Enhancing the sensitivity of colorimetric lateral flow assay (CLFA) through signal amplification techniques

An Artificial Miniaturized Peroxidase for Signal Amplification in Lateral Flow Immunoassays

Signal amplification strategies are widely used for improving the sensitivity of lateral flow immunoassays (LFiAs). Herein, the artificial miniaturized peroxidase Fe(III)-MimochromeVI*a (FeMC6*a), immobilized on gold nanoparticles (AuNPs), is used as a strategy to obtain catalytic signal amplification in sandwich immunoassays on lateral flow strips. The assay scheme uses AuNPs decorated with the mini-peroxidase FeMC6*a and anti-human-IgG as a detection antibody (dAb), for the detection of human-IgG, as a model analyte. Recognition of the analyte by the capture and detection antibodies is first evidenced by the appearance of a red color in the test line (TL), due to the accumulation of AuNPs. Subsequent addition of 3,3',5,5'-tetramethylbenzidine (TMB) induces an increase of the test line color, due to the TMB being converted into an insoluble colored product, catalyzed by FeMC6*a. This work shows that FeMC6*a acts as an efficient catalyst in paper, increasing the sensitivity of an LFiA up to four times with respect to a conventional LFiA. Furthermore, FeMC6*a achieves lower limits of detection that are found in control experiments where it is replaced with horseradish peroxidase (HRP), its natural counterpart. This study represents a significant proof-of-concept for the development of more sensitive LFiAs, for different analytes, based on properly designed artificial metalloenzymes.

Gold-Silver Alloy Nanoparticle-Incorporated Pitaya-Type Silica Nanohybrids for Sensitive Competitive Lateral Flow Immunoassay

Although the competitive lateral flow immunoassay (CLFIA) using gold nanoparticles (AuNPs) as labels has been widely adopted for the rapid detection of small molecules, its sensitivity is often constrained by the insufficient colorimetric signal produced by conventional AuNPs labels. Herein, we introduce a new type of intensified colorimetric label, denoted as SAAS, which is engineered by integrating gold-silver alloy nanoparticles (Au-Ag NPs) within a dendritic silica scaffold. These pitaya-type silica nanohybrids combine the advantages of the amplified molar extinction coefficient of alloy units with the signal collective effect of numerous Au-Ag NPs in a singular label. The SAAS-based CLFIA strips not only achieve qualitative screening of aflatoxin B1 (AFB1) at an extraordinarily low concentration of 0.2 ng/mL by the naked eye but also enable precise AFB1 quantification through a smartphone, with a remarkable limit of detection of 0.00314 ng/mL. Moreover, by leveraging SAAS as a quencher, we have delved into transforming the conventional signal-off mode of competitive immunoassay into a signal-on configuration. This innovation led to the development of a fluorescent LFIA that augments interpretative precision and sensitivity. Our study demonstrates the substantial potential of the proposed nanohybrid labels in enhancing the sensitivity of CLFIA for detecting small molecules.

One-pot synthesis of AuPt@FexOy nanoparticles with excellent peroxidase-like activity for development of ultrasensitive colorimetric lateral flow immunoassay of cardiac troponin I

Detection of cardiac troponin I (cTnI) plays a critical role in diagnosing acute myocardial infarction (AMI). In this report, a new kind of spherical AuPt@FexOy core@shell nanoparticles (termed as AuPt@FexOy NPs) were one-pot synthesized by a redox interaction-engaged strategy (RIES) without the addition of any surfactants or reducing agents. The as-synthesized AuPt@FexOy NPs not only retain the plasmonic activity of gold nanoparticles (AuNPs), but also possess excellent catalytic activities of platinum nanoparticles (PtNPs) and FexOy nanoclusters. The features of AuPt@FexOy NPs enable greatly enhance the colorimetric detection sensitivity of lateral flow immunoassay (LFIA) through integrating AuPt@FexOy NPs labeling procedure and catalyzing oxidation of chromogenic substrate 3,3',5,5'-tetramethylbenzidine (TMB) signal amplification strategy. The as-developed colorimetric LFIA (termed as AuPt@FexOy-LFIA) exhibits the limit of detection (LOD) as 26.0 pg mL-1 cTnI under the TMB signal amplification mode. In particular, the detection results of cTnI in 40 clinical seral samples by AuPt@FexOy-LFIA are correlated well with those of cTnI in the same samples by commercial enzyme-linked immunosorbent assay (ELISA) detection kit (R2 = 0.97, slope = 1), demonstrating the highly reliable analytical performance and good application prospect of AuPt@FexOy-LFIA.

New technologies and reagents in lateral flow assay (LFA) designs for enhancing accuracy and sensitivity

Lateral flow assays (LFAs) are a popular method for quick and affordable diagnostic testing because they are easy to use, portable, and user-friendly. However, LFA design has always faced challenges regarding sensitivity, accuracy, and complexity of the operation. By integrating new technologies and reagents, the sensitivity and accuracy of LFAs can be improved while minimizing the complexity and potential for false positives. Surface enhanced Raman spectroscopy (SERS), photoacoustic techniques, fluorescence resonance energy transfer (FRET), and the integration of smartphones and thermal readers can improve LFA accuracy and sensitivity. To ensure reliable and accurate results, careful assay design and validation, appropriate controls, and optimization of assay conditions are necessary. Continued innovation in LFA technology is crucial to improving the reliability and accuracy of rapid diagnostic testing and expanding its applications to various areas, such as food testing, water quality monitoring, and environmental testing.

