Abstract
Sweat potentially contains a wealth of physiologically relevant information, but has traditionally been an underutilized resource for non-invasive health monitoring. Recent advances in wearable sweat sensors have overcome many of the historic drawbacks of sweat sensing and such sensors now offer methods of gleaning molecular-level insight into the dynamics of our bodies. Here we review key developments in sweat sensing technology. We highlight the potential value of sweat-based wearable sensors, examine state-of-the-art devices and the requirements of the underlying components, and consider ways to tackle data integrity issues within these systems. We also discuss challenges and opportunities for wearable sweat sensors in the development of personalized healthcare.
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adapted from ref. 18, AIP.


reproduced from ref. 6, Macmillan Publishers Ltd.
References
Zheng, Y. L. et al. Unobtrusive sensing and wearable devices for health informatics. IEEE Trans. Biomed. Eng. 61, 1538–1554 (2014).
Andreu-Perez, J., Poon, C. C. Y., Merrifield, R. D., Wong, S. T. C. & Yang, G. Z. Big data for health. IEEE J. Biomed. Health Inform. 19, 1193–1208 (2015).
Li, X. et al. Digital health: tracking physiomes and activity using wearable biosensors reveals useful health-related information. PLOS Biol. 15, e2001402 (2017).
Bottles, K., Begoli, E. & Worley, B. Understanding the pros and cons of big data analytics. Physician Exec. 40, 6–12 (2014).
Bandodkar, A. J. & Wang, J. Non-invasive wearable electrochemical sensors: a review. Trends Biotechnol. 32, 363–371 (2014).
Gao, W. et al. Fully integrated wearable sensor arrays for multiplexed in situ perspiration analysis. Nature 529, 509–514 (2016).
Emaminejad, S. et al. Autonomous sweat extraction and analysis applied to cystic fibrosis and glucose monitoring using a fully integrated wearable platform. Proc. Natl Acad. Sci. USA 114, 4625–4630 (2017).
Koh, A. et al. A soft, wearable microfluidic device for the capture, storage, and colorimetric sensing of sweat. Sci. Transl. Med. 8, 366ra165 (2016).
Rose, D. P. et al. Adhesive RFID sensor patch for monitoring of sweat electrolytes. IEEE Trans. Biomed. Eng. 62, 1457–1465 (2015).
Sonner, Z., Wilder, E., Gaillard, T., Kasting, G. & Heikenfeld, J. Integrated sudomotor axon reflex sweat stimulation for continuous sweat analyte analysis with individuals at rest. Lab Chip 17, 2550–2560 (2017).
Bandodkar, A. J. et al. Tattoo-based noninvasive glucose monitoring: a proof-of-concept study. Anal. Chem. 87, 394–398 (2014).
Jia, W. et al. Electrochemical tattoo biosensors for real-time noninvasive lactate monitoring in human perspiration. Anal. Chem. 85, 6553–6560 (2013).
Kim, J. et al. Wearable salivary uric acid mouthguard biosensor with integrated wireless electronics. Biosens. Bioelectron. 74, 1061 (2015).
Huang, X. et al. Stretchable, wireless sensors and functional substrates for epidermal characterization of sweat. Small 10, 3083–3090 (2014).
Lee, H. et al. Wearable/disposable sweat-based glucose monitoring device with multistage transdermal drug delivery module. Sci. Adv. 3, e1601314 (2017).
Heikenfeld, J. Non-invasive analyte access and sensing through eccrine sweat: challenges and outlook circa 2016. Electroanalysis 28, 1242–1249 (2016).
Heikenfeld, J. Bioanalytical devices: Technological leap for sweat sensing. Nature 529, 475–476 (2016).
Sonner, Z. et al. The microfluidics of the eccrine sweat gland, including biomarker partitioning, transport, and biosensing implications. Biomicrofluidics 9, 031301 (2015).
Kim, J. et al. Noninvasive alcohol monitoring using a wearable tattoo-based iontophoretic-biosensing system. ACS Sens. 1, 1011–1019 (2016).
Gao, W. et al. Wearable microsensor array for multiplexed heavy metal monitoring of body fluids. ACS Sens. 1, 866–874 (2016).
De Giovanni, N. & Fucci, N. The current status of sweat testing for drugs of abuse: a review. Curr. Med. Chem. 20, 545–561 (2013).
Kidwell, D. A., Holland, J. C. & Athanaselis, S. Testing for drugs of abuse in saliva and sweat. J. Chromatogr. B. Biomed. Sci. App. 713, 111–135 (1998).
Desax, M.-C. et al. Nanoduct sweat testing for rapid diagnosis in newborns, infants and children with cystic fibrosis. Eur. J. Pediatr. 167, 299–304 (2008).
