Point-of-critical-care diagnostics for sepsis enabled by multiplexed micro and nanosensing technologies.
Point-of-critical-care diagnostics for sepsis enabled by multiplexed micro and nanosensing technologies.
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DOI：
10.1002/wnan.1701
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Hassan U
中科院分区：
文献类型：
--
作者：
Ashley BK;Hassan U
脓毒症是世界各地重症监护环境中最高的经济和死亡负担，促使世界卫生组织在2018年将其指定为全球卫生优先事项。尽管其普遍的患病率和死亡率很高，但赞助的研究资金不成比例地低，用于脓毒症的诊断和治疗，而早期治疗已被证明可显着提高生存率。此外，目前的技术和方法不足以在多种临床环境中提供脓毒症患者的准确和及时的诊断。为了改善患者预后，全面的免疫学评估至关重要，其中包括传统测试和量化最近提出的脓毒症生物标志物。迫切需要开发新的护理点，低成本的系统，可以准确地分层患者。这些重症监护点（POCC）传感器应采用多路复用方法，利用多模式传感进行异质生物标志物检测。为了实现有效的多路复用，传感器必须满足以下标准，包括快速的样品到结果（STR）递送、用于临床样品比对的低样品体积以及降低每次测试的成本。目前开发的多路复用的微米和纳米（M/N）为基础的诊断技术对脓毒症的潜在应用纲要。我们还探索了针对脓毒症的各种生物标志物，包括免疫细胞形态学变化、循环蛋白、小分子和感染性病原体的存在。还提供了不同的M/N检测机制的概述，沿着相关纳米技术的最新进展，这些进展已显示出改善的患者结局和未来成功技术可能涵盖的前景。为了降低常见但复杂的脓毒症感染的死亡率，针对多种脓毒症生物标志物的微米和纳米技术可以提供更快，更准确和个性化的诊断，以支持早期治疗
Sepsis is responsible for the highest economic and mortality burden in critical care settings around the world, prompting the World Health Organization in 2018 to designate it as a global health priority. Despite its high universal prevalence and mortality rate, a disproportionately low amount of sponsored research funding is directed towards diagnosis and treatment of sepsis, when early treatment has been shown to significantly improve survival. Additionally, current technologies and methods are inadequate to provide an accurate and timely diagnosis of septic patients in multiple clinical environments. For improved patient outcomes, a comprehensive immunological evaluation is critical which is comprised of both traditional testing and quantifying recently proposed biomarkers for sepsis. There is an urgent need to develop novel point-of-care, low-cost systems which can accurately stratify patients. These point-of-critical-care (POCC) sensors should adopt a multiplexed approach utilizing multi-modal sensing for heterogenous biomarker detection. For effective multiplexing, the sensors must satisfy criteria including rapid sample to result (STR) delivery, low sample volumes for clinical sample sparring, and reduced costs per test. A compendium of currently developed multiplexed micro and nano (M/N) based diagnostic technologies for potential applications towards sepsis are presented. We have also explored the various biomarkers targeted for sepsis including immune cell morphology changes, circulating proteins, small molecules, and presence of infectious pathogens. An overview of different M/N detection mechanisms are also provided, along with recent advances in related nanotechnologies which have shown improved patient outcomes and perspectives on what future successful technologies may encompass. To reduce mortality from common yet complicated septic infections, micro and nano technologies which target multiple sepsis biomarkers can provide faster, more accurate, and personalized diagnosis to support early treatment
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