Point-of-care testing (POCT) is defined as medical testing at or near the site of patient care and has become a critical component of the diagnostic industry. POCT has many advantages over tests in centralized laboratories including small reagent volumes, small size, rapid turnaround time, cost-effectiveness, low power consumption and functional integration of multiple devices. Paper-based POCT sensors are a new alternative technology for fabricating simple, low-cost, portable and disposable analytical devices for clinical diagnosis. The focus of this dissertation was to develop simple, rapid and low cost paper-based POCT sensors with high sensitivity and portability for disease biomarker detection. Lateral flow strips (LFS) were used as the basic platform as it provides several key advantages such as simplicity, fast response time, on site and cost-effectiveness, and it can be used to detect specific substances including small molecules, large proteins and even whole pathogens, in a sample by immunological reactions. Earlier designs of paper strips lacked the quantitative information of the analyte concentration and could only provide single analyte detection at a time. In this study, a series of modifications were made to upgrade the platform to compensate for these limitations. First, we developed a gold nanoparticle based LFS for qualitative colorimetrical detection of bladder cancer related biomarkers in standard solutions and in urine samples. Second, by incorporating an image processing program “ImageJ”, a semi-quantitative LFS platform was established. The capability of the strip was evaluated by testing a small DNA oxidative damage biomarker in urine and cell culture models. Third, we combined the electrochemical method and colorimetrical method for quantitative biomarker detection. Finally, we integrated a commercialized blood glucose meter to quantitatively detection of two non-glucose biomarkers by converting their signals to that of glucose. The upgraded sensor could provide a noninvasive, rapid, visual, quantitative and convenient detection platform for various disease biomarkers. In addition, this platform does not require expensive equipments or trained personnel, deeming it suitable for use as a simple, economical and portable field kit for on-site biomarker monitoring in a variety of clinical settings.

No description available.

In der vorliegenden Arbeit wird eine integrierbare Pumpentechnologie für polymerbasierte mikrofluidische Systeme entwickelt. Ausgehend von den Anforderungen für die Durchführung molekulardiagnostischer Nachweise kommen dabei Fertigungsverfahren zum Einsatz, die sich auch für Einweg-Anwendungen eignen. Das genutzte Aktorprinzip für die integrierten Mikropumpen basiert auf der Elektrolyse von Wasser. Zur besseren technologischen Integrierbarkeit wird das Wasser in Form eines Hydrogels appliziert. Der Elektrolyt wird dabei mit einer Polymermembran mit geringer Wasserdampfdurchlässigkeit verschlossen. Die Membran wird in ihrem plastischen Verformbereich genutzt. Zur Dimensionierung der Mikropumpen und des mikrofluidischen Systems werden analytische und numerische Modelle entwickelt, die eine gute Übereinstimmung mit den Messwerten zeigen. Die Funktionsfähigkeit wird anhand zweier vollständig integriert ablaufender Immunoassays demonstriert. Dabei kommt ein polymerbasierter, optischer Biosensor zum Einsatz.

No description available.

Recombinant proteins have many medical and industrial applications, but their use is complicated by commercial production and stability constraints. These issues are particularly challenging for recombinant proteins used in pharmaceutical therapeutics and clinical diagnostics. Expensive production and distribution limit the accessibility of therapeutics and diagnostics especially in the developing world. Additionally, clinical use of recombinant proteins face further challenges within biological systems including biological degradation and immunogenicity. To increase the accessibility of recombinant proteins, the cost and inefficiencies of protein manufacturing and distribution need to be significantly reduced. A powerful tool to aid in this endeavor is cell-free protein synthesis (CFPS) technology. CFPS is a versatile platform for recombinant protein production due to its open reaction environment, flexible reaction conditions, and rapid protein expression capabilities. These avoid the disadvantages of conventional manufacturing and present the capability of on-demand protein therapeutic production outside of centralized facilities. To improve the efficacy of recombinant proteins for medicinal use, protein engineering techniques such as PEGylation, or the conjugation of PEG polymers to protein surfaces, can be employed. PEGylation is widely used to enhance the pharmacokinetic properties of protein therapeutics. Deciphering optimal PEG conjugation sites is a continuing area of research that can be facilitated by CFPS systems that enable high-throughput, site-specific PEGylation. This dissertation presents advances in CFPS technology to promote increased accessibility and stability of life-saving therapeutics and diagnostics. The work presented here (1) improves on-demand therapeutic production capabilities by creating shelf-stable, endotoxin-free CFPS systems, (2) aids the rational design of next-generation PEGylated protein therapeutics through an in silico-in vitro CFPS screening platform, and (3) advances the development of portable clinical diagnostics for rapid and sustainable deployment at point-of-care through CFPS biosensor technology. The innovations of this dissertation are described in four publications. Specifically, an endotoxin-free CFPS system lyophilized with lyoprotectants is demonstrated that shows improved shelf-stability over standard lyophilized systems. A streamlined procedure for preparing endotoxin-free extract using auto-induction media is presented that significantly reduces CFPS preparation labor and time. A combinatorial screening approach is demonstrated in which coarse-grain molecular simulation informs PEGylation site selection as verified by CFPS experimental results. An inexpensive paper-based, saliva-activated CFPS biosensor platform is developed for the detection of SARS-CoV-2 sequences.

