METHOD AND DEVICE FOR MEASURING THE FIBRINOGEN CONCENTRATION IN BLOOD SAMPLES
20220187292 · 2022-06-16
Inventors
- Jim MANOLIOS (Red Hill, AU)
- Marek BIALKOWER (Clayton, AU)
- Clare HENDERSON (Clayton, AU)
- Rico TABOR (Clayton, AU)
- Gil GARNIER (Clayton, AU)
- Heather MCLEISH (Clayton, AU)
Cpc classification
G01N2800/226
PHYSICS
B01L2200/16
PERFORMING OPERATIONS; TRANSPORTING
G01N33/86
PHYSICS
G01N2333/96463
PHYSICS
B01L3/5023
PERFORMING OPERATIONS; TRANSPORTING
B01L2300/161
PERFORMING OPERATIONS; TRANSPORTING
International classification
Abstract
A diagnostic device which enables measurement of fibrinogen concentration in a blood sample. The device comprises; a wettable testing substrate including viewing indicators which allow determination of a status of a test. The substrate has a first end and second end and intermediate therebetween a flow receiving zone, a flow path zone and a reaction zone; the reaction zone pre charged with at least one reagent. A blood sample to be tested is deposited near or in either of said flow receiving zone or said reaction zone, the sample reacting with the reagents inducing clotting of the sample. Water added to a dye added to said reaction zone, advances a distance along said substrate. The distance travelled along the substrate by the dye and through the sample is indicative of a measure of concentration of fibrinogen in said blood sample under test.
Claims
1. A diagnostic device which enables measurement of fibrinogen concentration in a blood sample, the device comprising; a wettable testing substrate including viewing indicators which allow determination of a status of a test; the substrate having a first end and second end and intermediate therebetween a flow receiving zone, a flow path zone and a reaction zone; the reaction zone pre charged with at least one reagent; wherein, when a blood sample to be tested is deposited near or in either of said flow receiving zone or said reaction zone, the sample reacting with said reagents inducing clotting of the sample; water added to a dye added to said reaction zone, advances a distance along said substrate; the distance travelled along said substrate by the dye and through the sample providing a measure of concentration of fibrinogen in said blood sample under test.
2. A device according to claim 1 wherein a zone of hydrophobicity is created in or near said reaction zone when blood or plasma is applied to the reaction zone.
3. A device according to claim 2 wherein the reaction zone pre charged reagents are selected from the group comprising; physical factors, biological factors, and chemical factors pre applied to the substrate.
4. A device according to claim 5 wherein, the concentration of fibrinogen is related to the behavior of the blood sample introduced into the fluid receiving zone or reaction zone and a hydrophobicity induced into the substrate.
5. A device according to claim 4 wherein the substrate is porous and manufactured from cellulose fibre (paper).
6. A device according to claim 5 wherein when the sample is deposited in or near said flow receiving zone or reagent zone; the porosity of said substrate urging said dye under the action of capillary (elution), a distance along said substrate, the distance travelled along said substrate and through said sample, providing a measure of concentration of fibrinogen in said blood sample under test.
7. A device according to claim 6 wherein said elution causes a release of antibody molecules from the red blood cell membrane of the test sample.
8. A device according to claim 7 wherein said released antibodies are tested against reagent red blood cells to determine if an immune antibody specificity is present.
9. A device according to claim 8 wherein the physical factor and/or chemical factor or biological factor applied to the porous substrate, influences hydrophobicity of the substrate.
10. A device according to claim 9 wherein the zone of hydrophobicity is measurable.
11. A device according to claim 10 wherein the physical factor and/or chemical factor or biological factor applied to the porous substrate, decreases or increases hydrophobicity of the substrate.
12. A device according to claim 11 wherein the pre charging of chemical factor modification of the substrate comprises coating the substrate with a chemical.
13. A device according to claim 12 wherein when blood or plasma is applied to or near the reaction zone, a zone of hydrophobicity is formed after initiation a clot formation.
14. A device according to claim 13 wherein the biological factors, physical factors, chemical factors and/or derivatives of the biological factors and/or chemical factors used may optionally be applied and/or pre-applied outside of the reaction zone.
