Da Som
Yang‡
ab,
Yixin
Wu‡
ac,
Evangelos E.
Kanatzidis‡
ad,
Raudel
Avila
ef,
Mingyu
Zhou
ag,
Yun
Bai
ac,
Shulin
Chen
ag,
Yurina
Sekine
h,
Joohee
Kim
ai,
Yujun
Deng
ej,
Hexia
Guo
ac,
Yi
Zhang
kl,
Roozbeh
Ghaffari
agm,
Yonggang
Huang
acen and
John A.
Rogers
*acegmopq
aQuerrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA. E-mail: jrogers@northwestern.edu
bPrecision Biology Research Center (PBRC), Sungkyunkwan University, Suwon, 16419, South Korea
cDepartment of Materials Science and Engineering, Northwestern University, Evanston, IL 60208, USA
dDepartment of Molecular Biosciences, Northwestern University, Evanston, IL, USA
eDepartment of Mechanical Engineering, Northwestern University, Evanston, IL 60208, USA
fDepartment of Mechanical Engineering, Rice University, Houston, TX 77005, USA
gDepartment of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA
hMaterials Sciences Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
iCenter for Bionics of Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
jState Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai, China
kPolymer Program, Institute of Materials Science, University of Connecticut, Storrs, Connecticut 06269, USA
lDepartment of Biomedical Engineering, University of Connecticut, Storrs, Connecticut 06269, USA
mEpicore Biosystems Inc., Cambridge, MA, USA
nDepartment of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208, USA
oDepartment of Neurological Surgery, Northwestern University, Evanston, IL 60208, USA
pDepartment of Electrical and Computer Engineering, Northwestern University, Evanston, IL 60208, USA
qDepartment of Chemistry, Northwestern University, Evanston, IL 60208, USA
First published on 21st August 2023
Systems for capture, storage and analysis of eccrine sweat can provide insights into physiological health status, quantify losses of water, electrolytes, amino acids and/or other essential species, and identify exposures to adverse environmental species or illicit drugs. Recent advances in materials and device designs serve as the basis for skin-compatible classes of microfluidic platforms and in situ colorimetric assays for precise assessments of sweat rate, sweat loss and concentrations of wide-ranging types of biomarkers in sweat. This paper presents a set of findings that enhances the performance of these systems through the use of microfluidic networks, integrated valves and microscale optical cuvettes formed by three dimensional printing in hard/soft hybrid materials systems, for accurate spectroscopic and fluorometric assays. Field studies demonstrate the capability of these microcuvette systems to evaluate the concentrations of copper, chloride, and glucose in sweat, along with the pH of sweat, with laboratory-grade accuracy and sensitivity.
New conceptsAnalysis of biochemical content in sweat can provide insights into overall physiological health conditions, yield information for disease diagnostics, produce alerts into environmental exposures and define the loss of essential substances. Recent advances in materials science and device engineering serve as the basis for skin-compatible classes of microfluidic platforms for in situ analysis and continuous monitoring via colorimetric assays. The accuracy of this type of platform can, however, be limited by artifacts of digital imaging processes that are used for colorimetric quantitation and by mechanical deformations of the analysis chambers during on-body tests. This paper reports new materials and 3D printing concepts for microfluidic networks that incorporate microscale optical cuvettes in hard/soft composite constructs. These mechanically stable systems enable precise spectroscopic and fluorometric measurements, without limitations of past approaches. Specifically, this hard/soft hybrid platform not only provides options for in situ analysis, but it is also compatible with laboratory-grade analysis via bench-top spectrometers. This paper systematically explores various polymeric materials for these devices, with quantitative experimental investigations and computational modeling of their capabilities in these wearable microfluidic sensing technologies. Field studies demonstrate applications in evaluating the concentrations of copper, chloride, glucose in sweat and the pH of sweat, with laboratory-grade accuracy and sensitivity. |
Conventional methods for sweat collection rely on absorbent pads taped on the skin, followed by sample transfer, centrifugation and dilution for analysis using benchtop equipment. Drawbacks of this method include contamination from oils and other substances on the skin or in the pads, as well as unavoidable sample loss via evaporation and manual manipulation.6 Recently developed alternative approaches rely on wearable flexible electronic devices and/or microfluidic systems integrated with potentiometric,7–11 colorimetric12–16 or fluorometric17–20 sensors. Systems for electrochemical detection and wireless data communication support capabilities for in situ analysis and continuous monitoring but they require power sources and they are susceptible to biofouling and other effects that can reduce robustness and reliability.21 Colorimetric or fluorometric chemistries, particularly when integrated into soft microfluidic structures, allow for in situ operation without additional components, where digital cameras and color extraction algorithms provide mechanisms for wireless readout.12–17 The accuracy of this type of scheme can be limited, however, by artifacts of the imaging process and by slight mechanical deformations of the analysis chambers.13,21 Recent reports introduce hybrid hard/soft structures to minimize the latter effects while maintaining sufficient flexibility for gentle interfaces to the skin by laser processing13 or 3D printing.14 Cumbersome fabrication schemes13 and remaining challenges in color extraction13,14 represent two key disadvantages.
