Lyme disease (LD) diagnosis using the current two-tier algorithm is constrained by low sensitivity for early-stage infection and ambiguity in determining treatment response. We recently developed a protein microarray biochip that measures diagnostic serum antibody targets using grating-coupled fluorescent plasmonics (GC-FP) technology. This strategy requires microliters of blood serum to enable multiplexed biomarker screening on a compact surface and generates quantitative results that can be further processed for diagnostic scoring. The GC-FP biochip was used to detect serum antibodies in patients with active and convalescent LD, as well as various negative controls. We hypothesized that the quantitative, high-sensitivity attributes of the GC-FP approach permit: 1) screening of antibody targets predictive for LD status, and 2) development a diagnostic algorithm that is more sensitive, specific, and informative than the standard ELISA and Western blot assays. Notably, our findings led to a diagnostic algorithm that may be more sensitive than the current standard for detecting early LD, while maintaining 100% specificity. We further show that analysis of relative antibody levels to predict disease status, such as in acute and convalescent stages of infection, is possible with a highly sensitive and quantitative platform like GC-FP. The results from this study add to the urgent conversation regarding better diagnostic strategies and more effective treatment for patients affected by tick-borne disease.

In this work, a novel biosensor technology was used to measure antibody levels that resulted from vaccination against COVID-19 and/or from infection with the virus. Importantly, this approach enables quantification of antibody levels, which can provide information about the timing and level of immune response.

There is a continuing need for biosensors that can be used in the diagnosis of COVID-19 infection and to measure a subject’s immune response to the virus itself (SARS-CoV-2). In this study, grating-coupled fluorescent plasmonic (GC-FP)-based detection of SARS-CoV-2 antigens was coupled with antibody detection to yield a dual-mode detection assay. Pairs of capture and detection antibodies were screened for direct detection of the SARS-CoV-2 nucleocapsid (Nuc) antigen, which were then combined with an existing GC-FP antibody detection assay. Nuc could be detected as low as 1 µg/mL concentrations, while antibodies were detectable to 50 ng/mL. The dual detection assay was tested by adding purified Nuc antigen to serum from a polymerase chain reaction (PCR)-positive COVID-19-infected individual. Using this sample, co-detection of Nuc antigen and anti-spike protein antibodies was successfully performed on a single GC-FP chip. Total assay time was 1 h, making this the first known example of rapid dual antibody and antigen detection on the same biosensor chip.