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Biosensors and Bioelectronics 78 (2016) 447–453

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Biosensors and Bioelectronics


journal homepage: www.elsevier.com/locate/bios

Paper-based α-amylase detector for point-of-care diagnostics


Satarupa Dutta a, Nilanjan Mandal b, Dipankar Bandyopadhyay a,b,n
a
Department of Chemical Engineering, Indian Institute of Technology, Guwahati, Assam 781039, India
b
Centre for Nanotechnology, Indian Institute of Technology, Guwahati, Assam 781039, India

art ic l e i nf o a b s t r a c t

Article history: We report the fabrication of a paper-sensor for quantitative detection of α-amylase activity in human
Received 10 September 2015 blood serum. Pieces of filter papers were coated with starch–iodine solution leading to an intense blue
Received in revised form coloration on the surface. Dispensing α-amylase solution on the starch–iodine coated paper reduced the
10 November 2015
intensity of the color because of starch-hydrolysis catalyzed by amylase. The variation in the intensity of
Accepted 24 November 2015
the color with the concentration of amylase was estimated in three stages: (i) initially, the paper-surface
Available online 26 November 2015
was illuminated with a light emitting diode, (ii) then, the transmitted (reflected) rays emitted through
Keywords: (from) the paper were collected on a photoresistor, and (iii) the variations in the electrical resistance of
Paper the photoresistor were correlated with the amylase concentration in analyte. The resistance of photo-
Bio-sensor
resistor decreased monotonically with an increase in amylase concentration because the intensity of the
Diagnostic tool
reflected (transmitted) rays collected from (through) the paper increased with reduction in the color
Photoresistor
Point-of-care device intensity on the paper surface. Since a specific bio-reaction was employed to detect the activity of
Amylase amylase, the sensor was found to be equally efficient in detecting unknown quantities of amylase in
human blood serum. The reported sensor has shown the potential to graduate into a point-of-care de-
tection tool for α-amylase.
& 2015 Elsevier B.V. All rights reserved.

1. Introduction free, and deliverable, healthcare devices are the need of the hour
(Chin et al., 2012; Costa et al., 2014).
Quantitative estimation of biomarkers to monitor the health Among the other important biomarkers, activity of α-amylase
conditions has become an essential part of human life (Chin et al., (endo-1,4-α-D-glucan glucanohydrolase, EC 3.2.1.1) in different
2007; Martinez et al., 2010a; Mao and Huang, 2012; Chen et al., body fluids requires regular monitoring because abnormal values
2015). The glucometer, blood pressure meters, and pregnancy kits of this enzyme in saliva, urine, sebum or blood serum indicate the
are already commercially available to fulfill some of the neces- diseased state of health. Amylase is produced in human pancreas
sities. However, there are other important biomarkers for which and salivary glands to hydrolyze starch into simple sugars such as
either there is no such technique available for quantitative esti- glucose, maltose, and limit dextrin (Metzler and Metzler, 2003). A
mation (Peeling, 2006) or the presently available measuring trace amount of this enzyme is always found in most of the body
techniques are rather costly and time consuming (Haschek et al., fluids and a healthy human body contains α-amylase in the range
25–85 U/L (units/liter) in the blood serum (Donofrio and Labus,
2013). Further, the facilities associated with the tests are available
2009). While the increased level of amylase indicates the onset of
only through the centralized pathological agencies, which fail to
acute pancreatitis, pancreatic cancer, salivary gland infection, bile
fulfill the immediate necessities of a significantly large number of
duct blockage, or gastroenteritis, the reduced level indicates pan-
populations across the globe (Peeling, 2006; Haschek et al., 2013).
creatic or kidney malfunctioning, and toxemia of pregnancy
In this situation, the next ‘tipping point’ can be the cost-effective
(Donofrio and Labus, 2009). There are number of methods avail-
point-of-care diagnostic tools aided by the efficacies of micro or able to estimate amylase activity in body fluids, which encompass
nanotechnology (Martinez et al., 2008a; Ellerbee et al., 2009; Chin spectrophotometry (Gella et al., 1997; van Staden and Mulaudzi,
et al., 2011; Yetisen et al., 2013; Li et al., 2014a, 2014c). As per 2000; Attia et al., 2014), colorimetry (Foo and Bais, 1998), fluoro-
World Health Organization (WHO) guidelines, ASSURED – afford- metry (Zhang et al., 1990; Murayama et al., 2006), isoelectric fo-
able, sensitive, specific, user-friendly, rapid and robust, equipment cusing (Takeuchi et al., 1975), electrokinetic processes (Watanabe
et al., 1998), chromatography (Battershell and Henry, 1990), weight
n
Corresponding author at: Department of Chemical Engineering, Indian Institute
based detections (Sasaki et al., 2008), electrochemical methods
of Technology, Guwahati, Assam 781039, India. (Zajoncová et al., 2004; Yamaguchi et al., 2005; Mahosenaho et al.,
E-mail address: dipban@iitg.ernet.in (D. Bandyopadhyay). 2010; Sakač et al., 2011; Sakač and Sak-Bosnar, 2012),

