Multiplexed detection of cancer biomarkers using a microfluidic platform integrating single bead trapping and acoustic mixing techniques

Recent Advances in Acoustofluidics for Point-of-Care Testing

Point-of-care testing (POCT) has played important role in clinical diagnostics, environmental assessment, chemical and biological analyses, and food and chemical processing due to its faster turnaround compared to laboratory testing. Dedicated manipulations of solutions or particles are generally required to develop POCT technologies that achieve a "sample-in-answer-out" operation. With the development of micro- and nanotechnology, many tools have been developed for sample preparation, on-site analysis and solution manipulations (mixing, pumping, valving, etc.). Among these approaches, the use of acoustic waves to manipulate fluids and particles (named acoustofluidics) has been applied in many researches. This review focuses on the recent developments in acoustofluidics for POCT. It starts with the fundamentals of different acoustic manipulation techniques and then lists some of representative examples to highlight each method in practical POC applications. Looking toward the future, a compact, portable, highly integrated, low power, and biocompatible technique is anticipated to simultaneously achieve precise manipulation of small targets and multimodal manipulation in POC applications.

A tempo-spatial controllable microfluidic shear-stress generator for in-vitro mimicking of the thrombus

Pathological conditions linked to shear stress have been identified in hematological diseases, cardiovascular diseases, and cancer. These conditions often exhibit significantly elevated shear stress levels, surpassing 1000 dyn/cm2 in severely stenotic arteries. Heightened shear stress can induce mechanical harm to endothelial cells, potentially leading to bleeding and fatal consequences. However, current technology still grapples with limitations, including inadequate flexibility in simulating bodily shear stress environments, limited range of shear stress generation, and spatial and temporal adaptability. Consequently, a comprehensive understanding of the mechanisms underlying the impact of shear stress on physiological and pathological conditions, like thrombosis, remains inadequate. To address these limitations, this study presents a microfluidic-based shear stress generation chip as a proposed solution. The chip achieves a substantial 929-fold variation in shear stress solely by adjusting the degree of constriction in branch channels after PDMS fabrication. Experiments demonstrated that a rapid increase in shear stress up to 1000 dyn/cm2 significantly detached 88.2% cells from the substrate. Long-term exposure (24 h) to shear stress levels below 8.3 dyn/cm2 did not significantly impact cell growth. Furthermore, cells exposed to shear stress levels equal to or greater than 8.3 dyn/cm2 exhibited significant alterations in aspect ratio and orientation, following a normal distribution. This microfluidic chip provides a reliable tool for investigating cellular responses to the wide-ranging shear stress existing in both physiological and pathological flow conditions.

Acoustohydrodynamic micromixers: Basic mixing principles, programmable mixing prospectives, and biomedical applications

Acoustohydrodynamic micromixers offer excellent mixing efficiency, cost-effectiveness, and flexible controllability compared with conventional micromixers. There are two mechanisms in acoustic micromixers: indirect influence by induced streamlines, exemplified by sharp-edge micromixers, and direct influence by acoustic waves, represented by surface acoustic wave micromixers. The former utilizes sharp-edge structures, while the latter employs acoustic wave action to affect both the fluid and its particles. However, traditional micromixers with acoustic bubbles achieve significant mixing performance and numerous programmable mixing platforms provide excellent solutions with wide applicability. This review offers a comprehensive overview of various micromixers, elucidates their underlying principles, and explores their biomedical applications. In addition, advanced programmable micromixing with impressive versatility, convenience, and ability of cross-scale operations is introduced in detail. We believe this review will benefit the researchers in the biomedical field to know the micromixers and find a suitable micromixing method for their various applications.

Continuous production of bimetallic nanoparticles on carbon nanotubes based on 3D-printed microfluidics

Nanoparticle-functionalized carbon nanotubes are promising in many research fields, especially in sensing, due to their intriguing performance in catalysis. However, these nanomaterials are mainly produced through batch processes under harsh conditions, thus encountering inherent limitations of low throughput and uncontrollable morphology of functional nanoparticles (NPs). In this work, we propose a method for high-yield and continuous production of bimetallic (Pt-Pd) NPs on multi-walled carbon nanotubes (MWCNTs) at room temperature through a custom 3D-printed microfluidic platform. A homogenous particle nucleation and growth environment could be created on the microfluidic platform that was equipped with two 3D-printed micromixers. Pt-Pd NPs loaded on MWCNTs were prepared in the microfluidic platform with high throughput and controlled size, dispersity and composition. The synthetic parameters for these nanocomposites were investigated to optimize their electrocatalytic performance. The optimized nanocomposites exhibited excellent electrocatalytic activity with exceptional sensitivity and wide detection range, superior to their counterparts prepared via conventional approaches. This method proposed here could be further adapted for manufacturing other catalyst support materials, opening more avenues for future large-scale production and catalytic investigation of functional nanomaterials.

Capacitive biosensors for label-free and ultrasensitive detection of biomarkers

Capacitive biosensors are label-free capacitors that can detect biomarkers with the outstanding advantages of simplicity, low cost, and ultrahigh sensitivity. A typical capacitive biosensor consists of a bioreceptor and a transducer, where the bioreceptor captures the biomarker to form a bioreceptor/biomarker conjugate and the transducer generates a detectable signal. In general, antibodies, aptamers, or proteins are exploited as the bioreceptor, while various electrodes including carbon electrodes (CEs), gold electrodes (AuEs), or interdigitated electrodes (IDEs) may serve as the transducer. Because the formation of bioreceptor/biomarker conjugates often leads to a change in capacitance, the capacitive signal is then employed for biomarker detection. This review summarizes recent advances in capacitive biosensors for the detection of biomarkers over the last five years. With a focus on the three common types of bioreceptors, i.e., antibodies, aptamers, and proteins, capacitive biosensors using CEs, AuEs, and IDEs as the transducers are discussed in detail. The immobilization of bioreceptors and signal amplification strategies are described to provide a robust overview of capacitive biosensors for biomarker detection. In addition, analytical methods and future prospects are given to support the application of capacitive biosensors.

Pragmatic randomised controlled trial of guided self-help versus individual cognitive behavioural therapy with a trauma focus for post-traumatic stress disorder (RAPID)

Background

Guided self-help has been shown to be effective for other mental conditions and, if effective for post-traumatic stress disorder, would offer a time-efficient and accessible treatment option, with the potential to reduce waiting times and costs.