Techniques in 3D-printing offer potential alternatives, with versatile options in 3D structure geometries and fine features, along with automated operational modes suitable for high throughput production.22,23 Likewise, spectrophotometric methods for colorimetry and fluorometry, as widely used in analytical chemistry,24 could form the basis for improvements over image capture/analysis. A key requirement is in optical cuvettes that have sufficient, consistent path lengths, fixed dimensions, high optical quality and low background fluorescence intensities.25
This paper introduces a set of ideas, materials and processing approaches that exploit these two opportunities. Specifically, 3D-printed hard-core/soft-shell microfluidic systems that integrate microcuvettes offer skin-compatible mechanics with capabilities for removal and insertion into bench-top spectrometers for laboratory-grade evaluations. 3D printing is important as a manufacturing method due to its ability for rapid and low-cost prototyping of microfluidic structures with complex valve features, interconnecting microfluidic channels, and microcuvettes in various optical-grade resins. Serpentine layouts and soft elastomeric encapsulating structures are other essential design features. These mechanically robust constructs ensure fixed, well-defined optical pathways with necessary valving features to ensure controlled filling dynamics. The result enables precise spectroscopic measurements without motion artifacts during usage and removal. Examples of sensors for copper, chloride, and pH of sweat as well as enzymatic glucose assays support precise colorimetric and fluorometric analysis, respectively. Field trials in healthy volunteers validate the performance of the devices in practical examples, with sweat induced by exercise and exposure to high heat and humidity.
A = εcl | (1) |
Fig. 1a illustrates the procedures for fabrication. As described in detail in the Methods section, a 3D printing process generates a skeletal structure (Fig. S1a, ESI†) in an acrylate polymer selected to ensure mechanical stability and to provide high optical transparency, as described in the following section. This structure defines the microfluidic channels, valves and microcuvettes for routing and storing samples of sweat in geometries that allow for spectrophotometric analysis.26 The microcuvettes contain assays for either colorimetric (Cu2+, Cl−, pH) or fluorometric (glucose) detection of sweat biomarkers. A double-sided adhesive (90880, Adhesive Research, Inc., PA, USA) seals the top surface of this printed structure to complete the microfluidic construct (Fig. S1b, ESI†). A silicone elastomer (poly(dimethylsiloxane), PDMS) serves as a soft encapsulating material that defines a composite device, in layouts with effective mechanical properties that facilitate mounting on the soft, curved surfaces of the skin. A thin, medical grade adhesive (PC2723U; ScapaHealthcare, CT, USA) provides strong adhesion to the skin, with minimal dead volume near the inlet region.27 A laser profiling process opens inlets and outlets for collection of sweat and release of air, to complete the fabrication. An exploded view schematic illustration appears in Fig. 1b. After a period of sweat collection, the device can be removed from the skin and directly inserted into a UV-visible spectrometer or fluorescent imager for precise optical analysis (Fig. 1c). Photographs of devices filled using water with fluorescent and ultraviolet dyes are in Fig. 1d–f and Fig. S2 (ESI†). The microcuvettes can be designed with thicknesses that optimize the optical path length for spectroscopic evaluation tailored to specific assays. Photographs of devices with thick (depth: 1 mm) and thin (depth: 200 μm) microcuvettes mounted on the arm are in Fig. 1g and Fig. S3 (ESI†).
