Electrochemiluminescence (ECL)-based sensing systems rely on light emissions from luminophores, which are generated by high-energy electron transfer reactions between electrogenerated species on an electrode. ECL systems have been widely used in the detection and monitoring of diverse, disease-related biomarkers due to their high selectivity and fast response times, as well as their spatial and temporal control of luminance, high controllability, and a wide detection range. This review focuses on the recent strategic and technological advances in ECL-based biomarker detection systems. We introduce several sensing systems for medical applications that are classified according to the reactions that drive ECL signal emissions. We also provide recent examples of sensing strategies and technologies based on factors that enhance sensitivity and multiplexing abilities as well as simplify sensing procedures. This review also discusses the potential strategies and technologies for the development of ECL systems with an enhanced detection ability.
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