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D-dimer is a useful diagnostic biomarker for deep vein thrombosis or pulmonary embolism, collectively referred to as venous thromboembolism (VTE). The ability to detect in real-time the amount of D-dimer with a fast and reliable method is a key step to anticipate the appearance of these diseases. The combination of fiber-optic–based platforms for biosensing with the nanotechnologies is opening up the chance for the development of in situ, portable, lightweight, versatile, reliable and high-performance optical sensing devices towards lab-on-fiber technology. The generation of lossy mode resonances (LMRs) by means of the deposition of nm-thick absorbing metal-oxide films on special geometric-modified fibers allows measuring precisely and accurately surface refractive index changes, which are due to the binding interaction between a biological recognition element and the analyte under investigation. This approach enhances the light-matter interaction in a strong way, thus turning out to be more sensitive compared to other optical technology platforms, such as fiber gratings or surface plasmon resonance. Here, the results of a highly specific and sensitive biosensor for the detection of D-dimer based on LMR in fiber-optics are presented by monitoring in real-time the shift of the LMR related to the biomolecule interactions thanks to a conventional wavelength-interrogation system and an ad-hoc developed microfluidics. A detection limit of 100 ng/mL, a value 5-fold below the clinical cutoff value, has been attained for D-dimer spiked in human serum. The comparison of the results achieved with proteomics-based methodologies, which allows for the identification of betaand gamma-chains of fibrinogen, demonstrates the ability of our platform to specifically (<90%) recognize D-dimer.
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