Other considerations are in the mechanical and water barrier properties, to ensure dimensional stability and minimal evaporative losses, respectively. MA–MA (Young's modulus: 2.2 GPa) and b-MA-UDMA (Young's modulus: 2.9 GPa) are relatively stiff materials that offer high impact resistance and mechanical stability during use on the skin, well-matched to requirements in demanding applications such as those encountered in the military or in contact sports. A disadvantage is in the reduced compliance, with negative implications for user comfort. Acrylate-IBA (Young's modulus: 3.23 MPa) and MA-UDMA (Young's modulus: 8.9 MPa), which have comparatively lower modulus, avoid this drawback (Fig. 2c and Fig. S4, ESI†).
These differences in mechanical properties can be understood based on free-volume theory and the chemical compositions of the resins (ESI† Note 1). As shown in Table S1 (ESI†), rubbery resins with low moduli (MA-UDMA, Acrylate-IBA) consist mainly of acrylate monomer. Substitution of acrylate monomer with urethane methacrylate/methacrylate monomer increases the modulus (MA–MA, b-MA-UDMA) due to the presence of larger side groups. These methyl groups cause steric hindrance for rotary isomerization around bonds in the main chain, thereby reducing the kinetic mobility and free volume, and subsequently increasing the modulus.28
The free volume not only facilitates local segmental mobility of the polymer chain, but it also allows the diffusion of small molecules including water, ions, and gases into the polymer film. As a result, the water-vapor transmission rate (WVTR) depends on the free volume fraction of polymer (ESI† Note 1). As might be expected due to free volume considerations, MA–MA and b-MA-UDMA have lower water permeabilities than Acrylate-IBA and MA-UDMA, thereby reducing their ability to retain sweat without losses.29 The rates for such losses can be evaluated using completed devices, as illustrated in the cross-sectional image of the layered configuration of Fig. 2d. The ability to retain sweat depends primarily on the resin materials, as the sealing adhesive serves as a highly impermeable barrier to water penetration (Fig. S5, ESI†). Experiments to quantify the efficiency in sweat retention involve aqueous solutions of triarylmethane blue dye loaded within the microfluidic structure. Epoxy applied to the inlets and outlets eliminates losses through these regions. Comparisons include structures made of the four materials described above, along with an otherwise similar structure formed using PDMS as a reference. Images captured over 26 h at room temperature (Fig. S6, ESI†) quantify the loss of water as a function of time, as shown in Fig. 2e. The results at 12 h (Fig. 2f) reveal vast improvements in retention for devices formed with all of the resins, compared to those with PDMS. At 26 h, the water loss for the MA–MA, MA-UDMA, b-MA-UDMA, Acrylate-IBA and PDMS cases are 6%, 9%, 12%, 13% and 67%, respectively.
Capillary bursting valves (CBVs) route sweat into microcuvettes in a sequential manner, with negligible mixing of early and late sweat (Fig. 2g), as a passive form of chronometric sampling.26 The bursting pressures depend on the surface tension, the width of the microchannel, and the height and diverging angle of the features that define the valve.30 Measured data and calculated bursting pressures for three different types of CBVs appear in Fig. 2h. The contact angles used in the calculations follow from determinations using a goniometer (VCA Optima XE, ASI Products, Inc), as in Fig. S7 (ESI†). As sweat passes through the inlet, the filling front diverts into two paths. One passes into CBV #2, and another into CBV #3. Because the bursting pressure of CBV #2 is smaller than that of CBV #3, the front passes through CBV #2 first and fills the corresponding microcuvette. Afterward, the front meets CBV #1, which has a higher bursting pressure than CBV #2. As a result, the front at CBV #3 halts while the front at CBV #2 moves forward. This combination of three CBVs allows for a desired sequential filling process with simple 3D printing steps, as demonstrated in Fig. 2i. The critical features in the CBVs must be defined precisely for repeatable, high-performance operation. The resolution of these features depends on the parameters of the printer and the photochemical properties of the resins.31,32 For microchannels with depths of 1 mm defined with the printer used here, the minimum widths of microchannels in structures formed with MA-UDMA, b-MA-UDMA and Acrylate-IBA are 500 μm, while those in MA–MA can be as narrow as 200 μm with enhanced precision in the diverging angles (Fig. S8, ESI†). For comparatively shallow microchannels (depths of 200 μm), the minimum widths with MA–MA, MA-UDMA and b-MA-UDMA are 200 μm, and that for Acrylate-IBA is 500 μm (Fig. S8g–j, ESI†).
