Developing Paper Based Diagnostic Technique to Detect Uric Acid in Urine

Paper-based uric acid assay in whole blood samples by Zn2+ protein precipitation and enzyme-free colorimetric detection

Uric acid (UA) is an important biomarker, as a high concentration in blood can lead to gout and further renal syndrome. Although several point-of-care testing (POCT) devices have been reported to detect UA, there are some limitations such as the requirement for uricase and the complicated pretreatment of serum/plasma samples, which restricts their use at home or in undeveloped areas. In this work, we developed an approach by applying Zn2+ to precipitate proteins and cells in whole blood to avoid interference with the chromogenic reaction. We used carboxymethylcellulose (CMC) to immobilize tetramethylbenzidine (TMB) on a nitrocellulose membrane for colorimetric detection. Using the oxidization properties of H2O2, which turns TMB into oxidized tetramethylbenzidine (TMBox) in the presence of catalyst gold nanoparticles (AuNPs), we successfully constructed an enzyme-free paper-based POCT device using the reduction reaction of UA and TMBox for simple, speedy, and cheap colorimetric detection of UA, achieving a detection time of 8 min, a linear range of 0-150 μg/mL, and an LOD of 25.79 μg/mL. The UA concentration in whole blood samples was further measured and correlated well with the clinical value (R2 = 0.8212). Thus, the proposed assay has the potential for POCT diagnosis, monitoring, and prognosis of diseases related to UA.

High-Throughput Continuous Free-Flow Dielectrophoretic Trapping of Micron-Scale Particles and Cells in Paper Using Localized Nonuniform Pore-Scale-Generated Paper-Based Electric Field Gradients

Dielectrophoresis (DEP) utilizes a spatially varying nonuniform electrical field to induce forces on suspended polarizable soft matter including particles and cells. Such nonuniformities are conventionally created using 2D or 3D micrometer-scale electrode arrays. Alternatively, insulator-based dielectrophoresis (iDEP) uses small micrometer-scale insulating structures to spatially distort and generate regions of localized field gradients to selectively trap, isolate, and concentrate bioparticles, including bacteria, viruses, red blood cells, and cancer cells from a suspending electrolyte solution. Despite significant advances in the microfabrication technology, the commercial adoption of DEP devices for soft matter manipulation remains elusive. One reason for low market penetration is a lack of low-cost and scalable fabrication methods to quickly microfabricate field-deforming structures to generate localized DEP-inducing electric field gradients. We propose here that paper-based devices can offer a low-cost and easy-to-use alternative to traditional iDEP devices. In this article, we demonstrate for the first time the ability to perform iDEP-style particle trapping using the naturally occurring micrometer-scale insulating porous structures of paper. In particular, we use polymeric laminated nonwoven fiberglass paper channels as a source of insulating structures for iDEP. We apply a flow of polarizable microparticles directly within the nonwoven channel and simultaneously drop an electric field perpendicular to the flow direction to induce DEP. We show the ability to readily trap and concentrate particles in paper by DEP with an applied voltage as low as 2 V using two different flow mechanisms: a constant fluid flow rate using an external pump and passive fluid flow by capillary wicking. Using a combination of micro computed tomography and finite element analysis, we then present a computational model to probe the microscale DEP force formation dynamics within the paper structure. This new paper-based iDEP platform enables the development of robust, low-cost, and portable next-generation iDEP systems for a wide variety of sample purification and liquid handling applications.

Current trends in digital camera-based bioassays for point-of-care tests

Point-of-care and bedside tests are analytical devices suitable for a growing role in the current healthcare system and provide the opportunity to achieve an exact diagnosis by an untrained person and in various conditions and sites where it is necessary. Using a digital camera integrated into a well-accessible device like a smartphone brings a new way in which a colorimetric point-of-care diagnostic test can provide unbiased data. This review summarizes basic facts about the colorimetric point-of-care tests, principles of how to use a portable device with a camera in the assay, applications of digital cameras for the current tests, and new devices described in the recent papers. An overview of the recent literature and a discussion of recent developments and future trends are provided.

Smartphone based colorimetric approach for quantitative determination of uric acid using Image J

Recently, significant attention has been directed towards digital image colorimetry DIC using mobile applications or available software programs, which offer the advantage of analyzing samples without the need for sophisticated instruments. One such image processing program is Image J, widely used for obtaining quantitative information from scientific images. Image J could measure the color intensities by quantifying of the RGB (red-green-blue) gray levels across the images of colored substances. These values are correlated to the color intensities through conversion to CMY (cyan-magenta-yellow) values which are proportional to the color intensities. The objective of this study is to develop an innovative analytical method for the quantitative determination of uric acid using Image J for color quantification. Image J was utilized to analyze images captured by smart phone for successive concentrations of uric acid that were previously treated with phosphotungstate to develop a blue color. The proposed method has been applied for determination of uric acid in real urine using standard addition method and the results were compared with UV/VIS spectrophotometry as a reference method. In this research, we will also assess the effectiveness of quantitative analysis using Image J in comparison to a mobile application, namely RGB Color Detector.