Catalytic Gold-Iridium Nanoparticles as Labels for Sensitive Colorimetric Lateral Flow Assay

The colorimetric lateral flow assay (CLFA, also known as test strip) is a widely used point-of-care diagnostic technology. It has been a challenge to significantly improve the detection sensitivity of CLFA without involving additional equipment and/or compromising its simplicity. In this work, we break through the detection limit barrier of CLFA by developing a type of catalytic nanoparticles (NPs) used as labels. Specifically, the NPs were engineered by coating conventional gold NPs (AuNPs) with iridium (Ir) to form an Au-Ir core-shell structure. Such Au-Ir NPs possess ultrahigh peroxidase-like catalytic activities. A single Au-Ir NP can generate up to 10⁷ colored molecules per second by catalyzing peroxidase substrates. The strong color signal from the catalysis ensures a high sensitivity of associated CLFA. The Au-Ir NP-based CLFA was successfully applied to the detection of two different cancer biomarkers that achieved limits of detection at the low picogram per milliliter level, hundreds of times lower than those of conventional AuNP-based CLFA.

Lateral Flow Immunoassay Reader Technologies for Quantitative Point-of-Care Testing

Due to the recent pandemic caused by coronavirus disease 2019 (COVID-19), the lateral flow immunoassay used for its rapid antigen test is more popular than ever before. However, the history of the lateral flow immunoassay is about 60 years old, and its original purpose of use, such as a COVID-19 rapid antigen test or a pregnancy test, was the qualitative detection of a target analyte. Recently, the demand for quantitative analysis of lateral flow immunoassays is increasing in various fields. Lateral flow immunoassays for quantitative detection using various materials and sensor technologies are being introduced, and readers for analyzing them are being developed. Quantitative analysis readers are highly anticipated for their future development in line with technological advancements such as optical, magnetic field, photothermal, and electrochemical sensors and trends such as weight reduction, miniaturization, and cost reduction of systems. In addition, the sensing, processing, and communication functions of portable personal devices such as smartphones can be used as tools for the quantitative analysis of lateral flow immunoassays. As a result, lateral flow immunoassays can efficiently achieve the goal of rapid diagnosis by point-of-care testing. Readers used for the quantification of lateral flow immunoassays were classified according to the adopted sensor technology, and the research trends in each were reviewed in this paper. The development of a quantitative analysis system was often carried out in the assay aspect, so not only the readers but also the assay development cases were reviewed if necessary. In addition, systems for quantitative analysis of COVID-19, which have recently been gaining importance, were introduced as a separate section.

Toward Next Generation Lateral Flow Assays: Integration of Nanomaterials

Lateral flow assays (LFAs) are currently the most used point-of-care sensors for both diagnostic (e.g., pregnancy test, COVID-19 monitoring) and environmental (e.g., pesticides and bacterial monitoring) applications. Although the core of LFA technology was developed several decades ago, in recent years the integration of novel nanomaterials as signal transducers or receptor immobilization platforms has brought improved analytical capabilities. In this Review, we present how nanomaterial-based LFAs can address the inherent challenges of point-of-care (PoC) diagnostics such as sensitivity enhancement, lowering of detection limits, multiplexing, and quantification of analytes in complex samples. Specifically, we highlight the strategies that can synergistically solve the limitations of current LFAs and that have proven commercial feasibility. Finally, we discuss the barriers toward commercialization and the next generation of LFAs.

Vanadium Disulfide Nanosheet Boosts Optical Signal Brightness as a Superior Enzyme Label to Improve the Sensitivity of Lateral Flow Immunoassay

The color-enzyme lateral flow immunoassay (LFIA) has attracted widespread attention to expand the detection range and improve sensitivity via amplifying the color signal after catalyzing the substrate. As a kind of layered transition-metal dichalcogenide (TMD), the vanadium disulfide nanosheet (VS₂NS) possesses superior peroxidase-like catalytic activity. Here, a VS₂NS was applied as an enzyme label in the LFIA to detect 17β-estradiol (E2). Compared to natural horseradish peroxidase, the VS₂NS expresses a more prominent enzyme catalytic performance, stability, and adsorption ability. Under optimal conditions, the calculated limit of detection (cLOD) of the VS₂NS-based LFIA is 0.065 ng mL^-1 for E2, which is sixfold lower than that of the optimized colloidal nanoparticle-based LFIA (cLOD = 0.406 ng mL^-1). Besides, the detection linear range of the VS₂NS-based LFIA can be widened by 1.5 times after the catalytic reaction. Moreover, the VS₂NS-based LFIA exhibits excellent practicability in real sample detection. Simultaneously, this study helps open up the application of the VS₂NS in the trace analysis of LFIAs, which can broaden TMDs' scope of application and better show their properties of color enzymes.

Recent Advances in Silica-Nanomaterial-Assisted Lateral Flow Assay

Lateral flow assays (LFAs) have attracted much attention as rapid and affordable point-of-care devices for medical diagnostics. The global SARS-CoV-2 pandemic has further highlighted the importance of LFAs. Many efforts have been made to enhance the sensitivity of LFAs. In recent years, silica nanomaterials have been used to either amplify the signal of label materials or provide stability, resulting in better detection performance. In this review, the recent progress of silica-nanomaterial-assisted LFAs is summarized. The impact of the structure of silica nanomaterials on LFA performance, the challenges and prospects in this research area are also discussed.

