Institute of NanoEngineering and Microsystems, National Tsing Hua University, Hsinchu, Taiwan.
Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Anal Chim Acta. 2023 Nov 15;1281:341879. doi: 10.1016/j.aca.2023.341879. Epub 2023 Oct 12.
Total joint arthroplasty (TJA) has significantly improved the quality of life for millions suffering from end-stage arthritis. However, periprosthetic joint infections (PJI) remain a serious complication, necessitating extensive interventions and prolonged antimicrobial treatments. The aging population is expected to lead to a rise in TJA cases, subsequently increasing the incidence of PJI, particularly in the elderly who face higher mortality rates. Current diagnostic methods for suspected PJI, such as radiographs and biochemical markers like CRP and ESR, exhibit limited sensitivity. Therefore, there is a critical need for a specific synovial fluid biomarker assay to enhance PJI diagnosis using specific SF-based assay.
This study introduces a novel microfluidic chip with a paper-based aptamer-sandwich assay for the quantitative detection of HNP 1, a crucial PJI biomarker, in synovial fluid. The assay leverages the advantages of aptamers over antibodies, demonstrating high selectivity and affinity for target molecules. The integration of a nitrocellulose (NC) membrane onto the microfluidic platform represents a significant advancement, reducing background signals and simplifying the assay procedure without intricate procedure and pre-treatment. The NC membrane-based microfluidic device offers rapid, cost-effective, and highly sensitive detection of HNP 1, with a limit of detection of 0.5 mg L. The microfluidic device demonstrates exceptional performance, detecting up to four clinical samples in approximately 42 min on a single chip with 100 % accuracy, as confirmed by analysis of 12 clinical samples and comparison with "gold-standard". Moreover, the assay exhibits a wide dynamic range of 0.5-100 mg L-1, underscoring its potential as a powerful tool for PJI diagnosis in clinical settings.
This work introduces a paper-based microfluidic system tailored for rapid HNP 1 detection using synovial fluid near joint region (and not serum via blood) for better diagnosis. The innovative paper-based aptamer-sandwich assay yields results within 42-min. Significantly, it boasts a wide dynamic range, detecting levels from an impressive 0.5 mg L-1, crucial in the 2.6 mg L-1 threshold region. This heightened sensitivity and expansive detection capability establish our assay as a leader in PJI diagnostics, promising unmatched precision and efficiency in clinical applications.
全关节置换术（TJA）显著提高了数百万晚期关节炎患者的生活质量。然而，假体周围关节感染（PJI）仍然是一种严重的并发症，需要广泛的干预和长期的抗菌治疗。预计人口老龄化将导致 TJA 病例增加，从而增加 PJI 的发病率，特别是在死亡率较高的老年人中。目前用于疑似 PJI 的诊断方法，如 X 光和 CRP 和 ESR 等生化标志物，其灵敏度有限。因此，迫切需要一种特定的滑膜液生物标志物检测方法，以使用特定的基于 SF 的检测方法提高 PJI 的诊断。
本研究介绍了一种新型的微流控芯片，该芯片采用基于纸的适体夹心检测法，用于定量检测关节滑液中的重要 PJI 生物标志物 HNP 1。该检测法利用适体优于抗体的优点，对靶分子表现出高选择性和亲和力。将硝酸纤维素（NC）膜集成到微流控平台上是一个重大的进步，它减少了背景信号，简化了检测程序，无需复杂的程序和预处理。基于 NC 膜的微流控装置可快速、经济高效地检测 HNP 1，检测限为 0.5 mg L。该微流控装置具有出色的性能，在单个芯片上可在大约 42 分钟内检测多达四个临床样本，准确率为 100%，这一点已通过对 12 个临床样本的分析和与“金标准”的比较得到证实。此外，该检测法的动态范围为 0.5-100 mg L-1，这表明它有潜力成为临床环境中 PJI 诊断的有力工具。
本工作介绍了一种针对关节附近区域（而非通过血液从血清中）的滑膜液中快速检测 HNP 1 的基于纸的微流控系统，用于更好的诊断。该创新的基于纸的适体夹心检测法可在 42 分钟内得到结果。重要的是，它具有很宽的动态范围，可检测到 0.5 mg L-1 的令人印象深刻的水平，在 2.6 mg L-1 的阈值区域至关重要。这种更高的灵敏度和广泛的检测能力使我们的检测法成为 PJI 诊断领域的佼佼者，在临床应用中提供无与伦比的精度和效率。
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