TECHNICAL FIELD
[0001] The present invention relates to assays.
BACKGROUND
[0002] Heart failure is a chronic, progressive disease that affects a substantial portion
of the world's population. The prevalence and incidence of heart failure is growing
due to an aging population and a greater number patients who survive a myocardial
infarction.
[0003] Clinically, heart failure can be characterized by a syndrome of breathlessness and
fatigue, often accompanied by fluid retention, as indicated by an elevated jugular
venous pressure and edema. The progression of heart failure is defined in four stages.
The term heart failure refers to all of these. Stage A-at risk: patients at high-risk
of developing heart failure (patients with coronary heart disease, diabetes, hypertension,
and/or valvular heart disease). Stage B-pre-heart failure: patients with structural
heart disease but without clinical heart failure symptoms, many of whom have decreased
systolic function. Stage C-heart failure: patients who have prior or current symptomatic
heart failure due to systolic or diastolic dysfunction and who are responding to therapy.
Stage D-advanced heart failure: patients in end-stage or refractory-to-therapy.
[0004] Many of the tests and procedures for accurately and successfully diagnosing, managing
and treating heart failure are complex, expensive and available only at a hospital
or other health-care setting.
[0005] WO 2007/002579 relates to devices and methods for performing a test to detect and/or quentify the
presence of an analyte of interest within a sample using a portable instrument.
[0006] US 5,279,936 relates to methods for separating a component of interest from a mixture containing
the component of interest and other components.
[0007] WO 2007/110779 relates to an essay method and device that can perform at least one assay on a single
aliquot of a sample liquid. The device can mix the sample liquid with assay reagents
including magnetically susceptible particles.
WO 2007/110739 relates to a method and apparatus for processing of particles in which the particles
suspended in a first fluid are introduced under laminar flow conditions into at least
one first micro chamber of first region of the same, in which a second fluid is introduced
under laminar flow conditions into at least one second region of the micro chamber
or a second micro chamber in such a way as not to mix with the first fluid.
SUMMARY
[0008] The present invention relates to assays.
[0009] Also disclosed is a method comprising: (a) introducing a liquid sample to a first
portion of a channel of a micro fluidic device; (b) contacting, within the microfluidic
device, reagent with the liquid sample; (c) contacting, within the microfluidic device,
liquid sample with a second liquid wherein the second liquid contains substrate of
the reagent; (d) detecting a characteristic of the substrate in the second liquid
at a first position in the microfluidic device; (e) contacting the second liquid with
reagent at a second position in the microfluidic device and detecting a characteristic
of the contacted substrate and/or reagent; (f) contacting reagent from said liquid
sample with substrate in the second liquid and detecting a characteristic of the contacted
liquid sample reagent and/or substrate; (g) using the characteristics detected in
(d) and (e) to validate or adjust the characteristic detected in (f).
[0010] In one instance detection of a characteristic of the substrate at the first position
is in the absence of reagent, i.e. reagent concentration is zero. Preferably, therefore,
the second liquid has not contacted reagent.
[0011] In other instances detection of a characteristic of the substrate at the first position
is where the second liquid has contacted a first concentration of reagent. Thus, step
(d) can comprise contacting the second liquid with a first concentration of reagent
and detecting a characteristic of the contacted substrate and/or reagent at the first
position. At the second position substrate in the second liquid can contact a second
concentration of reagent wherein the second concentration of reagent is different
to the first concentration of reagent.
[0012] In some instances contacting of the liquid sample with second liquid comprises forming,
proximal to a junction between the first portion of the channel and a second portion
of the channel, a liquid sample:gas interface; and forming a liquid sample:second
liquid interface by flowing a second liquid toward said junction and displacing gas
of the liquid sample:gas interface with a second liquid.
[0013] In some instances detecting a characteristic of the substrate in (d) occurs in the
second liquid. Detecting a characteristic of the substrate in (d) can take place prior
to formation of the liquid sample:second liquid interface. Detecting a characteristic
of the substrate in (d) can occur at a location upstream of said junction with respect
to the direction of flow of said second liquid.
[0014] In some instances detecting a characteristic of the substrate and/or reagent in (e)
occurs in the second liquid. Detecting a characteristic of the substrate and/or reagent
in (e) can take place after formation of the liquid sample:second liquid interface.
Detecting a characteristic of the substrate and/or reagent in (e) can occur at a location
downstream of said junction with respect to the direction of flow of said second liquid.
[0015] In some instances detection of the characteristic of the contacted liquid sample
reagent and/or substrate in (f) occurs in the second liquid. Detection of the characteristic
of the contacted liquid sample reagent and/or substrate in (f) can take place after
formation of the liquid sample:second liquid interface. Detection of the characteristic
of the contacted liquid sample reagent and/or substrate in (f) can occur at a location
upstream of said junction with respect to the direction of flow of the second liquid.
The detection of this characteristic can involve the detection of an assay result
at a detection zone in the second channel portion of the microfluidic device.
[0016] In some instances, the first and second position are in a second channel portion
of the microfluidic device, wherein the first position is in a detection zone for
detecting an assay result and the second position is in an overflow channel, e.g.
at a reagent control zone. The first and second positions are spatially separated
in the channel network of the microfluidic device such that following contact with
the second liquid mixing, between respective positions, of reagents deposited at or
near the respective positions does not occur or is negligible. Reagent can be deposited
at the first and/or second positions, or adjacent or proximal to the respective position(s).
Detection of the characteristic can occur close to the location of deposited reagent
and can be at, adjacent or proximal to, the first and second positions. Sensors can
be positioned at the respective positions to detect the characteristic.
[0017] Also disclosed is a method further comprising the step of comparing a detected characteristic
against a reference value. A reference value can be a laboratory standard. It can
represent a known activity of the substrate or reagent prior to incorporation in the
microfluidic device such that a change in the activity of the substrate or reagent
following storage in the microfluidic device can be determined. The comparison step
can therefore provide a control for changes in substrate and/or reagent activity.
[0018] The detected characteristics of the substrate and reagent at the first and second
positions can be used as controls for reagent and/or substrate activity, which are
useful to determine whether reagents used in the assay have undergone a change in
activity (e.g. reduction in activity) which may affect the assay result. The control
values detected can be used to validate the assay result or adjust the assay result
to take account of a change in reagent or substrate activity.
[0019] Therefore the method can comprise using the detected characteristics from (d) and
(e) to determine a difference in activity of substrate and/or reagent contained in
the microfluidic device from a respective reference activity or activities. Determining
the difference can involve calculating a difference in activity of substrate and/or
reagent contained in the microfluidic device from a respective reference activity
or activities. This difference can be used to validate the detected characteristic
of the contacted liquid sample reagent and/or substrate, e.g. the assay result. This
difference can also be used to adjust a detected characteristic of the contacted liquid
sample reagent and/or substrate, e.g. to calculate and apply a correction to the characteristic
of the contacted liquid sample reagent and/or substrate. Thus, in some disclosed methods
the initial assay result is corrected to provide an adjusted final assay result.
[0020] The step of contacting, within the microfluidic device, reagent with the liquid sample
comprises contacting, in the first portion of the channel, reagent and magnetically
susceptible particles with the liquid sample, the magnetically susceptible particles
forming a complex with the reagent and comprising a binding agent configured to bind
an analyte in the liquid sample. The method may further comprise the step of magnetically
moving magnetically susceptible particle .reagent complexes across the liquid sample:second
liquid interface into the second liquid and to a detection zone in the second channel
portion.
[0021] The reagent can be, or comprise, one or more enzymes. In some embodiments the reagent
is horse radish peroxidase and the substrate is ABTS. The second liquid can also contain
hydrogen peroxide.
[0022] Also disclosed is a method comprising: (a) mobilizing, within a microfluidic device
and using a liquid sample, a dry reagent, the liquid sample containing an analyte,
(b) subsequently forming, within the microfluidic device, a second liquid-liquid sample
interface between a second liquid and the liquid sample, the second liquid comprising
a second reagent which is a substrate of the dry reagent; (c) subsequently detecting,
at a first position within the microfluidic device, a characteristic of a first amount
of the substrate in the second liquid; (d) moving an amount of the mobilized dry reagent
and the analyte from the liquid sample into the second liquid to a second position
within the microfluidic device, the amount of moved mobilized dry reagent being indicative
of the amount of analyte present in the liquid sample; (e) detecting a characteristic
of the substrate at the second position; (f) using the characteristics detected in
(c) and (e) to validate or adjust the characteristic detected in (e), the validated
or adjusted characteristic being indicative of the amount of mobilized dry reagent
moved to the second position.
[0023] In some instances the first amount of substrate is the amount or portion of substrate
contained in the second liquid in the region of the reagent control zone and from
which the characteristic is detected. The characteristic of the first amount of the
substrate can be independent of the amount of analyte present in the liquid sample.
[0024] Detection of a characteristic can comprise determination of a characteristic. This
may comprise determining, measuring or detecting a signal (quantitatively or qualitatively).
The detection can be determining the conversion of one or more substrates into one
or more products. In some embodiments detecting a characteristic of the substrate
comprises electrochemical detection of oxidized or reduced substrate. This can comprise
detection of the oxidation or reduction state of the substrate. In other embodiments
it can comprise detection of a fluorescent marker or label.
[0025] In one aspect, a method includes transporting a magnetic or magnetically susceptible
particle across an interface between a sample reagent mixture and another medium (e.g.,
a fluid such as a gas or liquid). The particle includes a binder for an analyte or
analyte complex. The analyte is determined after transporting the particle and bound
analyte across the interface. At least the step of transporting can be performed in
a microfluidic device.
[0026] The method may include introducing a liquid sample to a first portion of a channel
of a microfluidic device; contacting, within the microfluidic device, magnetically
susceptible particles with the liquid sample, the magnetically susceptible particles
comprising a binding agent configured to bind an analyte; forming, proximal to a junction
between the first portion of the channel and a second portion of the channel, a liquid
sample:gas interface; forming a liquid sample:second liquid interface by displacing
gas of the liquid sample:gas interface with a second liquid, and magnetically moving
the magnetically susceptible particles across the liquid sample:second liquid interface
into the second liquid.
[0027] The method may be a method for detecting an analyte in the liquid sample, the magnetically
susceptible particles adapted to bind the analyte wherein the method further comprises
the step of detecting analyte in the second liquid.
[0028] The method may be for detecting an analyte and comprise the step of determining an
amount of the analyte.
[0029] The method may include separating an analyte from the liquid sample and transporting
the analyte into the second liquid.
[0030] The method may be an in vitro method.
[0031] The first and second liquids are typically different. The first liquid may be a bodily
fluid from a human or mammal (e.g., blood, serum, or plasma). The second liquid may
be a buffer solution.
[0032] The method may be an in vitro method for detecting an analyte in a liquid sample
of blood, plasma or serum from a human comprising introducing the liquid sample to
a first portion of a channel of a microfluidic device; contacting, within the microfluidic
device, magnetically susceptible particles with the liquid sample, the magnetically
susceptible particles comprising a binding agent configured to bind an analyte; forming,
proximal to a junction between the first portion of the channel and a second portion
of the channel, a liquid sample:gas interface; forming a liquid sample:second liquid
interface by displacing gas of the liquid sample:gas interface with a second liquid,
and magnetically moving the magnetically susceptible particles across the liquid sample:second
liquid interface into the second liquid.
[0033] The method may include determining an assay result. The method may include determining
an amount of the analyte. The method may include comparing the amount of analyte determined
against a reference amount to produce an assay result. The method may include displaying
the determined amount of analyte. The method may include displaying information based
on an assay result. The information may be indicative of the assay result (e.g., may
be indicative of the amount of analyte in the second liquid). The assay result displayed
may be proportional to the amount of analyte in the second liquid.
[0034] Forming a liquid sample:second liquid interface by displacing gas of the liquid sample:gas
interface with a second liquid may comprise directing the second liquid across the
face of the liquid sample at the liquid sample:gas interface.
[0035] Forming a liquid sample:second liquid interface by displacing gas of the liquid sample:gas
interface with a second liquid may comprise directing a flow of second liquid across
the face of the liquid sample at the liquid sample:gas interface to decrease an area
of the liquid sample:gas interface. During flow of the second liquid across the face
of the liquid sample the first liquid may be held essentially static.
[0036] The method may comprise the step of forming a liquid sample .second liquid interface
in which substantially no bulk movement of liquid (other than diffusion) occurs across
the interface.
[0037] The method may comprise the step of magnetically positioning magnetically susceptible
particles at a predetermined detection zone in the second channel portion.
[0038] The method may comprise magnetically moving the magnetically susceptible particles
adjacent or upon a sensor located in, or juxtaposed to, the second channel portion
of the device. The particles may be magnetically retained adjacent or upon the sensor
for an amount of time sufficient for the sensor to detect a characteristic of the
second liquid.
