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Triolo V, Spanò M, Buscemi R, Gioè S, Malta G, Čaplinskiene M, Vaiano F, Bertol E, Zerbo S, Albano GD, Argo A. EtG Quantification in Hair and Different Reference Cut-Offs in Relation to Various Pathologies: A Scoping Review. TOXICS 2022; 10:toxics10110682. [PMID: 36422890 PMCID: PMC9696213 DOI: 10.3390/toxics10110682] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 06/02/2023]
Abstract
Ethyl glucuronide (EtG) is a non-volatile, non-oxidative, hydrophilic, and stable ethanol phase II metabolite. EtG is produced through ethanol glucuronidation by UDP-glucuronosyltransferase (UGT), a phase II enzyme. EtG can be extracted from different biological matrices, including keratin ones, such as hair or nails. The purpose of this scoping review is to describe the relationship between EtG levels in hair and some of the most common and frequent pathological conditions and verify whether different reference cut-offs in relation to various pathologies have been identified in the scientific literature. In fact, in-depth knowledge of the influence of pathologies, such as diabetes mellitus, hepatic and renal dysfunction, on EtG production and its storage in keratin matrices would allow a more appropriate interpretation of obtained data and rule out false positives or false negatives. This scoping review is based on bibliographic research carried out on PubMed regarding the quantification of EtG in hair of subjects affected by different pathological conditions. According to the scientific literature, the main and most common pathologies that can affect the concentration of EtG in hair are liver and kidney diseases and diabetes. The EtG quantification analytical data should be interpreted carefully as they may have a great impact in both forensic and clinical contexts.
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Affiliation(s)
- Valentina Triolo
- Policlinic Hospital, AOUP “P. Giaccone”, Via del Vespro 129, 90127 Palermo, Italy
| | - Mario Spanò
- Policlinic Hospital, AOUP “P. Giaccone”, Via del Vespro 129, 90127 Palermo, Italy
- Section of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90129 Palermo, Italy
| | - Roberto Buscemi
- Section of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90129 Palermo, Italy
| | - Simona Gioè
- Policlinic Hospital, AOUP “P. Giaccone”, Via del Vespro 129, 90127 Palermo, Italy
| | - Ginevra Malta
- Section of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90129 Palermo, Italy
| | - Marija Čaplinskiene
- State Forensic Medicine Service, Mykolas Romeris University, Ateities St. 20, LT-08303 Vilnius, Lithuania
| | - Fabio Vaiano
- Forensic Toxicology Division, Department of Health Sciences, University of Firenze, 50134 Firenze, Italy
| | - Elisabetta Bertol
- Forensic Toxicology Division, Department of Health Sciences, University of Firenze, 50134 Firenze, Italy
| | - Stefania Zerbo
- Policlinic Hospital, AOUP “P. Giaccone”, Via del Vespro 129, 90127 Palermo, Italy
- Section of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90129 Palermo, Italy
| | - Giuseppe Davide Albano
- Section of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90129 Palermo, Italy
| | - Antonina Argo
- Policlinic Hospital, AOUP “P. Giaccone”, Via del Vespro 129, 90127 Palermo, Italy
- Section of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90129 Palermo, Italy
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Bastiani M, Lizot L, Da Silva A, Hahn R, Dries S, Perassolo M, Antunes M, Linden R. Improved measurement of ethyl glucuronide concentrations in hair using UPLCMS/MS for the evaluation of chronic ethanol consumption. Forensic Sci Int 2020; 306:110071. [DOI: 10.1016/j.forsciint.2019.110071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/02/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
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3
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Malaca S, Mastrobattista L, Mortali C, Giorgetti R, Zaami S. Improvement of hair testing for Ethylglucuronide by supported liquid extraction and ultra-high performance liquid chromatography tandem mass spectrometry. J Pharm Biomed Anal 2019; 174:707-710. [PMID: 31288193 DOI: 10.1016/j.jpba.2019.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 06/28/2019] [Accepted: 07/02/2019] [Indexed: 01/10/2023]
Abstract
To improve the reproducibility, suitability and speed of hair testing for Ethylglucuronide (EtG), an ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS) method was developed and validated together with a supported liquid extraction (SLE) EtG from the keratin matrix. EtG was analyzed using reversed phase chromatography with gradient elution and detection with tandem mass spectrometry operated in multiple reaction monitoring (MRM) mode via negative electrospray ionization (ESI). The method showed good linearity from limit of quantification (LOQ) to 100 pg/mg hair (r2 0.996 ± 0.004). Recovery of the analyte was always higher than 80%, whereas intra- and inter-assay precision were always better than 15%. The developed method was applied to the analysis of more than 200 samples with medico-legal and epidemiological purposes ranging from non-detection of the analyte to 88.1 pg/mg and its robustness was proved by reanalysis of six different proficiency testing samples from the Society of hair testing obtaining a Z-score always less than 2.