Diabetic ketoacidosis (DKA) is a life-threatening condition that can appear in patients with diabetes. High ketones in the blood lead to acidity of the blood. For DKA diagnosis and management, ketones such as hydroxybutyrate (HB) can be used to quantify the severity of the disease. The fabrication of electrochemical biosensors for the detection of HB is attractive since their capability to deliver fast response, high sensitivity, good selectivity and potential for miniaturisation. In this thesis, an integrated electrode system was prepared for the detection of HB. Laser-induced graphene (LIG) with a 3D porous structure was used as the flexible platform. Poly (toluidine blue O) (PTB) was electro-deposited on LIG (PTB/LIG) under the optimised conduction (pH of 9.7 and from 0.4 to an upper cyclic potential of 0.8 V). The single PTB/LIG working electrode demonstrated excellent performance towards the detection of NADH with a linear range of 6.7 M to 3 mM using chronoamperometry, high sensitivity of detecting NADH and excellent anti-fouling ability (94 % response current retained after 1500 s). Further integration of the 3-electrode system realised the static amperometric detection of NADH over the range of 78 M to 10 mM. Based on the excellent performance of PTB/LIG to NADH sensing, hydroxybutyrate dehydrogenase was immobilised via encapsulation with chitosan and polyvinyl butyral (PVB) which was used for HB biosensing over the linear range of 0.5 M to 1 mM with NAD+ dissolved in solution. In addition, the co-immobilisation of NAD+ and HBD on PTB/LIG was conducted by optimisation of enzyme and NAD+ amount per electrode, which shows excellent reproducibility and satisfactory HB biosensing performance. Further experiments to improve the long-term stability of the enzyme electrode is expected in the future. The proposed integrated electrode system also possesses the potential to extend to a multichannel sensor array for the detection of multiple biomarkers (e.g. pH and glucose) for diagnosis and management of DKA.

Le but de ce projet, en collaboration avec Héma-Québec, était de développer une méthode point de service (POC) pour la quantification des immunoglobulines A (IgA) dans un petit volume de plasma humain. Les IgA jouent un rôle important au niveau de notre système immunitaire, surtout au niveau des bio fluides sur les muqueuses comme la salive. On peut les retrouver normalement dans le plasma à des concentrations plus grandes que 2000 ng/mL pour la majorité des gens. Dans le cas d’une personne immunosupprimée, une concentration plus basse que 500 ng/mL est observée. La déficience en IgA est souvent associée à des maladies auto-immunes comme la maladie de Crohn. Ces individus peuvent éprouver un choc anaphylactique à la suite d’une transfusion de sang, ce qui nous motive à utiliser la résonance des plasmons de surface (SPR) sur place à des collectes de sang et dans les milieux hospitaliers. Pour réaliser ce capteur d’immunodéficience en IgA, un anticorps primaire spécifique aux IgA fut lié à un peptide formant une monocouche auto-assemblée sur une surface d’or du capteur SPR. Un deuxième anticorps a été utilisé pour quantifier spécifiquement cet analyte dans une matrice humaine complexe. Plusieurs étapes ont été optimisées pour obtenir une limite de détection basse, soit l’étape d’immobilisation de l’anticorps de capture, le type d’anticorps, le pH pour l’immobilisation, la détection secondaire, la validation dans différentes matrices biologiques, parmi d’autres. Le capteur a été validé avec quelques échantillons cliniques et la réponse SPR fut comparée avec ELISA. Ainsi, nous anticipons que cette méthode pourrait être utile à des collectes de sang pour assurer les réserves de sang déficient en IgA. / The goal of this project, in collaboration with Héma-Québec, was to develop a point-ofcare (POC) method to quantify immunoglobulin A (IgA) in a small volume of human plasma. Immunoglobulin A play an important role in immunity, specifically in biofluids on mucosaes like saliva. It can generally be found in plasma at concentrations higher than 2000 ng/mL for most people. In the case of an immunosuppressed individual, a concentration under 500 ng/mL is observed. IgA-deficiency is often associated with autoimmune diseases, such as Crohn’s disease. These individuals may experience an anaphylactic shock following a blood transfusion, which motivated us to use surface plasmon resonance (SPR) on site at blood drives and in a hospital setting. SPR quantifies the interactions between biomolecules. It is a complementary technique to ELISA that can test more rapidly individuals susceptible of being IgA-deficient in a hospital setting or at blood drives. To develop an IgA SPR sensor, a specific capture antibody to IgA was bound to a peptide monolayer on the gold surface. A second antibody was used to specifically quantify IgA in a complex matrix. Multiple steps were optimized to achieve the low detection limits required for IgA detection, such as the capture antibody immobilisation step, type of antibody, pH of immobilisation buffer, secondary detection, validation in different biological matrices, among others. The SPR sensor was validated with a few clinical samples, and compared to ELISA, to demonstrate the potential. As such, we envision that this rapid method may be used at blood drives to ensure sufficient reserves of IgA-deficient blood.

