A novel lab-on-paper device combining the simplicity and low-cost of microfluidic paper-based analytical devices (μPADs) and the sensitivity and selectivity of chemiluminescence ELISA (CL-ELISA) for the high-throughput, rapid, stable and reusable point-of-care testing is presented here. Chitosan was used to modify μPADs to covalently immobilize antibodies on μPADs. Thus, sandwich CL-ELISA on μPADs can be easily realized for further development of this technique in sensitive, specific and low-cost application. The paper device was fabricated by a low-cost, simple, and rapid wax-screen-printing method. Using tumor markers and paper microzone plate as model, the application test of this paper-based CL-ELISA was successfully performed with a linear range of 0.1-35.0 ng mL(-1) for α-fetoprotein, 0.5-80.0 U mL(-1) for cancer antigen 125 and 0.1-70.0 ng mL(-1) for carcinoembryonic antigen. Since the cutoff values of the three tumor markers in clinical diagnosis are 25 ng mL(-1), 35 U mL(-1) and 5 ng mL(-1), the sensitivity and linear ranges of the proposed method were enough for clinical application. In addition, this lab-on-paper immunodevice can provide reproducible results upon storage at 4 °C (sealed) for at least 5 weeks. Ultimately, this novel chitosan modification and wax-screen-printing methodology for μPADs can be readily translated to other signal reporting mechanism including electrochemiluminescence and photoelectrochemistry, and other receptors such as enzyme receptors and DNA receptors for determination of DNA, proteins and small molecules in point-of-care testing.
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