Dengue virus (DENV) is the causative agent of a mosquito-transmitted disease mainly in tropical regions of the earth. Dengue is commonly diagnosed using polymerase chain reaction (PCR) or enzyme-linked immunosorbent assay (ELISA); however, these diagnostic methods both require complicated blood sample preparation, highly trained personnel, and centralized laboratory facilities, all of which are difficult to realize in many clinical settings where resources are limited. In the current study, a novel ultra-sensitive dendrimer-aptamer-based lateral flow assay (LFA) is designed to detect the presence of the DENV by detecting the envelope protein (E-Protein) of the DENV in phosphate-buffered saline (PBS) buffer and bovine serum albumin (BSA) sample. To achieve this, a “bioink”, a muti-handled streptavidin-dendrimer-aptamer conjugation is used to construct the modified test line in order to enhance the capturing efficiency of the signaling gold nanoparticle complexes on the test line. This work is the first time reported aptamer-based LFA of dengue virus detection. Our results show that the new LFA has a limit of detection of 24 pg/mL when tested using samples in PBS buffer (27 pg/mL in BSA solution), which is more sensitive that of a parallel ELISA test of 32 pg/mL and about ten-fold more sensitive than a conventional aptamer-based LFA. In addition, the new LFA shows that no non-specific binding with other E-protein in the flavivirus family and exhibits a long shelf-time for more than five weeks when stored in ambient conditions under subdued light. It can be concluded that the use of “bioink” -- a streptavidin-dendrimer-aptamer -- complex on the T-line can significantly enhance the detection sensitivity of the LFA assay. As a result, it is perceivable that the intrinsic portable, rapid, user-friendly, and cost-effective natures of LFAs in combination with the enhanced sensitivity due to the special fishnet-liked design will find broader applications for the LFAs as an effective and sufficiently sensitive diagnostic tool in many resources limited clinical settings.

Nitrocellulose is currently the most common porous material used in commercially available lateral flow assays. It is, however, unsafe to manufacture and time consuming to incorporate into multi-component assay devices. Precipitated calcium carbonate is a material produced from naturally occurring lime that can be suspended in a binder and extruded onto a surface. This extruded suspension forms a porous coating through which a solution can be wicked. The physical characteristics of three different types of calcium carbonate types were investigated to determine differences that may yield better lateral flow. The capillary flow rate through the coating was found to be largely affected by the calcium carbonate type used, the binder concentration and whether any post-printing treatment was applied, specifically heating the print. Calcium carbonate has a high specific surface area, which results in a high protein binding capacity. To prevent protein binding, pre-treating calcium carbonate particles prior to forming the suspension in a binder was attempted. Pre-treatment with bovine serum albumin, casein or methoxy-PEG phosphate did not show prevention of protein binding. Furthermore, by treating the calcium carbonate particles with a protein before suspension formulation, the wicking rate after printing was found to be diminished. / Thesis / Master of Applied Science (MASc)

<div>The eradication of yaws a neglected tropical disease caused by Treponema pallidum subsp. pertenue, which affects children living in very deprived hard to reach rural communities is constrained by the lack of rapid, accurate diagnosis. I sought to develop a molecular point-of-care test for the diagnosis of yaws. A Loop-mediated isothermal amplification (LAMP) assay with primers targeting the conserved gene, tp0967, with visual detection by lateral flow test strip was developed and optimized. The limit of detection was evaluated while 63 samples from clinical cases of yaws and 5 samples with PCR-confirmed syphilis were used to determine the sensitivity and specificity of the assay compared to the current molecular testing protocol. Reagents were dried in tubes and tested up to 14 days. The developed LAMP assay was found to be optimal when run at 65oC in a water bath for 30 minutes. The limit of detection was 2.7*104 DNA copies/ml. The sensitivity of the LAMP assay using unextracted and DNA extracted samples were 0.67 and 1.00 respectively. None of the syphilis samples tested positive in any of the assays. We show the development of a fast and sensitive LAMP assay for yaws detected by lateral flow test strip. Using extracted DNA, the assay sensitivity is at par with gold standard detection. The assay can be adapted to minimal sample processing required for in-field detection without DNA extraction.</div><div><br></div>

