within a short amount of time. The sleeve is easy-to-use, is completely resource independent, and achieves highly efficient separation in sample volumes as large as 1 mL by means of a unique mixing scheme. We demonstrate the performance of the sleeve with human blood samples and compare it against conventional end-over-end mixing.

Development and Characterization of Monoclonal Antibodies Against Glycophorin A Applicable for Blood Sample Processing

The separation of plasma from blood cells is critical for the accuracy of blood tests because cellular fractions can create discrepancies in analysis. The most common method to separate blood cells from the liquid part of the blood is centrifugation, which is not always applicable in resource-constrained areas and countries. In this study, we describe the generation of monoclonal antibodies (mAbs) against glycophorin A (GPA) of human erythrocytes. BALB/c mice were immunized with human erythrocytes followed by purified GPA. The splenocytes of the immunized mice were fused with Sp2/0 myeloma cells by hybridoma technique. Hybridoma clones were screened by hemagglutination assay and enzyme-linked immunosorbent assay (ELISA). Six hybridoma clones were obtained and subcloned. The characterization of the purified mAbs demonstrates that they are able to bind and retain erythrocytes in hemagglutination assay. Furthermore, one of the mAbs 1A9 recognizes purified GPA in ELISA, whereas the other mAb 1G7 is able to immunoprecipitate GPA from human erythrocyte lysates, and a band of 38 kDa is detected. In conclusion, the anti-GPA mAbs are useful tools in developing a quick and easy way to separate blood plasma from whole blood for clinical tests, and in developing bi-specific antibodies for other clinical applications.

Thermopneumatic suction integrated microfluidic blood analysis system

Blood tests provide crucial diagnostic information regarding several diseases. A key factor that affects the precision and accuracy of blood tests is the interference of red blood cells; however, the conventional methods of blood separation are often complicated and time consuming. In this study, we devised a simple but high-efficiency blood separation system on a self-strained microfluidic device that separates 99.7 ± 0.3% of the plasma in only 6 min. Parameters, such as flow rate, design of the filter trench, and the relative positions of the filter trench and channel, were optimized through microscopic monitoring. Moreover, this air-difference-driven device uses a cost-effective and easy-to-use heater device that creates a low-pressure environment in the microchannel within minutes. With the aforementioned advantages, this blood separation device could be another platform choice for point-of-care testing.

From Point-of-Care Testing to eHealth Diagnostic Devices (eDiagnostics)

Point-of-care devices were originally designed to allow medical testing at or near the point of care by health-care professionals. Some point-of-care devices allow medical self-testing at home but cannot fully cover the growing diagnostic needs of eHealth systems that are under development in many countries. A number of easy-to-use, network-connected diagnostic devices for self-testing are needed to allow remote monitoring of patients' health. This Outlook highlights the essential characteristics of diagnostic devices for eHealth settings and indicates point-of-care technologies that may lead to the development of new devices. It also describes the most representative examples of simple-to-use, point-of-care devices that have been used for analysis of untreated biological samples.

The Many Roads to an Ideal Paper-based Device

The recent Zika and Ebola virus outbreaks highlight the need for low-cost diagnostics that can be rapidly deployed and used outside of established clinical infrastructure. This demand for robust point-of-care (POC) diagnostics is further driven by the increasing burden of drug-resistant diseases, concern for food and water safety, and bioterrorism. As has been discussed in previous chapters, paper-based tests provide a simple and compelling solution to such needs.

High-Yield Passive Plasma Filtration from Human Finger Prick Blood

Whole-blood microsampling provides many benefits such as remote, patient-centric, and minimally invasive sampling. However, blood plasma, and not whole blood, is the prevailing matrix in clinical laboratory investigations. The challenge with plasma microsampling is to extract plasma volumes large enough to reliably detect low-concentration analytes from a small finger prick sample. Here we introduce a passive plasma filtration device that provides a high extraction yield of 65%, filtering 18 μL of plasma from 50 μL of undiluted human whole blood (hematocrit 45%) within less than 10 min. The enabling design element is a wedge-shaped connection between the blood filter and the hydrophilic bottom surface of a capillary channel. Using finger prick and venous blood samples from more than 10 healthy volunteers, we examined the filtration kinetics of the device over a hematocrit range of 35-55% and showed that 73 ± 8% of the total protein content was successfully recovered after filtration. The presented plasma filtration device tackles a major challenge toward patient-centric blood microsampling by providing high-yield plasma filtration, potentially allowing reliable detection of low-concentration analytes from a blood microsample.

