Every day, thousands of patients worldwide show up at the accident and emergency departments of hospitals complaining about chest pain, which might be a symptom for cardiac infarction. In those cases, the diagnosis and treatment judgments of the emergency medical personnel often determinate the outcomes for the patients and sometimes decide between life and death. Yet, only 15 percent of those patients presenting at the emergency departments are, indeed, suffering a heart attack.
It is, therefore, essential for doctors to be able to assess quickly what the patient is suffering from. Certain markers in the blood, such as elevated levels of the protein Troponin-I, can help to determine whether a patient in fact has a cardiac infarction. However, Standard lab test can take up to 90 minutes before the results are in the hands of the physician.
The Dutch electronics company Philips is currently working on a technology platform for point-of-care testing that might accelerate this process and provide results within minutes. The Minicare system is intended to measure the level of Troponin-I directly at the site of the emergency, in the ambulance or the emergency department.
The challenge for this application is that the protein is only found in the patients’ blood in picomolar concentrations. While devices that measure biomarkers which are highly concentrated in the blood, such as glucose, are already pretty common, the Troponin-I level could until recently only be examined in the laboratory. Yet, in proof-of-concept tests the system managed to detect picomolar Troponin-I concentrations successfully in less than 5 minutes, according to Philips.
Minicare is based on the company’s Magnotech technology. The system uses magnetic nanoparticles that are coated with ligand molecules that bind to target protein molecules, such as Troponin-I. After the nanoparticles have ‘garnered’ the target proteins, a magnetic field is applied that directs the particles biosensor’s surface, which itself is coated with ligand molecules. As a result, target protein molecules is bound both to the active surface and the nanoparticles. A second magnet pulls out nanoparticles that haven’t bound to the target. Afterwards, the bound nanoparticles can be counted using an optical technique.
The entire process takes place in the system’s cartridge. Since the technology allows several measurement chambers per cartridge, the device can detect multiple target molecules in one go. According to Philips, the system can potentially be used in a wide range of applications. For example, it can be used to monitor the concentration of white blood cells in the blood of cancer patients that receive chemotherapy. The company says that the system could be used in the patient’s home and alert doctors if the immune system shows signs of deterioration resulting from the treatment. Additionally, in proof-of-concept tests, the system successfully detected parathyroid hormones and several molecules that indicate drugs abuse.
“Near-patient diagnostics like Minicare have the potential to revolutionize the way clinicians diagnose disease and determine intervention. In some cases, this could be in a home setting when caring for the elderly or those with chronic disease,” said Marcel van Kasteel, general manager of Philips Handheld Diagnostics, about the potential for their system. “The potential for near-patient testing is far-reaching, and not just in the developed countries. In emerging markets and the Third World, assessing drug compliance or diagnosing potentially fatal disease, for example, from only a small volume of blood by means of a handheld device, may well have the greatest impact on saving lives.”
Philips has entered into a number of strategic partnerships to develop dedicated assays for specific blood tests, such as the French bioMérieux. Recently, the company announced that they would cooperate with J&J subsidiary Janssen Pharmaceutical to work on assays for diagnosing brain disorders. ← Standards for microfluidics, update June 2015
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