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Schobesberger S, Thumfart H, Selinger F, Schlimp CJ, Zipperle J, Ertl P. Development of a Paper-based Hematocrit Test and a Lateral Flow Assay to Detect Critical Fibrinogen Concentrations Using a Bottom-Up Pyramid Workflow Approach. ACS OMEGA 2024; 9:8533-8542. [PMID: 38405462 PMCID: PMC10882670 DOI: 10.1021/acsomega.3c10045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 02/27/2024]
Abstract
Fibrinogen is a coagulation factor in human blood and the first one to reach critical levels in major bleeding. Hypofibrinogenemia (a too low fibrinogen concentration in blood) poses great challenges to first responders, clinicians, and healthcare providers since it represents a risk factor for exsanguination and massive transfusion requirements. Thus, the rapid assessment of the fibrinogen concentration at the point of care has gained considerable importance in preventing and managing major blood loss. However, in whole blood measurements, hematocrit variations affect the amount (volume fraction) of plasma that passes the detection zone. In an attempt to accurately determine realistic critical levels of fibrinogen (<1.5 mg/mL) in patients needing immediate treatment and medical interventions, we have developed novel diagnostic systems capable of estimating hematocrit and critical fibrinogen concentrations. A lateral flow assay (LFA) for the detection of fibrinogen has been developed by establishing a workflow employing rapid characterization methods to streamline LFA development. The integration of two detection lines enables (i) the identification of fibrinogen (first line) present in the sample and (ii) the determination of the clinically critical fibrinogen concentrations below 1.5 mg/mL (second line). Furthermore, the paper-based separation of blood cells from plasma provides a semiquantitative estimate of the hematocrit by analyzing the fractions. Initial validation of the point-of-care (PoC) hematocrit test revealed good comparability to a standard laboratory method. The developed diagnostic systems have the ability to accelerate decision-making in cases with major bleeding.
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Affiliation(s)
| | - Helena Thumfart
- Faculty of Technical Chemistry, TU Wien, Getreidemarkt 9, 1060 Vienna, Austria
| | - Florian Selinger
- Faculty of Technical Chemistry, TU Wien, Getreidemarkt 9, 1060 Vienna, Austria
| | - Christoph J Schlimp
- Ludwig-Boltzmann-Institute for Traumatology, The Research Center in Cooperation with AUVA, Donaueschingenstraße 13, 1200 Vienna, Austria
- Department of Anaesthesiology and Intensive Care, AUVA Trauma Center Linz, Garnisonstraße 7, 4010 Linz, Austria
| | - Johannes Zipperle
- Ludwig-Boltzmann-Institute for Traumatology, The Research Center in Cooperation with AUVA, Donaueschingenstraße 13, 1200 Vienna, Austria
| | - Peter Ertl
- Faculty of Technical Chemistry, TU Wien, Getreidemarkt 9, 1060 Vienna, Austria
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2
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Gao C, Bao B, Bao C, Wu W. Fungi Fibrinolytic Compound 1 Plays a Core Role in Modulating Fibrinolysis, Altering Plasma Clot Structure, and Promoting Susceptibility to Lysis. Pharmaceutics 2023; 15:2320. [PMID: 37765289 PMCID: PMC10536852 DOI: 10.3390/pharmaceutics15092320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Fibrin clot structure and function are major determinants of venous and arterial thromboembolic diseases, as well as the key determinants of the efficiency of clot lysis. Studies have revealed that fungi fibrinolytic compound 1 (FGFC1) is a novel marine pyranisoindolone natural product with fibrinolytic activity. Here, we explore the impacts of FGFC1 on clot structure, lysis, and plasminogen activation in vitro using turbidimetric, enzyme-linked immunosorbent assay, confocal and electron microscopy, urokinase, or plasmin chromogenic substrate. Clots formed in the presence of FGFC1 expressed reduced fibrin polymerization rate and maximum turbidity; however, they did not influence the lag phase of fibrin polymerization. In the absence of scu-PA (single-chain urokinase plasminogen activator), microscopy revealed that FGFC1 increased the number of protofibrils within fibrin fiber and the pore diameter between protofibrils, inducing clots to form a region of thinner and looser networks separated by large pores. The effects of FGFC1 on scu-PA-mediated plasma clot structure were similar to those in the absence of scu-PA. In addition, FGFC1 promoted the lysis of clots and increased the D-dimer concentration in lysate. FGFC1 increased the generation rate of p-nitroaniline in plasma. These results show that FGFC1 has fibrinolytic activity in plasma, leading to interference with the release of fibrinopeptide B to affect lateral aggregation of protofibrils and increase clot susceptibility to fibrinolysis by altering its structure.
