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bioRxiv · 10.64898/2025.12.03.692085

Ultrasensitive saliva-based detection of early Alzheimer's disease biomarkers via nanoparticle-enhanced evanescent scattering microscopy

Abstract

Alzheimers disease (AD) is the most common neurodegenerative disease, yet early diagnosis remains a major challenge. Current cerebrospinal fluid (CSF) assays are invasive and unsuitable for large-scale or repeated screening. Blood-based biomarkers have achieved sensitivities above 90%, but still face challenges of standardization, cost, technical complexity, and the need for sophisticated instrumentation. Saliva offers an attractive, non-invasive solution; however, the low concentrations of AD biomarkers have thus far hindered its clinical applicability. Here, we introduce a saliva-based diagnostic platform that combines Total Internal Reflection Scattering (TIRS) microscopy with antibody-functionalized metallic nanoparticles (NPs), for ultrasensitive, real-time quantification of salivary amyloid-{beta} (A{beta}) proteins. Using two established AD mouse models (APPsl and 5xFAD), we found that salivary A{beta}2 levels robustly distinguish transgenic from wild-type animals and correlate with brain amyloid deposition. Pooled and stratified analyses suggest these associations are primarily driven by the transgenic-wild-type contrast rather than linear changes within groups. Predictive modeling further confirmed diagnostic utility: in APPsl, Logistic Regression and Support Vector Machine (SVM) classifiers both achieved 92% accuracy with balanced sensitivity and specificity, while in 5xFAD, SVM reached 88% accuracy with perfect specificity. These results establish the NPs-enhanced TIRS sensor as a rapid, accurate and non-invasive tool for AD detection via saliva. By addressing a critical unmet need in neurodegenerative disease screening, this platform has strong potential to transform early diagnosis, enable timely interventions, and support biomarker-guided clinical trials. Its simplicity, speed, and scalability, make it well-suited for point-of-care diagnostics and large-scale screening initiatives. One Sentence SummaryUltrasensitive saliva test detects early Alzheimers biomarkers using nanoparticle-enhanced scattering microscopy

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BibTeXRIS

Dallari, C., Ladurner, G., Kendrisic, M., Caria, F. F., Manzl, C., Ponticelli, L., Perego, L., Goretti, F., Credi, C., Prokesch, M., Woehrer, A., Baumann, B., Leitgeb, R., Pavone, F. S.. 2025-12-05. Ultrasensitive saliva-based detection of early Alzheimer's disease biomarkers via nanoparticle-enhanced evanescent scattering microscopy. https://doi.org/10.64898/2025.12.03.692085

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