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Zheng Y, Sparve E, Sparring S, Bergström M. Detection of Drugs in Oral Fluid Samples Using a Commercially Available Collection Device: Agreement with Urine Testing and Evaluation of A and B Samples Obtained from Employees at Different Workplace Settings with Uncontrolled Sampling Procedures. J Anal Toxicol 2021; 44:1004-1011. [PMID: 32128555 DOI: 10.1093/jat/bkaa024] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The use of oral fluid tests to detect drugs is of growing interest in various areas, including treatment centers, roadside and workplace testing. In this study, we investigated drug detection in oral fluid samples collected using a commercially available device, Oral Eze. Drug detection in oral fluid was compared to paired urine samples, which were simultaneously collected. We also evaluated the collection device by comparing A and B oral fluid samples. Finally, we studied the stability of various drugs in samples stored for at least 1 year. The drug profile was investigated by comparing the drugs detected in oral fluid samples with paired urine samples collected in a treatment center. A total of 113 paired oral fluid and urine samples were investigated for the presence of drugs in the following groups: amphetamines, benzodiazepines, opiates and opioids, cocaine and cannabis. A and B samples were collected from different workplaces through an uncontrolled sampling procedure (n = 76). The stability of drugs in A samples was assessed after storage at -20°C for 1 year. Generally, there was a good correlation between drugs detected in oral fluid samples and urine samples. The heroin metabolite, 6-MAM, was more frequently detected in oral fluid samples than in urine samples, while cannabis was better detected in urine samples. Drugs in oral fluid samples were stable when stored at -20°C for at least 1 year. However, in many positive A and B oral fluid samples, there was significant variation in the concentrations obtained. Hence, the collection device may need to be further standardized and improved.
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Affiliation(s)
- Yufang Zheng
- Clinical Chemistry, Unilabs, Mälarsjukhuset, SE-63188 Eskilstuna, Sweden
| | - Erik Sparve
- Clinical Chemistry, Unilabs, Mälarsjukhuset, SE-63188 Eskilstuna, Sweden
| | - Stefan Sparring
- Psychiatric Clinic, Mälarsjukhuset, SE-63188 Eskilstuna, Sweden
| | - Mats Bergström
- Clinical Chemistry, Unilabs, Mälarsjukhuset, SE-63188 Eskilstuna, Sweden
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González-de-la-Presa B, Fernández-Bonifacio R, Fernández-Galán E, Mares L, Muñoz R, Parra-Robert M, To-Figueras J. Evaluation of an immunoassay procedure to measure 6-monoacetylmorphine. Toxicol Mech Methods 2020; 30:450-453. [PMID: 32375552 DOI: 10.1080/15376516.2020.1760985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: 6-Monoacetylmorphine (6-MAM) is a specific metabolite of heroin. Thus, the presence of 6-MAM in urine is a definitive indication of heroin intake. The possibility of having an immunoassay procedure to measure 6-MAM would be a diagnosis tool to discriminate, among opiates-positive, those patients who have consumed heroin and those who have not.Methods: EMIT® II Plus 6-Acetylmorphine Assay was used to measure 6-MAM in urine. The positive opiate screening results were confirmed at the Toxicology laboratory of our hospital by GC-MS.Results: This study includes 63 urine samples from subjects admitted to emergency department with suspicion of opiate consumption. Specificity was evaluated in the two groups of samples studied. In the first group all samples which resulted negative by opiate immunoassay (n = 33) were negative for 6-MAM immunoassay test. Thus, the specificity obtained for 6-MAM immunoassay in this group was 100%. Regarding the second specificity study, performed in positive samples by opiate immunoassay which were negative to 6 MAM by GC-MS, the specificity decreased down to 75%. In the study of sensitivity all samples confirmed as positive to 6-MAM by confirmatory method (GC-MS) resulted positive by the screening method, thus sensitivity obtained was 100%.Discussion: In this study no FN for 6-MAM was observed and therefore the new Emit® II Plus 6- Acetylmorphine Assay procedure has a high NPV, thus a negative result with 6-MAM immunoassay practically excludes heroine consume. The positive results to 6-MAM by immunoassay should be confirmed by a more analytically specific method, such as GCMS.
