The background description provided herein is for the purpose of generally presenting the context of the disclosure. Work of the presently named inventors, to the extent it is described in this background section, as well as aspects of the description that may not otherwise qualify as prior art at the time of filing, are neither expressly nor impliedly admitted as prior art against the present disclosure.
Systemic pro-inflammatory illnesses, such as sepsis, systemic inflammatory response syndrome (SIRS), acute respiratory distress syndrome (ARDS), cytokine release syndrome (CRS), resulting from infection, trauma, burns, surgery, cancer immune therapy, and severe allergy pose serious threats to human health leading to organ dysfunction, organ failure, or mortality. The highly complex and dynamic nature of the immune system experiencing acute inflammation makes it challenging to provide timely precision medicine based therapies. Challenge also exists in providing precision therapies for chronic inflammatory diseases such as inflammatory bowel disease, arthritis, and others. Early identification, trajectory tracking, and precision-health approaches are critical for treating systemic inflammatory illnesses. There is a need for precision diagnosis and treatment of life-threatening and chronic pro-inflammatory disorders at the point of care or injury. Inflammatory and other biologic biomarkers associated with inflammation could greatly aid diagnosis and treatment, but no robust technology to measure such markers exists. In recent years, research efforts have been made for developing point-of-care diagnosis technologies. But existing systems are still premature with limited performance and yet to be implemented in systemic illness analysis outside a hospital setting.
The evolution of biomarker-guided precision-medicine therapies targeting specific pathological processes has advanced rapidly, based on a greater understanding of genomic, molecular, and cellular data of an individual patient. With increasing mortality attributed to hundreds of cancer-related diseases, researchers have explored new precision-medicine approaches for these diseases and shown their great promise to guide clinicians in making viable and timely diagnoses and accurate prognoses. In particular, diagnostics guided by prognostic and predictive protein biomarkers in blood offers unprecedented opportunities for discovering cancer at an early stage and continuously monitoring its progression.
Blood-based assays may eliminate cost, time, inconvenience, and invasiveness imposed by conventional cancer screening techniques, such as mammography, colonoscopy, tissue biopsy, radiological imaging, and genetic testing. The early detection of a low-abundant cancer biomarker can significantly reduce cancer mortality and save lives. The conventional “gold standard” methods for such protein biomarker quantification are enzyme-linked immunosorbent assay (ELISA) and bead-based immunoassays, wherein signals are detected by microplate readers. These methods involve sample preparation, incubation with the primary antibody and labeling reagent, along with multiple washing steps; therefore, these methods suffer technological limitations, such as slow detection (˜3-8 h) and consumption of expensive reagents in each assay. Although a large population of people suffers from cancer-related diseases, these methods are not proficient in the frequent monitoring of an individual patient during the treatment, and they require a centralized laboratory involving analytical processes managed by highly trained experts. Therefore, a device allowing the highly-sensitive detection of cancer biomarkers near the patient is essential for continuous cancer monitoring and prognosis, and especially for an early detection.
Point-of-care testing (PoCT) that enables medical/clinical analysis at or near the location of patient care has shown a great potential for precise and personalized health care. PoC systems are to provide fast, cost-effective, and easy-to-use diagnostic testing that shortens the therapeutic turnaround time. Importantly, they are expected to cover patient populations with low socioeconomic status. A potential global market growth from us $23.16 billion in 2016 to us $36.96 billion in 2021, which is estimated based on a compound annual growth rate (CAGR) of 9.8%, truly reflects the future promise of PoCT. Recently, there is a growing interest in PoCT for cancer-related diseases that incorporates nano/biosensors with superior analytical performances and label-free measurement capabilities. However, many of existing biosensors suffer from limited sensitivity. This limits the ability to detect low-abundance (˜pm-level) biomarkers in physiological samples required for diagnosing cancer at a very early stage. Furthermore, achieving high detection accuracy with these biosensors requires high sample purity to suppress background noise due to non-specific binding of blood constituents other than the target biomarker proteins. Therefore, a resource-demanding sample preparation process is needed to isolate purified plasma or serum from whole blood prior to the assay. This process cannot be done by individuals or clinicians at or near the location of the patient, and it poses a major challenge in PoCT using existing biosensors. A biosensor enabling portable, easy-to-operate, high-sensitivity blood protein measurement without sample preparation is imperative for PoCT adoptable in real cancer test.
The present techniques provide novel blood biomarker analysis systems for fast biomarker identification through the use of a multimodal bioassay device capable of operation in the field and health care systems at the point-of-care or near point-of-care. In various examples, biomarker analysis systems include a smartphone-connected, highly portable, pipette-shaped platform device as the bioassay device. In some examples, the biomarker analysis system is trained using machine learning algorithms to detect one or more biomarkers in a very short time window (e.g., in 10 mins or less, in 5 mins or less, or in 1 min or less), with high accuracy.
The biomarker analysis system can therefore be used at the point-of-care, soon after the time of an injury or illness, to allow medical personnel more accurate assessments of a subject's condition and treatment options. The biomarker analysis system may be used at the point-of-care in the intensive care unit (ICU), the general ward, the emergency department, the clinical laboratory, an ambulance, and a remote area under limited resources to detect the early onset and predict outcomes of acute illnesses, such as injury, surgery, sepsis/sepsis shock, asthma, systemic inflammatory response disorder (SIRS), acute respiratory distress syndrome (ARDS), cytokine release syndrome (CRS), and so forth.
In some examples, a smart pipette is provided including a multimodal biomarker sensor and data transmitter. In some examples, the smart pipette includes a wireless data transmitter. In some examples, the smart pipette is part of a biomarker analysis system including a mobile platform, such as a smartphone, that communicates with the smart pipette via the wireless data transmitter to diagnosis biomarker data and generate a biomarker report and/or suggested treatment.