An Overview for the Nanoparticles-Based Quantitative Lateral Flow Assay

The development of the lateral flow assay (LFA) has received much attention in both academia and industry because of their broad applications to food safety, environmental monitoring, clinical diagnosis, and so forth. The user friendliness, low cost, and easy operation are the most attractive advantages of the LFA. In recent years, quantitative detection has become another focus of LFA development. Here, the most recent studies of quantitative LFAs are reviewed. First, the principles and corresponding formats of quantitative LFAs are introduced. In the biomaterial and nanomaterial sections, the detection, capture, and signal amplification biomolecules and the optical, fluorescent, luminescent, and magnetic labels used in LFAs are described. The invention of dedicated strip readers has drawn further interest in exploiting the better performance of LFAs. Therefore, next, the development of dedicated reader devices is described and the usefulness and specifications of these devices for LFAs are discussed. Finally, the applications of LFAs in the detection of metal ions, biotoxins, pathogenic microorganisms, veterinary drugs, and pesticides in the fields of food safety and environmental health and the detection of nucleic acids, biomarkers, and viruses in clinical analyses are summarized.

Rapid testing for coronavirus disease 2019 (COVID-19)

Rapid testing, generally refers to the paper-based diagnostic platform known as "lateral flow assay" (LFA), has emerged as a critical asset to the containment of coronavirus disease 2019 (COVID-19) around the world. LFA technology stands out amongst peer platforms due to its cost-effective design, user-friendly interface, and low sample-to-readout times. This article aims to introduce its design, use, and practicality for the purpose of diagnosing SARS-CoV-2 infection. A connection is made from the normal COVID-19 immune response to the design and efficacy of rapid testing. Interference in test results is a challenge shared by most diagnostic platforms and can be rooted in various underlying issues. The current knowledge and situation about interference in rapid COVID-19 tests due to variant strains as well as vaccination are discussed. The cost and societal impact are reviewed as they play important roles in determining how to properly implement public testing practices. Perspectives on improving the performance, especially detection sensitivity, of LFA for COVID-19 are provided.

Sensitive Colorimetric Detection of Interleukin-6 via Lateral Flow Assay Incorporated Silver Amplification Method

Interleukin-6 (IL-6) is a pro/anti-inflammatory cytokine, the quantitative detection of which has been extensively considered for diagnosis of inflammatory associated diseases. However, there has not yet been a reliable, low-cost, and user-friendly platform developed for point-of-care (POC) detection of IL-6, which will eliminate the conventional costly, time-consuming, and complex assays. In this work, we developed a lateral flow assay for colorimetric detection of IL-6, using anti-IL-6 antibodies conjugated to gold nanoparticles (AuNPs) as the detection probes. Silver amplification technique was incorporated with the newly developed assay in order to enhance the obtained colorimetric signals, allowing sensitive detection of IL-6 in human serum in the desired physiological ranges (i.e., 5–1000 pg/mL). A limit of detection of 5 pg/mL could be achieved for IL-6 detection in serum with the amplification step which was not achievable in the standard assay. The corresponding specificity and reproducibility tests were all preformed to confirm the reliability of this assay for quantitative measurement of IL-6 in a POC manner.

Dual Photoredox Catalysis Strategy for Enhanced Photopolymerization-Based Colorimetric Biodetection

Catalytic redox reactions have been employed to enhance colorimetric biodetection signals in point-of-care diagnostic tests, while their time-sensitive visual readouts may increase the risk of false results. To address this issue, we developed a dual photocatalyst signal amplification strategy that can be controlled by a fixed light dose, achieving time-independent colorimetric biodetection in paper-based tests. In this method, target-associated methylene blue (MB⁺) photocatalytically amplifies the concentration of eosin Y by oxidizing deactivated eosin Y (EYH^3-) under red light, followed by photopolymerization with eosin Y autocatalysis under green light to generate visible hydrogels. Using the insights from mechanistic studies on MB⁺-sensitized photo-oxidation of EYH^3-, we improved the photocatalytic efficiency of MB⁺ by suppressing its degradation. Lastly, we characterized 100- to 500-fold enhancement in sensitivity obtained from MB⁺-specific eosin Y amplification, highlighting the advantages of using dual photocatalyst signal amplification.

Advanced Nanomaterials for Preparedness Against (Re-)Emerging Viral Diseases

While the coronavirus disease (COVID-19) accounts for the current global pandemic, the emergence of other unknown pathogens, named "Disease X," remains a serious concern in the future. Emerging or re-emerging pathogens continue to pose significant challenges to global public health. In response, the scientific community has been urged to create advanced platform technologies to meet the ever-increasing needs presented by these devastating diseases with pandemic potential. This review aims to bring new insights to allow for the application of advanced nanomaterials in future diagnostics, vaccines, and antiviral therapies, thereby addressing the challenges associated with the current preparedness strategies in clinical settings against viruses. The application of nanomaterials has advanced medicine and provided cutting-edge solutions for unmet needs. Herein, an overview of the currently available nanotechnologies is presented, highlighting the significant features that enable them to control infectious diseases, and identifying the challenges that remain to be addressed for the commercial production of nano-based products is presented. Finally, to conclude, the development of a nanomaterial-based system using a "One Health" approach is suggested. This strategy would require a transdisciplinary collaboration and communication between all stakeholders throughout the entire process spanning across research and development, as well as the preclinical, clinical, and manufacturing phases.

