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Song SW, Gupta R, Jothilingam N, Qian X, Gu Y, Lee VV, Sapanel Y, Allen DM, Wong JEL, MacAry P, Ho D, Blasiak A. SHEAR saliva collection device augments sample properties for improved analytical performance. Bioeng Transl Med 2023; 8:e10490. [PMID: 38023718 PMCID: PMC10658560 DOI: 10.1002/btm2.10490] [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: 09/05/2022] [Revised: 12/12/2022] [Accepted: 12/29/2022] [Indexed: 01/19/2023] Open
Abstract
Despite being a convenient clinical substrate for biomonitoring, saliva's widespread utilization has not yet been realized. The non-Newtonian, heterogenous, and highly viscous nature of saliva complicate the development of automated fluid handling processes that are vital for accurate diagnoses. Furthermore, conventional saliva processing methods are resource and/or time intensive precluding certain testing capabilities, with these challenges aggravated during a pandemic. The conventional approaches may also alter analyte structure, reducing application opportunities in point-of-care diagnostics. To overcome these challenges, we introduce the SHEAR saliva collection device that mechanically processes saliva, in a rapid and resource-efficient way. We demonstrate the device's impact on reducing saliva's viscosity, improving sample's uniformity, and increasing diagnostic performance of a COVID-19 rapid antigen test. Additionally, a formal user experience study revealed generally positive comments. SHEAR saliva collection device may support realization of the saliva's potential, particularly in large-scale and/or resource-limited settings for global and community diagnostics.
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Affiliation(s)
- Shang Wei Song
- The N.1 Institute for Health (N.1), National University of SingaporeSingaporeSingapore
| | - Rashi Gupta
- Life Sciences Institute, National University of SingaporeSingaporeSingapore
- Department of Microbiology and ImmunologyYong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Niharika Jothilingam
- The N.1 Institute for Health (N.1), National University of SingaporeSingaporeSingapore
| | - Xinlei Qian
- Life Sciences Institute, National University of SingaporeSingaporeSingapore
- Department of Microbiology and ImmunologyYong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Yue Gu
- Life Sciences Institute, National University of SingaporeSingaporeSingapore
| | - V Vien Lee
- The N.1 Institute for Health (N.1), National University of SingaporeSingaporeSingapore
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Yoann Sapanel
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - David Michael Allen
- Department of MedicineYong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
- Division of Infectious DiseasesNational University HospitalSingaporeSingapore
| | - John Eu Li Wong
- Department of MedicineYong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
- Department of Haematology‐OncologyNational University Cancer Institute, National University HospitalSingaporeSingapore
| | - Paul MacAry
- Life Sciences Institute, National University of SingaporeSingaporeSingapore
- Department of Microbiology and ImmunologyYong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Dean Ho
- The N.1 Institute for Health (N.1), National University of SingaporeSingaporeSingapore
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
- Department of Biomedical EngineeringCollege of Design and Engineering, National University of SingaporeSingaporeSingapore
- Department of PharmacologyYong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Agata Blasiak
- The N.1 Institute for Health (N.1), National University of SingaporeSingaporeSingapore
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
- Department of Biomedical EngineeringCollege of Design and Engineering, National University of SingaporeSingaporeSingapore
- Department of PharmacologyYong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
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2
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Liu S, Hou Y, Li Z, Yang C, Liu G. μPADs on Centrifugal Microfluidic Discs for Rapid Sample-to-Answer Salivary Diagnostics. ACS Sens 2023; 8:3520-3529. [PMID: 37669403 DOI: 10.1021/acssensors.3c01093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
A fully integrated device for salivary detection with a sample-in-answer-out fashion is critical for noninvasive point-of-care testing (POCT), especially for the screening of contagious disease infection. Microfluidic paper-based analytical devices (μPADs) have demonstrated their huge potential in POCT due to their low cost and easy adaptation with other components. This study developed a generic POCT platform by integrating a centrifugal microfluidic disc with μPADs to realize sample-to-answer salivary diagnostics. Specifically, a custom centrifugal microfluidic disc integrated with μPADs is fabricated, which demonstrated a high efficiency in saliva treatment. To demonstrate the capability of the integrated device for salivary analysis, the SARS-CoV-2 Nucleocapsid (N) protein, a reliable biomarker for SARS-CoV-2 acute infection, is used as the model analyte. By the chemical treatment of the μPAD surface, and by optimizing the protein immobilization conditions, the on-disc μPADs were able to detect the SARS-CoV-2 N protein down to 10 pg mL-1 with a dynamic range of 10-1000 pg mL-1 and an assay time of 8 min. The integrated device was successfully used for the quantification of the N protein of pseudovirus in saliva with high specificity and demonstrated a comparable performance to the commercial paper lateral flow assay test strips.