http://dx.doi.org/10.1016/j.bios.2015.11.075
0956-5663/& 2015 Elsevier B.V. All rights reserved.
448 S. Dutta et al. / Biosensors and Bioelectronics 78 (2016) 447–453

electromagnetic sensing (Wu et al., 2007), and immunological biomarkers makes them ideal candidate for biomedical applica-
methods (Svens et al., 1989). However, the most popular, robust, tions (Li et al., 2012). For example, while blood group detection, for
and accurate method of estimation of α-amylase in human serum ages we know that the agglutinated red blood cells cannot pass
involves spectrophotometry (Chavez et al., 1990), which is ex- through a porous paper matrix indicating a positive interaction
pensive, non-portable, and requires skilled personnel for operation between antibody and antigen while the non-agglutinated blood
and analysis. Unfortunately, point-of-care detection tool for α- can disperse easily through the paper structure indicating a ne-
amylase in human body fluids is yet to appear in the market. gative interaction (Then et al., 2015). Furthermore, the white color
Recent studies suggest that, the paper based diagnostic tools serves as an excellent background for the colorimetric assays
can lead to the development of simple point-of-care devices for employing the paper as substrate.
monitoring of environmental parameters, quality of food products, Herein, we report the fabrication of a paper-sensor for quan-
immunoassays, and human health condition (Martinez et al., titative estimation of α-amylase in human blood serum. The
2007; Liana et al., 2012; Li et al., 2014b; Hu et al., 2014; Davaji and schematic illustration in Fig. 1 shows the steps to fabricate the α-
Lee, 2014; Choi et al., 2015; Zhang et al., 2015). The popularity of amylase sensor. Initially, a Prussian blue colored starch–iodine (SI)
the paper-based micro analytical devices (m-PADS) is attributed to solution was coated on the paper-surface. Following this, the
the advantages associated with lower cost, easy disposability, aqueous α-amylase solution was dispensed on the SI coated paper,
biodegradability, and portability (Zhao and van der Berg, 2008; which led to hydrolysis of starch molecules and subsequent fading
Martinez et al., 2008b, 2010b; Pelton, 2009; Dungchai et al., 2009; of the blue color. Thereafter, the paper-surface was illuminated
Fu et al., 2010; Cheng et al., 2010a, 2010b; Martinez, 2011; Ballerini with a light emitting diode (LED) source (Sorouraddin and Saadati,
et al., 2012; Li et al., 2012; Wang et al., 2012; Cate et al., 2015). 2010) and the transmitted (reflected) rays emitted through (from)
Further, the compatibility of the cellulosic materials with the the paper were collected on a photoresistor. The variations in the