Integrated Nanomaterials and Nanotechnologies in Lateral Flow Tests for Personalized Medicine Applications

The goal of personalized medicine is to target the right treatments to the right patients at the right time. Patients with a variety of cancers and other complex diseases are regularly tested as part of patient care, enabling physicians to personalize patient monitoring and treatment. Among the sought-after diagnostic tools, there is an increasing interest and need for those based on a low-cost, easy, rapid, and accurate method for the detection of specific circulating biomarkers above a detection threshold. Lateral flow tests (LFTs), enhanced by nanotechnology, can fulfil these requirements, providing a significant support to personalized patient monitoring. In this review, after a short historical synopsis of membrane-based lateral flow assays, including a description of a typical configuration of a LFT strip, a careful collection is presented of the best characterized nanotechnology approaches previously reported for the enhancement of target detection performance. The attempt is to offer an overview of currently integrated nanotechnologies in LFTs, fostering the actual future development of advantageous diagnostic devices for patient monitoring.

Integrating high-performing electrochemical transducers in lateral flow assay

Lateral flow assays (LFAs) are the best-performing and best-known point-of-care tests worldwide. Over the last decade, they have experienced an increasing interest by researchers towards improving their analytical performance while maintaining their robust assay platform. Commercially, visual and optical detection strategies dominate, but it is especially the research on integrating electrochemical (EC) approaches that may have a chance to significantly improve an LFA's performance that is needed in order to detect analytes reliably at lower concentrations than currently possible. In fact, EC-LFAs offer advantages in terms of quantitative determination, low-cost, high sensitivity, and even simple, label-free strategies. Here, the various configurations of EC-LFAs published are summarized and critically evaluated. In short, most of them rely on applying conventional transducers, e.g., screen-printed electrode, to ensure reliability of the assay, and additional advances are afforded by the beneficial features of nanomaterials. It is predicted that these will be further implemented in EC-LFAs as high-performance transducers. Considering the low cost of point-of-care devices, it becomes even more important to also identify strategies that efficiently integrate nanomaterials into EC-LFAs in a high-throughput manner while maintaining their favorable analytical performance. Graphical abstract.

Low-Cost Optical Assays for Point-of-Care Diagnosis in Resource-Limited Settings

Readily deployable, low-cost point-of-care medical devices such as lateral flow assays (LFAs), microfluidic paper-based analytical devices (μPADs), and microfluidic thread-based analytical devices (μTADs) are urgently needed in resource-poor settings. Governed by the ASSURED criteria (affordable, sensitive, specific, user-friendly, rapid and robust, equipment-free, and deliverability) set by the World Health Organization, these reliable platforms can screen a myriad of chemical and biological analytes including viruses, bacteria, proteins, electrolytes, and narcotics. The Ebola epidemic in 2014 and the ongoing pandemic of SARS-CoV-2 have exemplified the ever-increasing importance of timely diagnostics to limit the spread of diseases. This review provides a comprehensive survey of LFAs, μPADs, and μTADs that can be deployed in resource-limited settings. The subsequent commercialization of these technologies will benefit the public health, especially in areas where access to healthcare is limited.

Recent Advancements in Enzyme-Based Lateral Flow Immunoassays

Paper-based lateral-flow immunoassays (LFIAs) have achieved considerable commercial success and their impact in diagnostics is continuously growing. LFIA results are often obtained by visualizing by the naked eye color changes in given areas, providing a qualitative information about the presence/absence of the target analyte in the sample. However, this platform has the potential to provide ultrasensitive quantitative analysis for several applications. Indeed, LFIA is based on well-established immunological techniques, which have known in the last year great advances due to the combination of highly sensitive tracers, innovative signal amplification strategies and last-generation instrumental detectors. All these available progresses can be applied also to the LFIA platform by adapting them to a portable and miniaturized format. This possibility opens countless strategies for definitively turning the LFIA technique into an ultrasensitive quantitative method. Among the different proposals for achieving this goal, the use of enzyme-based immunoassay is very well known and widespread for routine analysis and it can represent a valid approach for improving LFIA performances. Several examples have been recently reported in literature exploiting enzymes properties and features for obtaining significative advances in this field. In this review, we aim to provide a critical overview of the recent progresses in highly sensitive LFIA detection technologies, involving the exploitation of enzyme-based amplification strategies. The features and applications of the technologies, along with future developments and challenges, are also discussed.

Network of gold conjugates for enhanced sensitive immunochromatographic assays of troponins

Highly sensitive detection of cardiac troponins I and T (cTnI and cTnT) was completed by immunochromatography with double amplification, through the binding of functionalized gold nanoparticles (GNPs). The robust nature of the approach, based on the formation of nanoparticle networks through the biotin-streptavidin interaction, was confirmed; the choice of the best assay parameters for maximal increase in ICA sensitivity was demonstrated. A bifunctional conjugate of GNPs with biotinylated specific IgG and two auxiliary conjugates, GNP-biotin and GNP-streptavidin, form three-component aggregates in the analytical zone of the test strip. The inclusion of abundant gold labels in the resulting immune complex leads to an amplified colorimetric signal. The limits of detection (LoDs) of cTnI and cTnT were 0.9 and 0.4 ng mL-1, respectively, which is 3 times lower than the LoDs of more commonly used systems. Visual LoDs were 10-fold lower in concentration. The enhancement has been realized both in single and double assay formats; analysis of cTnI and cTnT presented the same characteristics.