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Affiliation(s)
- Shixian Liu
- CUHK(SZ)-Boyalife Joint Laboratory of Regenerative Medicine Engineering, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
- Ciechanover Institute of Precision and Regenerative Medicine, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
| | - Yuting Hou
- CUHK(SZ)-Boyalife Joint Laboratory of Regenerative Medicine Engineering, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
- Ciechanover Institute of Precision and Regenerative Medicine, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
| | - Zirui Li
- CUHK(SZ)-Boyalife Joint Laboratory of Regenerative Medicine Engineering, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
- Ciechanover Institute of Precision and Regenerative Medicine, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
| | - Chenyu Yang
- CUHK(SZ)-Boyalife Joint Laboratory of Regenerative Medicine Engineering, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
- Ciechanover Institute of Precision and Regenerative Medicine, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
| | - Guozhen Liu
- CUHK(SZ)-Boyalife Joint Laboratory of Regenerative Medicine Engineering, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
- Ciechanover Institute of Precision and Regenerative Medicine, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
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3
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Bostanci N, Belibasakis GN. Precision periodontal care: from omics discoveries to chairside diagnostics. Clin Oral Investig 2023; 27:971-978. [PMID: 36723713 PMCID: PMC9985578 DOI: 10.1007/s00784-023-04878-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/22/2023] [Indexed: 02/02/2023]
Abstract
The interface of molecular science and technology is guiding the transformation of personalized to precision healthcare. The application of proteomics, genomics, transcriptomics, and metabolomics is shaping the suitability of biomarkers for disease. Prior validation of such biomarkers in large and diverse patient cohorts helps verify their clinical usability. Incorporation of molecular discoveries into routine clinical practice relies on the development of customized assays and devices that enable the rapid delivery of analytical data to the clinician, while the patient is still in session. The present perspective review addresses this topic under the prism of precision periodontal care. Selected promising research attempts to innovate technological platforms for oral diagnostics are brought forward. Focus is placed on (a) the suitability of saliva as a conveniently sampled biological specimen for assessing periodontal health, (b) proteomics as a high-throughput approach for periodontal disease biomarker identification, and (c) chairside molecular diagnostic assays as a technological funnel for transitioning from the laboratory benchtop to the clinical point-of-care.
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Affiliation(s)
- Nagihan Bostanci
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels alle 8, 141 52, Huddinge, Stockholm, Sweden.
| | - Georgios N Belibasakis
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels alle 8, 141 52, Huddinge, Stockholm, Sweden.
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4
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Kashaninejad N, Nguyen NT. Microfluidic solutions for biofluids handling in on-skin wearable systems. LAB ON A CHIP 2023; 23:913-937. [PMID: 36628970 DOI: 10.1039/d2lc00993e] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
On-skin wearable systems for biofluid sampling and biomarker sensing can revolutionize the current practices in healthcare monitoring and personalized medicine. However, there is still a long path toward complete market adoption and acceptance of this fascinating technology. Accordingly, microfluidic science and technology can provide excellent solutions for bridging the gap between basic research and clinical research. The research gap has led to the emerging field of epidermal microfluidics. Moreover, recent advances in the fabrication of highly flexible and stretchable microfluidic systems have revived the concept of micro elastofluidics, which can provide viable solutions for on-skin wearable biofluid handling. In this context, this review highlights the current state-of-the-art platforms in this field and discusses the potential technologies that can be used for on-skin wearable devices. Toward this aim, we first compare various microfluidic platforms that could be used for on-skin wearable devices. These platforms include semiconductor-based, polymer-based, liquid metal-based, paper-based, and textile-based microfluidics. Next, we discuss how these platforms can enhance the stretchability of on-skin wearable biosensors at the device level. Next, potential microfluidic solutions for collecting, transporting, and controlling the biofluids are discussed. The application of finger-powered micropumps as a viable solution for precise and on-demand biofluid pumping is highlighted. Finally, we present the future directions of this field by emphasizing the applications of droplet-based microfluidics, stretchable continuous-flow micro elastofluidics, stretchable superhydrophobic surfaces, liquid beads as a form of digital micro elastofluidics, and topological liquid diodes that received less attention but have enormous potential to be integrated into on-skin wearable devices.