Paper-fluidic devices are a popular platform for point-of-care diagnostics due to their low cost, ease of use, and equipment-free detection of target molecules. The most common example is the lateral flow assay, in which samples are added to a paper membrane and a colorimetric indicator provides a binary signal indicating whether the molecule of interest is present. A novel lateral flow assay was developed to detect a protein biomarker for early stage cervical cancer. Cervical cancer can be cured if detected and treated at an early stage, but approximately 90% of cervical cancer deaths occur in low and middle-income countries due to lack of accessible testing. Methods for detecting the biomarker, valosin-containing protein (VCP), were optimized using enzymatic and gold nanoparticle dot blots, then lateral flow assays were developed and validated using purified VCP and cervical cancer HeLa cells. Future validation with patient tissue samples will permit translation of this device to testing clinics in low-resource areas. Despite advantages for use in resource limited settings, lateral flow assays are limited by their inability to perform more complex or multi-step processes, such as nucleic acid amplification or enzymatic signal enhancement. Thermally actuated wax valves are one mechanism that provides complete control over fluid obstruction and release. To better understand how wax valves can be used in fully automated, self-contained lateral flow assays, different sizes and geometries of valves were tested to investigate their effects on actuation time, flow rate, and flow pattern. Another limitation in the understanding of lateral flow assays is the lack of experimental data describing the microscale flow within the pores of the paper membrane that drives the biophysical reactions in the assay. Mathematical models can be designed to explain macroscopic phenomena, but so far, no literature has compared microfluidic models to microfluidic data. To quantify microfluidic properties within lateral flow assays, fluorescent nanoparticles were imaged flowing through different areas of the membrane and their velocity was quantified using micro-particle image velocimetry (µPIV). Scanning electron microscope images were used to verify that this experimental model was reasonable for describing microfluidic properties of the lateral flow assay. Altogether, this document investigates how developing lateral flow assays for cervical cancer detection can save lives by improving the accessibility of an early diagnosis, and how more robust lateral flow assay characterization can expand their applicability to a broad range of detection processes.