In some examples, the multimodal biomarker sensor is a bioassay implemented in a single channel configuration, where a sample is provided to a single biomarker channel.
In some examples, the multimodal biomarker sensor is a bioassay implemented in a multichannel configuration, where each channel is multiplexed to allow for selectable detection of a different biomarker from the same device. In some examples, the biomarker sensor operates multiple channels simultaneously to allow for multiple different biomarkers to be detected in parallel, for example, at the same time.
In some examples, the biomarker analysis systems include structurally engineered gold nanoparticle biosensor arrays or colloidal nanoparticle biosensors together with atomically thin photoconductive nanosheet channels. These modalities are combined into a highly compact module architecture.
Due to its high-speed, high-sensitivity, and user-friendly operation, the present techniques enable near-real-time bedside monitoring of blood biomarker variations in patients over the course of their systemic illnesses. Patient data can be acquired and transmitted using a smartphone connected with the smart pipette device via Bluetooth. The integration of time-series biomarkers of illness coupled with traditional and nontraditional markers and physiology and organ function, coupled with artificial intelligence techniques like machine learning allows for precision phenotyping and the development of new precision therapies for systemic illnesses and other complex states of inflammation and immune dysfunction.
In an example, a biomarker detector is provided comprising: a sealable housing; an inlet configured to receive fluid; and a sensor device within the sealable housing and communicatively coupled to the inlet to receive the fluid, the sensor further comprising an illumination source, a photodetector array, and a microfluidic chip positioned between the illumination source and the photodetector array, the microfluidic chip comprising a plurality of barcode channels, each barcode channel configured to detect to a different biomarker and each barcode channel configured to affect illumination from the illumination source in response to detection of the respective biomarker, where such affected illumination is detectable by the photodetector array.
In some such examples, a biomarker analysis system having the biomarker detector device further comprises: a mobile computing device external to and configured to wirelessly communication with the biomarker detector device, the mobile computing device having a display and a wireless data transmitter, the mobile computing communicatively coupled to receive biomarker data from the biomarker detector device over a wireless communication link, the mobile computing device having a processor and a memory storing instructions that when executed cause the processor to generate a biomarker report indicating a presence of one or more biomarkers detected by the biomarker detector device and to display the biomarker report on the display of the mobile computing device.
In an example, a biomarker detector device comprises: a sealable housing; an inlet configured to receive fluid; and a biosensor assembly within the sealable housing and communicatively coupled to the inlet to receive the fluid, the biosensor assembly being a multilayered structure comprising an illumination source in a first layer, a photodetector array in a second layer opposing the first layer, and a biosensor in an intermediate layer positioned between the first layer and the second layer, the biosensor being configured with at least one near infrared (NIR) sensitive plasmonic nanoprobe for colorimetric cancer biomarker detection by affecting illumination from the illumination source, where such affected illumination is detectable by the photodetector array.
In an example, a biomarker detector is provided comprising: a sealable housing; an inlet configured to receive fluid; and a sensor device within the sealable housing and communicatively coupled to the inlet to receive the fluid, the sensor further comprising an illumination source, a photodetector array, and a microfluidic chip positioned between the illumination source and the photodetector array, the microfluidic chip comprising a microfluidic chamber holding a sample/colloidal nanoparticle biosensor mixture solution to permit colorimetric analysis of analyte-induced nanoparticle aggregation while it is aligned with the illumination source and the photodetector array in the biomarker detector architecture.
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The figures described below depict various aspects of the system and methods disclosed herein. It should be understood that each figure depicts an embodiment of a particular aspect of the disclosed system and methods, and that each of the figures is intended to accord with a possible embodiment thereof. Further, wherever possible, the following description refers to the reference numerals included in the following figures, in which features depicted in multiple figures are designated with consistent reference numerals.
The present techniques provide blood biomarker analysis systems for fast biomarker identification. In some examples, the blood biomarker analysis system includes a multimodal bioassay device capable of operation in the field, at the point-of-care. The bioassay device may be implemented as a smartphone-connected, highly portable, pipette-shaped platform device, having a multimodal sensor arrangement. The bioassay device may interface with connected computing devices that generate and display medical reports, such as biomarker summary reports based on the bioassay device, for use by medical professionals during patient treatment. The biomarker analysis system may be trained using machine learning algorithms to detect one or more biomarkers and patterns in a very short time window (e.g., within 10 mins, 5 mins, or lower), with high accuracy, to provide further benefit for emergency and chronic care applications. Thus, in some examples, the present techniques provide a biomarker analysis system can be used at the point-of-care, soon after the time of illness or injury and at the location of the illness or injury, to allow medical personnel more accurate assessments of a subject's condition and treatment options.
In some examples, the biomarker analysis system may be used at the point-of-care in the intensive care unit (ICU), an ambulance, and a remote area under limited resources to detect the early onset and predict outcomes of acute illnesses, and situations where sending blood to a lab for analysis is impractical and may cost lives.
In various examples herein, multimodal bioassay devices are able to sensor for one or more biomarkers associated with a subject's injury, trauma, or other condition. Example biomarkers include cytokines (IL-2, INF-γ, IL-4, IL-10, IL-1β, TNF-α, IL-6), complement system biomarkers (C3a, C5a, C5b-9, Bb, C4d) sepsis biomarkers (CRP PCT, CitH3), lung-injury biomarkers (SPD, sRAGE, KL-6, CC-16, PAI-1, protein C, vWF, HMGB1), brain-injury biomarkers (NSE, S100(3, GFAP, UCHL1, BDNF, NFL), metabolites (D-lactate, histamine), and so forth. Example subject conditions associated with and thus identifiable from these biomarkers include, trauma or surgery-induced injury, sepsis/sepsis shock, asthma, systemic inflammatory response disorder (SIRS), acute respiratory distress syndrome (ARDS), cytokine release syndrome (CRS), acute allergic response, and others.
