1
|
Liu F, Zhang Y, Wang J, Ji J. Rapid detection of 10 benzodiazepines and metabolites in blood and urine using DART-MS/MS. Drug Test Anal 2024; 16:817-826. [PMID: 37715497 DOI: 10.1002/dta.3576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/02/2023] [Accepted: 09/01/2023] [Indexed: 09/17/2023]
Abstract
Benzodiazepines are essential screening targets for common sleeping and sedative drugs used in forensic toxicology. Direct analysis in real-time tandem mass spectrometry was used to rapidly identify 10 benzodiazepines and related metabolites in the blood and urine. The related direct analysis in real-time tandem mass spectrometry parameters were optimized. A liquid-liquid extraction method using ethyl acetate as the extraction solvent was used for sample preparation. The established method was validated and tested on case specimens. The limits of detection of this method ranged from 0.2 to 20 ng/mL and the limits of quantification from 1 to 50 ng/mL. The recoveries ranged from 78.8% to 114%, and the matrix effects were in the range of -21.2% to 17.9%. The precision and repeatability at high and medium concentrations did not exceed 14.6%, and the limit of quantification did not exceed 18.2%, indicating a desirable linear relationship. The established method was used to determine blood and urine specimens from authentic cases, and promising results were obtained.
Collapse
Affiliation(s)
- Fubang Liu
- School of Criminal Investigation, People's Public Security University of China, Beijing, China
- Forensic Science Service of Beijing Public Security Bureau, Key Laboratory of Forensic Toxicology, Ministry of Public Security, Beijing, China
| | - Ying Zhang
- Forensic Science Service of Beijing Public Security Bureau, Key Laboratory of Forensic Toxicology, Ministry of Public Security, Beijing, China
| | - Jifen Wang
- School of Criminal Investigation, People's Public Security University of China, Beijing, China
| | - Jiahua Ji
- School of Criminal Investigation, People's Public Security University of China, Beijing, China
| |
Collapse
|
2
|
Fernández-López L, Rodríguez S, Cánovas-Cabanes A, Teruel-Fernández FJ, Almela P, del Rincón JPH, Navarro-Zaragoza J, Falcón M. Identification of Benzodiazepine Use Based on Dried Blood Stains Analysis. Pharmaceuticals (Basel) 2024; 17:799. [PMID: 38931466 PMCID: PMC11206677 DOI: 10.3390/ph17060799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/07/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Biological matrices are typically used in forensic toxicological or pharmacological analysis: mainly blood, vitreous humor or urine. However, there are many cases in which crimes are a consequence of drug intoxication or drug abuse and they are not closed because over the months or years the samples become altered or decomposed. A dried blood stains test (DBS-MS) has recently been proposed to be used in drug toxicology when blood is found at a crime scene. This test could help an investigator to reveal what a person had consumed before the perpetration of the crime. In order to check the possibilities of this test, we analyzed several dried blood stains located on a cotton fabric. Therefore, the aim of this study was to determine if the analysis of a dried blood spot located on a cotton fabric could be an alternate source of obtaining toxicological results, particularly regarding benzodiazepines. We splashed blood stains on cotton fabric with different concentrations of the following benzodiazepines: alprazolam, bromazepam, clonazepam, diazepam and lorazepam, which were dried for 96 h and subsequently quantified by high-performance liquid chromatography coupled mass spectrometry (HPLC-MS). Our results show that it is possible to identify several benzodiazepines contained in a cotton fabric blood stain; consequently, this method may add another sample option to the toxicological analysis of biological vestiges found at a crime scene.
Collapse
Affiliation(s)
- Lucía Fernández-López
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain; (L.F.-L.); (P.A.)
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
| | - Sandra Rodríguez
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
- Forensic and Legal Medicine, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain
| | - Alberto Cánovas-Cabanes
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain; (L.F.-L.); (P.A.)
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
| | - Francisco-Javier Teruel-Fernández
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain; (L.F.-L.); (P.A.)