Fig. 1. (I) Schematic illustrations of the steps to fabricate paper-sensor. (II) Reflection mode – images (a) and (b) show the experimental setup and corresponding circuit
diagram for resistance measurement. (III) Transmitted mode – images (a) and (b) show the experimental setup and the corresponding circuit diagram for resistance
measurement. The notation LDR (LED) represents photoresistor or photodetector (light emitting diode). (For interpretation of the references to color in this figure, the reader
is referred to the web version of this article.)
S. Dutta et al. / Biosensors and Bioelectronics 78 (2016) 447–453 449

electrical resistance of the photoresistor were correlated with the The images (II) and (III) in Fig. 1 highlight two different types of
change in color intensity and amylase concentration. The sensor experimental measurements of the amylase levels in the reflected
showed remarkable potential to graduate into a point-of-care and transmitted modes. Initially, the paper-surface was illumi-
device for the rapid detection of α-amylase because it could nated with the help of an LED. Following this, the reflected rays
faithfully reproduce amylase level in human blood serum when from the paper-surface were collected on a photoresistor, as
compared with a standard testing methodology. shown in the image (II). The transmitted rays emitted through the
paper-surface were also collected on another photoresistor, as
shown in the image (III). The electrical resistance of the photo-
2. Materials and methods resistor for different SI coated paper was measured with the help
of a digital multimeter for both the transmitted and reflected rays.
Starch (C6H10O5)n, potassium iodate (KIO3), and iodine (I) were Thereafter, 5 ml α-amylase solutions of known concentrations (10–
procured from Merck (India). Porcine α-amylase enzyme was 110 U/L) were dispensed on the SI loaded paper kits before in-
procured from Sigma-Aldrich (India). 10  phosphate buffer, L- cubating for 15 min at 37 °C. Finally, the changes in the electrical
ascorbic acid (C6H8O6), and potassium iodide (KI) were procured resistance of the photoresistor were noted for different α-amylase
from SRL (India). Filter papers (Ø, 125 mm) were obtained from concentrations for both the transmitted and reflected rays. Mea-
Whatmann (India). The chemicals above were of analytical grade surements were repeated for three times to assure consistency.
and used without any further processing. Milli-Q grade water was The electrical resistances measured for the virgin SI coated paper
used in the experiments unless stated otherwise. kits before the addition of the analytes were termed as RiT and
RiR for the transmitted and reflected modes, respectively. The
2.1. Preparation of solutions electrical resistances measured for the transmitted and reflected
modes after the addition of analytes were termed as, RTf and RfR ,
The solutions employed in the experiments were freshly pre- respectively. The differences in resistances before and after the
pared. The concentrations of starch and iodine solutions were addition of the amylase were normalized by the initial resistances,
found to be optimum at 2% (w/v) and 0.2% (w/v), respectively, and RiT and RiR , to obtain the reported variables, ∆RNT =(RiT − RTf )/RiT and
used for the experiments. The detailed methodology of optimiza-
∆RNR=(RiR − RfR )/RiR for the transmitted and the reflected modes.
tion is discussed in the part A of ESI (electronic supporting in-
formation). The 2% (w/v) starch solution was prepared by adding
2.3. Characterization techniques
0.2 g starch in 10 ml distilled water followed by a controlled
heating to obtain a transparent solution. The Lugol's 5% iodine
Field emission scanning electron microscopy (FESEM, Supra 55,