Opportunistic infections (OIs) have been identified as a leading cause of poor outcomes in the ARV therapy (ART) programme. In order to reduce OIs, the Malawi, MoH introduced routine prescription of cotrimoxazole preventive therapy (CPT) in 2005. The MoH also started scaling up a point-of-care electronic medical record (EMR) system in 2007 to improve monitoring and evaluation. This study had the following objectives: i) to quantify prescription of CPT before and after implementing EMR; ii) to compare the difference in CPT prescription before and after implementing EMR. A historically controlled study design was used to compare CPT prescriptions one year before, and one year after implementation of the EMR at two health facilities. The data indicated that there was a significant (P <0.001) decrease in CPT prescribing at one health facility and a significant increase in CPT prescription at another. / Health Studies / M.A. (Public Health)

Le méthotrexate (MTX), un agent anti-cancéreux fréquemment utilisé en chimiothérapie, requiert généralement un suivi thérapeutique de la médication (Therapeutic Drug Monitoring, TDM) pour surveiller son niveau sanguin chez le patient afin de maximiser son efficacité tout en limitant ses effets secondaires. Malgré la fenêtre thérapeutique étroite entre l’efficacité et la toxicité, le MTX reste, à ce jour, un des agents anti-cancéreux les plus utilisés au monde. Les techniques analytiques existantes pour le TDM du MTX sont coûteuses, requièrent temps et efforts, sans nécessairement fournir promptement les résultats dans le délai requis. Afin d’accélérer le processus de dosage du MTX en TDM, une stratégie a été proposée basée sur un essai compétitif caractérisé principalement par le couplage plasmonique d’une surface métallique et de nanoparticules d’or. Plus précisément, l’essai quantitatif exploite la réaction de compétition entre le MTX et une nanoparticule d’or fonctionnalisée avec l’acide folique (FA-AuNP) ayant une affinité pour un récepteur moléculaire, la réductase humaine de dihydrofolate (hDHFR), une enzyme associée aux maladies prolifératives. Le MTX libre mixé avec les FA-AuNP, entre en compétition pour les sites de liaison de hDHFR immobilisés sur une surface active en SPR ou libres en solution. Par la suite, les FA-AuNP liées au hDHFR fournissent une amplification du signal qui est inversement proportionnelle à la concentration de MTX. La résonance des plasmons de surface (SPR) est généralement utilisée comme une technique spectroscopique pour l’interrogation des interactions biomoléculaires. Les instruments SPR commerciaux sont généralement retrouvés dans les grands laboratoires d’analyse. Ils sont également encombrants, coûteux et manquent de sélectivité dans les analyses en matrice complexe. De plus, ceux-ci n’ont pas encore démontré de l’adaptabilité en milieu clinique. Par ailleurs, les analyses SPR des petites molécules comme les médicaments n’ont pas été explorés de manière intensive dû au défi posé par le manque de la sensibilité de la technique pour cette classe de molécules. Les développements récents en science des matériaux et chimie de surfaces exploitant l’intégration des nanoparticules d’or pour l’amplification de la réponse SPR et la chimie de surface peptidique ont démontré le potentiel de franchir les limites posées par le manque de sensibilité et l’adsorption non-spécifique pour les analyses directes dans les milieux biologiques. Ces nouveaux concepts de la technologie SPR seront incorporés à un système SPR miniaturisé et compact pour exécuter des analyses rapides, fiables et sensibles pour le suivi du niveau du MTX dans le sérum de patients durant les traitements de chimiothérapie. L’objectif de cette thèse est d’explorer différentes stratégies pour améliorer l’analyse des médicaments dans les milieux complexes par les biocapteurs SPR et de mettre en perspective le potentiel des biocapteurs SPR comme un outil utile pour le TDM dans le laboratoire clinique ou au chevet du patient. Pour atteindre ces objectifs, un essai compétitif colorimétrique basé sur la résonance des plasmons de surface localisée (LSPR) pour le MTX fut établi avec des nanoparticules d’or marquées avec du FA. Ensuite, cet essai compétitif colorimétrique en solution fut adapté à une plateforme SPR. Pour les deux