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
| | - Pilar Almela
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain; (L.F.-L.); (P.A.)
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
| | - Juan-Pedro Hernández del Rincón
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
- Forensic and Legal Medicine, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain
| | - Javier Navarro-Zaragoza
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain; (L.F.-L.); (P.A.)
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
| | - María Falcón
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
- Forensic and Legal Medicine, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain
| |
Collapse
|
3
|
Meikopoulos T, Gika H, Theodoridis G, Begou O. Detection of 26 Drugs of Abuse and Metabolites in Quantitative Dried Blood Spots by Liquid Chromatography-Mass Spectrometry. Molecules 2024; 29:975. [PMID: 38474487 DOI: 10.3390/molecules29050975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/11/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
A method was developed for the determination of 26 drugs of abuse from different classes, including illicit drugs in quantitative dried blood spots (qDBSs), with the aim to provide a convenient method for drug testing by using only 10 μL of capillary blood. A satisfactory limit of quantification (LOQ) of 2.5 ng/mL for 9 of the compounds and 5 ng/mL for 17 of the compounds and a limit of detection (LOD) of 0.75 ng/mL for 9 of the compounds and 1.5 ng/mL for 17 of the compounds were achieved for all analytes. Reversed-phase liquid chromatography was applied on a C18 column coupled to MS, providing selective detections with both +ESI and -ESI modes. Extraction from the qDBS was performed using AcN-MeOH, 1:1 (v/v), with recovery ranging from 84.6% to 106%, while no significant effect of the hematocrit was observed. The studied drugs of abuse were found to be stable over five days under three different storage conditions (at ambient temperature 21 °C, at -20 °C, and at 35 °C), thus offering a highly attractive approach for drug screening by minimally invasive sampling for individuals that could find application in forensic toxicology analysis.
Collapse
Affiliation(s)
- Thomas Meikopoulos
- Laboratory of Analytical Chemistry, Department of Chemistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- BIOMIC_Auth, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
| | - Helen Gika
- BIOMIC_Auth, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
- Laboratory of Forensic Medicine & Toxicology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Georgios Theodoridis
- Laboratory of Analytical Chemistry, Department of Chemistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- BIOMIC_Auth, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
- ThetaBiomarkers, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), Balkan Center, 10th Km Thessaloniki-Thermi Rd., P.O. Box 8318, 57001 Thessaloniki, Greece
| | - Olga Begou
- BIOMIC_Auth, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
- ThetaBiomarkers, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), Balkan Center, 10th Km Thessaloniki-Thermi Rd., P.O. Box 8318, 57001 Thessaloniki, Greece
| |
Collapse
|
4
|
Wu D, Fu L. Recent findings and advancements in the detection of designer benzodiazepines: a brief review. Arh Hig Rada Toksikol 2023; 74:224-231. [PMID: 38146763 PMCID: PMC10750316 DOI: 10.2478/aiht-2023-74-3771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/01/2023] [Accepted: 11/01/2023] [Indexed: 12/27/2023] Open
Abstract
This review article takes a closer look at a new class of psychoactive substances called designer benzodiazepines (DBZs) and the challenges of their detection. These are adinazolam, clonazolam, deschloroetizolam, diclazepam, etizolam, flualprazolam, flubromazepam, flubromazolam, phenazepam, and pyrazolam. They are central nervous system depressants and sedatives that can cause psychomotor impairment and increase the overdose risk when combined with other sedatives. DBZs undergo phase I and II metabolism similar to traditional benzodiazepines, but their specific metabolic pathways and the influence of genetic polymorphisms are yet to be clarified. Advances in liquid chromatography-tandem mass spectrometry (LC-MS/MS) have enhanced the method's sensitivity for DBZs and their metabolites in biological samples and coupled with improved blood sampling methods require less blood for drug monitoring. Further research should focus on elucidating their pharmacokinetic properties and metabolism in humans, especially in view of genetic polymorphisms and drug interactions that could inform clinical treatment choices. Even though we have witnessed important advances in DBZ detection and measurement, further refinements are needed to expand the scope of detectable DBZs and their metabolites. All this should help toxicological research to better identify and characterise the risks of chronic and polydrug abuse and facilitate clinical, forensic, and regulatory responses to this growing issue.
