Managing Heart Failure at Home With Point-of-Care Diagnostics.
Managing Heart Failure at Home With Point-of-Care Diagnostics.
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DOI：
10.1109/jtehm.2017.2740920
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发表时间：
2017
影响因子：
3.4
通讯作者：
Crooks RM
中科院分区：
文献类型：
--
作者：
Degregory PR;Tapia J;Wong T;Villa J;Richards I;Crooks RM
本论文的目的是开发一种廉价的用于检测心力衰竭标志物多肽NT-proBNP的护理点传感器。该设备技术基于抗体夹心检测，但具有三个创新方面。首先，化学扩增是通过连接到信号抗体上的纳米银(NPs)的氧化来进行的，而不是通过酶扩增。电化学法速度更快，不需要长期保存酶。第二，抗体夹心形成在可移动磁珠上。这提高了生物标志物和信号抗体对固定在磁珠上的一级检测抗体的传质速度。第三，传感器本身是在带有丝网印刷电极的纸平台上制造的。再加上简单的折纸组装，使传感器的成本保持在较低的水平。在这里，我们报告两种不同的分析方法。第一种是基于一种简单的生物素-链霉亲和素结合物，这是抗体检测的初步模型。结果表明，银纳米粒子的检出限为2.1 pm，测定时间为7分钟。实际的NT-proBNP抗体检测耗时较长，动态检测范围较高：2.9-582 nm。根据本文提出的结果，我们得出结论，这种廉价的纸基传感器是一种可行的NT-proBNP点检测技术，但在临床实施之前仍存在一些挑战。这些措施包括达到更低的检测下限和更好的重复性，以及优化人体血液设备。仅在美国，心力衰竭(HF)就影响了580万人，每年导致大约100万人住院。每张门票的平均费用约为18,000美元。与糖尿病患者使用的血糖检测类似，我们相信定期在家中监测HF标志物多肽NT-proBNP可以降低医疗成本，同时为患者提供更好的护理。因此，我们开发了一种廉价(约1美元)的NT-proBNP传感器，该传感器基于简单的纸质平台和电化学检测。图中说明了检测原理。在这里，只有在目标多肽存在的情况下，银纳米颗粒才能与磁性微球偶联。然后，通过磁力将偶联物定向到丝网印刷电极上，并对银纳米颗粒进行电化学检测。
The objective of this paper is development of an inexpensive point-of-care sensor for detecting the primary heart failure marker peptide, NT-proBNP. The device technology is based on an antibody sandwich assay, but with three innovative aspects. First, chemical amplification is carried out via oxidation of silver nanoparticles (NPs) attached to signaling antibodies rather than by enzymatic amplification. The electrochemical method is faster and eliminates the need for long-term storage of enzymes. Second, the antibody sandwich is formed on mobile magnetic beads. This enhances the rate of mass transfer of the biomarker and the signaling antibody to the primary detection antibody, which is immobilized on the magnetic beads. Third, the sensor itself is fabricated on a paper platform with screen-printed electrodes. This coupled with assembly by simple paper folding, keeps the cost of the sensor low. Here, we report on two separate assays. The first is based on a simple biotin-streptavidin conjugate, which is a preliminary model for the antibody assay. The results indicate a detection limit of 2.1 pM of silver NPs and an assay time of 7 min. The actual NT-proBNP antibody assay takes somewhat longer, and the dynamic detection range is higher: 2.9–582 nM. On the basis of the results presented in this paper, we conclude that this inexpensive paper-based sensor represents a viable technology for point-of-care testing of NT-proBNP, but nevertheless several challenges remain prior to clinical implementation. These include attaining a lower detection limit and better reproducibility, and optimizing the device for human blood. Heart failure (HF) affects 5.8 million people in the United States alone, and it results in about one million hospitalizations per year. The average cost per admission is about $18,000. In analogy to blood glucose testing used by diabetics, we believe that regular home monitoring of the HF marker peptide NT-proBNP could reduce medical costs while simultaneously providing better care for patients. Accordingly, we have developed an inexpensive (~$1) sensor for NT-proBNP that is based on a simple paper platform and an electrochemical assay. The graphic illustrates the detection principle. Here silver nanoparticles are conjugate to magnetic microbeads only in the presence of the target peptide. The conjugate is then directed to a screen-printed electrode by a magnetic force, and the silver nanoparticles detected electrochemically.