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Affiliation(s)
| | - Rosa Fernández-Bonifacio
- Department of Biochemistry and Molecular Genetics & Core Lab (CDB), Hospital Clinic de Barcelona, Barcelona, Spain
| | - Esther Fernández-Galán
- Department of Biochemistry and Molecular Genetics & Core Lab (CDB), Hospital Clinic de Barcelona, Barcelona, Spain
| | - Lourdes Mares
- Department of Biochemistry and Molecular Genetics & Core Lab (CDB), Hospital Clinic de Barcelona, Barcelona, Spain
| | - Rebeca Muñoz
- Department of Biochemistry and Molecular Genetics & Core Lab (CDB), Hospital Clinic de Barcelona, Barcelona, Spain
| | - Marina Parra-Robert
- Department of Biochemistry and Molecular Genetics & Core Lab (CDB), Hospital Clinic de Barcelona, Barcelona, Spain
| | - Jordi To-Figueras
- Department of Biochemistry and Molecular Genetics & Core Lab (CDB), Hospital Clinic de Barcelona, Barcelona, Spain
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Wang L, Ni C, Shen H, Sheng Z, Liang C, Wang R, Zhang Y. Comparison of the Detection Windows of Heroin Metabolites in Human Urine Using Online SPE and LC-MS/MS: Importance of Morphine-3-Glucuronide. J Anal Toxicol 2020; 44:22-28. [PMID: 31095707 DOI: 10.1093/jat/bkz040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 02/21/2019] [Accepted: 04/24/2019] [Indexed: 11/12/2022] Open
Abstract
Heroin abuse is a serious problem that endangers human health and affects social stability. Though often being used as confirmation of heroin use, 6-monoacetylmorphine (6-MAM) has limitations due to its short detection window. To compare the detection windows of heroin metabolites (morphine (MOR), 6-MAM, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G)) in human urine, an automated online solid phase extraction (SPE) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and fully validated. The limits of detections (LODs) of the four metabolites were in the range of 1.25-5 ng/mL. Intra and inter-day precision for all the metabolites was 0.4-6.7% and 1.8-7.3%, respectively. Accuracy ranged from 92.9 to 101.7%. This method was then applied to the analysis of urine samples of 20 male heroin abusers. M3G was detected 9-11 days after admission to the drug rehabilitation institute in 40% of heroin users while MOR or M6G was not always detected. The detection window of M3G was thus the longest. Furthermore, M3G had a much higher concentration than MOR and M6G. Therefore, M3G could provide diagnostic information with regard to heroin exposure in the combination with other clues (e.g., heroin seizures at the scene).
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Affiliation(s)
- Luying Wang
- State Key Laboratory of New Drug and Pharmaceutical Process, China State Institute of Pharmaceutical Industry, Shanghai, China.,Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Chunfang Ni
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | | | - Zhenhai Sheng
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Chen Liang
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Rong Wang
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Yurong Zhang
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
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Detection of heroin intake in patients in substitution treatment using oral fluid as specimen for drug testing. Drug Alcohol Depend 2019; 198:136-139. [PMID: 30927716 DOI: 10.1016/j.drugalcdep.2019.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 02/03/2019] [Accepted: 02/05/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Detection of heroin use is among the major tasks for drug testing and can be best performed by using 6-acetylmorphine as the target analyte. This study was performed to document analytical findings in oral fluid after OF heroin intake. METHODS The samples were from routine drug testing of patients in substitution treatment. The analytical investigation was made with a forensic accredited liquid chromatography-tandem mass spectrometry method. RESULTS Out of 2814 samples, from 1875 patients, sent for routine drug testing, 406 contained one or more opiate in the drug screening when applying a cutoff limit of 1 ng/mL neat OF. Out of these 406, 314 had a measured 6-AM concentration in neat OF ≥ 1 ng/mL. The study demonstrated that 6-AM is a viable parameter in oral fluid drug testing with an about 80% sensitivity compared to using morphine and codeine as biomarkers. An additional value of using 6-AM is the confidence in concluding a heroin intake. The 6-AM concentrations varied between 1 and >1000 ng/mL, with a median value of 18.6 ng/mL. Heroin was measured in 35 samples with a median value of 0.72 ng/mL. The positive rate for opiates in urine and OF drug testing was the same, 13.5%, in similar populations of patients. CONCLUSIONS 6-AM is a preferred parameter in OF drug testing for monitoring heroin use and makes OF drug testing for detecting heroin use more effective than urine drug testing when using highly sensitive mass spectrometry methods.
