A fully integrated microfluidic platform for highly sensitive analysis of immunochemical parameters.

We present a novel fully integrated centrifugal microfluidic platform for highly sensitive immunoassays in point-of-care settings. The platform consists of a disposable cartridge containing structures for assay processing, a porous membrane and all dried reagents required for the analysis. Additionally, a blister containing a washing buffer is connected to a new aliquoting structure enabling the serial aliquoting of washing buffer for repetitive bound-free separation steps. The proof-of-concept for two immunoassays is shown in the cartridge with each requiring only 30 µL of whole blood or plasma as the sample material. The detection of the cardiac marker Troponin T with a functional sensitivity of 7.55 ng L-1 (cv = 10%) within 11 minutes is shown based on samples from ten donors which were measured with six breadboard instruments to prove the platform capability for highly sensitive measurements at diagnostic relevant concentrations. Furthermore an assay for the cardiac marker NT-proBNP (five donors, six instruments) with a time-to-result of 12 minutes demonstrates that high-titer analytes (43 to 16.566 ng L-1) can be measured as well. A method comparison of our platform with a state-of-the-art laboratory analyzer proves an excellent correlation of the measured analyte concentrations. All results are obtained from injection moulded cartridges and all components of the platform are compatible for mass production.

A new immunochemistry platform for a guideline-compliant cardiac troponin T assay at the point of care: proof of principle.

BACKGROUND: A multitude of troponin assays for the point-of-care (POC) have been developed showing a lack of analytical sensitivity and precision. We present a new platform solution for the high-sensitivity detection of cardiac troponin T (cTnT) in a 30 µL whole blood sample with a turnaround time of 11 min. METHODS: The immunoassay was completely run in a ready-to-use plastic disposable, a centrifugal microfluidic disc with fully integrated reagents. After the sample application, the assay was automatically processed by separating the cellular blood components via centrifugation, followed by incubation of a defined volume from the generated plasma with the immunoreagents. The fluorescence in the signal zone of a membrane was measured after its washing for the cTnT quantitation. RESULTS: A calibration curve, measured in whole blood samples spiked with native human cTnT, was generated covering a range up to a concentration of approximately 8300 ng/L. The lower detection limit was determined to be 3.0 ng/L. At a concentration of 14 ng/L, the 99th percentile value from the high-sensitivity cardiac troponin T (hs-cTnT) assay in the Elecsys® system, the imprecision (CV) was 3.8%. A CV profile indicated that the functional sensitivity for a CV <10% was 6.8 ng/L. The assay did not show any significant cross-reaction with human skeletal troponin T. We observed an excellent correlation with the hs-TnT Elecsys® assay for 49 clinical plasma samples (r=0.9744). CONCLUSIONS: The described technology shows that an analytical performance for a highly sensitive determination of cTnT can be achieved in a POC setting.

Pre-storage of liquid reagents in glass ampoules for DNA extraction on a fully integrated lab-on-a-chip cartridge.

Self-containing, ready-to-use cartridges are essential for mobile Lab-on-a-Chip (LoaC) systems intended for Point-of-Care (POC) use. Up to now, a common weak point in many LoaC developments is the need to dispense liquid reagents into the test cartridge before or during processing of the assay. To address this issue we have developed an efficient method for fusing liquid reagents into glass ampoules, which are then sealed into a centrifugally operated cartridge. For on-demand reagent release, the ampoules are disrupted through the flexible lid of the cartridge. Upon centrifugation, 98.7 microL out of 100 microL (CV = 2.5%) of the pre-stored contents are released into the microfluidic system. No liquid loss is observed for ethanol and H(2)O stored for 300 days at room temperature. Frozen storage is possible without damage to the ampoules. Applicability of this concept is demonstrated by performing a LoaC integrated DNA extraction after 140 days of reagent pre-storage. DNA yield from 32 microL of whole blood was up to 199 ng, which is 77% of an off-chip reference extraction. The presented approach allows the improvement of existing LoaC cartridges where pre-storage of liquid reagents was not implemented yet.