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Affiliation(s)
- Navid Kashaninejad
- Queensland Micro- and Nanotechnology Centre, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia.
| | - Nam-Trung Nguyen
- Queensland Micro- and Nanotechnology Centre, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia.
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5
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Thiha A, Ibrahim F, Joseph K, Petrović B, Kojić S, Dahlan NA, Jamaluddin NF, Qureshi S, Stojanović GM. A novel microfluidic compact disc to investigate electrochemical property changes between artificial and real salivary samples mixed with mouthwashes using electrical impedance analysis. PLoS One 2023; 18:e0280381. [PMID: 36795661 PMCID: PMC9934320 DOI: 10.1371/journal.pone.0280381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/26/2022] [Indexed: 02/17/2023] Open
Abstract
Diagnosing oral diseases at an early stage may lead to better preventive treatments, thus reducing treatment burden and costs. This paper introduces a systematic design of a microfluidic compact disc (CD) consisting of six unique chambers that run simultaneously from sample loading, holding, mixing and analysis. In this study, the electrochemical property changes between real saliva and artificial saliva mixed with three different types of mouthwashes (i.e. chlorhexidine-, fluoride- and essential oil (Listerine)-based mouthwashes) were investigated using electrical impedance analysis. Given the diversity and complexity of patient's salivary samples, we investigated the electrochemical impedance property of healthy real saliva mixed with different types of mouthwashes to understand the different electrochemical property which could be a foundation for diagnosis and monitoring of oral diseases. On the other hand, electrochemical impedance property of artificial saliva, a commonly used moisturizing agent and lubricant for the treatment of xerostomia or dry mouth syndrome was also studied. The findings indicate that artificial saliva and fluoride-based mouthwash showed higher conductance values compared to real saliva and two other different types of mouthwashes. The ability of our new microfluidic CD platform to perform multiplex processes and detection of electrochemical property of different types of saliva and mouthwashes is a fundamental concept for future research on salivary theranostics using point-of-care microfluidic CD platform.
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Affiliation(s)
- Aung Thiha
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Fatimah Ibrahim
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Centre for Printable Electronics, Universiti Malaya, Kuala Lumpur, Malaysia
- Microwave Research Institute, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- * E-mail: (FI); (BP)
| | - Karunan Joseph
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Bojan Petrović
- Department of Dental Medicine, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- * E-mail: (FI); (BP)
| | - Sanja Kojić
- Faculty of Technical Science, University of Novi Sad, Novi Sad, Serbia
| | - Nuraina Anisa Dahlan
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nurul Fauzani Jamaluddin
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Saima Qureshi
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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6
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Hauser J, Dale M, Beck O, Schwenk JM, Stemme G, Fredolini C, Roxhed N. Microfluidic Device for Patient-Centric Multiplexed Assays with Readout in Centralized Laboratories. Anal Chem 2022; 95:1350-1358. [PMID: 36548393 PMCID: PMC9850402 DOI: 10.1021/acs.analchem.2c04318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Patient-centric sampling strategies, where the patient performs self-sampling and ships the sample to a centralized laboratory for readout, are on the verge of widespread adaptation. However, the key to a successful patient-centric workflow is user-friendliness, with few noncritical user interactions, and simple, ideally biohazard-free shipment. Here, we present a capillary-driven microfluidic device designed to perform the critical biomarker capturing step of a multiplexed immunoassay at the time of sample collection. On-chip sample drying enables biohazard-free shipment and allows us to make use of advanced analytics of specialized laboratories that offer the needed analytical sensitivity, reliability, and affordability. Using C-Reactive Protein, MCP1, S100B, IGFBP1, and IL6 as model blood biomarkers, we demonstrate the multiplexing capability and applicability of the device to a patient-centric workflow. The presented quantification of a biomarker panel opens up new possibilities for e-doctor and e-health applications.