essais développés, la sensibilité, sélectivité, limite de détection, l’optimisation de la gamme dynamique et l’analyse du MTX dans les milieux complexes ont été inspectés. De plus, le prototype de la plateforme SPR miniaturisée fut validé par sa performance équivalente aux systèmes SPR existants ainsi que son utilité pour analyser les échantillons cliniques des patients sous chimiothérapie du MTX. Les concentrations de MTX obtenues par le prototype furent comparées avec des techniques standards, soit un essai immunologique basé sur la polarisation en fluorescence (FPIA) et la chromatographie liquide couplée avec de la spectrométrie de masse en tandem (LC-MS/MS) pour valider l’utilité du prototype comme un outil clinique pour les tests rapides de quantification du MTX. En dernier lieu, le déploiement du prototype à un laboratoire de biochimie dans un hôpital démontre l’énorme potentiel des biocapteurs SPR pour utilisation en milieux clinique. / Methotrexate (MTX) cancer therapy requires therapeutic drug monitoring (TDM) for following its levels in a patient during the course of treatment in order to maximize efficacy while minimizing side effects. Despite its narrow therapeutic window, MTX remains until this date, one of the most employed chemotherapy agents. Existing TDM analytical techniques for MTX are costly, time-consuming and labor intensive which are not suitable to promptly generate results within the therapy timeframe. To provide rapid MTX quantification for TDM, a strategy is proposed based on a competitive assay featuring gold nanoparticles and surface plasmonic coupling. More specifically, the inhibition of MTX with its molecular receptor, human dihydrofolate reductase (hDHFR), an enzyme associated with proliferative diseases, is explored. Free MTX mixed with folic acid-functionalized gold nanoparticles (FA-AuNP) are in competition for hDHFR binding sites immobilized on a SPR active surface or free in solution. FA-AuNP binding to hDHFR provides signal amplification which is inversely proportional to the concentration of MTX. Surface plasmon resonance (SPR) is commonly used as a spectroscopic technique for the interrogation of biomolecular interactions. Current commercial SPR instruments are laboratory-based, bulky, expensive, lack sensitivity in complex matrix and have not shown adaptability in clinical settings. In addition, SPR analysis of small molecules such as drugs has not been extensively explored due to lack of sensitivity. The recent advances in materials science and surface chemistry exploiting gold nanoparticle integration for SPR response enhancement and peptide surface chemistry have shown potential in overcoming the poor sensitivity and surface-fouling limitations for crude biofluids analysis. These novel concepts of SPR technology are incorporated with a miniaturized fully integrated SPR prototype to conduct fast, reliable and sensitive analysis to monitor MTX levels of a patient undergoing chemotherapy. The objective of the thesis is to explore different strategies in improving drug analysis in a complex matrix using SPR biosensors and to put in perspective of the potential of SPR biosensors as a useful TDM tool in clinical laboratories or at a point-of-care situation. To achieve these objectives, a colorimetric solution-based MTX competitive assay is first established with FA-AuNP. Then, the solution-based MTX competitive assay is translated onto a SPR platform. For both developed assays, sensitivity, selectivity, detection limit, dynamic range optimization as well as analysis of methotrexate in complex matrix are inspected. Furthermore, the SPR prototype is validated by its equivalent performance to existing SPR systems and by its utility in executing MTX analysis in actual serum samples from patients undergoing chemotherapy. The concentrations of MTX obtained by SPR biosensing are compared to standard techniques: fluorescence polarization immunoassay (FPIA) and liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) in order to confirm the feasibility of SPR biosensors as a useful clinical tool for performing rapid MTX concentration evaluation. Finally, the successful deployment of the prototype to a hospital laboratory demonstrates enormous prospective of SPR biosensors in clinical use.

No description available.