15. A device according to claim 14 wherein the blood plasma is applied on the porous substrate outside the reaction zone.
16. A device according to claim 15 wherein, the aforesaid biological factors, physical factors, chemical factors and/or derivatives of the biological factors, physical factors and/or chemical factors used are involved in the initiation, execution, amplification and/or acceleration of the clot formation.
17. A device according to claim 16 wherein the aforesaid biological factors, physical factors, chemical factors and/or derivatives of the biological factors, physical factors and/or chemical factors used are involved in the enhancement or diminishment of the hydrophobicity of the clot.
18. A device according to claim 17 wherein the physical factors used influence hydrophobicity of the clot.
19. A device according to claim 18 wherein the aforesaid physical factors determine the creation or prevention of clot formation.
20. A device according to claim 19 wherein the device is single use and disposable.
21. A device according to claim 20 wherein the reaction zone is pre charged with Thrombin chromogenic substrate and a dye.
22. A device according to claim 21 wherein the hydrophobicity is induced by the polymerization of fibrinogen in the blood sample to fibrin upon enzymatic reaction with thrombin and/or FXIIIa deposited onto the receiving or reaction zones.
23. A device according to claim 22 wherein diagnosis relies on a significant change of hydrophobicity induced by polymerization of the fibrinogen in the blood sample to fibrin upon enzymatic reaction with thrombin and/or FXIIIA deposited in the receiving or reaction zone.
24. A device according to claim 23 wherein capillarity distributes the blood sample into the receiving zone treated with thrombin, and a wash solution is transported through the receiving zone to remove dye deposited in the receiving zone out of the porous material.
25. A device according to claim 24 wherein colour intensity after washing is used to measure and visualize the hydrophobicity of the zone and relate to the fibrinogen concentration in the blood sample.
26. A device according to claim 25 wherein the porous substrate is contained in a housing including viewing indicators.
27. A device according to claim 26 wherein the viewing indicators are observed through viewing windows that reveal status of testing as the indicator dye and/or sample progresses along the substrate.
28. A device according to claim 27 wherein the distance is a measurement of how far that the water wicks blue dye through clotted plasma.
29. A device according to claim wherein the blue dye moves the zone of hydrophobicity with it (whilst simultaneously moving through it).
30. A disposable diagnostic indicator device which enables measurement of fibrinogen concentration in a blood plasma sample applied to said device, the indicator comprising: a wettable porous testing substrate, the porous testing substrate having a first end and second end and intermediate therebetween a flow receiving zone, a flow path zone and a reaction zone; the reaction zone of the substrate pre charged with Thrombin and an indicating dye; wherein, when said sample is deposited in said flow receiving zone or in said reaction zone, a zone of hydrophobicity is created; and wherein when water mixes with the dye, the dye advances along the flow path zone; also urging said sample a distance along said substrate, the distance travelled along said substrate of the indicating dye providing a measure of concentration of fibrinogen in said blood sample under test.
31. A method of testing for the concentration of fibrinogen in a blood sample using a diagnostic device which enables measurement of fibrinogen concentration in the blood sample, the device comprising; a wettable testing substrate and a housing including viewing indicators which allow determination of a status of a test; the substrate having a first end and second end and intermediate therebetween a flow receiving zone, a flow path zone and a reaction zone; the reaction zone pre charged with reagents; the method comprising the steps of: a) pre charging said porous substrate with Thrombin chromogenic substrate and a dye/buffer solution, to provide a reagent reaction mixture in a reaction zone; b) adding a blood or plasma sample near or in said receiving zone or near or in said reaction zone so that is engages with the reagent; c) allowing the plasma to react with the thrombin to create a zone of hydrophobicity and induce clotting; d) using the porosity in the substrate to transport the dye/buffer solution along the substrate and through the reaction zone, e) observing a distance along the porous substrate that the dye/buffer solution passes; f) determining fibrinogen concentration in said sample with reference to said distance that the dye/buffer solution travels along the flow path zone.