[0039] The method may include magnetically positioning the magnetically susceptible particles
adjacent one or more electrodes configured in the second channel portion to contact
the second liquid. The method may include detecting a characteristic of the second
liquid at the electrode(s). The step of detecting a characteristic may comprise detecting
an electrochemical signal in the second liquid. The magnetically susceptible particles
may be held adjacent or upon the one or more electrodes for an amount of time sufficient
for the electrodes to detect an electrochemical signal in the second liquid. The detection
may comprise detecting the presence of analyte in the second liquid. The detection
may comprise detecting an amount of analyte in the second liquid.
[0040] The step of introducing the liquid sample may comprise depositing a quantity of the
liquid sample at an inlet of the device, wherein the inlet is in fluid connection
with the first channel portion.
[0041] The method may be a diagnostic method.
[0042] The method may be performed outside of the presence of a medical practitioner. In
some embodiments, the method is a method for detecting NTproBNP in a liquid sample
of blood, plasma or serum from a human and the method includes introducing the liquid
sample to a first portion of a channel of a microfluidic device; contacting, within
the microfluidic device, the liquid sample with reagents comprising magnetically susceptible
particles conjugated to a first anti-NTproBNP antibody, and a second anti-NTproBNP
antibody conjugated to an enzyme label, to form complexes comprising magnetically
susceptible particle, NTproBNP and enzyme label; forming, proximal to a junction between
the first portion of the channel and a second portion of the channel, a liquid sample:gas
interface; forming a liquid sample:second liquid interface by displacing gas of the
liquid sample:gas interface with a second liquid; magnetically moving the magnetically
susceptible particles across the liquid sample:second liquid interface into the second
liquid; and detecting NTproBNP in the second liquid.
[0043] The liquid sample:gas interface may be essentially static with respect to movement
along the channel between forming the liquid sample:gas interface and forming the
liquid sample:second liquid interface.
[0044] The invention relates to a device as set out in independent claim 1.
[0045] In some embodiments proximal to the junction one or more of the internal wall(s)
of the first channel portion are hydrophobic. Proximal to the junction one or more
of the internal wall(s) of the first channel portion can have a hydrophobic patch,
a hydrophobic line or a hydrophobic ring extending around the circumference of the
first channel portion.
[0046] In some embodiments the inlet is partitioned into one or more first compartments
in fluid connection with the first channel portion thereby defining a total volume
of the first channel portion and first compartments (V
i), and one or more second compartments not in fluid connection with the first channel
portion.
[0047] In some embodiments the second channel portion has a liquid overflow channel portion,
said overflow channel portion partitioned into a first overflow channel portion proximal
the junction and a second overflow channel portion distal to the junction, wherein
the reagent control zone is located in the second overflow channel portion. The main
longitudinal axis of at least one of the first and second overflow portions can be
substantially parallel to the first channel portion.
[0048] Also described is a device that comprises:
an inlet in fluid connection with a first portion of a channel, the inlet configured
to receive a liquid;
a second portion of the channel connected to the first portion at a junction;
magnetically susceptible particles disposed in the first channel portion;
wherein the device is configured to form, with a liquid received by the inlet, a liquid
interface proximal the junction,
the device further comprising:
a reservoir containing a quantity of second liquid and configured to deliver second
liquid released from the reservoir into the second channel portion such that the second
liquid flows towards the junction, and
at least one sensor configured on the second channel portion to detect a signal from
the second liquid,
wherein the second channel portion has a liquid overflow channel portion, said overflow
channel portion partitioned into a first overflow channel portion proximal the junction
and a second overflow channel portion distal to the junction, wherein the reagent
control zone is located in the second overflow channel portion.
[0049] In some embodiments the main longitudinal axis of at least one of the first and second
overflow portions can be substantially parallel to the first channel portion.
[0050] The first portion of the channel has a main channel height h
1 and a
channel height h'
1 at the junction, wherein h
1>h'
1 and wherein at the junction, the first channel portion has height h'
1 and the second channel portion has height h
2, wherein h
2>h
1>h'
1. Proximal to the junction one or more of the internal wall(s) of the first channel
portion can be hydrophobic.
[0051] The assay method and device can be used in home testing kits for analyzing species
present in the blood. In particular, the device and method facilitate the performance
of more than one assay on a small sample volume, and are suitable for use with home
testing kits that use the "finger stick" or "finger prick" procedure.
[0052] The assay device and method can accept small fluid samples in a simple step, and
is able to present small fluid samples for immediate testing in a reliable and reproducible
fashion. The present invention provides an efficient way to utilise obtained blood
samples in a home testing kit by allowing the performance of a series of tests on
the same sample. Finally, the device and method facilitate the execution of more than
one assay on the same blood sample by separating and isolating analytes of interest,
within a complex mixture. This enables the visualisation of the analytes by a detection
procedure. In particular, the present invention affords the use a specific reagent
for visualising a marker related to an analyte and the reliable quantification of
its presence to inform on a disease state in a subject.
[0053] Embodiments permit determination of one or several analytes, such as analytes indicative
of disease states in a subject, to be detected.
[0054] The invention includes the combination of the described aspects and features except
where such a combination is clearly impermissible or expressly excluded.
BRIEF DESCRIPTION OF THE DRAWINGS
[0055]
Figure 1 is a flow chart of an assay method;
Figure 2 is perspective view of an assay device and meter suitable for performing
the assay method;
Figure 3 shows a perspective view of an assay device (including buffer pouch);
Figure 4 shows a plan view of an assay device above (excluding buffer pouch);
Figure 5 shows a perspective view of an assay device from underneath;
Figure 6 shows a perspective view from above of the component layers of an assay device;
Figure 7 shows a plan view of an exemplary embodiment of an assay device from above,
including component dimensions (mm);
Figure 8 shows an enlarged view of the interface zone Z from Figure 7; Figure 9 shows
a plan view of the upper part of an assay device (excluding buffer pouch);
Figure 10A shows a cross-section through the assay device along line B-B, shown in
Figure 10B; Figure 10C shows an enlarged view of detail W from Figure 10A; Figure
10D shows an enlarged view of detail U from Figure 10A; Figure 1 IA shows a cross-section
through the assay device along line C-C, shown in
Figure 1 IB;
Figure 11C shows an enlarged view of detail V from Figure 1 IA;
Figures 12A and 12B show plan views of the microfluidic network of one exemplary embodiment
of the assay device (dimensions in Figure 12B in mm);
Figure 13 shows an enlarged view of the interface of the buffer pouch and sharp projection;
Figure 14 shows an enlarged view of the junction in one exemplary embodiment of the
assay device;
Figures 15A-B show on-board control configurations; Figures 16A-D show on-board control
configurations; Figure 17 shows a typical dose response curve for NT-proBNP concentrations
0-20,000 pg/ml;
Figure 18 illustrates summary HRP titration data at turnover times of 10 mins, 1 min,
30 sec and 15 seconds;
Figure 19 illustrates NT-proBNP electrochemical assay results for 0, 5000, 10,000,
20,000 and 40,000 pg/ml NT-proBNP with HRP turnover times of 1 min, 30, 15 and 5 seconds;
Figure 20 illustrates a semi-log plot of NT-proBNP electrochemical assay results at
a 15 sec turnover time.
DETAILED DESCRIPTION
[0056] Assays for determining (e.g. quantitatively or qualitatively) one or more analytes
or indicators in sample material (e.g., a biological sample) are described. Typical
analytes are biomarkers related to (e.g., indicative of) the presence of a physiological
condition in a mammalian subject. The presence of the physiological condition can
be determined based at least in part on the result of the determination of the biomarker
(e.g., by comparing the result to a reference value).
[0057] The assays can be for use in reaching a diagnosis or prognosis. Assay methods can
comprise methods of diagnosis or prognosis of a pathological condition or disease
state in a user or susceptibility of the user to a pathological condition or disease
state. The assay device can be provided for use in a method of diagnosis or prognosis
of a pathological condition or disease state in a user or susceptibility of a user
to a pathological condition or disease state. In exemplary embodiments the assay method
is an in vitro method not practised on the human or animal body. In exemplary embodiments
the assay method is practised on a liquid sample which may be a sample collected from
the human or animal body, e.g. a bodily fluid sample such as a human blood sample.
In exemplary embodiments the sample is used to conduct the assay and is then discarded,
and is not returned to the human or animal from which it was collected.
[0058] In exemplary embodiments, magnetically susceptible particles are used in the capture
of an analyte, the separation of an analyte from a liquid sample, and in the positioning
of the analyte proximal a detection zone.
[0059] In some embodiments, an analyte is separated from a liquid sample. After being separated,
the analyte is detected in a second medium (e.g., another fluid (e.g., a gas such
as air, a different liquid such as a buffer) or flowable medium (e.g., a gel, such
as an electrophoresis gel). An exemplary method includes combining magnetically susceptible
particles adapted to bind the analyte with the liquid sample to form complexes of
magnetically susceptible particle bound analyte. The complexes are magnetically separated
from the liquid sample into the second medium.
[0060] Separation of the complexes from the liquid sample into the second medium (e.g.,
another fluid (e.g., a gas such as air, a different liquid such as a buffer) or flowable
medium (e.g., a gel, such as an electrophoresis gel)) is typically achieved by a method
that includes forming an interface between the liquid sample and second medium. In
embodiments, the interface is stable, and essentially static (i.e. diffusion may occur
with respect to the interface but the position of the interface is essentially constant).
For example, in embodiments in which the interface is performed within a microfluidic
device, the position of the interface relative to the microfluidic device may be essentially
constant (e.g., the relative position may change by about 5 mm or less, about 2.5
mm or less, about 1 mm or less) at least prior to the transport of the magnetically
susceptible particles across the interface as described below. Typically, bulk movement
of at least one (e.g., both) of the liquid sample and second medium does not occur
with respect to the interface at least prior to the transport of the particles across
the interface. In an exemplary embodiment, the position of the interface is essentially
constant at least prior to determination of the analyte.
[0061] The interface is typically substantially free of gas bubbles. For example, it can
be free of gas bubbles or may contain a small number of gas bubbles that do not prevent
transfer across the interface of substantially all of the magnetically susceptible
particles clustered in the liquid sample adjacent the interface, wherein substantially
all of the magnetically susceptible particles is at least about 70% (e.g. at least
about 80%, at least about 85%, at least about 90%, at least about 95%, at least about
98%) of the clustered magnetically susceptible particles.
[0062] In exemplary embodiments, the interface is formed between the liquid sample and the
second medium (e.g., another fluid (e.g., a gas such as air, a different liquid such
as a buffer) or flowable medium (e.g., a gel, such as an electrophoresis gel)). In
exemplary embodiments the interface is defined by the contacting parts of the liquid
sample and the second medium.
[0063] A magnetic field is applied to the magnetically susceptible particle:analyte complexes
in the liquid sample and the complexes are magnetically moved towards the liquid sample:second
medium interface. The magnetic field moves the complexes across the interface and
into the second medium. The transport across the interface separates the complexes
from the liquid sample.
[0064] In exemplary embodiments movement of substantially all of the magnetically susceptible
particle:analyte complexes across the liquid sample:liquid interface is optimized
by controlling the speed of movement of the magnetic field towards the interface,
and across the interface. The timing of movement of the magnetically susceptible particle:analyte
complexes across the interface can be controlled to be coincident with, or very shortly
after, formation of the liquid sample:second liquid interface.
[0065] Having separated the complexes from the liquid sample, the complexes can be further
magnetically moved to a sensor (e.g., an electrochemical sensor including one or more
electrodes), where the presence of analyte can be detected directly or indirectly.
[0066] In exemplary embodiments an indirect detection is performed wherein the complexes
include an enzyme label capable of producing a detectable reaction in the presence
of one or more enzyme substrates and/or cofactors. For example, the enzyme may produce
a product such as an oxidized or reduced enzyme substrate, cofactor or byproduct.
The product can be detected electrochemically using the electrochemical sensor. For
example, the electrochemical sensor may include one or more electrodes in contact
with the second medium.
[0067] In exemplary embodiments, the separation of analyte from the liquid sample is desirable
as the presence of analyte can then be detected without interference from contaminants
(e.g., molecular components such as biological compounds) of the liquid sample. For
example, some liquid samples (e.g. blood) produce a non-negligible background electrochemical
signal which can interfere with electrochemical determination of certain analytes.
Hence separation of analyte from blood may be desirable in order to accurately determine
the presence of the analyte.
[0068] A device is provided to perform the method of detecting an analyte. The method of
detection is an assay for the presence of analyte in the liquid sample and the device
an assay device for that method.
[0069] The assay device is a microfluidic device having a channel network. The network comprises
an inlet connected to a first channel portion, which is connected to a second channel
portion at a junction (e.g., a capillary stop) at an intermediate position in the
channel network. At the junction the second channel portion can have a cross-sectional
area that is larger than the first channel portion creating a capillary stop pressure
(p
capstop) and forming the capillary stop. The capillary stop can alternatively be formed by
other means, such as the use of a hydrophobic patch disposed on one or more interior
surfaces of the channel.