stock solution was prepared by dissolving 10% KI and 5% iodine in
Zeiss, Oberkochen, Germany) was used to examine the surface
water (w/v). The stock solution was then diluted to 0.2% (w/v)
morphology of the sensors. Energy-dispersive-x-ray analysis (EDX)
before further use. The α-amylase solutions of concentrations
was performed to confirm the presence of starch, iodine, and
ranging between 10–110 U/L (22 U ¼1 mg) were prepared by dis-
amylase on the paper. The pH of the solutions was measured by
solving the required amount of enzyme in 1  phosphate buffer
Cyber Scan pH 510 m (Eutech Instruments). The pictures of the
solution of pH 7. Ascorbic acid stock solution was prepared by
sensor were taken by Nikon D5100 digital camera (Nikon Corp.,
dissolving 5 mg L-ascorbic acid in 1 ml distilled water and then the
Japan). The FTIR analysis was performed using a Thermo Scientific
stock solution was diluted to 2 mg/dl. Experiments were carried
Nicolet iS10 FT-IR spectrometer, USA.
out to optimize the concentration and volume of KIO3 solution to
be used and they are described in detail in the part B of ESI. The
optimized concentration for KIO3 was found to be 5 mg/ml, which
3. Results and discussion
was prepared by dissolving KIO3 in water. The KIO3 solution was
mixed with ascorbic acid solution (2 mg/dl) in 2:1 volume ratio to
In the present study, we employed a specific bio-reaction to
allow oxidation of ascorbic acid to dehydroascorbic acid. The KIO3
detect the activity of α-amylase because the objective was to de-
treated ascorbic acid solutions were mixed with α-amylase solu-
velop a sensor having equal sensitivity towards human body fluids
tions in proportions corresponding to human blood serum to in-
such as the saliva, urine, or blood serum. The sensors were de-
vestigate the effect of ascorbic acid.
veloped based on colorimetric effects originating from two dif-
2.2. Experimental methodology ferent reactions. The reaction between starch and Lugol's iodine
led to the dark blue colored SI complex (Wilding, 1965; Teitelbaum
The schematic illustration in Fig. 1 shows the steps to fabricate et al., 1980; Minick et al., 1991; Gibson et al., 1997; Metzler and
the α-amylase sensor. Initially, the filter papers were cut into Metzler, 2003). The first image in Fig. 2 shows the typical
pieces of dimension, 1 cm  1 cm. Following this, equal quantities
(v/v) of starch and Lugol's iodine were mixed to obtain the dark
blue colored SI solution. Thereafter, 60 ml of SI solution was dis-
pensed on the paper, which led to a dark blue colored coating on
the surface of the paper, as shown in the image (I) of Fig. 1. The
dark blue colored paper kit loaded with SI was then dried and
preserved in the vacuum desiccator at room temperature. Later,
5 ml of the α-amylase solutions of different known concentrations
were dispensed on the SI coated paper kit (image (I)) before
keeping them in the incubator at 37 °C for about 15 min. The SI
coated paper kits showed fading of the dark blue coloration with Fig. 2. Top views of the paper-sensors in which the numbers below indicate the
an increase in the concentration of α-amylase, which was esti- concentration of α-amylase in units/litre (U/L) in the analyte. The first image
corresponds to the SI coated paper-sensor before amylase was added while the
mated by an experimental setup consisting of an LED source, a other images were taken after the addition of different concentration of α-amylase
photoresistor (LDR, PMTC), and a digital multimeter (Mastech, solution. (For interpretation of the references to color in this figure, the reader is
India, range: 0–2 MΩ71.0%). referred to the web version of this article.)
450 S. Dutta et al. / Biosensors and Bioelectronics 78 (2016) 447–453