Collapse
Affiliation(s)
- Dihua Wu
- Hangzhou Dianzi University College of Materials and Environmental Engineering, Hangzhou, China
| | - Li Fu
- Hangzhou Dianzi University College of Materials and Environmental Engineering, Hangzhou, China
| |
Collapse
|
5
|
Zhang YX, Zhang Y, Bian Y, Liu YJ, Ren A, Zhou Y, Shi D, Feng XS. Benzodiazepines in complex biological matrices: Recent updates on pretreatment and detection methods. J Pharm Anal 2023. [DOI: 10.1016/j.jpha.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
|
6
|
Abarca R, Gerona R. Development and validation of an LC-MS/MS assay for the quantitative analysis of alprazolam, α-hydroxyalprazolam and hydrocodone in dried blood spots. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1220:123639. [PMID: 36906954 DOI: 10.1016/j.jchromb.2023.123639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/03/2023] [Accepted: 02/14/2023] [Indexed: 03/07/2023]
Abstract
Dried blood spot (DBS) has been used as an alternative matrix in drug testing. In forensic testing it offers enhanced stability of analytes and ease of storage that requires minimal space. This is compatible with long term archiving of large numbers of samples for future investigation. We employed liquid chromatography-tandem mass spectrometry (LC-MS/MS) to quantify alprazolam, α-hydroxyalprazolam, and hydrocodone in a DBS sample that has been stored for 17 years. We achieved linear dynamic ranges (0.1-50 ng/mL) that capture wide ranges of concentration of the analytes below and above their reported reference ranges, and limits of detection (0.05 ng/mL) of 40-100X lower than the lower limit of the analyte's reference ranges. The method was validated according to FDA and CLSI guidelines and successfully confirmed and quantified alprazolam and α-hydroxyalprazolam in a forensic DBS sample.
Collapse
Affiliation(s)
- Radek Abarca
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, USA
| | - Roy Gerona
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, USA.
| |
Collapse
|
7
|
Almofti N, Ballesteros-Gómez A, Rubio S, Girela-López E. Analysis of conventional and nonconventional forensic specimens in drug-facilitated sexual assault by liquid chromatography and tandem mass spectrometry. Talanta 2022; 250:123713. [PMID: 35779361 DOI: 10.1016/j.talanta.2022.123713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/22/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
The incidence of drug-facilitated sexual assault (DFSA) has dramatically increased in the last decades. Forensic analytical scientists continuously seek new methods and specimens to prove the incidence of intoxication for the judiciary system. Factors influencing sample selection include the ease of obtaining the samples and the window of detection of the drugs, among others. Both conventional (blood, urine) and non-conventional specimens (hair, nails, fluids) have been proposed as suitable in DFSA cases. Reported sample treatments include a variety of liquid-liquid and solid-phase extraction as well as dilute-and-shoot procedures and microextraction techniques. Regarding analysis, liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) has emerged as the preferred confirmatory technique, due to its sensitivity, selectivity, and wide-scope applicability. In this review, we critically discuss the most common specimens and sample treatments/analysis procedures (related to LC-MS/MS) that have been reported during the last ten years. As a final goal, we intend to provide a critical overview and suggest analytical recommendations for the establishment of suitable analytical strategies in DFSA cases.