[0070] Liquid sample deposited at the inlet can flow into the first channel portion and
fill the first channel portion up to the junction. Liquid sample forms an interface
(e.g., a liquid sample:second medium interface) proximal to the junction of the first
and second channel portions. The second medium is typically another fluid (e.g., a
gas such as air, a different liquid such as a buffer) or flowable medium (e.g., a
gel, such as an electrophoresis gel). In embodiments, the second medium is a gas and
the interface is a liquid sample-gas interface (e.g., a meniscus).
[0071] In some embodiments, the interface is formed by contacting a first interface between
(a) one of the liquid sample and the second medium and (b) third medium with the other
of the liquid sample and the second medium such that the other of the liquid sample
and the second medium displaces the third medium from the first interface. In some
embodiments, the third medium is a second liquid (e.g., a buffer) and the device further
includes, or is configured to cooperate with, a reservoir of second liquid from which
second liquid can be released into the second channel portion to flow towards the
junction (e.g., towards the interface). For example, in embodiments where the interface
is a liquid sample-gas interface, the second channel portion directs released second
liquid to the liquid sample:gas interface to displace the gas (e.g., air) and form
a liquid sample:second liquid interface.
[0072] In exemplary embodiments the region of the second channel portion adjacent the junction
is configured to direct second liquid transversely across a face of the liquid sample:air
interface to progressively decrease the area of the liquid sample:air interface as
the second liquid flows across the face of the liquid sample:air interface. Subsequent
to forming the liquid sample:second liquid interface, the interface may be essentially
static and/or bulk movement of liquid relative to the interface may be absent at least
until transport across the interface as described above.
[0073] The configuration of the second channel portion adjacent the interface can include
a change in height and/or width of the second channel portion. In exemplary embodiments
the configuration of the second channel portion adjacent the interface includes a
tapering of the width and height of the second channel portion to increase the second
channel portion width and height at the junction. The second channel portion can further
include a change of direction proximal to the junction provided by a bend portion
in the second channel portion adjacent the junction. An inside wall of the bend portion
can further comprise a capillary stop (e.g. a notch or vent in the inside wall and/or
a hydrophobic patch), whilst an outside wall of the bend does not have a corresponding
capillary stop. Second liquid advancing towards the junction is retarded at the capillary
stop on the inside wall of the bend such that the second liquid advances more rapidly
around the outside wall of the bend, in which the junction of the first and second
channel portions can be located (at least partially). Typically, the portion of second
liquid adjacent the outside wall pivots with respect to the capillary stop. This directs
the flow of second liquid transversely across the face of the liquid sample:air interface
formed at the junction and facilitates formation of a liquid sample:second liquid
interface that is substantially free of air bubbles.
[0074] Reagents in the first channel portion form magnetically susceptible particle:analyte
complexes with analyte in the liquid sample. These complexes can now be magnetically
moved across the liquid sample:second liquid interface and towards a sensor, e.g.
one or more electrodes, in the second channel portion where the presence of the analyte
can be detected.
[0075] The device is configured for operation in conjunction with a meter or reader into
which the device is inserted. The meter includes a magnet, which may be an electromagnet,
for magnetically moving the magnetically susceptible particles and complexes. The
meter also includes components configured to receive signals from the assay device,
and a processor and display for determining and displaying an assay result.
[0076] The device can be configured to detect more than one analyte.
[0077] Assays for determining (e.g. quantitatively or qualitatively) one or more analytes
or indicators in sample material (e.g., a biological sample) are described. Typical
analytes are biomarkers related to (e.g., indicative of) the presence of a physiological
condition in a mammalian subject. The presence of the physiological condition is determined
based at least in part on the result of the determination of the biomarker (e.g.,
by comparing the result to a reference value). Determination of an analyte can be
direct or indirect. For example, the presence of an analyte can be indirectly determined
by detecting a signal (e.g., an electrochemical or optical signal) resulting from
a detectable label (e.g., an enzyme label) conjugated to the analyte. An analyte can
be directly determined by, for example, detecting a signal (e.g., an electrochemical
or optical signal) resulting from the analyte itself.
[0078] Any of the devices or methods described herein can be further configured or implemented
to perform at least one action at least in part based on and/or using a result of
the determination. For example, the at least one action can be selected from the group
consisting of storing the result, making the result available for further processing,
displaying the at least one result, recording the result, transmitting the result
to a remote location, comparing the result to a reference value, displaying information
related to the result, choosing from among multiple actions based on the result, or
combination thereof. Here, the term "result" includes values or indicia indicative
of the result.
[0079] For example, an assay may result in the detection or determination of a characteristic
or the detection of an analyte. The result of the determination or detection may be
further stored, and/or processed and/or recorded and/or transmitted to a remote location
and/or compared to a reference value (e.g. a standard subject population reference
value or an individual subject reference value (e.g., a baseline determined from one
or more prior determinations of the analyte from the patient)) and/or displayed as
an assay result (e.g. to a user of the apparatus) and/or acted on (e.g. through the
alteration of a therapeutic programme or strategy). Transmission of a determination
or detection to a remote location can be carried out by a communications network,
e.g. LAN, WAN, and may be via the internet. Transmission can be wireless transmission
to a server, host or proxy. Wireless transmission can be implemented using the Bluetooth®
transmission protocol.
[0080] The analyte may be any analyte, and more particularly any analyte to which a binding
agent, such as an antibody, may be raised and coupled to a magnetically susceptible
particle.
[0081] In exemplary embodiments an analyte is a natriuretic peptide such as at least one
of BNP or NT-proBNP. NT-proBNP (N-terminal truncated pro-brain natriuretic peptide)
is the amino- terminal fragment of BNP (brain natriuretic peptide or B-type natriuretic
peptide). BNP is the 32 amino acid (aa) peptide cardiac hormone synthesized by ventricular
cells and stored as a 108aa pro-peptide. It is secreted in response to ventricular
expansion or pressure overload. The pro-peptide is cleaved to release the 32aa active
BNP and a 76aa N-terminal fragment (NT-proBNP). BNP and NT-proBNP are markers of ventricular
distension and overload. NT-proBNP is correlated with ambulatory cardiac filling pressures
in outpatients with chronic heart failure (
Braunschweig et al., European Journal of Heart Failure 8 (2006) 797-803) and is indicated as a biomarker of myocardial stretch and chronic heart failure
(
Murdoch et al., Am Heart J 138(6):1126-1132, 1999) and as a predictor of mortality in acute heart failure (
Sakhuja et al., Clinical Chemistry 53:3 412-420 (2007).
[0082] Exemplary assays for determining a concentration or amount (qualitative or quantitative)
of NT-proBNP in a human blood sample can therefore be used in the monitoring, diagnosis,
prognosis, assessment of risk of, and/or assessment of susceptibility to a pathological
condition or disease wherein, for example, the pathological condition or disease is
chosen from a cardiac condition or disease; heart failure; chronic heart failure;
congestive heart failure; myocardial infarction; hypertension.
[0083] In other exemplary embodiments the analyte can be chosen from potassium ion, cystatin
C, troponin T, troponin I, myeloperoxidase, creatine kinase MB.
[0084] The analyte can be a biomarker for a condition that afflicts the mammalian body.
The term "biomarker" refers to a biochemical in the body that has a particular molecular
trait to make it useful for diagnosing a condition, disorder, or disease and for measuring
or indicating the effects or progress of a condition, disorder, or disease. For example,
common biomarkers found in a person's bodily fluids (i.e., breath or blood), and the
respective diagnostic conditions of the person providing such biomarkers include,
but are not limited to, ischemia modified albumin "IMA" (source: lack of oxygen to
the blood; diagnosis: coronary artery disease), N-terminal truncated pro-brain natriuretic
peptide "NT pro-BNP" (source: stretching of myocytes; exemplary diagnosis related
to congestive heart failure), acetaldehyde (source: ethanol; diagnosis: intoxication),
acetone (source: acetoacetate; diagnosis: diet; ketogenic/diabetes), ammonia (source:
deamination of amino acids; diagnosis: uremia and liver disease), CO (carbon monoxide)
(source: CH
2Cl
2, elevated % COH; diagnosis: indoor air pollution), chloroform (source: halogenated
compounds), dichlorobenzene (source: halogenated compounds), diethylamine (source:
choline; diagnosis: intestinal bacterial overgrowth), H (hydrogen) (source: intestines;
diagnosis: lactose intolerance), isoprene (source: fatty acid; diagnosis: metabolic
stress), methanethiol (source: methionine; diagnosis: intestinal bacterial overgrowth),
methylethylketone (source: fatty acid; diagnosis: indoor air pollution/diet), O-toluidine
(source: carcinoma metabolite; diagnosis: bronchogenic carcinoma), pentane sulfides
and sulfides (source: lipid peroxidation; diagnosis: myocardial infarction), H
2S (source: metabolism; diagnosis: periodontal disease/ovulation), MeS (source: metabolism;
diagnosis: cirrhosis), and Me
2S (source: infection; diagnosis: trench mouth). The biomarker can be a marker of heart
failure (e.g. chronic heart failure, heart disease or susceptibility to myocardial
infarction (MI), e.g. a marker of MI risk) or a renal marker, e.g. a marker of glomerular
filtration rate, which may provide information on blood volume.
[0085] In exemplary embodiments the sample material is a liquid such as a biological liquid
(e.g., blood, blood plasma, serum, urine, saliva, mucous, tears, semen, cerebrospinal
fluid (CSF), lymph or other bodily fluid). In exemplary embodiments the sample material
is a bodily fluid from a mammal (e.g. a human who may be male or female). In exemplary
embodiments the sample material is whole blood from a human. The analyte can be any
component that is found (or may potentially be found) in the sample, such as, for
example, a protein, a peptide, a nucleic acid, a metabolite, a saccharide or polysaccharide,
a lipid, a drug or drug metabolite, or other component. The assay device can optionally
be supplied with a blood separation membrane arranged between a sample inlet and the
detection zone, such that when whole blood is available as a sample, only blood plasma
reaches the detection zone.
[0086] Magnetically susceptible particles can include magnetic particles or particles that
can be manipulated (e.g., moved) and/or positioned by a magnetic field. The magnetically
susceptible particles can be non-magnetic but susceptible to manipulation or positioning
by a magnetic field or be magnetic (e.g. a source of a magnetic field lines). The
magnetically susceptible particles can be spherical beads and can have a diameter
of at least about 0.05 microns, at least about 1 micron, at least about 2.5 microns,
and typically less than about 20µm. A magnetically susceptible particle can be, for
example, a magnetic particle described, in
U.S. Patent Application Publication Nos. 20050147963 or
20050100930, or
U.S. Patent No. 5,348,876, or commercially available beads, for example, those produced by Dynal AS (Invitrogen
Corporation, Carlsbad, California USA) under the trade name DYNABEADS™ and/or MYONE™.
In particular, antibodies linked to magnetic particles are described in, for example,
United States Patent Application Nos.
20050149169,
20050148096,
20050142549,
20050074748,
20050148096,
20050106652, and
20050100930, and
U.S. Patent No. 5,348,876. The magnetically susceptible particles may be ferrous particles.
[0087] The magnetic field to which the particles are susceptible can be applied by a magnet,
which can be any kind of magnet including a permanent magnet, temporary magnet, or
electromagnet. The magnet can be used as a magnetic source for application of a magnetic
field towards magnetically susceptible particles.
[0088] In exemplary embodiments components or Iiquid:gas or liquid:liquid interfaces can
be positioned proximal to a physical structure. Proximal positioning refers to positioning
close to the physical structure. The positioning can be at, or adjacent, the physical
structure.
[0089] Exemplary embodiments include a microfluidic device. A microfluidic device can comprise
a support in which one or more channels are formed to provide a channel network capable
of directing flow, and optionally controlling flow, of liquid through part or all
of the network. Typically the channel network will have multiple channel portions.
In exemplary embodiments the microfluidic device is configured to perform a desired
assay, and can be configured to interact with a meter in order to provide an assay
result. The microfluidic device is generally small enough to fit on a laboratory bench,
and in exemplary embodiments is small enough to be carried by an individual human
user in one or two hands.
[0090] In exemplary embodiments, channels and channel portions are generally enclosed spaces
defined by surrounding walls. The channel can have any cross-sectional shape (e.g.
rectangular, trapezoidal, or circular). Channels can be in fluid communication with
the atmosphere external to the microfluidic device by means of apertures (e.g., inlets,
outlets or vents) formed in the channel network. Channels or channel portions can
be open to the atmosphere for part or all of their length, e.g. by not having an enclosing
lid. Channels or channel portions can comprise a capillary, i.e. a channel of small
internal diameter capable of holding or transporting liquid by capillary action, wherein
capillary action is (at least in part) the effect of surface tension that draws a
liquid into or along the channel.
[0091] Devices according to embodiments can be for use in performing an assay, e.g. on a
blood sample. The user can be a human (male or female). In exemplary embodiments the
user can perform the assay in the absence of the presence, or in-person assistance,
(verbal or otherwise) of a medical practitioner (e.g. nurse, physician, medical doctor,
general practitioner, surgeon or phlebotomist). Accordingly, the assay devices can
be configured for use away from the hospital, doctor's office, surgery or other medical
establishment and can be used in a domestic environment, such as the home or office,
or in any convenient location.