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Affiliation(s)
- Chunli Gao
- Department of Marine Bio-Pharmacology, College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, China; (C.G.)
| | - Bin Bao
- Department of Marine Bio-Pharmacology, College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, China; (C.G.)
- Shanghai Engineering Research Center of Aquatic-Product Processing and Preservation, Shanghai 201306, China
| | - Chunling Bao
- The Sixth People’s Hospital Affiliated, Shanghai Jiao Tong University, Shanghai 201306, China
| | - Wenhui Wu
- Department of Marine Bio-Pharmacology, College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, China; (C.G.)
- Putuo Sub-Center of International Joint Research Center for Marine Biological Sciences, Zhongke Road, Putuo District, Zhoushan 316104, China
- Marine Biomedical Science and Technology Innovation Platform of Lin-gang Special Area, Lane 218, Haiji Sixth Road, Shanghai 201306, China
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3
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Al-Tamimi M, El-sallaq M, Altarawneh S, Qaqish A, Ayoub M. Development of Novel Paper-Based Assay for Direct Serum Separation. ACS OMEGA 2023; 8:20370-20378. [PMID: 37332822 PMCID: PMC10268636 DOI: 10.1021/acsomega.3c00215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023]
Abstract
Background: Many conventional laboratory tests require serum separation using a clot activator/gel tube, followed by centrifugation in an equipped laboratory. The aim of this study is development of novel, equipment-free, paper-based assay for direct and efficient serum separation. Methods: Fresh blood was directly applied to wax-channeled filter paper treated with clotting activator/s and then observed for serum separation. The purity, efficiency, recovery, reproducibility, and applicability of the assay were validated after optimization. Results: Serum was successfully separated using activated partial thromboplastin time (APTT) reagent and calcium chloride-treated wax-channeled filter paper within 2 min. The assay was optimized using different coagulation activators, paper types, blood collection methods, and incubation conditions. Confirmation of serum separation from cellular components was achieved by direct visualization of the yellow serum band, microscopic imaging of the pure serum band, and absence of blood cells in recovered serum samples. Successful clotting was evaluated by the absence of clotting of recovered serum by prolonged prothrombin time and APTT, absence of fibrin degradation products, and absence of Staphylococcus aureus-induced coagulation. Absence of hemolysis was confirmed by undetectable hemoglobin from recovered serum bands. The applicability of serum separated in paper was tested directly by positive color change on paper using bicinchoninic acid protein reagent, on recovered serum samples treated with Biuret and Bradford reagents in tubes, or measurement of thyroid-stimulating hormone and urea compared to standard serum samples. Serum was separated using the paper-based assay from 40 voluntary donors and from the same donor for 15 days to confirm reproducibility. Dryness of coagulants in paper prevents serum separation that can be re-stored by a re-wetting step. Conclusions: Paper-based serum separation allows for development of sample-to-answer paper-based point-of-care tests or simple and direct blood sampling for routine diagnostic tests.
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Affiliation(s)
- Mohammad Al-Tamimi
- Department
of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
| | - Mariam El-sallaq
- Department
of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
| | - Shahed Altarawneh
- Department
of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
| | - Arwa Qaqish
- Department
of Biology and Biotechnology, Faculty of Science, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
| | - Mai Ayoub
- Department
of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
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4
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Handrea-Dragan IM, Botiz I, Tatar AS, Boca S. Patterning at the micro/nano-scale: Polymeric scaffolds for medical diagnostic and cell-surface interaction applications. Colloids Surf B Biointerfaces 2022; 218:112730. [DOI: 10.1016/j.colsurfb.2022.112730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/15/2022] [Accepted: 07/25/2022] [Indexed: 11/27/2022]
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5
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Li X, Duan H, Song Z, Xu R. Comparative study on the interaction between fibrinogen and flavonoids. J Mol Struct 2022. [DOI: 10.1016/j.molstruc.2022.132963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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6
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Zhu Y, Liu R, Wu D, Yu Q, Shea KJ, Zhu Q. Engineered polymer nanoparticles incorporating l-amino acid groups as affinity reagents for fibrinogen. J Pharm Anal 2021; 11:596-602. [PMID: 34765272 PMCID: PMC8572708 DOI: 10.1016/j.jpha.2020.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 12/24/2022] Open
Abstract
Synthetic polymer hydrogel nanoparticles (NPs) were developed to function as abiotic affinity reagents for fibrinogen. These NPs were made using both temperature-sensitive N-isopropyl acrylamide (NIPAm) and l-amino acid monomers. Five kinds of l-amino acids were acryloylated to obtain functional monomers: l-phenylalanine (Phe) and l-leucine (Leu) with hydrophobic side chains, l-glutamic acid (Glu) with negative charges, and l-lysine (Lys) and l-arginine (Arg) with positive charges. After incubating the NPs with fibrinogen, γ-globulin, and human serum albumin (HSA) respectively, the NPs that incorporated N-acryloyl-Arg monomers (AArg@NPs) showed the strongest and most specific binding affinity to fibrinogen, when compared with γ-globulin and HSA. Additionally, the fibrinogen-AArg binding model had the best docking scores, and this may be due to the interaction of positively charged AArg@NPs and the negatively charged fibrinogen D domain and the hydrophobic interaction between them. The specific adsorption of AArg@NPs to fibrinogen was also confirmed by the immunoprecipitation assay, as the AArg@NPs selectively trapped the fibrinogen from a human plasma protein mixture. AArg@NPs had a strong selectivity for, and specificity to, fibrinogen and may be developed as a potential human fibrinogen-specific affinity reagent.