32. The method according to claim 31 comprising the further step of: allowing blood or plasma sample to form a clot and measuring an extent of clotting after initiating clotting of the sample, by measuring mass or volume or height of the clot.
33. The method according to claim 32 comprising the further step of; removing clotted blood or plasma from the non-porous substrate's surface by physical factors;
34. A testing method for determining the concentration of fibrinogen in a test sample using a porous substrate; the substrate having a first end and second end and intermediate therebetween a flow receiving zone, a flow path zone and a reaction zone; the method comprising the steps of: g) pre charging said porous substrate with Thrombin chromogenic substrate to provide a reaction zone and an indicating dye; h) adding a plasma sample to said reaction zone; i) allowing the plasma to react with the thrombin to clot and create a zone of hydrophobicity; j) washing the dye/buffer solution in the reaction zone, k) observing a distance that the dye/buffer solution travels along the flow path zone and any colour change; l) determining fibrinogen concentration in said sample with reference to said distance and/or said colour change.
35. The method according to claim 34 comprising the further step of quantifying the zone of hydrophobicity/hydrophobicity by measuring the distance travelled by at least one chromogenic marker through or away from the zone of hydrophobicity in a lateral flow.
36. The method of testing according to claim 35 comprising the additional step of quantifying the zone of hydrophobicity's surface hydrophobicity by measuring the shape, height and/or contact angle of any deposited liquid droplets on top of the non-porous substrate's surface.
37. The method according to claim 36 wherein the hydrophobicity is induced by the polymerization of the fibrinogen in the blood sample to fibrin upon enzymatic reaction with thrombin and/or FXIIIa deposited onto a receiving surface of the reaction zone.
38. The method according to claim 37 wherein diagnosis relies on a significant change of hydrophobicity induced by polymerization of the fibrinogen in the blood sample to fibrin upon enzymatic reaction with thrombin and/or FXIIIA deposited in the receiving zone.
39. The method according to claim 39 wherein said diagnosis of fibrinogen concentration can be made using the following combined three mechanisms; 1) a change in dye adhesiveness induced by polymerization of the fibrinogen in the blood sample to fibrin upon enzymatic reaction with thrombin and/or FXIIIa deposited onto the receiving zone; 2) adhesion of the dye deposited in the receiving zone to the fibrin directly (or indirectly via the assistance of dye binders); and 3) capillarity used to distribute the blood sample into the receiving zone treated with thrombin, and transport wash solution through the receiving surface to remove dye out of the porous material.
40. The method according to claim 39 wherein a colour intensity after washing is used to measure and visualize the quantity of fibrin-adhered dye remaining in the zone; thereby enabling a determination of fibrinogen concentration in the blood sample.
41. A method according to claim 40 wherein said Thrombin is Lyophillised.
42. A method according to claim 41 wherein the dye includes a buffer.
Description
BRIEF DESCRIPTION OF DRAWINGS
[0062] The invention will be better understood and objects other than those set forth above will become apparent when consideration is given to the following detailed description thereof. Such description will now be described in more detail according to a preferred but non-limiting embodiments and with reference to the accompanying illustrations; wherein
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DETAILED DESCRIPTION
[0069] The present invention will now be described in more detail according to a preferred embodiment but non limiting embodiment and with reference to the accompanying illustrations. The examples referred to herein are illustrative and are not to be regarded as limiting the scope of the invention. While various embodiments of the invention are described herein, it will be appreciated that these are capable of modification, and therefore the disclosures herein are not to be construed as limiting of the precise details set forth, but to avail such changes and alterations as fall within the purview of the description.
Terminology
[0070] Throughout the description a reference to substrate can be taken to include a reference to: Active Base/medium of diagnostic which facilitates assaying. A reference to Factor can be taken to include a reference to: a component of diagnostic that impacts on results. a reference to Biological factor can be taken to include a reference to: a Factor derived from biological source. Eg. Thrombin, Platelets, etc. . . . . A reference to Chemical Factor: can be taken to include a reference to: a factor derived from non-biological source. Eg. Calcium Chloride, etc. . . . . A reference to physical factor can be taken to include a reference to: a Factor: not composed of chemical matter. Eg. UV Radiation, Temperature, Pressure.
