Introduction

Biosensors are devices that are designed to detect biological molecules and other biologically relevant species utilizing a biological recognition element, typically immobilized on a transducer that converts the binding event into a measurable signal ⁽¹⁾. Biosensors as a disease diagnostic tool are promising, providing sensitive and specific detection of disease biomarkers and contributing to the development of personalized medicine ⁽²⁾. The creation and uses of biosensors in the diagnosis of diseases, as well as the most popular biosensors, their benefits and drawbacks, and their present clinical status, are all covered in detail in this study.

Figure 1: A biosensor is shown generally as having three parts: a detector, a transducer, and an output system.  (Said & NUR AZURA, 2014)

Biosensors for Disease Diagnosis

Biosensors as a disease diagnostic tool are widely used for the detection of diseases, including cancer, cardiovascular diseases, infectious diseases, and others. The most commonly used biosensors are electrochemical biosensors, optical biosensors, and piezoelectric biosensors ⁽³⁾.

Electrochemical Biosensors

The most popular type of biosensors is electrochemical ones for disease diagnosis. They are based on the principle of electrical currents that are produced when electroactive compounds are oxidized or reduced at the surface of a sensing electrode ⁽⁴⁾. The high sense of electrochemical biosensors is just one of their many benefits, low cost, and fast response time. Moreover, they can be miniaturized, making them suitable for point-of-care (POC) testing ⁽⁵⁾.

One of the most commonly used electrochemical biosensors for disease diagnosis is the glucose biosensor. Glucose biosensors are used to monitor blood glucose levels in diabetes patients, providing an easy and convenient way to monitor the disease (6). Another example is the biosensor for the detection of cardiac markers, such as myoglobin and troponin, which are important biomarkers for the diagnosis of myocardial infarction ⁽⁷⁾.

Optical Biosensors

Optical biosensors are based on the principle of the interaction between light and biological molecules. They can detect changes in the optical properties of a biological sample due to the binding of the target analyte ⁽⁸⁾. Optical biosensors have a few focal points, counting tall selectivity, tall affectability, and the capacity to multiplex tests ⁽⁹⁾.

An example of an optical biosensor is the biosensor for the detection of prostate-specific antigen (PSA), which is used in the diagnosis of prostate cancer ⁽¹⁰⁾. Another example is the biosensor for the detection of hepatitis B virus (HBV), this is an important symptomatic tool for screening HIV infection.  ⁽¹¹⁾.

Piezoelectric Biosensors

Piezoelectric biosensors are based on the principle of the interaction between mechanical stress and electrical charges, and they are capable of detecting changes in the electrical charge due to the binding of the target analyte ⁽¹²⁾. Piezoelectric biosensors have numerous advantages, inclusive of excessive sensitivity, fast response time, and the ability to perform multiplex assays ⁽¹³⁾.

An example of a piezoelectric biosensor is the biosensor for the detection of human chorionic gonadotropin (HCG), which is used in the diagnosis of pregnancy ⁽¹⁴⁾. Another example is the biosensor for the detection of the influenza virus, which is important for the rapid diagnosis of influenza infections ⁽¹⁵⁾.

Figure 2: Different applications of biosensors. (Singh et al., 2020)

Figure 3: Biosensors as a disease diagnostic tool: comparison of point-of-care urinalysis with test swabs and biosensors.  (a) The figure demonstrates the procedure for conducting a dipstick test on urine to perform a urinalysis. (b) A diagram is used to illustrate the benefits of utilizing biosensors for urinalysis, which include enhanced sensitivity, selectivity, and the ability to be reused, as compared to dipstick testing. (Hwang et al., 2022)

Advantages and Limitations of Biosensors

Biosensors as a disease diagnostic tool have several advantages over traditional diagnostic methods, including high sensitivity, specificity, and speed. They are also easy to use and can be miniaturized, making them suitable for point-of-care (POC) testing (5). Furthermore, biosensors can perform multiplex assays, allowing the simultaneous detection of multiple analytes in a single sample, which increases the efficiency of disease diagnosis ^{(9, 13).}

However, biosensors also have several limitations, including limited stability and shelf-life, high costs, and the need for specialized equipment and trained personnel ⁽¹⁶⁾. In addition, some biosensors may not be suitable for the detection of certain diseases due to their limited selectivity or specificity, and the results obtained from biosensors may be affected by the presence of interfering substances in the sample ⁽¹⁷⁾.

Figure 4: A bar chart is presented that displays the sensitivity, specificity, and accuracy of four distinct tests used for diagnosing anterior cruciate ligament (ACL) rupture. The statistical significance of the accuracy of the Lachman, pivot, and front drawer tests, in relation to the accuracy of the lever test, is indicated by the corresponding p-values (0.78, 0.99, and 0.07, respectively). (Massey, Harris, Winston, & Noble, 2017).

Current Status and Future Perspectives of Biosensors in the Clinic

Despite their limitations, biosensors have made significant progress in the field of disease diagnosis, and they are increasingly being used in the clinic. For example, glucose biosensors have become a widely used tool for monitoring blood glucose levels in diabetes patients, and cardiac markers biosensors are widely used for the diagnosis of myocardial infarction ^(6,7). Biosensors for the detection of PSA and HBV have also been used in the diagnosis of prostate cancer and HBV infection, respectively ^{(10, 11).}

In the future, the development of new biosensors with improved stability, specificity, and sensitivity is expected to further increase their use in disease diagnosis. The development of portable and low-cost biosensors is also expected to make them more accessible to patients and increase the availability of POC testing ⁽¹⁸⁾. Furthermore, the integration of biosensors with other diagnostic tools, such as imaging technologies, is expected to provide more comprehensive information about diseases and contribute to the development of personalized medicine ⁽¹⁹⁾.

Conclusion

In conclusion, biosensors as a disease diagnostic tool are very promising by providing sensitive and specific detection of disease biomarkers. They have several advantages, such as high sensitivity, specificity, and speed, leading to their increasing clinical use. Despite their limitations, the development of new biosensors with improved stability, specificity, and sensitivity is expected to further increase their use in disease diagnosis. The integration of biosensors with other diagnostic tools is also expected to contribute to the development of personalized medicine.

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