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        IMA

Medical Plastics: Frugal innovations on a chip

Also, download this story from the electronic issue here

Quality, affordable and universally accessible healthcare remains a challenge for low and middle-income countries. Given that advancement in healthcare technologies promises accuracy and faster diagnostics, the cost dynamics of availing them can also create a huge burden. Thus, low cost, speed, and accuracy are big features packed in nano-sized lab-on-chip devices, according to Angelica Buan in this article.

Lab-on-chip medical devices

The 35-nation OECD (Organisation for Economic Cooperation and Development), in a 2014 report, stated that several countries in the region need to improve access to affordable, quality healthcare. A significant portion of its population, in rural areas and in certain demographic groups, could not obtain medical treatment because of high costs or lack of health workers.

Lab-onchip-(LOC)-technology

What is suggested is the availability of diagnostic devices efficient in early detection of diseases; and technologies that are low cost and feature ease of use and application in broader healthcare settings.

Lab-on-chip (LOC) technology has been envisaged to fill this gap in universal healthcare access. A LOC is a device with a size varying from a few mm to a few sq cm. It merges one or several laboratory functions, such as chemical synthesis and analysis, on a single integrated circuit, and on a miniaturised scale, resulting in a portable device that requires less power compared to conventional laboratory devices.

Market expands; healthcare spending ramps up

The OECD report added that Asian economies spend only 20% of the US$3,510 per person/year health spending in OECD countries. Nonetheless, global health expenditure cited by the World Health Organisation (WHO) was at US$7.8 trillion in 2013, and is expected to more than double to US$18.3 trillion by 2040.

The LOC market is expected to more than double to US$8 billion by 2022, growing at a CAGR of 11% from US$4.2 billion in 2016, says research firm Stratistics MRC. It expounded that LOC has a wide range of applications, such as point of care diagnostics, genomic and proteomics research, analytical chemistry, environmental monitoring, and biohazards detection.

On the other hand, Coherent Market Insight, in its market outlook for the period from 2017-2025, cited the growth drivers in regions that are pushing the LOC market. North America’s geriatric (over 65) population, which is expected to reach 19 million by 2050, is a factor, followed by Europe, being an early adopter of advanced technologies.

Meanwhile, Asia Pacific’s over 4.5 billion population beckons a robust demand for LOC devices, and especially since, the region also contends with inadequate healthcare access. Stratistics MRC stated that China and India are the prime movers in Asia, owing to their ample R&D investments, and support by government funding.

A one-cent device to measure cells

“Isolation and characterisation of rare cells and molecules from a heterogeneous population is of critical importance in diagnosis of common lethal diseases such as malaria, tuberculosis, HIV, and cancer,” according to a team of Stanford University School of Medicine research engineers who developed an LOC platform by integrating microfluidics, electronics, and inkjet printing to build a low-cost and reusable microchip that can diagnose multiple diseases.

The FINP platform costs only US$0.01 to make, and takes only 20 minutes to assemble, yet is capable of performing complex, minimally invasive analyses of single cells without specialised equipment, except for an inkjet printer. Hence, skilled personnel and clean-room facilities are no longer required.

The two-part LOC system features clear silicone microfluidic chamber for housing cells that sit on top of a reusable electronic strip. A regular inkjet printer can be used to print the electronic strip onto a flexible sheet of polyester using commercially available conductive nanoparticle ink. The tool can handle small-volume samples.

FINP-platform

The design takes into account the limited funds, modest public health infrastructure, and low power availability in developing and resource-poor countries that can benefit from this LOC platform.

The researchers said that the FINP chip is as efficient as the US$100,000 cytometry technique used to count immune cells. The National Institute of Health-funded study was published online in the Proceedings of the National Academy of Sciences.

Cheaper laboratory tests for autoimmune diseases

Rutgers University engineers have developed a breakthrough device that can significantly reduce the cost of sophisticated laboratory tests for medical disorders and diseases, such as HIV, Lyme disease and syphilis.

Called ELISA-on-a-chip, where ELISA stands for enzyme-linked immunosorbent assay, it is a single device that can analyse 32 samples at once and can measure widely varying concentrations of as many as six proteins in a sample. The LOC device employs microfluidics technology and is capable of performing complex analyses using 90% less sample fluid than needed in conventional tests.

According to the researchers, it uses miniaturised channels and valves to replace ‘benchtop assays’, tests that require large samples of blood or other fluids and expensive chemicals that laboratory technicians manually mix in trays of tubes or plastic plates with cup-like depressions.

one-tenth-of-the-chemicals

“The main advantage is cost – these assays are done in laboratories and clinics everywhere,” said researcher, Mehdi Ghodbane.

Findings of the study, which was funded by the National Institute of Health, the National Science Foundation, and the New Jersey Commission on Brain Injury Research and Corning, was published in the Royal Society of Chemistry’s journal Lab on a Chip.

