Emerging point-of-care biosensors offer rapid and sensitive monkeypox detection solutions
image: Schematic mechanism of the MPXV-LAMP assay. (A) The MPXV-LAMP-LFB assay uses loop-mediated isothermal amplification (LAMP) with specific primers to detect Monkeypox virus strains. FIP and LF primers, labeled with hapten and biotin, produce detectable amplicons monitored by a lateral flow biosensor (LFB). (B) This assay distinguishes between Central and West African strains, providing rapid, sensitive, and specific results. (C) It involves two LAMP reactions, generating digoxin/biotin and FAM/biotin labeled amplicons. The LFB visually interprets results, indicating positive or negative outcomes based on the presence of test lines for each strain, thus offering a practical tool for point-of-care diagnostics.
Credit: Abhimanyu Thakur.
This article examines the current state and future potential of point-of-care (POC) biosensors for monkeypox virus (mpox) detection. Sparked by the global 2022–2023 mpox outbreak, the article emphasizes the urgent demand for diagnostic tools that are fast, accurate, affordable, and usable outside traditional lab settings—especially in low-resource or outbreak-prone regions.
The author outlines the limitations of conventional diagnostic methods like PCR and ELISA, which, although reliable, require complex equipment, trained staff, and can lead to delays in diagnosis. These drawbacks create barriers to effective outbreak control and early treatment. In contrast, POC biosensors offer rapid, on-site, and user-friendly alternatives.
The article reviews a wide range of POC technologies, including:
- Lateral Flow Biosensors (LFBs): Combine LAMP (loop-mediated isothermal amplification) with strip-based detection. Fast (results in ~1 hour), visual, and require minimal equipment.
- Optical Biosensors: Use light-based detection like interferometry and fluorescence. Highly sensitive and capable of multiplexing (detecting multiple pathogens). Examples include fiber-optic sensors and PD-IRIS.
- CRISPR/Cas-based Biosensors: Among the most promising, these systems (e.g., CRISPR-gFET, SCOPE) offer exceptional sensitivity (down to attomolar levels) and speed (as little as 15–20 minutes). Some require no amplification, making them highly suitable for field deployment.
- Nanopore Sensors: Detect single proteins or nucleic acids by monitoring changes in ionic current. These systems offer molecular-level precision and work directly in saliva or serum without amplification.
- Electrochemical Biosensors: Often built on paper substrates, these are portable, cost-effective, and compatible with smartphones, making them ideal for decentralized testing.
- Split Catalytic Probes: Use color-changing DNAzyme systems to detect mpox genetic material. These colorimetric assays are low-cost and require no sophisticated readers.
- Integrated Platforms: Combine methods (e.g., colorimetric + electrochemiluminescence) for enhanced performance and dual-mode readout, such as in microfluidic chips that simplify sample handling and automate detection.
Each technology is evaluated in terms of sensitivity, specificity, detection time, ease of use, portability, and cost. While most demonstrate strong potential, many still require further clinical validation, optimization for real-world settings, and improvements in mass production and scalability.
The article concludes by discussing future directions, such as:
- Combining multiple detection mechanisms in one device.
- Enhancing AI and smartphone integration for data analysis.
- Improving sensitivity in complex environments like wastewater.
- Enabling multiplex detection of various pathogens.
- Ensuring adaptability to viral mutations.
In summary, POC biosensors are shown to be essential tools for the early detection and control of mpox and similar emerging infectious diseases. With continued innovation and validation, these technologies could transform outbreak response and public health preparedness worldwide.