To facilitate blood draw, the pipette 100 includes a detection tube 104 extending from a sensor end 106 of the pipette 100. The detection tube 104 may be held in place and in a sealed engagement by the housing 102. The detection tube 104 may be formed of plastic (PTFE) and is fixedly connected to a sensor 108 at a proximal end and may include an adaptor, Luer connector, or other engagement it a distal end (not shown) for attaching to a blood drawing system.
In the illustrated example, the sensor 108 is fixedly mounted in the housing portion 102A, for example, against an engagement bottom surface thereof. Opposite the fluid accepting connection to the detection tube, the sensor 108 is coupled to a plunger apparatus 110 adjustable between an initial position and a fluid drawing position. The plunger apparatus 110, for example, may be formed with a push button 112 and spring assembly 114, where pushing the push button 112 toward the housing, activates the spring assembly 114 to draw fluid (e.g., blood) through detection tube 104 into the sensor 108 through suction pressure differential. The housing portions 102A and 102B may be configured to form a sealed engagement around the push button 112, for example, through a sealing rubber ring or other friction-based engagement between the push button 112 and circular receiving opening defined by the housing portions 102A and 102B. In other examples, sealing of an inner chamber of the housing may be achieved by one or more sealing structures 116.
In some examples, the pipette 100 may be a one-time use device, in which the device is discarded after completion of biomarker detection. In some examples, the pipette 100 may be reusable, for example, where the sensor 108 may be removed along with the detection tube 104 and replaced with a replacement sensor and detection tube (
In addition to the sensor, the pipette 100 includes a battery power source 150 and a data transmitter 152 (shown in
The data transmitter 152 may include one or more processors and one or more memories and may be configured, through software, hardware, or some combination thereof, as a wireless transmitter capable of wireless communications according to any suitable communication protocol, including, by way of example, the many variants of IEEE 802.11 (Wi-Fi), MU-MIMO, Wireless ax, Wireless ad, Message Queue Telemetry Transport (MQTT), ZigBEE, ZWave, Thread, Near Field Communication (NFC), Bluetooth (BT), and Bluetooth Low Energy (BLE).
There are numerous conventional sensor technologies in the art, including nanoplasmonic point of care (POC) biosensor technologies, each with numerous shortcomings. Label-free biosensors, for example, have seen growing interest. With the elimination of labeling agents, such as isotopes, fluorophores, and enzymes, label-free biosensors can avoid adverse effects on biomolecular binding events and error due to the inconsistent binding behavior of labels to analytes, which all theoretically saves money and time. Localized surface plasmon resonance (LSPR) nanoplasmonic biosensors, for example, perform label-free biomarker analysis using various types of sensors, including mechanical (microcantilever, acoustic wave, and quartz crystal microbalance mass), electrical (electrochemical impedance spectroscopy, amperometric detection, capacitive affinity detection, nanoelectronic field-effect transistors), optical (photonic crystal, optical resonator), and plasmonic (surface plasmon resonance, localized surface plasmon resonance (LSPR)) sensors. Compared to other label-free sensors, LSPR-based nanoplasmonic biosensors have been shown to be particularly advantageous for POC measurements. They are robust, rapid, cost effective, easy to integrate into miniaturized fluidic devices with simple optics, and well suited for multiplex biomarker measurements. These biosensors are attractive for diagnosing and trajectory monitoring of critically ill patients as they allow for a biomarker measurement within 20-40 minutes. An example implementation of LSPR sensors is described in U.S. Application Ser. No. 62/489,872, entitled, “Systems and Methods For Performing Immunoassays,” and in PCT/US2018/028856, filed Apr. 23, 2018, the entirety of both of which are hereby incorporated by reference. In contrast, non-label-free techniques represented by enzyme-linked immusorbent assay (ELISA) normally require a long assay time and many steps in a centralized clinical laboratory setting. To make the assay time as short as that of label-free biosensing in a miniaturized device (e.g., microfluidic) setting, some research groups have introduced sandwich immunoassay protocols with one-step mixing of all reagents. However, these protocols resulted in 10-1,000-fold reduction of the detection sensitivity as compared to the widely accepted regular ELISA protocol.
Other conventional systems include nanoplasmonic POC immune biosensors. A truly portable and self-containing system should incorporate several key components, including LSPR bionsensing nanostructures, a fluidic system for sample handling, optical components, a light source, a photodetector for signal reading, and a photo-signal processing electronic unit. Table 1 summarizes state-of-the-art LSPR-based POC immunosensor systems found in the literature. The most common detector used for these systems is a smartphone. Because smartphones contain a built-in LED flash light source, a CMOS (complementary metal oxide semiconductor) imager, and embedded central processing and graphics processing units, they facilitate rapid, user-friendly analyte detection and wireless data transmission. At present, >2 billion people possess a smartphone, making smartphone-based signal detection and processing the most rational approach because it would enable the most people, even those in developing countries with limited resources, to access POC systems.
There are many recognized shortcomings of current technology. For example, although the existing POC immune biosensor systems show promise to some degree (some with an impressively short assay time), their implementations in real clinical settings are yet to be realized. Previous work on LSPR-based POC testing largely focused on the development of “proof-of-concept” laboratory prototype devices. None of them have been used for multiplex analysis of sepsis-relevant blood biomarkers in a POC setting. Furthermore, the optical signal detection using a phone camera suffers a relatively low signal-to-noise ratio resulting from a high level of background noise in CMOS image sensors (unlike the photoconductive nanosheet channel-based detection proposed here). Hence, the existing state-of-the-art, portable LSPR POC devices unquestionably have much lower sensitivity than the gold standard ELISA. Biomarker detection for rapidly evolving and dynamic disease states like sepsis must meet more stringent requirements compared to cancer and other chronic disease diagnoses. Specifically, the limit of detection must be at least comparable to that of the gold standard Enzyme-linked immunosorbent assay (ELISA) assays with a much faster sampling-to-answer time of <30 minutes (excluding the serum sample preparation time of ˜30 min). Rapidly detecting biomarkers in highly dynamic diseases such as sepsis within these specifications is not feasible with existing technologies and prototypes. In various examples herein, however, the sensor configurations of smart pipettes are able to overcome these deficiencies in the art.
