A simplified algorithm to evaluate the risk of submucosal invasive cancer in large (>/=20mm) non-pedunculated colonic polyps.

BACKGROUND AND AIMS: Recognition of submucosal invasive cancer (SMIC) in large (20mm) non-pedunculated colonic polyps (LNPCPs) informs selection of the optimal resection strategy. LNPCP location, morphology and size influence the risk of SMIC, however currently no meaningful application of this information has simplified the process to make it accessible and broadly applicable. We developed a decision-making algorithm to simplify the identification of LNPCP subtypes with increased risk of potential SMIC. METHODS: Patients referred for LNPCP resection from September 2008-November 2022 were enrolled. LNPCPs with SMIC were identified from endoscopic resection specimens, lesion biopsies, or surgical outcomes. Decision tree analysis of lesion characteristics identified in multivariable analysis was used to create a hierarchical classification of SMIC prevalence. RESULTS: 2451 LNPCPs were analysed. 1289 (52.6%) were flat, 1043 (42.6%) nodular and 118 (4.8%) depressed. SMIC was confirmed in 273 (11.1%) of LNPCPs and associated with depressed and nodular versus flat morphology (OR 35.7 CI 22.6-56.5 and 3.5 CI 2.6-4.9, p<0.001 respectively); left versus right colon location (OR 3.2, CI 2.5-4.1, p<0.001); non-granular (NG) versus granular (G) (OR 2.4 CI 1.9-3.1, p<0.001) and size (OR 1.12 per 10mm increase CI 1.05-1.19, p<0.001). Decision tree analysis targeting SMIC identified 8 terminal nodes: SMIC prevalence was 62% in depressed LNPCPs, 19% in nodular left colon LNPCPs and 20% in nodular right colon NG LNPCPs. CONCLUSIONS: This decision-making algorithm simplifies identification of LNPCPs with an increased risk of potential SMIC. When combined with surface optical evaluation, it facilitates accurate lesion characterisation and resection choices.

When less is more: lower esophageal sphincter-preserving peroral endoscopic myotomy is effective for non-achalasia esophageal motility disorders.

BACKGROUND: Non-achalasia esophageal motility disorders (NAEMDs), encompassing distal esophageal spasm (DES) and hypercontractile esophagus (HCE), are rare conditions. Peroral endoscopic myotomy (POEM) is a promising treatment option. In NAEMDs, unlike with achalasia, the lower esophageal sphincter (LES) functions normally, suggesting the potential of LES preservation during POEM. METHODS: This retrospective two-center observational study focused on patients undergoing LES-preserving POEM (LES-POEM) for NAEMD. Eckardt scores were assessed pre-POEM and at 6, 12, and 24 months post-POEM, with follow-up endoscopy at 6 months to evaluate for reflux esophagitis. Clinical success, defined as an Eckardt score ≤3, served as the primary outcome. RESULTS: 227 patients were recruited over 84 months until May 2021. Of these, 16 underwent LES-POEM for an NAEMD (9 with HCE and 7 with DES). The median pre-POEM Eckardt score was 6.0 (interquartile range [IQR] 5.0-7.0), which decreased to 1.0 (IQR 0.0-1.8; P<0.001) 6 months post-POEM. This was sustained at 24 months, with an Eckardt score of 1.0 (IQR 0.0-1.8; P<0.001). Two patients (12.5%) developed Los Angeles grade A or B esophagitis. CONCLUSIONS: LES-POEM for NAEMD demonstrates favorable clinical outcomes, with infrequent esophagitis and reintervention for LES dysfunction rarely required.

Hybrid resection versus conventional resection for laterally spreading lesions of the papilla.