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Affiliation(s)
- Janosch Hauser
- KTH
Royal Institute of Technology, Micro and Nanosystems, 10044 Stockholm, Sweden
| | - Matilda Dale
- KTH
Royal Institute of Technology, Affinity Proteomics, Science for Life
Laboratory, 17165 Solna, Sweden
| | - Olof Beck
- Karolinska
Institutet, Clinical Neuroscience, 17177 Stockholm, Sweden
| | - Jochen M. Schwenk
- KTH
Royal Institute of Technology, Affinity Proteomics, Science for Life
Laboratory, 17165 Solna, Sweden
| | - Göran Stemme
- KTH
Royal Institute of Technology, Micro and Nanosystems, 10044 Stockholm, Sweden
| | - Claudia Fredolini
- KTH
Royal Institute of Technology, Affinity Proteomics, Science for Life
Laboratory, 17165 Solna, Sweden,
| | - Niclas Roxhed
- KTH
Royal Institute of Technology, Micro and Nanosystems, 10044 Stockholm, Sweden,MedTechLabs,
BioClinicum, Karolinska University Hospital, 17164 Solna, Sweden,
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7
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Johannsen B, Baumgartner D, Karkossa L, Paust N, Karpíšek M, Bostanci N, Zengerle R, Mitsakakis K. ImmunoDisk—A Fully Automated Bead-Based Immunoassay Cartridge with All Reagents Pre-Stored. BIOSENSORS 2022; 12:bios12060413. [PMID: 35735560 PMCID: PMC9221266 DOI: 10.3390/bios12060413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 11/16/2022]
Abstract
In this paper, we present the ImmunoDisk, a fully automated sample-to-answer centrifugal microfluidic cartridge, integrating a heterogeneous, wash-free, magnetic- and fluorescent bead-based immunoassay (bound-free phase detection immunoassay/BFPD-IA). The BFPD-IA allows the implementation of a simple fluidic structure, where the assay incubation, bead separation and detection are performed in the same chamber. The system was characterized using a C-reactive protein (CRP) competitive immunoassay. A parametric investigation on air drying of protein-coupled beads for pre-storage at room temperature is presented. The key parameters were buffer composition, drying temperature and duration. A protocol for drying two different types of protein-coupled beads with the same temperature and duration using different drying buffers is presented. The sample-to-answer workflow was demonstrated measuring CRP in 5 µL of human serum, without prior dilution, utilizing only one incubation step, in 20 min turnaround time, in the clinically relevant concentration range of 15–115 mg/L. A reproducibility assessment over three disk batches revealed an average signal coefficient of variation (CV) of 5.8 ± 1.3%. A CRP certified reference material was used for method verification with a concentration CV of 8.6%. Our results encourage future testing of the CRP-ImmunoDisk in clinical studies and its point-of-care implementation in many diagnostic applications.
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Affiliation(s)
- Benita Johannsen
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (L.K.); (N.P.); (R.Z.)
- Correspondence: (B.J.); (K.M.); Tel.: +49-761-203-7252 (B.J.); +49-761-203-73252 (K.M.)
| | - Desirée Baumgartner
- Laboratory for MEMS Applications, IMTEK—Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
| | - Lena Karkossa
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (L.K.); (N.P.); (R.Z.)
| | - Nils Paust
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (L.K.); (N.P.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK—Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
| | - Michal Karpíšek
- BioVendor-Laboratorní Medicína a.s., Research & Diagnostic Products Division, Karasek 1767/1, Reckovice, 62100 Brno, Czech Republic;
- Faculty of Pharmacy, Masaryk University, Palackeho trida 1946/1, 61242 Brno, Czech Republic
| | - Nagihan Bostanci
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden;
| | - Roland Zengerle
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (L.K.); (N.P.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK—Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
| | - Konstantinos Mitsakakis
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (L.K.); (N.P.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK—Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
- Correspondence: (B.J.); (K.M.); Tel.: +49-761-203-7252 (B.J.); +49-761-203-73252 (K.M.)