Integrating high-performing electrochemical transducers in lateral flow assay

Lateral flow assays (LFAs) are the best-performing and best-known point-of-care tests worldwide. Over the last decade, they have experienced an increasing interest by researchers towards improving their analytical performance while maintaining their robust assay platform. Commercially, visual and optical detection strategies dominate, but it is especially the research on integrating electrochemical (EC) approaches that may have a chance to significantly improve an LFA’s performance that is needed in order to detect analytes reliably at lower concentrations than currently possible. In fact, EC-LFAs offer advantages in terms of quantitative determination, low-cost, high sensitivity, and even simple, label-free strategies. Here, the various configurations of EC-LFAs published are summarized and critically evaluated. In short, most of them rely on applying conventional transducers, e.g., screen-printed electrode, to ensure reliability of the assay, and additional advances are afforded by the beneficial features of nanomaterials. It is predicted that these will be further implemented in EC-LFAs as high-performance transducers. Considering the low cost of point-of-care devices, it becomes even more important to also identify strategies that efficiently integrate nanomaterials into EC-LFAs in a high-throughput manner while maintaining their favorable analytical performance.

16S rRNA Monitoring Point-of-Care Magnetic Focus Lateral Flow Sensor

The detection and profiling of pathogenic bacteria is critical for human health, environmental, and food safety monitoring. Herein, we propose a highly sensitive colorimetric strategy for naked eye screening of 16S ribosomal RNA (16S rRNA) from pathogenic agents relevant to infections, human health, and food safety monitoring with a magnetic focus lateral flow sensor (mLFS) platform. The method developed was demonstrated in model 16S rRNA sequences of the pathogen Escherichia coli O157:H7 to detect as low as 1 fM of targets, exhibiting a sensitivity improved by ∼5 × 10⁵ times compared to the conventional GNP-based colorimetric lateral flow assay used for oligonucleotide testing. Based on the grayscale values, semi-quantitation of up to 1 pM of target sequences was possible in ∼45 min. The methodology could detect the target 16S rRNA from as low as 32 pg/mL of total RNA extracted from pathogens. Specificity was demonstrated with total RNA extracted from E. coli K-12 MG1655, Bacillus subtilis (B. subtilis), and Pseudomonas aeruginosa (P. aeruginosa). No signal was observed from as high as 320 pg/mL of total RNA from the nontarget bacteria. The recognition of target 16S rRNA from 32 pg/mL of total RNA in complex matrices was also demonstrated. The proposed mLFS method was then extended to monitoring B. subtilis and P. aeruginosa. Our approach highlights the possibility of extending this concept to screen specific nucleic acid sequences for the monitoring of infectious pathogens or microbiome implicated in a range of diseases including cancer.

Point-of-care diagnostics for infectious diseases: From methods to devices

The current widespread of COVID-19 all over the world, which is caused by SARS-CoV-2 virus, has again emphasized the importance of development of point-of-care (POC) diagnostics for timely prevention and control of the pandemic. Compared with labor- and time-consuming traditional diagnostic methods, POC diagnostics exhibit several advantages such as faster diagnostic speed, better sensitivity and specificity, lower cost, higher efficiency and ability of on-site detection. To achieve POC diagnostics, developing POC detection methods and correlated POC devices is the key and should be given top priority. The fast development of microfluidics, micro electro-mechanical systems (MEMS) technology, nanotechnology and materials science, have benefited the production of a series of portable, miniaturized, low cost and highly integrated POC devices for POC diagnostics of various infectious diseases. In this review, various POC detection methods for the diagnosis of infectious diseases, including electrochemical biosensors, fluorescence biosensors, surface-enhanced Raman scattering (SERS)-based biosensors, colorimetric biosensors, chemiluminiscence biosensors, surface plasmon resonance (SPR)-based biosensors, and magnetic biosensors, were first summarized. Then, recent progresses in the development of POC devices including lab-on-a-chip (LOC) devices, lab-on-a-disc (LOAD) devices, microfluidic paper-based analytical devices (μPADs), lateral flow devices, miniaturized PCR devices, and isothermal nucleic acid amplification (INAA) devices, were systematically discussed. Finally, the challenges and future perspectives for the design and development of POC detection methods and correlated devices were presented. The ultimate goal of this review is to provide new insights and directions for the future development of POC diagnostics for the management of infectious diseases and contribute to the prevention and control of infectious pandemics like COVID-19.

Upconverting nanoparticle clustering based rapid quantitative detection of tetrahydrocannabinol (THC) on lateral-flow immunoassay

Cannabis, also known as marijuana, is the most abused psychoactive drug worldwide.

Deep Learning on chromatographic data for Segmentation and Sensitive Analysis

Lateral flow immunoassay (LFIA) is one of the most common methods in point-of-care testing, which is widely applied in some conditions for various applications. Image segmentation is an increasingly popular experimental paradigm to efficiently test the target area in LFIA. However, due to process pollution, and problems related to the experimental operation and irregular structure of the background of the reaction, currently available tools cannot be used to extract correct signals from these images, which affects the accuracy of detection. Machine learning has significantly improved modern biochemical analysis by pushing the limits of traditional techniques for the recognition and processing of images. In this paper, the U-Net, a variant of the convolutional neural network (CNN) is used for the quantitative analysis of LFIA images for the accurate quantification of single- and multi-target images. By graying, binarizing, and labeling different concentrations of test strips, the target area of LFIA images containing the T-/C-lines is extracted and obtained. Then it provides updated trends and directions for the development of LFIA technology. Several indicators are introduced to evaluate the proposed U-Net structure to verify the feasibility and effectiveness of its image processing capability. When the trained U-Net model was used to process images, the peak signal-to-noise ratio was 22.4 dB, significantly higher than prevalent methods in the area that have reported only a 4 dB improvement in the quality of the graphics. The intersection-over-union between samples also increased to above 93%. Our results show that the proposed method has significant potential for detecting a segmented target in an LFIA area, especially weak positive signals and multichannel detection. With other modifications, this deep learning method can be applied as a powerful tool to study rapid detection devices, systems, and biological images.