Collapse
Affiliation(s)
- N Almofti
- Department of Analytical Chemistry, Institute of Fine Chemistry and Nanochemistry, Marie Curie Annex Building, Campus of Rabanales, University of Córdoba, 14071, Córdoba, Spain; Section of Forensic and Legal Medicine, Department of Morphological and Sociosanitary Sciences, Faculty of Medicine and Nursing, University of Córdoba, 14071, Córdoba, Spain
| | - A Ballesteros-Gómez
- Department of Analytical Chemistry, Institute of Fine Chemistry and Nanochemistry, Marie Curie Annex Building, Campus of Rabanales, University of Córdoba, 14071, Córdoba, Spain.
| | - S Rubio
- Department of Analytical Chemistry, Institute of Fine Chemistry and Nanochemistry, Marie Curie Annex Building, Campus of Rabanales, University of Córdoba, 14071, Córdoba, Spain
| | - E Girela-López
- Section of Forensic and Legal Medicine, Department of Morphological and Sociosanitary Sciences, Faculty of Medicine and Nursing, University of Córdoba, 14071, Córdoba, Spain
| |
Collapse
|
8
|
Validation of a dried blood spot method to measure tacrolimus concentrations in small volumes of mouse blood. Bioanalysis 2022; 14:441-449. [PMID: 35289217 DOI: 10.4155/bio-2021-0247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The small blood volume of mice complicates tacrolimus pharmacokinetic studies in these animals. Here we explored dried blood spot (DBS) as a novel method to measure tacrolimus blood concentrations in mice. DBS samples were collected from three sampling sites (cheek, tail and heart) and compared with heart whole blood samples measured via LC-MS/MS. Results: Tacrolimus concentrations in the whole blood samples ranged from 2.56 to 27.64 μg/l. DBS of cheek vein blood was the most reliable sampling site, with a mean bias of 0.15 μg/l (95% CI: -4.20 to 4.50). Conclusion: The DBS cheek method can be used for serial monitoring of tacrolimus blood concentrations in mice, offering an animal-friendly method for tacrolimus pharmacokinetic studies in mice.
Collapse
|
9
|
Fabris AL, Yonamine M. Dried matrix spots in forensic toxicology. Bioanalysis 2021; 13:1441-1458. [PMID: 34551580 DOI: 10.4155/bio-2021-0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Dried matrix spots (DMS) has gained the attention of different professionals in different fields, including toxicology. Investigations have been carried out in order to assess the potential of using DMS for the analysis of illicit substances, the main interest of forensic toxicologists. This technique uses minimal volumes of samples and solvents, resulting in simple and rapid extraction procedures. Furthermore, it has proved to increase analyte stability, improving storage and transportation. However, DMS presents some limitations: the hematocrit influencing accuracy and inconsistencies regarding the means of spotting samples and adding internal standard on paper. Thus, we provide an overview of analytical methodologies with forensic applications focusing on drugs of abuse and discussing the main particularities, limitations and achievements.
Collapse
Affiliation(s)
- André Luis Fabris
- Department of Clinical & Toxicological Analyses, School of Pharmaceutical Sciences, University of Sao Paulo, Av. Professor Lineu Prestes, 580, 13B, Sao Paulo, SP, 05508-000, Brazil
| | - Mauricio Yonamine
- Department of Clinical & Toxicological Analyses, School of Pharmaceutical Sciences, University of Sao Paulo, Av. Professor Lineu Prestes, 580, 13B, Sao Paulo, SP, 05508-000, Brazil
| |
Collapse
|
10
|
Moretti M, Freni F, Carelli C, Previderé C, Grignani P, Vignali C, Cobo-Golpe M, Morini L. Analysis of Cannabinoids and Metabolites in Dried Urine Spots (DUS). Molecules 2021; 26:molecules26175334. [PMID: 34500772 PMCID: PMC8434267 DOI: 10.3390/molecules26175334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 12/02/2022] Open
Abstract
Dried urine spots (DUS) represent a potential alternative sample storage for forensic toxicological analysis. The aim of the current study was to develop and validate a liquid chromatographic tandem mass spectrometric procedure for the detection and quantitative determination of cannabinoids and metabolites in DUS. A two-step extraction was performed on DUS and urine samples. An LC-MS/MS system was operated in multiple reaction monitoring and positive polarization mode. The method was checked for sensitivity, specificity, linearity, accuracy, precision, recovery, matrix effects and carryover. The method was applied to 70 urine samples collected from healthy volunteers and drug addicts undergoing withdrawal treatment. The method was successfully developed for DUS. LODs lower than 2.0 ng/mL were obtained for all the monitored substances. All the validation parameters fulfilled the acceptance criteria either for DUS or urine. Among the real samples, 45 cases provided positive results for at least one compound. A good quali-quantitative agreement was obtained between DUS and urine. A good stability of THC, THCCOOH and THCCOOH-gluc was observed after a 24 h storage, in contrast to previously published results. DUS seems to provide a good alternative storage condition for urine that should be checked for the presence of cannabinoids and metabolites.