Simultaneous Determination of Uric Acid and Caffeine by Flow Injection Using Multiple-Pulse Amperometry

The present study reports the development and application of a flow injection analysis (FIA) system for the simultaneous determination of uric acid (UA) and caffeine (CAF) using cathodically pretreated boron-doped diamond electrode (CPT-BDD) and multiple-pulse amperometry (MPA). The electrochemical profiles of UA and CAF were analyzed via cyclic voltammetry in the potential range of 0.20-1.7 V using 0.10 mol L^-1 H₂SO₄ solution as supporting electrolyte. Under optimized conditions, two oxidation peaks at potentials of 0.80 V (UA) and 1.4 V (CAF) were observed; the application of these potentials using multiple-pulse amperometry yielded concentration linear ranges of 5.0 × 10^-8-2.2 × 10^-5 mol L^-1 (UA) and 5.0 × 10^-8-1.9 × 10^-5 mol L^-1 (CAF) and limits of detection of 1.1 × 10^-8 and 1.3 × 10^-8 mol L^-1 for UA and CAF, respectively. The proposed method exhibited good repeatability and stability, and no interference was detected in the electrochemical signals of UA and CAF in the presence of glucose, NaCl, KH₂PO₄, CaCl₂, urea, Pb, Ni, and Cd. The application of the FIA-MPA method for the analysis of environmental samples resulted in recovery rates ranging between 98 and 104%. The results obtained showed that the BDD sensor exhibited a good analytical performance when applied for CAF and UA determination, especially when compared to other sensors reported in the literature.

Porous Cellulose Substrate Study to Improve the Performance of Diffusion-Based Ionic Strength Sensors

Microfluidic paper-based analytical devices (µPADs) are leading the field of low-cost, quantitative in-situ assays. However, understanding the flow behavior in cellulose-based membranes to achieve an accurate and rapid response has remained a challenge. Previous studies focused on commercial filter papers, and one of their problems was the time required to perform the test. This work studies the effect of different cellulose substrates on diffusion-based sensor performance. A diffusion-based sensor was laser cut on different cellulose fibers (Whatman and lab-made Sisal papers) with different structure characteristics, such as basis weight, density, pore size, fiber diameter, and length. Better sensitivity and faster response are found in papers with bigger pore sizes and lower basis weights. The designed sensor has been successfully used to quantify the ionic concentration of commercial wines with a 13.6 mM limit of detection in 30 s. The developed µPAD can be used in quantitative assays for agri-food applications without the need for any external equipment or trained personnel.

Optimization of uric acid detection with Au nanorod-decorated graphene oxide (GO/AuNR) using response surface methodology

A modified glassy carbon electrode (GCE) was developed based on a synthesized graphene oxide (GO) gold nanorod (AuNR) decorated composite (GO/AuNR) for sensitive electrochemical sensing of uric acid (UA). The electrochemical performance of GO/AuNR/GCE for UA detection was investigated employing the differential pulse voltammetry (DPV) technique. Central composite design (CCD) was applied to obtain the optimum composition of the GO and AuNR composite, which provide the highest possible UA oxidation peak current. The optimum composition was obtained at a GO concentration of 5 mg mL-1 and AuNR volume of 10 mL. Under the optimum conditions, GO/AuNR/GCE showed acceptable analytical performance for UA detection with good linearity (concentration range of 10-90 μM) and both a low detection limit (0.4 μM) and quantitation limit (1.0 μM). Furthermore, the proposed sensor exhibits superior stability, reproducibility, and selectivity using ascorbic acid (AA), dopamine (DA), urea, glucose, and magnesium as interferents. Finally, practical use of GO/AuNR/GCE was demonstrated by successfully determining the content of UA in human urine samples with the standard addition approach.

Digital Quantification Method for Sensitive Point-of-Care Detection of Salivary Uric Acid Using Smartphone-Assisted μPADs

Uric acid (UA) is an important biomarker for many diseases. A sensitive point-of-care (POC) testing platform is designed for the digital quantification of salivary UA based on a colorimetric reaction on an easy-to-build smartphone-assisted microfluidic paper-based analytical device (SμPAD). UA levels are quantified according to the color intensity of Prussian blue on the SμPAD with the aid of a MATLAB code or a smartphone APP. A color correction method is specifically applied to exclude the light effect. Together with the engineering design of SμPADs, the background calibration function with the APP increases the UA sensitivity by 100-fold to reach 0.1 ppm with a linear range of 0.1-200 ppm. The assay time is less than 10 min. SμPADs demonstrate a correlation of 0.97 with a commercial UA kit for the detection of salivary UA in clinical samples. SμPADs provide a sensitive, fast, affordable, and reliable tool for the noninvasive POC quantification of salivary UA for early diagnosis of abnormal UA level-associated health conditions.

