Point-of-care technologies for molecular diagnostics using a drop of blood

doi:10.1016/j.tibtech.2014.01.003

Trends in Biotechnology

Volume 32, Issue 3, March 2014, Pages 132-139

https://doi.org/10.1016/j.tibtech.2014.01.003 Get rights and content

Highlights

•
We discuss the frontiers of POC diagnostic technologies using a drop of blood obtained from a finger prick.
•
A great challenge is still required to develop simple, inexpensive, rapid, and easy-to-use technologies for blood molecular diagnostics.
•
Proteins, nucleic acids, and other molecules, as well as downstream molecular analyses based on cancer cells isolated from the blood are surveyed for molecular diagnostics in a drop of blood.
•
Various technologies, including emerging biotechnologies, nanotechnologies, and microfluidics, hold the potential for rapid, accurate, and nonexpensive disease diagnostics.

Molecular diagnostics is crucial for prevention, identification, and treatment of disease. Traditional technologies for molecular diagnostics using blood are limited to laboratory use because they rely on sample purification and sophisticated instruments, are labor and time intensive, expensive, and require highly trained operators. This review discusses the frontiers of point-of-care (POC) diagnostic technologies using a drop of blood obtained from a finger prick. These technologies, including emerging biotechnologies, nanotechnologies, and microfluidics, hold the potential for rapid, accurate, and inexpensive disease diagnostics.

Section snippets

Blood as a target for molecular diagnostics

Blood is a bodily fluid that contains abundant information about the health status of the individual. The average human adult has a blood volume of ∼5 l continuously circulating throughout the body to deliver necessary nutrients and transport metabolic waste [1]. Blood consists of 54.3% plasma, 45% red blood cells (RBCs), and 0.7% white blood cells (WBCs) by volume [2]. Plasma is composed of proteins, nucleic acids, and nutrients or waste products, and it maintains electrolyte balance and

Detection of proteins

Proteins are well known to be required for numerous biological functions and processes, ranging from enzymatic reactions to hormone synthesis, maintenance of metabolic equilibrium, and tissue repair [14]. For clinical applications, levels of certain protein biomarkers directly reflect disease stages and have been regarded as one of the most convenient clinical sources for disease diagnosis. Blood contains >20 000 different proteins, with concentrations ranging from <1 ng/l (troponin) [15] to 50

Detection of nucleic acids

Nucleic acids are the intracellular carriers of genetic information 36, 37, 38, 39 and are also found in small amounts in healthy and diseased human serum [40]. These circulating nucleic acid molecules are thought to be released from dying cells as they break down 41, 42, and their extraction and analysis from a drop of blood provides a relatively noninvasive, highly patient-compliant method for detection of genetic disease states. Current methods for detection of nucleic acids are mainly based

Detection of other types of biomolecules

Other types of biomolecules in blood come from metabolic processes or drug use. The levels of metabolites, including hormones and blood chemicals, are often indicators of disease, whereas the presence of addictive drugs, such as cocaine, in the blood, is often monitored to detect and prevent drug abuse and illicit trafficking [8]. Because of small size or similar chemical structure, commercially available antibodies recognizing these molecules always exhibit high cross-reactivity in

Cell based molecular analyses

Circulating tumor cells (CTCs) shed from the primary tumor site and present in the bloodstream provide a rare model system for potential downstream molecular analyses to understand the mechanism of cancer development. Advanced technologies developed in genomics and proteomics can be further applied to determine the activity patterns of genes and proteins in different types of cancerous or precancerous cells. Such molecular signatures can significantly improve the clinician's ability to diagnose

Concluding remarks and future perspectives

Molecular diagnostics provide the signatures of diseases throughout their development. As more blood biomarkers are discovered, diagnosis of disease by determining levels of proteins, nucleic acids, small molecules, or cell derived molecules in blood remains an exciting area of modern medicine. In this review, we have presented an overview of recent developments in molecular diagnostic technologies that are applicable to a single drop of blood obtained by a simple finger prick. These new

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Trends in Biotechnology

ReviewPoint-of-care technologies for molecular diagnostics using a drop of blood

Highlights

Section snippets

Blood as a target for molecular diagnostics

Detection of proteins

Detection of nucleic acids

Detection of other types of biomolecules

Cell based molecular analyses

Concluding remarks and future perspectives

Surg. Neurol.

Curr. Opin. Microbiol.

Curr. Opin. Chem. Biol.

Mol. Cell. Proteomics

Trends Biotechnol.

Clin. Chim. Acta

Clinical review: hemorrhagic shock

Crit. Care

Essentials of Human Anatomy and Physiology

Pathogenic T-cell recruitment into the airway in human disease

Ann. N. Y. Acad. Sci.

Early nutrition and immunity – progress and perspectives

Br. J. Nutr.

Human Biology and Health

Highlights from the 7th European meeting on molecular diagnostics

Expert Rev. Mol. Diagn.

Point of care diagnostics: status and future

Anal. Chem.

Point-of-care diagnostics for global health

Annu. Rev. Biomed. Eng.

Microfluidic chips for point-of-care immunodiagnostics

Adv. Mater.

Innovations in optical microfluidic technologies for point-of-care diagnostics

Lab Chip

Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes

N. Engl. J. Med.

The human serum proteome: display of nearly 3700 chromatographically separated protein spots on two-dimensional electrophoresis gels and identification of 325 distinct proteins

Proteomics

Point-of-care testing of proteins

Anal. Bioanal. Chem.

Microfluidics-based diagnostics of infectious diseases in the developing world

Nat. Med.

Single-molecule enzyme-linked immunosorbent assay detects serum proteins at subfemtomolar concentrations

Nat. Biotechnol.

Plasmonic ELISA for the ultrasensitive detection of disease biomarkers with the naked eye

Nat. Nanotechnol.

Label-free biomarker detection from whole blood

Nat. Nanotechnol.

Matrix-insensitive protein assays push the limits of biosensors in medicine

Nat. Med.

Integrated barcode chips for rapid, multiplexed analysis of proteins in microliter quantities of blood

Nat. Biotechnol.

Self-powered microfluidic chips for multiplexed protein assays from whole blood

Lab Chip

A paper-based multiplexed transaminase test for low-cost, point-of-care liver function testing

Sci. Transl. Med.

Measuring markers of liver function using a micropatterned paper device designed for blood from a fingerstick

Anal. Chem.

Paper-based ELISA

Angew. Chem. Int. Ed. Engl.

Multiplexed volumetric bar-chart chip for point-of-care diagnostics

Nat. Commun.

A multistage volumetric bar chart chip for visualized quantification of DNA

J. Am. Chem. Soc.

Sensing of proteins in human serum using conjugates of nanoparticles and green fluorescent protein

Nat. Chem.

Tailoring of the nanotexture of mesoporous silica films and their functionalized derivatives for selectively harvesting low molecular weight protein

ACS Nano

Nanostructures in biodiagnostics

Chem. Rev.

A one-step homogeneous immunoassay for cancer biomarker detection using gold nanoparticle probes coupled with dynamic light scattering

J. Am. Chem. Soc.

Gold nanoparticle-enabled biological and chemical detection and analysis

Chem. Soc. Rev.

Initial sequencing and analysis of the human genome

Nature

Review
Point-of-care technologies for molecular diagnostics using a drop of blood