Shay
Mailloux
a,
Oleksandr
Zavalov
a,
Nataliia
Guz
a,
Evgeny
Katz
a and
Vera
Bocharova
*b
aDepartment of Chemistry and Biomolecular Science, Clarkson University, Potsdam, NY 13699-5810, USA
bChemical Sciences Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37830-6197, USA. E-mail: bocharovav@ornl.gov; Fax: +1-(865)5744961; Tel: +1-(865)576-6490
First published on 17th October 2013
The major challenge for the application of autonomous medical sensing systems is the noise produced by non-zero physiological concentrations of the sensed target. If the level of noise is high, then a real signal indicating abnormal changes in the physiological levels of the analytes might be hindered. Inevitably, this could lead to wrong diagnostics and treatment, and would have a negative impact on human health. Here, we report the realization of a filter system implemented to improve both the fidelity of sensing and the accuracy of consequent drug release. A new filtering method was tested in the sensing system for the diagnosis of liver injury. This sensing system used the enzymes alanine transaminase (ALT) and aspartate transaminase (AST) as the inputs. Furthermore, the output of the sensing system was designed to trigger drug release, and therefore, the role of the filter in drug release was also investigated. The drug release system consists of beads with an iron-cross-linked alginate core coated with different numbers of layers of poly-L-lysine. Dissolution of the beads by the output signals of the sensing system in the presence and absence of the filter was monitored by the release of rhodamine-6G dye encapsulated in the beads, mimicking the release of a real drug. The obtained results offer a new view of the problem of noise reduction for systems intended to be part of sense and treat medical devices.
In general, the major challenge for the practical application of medical sensing systems based on enzymes is the accumulation of the noise15 produced by non-zero physiological concentrations of sensing analytes. Distinguishing between a true biochemical signal corresponding to injury or disease and a high level of noise generated in the system is a complicated task. In the sensing stage, poor separation between logic-0 and logic-1 can perhaps be partially solved by establishing a threshold for noise electronically. The situation is different for systems where the output signal is directly coupled with the drug release systems. In such a case electronic adjustment of the signal will not eliminate its physical presence. In these specific systems, prolonged accumulation of the logic-0 output could lead to release of the drug even under healthy conditions.32,33 Solving the problem of built-up noise in these systems is crucial to avoid false diagnostics and unneeded medical treatment that may have lasting adverse effects on the individual's health.
Recently, the concept of biochemical34 and chemical35 filters has been employed to reduce the noise levels in biomedical analytical systems utilizing binary logic. A special feature of this approach has been that the integration of the filtering step with a digital gate process significantly improves the signal-to-noise ratio, transforming the convex shape of response for enzymatic cascade into a sigmoidal response.34–38 This behavior is particularly desired when using binary values 0 and 1 as an output response, corresponding to the normal physiological and pathophysiological concentration of biomarkers.36
In the present paper, for the first time, the concept of filter systems is implemented to improve not only the sensing capability of an enzymatic cascade but also to better control the release of a drug. In an attempt to sufficiently suppress the interfering logic-0 outputs from the enzymatic cascade, an enzymatic filter was incorporated into the biocatalytic cascade. The effect of the enzymatic filter on the fidelity of the signals processed in the biocatalytic cascade was evaluated for the sensing of liver injury. Effectiveness of the filter was tested on the drug release systems composed of an iron-cross-linked alginate core coated with different numbers of poly-L-lysine layers. Comparison between release mechanisms from the drug release system in the presence and absence of the filter is discussed.
The present study is focused on the improvement of the reliability of the output signals after introduction of the enzymatic filter into the biocatalytic cascade.
