Rapid, simple, and cost-effective diagnostics are needed to improve healthcare at
the point of care (POC). However, the most widely used POC diagnostic, the lateral flow
immunoassay (LFA), is ~1000-times less sensitive and has a smaller analytical
range than laboratory tests, requiring a confirmatory test to establish truly negative
results. Here, a rational and systematic strategy is used to design the LFA contrast label
(i.e., gold nanoparticles) to improve the analytical sensitivity, analytical detection
range, and antigen quantification of LFAs. Specifically, we discovered that the size (30,
60, or 100 nm) of the gold nanoparticles is a main contributor to the LFA analytical
performance through both the degree of receptor interaction and the ultimate visual or
thermal contrast signals. Using the optimal LFA design, we demonstrated the ability to
improve the analytical sensitivity by 256-fold and expand the analytical detection range
from 3 log10 to 6 log10 for diagnosing patients with inflammatory
conditions by measuring C-reactive protein. This work demonstrates that, with appropriate
design of the contrast label, a simple and commonly used diagnostic technology can compete
with more expensive state-of-the-art laboratory tests.