[0071] A reference to apply/applied can be taken to include a reference to: the addition of a chemical to diagnostic as a part of test procedure. A reference to pre-apply can be taken to include a reference to: incorporation of a chemical into diagnostic as part of intrinsic design. A reference to clot can be taken to include a reference to: a Network composed of polymerized fibrin monomers and a reference to clotting or clot formation can be taken to include a reference to Conversion of fibrinogen into fibrin network. A reference to Amplification (of clot formation) can be taken to include a reference to: generation of a larger magnitude clot network in the time allowed for reacting.
[0072] A reference to Chromogenic Marker, also termed a dye, can be taken to include a reference to: a coloured chemical that is clearly visible to the naked eye. A reference to Lateral Flow can be taken to include a reference to: movement of liquid through a long, narrow channel via capillary forces. A reference to Wicking Liquid can also be taken to include a reference to: a liquid that moves through a substrate through the action of capillary forces. A wicking fluid is also a fluid that saturates the flow receiving zone in order to travel through the flow path zone.
[0073] A reference to a flow receiving zone can be taken to include a reference to: a zone in which wicking liquid can be applied. A reference to a flow path zone, can be taken to include a reference to: a Zone in which wicking liquid can move into from the flow receiving zone.
[0074] A reference to a Washing Liquid, can be taken to include a reference to: a liquid used to dislocate the chromogenic marker(s) out of the substrate. The plasma/blood solution too can be defined as washing liquid in this case as it is able to dislocate the dye out of the paper (if the dye is pre-charged Into the reaction zone).
[0075] A reference to a, Threshold Result can be taken to include a reference to: a simplified quantification in which the result provided from a measurement is only readable as above or below a certain value (i.e. the reading is positive or negative).
[0076] A reference to a, surface (of substrate) can be taken to include a reference to: a solid interface of substrate's surface that is only exposable to liquid or gas; includes any chemical modifications or coatings applied and/or pre-applied to this interface. A reference to Capillary can be taken to include a reference to: a thin tube which can hold blood or plasma. A reference to a centrifuge or centrifuge device, can be taken to include a reference to: a device that applies centripetal or centrifugal forces (to a sample).
[0077] The invention is described herein with reference to paper strips for the purpose of illustration but it will be appreciated by persons skilled in the art that the invention has applications apart from fibrinogen testing. Throughout the description a reference to wicking can be taken to include a reference to acting to absorb or draw off liquid by capillary.
[0078] According to one embodiment there is provided a paper indicator using thrombin and a dyed solution to ascertain concentration of fibrinogen in a blood sample using distance increments which can potentially be measured in mm or cms. The indicator is intended for measuring between 0-2 g/L to diagnose hypofibrinogenemia (especially in the early stages of hemorrhage). According to the method aspect, the test employs plasma and measures based on clot hydrophobicity rather than clot formation time as in the known art.
[0079] According to a preferred embodiment a paper substrate is provided which has one section coated with thrombin and another section coated with blue dye. Plasma is added to the section with thrombin to react for a short period of time, then water is added to the section with blue dye. It is preferred to use the blue dye in the reaction zone (and causing it to wick in the eventual zone of hydrophobicity) instead. The distance that is measured is how far that the water wicks the blue dye through the clotted plasma. In reality it also moves the zone of hydrophobicity with it (whilst simultaneously moving through it). This is to be distinguished from the prior art which measures how far the plasma moves through the device whilst clotting. The front of the zone of hydrophobicity can be used as a distance marker as it can be much clearer than that produced by the wicking fluid moving through it.
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[0086] The present invention employs paper, cellulose or any porous and wettable material as a medium for both the plasma and water to wick through. The porous structure of the cellulose induces a capillary action but without reliance on action from micropillar extrusions. Paper is economic in comparison to plastics, glass or silicon (AU$5 cents per test vs AU$50 cents per test). Paper is a flexible material that can be cut into many different shapes, configurations and structures and can be easily incorporated with hydrophobic barriers and hydrophilic channels. Therefore, its fabrication costs are very economic compared to the prior art.
