Development of an Immunosensor for PfHRP 2 as a Biomarker for Malaria Detection

Electrochemical immunosensor based on carbon nanofibers and gold nanoparticles for detecting anti-Toxoplasma gondii IgG antibodies

An electrochemical immunosensor based on carbon nanofibers (CNFs) and gold nanoparticles (AuNPs) was developed for detecting anti-Toxoplasma gondii antibodies  (anti-T. gondii) IgG in human serum. CNFs were produced using electrospinning and carbonization processes. Screen-printed carbon electrode (SPCE) surface was modified with CNFs and AuNPs which were electrodeposited onto the CNFs. Then, T. gondii antigen was immobilized onto the AuNPs/CNFs/SPCE. Afterward, anti-T. gondii IgG positive serum samples were coated on the modified electrode and assessed via adding anti-human IgG labeled with horseradish peroxidase (HRP) enzyme. The morphology of SPCE, CNFs, and AuNPs/CNFs/SPCE surface was characterized using field emission scanning electron microscopy (FESEM) equipped with energy dispersive spectroscopy (EDS). Characterization of CNFs was evaluated by Raman spectroscopy and X-ray diffraction (XRD). Electrochemical characterization of the immunosensor was verified using cyclic voltammetry (CV), and electrochemical response of modified electrode for anti-T. gondii IgG was detected via differential pulse voltammetry (DPV). This immunosensor was detected in the range 0-200 U mL-1 with a low detection limit (9 × 10-3 U mL-1). In addition, the proposed immunosensor was exhibited with high selectivity, strong stability, and acceptable reproducibility and repeatability. Furthermore, there was a strong correlation between results obtained via the designed immunosensor and enzyme-linked immunosorbent assay (ELISA) as gold standard. In conclusion, the developed immunosensor is a promising route for rapid and accurate clinical diagnosis of toxoplasmosis.

Development and Clinical Validation of RT-LAMP-Based Lateral-Flow Devices and Electrochemical Sensor for Detecting Multigene Targets in SARS-CoV-2

Consistently emerging variants and the life-threatening consequences of SARS-CoV-2 have prompted worldwide concern about human health, necessitating rapid and accurate point-of-care diagnostics to limit the spread of COVID-19. Still, However, the availability of such diagnostics for COVID-19 remains a major rate-limiting factor in containing the outbreaks. Apart from the conventional reverse transcription polymerase chain reaction, loop-mediated isothermal amplification-based (LAMP) assays have emerged as rapid and efficient systems to detect COVID-19. The present study aims to develop RT-LAMP-based assay system for detecting multiple targets in N, ORF1ab, E, and S genes of the SARS-CoV-2 genome, where the end-products were quantified using spectrophotometry, paper-based lateral-flow devices, and electrochemical sensors. The spectrophotometric method shows a LOD of 10 agµL−1 for N, ORF1ab, E genes and 100 agµL−1 for S gene in SARS-CoV-2. The developed lateral-flow devices showed an LOD of 10 agµL−1 for all four gene targets in SARS-CoV-2. An electrochemical sensor developed for N-gene showed an LOD and E-strip sensitivity of log 1.79 ± 0.427 pgµL−1 and log 0.067 µA/pg µL−1/mm2, respectively. The developed assay systems were validated with the clinical samples from COVID-19 outbreaks in 2020 and 2021. This multigene target approach can effectively detect emerging COVID-19 variants using combination of various analytical techniques at testing facilities and in point-of-care settings.

Development of a Nanostructured Electrochemical Genosensor for the Detection of the K-ras Gene

In the scientific literature, it has been documented that electrochemical genosensors are novel analytical tools with proven clinical diagnostic potential for the identification of carcinogenic processes due to genetic and epigenetic alterations, as well as infectious diseases due to viruses or bacteria. In the present work, we describe the construction of an electrochemical genosensor for the identification of the k12p.1 mutation; it was based on use of Screen-Printed Gold Electrode (SPGE), Cyclic Voltammetry (CV), and Atomic Force Microscopy (AFM), for the monitoring the electron transfer trough the functionalized nanostructured surface and corresponding morphological changes. The sensitivity of the genosensor showed a linear response for the identification of the k12p.1 mutation of the K-ras gene in the concentration range of 10 fM to 1 μM with a detection limit of 7.96 fM in the presence of doxorubicin (Dox) as DNA intercalating agent and indicator of the hybridization reaction. Thus, the electrochemical genosensor developed could be useful for the identification of diseases related with the K-ras oncogene.

