An Optimized Colorimetric Readout Method for Lateral Flow Immunoassays

Recent advances in the CRISPR/Cas system-based visual detection method

Currently, various infectious pathogens and bacterial toxins as well as heavy metal pollution pose severe threats to global environmental health and the socio-economic infrastructure. Therefore, there is a pressing need for rapid, sensitive, and convenient visual molecular detection methods. The rapidly evolving detection approach based on clustered regularly interspaced short palindromic repeats (CRISPR)/associated nucleases (Cas) has opened a new frontier in the field of molecular diagnostics. This paper reviews the development of visual detection methods in recent years based on different Cas and analyzes their advantages and disadvantages as well as the challenges of future research. Firstly, different CRISPR/Cas effectors and their working principles in the diagnosis of various diseases are briefly reviewed. Subsequently, the article focuses on the development of visual readout signals in point-of-care testing using laboratory-based CRISPR/Cas technology, including colorimetric, fluorescence, and lateral flow analysis. Finally, the challenges and prospects of visual detection methods based on CRISPR/Cas technology are discussed.

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.

Facemask analyses for the non-invasive detection of chronic and acute P. aeruginosa lung infections using nanoparticle-based immunoassays

Pseudomonas aeruginosa (P. aeruginosa) is a pathogen that persistently colonizes the respiratory tract of patients with chronic lung diseases. The risk of acquiring a chronic P. aeruginosa infection can be minimized by rapidly detecting the pathogen in the patient's airways and promptly administrating adequate antibiotics. However, the rapid detection of P. aeruginosa in the lungs involves the analysis of sputum, which is a highly complex matrix that is not always available. Here, we propose an alternative diagnosis based on analyzing breath aerosols. In this approach, nanoparticle immunosensors identify bacteria adhered to the polypropylene layer of a surgical facemask that was previously worn by the patient. A polypropylene processing protocol was optimized to ensure the efficient capture and analysis of the target pathogen. The proposed analytical platform has a theoretical limit of detection of 105 CFU mL-1 in aerosolized mock samples, and a dynamic range between 105 and 108 CFU mL-1. When tested with facemasks worn by patients, the biosensors were able to detect chronic and acute P. aeruginosa lung infections, and to differentiate them from respiratory infections caused by other pathogens. The results shown here pave the way to diagnose Pseudomonas infections at the bedside, as well as to identify the progress from chronic to acute infection.

Development of a thermochromic lateral flow assay to improve sensitivity for dengue virus serotype 2 NS1 detection

Dengue disease is a viral infection that has been widespread in tropical regions, such as Southeast Asia, South Asia and South America. A worldwide effort has been made over a few decades to halt the spread of the disease and reduce fatalities. Lateral flow assay (LFA), a paper-based technology, is used for dengue virus detection and identification because of its simplicity, low cost and fast response. However, the sensitivity of LFA is relatively low and is usually insufficient to meet the minimum requirement for early detection. In this study, we developed a colorimetric thermal sensing LFA format for the detection of dengue virus NS1 using recombinant dengue virus serotype 2 NS1 protein (DENV2-NS1) as a model antigen. Plasmonic gold nanoparticles, including gold nanospheres (AuNSPs) and gold nanorods (AuNRs), and magnetic nanoparticles (MNPs), namely iron oxide nanoparticles (IONPs) and zinc ferrite nanoparticles (ZFNPs), were studied for their thermal properties for sensing assays. AuNSPs with 12 nm diameter were chosen due to their great photothermal effect against light-emitting diodes (LEDs). In the thermal sensing assay, a thermochromic sheet is used as a temperature sensor transforming heat into a visible colour. In the typical LFA, the test line is visible at 6.25 ng mL-1 while our thermal sensing LFA offers a visual signal that can be observed at as low as 1.56 ng mL-1. The colorimetric thermal sensing LFA is capable of reducing the limit of detection (LOD) of DENV2-NS1 by 4 times compared to the typical visual readout. The colorimetric thermal sensing LFA can enhance the sensitivity of detection and deliver visuality to the user to translate without the need for an infrared (IR) camera. It has the potential to expand the utilities of LFA and satisfy early diagnostic applications.

Characterization by image analysis of the dose vs response curve for a qualitative serum hCG lateral flow immunoassay

BACKGROUND

As an adjunct to verification of performance characteristics of a qualitative serum hCG lateral flow immunoassay (LFI), we performed image analysis to characterize the dose vs response curve (visibility of the test line), as a means of understanding the transition from negative to positive as a function of increasing [hCG].

METHODS

Using serum samples of known [hCG], device images were obtained using a scanner at the prescribed reading time (5 min). Image analysis (using Python and R) was used to obtain the integral (S) of the test-line color as a function of [hCG].

RESULTS

Data for S as a function of [hCG] were well characterized by a simple hyperbola: S = Smax [hCG]/([hCG] + K), where K = 202 mIU/ml (r = 0.997). Replicates of S at K had CV of 7.3 %. By eye, uncertainty of test results among users occurred only below the assay's stated sensitivity of 10 mIU/ml, in region of S < 3 % of Smax, and signal:noise ratio < 3.

