Tethered Enzyme Technology for PoC and At-home Real-time Monitoring of Liver Function - Abstract
TETmedical Inc. is developing a tethered enzyme technology (TET) for rapid point-of-care (PoC) and/or at-home
testing of liver enzyme levels, enabling convenient and timely tracking of drug-induced liver injury (DILI) and
other sources of liver damage. When the liver is damaged or diseased, the enzymes aspartate aminotransferase
(AST) and alanine aminotransferase (ALT) are released into the blood, making these the most frequently used
markers of hepatocellular injury. Because the liver is the primary site of drug metabolism, patients’ AST and ALT
levels are often evaluated to monitor DILI as a key component of clinical trials to determine drug safety. Currently,
to have the test performed, patients must travel to a clinic to have a blood sample drawn, which is then tested in
an in-house laboratory or mailed off to a central laboratory testing facility. Visits to the clinic place a burden on
the elderly and/or those with limited mobility, and add a geographic constraint to clinical trial participants,
reducing the diversity of subjects. The testing process is slow, burdensome, and costly, and severely limits the
frequency of testing and the speed with which a problem can be detected. In response to this need, TETmedical
is advancing a simple, rapid, and affordable test for AST/ALT measurement that can be performed at the PoC
or in the patient’s own home based on a biomimetic approach to oriented immobilization of enzymes on
nanoparticles (NPs). This method significantly improves the efficiency of coupled enzymatic reactions and is
based on the TET platform that enables ultra-rapid, highly sensitive, and quantitative detection of analytes. Of
note, TETmedical has enabled luminescence readouts of AST/ALT in the highly reducing environment of human
serum/plasma, thus overcoming a challenge that prevented luminescent quantification of AST/ALT.
TETmedical’s AST/ALT test will include disposable cartridges with the TET biosensor embedded on a paper-
based blood separator and, due to a recent partnership, a lancet based blood sample collection device to enable
repeated at-home testing of liver enzymes. Once the sample is added to the cartridge, it will then be inserted
into an electronic reader that will measure the luminescence-based readout and provide a quantitative result.
For this Phase I project, TETmedical’s Specific Aims are: 1) Optimize the tethered enzyme assays for detection
of AST and ALT including the speed, range of detection, and calibration of luminescence outputs, 2) Improve
separation of blood components and design of cartridges, and 3) Validate technology using spiked human blood
samples. Completion of these Aims will result in a cartridge integrating blood separation and TET biosensors to
quantify AST and ALT, and controls for hemolysis, which are already under development. This will provide the
necessary proof of concept for a future Phase II application, which will include a validation study in clinical
samples, integration with the at-home blood collection device, and further development of the prototype
electronic reader device, enabling simple PoC or at-home use.