Sweat-based diagnostics offer an exciting avenue to noninvasively monitor analytes which had previously only been avail-able through painful blood draws.Sweat is enriched with physiologically valuable information,and ...Sweat-based diagnostics offer an exciting avenue to noninvasively monitor analytes which had previously only been avail-able through painful blood draws.Sweat is enriched with physiologically valuable information,and recent proteomic studies have identified numerous critical analytes which have highly correlated levels in blood,interstitial fluid and sweat.How-ever,usage of sweat for health monitoring has not been studied extensively due to the substantial challenge of assembling a composite clinic-ready device.Recent advances in soft electronics have made this goal realizable,as these devices can perform electronic or optical monitoring on a flexible substrate using small volumes of liquid.While this field is still in its infancy,this review examines the physiological composition of sweat,various improvements in material science that improve sensor design,existing FDA approvals,methods of extracting sweat and comparisons to blood-based tests.Furthermore,this review assesses the critical challenges which must be overcome for this type of technology to make it out of research laboratories and into continuous clinical use.We believe that once properly harnessed,sweat-based diagnostics can provide patients a painless monitoring tool which can be customized to track a wide variety of medical conditions from the comfort of a patient’s own home.展开更多
BACKGROUND Acute recurrent pancreatitis(ARP)is characterized by episodes of acute pancreatitis in an otherwise normal gland.When no cause of ARP is identifiable,the diagnosis of"idiopathic"ARP is given.Mutat...BACKGROUND Acute recurrent pancreatitis(ARP)is characterized by episodes of acute pancreatitis in an otherwise normal gland.When no cause of ARP is identifiable,the diagnosis of"idiopathic"ARP is given.Mutations in the cystic fibrosis transmembrane conductance regulator(CFTR)gene increase the risk of ARP by 3-to 4-times compared to the general population,while cystic fibrosis(CF)patients present with a 40-to 80-times higher risk of developing pancreatitis.CASE SUMMARY In non-classical CF or CFTR-related disorders,CFTR functional tests can help to ensure a proper diagnosis.We applied an individualized combination of standardized and new CFTR functional bioassays for a patient referred to the Verona CF Center for evaluation after several episodes of acute pancreatitis.The CFTR genotype was G542X+/-with IVS8Tn:T7/9 polymorphism.The sweat(Cl-)values were borderline.Intestinal current measurements were performed according to the European Cystic Fibrosis Society Standardized Operating Procedure.Recent nasal surgery for deviated septum did not allow for nasal potential difference measurements.Lung function and sputum cultures were normal;azoospermia was excluded.Pancreas divisum was excluded by imaging but hypoplasia of the left hepatic lobe was detected.Innovative tests applied in this case include sweat rate measurement by image analysis,CFTR function in monocytes evaluated using a membrane potential-sensitive fluorescent probe,and the intestinal organoids forskolin-induced swelling assay.CONCLUSION Combination of innovative CFTR functional assays might support a controversial diagnosis when CFTR-related disorders and/or non-classical CF are suspected.展开更多
基金the National Science Foundation under NSF Cooperative Agreement(Nos.EEC-1648451 and EEC-1647837)Dr.Li also thanks the support sponsored by NSF Independent Research/Development(IRD)Program.
文摘Sweat-based diagnostics offer an exciting avenue to noninvasively monitor analytes which had previously only been avail-able through painful blood draws.Sweat is enriched with physiologically valuable information,and recent proteomic studies have identified numerous critical analytes which have highly correlated levels in blood,interstitial fluid and sweat.How-ever,usage of sweat for health monitoring has not been studied extensively due to the substantial challenge of assembling a composite clinic-ready device.Recent advances in soft electronics have made this goal realizable,as these devices can perform electronic or optical monitoring on a flexible substrate using small volumes of liquid.While this field is still in its infancy,this review examines the physiological composition of sweat,various improvements in material science that improve sensor design,existing FDA approvals,methods of extracting sweat and comparisons to blood-based tests.Furthermore,this review assesses the critical challenges which must be overcome for this type of technology to make it out of research laboratories and into continuous clinical use.We believe that once properly harnessed,sweat-based diagnostics can provide patients a painless monitoring tool which can be customized to track a wide variety of medical conditions from the comfort of a patient’s own home.
基金Supported by Italian CF Research Foundation with the contributions of Delegazione FFC di Palermo e di Vittoria Ragusa Catania 2,No.FFC grants No.4/2013Delegazione FFC di Treviso Montebelluna La Bottega delle Donne,No.3/2014+3 种基金Delegazione FFC di Belluno,No.7/2016Delegazione FFC di Taranto Massafra,Cosenza sud,della Valpolicella,Guadagnin SRL,No.6/2018Delegazione FFC di Tradate Gallarate,No.13/2018CFFT-USA and Lega Italiana Fibrosi Cistica-Associazione Veneta ONLUS
文摘BACKGROUND Acute recurrent pancreatitis(ARP)is characterized by episodes of acute pancreatitis in an otherwise normal gland.When no cause of ARP is identifiable,the diagnosis of"idiopathic"ARP is given.Mutations in the cystic fibrosis transmembrane conductance regulator(CFTR)gene increase the risk of ARP by 3-to 4-times compared to the general population,while cystic fibrosis(CF)patients present with a 40-to 80-times higher risk of developing pancreatitis.CASE SUMMARY In non-classical CF or CFTR-related disorders,CFTR functional tests can help to ensure a proper diagnosis.We applied an individualized combination of standardized and new CFTR functional bioassays for a patient referred to the Verona CF Center for evaluation after several episodes of acute pancreatitis.The CFTR genotype was G542X+/-with IVS8Tn:T7/9 polymorphism.The sweat(Cl-)values were borderline.Intestinal current measurements were performed according to the European Cystic Fibrosis Society Standardized Operating Procedure.Recent nasal surgery for deviated septum did not allow for nasal potential difference measurements.Lung function and sputum cultures were normal;azoospermia was excluded.Pancreas divisum was excluded by imaging but hypoplasia of the left hepatic lobe was detected.Innovative tests applied in this case include sweat rate measurement by image analysis,CFTR function in monocytes evaluated using a membrane potential-sensitive fluorescent probe,and the intestinal organoids forskolin-induced swelling assay.CONCLUSION Combination of innovative CFTR functional assays might support a controversial diagnosis when CFTR-related disorders and/or non-classical CF are suspected.