[0092] A method and/or device and/or meter can be configured for conduct of an assay and
production of an assay result to a user in a total test time of less than about 30
minutes (e.g. less than about 20 minutes, less than about 15 minutes, less than about
10 minutes) and in one embodiment in about 10, 11 or 12 minutes.
[0093] In exemplary embodiments one or more sensors can be used to determine a characteristic
of a liquid and/or to detect a signal. The signal can be the presence or absence of
a component, e.g. analyte or oxidized compound. In preferred exemplary embodiments
the sensor is an electrochemical sensor including one or more electrodes and the signal
is an electrochemical signal (e.g., a signal formed by the reduction of an oxidized
compound at an electrode, or the oxidation of a reduced compound at an electrode),
which can be detected and/or measured amperometrically and/or voltametrically at the
electrode(s). Other sensors include detectors of radiation (e.g. light, X-ray, γ-ray
radiation) and/or optical (e.g., fluorescence, reflectance, or absorbance).
[0094] In exemplary embodiments components can be bound or conjugated to one another to
form complexes (e.g. a magnetically susceptible particle can be conjugated to a binding
agent). Binding or conjugation of components can be direct (e.g. binding of an analyte
to an anti-analyte antibody) or indirect (e.g. binding of a magnetically susceptible
particle to a binding agent through linkers such as streptavidin and biotin).
[0095] In exemplary embodiments binding agents are molecules capable of specifically binding
to a selected target with high affinity, having a K
d for the target of about 100µM or less (e.g. less than about 50µM, less than about
10µM, less than about 1µM, less than about 100nM, less than about 10nM, less than
about 1nM, less than about 100pM, less than about 10pM). The first and second binding
agents can be respectively chosen from an antibody (monoclonal or polyclonal), antibody
fragment (e.g. scFV fragment), antibody binding domain, aptamer or other recognition
reagent. The first and second binding agents can be different, e.g. an antibody and
an aptamer.
[0096] In exemplary embodiments reagents are provided in an assay device (e.g., in dry form).
The reagents can be configured to participate in an assay, e.g. to detect presence
of analyte, and can be configured to form conjugates and/or bind the analyte. In exemplary
embodiments, the reagents include conjugates of magnetically susceptible particle
and at least one reagent (e.g., an antibody labeled enzyme) configured to bind the
analyte and form a ternary complex with the magnetically susceptible particle. In
exemplary embodiments conjugates of magnetically susceptible particle and reagents
are configured to participate in a sandwich assay involving first and second binding
agents to form a ternary complex.
[0097] Exemplary embodiments provide a device and method for performing an assay on a single
small volume blood sample, or other biological materials or complex mixtures.
[0098] Exemplary embodiments will now be described in detail, with reference to the accompanying
figures. The invention includes the combination of the features described in the exemplary
embodiments except where such a combination is clearly impermissible or expressly
avoided.
[0099] Referring to Fig 1 an assay method 1000 includes a mixture formation step 1001, a
reagent/analyte capture step 1002, a complex transport step 1003, a complex determination
step 1004 and a formation of an assay result step 1005. Typically, method 1000 is
performed using an assay device including a reagent zone, in which the sample reacts
with the reagents, a detection zone in which determination of the analyte is performed
(either qualitatively or quantitatively), and an interface zone, which provides an
interface between the reagent zone and the detection zone.
[0100] In mixture formation step 1001 a mixture including a quantity of sample material
(e.g. a sample liquid such as blood from a human) and reagents capable of binding
to an analyte is formed. In an exemplary embodiment the reagent capable of binding
to the analyte may be an antibody or antibody domain or fragment (e.g. scFv) capable
of binding to the analyte. In reagent/analyte capture step 1002 the reagents capable
of binding the analyte form complexes with analyte that is present in the sample.
In complex transport step 1003 reagent:analyte complexes formed during the previous
step may be washed to remove non-complex material and are transported to a detection
zone. In complex determination step 1004, the presence of reagent:analyte complexes
that have been transported to the detection zone is determined (e.g. qualitatively
or quantitatively). The assay result is formed in step 1005 as a result of the extent
of detection of reagent:analyte complexes in the preceding step. For example, detection
of reagent:analyte complexes may be indicative of the diagnosis or prognosis (new
or continued) of a disease state or pathological condition of a user or patient. Therefore,
the detection of reagent:analyte complexes may be used or processed (e.g. by comparison
with a reference value), to provide an assay result, which may be displayed to the
user.
[0101] Assay method 1000 will now be discussed in greater detail.
[0102] In mixture formation step 1001 a mixture is formed between reagent materials that
are disposed within a reagent zone of an assay device and a quantity of sample material
sufficient to fill the reagent zone of the assay device. A sample of blood can be
obtained from a finger stick or a venous puncture. The volume of blood is typically
about 10 µl or about 5µl.
[0103] Several reagents are present within the reagent zone of the assay device. The reagents
typically include the following species; magnetically susceptible particles, a first
reagent capable of binding to the analyte, a second reagent capable of binding to
the analyte concurrently with the first reagent (e.g., as in a sandwich). Typically,
the reagent binds to a first unique region of the analyte and the second reagent binds
to a second unique region of the analyte. The first reagent is configured to bind
to the magnetically susceptible particles even in the absence of analyte (e.g., in
a non-specific binding reaction). For example, the first reagent may include a biotin
portion and the particle may be coated with streptavidin, which captures the biotin
modified first reagent. The second reagent includes a detectable label (e.g., an enzymatic
label such as an enzyme). In an exemplary embodiment, the second reagent is a labeled
particle (e.g., a non-magnetically susceptible particle such as a colloidal gold sol
particle) that is conjugated with a binding reagent for the analyte (e.g., an antibody
for the analyte) and with an enzymatic label. Typically, the particle includes multiple
enzymatic labels thus increasing the number of enzyme labels that become part of the
reagent:analyte complex. The second antibody-enzyme conjugate is typically provided
pre-associated with the labeled particles.
[0104] In general, the first and second recognition reagents do not associate with one another
in the absence of analyte. The presence of analyte, however, can associate the first
and second recognition reagents together, in a ternary complex
The second reagent can recognize the same or a different analyte and can be a binding
agent that specifically binds the same or a different analyte. The reagent zones can
include further reagents such as redox mediators, substrates for particular enzymes
and salts suitable for forming buffer solutions. The second binding agent can be linked
to a particle that can induce mobility on the so-formed ternary complex. The particle
can be, for example, a polymer microsphere, a metal nanoparticle, or a magnetically
susceptible particle.
[0105] When the reagents are mobilized by a sample liquid including the analyte, the reagents
interact with the analyte to form a complex including the magnetically susceptible
particle, the first reagent, the analyte, and the second reagent. The streptavidin
coated magnetically susceptible particle can accommodate a number of biotin modified
reagents capable of binding to the analyte. Accordingly, each complex may include
multiple analyte molecules and multiple second reagents.
[0106] The reagent zone may include one or more additional reagents such as, for example,
an anti-coagulant to inhibit clotting of blood within the reagent zone and/or buffer
salts. Buffer salts present in the reagent zone control the pH of the mixture to give
a pH value that favours the formation of complexes. The pH value is maintained at
a desired pH, for example the pH may be maintained within a range of between about
pH 7.2 and about pH 7.6.
[0107] Reagent/analyte capture step 1002 includes forming complexes between the reagents
and analyte contained within the sample. When a sample is applied to the assay device,
the dried reagents initially form an inhomogeneous mixture with the sample. Within
a short interval of time, the reagents become sufficiently hydrated that they begin
to interact with the sample. The first and second antibodies bind to analyte and form
complexes. The biotin labeled first reagent binds to the streptavidin coated magnetically
susceptible particle(s). The second reagent (e.g., a non-magnetically susceptible
particle conjugated to an enzyme label and a binding agent for the analyte) binds
the analyte.
[0108] Complex transport/wash step 1003 includes moving the reagent:antibody complexes from
the reagent zone to the detection zone. The detection zone is filled (e.g., actively)
with a buffer solution during the course of a sample assay. Buffer is released from
a reservoir at a predefined time after sample has been applied to the assay device.
Buffer solution fills the detection zone and the interface zone. When buffer solution
is delivered into the interface zone, the buffer forms a sample liquid:second liquid
interface with the sample in the reagent zone (as will be described in more detail
below). Excess buffer solution moves in to an overflow channel. When buffer has made
contact with and formed an interface with the
[0109] sample there is a continuous liquid path through the microfluidic network of the
assay device. The reagentranalyte complex can thus be moved along the length of the
assay device supported in a continuous liquid stream.
[0110] A magnetic field can be used to manipulate the reagent:analyte complex within the
assay device. The reagent:analyte complex can be drawn along the reagent zone, through
the interface zone to the detection zone by a magnetic field. The path of the magnetic
field moves in a direction that transfers magnetically susceptible particle complexes
from the reagent zone to the detection zone.
[0111] In some embodiments, one or more of the detection zones include one or more electrodes.
The electrodes can be formed of a material selected for electrical conductivity and
low reactivity with sample components, for example, silver, gold, aluminum, palladium,
platinum, iridium, a conductive carbon, a doped tin oxide, stainless steel, or a conductive
polymer. The electrodes in the detection zones (the working electrodes), in conjunction
with second electrodes in the reference zones (the reference electrodes) can measure
an electrical property of the sample, such as a voltage or a current. Alternatively,
the detection zones and the reference zones can each have at least one working electrode
and counter electrode. That is, the detection and reference zones can make independent
measurements. Optionally, counter electrodes are also included in the assay device.
Assay devices including electrodes for measuring electrical properties of a sample
are described in, for example,
U.S. Patent Nos. 5,708,247,
6,241,862, and
6,733,655.
[0112] In some embodiments, the assay device base, assay device lid, or both have a translucent
or transparent window aligned with the detection zone. An optical change that occurs
in the detection zone can be detected through the window. Detection can be done visually
(i.e., the change is measured by the user's eye) or measured by an instrument (e.g.,
a photodiode, photomultiplier, or the like). In general, the reference zone is similar
in nature to the detection zone. In other words, when the detection zone includes
an electrode, the reference zone can likewise include an electrode. When the detection
zone is aligned with a window for optical measurement, the reference zone can similarly
be aligned with a window for optical measurement. In some embodiments, the reference
zone is not adapted to collect analyte. Alternatively, the reference zone is adapted
to collect analyte, but performs a different analysis on said analyte. Thus, the detectable
change measured in the reference zone can be considered a background measurement to
be accounted for when determining the amount or concentration of analyte present in
the sample.
[0113] During complex determination step 1004 magnetically susceptible reagent:analyte complexes
that have been transferred to the detection zone can be measured. In an exemplary
embodiment the detection zone includes electrodes that can be used to perform an electrochemical
analysis of the sample. The enzyme labeled second reagent that is part of reagentranalyte
complex can convert a substrate present in the buffer used to fill the detection zone.
The substrate can be converted from a first form that is not detectable to a second
form that is detectable. A measurement electrode within the detection zone can be
used to measure the detectable form of the substrate. For example, an amperometric
measurement can be made, in which a working electrode is polarised at a certain potential
versus a reference electrode e.g. a silver/silver chloride (Ag/AgCl) reference electrode.
For example, potassium ferricyanide can be converted (reduced) to potassium ferrocyanide
by glucose oxidase during the conversion of glucose to gluconic acid. Any potassium
ferrocyanide formed can be measured at about +400 mV vs Ag/AgCl as a positive current.
The ferrocyanide is re-oxidised back to ferricyanide by the working electrode. An
electroactive species can be oxidised, in which case it loses electrons to the electrode,
or reduced, in which case it receives electrons from the electrode. The transfer of
electrons between the electrode and the electroactive substance results in a measurable
current, which may be a positive or negative current.
[0114] An amperometric measurement of an electroactive substance can be used to construct
a calibration line. A known amount of substance yields a unique current, which can
be described by the equation

where y represents the measured current, x represents the concentration of substance,
m is the gradient of the line and c is the intercept of the line on the y-axis. Thus
the measured current can be used to determine the concentration of an unknown amount
of substance in solution following rearrangement of Eq. 1 to give

[0115] The buffer contained within the reservoir of the assay device includes a buffer salt
and a substrate for the enzyme. The buffer salt buffers the pH to provide an environment
suitable for the enzyme to convert the substrate to a product which can be detected.
For example, the buffer salt may be an acetate buffer (e.g., sodium acetate). In some
embodiments, the buffer can include at least about 100 mM sodium acetate (e.g., at
least about 110 mM sodium acetate). The buffer solution can also contain a chloride
salt to stabilise the electrochemistry of the reference electrode during analysis
(e.g. potassium chloride (KCl)). In some embodiments the chloride salt can include
at least about 100 mM KCl (e.g. at least about 125mM KCl). The buffer solution can
also include a detergent to reduce the likelihood of antibody complexes from adhering
to the internal surfaces of microfluidic network 508. In an exemplary embodiment the
buffer solution includes 0.1% (v/v) Tween-20™. The buffer also includes substrate(s)
for the enzyme label, which in the case of horse radish peroxidase is 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulphonic
acid) (ABTS) and hydrogen peroxide (H
2O
2). In some embodiments the buffer contains at least about 5mM ABTS and at least about
5mM H
2O
2.