Fästingburet encefalitvirus (TBEV) är ett RNA-virus som tillhör genuset flavivirus. Vid en TBEV-infektion är feber, trötthet, allmänpåverkan samt huvudvärk och muskelvärk vanligt förekommande symtom. Viruset överförs via saliven från fästingar under de första minuterna efter fästingbett. TBEV-IgM och ibland även TBEV-IgG återfinns i serum då symtom i centrala nervsystemet (CNS) yttrar sig i den andra fasen av sjukdomsförloppet. De senaste åren har prevalensen av fästingburen encefalit (TBE) ökat. Sedan 2017 har över 300 fall av TBE rapporterats årligen i Sverige. Laterala flödesanalyser (lateral flow assays, LFA) är billiga, enkla, snabba och baseras på portabla instrument som används bland annat inom biomedicinsk vetenskap. ReaScan® TBE IgM från det finska företaget Reagena är ett snabbtest, baserat på LFA-tekniken, för detektion av TBE-specifika IgM-antikroppar i humant serum och likvor. Syftet med studien var att undersöka om ReaScan® TBE IgM kan användas för att diagnostisera TBE på laboratoriet för Klinisk Mikrobiologi på länssjukhuset i Kalmar. Metodens prestanda undersöktes genom att analysera totalt 23 serumprover, 13 prover från TBE-patienter och 10 prover från icke-TBE-patienter. Sensitiviteten uppskattades genom att analysera 13 serumprover där förekomst av TBE-antikroppar sedan tidigare konfirmerats. Specificiteten uppskattades genom att analysera 10 serumprover från patienter utan känd TBEV-infektion. Den diagnostiska sensitiviteten respektive specificiteten beräknades till 100 %. På grund av den begränsade storleken på undersökningsmaterialet är dock den beräknade sensitiviteten och specificiteten ej helt tillförlitlig. Metodens prestanda ansågs vara tillräckligt god för att den skall kunna användas som en screening-metod för TBEV-IgM-antikroppar på laboratoriet för Klinisk Mikrobiologi på länssjukhuset i Kalmar. / Tick-borne encephalitis virus (TBEV) is an RNA virus that belongs to the genus flavivirus. Symptoms that commonly present during a TBEV infection include headaches, muscle pains, fever and malaise. The virus is transmitted with the saliva from ticks during the first minutes of their blood meal. TBEV-IgM and sometimes TBEV-IgG antibodies can be detected in the patient’s serum when central nervous system (CNS) symptoms present in the second phase of the disease. Over the last couple of years, the prevalence of tick-borne encephalitis (TBE) has increased. Since 2017 over 300 cases of TBE are reported every year in Sweden. Lateral flow assays (LFA) is the technology behind inexpensive, simple, quick and portable instruments that are used within the biomedical science field among others. ReaScan® TBE IgM developed by the Finnish company Reagena is a rapid test, based on the LFA technique, used for the detection of TBEV specific IgM antibodies in human serum and cerebrospinal fluid. The trial aimed to evaluate whether ReaScan® TBE IgM could be used to diagnose TBE at the laboratory of Clinical microbiology at the County hospital in Kalmar. The performance of the test was determined by analysing a total of 23 serum samples, 13 of which consisted of samples from patients with a previously confirmed TBE diagnosis and 10 samples from patients with no known TBEV infection. The diagnostic sensitivity and specificity were both determined to be 100 %. Due to the limited sample size, the calculated sensitivity and specificity are not particularly reliable.  The performance of the test was satisfactory and it could be used as a screening method for the detection of TBEV IgM antibodies at the department of Clinical microbiology at Kalmar County Hospital.

Existing methods for pathogen/pollutant detection or wound infection monitoring employ high-cost instruments that could only be operated by trained personnel, and costly device-based detection requires a time-consuming field-to-lab process. This expensive process with multiple prerequisites prolongs the time that patients must wait for a diagnosis. Therefore, improved methods for point-of-care biosensing are necessary. In this study, we aimed to develop a direct, easy-to-use, portable, low cost, highly sensitive and selective sensor platform with the goal of pollutant detection and wound infection/cancer migration monitoring. This study has two main parts, including microfluidic, electrical, and optical sensing platforms. The first part, including chapters 2, 3, and 4, focuses on Bisphenol A (BPA) lateral flow assay (LFA) detection; the second part, including chapter 5 focuses on the electrical sensing platform fabrication for one of the markers of inflammation, matrix metalloproteinases-9 (MMP-9), monitoring/detection. In chapters 2, 3, and 4, we found that the few lateral flow assays (LFAs) established for detecting the endocrine-disrupting chemical BPA have employed citrate-stabilized gold nanoparticles (GNPs), which have inevitable limitations and instability issues. To address these limitations, in chapter 2, a more stable and more sensitive biosensor is developed by designing strategies for modifying the surfaces of GNPs with polyethylene glycol and then testing their effectiveness and sensitivity toward BPA in an LFA. In chapter 3, we describe the development of a new range-extended bisphenol A (BPA) detection method that uses a surface enhanced Raman scattering lateral flow assay (SERS-LFA) binary system. In chapter 4, we examine advanced bisphenol A (BPA) lateral flow assays (LFAs) that use multiple nanosystems. The assays include three nanosystems, namely, gold nanostars, gold nanocubes, and gold nanorods, which are rarely applied in LFAs, compared with general gold nanoparticles. The developed LFAs show different performances in the detection of BPA. In chapter 5, a stable electrical sensing platform is developed for MMP-9 detection.