CONCLUSIONS

By image analysis, the dose vs response (Test line integral) for this qualitative serum hCG LFI was a simple hyperbola. Characterization of the dose vs response curve was useful in verification of the assay's performance characteristics.

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

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

The Revolution of Lateral Flow Assay in the Field of AMR Detection

The global spread of antimicrobial resistant (AMR) bacteria represents a considerable public health concern, yet their detection and identification of their resistance mechanisms remain challenging. Optimal diagnostic tests should provide rapid results at low cost to enable implementation in any microbiology laboratory. Lateral flow assays (LFA) meet these requirements and have become essential tools to combat AMR. This review presents the versatility of LFA developed for the AMR detection field, with particular attention to those directly triggering β-lactamases, their performances, and specific limitations. It considers how LFA can be modified by detecting not only the enzyme, but also its β-lactamase activity for a broader clinical sensitivity. Moreover, although LFA allow a short time-to-result, they are generally only implemented after fastidious and time-consuming techniques. We present a sample processing device that shortens and simplifies the handling of clinical samples before the use of LFA. Finally, the capacity of LFA to detect amplified genetic determinants of AMR by isothermal PCR will be discussed. LFA are inexpensive, rapid, and efficient tools that are easy to implement in the routine workflow of laboratories as new first-line tests against AMR with bacterial colonies, and in the near future directly with biological media.

Improving the Quantification of Colorimetric Signals in Paper-Based Immunosensors with an Open-Source Reader

Measuring the colorimetric signals produced by the biospecific accumulation of colorimetric probes and recording the results is a key feature for next-generation paper-based rapid tests. Manual processing of these tests is time-consuming and prone to a loss of accuracy when interpreting faint and patchy signals. Proprietary, closed-source readers and software companies offering automated smartphone-based assay readings have both been criticized for interoperability issues. Here, we introduce a minimal reader prototype composed of open-source hardware and open-source software that has the benefits of automatic assay quantification while avoiding the interoperability issues associated with closed-source readers. An image-processing algorithm was developed to automate the selection of an optimal region of interest and measure the average pixel intensity. When used to quantify signals produced by lateral flow immunoassays for detecting antibodies against SARS-CoV-2, results obtained with the proposed algorithm were comparable to those obtained with a manual method but with the advantage of improving the precision and accuracy when quantifying small spots or faint and patchy signals.

REASSURED Multiplex Diagnostics: A Critical Review and Forecast

The diagnosis of infectious diseases is ineffective when the diagnostic test does not meet one or more of the necessary standards of affordability, accessibility, and accuracy. The World Health Organization further clarifies these standards with a set of criteria that has the acronym ASSURED (Affordable, Sensitive, Specific, User-friendly, Rapid and robust, Equipment-free and Deliverable to end-users). The advancement of the digital age has led to a revision of the ASSURED criteria to REASSURED: Real-time connectivity, Ease of specimen collection, Affordable, Sensitive, Specific, User-friendly, Rapid and robust, Equipment-free or simple, and Deliverable to end-users. Many diagnostic tests have been developed that aim to satisfy the REASSURED criteria; however, most of them only detect a single target. With the progression of syndromic infections, coinfections and the current antimicrobial resistance challenges, the need for multiplexed diagnostics is now more important than ever. This review summarizes current diagnostic technologies for multiplexed detection and forecasts which methods have promise for detecting multiple targets and meeting all REASSURED criteria.

A review on colorimetric assays for DNA virus detection

Early detection is one of the ways to deal with DNA virus widespread prevalence, and it is necessary to know new diagnostic methods and techniques. Colorimetric assays are one of the most advantageous methods in detecting viruses. These methods are based on color change, which can be seen either with the naked eye or with special devices. The aim of this study is to introduce and evaluate effective colorimetric methods based on amplification, nanoparticle, CRISPR/Cas, and Lateral flow in the diagnosis of DNA viruses and to discuss the effectiveness of each of the updated methods. Compared to the other methods, colorimetric assays are preferred for faster detection, high efficiency, cheaper cost, and high sensitivity and specificity. It is expected that the spread of these viruses can be prevented by identifying and developing new methods.

An Overview for the Nanoparticles-Based Quantitative Lateral Flow Assay

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

Pumpless three-dimensional photo paper-based microfluidic analytical device for automatic detection of thioredoxin-1 using enzyme-linked immunosorbent assay