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8
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Baumgartner D, Johannsen B, Specht M, Lüddecke J, Rombach M, Hin S, Paust N, von Stetten F, Zengerle R, Herz C, Peham JR, Paqué PN, Attin T, Jenzer JS, Körner P, Schmidlin PR, Thurnheer T, Wegehaupt FJ, Kaman WE, Stubbs A, Hays JP, Rusu V, Michie A, Binsl T, Stejskal D, Karpíšek M, Bao K, Bostanci N, Belibasakis GN, Mitsakakis K. OralDisk: A Chair-Side Compatible Molecular Platform Using Whole Saliva for Monitoring Oral Health at the Dental Practice. BIOSENSORS 2021; 11:bios11110423. [PMID: 34821641 PMCID: PMC8615610 DOI: 10.3390/bios11110423] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 05/04/2023]
Abstract
Periodontitis and dental caries are two major bacterially induced, non-communicable diseases that cause the deterioration of oral health, with implications in patients' general health. Early, precise diagnosis and personalized monitoring are essential for the efficient prevention and management of these diseases. Here, we present a disk-shaped microfluidic platform (OralDisk) compatible with chair-side use that enables analysis of non-invasively collected whole saliva samples and molecular-based detection of ten bacteria: seven periodontitis-associated (Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola) and three caries-associated (oral Lactobacilli, Streptococcus mutans, Streptococcus sobrinus). Each OralDisk test required 400 µL of homogenized whole saliva. The automated workflow included bacterial DNA extraction, purification and hydrolysis probe real-time PCR detection of the target pathogens. All reagents were pre-stored within the disk and sample-to-answer processing took < 3 h using a compact, customized processing device. A technical feasibility study (25 OralDisks) was conducted using samples from healthy, periodontitis and caries patients. The comparison of the OralDisk with a lab-based reference method revealed a ~90% agreement amongst targets detected as positive and negative. This shows the OralDisk's potential and suitability for inclusion in larger prospective implementation studies in dental care settings.
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Affiliation(s)
- Desirée Baumgartner
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Correspondence: (K.M.); (D.B.); Tel.: +49-761-203-73252 (K.M.); +49-761-203-98724 (D.B.)
| | - Benita Johannsen
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Mara Specht
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Jan Lüddecke
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Markus Rombach
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Sebastian Hin
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Nils Paust
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Felix von Stetten
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Roland Zengerle
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Christopher Herz
- AIT Austrian Institute of Technology, Molecular Diagnostics, Giefinggasse 4, 1210 Wien, Austria; (C.H.); (J.R.P.)
| | - Johannes R. Peham
- AIT Austrian Institute of Technology, Molecular Diagnostics, Giefinggasse 4, 1210 Wien, Austria; (C.H.); (J.R.P.)
| | - Pune N. Paqué
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Joël S. Jenzer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Philipp Körner
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Thomas Thurnheer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Florian J. Wegehaupt
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Wendy E. Kaman
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre Rotterdam (Erasmus MC), 3015 CN Rotterdam, The Netherlands; (W.E.K.); (J.P.H.)
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Free University of Amsterdam and University of Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Andrew Stubbs
- Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Centre Rotterdam (Erasmus MC), 3015 CN Rotterdam, The Netherlands;
| | - John P. Hays
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre Rotterdam (Erasmus MC), 3015 CN Rotterdam, The Netherlands; (W.E.K.); (J.P.H.)
| | - Viorel Rusu
- Magtivio B.V., Daelderweg 9, 6361 HK Nuth, The Netherlands;
| | - Alex Michie
- ClinicaGeno Ltd., 11 Station Approach, Coulsdon CR5 2NR, UK; (A.M.); (T.B.)
| | - Thomas Binsl
- ClinicaGeno Ltd., 11 Station Approach, Coulsdon CR5 2NR, UK; (A.M.); (T.B.)