Houglum, J. E, Harrelson, G. & Seefeldt, T. Principles of Pharmacology for Athletic Trainers. Ch. 17, (Slack: New Jersey, 2016).
Gao, W. et al. Wearable sweat biosensors. 2016 IEEE Int. Electron Dev. Meet. https://doi.org/10.1109/IEDM.2016.7838363 (2016).
Choi, J., Kang, D., Han, S., Kim, S. B. & Rogers, J. A. Thin, soft, skin-mounted microfluidic networks with capillary bursting valves for chrono-sampling of sweat. Adv. Healthc. Mater. 6, 1601355 (2017).
Daniels, J. S. & Pourmand, N. Label-free impedance biosensors: opportunities and challenges. Electroanalysis 19, 1239–1257 (2007).
Singh, M., Truong, J., Reeves, W. B. & Hahm, J. Emerging cytokine biosensors with optical detection modalities and nanomaterial-enabled signal enhancement. Sensors 17, 428 (2017).
Morris, D. et al. Bio-sensing textile based patch with integrated optical detection system for sweat monitoring. Sens. Actuators B Chem. 139, 231–236 (2009).
Corrie, S. R., Coffey, J. W., Islam, J., Markey, K. A. & Kendall, M. A. F. Blood, sweat, and tears: developing clinically relevant protein biosensors for integrated body fluid analysis. Analyst 140, 4350–4364 (2015).
Uzun, L. & Turner, A. P. Molecularly-imprinted polymer sensors: realising their potential. Biosens. Bioelectron. 76, 131–144 (2016).
Pfeiffer, F. & Mayer, G. Selection and biosensor application of aptamers for small molecules. Front. Chem. https://doi.org/10.3389/fchem.2016.00025 (2016).
Prausnitz, M. R. The effects of electric current applied to skin: A review for transdermal drug delivery. Adv. Drug Deliv. Rev. 18, 395–425 (1996).
Garg, S. K. et al. Correlation of fingerstick blood glucose measurements with GlucoWatch biographer glucose results in young subjects with type 1 diabetes. Diabetes Care 22, 1708–1714 (1999).
Tierney, M. J. et al. The GlucoWatch biographer: a frequent, automatic and noninvasive glucose monitor. Ann. Med. 32, 632–641 (2010).
Tierney, M. J. et al. Clinical evaluation of the GlucoWatch biographer: a continual, non-invasive glucose monitor for patients with diabetes. Biosens. Bioelectron. 16, 621–629 (2001).
Tierney, M. J. et al. Design of a biosensor for continual, transdermal glucose monitoring. Clin. Chem. 45, 1681–1683 (1999).
Bantle, J. P. & Thomas, W. Glucose measurement in patients with diabetes mellitus with dermal interstitial fluid. J. Lab. Clin. Med. 130, 436–441 (1997).
Nemiroski, A. et al. Universal mobile electrochemical detector designed for use in resource-limited applications. Proc. Natl Acad. Sci. USA 111, 11984–11989 (2014).
Windmiller, J. R. & Wang, J. Wearable electrochemical sensors and biosensors: a review. Electroanalysis 25, 29–46 (2013).
Zeng, W. et al. Fiber-based wearable electronics: a review of materials, fabrication, devices, and applications. Adv. Mater. 26, 5310–5336 (2014).
Grau, G. et al. Gravure-printed electronics: recent progress in tooling development, understanding of printing physics, and realization of printed devices. Flex. Print. Electron. 1, 023002 (2016).
Khan, Y. et al. Flexible hybrid electronics: direct interfacing of soft and hard electronics for wearable health monitoring. Adv. Funct. Mater. 26, 8764–8775 (2016).
Schazmann, B. et al. A wearable electrochemical sensor for the real-time measurement of sweat sodium concentration. Anal. Methods 2, 342–348 (2010).
Anastasova, S. et al. A wearable multisensing patch for continuous sweat monitoring. Biosens. Bioelectron. 93, 139–145 (2017).
Abellán-Llobregat, A. et al. A stretchable and screen-printed electrochemical sensor for glucose determination in human perspiration. Biosens. Bioelectron. 91, 885–891 (2017).
Windmiller, J. R. et al. Electrochemical sensing based on printable temporary transfer tattoos. Chem. Commun. 48, 6794–6796 (2012).
Kim, J. et al. Wearable temporary tattoo sensor for real-time trace metal monitoring in human sweat. Electrochem. Commun. 51, 41–45 (2015).
Munje, R. D., Muthukumar, S., Selvam, A. P. & Prasad, S. Flexible nanoporous tunable electrical double layer biosensors for sweat diagnostics. Sci. Rep. 5, 14586 (2015).
