biostudies-literatureZhou XArizona State University/Mayo Clinic Collaborative Research Seed GrantMayo ClinicNIGMS NIH HHSNational Institute of General Medical Sciences of National Institute of Healthe05207https://www.ebi.ac.uk/biostudies/studies/S-EPMC12376538biostudies-literatureUnknown12(31)Single-molecule immunoassay is a reliable technique for the detection and quantification of low-abundance blood biomarkers, which are essential for early disease diagnosis and biomedical research. However, current single-molecule methods predominantly rely on endpoint detection and necessitate signal amplification via labeling, which brings a variety of unwanted effects, like matrix effect and autofluorescence interference. This study introduces a real-time mass imaging-based label-free single-molecule immunoassay (LFSMiA). Featuring plasmonic scattering microscopy-based mass imaging, a 2-step sandwich assay format enables background reduction, minimization of matrix effect by dynamic tracking of single binding events, and fully leveraging real-time data for improved measurement precision through a Bayesian Gaussian process model, the LFSMiA enables ultra-sensitive and direct protein detection at the single-molecule level in neat blood sample matrices. LFSMiA measurement is demonstrated for interleukin-6 and prostate-specific antigen in buffer, undiluted serum, and whole blood with sub-femtomolar detection limits and eight logs of dynamic ranges. Moreover, comparable performance is achieved with an inexpensive miniaturized setup. To show its translational potential to clinical settings and point-of-care diagnostics, N-terminal pro-B-type natriuretic peptide is examined in patient whole blood samples using the LFSMiA and results in a strong linear correlation (r > 0.99) with standard clinical lab results.Advanced science (Weinheim, Baden-Wurttemberg, Germany)Label-Free Single-Molecule Immunoassay.PMC12376538ARI-285360-01SPA00007255/ARI-333334R01GM140193R01 GM140193Jiang JSnozek CLHZhou SWang SWan ZBraswell BChen CYang EHZhou XChemerkouh MJHNMa GfalseLabel-Free Single-Molecule Immunoassay.Single-molecule immunoassay is a reliable technique for the detection and quantification of low-abundance blood biomarkers, which are essential for early disease diagnosis and biomedical research. However, current single-molecule methods predominantly rely on endpoint detection and necessitate signal amplification via labeling, which brings a variety of unwanted effects, like matrix effect and autofluorescence interference. This study introduces a real-time mass imaging-based label-free single-molecule immunoassay (LFSMiA). Featuring plasmonic scattering microscopy-based mass imaging, a 2-step sandwich assay format enables background reduction, minimization of matrix effect by dynamic tracking of single binding events, and fully leveraging real-time data for improved measurement precision through a Bayesian Gaussian process model, the LFSMiA enables ultra-sensitive and direct protein detection at the single-molecule level in neat blood sample matrices. LFSMiA measurement is demonstrated for interleukin-6 and prostate-specific antigen in buffer, undiluted serum, and whole blood with sub-femtomolar detection limits and eight logs of dynamic ranges. Moreover, comparable performance is achieved with an inexpensive miniaturized setup. To show its translational potential to clinical settings and point-of-care diagnostics, N-terminal pro-B-type natriuretic peptide is examined in patient whole blood samples using the LFSMiA and results in a strong linear correlation (r > 0.99) with standard clinical lab results.2025-01-01T00:00:00Z2025 Aug2026-05-09T17:50:58.898Z2026-04-08T01:08:50.981ZS-EPMC123765384053819910.1002/advs.202505207