Gold nanoparticle-decorated metal organic frameworks on immunochromatographic assay for human chorionic gonadotropin detection

Gold nanoparticle-decorated metal organic frameworks (MOF@AuNPs) with significantly enhanced color signal intensity were synthesized through in situ growth of AuNPs on the MOF skeleton. The resultant MOF@AuNP nanocomposites were characterized with 16.7-fold higher absorbance than conventional 40 nm AuNPs (AuNP₄₀). Thus, for the first time, we applied it as a signal amplification label to improve the immunochromatographic assay (ICA) of human chorionic gonadotropin (HCG). The detection limit of our enhanced ICA was 1.69 mIU/mL, which is ca. 10.6-fold improvement in sensitivity compared to traditional AuNP₄₀-ICA. The recoveries of this MOF@AuNPs-ICA ranged from 86.03 to 119.22%, with coefficients of variation of 3.05 to 13.74%. The reliability and practicability were further validated by the clinically used chemiluminescence immunoassay method. Given their excellent signal amplification ability, the proposed MOF@AuNPs could serve as an ideal ICA label for rapid and sensitive detection of disease biomarkers. Graphical abstract.

Microfluidic compartmentalization to identify gene biomarkers of infection

Infectious diseases caused by pathogens, such as SARS-COV, H7N9, severe fever with thrombocytopenia syndrome virus, and human immunodeficiency virus, have fatal outcomes with common features of severe fever and subsequent bacterial invasion progressing to multiorgan failure. Gene biomarkers are promising to distinguish specific infections from others with similar presenting symptoms for the prescription of correct therapeutics, preventing pandemics. While routine laboratory methods based on polymerase chain reaction (PCR) to measure gene biomarkers have provided highly sensitive and specific viral detection techniques over the years, they are still hampered by their precision and resource intensity precluding their point-of-care use. Recently, there has been growing interest in employing microfluidic technologies to advance current methods for infectious disease determination via gene biomarker measurements. Here, based on the requirement of infection detection, we will review three microfluidic approaches to compartmentalize gene biomarkers: (1) microwell-based PCR platforms; (2) droplet-based PCR; and (3) point-of-care devices including centrifugal chip, SlipChip, and self-powered integrated microfluidic point-of-care low-cost enabling chip. By capturing target genes in microwells with a small sample volume (∼μl), sensitivity can be enhanced. Additionally, with the advance of significant sample volume minimization (∼pl) using droplet technology, gene quantification is possible. These improvements in cost, automation, usability, and portability have thereby allowed point-of-care applications to decentralize testing platforms from laboratory-based settings to field use against infections.

Bead-based multiplex detection of dengue biomarkers in a portable imaging device

Dengue is one of the most rapidly spreading mosquito-borne viral diseases in the world. Differential diagnosis is a crucial step for the management of the disease and its epidemiology. Point-of-care testing of blood-borne dengue biomarkers provides an advantageous approach in many health care settings, and the ability to follow more than one biomarker at once could significantly improve the management of the disease. Bead-based multiplex technologies (suspension array) can measure multiple biomarker targets simultaneously by using recognition molecules immobilized on microsphere beads. The overarching objective of our work is to develop a portable detection device for the simultaneous measurement of multiple biomarkers important in dengue diagnosis, monitoring and treatment. Here, we present a bead-based assay for the detection of one of the four serotypes of dengue virus non-structural protein (DENV-NS1) as well as its cognate human IgG. In this system, the fluorescent microspheres containing the classification fluorophore and detection fluorophore are imaged through a microfluidic chip using an infinity-corrected microscope system. Calibration curves were plotted for median fluorescence intensity against known concentrations of DENV-NS1 protein and anti-NS1 human IgG. The limit of quantitation was 7.8 ng/mL and 15.6 ng/mL, respectively. The results of this study demonstrate the feasibility of the multiplex detection of dengue biomarkers and present its analytical performance parameters. The proposed imaging device holds potential for point-of-care testing of biomarkers on a highly portable system, and it may facilitate the diagnosis and prevention of dengue as well as other infectious diseases.