Objective

To determine if trauma-focused guided self-help is non-inferior to individual, face-to-face cognitive-behavioural therapy with a trauma focus for mild to moderate post-traumatic stress disorder to a single traumatic event.

Design

Multicentre pragmatic randomised controlled non-inferiority trial with economic evaluation to determine cost-effectiveness and nested process evaluation to assess fidelity and adherence, dose and factors that influence outcome (including context, acceptability, facilitators and barriers, measured qualitatively). Participants were randomised in a 1 : 1 ratio. The primary analysis was intention to treat using multilevel analysis of covariance.

Setting

Primary and secondary mental health settings across the United Kingdom's National Health Service.

Participants

One hundred and ninety-six adults with a primary diagnosis of mild to moderate post-traumatic stress disorder were randomised with 82% retention at 16 weeks and 71% at 52 weeks. Nineteen participants and ten therapists were interviewed for the process evaluation.

Interventions

Up to 12 face-to-face, manualised, individual cognitive-behavioural therapy with a trauma focus sessions, each lasting 60-90 minutes, or to guided self-help using Spring, an eight-step online guided self-help programme based on cognitive-behavioural therapy with a trauma focus, with up to five face-to-face meetings of up to 3 hours in total and four brief telephone calls or e-mail contacts between sessions.

Main outcome measures

Primary outcome: the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, at 16 weeks post-randomisation. Secondary outcomes: included severity of post-traumatic stress disorder symptoms at 52 weeks, and functioning, symptoms of depression, symptoms of anxiety, alcohol use and perceived social support at both 16 and 52 weeks post-randomisation. Those assessing outcomes were blinded to group assignment.

Results

Non-inferiority was demonstrated at the primary end point of 16 weeks on the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [mean difference 1.01 (one-sided 95% CI -∞ to 3.90, non-inferiority p = 0.012)]. Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, score improvements of over 60% in both groups were maintained at 52 weeks but the non-inferiority results were inconclusive in favour of cognitive-behavioural therapy with a trauma focus at this timepoint [mean difference 3.20 (one-sided 95% confidence interval -∞ to 6.00, non-inferiority p = 0.15)]. Guided self-help using Spring was not shown to be more cost-effective than face-to-face cognitive-behavioural therapy with a trauma focus although there was no significant difference in accruing quality-adjusted life-years, incremental quality-adjusted life-years -0.04 (95% confidence interval -0.10 to 0.01) and guided self-help using Spring was significantly cheaper to deliver [£277 (95% confidence interval £253 to £301) vs. £729 (95% CI £671 to £788)]. Guided self-help using Spring appeared to be acceptable and well tolerated by participants. No important adverse events or side effects were identified.

Limitations

The results are not generalisable to people with post-traumatic stress disorder to more than one traumatic event.

Conclusions

Guided self-help using Spring for mild to moderate post-traumatic stress disorder to a single traumatic event appears to be non-inferior to individual face-to-face cognitive-behavioural therapy with a trauma focus and the results suggest it should be considered a first-line treatment for people with this condition.

Future work

Work is now needed to determine how best to effectively disseminate and implement guided self-help using Spring at scale.

Trial registration

This trial is registered as ISRCTN13697710.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 14/192/97) and is published in full in Health Technology Assessment; Vol. 27, No. 26. See the NIHR Funding and Awards website for further award information.

Multiplexed detection of biomarkers using a microfluidic chip integrated with mass-producible micropillar array electrodes

Quantifying multiple biomarkers with high sensitivity in tiny biological samples is essential to meet the growing demand for point-of-care testing. This paper reports the development of a novel microfluidic device integrated with mass-producible micropillar array electrodes (μAEs) for multiple biomarker detections. The μAE are mass-fabricated by soft lithography and hot embossing technique. Pt-Pd bimetallic nanoclusters (BNC) are modified on the surface of μAEs by constant potential (CP)/multi-potential step (MPS) electrodeposition strategies to improve the electroanalytical performance. The experimental result displays that Pt-Pd BNC/μAEs have good sensitivity enhancement compared with bare planar electrodes and bare μAEs, the enhancement being 56.5 and 9.5 times respectively, from the results of the H₂O₂ detection. Furthermore, glucose, uric acid and sarcosine were used as model biomarkers to show the biosensing capability with high sensitivity. The linear range and LOD of the glucose, uric acid and sarcosine detection are 0.1 mM-12 mM, 10 μM-800 μM and 2.5 μM-100 μM, 58.5, 3.4 and 0.4 μM, respectively. In particular, biosensing chips show wide linear ranges covering required detection ranges of glucose, uric acid and sarcosine in human serum, indicating the developed device has great potential in self-health management and clinical requirements.

Manipulation with sound and vibration: A review on the micromanipulation system based on sub-MHz acoustic waves

Manipulation of micro-objects have been playing an essential role in biochemical analysis or clinical diagnostics. Among the diverse technologies for micromanipulation, acoustic methods show the advantages of good biocompatibility, wide tunability, a label-free and contactless manner. Thus, acoustic micromanipulations have been widely exploited in micro-analysis systems. In this article, we reviewed the acoustic micromanipulation systems that were actuated by sub-MHz acoustic waves. In contrast to the high-frequency range, the acoustic microsystems operating at sub-MHz acoustic frequency are more accessible, whose acoustic sources are at low cost and even available from daily acoustic devices (e.g. buzzers, speakers, piezoelectric plates). The broad availability, with the addition of the advantages of acoustic micromanipulation, make sub-MHz microsystems promising for a variety of biomedical applications. Here, we review recent progresses in sub-MHz acoustic micromanipulation technologies, focusing on their applications in biomedical fields. These technologies are based on the basic acoustic phenomenon, such as cavitation, acoustic radiation force, and acoustic streaming. And categorized by their applications, we introduce these systems for mixing, pumping and droplet generation, separation and enrichment, patterning, rotation, propulsion and actuation. The diverse applications of these systems hold great promise for a wide range of enhancements in biomedicines and attract increasing interest for further investigation.