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Affiliation(s)
- Yongyan Zhu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
- Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Guangzhou, 510515, China
- Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou, 510515, China
| | - Ruixuan Liu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Dengyu Wu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Qianqian Yu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Kenneth J. Shea
- Department of Chemistry, University of California, Irvine, CA, 92697, USA
- Corresponding author.
| | - Quanhong Zhu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China
- Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Guangzhou, 510515, China
- Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou, 510515, China
- Corresponding author. School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China.
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7
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Saidykhan J, Selevic L, Cinti S, May JE, Killard AJ. Paper-Based Lateral Flow Device for the Sustainable Measurement of Human Plasma Fibrinogen in Low-Resource Settings. Anal Chem 2021; 93:14007-14013. [PMID: 34615344 PMCID: PMC8529579 DOI: 10.1021/acs.analchem.1c03665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
![]()
Fibrinogen
concentration is a major determinant of both clotting
and bleeding risk. Clotting and bleeding disorders cause extensive
morbidity and mortality, particularly in resource-poor and emergency
settings. This is exacerbated by a lack of timely intervention informed
by measurement of fibrinogen levels under conditions such as thrombosis
or postpartum haemorrhage. There is an absence of simple, rapid, low-cost,
and sustainable diagnostic devices for fibrinogen measurement that
can be deployed in such environments. Paper-based analytical devices
are of significant interest due to their potential for low-cost production,
ease of use, and environmental sustainability. In this work, a device
for measuring blood plasma fibrinogen using chromatography paper was
developed. Wax printing was used to create hydrophobic structures
to define the test channel and sample application zone. Test strips
were modified with bovine thrombin. Plasma samples (22 μL) were
applied, and the flow rate was monitored over 5 min. As the sample
traversed the strip, clotting was induced by the conversion of soluble
fibrinogen to insoluble fibrin. The flow rate and distance travelled
by the sample were dependent on fibrinogen concentration. The device
was able to measure fibrinogen concentration in the range of 0.5–7.0
± 0.3 mg/mL (p < 0.05, n = 24) and had excellent correlation with laboratory coagulometry
in artificial samples (r2 = 0.9582, n = 60). Devices were also stable at 4–6 °C
for up to 3 weeks.
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Affiliation(s)
- Jerro Saidykhan
- Centre for Research in Biosciences (CRIB), Department of Applied Sciences, University of the West of England, Coldhar-bour Lane, Bristol BS16 1QY, U.K
| | - Laura Selevic
- Centre for Research in Biosciences (CRIB), Department of Applied Sciences, University of the West of England, Coldhar-bour Lane, Bristol BS16 1QY, U.K
| | - Stefano Cinti
- Department of Pharmacy, University of Naples "Federico II", Via Domenico Montesano 49, Napoli 80131, Italy
| | - Jennifer E May
- Centre for Research in Biosciences (CRIB), Department of Applied Sciences, University of the West of England, Coldhar-bour Lane, Bristol BS16 1QY, U.K
| | - Anthony J Killard
- Centre for Research in Biosciences (CRIB), Department of Applied Sciences, University of the West of England, Coldhar-bour Lane, Bristol BS16 1QY, U.K
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8
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Bialkower M, Manderson CA, McLiesh H, Tabor RF, Garnier G. Paper Diagnostic for Direct Measurement of Fibrinogen Concentration in Whole Blood. ACS Sens 2020; 5:3627-3638. [PMID: 33095567 DOI: 10.1021/acssensors.0c01937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The ability to diagnose and treat critically bleeding patients can save more than 2 million lives a year. Diagnosing hypofibrinogenemia is essential in these patients. Recently, with the development of new handheld diagnostics, fibrinogen concentration can be measured rapidly at the point of care. However, these diagnostics can only work with plasma and hence need blood cells to be separated before use. In this study, we demonstrate a handheld fibrinogen diagnostic that works with whole blood. The test works by (1) forming a premixed droplet of a whole blood sample and thrombin solution on a solid surface, (2) allowing it to clot, and (3) dropping a paper strip on top. The further that blood moves down the strip, the lower the fibrinogen concentration. The diagnostic can easily measure plasma fibrinogen concentrations below 1.6 g/L for blood samples with hematocrits between 40 and 50%. Furthermore, diluting blood samples not only increases the test's sensitivity but also eliminates the effect of hematocrit and thrombin inhibitors. The test can be completed in 3-4 min, making it suitable for diagnosing early hypofibrinogenemia and allowing for fibrinogen replacement therapy in critically bleeding patients.
