Immuno Diagnostix (IDX) - An ultrasensitive, low cost photonic biosensor

英国大约有40万人患有类风湿性关节炎（RA）。类风湿性关节炎是一种影响关节的炎症性疾病，会引起肿胀、活动受限和疼痛。虽然目前还没有治愈类风湿性关节炎的方法，但现在有各种各样的治疗方法可以帮助减少炎症，缓解疼痛，最大限度地减少关节损伤。既然有这么多的治疗方法，我们怎么知道哪种治疗方法对每个病人都是最好的呢？此外，用于治疗类风湿性关节炎的药物可能有有害的副作用，包括心血管疾病和更容易感染。因此，对患者进行定期监测以检查他们的治疗是否有效以及药物的副作用是否减少是至关重要的。目前，这是通过血液检查完成的，通常每月在医院进行一次。然而，这些检测的频率导致患者受到干扰，他们往往因疾病而丧失功能，并给NHS带来了巨大的成本。在过去几年中，人们越来越关注通过引进能够进行远程监测的技术来减少病人就诊的次数和频率。新冠肺炎大流行的到来加速了对这项技术的需求，因为电话或互联网预约已成为常态，免疫功能低下的患者最好不要去医疗中心接受血液检查。我们之前展示了一种新的诊断技术，可以检测和量化血液中的蛋白质，用于检查类风湿性关节炎治疗的疗效。这种诊断技术被称为引导模式共振（GMR）传感器芯片，它基于光学衍射光栅，通过在传感器表面嫁接抗体，使其对特定蛋白质敏感。与传统的血液检测不同，我们的技术只需要非常小的血液量（只是一个手指刺），可以由非专业人员，甚至可能是病人自己来执行，并且只需要非常低成本的部件。尽管如此，该技术的灵敏度可与目前医院中用于血液检测的更大、更复杂的系统相媲美。迄今为止，这项新技术在我们专门实验室的试验中表现良好。在这个项目中，我们将与工业合作伙伴合作开发这项技术，包括专门研究类风湿性关节炎的临床医生和类风湿性关节炎患者自己，因此它可以用于远程血液检测。具体来说，我们将设计、制造和测试一种小型、低成本的仪器，它能够读取传感器芯片并定量蛋白质浓度。同时，我们将构建一个简单的微流控装置，它能够接受从手指刺入的一滴血液，将样本送到传感器进行分析和计数白细胞和红细胞的数量。最后，我们将使用RA患者的血液样本测试该设备，并将我们的新技术与医院使用既定方法进行的测试进行比较。

Around 400,000 people in the UK live with rheumatoid arthritis (RA). RA is an inflammatory disease that affects the joints, causing swelling, restricted movement and pain. Although there is no cure for RA, there are today a wide variety of treatments that can help reduce inflammation, relieve pain and minimise joint damage. Given the wide number of treatments, how do we know which treatment is the best for each individual patient? Furthermore, the drugs used to treat RA can have detrimental side effects, including cardiovascular disease and a higher susceptibility to infection. It is therefore critical that patients are monitored regularly to check whether their treatments are working and that the side effects of their medication are reduced. At present, this is done using blood tests which are usually performed every month at the hospital. However, the frequency of these tests leads to disruption to patients who are often functionally incapacitated by their disease, and significant costs to the NHS. In the last few years, there has been increasing interest in reducing the number and frequency of patient visits through the introduction of technology that would enable remote monitoring. The advent of the COVID-19 pandemic has accelerated the need for this technology, as telephone or internet-based appointments have become the norm and it is desirable to not have immunocompromised patients attending medical centers for blood tests.We previously demonstrated a new diagnostic technology that can detect and quantify the proteins in blood that are used to check the efficacy of RA treatments. This diagnostic technology, called a guided mode resonance (GMR) sensor chip, is based on an optical diffraction grating that is rendered sensitive to specific proteins by grafting of antibodies on the sensor surface. Unlike traditional blood tests, our technology only requires very small volumes of blood (just a fingerprick), can be performed by non-specialists, potentially even the patient themselves, and only requires very low cost components. Despite this, the sensitivity of the technology is comparable to the larger, more complicated systems currently used for blood tests in hospitals. To date, this new technology has been shown to work well in trials in our dedicated laboratories. In this project, we will work with industrial partners to develop the technology, involving clinicians specialising in RA and with RA patients themselves, so it can be used to allow blood testing remotely. Specifically, we will design, build and test a small, low-cost instrument that is capable of reading the sensor chip and quantifying the protein concentration. At the same time, we will construct a simple microfluidic device that is capable of accepting a droplet of blood from a fingerprick, delivering the sample to the sensor for analysis and counting the number of white and red blood cells. Finally, we will test the device using blood samples from RA patients and compare our new technology to tests performed in the hospital using established methods.