BACKGROUND AND AIMS: Although conventional hot snare resection (CR) of laterally spreading lesions of the major papilla (LSL-Ps) is effective, it can be associated with delayed bleeding in upward of 25% of cases. Given the excellent safety profile of cold snare polypectomy in the colorectum, we investigated the efficacy and safety of a novel hybrid resection (HR) technique for LSL-P management, consisting of hot snare papillectomy plus cold snare resection of the laterally spreading component. METHODS: A prospective cohort of patients underwent HR in a tertiary referral center over 60 months until December 2022. This cohort was compared with a historical cohort of patients who underwent CR at the same institution over 120 months until August 2017. The primary outcomes were recurrence and bleeding. RESULTS: Twenty patients underwent HR (14 female; mean age 65.2 ± 12.2 years). Median lesion size was 30 mm (interquartile range, 25.0-47.5 mm). Recurrent or residual adenoma (RRA) was greater with HR (58.8% [n = 10] vs 29.8% [n = 14]; P = .034). The odds ratio for recurrence was 3.6 times (95% CI, 1.2-11.0) higher with HR (P = .027). RRA was multifocal in 4 (40%) and had a composite RRA volume >10 mm in 7 (70%). The median number of procedures required to treat RRA was higher with HR (4 vs 1, P = .002). There was no difference between CR and HR for intraprocedural bleeding (41.1% [n = 23] vs 25% [n = 5]; P = .587) or delayed bleeding (25.0% vs 10.0%, P = .211). There were no perforations. CONCLUSIONS: The novel HR technique for LSL-P management is associated with a high rate of RRA that is recalcitrant to treatment, without mitigating the risk of intraprocedural or delayed bleeding. Therefore, CR should remain the mainstay management option for treating patients with an LSL-P. (Clinical trial registration number: NCT02306603.).

Innovative, Flexible, and Miniaturized Microfluidic Paper-Based Plasmonic Chip for Efficient Near-Infrared Metal Enhanced Fluorescence Biosensing and Imaging.

The implementation of metal enhanced fluorescence (MEF) as an efficient detection tool, especially in the near-infrared region of the electromagnetic spectrum, is a rather new direction for diagnostic analytical technologies. In this context, we propose a novel microfluidic plasmonic design based on paper for efficient MEF detection of the "proof-of-concept" biotin-streptavidin recognition interaction. Our design made use of the benefits of gold nanobipyramids (AuBPs), considering the strong enhanced electromagnetic field present at their sharp tips, and filter paper to operate as a natural microfluidic channel due to excellent wicking abilities. The calligraphed plasmonic paper, obtained using a commercial pen filled with AuBPs, was integrated in a robust sandwich optically transparent polydimethylsiloxane chip, exhibiting portability and flexibility while preserving the chip's properties. To place the Alexa 680 fluorophore at an optimal distance from the nanobipyramid substrate, the human IgG-anti-IgG-conjugated biotin sandwich reaction was employed. Thus, upon the capture of Alexa 680-conjugated streptavidin by the biotinylated system, a 1.3-fold average enhancement of the fluorophore's emission was determined by bulk fluorescence measurements. However, the local enhancement factor was considerably higher with values spanning from 5 to 6.3, as proven by mapping the fluorescence emission under both re-scan microscopy and fluorescence lifetime imaging, endorsing the proposed chip's feasibility for bulk MEF biosensing as well as high-resolution MEF bioimaging. Finally, the versatility of our chip was demonstrated by adapting the biosensing protocol for cardiac troponin I biomarker detection, validated using 10 plasma samples collected from pediatric patients and corroborated with a conventional ELISA assay.

Dual-emissive solid-state histidine-stabilized gold nanoclusters for applications in white-light generation.

