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通过多重微纳传感技术实现脓毒症关键护理点诊断。

Point-of-critical-care diagnostics for sepsis enabled by multiplexed micro and nanosensing technologies.

机构信息

Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.

Department of Electrical and Computer Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.

出版信息

Wiley Interdiscip Rev Nanomed Nanobiotechnol. 2021 Sep;13(5):e1701. doi: 10.1002/wnan.1701. Epub 2021 Mar 1.

Abstract

Sepsis is responsible for the highest economic and mortality burden in critical care settings around the world, prompting the World Health Organization in 2018 to designate it as a global health priority. Despite its high universal prevalence and mortality rate, a disproportionately low amount of sponsored research funding is directed toward diagnosis and treatment of sepsis, when early treatment has been shown to significantly improve survival. Additionally, current technologies and methods are inadequate to provide an accurate and timely diagnosis of septic patients in multiple clinical environments. For improved patient outcomes, a comprehensive immunological evaluation is critical which is comprised of both traditional testing and quantifying recently proposed biomarkers for sepsis. There is an urgent need to develop novel point-of-care, low-cost systems which can accurately stratify patients. These point-of-critical-care sensors should adopt a multiplexed approach utilizing multimodal sensing for heterogenous biomarker detection. For effective multiplexing, the sensors must satisfy criteria including rapid sample to result delivery, low sample volumes for clinical sample sparring, and reduced costs per test. A compendium of currently developed multiplexed micro and nano (M/N)-based diagnostic technologies for potential applications toward sepsis are presented. We have also explored the various biomarkers targeted for sepsis including immune cell morphology changes, circulating proteins, small molecules, and presence of infectious pathogens. An overview of different M/N detection mechanisms are also provided, along with recent advances in related nanotechnologies which have shown improved patient outcomes and perspectives on what future successful technologies may encompass. This article is categorized under: Diagnostic Tools > Biosensing.

摘要

脓毒症在全球重症监护环境中造成的经济和死亡率负担最高,促使世界卫生组织于 2018 年将其指定为全球卫生重点。尽管脓毒症普遍存在且死亡率高,但针对其诊断和治疗的赞助研究资金却少得不成比例,因为早期治疗已被证明可显著提高生存率。此外,目前的技术和方法不足以在多种临床环境中为脓毒症患者提供准确和及时的诊断。为了改善患者的预后,全面的免疫评估至关重要,包括传统检测和量化最近提出的脓毒症生物标志物。迫切需要开发新的即时护理、低成本系统,以便准确分层患者。这些关键护理点传感器应采用基于多模式传感的多重方法,用于异质生物标志物检测。为了实现有效的多重检测,传感器必须满足包括快速提供样本到结果、节省临床样本、降低每次检测成本等标准。本文介绍了目前开发的用于脓毒症的多种基于微纳(M/N)的诊断技术,包括免疫细胞形态变化、循环蛋白、小分子和传染性病原体。还概述了不同的 M/N 检测机制,以及相关纳米技术的最新进展,这些进展已经显示出改善了患者的预后,并对未来成功的技术可能涵盖的内容进行了展望。本文属于诊断工具>生物传感这一分类。

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