High-gradient magnetophoretic bead trapping for enhanced electrochemical sensing and particle manipulation

Magnetic particles are routinely used in many biochemical techniques. As such, the manipulation of these particles is of paramount importance for proper detection and assay preparation. This paper describes a magnetic manipulation and detection paradigm that allows sensing and handling highly sensitive magnetic bead-based assays. The simple manufacturing process presented in this manuscript employs a CNC machining technique and an iron microparticle-doped PDMS (Fe-PDMS) compound to create magnetic microstructures that enhance magnetic forces for magnetic bead confinement. Said confinement, generates increases in local concentrations at the detection site. Higher local concentrations increase the magnitude of the detection signal, leading to higher assay sensitivity and lower limit of detection (LOD). Furthermore, we demonstrate this characteristic signal enhancement in both fluorescence and electrochemical detection techniques. We expect this new technique to allow users to design fully integrated magnetic bead-based microfluidic devices with the goal of preventing sample losses and enhancing signal magnitudes in biological experiments and assays.

Skipping the Boundary Layer: High-Speed Droplet-Based Immunoassay Using Rayleigh Acoustic Streaming

Acoustic mixing of droplets is a promising way to implement biosensors that combine high speed and minimal reagent consumption. To date, this type of droplet mixing is driven by a volume force resulting from the absorption of high-frequency acoustic waves in the bulk of the fluid. Here, we show that the speed of these sensors is limited by the slow advection of analyte to the sensor surface due to the formation of a hydrodynamic boundary layer. We eliminate this hydrodynamic boundary layer by using much lower ultrasonic frequencies to excite the droplet, which drives a Rayleigh streaming that behaves essentially like a slip velocity. At equal average flow velocity in the droplet, both experiment and three-dimensional simulations show that this provides a three-fold speedup compared to Eckart streaming. Experimentally, we further shorten a SARS-CoV-2 antibody immunoassay from 20 min to 40 s taking advantage of Rayleigh acoustic streaming.

Pollution-Free and Highly Sensitive Lactate Detection in Cell Culture Based on a Microfluidic Chip

Cell metabolite detection is important for cell analysis. As a cellular metabolite, lactate and its detection play an important role in disease diagnosis, drug screening and clinical therapeutics. This paper reports a microfluidic chip integrated with a backflow prevention channel for cell culture and lactate detection. It can effectively realize the upstream and downstream separation of the culture chamber and the detection zone, and prevent the pollution of cells caused by the potential backflow of reagent and buffer solutions. Due to such a separation, it is possible to analyze the lactate concentration in the flow process without contamination of cells. With the information of residence time distribution of the microchannel networks and the detected time signal in the detection chamber, it is possible to calculate the lactate concentration as a function of time using the de-convolution method. We have further demonstrated the suitability of this detection method by measuring lactate production in human umbilical vein endothelial cells (HUVEC). The microfluidic chip presented here shows good stability in metabolite quick detection and can work continuously for more than a few days. It sheds new insights into pollution-free and high-sensitivity cell metabolism detection, showing broad application prospects in cell analysis, drug screening and disease diagnosis.

Lab-on-a-chip systems for cancer biomarker diagnosis

Lab-on-a-chip (LOC) or micro total analysis system is one of the microfluidic technologies defined as the adaptation, miniaturization, integration, and automation of analytical laboratory procedures into a single instrument or "chip". In this article, we review developments over the past five years in the application of LOC biosensors for the detection of different types of cancer. Microfluidics encompasses chemistry and biotechnology skills and has revolutionized healthcare diagnosis. Superior to traditional cell culture or animal models, microfluidic technology has made it possible to reconstruct functional units of organs on chips to study human diseases such as cancer. LOCs have found numerous biomedical applications over the past five years, including integrated bioassays, cell analysis, metabolomics, drug discovery and delivery systems, tissue and organ physiology and disease modeling, and personalized medicine. This review provides an overview of the latest developments in microfluidic-based cancer research, with pros, cons, and prospects.

Development of a novel microfluidic biosensing platform integrating micropillar array electrode and acoustic microstreaming techniques

Quantifying biomarkers at the early stage of the disease is challenging due to the low abundance of biomarkers in the sample and the lack of sensitive techniques. This article reports the development of a novel microfluidic electrochemical biosensing platform to address this challenge. The electrochemical sensing is achieved by utilizing a micropillar array electrode (μAE) coated with 3D bimetallic Pt-Pd nanotrees to enhance the sensitivity. A bubble-based acoustic microstreaming technique is integrated with the device to increase the contact of analyte molecules with the surface of electrodes to further enhance the electrochemical performance. The current density of Pt-Pd NTs/μAE with acoustic microstreaming is nearly 22 times that of the bare planar electrode in potassium ferrocyanide solution. The developed biosensor has demonstrated excellent sensing performance. For hydrogen peroxide detection, both the Pt-Pd NTs/μAE and acoustic microstreaming contribute to the sensitivity enhancement. The current density of the Pt-Pd NTs/μAE is approximatively 28 times that of the bare μAE. With acoustic microstreaming, this enhancement is further increased by nearly 1.6 times. The platform has a linear detection range of 5-1000 μM with a LOD of 1.8 μM toward hydrogen peroxide detection, while for sarcosine detection, the linear range is between 5 and 100 μM and LOD is 2.2 μM, respectively. Furthermore, the sarcosine biosensing shows a high sensitivity of 667 μA mM^-1∙cm^-2. Such a sensing platform has the potential as a portable device for high sensitivity detection of biomarkers.

Microfluidic Acoustic Method for High Yield Extraction of Cell-Free DNA in Low-Volume Plasma Samples

Cell-free DNA has many applications in clinical medicine, in particular in cancer diagnosis and cancer treatment monitoring. Microfluidic-based solutions could provide solutions for rapid, cheaper, decentralized detection of cell-free tumoral DNA from a simple blood draw, or liquid biopsies, replacing invasive procedures or expensive scans. In this method, we present a simple microfluidic system for the extraction of cell-free DNA from low volume of plasma samples (≤500 μL). The technique is suitable for either static or continuous flow systems and can be used as a stand-alone module or integrated within a lab-on-chip system. The system relies on a simple yet highly versatile bubble-based micromixer module whose custom components can be fabricated with a combination of low-cost rapid prototyping techniques or ordered via widely available 3D-printing services. This system is capable of performing cell-free DNA extractions from small volumes of blood plasma with up to a tenfold increase in capture efficiency when compared to control methods.

