Yilin Liu

The SARS-CoV-2 global pandemic created an unprecedented need for rapid, sensitive, and inexpensive point-of-care (POC) diagnostic tests to treat and control the disease. Many POC SARS-CoV-2 lateral flow immunoassays (LFAs) have been developed and/or commercialized, but with only limited sensitivity (μM–fM). We created an advanced LFA based on gold nanospheres (GNSs) with comprehensive assay redesign for enhanced specific binding and thermal contrast amplification (TCA) on GNSs for signal amplification, which enabled fM–aM detection sensitivity for SARS-CoV-2 spike receptor-binding domain (RBD) proteins within 30 min. The advanced LFA can visually detect RBD proteins down to 3.6 and 28.6 aM in buffer and human nasopharyngeal wash, respectively. This is the first reported LFA achieving sensitivity comparable to that of the PCR (aM–zM) by visual reading, which was much more sensitive than traditional LFAs. We also developed a fast (<1 min) TCA reading algorithm, with results showing that this TCA could distinguish 26–32% visual false negatives for clinical commercial LFAs. When our advanced LFAs were applied with this TCA, the sensitivities were further improved by eightfold to 0.45 aM (in buffer) and 3.6 aM (in the human nasopharyngeal wash) with a semiquantitative readout. Our proposed advanced LFA with a TCA diagnostic platform can help control the current SARS-CoV-2 pandemic. Furthermore, the simplicity and speed with which this assay was assembled may also facilitate preparedness for future pandemics.

Influenza poses a serious health threat and creates an economic burden for people around the world. The accurate diagnosis of influenza is critical to the timely clinical treatment of patients and the control of outbreaks to protect public health. Commercially available rapid influenza diagnostic tests (RIDTs) that are operated by visual readout are widely used in clinics to screen influenza infections, but RIDTs suffer from imperfect analytical sensitivity, especially when the virus concentration in the sample is low. Fortunately, the sensitivity can be simply improved through an add-on signal amplification step, i.e., thermal contrast amplification (TCA). To demonstrate the advantage of TCA for influenza diagnosis, we conducted a prospective cohort study on 345 clinical specimens collected for influenza A and B testing during the 2017–2018 influenza season. All samples were tested using the Quidel QuickVue Influenza A + B test, followed by a TCA readout, and then confirmatory polymerase chain reaction testing. Through the TCA detecting sub-visual weak positives, TCA reading improved the overall influenza sensitivity by 53% for influenza A and 33% for influenza B over the visual RIDTs readings. Even though the specificity was compromised slightly by the TCA protocol (relative decrease of 0.09% for influenza A and 0.01% for influenza B), the overall performance was still better than that achieved by visual readout based on comparison of their plots in receiver operating characteristic space and F1 scores (relative increase of 14.5% for influenza A and 12.5% for influenza B). Performing a TCA readout on wet RIDTs also improved the overall TCA performance (relative increase in F1 score of 48%). Overall, the TCA method is a simple and promising way to improve the diagnostic performance of commercial RIDTs for infectious diseases, especially in the case of specimens with low target analytes.

Lateral flow assays (LFAs) are paper-based point-of-care (POC) diagnostic tools that are widely used because of their low cost, ease of use, and rapid format. Unfortunately, traditional commercial LFAs have significantly poorer sensitivities (μM) and specificities than standard laboratory tests (enzyme-linked immunosorbent assay, ELISA: pM–fM; polymerase chain reaction, PCR: aM), thus limiting their impact in disease control. In this Perspective, we review the evolving efforts to increase the sensitivity and specificity of LFAs. Recent work to improve the sensitivity through assay improvement includes optimization of the assay kinetics and signal amplification by either reader systems or additional reagents. Together, these efforts have produced LFAs with ELISA-level sensitivities (pM–fM). In addition, sample preamplification can be applied to both nucleic acids (direct amplification) and other analytes (indirect amplification) prior to LFA testing, which can lead to PCR-level (aM) sensitivity. However, these amplification strategies also increase the detection time and assay complexity, which inhibits the large-scale POC use of LFAs. Perspectives to achieve future rapid (<30 min), ultrasensitive (PCR-level), and “sample-to-answer” POC diagnostics are also provided. In the case of LFA specificity, recent research efforts have focused on high-affinity molecules and assay optimization to reduce nonspecific binding. Furthermore, novel highly specific molecules, such as CRISPR/Cas systems, can be integrated into diagnosis with LFAs to produce not only ultrasensitive but also highly specific POC diagnostics. In summary, with continuing improvements, LFAs may soon offer performance at the POC that is competitive with laboratory techniques while retaining a rapid format.

Correction for ‘Photothermal conversion of gold nanoparticles for uniform pulsed laser warming of vitrified biomaterials’ by Yilin Liu et al., Nanoscale, 2020, 12, 12346–12356, DOI: 10.1039/D0NR01614D.

Pulsed laser (ms, 1064 nm) gold nanoparticle (GNP) heating has been used recently to achieve fast (>10 000 000 °C min⁻¹) warming of vitrified droplets using gold nanorods (GNRs) as photon-absorbers. To maximize the viability of biomaterials in vitrified droplets, the droplets must be warmed as uniformly as possible. A potential approach to such warming is to use an appropriate combination of photon-absorption and -scattering to distribute heat more uniformly throughout a droplet. To investigate this, 2 plasmonic gold nanorods (GNRs), 1 hollow gold nanoshell, and 2 silica-core gold nanoshells (GNSs) were synthesized and characterized under 1064 nm laser irradiation in water, propylene glycol, and protein-rich (egg white) solutions. Using a modified cuvette laser calorimetry experiment with complementary Monte Carlo modeling, the GNSs were found to have higher per-particle absorption and scattering cross sections, while the GNRs had higher photothermal conversion efficiency, absorption efficiency, and Au mass normalized absorption cross sections. In the characterization, the GNSs with larger scattering-to-absorption ratios could have ∼30% over-estimation of photothermal conversion efficiency if scattering and reabsorption inside the solution were not considered, while GNRs with lower ratios were less impacted. Combined Monte Carlo and COMSOL simulations were used to predict the specific absorption rate (W m⁻³) and heating behavior of GNP-loaded hemispherical droplets, thereby demonstrating that the GNS case with higher scattering-to-absorption ratio achieved more uniform heating than the GNR case. Interestingly, further tuning of the scattering and absorption coefficients of the hemispherical GNP-loaded droplet within the model suggests the ability to obtain an optimal scattering-to-absorption ratio for uniform heating. These results show the importance of considering the reabsorption of scattered light to accurately characterize the photothermal conversion efficiency of GNP solutions during laser irradiation. We also show that the relative scattering and absorption properties of the nanoparticles can be designed to promote both rapid and uniform laser rewarming of vitrified droplets for application in cryopreservation.

Lateral flow assay (LFA) has become one of the most widely used point-of-care diagnostic methods due to its simplicity and low cost. While easy to use, LFA suffers from its low sensitivity and poor quantification, which largely limits its applications for early disease diagnosis and requires further testing to eliminate false-negative results. Over the past decade, signal enhancement strategies that took advantage of the laser excitation of plasmonic nanomaterials have pushed down the detection limit and enabled quantification of analytes. Significantly, these methods amplify the signal based on the current LFA design without modification. This review highlights these strategies of signal enhancement for LFA including surface enhanced Raman scattering (SERS), photothermal and photoacoustic methods. Perspectives on the rational design of the reader systems are provided. Future translation of the research toward clinical applications is also discussed.