[0116] The enzyme label that is conjugated to second binding agent can be horse radish peroxidase
(HRP), for example. HRP catalyses the conversion of hydrogen peroxide and ABTS to
water and oxidised-ABTS. Any oxidised-ABTS that is produced can be measured electrochemically
at a working electrode. Therefore during complex determination step 1004 any reagent:antibody
complexes that have been transported through the microfluidic network of assay device
can be measured according to the amount of oxidised-ABTS that is produced in the proximity
of a measurement electrode. The measured current is proportional to the amount of
oxidised-ABTS according to Eq. 2 and hence the measured current is proportional to
the amount of analyte in the complexes that have been transported to the electrode.
[0117] In forming an assay result step 1005, the measurement result obtained during complex
determination step 1004 is used to determine an assay result. In exemplary embodiments
the assay result comprises displaying or communicating a value or signal indicative
of the amount or concentration (quantitative or qualitative) of analyte detected in
the assay. In exemplary embodiments the assay result comprises determining the status
of the user, as regards the analyte. Depending on the analyte under investigation
an elevated measurement result can indicate a diagnosis or prognosis for a disease
state or pathological condition associated with the analyte.
[0118] In forming an assay result step 1005 a user of the assay device can be presented
with information. If the user is qualified to make a clinical judgment (such as a
medical doctor) the information might be different compared with a non qualified person,
such as a user performing a self-test measurement. A health care professional will
typically want numerical data that will facilitate a prognosis or provide a diagnosis.
An end user will typically want reassurance that "the way they feel" is a consequence
of (i) an unrelated issue, e.g. indigestion or (ii) occurrence or re-occurrence of
heart failure, in which case they will be prompted to dial 911, for example.
Assay device
[0119] Referring to Figures 3-11, an exemplary embodiment of the assay device is shown.
The assembled device is shown in Fig. 3. Referring to Figures 3 and 6, the assay device
is a microfluidic device in which a channel network is formed. The device has a base
502 that can be formed from a plastics substrate, such as polycarbonate in which the
channel network can be formed by techniques well known to persons skilled in the art
such as moulding, laser ablation or milling of the substrate (as described above).
[0120] The device has a laminate structure (as shown in Fig.6) being made up of multiple
layers. The microfluidic network is defined by a three layer laminate in which a first
substrate layer 502 is joined to a third substrate layer 506 by a second substrate
layer 504 comprising an adhesive strip, as described above. In an exemplary embodiment
a further adhesive strip joins the third substrate layer 506 with a packing piece
3502 to form a device having five laminate layers. The packing piece has a cut-out
section 3511 configured to permit a magnet in meter 400 to be positioned in close
proximity with the external surface of the third substrate layer 506.
[0121] The first substrate layer 502 further comprises a raised annulus 3510 having a liquid
inlet 520 proximal its centre and a sharp projection 3506 positioned at or adjacent
the inlet. An O-ring seal 2402 is seated on or adjacent the annulus and a liquid containing
reservoir 507 is received in the annulus, a wall of which is positioned adjacent the
sharp element or projection 3506.
[0122] Referring to Fig.s 4 and 10D, the sharp projection 3506 is formed as part of the
substrate 502. In an exemplary embodiment the projection 3506 has a pyramid structure
the apex of which forms the sharp point 3506 which facilitates puncture of reservoir
507. In an exemplary embodiment the sharp projection is an integral part of substrate
502 and both may be moulded from plastics material. The sharp projection is located
adjacent liquid inlet 520, wherein the entrance to liquid inlet 520 is formed by an
aperture in one side of the pyramid structure. Projection 3506 projects into the centre
of the space defined by the raised annulus 3510 and towards a base wall of the reservoir
507 when received in the annulus. In other embodiments the sharp projection 3506 can
be made of metal (e.g. steel) or plastics material.
[0123] In exemplary embodiments the reservoir 507 is a pouch having a wall, e.g. a base
wall, that may be ruptured by sharp projection 3506 on the assay device 500. In one
exemplary embodiment the base wall has a generally smooth outer surface which may
be generally planar or convex.
[0124] Referring to Fig.13, in an exemplary embodiment a seal or gasket (e.g. an O-ring
seal) 2401, e.g. of about 400-600µm thickness, having an internal diameter sufficient
to encompass the sharp projection and inlet 520 (e.g. at least about 1.5mm, at least
about 2mm, at least about 3mm, less than about 5mm, less than about 4mm) is formed
or placed around the sharp projection 3506 such that when the reservoir 507 is compressed
against the assay device and toward the sharp projection 3506 a gas-tight seal is
formed between the reservoir and the assay device preventing air from entering the
assay device via the inlet 520 such that liquid in the second channel portion 4304
is substantially free of air or other gas bubbles.
[0125] In an exemplary embodiment seal 2401 is integrally formed with the substrate 502
and is a raised circular ridge encompassing the sharp projection 3506 and liquid inlet
520. In operation, buffer pouch 507 is pushed towards the sharp projection 3506 so
as to rupture the buffer pouch and release liquid. The surface of the buffer pouch
507 adjacent the sharp projection is urged against seal 2401 to form an air-tight
seal around the sharp-projection 3506. The liquid forced from buffer pouch 507 and
entering inlet 520 is therefore substantially free of air, or gas bubbles. Accordingly,
a slug of liquid is forced into second channel portion 4304 and towards the junction
4305. The absence of air, or large gas bubbles, in the slug of liquid helps form a
stable liquid:liquid interface at junction 4305 and provides for high performance
electrochemical detection at the working electrode.
[0126] In some exemplary embodiments the reservoir 507 is made from plastics and/or metal
foil material and sealed to form a pouch, bag or sachet containing liquid, e.g. buffer
liquid. The reservoir 507 can be made from first and second materials, wherein one
of the materials is softer and/or thinner than the other, the softer or thinner material
forming at least part of the wall that is configured for rupture by the sharp projection
3506 on the assay device 500. In one exemplary embodiment the reservoir 507 has a
volume of about 40µl (e.g. at least about 50µl, at least about 60µl, less than about
100µl).
[0127] In one exemplary embodiment the reservoir 507 is made from a first material (e.g.
plastics material) and a second material (e.g. metal foil such as aluminium foil).
The reservoir is dome-shaped having an upper convex part formed by the first material
and a lower planar part made from the second material and forming the base of the
dome. The planar part is thin (e.g. at least about 20µm thickness) and can be punctured
when forced towards the sharp projection. The lower planar part is positioned adjacent
the sharp projection. Application of force to the upper convex part forces the lower
planar part and sharp projection together, rupturing the reservoir and releasing fluid
into inlet 520. The lower planar part is pushed against the seal located around the
sharp projection and inlet to prevent air mixing with fluid entering inlet 520.
[0128] Referring to Fig 7, an exemplary embodiment of the device has an inlet 510 at one
end of the strip, the inlet 510 is connected to the channel network 508 such that
sample liquid received at the inlet can enter the channel network. The channel network
508 has a first channel portion 4302 forming a reagent zone. In an exemplary embodiment
the first channel portion 4302 is connected directly to the inlet 510. In other exemplary
embodiments, an inlet channel 4303 connects the inlet 510 and first channel portion
4302.
[0129] The first channel portion 4302 is connected to a second channel portion 4304 at a
junction 4305. In an exemplary embodiment the plane of the junction is substantially
orthogonal to the main longitudinal axis of the second channel portion. The first
and second channel portions can have a common longitudinal axis.
[0130] The first channel portion 4302 is generally rectangular in cross-section, although
it may have a different cross-sectional shape, e.g. circular. At the junction 4305
the first channel portion 4302 has a cross-sectional area A
1 which is less than the cross-sectional area A
2 of the second channel portion 4304 at the junction 4305. The difference in cross-sectional
area of the first and second channel portions at the junction 4305 provides a capillary
stop 530, as described above. A liquid sample deposited at inlet 510 flows into first
channel portion 4302 (e.g. by capillary action) and on reaching the capillary stop
530 the liquid sample meniscus forms a liquid sample:air interface with air contained
in the second channel portion. The interface is positioned proximal the junction 4305.
Cross-sectional area A
1 is at least about 0.375mm
2 and A
2 is about 4.67mm
2. The ratio of A
1:A
2 is about 1:12.
[0131] Referring to Figures 7 and 8, adjacent the junction 4305, the second channel portion
has a tapered neck region 4306 in which the width and height of the second channel
portion 4304 increases when moving along the second channel portion from the liquid
inlet 520 towards the junction 4305. The tapered neck region 4306 provides an increase
in the width of the second channel portion from width w6 distal to junction 4305 to
width w5 at the junction 4305 and an increase in the height of the second channel
portion from height h3 distal to the junction 4305 to height h2 at the junction 4305.
[0132] Referring to Figure 8, the tapered neck region 4306 of the second channel portion
further comprises a bend portion in which the flow path defined by the second channel
portion 4304 is changed from a direction that is substantially toward the junction
4305 to one that is substantially across the junction 4305. The bend portion is formed
by an inside wall 4307 and an outside wall 4308 of the second channel portion 4304.
The outside wall 4308 contains a corner 536 and the inside wall 4307 has a means 532
to retard the flow of liquid towards the junction 4305. The means 532 can be a capillary
stop. The outside wall 4308 also comprises, at least partially, the junction 4305
of the first and second channel portions.
[0133] Between the corner 536 and the capillary stop 532 the base of the second channel
portion has a slope or chamfer 534 which connects a region 4309 of the second channel
portion 4304 that is distal to the junction 4305 and has height h3 with a region 4310
of the second channel portion 4304 that is proximal the junction 4305 and has height
h2, wherein h2>h3. The slope 534 extends obliquely across the second channel portion
from a region proximal the capillary stop 532 towards the opposing channel wall and
corner 536. The upper edge of slope 534 extends from a region proximal the capillary
stop 532 at the inside wall 4307 of the bend portion across the second channel portion
4304 slanting forwards towards the junction 4305. The upper edge of slope 534 extends
from the region near the capillary stop 532 obliquely forwards towards the junction
4305 and towards a region of the second channel portion having a greater width. The
lower edge of slope 534 contacting the region 4310 of second channel portion 4304
having height h2 makes an angle of about 20° (e.g. at least about 15°, at least about
30°, at least about 35°, less than about 45°, less than about 40°) with the plane
of junction 4305. The oblique direction of the slope across the second channel portion
towards the junction can thus also be described as an oblique slant of about 70° (e.g.
at least about 75°, at least about 65°, at least about 60°, at least about 55°, less
than about 45°, less than about 50°) from a main width w2 of the second channel portion
4304, wherein the main width w2 is perpendicular to the main longitudinal axis of
the second channel portion 4304 extending towards the junction 4305.
[0134] The upper edge of slope 534 (distal to junction 4305) at its most distal from the
junction, and in the region of capillary stop 532, is about 2.5mm from the wall of
the second channel portion 4304 in which the junction 4305 is formed in a direction
along a line parallel to the main longitudinal axis of the second channel portion.
This distance d2 is about 2.5mm (e.g. at least about 2.0mm, at least about 3.0mm,
less than about 5.5mm, less than about 5.0mm). The distance between lower edge of
slope 534 (proximal to junction 4305) at its most distal from the wall of the second
channel portion 4302 in which the junction 4305 is formed, and in a direction along
a line parallel to the main longitudinal axis of the second channel portion 4304,
is called d3 and is about 0.5mm (e.g. at least about 0.4mm, at least about 1.0mm,
less than about 2.0mm, less than about 1.8mm). The shortest distance from the upper
edge of slope 534 to the lower edge of slope 534 is d4, which is about 2.0mm (e.g.
at least about 1.5mm, at least about 2.5mm, less than about 3.0mm, less than about
3.5mm, less than about 4.0mm).
[0135] The slope 534 has an angle of inclination θ of about 8° (e.g. at least about 5°,
less than about 15°, less than about 25°), being the angle of inclination of the slope
534 from the base of the second channel portion 4304 adjacent the junction 4305 and
having height h3.
[0136] Slope 534 and capillary stop 532 control movement of liquid through the second channel
portion 4304 from liquid inlet 520 towards junction 4305. Liquid moving through the
second channel portion 4304 from liquid inlet 520 towards junction 4305 has an advancing
liquid meniscus forming a liquid:gas interface that is advancing towards junction
4305. Prior to reaching junction 4305 the advancing meniscus encounters capillary
stop 532 which retards the movement of the advancing liquid meniscus along the inside
wall 4307 of the bend portion. Capillary stop 532 thus acts to steer the liquid:gas
interface around the corner in which capillary stop 532 is located, as described above.
The advancing liquid:gas interface thus moves down chamfer 534 and across the face
of the junction 4305 of the first and second channel portions.
