Single-Use Microfluidics Could Boost Men’s Health Diagnostics

Needing medical care is difficult enough all on its own. But the process of obtaining that medical care is almost more of a hassle than it’s worth. A lot of the time, you end up waiting for lab results. Sometimes, that’s because the doc had to take a culture, and the bacteria need time to increase and multiply in a petri dish before the lab techs can test for what kills them. That’s reasonable. But sometimes, the time delay between test and results is just because the facility that took the sample doesn’t have the equipment to perform the actual test. That’s why they have to send it off to a lab.

The difference between a fully featured emergency department and an urgent care facility is often that an emergency room has access to the hospital’s own trauma facilities and labs. An urgent care ward will often be associated with a hospital, but not privy to other facilities in the same building. The resources that any given medical facility has access to will differ. Where a patient goes for their health care will depend on the kind of care they’re seeking.

But a lot of medical diagnostic tests are just looking for a specific chemical within a fluid sample. That’s a core competency of microfluidics: accurate and precise handling of tiny amounts of fluids, especially when exposing the tiny sample to a reagent. Advancements in microfluidics, in fact, are dragging point-of-care diagnostics into the present era from where they’ve been stuck since the mid-1990s.

The Advantages of Microfluidics

Take, for an example, the omnipresent HIV cheek-swab test. It only takes just a moment to take the test, and you can have the results of that HIV test back while you’re still in the doctor’s office at that same appointment. It’s really fast. You pay for that speed in the false-positive rate; a positive result on the cheek swab means a patient needs to go back for the ELISA test, which is the most conclusive test we currently have. It’s as if the test is a little over-eager to catch the signs of the virus, so it’ll snap at anything that looks right. But the cheek swab test isn’t nearly as prone to false negatives as it is to false positives. Hearing a “no” result means the patient can go home assured that they are free of HIV.

Now, a recent study by Columbia University and the University of Amsterdam reports that point-of-care HIV tests can reliably be performed on a single microliter of blood, using cutting-edge microfluidics tech. And we use microfluidics equipment to test for a huge variety of diagnostically important things, including antibodies, blood gases, blood chemistry, and even cancer cells. There’s no reason a similar apparatus with a different diagnostic reagent couldn’t be put to use here. And because these tests tend toward overzealous results, they could make an important addition to first-line diagnostics. Taken together, these factors open up the range of diseases that a given point-of-care testing kit can test for.

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Moving Beyond Theranos: the Single-Use Test

This is the field Theranos died on, because it claimed it could use just a few microliters of blood to conduct a whole battery of tests. The intellectual property that Theranos would’ve needed to carry out the capabilities they claimed just flat doesn’t exist, for a lot of reasons — including, but not limited to, the degree to which the samples had to be diluted, and the differences in blood samples from capillaries and veins. But responsible use of microfluidics, as in a single-use diagnostic test for a single malady or antigen, could succeed where Theranos failed. And they could make medicine a whole lot more personal.

The difference between venous blood and capillary blood, for example, is of critical importance in diagnosing and treating erectile dysfunction. ED has a lot of causes, physiological and psychological both. One of the things we know about ED is that dissolved nitrous oxide (NO) in the bloodstream plays a pivotal role in the appropriate dilation of blood vessels in order to achieve erection. Viagra acts on a biomolecule that’s “upstream” of NO production in order to do its work.

But NO is also an important neurotransmitter, so there will always be a little of it in the body, even in venous blood. That could confound diagnostic testing for the cause of a patient’s sexual dysfunction, especially if they’re taking Viagra and it isn’t helping. A point-of-care test for NO or other biomolecules important to arousal, that a patient could take at an opportune moment in the comfort and privacy of their home, could completely change how we diagnose and treat erectile dysfunction. All of a sudden, we have a way to know whether the right amount of NO is being released in situ, in the right places in the body, in the moment.

Advances in Microfluidics Could Change Medicine

Such a test could be customized to look for almost any biomolecule, including biomarkers for STDs, insulin resistance, and prostate cancer. It could be used to determine the need for a biopsy. The use cases just go on and on. This kind of instant read on the body’s local biochemistry could change medicine.

Let’s speculate even further: Paper-based microfluidics have been pushing the proverbial envelope since the very first paper-and-paraffin chromatography film decades ago. Envision a slip of special chromatographic paper treated with the right indicator reagent, paired with a slender single-use lancet — doesn’t this sound exactly like the home glucose monitors in worldwide use by people with diabetes? This is how these point-of-care tests could become disposable single-use kits, which expands patient access to sophisticated diagnostics, right into the living room.

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