The majority of present-day white-light emitting devices (WLEDs) are built upon the use of rare-earth elements, which have a short supply, are expensive and can become extremely toxic. Thus, in this work, we synthesized an eco-friendly, efficient and cheap white-light emitting material (WLEM) based on solid-state histidine-stabilized gold nanoclusters (His-AuNCs), obtained through the lyophilization of microwave-synthesized photoluminescent His-AuNCs. Their morphological and structural characterization was followed by thorough evaluation of their intrinsic solid-state photoluminescence properties via steady-state and time-resolved fluorescence spectroscopy and microscopy, at multiple excitation wavelengths. A white-light emission was observed under UV light excitation due to the two-band broad emission, with maxima at 475 and 520 nm, covering a large area of the visible spectrum. In order to evaluate the purity of the white-light emission we calculated the chromaticity coordinates, at different wavelengths, and displayed them on a CIE (Commision Internationale d'Eclairage) diagram. An excellent value of (0.36, 0.33) was found at 420 nm excitation, which falls within the range of pure white-light emission. Moreover, the His-AuNCs show great photo- and thermo-stability, thus proving their ability to perform as a reliable WLEM with potential use in the development of eco-friendly WLEDs.

The Surface Morphology of Large Nonpedunculated Colonic Polyps Predicts Synchronous Large Lesions.

BACKGROUND & AIMS: Large (≥20 mm) nonpedunculated colorectal polyps (LNPCPs) may have synchronous LNPCPs in up to 18% of cases. The nature of this relationship has not been investigated. We aimed to examine the relationship between individual LNPCP characteristics and synchronous colonic LNPCPs. METHODS: Consecutive patients referred for resection of LNPCPs over 130 months until March 2022 were enrolled. Serrated lesions and mixed granularity LNPCPs were excluded from analysis. Patients with multiple LNPCPs resected were identified, and the largest was labelled as dominant. The primary outcome was the identification of individual lesion characteristics associated with the presence of synchronous LNPCPs. RESULTS: There were 3149 of 3381 patients (93.1%) who had a single LNPCP. In 232 (6.9%) a synchronous lesion was detected. Solitary lesions had a median size of 35 mm with a predominant Paris 0-IIa morphology (42.9%) and right colon location (59.5%). In patients with ≥2 LNPCPs, the dominant lesion had a median size of 40 mm, Paris 0-IIa (47.6%) morphology, and right colon location (65.9%). In this group, 35.8% of dominant LNPCPs were non-granular compared with 18.7% in the solitary LNPCP cohort. Non-granular (NG)-LNPCPs were more likely to demonstrate synchronous disease, with left colon NG-LNPCPs demonstrating greater risk (odds ratio, 4.78; 95% confidence interval, 2.95-7.73) than right colon NG-LNPCPs (odds ratio, 1.99; 95% confidence interval, 1.39-2.86). CONCLUSIONS: We found that 6.9% of LNPCPs have synchronous disease, with NG-LNPCPs demonstrating a greater than 4-fold increased risk. With post-colonoscopy interval cancers exceeding 5%, endoscopists must be cognizant of an individual's LNPCP phenotype when examining the colon at both index procedure and surveillance. CLINICALTRIALS: gov, NCT01368289; NCT02000141; NCT02198729.

Photoluminescent Histidine-Stabilized Gold Nanoclusters as Efficient Sensors for Fast and Easy Visual Detection of Fe Ions in Water Using Paper-Based Portable Platform.

Herein is presented a novel and efficient portable paper-based sensing platform using paper-incorporated histidine stabilized gold nanoclusters (His-AuNCs), for the sensitive and selective detection of Fe ions from low-volume real water samples based on photoluminescence (PL) quenching. Highly photoluminescent colloidal His-AuNCs are obtained via a novel microwave-assisted method. The His-AuNCs-based sensor reveals a limit of detection (LOD) as low as 0.2 µM and a good selectivity towards Fe ions, in solution. Further, the fabricated portable sensing device based on paper impregnated with His-AuNCs proves to be suitable for the easy detection of hazardous Fe levels from real water samples, under UV light exposure, through evaluating the level of PL quenching on paper. Photographic images are thereafter captured with a smartphone camera and the average blue intensity ratio (I/I0) of the His-AuNCs-paper spots is plotted against [Fe2+] revealing a LOD of 3.2 µM. Moreover, selectivity and competitivity assays performed on paper-based sensor prove that the proposed platform presents high selectivity and accuracy for the detection of Fe ions from water samples. To validate the platform, sensing assays are performed on real water samples from local sources, spiked with 35 µM Fe ions (i.e., Fe2+). The obtained recoveries prove the high sensitivity and accuracy of the proposed His-AuNCs-paper-based sensor pointing towards its applicability as an easy-to-use, fast, quantitative and qualitative sensor suitable for on-site detection of toxic levels of Fe ions in low-volume real water samples.