Paper/Soluble Polymer Hybrid-Based Lateral Flow Biosensing Platform for High-Performance Point-of-Care Testing

As a global shift continues to occur in high burden diseases toward developing countries, the importance of medical diagnostics based on point-of-care testing (POCT) is rapidly increasing. However, most diagnostic tests that meet clinical standards rely on high-end analyzers in central hospitals. Here, we report the development of a simple, low-cost, mass-producible, highly sensitive/quantitative, automated, and robust paper/soluble polymer hybrid-based lateral flow biosensing platform, paired with a smartphone-based reader, for high-performance POCT. The testing architecture incorporates a polymeric barrier that programs/automates sequential reactions via a polymer dissolving mechanism. The smartphone-based reader with simple opto-mechanical parts offers a stable framework for accurate quantification. Analytical performance of this platform was evaluated by testing human cardiac troponin I (cTnI), a preferred biomarker for the diagnosis of myocardial infarction, in serum/plasma samples. Coupled with catalytic/colorimetric gold-ion amplification, this platform produced results within 20 min with a detection limit of 0.92 pg mL^-1 and a coefficient of variation <10%, which is equivalent to the performance of a high-sensitivity standard analyzer, and operated within acceptable levels stipulated by clinical guidelines. Moreover, cTnI clinical sample tests indicate a high correlation (r = 0.981) with the contemporary analyzers, demonstrating the clinical utility of this platform in high-performance POCT.

Recent Advances in Microfluidic Paper-Based Analytical Devices toward High-Throughput Screening

Microfluidic paper-based analytical devices (µPADs) have become promising tools offering various analytical applications for chemical and biological assays at the point-of-care (POC). Compared to traditional microfluidic devices, µPADs offer notable advantages; they are cost-effective, easily fabricated, disposable, and portable. Because of our better understanding and advanced engineering of µPADs, multistep assays, high detection sensitivity, and rapid result readout have become possible, and recently developed µPADs have gained extensive interest in parallel analyses to detect biomarkers of interest. In this review, we focus on recent developments in order to achieve µPADs with high-throughput capability. We discuss existing fabrication techniques and designs, and we introduce and discuss current detection methods and their applications to multiplexed detection assays in relation to clinical diagnosis, drug analysis and screening, environmental monitoring, and food and beverage quality control. A summary with future perspectives for µPADs is also presented.

Advantages of Highly Spherical Gold Nanoparticles as Labels for Lateral Flow Immunoassay

The use of lateral flow immunoassays (LFIAs) for rapid on-site testing is restricted by their relatively high limit of detection (LoD). One possible way to decrease the LoD is to optimize nanoparticle properties that are used as labels. We compare two types of Au nanoparticles: usual quasispherical gold nanoparticles (C-GNPs), obtained by the Turkevich–Frens method, and superspherical gold nanoparticles (S-GNPs), obtained by a progressive overgrowth technique. Average diameters were 18.6–47.5 nm for C-GNPs and 20.2–90.4 nm for S-GNPs. Cardiomarker troponin I was considered as the target analyte. Adsorption and covalent conjugation with antibodies were tested for both GNP types. For C-GNPs, the minimal LoD was obtained with 33.7 nm nanoparticles, reaching 12.7 ng/mL for covalent immobilization and 9.9 ng/mL for adsorption. The average diameter of S-GNPs varied from 20.2 to 64.5 nm, which resulted in a decrease in LoD for an LFIA of troponin I from 3.4 to 1.2 ng/mL for covalent immobilization and from 2.9 to 2.0 ng/mL for adsorption. Thus, we obtained an 8-fold decrease in LoD (9.9 to 1.2 ng/mL) by using S-GNPs. This effect can be related to more effective antibody immobilization and improved S-GNP optical properties. The obtained results can improve LFIAs for various practically significant analytes.

Signal amplification and quantification on lateral flow assays by laser excitation of plasmonic nanomaterials

Lateral flow assay (LFA) has become one of the most widely used point-of-care diagnostic methods due to its simplicity and low cost. While easy to use, LFA suffers from its low sensitivity and poor quantification, which largely limits its applications for early disease diagnosis and requires further testing to eliminate false-negative results. Over the past decade, signal enhancement strategies that took advantage of the laser excitation of plasmonic nanomaterials have pushed down the detection limit and enabled quantification of analytes. Significantly, these methods amplify the signal based on the current LFA design without modification. This review highlights these strategies of signal enhancement for LFA including surface enhanced Raman scattering (SERS), photothermal and photoacoustic methods. Perspectives on the rational design of the reader systems are provided. Future translation of the research toward clinical applications is also discussed.

Template Regeneration in Galvanic Replacement: A Route to Highly Diverse Hollow Nanostructures

The ability to produce a diverse spectrum of hollow nanostructures is central to the advances in many current and emerging areas of technology. Herein, we report a general method to craft hollow nanostructures with highly tunable physical and chemical parameters. The key strategy is to regenerate the nanoscale sacrificial templates in a galvanic replacement reaction through site-selective overgrowth. As examples, we demonstrate the syntheses of nanocages and nanotubes made of silver, gold, palladium, and/or platinum with well-controlled wall thicknesses and elemental distributions. Using the nanocages of silver and gold as models, we demonstrate they possess intriguing plasmonic properties and offer superior performance in biosensing applications. This study provides a powerful platform to customize hollow nanostructures with desired properties and therefore is expected to enable a variety of fundamental studies and technologically important applications.

Immunochromatographic System for Serodiagnostics of Cattle Brucellosis Using Gold Nanoparticles and Signal Amplification with Quantum Dots

In this article, we describe an immunochromatographic test system developed for rapid serodiagnostics of cattle brucellosis using two markers: Gold nanoparticles (GNPs) and quantum dots (QDs). The test system was compared with immunochromatographic serodiagnostics systems that use only one marker. The approbation of the test system was conducted on samples of cattle sera with low, but diagnostically significant titers of specific antibodies. We show that when two conjugates are used, the intensity of the detectable signal increases by 2–3 times compared with the test system using the QD conjugate and by more than nine times compared with the system using the GNP conjugate.