[0137] When a liquid sample is contained in the first channel portion 4302 forming a liquid
sample:air interface at the junction, movement of liquid through the second channel
portion towards the junction 4305 and across the face of the junction 4305 acts to
displace the air from the liquid sample:air interface and form an interface of the
liquid sample and liquid contained in the second channel portion, e.g. buffer liquid.
[0138] The bend portion, capillary stop 532 and slope 534 act together to advance the flow
of liquid in the second channel portion 4304 towards the junction 4305 initially around
the outside wall 4308 of the bend portion and past corner 536, thereby directing liquid
flow across the wall in which the junction 4305 is formed. This acts to displace air
from the liquid sample:air interface and form the liquid sample:liquid interface with
minimum retention of air bubbles at the interface. Excess liquid flowing in the second
channel moves into overflow channel 524 until it reaches vent 526.
[0139] A liquid sample:liquid interface is thereby formed at the junction 4305 by flowing
liquid in the second channel portion 4304 across a face of the liquid sample:air interface
so as to displace the air from that interface and progressively decrease the area
of the liquid sample:air interface until the air is displaced and the liquid sample:air
interface is replaced by a liquid sample:liquid interface.
[0140] During flow of liquid in the second channel portion 4304 across the liquid sample:air
interface, liquid sample in the first channel portion is held substantially static.
Once the liquid sample:liquid interface is formed and flow of liquid in the second
channel part 4304 and overflow 524 has stopped the liquid sample:liquid interface
is also substantially static with no bulk movement of liquid occurring across the
interface, in either direction.
[0141] To avoid breach of the liquid:air interface, e.g. where liquid in the first channel
portion breaches the capillary stop formed at the junction 4305 and enters the second
channel portion 4304, the capillary stop formed at junction 4305 is designed to withstand
normal capillary forces exerted by the sample fluid. However, the capillary stop can
be breached if the force of the sample fluid flowing in the first channel portion
is further increased, which may happen if excess sample is applied at the inlet or
an external force is applied to the assay device.
[0142] It is also preferred that the liquid:liquid interface is stable and substantially
static. In particular, the passive movement of particles across the interface, e.g.
from the liquid sample into the buffer liquid, should be kept to a minimum, e.g. in
order to avoid unwanted cross-reaction of buffer substrate with components of the
liquid sample and to minimise loss of magnetically susceptible particles from the
liquid sample into overflow 524.
[0143] Prevention or reduction of interface breach can be provided in one or a combination
of ways. According to the invention, and referring to Figure 14, the height (h'
1) of the first channel portion 4302 at the junction 4305 is less than the height (h
1) of the main body of the first channel portion 4302 (i.e. h
1>h'
1). The base of the first channel portion 4302 includes a ramp extending upwards towards
the junction 4305 (as shown in Figure 21), or alternatively (or additionally) extending
downwards towards the junction 4305 from the lid of the first channel portion 4302.
The ramp connects the parts of the first channel portion having heights h
1 and h'
1. The first channel portion 4302 thus has restricted dimensions at the junction 4305
compared to the main body of the channel.
[0144] The reduction in height of the first channel portion 4302 from h
1 to h'
1 has the effect of increasing the difference in height between the height of the first
channel portion 4302 at junction 4305 (this being h'
1) and the height of the second channel portion 4304 at junction 4305 (h
2). This increases the capillary stop.
[0145] In combination with, or as an alternative to, the use of a change in height of the
first channel portion 4302 proximal the junction 4305 one or more of the internal
wall(s) (optionally including base and/or lid) of the first channel portion can be
coated in a hydrophobic material at, and or proximal to, the junction 4305. This coating
can be in the form of a hydrophobic patch, line or ring extending around the circumference
of the first channel portion. The patch, line or ring can have a thickness of about
3mm (e.g. at least about 0.5mm, at least about 1mm, at least about 2mm, at least about
3mm, at least about 5mm).
[0146] The possibility of interface breach occurring can also be prevented or reduced by
controlling the quantity of sample fluid deposited at the inlet 510. Sample fluid
deposited at inlet 510 and in fluid connection with sample fluid in the first channel
portion 4302 provides a head of pressure and the capillary stop pressure provided
at junction 4305 is required to equal or exceed this in order to provide a stable
liquid:air interface. In some embodiments deposit of an excess of sample fluid is
prevented by partitioning the inlet into at least two compartments. One or more first
compartments are in fluid connection with the first channel portion 4302 and, in combination
with the first channel portion 4302, have a predetermined total volume (V
i) configured to provide a head of pressure that will not exceed the capillary stop
pressure at junction 4305. In a preferred embodiment V
i is about 5µl or about 10µl (e.g. at least about 2µl, at least about 5µl, at least
about 10µl, less than about 30µl, less than about 20µl, less than about 15µl). Excess
sample fluid deposited at the inlet overflows from the first compartment(s) into one
or more second compartments not fluidly connected to the first channel portion 4302.
[0147] In an exemplary embodiment where the liquid sample is blood a filter is positioned
at inlet 510 to prevent entry of red blood cells into first channel portion 4302 but
allow entry of the fluid parts of the blood sample.
[0148] In an exemplary embodiment the use of a second liquid introduced to the second channel
portion of assay device 500 to form the liquid sample:liquid interface is replaced
by inclusion of a flowable media in the second channel portion. On introduction of
the liquid sample to the first channel portion 4302 a liquid sample:flowable media
interface is formed proximal the junction 4305. Magnetic transfer of magnetically
susceptible particles across the interface into the flowable media and to the working
electrode is then performed as described herein with respect to the other embodiments
described. In such embodiments the assay device 500 does not require integration of
reservoir 507.
[0149] The flowable media can be a liquid. However, in exemplary embodiments, the flowable
media is a viscous liquid or gel. For example, the gel can be a matrix or electrophoresis
gel such as an agarose or polyacrylamide gel, or other crosslinked polymer. The gel
should provide a continuous flowable media path between the interface and sensor (e.g.
working electrode 516w) allowing for movement of magnetically susceptible particle:first
binding agent:analyte complexes from the interface through the gel to the sensor.
The gel can also contain substrates (e.g. ABTS and H
2O
2) required to detect analyte at the sensor.
[0150] The first channel portion 4302 contains reagents. The reagents include multiple magnetically
susceptible particles (e.g. at least about 50, at least about 100, at least about
150 magnetically susceptible particles) and a first binding agent configured to bind
an analyte. The first binding agent is configured to also bind to the magnetically
susceptible particles such that complexes of analyte:first binding agent:magnetically
susceptible particle can be formed when the reagents are contacted with a liquid sample
containing the analyte. These complexes can be magnetically moved through the liquid
sample:liquid interface.
[0151] In one exemplary embodiment the reagents include a second binding agent configured
to bind the analyte at a different spatial location (epitope) on the analyte to the
first binding agent. The first and second binding agents can both be bound to an analyte
molecule at the same time to form a "sandwich" complex. The sandwich complex can comprise
first and second binding agents bound to the analyte and magnetically susceptible
particle bound to the first binding agent. These complexes can be magnetically moved
through the liquid sample:liquid interface.
[0152] The first or second binding agent can be conjugated to a detectable marker. The detectable
marker can be any detectable label, e.g. enzyme label, fluorescent marker, radiolabel.
An enzyme label can provide or cause a detectable signal, e.g. an electrochemical
signal - oxidation or reduction at an electrode - following interaction with a substrate
of the enzyme. A fluorescent marker can provide an optical signal - fluorescence -
which can be detected by an optical sensor or scintillation counter. A radiolabel
can provide an electromagnetic signal which can be detected by a sensor that can detect
the electromagnetic radiation.
[0153] In an exemplary embodiment, the second binding agent is conjugated to an enzyme label,
e.g. horse radish peroxidise. Second binding agent:enzyme label conjugates are further
absorbed onto a colloidal sol particle, e.g. colloidal gold sol particles. The colloidal
sol particles can have a diameter of about 20nm or about 40nm.
[0154] The magnetically susceptible particles and first binding agent are modified to incorporate
complementary linkers, e.g. one of biotin and streptavidin, in order to provide conjugates
of the magnetically susceptible particles and first binding agent. The magnetically
susceptible particles and first binding agent can be deposited in the first channel
portion in pre-conjugated form, or can be deposited separately such that the conjugates
form on mixing of the reagents in the liquid sample.
[0155] In an alternative exemplary embodiment a mixture of liquid/fluid reagents is introduced
to the first channel portion 4302 and is then dried to provide a dry mixture reagent
deposit.
[0156] In an exemplary embodiment, the analyte for detection in a blood sample contained
in the first channel portion is NT-proBNP (e.g. human NT-proBNP). The first and second
binding agents are anti-NT-proBNP antibodies that bind different epitopes on NT-proBNP.
The first binding agent is:
- a monoclonal mouse anti-human NT-proBNP antibody 15C4 (HyTest Ltd., Intelligate 6th
floor, Joukahaisenkatu 6, 20520, Turku Finland; Catalogue #:4NT1) and the second binding
agent is chosen from:
- monoclonal mouse anti-human NT-proBNP antibody 15F11 (HyTest Ltd., Intelligate 6th
floor, Joukahaisenkatu 6, 20520, Turku Finland; Catalogue #:4NT1);
- monoclonal mouse anti-human NT-proBNP antibody 29D12 (HyTest Ltd., Intelligate 6th
floor, Joukahaisenkatu 6, 20520, Turku Finland; Catalogue #:4NT1).
[0157] The first binding agent can be biotinylated to facilitate conjugation to streptavidin
coated magnetically susceptible particles. The second binding agents can be conjugated
to horse radish peroxidise and 20nm or 40nm diameter colloidal gold sol particles.
[0158] Other antibodies to NT-proBNP are publicly available, e.g. those available from HyTest
Ltd., Intelligate 6th floor, Joukahaisenkatu 6, 20520, Turku Finland, e.g. monoclonal
mouse anti-human NT-proBNP antibodies 5B6, 7B5, 13G12, 11D1, 16E6, 15D7, 24E11, 28F8,
18H5, 16F3 (Catalogue #:4NT1).
[0159] In an exemplary embodiment in the electrode set 516w, 516c, 516r positioned in the
second channel portion 4304 the working electrode 516w is positioned closest the junction
4305 at a distance of about 3.6mm to the centre line of the electrode from the junction
(e.g. at least about 2mm, at least about 3mm, at least about 3.5mm, at least about
4mm, at least about 5mm, at least about 6mm, less than about 8mm, less than about
10mm). Electrode 516w has a width of about 2.4mm (e.g. at least about 2.0mm, at least
about 2.5mm, less than about 3.5mm, less than about 3.0mm). The width of electrode
516w is sufficient to tolerate small variations in the positioning of magnetically
susceptible particles and retain the ability to detect an electrochemical signal produced
by reagent-substrate interaction at those particles. Between the working electrode
and reference electrode 516r is a counter electrode 516c. The working and counter
electrodes are made from carbon paste and the reference electrode from silver paste.
The reference electrode is an Ag/AgCl reference electrode and is about 1mm wide (e.g.
at least about 0.6mm, at least about 0.8mm, less than about 2.0mm, less than about
1.4mm, less than about 1.2mm) and about 5mm from the centre line of the electrode
from the junction 4305 (e.g. at least about 4mm, at least about 6mm, less than about
9mm, less than about 12mm).
[0160] In one exemplary embodiment the enzyme label is horse radish peroxidase and the liquid
in the second channel portion 4304 is a reaction buffer containing sodium acetate
buffer, hydrogen peroxide substrate, and the redox mediator 2,2'-azino-bis-(3-ethylbenzo-thiazoline-sulfonic
acid) (ABTS), as described above. In one exemplary embodiment the buffer liquid is
10mM ABTS, 10mM H
2O
2, 150mM KCl, 125mM sodium acetate; 0.1% v/v Tween-20™ , made to a final pH 4.2.
[0161] In other embodiments where detection of analyte in the second channel portion is
other than by electrochemical detection - e.g. detection of fluorescence or colour
- the sensor may comprise a region of the second channel portion at which a signal,
e.g. fluorescence or colour, can be detected. In such embodiments the sensor can comprise
a transparent portion of the device permitting interaction with a detector, e.g. a
photodetector or scintillation counter, in meter 400.
[0162] The device can have one or more "on-board controls" to serve as checkpoints for the
proper operation of the device. For example, a first on-board control can be the use
of one of the electrodes 516w, 516c, 516r to detect flow of liquid from the liquid
inlet 520 towards the junction 4305. Flow of liquid through the second channel portion
4304 will form a conductive bridge between two of the electrodes 516w, 516c, 516r.
By operating meter 400 during liquid flow through the second channel portion 4304
towards the junction 4305 to detect current flow through two electrodes, e.g. the
working and counter electrodes 516w and 516r, the meter can detect progress of the
liquid towards the junction 4305. Referring to Figure 16A, a second on-board control
can be the use of an electrode or electrode pair 3601 positioned in overflow channel
524 to detect flow of liquid into the overflow channel and provide an indication of
liquid sample:liquid interface formation at junction 4305.
