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Environmental enteric dysfunction (EED) is a subclinical disorder of intestinal function common in tropical countries and settings of poverty and economic disadvantage. EED manifests during infancy and is associated with undernutrition, poor sanitation, and gut infections. EED is characterised by inflammation, reduced absorptive capacity, and reduced barrier function (i.e., increased permeability) in the small intestine. The precise mechanisms underlying changes in gut barrier function (and other aspects of intestinal function) in EED remain elusive. Furthermore, current diagnostic methods to assess gut permeability (e.g., endoscopic biopsies or permeability assays such as the Lactulose:Mannitol test) are invasive, unreliable and/or challenging to perform in infants and patients with other coexisting urological conditions. Consequently, there is an urgent need to develop diagnostic technologies that can non-invasively and affordably monitor intestinal permeability in low-resource settings where EED is prevalent.
To address this need, we present a prototype semi-wearable, wireless sensor for non-invasive assessment of intestinal permeability via transcutaneous fluorescence spectroscopy. The approach relies on the ingestion of a fluorescent contrast agent (fluorescein) and the subsequent detection of its permeation from the gut into the bloodstream using a wearable probe. We outline the development of the semi-wearable sensor and report preliminary in vivo deployment. This showcases the potential of transcutaneous fluorescence spectroscopy as a wearable and non-invasive diagnostic tool for assessing gut function in low-resource settings.
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