Bio-integrated wearable systems can measure a broad range of biophysical, biochemical, and environmental signals to provide critical insights into overall health status and to quantify human performance. Recent advances in material science, chemical analysis techniques, device designs, and assembly methods form the foundations for a uniquely differentiated type of wearable technology, characterized by noninvasive, intimate integration with the soft, curved, time-dynamic surfaces of the body. This review summarizes the latest advances in this emerging field of “bio-integrated” technologies in a comprehensive manner that connects fundamental developments in chemistry, material science, and engineering with sensing technologies that have the potential for widespread deployment and societal benefit in human health care. An introduction to the chemistries and materials for the active components of these systems contextualizes essential design considerations for sensors and associated platforms that appear in following sections. The subsequent content highlights the most advanced biosensors, classified according to their ability to capture biophysical, biochemical, and environmental information. Additional sections feature schemes for electrically powering these sensors and strategies for achieving fully integrated, wireless systems. The review concludes with an overview of key remaining challenges and a summary of opportunities where advances in materials chemistry will be critically important for continued progress.

Battery-free, wireless microfluidic/electronic system for multiparameter sweat analysis.

Waterproof epidermal microfluidics enable collection and analysis of sweat during aquatic exercise.

Real-time measurements of the total loss of sweat, the rate of sweating, the temperature of sweat, and the concentrations of electrolytes and metabolites in sweat can provide important insights into human physiology. Conventional methods use manual collection processes (e.g., absorbent pads) to determine sweat loss and lab-based instrumentation to analyze its chemical composition. Although such schemes can yield accurate data, they cannot be used outside of laboratories or clinics. Recently reported wearable electrochemical devices for sweat sensing bypass these limitations, but they typically involve on-board electronics, electrodes, and/or batteries for measurement, signal processing, and wireless transmission, without direct means for measuring sweat loss or capturing and storing small volumes of sweat. Alternative approaches exploit soft, skin-integrated microfluidic systems for collection and colorimetric chemical techniques for analysis. Here, we present the most advanced platforms of this type, in which optimized chemistries, microfluidic designs, and device layouts enable accurate assessments not only of total loss of sweat and sweat rate but also of quantitatively accurate values of the pH and temperature of sweat, and of the concentrations of chloride, glucose, and lactate across physiologically relevant ranges. Color calibration markings integrated into a graphics overlayer allow precise readout by digital image analysis, applicable in various lighting conditions. Field studies conducted on healthy volunteers demonstrate the full capabilities in measuring sweat loss/rate and analyzing multiple sweat biomarkers and temperature, with performance that quantitatively matches that of conventional lab-based measurement systems.

Recently developed classes of ultrasmall, fully implantable devices for optogenetic neuromodulation eliminate physical tethers associated with conventional setups and avoid bulky head-stages and batteries in alternative wireless technologies. The resulting systems enable completely untethered, battery-free operation for high fidelity behavioral studies that eliminate motion constraints and enable experiments in a range of environments and contexts (e.g. social interactions) that would be otherwise difficult or impossible to explore. These devices are, however, purely passive in their electronics design, thereby precluding any form of active control or programmability; independent operation of multiple devices or of multiple active components in a single device is impossible. This paper introduces a series of important concepts in integrated circuit and antenna design which, taken together, enable low power operation, energy efficient and position and angle independent wireless power harvesting with full user-programmability over individual devices or collections of them, in integrated platforms that have sizes and weights not significantly larger than those of previous, passive systems. The results qualitatively expand options in output stabilization, intensity control and multimodal operation, with broad potential applications in neuroscience research, with specific advances in precise dissection of neural circuit function during unconstrained behavioral studies.

At the intersection of the outwardly disparate fields of nanoparticle science and three-dimensional printing lies the promise of revolutionary new “nanocomposite” materials. Emergent phenomena deriving from the nanoscale constituents pave the way for a new class of transformative materials with encoded functionality amplified by new couplings between electrical, optical, transport, and mechanical properties. We provide an overview of key scientific advances that empower the development of such materials: nanoparticle synthesis and assembly, multiscale assembly and patterning, and mechanical characterization to assess stability. The focus is on recent illustrations of approaches that bridge these fields, facilitate the design of ordered nanocomposites, and offer clear pathways to device integration. We conclude by highlighting the remaining scientific challenges, including the critical need for assembly-compatible particle–fluid systems that ultimately yield mechanically robust materials. The role of domain boundaries and/or defects emerges as an important open question to address, with recent advances in fabrication setting the stage for future work in this area.

The rich composition of solutes and metabolites in sweat and its relative ease of collection upon excretion from skin pores make this class of biofluid an attractive candidate for point of care analysis. Wearable technologies that combine electrochemical sensors with conventional or emerging semiconductor device technologies offer valuable capabilities in sweat sensing, but they are limited to assays that support amperometric, potentiometric, and colorimetric analyses. Here, we present a complementary approach that exploits fluorometric sensing modalities integrated into a soft, skin-interfaced microfluidic system which, when paired with a simple smartphone-based imaging module, allows for in situ measurement of important biomarkers in sweat. A network array of microchannels and a collection of microreservoirs pre-filled with fluorescent probes that selectively react with target analytes in sweat (e.g. probes), enable quantitative, rapid analysis. Field studies on human subjects demonstrate the ability to measure the concentrations of chloride, sodium and zinc in sweat, with accuracy that matches that of conventional laboratory techniques. The results highlight the versatility of advanced fluorescent-based imaging modalities in body-worn sweat microfluidics platforms, and they suggest some practical potential for these ideas.

During periods of activity, sweat glands produce pressures associated with osmotic effects to drive liquid to the surface of the skin. The magnitudes of these pressures may provide insights into physiological health, the intensity of physical exertion, psychological stress factors and/other information of interest, yet they are currently unknown due to absence of means for non-invasive measurement. This paper introduces a thin, soft wearable microfluidic system that mounts onto the surface of the skin to enable precise and routine measurements of secretory fluidic pressures generated at the surface of the skin by eccrine sweat glands (surface SPSG, or s-SPSG) at nearly any location on the body. These platforms incorporate an arrayed collection of unit cells each of which includes an opening to the skin, an inlet through which sweat can flow, a capillary bursting valve (CBV) with a unique bursting pressure (BP), a corresponding microreservoir to receive sweat and an outlet to the surrounding ambient to allow release of backpressure. The BPs systematically span the physiologically relevant range. The set of unit cells is designed such that the BP difference between any two unit cells is greater than the combined uncertainty. Human studies demonstrate measurements of s-SPSG under different conditions, from various regions of the body. Average values in healthy young adults lie between 2.4 and 2.9 kPa. Sweat associated with vigorous exercise have s-SPSGs that are somewhat higher than those associated with sedentary activity. For all conditions, the forearm and lower back tend to yield the highest and lowest s-SPSGs, respectively.