Incorporating these CBVs and microchannels allows collection of sweat into the microcuvettes under physiological conditions (Fig. S9, ESI†). Fig. S9 (ESI†) shows a fluid dynamic simulation (CFD) that captures the moving interface between air/sweat to show the sweat collection efficiency under natural sweating conditions. As shown in Fig. S9 (ESI†), the microfluidic structures collect sweat into the entire volumes of the microcuvettes with given boundary conditions without any leakage to the air vent channel or formation of air bubbles (ESI† Note 2). An alternative route to these types of structures relies on 3D printing to form corresponding molds (Fig. S10, ESI†). Fig. S10a (ESI†) shows a mold printed in Acrylate-IBA with a minimum microchannel width of 200 μm. The soft and elastic properties of the Acrylate-IBA facilitates demolding from a UV curable optical adhesive (NOA63, Norland Products Inc., NJ, USA), selected as the skeletal material for its high transparency (Average of 500–700 nm: 90.6%), low fluorescence background intensity (Fig. S11, ESI†), and high modulus (Young's modulus: 1.1 GPa). An ultraviolet laser system (ProtoLaser U4, LPKF, Germany) removes excess materials and defines the overall profile the molded structure. As with the 3D printed examples, these molded parts can be loaded with chemical assays, capped with adhesives and encapsulated in PDMS to yield complete devices.
Another advantage of 3D-printed microcuvettes or NOA compared to PDMS, is their low permeability to diffusion of small molecules. As described in other studies, uncontrolled absorption of small molecule species of interest into PDMS can limit use of this material in platforms for biomarker sensing or drug screening.33 As shown in Fig. S12a and b (ESI†), PDMS substrates not only strongly absorb small hydrophobic molecules such as rhodamine B, but also water-soluble bromothymol blue dye used for pH assays. 3D-printed resins or NOA based microfluidics are, in this sense, attractive alternatives. Incubation of rhodamine B solution in 3D-printed and NOA microcuvettes allows for measurements of the absorption rate by fluorescence imaging (Fig. S12c and S13, ESI†). The results show the molecular absorption rates for MA–MA and NOA much smaller than that of PDMS, such that these effects can be neglected for the timescales for sweat collection and analysis. Table S2 (ESI†) summarizes the optical, chemical, and mechanical properties of resins explored here and their effect on sweat detection accuracy.
Fig. S14a (ESI†) shows the details and key dimensions, including widths of the channel walls and the thickness of the encapsulation used in the FEA analysis. The results correspond to a device that includes a disk-shaped encapsulation structure that has a diameter of 33 mm and a thickness of 400 μm, stretched by 30%, bent to a radius of 30 mm, and twisted by 90° across the opposite edges. For 30% stretching of the skin, the skeleton structure experiences an effective stretch of ∼15%. Strong adhesion to the bottom adhesive prevents leakage under these and related conditions (Fig. S15, ESI†). Photographs of a device with 200 μm microcuvette thicknesses under various deformations are in Fig. S14b–d (ESI†). The strains appear mostly in the soft encapsulation material. Increasing the Young's modulus of the skeleton material decreases the change in optical path length during mechanical manipulation (Fig. 3g and Fig. S14e, ESI†). Specifically, under stretching to strains of 30%, the volume change in the fluid microcuvettes decreases from approximately 7% in a device made only of PDMS compared to less than 0.5% for a corresponding device that uses a skeletal structure of MA–MA. Skeletal structures formed with the other materials show even further reduced changes.