Microfluidic pressure in paper (μPiP): rapid prototyping and low-cost liquid handling for on-chip diagnostics

Paper-based microfluidics was initially developed for use in ultra-low-cost diagnostics powered passively by liquid wicking. However, there is significant untapped potential in using paper to internally guide porous microfluidic flows using externally applied pressure gradients. Here, we present a new technique for fabricating and utilizing low-cost polymer-laminated paper-based microfluidic devices using external pressure. Known as microfluidic pressure in paper (μPiP), devices fabricated by this technique are capable of sustaining a pressure gradient for use in precise liquid handling and manipulation applications similar to conventional microfluidic open-channel designs, but instead where fluid is driven directly through the porous paper structure. μPiP devices can be both rapidly prototyped or scalably manufactured and deployed at commercial scale with minimal time, equipment, and training requirements. We present an analysis of continuous pressure-driven flow in porous paper-based microfluidic channels and demonstrate broad applicability of this method in performing a variety of different liquid handling applications, including measuring red blood cell deformability and performing continuous free-flow DNA electrophoresis. This new platform offers a budget-friendly method for performing microfluidic operations for both academic prototyping and large-scale commercial device production.

Biomarkers of iron status in allopurinol-treated renal stone patients

Limited evidence exists on the effect of xanthine oxidase inhibitors in nephrolithiasis patients on iron status markers, beyond their effects on urate. The aim of this study was to investigate whether allopurinol therapy was associated with a significant impact on parameters related to iron status, in patients with renal stones. Allopurinol treatment was associated with a nonsignificant decline in serum uric acid. There were no significant differences in serum levels of transferrin and ferritin after treatment with allopurinol compared to pre-treatment levels. A non-significant fall in serum levels of haptoglobin was registered. The drug was associated with a significant rise in serum iron levels. Serum uric acid and iron did not show a significant correlation with any parameter in the study. Allopurinol exerted an overall non-significant effect on iron metabolism in nephrolithiasis patients, save for serum iron, this entails lack of untoward effects in populations with-iron related conditions.

Lab-on-Paper Devices for Diagnosis of Human Diseases Using Urine Samples-A Review

In recent years, microfluidic lab-on-paper devices have emerged as a rapid and low-cost alternative to traditional laboratory tests. Additionally, they were widely considered as a promising solution for point-of-care testing (POCT) at home or regions that lack medical infrastructure and resources. This review describes important advances in microfluidic lab-on-paper diagnostics for human health monitoring and disease diagnosis over the past five years. The review commenced by explaining the choice of paper, fabrication methods, and detection techniques to realize microfluidic lab-on-paper devices. Then, the sample pretreatment procedure used to improve the detection performance of lab-on-paper devices was introduced. Furthermore, an in-depth review of lab-on-paper devices for disease measurement based on an analysis of urine samples was presented. The review concludes with the potential challenges that the future development of commercial microfluidic lab-on-paper platforms for human disease detection would face.

Recent advances in visual detection for cancer biomarkers and infectious pathogens

It is an urgency to detect infectious pathogens or cancer biomarkers using rapid, simple, convenient and cost-effective methods in complex biological samples. Many existing approaches (traditional virus culture, ELISA or PCR) for the pathogen and biomarker assays face several challenges in the clinical applications that require lengthy time, sophisticated sample pre-treatment and expensive instruments. Due to the simple and rapid detection manner as well as no requirement of expensive equipment, many visual detection methods have been considered to resolve the aforementioned problems. Meanwhile, various new materials and colorimetric/fluorescent methods have been tried to construct new biosensors for infectious pathogens and biomarkers. However, the recent progress of these aspects is rarely reviewed, especially in terms of integration of new materials, microdevice and detection mechanism into the visual detection systems. Herein, we provide a broad field of view to discuss the recent progress in the visual detection of infectious pathogens and cancer biomarkers along with the detection mechanism, new materials, novel detection methods, special targets as well as multi-functional microdevices and systems. The novel visual approaches for the infectious pathogens and biomarkers, such as bioluminescence resonance energy transfer (BRET), metal-induced metallization and clustered regularly interspaced short palindromic repeats (CRISPR)-based biosensors, are discussed. Additionally, recent advancements in visual assays utilizing various new materials for proteins, nucleic acids, viruses, exosomes and small molecules are comprehensively reviewed. Future perspectives on the visual sensing systems for infectious pathogens and cancers are also proposed.

