A team of bioengineers has designed a wearable sensor that can detect two key biomarkers of infection in human sweat, a significant step toward making it possible for users to receive early warnings of infections such as COVID-19 and influenza.

The sensor developed by bioengineers at University of Texas at Dallas (Richardson, TX, USA) in collaboration with EnLiSense LLC (Allen, TX, USA) uses passive sweat, which means that the wearer does not need to engage in physical activity or have their sweat glands expressed to generate a sample. Real-time continuous monitoring is possible as sweat is collected on a removable strip, which must be changed daily. The latest research builds on an earlier study by the team which demonstrated that the sweat sensor could detect C-reactive protein (CRP) to indicate an impending cytokine storm. A molecular test, such as a polymerase chain reaction (PCR) test, would still be needed to confirm the type of pathogen causing an infection, according to the researchers.

In a study to test the sensor, the researchers collected sweat from 18 healthy people who wore the sensor. They also drew blood from the subjects and compared the results. The study demonstrated that the sweat sensor can identify the biomarkers interferon-gamma-inducible protein (IP-10) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Elevated levels of IP-10 and TRAIL indicate what is known as a cytokine storm, a surge of pro-inflammatory immune proteins generated in the most serious infections. The ability to detect IP-10 and TRAIL is important because, in addition to CRP, they allow diagnosticians to distinguish between viral and bacterial infections. Researchers next plan to evaluate the sensor in clinical studies with patients experiencing respiratory infections.

“Our work is pioneering since, until this date, it was unclear whether these molecules were present in sweat,” said Dr. Shalini Prasad, head of bioengineering and the Cecil H. and Ida Green Professor in Systems Biology Science. “We established that our low-volume passive sweat technology is indeed able to measure these biomarkers.”

“We have built a technology to unlock and explore the latest frontier in sweat diagnostics,” added Prasad. “This sweat-based, wearable technology from EnLiSense is truly transformational in that it can measure and report human host response messenger molecules associated with inflammation and infection in a real-time and continuous manner.”

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