Review of the Current Landscape of the Potential of Nanotechnology for Future Malaria Diagnosis, Treatment, and Vaccination Strategies

Malaria eradication has for decades been on the global health agenda, but the causative agents of the disease, several species of the protist parasite Plasmodium, have evolved mechanisms to evade vaccine-induced immunity and to rapidly acquire resistance against all drugs entering clinical use. Because classical antimalarial approaches have consistently failed, new strategies must be explored. One of these is nanomedicine, the application of manipulation and fabrication technology in the range of molecular dimensions between 1 and 100 nm, to the development of new medical solutions. Here we review the current state of the art in malaria diagnosis, prevention, and therapy and how nanotechnology is already having an incipient impact in improving them. In the second half of this review, the next generation of antimalarial drugs currently in the clinical pipeline is presented, with a definition of these drugs' target product profiles and an assessment of the potential role of nanotechnology in their development. Opinions extracted from interviews with experts in the fields of nanomedicine, clinical malaria, and the economic landscape of the disease are included to offer a wider scope of the current requirements to win the fight against malaria and of how nanoscience can contribute to achieve them.

Innovations in Plasmodium spp. diagnosis on diverse detection platforms

In 2019, 229 million cases of malaria were recorded worldwide. For epidemiologic surveillance and proper treatment of persons infected with Plasmodium spp., rapid detection of infections by Plasmodium spp. is critical. Thus, Plasmodium spp. diagnosis is one of the indispensable measures for malaria control. Although microscopy is the gold standard for diagnosis, it has restrictions related mainly to the lack of qualified human resources, which is a problem in many regions. Thus, this review presents major innovations in diagnostic methods as alternatives to or complementary to microscopy. Detection platforms in lateral flow systems, electrochemical immunosensors, molecular biology and, more recently, those integrated with smartphones, are highlighted, among others. The advanced improvement of these tests aims to provide techniques that are sensitive and specific, but also quick, easy to handle and free from the laboratory environment. In this way, the tracking of malaria cases can become increasingly effective and contribute to controlling the disease.

Electrochemical biosensors for neglected tropical diseases: A review

A group of infectious and parasitic diseases with prevalence in tropical and subtropical regions of the planet, especially in places with difficult access, internal conflicts, poverty, and low visibility from the government and health agencies are classified as neglected tropical diseases. While some well-intentioned isolated groups are making the difference on a global scale, the number of new cases and deaths is still alarming. The development and employment of low-cost, miniaturized, and easy-to-use devices as biosensors could be the key to fast diagnosis in such areas leading to a better treatment to further eradication of such diseases. Therefore, this review contains useful information regarding the development of such devices in the past ten years (2010-2020). Guided by the updated list from the World Health Organization, the work evaluated the new trends in the biosensor field applied to the early detection of neglected tropical diseases, the efficiencies of the devices compared to the traditional techniques, and the applicability on-site for local distribution. So, we focus on Malaria, Chagas, Leishmaniasis, Dengue, Zika, Chikungunya, Schistosomiasis, Leprosy, Human African trypanosomiasis (sleeping sickness), Lymphatic filariasis, and Rabies. Few papers were found concerning such diseases and there is no available commercial device in the market. The works contain information regarding the development of point-of-care devices, but there are only at proof of concepts stage so far. Details of electrode modification and construction of electrochemical biosensors were summarized in Tables. The demand for the eradication of neglected tropical diseases is increasing. The use of biosensors is pivotal for the cause, but appliable devices are scarce. The information present in this review can be useful for further development of biosensors in the hope of helping the world combat these deadly diseases.

Laboratory Detection of Malaria Antigens: a Strong Tool for Malaria Research, Diagnosis, and Epidemiology

The identification and characterization of proteins produced during human infection with Plasmodium spp. have guided the malaria community in research, diagnosis, epidemiology, and other efforts. Recently developed methods for the detection of these proteins (antigens) in the laboratory have provided new types of data that can inform the evaluation of malaria diagnostics, epidemiological investigations, and overall malaria control strategies. Here, the focus is primarily on antigens that are currently known to be detectable in human specimens and on their impact on the understanding of malaria in human populations. We highlight historical and contemporary laboratory assays for malaria antigen detection, the concept of an antigen profile for a biospecimen, and ways in which binary results for a panel of antigens could be interpreted and utilized for different analyses. Particular emphasis is given to the direct comparison of field-level malaria diagnostics and laboratory antigen detection for the development of an external evaluation scheme. The current limitations of laboratory antigen detection are considered, and the future of this developing field is discussed.