Microfluidic-based biosensors have been developed for their precise automatic reaction control. However, these biosensors require external devices that are difficult to transport and use. To overcome this disadvantage, our group made an easy-to-use, cheap, and light pumpless three-dimensional photo paper-based microfluidic analytical device (3D-μPAD; weight: 1.5 g). Unlike conventional paper-based microfluidic analytical devices, the 3D-μPAD can be used to control fluid flow in a 3D manner, thus allowing sophisticated multi-step reaction control. This device can control fluid flow speed and direction accurately using only the capillary-driven flow without an external device like a pump. The flow speed is controlled by the width of the microfluidic channel and its surface property. In addition, fluid speed control and 3D-bridge structure enable the control of fluid flow direction. Using these methods, multi-step enzyme-linked immunosorbent assay (ELISA) can be done automatically in sequence by injecting solutions (sample, washing, and enzyme's substrate) at the same time in the 3D-μPAD. All the steps can be performed in 14 min, and data can be analyzed immediately. To test this device, thioredoxin-1 (Trx-1), a biomarker of breast cancer, is used as the target. In the 3D-μPAD, it can detect 0-200 ng/mL of Trx-1, and the prepared 3D-μPAD Trx-1 sensor displays excellent selectivity. Moreover, by analyzing the concentration of Trx-1 in real patients and healthy individuals' blood serum samples using the 3D-μPAD, and comparing results to ELISA, it can be confirmed that the 3D-μPAD is a good tool for cancer diagnosis.

Magnetic field-enhanced agglutination as a readout for rapid serologic assays with human plasma

Recent virus outbreaks have revealed a critical need for large scale serological assays. However, many available tests either require a cumbersome, costly apparatus or lack the availability of full automation. In order to address these limitations, we describe a homogeneous assay for antibody detection via measurement of superparamagnetic particles agglutination. Application of a magnetic field permits to overcome the limitations governed by Brownian translational diffusion in conventional assays and results in an important acceleration of the aggregation process as well as an improvement of the limit of detection. Furthermore, the use of protein-concentrated fluid such as 5 times-diluted human plasma does not impair the performances of the method. Screening of human plasma samples shows a strict discrimination between seropositive and seronegative samples in an assay duration as short as 14 s. The sensitivity of this method, combined with its quickness and simplicity, makes it a promising diagnostic tool.

Nonspecific Binding-Fundamental Concepts and Consequences for Biosensing Applications

Nature achieves differentiation of specific and nonspecific binding in molecular interactions through precise control of biomolecules in space and time. Artificial systems such as biosensors that rely on distinguishing specific molecular binding events in a sea of nonspecific interactions have struggled to overcome this issue. Despite the numerous technological advancements in biosensor technologies, nonspecific binding has remained a critical bottleneck due to the lack of a fundamental understanding of the phenomenon. To date, the identity, cause, and influence of nonspecific binding remain topics of debate within the scientific community. In this review, we discuss the evolution of the concept of nonspecific binding over the past five decades based upon the thermodynamic, intermolecular, and structural perspectives to provide classification frameworks for biomolecular interactions. Further, we introduce various theoretical models that predict the expected behavior of biosensors in physiologically relevant environments to calculate the theoretical detection limit and to optimize sensor performance. We conclude by discussing existing practical approaches to tackle the nonspecific binding challenge in vitro for biosensing platforms and how we can both address and harness nonspecific interactions for in vivo systems.

A new point-of-care test for the diagnosis of infectious diseases based on multiplex lateral flow immunoassays

Infectious diseases are transmissible or communicable illnesses and can spread quickly in some areas and become epidemics. It is critical to quickly diagnose initial infections and prevent further spread through in vitro diagnosis. However, current detection strategies have exhibited a lack of balance with regard to accuracy, time consumption, and portability until recently (e.g. serology, culturing, molecular tests, etc.). Alternatively, many studies have focused on point-of-care testing (POCT), which combines simple, rapid, and exact on-site diagnostic platforms. Moreover, multiplex detectability is necessary for emergency treatment depending on the stage of the disease or interactional infections. The lateral flow assay (LFA) is the most popular diagnostic tool that meets the required standards for colorimetric assays. Here, we review lateral flow assays based on the immune reactions for the simultaneous diagnosis of infectious diseases as the POC test. The assays employed various forms and approaches in terms of the multiplexing level system for improving the sensitivity and specificity. We briefly describe the state-of-the-art infection diagnostic methods and published performances that have been classified into three categories based on the application forms of the lateral flow immunoassay. Also, we discuss further uses of LFA and other technologies for more effective infectious disease POCT.

Robust Smartphone Assisted Biosensing Based on Asymmetric Nanofluidic Grating Interferometry

Point-of-care systems enable fast therapy decisions on site without the need of any healthcare infrastructure. In addition to the sensitive detection, stable measurement by inexperienced persons outside of laboratory facilities is indispensable. A particular challenge in field applications is to reduce interference from environmental factors, such as temperature, to acceptable levels without sacrificing simplicity. Here, we present a smartphone-based point-of-care sensor. The method uses an optofluidic grating composed of alternating detection and reference channels arranged as a reflective phase grating. Biomolecules adsorbing to the detection channel alter the optical path length, while the parallel reference channels enable a direct common mode rejection within a single measurement. The optical setup is integrated in a compact design of a mobile readout device and the usability is ensured by a smartphone application. Our results show that different ambient temperatures do not have any influence on the signal. In a proof-of concept experiment we measured the accumulation of specific molecules in functionalized detection channels in real-time and without the need of any labeling. Therefore, the channel walls have been modified with biotin as capture molecules and the specific binding of streptavidin was detected. A mobile, reliable and robust point-of-care device has been realized by combining an inherently differential measurement concept with a smartphone-based, mobile readout device.