Sweat Sensors Bring Arthritis Monitoring Closer to Home

As medical technology progresses, more accurate and less invasive diagnostics are a constant goal. For example, the first X-ray, and then ultrasound, MRI, and other scanner technologies have made it possible to detect and assess injuries and other problems without any invasive actions. Similarly, most of the time when an observation is needed inside the body, a very small opening and a flexible camera can now be used instead of more invasive surgery.

Another trend is biochemical analysis for detecting chronic issues promptly. For example, glucose monitoring is an important tool in detecting, preventing, and slowing the progression of diabetes.

So researchers are often looking for new biomarkers that could help assess medical conditions painlessly and cheaply from body fluids.

Researchers at the University of Alberta (Canada) and Northumbria University (UK) have created a new type of non-invasive wearable sensors, using sweat to track rheumatoid arthritis and gout-related biomarkers. This could create a much more continuous monitoring method, instead of the intermittent serology (analysis of serum and body fluids), imaging, and clinical assessments currently used.

Source: Chemical Engineering Journal

They published their results in Chemical Engineering Journal¹, under the title “Wearable sweat sensors for arthritis monitoring”.

The Growing Burden Of Arthritis

When articulations get damaged by rheumatic diseases, most cases are from either gout or rheumatoid arthritis.

Rheumatoid arthritis is a systemic autoimmune condition driven by complex genetic and environmental factors, and is mostly stable.

In contrast, gout is fundamentally a metabolic disorder characterized by uric acid supersaturation and the crystallization of monosodium urate within joints. As such, gout is tightly linked to diets and lifestyle, especially large quantities of red meat, shellfish, sugary drinks, and alcohol.

As such, there is an expectation of a quickly rising number of rheumatic diseases in the near future, with almost 96 million gout cases worldwide by 2050. The growth is expected to occur especially in areas with already low healthcare resources, like Africa.

Source: Chemical Engineering Journal

It will be challenging for already poorly served regions to handle such diseases, as the current equipment and diagnostic tools & procedures are expensive.

“Current diagnostics rely on invasive fluid aspiration, serum assays (e.g., UA, C-reactive protein (CRP)), and imaging such as dual-energy computed tomography (DECT), ultrasonography, or magnetic resonance imaging (MRI).”

Another problem with current diagnostics is that these infrastructure-intensive methods are not often enough for steady monitoring, as they cannot capture the rapid physiological fluctuations that precede acute flares.

So, improvements that allow better tracking of disease dynamics would facilitate earlier intervention and personalized therapy.

Metabolic Sensing From Sweat

Many Biomarkers To Follow

There is a growing body of research establishing that the metabolic conditions of a patient’s body can be established from the composition of his sweat. For example, it can be used to measure salt in cystic fibrosis.

Similarly, gout and rheumatoid arthritis can be monitored through the presence of metabolic triggers (uric acid, xanthines, hydrogen peroxide) and inflammatory proteins (CRP, calprotectin, and cytokines).

Interestingly, such proteins have also been shown to be useful for monitoring diseases like inflammatory bowel disease (IBD).

When it comes to detection of these molecules in sweat with wearables, uric acid is a strong candidate, as it is a direct cause of gout. A wide array of potential solutions exists for wearable sensors, including electrochemical enzymatic UA sensing, electrode-based, single-atom nanozyme-based, microfluidic biosensor, plasmonic double network hydrogel, etc.

Source: Chemical Engineering Journal

As gout is the result of purines being metabolized into uric acid, the intermediary molecules of this process, xanthines, are also good candidates. Here too, multiple candidate technologies exist, including colorimetric microfluidic device, flexible electrochemical patch, flexible multi-enzyme biosensor, electrochemical biosensor, etc.

Source: Chemical Engineering Journal

CRP (C-Reactive Protein) is among the inflammatory proteins that are relevant to arthritic diseases. The SWEATSENSER device, developed by Enlisense, uses zinc oxide (ZnO) electrodes with CRP antibodies to measure CRP in undiluted sweat. Other devices like the “InflaStat” wireless wearable patch or other electrochemical sensors are also possible.