Size-Based Sorting and In Situ Clonal Expansion of Single Cells Using Microfluidics

Separation and clonal culture and growth kinetics analysis of target cells in a mixed population is critical for pathological research, disease diagnosis, and cell therapy. However, long-term culture with time-lapse imaging of the isolated cells for clonal analysis is still challenging. This paper reports a microfluidic device with four-level filtration channels and a pneumatic microvalve for size sorting and in situ clonal culture of single cells. The valve was on top of the filtration channels and used to direct fluid flow by membrane deformation during separation and long-term culture to avoid shear-induced cell deformation. Numerical simulations were performed to evaluate the influence of device parameters affecting the pressure drop across the filtration channels. Then, a droplet model was employed to evaluate the impact of cell viscosity, cell size, and channel width on the pressure drop inducing cell deformation. Experiments showed that filtration channels with a width of 7, 10, 13, or 17 μm successfully sorted K562 cells into four different size ranges at low driving pressure. The maximum efficiency of separating K562 cells from media and whole blood was 98.6% and 89.7%, respectively. Finally, the trapped single cells were cultured in situ for 4-7 days with time-lapse imaging to obtain the lineage trees and growth curves. Then, the time to the first division, variation of cell size before and after division, and cell fusion were investigated. This proved that cells at the G1 and G2 phases were of significantly distinct sizes. The microfluidic device for size sorting and clonal expansion will be of tremendous application potential in single-cell studies.

Generation of Dynamic Concentration Profile Using A Microfluidic Device Integrating Pneumatic Microvalves

Generating and maintaining the concentration dilutions of diffusible molecules in microchannels is critical for high-throughput chemical and biological analysis. Conventional serial network microfluidic technologies can generate high orders of arbitrary concentrations by a predefined microchannel network. However, a previous design requires a large occupancy area and is unable to dynamically generate different profiles in the same chip, limiting its applications. This study developed a microfluidic device enabling dynamic variations of both the concentration in the same channel and the concentration distribution in multiple channels by adjusting the flow resistance using programmable pneumatic microvalves. The key component (the pneumatic microvalve) allowed dynamic adjustment of the concentration profile but occupied a tiny space. Additionally, a Matlab program was developed to calculate the flow rates and flow resistance of various sections of the device, which provided theoretical guidance for dimension design. In silico investigations were conducted to evaluate the microvalve deformation with widths from 100 to 300 µm and membrane thicknesses of 20 and 30 µm under the activation pressures between 0 and 2000 mbar. The flow resistance of the deformed valve was studied both numerically and experimentally and an empirical model for valve flow resistance with the form of Rh=aebP was proposed. Afterward, the fluid flow in the valve region was characterized using Micro PIV to further demonstrate the adjustment mechanism of the flow resistance. Then, the herringbone structures were employed for fast mixing to allow both quick variation of concentration and minor space usage of the channel network. Finally, an empirical formula-supported computational program was developed to provide the activation pressures required for the specific concentration profile. Both linear (Ck = -0.2k + 1) and nonlinear (Ck = (110)k) concentration distribution in four channels were varied using the same device by adjusting microvalves. The device demonstrated the capability to control the concentration profile dynamically in a small space, offering superior application potentials in analytical chemistry, drug screening, and cell biology research.

An intelligent DNA nanorobot for detection of MiRNAs cancer biomarkers using molecular programming to fabricate a logic-responsive hybrid nanostructure

Herein, we designed a DNA framework-based intelligent nanorobot using toehold-mediated strand displacement reaction-based molecular programming and logic gate operation for the selective and synchronous detection of miR21 and miR125b, which are known as significant cancer biomarkers. Moreover, to investigate the applicability of our design, DNA nanorobots were implemented as capping agents onto the pores of MSNs. These agents can develop a logic-responsive hybrid nanostructure capable of specific drug release in the presence of both targets. The prosperous synthesis steps were verified by FTIR, XRD, BET, UV-visible, FESEM-EDX mapping, and HRTEM analyses. Finally, the proper release of the drug in the presence of both target microRNAs was studied. This Hybrid DNA Nanostructure was designed with the possibility to respond to any target oligonucleotides with 22 nucleotides length.

Development of Paper Microfluidics with 3D-Printed PDMS Barriers for Flow Control

Paper microfluidics has been extensively exploited as a powerful tool for environmental and medical detection applications. Both flow delay and compatibility with either polar or non-polar reagents are indispensable for the automation of detections requiring multiple reaction steps. This article reports the systematic studies of a 3D-printing protocol, characterization, and application of both the partially and fully penetrated polydimethylsiloxane (PDMS) barriers for flexible flow control in paper microfluidics. The physical parameters of PDMS barriers printed using a simple liquid dispenser were found related to the printing pressure, speed, diffusion time after printing, baking temperature, and PDMS viscosity. The capability of PDMS barriers to confine the flow of non-polar solvents was demonstrated using oil flow in both wax- and PDMS-surrounded channels. It was identified that the minimum width of channels to prevent leakage was 470 ± 54 μm, which was as narrow as that fabricated using stamps from lithography. Both the partially penetrated barriers (PPBs) and constriction channels were of the capability to delay flow in paper microfluidics. Additionally, an in silico investigation led to the further understanding that the reduction of channel cross-section resulting from PPBs was the primary reason for flow delay. Our results suggest that increasing the penetration depth of the barriers is more efficient in delaying flow than increasing the PPB length. Finally, devices with four inlet channels and 0-6 PPBs across each channel were successfully applied in flow delay for sequential fluid delivery. These results improve the understanding of the major factors, affecting the 3D PDMS barrier fabrication and the resulting flow control in paper microfluidics, providing practical implications for applications in various fields.

Diagnostic Accuracy of Liquid Biomarkers in Airway Diseases: Toward Point-of-Care Applications

Background

Liquid biomarkers have shown increasing utility in the clinical management of airway diseases. Salivary and blood samples are particularly amenable to point-of-care (POC) testing due to simple specimen collection and processing. However, very few POC tests have successfully progressed to clinical application due to the uncertainty and unpredictability surrounding their diagnostic accuracy.

Objective

To review liquid biomarkers of airway diseases with well-established diagnostic accuracies and discuss their prospects for future POC applications.

Methodology

A literature review of publications indexed in Medline or Embase was performed to evaluate the diagnostic accuracy of liquid biomarkers for chronic obstructive pulmonary disease (COPD), asthma, laryngopharyngeal reflux (LPR), and COVID-19.

