Development of a Biosensor for the Early Detection of Tuberculous Meningitis in Infants ^†

Tuberculous meningitis (TBM) is a severe illness that is predominantly observed in countries with a high burden of tuberculosis. It is primarily found in infants and human immunodeficiency virus (HIV)-infected adults, and, if left untreated, causes irreversible damage to the host’s nerve and brain tissue, often leading to mortality. Current methods of TBM detection relies on cerebrospinal fluid (CSF) culture, which may only yield results in up to 6 weeks, is not very sensitive, and requires a biological safety level III laboratory to conduct. Other detection methods are equally not very sensitive and laborious. This research investigates the detection of interferon-gamma (IFN-γ) protein biomarker using fluoroimmunoassay with an optical biosensor and a custom-manufactured chip. The glass-surface of the chip was treated with 3-aminopropyltriethoxysilane (APTES) and incubated with glutaraldehyde to prepare for immobilization, after which a sandwich ELISA format was used to perform a dilution series by immobilizing the capture antibody, IFN-γ protein, and fluorescein isothiocyanate (FITC)-stained detection antibody onto the chip. The optical biosensor excited the FITC-stained antibodies to capture the emission light at multiple exposures, which were then merged to create a high dynamic range (HDR) image for image processing. The results from the optical biosensor were verified with a Zeiss LSM780 confocal microscope (Carl Zeiss (Pty) Limited, Cape Town, South Africa). The system demonstrated the capability to rapidly identify the biomarker, detect the binding sites, and quantify IFN-γ in blood serum. This fluorescent optical sensor proposes a possible approach for the development of a point-of-care system for TBM, providing a quicker and simpler method for the early detection of TBM.