Source: Chemical Engineering Journal

However, cytokines are generally too big to be present in much quantity in sweat, making their detection difficult. Sensors with graphene could be useful for detection of the cytokine TNF-α, and ZnO thin films functionalized with monoclonal antibodies on a porous membrane could be used to detect the cytokine IFN-γ.

Detection of the cytokines IL-1 and IL-6 is also possible, but less investigated for wearable detection, even if “SWEATSENSER” could maybe perform that task as well. The same device could also be used to detect multiple cytokines at once.

Source: Chemical Engineering Journal

Electrochemical immunosensors similar to the SWEATSENSER and IBD AWARE platforms can also be used to measure the protein calprotectin, a prominent inflammation biomarker traditionally measured in serum or stool. In this specific case, multi-day monitoring that revealed distinct circadian rhythms in inflammatory markers is of special interest to medical researchers.

Engineering Skin-Sensor Interface

The Right Substrate

In order to make a wearable sweat sensor to work, a stable, safe, and comfortable skin-sensor interface is required.

The first part is the substrate that bridges the mechanical mismatch between rigid sensing elements and soft, flexible skin. For these diseases, it can be especially difficult, as the skin overlying an actively inflamed rheumatoid or gouty joint is often taut, “hot”, and abnormally tender. So different synthetic polymers, porous matrices, and textile integrations have been explored.

Source: Chemical Engineering Journal

This includes synthetic polymeric and elastomeric platforms, often using Polyethylene terephthalate (PET) and Polyimide (PI), as well as porous (cellulose paper) and hydrogel interfaces.

Another option is integration of the substrate directly into textiles, a method with its own advantages and challenges.

“While ideal for electrochemical sensing via conductive yarns or screen-printed inks, textiles present opacity challenges for optical methods. Microfluidic-on-fabric systems using hydrophobic wax or octadecane patterning can guide sweat to specific sensing zones”

Performance Vs User Compliance

The most efficient sensor is not necessarily the most medically relevant one, as when patients are uncomfortable, they tend to use a medical device poorly.

“Severe joint deformities, morning stiffness, and a profound loss of fine motor dexterity dictate that device mechanics—such as substrate rigidity, and ease of application—ultimately determine a sensor’s clinical viability. While skin-adhesive patches remain the standard, innovations have expanded into accessory-integrated, textile-based, and modular form factors.”

One option is microfluidic patches, which are as close as possible to the skin.

“Skin-interfaced patches are widely favored for their ability to minimize dead volume via direct adhesion to sweat glands. Advanced iterations include “InflaStat,” a fully integrated system combining iontophoresis and wireless electronics for automatic CRP quantification”

For wearable accessories and textiles, a challenge can be to take account of disease-specific anatomical changes. For example, ring-type sensors that monitor atherosclerosis and arthritis biomarkers can be good for analytics, but a deformed joint will not fit them painlessly.

For this reason, the researchers argue for seamless integration into loose apparel being a superior option, for example, aptamer-functionalized carbon nanotube/graphene composite fibers woven directly into commercial fabrics.

“These textile formats eliminate the need for intricate application steps, requiring no complex wearability, while providing a breathable, anti-fatigue platform for real-time monitoring.”

Another way to improve these sensors is to separate the sensing element from the processing hardware, or use momentary sampling.

“These systems are particularly advantageous for patients whose limited dexterity precludes the application of complex wearable patches. Examples include “touch-based” sensors that facilitate rapid spot-checks, such as hydrogel-coated strips pressed by the fingertip.”

Source: Chemical Engineering Journal

The Right Sensor

In general, the efficacy of any wearable platform hinges on its transduction interface, or where the actual chemical detection occurs.

“The selection of an electrochemical transduction methodology is critically dictated by the target biomarker’s physical properties—such as its electro activity, molecular size, and physiological abundance. Conversely, optical methods often offer equipment-free, point-of-care readouts allowing on-demand spot-checking of metabolites like uric acid”

Between the diversity of molecules that can be detected and the diversity of potential sensors, the many combinations this creates provide a rather wide array of potential wearable sensors.