Results

Of 3,628 studies, 71 fulfilled the inclusion criteria. Sputum and blood eosinophils were the most frequently investigated biomarkers for the management of asthma and COPD. Salivary pepsin was the only biomarker with a well-documented accuracy for the diagnosis of LPR. Inflammatory blood biomarkers (e.g., CRP, D-dimers, ferritin) were found to be useful to predict the severity, complications, and mortality related to COVID-19 infection.

Conclusion

Multiple liquid biomarkers have well-established diagnostic accuracies and are thus amenable to POC testing in clinical settings.

Recent Advances in Plasma-Engineered Polymers for Biomarker-Based Viral Detection and Highly Multiplexed Analysis

Infectious diseases remain a pervasive threat to global and public health, especially in many countries and rural urban areas. The main causes of such severe diseases are the lack of appropriate analytical methods and subsequent treatment strategies due to limited access to centralized and equipped medical centers for detection. Rapid and accurate diagnosis in biomedicine and healthcare is essential for the effective treatment of pathogenic viruses as well as early detection. Plasma-engineered polymers are used worldwide for viral infections in conjunction with molecular detection of biomarkers. Plasma-engineered polymers for biomarker-based viral detection are generally inexpensive and offer great potential. For biomarker-based virus detection, plasma-based polymers appear to be potential biological probes and have been used directly with physiological components to perform highly multiplexed analyses simultaneously. The simultaneous measurement of multiple clinical parameters from the same sample volume is possible using highly multiplexed analysis to detect human viral infections, thereby reducing the time and cost required to collect each data point. This article reviews recent studies on the efficacy of plasma-engineered polymers as a detection method against human pandemic viruses. In this review study, we examine polymer biomarkers, plasma-engineered polymers, highly multiplexed analyses for viral infections, and recent applications of polymer-based biomarkers for virus detection. Finally, we provide an outlook on recent advances in the field of plasma-engineered polymers for biomarker-based virus detection and highly multiplexed analysis.

Microfluidic Point-of-Care (POC) Devices in Early Diagnosis: A Review of Opportunities and Challenges

The early diagnosis of infectious diseases is critical because it can greatly increase recovery rates and prevent the spread of diseases such as COVID-19; however, in many areas with insufficient medical facilities, the timely detection of diseases is challenging. Conventional medical testing methods require specialized laboratory equipment and well-trained operators, limiting the applicability of these tests. Microfluidic point-of-care (POC) equipment can rapidly detect diseases at low cost. This technology could be used to detect diseases in underdeveloped areas to reduce the effects of disease and improve quality of life in these areas. This review details microfluidic POC equipment and its applications. First, the concept of microfluidic POC devices is discussed. We then describe applications of microfluidic POC devices for infectious diseases, cardiovascular diseases, tumors (cancer), and chronic diseases, and discuss the future incorporation of microfluidic POC devices into applications such as wearable devices and telemedicine. Finally, the review concludes by analyzing the present state of the microfluidic field, and suggestions are made. This review is intended to call attention to the status of disease treatment in underdeveloped areas and to encourage the researchers of microfluidics to develop standards for these devices.

A low-cost and high-performance 3D micromixer over a wide working range and its application for high-sensitivity biomarker detection

Homogenous mixing in microfluidic devices is often required for efficient chemical and biological reactions.Passive micromixing without external energy input has attracted much research interest. We have developed a high-performance 3D...

A perspective on magnetic microfluidics: Towards an intelligent future

Magnetic microfluidics has been gradually recognized as an area of its own. Both conventional microfluidic platforms have incorporated magnetic actuation for microfluidic operation and microscale object manipulation. Nonetheless, there is still much room for improvement after decades of development. In this Perspective, we first provide a quick review of existing magnetic microfluidic platforms with a focus on the magnetic tools and actuation mechanisms. Next, we discuss several emerging technologies, including magnetic microrobots, additive manufacture, and artificial intelligence, and their potential application in the future development of magnetic microfluidics. We believe that these technologies can eventually inspire highly functional magnetic tools for microfluidic manipulation and coordinated microfluidic control at the system level, which eventually drives magnetic microfluidics into an intelligent system for automated experimentation.

Pump-Free Microfluidic Device for the Electrochemical Detection of α1-Acid Glycoprotein

α₁-Acid glycoprotein (AGP) is a glycoprotein present in serum, which is associated with the modulation of the immune system in response to stress or injuries, and a biomarker for inflammatory diseases and cancers. Here, we propose a pump-free microfluidic device for the electrochemical determination of AGP. The microfluidic device utilizes capillary-driven flow and a passive mixing system to label the AGP with the Os (VI) complex (an electrochemical tag) inside the main channel, before delivering the products to the electrode surface. Furthermore, thanks to the resulting geometry, all the analytical steps can be carried out inside the device: labeling, washing, and detection by adsorptive transfer stripping square wave voltammetry. The microfluidic device exhibited a linear range from 500 to 2000 mg L^-1 (R² = 0.990) and adequate limit of detection (LOD = 231 mg L^-1). Commercial serum samples were analyzed to demonstrate the success of the method, yielding recoveries around 83%. Due to its simplicity, low sample consumption, low cost, short analysis time, disposability, and portability, the proposed method can serve as a point-of-care/need testing device for AGP.

The method to quantify cell elasticity based on the precise measurement of pressure inducing cell deformation in microfluidic channels

The cell elasticity has attracted extensive research interests since it not only provides new insights into cell biology but also is an emerging mechanical marker for the diagnosis of some diseases. This paper reports the method for the precise measurement of mechanical properties of single cells deformed to a large extent using a novel microfluidic system integrated with a pressure feedback system and small particle separation unit. The particle separation system was employed to avoid the blockage of the cell deformation channel to enhance the measurement throughput. This system is of remarkable application potential in the precise evaluation of cell mechanical properties. In brief, this paper reports:•

The manufacturing of the chip using standard soft lithography;

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The methods to deform single cells in a microchannel and measure the relevant pressure drop using a pressure sensor connecting to the microfluidic chip;

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Calculation of the mechanical properties including stiffness and fluidity of each cell based on a power-law rheology model describing the viscoelastic behaviors of cells;

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Automatic and real-time measurement of the mechanical properties using video processing software.