| | - David Stejskal
- Department of Biomedical Sciences, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300 Ostrava, Czech Republic;
- Institute of Laboratory Diagnostics, University Hospital Ostrava, 17. Listopadu 1790/5, 70800 Ostrava, Czech Republic
| | - Michal Karpíšek
- BioVendor-Laboratorní Medicína a.s., Research & Diagnostic Products Division, Karasek 1767/1, Reckovice, 62100 Brno, Czech Republic;
- Faculty of Pharmacy, Masaryk University, Palackeho trida 1946/1, 61242 Brno, Czech Republic
| | - Kai Bao
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (N.B.); (G.N.B.)
| | - Nagihan Bostanci
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (N.B.); (G.N.B.)
| | - Georgios N. Belibasakis
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (N.B.); (G.N.B.)
| | - Konstantinos Mitsakakis
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Correspondence: (K.M.); (D.B.); Tel.: +49-761-203-73252 (K.M.); +49-761-203-98724 (D.B.)
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9
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Shi Y, Ye P, Yang K, Meng J, Guo J, Pan Z, Zhao W, Guo J. Application of centrifugal microfluidics in immunoassay, biochemical analysis and molecular diagnosis. Analyst 2021; 146:5800-5821. [PMID: 34570846 DOI: 10.1039/d1an00629k] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Rapid diagnosis plays a vital role in daily life and is effective in reducing treatment costs and increasing curability, especially in remote areas with limited availability of resources. Among the various common methods of rapid diagnosis, centrifugal microfluidics has many unique advantages, such as less sample consumption, more precise valve control for sequential loading of samples, and accurately separated module design in a microfluidic network to minimize cross-contamination. Therefore, in recent years, centrifugal microfluidics has been extensively researched, and it has been found to play important roles in biology, chemistry, and medicine. Here, we review the latest developments in centrifugal microfluidic platforms in immunoassays, biochemical analyses, and molecular diagnosis, in recent years. In immunoassays, we focus on the application of enzyme-linked immunosorbent assay (ELISA); in biochemical analysis, we introduce the application of plasma and blood cell separation; and in molecular diagnosis, we highlight the application of nucleic acid amplification tests. Additionally, we discuss the characteristics of the methods under each platform as well as the enhancement of the corresponding performance parameters, such as the limit of detection, separation efficiency, etc. Finally, we discuss the limitations associated with the existing applications and potential breakthroughs that can be achieved in this field in the future.
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Affiliation(s)
- Yuxing Shi
- School of Automation Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Peng Ye
- School of Automation Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Kuojun Yang
- School of Automation Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Jie Meng
- School of Automation Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Jiuchuan Guo
- School of Automation Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Zhixiang Pan
- School of Automation Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Wenhao Zhao
- School of Automation Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Jinhong Guo
- School of Information and Communication Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China.
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10
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Dunphy K, O’Mahoney K, Dowling P, O’Gorman P, Bazou D. Clinical Proteomics of Biofluids in Haematological Malignancies. Int J Mol Sci 2021; 22:ijms22158021. [PMID: 34360786 PMCID: PMC8348619 DOI: 10.3390/ijms22158021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/23/2021] [Accepted: 07/23/2021] [Indexed: 12/25/2022] Open
Abstract
Since the emergence of high-throughput proteomic techniques and advances in clinical technologies, there has been a steady rise in the number of cancer-associated diagnostic, prognostic, and predictive biomarkers being identified and translated into clinical use. The characterisation of biofluids has become a core objective for many proteomic researchers in order to detect disease-associated protein biomarkers in a minimally invasive manner. The proteomes of biofluids, including serum, saliva, cerebrospinal fluid, and urine, are highly dynamic with protein abundance fluctuating depending on the physiological and/or pathophysiological context. Improvements in mass-spectrometric technologies have facilitated the in-depth characterisation of biofluid proteomes which are now considered hosts of a wide array of clinically relevant biomarkers. Promising efforts are being made in the field of biomarker diagnostics for haematologic malignancies. Several serum and urine-based biomarkers such as free light chains, β-microglobulin, and lactate dehydrogenase are quantified as part of the clinical assessment of haematological malignancies. However, novel, minimally invasive proteomic markers are required to aid diagnosis and prognosis and to monitor therapeutic response and minimal residual disease. This review focuses on biofluids as a promising source of proteomic biomarkers in haematologic malignancies and a key component of future diagnostic, prognostic, and disease-monitoring applications.
