Development of a Paper-Based Luminescence Bioassay for Therapeutic Monitoring of Aminoglycosides: a Proof-of-Concept Study

Aminoglycosides are widely used antibiotics that bind to the bacterial 30S ribosomal subunit to inhibit translation. Owing to their adverse side effects and narrow therapeutic index, monitoring blood levels of aminoglycosides is important to maximize their effectiveness and minimize their toxicity. Current monitoring techniques require a well-equipped diagnostic laboratory. The present study aimed to present a proof-of-concept for a simple, low-cost biochemical assay utilizing a paper platform for the detection of serum/whole blood aminoglycosides. A paper-based bioassay chip for the assay was developed by spotting and freeze-drying cell-free transcription/translation reaction machinery for a luminescent reporter protein (NanoLuc) within an array of wax circles printed on filter paper. The paper-based chip could be used to quantify serum/whole blood aminoglycosides within clinically relevant concentrations in 30-60 min by spotting minimal volumes of samples, followed by the NanoLuc substrate, in the wax circles and detecting the associated changes in luminescence signals, using a simple digital camera. Furthermore, a one-pot assay in which cell-free transcription/translation reaction machinery and NanoLuc substrate are mixed in advance and embedded in paper could be used to detect an aminoglycoside in serum. Overall, our paper-based bioassay can potentially provide a basic platform for the simple and low-cost therapeutic monitoring of aminoglycosides, especially in resource-limited regions.