Aspects of Point-of-Care Diagnostics for Personalized Health Wellness

Abstract

Advancements in analytical diagnostic systems for point-of-care (POC) application have gained considerable attention because of their rapid operation at the site required to manage severe diseases, even in a personalized manner. The POC diagnostic devices offer easy operation, fast analytical outcome, and affordable cost, which promote their advanced research and versatile adoptability. Keeping advantages in view, considerable efforts are being made to design and develop smart sensing components such as miniaturized transduction, interdigitated electrodes-based sensing chips, selective detection at low level, portable packaging, and sustainable durability to promote POC diagnostics according to the needs of patient care. Such effective diagnostics systems are in demand, which creates the challenge to make them more efficient in every aspect to generate a desired bio-informatic needed for better health access and management. Keeping advantages and scope in view, this mini review focuses on practical scenarios associated with miniaturized analytical diagnostic devices at POC application for targeted disease diagnostics smartly and efficiently. Moreover, advancements in technologies, such as smartphone-based operation, paper-based sensing assays, and lab-on-a-chip (LOC) which made POC more sensitive, informative, and suitable for major infectious disease diagnosis, are the main focus here. Besides, POC diagnostics based on automated patient sample integration with a sensing platform is continuously improving therapeutics interventions against specific infectious disease. This review also discussed challenges associated with state-of-the-art technology along with future research opportunities to design and develop next generation POC diagnostic systems needed to manage infectious diseases in a personalized manner.

Keywords: infectious diseases; lateral flow strips; microfluidics; point-of-care devices.

Figure 1

Rapid diagnostic platform for Dengue and Chikungunya using (A) multiplex lateral flow test strip, (B) optical reader for color detection, (C) structural representation of optical reader, (D) lightproof casing of optical reader, and (E) appearance of test strip corresponding to different diagnostic scenarios. Note: Reproduced with the permission from Wang R, Ongagna-Yhombi SY, Lu Z, Centeno-Tablante E, Colt S, Cao X, Ren Y, Caardenas WB, Mehta S, Erickson D. Rapid diagnostic platform for colorimetric differential detection of dengue and Chikungunya viral infections. Analytical chemistry. 2019 21;91(8):5415-23. Copyright (2019) American Chemical Society.

Figure 2

Schematic representation of novel lipoarabinomannan POC device for Tuberculosis diagnosis and its working principle.Note: Reproduced with the permission form Broger T, Sossen B, du Toit E, Kerkhoff AD, Schutz C, Reipold EI, Ward A, Barr DA, Macé A, Trollip A, Burton R. Novel lipoarabinomannan point-of-care tuberculosis test for people with HIV: a diagnostic accuracy study. The Lancet Infectious Diseases. 2019 Aug 1;19(8):852-61. Copyright (2019) Elsevier.

Figure 3

Interdigitated electrodes cultured with Astrocytes and infected by HIV in the presence of cocaine to understand the electrochemical assessment of cell physiology. Note: Reproduced with the permission from Kaushik A, Vabbina PK, Atluri V, Shah P, Vashist A, Jayant RD, Yandart A, Nair M. Electrochemical monitoring-on-chip (E-MoC) of HIV-infection in presence of cocaine and therapeutics. Biosensors and Bioelectronics. 2016 86:426–31. Copyright (2016) Elsevier.

Figure 4

Illustration of an interdigitated electrodes based immunosensor for the detection of ZIKA protein at (pM), to perform POC diagnostics, this sensing chip is projected to be operated by a miniaturized analyzer and data analysis using internet of medical things. Note: Reproduced with the permission from Kaushik A, Yndart A, Kumar S, Jayant RD, Vashist A, Brown AN, Li CZ, Nair M. A sensitive electrochemical immunosensor for label-free detection of Zika-virus protein. Scientific reports. 2018 8: 97000. Copyright (2018) Scientific Reports under Creative Commons Attribution 4.0 International License.

Figure 5

Design and applicability of smartphone-based fluorescent lateral flow immunoassay (LFIA) platform: (A) 3D schematic of internal structure of the device, (B) image of fluorescent LFIA reader, (C) schematic representation of ZIKV NS1 detection using fluorescent LFIA, and (D) images of test strips in the absence (right) and presence (left) of ZIKV NS1. Note: Reproduced with the permission from Rong Z, Wang Q, Sun N, Jia X, Wang K, Xiao R, Wang S. Smartphone-based fluorescent lateral flow immunoassay platform for highly sensitive point-of-care detection of Zika virus nonstructural protein 1. Analytica chimica acta. 2019 1055:140–7. Copyright (2019) Elsevier.

Figure 6

Overview of smartphone-based lateral flow POC test for detection of Ebola-specific antibodies illustrating (A) lateral flow strips and (B) smartphone applicationinterface login window for providing a description of the test and further recording of patient details. Note: Reproduced with the permission from Brangel P, Sobarzo A, Parolo C, Miller BS, Howes PD, Gelkop S, Lutwama JJ, Dye JM, McKendry RA, Lobel L, Stevens MM. A serological point-of-care test for the detection of IgG antibodies against Ebola virus in human survivors. ACS nano. 2018 12(1):63-73. Copyright (2018) American Chemical Society.

Figure 7

Strategic illustration of developing a miniaturized COVID-19 diagnostics tool for POC application. Note: Reproduced with the permission from Mujawar MA, Gohel H, Bhardwaj SK, Srinivasan S, Hickman N, Kaushik A. Aspects of nano-enabling biosensing systems for intelligent healthcare; towards COVID-19 management. Materials Today Chemistry. 2020 5:100306. Copyright (2020) Elsevier.