In the example of
The microfluidic chip 202 may be formed of a substrate formed of poly (methyl methacrylate) (PMMA), polycarbonate (PC), polystyrene (PS), polyvinyl chloride (PVC), polyimide (PI), and the family of cyclic olefin polymers (i.e., cyclic olefin copolymer (COC), cyclic olefin polymer (COP), and cyclic block copolymer (CBC)) and Glass with a rectangular-, cylindrical-, or conical-feature.
In the illustrated example, the microfluidic chip 202 is formed of a substrate 208 that is fed by an inlet channel 210 connected to the detection tube for receiving whole blood, or other fluid, during detection. The downstream of the inlet channel is a plasma separation chamber 212 configured to separate plasma from white blood cells (WBC), red blood cells (RBC), and platelets. The chamber 212 feeds a plasma channel 214 and a remaining fluid channel 216. The plasma channel 214 feeds a multimode biomarker detection chamber 218 having multiple barcode-shaped nanoplasmonic biosensor patterns, each for detecting a different biomarker, a substrate pattern, or a D-Lactate enzymatic reagent pattern. The separation chamber 212 allows for avoiding false positive signals resulting from the settling of WBC, RBC, and platelets within the biomarker detection chamber 218. The separated WBC, RBC, etc. are collected in the cell collecting chamber 220 which is placed next to the biomarker detection chamber 218. The end of the biomarker detector chamber 218 and the cell collecting chamber 220 are connected through the curved channel 222, which is connected to a waste at the end of the pipette tip. Negative pressure from the main pipette body goes into the biomarker detector chamber 218 and the cell collecting chamber 220 through the curved channel 222 to generate the fluidic flow manually. The curved channel 222 may be connected to a plunger apparatus (not shown), such as the plunger 110 through an outlet tubing 223 connected to a receiver end of the plunger apparatus.
In an example, the photodetector array 206 is MoS2 photodetector channel array. A MoS2 photodetector channel array can be formed as a monolayer structure, where a MoS2 monolayer operates as a direct-bandgap semiconductor due to quantum-mechanical confinement. Furthermore, as a monolayer, the direct bandgap structure allows for a high absorption coefficient and efficient electron-hole pair generation under photoexcitation. Furthermore, a MoS2 photodetector channel array can be implemented with a photo-responsiveness across a range of frequencies, including from about 400 nm-about 680 nm, thus allowing for multimodal operation and more accurate operation, in general.
The photodetector array 206 may be configured as a channel array having a pattern that places rows of photodetector elements (arrays) aligned with each of the nanoplasmonic barcode detectors for separate detection of illumination of each of the nanoplasmonic barcodes detectors. In an example, the MoS2 photodetector channel array was formed of an ultrasensitive MoS2 nanosheet photodetector channel arrays on a silicon substrate using a nanofabrication technique, whose signal acquisitions, signal analyses, and data transmissions are achievable by a wirelessly connected smartphone or other portable device. A smartphone application may enable user-friendly, nonresource-demanding quantification of the blood biomarkers.
In examples, the proposed photodetector arrays have high uniformity in their photo-response parameters, such as short-circuit photocurrent (Isc), open-circuit voltage (Voc), and responsivity. The relative detector-to-detector variation of these parameters is <10%, <5%, or <1% over the whole chip.
Any of the sensors with multimodal bioassay chip like that of
Sensors with a multimodal bioassay chip like that of
Major advances in the ability to detect tumor-derived biomarkers in the circulation has driven the development of minimally invasive cancer diagnostic methods called “liquid biopsies”. Sensitive assays capable of detecting rare cancer specific analytes immersed in many analytes derived from normal cells are the key to these advances. The analytes used for liquid biopsy include circulating tumor cells (CTCs), cell-free tumor DNA (ctDNA), proteins, metabolites, exosomes, mRNA, and miRNAs. Many conventional liquid biopsies detect ctDNA indicating genetic alterations because of the ease with which DNA molecules are isolated in comparison to other analytes. However, a major fraction of early-stage tumors does not release detectable amounts of ctDNA, even when extremely sensitive techniques are used to identify them. This has kept liquid biopsy from being readily available for discovering cancers at an early stage. In contrast, the literature shows that many protein biomarkers are potentially useful for early detection and diagnosis of cancer in the literature. For example, carcinoembryonic antigen (CEA), cancer antigen (CA)19-9, prostate-specific antigen (PSA, Pro2PSA), a human epidermal growth factor receptor (HER)2 have been extensively studied as analytes to assess cancers through blood tests. Other cancer biomarkers include AFP, (CA)125, HE4, OVA1 test, ROMA test, (CA)15-2, (CA)27-29, Tg, and hCG. Additionally, these biomarkers have been approved for assessing tumor burden in patients already diagnosed with cancer, particularly during therapy in patients with advanced cancer. Carefully selecting a panel of several protein biomarkers, a recent study has proved that blood test is particularly useful for discriminating cancer patients from healthy controls. This multi-analyte blood test has been shown to yield sensitivity nearly 98% to ovary and liver cancers, and 70% to stomach, pancreas, and esophagus cancers with data obtained from more than 1,000 patients. Advances in mass spectrometry are expected to make a new generation of protein biomarkers for cancer available soon. Multiplexed POCT (i.e., POC test capable of simultaneously detecting multiple analytes) can be used to target the above-mentioned proteins (CEA, CA19-9, PSA, and HER2) for cancer diagnosis.