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Rapid and easy determination of morphine in chafing dish condiments with colloidal gold labeling based lateral flow strips. FOOD SCIENCE AND HUMAN WELLNESS 2019. [DOI: 10.1016/j.fshw.2018.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Picht F, Beck O, Böttcher M. Evaluation of an on‐site test device for the heroin metabolite 6‐acetylmorphine in urine. Drug Test Anal 2019; 11:536-540. [DOI: 10.1002/dta.2559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/15/2018] [Accepted: 12/15/2018] [Indexed: 11/10/2022]
Affiliation(s)
| | - Olof Beck
- MVZ Labor Dessau GmbH Dessau Germany
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Liu J, Hu X, Cao F, Zhang Y, Lu J, Zeng L. A lateral flow strip based on gold nanoparticles to detect 6-monoacetylmorphine in oral fluid. ROYAL SOCIETY OPEN SCIENCE 2018; 5:180288. [PMID: 30110425 PMCID: PMC6030262 DOI: 10.1098/rsos.180288] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/14/2018] [Indexed: 05/25/2023]
Abstract
We used lateral flow strips based on gold nanoparticles to detect 6-monoacetylmorphine (6-MAM; heroin's unique metabolite) in oral fluid samples. In this competitive lateral chromatographic immunoassay, the 6-MAM was chemically synthesized and conjugated to bovine serum albumin. The results were qualitatively detected via the colour change of the test line. By using a proper sample pad, a suitable nitrocellulose membrane and a customized sponge device adsorbed the oral fluid directly from the mouth; the total test time was 3 min. The sensitivity of the assay was 4.0 ng ml-1 without any cross-reactivity with 10 normal drugs, which are widely subject to abuse, including morphine and codeine. This test could be easily used on site to detect heroin in oral fluid, and it could be a promising product in the future including for driving under the influence.
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Affiliation(s)
- Jia Liu
- School of Pharmacy, Fudan University, Shanghai 200433, People's Republic of China
- Shanghai Institute of Pharmaceutical Industry, Shanghai 200437, People's Republic of China
| | - Xiaolong Hu
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai 200083, People's Republic of China
| | - Fangqi Cao
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Research Institute of Criminal Science and Technology, Shanghai, People's Republic of China
| | - Yurong Zhang
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai 200083, People's Republic of China
| | - Jianzhong Lu
- School of Pharmacy, Fudan University, Shanghai 200433, People's Republic of China
| | - Libo Zeng
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai 200083, People's Republic of China
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Kočová Vlčková H, Pilařová V, Svobodová P, Plíšek J, Švec F, Nováková L. Current state of bioanalytical chromatography in clinical analysis. Analyst 2018; 143:1305-1325. [DOI: 10.1039/c7an01807j] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Chromatographic methods have become popular in clinical analysis in both routine and research laboratories.
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Affiliation(s)
- H. Kočová Vlčková
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
| | - V. Pilařová
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
| | - P. Svobodová
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
| | - J. Plíšek
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
| | - F. Švec
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
| | - L. Nováková
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
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Andersson M, Björkhem-Bergman L, Beck O. Possible mechanism for inhibition of morphine formation from 6-acetylmorphine after intake of street heroin. Forensic Sci Int 2015; 252:150-6. [DOI: 10.1016/j.forsciint.2015.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 04/14/2015] [Accepted: 05/03/2015] [Indexed: 12/21/2022]
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Matic M, Norman E, Rane A, Beck O, Andersson M, Elens L, Tibboel D, Fellman V, van Schaik RHN. Effect of UGT2B7 -900G>A (-842G>A; rs7438135) on morphine glucuronidation in preterm newborns: results from a pilot cohort. Pharmacogenomics 2015; 15:1589-97. [PMID: 25340733 DOI: 10.2217/pgs.14.115] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
AIM Assess association between UGT2B7 polymorphism -900G>A (rs7438135, also known as -842G>A) with morphine kinetics in preterm newborns undergoing mechanical ventilation. MATERIALS & METHODS Thirty-four infants were enrolled in a randomized clinical trial and allocated to rapid sequence intubation with remifentanil (1 µg/kg) or morphine (0.3 mg/kg). The latter group was included in our study. RESULTS Morphine plasma concentrations at 20 min post intubation were associated with postnatal age (p=0.017) and UGT2B7 -900G>A (p=0.036). UGT2B7 -900A allele carriers (n=13) had lower morphine levels compared with UGT2B7 -900G/G patients (n=2). Morphine-3-glucuronide and morphine-6-glucuronide plasma concentrations were only found to be associated with gestational and postnatal age. However, -900A allele carriers had a higher morphine-3-glucuronide:morphine metabolic ratio compared with patients genotyped as -900G/G (p=0.005), as determined by linear regression. CONCLUSION Our small pilot study illustrates that in addition to gestational and postnatal age, the UGT2B7 -900G>A polymorphism significantly alters morphine pharmacokinetics in preterm infants.