Alarming increase of NASH as cause of liver cancer.

A very interesting recent article by Huang and colleagues evaluated the global epidemiology of liver cancer from 2010 to 2019 and showed that non-alcoholic steatohepatitis (NASH) is the fastest growing cause of hepatocellular carcinoma (HCC).1.

Glutathione-capped gold nanoclusters as near-infrared-emitting efficient contrast agents for confocal fluorescence imaging of tissue-mimicking phantoms.

An innovative research has been conducted focused on demonstrating the ability of novel dual-emissive glutathione-stabilized gold nanoclusters (GSH-AuNCs) to perform bright near-infrared (NIR)-emitting contrast agents inside tissue-mimicking agarose-phantoms via two complementary confocal fluorescence imaging techniques. First, using a new and fast microwave-assisted approach, we synthesized photostable dual-emitting GSH-AuNCs with an average size of 3.2 ± 0.4 nm and NIR emission quantum yield of 9.9%. Steady-state fluorescence measurements coupled with fluorescence lifetime imaging microscopy (FLIM) assays performed on lyophilized GSH-AuNCs revealed that the obtained GSH-AuNCs exhibit PL emissions at 610 nm (red PL) and, respectively, 800 nm (NIR PL) in both solution and powder solid-state. Time-resolved fluorescence measurements showed that the two PL components are characterized by average lifetimes of 407 ns (red PL) and 1821 ns (NIR PL), respectively. Additionally, due to a partial overlap between the red PL and the absorption of the NIR PL, an energy transfer between the two coexisting emissive centers was discovered and confirmed via steady-state and time-resolved fluorescence measurements. Furthermore, the FLIM analysis performed on powder GSH-AuNCs under 640 nm, an excitation more suitable for bioimaging applications, revealed a homogeneous and photostable NIR PL signal from GSH-AuNCs. Finally, the ability of GSH-AuNCs to operate as reliable NIR-emitting contrast agents inside tissue-mimicking agarose-phantoms was demonstrated here for the first time via complementary FLIM and re-scan confocal fluorescence imaging techniques. In consequence, GSH-AuNCs show great promise for future in vivo imaging applications via confocal fluorescence microscopy.

Cardiac Troponin Biosensor Designs: Current Developments and Remaining Challenges.

Acute myocardial infarction (AMI) is considered as one of the main causes of death, threating human lives for decades. Currently, its diagnosis relies on electrocardiography (ECG), which has been proven to be insufficient. In this context, the efficient detection of cardiac biomarkers was proposed to overcome the limitations of ECG. In particular, the measurement of troponins, specifically cardiac troponin I (cTnI) and cardiac troponin T (cTnT), has proven to be superior in terms of sensitivity and specificity in the diagnosis of myocardial damage. As one of the most life-threatening conditions, specific and sensitive investigation methods that are fast, universally available, and cost-efficient to allow for early initiation of evidence-based, living-saving treatment are desired. In this review, we aim to present and discuss the major breakthroughs made in the development of cTnI and cTnT specific biosensor designs and analytical tools, highlighting the achieved progress as well as the remaining challenges to reach the technological goal of simple, specific, cheap, and portable testing chips for the rapid and efficient on-site detection of cardiac cTnI/cTnT biomarkers in order to diagnose and treat cardiovascular diseases at an incipient stage.