H.E.R.M.E.S: rapid blood-plasma separation at the point-of-need

The global healthcare landscape is experiencing increasing demand for CLIA-waived testing facilities that offer diagnostic capabilities at lower costs and greater convenience than traditional laboratory testing. While several new diagnostic tools have emerged to fulfill testing requirements in these environments, centrifuges have been stymied from transitioning to the point-of-need as the US Food and Drug Administration (FDA) classifies them as mostly unsuitable for use in CLIA-waived environments. Limitations in sample processing capabilities adversely affects the ability for CLIA-waived testing environments to offer a broad testing portfolio and present-day diagnostics are bottlenecked by the requirement for centrifugation. Here we present the High Efficiency Rapid Magnetic Erythrocyte Separator (H.E.R.M.E.S), a rapid low-cost technology that can perform the separation of red blood cells from plasma at a fraction of the time and cost of that of a centrifuge. We demonstrate that H.E.R.M.E.S is able to obtain highly-pure plasma (greater than 99.9% purity) at less than 2 minutes per test. Further, we detail that it is an easy-to-use method capable of being incorporated with present-day diagnostic technologies and prove that it is superior to existing alternatives to centrifugation by validation with a ferritin lateral flow test. H.E.R.M.E.S is a suitable alternative for centrifugation in point-of-need settings and aims to facilitate the decentralization of commercial blood testing.

One-step procedure for enhancing the antibacterial and antioxidant properties of a polysaccharide polymer: Kojic acid grafted onto chitosan

The purpose of this work was to develop a nontoxic bioactive material based on a natural pyrone compound (kojic acid, KA) and chitosan oligosaccharides (COS). The bioactive material, chitosan oligosaccharide-N-kojic acid polymer (COS-N-KA), was prepared by one-step environmentally friendly approach. Then, the physicochemical properties and biological activities of COS-N-KA as a prepared water-soluble COS derivative were evaluated. The polymer was characterized by using UV-vis, FTIR, ¹H NMR, and ¹³C NMR spectroscopy, Mw, PID, TGA, water solubility, hemolysis assay, and animal toxicity studies. Particularly, the antioxidant and antimicrobial assays revealed that COS-N-KA significantly enhanced the antimicrobial and antioxidant activities, which remarkably stronger than that of free COS and KA. Hence, the low hemolytic activity to human red blood cells, and nontoxic to female mice of SLAC KM strain made this novel polymer material a promising and effective compound for food and pharmaceutical industries.

A low cost, membranes based serum separator modular

To fulfill the requirement of sample preparation in a microfluidic analysis system designed for "sample in, answer out" testing which was urgently needed by resource limited clinical facilities, we proposed a critical low cost, membrane-based serum separator design in this article. With a specially designed microchip, this device can easily separate serum from the whole blood sample in 5 min. Different from techniques which have been reported earlier, this approach does not require either centrifugation or sample dilution which may cause hemolysis or decreased testing sensitivity. By applying 300 μl of the whole blood sample, 50-70 μl of serum can be recovered from each device, and the serum volume recovery rate compared with centrifuged control is around 73% which is sufficient for most of the microfluidic-based assays. The protein recovery rate ranged from 70% to 95% which was compared with centrifuged control. The evaluation results indicate that this sample preparation device can offer sufficient amount of purified serum sample for any kind of diagnostic assays such as immunoassay and serum nucleic acid assay.

Label-free extraction of extracellular vesicles using centrifugal microfluidics

Extracellular vesicles (EVs) play an important role as active messengers in intercellular communication and distant microenvironment modeling. Increasingly, these EVs are recognized as important biomarkers for clinical diagnostics. However, current isolation methods of EVs are time-consuming and ineffective due to the high diffusive characteristics of nanoparticles coupled with fluid flow instability. Here, we develop a microfluidic CEntrifugal Nanoparticles Separation and Extraction (µCENSE) platform for the rapid and label-free isolation of microvesicles. By utilizing centrifugal microhydrodynamics, we subject the nanosuspensions between 100 nm and 1000 nm to a unique fluid flow resulting in a zonal separation into different outlets for easy post-processing. Our centrifugal platform utilizes a gentle and efficient size-based separation without the requirements of syringe pump and other accessories. Based on our results, we report a high separation efficiency of 90% and an extraction purity of 85% within a single platform. Importantly, we demonstrate high EV extraction using a table top centrifuge within a short duration of eight minutes. The simple processes and the small volume requirement further enhance the utility of the platform. With this platform, it serves as a potential for liquid biopsy extraction and point-of-care diagnostics.