Sensitive Immunoassay Detection of Plasmodium Lactate Dehydrogenase by Inductively Coupled Plasma Mass Spectrometry

Rapid, reliable, and sensitive detection of Plasmodium infection is central to malaria control and elimination. Many Malaria Rapid Diagnostic Tests (RDTs) developed for this purpose depend upon immunoassays that can be improved by advances in bound antibody sensor technology. In a previous study, immuno-polymerase chain reaction (PCR) was shown to provide highly sensitive detection of Plasmodium falciparum lactate dehydrogenase (PfLDH) in monoclonal antibody (mAb) sandwich assays. Here, we show comparably high immunoassay sensitivity by inductively coupled plasma mass spectrometry (ICP-MS) detection of gold nanoparticles (AuNPs). Following capture of PfLDH with the primary mAb and binding of the AuNP-labeled detection mAb, ICP-MS signals from the AuNPs provided quantitative measures of recombinant PfLDH test dilutions and P. falciparum-infected erythrocytes. A detection limit of 1.5 pg/mL was achieved with the PfLDH protein. Parasitemia in cultures of P. falciparum-infected erythrocytes could be detected to a lower limit of 1.6 parasite/μl (p/μl) for early ring-stage forms and 0.3 p/μl for mixed stages including mature trophozoites and schizont-stages. These results show that ICP-MS detection of AuNPs can support highly sensitive and accurate detection of Plasmodium infection.

One-step enzyme-free dual electrochemical immunosensor for histidine-rich protein 2 determination

In the present work, we describe a novel one-step enzyme-free dual electrochemical immunosensor for the determination of histidine-rich protein 2 (Ag-PfHRP2), a specific malaria biomarker. A gold electrode (GE) was functionalized with the PfHRP2 antibody (Ab-PfHRP2) using dihexadecyl phosphate (DHP) polymer as an immobilization platform. The Ab-PfHRP2/DHP/GE sensor was characterized by cyclic voltammetry, electrochemical impedance spectroscopy, Fourier-transform infrared spectroscopy, scanning electron microscopy, and atomic force microscopy. The developed immunosensor was employed for indirect Ag-PfHRP2 determination by differential pulse voltammetry (DPV) and electrochemical impedance spectroscopy (EIS). The linear range was 10-400 ng mL-1 and 10-500 ng mL-1 for EIS and DPV, while the limit of detection was 3.3 ng mL-1 and 2.8 ng mL-1, respectively. The electrochemical immunosensor was successfully applied for Ag-PfHRP2 determination in human serum samples. Its performance was compared with an ELISA test, and good correspondence was achieved. The coefficients of intra- and inter-assay variations were less than 5%. The electrochemical immunosensor is a useful and straightforward tool for in situ malaria biomarker determination.

Recent Advances in the Development of Biosensors for Malaria Diagnosis

The impact of malaria on global health has continually prompted the need to develop more effective diagnostic strategies that could overcome deficiencies in accurate and early detection. In this review, we examine the various biosensor-based methods for malaria diagnostic biomarkers, namely; Plasmodium falciparum histidine-rich protein 2 (PfHRP-2), parasite lactate dehydrogenase (pLDH), aldolase, glutamate dehydrogenase (GDH), and the biocrystal hemozoin. The models that demonstrate a potential for field application have been discussed, looking at the fabrication and analytical performance characteristics, including (but not exclusively limited to): response time, sensitivity, detection limit, linear range, and storage stability, which are first summarized in a tabular form and then described in detail. The conclusion summarizes the state-of-the-art technologies applied in the field, the current challenges and the emerging prospects for malaria biosensors.

Ultrasensitive and label-free biosensor for the detection of Plasmodium falciparum histidine-rich protein II in saliva

Malaria elimination is a global public health priority. To fulfil the demands of elimination diagnostics, we have developed an interdigitated electrode sensor platform targeting the Plasmodium falciparum Histidine Rich Protein 2 (PfHRP2) protein in saliva samples. A protocol for frequency-specific PfHRP2 detection in phosphate buffered saline was developed, yielding a sensitivity of 2.5 pg/mL based on change in impedance magnitude of the sensor. This protocol was adapted and optimized for use in saliva with a sensitivity of 25 pg/mL based on change in resistance. Further validation demonstrated detection in saliva spiked with PfHRP2 from clinical isolates in 8 of 11 samples. With a turnaround time of ~2 hours, the label-free platform based on impedance sensors has the potential for miniaturization into a point-of-care diagnostic device for malaria elimination.