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Affiliation(s)
- Marek Bialkower
- BioPRIA and Department of Chemical Engineering, Monash University, Clayton, VIC 3800, Australia
| | - Clare A. Manderson
- BioPRIA and Department of Chemical Engineering, Monash University, Clayton, VIC 3800, Australia
| | - Heather McLiesh
- BioPRIA and Department of Chemical Engineering, Monash University, Clayton, VIC 3800, Australia
| | - Rico F. Tabor
- School of Chemistry, Monash University, Clayton, VIC 3800, Australia
| | - Gil Garnier
- BioPRIA and Department of Chemical Engineering, Monash University, Clayton, VIC 3800, Australia
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9
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Guan Y, Zhang K, Xu F, Guo R, Fang A, Sun B, Meng X, Liu Y, Bai M. An integrated platform for fibrinogen quantification on a microfluidic paper-based analytical device. LAB ON A CHIP 2020; 20:2724-2734. [PMID: 32588856 DOI: 10.1039/d0lc00439a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Fibrinogen (FIB) plays a key role in blood coagulation and thrombosis and its concentration in blood can directly reflect health conditions, thus efficient detection of FIB would benefit the treatments of certain diseases such as liver and heart diseases. However, there is a lack of sensitive, simple, rapid and cheap FIB detection device currently, in lieu of expensive and sophisticated approaches in laboratories. Here, we propose a novel plasma separation and FIB detection platform based on a microfluidic paper-based analytical device (μPAD). It is the first time that dielectrophoretic (DEP) force is combined with capillary force on paper for plasma separation, and the separation efficiency of plasma reaches about 95%, ensuring reliable downstream FIB detection, for which we also propose a new method called the resistance-fibrinogen detection (RFD) method. It not only avoids the use of large-scale instruments for detection, but also possesses high precision and simplicity. The method is found to be reliable in FIB detection for various concentrations ranging from 127.0 to 508.0 mg dL-1. Moreover, the results obtained from the proposed μPAD show an excellent agreement (R2 = 0.9985) with those obtained from an automatic coagulation analyzer with natural human blood samples. Overall, the proposed platform provides a low-cost and reliable approach for FIB detection, especially for clinical use in resource-limited areas.
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Affiliation(s)
- Yanfang Guan
- College of Electromechanical Engineering, Henan University of Technology, Zhengzhou 450001, China.
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10
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Abstract
Fibrinogen is one of the first factors to fall to critically low levels in the blood in many coagulopathic events. Patients with hypofibrinogenemia are at a significantly greater risk of major hemorrhage and death. The rapid replacement of fibrinogen early on in hypofibrinogenemia may significantly improve outcomes for patients. Fibrinogen is present at concentrations between 2 and 4 g/L in the plasma of healthy people. However, hypofibrinogenemia is diagnosed when the fibrinogen level drops below 1.5-2 g/L. This review analyses different types of fibrinogen assays that can be used for diagnosing hypofibrinogenemia. The scientific mechanisms and limitations behind these tests are then presented. Additionally, the current state of clinical major hemorrhage protocols (MHPs) is presented and the structure, function and physiological role of fibrinogen is summarized.
