Abstract

In a pandemic era, rapid infectious disease diagnosis is essential. Surface-enhanced Raman spectroscopy (SERS) promises sensitive and specific diagnosis including rapid point-of-care detection and drug susceptibility testing. SERS utilizes inelastic light scattering arising from the interaction of incident photons with molecular vibrations, enhanced by orders of magnitude with resonant metallic or dielectric nanostructures. While SERS provides a spectral fingerprint of the sample, clinical translation is lagged due to challenges in consistency of spectral enhancement, complexity in spectral interpretation, insufficient specificity and sensitivity, and inefficient workflow from patient sample collection to spectral acquisition. Here, we highlight the recent, complementary advances that address these shortcomings, including (1) design of label-free SERS substrates and data processing algorithms that improve spectral signal and interpretability, essential for broad pathogen screening assays; (2) development of new capture and affinity agents, such as aptamers and polymers, critical for determining the presence or absence of particular pathogens; and (3) microfluidic and bioprinting platforms for efficient clinical sample processing. We also describe the development of low-cost, point-of-care, optical SERS hardware. Our paper focuses on SERS for viral and bacterial detection, in hopes of accelerating infectious disease diagnosis, monitoring, and vaccine development. With advances in SERS substrates, machine learning, and microfluidics and bioprinting, the specificity, sensitivity, and speed of SERS can be readily translated from laboratory bench to patient bedside, accelerating point-of-care diagnosis, personalized medicine, and precision health.

Highlights

  • As of June 18, 2020, the COVID-19 pandemic has infected over 8 million individuals and claimed the lives of nearly450 thousand individuals worldwide

  • It is challenging to translate polymerase chain reaction (PCR) across diverse clinical settings, as highlighted by COVID-19.5–7 To complement PCR, antigen detection based rapid tests and immunoassays such as fluorescence-based ELISA have gained traction.8. These immunoassays are dependent on specific target antigen/antibody binding for each infectious agent and require knowledge of which pathogens might be present; fluorescent based immunoassays are influenced by low sensitivity, higher limits of detection (LOD), long assay times in the case of ELISA, and fluorophore bleaching and blinking

  • Raman spectroscopy has suffered from relatively low signal-tonoise ratios, complexity in spectral interpretation, and a lack of an efficient workflow from sample collection to spectral acquisition, challenging clinical translation

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Summary

INTRODUCTION

As of June 18, 2020, the COVID-19 pandemic has infected over 8 million individuals and claimed the lives of nearly. It is challenging to translate PCR across diverse clinical settings, as highlighted by COVID-19.5–7 To complement PCR, antigen detection based rapid tests and immunoassays such as fluorescence-based ELISA (an “enzyme-linked immunosorbent assay”) have gained traction.8 These immunoassays are dependent on specific target antigen/antibody binding for each infectious agent and require knowledge of which pathogens might be present; fluorescent based immunoassays are influenced by low sensitivity, higher limits of detection (LOD), long assay times in the case of ELISA, and fluorophore bleaching and blinking. Particular, we focus on three complementary approaches, summarized, that are quickly advancing Raman spectroscopy: (1) Design of data processing algorithms and SERS substrates that improve spectral interpretability These advances are critical for interrogating patient samples that could contain a wide variety of pathogens (i.e., in developing a sensitive, specific assay for respiratory viruses or bacterial bloodstream infections). These advances are critical for rapid and sensitive determination of the presence or absence of a particular pathogen (for example, in deploying a binary test that determines if a patient is positive for coronavirus). (3) Development of microfluidic and bioprinting platforms for efficient clinical sample processing across a variety of complex fluids and infectious disease agents

ROBUST SPECTRAL INTERPRETATION AND ENHANCEMENT WITH LABEL-FREE RAMAN AND SERS
Method Volume Time LOD
ROBUST SERS SAMPLE PROCESSING WITH MICROFLUIDICS AND BIOPRINTING
Findings
CONCLUSION AND OUTLOOK
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