Collapse
Affiliation(s)
- Matteo Moretti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Francesca Freni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Claudia Carelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Carlo Previderé
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Pierangela Grignani
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Claudia Vignali
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Maria Cobo-Golpe
- Servizo de Toxicología, Instituto de Ciencias Forenses, Universidade de Santiago de Compostela, San Francisco s/n, 27002 Santiago de Compostela, Spain;
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
- Correspondence:
| |
Collapse
|
11
|
Vignali C, Moretti M, Quaiotti J, Freni F, Tajana L, Osculati AMM, Morini L. Distribution of Fluvoxamine and Identification of the Main Metabolite in a Fatal Intoxication. J Anal Toxicol 2021; 45:e1-e5. [PMID: 32672818 DOI: 10.1093/jat/bkaa084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 01/21/2023] Open
Abstract
Fluvoxamine is a selective serotonin reuptake inhibitor, with a half-life of about 30 hours, that is commonly prescribed in the treatment of depression and obsessive and compulsive disorders. Though its more favorable adverse effect profile in comparison to tricyclic antidepressants, overdosages could lead to severe central nervous system depression. We hereby report the case of a 48-year-old woman with psychiatric disorders, who died in the Protected Community where she lived. An autopsy, during which multiorgan congestion and aspiration of gastric content were found, was performed 9 days after the death. Femoral and cardiac blood, urine and bile were collected for toxicological analysis. GC-MS, LC-MS-MS and LC-HRMS screenings were performed on blood samples. The analysis allowed to identify the following drugs: fluvoxamine, clotiapine, 7-aminoclonazepam, propranolol, gabapentin and haloperidol. Quantification of the detected drugs in blood was performed by means of a validated LC-MS-MS analytical procedure, and the following results were achieved: fluvoxamine (2.20 mg/L), gabapentin (41.00 mg/L), 7-aminoclonazepam (0.24 mg/L), clotiapine (0.07 mg/L), haloperidol (<0.01 mg/L) and propranolol (0.24 mg/L). Fluvoxamine concentration in blood exceeded ~10 times the upper limit of therapeutic blood levels (0.23 mg/L). Contributory causes of death, such as due to multiple drug use, however, cannot be excluded. The distribution of fluvoxamine in all biological fluids was evaluated and a postmortem redistribution effect was observed (C/P blood ratio: 1.86). Fluvoxamine acid metabolite was identified in urine, bile and in cardiac blood, through an LC-QTOF analytical procedure.
