Advances in Plasmonic Technologies for Point of Care Applications

Demand for accessible and affordable healthcare for infectious and chronic diseases present significant challenges for providing high-value and effective healthcare. Traditional approaches are expanding to include point-of-care (POC) diagnostics, bedside testing, and community-based approaches to respond to these challenges.1 Innovative solutions utilizing recent advances in mobile technologies, nanotechnology, imaging systems, and microfluidic technologies are envisioned to assist this transformation. Infectious diseases have considerable economic and societal impact on developing settings. For instance, malaria is observed more commonly in sub-Saharan Africa and India.2 The societal impact of acquired immune deficiency syndrome (AIDS) and tuberculosis is high, through targeting adults in villages and leaving behind declining populations.3 In resource-constrained settings, it is estimated that about 32% of the disease burden is from communicable diseases such as respiratory infections, AIDS, and malaria, while 43% of the burden is from noncommunicable diseases, such as cardiovascular diseases, neuropsychiatric conditions, and cancer.4 Developing diagnostic platforms that are affordable, robust, and rapid-targeting infectious diseases is one of the top priorities for improving healthcare delivery in the developing world.5 The early detection and monitoring of infectious diseases and cancer through affordable and accessible healthcare will significantly reduce the disease burden and help preserve the social fabric of these communities. Further, improved diagnostics and disease monitoring technologies have potential to enhance foreign investment, trade, and mobility in the developing countries.6 Highly sensitive and specific lab assays such as cell culture methods, polymerase chain reaction (PCR), and enzyme-linked immunosorbent assay (ELISA) are available for diagnosis of infectious diseases in the developed world. They require sample transportation, manual preparation steps, and skilled and well-trained technicians. These clinical conventional methods provide results in several hours to days, precluding rapid detection and response at the primary care settings. Another diagnostic challenge is identifying multiple pathogens. Since common symptoms like sore throat and fever can be caused by multiple infectious agents (e.g., bacteria and viruses), it is important to accurately identify the responsible agent for targeted treatment. Therefore, high-throughput sensors for multiplexed identification would help improve patient care.7 Medical instruments in centrally located institutions in the developed world rely on uninterrupted electricity and running water and require controlled environmental conditions. It may not be viable to satisfy some of these criteria in some POC settings, where well-trained healthcare personnel are not available and clean water access is unreliable.7,8 Further, in remote settings without infrastructure, rain and dust can act as contaminants.7 Diagnostic devices for POC testing in these settings are identified by the World Health Organization to be affordable, sensitive, user-friendly, specific to biological agents, and providing rapid response to small sample volumes.9 Optical biosensor devices are emerging as powerful biologic agent detection platforms satisfying these considerations.10 Optical sensing platforms employ various methods, including refractive index change monitoring, absorption, and spectroscopic-based measurements.11 Optical sensors that are based on refractive index monitoring cover a range of technologies, including photonic crystal fibers, nano/microring resonator structures, interferometric devices, plasmonic nano/micro arrays, and surface plasmon resonance (SPR)-based platforms.11,12 The latter two are plasmonic-based technologies. Plasmonics is an enabling optical technology with applications in disease monitoring, diagnostics, homeland security, food safety, and biological imaging applications. The plasmonic-based biosensor platforms along with the underlying technologies are illustrated in the Figure ​Figure1.1. Here, we reviewed SPR, localized surface plasmon resonance (LSPR), and large-scale plasmonic arrays (e.g., nanohole arrays). Figure 1 Plasmonic-based technologies for versatile biosensor applications. SPR stands for surface plasmon resonance, LSPR for localized surface plasmon resonance, SPRi for surface plasmon resonance imaging, and SERS for surface-enhanced Raman scattering.