The platform only requires one-tenth of the chemicals used in a conventional multiplex immunoassay, which can cost as much as US$1,500. It also automates much of the skilled labour involved in performing tests, the researchers said.

Professor Martin Yarmush at Rutgers vouched that the technology can enable researchers to perform large-scale controlled studies with comparable accuracy to conventional assays.

Additionally, he said that the discovery could also lead to more comprehensive research on autoimmune joint diseases, such as rheumatoid arthritis, through animal studies. “As with spinal fluid, the amount of joint fluid, or synovial fluid, researchers are able to collect from laboratory animals is minuscule,” he said.

Diabetes check via mobile device

Diabetes, one of the leading causes of deaths worldwide, is characterised by high glucose in the blood. The WHO reported that the number of diabetes-afflicted people crossed to 422 million in 2014 from 108 million in 1980, rising rapidly in middle and low-income countries. Mortality is also scoring millions and WHO projects diabetes to become the seventh leading cause of deaths in 2030.

The OECD also reported the high prevalence of diabetes in Asia, accounting for over 60% of the deaths worldwide caused by the disease in 2013. Plus, an estimated 215 million people live with diabetes in the region, with half of them undiagnosed.

Dianax’s-POCT-device

Hence, the LOC innovation by Italian medtech diagnostic start-up Dianax and similar breakthroughs can benefit patients who may have limited access to full diagnostic systems.

Dianax’s point of care testing (POCT) device is portable, inexpensive and easy to use plus it delivers reliable results on the spot and in near-real time, via a smart phone or a handheld reader, the company said. The diagnostic LOC, which can provide immediate and precise on-site measurements of glycated haemoglobin, is designed for the prevention and monitoring of diabetes.

The LOC device received an EU grant of EUR2 million in 2016, in aid of its development and moving it up for industrial production phase.

The Milanese company says it comprises a silicon-based disposable cartridge, small as a USB key, connected to a hand-held reader, or a smartphone or a tablet to allow results viewing.

Through a system of chambers and conduits etched into a silicon wafer, it purifies proteins from a fraction of a drop of body fluid sample. Then, it measures the concentration of the target protein in the sample, by producing an electronic signal through sensors embedded in the chip. It works through a sequence of steps including anticoagulation and dilution of blood, target, and purification and, finally, electrochemical detection allowing specific target quantitation, says the firm.

Prenatal care in the palm of your hand

The WHO estimates that 15 million babies/year are born preterm and complications at birth are found to be the leading cause of death among children less than 5 years of age, with a 1 million deaths in 2015. WHO also says 75% of these could be prevented with cost-effective interventions.

researchers

Utah’s Brigham Young University researchers developed a small chip integrated microfluidic device that is designed to predict, with up to 90% accuracy, a woman’s risk for a future preterm birth.

The palm-sized plastic rectangle has a few pinholes in it, allowing it to take a finger-prick’s worth of blood and measuring a panel of nine identified preterm birth biomarkers, which are essentially biological flags that tip off diseases or other conditions, the researchers said. There aren’t any current biomarker-based diagnostics for preterm births, and doctors typically only keep tabs on women who have other clear risk factors.

placenta-on-a-chip

Mukul Sonker, the lead author of a study published in Electrophoresis, and researchers Adam Woolley, Radim Knob and Vishal Sahore, created the chip and the system. The device is cheap, small and fast: once fully developed, it will help make detecting biomarkers a simple, automated task, Woolley said.

In a related development, scientists at the University of Pennsylvania have developed the first placenta-on-a-chip (POAC) that can fully model the transport of nutrients across the placental barrier.

Small (the size of a flash drive), the clear silicone device has two parallel microfluidic channels separated by a porous membrane. It contains two layers of human cells that mimic the interface between mother and fetus. Microfluidic channels on either side of the layers allow researchers to study how molecules are transported or blocked by the interface. The study showed that the two layers of cells continue to grow and develop while inside the chip, undergoing a process known as “syncytialisation.”

The POAC aims to identify causes and prevention of preterm birth. “Prematurely born babies may experience lifelong, debilitating consequences, but the underlying mechanisms of this condition are not well understood due in part to the difficulties of experimenting with intact, living human placentae,” said the research team led by Dan Huh, Professor at University of Pennsylvania, and graduate student Cassidy Blundell.

The study was supported by the March of Dimes Prematurity Research Centre and theNational Institute of Health Director’s New Innovator Award.

The innovations mentioned are still a work in progress, according to their developers. Nevertheless, they provide hope for patients in poor resource areas, who require lowcost basic primary care as a first line of defence against further expenditures for hospitalisation, rehabilitation or even mortality. The LOC technology offers the most practical solution – for now.

(IMA)


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