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Affiliation(s)
- Sara Malaca
- Research Center in Health Sciences (CICS-UBI), University of Beira Interior, Covilhã, Portugal; Laboratory of Pharmaceutical -Toxicology - UBIMedical, University of Beira Interior, Covilhã, Portugal.
| | - Luisa Mastrobattista
- National Centre on Addiction and Doping, National Institute of Health, Rome, Italy
| | - Claudia Mortali
- National Centre on Addiction and Doping, National Institute of Health, Rome, Italy
| | - Raffaele Giorgetti
- Section of Legal Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Unit of Forensic Toxicology (UoFT), Sapienza University of Rome, Rome, Italy
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Biondi A, Freni F, Carelli C, Moretti M, Morini L. Ethyl glucuronide hair testing: A review. Forensic Sci Int 2019; 300:106-119. [PMID: 31096163 DOI: 10.1016/j.forsciint.2019.05.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/29/2019] [Accepted: 05/01/2019] [Indexed: 12/18/2022]
Abstract
Ethyl glucuronide (EtG) is a minor, non-oxidative ethanol metabolite that can be detected in several matrices (e.g. blood, urine, hair, meconium) for variable periods of time. Quantification of EtG in hair (hEtG) has established itself, over recent years, as one of the most reliable biomarkers of long-term alcohol consumption habits, with the Society of Hair Testing (SoHT) offering cut-off values for assessment of both abstinence and heavy drinking (>60 g/day). Despite its high diagnostic performance, however, issues concerning inter- and intra-laboratory variability as well as data interpretation are still being investigated and represent the ultimate barrier to widespread acceptance of hEtG in the forensic context. The aim of this review is to summarize currently available analytical methods of hEtG testing, provide a framework to understand current hEtG cut-offs and their possible upcoming changes (in particular, a lower abstinence cut-off has been proposed for the 2019 revision of the SoHT consensus), and offer a schematic but exhaustive overview of the pitfalls in result reproducibility and interpretation that may limit applications of hEtG testing in the forensic context. Ultimately, the purpose of the authors is not to undermine the reliability of hEtG as an alcohol use marker, but rather to enhance it by promoting familiarization with all aspects related to it, from ethanol pharmacokinetics and EtG incorporation into hair, to sample preparation and analytical methods, to specific cases warranting close attention and additional tests for correct interpretation of hEtG results.
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Affiliation(s)
- Anna Biondi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Francesca Freni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Claudia Carelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Matteo Moretti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
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Novel zwitterionic HILIC stationary phase for the determination of ethyl glucuronide in human hair by LC-MS/MS. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1100-1101:33-38. [DOI: 10.1016/j.jchromb.2018.09.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/01/2018] [Accepted: 09/26/2018] [Indexed: 11/24/2022]
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Santunione AL, Verri P, Marchesi F, Rustichelli C, Palazzoli F, Vandelli D, Licata M, Silingardi E. The role of ethyl glucuronide in supporting medico-legal investigations: Analysis of this biomarker in different postmortem specimens from 21 selected autopsy cases. J Forensic Leg Med 2018; 53:25-30. [DOI: 10.1016/j.jflm.2017.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 09/12/2017] [Accepted: 10/30/2017] [Indexed: 11/26/2022]
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Mueller A, Jungen H, Iwersen-Bergmann S, Raduenz L, Lezius S, Andresen-Streichert H. Determination of ethyl glucuronide in human hair samples: A multivariate analysis of the impact of extraction conditions on quantitative results. Forensic Sci Int 2017; 271:43-48. [DOI: 10.1016/j.forsciint.2016.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 11/29/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
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Oppolzer D, Barroso M, Passarinha L, Gallardo E. Determination of ethyl glucuronide and fatty acid ethyl esters in hair samples. Biomed Chromatogr 2016; 31. [DOI: 10.1002/bmc.3858] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 09/15/2016] [Accepted: 09/27/2016] [Indexed: 12/28/2022]
