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      Ultrasensitive Immunosensor Array for TNF-α Detection in Artificial Saliva using Polymer-Coated Magnetic Microparticles onto Screen-Printed Gold Electrode

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          Abstract

          Tumor necrosis factor-α (TNF-α) is a biomarker of inflammation that occurs in patients suffering from heart failure (HF). Saliva can be sampled in a non-invasive way, and it is currently gaining importance as matrix alternative to blood in diagnostic and therapy monitoring. This work presents the development of an immunosensor array based on eight screen-printed gold electrodes to detect TNF-α in saliva samples. Two different functionalization strategies of electrodes were compared. In the first, anti-TNF-α antibodies were chemically bonded onto the electrode by functionalization with 4-carboxymethylaniline. The other functionalization procedure involved the binding of antibodies onto polymer-coated magnetic microparticles, which were then deposited onto the electrode by pulsed chronoamperometry. Finally, the chronoamperometry technique was applied to characterize the modified SPEAu. The use of a secondary antibody anti-TNF-α (Ab-TNF-α-HRP) labelled with horseradish peroxidase (HRP, 2 µg·mL −1) was investigated using tetramethylbenzidine (TMB, pH = 3.75) as electrochemical substrate containing 0.2 mM of H 2O 2. A sandwich-type detection strategy with a secondary antibody anti-TNF-α provided chronoamperometric analyses in 10 s for each sample. Linearity, precision, limit of detection, and selectivity of devices were investigated. Interferences were evaluated by analyzing solutions containing other cytokine produced during the acute stage of inflammation. The immunosensor showed good performance within the clinically relevant concentration range, with a precision of 8%, and a limit of detection of 0.3 pg/mL. Therefore, it may represent a promising tool for monitoring HF in a non-invasive way.

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          Systemic inflammation in heart failure--the whys and wherefores.

          Patients with chronic heart failure (HF) are characterized by systemic inflammation, as evident by raised circulating levels of several inflammatory cytokines with increasing levels according to the degree of disease severity. In addition to the myocardium itself, several tissues and cells can contribute to this inflammation, including leukocytes, platelets, tissue macrophages and endothelial cells. Although the mechanisms for the systemic inflammation is unknown, both infectious (e.g., endotoxins) and non-infectious (e.g., oxidative stress and hemodynamic overload) events could be operating, also including activation of Toll-like receptors as well as interaction with the neurohormone system. A growing body of evidence suggests that this systemic inflammation in chronic HF may play a role in the development and progression of this disorder, not only by promoting myocardial dysfunction, but also by inducing pathogenic consequences in other organs and tissues, thereby contributing to additional aspects of the HF syndrome such as cachexia, endothelial dysfunction and anemia. Although this inappropriate immune activation and inflammation could represent a new target for therapy in patients with chronic HF, the anti-tumor necrosis factor trials have been disappointing, and future research in this area will have to more precisely identify the most important mechanisms and actors in the immunopathogenesis of chronic HF in order to develop better immunomodulating agents for this disorder.
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            Human saliva as a diagnostic specimen.

            Human saliva can be easily obtained by noninvasive techniques and contains many analytes of interest for screening, diagnosis and monitoring. These include steroid and other nonpeptide hormones, therapeutic drugs, drugs of abuse and antibodies. Numerous studies in the past 40 y have shown correlations between serum and saliva levels. Both diurnal and monthly profiles of hormone levels parallel traditional serum patterns. Multiple specimens for steroid hormone analysis can be easily collected by the patient, at home, to monitor fertility cycles, menopausal fluctuations, stress and other diurnal variations. Drug doses can be monitored without inconvenient and costly visits to blood-drawing facilities. Antibody levels can be determined to screen for infectious diseases. Saliva can be collected directly by spitting into a tube or with one of several devices, each of which has its own special advantages and disadvantages. Salivary levels of steroid hormones and other analytes that are protein bound in serum reflect the unbound and active concentration of the hormone. Saliva can be used as a diagnostic specimen not only to obtain information more inexpensively and efficiently than serum, but also to provide information not readily available from serum testing.
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              Heart Failure Epidemiology: European Perspective