Scheme 1 shows the general composition and operation of the biocatalytic cascade that can either be used to sense the presence of liver injury if the TNB (2-nitro-5-thiobenzoic acid; product of enzymatic conversion of DTNB; see Scheme 1) output is analyzed or to initiate release of a drug from alginate beads with citric acid as the output. The purple square in Scheme 1 outlines the presence of the filter. For a detailed description of the system refer to ref. 31 and the Experimental section of the present paper. Briefly, two enzymes, alanine transaminase (ALT) and aspartate transaminase (AST), were selected as biomarkers signaling liver injury. Their simultaneous presence at elevated concentrations (combination 1,1) produced a logic-1 output related to the sensing of liver injury, where all other combinations were processed as logic-0 refuting the presence of this injury. Citric acid produced in the biocataytic cascade was used as a chemical signal to dissolve iron-cross-linked alginate beads. In the present study, malate dehydrogenase (MDH) was introduced into the system as a filter to regulate the production of citric acid. Particularly, this enzyme regulates the production of citric acid by partially removing oxaloacetate (Oxa) produced by AST in the biocatalytic cascade. The rate of conversion of oxaloacetate to malate (Mal) can be controlled by the concentrations of the enzyme and NADH. It is noteworthy, for the future utilization of this type of system for medical sensing and/or drug release, that the following parameters should be taken into account while tuning the biocatalytic cascade: maximal suppression of all logic-0 outputs and minimal changes in the logic-1 output. Concentrations of 1 U ml−1 of the filtering enzyme and 2 mM NADH were found satisfactory in achieving these conditions.
Fig. 1 depicts a bar diagram representing the production of citric acid in the biocatalytic cascade for the four input combinations with and without the filter at cut-off times of 40 and 120 min. The kinetics of the production of citric acid from the biocatalytic cascade for all input combinations in the presence (Fig. S1†) and absence (Fig. S2†) of the filter can be found in ESI.† For convenience, the performance of the filter was evaluated for two specific cases; however, the overall trend remains the same for any selected time pairs.
The role of the filter is the initiation of the suppression of the production of citric acid for logic-0 and logic-1 outputs (Fig. 1). Interestingly, the degree of suppression increases as a function of time within the same output. For example, the production of citric acid by the 1,0 combination is suppressed almost 2 times for 40 min and 3.7 times for 120 min. This behavior can be explained by the nature of the filter itself. The rate of conversion in any enzymatic reaction depends on the concentrations of the substrates, typically increasing for a while before reaching a constant rate of conversion and, eventually, saturation. Thus, better suppression for a longer reaction time (where there is more substrate for the enzymatic filter) is expected for an enzyme-based filter. Notably, a rate of 3.7 is the maximal magnitude of suppression of the signal achieved within the present biocatalytic cascade. Unexpectedly, the production of citric acid for logic-1 was not significantly affected by the filter. This signal is approximately 1.2 times higher in the absence of the filter for both 40 and 120 min. The system itself has a very complex structure, with many dynamically changing variables affecting the production of citric acid. One of the possible explanations is that citrate synthase is inhibited by the high concentration of citrate42 produced by the 1,1 input combination. Citrate synthase can then be ‘reactivated’ in the presence of the filter, resulting in an increase in citric acid production. On the other hand, the working filter itself serves as a compensatory force, decreasing the production of citric acid, and thus the final concentration of citrate produced by the 1,1 combination remains unchanged. However, there are also other components in the system, such as NADH and NAD+, which might affect the activity of citrate synthase.43 Seemingly, the final concentration of citrate is a product of the interplay between the activation and inhibition of citrate synthase induced by different components of the system. The influence of each of these separate components requires further investigation.
To evaluate the diagnostic potential of the biocatalytic cascade with and without the addition of the filter a receiver operating characteristic analysis (ROC) was used.44–46 We have used this method previously to evaluate the diagnostic features of other biocatalytic systems.47 Typically, an ROC curve is created by analyzing the rate of true positives to positives and false positives to negatives at different threshold settings. In our case, the signals produced by physiological and pathophysiological levels of biomarkers for liver injury diagnosis in the human body39 were chosen as thresholds.
We collected two sets of data for the four logic combinations representing logic-0 and logic-1 values, limiting our selection from 60 to 120 min where “filtering” clearly separates the 0 and 1 outcomes. We did our analysis in terms of the logically scaled variables to minimize the time-dependent drift in the values by dividing the data by the average level of logic-1 fitted as a time-dependent curve to the output in logic-1. Note that the distribution of the output signals for use in real medical applications will be changed. Testing our system in all time points, we obtained two ROC curves (Fig. 2), which are drawn as plots of test sensitivity (the y coordinate) versus specificity or false positive rate (the x coordinate). The area under the ROC curve (AUC) is a common characteristic of the test, a measure of its accuracy, and a sign that it is highly probable that a randomly chosen diagnostic test will give us the correct answer.48 It allows the user to properly diagnose the condition relative to the normal or pathophysiological concentrations.44
The AUC of the ROC curve for the system without the filter produces reliable results in 88% of cases (Fig. 2). On the other hand, tests carried out for the system with the inclusion of the filter allows a proper diagnostic result in 100% of cases. The ROC curve has an AUC of about 1.00 and, as a result, corresponds to 100% sensitivity and 100% specificity. Thus, the integration of the filter into the enzymatic cascade sufficiently increases the potential for this system to work as a diagnostic tool.
