Could your mobile phone detect anaemia?

You’re finding it difficult to get out of bed in the mornings. When you do your movement is slow. Running anywhere feels like climbing Mount Everest, Ayres Rock and the Grand Canyon combined.

You don’t run. Your skin has lost its shine and your nails are brittle. You have chest pains and feel lightheaded. Finally, your doctor sends you to the hospital for a blood test and as you walk home you get a call from the hospital informing you, you’re anaemic, and it is so severe that they are calling you in for an emergency blood transfusion.

This is a scenario that is all too common for many people across the world. 

Common blood disorders

Iron deficiency, a leading cause of anaemia, is one of the Globe’s top nutritional disorders according to the World Health Organization (WHO). A target has been set for a 50% reduction of anaemia in women of reproductive age by 2025.

Hemochromatosis is another blood disorder but one associated with excess iron that is usually diagnosed late in the stages of irreversible organ damage. Hemochromatosis is a genetic disease with an incidence of 1 in 200 people of northern European origin.

This disease is characterised initially by vague symptoms such as fatigue that progressively worsen leading potentially to damage in various organs and liver disease, pancreatic impairment (diabetes), heart arrhythmias and failure, and neurodegenerative disorders of the brain.

How PLuS Alliance is helping to help combat iron-related diseases

Dr Erica Forzani is a PLuS Alliance Fellow and Associate Professor at Arizona State University (ASU) in the School for Engineering of Matter, Transport & Energy. Her research concentrates on the development of novel hybrid sensors and their integration into wireless, passive, and inexpensive medical devices, such as mobile phones.

Working with colleagues at King's and ASU, Dr Forzani has developed an analyser that can detect, screen and monitor for Iron Deficiency and Hemochromatosis, diseases which she suggests are two of the most overlooked diseases of all times.

Dr Forzani said, "Since abnormally low or high blood iron levels are common worldwide and can be of serious detriment to human health, a ubiquitously available technique for measurement of blood iron could represent a substantial improvement in point-of-care medical technology for monitoring iron-related blood disorders and could potentially spark a trend toward proper early prevention of diseases and health maintenance throughout the life span. Here, we aim to introduce a smartphone-based colorimetric detection system for iron measurement."

^{Dr Erica Forzani research aims to introduce a smartphone-based detection system for blood iron measurement.} 

Behind the science 

"In normal circumstances, the measurements of iron panel biomarkers are time-consuming, expensive, and painful requiring venous blood draw, temperature-controlled storage and shipping, and use of laboratory-based expertise and instruments such as spectrophotometry."

She added, "Due to these limitations of clinical assessment of iron metabolism, the team have developed a dry reagent sensing strip for iron detection that gives accurate point-of-care performance, is easy to use (handling and disposal), has a reasonable shelf-life at room temperature, and low manufacturing cost, avoiding the need of laboratory space and instrumentation.

"Thus, we set out to build a point-of-care device for total iron measurement. We introduced a smartphone colorimetric measurement of total iron from human serum. The choice of utilizing phone-based point of care is due to this emerging technology as a point of care diagnostics. The fact that more than 2.5 billion individuals own at least one smartphone or use smartphones at least once a month, make cell phones the most widespread potential clinical device."

How did the research project begin?

"The topic of the blood iron panel analyser started with PLuS Alliance. In my professional career, I have held primarily the goal of accomplishing translational work (i.e. engineering that bridges the gap between research and device implementation in actual clinical settings). I found that the key points to accomplish this challenge are innovation with transdisciplinary teams.

"A transdisciplinary team enables innovation because innovative ideas emerge only when people from different backgrounds communicate needs and work together understanding each other’s language. Dr Maret brought his expertise in the study of the Metabolism and Dr Diez Perez his knowledge and expertise in Chemistry. Both are based at King’s. 

"Mr Jackemeyer and Dr Tao at Arizona State University work in highly complementary fields, and with the work of a highly motivated student, Michael Serhan, the research generated successful and unprecedented ideas, concepts, methods, and a gadget! The PLuS Alliance has been key to all the development and research to date, without its support the work wouldn’t have been possible."

Professor Wolfgang Maret commented, "I met Dr Forzani at the PLuS Alliance Symposium in 2017 when she gave a talk 'Towards innovative Technologies for Regulation of Iron, and Diabetes-related Metabolism' Iron metabolism is a long tradition here at King's and relates to metal metabolism, one of my research areas.

"Understanding the need for clinical analyses and combining this with novel developments in sensor technologies is the strength of this project and will make important contributions to the field."

He added, "For large population studies, in particular in developing countries, phlebotomy and classical blood analyses are not always viable. The devices Dr Forzani is developing will overcome these issues. An example is the widespread use of glucose sensors, the development of which goes back to groups in the UK. We have discussed the need for similar sensors for routinely analysing zinc status. We are planning to develop such a sensor."

The challenges ahead 

"The biggest challenge is to sustain the project independently from PLuS Alliance," Dr Forzani said. "We will continue seeking further funding for it. We filed a provisional patent in June 2019. In our next phase, we are partnering with a giant: Mayo Clinic Laboratories, Rochester, Minnesota.

"PLuS Alliance was born to be big and have a big impact. We will take the approach of hard science and technology developed from the most prestigious clinical institutions such as Mayo Clinic, and the most valuable expertise and history of Iron Metabolism and hard-core Chemistry of Iron Proteins from King's."

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