              Heart failure poses an increasing problem for global healthcare systems. The epidemiological data which has been accrued over the last thirty years has predominantly been accumulated from experience within North America and Europe. Initial large cohort, prospective longitudinal studies produced the first publications; however latterly the focus has shifted onto epidemiological data governing hospitalisation and mortality. The emphasis behind this shift has been the resource implications with regards to repetitive, costly and prolonged hospitalisation. The European experience in heart failure, though similar to North America has recently demonstrated differences in hospitalisation which may underlie the differences between healthcare system configuration. Heart failure however remains an increasing global problem and the endpoint of a variety of cardiovascular diseases. Allied with the fact of increasingly elderly populations and prior data demonstrating a steep rise in prevalent cases within more elderly populations, it is likely that the increasing burden of disease will continue to pose challenges for modern healthcare. Despite the predicted increase in the number of patients affected by heart failure, over the last thirty years, a clear management algorithm has evolved for the use of pharmacotherapies (neuro-hormonal antagonists), device based therapies (Implantable Cardioverting Defibrillator (ICD) and Cardiac Resynchronisation Therapy (CRT)) and mechanical therapies including left ventricular assist devices and cardiac transplantation. Though the management of such patients has been clearly delineated in national and international guidelines, the underuse of all available and appropriate therapies remains a significant problem. When comparing various epidemiological studies from different settings and timepoints, it should be remembered that rates of prevalence and incidence may vary depending upon the definition used, methods of accumulating information (with the possibility of bias) and the chosen cut point of defining left ventricular systolic dysfunction (LVSD).
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                Author and article information

                Journal
                Sensors (Basel)
                Sensors (Basel)
                sensors
                Sensors (Basel, Switzerland)
                MDPI
                1424-8220
                08 February 2019
                February 2019
                : 19
                : 3
                : 692
                Affiliations
                [1 ]NANOMISENE Lab, LR16CRMN01, Centre for Research on Microelectronics and Nanotechnology of Sousse, Technopole of Sousse B.P. 334, Sahloul 4034, Sousse, Tunisia; barhoumilassaad@ 123456yahoo.fr (L.B.); mounirbenali@ 123456yahoo.com (M.B.A.)
                [2 ]University of Sousse, Higher Institute of Applied Sciences and Technology of Sousse, GREENS-ISSAT, Cité Ettafala, Ibn Khaldoun 4003, Sousse, Tunisia
                [3 ]Department of Chemistry and Industrial Chemistry, University of Pisa, via Giuseppe Moruzzi 13, 56124 Pisa, Italy; francesca.bellagambi@ 123456dcci.unipi.it (F.G.B.); federicomaria.vivaldi@ 123456phd.unipi.it (F.M.V.)
                [4 ]Université de Lyon 1, Institut des Sciences Analytiques, UMR 5280, CNRS, 5 rue de la Doua, 69100 Villeurbanne, France; a.baraket@ 123456gmail.com (A.B.); yohann.clement@ 123456isa-lyon.fr (Y.C.); nadia.zine@ 123456univ-lyon1.fr (N.Z.); abdelhamid.errachid@ 123456univ-lyon1.fr (A.E.)
                [5 ]Univ Lyon, University Claude Bernard Lyon-1, CNRS, LAGEP-UMR 5007, F69622 Lyon, France
                Author notes
                [* ]Correspondence: abdelhamid.elaissari@ 123456univ-lyon1.fr ; Tel.: +33-472-431-841
                Article
                sensors-19-00692
                10.3390/s19030692
                6387098
                30744018
                76f7802e-ccbf-4a82-8a99-53060d274a11
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 26 November 2018
                : 01 February 2019
                Categories
                Article

                Biomedical engineering
                magnetic microparticles,immunosensor,tumor necrosis factor-α,chronoamperometry,saliva analysis,heart failure

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