The research community has seen a growing interest in label-free biomolecular analysis techniques. This interest has emerged along with a wider awareness of technical and practical advantages offered by label-free biosensing. With the elimination of labeling agents, such as isotopes, fluorophores, and enzymes, label-free biosensors can avoid adverse effects on biomolecular binding events and error due to the inconsistent binding behavior of labels to analytes, thus saving money and time. Label-free biomarker analysis has been performed using various types of sensors, including mechanical (microcantilever, acoustic wave, quartz crystal microbalance mass), electrical (electrochemical impedance spectroscopy, amperometric detection, capacitive affinity detection, nanoelectronic field-effect transistors), optical (photonic crystal, optical resonator), and plasmonic (surface plasmon resonance, localized surface plasmon resonance [LSPR]) sensors. Compared to other label-free sensors, LSPR-based nanoplasmonic biosensors are particularly advantageous for POC measurements. In LSPR biosensing, the surface binding of analyte molecules is detected in real time from a shift in photon absorbing and scattering behaviors of collectively oscillating conduction-band electrons highly localized on the surfaces of metallic nanoparticles. These biosensors permit ref ractometric detection of concentration-dependent biomolecular surface binding and sensor miniaturization, both leading to rapid and sample-sparing analyte analysis. They are robust, rapid, and cost effective, making them easy to integrate into miniaturized fluidic devices with simple optics.
Returning to
The mobile platform 504 may be mobile computing device, including a personal computer, tablet, wearable smart device, smartphone, etc. The mobile platform 504 includes a display 520 that may display various displays and interfaces to a user, including, by way of example, a biomarker report 522 and a treatment options report 524. The mobile platform includes a data transmitter 526 and a power source 528, as well as separate processor(s) 530 and memory 532.
In an example, the biomarker system 500 is configured as a point of care sepsis diagnostic system, that provides a self-contained, portable, multi-biomarker detection device in the form of the smart pipette 502 that upon activation, e.g., depression of a triggering plunger, captures target biomarkers at antibodies on barcode surfaces of a sensor, where under controlled illumination, biomarker binding events leading to changes in the LSPR spectral intensity are recorded by nanosheet photodetector channel arrays, and the measured signal change is transmitted to the mobile platform 504 and processed through calibration curves for each of the biomarkers (e.g., IL-1β, PCT, IL-6, and IL-10). As a smartphone, for example, the mobile platform 504 may display concentration values of the biomarkers in the biomarker report 522.
In some examples, the mobile platform includes a machine learning framework 534 that includes machine learning algorithms for analyzing data collected from the sensor 508, such as including levels of circulating biomarkers in blood, as well as other stored and/or sensed data on the mobile platform 504. In some examples, the machine learning framework 534 is configured to augment diagnostic and prognostic accuracy by providing classifiers based on this data to establish a panel of biomarkers enabling personalized or precision medicine in the diagnosis, trajectory monitoring and treatment of sepsis and other inflammatory/immune based disorders. Conventional machine learning algorithms for prediction-based retrospective tests fail to achieve levels of precision that are actionable. However, using machine learning algorithms and time-series detection using the smart pipette and biosensors herein, an accurate machine learning based sepsis diagnosis and suggested treatment medicine system is now achievable. The machine learning framework, for example, may be taught based on a comparison of time-series smart pipette biomarker panel for multiple patient cohorts. Even with small sample size, performing a univariate analysis using logistic regression, allows for evaluation of each biomarker using area under the receiver operating characteristic curve (AUROC) and area under the precision-recall curve (AUPR) using leave one out cross validation. With such configurations, the single most predictive biomarker or a subset combination of biomarkers that provide prediction may be identified. In some examples, such processes are performed by the machine learning framework 534 during training. Further, by performing regularized multivariate logistic regression using all biomarkers and comparing the AUROC and AUPR using leave one out cross validation we have shown the utility of jointly analyzing all biomarkers, as may be further determined as a part of a training process of the machine learning framework 534. From the analysis of a predictive biomarker or a combination of biomarkers that provided prediction, the machine learning framework 534 may then be established with trained classifiers for accurate diagnosis and prediction of the sepsis trajectory, for example, by incorporating clinical variables using enriched data from the electronic medical record (routine laboratory values, vital signs, comorbidities, demographics, and treatments). Further still, in some examples, a non-linear classification process (e.g., gradient-boosting trees) may be used by the machine learning framework 534 to distinguish between biomarker signatures between the sepsis and non-sepsis (but inflammatory) or any other condition under examination. For example, data can be correlated with sepsis severity, treatments, and outcomes, and this can serve as a basis for future trials in the diagnosis and precision phenotyping of sepsis. The machine learning framework 534, as trained, may classify subjects, from their biomarker data from the smart pipette 502, among sepsis patients as classifications: mortality, high sepsis severity, ICU stay >2 days, or need for advanced therapies such as vasopressors, for example. In some examples, the machine learning framework 534 may perform survival analysis using a regularized person-time logistic regression model. Further still, the machine learning framework 534 may be configured to recommend a listing of possible treatment options in the report 524, based on the biomarker data in report 522. In some examples, the mobile platform 504 may communicate with network accessible server 536 for storing biomarker data, biomarker reports, treatment options reports, etc. In some examples, one or more of the processes described herein may be performed by the server 536 interfacing with one or both of the smart pipette 502 or the mobile platform 504, including the processes of the machine learning framework 534 with may alternatively be implemented in the server 536.
The system 500 provides for analysis and diagnosis of staging of a condition, such as sepsis, while allowing delivery of appropriate therapies at dose amounts suitable to the patient's immune response, where those therapies may differ from subject to subject and where the dose amounts may different from subject to subject, as well as during improvement or degradation of the subject's condition.