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Affiliation(s)
- Maja Matic
- Department Clinical Chemistry, Erasmus MC - University Medical Center Rotterdam, The Netherlands
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Mathias PC, Hayden JA, Laha TJ, Hoofnagle AN. Evaluation of matrix effects using a spike recovery approach in a dilute-and-inject liquid chromatography–tandem mass spectrometry opioid monitoring assay. Clin Chim Acta 2014; 437:38-42. [DOI: 10.1016/j.cca.2014.06.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 06/09/2014] [Accepted: 06/23/2014] [Indexed: 11/15/2022]
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Andersson M, Björkhem-Bergman L, Ekström L, Bergqvist L, Lagercrantz H, Rane A, Beck O. Detection of morphine-3-sulfate and morphine-6-sulfate in human urine and plasma, and formation in liver cytosol. Pharmacol Res Perspect 2014; 2:e00071. [PMID: 25505615 PMCID: PMC4186450 DOI: 10.1002/prp2.71] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 07/17/2014] [Indexed: 11/26/2022] Open
Abstract
Morphine is still the mainstay in treatment of severe pain and is metabolized in the liver mainly by glucuronidation, partly to the pharmacologically active morphine-6-glucuronide (M6G). The sulfation pathway has attracted much less attention but may also form active metabolites. The aim of the present study was to study two sulfate metabolites of morphine in humans. Urine and plasma from newborns, adult heroin addicts, and terminal cancer patients was analyzed for the presence of morphine-3-sulfate (M3S) and morphine-6-sulfate (M6S) by a new liquid chromatography – tandem mass spectrometry (LC-MS/MS) method. In addition, morphine sulfation was studied in vitro in human liver cytosol preparations. M3S was present in urine and plasma from all study groups although at lower concentrations than morphine-3-glucuronide (M3G). The plasma M3S/M3G ratio was 30 times higher in newborns than in adults indicating that the relative sulfation is more important at early stage of life. M6S was measurable in only one plasma sample from a newborn patient, and in one of the urine sample from the drug testing group. The incubation of morphine with liver cytosol extracts resulted in approximately equal rate of formation of both M3S and M6S. In conclusion, sulfation of morphine is catalyzed in human liver but this minor metabolic pathway probably lacks clinical significance. The M6S metabolite is formed at a low rate, making it undetectable in most individuals.
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Affiliation(s)
- Maria Andersson
- Division of Clinical Pharmacology, Department of Laboratory Medicine Karolinska Institute, Stockholm, Sweden
| | | | - Lena Ekström
- Division of Clinical Pharmacology, Department of Laboratory Medicine Karolinska Institute, Stockholm, Sweden
| | - Lena Bergqvist
- Department of Woman and Child Health, Karolinska Institute Stockholm, Sweden
| | - Hugo Lagercrantz
- Department of Woman and Child Health, Karolinska Institute Stockholm, Sweden
| | - Anders Rane
- Division of Clinical Pharmacology, Department of Laboratory Medicine Karolinska Institute, Stockholm, Sweden
| | - Olof Beck
- Division of Clinical Pharmacology, Department of Laboratory Medicine Karolinska Institute, Stockholm, Sweden
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Methods for urine drug testing using one-step dilution and direct injection in combination with LC–MS/MS and LC–HRMS. Bioanalysis 2014; 6:2229-44. [DOI: 10.4155/bio.14.192] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The advent of LC combined with MS made it possible to design analytical methods for urine drug testing based on the very simple concept of diluting urine with an internal standard as the sole preparation procedure prior to instrumental analysis. The number of publications using this method design increased after the development of high-efficiency LC based on sub-2 μm particles. The success of this method design for drug testing, doping control and toxicological investigations of urine is now well documented and comprise both screening and confirmation methods. The nondiscriminating nature of this method design makes it even more attractive in combination with high-resolution MS for multicomponent target and general unknown analysis applications.
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