Label-Free Ultrasensitive Detection of Abnormal Chiral Metabolites in Diabetes

Homochirality is necessary for normal biochemical processes in humans. Abnormal amounts of chiral molecules in biofluids have been found in patients with diabetes. However, the detailed analysis of diabetes-related abnormal chirality in biofluids and its potential use for clinical applications have been hindered by the difficulty in detecting and monitoring the chiral changes in biofluids, due to their low molar mass and trace concentrations. Herein, we demonstrate the label-free detection of chiral molecules using only 10 microL with 10⁷-fold enhancement in sensitivity compared with traditional plasmonic chiral metamaterials. The ultrahigh sensitivity and low sample consumption were enabled by microbubble-induced rapid accumulation of biomolecules on plasmonic chiral sensors. We have applied our technique on mouse and human urine samples, uncovering the previously undetectable diabetes-induced abnormal dextrorotatory shift in chirality of urine metabolites. Furthermore, the accumulation-assisted plasmonic chiral sensing achieved a diagnostic accuracy of 84% on clinical urine samples from human patients. With the ultrahigh sensitivity, ultralow sample consumption, and fast response, our technique will benefit diabetes research and could be developed as point-of-care devices for first-line noninvasive screening and prognosis of prediabetes or diabetes and its complications.