Toward point-of-care diagnostics: Running enzymatic assays on a photonic waveguide-based sensor chip with a portable, benchtop measurement system.

We demonstrate a portable, compact system to perform absorption-based enzymatic assays at a visible wavelength of 639 nm on a photonic waveguide-based sensor chip, suitable for lab-on-a-chip applications. The photonic design and fabrication of the sensor are described, and a detailed overview of the portable measurement system is presented. In this publication, we use an integrated photonic waveguide-based absorbance sensor to run a full enzymatic assay. An assay to detect creatinine in plasma is simultaneously performed on both the photonic sensor on the portable setup and on a commercial microplate reader for a clinically relevant creatinine concentration range. We observed a high correlation between the measured waveguide propagation loss and the optical density measurement from the plate reader and measured a limit-of-detection of 4.5 µM creatinine in the sensor well, covering the relevant clinical range for creatinine detection.

Rapid Quantification of Plasma Creatinine Using a Novel Kinetic Enzymatic Assay.

BACKGROUND: Enzymatic assays are among the most common diagnostic tests performed in the clinical laboratory. Enzymatic substrate analysis is most commonly measured using endpoint methods; however, modulating the reaction kinetics allows fine control of the reaction rate, which can be adjusted based on specific monitoring technologies. METHODS: We developed and optimized an enzymatic method for measurement of creatinine in plasma, using commonly paired enzymes of creatininase (Crtnnase), creatinase (Crtase), sarcosine oxidase (SOX), ascorbate oxidase (AOX), and horseradish peroxidase (HRP). The novel aspect of the assay is that it is fast and uses SOX as the limiting enzyme. The assay performance was assessed with respect to precision, accuracy, and interferences. RESULTS: The intrarun %CV (n = 12) was approximately 5% for each concentration tested, with biases ranging from -3 to -9%. The interrun %CV (n = 39) ranged from 5 to 8%, with biases ranging from -2 to -6%. During the accuracy assessment (n = 127), only 4 samples did not meet the minimum acceptability criteria. Minimal interference was observed, except at low creatinine concentrations with elevated creatine. CONCLUSION: Our novel and versatile enzymatic assay to measure plasma creatinine using kinetic analysis with SOX as the limiting enzyme is rapid (<2 mins), sensitive, and specific and demonstrates excellent concordance with the laboratory standard. We anticipate this rapid kinetic assay to be compatible with emerging technologies in the field of portable diagnostic devices, such as the usage of silicon photonics to monitor biochemical reactions.

An evaluation of the SD Bioline HIV/syphilis duo test.

Many health agencies now recommend routine HIV and syphilis testing for pregnant women and most-at-risk populations such as men who have sex with men. With the increased availability of highly sensitive, low cost rapid point-of-care tests, the ability to meet those recommendations has increased, granting wider access to quick and accurate diagnoses. Using blood specimens collected from a Baltimore City Health Department (BCHD) sexually transmitted infection clinic, we evaluated the SD Bioline HIV/Syphilis Duo, a rapid test that simultaneously detects antibodies to HIV and syphilis and has the potential to further benefit clinics and patients by reducing costs, testing complexity, and patient wait times. SD DUO HIV sensitivity and specificity, when compared to BCHD results, were 91.7 and 99.5%, respectively. SD DUO syphilis sensitivity and specificity, when compared to rapid plasma reagin, were 85.7 and 96.8%, respectively, and 69.7 and 99.7%, respectively, when compared to Treponema pallidum particle agglutination (TPPA). SD DUO syphilis sensitivity and specificity, when compared to a traditional screening algorithm, improved to 92.3 and 100%, respectively, and improved to 72.9 and 99.7%, respectively, when compared to a reverse screening algorithm. The HIV component of the SD DUO performed moderately well. However, results for the SD DUO syphilis component, when compared to TPPA, support the need for further testing and assessment.

Enhanced Stability of the Fe(II)/Mn(II) State in a Synthetic Model of Heterobimetallic Cofactor Assembly.

Heterobimetallic Mn/Fe cofactors are found in the R2 subunit of class Ic ribonucleotide reductases (R2c) and R2-like ligand binding oxidases (R2lox). Selective cofactor assembly is due at least in part to the thermodynamics of M(II) binding to the apoprotein. We report here equilibrium studies of Fe(II)/Mn(II) discrimination in the biomimetic model system H5(F-HXTA) (5-fluoro-2-hydroxy-1,3-xylene-α,α'-diamine-N,N,N',N'-tetraacetic acid). The homobimetallic F-HXTA complexes [Fe(H2O)6][1]2·14H2O and [Mn(H2O)6][2]2·14H2O (1 = [Fe(II)2(F-HXTA)(H2O)4](-); 2 = [Mn(II)2(F-HXTA)(H2O)4](-)) were characterized by single crystal X-ray diffraction. NMR data show that 1 retains its structure in solution (2 is NMR silent). Metal exchange is facile, and the heterobimetallic complex [Fe(II)Mn(II)(F-HXTA)(H2O)4](-) (3) is formed from mixtures of 1 and 2. (19)F NMR was used to quantify 1 and 3 in the presence of excess M(II)(aq) at various metal ratios, and equilibrium constants for Fe(II)/Mn(II) discrimination were calculated from these data. Fe(II) is preferred over Mn(II) with K1 = 182 ± 13 for complete replacement (2 ⇌ 1). This relatively modest preference is attributed to a hard-soft acid-base mismatch between the divalent cations and the polycarboxylate ligand. The stepwise constants for replacement are K2 = 20.1 ± 1.3 (2 ⇌ 3) and K3 = 9.1 ± 1.1 (3 ⇌ 1). K2 > K3 demonstrates enhanced stability of the heterobimetallic state beyond what is expected for simple Mn(II) → Fe(II) replacement. The relevance to Fe(II)/Mn(II) discrimination in R2c and R2lox proteins is discussed.

Prospective comparison of RT-PCR/ESI-MS to Prodesse ProFlu Plus and Cepheid GenXpert for the detection of Influenza A and B viruses.

RT-PCR/ESI-MS has previously demonstrated the capability to detect and identify respiratory viral pathogens in nasopharyngeal swabs. This study expands on previous research by performing a prospective evaluation of RT-PCR/ESI-MS to detect and identify Influenza A and B viruses compared to Prodesse ProFlu Plus and combined ProFlu Plus and Cepheid Xpert Flu. ProFlu Plus was also used as a gold standard for comparison for respiratory syncytial virus detection. Using ProFlu Plus as a gold standard, RT-PCR/ESI-MS had sensitivity and specificity of 82.1% (23/28) and 100% (258/258), respectively, for Influenza A, 100% (16/16) and 99.6% (269/270), respectively for Influenza B, and 88.6% (39/44) and 99.6% (241/242) for any Influenza virus. Using matching results from ProFlu Plus and Xpert Flu as a gold standard, RT-PCR/ESI-MS had 85.2% (23/27) and 100% (259/259) sensitivity and specificity respectively for Influenza A, 100% (14/14) and 99.6% (270/272), respectively for Influenza B virus. Overall, RT-PCR/ESI-MS was not as sensitive as the combined gold standard of ProFlu Plus and Xpert Flu, although it has the capability of detecting other respiratory viruses.