Novel Opportunities for Improving the Quality of Preanalytical Phase. A Glimpse to the Future?

The preanalytical phase is crucial for assuring the quality of in vitro diagnostics. The leading aspects which contribute to enhance the vulnerability of this part of the total testing process include the lack of standardization of different practices for collecting, managing, transporting and processing biological specimens, the insufficient compliance with available guidelines and the still considerable number of preventable human errors. As in heavy industry, road traffic and aeronautics, technological advancement holds great promise for decreasing the risk of medical and diagnostic errors, thus including those occurring in the extra-analytical phases of the total testing process. The aim of this article is to discuss some potentially useful technological advances, which are not yet routine practice, but may be especially suited for improving the quality of the preanalytical phase in the future. These are mainly represented by introduction of needlewielding robotic phlebotomy devices, active blood tubes, drones for biological samples transportation, innovative approaches for detecting spurious hemolysis and preanalytical errors recording software products.

Capillary flow-driven microfluidic device with wettability gradient and sedimentation effects for blood plasma separation

We report a capillary flow-driven microfluidic device for blood-plasma separation that comprises a cylindrical well between a pair of bottom and top channels. Exposure of the well to oxygen-plasma creates wettability gradient on its inner surface with its ends hydrophilic and middle portion hydrophobic. Due to capillary action, sample blood self-infuses into bottom channel and rises up the well. Separation of plasma occurs at the hydrophobic patch due to formation of a ‘self-built-in filter’ and sedimentation. Capillary velocity is predicted using a model and validated using experimental data. Sedimentation of RBCs is explained using modified Steinour’s model and correlation between settling velocity and liquid concentration is found. Variation of contact angle on inner surface of the well is characterized and effects of well diameter and height and dilution ratio on plasma separation rate are investigated. With a well of 1.0 mm diameter and 4.0 mm height, 2.0 μl of plasma was obtained (from <10 μl whole blood) in 15 min with a purification efficiency of 99.9%. Detection of glucose was demonstrated with the plasma obtained. Wetting property of channels was maintained by storing in DI water under vacuum and performance of the device was found to be unaffected over three weeks.

Microfluidic blood plasma separation for medical diagnostics: is it worth it?

Circulating biomarkers are on the verge of becoming powerful diagnostic tools for various human diseases. However, the complex sample composition makes it difficult to detect biomarkers directly from blood at the bench or at the point-of-care. Blood cells are often a source of variability of the biomarker signal. While the interference of hemoglobin is a long known source of variability, the release of nucleic acids and other cellular components from hemocytes is a new concern for measurement and detection of circulating extracellular markers. Research into miniaturised blood plasma separation has been thriving in the last 10 years (2006-2016). Most point-of-care systems need microscale blood plasma separation, but developed solutions differ in complexity and sample volume range. But could blood plasma separation be avoided completely? This focused review weights the advantages and limits of miniaturised blood plasma separation and highlights the most interesting advances in direct capture as well as smart blood plasma separation.

Capillary flow of blood in a microchannel with differential wetting for blood plasma separation and on-chip glucose detection

We report capillary flow of blood in a microchannel with differential wetting for the separation of a plasma from sample blood and subsequent on-chip detection of glucose present in a plasma. A rectangular polydimethylsiloxane microchannel with hydrophilic walls (on three sides) achieved by using oxygen plasma exposure enables capillary flow of blood introduced at the device inlet through the microchannel. A hydrophobic region (on all four sides) in the microchannel impedes the flow of sample blood, and the accumulated blood cells at the region form a filter to facilitate the separation of a plasma. The modified wetting property of the walls and hence the device performance could be retained for a few weeks by covering the channels with deionised water. The effects of the channel cross-section, exposure time, waiting time, and location and length of the hydrophobic region on the volume of the collected plasma are studied. Using a channel cross-section of 1000 × 400 μm, an exposure time of 2 min, a waiting time of 10 min, and a hydrophobic region of width 1.0 cm located at 10 mm from the device inlet, 450 nl of plasma was obtained within 15 min. The performance of the device was found to be unaffected (provides 450 nl of plasma in 15 min) even after 15 days. The purification efficiency and plasma recovery of the device were measured and found to be comparable with that obtained using the conventional centrifugation process. Detection of glucose at different concentrations in whole blood of normal and diabetic patients was performed (using 5 μl of sample blood within 15 min) to demonstrate the compatibility of the device with integrated detection modules.

