{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:10:40Z","timestamp":1790071840785,"version":"4.0.1"},"reference-count":40,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biosensors"],"abstract":"<jats:p>Background: Wearable sweat biosensors have emerged as a promising non-invasive approach for monitoring inflammatory biomarkers, offering an alternative to repeated blood sampling. This systematic review evaluated the current evidence on the detection of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-\u03b1 (TNF-\u03b1) in sweat for infection and inflammatory disease monitoring. Methods: Following PRISMA 2020 guidelines (PROSPERO: CRD420261371221), PubMed\/MEDLINE, Scopus, Web of Science, IEEE Xplore, and Google Scholar were searched through April 2026. Human studies measuring CRP, IL-6, or TNF-\u03b1 in sweat using wearable or biosensor-based platforms were included. Risk of bias and certainty of evidence were assessed using a modified Newcastle\u2013Ottawa Scale\/JBI checklist and GRADE. Results: Thirteen studies (2020\u20132025, 5\u201380 participants) were included. CRP showed the most consistent sweat-serum agreement (r = 0.844) and good diagnostic performance in one inflammatory bowel disease cohort (AUC = 0.845). TNF-\u03b1 demonstrated the highest diagnostic accuracy in a single longitudinal study (AUC = 0.962), whereas IL-6 showed moderate sweat-serum correlations (R2 = 0.60\u20130.72) but limited diagnostic discrimination. IL-6 and TNF-\u03b1 were more consistently detected in passively collected eccrine sweat, although IL-6 was also successfully measured following pilocarpine iontophoresis in one study. Most studies had moderate methodological quality. Conclusions: Sweat-based measurement of CRP, IL-6, and TNF-\u03b1 is analytically feasible for non-invasive inflammatory biomarker monitoring. However, current evidence remains limited by small, heterogeneous studies, underscoring the need for standardized protocols and larger prospective clinical validation.<\/jats:p>","DOI":"10.3390\/bios16090521","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:04:17Z","timestamp":1790067857000},"page":"521","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Wearable Sweat Biosensors for Inflammatory Biomarkers (CRP, IL-6 and TNF-\u03b1): A Systematic Review of Analytical and Clinical Evidence"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8506-0799","authenticated-orcid":false,"given":"Raghad S.","family":"Alsharidah","sequence":"first","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9223-1951","authenticated-orcid":false,"given":"Razique","family":"Anwer","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maysoon Anwar","family":"Abdelhamid","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman Amer","family":"Alanazi","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah Mfwadh","family":"Alanazi","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haneen Fahaid","family":"Alanazi","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jumanah Naif","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0700-5705","authenticated-orcid":false,"given":"Lama Abdulaziz","family":"Alshathri","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6326-492X","authenticated-orcid":false,"given":"Renad Ali","family":"Alshehri","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rania","family":"Alsuhibani","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0939-3459","authenticated-orcid":false,"given":"Raghad H.","family":"Majrashi","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2004433","DOI":"10.1002\/advs.202004433","article-title":"Cytokines: From clinical significance to quantification","volume":"8","author":"Liu","year":"2021","journal-title":"Adv. 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