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Rapid diagnostics for point-of-care quantification of soluble transferrin receptor
Balaji Srinivasan1, Julia L Finkelstein1, Dakota O'Dell2
1Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA; Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, NY, USA.
Insights
A new point-of-care test accurately measures soluble transferrin receptor (sTfR) for iron deficiency screening. This rapid diagnostic offers potential for home-use and field settings, improving iron status assessment.
Area of Science:
- Biomedical Diagnostics
- Point-of-Care Testing
- Iron Metabolism
Background:
- Iron deficiency (ID) and anemia are significant global health issues, especially in children.
- Hemoglobin (Hb) screening for ID lacks sensitivity and specificity.
- Soluble transferrin receptor (sTfR) is recommended for ID screening, but requires centralized labs.
Purpose of the Study:
- To develop a rapid, sensitive, and affordable point-of-care diagnostic device for sTfR.
- To enable efficient iron status assessment outside of laboratory settings.
Main Methods:
- Development of an immunochromatographic assay for sTfR quantification.
- Assay optimization using spiked buffer and commercial calibrators.
- Proof-of-concept validation with archived serum samples.
Main Results:
- The developed device provides rapid sTfR quantification from a small serum sample.
- Preliminary testing showed a strong correlation (0.93, P < 0.0001) with ELISA.
- The device demonstrates potential for accurate point-of-care iron status assessment.
Conclusions:
- The point-of-care sTfR device shows promising analytical performance for home-use and field applications.
- Ideal for low- and middle-income settings lacking laboratory infrastructure.
- Combined with ferritin diagnostics, it enables quantitative assessment of total body iron stores.
Background:
Iron deficiency (ID) and anaemia are major health concerns, particularly in young children. Screening for ID based on haemoglobin (Hb) concentration alone has been shown to lack sensitivity and specificity. The American Academy of Pediatrics (AAP) recommends soluble transferrin receptor (sTfR) as a promising approach to screen for iron deficiency. However, in most settings, assessment of iron status requires access to centralized laboratories. There is an urgent need for rapid, sensitive, and affordable diagnostics for sTfR at the point-of-care.
Methods:
An immunochromatographic assay-based point-of-care screening device was developed for rapid quantification of sTfR from a drop of serum within a few minutes. Performance optimization of the assay was done in sTfR-spiked buffer and commercially available sTfR calibrator, followed by a small-scale proof-of-concept validation with archived serum samples.
Findings:
On preliminary testing with archived serum samples and comparison with Ramco ELISA, a correlation of 0.93 (P < 0.0001) was observed, demonstrating its potential for point-of-care assessment of iron status.
Interpretation:
The analytical performance of the point-of-care sTfR screening device indicates the potential for application in home-use test kits and field settings, especially in low- and middle-income settings. An added advantage of sTfR quantification in combination with our previously reported serum ferritin diagnostics is in integration of Cook's equation as a quantitative and minimally-invasive indicator of total body iron stores. FUND: Thrasher Research Fund (Early Career Award #13379), NIH R03 EB 023190, NSF grant #1343058, and Nutrition International (project #10-8007-CORNE-01).
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