In addition to evaluating the enzymatic system in the presence of the filter as a standalone biomedical analytical tool for the detection of liver injury, we have also reviewed the possibility of utilizing filtered outputs of the system for triggering the dissolution of beads containing a model drug, specifically a rhodamine-6G dye. In this case, maximal concentrations of citric acid produced by 1,1 and 1,0 input combinations for the system with and without a filter were applied to dissolve uncoated and coated iron-cross-linked alginate beads containing the ‘drug’ within their cores. The 1,0 combination was selected because citric acid production is at its maximal point among all logic-0 values at this combination and is consistent with our previous results.31Fig. 3 shows the kinetics of the fluorescence increase at 550 nm from rhodamine-6G released from a single bead with no (A), one (B), two (C) and three (D) layers of PLA dissolved by citric acid produced by 1,0 and 1,1 input combinations in the biocatalytic cascade with and without the enzymatic filter.
The shapes of the release curves are different for coated beads compared to beads without PLA layers. Major portions of the observation periods of release for a bead without PLA layers follow zero order kinetics with different rates of release for logic-0 and logic-1 outputs (Fig. 3A), and beads with PLA layers demonstrate both a sigmoidal pattern of release with a characteristic delay time and zero-order kinetics (Fig. 3B–D). It has to be pointed out that due to uncontrolled leaching of the dye from the beads during the layering process, slightly different absolute amounts of dye were encapsulated in the beads, and so, to compare the kinetics of release normalized values (An) of intensity were plotted on Fig. 3. These values are used for analyses within sets of the same type of beads. The comparison between beads of different design is based on qualitative evaluation and on the comparison between the relative values.
Fig. 3A demonstrates the release of the dye from an uncoated bead (alginate core only). For this system, release starts immediately for all input combinations, which is consistent with our previous results.31 Additionally, this system demonstrates poor separation between the release initiated by 1,1 and 1,0 combinations without a filter, thus challenging its practical application. An uncoated bead is a good model in analyzing the effect of purely the filter on the dissolution of the alginate core. In the presence of the filter, the release generated by the 1,0 input is suppressed 1.57 times on the scale of 120 min, where the filter only negligibly suppresses the 1,1 combination for the same period of time. Importantly, the degree of suppression of drug release is not equal to the degree of suppression of citric acid by the enzymatic cascade in the presence of the filter. The amount of drug encapsulated in the alginate beads is higher than the amount of cross-linker and, assuming that one molecule of citric acid binds one ion of iron, the amount of suppression of drug release is lower (1.57) than the amount of suppression of citric acid production (3.7) from the cascade for the same amount of time. When the enzymatic filter is applied, release for the 1,0 input from the beads is slowed down, but not completely suppressed. Manipulation of the enzymatic cascade is limited in that we must maintain a proper release signal for the 1,1 combination of inputs. To tackle this problem, we decided to manipulate, instead, the beads themselves, and test our cascade on beads with improved mechanical properties with the hope of controlling their dissolution more precisely.
It is known that the introduction of a protective layer can increase the stability of alginate gel to withstand dissolution.49,50 Additionally, based on the results of our previous research where a significant improvement in release for a bead coated with 1 layer of PLA was demonstrated, we decided to introduce different numbers of PLA layers. The influence of the filter was evaluated on beads with one, two, and three layers. Multiple layers were achieved by layer-by-layer coating of PLL and alginate (PLA layer) over the alginate core. Confocal microscope images of beads with different thicknesses of PLA layers are presented in Fig. 4, where micrograph A represents a bead with one PLA layer equal to 0.018 mm, B represents two PLA layers with a thickness of 0.026 mm, and the thickness of 0.046 mm corresponds to the bead in C with three PLA layers.
Fig. 3 presents the kinetics of release from the bead with one PLA layer (B), two (C) and three (D) PLA layers initiated by 1,1 and 1,0 input combinations in the presence and absence of the filter.
