Further development of a liquid chromatography-high-resolution mass spectrometry/mass spectrometry-based strategy for analyzing eight biomarkers in human urine indicating toxic mushroom or Ricinus communis ingestions

Stability of PEth 16:0/18:1, 16:0/18:2, 16:0/20:4, 18:0/18:1, 18:0/18:2, and 18:1/18:1 in authentic whole blood samples (at room temperature)

Phosphatidylethanol (PEth) is a direct alcohol biomarker to monitor individuals' drinking behavior that has gained recognition in clinical and forensic settings. The increasing application of the marker makes investigation of the preanalytical handling necessary, and analyte stability deserves major attention. This study was conducted to investigate the change of six PEth homologues' concentration, stored in authentic samples of EDTA blood over a course of 30 days at room temperature (n = 62). The stability criterion of concentration being ±15% of the original concentration was fulfilled at mean for 10, 3, 2, 5, 2, and 7 days for PEth 16:0/18:1, 16:0/18:2, 16:0/20:4, 18:0/18:1, 18:0/18:2, and 18:1/18:1, respectively. Regarding all homologues, there were samples in which concentration had declined by >15% or by more than the critical difference on day 1. Overall, calculated concentration declines were very inhomogeneous, with inter-sample differences of 43%-73% after 30 days. PEth 16:0/18:2, 16:0/20:4, and 18:0/18:2 declined to a greater extent than PEth 16:0/18:1. Blood alcohol concentration was measured >0.1‰ in 25 samples. Three of the six samples that exceeded 115% of initial concentrations were positive for blood alcohol. The study results add to the previously reported information on PEth stability and firstly look at six homologues in comparison. Due to the high scatter of stability among the samples and the observed poor stabilities in some, it can be concluded that transportation and storage times, especially if cooling cannot be provided, must be kept short. If analyzing from dried blood, spotting should preferably be conducted at the site of sampling.

Application to several suspected poisoning cases of a validated analytical method for the determination of muscarine in human biological matrices using liquid chromatography with high-resolution mass spectrometry detection

Despite prevention efforts, many cases of mushroom poisoning are reported around the world every year. Among the different toxins implicated in these poisonings, muscarine may induce parasympathetic neurological damage. Muscarine poisonings are poorly reported in the current literature, implying a lack of available data on muscarine concentrations in human matrices. A validated liquid chromatography with high-resolution mass spectrometry detection (Orbitrap technology) method was developed to determine muscarine concentrations in human urine, plasma, and whole blood samples. Muscarine was determined using 100 μL of biological fluids, and precipitation was used for sample preparation. Liquid chromatography-mass spectrometry was performed using an Accucore Phenyl-X analytical column with the electrospray source in positive ion mode. Muscarine was quantitated in parallel reaction monitoring (PRM) mode with D9-muscarine as the internal standard. The method was validated successfully over the concentration range 0.1-100 μg/L for plasma and whole blood and 1-100 μg/L for urine, with acceptable precision and accuracy (<13.5%), including the lower limit of quantification. Ten real cases of suspected muscarine poisoning were successfully confirmed with this validated method. Muscarine concentrations in these cases ranged from 0.12 to 14 μg/L in whole blood, Collapse

Key Words

• blood
• high‐resolution mass spectrometry
• muscarine
• poisoning
• urine

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MESH Headings

• Humans
• Muscarine/analysis
• Tandem Mass Spectrometry/methods
• Chromatography, Liquid/methods
• Mushroom Poisoning/diagnosis
• Mushroom Poisoning/urine
• Body Fluids/chemistry
• Chromatography, High Pressure Liquid/methods

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Affiliation(s)

Estelle Flament Laboratory LAT LUMTOX, La Voulte sur Rhône, France
Jean-Michel Gaulier CHU Lille, Laboratory of toxicology, Lille, France
Nathalie Paret Poison Control Centre of Lyon, SHUPT, Hospices Civils de Lyon, Lyon, France
Nathalie Jarrier Poison Control Centre of Lyon, SHUPT, Hospices Civils de Lyon, Lyon, France
Chloé Bruneau Poison Control Centre of Angers, CHU, Angers, France
Gaelle Creusat Poison Control Centre of Nancy, University Hospital, Nancy, France
Jérôme Guitton CHU Lyon, Medical unity Pharmacology-Pharmacogenetic-Toxicology, Pierre Bénite, France Faculty of Pharmacy Lyon, Toxicology Laboratory, Lyon, France
Yvan Gaillard Laboratory LAT LUMTOX, La Voulte sur Rhône, France