Probing polyvinylpyrrolidone-passivated graphene oxide nanoflakes as contrast agents inside tissue-like phantoms via multimodal confocal microscopy.

Beside attractive electrical, thermal and mechanical properties, graphene oxide (GO) exhibits visible and near-infrared (NIR) photoluminescence (PL) and well-defined fingerprint Raman bands which are remarkable optical signatures to implement GO as new contrast agent for the visualization of cells or tissue, including cancer tumors. However, the biomedical use of GO as optical contrast agent is to some extent hindered by the intrinsic low emission efficiency especially at neutral pH. Herein, we successfully modulate the PL of GO nanoflakes in acidic and neutral medium by passivating them with polyvinylpyrrolidone (PVP), an amphiphilic and biocompatible polymer, thus improving the PL at pH relevant for biomedical applications. We demonstrate the potential of as-fabricated PVP-GO nanocomposites to operate as dual Raman-PL contrast agents inside tissue-like agarose-phantoms via scanning confocal Raman microscopy (CRM) under excitation at 532 nm. Super-resolution re-scan confocal microscopy (RCM) was further employed to investigate the distribution of PVP-GO inside biological phantoms at 3D level under three excitation lines (405, 488, and 561 nm). Finally, two-photon excited fluorescence lifetime imaging microscopy (TPE-FLIM) at 810 nm excitation reveals the ability of PVP-GO to serve as NIR-activatable contrast agent inside tissue-like phantom. Notably, PVP coating empowers GO nanoflakes not only with enhanced optical signature, but also with excellent dispersibility inside biological phantoms, thus offering improved labeling performance of as-designed imaging contrast agent.

Do MAFLD Patients with Harmful Alcohol Consumption Have a Different Dietary Intake?

The term metabolic-associated fatty liver disease (MAFLD) has been proposed to define positively fatty liver disease in the form associated with metabolic risk factors. The aim of this study was to assess the dietary intake of MAFLD and explore a possible relationship between its inflammatory characteristics (assessed by Dietary Inflammatory Index-DII®), the degree of liver fibrosis (assessed by transient elastography), and the amount of alcohol intake. MAFLD patients were included (n = 161) and were classified, according to the amount of alcoholic intake, as MAFLD without alcohol intake (n = 77) and MAFLD with alcohol intake (n = 84), with 19 presenting harmful alcoholic consumption. Dietary intake was 1868 ± 415 kcal/day and did not present differences in energy or nutrient intake based on the presence of metabolic comorbidities. Patients with MAFLD and alcohol intake consumed significantly more energy and presented a tendency for higher intake of carbohydrates and sugar. Patients with harmful alcohol intake presented a higher intake of total fat and cholesterol compared with moderate alcohol intake. There were no differences in DII® based on fibrosis severity or the amount of alcohol consumption. This work contributes to the characterization of baseline dietary intake in MAFLD patients, paving the way to design more suited dietary interventional trials.

Gold nanoclusters performing as contrast agents for non-invasive imaging of tissue-like phantoms via two-photon excited fluorescence lifetime imaging.

