Next Generation Rapid Diagnostic Tests for Acute Aortic Dissection (AAD)

Acute aortic dissection (AAD) is a potentially fatal illness that often affects young individuals, with an annual incidence of 3-4 per 100,000 in the United Kingdom1. Because the predominant symptom of AAD is acute chest and upper back pain, it is difficult to diagnose because it is frequently confused with other cardiovascular disorders such as heart attack2.

Without early detection and intervention, the prognosis for AAD patients is bleak, with mortality increasing by 1-2% every hour undiagnosed3. AAD is typically diagnosed with a combination of imaging techniques such as computed tomography (CT), magnetic resonance angiography (MRA), or transoesophageal echocardiography (TOE) 4, but these are not always available in some urgent care facilities.

Due to the rapid occurrence of AAD fatalities, an easy-to-use diagnostic test that allows for a faster and more accurate diagnosis in an emergency environment will allow patients to obtain fast, life-saving medical care.

Lateral flow tests (LFTs) are membrane-based diagnostic procedures that are easy to use, inexpensive, robust, and widely available. They are most commonly employed for pregnancy testing5, environmental monitoring, and infectious disease monitoring6. However, their usefulness and versatility have only recently become apparent.

During the COVID-19 pandemic, LFT technology was quickly developed to identify the virus, leading to global scale testing, allowing monitoring and diagnosis to occur outside of healthcare facilities in community and home settings. Despite their various advantages, LFTs are frequently disregarded as a diagnostic platform due to their lack of sensitivity and selectivity.

These issues, however, can be resolved with careful design of the LFTS membrane materials, biological molecules used in the test, and the nanoparticle label.

The objective of the project is to create the next generation of LFTs capable of detecting numerous AAD biomarkers at the same time. By investigating membrane materials and nanoparticle labels in LFTs, novel fabrication techniques to produce new membranes with optimum characteristics and applying these optimised LFTS for the detection of specific biomarkers indicative of AAD, it paves the way to tailor material properties and surface chemistry to improve sensitivity and selectivity in LFTs with a range of applications, both commercially available and novel.

References:

1. Thrumurthy SG, Karthikesalingam A, Patterson BO, Holt PJE, Thompson MM. The diagnosis and management of aortic dissection. BMJ. 2011 Jan 11;344(jan11 1):d8290-d8290. 2. BHF. Aortic Aneurysm, Dissection and Rupture. 2022. 3. Ranasinghe AM, Strong D, Boland B, Bonser RS. Acute aortic dissection. BMJ. 2011 Jul 29;343(jul29 2):d4487-d4487.

4. Olin JW, Fuster V. Acute Aortic Dissection. Arterioscler Thromb Vasc Biol. 2003 Oct;23(10):1721-3.

5. Marino E, Threlfall WR, Schwarze RA. Early conception factor lateral flow assays for pregnancy in the mare. Theriogenology. 2009 Apr;71(6):877-83.

6. Wang C, Wang C, Wang X, Wang K, Zhu Y, Rong Z, et al. Magnetic SERS Strip for Sensitive and Simultaneous Detection of Respiratory Viruses. ACS Appl Mater Interfaces. 2019 May 29;11(21):19495-505.