Collapse
Affiliation(s)
- Claudia Vignali
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
| | - Matteo Moretti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
| | - Jessica Quaiotti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
| | - Francesca Freni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
| | - Luca Tajana
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
| | - Antonio Marco Maria Osculati
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
| |
Collapse
|
12
|
Degreef M, Vits L, Berry EM, Maudens KEK, van Nuijs ALN. Quantification of 54 Benzodiazepines and Z-Drugs, Including 20 Designer Ones, in Plasma. J Anal Toxicol 2021; 45:141-153. [PMID: 32507898 DOI: 10.1093/jat/bkaa059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/03/2020] [Accepted: 04/19/2020] [Indexed: 02/07/2023] Open
Abstract
Benzodiazepines are widely used in the treatment of sleep and anxiety disorders, as well as epileptic seizures and alcohol withdrawal because of their broad therapeutic index and low cost. Due to their central nervous system depressant effects they are also often implicated in traffic accidents and drug-related intoxications. With an increasing number of designer benzodiazepines used in a recreational setting, there is a need for analytical methods to be able to quantify both the prescribed and designer benzodiazepines. A liquid chromatography-triple quadrupole mass spectrometry method was developed for the quantification of 34 prescribed and 20 designer benzodiazepines in plasma. Different sample preparation strategies, including protein precipitation, liquid-liquid extraction, solid-phase extraction and mini-QuEChERS, were tested. The best recoveries for all compounds of interest were obtained with a liquid-liquid extraction using methyl-tertiary-butyl-ether and 500 μL plasma. The method was fully validated according to the European Medicines Agency guidelines for all compounds, except pivoxazepam, which is included for qualitative purposes only. In-sample stability issues were observed for cloxazolam, both at ambient temperature and during long-term storage at -20°C. Due to the large number of compounds included, the simple and time-efficient sample preparation and the relatively inexpensive instrumentation used, the presented method can be readily implemented in both therapeutic drug monitoring and forensic analyses.
Collapse
Affiliation(s)
- Maarten Degreef
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - Lore Vits
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - Eleanor M Berry
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | | | | |
Collapse
|
13
|
Moretti M, Manfredi A, Freni F, Previderé C, Osculati AMM, Grignani P, Tronconi L, Carelli C, Vignali C, Morini L. A comparison between two different dried blood substrates in determination of psychoactive substances in postmortem samples. Forensic Toxicol 2021; 39:385-393. [PMID: 33488834 PMCID: PMC7812343 DOI: 10.1007/s11419-020-00567-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/20/2020] [Indexed: 11/01/2022]
Abstract
Purpose Whatman™ 903 cards represent a valid type of support for collection, storage, and analysis of dried blood spots (DBS). Whatman™ FTA (Flinders Technology Associates) are a type of cards soaked in chemicals that cause denaturation of proteins, while preserving DNA and ensuring the safe handling of DBS; to date, these cards are still rarely employed in forensic toxicology. The aim of this study was to analyze several psychoactive substances on not-dried blood on the two different cards and to compare the qualitative and quantitative results. Methods Twenty cardiac postmortem blood samples were collected and deposed on Whatman™ 903 and Whatman™ FTA cards. Spots and not-dried blood were analyzed following our validated and previously published liquid chromatography-mass spectrometry methods. Results We were able to identify: eight drugs of abuse and their metabolites (15 cases), five benzodiazepines and their metabolites (3 cases), six antidepressants (6 cases) and two antipsychotics (3 cases). We observed a perfect qualitative correspondence and a general good quantitative correlation between data obtained from not-dried blood and the two different DBS cards, except for alprazolam, diazepam, desmethyldiazepam, fluoxetine and sertraline, that showed a lower concentration on FTA. Additional experiments suggest that the chemicals, adsorbed on FTA, are not the cause of the loss of signal observed for the substances previously mentioned and that methanol should be preferred as extraction solvent. Conclusions This study proved that FTA cards are a good and a hazard-free alternative sample storage method for analysis of several psychoactive substances in postmortem blood. Supplementary Information The online version contains supplementary material available at 10.1007/s11419-020-00567-2.