[0163] Further on-board controls can act as controls for the assay being performed. For
example, because substrates or reagents can decompose or lose activity over time,
one may wish to test for activity of these substrates or reagents, e.g. of a substrate
contained in liquid introduced into the second channel portion 4304. In one exemplary
arrangement the enzyme label can be horse radish peroxidase, which catalyses conversion
of hydrogen peroxide and ABTS to water and oxidised-ABTS. Hydrogen peroxide and ABTS
are provided in the buffer liquid introduced to the second channel portion 4304. Referring
to Figure 16B, the presence and/or activity of the hydrogen peroxide and ABTS can
be verified by immobilizing a predetermined quantity of the horse radish peroxidase
enzyme label 5501 at electrode(s) 3601 in the overflow channel 524. Active buffer
liquid components reaching the overflow will be catalysed and produce oxidized ABTS
and an electrochemical signal that can be detected by electrode(s) 3601. Detection
of a signal is indicative of active buffer components and serves to verify the validity
of the determination made at working electrode 516w. Referring to Figure 16C, in an
alternative arrangement the immobilized horse radish peroxidase can be substituted
for an immobilized complex of magnetically susceptible particle:first binding agent:analyte:second
binding agent, wherein the horse radish peroxidase is conjugated to the second binding
agent. Such an arrangement may more accurately reflect the form of ternary complex
formed at the working electrode 516w and provide an improved control.
[0164] Variations of the controls illustrated in Figures 16B and 16C are illustrated in
Figures 15A and 15B respectively. Referring to Figure 15A, first and second electrodes
(or pairs of electrodes) 5405, 5406 are provided in the overflow channel 524. A predetermined
amount of horse radish peroxidase is immobilized 5401 at the first electrode pair
5405 and will produce a first electrochemical signal R
1 when buffer liquid containing hydrogen peroxide and ABTS is present. A second predetermined
amount of horse radish peroxidase is immobilized 5402 at electrode pair 5406, wherein
the second amount is larger than the first amount at electrode 5401. The second amount
of horse radish peroxidase will produce an electrochemical signal R
2 when buffer liquid containing hydrogen peroxide and ABTS is present, where R
2>R
1. R
2 and R
1 can be configured to provide high and low control electrochemical signals, with respect
to the selected assay and provide verification of the operable range of the assay.
Referring to Figure 15B, in an alternative arrangement the immobilized horse radish
peroxidase can be substituted for an immobilized complex of magnetically susceptible
particle:first binding agent:analyte:second binding agent, wherein the horse radish
peroxidase is conjugated to the second binding agent. Such an arrangement may more
accurately reflect the form of ternary complex formed at the working electrode 516w
and provide an improved control.
[0165] In a microfluidic assay involving the interaction of a substrate with reagents in
a fluid or liquid, on-board controls can be used to assess the state of the substrate(s)
and/or reagent(s). For example, they can validate the activity of the substrate(s)
and/or reagent(s) such that a valid assay result can be obtained. In another example,
they can indicate that one or more of the substrate(s) and/or reagent(s) have lost
or gained an activity or chemical state (e.g. oxidized/reduced), indicating that the
assay result will not be valid within normal parameters and may need to be deemed
void or be corrected. On-board controls of this kind can be performed independently
of the presence of the sample, and provide information on the reagents and substrates
used in the assay device.
[0166] In exemplary embodiments of the assay device, in which reagent(s) interact with sample
in a first zone and are then moved into a different media, e.g. different liquid or
fluid, in which the reagent(s) interact with substrate(s) resulting in a signal that
is detected at different zone, an on-board control that indicates the activity or
viability of the reagent(s) and/or substrate(s) is provided. In exemplary embodiments
electrochemical detection of substrate and/or reagent activities is used to provide
control values. In exemplary embodiments where dry reagent or substrate is used in
the assay the on-board control will use a corresponding dry reagent or substrate,
which may be re-hydrated prior to detecting the control signal.
[0167] The on-board control for activity of the reagents comprises a predetermined quantity
of reagent, e.g. enzyme reagent, deposited at or adjacent a defined location in the
microfluidic network 508. In an exemplary embodiment this quantity of reagent is deposited
at the same time as reagent is deposited in the reagent zone for interaction with
the sample and is from the same batch of reagent. The reagent is deposited in the
second channel portion 4304 at a location downstream of the junction 4305 with respect
to the direction of flow of the second liquid, i.e. in the overflow 524. This reagent
control is positioned in the overflow channel 524 such that reaction of the reagent
and substrate does not affect or interfere with signal detection at the working electrode
516w which relies on the interaction of reagent bound to magnetically susceptible
particles from the sample with substrate in the second liquid.
[0168] A predetermined quantity of reagent is deposited in the overflow 524 at or adjacent
a reagent control zone. According to the invention the reagent control zone has one
or more detection electrodes 3601, e.g. a set of three electrodes (working, counter
and reference), to detect the reagent control signal. Following formation of the liquid
sample:second liquid interface and flow of the second liquid into the overflow 524,
substrate contained in the second liquid reacts with reagent at the reagent control
zone to produce a signal that is detected by meter 400.
[0169] The signal may be electrochemical or optical, for example. In an exemplary embodiment
the reagent is horse radish peroxidase (HRP) and substrates are ABTS and H
2O
2. The reaction of HRP with ABTS and H
2O
2 yields oxidized ABTS which can be electrochemically detected by the electrode set.
Accordingly, the extent of oxidation of ABTS (and effectively loss of active (reduced)
ABTS for conversion to oxidized ABTS by reaction with reagent) can be detected in
the second liquid at the working electrode prior to interaction with reagent to provide
a substrate control.
[0170] In an exemplary embodiment a substrate control is also provided. The activity of
the substrate may be determined at any chosen location in the second channel portion
4304 (or in a further channel portion provided for this purpose) provided that location
is substantially free of reagent. In an exemplary embodiment the activity of the substrate
is determined in the second liquid upstream of the junction 4305 and prior to transfer
of magnetically susceptible particles across the junction 4305 into the second liquid.
Accordingly, the substrate control signal indicates activity of the substrate in the
absence of reagent. In an exemplary embodiment the substrate control signal is determined
at electrodes 516w, 516r, 516c.
[0171] Determining a control signal for substrate activity in the absence of reagent provides
a signal for the substrate at zero reagent concentration (i.e. [R]=0). Determining
a control signal for reagent activity in a reagent control zone provides a signal
at known reagent concentration (e.g. [R]=1). The control signal values can be plotted
against reagent concentration to provide a curve or line. Where more than one reagent
control is provided the data from the additional reagent control(s), having different
reagent concentrations, can also be used to plot the curve or line. This can be compared
against a standard curve or line to determine the extent of deterioration of substrate
or reagent activity and to calculate any adjustment that is required to be made to
the assay result. In an exemplary embodiment the control signal detected is an electrochemical
signal (e.g. µA).
[0172] Accordingly, in one exemplary embodiment, following formation of the liquid:air interface
second liquid is forced from buffer pouch 507 into second channel portion 4304 such
that the second liquid is directed towards junction 4305. Prior to contact with the
liquid:air interface, the second liquid contacts electrodes 516w, 516r and 516c and
a substrate control signal is detected. Second liquid continues to flow towards junction
4305 to form the liquid sample:second liquid interface and second liquid flows into
overflow 524 to contact the reagent control zone where the reagent control signal
is detected. The substrate control and/or reagent control signals are processed by
meter 400 to determine the activity of the substrate and/or reagent. The processing
step can involve comparing the substrate control and/or reagent control signals against
standard reference values for reagent and/or substrate activity, e.g. against an activity
value for a laboratory standard. The determined control activity may be within a normal
(expected) activity indicating that the assay may proceed and the assay result is
valid. Alternatively the determined control activities may be outside tolerated ranges
(e.g. activity too low) and the assay result may be indicated as 'Void'. In another
exemplary alternative, by using the reagent control and substrate control values to
determine the degree to which the activity of the substrate and/or reagent is diminished
(or increased) a modification or correction may be applied to the assay result to
provide a valid assay result that is displayed to the user. For example, the modification
or correction assumes that the activity of all reagent and/or substrate contained
in the assay device has deteriorated by the same amount or factor such that the assay
result needs to be increased by a corresponding amount or factor.
[0173] In exemplary embodiments reagent activity is determined by detection of substrate
activity, e.g. by detecting conversion of ABTS from reduced to oxidized form by the
reagent. Thus, an on-board control for activity of substrate and reagent is provided
by detecting the substrate activity (e.g. extent of oxidation of reduced ABTS substrate)
at two positions in the second channel portion, each having different reagent concentrations.
In one exemplary embodiment, one of the reagent concentrations can be zero. To ensure
substrate activity is measured at zero reagent concentration it can be detected at
the working electrodes prior to movement of magnetic particles across the junction.
[0174] Although the assay device provides for a stable, substantially static liquid sample:second
liquid interface small quantities of liquid sample can be washed into the second liquid
and into overflow 524. Reagent:magnetically susceptible particle complexes washed
from the liquid sample into the second liquid will increase the quantity of reagent
at the reagent control zone such that the reagent control signal detected is no longer
a result only of interaction of the predetermined quantity of reagent deposited at
the reagent control with the substrate but is affected by the presence of small quantities
of additional reagent.
[0175] This problem can be overcome by partitioning the overflow channel into two parts.
Referring to Figures 12A and 12B, the overflow channel is generally parallel to the
first channel portion 4302 and is divided by a partition that is also substantially
parallel to the first channel portion 4302 thereby forming a first overflow channel
2301 and a second overflow channel 2302. The first overflow channel 2301 provides
an excess channel volume to receive second liquid, displacing air through vent 526
as the second liquid progresses along the first overflow channel 2301. This excess
channel volume reduces the possibility of backflow of the second liquid.
[0176] The second overflow channel 2302 is configured to receive at least some of the second
liquid overflowing from the interface zone through an inlet. Distal to, and downstream
of, the inlet the second overflow channel 2302 is tapered to form a narrow channel
providing a vent 2303 through which air is dispelled as liquid fills the second overflow
channel 2302. Vent 2303 is connected to the first overflow channel 2301. Vent 2303
is sufficiently narrow and hydrophobic that second liquid is substantially completely
prevented from flowing through vent 2303 into the first overflow channel 2301. Accordingly,
once filled the second overflow channel 2302 provides a defined volume of second liquid.
[0177] Particles washed away from the liquid sample:second liquid interface into the second
liquid are carried in the second liquid close to the wall 2305 separating the first
channel portion 4302 and first overflow channel 2301 and into the first overflow channel
2301. Second liquid free or substantially completely free of reagent is thereby carried
into the second overflow channel 2302.
[0178] The reagent control zone is positioned in the second channel portion in which detection
of the reagent control signal takes place in a defined volume of second liquid. Any
reagent particles washed into the overflow from the liquid sample:second liquid interface
flow into the first overflow channel 2301 and do not interfere with detection of reagent
activity in the reagent control zone. Where the second liquid contains a predetermined
known quantity of substrate, the defined volume of second liquid in the second overflow
channel 2302 can be used to determine the extent of reaction of substrate and reagent
and the activity of substrate and/or reagent.
[0179] According to the invention, a single overflow channel is provided. In this arrangement
the reagent control zone is positioned sufficiently far away from the interface zone
that any particles washed into the second liquid overflow settle out in the overflow
channel prior to reaching the reagent control zone such that detection of the reagent
control signal takes place in second liquid that is free or substantially completely
free of reagent.
[0180] Referring to Figure 7, the overflow channel 524 has a length in the region of at
least about 2 times the length of the second channel portion 4304 (e.g. at least about
2.5 times, at least about 3 times, at least about 4 times). The overflow channel defines
a flow path initially substantially parallel to the flow path defined by the first
channel portion, but thereafter may take any desired flow path to provide the required
length of channel. In an exemplary embodiment the overflow channel may include one
or more bend portions changing the direction of the flow path defined by the channel.
[0181] According to the invention the reagent control zone is located in the overflow channel
524 at least about 20mm (e.g. at least about 30mm, at least about 40mm, at least about
50mm, at least about 60mm, at least about 70mm, at least about 80mm, at least about
90mm, at least about 100mm) downstream of junction 4305. In an exemplary embodiment
the reagent control zone is located downstream of a first bend portion in the overflow
channel (not including any bend portion at the connection between the second channel
portion and the overflow 524 immediately downstream of the junction 4305).
Interaction of assay device and meter
[0182] Referring to Figure 2, meter 400 accepts test assay device 500 and includes display
406. The display 406 may be used to display images in various formats,. Display 406
can also be used to display information to patients. Display 406 can provide a user
with an input region 404. Input region 404 can include keys. User instructions and
queries are presented to the user on display 406. The user can respond to the queries
via the input region.
[0183] Meter 400 also includes an assay device reader, which accepts diagnostic test assay
devices 500 for reading. The assay device reader can measure the level of an analyte
based on, for example, the magnitude of an optical change, an electrical change, or
other detectable change that occurs on a test assay device 500. For reading assay
devices that produce an electrical change in response to analyte, the assay device
reader can include electrical systems for measuring the detectable change, including,
for example, a voltameter or amperometer.