Integration of a fiber-based cell culture and biosensing system for monitoring of multiple protein markers secreted from stem cells

We propose a new platform that can integrate three-dimensional cell culture scaffold and a surface-enhanced Raman spectroscopy (SERS)-based biosensor by stacking them to form a multilayer system, which would allow monitoring of the protein markers secreted from cultured stem cells without periodic cell and/or media collection. The cell culture scaffold supported the proliferation and osteogenic differentiation of adipose-derived mesenchymal stem cells (ADSCs). The SERS capture substrate detected protein markers in combination with SERS tag made with Au-Ag alloy nanoboxes. Incorporating the different Raman reporters into the SERS tag allowed easy identification of target proteins for multiplex assays. The resultant SERS-based immunoassay could detect the pg/mL levels of protein markers without crosstalk and interference. When one ADSC culture scaffold and multiple SERS capture substrates were integrated and incubated in differentiation culture media, our system was sufficiently sensitive to monitor time-dependent secretion of three different osteogenic protein markers from ADSCs during their osteogenic differentiation. Since the sensor and cell culture scaffold can be manipulated independently, various cell and biomarker combinations are possible to obtain relevant information regarding the actual state of the different types of cells.

Advanced Devices for Tumor Diagnosis and Therapy

At present, tumor diagnosis is performed using common procedures, which are slow, costly, and still presenting difficulties in diagnosing tumors at their early stage. Tumor therapeutic methods also mainly rely on large-scale equipment or non-intelligent treatment approaches. Thus, an early and accurate tumor diagnosis and personalized treatment may represent the best treatment option for a successful result, and the efforts in finding them are still in progress and mainly focusing on non-destructive, integrated, and multiple technologies. These objectives can be achieved with the development of advanced devices and smart technology that represent the topic of the current investigations. Therefore, this review summarizes the progress in tumor diagnosis and therapy and briefly explains the advantages and disadvantages of the described microdevices, finally proposing advanced micro smart devices as the future development trend for tumor diagnosis and therapy.

A Fully Automated and Integrated Microfluidic System for Efficient CTC Detection and Its Application in Hepatocellular Carcinoma Screening and Prognosis

Analysis of circulating tumor cells (CTCs) is regarded as a useful diagnostic index to monitor tumor development and guide precision medicine. Although the immunoassay is a common strategy for CTC identification and heterogeneity characterization, it is challenged by poor reaction efficiency and laborious manipulations in microdevices, which hinder the sensitivity, throughput, simplification, and applicability. To meet the need for rapid, sensitive, and simple CTC analysis, we developed an efficient CTC detection system by integrating a 3D printed off-chip multisource reagent platform, a bubble retainer, and a single CTC capture microchip, which can achieve CTC capture and identification within 90 min. Compared with traditional CTC identification methods, this system decreases immunostaining time and antibody consumption by 90% and performs the on-chip immunoassay in a fully automated manner. Using this system, CTCs from the peripheral blood of 19 patients with various cancers were captured, detected, and compared with clinical data. The system shows great potential for early screening, real-time monitoring, and precision medicine for hepatocellular carcinoma (HCC). With the advantages of automation, stability, economy, and user-friendly operation, the proposed system is promising for clinical scenarios.

Mixing during Trapping Enabled a Continuous-Flow Microfluidic Smartphone Immunoassay Using Acoustic Streaming

Smartphone-enabled microfluidic chemiluminescence immunoassay is a promising portable system for point-of-care (POC) biosensing applications. However, due to the rather faint emitted light in such a limited sample volume, it is still difficult to reach the clinically accepted range when the smartphone serves as a standalone detector. Besides, the multiple separation and washing steps during sample preparation hinder the immunoassay's applications for POC usage. Herein, we proposed a novel acoustic streaming tweezers-enabled microfluidic immunoassay, where the probe particles' purification, reaction, and sensing were simply achieved on the same chip at continuous-flow conditions. The dedicatedly designed high-speed microscale vortexes not only enable dynamic trapping and washing of the probe particles on-demand but also enhance the capture efficiency of the heterogeneous particle-based immunoassay through active mixing during trapping. The enriched probe particles and enhanced biomarker capture capability increase the local chemiluminescent light intensity and enable direct capture of the immunobinding signal by a regular smartphone camera. The system was tested for prostate-specific antigen (PSA) sensing both in buffer and serum, where a limit of detection of 0.2 ng/mL and a large dynamic response range from 0.3 to 10 ng/mL using only 10 μL of sample were achieved in a total assay time of less than 15 min. With the advantages of on-chip integration of sample preparation and detection and high sensing performance, the developed POC platform could be applied for many on-site diagnosis applications.

Mixing Mechanism of Microfluidic Mixer with Staggered Virtual Electrode Based on Light-Actuated AC Electroosmosis

In this paper, we present a novel microfluidic mixer with staggered virtual electrode based on light-actuated AC electroosmosis (LACE). We solve the coupled system of the flow field described by Navier–Stokes equations, the described electric field by a Laplace equation, and the concentration field described by a convection–diffusion equation via a finite-element method (FEM). Moreover, we study the distribution of the flow, electric, and concentration fields in the microchannel, and reveal the generating mechanism of the rotating vortex on the cross-section of the microchannel and the mixing mechanism of the fluid sample. We also explore the influence of several key geometric parameters such as the length, width, and spacing of the virtual electrode, and the height of the microchannel on mixing performance; the relatively optimal mixer structure is thus obtained. The current micromixer provides a favorable fluid-mixing method based on an optical virtual electrode, and could promote the comprehensive integration of functions in modern microfluidic-analysis systems.

Non-invasive acquisition of mechanical properties of cells via passive microfluidic mechanisms: A review

The demand to understand the mechanical properties of cells from biomedical, bioengineering, and clinical diagnostic fields has given rise to a variety of research studies. In this context, how to use lab-on-a-chip devices to achieve accurate, high-throughput, and non-invasive acquisition of the mechanical properties of cells has become the focus of many studies. Accordingly, we present a comprehensive review of the development of the measurement of mechanical properties of cells using passive microfluidic mechanisms, including constriction channel-based, fluid-induced, and micropipette aspiration-based mechanisms. This review discusses how these mechanisms work to determine the mechanical properties of the cell as well as their advantages and disadvantages. A detailed discussion is also presented on a series of typical applications of these three mechanisms to measure the mechanical properties of cells. At the end of this article, the current challenges and future prospects of these mechanisms are demonstrated, which will help guide researchers who are interested to get into this area of research. Our conclusion is that these passive microfluidic mechanisms will offer more preferences for the development of lab-on-a-chip technologies and hold great potential for advancing biomedical and bioengineering research studies.