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Affiliation(s)
- Katie Dunphy
- Department of Biology, National University of Ireland, W23 F2K8 Maynooth, Ireland; (K.D.); (P.D.)
| | - Kelly O’Mahoney
- Department of Haematology, Mater Misericordiae University Hospital, D07 WKW8 Dublin, Ireland; (K.O.); (P.O.)
| | - Paul Dowling
- Department of Biology, National University of Ireland, W23 F2K8 Maynooth, Ireland; (K.D.); (P.D.)
| | - Peter O’Gorman
- Department of Haematology, Mater Misericordiae University Hospital, D07 WKW8 Dublin, Ireland; (K.O.); (P.O.)
| | - Despina Bazou
- Department of Haematology, Mater Misericordiae University Hospital, D07 WKW8 Dublin, Ireland; (K.O.); (P.O.)
- Correspondence:
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11
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Haririan H, Andrukhov O, Laky M, Rausch-Fan X. Saliva as a Source of Biomarkers for Periodontitis and Periimplantitis. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.687638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Saliva has the potential to be used as a diagnostic and monitoring tool for various diseases if biomarkers of an adequate sensitivity and specificity could be identified. Several reviews and even meta-analyses have been performed in recent years, which have found some candidate biomarkers for periodontitis, like macrophage inflammatory protein-1 alpha, interleukin-1ß, interleukin-6, matrix metalloproteinase-8, or hemoglobin. However, none of those are currently in use to replace conventional periodontal diagnostics with a periodontal probe. For periimplantitis, to date, heterogeneity of different study protocols and implant types did not permit to discover clear biomarkers, which were able to distinguish between healthy and diseased implants. Few proinflammatory cytokines, similar to periodontitis, have been characterized as adjunct tools to clinical diagnosis. The additional determination of antimicrobial peptides, bone turnover markers, and bacteria could help to enhance sensitivity and specificity in a combined model for periodontitis and periimplantitis. Furthermore, proteomic approaches might be preferred over single biomarker determinations. A global consensus is also needed to harmonize salivary sampling methods as well as procedures of biomarker analysis to ensure future comparability.
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12
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Mitsakakis K. Novel lab-on-a-disk platforms: a powerful tool for molecular fingerprinting of oral and respiratory tract infections. Expert Rev Mol Diagn 2021; 21:523-526. [PMID: 33902369 DOI: 10.1080/14737159.2021.1920400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Konstantinos Mitsakakis
- Hahn-Schickard, Freiburg, Germany.,Laboratory for MEMS Applications, IMTEK - Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany
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13
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Johannsen B, Karpíšek M, Baumgartner D, Klein V, Bostanci N, Paust N, Früh SM, Zengerle R, Mitsakakis K. One-step, wash-free, bead-based immunoassay employing bound-free phase detection. Anal Chim Acta 2021; 1153:338280. [DOI: 10.1016/j.aca.2021.338280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/14/2021] [Accepted: 01/31/2021] [Indexed: 12/28/2022]
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14
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Kainz DM, Breiner BJ, Früh SM, Hutzenlaub T, Zengerle R, Paust N. Eliminating viscosity bias in lateral flow tests. MICROSYSTEMS & NANOENGINEERING 2021; 7:72. [PMID: 34567784 PMCID: PMC8433459 DOI: 10.1038/s41378-021-00296-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/17/2021] [Accepted: 06/28/2021] [Indexed: 05/15/2023]
Abstract
Despite the widespread application of point-of-care lateral flow tests, the viscosity dependence of these assay results remains a significant challenge. Here, we employ centrifugal microfluidic flow control through the nitrocellulose membrane of the strip to eliminate the viscosity bias. The key feature is the balancing of the sample flow into the cassette of the lateral flow test with the air flow out of the cassette. A viscosity-independent flow rate of 3.01 ± 0.18 µl/min (±6%) is demonstrated for samples with viscosities ranging from 1.1 mPas to 24 mPas, a factor greater than 20. In a model human IgG lateral flow assay, signal-intensity shifts caused by varying the sample viscosity from 1.1 mPas to 2.3 mPas could be reduced by more than 84%.