Collapse
Affiliation(s)
- Matteo Moretti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Alessandro Manfredi
- Department of Medicine, Surgery and Health, University of Trieste, Piazzale Europa 1, Trieste, Italy
| | - Francesca Freni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Carlo Previderé
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Antonio Marco Maria Osculati
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy.,Legal Medicine Operative Unit, IRCCS Fondazione Mondino, Pavia, Via Mondino 2, 27100 Pavia, PV Italy
| | - Pierangela Grignani
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Livio Tronconi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy.,Legal Medicine Operative Unit, IRCCS Fondazione Mondino, Pavia, Via Mondino 2, 27100 Pavia, PV Italy
| | - Claudia Carelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Claudia Vignali
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| |
Collapse
|
14
|
Dried Blood Spot in Laboratory: Directions and Prospects. Diagnostics (Basel) 2020; 10:diagnostics10040248. [PMID: 32340321 PMCID: PMC7235996 DOI: 10.3390/diagnostics10040248] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/16/2020] [Accepted: 04/21/2020] [Indexed: 12/14/2022] Open
Abstract
Over the past few years, dried blood spot (DBS) technology has become a convenient tool in both qualitative and quantitative biological analysis. DBS technology consists of a membrane carrier (MC) on the surface of which a biomaterial sample becomes absorbed. Modern analytical, immunological or genomic methods can be employed for analysis after drying the sample. DBS has been described as the most appropriate method for biomaterial sampling due to specific associated inherent advantages, including the small volumes of biomaterials required, the absence of a need for special conditions for samples’ storage and transportation, improved stability of analytes and reduced risk of infection resulting from contaminated samples. This review illustrates information on the current state of DBS technology, which can be useful and helpful for biomedical researchers. The prospects of using this technology to assess the metabolomic profile, assessment, diagnosis of communicable diseases are demonstrated.
Collapse
|
15
|
Moretti M, Freni F, Valentini B, Vignali C, Groppi A, Visonà SD, Osculati AMM, Morini L. Determination of Antidepressants and Antipsychotics in Dried Blood Spots (DBSs) Collected from Post-Mortem Samples and Evaluation of the Stability over a Three-Month Period. Molecules 2019; 24:molecules24203636. [PMID: 31600953 PMCID: PMC6832719 DOI: 10.3390/molecules24203636] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 10/04/2019] [Accepted: 10/06/2019] [Indexed: 01/17/2023] Open
Abstract
An LC-MS/MS method for the identification and quantification of antidepressants and antipsychotics was developed on dried blood spots (DBSs). Moreover, analyte stability on DBSs within a 3-month period was monitored. Aliquots of 85 µL of blood from autopsy cases were pipetted onto DBS cards, which were dried and stored at room temperature. DBSs were analyzed in triplicate immediately, within the following 3 weeks, and after 3 months. For each analysis, a whole blood stain was extracted in phosphate buffer and purified using Solid Phase Extraction (SPE) cartridges in order to avoid matrix effects and injected in the LC-MS/MS system. Thirty-nine molecules were screened. Limits of detection (LODs) ranged between 0.1 and 3.2 ng/mL (g) and 0.1 and 5.2 ng/mL (g) for antidepressants and antipsychotics, respectively. Limits of quantification (LOQs) varied from 5 to 10.0 ng/mL for both. Sixteen cases among the 60 analyzed resulted positive for 17 different analytes; for 14 of these the method was fully validated. A general good agreement between the concentrations on DBSs and those measured in conventional blood samples (collected concurrently and stored at -20 °C) was observed. The degradation/enhancement percentage for most of the substances was lower than 20% within the 3-month period. Our results, obtained from real post-mortem cases, suggest that DBSs can be used for routine sample storage.
Collapse
Affiliation(s)
- Matteo Moretti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, 27100 Pavia, Italy.
| | - Francesca Freni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, 27100 Pavia, Italy.
| | - Beatrice Valentini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, 27100 Pavia, Italy.
| | - Claudia Vignali
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, 27100 Pavia, Italy.
| | - Angelo Groppi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, 27100 Pavia, Italy.
| | - Silvia Damiana Visonà
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, 27100 Pavia, Italy.
| | - Antonio Marco Maria Osculati
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, 27100 Pavia, Italy.
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, 27100 Pavia, Italy.
| |
Collapse
|