Toward embryo cryopreservation-on-a-chip: A standalone microfluidic platform for gradual loading of cryoprotectants to minimize cryoinjuries

Embryo vitrification is a fundamental practice in assisted reproduction and fertility preservation. A key step of this process is replacing the internal water with cryoprotectants (CPAs) by transferring embryos from an isotonic to a hypertonic solution of CPAs. However, this applies an abrupt osmotic shock to embryos, resulting in molecular damages that have long been a source of concern. In this study, we introduce a standalone microfluidic system to automate the manual process and minimize the osmotic shock applied to embryos. This device provides the same final CPA concentrations as the manual method but with a gradual increase over time instead of sudden increases. Our system allows the introduction of the dehydrating non-permeating CPA, sucrose, from the onset of CPA-water exchange, which in turn reduced the required time of CPA loading for successful vitrification without compromising its outcomes. We compared the efficacy of our device and the conventional manual procedure by studying vitrified-warmed mouse blastocysts based on their re-expansion and hatching rates and transcription pattern of selected genes involved in endoplasmic reticulum stress, oxidative stress, heat shock, and apoptosis. While both groups of embryos showed comparable re-expansion and hatching rates, on-chip loading reduced the detrimental gene expression of cryopreservation. The device developed here allowed us to automate the CPA loading process and push the boundaries of cryopreservation by minimizing its osmotic stress, shortening the overall process, and reducing its molecular footprint.

The method to dynamically screen and print single cells using microfluidics with pneumatic microvalves

Printing single cells into individual chambers is of critical importance for single-cell analysis using traditional equipment, for instance, single-cell clonal expansion or sequencing. The size of cells can usually be a reflection of their types, functions, and even cell cycle phases. Therefore, printing individual cells within the desired size range is of essential application potential in single-cell analysis. This paper presents a method for the development of a microfluidic chip integrating pneumatic microvalves to print single cells with appropriate size into standard well plates. The reported method provided essential guidelines for the fabrication of multi-layer microfluidic chips, control of the membrane deflection to screen cell size, and printing of single cells. In brief, this paper reports:•

the manufacturing of the chip using standard soft lithography;

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the protocol to dynamically screen both the lower and the upper size limit of cells passing through the valves by deflection of the valve membrane;

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the screening and dispensing of suspended human umbilical vein endothelial cells (HUVECs) into 384-well plates with high viability.

Development of micropillar array electrodes for highly sensitive detection of biomarkers

Micropillar array electrodes (μAEs) have been widely applied in electrochemical detection owing to their advantages of increased mass transport, lower detection limit, and potential to be miniaturized. This paper reports the fabrication, simulation, surface modification, and characterization of PDMS-based μAEs coated with gold films. The μAEs consist of 9 × 10 micropillars with a height of either 100 μm, 300 μm, or 500 μm in a 0.09 cm2 region. Numerical simulation was employed to study the influence of geometrical parameters on the current density. The μAEs were fabricated by soft lithography and characterized using both SEM and cyclic voltammetry. Experiments revealed that high pillars enabled enhanced voltammetric current density regardless of the scan rates. The platinum-palladium/multi-walled carbon nanotubes (Pt-Pd/MWCNTs) were coated on the μAEs to improve their electrochemical detection capability. The μAEs demonstrated 1.5 times larger sensitivity compared with the planar electrode when hydrogen peroxide was detected. Furthermore, μAE500 with Pt-Pd/MWCNTs was employed to detect sarcosine, a potential biomarker for prostate cancer. The linear range and limit of detection for sarcosine were from 5 to 60 μM and 1.28 μM, respectively. This detection range covers the concentration of sarcosine in human tissues (0-60 μM). These results suggest that the μAEs have better detection performance in comparison to planar electrodes due to their large surface area and pillar height. This paper provides essential guidelines for the application of μAEs in high sensitivity electrochemical detection of low abundance analytes.

Cell elasticity measurement using a microfluidic device with real-time pressure feedback

The study of cell elasticity provides new insights into not only cell biology but also disease diagnosis based on cell mechanical state variation. Microfluidic technologies have made noticeable progress in studying cell deformation with capabilities of high throughput and automation. This paper reports the development of a novel microfluidic system to precisely measure the elasticity of cells having large deformation in a constriction channel. It integrated i) a separation unit to isolate rod- or flake-shaped particles that might block the constriction channel to increase the measurement throughput and ii) a pressure feedback system precisely detecting the pressure drop inducing the deformation of each cell. The fluid dynamics of the separation unit was modeled to understand the separation mechanism before the experimental determination of separation efficiency. Afterward, the pressure system was characterized to demonstrate its sensitivity and reproducibility in measuring the subtle pressure drop along a constriction channel. Finally, the microfluidic system was employed to study the stiffness of both K562 and endothelial cells. The cell protrusion and pressure drop were employed to calculate the mechanical properties based on a power-law rheology model describing the viscoelastic behaviors of cells. Both the stiffness and the fluidity of K562 and endothelial cells were consistent with those in previous studies. The system has remarkable application potential in the precise evaluation of cell mechanical properties.

Biomarkers detection with magnetoresistance-based sensors

Biosensing platforms for detecting and quantifying biomarkers have played an important role in the past decade. Among them, platforms based on magnetoresistance (MR) sensing technology are attractive. The resistance value of the material changes with the externally applied magnetic field is the core mechanism of MR sensing technology. A typical MR-based sensor has the characteristics of cost-effective, simple operation, high compactness, and high sensitivity. Moreover, using magnetic nanoparticles (MNPs) as labels, MR-based sensors have the ability to overcome the high background noise of complex samples, so they are particularly suitable for point-of-care testing (POCT). However, the problem still exists. How to obtain high-throughput, that is, multiple detections of biomarkers in MR-based sensors, thereby improving detection efficiency and reducing the burden on patients is an important issue in future work. This paper reviews three MR-based detection technologies for the detection of biomarkers, i.e., anisotropic magnetoresistance (AMR), giant magnetoresistance (GMR), and tunneling magnetoresistance (TMR). Based on these three common technologies, different typical applications that include biomedical diagnosis, food safety, and environmental monitoring are presented. Furthermore, the existing MR-based detection method is better expanded to make it more in line with present detection needs by combining different advanced technologies including microfluidics, Microelectromechanical systems (MEMS), and Immunochromatographic test strips (ICTS). And then, a brief discussion of current challenges and perspectives of MR-based sensors are pointed out.