appearance of the sensors from the top when SI solutions were the starch molecules. The images (a) and (b) in Fig. S4 show the
coated on the paper. Following this, when α-amylase analyte was surface morphologies of the paper coated with the SI complex
dispensed on these SI coated paper-sensors, the enzyme cleaved before and after the amylase treatment. Again, the EDX data
the α-1,4 glycosidic bonds of the starch molecules to form simple shown in the images (c) and (d) suggest that there was net re-
sugars (Metzler and Metzler, 2003). The intensity of the blue co- duction in the iodine weight from 20.51% to 4.58% before and after
lored complex reduced not only because of the breaking of the SI the amylase treatment on the SI coated paper, which suggested
complex but also due to the evaporation of iodine as the simple evaporation of the iodine from the paper surface after the starch
sugars formed due to the reaction did not bind with it. A tem- hydrolysis.
perature effect study on the evaporation of iodine was also carried Fig. 4 shows variations in normalized resistance differences for
out, which is described in the part C of ESI. The study confirmed transmitted (∆RNT ) and reflected (∆RNR ) modes with the variation in
that change in temperature had little effect and the evaporation of α-amylase concentration (C). Initially, the electrical resistances
iodine was solely due to the chemical reaction. The images in Fig. 2 from the photoresistor were obtained for the SI loaded paper-
depict the fading of the blue color with increase in concentration sensors before the addition of α-amylase solutions for both the
of α-amylase in the analyte. A detailed FTIR analysis was per- transmitted ( RiT ) and reflected ( RiR ) modes. Thereafter, the elec-
formed to study the reactions on the paper surface. For this, we trical resistances were measured for paper-sensors after addition
coated a SI film on a glass substrate and another SI film on another of the analytes for both the transmitted ( RTf ) and reflected ( RfR )
glass substrate followed by addition of α-amylase. The samples for modes. Finally, ∆RNT and ∆RNR were evaluated for each sensor. Image
the FTIR analyses were prepared by lifting an equal mass from (a) in Fig. 4 shows the results obtained for the reflected mode
these two films, which later helped in comparing the intensities of while the images (b) and (d) show the same for the transmitted
the peaks during the analysis. Even the mass of KBr added to the mode. Image (a) suggests that the increase in amylase loading (C)
samples for the FTIR study was kept identical. in analyte increased starch hydrolysis on the paper-surface, which
The FTIR spectra for the SI complex before and after the addi- led to the higher fading of the dark blue coloration. Thus, with
tion of α-amylase are shown by the curves with lighter and darker ( )
increase in C the difference in resistance, RiR − RfR increased. The
shades in Fig. 3. The peaks around 1153–904 cm  1 for C–O and C– discoloration of the paper surface increased the intensity of re-
C stretching modes were observed in magnified plot (a) and image flected rays to the photoresistor. Since the resistance of the pho-
(I). The image (a) also showed the presence of the starch specific toresistor decreased with increase in the light exposure, the nor-
peaks at 1021 and 1153 cm  1. Weakening of the peak intensities at malized resistance differences ( ∆RNR ) also increased with C. The
1034 and 1154 cm  1 were observed in the image (a), which in- images (b) and (d) in Fig. 4 showed that the normalized resistance
dicated starch hydrolysis in presence of amylase (Krieg et al., differences ( ∆RNT ) increased with C in transmitted mode. Hydro-
1996). The peaks between 1474 and 1199 cm  1 were attributed to lysis of starch by α-amylase produced simple sugars and released
the bending modes of O–C–H, C–C–H, C–O–H angles, as shown in iodine vapor from the paper surface to create more open space for
the images (I) and (b). The reduction in intensity of the peaks light transmission. Thus, the electrical resistance of the photo-
between 1500 and 1200 cm  1 in image (b) was caused due to the resistor reduced with increase in α-amylase activity and subse-
broken glycosidic linkages after the starch hydrolysis by amy- quently, the normalized resistance differences ( ∆RNT ) also
lase (Lambert, 2011). The increased water peak at 1634 cm  1 in increased.
Fig. 3(c) indicated water penetration into the film. The FESEM Experiments were also carried out with human serum to test
images and the corresponding EDX data shown in Fig. S4 of ESI the efficiency of the paper sensor in estimating the amylase levels
confirm that the color change was indeed due to the hydrolysis of in the real samples. Importantly, the tests with human serum were