[0184] Referring to Fig. 2 meter 400 is shown along with assay device 500. Meter 400 has
a port 402 that receives assay device 500. A user of meter 400 inserts an assay device
500 through port 402 prior to performing an analysis of a sample.
[0185] Meter 400 is configured to operate assay device 500 when assay device 500 has been
inserted through port 402. Meter 400 includes a liquid reservoir actuator, a magnetic
actuator, electrochemical detector, and a processor. Reservoir actuator is configured
to actuate reservoir 507 of device 500. The magnetic actuator is configured to manipulate
(e.g., move and/or position) magnetically susceptible particles within microfluidic
network 508 of assay device 500. The electrochemical detector is configured to determine
the presence of analyte transported to electrodes 516w, 516r, 516c by the magnetically
susceptible particles. The electrochemical detector includes electrical contacts which
respectively communicate with electrical contacts 518w, 518r, 518c of device 500 when
received within meter 400.
[0186] In use, assay device 500 is inserted into meter 400 via port 402. A sample, e.g.
a blood sample, is applied to inlet 510 of assay device 500. An amount of the sample
(e.g., at least about 5µl or 10 µl) moves into microfluidic network 508 (e.g. by capillary
action). The sample interacts with reagents in the reagent zone. Target analyte is
then transported to the detection zone where an electrochemical signal is recorded.
Target analyte interacts with electrodes 516w, 516r, 516c and a signal is detected
by the electrochemical detector. The processor interprets the signal detected by the
electrochemical detector and displays information to a user on interface 406.
Description of further exemplary embodiment - detection of NT-proBNP
[0187] In an exemplary embodiment, the analyte is N terminal pro-brain natriuretic peptide
(NT-proBNP) and the sample material is whole blood from a human. The presence of NT-proBNP
is indicative of a cardiac condition (i.e., a physiological condition related to the
heart (e.g., a cardiac dysfunction such as heart failure)). Based at least in part
on the result of the NT-proBNP determination, the presence of the cardiac condition
can be determined. For example, it can be determined whether the human has experienced,
is experiencing, or has a tendency to develop heart failure.
[0188] Several reagents are present within the reagent zone of the assay device. The reagents
include the following species; a first antibody capable of binding to NT-proBNP, a
second antibody capable of binding to NT-proBNP concurrently with the first antibody,
an anti-coagulant to prevent clotting of the blood sample within the reagent zone,
at least one magnetic particle, an enzyme label that can be used to produce a detectable
species, buffer salts, and at least one colloidal particle. The first antibody can
be modified with biotin, the second antibody can be conjugated with the enzyme label.
The second antibody-enzyme conjugate can be adsorbed onto a colloidal gold sol particle
to increase the number of antibody-enzyme conjugates. The magnetic particle can be
coated with streptavidin, which can be used to capture the biotin modified first antibody.
When the reagents interact with NT-proBNP a conjugate complex is formed, which can
be represented stylistically as follows:

[0189] The streptavidin coated magnetic particle can accommodate a number of biotin modified
antibodies. The biotin modified first antibody binds to a first unique region of NT-proBNP.
The second antibody-enzyme conjugate binds to a second unique region of NT-proBNP.
Second antibody-enzyme conjugate is provided pre-associated with gold sol particles
thus increasing the number of enzyme labels that become part of the NT-proBNP antibody
complex. In an exemplary embodiment a first monoclonal antibody, clone 15F11 was biotin
modified, and a second antibody, clone 24E11 was conjugated with HRP.
EXAMPLES
[0190] The following are non-limiting examples.
Example 1: Detection of NT-proBNP in a human blood sample
[0191] A human blood sample is added to the assay device 500 at inlet 510. The blood contains
an amount of an analyte: N-terminal truncated pro-brain natriuretic peptide (NT-proBNP).
[0192] The sample of blood enters the first channel portion 4302, e.g. via capillary action,
where it mixes with reagents in the reagent zone. The reagents in the reagent zone
include streptavidin coated magnetically susceptible particles and biotinylated first
binding agent which is an anti-NT-proBNP antibody 15C4 (HyTest Ltd.; Catalogue #:4NT)
and horseradish peroxidase ("HRP") conjugated to a second binding agent which is anti-NT-proBNP
antibody 15F11 or 29D12 (HyTest Ltd.; Catalogue #:4NT) (the antibody-linked enzyme).
The assay device and included reagents are provided in a dry state. Addition of a
liquid sample to the assay device (i.e., to the inlet and first channel portion) re-suspends
dry reagents.
[0193] The reagents are re-suspended in solution with the blood, and form a mixture. The
streptavidin coated magnetically susceptible particles bind to the biotinylated first
binding agent to form a conjugate (the antibody-linked magnetically susceptible particle).
The NT-proBNP in the blood is also bound by the first binding agent and a ternary
complex of NT-proBNP bound antibody-linked magnetically susceptible particle is formed.
A magnetic field is applied such that the magnetically susceptible particles undergo
an induced motion (e.g., a periodic or oscillatory motion) to promote resuspension
and mixing of the reagents with the sample.
[0194] The blood sample fills the first channel portion 4302 and on reaching junction 4305,
the liquid forms a meniscus. The change in cross-sectional area of the channel at
junction 4305 does not allow the blood sample to fill the second channel portion 4304.
Rather, capillary pressure in the second channel portion exceeds any capillary forces
that draw the sample liquid beyond junction 4305 into the second channel portion 4304.
Junction 4305 thus acts as a capillary stop, preventing substantial liquid sample
flow beyond that point. At this stage, a blood sample:air interface is formed by the
blood meniscus at junction 4305.
[0195] After mixing of the reagents and blood sample, a magnetic field is applied to the
first channel portion 4302. The applied field is manipulated so as to move the magnetically
susceptible particles, and all components bound to them. The magnetically susceptible
particles are magnetically moved along the first channel portion 4302 toward junction
4305.
[0196] A buffer liquid is added to the device at the second inlet 520. A buffer pouch 507
incorporated into the device delivers the reaction buffer. The buffer liquid contains
10mM of the redox mediator 2,2'-azino-bis-(3-ethylbenzo-thiazoline-sulfonic acid)
(ABTS), 10mM H
2O
2, 150mM KCl, 125mM sodium acetate; 0.1% v/v Tween20, made to a final pH 4.2. The buffer
does not contain analyte (NT-proBNP). The buffer liquid flows along the second channel
portion 4304 to junction 4305, where the buffer liquid contacts the blood sample at
the blood:air interface to form a blood:buffer interface.
[0197] The magnetically susceptible particles (and all that is bound to them) are moved
across the blood:buffer interface by moving the applied magnetic field across the
junction 4305 into the second channel portion 4304 and towards the working electrode
516w. The formation of the blood:buffer interface facilitates the magnetic movement
of the magnetically susceptible particles (and all that is bound to them) from the
blood to the buffer, leaving interfering sample components and analytes that are not
of interest in the blood in the first channel portion 4302. The magnetically susceptible
particles and all that is bound to them, including the NT-proBNP (in the form of a
ternary complex of NT-proBNP with antibody-linked magnetically susceptible particle
and antibody-linked enzyme) are transferred to the second liquid in the second channel
portion 4304.
[0198] The magnetically susceptible particles bound to NT-proBNP are next moved to the working
electrode 516w by manipulation of the applied magnetic field. The magnetically susceptible
particles are magnetically positioned and held at the detection zone for an incubation
time of e.g. 1 minute. Magnetically susceptible particles bound to NT-proBNP and the
second binding agent:HRP conjugates are detected electrochemically by HRP mediated
catalysis of hydrogen peroxide and ABTS to water and oxidised-ABTS. At the end of
the incubation time the electrochemical current produced by the reduction of oxidized
ABTS at the electrodes is measured at the working electrode for a measurement period
(e.g. 3 seconds).
[0199] The detected electrochemical current is received in meter 400 and compared against
a corresponding calibration dataset to determine an amount and/or concentration of
NT-proBNP. The meter displays or communicates an assay result to the user.
Example 2 - Extension/linearization of the measurable NT-proBNP range - Two Point
electrochemical measurements to extend the dynamic range
[0200] Electrochemical measurements can be made using a single time point of HRP turnover
time. A typical dose response curve for concentrations of 0-20,000 pg/ml NT-proBNP
in the liquid sample is shown in Figure 17. The performance of the electrochemical
NT-proBNP assay may be optimised by extending the measurable range and linearising
the response at the higher NT-proBNP concentrations. To achieve this we identified
whether the plateau effect was a reagent, electrochemical or combined reagent and
electrochemical limitation.
[0201] Within the current electrochemical measurement of NT-proBNP, effectively we are measuring
the concentration of HRP; this is illustrated in Figure 18. Therefore dose response
curves of NT-proBNP are effectively current vs. HRP concentration.
[0202] The ability to measure the HRP concentration electrochemically via the mediator ABTS
provides the flexibility to tune the immunoassay response. Typically, once the particles
were moved out of the blood and dragged to the electrode, captured HRP was allowed
to react for a 1 minute turnover period (incubation time). No potential was applied
to the electrode until after the 1 minute HRP turnover period, the subsequent potential
applied was used to reduce the oxidised ABTS generated by the HRP.
[0203] To investigate the limitation of a 1 minute HRP turnover period, HRP titrations were
performed to investigate the HRP turnover time on the sensitivity, linearity and range
of the response. In these experiments the HRP was homogeneously distributed within
the channel and not concentrated in the vicinity of the electrode when placed on the
electrode via the magnetic particles.
[0204] The linear range of the HRP is seen to vary with turnover time. A 10 minute turnover
time results in an approximately linear range up to 5000 pM HRP; a 1 minute turnover
time results in an approximately linear range up to 20,000 pM HRP; a 30 second turnover
time results in a approximately linear range of 50,000 pM HRP; a 15 second turnover
time results in an approximately linear range of 80,000 pM HRP.
[0205] The effect of HRP turnover time is summarised in Figure 18. There is a trade off
between increased linearity of the HRP response and sensitivity, as the HRP range
(pM) is increased the HRP measurement becomes less sensitive e.g. 10 minutes - limit
of detection (LOD) at least 25 pM; 1 min - LOD 50-100 pM; 30 secs 100 pM; 15 sees
LOD 100 pM.
[0206] From the titration data we conclude that we can significantly increase the measurable
HRP concentration (pM) range and the linear component.
[0207] Experiments were performed to test this hypothesis, the summary results are shown
in Figure 19.
[0208] The application of reduced HRP turnover times has a significant effect upon extending
and linearising the NT-proBNP response. This represents a significant optimisation
for the electrochemical measurement of NT-proBNP.
[0209] It is desirable to be able to measure NT-proBNP concentrations over a 50-20,000 pg/ml
range. This is a dynamic range for an immunoassay to measure. It would also be desirable
to distinguish a doubling in NT-proBNP concentration. It would also be desirable to
linearise the electrochemical response over the higher NT-proBNP concentrations.
[0210] For example, a 15 second turnover time allows the measurement of up 40,000 pg/ml
NT-proBNP and easily allows the ability to measure the doubling of 5000 to 10000 to
20000 to 40000 pg/ml. This result demonstrates how the assay can be tuned for optimum
performance.
[0211] For example if the 15 sec measurement is plotted on a semi log curve a good linear
response is observed as shown in Figure 20 (x-axis shows NT-proBNP concentration).
[0212] This result provides a good model system to understand the complex interplay between
many parameters. A two point electrochemical measurement can be made to measure the
desired range with optimum performance, for example a 15 second measurement to capture
the high NT-proBNP concentrations as shown and then a second measurement (e.g. 1,
2, 3 minutes) to measure the low NT-proBNP concentrations resulting in 2 calibrations
curves for maximum sensitivity and performance.
[0213] Further HRP titration experiments were performed to investigate the relationship
between increased HRP turnover time and increased HRP LOD. A clear trend was observed.
The LOD and the associated slope of the response changes as a function of HRP turnover
time. Specifically LOD of 10 pM are observed for the 10, 7 and 5 min HRP turnover
time whilst 25 pM is observed for 3 mins and a 100 pM LOD for a 1 minute HRP turnover
time. Significant increases in performance could be observed using a prolonged HRP
time period for measurement of lower NT-proBNP concentrations compared with the previously
used 1 minute turnover time. For example a secondary time point measurement after
5 minutes HRP turnover would result in changing the HRP LOD from 100 pM to 10 pM (x10
difference).
[0214] Two point HRP titrations experiments were performed. Identical titration responses
were observed whether a single HRP concentration is measured in a single or dual time
point manner, depletion of the generated oxidised ABTS over a 3 second period does
not affect the signal obtained with the second time point measurement (300 sec). Shorter
measurement times of the oxidised ABTS (<300 secs) may allow multiple time points
to be measured.
[0215] Other embodiments are conceivable as long as they fall within the scope of the following
claims.