Micropatterned Paper Monitoring Hepatotoxicity Less Developed Countries (Research Paper Sample)

MICROPATTERNED PAPER MONITORING HEPATOTOXICITY LESS DEVELOPED COUNTRIES
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Course Name: EATC001/ SATC001
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Table of Contents
Section

Topic

Page Number

1

Introduction

3

2.0
3.0

Preview
Design requirement of micropatterned paper
device

4
4

4.0
5.0

Structure of the device
Researching the analytes

6

6.0

Data testing the micro-patterned paper device

8

7.0
8.0

Conclusion
Reference

10
12

1. Introduction
Less industrialized countries are characterized by a lack of funds which contribute to the unavailability of equipment and poor setting for excellent monitoring of hepatotoxicity (Ballerini and Shen 2012, p. 770). Tests available in most industrialized for hepatotoxicity testing are beyond reach by developing nation (Pollock et al. 2012, p. 154). In response to poor resource setting, developing nation only rely on symptom diagnosis as the only method for hepatotoxicity monitoring. Symptoms usually appear after a considerable damage had been done. Thus, development of low-cost, simple-to-use (POC) method for diagnosing and monitoring for hepatotoxicity in poor resource country is crucial (Pollock et al. 2012, p. 153). According to Vella et al. (2012, p. 2885), reduction in price of drugs for acquired immunodeficiency syndrome (AIDS), tuberculosis (TB) and malaria drugs have increased cases of hepatotoxicity in less developed country. Although this has helped, lack of a suitable method for detection of liver induced-toxicity has led to noticeable deaths due to drug toxicity. Monitoring of patients does not only help in the curing of appropriate hepatotoxicity, but it also prevents treating of patient without the disease as well as over treating which could lead to developing drug-resistant organisms (Chang & Schiano, 2007, p. 1137).
As a move to address the issue of monitoring, Whiteside laboratory has developed a low cost paper based, a device using thread and magnetic levitation (method in which subjects are suspended with magnetic field only) which are configured to detect protein and glucose in the blood. Two different groups were also reported to have developed a paper-based enzyme-linked immunosorbent assays (P-ELISA), which uses colorimetric output to detect antibodies against human immunodeficiency virus infection (HIV) in blood.
2.0 Preview
This report explains of the basic features of micropatterned which make it able to monitor hepatotoxicity. It begins by brief introduction of meaning hepatotoxicity, condition associated with it, what is required to for the analyses in order to detect cases of hepatotoxicity. Hepatitis and how device detect it is discussed. Three assays are used during monitoring, which include AST, ALP and total protein. Results are analyzed through calorimetrically. In case of hepatitis the device registers color change in AST and ALP testing zones from colorless to pink and purple respectively. In the protein assay, presence of hepatitis is seen by lack of change or minimal changes. This is followed component of the device and how their functions. The parts are plastic sheaths, filter, and hydrophilic. Sheaths help to prevent contamination to workers, the filter separate red blood from plasma, and hydrophilic paper prevent cross-reaction. Finally, data testing of device is done. How the device measure hepatotoxicity.
3.0. Design requirement of micropatterned paper device
Durante-Mangoni et al. (2006, p. 1352) said that hepatotoxicity is a general name for liver damage. The conditions that fall within hepatotoxicity includes: hepatitis (inflammation of the liver) hepatic necrosis (death of liver cell) hepatic steatosis (too much fat in the liver) It results of various factors, including infection from disease micro-organism especially those that cause diseases such as hepatitis, HIV malaria and cancer, abuse of alcohol, overreaction or reaction toward medication (Ballerini & Shen 2012, p. 771). Drug induced hepatotoxicity occurs to 2- 28% of most patients taking medication such as isoniazid, and pyrazinamide which are used for tuberculosis and also occurs to 8-28% of HIV patient taking Nevirapine as their first line treatment and risk increases with patient’s co-infections. Thus, people under diabetic and heart therapy needs close monitoring of the liver (Pollock et al. 2012, p. 156).
Hepatitis is a disease condition defined by liver inflammation. The disease occurs with no symptoms, but leads to jaundice anoxia and malaise. The disease causes the release of AST and ALP in the blood stream. On the other hand, the disease reduces the amount of protein in the blood stream. To check both acute and chronic hepatitis, for the acute hepatitis, the damaged liver releases AST and ALP into the blood stream hence elevating their concentration to more than 10 times. On the other hand, in chronic hepatitis, it elevates 4 times. To detect this, the device registers color change in AST and ALP testing zones from colorless to pink and purple respectively. Using the chart interpretation basing on the color intensity, high intensity indicates acute hepatitis while low intensity indicates chronic hepatitis. Using total protein assay, reduced or low intensity in green color shows the presence of dysfunction (Pollock et al. 2012, p. 8).
Blood is most commonly used as a test medium, it contain markers of the liver that are absent in urine. Striking piercing or lancing the finger is the most common method used in the developing countries since it does not require trained personnel. Furthermore, an adult average finger produces between 10 and 20µL volume of blood (Vella et al 2012, p. 2886). The figure below shows how the blood from the fingerstick is taken.
4.0. Structure of the device
Micropatterned paper device a portable system designed to detect multiples of analytes (AST, ALP and protein) in the drop of blood from a fingerstick. The device comprises a paper chip patterned into hydrophilic and hydrophobic regions, self-adhesive laminating sheets. The figure below illustrates the components of the device which includes plastic sheaths, filter and hydrophilic paper.
Figure 2: Components of the device. Source: modified Vella et al.
As seen In figure (2), Its microsystem consist of (i) plastic sheaths, (ii) a filter to remove red blood cells (iii) a patterned paper with a wax ink functioning as hydrophobic barrier hence creating three hydrophilic zone for running three calorimetric assays. Two sheaths around the device protect excess blood from limiting water evaporation from the plasma. The sheaths also help in preventing reagents from contaminating, and workers from touching patient blood. Red blood cells applied to the device are adsorbed to the filter while the plasma proceeds to detection area. Patterning ensures no cross-reaction or mixing of coloring agent in hydrophilic zones. Calorimetric assay is used since they offer benefit of quickness in completion requiring less than 30 minutes, easy to interpretation, using a chart or digital scanning, and analyzing using software of if intergraded with telemedicine can be done off-site (Vella et al 2012, p. 2884).
The paper based devices will not only help the poor resource country to monitor hepatotoxicity. However, it will also help to prevent unnecessary treatment of the problem (Martinez, Phillips, Butte & Whitesides 2007, p. 1319).
5.0 Researching the analytes
Hepatotoxicity panel consist of several different assays which include aspartate aminotransferase (AST), total serum protein, alanine aminotransferase (ALT), bilirubin, albumin, and alkaline phosphatase (ALP). Liver damage (such as hepatitis elevate both AST and ALP. On the other hand, it reduces the concentration of total serum protein and albumin. Many researches undertaken to indicate the state of liver often use concentration of the two enzymes and total protein to base their judgment (Pollock et al. 2012, p. 158)
6.0. Data testing of micropatterned device
Common assays used in data analysis are (aspartate aminotransferase (AST), alkaline p...