Fig. 3. (I) The light (dark) colored curve shows the FTIR spectra (%Transmittance (T) to wavenumber (κ)) of SI complex before (after) the addition of α-amylase solution on the
paper-sensor coated with SI complex. Images (a)–(c) show the magnified regions of the image (I).
S. Dutta et al. / Biosensors and Bioelectronics 78 (2016) 447–453 451

Fig. 4. Variations in, (a) the normalized resistance differences ( ∆RNR ) with concentration of α-amylase (C) for the reflectance mode (RSD¼ 20.12%), and (b) normalized
resistance differences ( ∆RNT ) with C for the transmission mode (RSD¼ 6.54%). (c) The images of the paper-sensors show the colorimetric change when blood serums of
different α-amylase loading were dispensed. The first (second) row shows the results without (with) the pre-treatment of KIO3. (d) The variation in ∆RNT with C in trans-
mission mode when the initial analyte was composed of a mixture of ascorbic acid and α-amylase and then were pre-treated with KIO3 before dispensing on the paper-
sensor (RSD ¼2.89%). The square (triangular) symbols show the plot with known (unknown) amylase concentration in the analyte (human serum). (e) Showing the values
obtained from the Dimension RxL Max Integrated Chemistry System, SIEMENSTM, for human serum (RSD ¼ 8.97%). Error bars are standard deviations obtained from three
independent experiments.

carried out in a nearby diagnostic center under the supervision of For this reason, we pre-treated the human serum with adequate
medical experts. Initially, the amylase levels of different serum amount of KIO3 solution to oxidize ascorbic acid (Sigmann and
samples were measured employing the standard protocol for the Wheeler, 2004) and dispensed a drop (5 μL) of this pre-treated
instrument, Dimension RxL Max Integrated Chemistry System, human serum on the paper-sensor before measuring the change in
SIEMENS. Following this, we used the same samples on the paper- resistance in the transmitted mode.
sensors and measured the change in resistance employing the Fig. 4c shows the images of the paper-sensors when the human
transmitted mode. It is well known that human serum contains serum was dispensed without (1st row) and with (2nd row) pre-
ascorbic acid (vitamin C) in trace amounts (0.4–1.5 mg/dl) along- treatment. Clearly, the presence of ascorbic acid in human serum
side amylase (Burtis et al., 1996) and presence of ascorbic acid inhibited the sensor performance because the amylase level could
inhibits the starch–iodine reaction because it readily oxidizes in not be measured from the first row of Fig. 4c. The sensors showed
the presence of iodine to form dehydroascorbic acid (Sharma et al., a larger degree of the fading of the SI coating on the surface due to
1990; Sigmann and Wheeler, 2004; Burgess and Davidson, 2014). the combined effects of ascorbic acid and amylase. However, after
Thus, it was essential to neutralize the ascorbic acid present in the removal of the ascorbic acid through pre-treatment of the human
blood samples before we employed the SI coated paper-sensors. serum with KIO3 solution the paper-sensor regained sensitivity, as
452 S. Dutta et al. / Biosensors and Bioelectronics 78 (2016) 447–453

work. Further work is also necessary to develop the prototype into


an extreme-point-of-care device.

Acknowledgments

We thank DeitY Grant no. 5 (9)/2012-NANO, and DST FIST Grant


no. SR/FST/ETII-028/2010, Government of India, for the financial
aids. We thank CRF-ISM Dhanbad and CIF-IIT Guwahati for char-
acterization facilities. Discussions with Dr. Madhumita Das, Mi-
tradip Bhattacharjee, and Amit Kumar Singh are also gratefully
acknowledged.

Fig. 5. Schematic illustration of the proposed device for simple, fast, reliable,
economic, and point-of-care detection of amylase level in human blood serum. Appendix A. Supplementary material

Supplementary data associated with this article can be found in


can be observed in the second row of Fig. 4c. The discrete trian- the online version at http://dx.doi.org/10.1016/j.bios.2015.11.075.
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image (e) in Fig. 4 suggest that the predictions from the paper-
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