In this study, we designed a point-of-care (POC) testing electrochemical biosensor using an integrated biosensing assay based on hollow-like nitrogen-doped carbon nanostructures combined with cobalt nanoparticles (Co@HNCNs, Co3O4@HNCNs, and CoP@HNCNs). These are functionalized with Anti-Exendin-4 Antibodies (Anti-Ex-4-Abs) and Bovine Serum Albumin (BSA) to create sensitive probes (Co@HNCNs/Anti-Ex-4-Abs/BSA, Co3O4@HNCNs/Anti-Ex-4-Abs/BSA, and CoP@HNCNs/Anti-Ex-4-Abs/BSA) for the ultrasensitive detection of exendin-4 (Ex-4), a peptide agonist used in the treatment of type 2 diabetes mellitus (T2DM). Among the cobalt-based carbon nanostructures, the Co3O4@HNCNs/Anti-Ex-4-Abs/BSA nanoprobe demonstrated superior ability to specifically recognize Ex-4. This was indicated by a significant decrease in the chronoamperometric (CA) i-t current response, facilitating low-level detection of Ex-4. The nanoprobe was capable of detecting Ex-4 concentrations ranging from 1.0 to 90.0 pM, with a sensitivity of 0.60 μA/pM and a limit of detection (LOD) of 0.46 pM (S/N = 3). Furthermore, the Co3O4@HNCNs/Anti-Ex-4-Abs/BSA nanoprobes demonstrated the ability to detect nanomolar levels of Ex-4 in blood serum and urine samples, achieving satisfactory recovery rates of 96–104%. The proposed electrostatic interaction chemistry approach establishes a remarkable platform for constructing a peptide agonist biosensor that is effective for detecting Ex-4 in real human serum and urine samples.
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