Kinnamon, D., Ghanta, R., Lin, K.-C., Muthukumar, S. & Prasad, S. Portable biosensor for monitoring cortisol in low-volume perspired human sweat. Sci. Rep. 7, 13312 (2017).
Kilic, T., Brunner, V., Audoly, L. & Carrara, S. Smart e-Patch for drugs monitoring in schizophrenia. 2016 IEEE Int. Conf. Electron. Circuits Syst. https://doi.org/10.1109/ICECS.2016.7841131 (2016).
Wang, J. Analytical Electrochemistry. 3rd edn, Ch. 2 (John Wiley & Sons: New Jersey, 2006).
Mugweru, A., Clark, B. L. & Pishko, M. V. Electrochemical sensor array for glucose monitoring fabricated by rapid immobilization of active glucose oxidase within photochemically polymerized hydrogels. J. Diabetes Sci. Technol. 1, 366–371 (2007).
Wang, J. Analytical Electrochemistry. 3rd edn, Ch. 3 (John Wiley & Sons: New Jersey, 2006).
Yoshizumi, J., Kumamoto, S., Nakamura, M. & Yamana, K. Target -induced strand release (TISR) from aptamer – DNA duplex: A general strategy for electronic detection of biomolecules ranging from a small molecule to a large protein. Analyst 133, 323–325 (2008).
Liu, X., Duckworth, P. A. & Wong, D. K. Y. Square wave voltammetry versus electrochemical impedance spectroscopy as a rapid detection technique at electrochemical immunosensors. Biosens. Bioelectron. 25, 1467–1473 (2010).
Current-polarized ion-selective membranes: The influence of plasticizer and lipophilic background electrolyte on concentration profiles, resistance, and voltage transients. Sens. Actuators B Chem. 136, 410–418 (2009).
Telting-Diaz, M. & Bakker, E. Effect of lipophilic ion-exchanger leaching on the detection limit of carrier-based ion-selective electrodes. Anal. Chem. 73, 5582–5589 (2001).
Patterson, M. J., Galloway, S. D. R. & Nimmo, M. A. Variations in regional sweat composition in normal human males. Exp. Physiol. 85, 869–75 (2000).
Nyein, H. Y. Y. et al. A wearable electrochemical platform for noninvasive simultaneous monitoring of Ca2+ and pH. ACS Nano 10, 7216–7224 (2016).
Njagi, J. I. & Kagwanja, S. M. in Interfaces and Interphases in Analytical Chemistry 225–247 (American Chemical Society, Washington, DC, 2011).
Mehrvar, M. & Abdi, M. Recent developments, characteristics, and potential applications of electrochemical biosensors. Anal. Sci. 20, 1113–1126 (2004).
Wang, J. Electrochemical glucose biosensors. Chem. Rev. 108, 814–825 (2008).
McKeague, M. & DeRosa, M. C. Challenges and opportunities for small molecule aptamer development. J. Nucleic Acids 2012, 748913 (2012).
Bandodkar, A. J., Jeerapan, I. & Wang, J. Wearable chemical sensors: present challenges and future prospects. ACS Sens. 1, 464–482 (2016).
Burugapalli, K, Wang, N, Trzebinski, J, Song, W. & Cass, A. Nanomaterials in Glucose Sensing. Ch. 5 (ASME Press: New York, 2014).
Bakker, E., Bühlmann, P. & Pretsch, E. Polymer membrane ion-selective electrodes — what are the limits? Electroanalysis 11, 915–933 (1999).
Grieshaber, D., MacKenzie, R., Vörös, J. & Reimhult, E. Electrochemical biosensors — sensor principles and architectures. Sensors 8, 1400–1458 (2008).
Ahmed, M. U, Zourob, M. & Tamiya, E. Food Biosensors. Ch. 9 (RSC Publishing: London, 2016).
Hurt, R. H., Monthioux, M. & Kane, A. Toxicology of carbon nanomaterials: Status, trends, and perspectives on the special issue. Carbon 44, 1028–1033 (2006).
Bakker, E. & Pretsch, E. Potentiometric sensors for trace-level analysis. Trends Anal. Chem. 24, 199–207 (2005).
Rathee, K., Dhull, V., Dhull, R. & Singh, S. Biosensors based on electrochemical lactate detection: A comprehensive review. Biochem. Biophys. Rep. 5, 35–54 (2016).
Zhu, C., Yang, G., Li, H., Du, D. & Lin, Y. Electrochemical sensors and biosensors based on nanomaterials and nanostructures. Anal. Chem. 87, 230–249 (2015).