Recently, gold nanoclusters (AuNCs) have received considerable scientific interest due to their ability to generate intrinsic photoluminescence (PL), making them suitable for a wide range of applications, such as sensing, biolabeling and bioimaging. Fluorescence lifetime imaging microscopy (FLIM) is an extremely promising technique when it comes to tissue imaging, especially once combined with near-infrared two-photon excitation (TPE) due to deep tissue penetration and improved spatial resolution. In this paper, we carried out an innovative study on the ability of bovine serum albumin stabilized gold nanoclusters (BSA-AuNCs) to perform as reliable label-free contrast agents for the visualization of tissue-like agarose phantoms via TPE-FLIM. We prove that BSA-AuNCs exhibit uniform and reproducible TPE PL in the first biological window, when embedded in phantoms, under 820 nm excitation provided by a Ti:Sapphire pulsed laser. The two-photon origin of the emission signal inside the phantom is demonstrated by the quadratic dependence of the PL intensity on the excitation power. Moreover, we focused on the evaluation of BSA-AuNCs' potential as contrast agents at different concentrations inside phantoms, simulating an ex vivo environment, at three NIR excitation wavelengths, in view of defining the optimal experimental conditions for future real-tissue imaging assays. The present study aims at translating our previous results on the successful performance of BSA-AuNCs as contrast agents for in vitro FLIM imaging, using visible light, towards non-invasive ex vivo NIR imaging applications. Besides the advantageous use of the combined techniques TPE-FLIM, the novelty of our work consists of demonstrating for the first time the capacity of BSA-AuNCs to perform as bright contrast agents inside cancer-tissue mimicking phantoms. We prove that BSA-AuNCs show great promise as fluorescent contrast agents for TPE-FLIM towards image-assisted tumor surgery.

Intrinsic Photoluminescence of Solid-State Gold Nanoclusters: Towards Fluorescence Lifetime Imaging of Tissue-Like Phantoms Under Two-Photon Near-Infrared Excitation.

Gold nanoclusters (AuNCs) have attracted extensive attention as light-emissive materials with unique advantages such as high photostability, large Stoke shifts and low toxicity. However, a better understanding of their solid-state photoluminescence properties is still needed. Herein, we investigated for the first time the intrinsic photoluminescence properties of lyophilized bovine serum albumin stabilized AuNCs (BSA-AuNCs) via fluorescence lifetime imaging microscopy (FLIM) studies performed under both one and two photon excitations (OPE and TPE) on individual microflakes, combined with fluorescence spectroscopic investigations. Both in solution and solid-state, the synthesized BSA-AuNCs exhibit photoluminescence in the first biological window with an absolute quantum yield of 6% and high photostability under continuous irradiation. Moreover, under both OPE and TPE conditions, solid BSA-AuNCs samples exhibited a low degree of photobleaching, while FLIM assays prove the homogeneous distribution of the photoluminescence signal inside the microflakes. Finally, we demonstrate the ability of BSA-AuNCs to perform as reliable bright and photostable contrast agents for the visualization of cancer tissue mimicking agarose-phantoms using FLIM approach under non-invasive TPE. Therefore, our results emphasize the great potential of the as synthesized BSA-AuNCs for ex vivo and in vivo non-invasive NIR imaging applications.

Novel (Phenothiazinyl)Vinyl-Pyridinium Dyes and Their Potential Applications as Cellular Staining Agents.

We report here the synthesis and structural characterization of novel cationic (phenothiazinyl)vinyl-pyridinium (PVP) dyes, together with optical (absorption/emission) properties and their potential applicability as fluorescent labels. Convective heating, ultrasound irradiation and mechanochemical synthesis were considered as alternative synthetic methodologies proficient for overcoming drawbacks such as long reaction time, nonsatisfactory yields or solvent requirements in the synthesis of novel dye (E)-1-(3-chloropropyl)-4-(2-(10-methyl-10H-phenothiazin-3-yl)vinyl)pyridin-1-ium bromide 3d and its N-alkyl-2-methylpyridinium precursor 1c. The trans geometry of the newly synthesized (E)-4-(2-(7-bromo-10-ethyl-10H-phenothiazin-3-yl)vinyl)-1-methylpyridin-1-ium iodide 3b and (E)-1-methyl-4-(2-(10-methyl-10H-phenothiazin-3-yl)vinyl)pyridin-1-ium tetrafluoroborate 3a' was confirmed by single crystal X-ray diffraction. A negative solvatochromism of the dyes in polar solvents was highlighted by UV-Vis spectroscopy and explanatory insights were supported by molecular modeling which suggested a better stabilization of the lowest unoccupied molecular orbitals (LUMO). The photostability of the dye 3b was investigated by irradiation at 365 nm in different solvents, while the steady-state and time-resolved fluorescence properties of dye 3b and 3a' in solid state were evaluated under one-photon excitation at 485 nm. The in vitro cytotoxicity of the new PVP dyes on B16-F10 melanoma cells was evaluated by WST-1 assay, while their intracellular localization was assessed by epi-fluorescence conventional microscopy imaging as well as one- and two-photon excited confocal fluorescence lifetime imaging microscopy (FLIM). PVP dyes displayed low cytotoxicity, good internalization inside melanoma cells and intense fluorescence emission inside the B16-F10 murine melanoma cells, making them suitable staining agents for imaging applications.