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Present and future of metabolic and metabolomics studies focused on classical psychedelics in humans

Psychedelics are classical hallucinogen drugs that induce a marked altered state of consciousness. In recent years, there has been renewed attention to the possible use of classical psychedelics for the treatment of certain mental health disorders. However, further investigation to better understand their biological effects in humans, their mechanism of action, and their metabolism in humans is needed when considering the development of future novel therapeutic approaches. Both metabolic and metabolomics studies may help for these purposes. On one hand, metabolic studies aim to determine the main metabolites of the drug. On the other hand, the application of metabolomics in human psychedelics studies can help to further understand the biological processes underlying the psychedelic state and the mechanisms of action underlying their therapeutic potential. This review presents the state of the art of metabolic and metabolomic studies after lysergic acid diethylamide (LSD), mescaline, N,N-dimethyltryptamine (DMT) and β-carboline alkaloids (ayahuasca brew), 5-methoxy-DMT and psilocybin administrations in humans. We first describe the characteristics of the published research. Afterward, we reviewed the main results obtained by both metabolic and metabolomics (if available) studies in classical psychedelics and we found out that metabolic and metabolomics studies in psychedelics progress at two different speeds. Thus, whereas the main metabolites for classical psychedelics have been robustly established, the main metabolic alterations induced by psychedelics need to be explored. The integration of metabolomics and pharmacokinetics for investigating the molecular interaction between psychedelics and multiple targets may open new avenues in understanding the therapeutic role of psychedelics.

Current state-of-the-art approaches for mass spectrometry in clinical toxicology: an overview

INTRODUCTION

Hyphenated mass spectrometry (MS) has evolved into a very powerful analytical technique of high sensitivity and specificity. It is used to analyze a very wide spectrum of analytes in classical and alternative matrices. The presented paper will provide an overview of the current state-of-the-art of hyphenated MS applications in clinical toxicology primarily based on review articles indexed in PubMed (1990 to April 2023).

AREAS COVERED

A general overview of matrices, sample preparation, analytical systems, detection modes, and validation and quality control is given. Moreover, selected applications are discussed.

EXPERT OPINION

A more widespread use of hyphenated MS techniques, especially in systematic toxicological analysis and drugs of abuse testing, would help overcome limitations of immunoassay-based screening strategies. This is currently hampered by high instrument cost, qualification requirements for personnel, and less favorable turnaround times, which could be overcome by more user-friendly, ideally fully automated MS instruments. This would help making hyphenated MS-based analysis available in more laboratories and expanding analysis to a large number of organic drugs, poisons, and/or metabolites. Even the most recent novel psychoactive substances (NPS) could be presumptively identified by high-resolution MS methods, their likely presence be communicated to treating physicians, and be confirmed later on.

Analytical methods for amatoxins: A comprehensive review

Amatoxins are toxic bicyclic octapeptides found in certain wild mushroom species, particularly Amanita phalloides. These mushrooms contain predominantly α- and β-amanitin, which can lead to severe health risks for humans and animals if ingested. Rapid and accurate identification of these toxins in mushroom and biological samples is crucial for diagnosing and treating mushroom poisoning. Analytical methods for the determination of amatoxins are critical to ensure food safety and prompt medical treatment. This review provides a comprehensive overview of the research literature on the determination of amatoxins in clinical specimens, biological and mushroom samples. We discuss the physicochemical properties of toxins, highlighting their influence on the choice of the analytical method and the importance of sample preparation, particularly solid-phase extraction with cartridges. Chromatographic methods are emphasised with a focus on liquid chromatography coupled to mass spectrometry as one of the most relevant analytical method for the determination of amatoxins in complex matrices. Furthermore, current trends and future perspectives in amatoxin detection are also suggested.