Emerging point-of-care technologies for sickle cell disease screening and monitoring

ABSTRACT

Introduction: Sickle Cell Disease (SCD) affects 100,000 Americans and more than 14 million people globally, mostly in economically disadvantaged populations, and requires early diagnosis after birth and constant monitoring throughout the life-span of the patient.

Areas covered: Early diagnosis of SCD still remains a challenge in preventing childhood mortality in the developing world due to requirements of skilled personnel and high-cost of currently available modalities. On the other hand, SCD monitoring presents insurmountable challenges due to heterogeneities among patient populations, as well as in the same individual longitudinally. Here, we describe emerging point-of-care micro/nano platform technologies for SCD screening and monitoring, and critically discuss current state of the art, potential challenges associated with these technologies, and future directions.

Expert commentary: Recently developed microtechnologies offer simple, rapid, and affordable screening of SCD and have the potential to facilitate universal screening in resource-limited settings and developing countries. On the other hand, monitoring of SCD is more complicated compared to diagnosis and requires comprehensive validation of efficacy. Early use of novel microdevices for patient monitoring might come in especially handy in new clinical trial designs of emerging therapies.

KEYWORDS:

• Sickle anemia
• hemoglobinopathies
• patient monitoring
• point-of-care microtechnologies
• electrophoresis
• red blood cells
• erythrocytes
• microfluidics

Acknowledgments

Authors acknowledge Cleveland Institute of Art Student, Grace Gongaware for crafting the scientific illustration. U. A. Gurkan would like to thank the Case Western Reserve University, University Center for Innovation in Teaching and Education (UCITE) for the Glennan Fellowship, which supports the scientific art program and the art student internship at Case Biomanufacturing and Microfabrication Laboratory.

Declaration of interest

Y. Alapan, U. Gurkan, J. Little and R. Ung have a financial interest in Hemex Health (licensor of the HemeChip Technology) including licensed intellectual property, stock ownership, and consulting. A patent application pertaining to HemeChip and SCD Biochip technologies described this paper has been filed: Patent Cooperation Treaty Application (PCT/US2015/042907): “Biochips to Diagnose Hemoglobin Disorders and Monitor Blood Cells”. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This work was supported by the Case-Coulter Translational Research Partnership (CCTRP) and the Clinical and Translational Science Collaborative (CTSC) of Cleveland [grant# UL1TR000439] from the National Center for Advancing Translational Sciences (NCATS) component of the National Institutes of Health (NIH) and NIH roadmap for Medical Research, the Doris Duke Charitable Foundation [grant #2013126], National Heart Lung and Blood Institute [grant #R01HL133574], NIH Center for Accelerated Innovation at Cleveland Clinic (NCAI-CC), and National Science Foundation CAREER Award [grant #1552782]. Authors acknowledge the Center for Integration of Medicine & Innovative Technology (CIMIT) Student Technology Prize for Primary Healthcare for supporting this study. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.