Versatile hybrid acoustic micromixer with demonstration of circulating cell-free DNA extraction from sub-ml plasma samples

Acoustic micromixers have attracted considerable attention in the last years since they can deliver high mixing efficiencies without the need for movable components. However, their adoption in the academic and industrial microfluidics community has been limited, possibly due to the reduced flexibility and accessibility of previous designs since most of them are application-specific and fabricated with techniques that are expensive, not widely available and difficult to integrate with other manufacturing technologies. In this work, we describe a simple, yet highly versatile, bubble-based micromixer module fabricated with a combination of low-cost rapid prototyping techniques. The hybrid approach enables the integration of the module into practically any substrate and the individual control of multiple micromixers embedded within the same monolithic chip. The module can operate under static and continuous flow conditions showing enhanced mixing capabilities compared to similar devices. We show that the system is capable of performing cell-free DNA extractions from small volumes of blood plasma (≤500 μl) with up to a ten-fold increase in capture efficiency when compared to control methods.

Multiplexed detection of biomarkers in lateral-flow immunoassays

Multiplexed detection of biomarkers, i.e., simultaneous detection of multiple biomarkers in a single assay, can enhance diagnostic precision, improve diagnostic efficiency, reduce diagnostic cost, and alleviate pain of patients.

Single droplet detection of immune checkpoints on a multiplexed electrohydrodynamic biosensor

Monitoring soluble immune checkpoints in circulating fluids has the potential for minimally-invasive diagnostics and personalised therapy in precision medicine. Yet, the sensitive detection of multiple immune checkpoints from small volumes of liquid biopsy samples is challenging. In this study, we develop a multiplexed immune checkpoint biosensor (MICB) for parallel detection of soluble immune checkpoints PD-1, PD-L1, and LAG-3. MICB integrates a microfluidic sandwich immunoassay using engineered single chain variable fragments and alternating current electrohydrodynamic in situ nanofluidic mixing for promoting biosensor-target interaction and reducing non-specific non-target binding. MICB provides advantages of simultaneous analysis of up to 28 samples in <2 h, requires as little as a single sample drop (i.e., 20 μL) per target immune checkpoint, and applies high-affinity yeast cell-derived single chain variable fragments as a cost-effective alternative to monoclonal antibodies. We investigate the assay performance of MICB and demonstrate its capability for accurate immune checkpoint detection in simulated patient serum samples at clinically-relevant levels. MICB provides a dynamic range of 5 to 200 pg mL-1 for PD-1 and PD-L1, and 50 to 1000 pg mL-1 for LAG-3 with a coefficient of variation <13.8%. Sensitive immune checkpoint detection was achieved with limits of detection values of 5 pg mL-1 for PD-1, 5 pg mL-1 for PD-L1, and 50 pg mL-1 for LAG-3. The multiplexing capability, sensitivity, and relative assay simplicity of MICB make it capable of serving as a bioanalytical tool for immune checkpoint therapy monitoring.

Highly Efficient Dual-Polar Electrochemiluminescence from Au25 Nanoclusters: The Next Generation of Multibiomarker Detection in a Single Step

For the first time, simultaneous cathodic and anodic electrochemiluminescence (ECL) emissions of bull serum albumin stabilized Au₂₅ nanoclusters (Au₂₅ NCs) as highly efficient bipolar ECL probes were constructed for the single-step and synchronous determination of carcinoembryonic antigen (CEA) and mucin 1 (MUC1) based on different coreactant and coreaction accelerators. Under the potential cathodic scanning, TiO₂ nanosheets (TiO₂ NSs) as cathodic coreaction accelerators could catalyze the reduction of coreactant dissolved O₂ for promoting cathodic ECL emission of Au₂₅ NCs, while, under the potential anodic scanning, Cu₂O@Cu nanoparticles (Cu₂O@Cu NPs) as anodic coreaction accelerators could stimulate the oxidation of coreactant N,N-diethylethylenediamine (DEDA) for enhancing anodic ECL emission of Au₂₅ NCs. Thus, the proposed strategy easily solved one main technical challenge of cross reactions of dual-luminophors for dual-biomarker detection, resulting in great sensitivity and accuracy toward the detection of CEA down to 0.43 pg/mL and MUC1 down to 5.8 fg/mL. As a proof of concept, this work realized single-step and simultaneous detection of dual biomarkers, which initiates a new thought in realizing a new generation of dual-biomarker ECL detection beyond the traditional ones in sensing analysis and diagnostic sensing.

Multiplexed Nucleic Acid Sensing with Single-Molecule FRET

Multiplex detection of biomolecules is important in bionanotechnology and clinical diagnostics. Multiplexing using engineered solutions such as microarrays, synthetic nanopores, and DNA barcodes is promising, but they require sophisticated design/engineering and typically yield semiquantitative information. Single-molecule fluorescence resonance energy transfer (smFRET) is an attractive tool in this regard as it enables both sensitive and quantitative detection. However, multiplexing with smFRET remains a great challenge as it requires either multiple excitation sources, an antenna system created by multiple FRET pairs, or multiple acceptors of the donor fluorophore, which complicates not only the labeling schemes but also data analysis, due to overlapping of FRET efficiencies ( E_FRET). Here, we address these currently outstanding issues by designing interconvertible hairpin-based sensors (iHabSs) with nonoverlapping E_FRET utilizing a single donor/acceptor pair and demonstrate a high-confidence multiplex detection of unlabeled nucleic acid sequences. We validated the reliability of our approach by systematically omitting one target at a time. Further, we demonstrate that these iHabSs are fully recyclable, sensitive with a limit of detection of ∼200 pM, and able to discriminate against single base mismatches. The multiplexed approach developed here has the potential to benefit the fields of biosensing and diagnostics by allowing simultaneous and quantitative detection of unlabeled nucleic acid biomarkers.