Recent advances in high-sensitivity detection methods for paper-based lateral-flow assay

Paper-based lateral-flow assays (LFAs) have achieved considerable commercial success and continue to have a significant impact on medical diagnostics and environmental monitoring. Conventional LFAs are typically performed by examining the color changes in the test bands by naked eye. However, for critical biochemical markers that are present in extremely small amounts in the clinical specimens, this readout method is not quantitative, and does not provide sufficient sensitivity or suitable detection limit for a reliable assay. Diverse technologies for high-sensitivity LFA detection have been developed and commercialization efforts are underway. In this review, we aim to provide a critical and objective overview of the recent progress in high-sensitivity LFA detection technologies, which involve the exploitation of the physical and chemical responses of transducing particles. The features and biomedical applications of the technologies, along with future prospects and challenges, are also discussed.

Liposome-Enhanced Polymerization-Based Signal Amplification for Highly Sensitive Naked-Eye Biodetection in Paper-Based Sensors

Polymerization-based signal amplification (PBA) is a material-based approach to improving the sensitivity of paper-based diagnostic tests. Eosin Y is used as an assay label to photo-initiate free-radical polymerization to produce colored hydrogels in the presence of target analytes captured by bioactive paper. PBA achieves high-contrast and time-independent signals, but its nanomolar detection limit makes it impractical for early diagnosis of many diseases. In this work, we demonstrated efficient localization of large quantities of eosin Y per captured target analyte by incorporating eosin Y-loaded liposomes into PBA. This new "materials approach" allowed 30-fold signal enhancement compared to conventional PBA. To further improve the detection limit of liposome-enhanced PBA, we used a continuous flow-through assay format with 100 μL of analyte solution, achieving sub-nanomolar detection limits with high-contrast signals that were easily discernible to the unaided eye.

Programmable Paper-Based Microfluidic Devices for Biomarker Detections

Recent advanced paper-based microfluidic devices provide an alternative technology for the detection of biomarkers by using affordable and portable devices for point-of-care testing (POCT). Programmable paper-based microfluidic devices enable a wide range of biomarker detection with high sensitivity and automation for single- and multi-step assays because they provide better control for manipulating fluid samples. In this review, we examine the advances in programmable microfluidics, i.e., paper-based continuous-flow microfluidic (p-CMF) devices and paper-based digital microfluidic (p-DMF) devices, for biomarker detection. First, we discuss the methods used to fabricate these two types of paper-based microfluidic devices and the strategies for programming fluid delivery and for droplet manipulation. Next, we discuss the use of these programmable paper-based devices for the single- and multi-step detection of biomarkers. Finally, we present the current limitations of paper-based microfluidics for biomarker detection and the outlook for their development.

Development of Replication Protein A-Conjugated Gold Nanoparticles for Highly Sensitive Detection of Disease Biomarkers

Paper-based lateral flow immunoassays (LFIAs) using conventional sandwich-type immunoassays are one of the most commonly used point-of-care (PoC) tests. However, the application of gold nanoparticles (AuNPs) in LFIAs does not meet sensitivity requirements for the detection of infectious diseases or biomarkers present at low concentrations in body fluids because of the limited number of AuNPs that can bind to the target. To overcome this problem, we first developed a single-stranded DNA binding protein (RPA70A, DNA binding domain A of human Replication Protein A 70 kDa) conjugated to AuNPs for a sandwich assay using a capture antibody immobilized in the LFIA and an aptamer as a detection probe, thus, enabling signal intensity enhancement by attaching several AuNPs per aptamer. We applied this method to detect the influenza nucleoprotein (NP) and cardiac troponin I (cTnI). We visually detected spiked targets at a low femtomolar range, with limits of detection for NP in human nasal fluid and for cTnI in serum of 0.26 and 0.23 pg·mL^-1, respectively. This technique showed significantly higher sensitivity than conventional methods that are widely used in LFIAs involving antibody-conjugated AuNPs. These results suggest that the proposed method can be universally applied to the detection of substances requiring high sensitivity and can be used in the field of PoC testing for early disease diagnosis.

Enlargement of Gold Nanoparticles for Sensitive Immunochromatographic Diagnostics of Potato Brown Rot

Lateral flow immunoassay (LFIA) is a convenient tool for rapid field-based control of various bacterial targets. However, for many applications, the detection limits obtained by LFIA are not sufficient. In this paper, we propose enlarging gold nanoparticles' (GNPs) size to develop a sensitive lateral flow immunoassay to detect Ralstonia solanacearum. This bacterium is a quarantine organism that causes potato brown rot. We fabricated lateral flow test strips using gold nanoparticles (17.4 ± 1.0 nm) as a label and their conjugates with antibodies specific to R. solanacearum. We proposed a signal enhancement in the test strips' test zone due to the tetrachloroauric (III) anion reduction on the GNP surface, and the increase in size of the gold nanoparticles on the test strips was approximately up to 100 nm, as confirmed by scanning electron microscopy. Overall, the gold enhancement approach decreased the detection limit of R. solanacearum by 33 times, to as low as 3 × 10⁴ cells∙mL⁻1 in the potato tuber extract. The achieved detection limit allows the diagnosis of latent infection in potato tubers. The developed approach based on gold enhancement does not complicate analyses and requires only 3 min. The developed assay together with the sample preparation and gold enlargement requires 15 min. Thus, the developed approach is promising for the development of lateral flow test strips and their subsequent introduction into diagnostic practice.