[0087] The present invention presents many advantages over the prior art. For example, in the prior art, a plastics diagnostic device is used which has no inherent capillary action to facilitate fluid flow. Accordingly, fluid flow must be artificially induced by the inclusion of micropillars. In addition, the prior art plastics diagnostic device needs to be coated with SiOx and treated with polyelectrolytes to increase the hydrophilicity of the flow path zone as in US20120107851A1. The extra manufacturing adds significantly to the costs of producing the device. According to the present invention, a paper indicator is used which requires no pre treatment to induce capillarity as the material itself has inherent capillarity requiring no pretreatment or modification to induce capillarity. One advantage of the present invention is that use of a paper indicator, has natural capillary flow without the need to add in parts or modify surfaces.
[0088] Another advantage is that the disadvantages of variability related to thrombin kinetics is eliminated. Furthermore, the employment of a porous material such as paper, allows fibrinogen concentration to be measured in other ways than a lateral flow assay. For example, the test can be converted into a flow-through type detection system that measures colour intensity after a certain number of washes. Another advantage of the present invention is that the sensitivity for the test is higher for concentration ranges of 1-2 g/L Fibrinogen. For example in the cited prior art US20120107851A1 a distance travelled for between 1 and 2 g/L plasma is only 0.6 cm before stopping.
[0089] According to the present invention there is for example, a 1.7 cm separation for the same concentrations after 7 minutes of elution. It is contemplated that substrate 2 includes a variety of user options for wicking fluid, including a wetable fibrous material and includes but is not limited to, non wetable materials treated by plasma treatment, radiation, surfactant coating and/or chemical reaction to make it wettable. The substrate may be woven or non-woven. It may be pre or post treated with thrombin and/or FXIIIa or derivatives of these enzymes. It may be treated with deposited desorbable dyes and/or desorbable dye binders and particles and nanoparticles. During testing the substrate is charged with water, buffer solution, dye solution and/or washing solution—collectively wicking fluids.
[0090] There are provided alternative methods for analyzing the testing and test results. A method of quantifying the zone of hydrophobicity/hydrophobicity includes measuring the distance travelled by at least one chromogenic marker with the zone of hydrophobicity 9 in a lateral flow. Preferably the lateral flow occurs in porous substrate 2 in flow receiving zone 5 and flow path zone 6. According to one embodiment, flow path zone 6 has a length L1 and a width W1. Flow receiving zone 5 has a length L2 and a width W2. L1 may be the same or different length from L2. Likewise W1 may be the same or a different length from W2. A lateral flow regime traverses the flow receiving zone 5 and flow path zone 6 and as described earlier. According to one embodiment, the biological factors, chemical factors and/or derivatives of the biological factors and/or chemical factors pre charge substrate 2 in flow path zone 6. Alternatively those factors may be applied during testing to at least part of the flow path zone 6 and/or the flow receiving zone 5. In use, a blood or plasma sample is introduced into either at least part of the flow path zone 6 and/or the flow receiving zone 5. Chromogenic marker(s) can be applied at this time or pre-applied to the substrate 2.
[0091] A wicking fluid is applied to the flow receiving zone 5 in order to induce the movement of the chromogenic marker(s) through the flow path zone 6 The wicking fluid is according to one embodiment applied to the flow receiving zone in the form of a finite reservoir or an infinite volume reservoir. The distance travelled by the chromogenic marker(s) is measured with ruling markers next to the flow path zone 6. When substrate 2 is held in casing 11 to form device 1, the distance travelled by the chromogenic marker(s) is/are measured via by observing the flow path zone 6 through transparent windows 12, 13, 14, 15 and 16 in casing 11. Windows 12, 14, 15 and 16 align with the flow path zone 6 and enable the observations described earlier with reference to
[0092] According to one embodiment, hydrophobicity of the zone of hydrophobicity 9 is determined by measurement of degree of retention of at least one chromogenic marker applied and/or pre-applied in (or outside of) the reaction zone, along with all the other biological factors, chemical factors and/or derivatives of the biological factors and/or chemical factors, after rinsing the porous substrate with a washing liquid. Hydrophobicity refers to the hydrophobicity at the surface of the non-porous substrate. The substrate's surface hydrophobicity is used to influence shape, height and/or contact angle of any deposited liquid droplets. Hydrophobicity can be modified with a physical factor and/or chemical factor that will or may increase or decrease the hydrophobicity of the substrate. One method of modifying the hydrophobicity is to apply a chemical coating to the substrate.
