Micro- and nanosensors for detecting blood pathogens and biomarkers at different points of sepsis care

Abstract

Severe infections can cause a dysregulated response leading to organ dysfunction known as sepsis. Sepsis can be lethal if not identified and treated right away. This requires measuring biomarkers and pathogens rapidly at the different points where sepsis care is provided. Current commercial approaches for sepsis diagnosis are not fast, sensitive, and/or specific enough for meeting this medical challenge. In this article, we review recent advances in the development of diagnostic tools for sepsis management based on micro- and nanostructured materials. We start with a brief introduction to the most popular biomarkers for sepsis diagnosis (lactate, procalcitonin, cytokines, C-reactive protein, and other emerging protein and non-protein biomarkers including miRNAs and cell-based assays) and methods for detecting bacteremia. We then highlight the role of nano- and microstructured materials in developing biosensors for detecting them taking into consideration the particular needs of every point of sepsis care (e.g., ultrafast detection of multiple protein biomarkers for diagnosing in triage , emergency room, ward, and intensive care unit; quantitative detection to de-escalate treatment; ultrasensitive and culture-independent detection of blood pathogens for personalized antimicrobial therapies; robust, portable, and web-connected biomarker tests outside the hospital). We conclude with an overview of the most utilized nano- and microstructured materials used thus far for solving issues related to sepsis diagnosis and point to new challenges for future development. Graphical abstract Supplementary Information The online version contains supplementary material available at 10.1007/s00604-022-05171-2.

On the Move-Sensitive Fluorescent Aptassay on Board Catalytic Micromotors for the Determination of Interleukin-6 in Ultra-Low Serum Volumes for Neonatal Sepsis Diagnostics

“…That is why ICU care for these patients is more expensive to save the incipient life. 24 The diagnosis of sepsis is extremely complicated today and still far from being addressed at the exact moment of sepsis development and with the required reliability. Blood biomarkers constitute an additional aid in the diagnosis due to their increase in the early phases of the infection when signs and symptoms are not so evident.…”

“…This technique needs relatively large volumes of sample and long analysis times besides displaying low sensitivities in neonates due to the irregularity of bacteremia and low sample volume, causing failure in the detection of sepsis. − This entails the initiation of antibiotic therapy before confirmation of the diagnosis, with its potential side effects being the possibility of development of antibiotics resistance and the increment of healthcare costs. , This challenge becomes even more complicated, if possible, in the diagnosis of neonatal sepsis, especially in very low-birth-weight infants who have a very small blood volume and given their increased vulnerability to infection due to the immaturity of their immune system. That is why ICU care for these patients is more expensive to save the incipient life …”

Use of Cysteamine and Glutaraldehyde Chemicals for Robust Functionalization of Substrates with Protein Biomarkers—An Overview on the Construction of Biosensors with Different Transductions

“…Moreover, corroboration with conventional invasive (liquid and tissue biopsy [ 77 ]) and non-invasive (e.g., enzyme-linked immunosorbent and immunology-based assays [ 78 ] and electrophoretic separation [ 79 ]) diagnostic methods with a smartphone-based mobile detection platform are urgently needed for rapid screening between false positive/negative data and to help physicians make an accurate diagnosis of patients before drug treatment and surgical investigations [ 80 , 81 , 82 , 83 , 84 ]. Thus, there is no doubt that low-cost portable cassette sets with pre-treated (e.g., improved Cys/GA chemistry coupled to milder reducing agents and blocking buffers [ 85 , 86 , 87 , 88 ]) stable supports based on paper [ 89 , 90 , 91 ], regular/ultrafine glass [ 92 , 93 , 94 ], or flexible fiber polymers [ 95 , 96 ] embedded with metallic nanoparticles will continue to attract great interest in the academic and medical [ 97 , 98 , 99 , 100 ] research communities.…”

Magnetic supercluster particles for highly sensitive magnetic biosensing of proteins

“…VEGF is a mediator of cancerous angiogenesis and is found to be at high levels in tumors [39]. CRP is produced mainly in response to inflammation, thus related to many morbid conditions including cancer, autoimmune diseases, and health problems [40,41]. A mixture of VEGF and CRP both at 0.005, 0.025, 0.125 or 0.625 ng mL −1 is incubated with two identically processed chips, but each chip is assayed with either streptavidin-MSPs or streptavidin-MNPs for comparison.…”