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Affiliation(s)
- Marek Bialkower
- BioPRIA and Department of Chemical Engineering, Monash University, Clayton, Australia
| | - Gil Garnier
- BioPRIA and Department of Chemical Engineering, Monash University, Clayton, Australia
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Gligorijević N, Radomirović M, Rajković A, Nedić O, Ćirković Veličković T. Fibrinogen Increases Resveratrol Solubility and Prevents it from Oxidation. Foods 2020; 9:E780. [PMID: 32545422 PMCID: PMC7353596 DOI: 10.3390/foods9060780] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 12/13/2022] Open
Abstract
The French paradox describes a lower incidence of cardiovascular problems despite a high intake of saturated fats. This phenomenon was associated with higher consumption of red wine, as it was later discovered that the presence of antioxidants, including resveratrol, have beneficial effects. We hypothesized that resveratrol may have a more direct role in protection from harmful oxidation, presumably through binding to important proteins of the blood coagulation process. Spectrofluorimetry demonstrated that resveratrol is capable of binding to fibrinogen, the main protein in the coagulation process, which is also important as a food additive. Various spectroscopic methods determined that binding does not cause fibrinogen unfolding or destabilization since protein melting temperature remains unchanged. A mutually protective effect against the free radical-induced oxidation of polyphenol and fibrinogen was found. The presence of fibrinogen caused only a negligible masking effect of the antioxidative abilities of resveratrol, measured by a reduction of hexacyanoferrate (III), while greatly increasing its solubility in an aqueous environment, thus increasing its potential bioavailability. Due to its interaction with fibrinogen, resveratrol may serve as an antioxidant at the site of injury. The antioxidative effect of resveratrol may also protect and thus keep the desired characteristics of fibrinogen during the application of this protein as a food additive.
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Affiliation(s)
- Nikola Gligorijević
- Institute for the Application of Nuclear Energy, Department for Metabolism, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia; (N.G.); (O.N.)
| | - Mirjana Radomirović
- Center of Excellence for Molecular Food Sciences & Department of Biochemistry, Faculty of Chemistry, University of Belgrade, Studentski trg 12–16, 11000 Belgrade, Serbia;
| | - Andreja Rajković
- Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium;
- Department of Food Safety and Quality Management, Faculty of Agriculture, University of Belgrade, Nemanjina 6, 11080 Zemun-Belgrade, Serbia
| | - Olgica Nedić
- Institute for the Application of Nuclear Energy, Department for Metabolism, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia; (N.G.); (O.N.)
| | - Tanja Ćirković Veličković
- Center of Excellence for Molecular Food Sciences & Department of Biochemistry, Faculty of Chemistry, University of Belgrade, Studentski trg 12–16, 11000 Belgrade, Serbia;
- Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium;
- Global Campus, Ghent University, Yeonsu-gu, Incheon 406-840, Korea
- Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000 Belgrade, Serbia
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12
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Bialkower M, McLiesh H, Manderson CA, Tabor RF, Garnier G. Rapid, hand-held paper diagnostic for measuring Fibrinogen Concentration in blood. Anal Chim Acta 2019; 1102:72-83. [PMID: 32043998 DOI: 10.1016/j.aca.2019.12.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/22/2019] [Accepted: 12/16/2019] [Indexed: 12/20/2022]
Abstract
Critical bleeding causes over 2 million deaths a year. Early hypofibrinogenemia is a strong predictor of mortality in critically bleeding patients. The early replenishment of fibrinogen can significantly improve outcomes. However, over replenishment can also be dangerous. Furthermore, there is no rapid, cheap, hand-held diagnostic that can aid critically bleeding patients in fibrinogen replacement therapy. In this study, we have developed a hand-held paper diagnostic that measures plasma fibrinogen concentrations. The diagnostic has the potential to be used as a point of care device both inside and outside of hospital settings. It can vastly reduce the time to treatment for fibrinogen replacement therapy. The diagnostic is a two-step process. First, thrombin and plasma are added onto horizontially-orientated paper strips where the fibrinogen is converted into fibrin, drastically increasing the plasma's hydrophobicity. Second, an aqueous blue dye is pipetted onto the strips and allowed to wick through the fibrin. The distance the blue dye wicks through the strip correlates precisely to the fibrinogen concentration. The diagnostic can provide results within a minute. It can distinguish low fibrinogen concentrations (ie. <2 g/L) from normal fibrinogen concentrations. It shows remarkable reproducibility between healthy individuals. It is unaffected by common blood conditions such as acidosis, blood alcohol, severe hypertriglyceridemia, severe haemolysis and warfarin administration. Finally, it is unaffected by humidity and can withstand cold temperatures.
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Affiliation(s)
- Marek Bialkower
- BioPRIA and Department of Chemical Engineering, Monash University, Australia
| | - Heather McLiesh
- BioPRIA and Department of Chemical Engineering, Monash University, Australia
| | - Clare A Manderson
- BioPRIA and Department of Chemical Engineering, Monash University, Australia
| | - Rico F Tabor
- School of Chemistry, Monash University, Clayton, Vic, 3800, Australia
| | - Gil Garnier
- BioPRIA and Department of Chemical Engineering, Monash University, Australia.
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