In early disease stages, biomolecules of interest exist in very low concentrations, presenting a significant challenge for analytical devices and methods. Here, we provide a comprehensive overview of an innovative optical biosensing technology, termed magnetic modulation biosensing (MMB), its biomedical applications, and its ongoing development. In MMB, magnetic beads are attached to fluorescently labeled target molecules. A controlled magnetic force aggregates the magnetic beads and transports them in and out of an excitation laser beam, generating a periodic fluorescent signal that is detected and demodulated. MMB applications include rapid and highly sensitive detection of specific nucleic acid sequences, antibodies, proteins, and protein interactions. Compared with other established analytical methodologies, MMB provides improved sensitivity, shorter processing time, and simpler protocols.

Inhibitor screening is an important tool for drug development, especially during the COVID-19 pandemic. The most used in vitro inhibitor screening tool is an enzyme-linked immunosorbent assay (ELISA). However, ELISA-based inhibitor screening is time consuming and has a limited dynamic range. Using fluorescently and magnetically modulated biosensors (MMB), we developed a rapid and sensitive inhibitor screening tool. This study demonstrates its performance by screening small molecules and neutralizing antibodies as potential inhibitors of the interaction between the spike protein 1 (S1) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the angiotensin-converting enzyme 2 (ACE2) receptor. The MMB-based assay is highly sensitive, has minimal non-specific binding, and is much faster than the commonly used ELISA (2 h vs. 7–24 h). We anticipate that our method will lead to a remarkable advance in screening for new drug candidates.

Background: Tuberculosis (TB) is one of the leading causes of death worldwide, even though it is curable using antibiotics. Most people who die of TB never begin treatment because diagnostics are insufficiently sensitive and accessible. We aimed to measure low-abundance biomarkers and diagnose TB in urine. Methods: We developed and clinically validated a multiplex Single Molecule Array (Simoa) assay to detect TB in urine by measuring two TB biomarkers: lipoarabinomannan (LAM) and antigen 85B (Ag85B). Using antibodies that recognize different epitopes of LAM in a four-plex assay with three LAM and one Ag85B antibody pairs, we trained a model and demonstrated its performance in retrospective cohorts totaling 576 individuals from South Africa, Peru, Vietnam, and Cambodia, including a blinded test cohort ( n = 215). Results: Here we present an assay that classifies samples with 98% specificity, 45% sensitivity overall, and 58% sensitivity among people living with the human immunodeficiency virus (HIV). Conclusions: Different antibody pairs detecting different epitopes on LAM report diverging concentrations. We do not find that adding antibody pairs to detect different epitopes on LAM improves the assay’s accuracy. Our assay is more sensitive than the existing AlereLAM lateral flow test for TB in HIV-positive individuals, uses safe and accessible urine samples, and represents a step towards an adjunctive diagnostic test to aid clinicians in starting treatment.

The paper introduces a photobleaching strategy for producing multiple bead populations on flow cytometry to accelerate and facilitate the discovery of antibody-binding pairs using a pooled antibody cross-testing assay.