The mechanical responses at the skin interface must be considered as well, as these attributes determine user comfort. The contours of the interfacial stresses on the skin evaluated by FEA appear in Fig. 3i and Fig. S14g (ESI†). The maximum interfacial stresses on the skin occur at the edges, where they reach the threshold for skin sensation (20 kPa) at a stretch of 8%. Thin devices enhance the ability to mount on body locations that involve strong curvature and/or large natural deformations because in such cases, the threshold is exceeded only for a stretch larger than 24%. The interfacial stresses averaged over the bottom surface of the thick and thin devices for stretching of the skin by 30% are 19 and 14 kPa, respectively (Fig. 3j). Decreasing the Young's modulus of the skeleton lead to corresponding decreases in the maximum interfacial stresses, as shown in Fig. 3k. Also of note is that the maximum interfacial stresses within the device occur at the interfaces between the skeletal structures and the surrounding encapsulation. The magnitude of the stresses for thin devices are approximately 2.25 times lower than those for thick devices.
Traditional colorimetric analysis gives simple, intuitive results for concentrations of biomarkers, but often suffers from uncertainties that arise from variabilities in the external lighting conditions, such as light intensity or color temperature. The microcuvette system introduced here is attractive in part because it eliminates the effects of such variabilities. Compared to previously reported strategies based on color intensity extraction from digital images, this spectrophotometric approach improves the linearity, lowers the detection limit, and increases the resolution (Table S3–S5, ESI†).
These features are especially beneficial in detecting analytes that have low concentrations in sweat. Copper, as an example, is of interest due to its relationship to Alzheimer's disease and other forms of neurodegeneration.35 A normal physiological concentration of copper in human sweat is 1.4 ± 0.5 ppm.36 A colorimetric assay for copper relies on the reaction of cuprizone and copper ions in a basic environment (pH ∼8.5). The copper cuprizone complex that results from this reaction presents a blue color with an absorbance peak at ∼600 nm. Fig. 4a and b show the spectra and peak absorbance values measured across concentrations from 0.25 to 3 ppm. The data indicate that the peak absorbance correlates linearly with copper concentration with a Pearson's r of 0.998. The lower detection limit and the resolution are both ∼0.25 ppm. Corresponding limits based on color analysis of digital images are in the range of ∼2.5 ppm under typical conditions (Fig. S16a, ESI†). Experiments show that the absorption properties are unchanged over a range of reaction temperatures relevant to the envisioned application (20–40 °C), with reaction timescales between 5 to 10 minutes (Fig. S16b–d, ESI†). Studies of the dependence of the reaction on pH (from 4 to 9) indicate that the color change is the most pronounced at pH 8.5 (Fig. S16e, ESI†). A HEPES(4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid) buffer added to the assay ensures that the reactions occur at a pH of 8.5. Since the Cu assay depends on pH, a HEPES buffer (buffer capacity, β ∼0.054) maintains the microcuvette pH to a value of 8.5. Measurements indicate that introduction of artificial sweat with a pH of 4.5 in a microcuvette that contains HEPES, leads to a pH of 8.5 (Fig. S16f, ESI†).
Another example is in measurements of sweat glucose, known to correlate loosely with blood glucose, with some potential for screening for hyper or hypoglycemic conditions.4 The assay used here exploits glucose oxidase to oxidize glucose into gluconic acid and hydrogen peroxide. The hydrogen peroxide then reacts with a fluorometric probe catalyzed by horseradish peroxidase (HRP), to produce a resorufin fluorophore (excitation: 530–570 nm, emission: 590–600 nm). Across the physiological range of glucose in sweat (6.25–160 μM), the fluorescence intensity (FI) of this assay correlates linearly with concentration with a Pearson's r of 0.99811 (Fig. 4c and d). With a visible color change, this assay can also be used simultaneously for colorimetric glucose sensing. Simple color intensity analysis of digital images of this assay fail, however, to determine glucose concentrations lower than 10 μM (Fig. S17a and b). Compared to previously reported results13 (Table S3, ESI†), the approach reported here improves the detection resolution by nearly two and a half times. Additional experiments show that temperature (20–40 °C) affects the overall reaction timescales (80–100 min), but with consistent final values (Fig. S17c). Variations in pH (pH 5–7), however, affect the stabilization of the fluorometric probe and glucose oxidase, leading to pH dependent fluorescence intensities (Fig. S17d, ESI†). Glucose assay buffers (β ∼0.065) pre-loaded in the microcuvette ensure that the pH remains at 7.5, independent of the pH of the sweat (Fig. S17e, ESI†).