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Affiliation(s)
- Daniel M. Kainz
- Laboratory for MEMS Applications, IMTEK - Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | | | - Susanna M. Früh
- Laboratory for MEMS Applications, IMTEK - Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Tobias Hutzenlaub
- Laboratory for MEMS Applications, IMTEK - Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Roland Zengerle
- Laboratory for MEMS Applications, IMTEK - Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Nils Paust
- Laboratory for MEMS Applications, IMTEK - Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
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15
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VectorDisk: A Microfluidic Platform Integrating Diagnostic Markers for Evidence-Based Mosquito Control. Processes (Basel) 2020. [DOI: 10.3390/pr8121677] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Effective mosquito monitoring relies on the accurate identification and characterization of the target population. Since this process requires specialist knowledge and equipment that is not widely available, automated field-deployable systems are highly desirable. We present a centrifugal microfluidic cartridge, the VectorDisk, which integrates TaqMan PCR assays in two feasibility studies, aiming to assess multiplexing capability, specificity, and reproducibility in detecting disk-integrated vector-related assays. In the first study, pools of 10 mosquitoes were used as samples. We tested 18 disks with 27 DNA and RNA assays each, using a combination of multiple microfluidic chambers and detection wavelengths (geometric and color multiplexing) to identify mosquito and malaria parasite species as well as insecticide resistance mechanisms. In the second study, purified nucleic acids served as samples to test arboviral and malaria infective mosquito assays. Nine disks were tested with 14 assays each. No false positive results were detected on any of the disks. The coefficient of variation in reproducibility tests was <10%. The modular nature of the platform, the easy adaptation of the primer/probe panels, the cold chain independence, the rapid (2–3 h) analysis, and the assay multiplexing capacity are key features, rendering the VectorDisk a potential candidate for automated vector analysis.
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16
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Belibasakis GN, Lund BK, Krüger Weiner C, Johannsen B, Baumgartner D, Manoil D, Hultin M, Mitsakakis K. Healthcare Challenges and Future Solutions in Dental Practice: Assessing Oral Antibiotic Resistances by Contemporary Point-Of-Care Approaches. Antibiotics (Basel) 2020; 9:E810. [PMID: 33202544 PMCID: PMC7696509 DOI: 10.3390/antibiotics9110810] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/17/2022] Open
Abstract
Antibiotic resistance poses a global threat, which is being acknowledged at several levels, including research, clinical implementation, regulation, as well as by the World Health Organization. In the field of oral health, however, the issue of antibiotic resistances, as well as of accurate diagnosis, is underrepresented. Oral diseases in general were ranked third in terms of expenditures among the EU-28 member states in 2015. Yet, the diagnosis and patient management of oral infections, in particular, still depend primarily on empiric means. On the contrary, on the global scale, the field of medical infections has more readily adopted the integration of molecular-based systems in the diagnostic, patient management, and antibiotic stewardship workflows. In this perspective review, we emphasize the clinical significance of supporting in the future antibiotic resistance screening in dental practice with novel integrated and point-of-care operating tools that can greatly support the rapid, accurate, and efficient administration of oral antibiotics.
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Affiliation(s)
- Georgios N. Belibasakis
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
| | - Bodil K. Lund
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
- Department of Clinical Dentistry, University of Bergen, 5009 Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, 5021 Bergen, Norway
| | - Carina Krüger Weiner
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
- Department of Oral and Maxillofacial Surgery, Folktandvården Stockholm, Eastman Institutet, 11324 Stockholm, Sweden
| | - Benita Johannsen
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
| | - Desirée Baumgartner
- Laboratory for MEMS Applications, IMTEK—Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
| | - Daniel Manoil
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
| | - Margareta Hultin
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
| | - Konstantinos Mitsakakis
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
- Laboratory for MEMS Applications, IMTEK—Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
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