Blood-based
tests have sparked tremendous attention in non-invasive
early diagnosis of Alzheimer’s disease (AD), a most prevalent
neurodegenerative malady worldwide. Despite significant progress in
the methodologies for detecting AD core biomarkers such as Aβ42 from serum/plasma, there remains cautious optimism going
forward due to its controversial diagnostic value and disease relevance.
Here, a graphene electrolyte-gated transistor biosensor is reported
for the detection of serum neuron-derived exosomal Aβ42 (NDE-Aβ42), which is an emerging, compelling trove
of blood biomarker for AD. Assisted by the antifouling strategy with
the dual-blocking process, the noise against complex biological background
was considerably reduced, forging an impressive sensitivity gain with
a limit of detection of 447 ag/mL. An accurate detection of SH-SY5Y-derived
exosomal Aβ42 was also achieved with highly conformable
enzyme-linked immunosorbent assay results. Importantly, the clinical
analysis for 27 subjects revealed the immense diagnostic value of
NDE-Aβ42, which can outclass that of serum Aβ42. The developed electronic assay demonstrates, for the first
time, nanosensor-driven NDE-Aβ42 detection, which
enables a reliable discrimination of AD patients from non-AD individuals
and even the differential diagnosis between AD and vascular dementia
patients, with an accuracy of 100% and a Youden index of 1. This NDE-Aβ42 biosensor defines a robust approach for blood-based confident
AD ascertain.