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使用电化学生物传感器同时检测全血中的脓毒症宿主反应生物标志物。

Simultaneous detection of sepsis host response biomarkers in whole blood using electrochemical biosensor.

作者信息

Tanak Ambalika S, Sardesai Abha, Muthukumar Sriram, Prasad Shalini

机构信息

Department of Bioengineering University of Texas at Dallas Dallas Texas USA.

Department of Computer engineering University of Texas at Dallas Dallas Texas USA.

出版信息

Bioeng Transl Med. 2022 Mar 17;7(3):e10310. doi: 10.1002/btm2.10310. eCollection 2022 Sep.

Abstract

Sepsis is a silent killer, caused by a syndromic reaction of the body's immune system to an infection that is typically the ultimate pathway to mortality due to numerous infectious diseases, including COVID-19 across the world. In the United States alone, sepsis claims 220,000 lives, with a dangerously high fatality rate between 25% and 50%. Early detection and treatment can avert 80% of sepsis mortality which is currently unavailable in most healthcare institutions. The novelty in this work is the ability to simultaneously detect eight (IL-6, IL-8, IL-10, IP-10, TRAIL, d-dimer, CRP, and G-CSF) heterogeneous immune response biomarkers directly in whole blood without the need for dilution or sample processing. The DETecT sepsis (Direct Electrochemical Technique Targeting Sepsis) 2.0 sensor device leverages electrochemical impedance spectroscopy as a technique to detect subtle binding interactions at the metal/semi-conductor sensor interface and reports results within 5 min using only two drops (~100 μl) of blood. The device positively ( >0.87) correlated with lab reference standard LUMINEX for clinical translation using 40 patient samples. The developed device showed diagnostic accuracy greater than 80% (AUC >0.8) establishing excellent specific and sensitive response. Portable handheld user-friendly feature coupled with precise quantification of immune biomarkers makes the device amenable in a versatile setting providing insights on patient's immune response. This work highlights an innovative solution of enhancing sepsis care and management in the absence of a decision support device in the continuum of sepsis care.

摘要

脓毒症是一种隐匿的杀手,它由人体免疫系统对感染的综合征反应引起,而这种反应通常是包括全球范围内的新冠病毒病在内的众多传染病导致死亡的最终途径。仅在美国,脓毒症就导致22万人死亡,其致死率高达25%至50%,危险程度极高。早期检测和治疗可避免80%的脓毒症死亡病例,而目前大多数医疗机构都无法做到这一点。这项工作的新颖之处在于能够直接在全血中同时检测八种(白细胞介素-6、白细胞介素-8、白细胞介素-10、干扰素诱导蛋白10、肿瘤坏死因子相关凋亡诱导配体、D-二聚体、C反应蛋白和粒细胞集落刺激因子)异质免疫反应生物标志物,无需稀释或样本处理。DETecT脓毒症(Direct Electrochemical Technique Targeting Sepsis)2.0传感器设备利用电化学阻抗谱作为一种技术,来检测金属/半导体传感器界面处的细微结合相互作用,并仅使用两滴(约100微升)血液在5分钟内报告结果。使用40份患者样本进行临床转化时,该设备与实验室参考标准LUMINEX呈正相关(>0.87)。所开发的设备显示出大于80%的诊断准确率(曲线下面积>0.8),建立了出色的特异性和敏感性反应。便携式手持且用户友好的特性,再加上对免疫生物标志物的精确量化,使得该设备适用于多种场景,能够提供有关患者免疫反应的见解。这项工作突出了一种创新解决方案,即在脓毒症护理的连续过程中缺乏决策支持设备的情况下,加强脓毒症的护理和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d25e/9471994/2dfa94e0bf1e/BTM2-7-e10310-g006.jpg

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