In some examples, the present techniques provide a biomarker analysis system forming a smartphone-connected, highly portable point-of-care diagnostic platform device. These techniques strategically integrate nanomaterial-based miniature components to form an optoelectronic biosensor pixel. In an example, one component is an optical glass window layer coated with structurally engineered metallic nanoparticle arrays that exhibits biologically tuned nanoplasmonic light absorbance resonance shifts accompanying 1000-fold near-surface electric field enhancement. Another component is a mechanically printed array of two-dimensional few-layered semiconducting transition metal dichalcogenide (TMDC) nanochannels on a silicon substrate that permits high-responsivity, high-quantum-efficiency photoelectronic conversion at extremely low noise (1000 times lower than reported in the literature). Biomarker analysis system integration may be achieved by contactless optical coupling between the two components, which can prevent unwanted electrical shorting during a wet biological measurement.
The smart pipette devices herein enable label-free, concurrent detection of multiple protein biomarkers at unprecedented levels of detectability (LOD<1 pg/mL˜50 fM) and response speed (<10 min) in point-of-care settings. This sensor response speed is equivalent to a total assay time more than 20-100 times shorter than that of the conventional ELISA gold standard technique.
The techniques herein may be implemented in any number of uses owing to their general applicability to assays involving receptor-analyte interactions. The receptor types used in accordance with the present techniques, for example, can be readily extended to a wide variety of antibodies, peptides, and oligonucleotides. This will allow these techniques to be implemented for other biological assays than cytokine protein biomarker analyses, such as receptor-ligand assays, enzyme assays, and DNA assays. In addition to protein binding assay, we have demonstrated that the system allows high-sensitivity on-chip colorimetric measurements of small metabolite molecules (e.g., D-lactate) in one of its assay modality modes.
The biomarker analysis systems herein may be implemented for use at the point of care or near point of care in the intensive care unit (ICU), general ward, emergency department, clinical laboratory, an ambulance, and a remote area under limited resources to detect the early onset and predict outcomes of acute illnesses, such as injury, surgery, sepsis/sepsis shock, asthma, systemic inflammatory response disorder (SIRS), acute respiratory distress syndrome (ARDS), cytokine release syndrome (CRS), and so forth.
The application of the Internet of Things (IoT)-based technologies in medicine promises to advance human healthcare, enabling real-time data acquisition and sharing by means of information networks. The real-time data allow for the monitoring and error-free precision/personalized treatment of patients outside a hospital. This could drastically shift the way of screening and monitoring cancer from a hospital setting-based approach to a personal location-based approach. IoT-based healthcare can monitor human diseases and prevent them at an early stage from advancing to a lethal stage in a “smart city” infrastructure using a network of remotely connected POC or wearable biosensors. For example,
A biosensor-enabled smart diagnostic system connected to the IoT environment opens up incredible opportunities to realize early-stage treatment or prevention of serious conditions caused by cancer-related diseases. A highly portable POC biosensor module enabling ultrasensitive label-free on-chip colorimetric detection of cancer blood biomarkers with no laborious sample preparation/assay procedures could is provided in various examples herein. The POC biosensor module, e.g., the pipette 100, may be adopted for IoT operation by wireless transmission of data to a mobile smartphone. A pipette design is employed for the aimed module so that the system permits easy manual sample loading and manipulation for biomarker detection. As shown in
Over the last decade, many studies have developed LSPR biosensors for POC testing. A truly portable and self-contained system needs to incorporate several key components, including LSPR biosensing nanostructures, a fluidic system for sample handling, optical components, a light source, a photodetector for signal reading, and a photosignal processing electronic unit.
Instead,
With such a device, the detection of cancer embryonic antigen (CEA) is possible in whole blood. As mentioned above, the CEA level (CCEA) is found to be elevated in many cancer-related diseases, which allows CEA to serve as the first analyte in cancer-screening blood tests. A previous study reports that detection of low CCEA in biofluids allows for monitoring early stages of cancer. When a biofluid sample containing CEA was loaded into the micro-chamber, the binding between CEA and anti-CEA-coated AuNPs increased the absorbance of incident light at λ=650 nm. The increased light absorbance decreased the photoconduction in the NIR-MoS2 channel beneath the micro-chamber of the device.
In some examples, the length of the 2D MoS2 channel can be as short as 1 μm,
In an example, the process involves mixing antibody-coated gold nanoparticles (AuNPs) suspended in a buffer solution with whole blood, loading the mixture to the device, incubating the mixture, where aggregation of the AuNPs gets induced by the presence of the analyte proteins in the whole blood, and detecting the near-infrared optical transmission change through the mixture due to the AuNP aggregation using the underlying photodetector. The near-infrared operation allows the photodetector to detect the signal change without any interference from the blood background (blood cells, platelets, and etc.). This leads to the label-free, wash-free analysis requiring any assay steps of sample processing, purification, modification, and washing.
This process involves controlling the thickness of the MoS2 photodetector layer to the optical thickness of 14 nm results in the ultralow-noise photoconductive characteristic of the device, allowing achievement of the very high-sensitivity analyte measurement.
Aspect 1. A biomarker detector device comprising:
Aspect 2. The biomarker detector device of aspect 1, wherein the microfluidic chip is a nanoplasmonic barcode chip having a plurality of different nanoplasmonic barcode detectors.
Aspect 3. The biomarker detector device of aspect 1, wherein each of the barcode channels comprises a different antibody each different antibody selected to capture a different biomarker.
Aspect 4. The biomarker detector device of aspect 3, wherein each barcode channel antibody has an antibody selected to capture one of cytokines, complement system biomarkers, sepsis biomarkers, lung-injury biomarkers, brain-injury biomarkers, and metabolites.