Microfluidic lab-on-a-foil for nucleic acid analysis based on isothermal recombinase polymerase amplification (RPA).

For the first time we demonstrate a self-sufficient lab-on-a-foil system for the fully automated analysis of nucleic acids which is based on the recently available isothermal recombinase polymerase amplification (RPA). The system consists of a novel, foil-based centrifugal microfluidic cartridge including prestored liquid and dry reagents, and a commercially available centrifugal analyzer for incubation at 37 degrees C and real-time fluorescence detection. The system was characterized with an assay for the detection of the antibiotic resistance gene mecA of Staphylococcus aureus. The limit of detection was <10 copies and time-to-result was <20 min. Microfluidic unit operations comprise storage and release of liquid reagents, reconstitution of lyophilized reagents, aliquoting the sample into < or = 30 independent reaction cavities, and mixing of reagents with the DNA samples. The foil-based cartridge was produced by blow-molding and sealed with a self-adhesive tape. The demonstrated system excels existing PCR based lab-on-a-chip platforms in terms of energy efficiency and time-to-result. Applications are suggested in the field of mobile point-of-care analysis, B-detection, or in combination with continuous monitoring systems.

Centrifugo-pneumatic valve for metering of highly wetting liquids on centrifugal microfluidic platforms.

We designed and experimentally validated a new type of passive valve for centrifugal microfluidic platforms. A liquid column entering an unvented receiving chamber is stopped by the counter-pressure of compressed air. This valve opens under defined conditions at high centrifugal frequencies at which the interface between liquid and air becomes unstable and enables a phase exchange, forwarding the liquid. Burst frequencies of the valve were determined for liquids typically used in biochemical assays: pure water, water with detergent concentrations between 0.01 and 10%, and pure ethanol. Burst frequencies between 8.5 +/- 0.6 and 27.9 +/- 2.0 Hz were measured for different surface tensions. The burst frequencies can be tuned by simple geometrical changes in the valving structure. The valve does not require ultra-precise structures or local surface modifications and is therefore ideal for low-cost microfluidic polymer disks. Potential applications are in the field of multiparameter and panel analysis, such as PCR-genotyping.

[On the necessity of improving the supply network for chronic alcoholics with multiple impairments]. / Uber die Notwendigkeit zur Verbesserung der Versorgungsstrukturen für die Gruppe der chronisch mehrfachbeeinträchtigten Alkoholabhängigen.

OBJECTIVES: Description of care offers for chronic multiple handicapped dependents on alcohol in the service area of the clinic for psychiatry and psychotherapy of the district of Heidenheim and comparison with the situation on the supra-regional and national level ("Länder und Bund"). The present study aims at drawing attention to potential deficiencies as well as analysing the needs of the target group in order to suggest measures for improvement. METHODS: Using a multi-perspective qualitative approach, the authors conducted interviews with experts from 15 institutions, services and associations of the area in question as well as semi-structured interviews with 16 patients undergoing qualified detoxification treatment. In addition, 14 patients being part of a group trying to prevent relapse into alcohol were interviewed to achieve triangulation. RESULTS: With regard to the group of chronic alcoholics with multiple impairements care offers are deficient by reason of insufficient communication within the network of existing institutions, a lack that was also stated by studies carried out on a supra-regional and national level. There is no multi-professional office for coordination and cooperation, whose primary aim should be remedial measures will regard to the lack of home- and day-care treatment e.g. in hospital. Moreover, an inadequate situation as to organizing a patient's day and his leisure activities can be stated. CONCLUSIONS: A case-management-model should be implemented into existing care structures. Patients in need of additional support ought to be given the possibility of day-care treatment. In this context the development of topic-centered qualification- and training programs is required, especially in the field of medical care. In the long run it will be necessary to realize a meeting place for dependents, run both by professionals and volunteers.