Low-Perturbation Whole-Blood CD11b Measurement by Biomimetic Acoustofluidic Preprocessing and Wash-Free Microsphere-Competition Readout.

Quantifying CD11b in whole blood from patients with sepsis is analytically challenging because conventional preprocessing can perturb activation state and bias the measured surface-marker abundance. To address this limitation, we report a biomimetic-acoustic cooperative platform for rapid CD11b-based neutrophil activation readout. CD11b expression is transduced into a quantitative microsphere-depletion signal using a competitive microsphere format, and residual microspheres are identified and counted by an object-detection model assisted by frequency-domain image-quality features to improve robustness during tilted-chip readout. A lotus-leaf-replica ceiling establishes pump-free transport within the flow-velocity window required for acoustic enrichment. In an expanded prospective pilot cohort of 36 clinical samples, the assay showed exploratory discrimination between qSOFA-defined groups, with an AUC of 0.92 (95% CI, 0.80-0.99) and a sample-to-answer time of around 40 min. These results establish an analytical proof of concept for this biomimetic-acoustic cooperative platform and provide preliminary evidence of clinical feasibility.