The different methods include electrochemical sensing, with a current variation if the molecule is present, and optical sensing, where color (colorimetric sensors), fluorescence, or transparency change in the presence of the molecule.

Source: Chemical Engineering Journal

Lastly, the reaction to specifically detect the molecule of interest (biorecognition) needs to be mediated by an element in the sensor. This can be achieved through enzymes, antibodies, aptamers (short, single-stranded DNA, RNA, XNA, or peptide sequences), or catalysts.

From Prototypes To Medical Protocol

Often, when reviewing the technical possibility for such sensors, it might seem that the issue is already solved. But in practice, there is a gap between laboratory prototypes and commercialized sensors tied to a defined diagnostic protocol and therapeutic decision.

Turning molecule detection into a medically proven useful data point takes clinical studies and comparison to existing medical options.

Source: Chemical Engineering Journal

Interferences with measurement from real-life conditions can also be an issue. This can include changes in concentration unrelated to the disease, but also “biofouling”, when sweat effectively “blinds” transducers.

“Physical factors (such as varying sweat excretion rates, sweat evaporation, and dead-volume mixing) can artificially concentrate biomarkers or blur temporal resolution, while micro-environmental shifts (such as pH fluctuations) can fundamentally alter electrocatalytic kinetics and mask target charges.”

Research is currently pivoting from passive membranes to active anti-fouling architectures, such as peptide hydrogels that filter interferents.

The end product should be a wearable, reliable, and durable sensor, whose benefits have been proven in large clinical studies, which connects to an array of cloud computing systems and apps to deliver an accurate forecast of the disease symptoms for both doctors and patients.

The end goal would be that when these sensors have proven accurate in detecting an upcoming flare of gout, it can become the trigger for an immediate and automated drug delivery in the joint to reduce or remove symptoms.

Source: Chemical Engineering Journal

So ultimately, the best wearable for arthritis will not just be the best technical options, but will depend on whether biomarker readings reliably guide treatment, predict flares, or support useful lifestyle changes.

Investing In Biosensors

Abbott Laboratories

With a strong presence in medical devices and diagnostics, Abbott is among the “big pharma” companies corresponding the most to the kind of research discussed in this study.

The 138-year-old company employs 114,000+ people, operates in 160+ countries, and generated $44.3B in sales in 2025.

Abbott’s biowearables products, FreeStyle Libre and Lingo products for glucose reading in diabetes, are a good example of how wearable monitors can bring a significant improvement to patients’ medical condition and everyday life. And prove to be a multi-billion dollar business.

“The Libre portfolio, Abbott’s flagship continuous glucose monitors, are the most widely used biowearables worldwide, helping more than 8 million people better manage their glucose.”

In 2025, the business lines for diagnostics generated $8.937B and diabetes care $8B, making sensing, measurements, and adjacent businesses a core of the company. Other important segments were nutrition ($8.4B) and cardiovascular treatment, especially implants ($12.3B).

This is not to say that Abbott will necessarily develop arthritis sweat sensors, but that a company with expertise in the wider “sensor” field will likely benefit from the overall growth of biomonitoring in many new medical applications, a market that is already $14B worldwide just for glucose monitoring.

This is especially likely to be true when the same company has deep expertise in molecular diagnostics in general, with leadership in testing for various molecules like troponin, infectious disease markers, blood composition, etc.

Besides this prospect, potential investors will still want to evaluate carefully the rest of the company’s business, as well as an R&D pipeline with a strong focus on cardiovascular implants, baby formula, advanced biosensing (Libre Duo), and cancer diagnostics.

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Study Referenced

^{1. Appurva Tiwari, Ben Bin Xu, and Xuehua Zhang. Wearable sweat sensors for arthritis monitoring. Chemical Engineering Journal. 1 Desember 2026. Article: 182747. Volume 549.}

^{10.1016/j.cej.2026.182747}