Aspect 5. The biomarker detector device of aspect 3, wherein each barcode channel antibody has an antibody selected to capture one of IL-2, INF-γ, IL-4, IL-10, IL-1β, TNF-α, IL-6, C3a, C5a, C5b-9, Bb, C4d, CRP PCT, CitH3, SPD, sRAGE, KL-6, CC-16, PAI-1, protein C, vWF, HMGB1, NSE, S100β, GFAP, UCHL1, BDNF, NFL, D-lactate, and histamine.
Aspect 6. The biomarker detector device of aspect 1, wherein each barcode channel has an antibody selected to capture a cancer biomarker selected from the group consisting of carcinoembryonic antigen (CEA), cancer antigen (CA)19-9, prostate-specific antigen (PSA), human epidermal growth factor receptor HER2, AFP, (CA)125, HE4, OVA1 test, ROMA test, (CA)15-2, (CA)27-29, Tg, and hCG.
Aspect 7. The biomarker detector device of aspect 1, wherein each barcode channel has an antibody selected to capture a SARS-Cov spike protein or a SARS-Cov-2 spike protein.
Aspect 8. The biomarker detector device of aspect 1, further comprising a plasma separation chamber configured to separate the fluid into plasma and non-plasma, wherein the plasma separation chamber is configured to send the plasma to the microfluidic chip, and wherein the microfluidic chip is a nanoplasmonic barcode chip having a plurality of nanoplasmonic barcode detectors.
Aspect 9. The biomarker detector device of aspect 1, wherein the photodetector array is MoS2 photodetector channel array.
Aspect 10. The biomarker detector device of aspect 1, wherein the illumination source is an organic light emitting diode (OLED) source.
Aspect 11. The biomarker detector device of aspect 1, wherein each barcode channel is configured as a localized surface plasmon resonance (LSPR) nanoplasmonic biosensor, and wherein the each LSPR nanoplasmonic biosensor is equally spaced from at least one other LSPR nanoplasmonic biosensor.
Aspect 12. The biomarker detector device of aspect 1, further comprising a plunger assembly engaged with the sensor and actionable to draw fluid into the inlet upon engagement of a push button of the plunger assembly, wherein a spring activation of the plunger assembly is housed with the housing.
Aspect 13. The biomarker detector device of aspect 1, further comprising a wireless data transmitter within the housing and configured to wirelessly transmit one or more detection signals from the photodetector array and corresponding to one or more different biomarkers detected by one or more of the barcode channels.
Aspect 14. A biomarker analysis system comprising the biomarker detector device of aspect 9 and further comprising:
Aspect 15. The biomarker analysis system of aspect 14, wherein the mobile computing device is a smartphone.
Aspect 16. The biomarker analysis system of aspect 14, further comprising a machine learning framework configured to classify biomarker data based on severity of illness or injury.
Aspect 17. The biomarker analysis system of aspect 14, further comprising a machine learning framework configured to classify biomarker data based on severity of sepsis.
Aspect 18. The biomarker analysis system of aspect 14, further comprising a machine learning framework configured to classify biomarker data based on severity of lung injury.
Aspect 19. The biomarker analysis system of aspect 14, further comprising a machine learning framework configured to classify biomarker data based on severity of brain injury.
Aspect 20. A biomarker detector device comprising:
Aspect 21. The biomarker detector device of aspect 20, wherein the at least one NIR sensitive plasmonic nanoprobe comprises an integrated a microfluidic chamber that suspends plasmonic gold nanoparticles (AuNPs) in a biofluid for the plasmonic nanoprobe and the photodetector is a NIR-two dimensional (2D) MoS2 photodetector operatively positioned to receive the affected illumination from the microfluidic chamber.
Aspect 22. The biomarker detector device of aspect 21, wherein the AuNPs are coated with at least one antibody for targeting a cancer specific biomarker selected from the group consisting of carcinoembryonic antigen (CEA), cancer antigen (CA)19-9, prostate-specific antigen (PSA), human epidermal growth factor receptor HER2, AFP, (CA)125, HE4, OVA1 test, ROMA test, (CA)15-2, (CA)27-29, Tg, and hCG.
Aspect 23. The biomarker detector device of aspect 21, wherein the NIR-2D MoS2 photodetector is a multiple layer structure having a drain and source control structure.
Aspect 24. The biomarker detector device of aspect 23, wherein the multiple layer structure comprises, in layer order, a n-Type graphene layer forming a cathode, a N-Type MoS2 layer, a p-Type MoS2 layer, and a p-Type graphene layer forming an anode.
Aspect 25. The biomarker detector device of aspect 23, wherein the multiple layer structure comprises, in layer order, a gate electrode graphene layer, a dielectric layer, a cathode graphene layer, a N-Type MoS2 layer, a p-Type MoS2 layer, and an anode graphene layer.
Aspect 26. The biomarker detector device of aspect 23, wherein the multiple layer structure comprises, in layer order, a gate electrode graphene layer, a dielectric layer, a cathode graphene layer, a NIR-Transition metal dichalcogenide monolayers (TMDC) photodetector heterostructure, and an anode graphene layer.
Aspect 27. A biomarker detector comprising:
Throughout this specification, plural instances may implement components, operations, or structures described as a single instance. Although individual operations of one or more methods are illustrated and described as separate operations, one or more of the individual operations may be performed concurrently, and nothing requires that the operations be performed in the order illustrated. Structures and functionality presented as separate components in example configurations may be implemented as a combined structure or component. Similarly, structures and functionality presented as a single component may be implemented as separate components. These and other variations, modifications, additions, and improvements fall within the scope of the subject matter herein.
Additionally, certain embodiments are described herein as including logic or a number of routines, subroutines, applications, or instructions. These may constitute either software (e.g., code embodied on a machine-readable medium or in a transmission signal) or hardware. In hardware, the routines, etc., are tangible units capable of performing certain operations and may be configured or arranged in a certain manner. In example embodiments, one or more computer systems (e.g., a standalone, client or server computer system) or one or more hardware modules of a computer system (e.g., a processor or a group of processors) may be configured by software (e.g., an application or application portion) as a hardware module that operates to perform certain operations as described herein.