Fibbioli, M. et al. Potential drifts of solid-contacted ion-selective electrodes due to zero-current ion fluxes through the sensor membrane. Electroanalysis 12, 1286–1292 (2000).
Zhu, J., Qin, Y. & Zhang, Y. Preparation of all solid-state potentiometric ion sensors with polymer-CNT composites. Electrochem. Commun. 11, 1684–1687 (2009).
Mir, M., Lugo, R., Tahirbegi, I. B. & Samitier, J. Miniaturizable ion-selective arrays based on highly stable polymer membranes for biomedical applications. Sensors 14, 11844–11854 (2014).
Rocchitta, G. et al. Enzyme biosensors for biomedical applications: strategies for safeguarding analytical performances in biological fluids. Sensors 16, 780 (2016).
Cosnier, S. Biomolecule immobilization on electrode surfaces by entrapment or attachment to electrochemically polymerized films. A review. Biosens. Bioelectron. 14, 443–456 (1999).
Zhang, M., Smith, A. & Gorski, W. Carbon nanotube−chitosan system for electrochemical sensing based on dehydrogenase enzymes. Anal. Chem. 76, 5045–5050 (2004).
Gomez, C., Oller, J. & Paradells, J. Overview and evaluation of bluetooth low energy: an emerging low-power wireless technology. Sensors 12, 11734–11753 (2012).
Burnette, D. W. et al. Intelligent wireless communications for continuous analyte monitoring. US patent US20170181628A1 (2016); https://patents.google.com/patent/US20170181628A1/en
Yilmaz, T., Foster, R. & Hao, Y. Detecting vital signs with wearable wireless sensors. Sensors 10, 10837–10862 (2010).
Bahk, J., Fang, H., Yazawa, K. & Shakouri, A. Flexible thermoelectric materials and device optimization for wearable energy harvesting. J. Mater. Chem. C 3, 10362–374 (2015).
Thierer, A. D. The Internet of Things and wearable technology: addressing privacy and security concerns without derailing innovation. Rich. J. L. & Tech. 21, 6 (2015).
Albert, K. J. et al. Cross-reactive chemical sensor arrays. Chem. Rev. 100, 2595–2626 (2000).
Marques-Deak, A. et al. Measurement of cytokines in sweat patches and plasma in healthy women: Validation in a controlled study. J. Immunol. Methods 315, 99–109 (2006).
Cizza, G. et al. Elevated neuroimmune biomarkers in sweat patches and plasma of premenopausal women with major depressive disorder in remission: the POWER study. Biol. Psychiatry 64, 907–911 (2008).
Raiszadeh, M. M. et al. A Proteomic analysis of eccrine sweat: implications for the discovery of schizophrenia biomarker proteins. J. Proteome Res. 11, 2127 (2012).
McGregor, C., Catley, C. & James, A. Variability analysis with analytics applied to physiological data streamsfrom the neonatal intensive care unit. 2012 25th IEEE Int. Symp. Computer-Based Med. Syst. (CBMS). https://doi.org/10.1109/CBMS.2012.6266385 (2012).
Buono, M. J. Sweat ethanol concentrations are highly correlated with co-existing blood values in humans. Exp. Physiol. 84, 401–404 (1999).
Guinovart, T., J Bandodkar, A., R Windmiller, J., J Andrade, F. & Wang, J. A potentiometric tattoo sensor for monitoring ammonium in sweat. Analyst 138, 7031–7038 (2013).
Mickelsen, O. & Keys, A. The composition of sweat, with special reference to vitamins. J. Biol. Chem. 149, 479–490 (1943).
Shields, J. B., Johnson, B. C., Hamilton, T. S. & Mitchell, H. H. The excretion of ascorbic acid and dehydroascorbic acid in sweat and urine under different environmental conditions. J. Biol. Chem. 161, 351–356 (1945).
Wang, J. Analytical Electrochemistry 3rd edn, Ch. 1 (John Wiley & Sons, New Jersey, 2006).
Lisdat, F. & Schäfer, D. The use of electrochemical impedance spectroscopy for biosensing. Anal. Bioanal. Chem. 391, 1555 (2008).
Acknowledgements
The authors acknowledge support from the National Science Foundation (NSF), Berkeley Sensor and Actuator Center (BSAC), NSF Nanomanufacturing Systems for Mobile Computing and Mobile Energy Technologies (NASCENT) Center, and a Bakar fellowship.
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Bariya, M., Nyein, H.Y.Y. & Javey, A. Wearable sweat sensors. Nat Electron 1, 160–171 (2018). https://doi.org/10.1038/s41928-018-0043-y
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DOI: https://doi.org/10.1038/s41928-018-0043-y
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