Methotrexate (MTX) or amethopterin is an anticancer drug that can suppress the immune system and interrupt the deoxyribonucleic acid production in cancer cells to halt or decrease unusual cell growth and division. A high dose of MTX (1 to 5 g/m
2) is usually prescribed in some diseases to penetrate the tumor cells and blood-brain barrier to overcome possible drug resistance (
1). To date, MTX has been broadly utilized to treat a broad range of cancers, including breast cancer, head and neck cancer, and leukemia (
2). In addition, MTX is utilized as an anti-inflammatory drug for the treatment of diverse forms of arthritis. The MTX has a narrow therapeutic dose window. Normal cells (especially renal and liver) could also be affected by MTX and cause the side effects of hepatotoxicity and nephrotoxicity with high incidences (
3).
The serum concentrations of MTX should be checked to retain within the range of 0.1 - 10 µM. Based on a report, a high dose of MTX can cause about 6% death incidence (
4). Therefore, clinicians try to balance the MTX dose to decrease the side effects by optimizing the dose and the time of administration to secure the efficacy of therapy and decrease possible side effects. For the achievement of this aim, therapeutic drug monitoring (TDM) for MTX is of great importance and has been implemented in medical centers.
Immunoassay-based, high-performance liquid chromatography (HPLC) and HPLC-mass spectrometry methods are currently used to detect MTX concentrations in biological samples. However, immunoassay approaches suffer from insufficient dynamic range and expensive and exhausting protocols (
5). The HPLC separation-based methods can largely enhance the specificity of MTX detection; nevertheless, their applications are hindered by some disadvantages, including extended analysis time and the need for highly skilled individuals to operate. Mass spectroscopy-based HPLC techniques provide more sensitive and specific approaches with lowered analysis time. In general, HPLC-based methods are high-cost that might not be provided by all clinical centers. Therefore, a highly sensitive and specific probe is needed for the routine TDM of MTX in biological fluids.
Researchers have developed several analytical techniques to detect MTX with different sensory systems, including optical, electrochemical, and separation-based methods. Liquid chromatography (with various detecting systems) (
6,
7), fluorescence (
8), electrochemistry (
9), and electrophoresis (
10) are the most applied techniques for MTX detection. Although the reported methods offer comparatively acceptable sensitivity and specificity, some have limitations. As previously mentioned, liquid chromatography methods are high-cost and time-consuming methods, and operating procedures are usually very complicated. Electrochemical methods show high sensitivity and ability to fabricate diverse types of sensing; however, their repeatability is questionable (
11,
12). However, optical-based approaches are simple and cheap with low-cost and simple instrumentation (
13). The routine absorption spectroscopy and naked-eye approaches, which directly approximate the colored products, generally suffer from low sensitivity due to the restricted amplification degree of the analyte signal. Optical-based methods, especially luminescence, provide high sensitivity, which is comparable to or better than the electrochemical and separation-based methods. The main problem of optical-based approaches is the influence of interfering agents (
14) which could be reduced on the analyte signal through different approaches, such as protein precipitation and extraction methods.
Carbon dots (CDs) are zero-dimensional new advanced nanomaterials with sizes smaller than 10 nm. Regarding the type of carbon precursor and the structure, CDs could be categorized into three large types, including carbon quantum dots, carbon nanodots, and graphene quantum dots (
15). The CDs possess several benefits in sensing due to their exceptional optical and morphological properties. The high luminescence emission of CDs is their main advantage with the capability to change the emission wavelength. The size-tunable fluorescence emission of CDs can be regulated through changes in reactants (or precursors), reaction conditions, and doping of various heteroatoms. Generally, the near-infrared region is the best range for fluorescence emission due to the fact that ultraviolet emission can be harmful to biomolecules, and visible emissions are mainly absorbed by various biological molecules (
16).
The photostability of CDs is another advantage. As compared to traditional fluorophores, such as organic dyes, CDs are highly stable materials even in the body, which confirms their low bleaching in the body. In addition, the produced CDs showed high stock solution stability, which could be stored at ambient temperature for months. As compared to organic dyes, CDs are biocompatible materials and could be used as biosensing probes without any serious effect on the organism (
17). In addition, several surface functional groups, such as hydroxyl, aldehydes, carboxylic acid, and amines, are available on the surface of CDs which could be applied for secondary modifications. Furthermore, the synthesis and production of CDs are simple and cheap. These unique benefits of CDs propose various approaches for sensitive and specific sensing of different analytes. Furthermore, highly fluorescent CDs are appropriate for high-resolution bioimaging of tumor cancer cells (
17).
The current study synthesized novel nitrogen, sulfur, phosphorus, and boron-doped (N, S, P, B-codoped) CDs for the first time through a simple hydrothermal approach. The produced N, S, P, B-codoped CDs were applied as a fluorescence nanoprobe for the sensitive and specific detection of MTX in real plasma samples and cell lysates. Additionally, the produced CDs showed a potential for bioimaging cancer cells. It is noteworthy that the produced CDs showed biocompatible nature even at high concentrations, confirmed as nontoxic agents for cell bioimaging (
18,
19).