Current Trends of Nanobiosensors for Point-of-Care Diagnostics

In order to provide better-quality health care, it is very important that high standards of health care management are achieved by making timely decisions based on rapid diagnostics, smart data analysis, and informatics analysis. Point-of-care testing ensures fast detection of analytes near to the patients facilitating a better disease diagnosis, monitoring, and management. It also enables quick medical decisions since the diseases can be diagnosed at an early stage which leads to improved health outcomes for the patients enabling them to start early treatment. In the recent past, various potential point-of-care devices have been developed and they are paving the way to next-generation point-of-care testing. Biosensors are very critical components of point-of-care devices since they are directly responsible for the bioanalytical performance of an essay. As such, they have been explored for their prospective point-of-care applications necessary for personalized health care management since they usually estimate the levels of biological markers or any chemical reaction by producing signals mainly associated with the concentration of an analyte and hence can detect disease causing markers such as body fluids. Their high selectivity and sensitivity have allowed for early diagnosis and management of targeted diseases; hence, facilitating timely therapy decisions and combination with nanotechnology can improve assessment of the disease onset and its progression and help to plan for treatment of many diseases. In this review, we explore how nanotechnology has been utilized in the development of nanosensors and the current trends of these nanosensors for point-of-care diagnosis of various diseases.

Development of Electrochemical Nanosensor for the Detection of Malaria Parasite in Clinical Samples

In this study, electrochemical nanosensors were developed from the synthesized metal oxide (MO) nanoparticles by supporting it on a gold electrode (Au). The activity of the developed nanosensor toward the detection of malaria biomarker (β-hematin) was determined and the optimum conditions at which the maximum detection and quantification occurred were established. β-Hematin current response at the sensors was higher when compared with the bare Au electrode and followed the order Au-CuO (C) > Au-CuO (M) > Au-Fe₂O3 (M) > Au-Fe₂O3 (C) > Au-Al₂O3 (M) > Au-Al₂O3 (C) > bare Au. The developed sensors were stable with a relatively low current drop (10.61-17.35 %) in the analyte. Au-CuO sensor had the best performance toward the biomarker and quantitatively detected P. berghei in infected mice's serum samples at 3.60-4.8 mM and P. falciparum in human blood serum samples at 0.65-1.35 mM concentration.

Nanoparticle-based Point of Care Immunoassays for in vitro Biomedical Diagnostics

In resource-limited settings, the availability of medical practitioners and early diagnostic facilities are inadequate relative to the population size and disease burden. To address cost and delayed time issues in diagnostics, strip-based immunoassays, e.g. dipstick, lateral flow assay (LFA) and microfluidic paper-based analytical devices (microPADs), have emerged as promising alternatives to conventional diagnostic approaches. These assays rely on chromogenic agents to detect disease biomarkers. However, limited specificity and sensitivity have motivated scientists to improve the efficiency of these assays by conjugating chromogenic agents with nanoparticles for enhanced qualitative and quantitative output. Various nanomaterials, which include metallic, magnetic and luminescent nanoparticles, are being used in the fabrication of biosensors to detect and quantify biomolecules and disease biomarkers. This review discusses some of the principles and applications of such nanoparticle-based point of care biosensors in biomedical diagnosis.

High-Sensitivity Assays for Plasmodium falciparum Infection by Immuno-Polymerase Chain Reaction Detection of PfIDEh and PfLDH Antigens

Background

Rapid diagnostic tests based on Plasmodium falciparum histidine-rich protein II (PfHRP-II) and P. falciparum lactate dehydrogenase (PfLDH) antigens are widely deployed for detection of P. falciparum infection; however, these tests often miss cases of low-level parasitemia, and PfHRP-II tests can give false-negative results when P. falciparum strains do not express this antigen.

Methods

We screened proteomic data for highly expressed P. falciparum proteins and compared their features to those of PfHRP-II and PfLDH biomarkers. Search criteria included high levels of expression, conservation in all parasite strains, and good correlation of antigen levels with parasitemia and its clearance after drug treatment. Different assay methods were compared for sensitive detection of parasitemia in P. falciparum cultures.

Results

Among potential new biomarkers, a P. falciparum homolog of insulin-degrading enzyme (PfIDEh) met our search criteria. Comparative enzyme-linked immunosorbent assays with monoclonal antibodies against PfLDH or PfIDEh showed detection limits of 100-200 parasites/µL and 200-400 parasites/µL, respectively. Detection was dramatically improved by use of real-time immuno-polymerase chain reaction (PCR), to parasitemia limits of 0.02 parasite/µL and 0.78 parasite/µL in PfLDH- and PfIDEh-based assays, respectively.

Conclusions

The ability of PfLDH- or PfIDEh-based immuno-PCR assays to detect <1 parasite/µL suggests that improvements of bound antibody sensor technology may greatly increase the sensitivity of malaria rapid diagnostic tests.