Another important biomarker is sweat chloride, used as a standard for diagnosing cystic fibrosis (CF)2 in clinical practice. The chloride assay presented here uses silver chloranilate immobilized in polyhydroxyethyl methacrylate (pHEMA). Silver chloranilate reacts with chloride ions to generate a purple-colored conjugate with peak absorbance at ∼510 nm.13Fig. 4e and f shows absorbance spectra at different chloride concentrations. The peak absorbance at 510 nm correlates linearly with chloride concentration with a Pearson's r of 0.996. Detection of the chloride concentration reaches a limit of 1 mM and a resolution of 1 mM, roughly a 5–10 times improvement over previous studies based on digital image analysis13 (Table S5, ESI†).
Sweat pH can serve as an indicator of overall hydration status, and this value can also enhance the accuracy of interpreting the responses of assays that depend on pH. The pH indicator presented here involves a mixture of bromocresol purple, bromocresol green and bromothymol blue. These weak acids react with water to form a conjugate base that provides the colorimetric response indicator. Results shows that sweat microcuvette with a mixture of these acids demonstrates pH detection limit of 4.6 and resolution of 0.2 which are comparable to the previous works of 0.513 (Table S4, ESI†) within physiological range of sweat pH from 4.5 to 7.5 (Fig. 4g and h). Additional experiments define the dependence of the assay on temperature and its kinetics. Results from the pH assay across a broad range of temperatures, from 20–40 °C indicates a minimal effect of temperature, in terms of both final color and kinetics. The reaction timescale is ∼3 min, largely independent of temperature over this range (Fig. S18, ESI†).
The colorimetric analysis gives simple, intuitive results of biomarkers, however, it often suffers from uncertainties from the external lighting conditions such as light intensity or color temperature. Under controlled lighting conditions with color references, uncertainties for the colorimetric assays are ∼2 mM for chloride, ∼7 mM for glucose, and 0.1 for pH. As shown in Table S3–S5 (ESI†), use of the microcuvette enables the lowest detection limit with best linearity compared to previously reported colorimetric approaches.
Coatings of parylene-C (thickness: 2 μm, Specialty Coating Systems) formed on skeletal structures of Acrylate-IBA and MA-UDMA facilitated curing of to define the encapsulating matrix.37 An alternative involved heating at 80 °C for 8 h, after curing38 for between one to three times. No surface treatments were required for MA–MA and b-MA-UDMA resins.
The molding process used a UV curable optical adhesive (NOA63, Norland Products Inc., NJ, USA) cast on the 3D-printed mold. After curing in a UV flood exposure system (Inpro Technologies F300S, INPRO Technologies, Inc., MD, USA) for 2 min, the part was demolded and profiled by an ultraviolet laser system (ProtoLaser U4, LPKF, Germany) to remove the access materials.
Assays were immobilized on the surfaces of the microcuvettes. Bonding of double-sided adhesives (90880, Adhesive Research, Inc., PA, USA) cut into appropriate shapes using a CO2 laser sealed the top sides of the microfluidic structures. Encapsulation in PDMS (elastomer/curing agent ratio, 15:1; Sylgard 184, Dow Corning) completed the fabrication.
Copper, pH, and chloride sensors were stored at room temperature prior to use. These assays were stable at room temperature for at least up to 3 months. The glucose assay was stored in the freezer since the fluorometric probe is light-sensitive. After loading all sensing assays, the devices were stored in an amber vacuum desiccator to minimize exposure to light and humidity prior to use. The devices were used within a week after preparation.
Footnotes |
† Electronic supplementary information (ESI) available. See DOI: https://doi.org/10.1039/d3mh00876b |
‡ These authors contributed equally to this work. |
This journal is © The Royal Society of Chemistry 2023 |