[0093] Preferably the clot formed acts as a hydrophobic barrier to prevent the washing liquid from dislocating of the chromogenic marker(s) out of the substrate. The forming or formed clot can coat the surface of the non-porous substrate to modify its hydrophobicity. Physical factors may allow or prevent the initiation of the clot formation. Physical, Biological factors, chemical factors and/or derivatives of the biological factors and/or chemical factors used are involved in the initiation, execution, amplification and/or acceleration of the clot formation. These factors also affect the clot's hydrophobicity. The retention of chromogenic marker(s) is measured by the absolute and/or relative colour intensity after washing the substrate with a given volume of washing liquid. The chromogenic marker(s) is applied and/or pre-applied in the reaction zone, along with all the other biological factors, chemical factors and/or derivatives of the biological factors and/or chemical factors.
[0094] There are many variations in the methodology of performing the fibrinogen concentration testing. The variations include:
applying blood or plasma on the non-porous substrate outside the reaction zone; application of the blood or plasma to the reaction zone to form a zone of hydrophobicity after initiating clot formation;
removing clotted blood or plasma from the non-porous substrate's surface by physical factors;
enhancing the visibility of the liquid droplet with the use of at least one chromogenic maker . . .
a threshold result for height measurements which can be determined by placing a porous, absorbent substrate directly above the non-porous substrate and allowing any deposited liquid droplet to make contact with the porous, absorbent substrate.
[0095] The method contemplates a process of measuring chromogenic staining which refers to the binding of at least one chromogenic substrate directly and/or indirectly to the formed or forming clot. Blood or plasma is applied to the reaction zone to form a zone of stained clot after initiating clot formation. Biological factors, chemical factors and/or derivatives of the biological factors and/or chemical factors can be used enhance the colour intensity of the chromogenic marker(s).
[0096] According to an alternative embodiment, the present invention one method of diagnosis of concentration of fibrinogen in a blood or plasma sample, involves using at least one capillary in a centrifuge, each including a reaction mixture of biological factors, chemical factors and/or derivatives of the biological factors and/or chemical factors applied and/or pre-applied inside of the at least one capillary. Blood or plasma is applied to the reaction mixture which forms a clot and the extent of clotting after initiating clotting is measured. Measuring the extent of clotting refers to quantifying the mass, volume or height of the clot in the capillary.
[0097] A centrifugal force is applied to the capillaries such that it causes the clot to compress in the direction away from the axis of spin. The extent of clotting is determined by measuring the height of the centrifugally compressed clot in the capillary. The height of the compressed clot can be measured with ruling markers on top of and/or next to the capillar(ies). Alternatively the compressed clot is measured by containing the capillary in an external casing with transparent windows that align with key heights up the capillary and hence will show whether the clot has reached and/or gone past the key heights or not.
[0098] As previously described, a chromogenic dye or other suitable marker is used. Biological factors, chemical factors and/or derivatives of the biological factors and/or chemical factors are used enhance the colour intensity of the chromogenic dye(s) and are involved in the initiation, execution, amplification and/or acceleration of the clot formation. Physical factors used that will or may allow or prevent the initiation of the clot formation. the biological factors, chemical factors and/or derivatives of the biological factors and/or chemical factors used are involved in the enhancement or diminishment of the clot's hydrophobicity. Physical factors used that will or may enhance or diminish the clot's hydrophobicity. The biological factors, chemical factors and/or derivatives of the biological factors and/or chemical factors used, are involved in the enhancement or diminishment of the clot's ability to bind directly and/or indirectly to at least one chromogenic marker.
[0099] It will be recognised by persons skilled in the art that numerous variations and modification may be made to the invention broadly described herein without departing from the overall spirit and scope of the invention.