Development of a Benzalkonium Chloride Based Antibacterial Paper for Health and Food Applications

Pathogenic bacteria and other microorganisms pose a potent threat to humans by causing various infectious diseases. To control the spread of infection, different antibacterial products have been developed. However, most of them are known to be associated with health hazards, environmental pollution, complex fabrication, and/or higher cost. To address these issues, in this study, a low cost, biodegradable and human skin compatible antibacterial paper has been developed. A quaternary ammonium compound, benzalkonium chloride (BKC) has been used for paper surface treatment. The concentration of aqueous solution of BKC coated on paper was varied from 0.1 wt% to 0.2 wt%. No external binder was required for coating BKC onto paper. The efficacy of the coated paper was investigated against Staphylococcus aureus ATCC 6538 and Escherichia coli ATCC 8739 bacterial strains. This antibacterial paper is highly effective against both strains with the concentrations of BKC being within the allowable limit for cytotoxic effects. The optimum concentration of BKC coated on paper can be considered as 0.15 wt%, as nearly 100% inhibition was achieved with it against both strains. The developed antibacterial paper is suitable for being used in the industry for disinfection and food packaging purposes, and also by the public for hand sanitization.

A New Paper-Based Microfluidic Device for Improved Detection of Nitrate in Water

In this paper, we report a simple and inexpensive paper-based microfluidic device for detecting nitrate in water. This device incorporates two recent developments in paper-based technology suitable for nitrate detection and has an optimized microfluidic design. The first technical advancement employed is an innovative fibrous composite material made up of cotton fibers and zinc microparticles that can be incorporated in paper-based devices and results in better nitrate reduction. The second is a detection zone with an immobilized reagent that allows the passage of a larger sample volume. Different acids were tested—citric and phosphoric acids gave better results than hydrochloric acid since this acid evaporates completely without leaving any residue behind on paper. Different microfluidic designs that utilize various fluid control technologies were investigated and a design with a folding detection zone was chosen and optimized to improve the uniformity of the signal produced. The optimized design allowed the device to achieve a limit of detection and quantification of 0.53 ppm and 1.18 ppm, respectively, for nitrate in water. This accounted for more than a 40% improvement on what has been previously realized for the detection of nitrate in water using paper-based technology.

Micro-fabrication by wax spraying for rapid smartphone-based quantification of bio-markers

A cheap/rapid technique for the fabrication of μPADs is presented for point of care analysis. Hydrophobic channels were formed across the width of the paper by spraying hot pure wax. This biocompatible novel process yielded uniform 300 ± 5 μm hydrophilic microchannels on paper, without the use of the cleanroom, UV lamp, or organic solvents and was completed in a single step without the need for a hotplate. Hot wax is properly impregnated across paper thickness by spraying under optimized temperature and pressure. Our method is advantageous in the cost and ease of fabrication, process time (<1 min), the feasibility of mass-fabrication, readout, environmental considerations and multiplexing due to the embossed structure of remnant wax. The performance of the resulting μPAD was assessed on a multiplexed Uric acid and Nitride assay, bearing 95% of confidence level in the readout against standardized tests. A novel RGB processing app was developed for smart-phones to quantify colorimetric read-outs through a heuristic normalization equation that converts RGB to integer systems. This combinatorial sensor demonstrates a good linear range (up to 800 μM for Uric acid and 1250 μM for Nitride), low detection limit (100 μM for uric acid and 156 μM for nitride).

Evaluation of electrochemical quartz crystal microbalance based sensor modified by uric acid-imprinted polypyrrole

Uric acid-imprinted polypyrrole-based (MIP_(UA)-Ppy) electrochemical quartz crystal microbalance sensor (EQCM) was developed. Experiments and theoretical calculations were focused on molecular interactions between uric acid molecule and: i) polypyrrole imprinted by uric acid (MIP_(UA)-Ppy) ii) polypyrrole film without any molecular imprints (NIP-Ppy). Resonant frequency differences during electrochemical deposition of MIP_(UA)-Ppy and NIP-Ppy films were observed and were attributed to the phenomenon of molecule capture within formed Ppy matrix. EQCM-resonators modified by MIP-Ppy showed the following advantages: selectivity, qualitative response, cost-effectiveness, and simple procedure. The selectivity of MIP_(UA)-Ppy was tested by the replacement of uric acid in the PBS solution with several different concentrations of caffeine and glucose. Langmuir isotherm based molecular adsorption model was applied to evaluate the interaction of MIP_(UA)-Ppy with uric acid. From experimental results calculated the standard Gibbs free energy of association (ΔG_a) of uric acid with MIP_(UA)-Ppy is -16.4 ± 2.05 kJ/mol and with NIP-Ppy is -13.3 ± 8.56 kJ/mol ΔG values illustrate that the formation of uric acid complex with MIP_(UA)-Ppy is thermodynamically more favourable than that for complexation with NIP-Ppy.