The curves representing the release initiated by the 1,0 combination in the absence of the filter are poorly separated from the curves produced by the 1,1 combination, especially for longer periods of time (values of intensity generated by different input combinations are the same for beads with one and two layers of PLA after 120 min of monitoring). This situation is critical in the drug release system. In the case of a bead with three layers of PLA, the 1,0 and 1,1 signals are well separated even in the absence of the filter (Fig. 3D). Because this effect is not observed in the case of the uncoated beads but is enhanced with increasing the number of coating layers we believe that the coating, which impedes diffusion of citric acid inside the bead and thus slows down the release, might be a cause of it.
The presence of the filter leads to significant suppression of the output from the 1,0 combination for all layers. To determine the maximal degree of suppression, the ratio between corresponding filtered and non-filtered signals for coated beads was calculated. We found that suppression of the 1,0 signal increases with increasing numbers of layers. For one layer, after 120 min, this ratio is 1.67, for two layers it is 1.70, and is 1.93 for three layers. It is worth mentioning that the degree of suppression for coated beads is higher than that for uncoated beads (1.57). Perhaps this effect also refers to the presence of the coating, suppressing diffusion of the citric acid. In contrast, release initiated by the 1,1 signal from beads with different layers is not affected by the presence of the filter (ratio is 0.96).
Based on our previous results and the results of the current experiments the drug release mechanism can be hypothesized. Citric acid penetrates through the shell at high concentrations and binds Fe3+, thus dissolving the core. The alginate takes up a significant amount of water, resulting in strong osmotic pressure inside the core. Consequently, a considerable hydrostatic pressure is exerted onto the polymeric coating. If the latter is weakened, cracks are formed and the drug is released from these cracks. Visualization of cracks formed in a coated bead was done using a fluorescent microscope and demonstrated in Fig. 4D. This type of drug release dominates for coated beads from 1,1 and 1,0 signals and also for the 1,1 signal in the presence of the filter. Formation of cracks for these systems was observed after some delay in time. The delay in dissolution, in our case, proportionally increased with an increase in the thickness of the polymer coating. Fig. 4 illustrates the delay of release as a function of the thickness of the polymer coating for the 1,0 input combination in the absence of the filter. This mechanism of release correlates well with our previous report, where a similar pattern of release was obtained and an increase in bead diameter during dissolution of the bead coated with one layer of PLA was recorded using a fluorescent microscope.31
Importantly, the pattern of release for coated beads initiated by the 1,0 input combination in the presence of the filter is different from the other input combinations. This is probably related to the very low concentration of citric acid being produced in the filter. In this bead, pressure within the core is much lower, and so, the polymer coating can withstand the pressure, and crack formation is suppressed. In this case, drug release is primarily controlled by diffusion through an intact film coating. Indeed, for these beads, there were no cracks observed. Additionally, our results indirectly confirmed that polymer coatings play an important role in the suppression of the diffusion of citric acid inside the beads, thus suppressing drug release.
The combination of the enzymatic filter and LBL polymer coating resulted in better separation between logic-0 and logic-1 output signals, which is important for practical applications. In our case, the best performance, in terms of maximal suppression, is achieved for beads coated with three layers of PLA. It is difficult to achieve the complete suppression of release from the logic-0 signal if concentrations of the input signals are not actually zero. However, we believe that simultaneous application of the filter and polymer coating has the potential to complete this task. While the filter suppresses the logic-0 signal, the shell withstands induced pressure inside the bead, thus preventing the bead from undergoing burst release. However, for each drug separately the type of polymer, molecular weight, specific charge and porosity should be optimized to prevent the drug from leaching through the shell.
The research was sponsored by the Laboratory Directed Research and Development Program of Oak Ridge National Laboratory, and managed by UT-Battelle, LLC, for the U. S. Department of Energy.
We would like to thank Prof. Alexei P. Sokolov (ORNL, University of Tennessee) and Prof. Vladimir Privman (Clarkson University) for fruitful discussions. Additionally, we would like to acknowledge Dr Maryna Ornatska (Elementis Specialties Inc.) for her valuable input in the preparation of the manuscript.
Footnote |
† Electronic supplementary information (ESI) available: Experimental details on the kinetics of the enzymatic reactions are available. See DOI: 10.1039/c3bm60197h |
This journal is © The Royal Society of Chemistry 2014 |