One-photon excited photoluminescence of gold nanospheres and its application in prostate specific antigen detection via fluorescence correlation spectroscopy (FCS).

Gold nanoparticles are known to exhibit appealing intrinsic plasmon-modulated photoluminescence (PL) properties which can be explored in various fluorescence-based sensing applications. In this paper, we evaluate the PL of different-sized gold nanospheres (AuNSs) under one-photon excitation (1PE) and develop a sensitive homogeneous immunoassay for the detection of prostate specific antigen (PSA) in colloidal suspension via fluorescence correlation spectroscopy (FCS). The 1PE PL of AuNSs of three different sizes are evaluated in solution phase under excitation at 405 nm via steady-state fluorescence spectroscopy measurements, while FCS analysis emphasizes the feasibility of using 1PE PL properties to monitor their diffusion behavior. Fluorescence lifetime imaging microscopy (FLIM) assays coupled with PL spectral profile analysis performed on single-particles-like structures conform the plasmonic origin of the detected PL and validate their potential of synthesized AuNSs as fluorescent probes in bioimaging and bioassays. Finally, to the best of our knowledge, we provide the first demonstration of the successful use of the 1PE PL of the synthesized AuNSs as probes for the FCS-based one-step label-free sensitive optical detection of PSA biomarker. The approach consisting in monitoring the diffusion of the AuNSs-oligomers induced by the interaction of anti-PSA-conjugated AuNSs with PSA molecules is successfully validated for the detection of PSA levels as low as 4.4 ng/ml in solution. Considering that the development of rapid, efficient and label-free biosensing methods is of continuous interest nowadays, we are confident that our results may have a strong impact on medicine towards more efficient, sensitive and reliable diagnosis.

Folic acid functionalized gold nanoclusters for enabling targeted fluorescence imaging of human ovarian cancer cells.

Photoluminescent gold nanoclusters have attracted an extensive research interest in bioimaging and therapeutics due to several distinctive advantages such as high fluorescent photostability, good dispersibility, low toxicity and large Stokes shift. However, a better understanding of the correlation between optical properties in various environments and their uptake by specific cancer cells is still needed. Herein, we developed bovine serum albumin stabilized gold nanoclusters (BSA-AuNCs) with an intrinsic tunable photoluminescence emission in the first biological window. The as-synthetized BSA-AuNCs agents consists in protein polymerized-chains dopped with AuNCs with an average size of 2-3 nm and were found to exhibit relevant properties as high photostability, temperature-dependent and excitation induced tunable red photoluminescence. The photostable BSA-AuNCs were functionalized with folic acid (FA-BSA-AuNCs) in order to achieve for the first time an active targeting of NIH:OVCAR-3 human ovarian adenocarcinoma cells, via AuNCs, towards bioimaging applications. After confirming their biocompatibility up to a concentration of 40 mg/ml, the improved cellular uptake and staining ability of FA-BSA-AuNCs compared to the BSA-AuNCs was validated by conventional wide-field epi-fluorescence microscopy, while the intracellular localization was monitored by confocal fluorescence lifetime imaging microscopy (FLIM). Considering their valuable intrinsic photoluminescent properties, the synthesized FA-BSA-AuNCs hold great promise for direct application in cellular imaging as efficient contrast agents towards early cancer diagnosis and image-guided therapy of cancer.