In various embodiments, a hardware module may be implemented mechanically or electronically. For example, a hardware module may comprise dedicated circuitry or logic that is permanently configured (e.g., as a special-purpose processor, such as a field programmable gate array (FPGA) or an application-specific integrated circuit (ASIC)) to perform certain operations. A hardware module may also comprise programmable logic or circuitry (e.g., as encompassed within a general-purpose processor or other programmable processor) that is temporarily configured by software to perform certain operations. It will be appreciated that the decision to implement a hardware module mechanically, in dedicated and permanently configured circuitry, or in temporarily configured circuitry (e.g., configured by software) may be driven by cost and time considerations.
Accordingly, the term “hardware module” should be understood to encompass a tangible entity, be that an entity that is physically constructed, permanently configured (e.g., hardwired), or temporarily configured (e.g., programmed) to operate in a certain manner or to perform certain operations described herein. Considering embodiments in which hardware modules are temporarily configured (e.g., programmed), each of the hardware modules need not be configured or instantiated at any one instance in time. For example, where the hardware modules comprise a general-purpose processor configured using software, the general-purpose processor may be configured as respective different hardware modules at different times. Software may accordingly configure a processor, for example, to constitute a particular hardware module at one instance of time and to constitute a different hardware module at a different instance of time.
Hardware modules can provide information to, and receive information from, other hardware modules. Accordingly, the described hardware modules may be regarded as being communicatively coupled. Where multiple of such hardware modules exist contemporaneously, communications may be achieved through signal transmission (e.g., over appropriate circuits and buses) that connects the hardware modules. In embodiments in which multiple hardware modules are configured or instantiated at different times, communications between such hardware modules may be achieved, for example, through the storage and retrieval of information in memory structures to which the multiple hardware modules have access. For example, one hardware module may perform an operation and store the output of that operation in a memory device to which it is communicatively coupled. A further hardware module may then, at a later time, access the memory device to retrieve and process the stored output. Hardware modules may also initiate communications with input or output devices, and can operate on a resource (e.g., a collection of information).
The various operations of the example methods described herein may be performed, at least partially, by one or more processors that are temporarily configured (e.g., by software) or permanently configured to perform the relevant operations. Whether temporarily or permanently configured, such processors may constitute processor-implemented modules that operate to perform one or more operations or functions. The modules referred to herein may, in some example embodiments, comprise processor-implemented modules.
Similarly, the methods or routines described herein may be at least partially processor-implemented. For example, at least some of the operations of a method may be performed by one or more processors or processor-implemented hardware modules. The performance of certain of the operations may be distributed among the one or more processors, not only residing within a single machine, but also deployed across a number of machines. In some example embodiments, the processor or processors may be located in a single location (e.g., within a home environment, an office environment or as a server farm), while in other embodiments the processors may be distributed across a number of locations.
The performance of certain of the operations may be distributed among the one or more processors, not only residing within a single machine, but also deployed across a number of machines. In some example embodiments, the one or more processors or processor-implemented modules may be located in a single geographic location (e.g., within a home environment, an office environment, or a server farm). In other example embodiments, the one or more processors or processor-implemented modules may be distributed across a number of geographic locations.
Unless specifically stated otherwise, discussions herein using words such as “processing,” “computing,” “calculating,” “determining,” “presenting,” “displaying,” or the like may refer to actions or processes of a machine (e.g., a computer) that manipulates or transforms data represented as physical (e.g., electronic, magnetic, or optical) quantities within one or more memories (e.g., volatile memory, non-volatile memory, or a combination thereof), registers, or other machine components that receive, store, transmit, or display information.
As used herein any reference to “one embodiment” or “an embodiment” means that a particular element, feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. The appearances of the phrase “in one embodiment” in various places in the specification are not necessarily all referring to the same embodiment.
Some embodiments may be described using the expression “coupled” and “connected” along with their derivatives. For example, some embodiments may be described using the term “coupled” to indicate that two or more elements are in direct physical or electrical contact. The term “coupled,” however, may also mean that two or more elements are not in direct contact with each other, but yet still co-operate or interact with each other. The embodiments are not limited in this context.
As used herein, the terms “comprises,” “comprising,” “includes,” “including,” “has,” “having” or any other variation thereof, are intended to cover a non-exclusive inclusion. For example, a process, method, article, or apparatus that comprises a list of elements is not necessarily limited to only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Further, unless expressly stated to the contrary, “or” refers to an inclusive or and not to an exclusive or. For example, a condition A or B is satisfied by any one of the following: A is true (or present) and B is false (or not present), A is false (or not present) and B is true (or present), and both A and B are true (or present).
In addition, use of the “a” or “an” are employed to describe elements and components of the embodiments herein. This is done merely for convenience and to give a general sense of the description. This description, and the claims that follow, should be read to include one or at least one and the singular also includes the plural unless it is obvious that it is meant otherwise.
This detailed description is to be construed as an example only and does not describe every possible embodiment, as describing every possible embodiment would be impractical, if not impossible. One could implement numerous alternate embodiments, using either current technology or technology developed after the filing date of this application.
This application claims benefit of the filing date of U.S. provisional patent application No. 62/925,369, filed Oct. 24, 2019 and U.S. provisional patent application No. 62/983,069, filed Feb. 28, 2020, which provisional applications are both hereby incorporated by reference in their entirety.
This invention was made with government support under ECCS1708706 awarded by the National Science Foundation. The government has certain rights in the invention.
Filing Document | Filing Date | Country | Kind |
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PCT/US20/57398 | 10/26/2020 | WO |
Number | Date | Country | |
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62983069 | Feb 2020 | US | |
62925369 | Oct 2019 | US |