Blood drop patterns: Formation and applications

The drying of a drop of blood or plasma on a solid substrate leads to the formation of interesting and complex patterns. Inter- and intra-cellular and macromolecular interactions in the drying plasma or blood drop are responsible for the final morphologies of the dried patterns. Changes in these cellular and macromolecular components in blood caused by diseases have been suspected to cause changes in the dried drop patterns of plasma and whole blood, which could be used as simple diagnostic tools to identify the health of humans and livestock. However, complex physicochemical driving forces involved in the pattern formation are not fully understood. This review focuses on the scientific development in microscopic observations and pattern interpretation of dried plasma and whole blood samples, as well as the diagnostic applications of pattern analysis. Dried drop patterns of plasma consist of intricate visible cracks in the outer region and fine structures in the central region, which are mainly influenced by the presence and concentration of inorganic salts and proteins during drying. The shrinkage of macromolecular gel and its adhesion to the substrate surface have been thought to be responsible for the formation of the cracks. Dried drop patterns of whole blood have three characteristic zones; their formation as functions of drying time has been reported in the literature. Some research works have applied engineering treatment to the evaporation process of whole blood samples. The sensitivities of the resultant patterns to the relative humidity of the environment, the wettability of the substrates, and the size of the drop have been reported. These research works shed light on the mechanisms of spreading, evaporation, gelation, and crack formation of the blood drops on solid substrates, as well as on the potential applications of dried drop patterns of plasma and whole blood in diagnosis.

A high-efficiency superhydrophobic plasma separator

To meet stringent limit-of-detection specifications for low abundance target molecules, a relatively large volume of plasma is needed for many blood-based clinical diagnostics. Conventional centrifugation methods for plasma separation are not suitable for on-site testing or bedside diagnostics. Here, we report a simple, yet high-efficiency, clamshell-style, superhydrophobic plasma separator that is capable of separating a relatively large volume of plasma from several hundred microliters of whole blood (finger-prick blood volume). The plasma separator consists of a superhydrophobic top cover with a separation membrane and a superhydrophobic bottom substrate. Unlike previously reported membrane-based plasma separators, the separation membrane in our device is positioned at the top of the sandwiched whole blood film to increase the membrane separation capacity and plasma yield. In addition, the device's superhydrophobic characteristics (i) facilitates the formation of well-defined, contracted, thin blood film with a high contact angle; (ii) minimizes biomolecular adhesion to surfaces; (iii) increases blood clotting time; and (iv) reduces blood cell hemolysis. The device demonstrated a "blood in-plasma out" capability, consistently extracting 65 ± 21.5 μL of plasma from 200 μL of whole blood in less than 10 min without electrical power. The device was used to separate plasma from Schistosoma mansoni genomic DNA-spiked whole blood with a recovery efficiency of >84.5 ± 25.8%. The S. mansoni genomic DNA in the separated plasma was successfully tested on our custom-made microfluidic chip by using loop mediated isothermal amplification (LAMP) method.

Smart Pipette and Microfluidic Pipette Tip for Blood Plasma Separation

An integrated method for blood plasma separation is presented by combining a pneumatic device, which is referred to as a "smart pipette," and a hydrophoretic microchannel as a microfluidic pipette tip for whole-blood sample preparation. This method enables hemolysis-free, high-purity plasma separation through smart pipetting of whole blood, potentially providing the means for rapid, inexpensive blood sample preparation for point-of-care testing.

A smart pipette for equipment-free separation and delivery of plasma for on-site whole blood analysis

A novel device of smart pipette has been suggested to extract and deliver plasma from whole blood in a disposable format. By operating an on-chip disposable micropump, approximately 30 μL of plasma was obtained from 100 μL of whole blood within 5 min without any external equipment for point-of-care blood analysis.