Affiliation(s)
- David Oppolzer
- Centro de Investigação em Ciências da Saúde (CICS-UBI); Universidade da Beira Interior; Covilhã Portugal
| | - Mário Barroso
- Instituto Nacional de Medicina Legal e Ciências Forenses - Delegação do Sul; Lisbon Portugal
| | - Luís Passarinha
- Centro de Investigação em Ciências da Saúde (CICS-UBI); Universidade da Beira Interior; Covilhã Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical; Universidade da Beira Interior; Covilhã Portugal
| | - Eugenia Gallardo
- Centro de Investigação em Ciências da Saúde (CICS-UBI); Universidade da Beira Interior; Covilhã Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical; Universidade da Beira Interior; Covilhã Portugal
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Alternative sampling strategies for the assessment of alcohol intake of living persons. Clin Biochem 2016; 49:1078-91. [PMID: 27208822 DOI: 10.1016/j.clinbiochem.2016.05.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/28/2016] [Accepted: 05/01/2016] [Indexed: 01/16/2023]
Abstract
Monitoring of alcohol consumption by living persons takes place in various contexts, amongst which workplace drug testing, driving under the influence of alcohol, driving licence regranting programs, alcohol withdrawal treatment, diagnosis of acute intoxication or fetal alcohol ingestion. The matrices that are mostly used today include blood, breath and urine. The aim of this review is to present alternative sampling strategies that allow monitoring of the alcohol consumption in living subjects. Ethanol itself, indirect (carbohydrate deficient transferrin, CDT%) as well as direct biomarkers (ethyl glucuronide, EtG; ethyl sulphate, EtS; fatty acid ethyl esters, FAEEs and phosphatidylethanol species, PEths) of ethanol consumption will be considered. This review covers dried blood spots (CDT%, EtG/EtS, PEths), dried urine spots (EtG/EtS), sweat and skin surface lipids (ethanol, EtG, FAEEs), oral fluid (ethanol, EtG), exhaled breath (PEths), hair (EtG, FAEEs), nail (EtG), meconium (EtG/EtS, FAEEs), umbilical cord and placenta (EtG/EtS and PEth 16:0/18:1). Main results, issues and considerations specific to each matrix are reported. Details about sample preparation and analytical methods are not within the scope of this review.
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Bioanalytical procedures and developments in the determination of alcohol biomarkers in biological specimens. Bioanalysis 2016; 8:229-51. [DOI: 10.4155/bio.15.240] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Excessive alcohol consumption is a global problem, and consequently its evaluation is of great clinical and forensic interest. Alcohol biomarkers have been the focus of several research works in the past decades, with new compounds being studied in more recent years. The main objective of this review is to discuss topics for an analyst to consider when evaluating alcohol consumption through the analysis of alcohol biomarkers in biological specimens. For this, existing alcohol biomarkers will be reviewed, including carbohydrate-deficient transferrin, 5-hydroxytryptophol, ethanol, hemoglobin-associated acetaldehyde, fatty acid ethyl esters, ethyl glucuronide, ethyl sulfate and phosphatidylethanol. Additionally, their potential will be discussed, as well as analytical considerations, main challenges, limitations, data interpretation and existing methodologies for their determination in biological specimens.
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Nanau RM, Neuman MG. Biomolecules and Biomarkers Used in Diagnosis of Alcohol Drinking and in Monitoring Therapeutic Interventions. Biomolecules 2015; 5:1339-85. [PMID: 26131978 PMCID: PMC4598755 DOI: 10.3390/biom5031339] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 05/15/2015] [Accepted: 05/29/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The quantitative, measurable detection of drinking is important for the successful treatment of alcohol misuse in transplantation of patients with alcohol disorders, people living with human immunodeficiency virus that need to adhere to medication, and special occupational hazard offenders, many of whom continually deny drinking. Their initial misconduct usually leads to medical problems associated with drinking, impulsive social behavior, and drunk driving. The accurate identification of alcohol consumption via biochemical tests contributes significantly to the monitoring of drinking behavior. METHODS A systematic review of the current methods used to measure biomarkers of alcohol consumption was conducted using PubMed and Google Scholar databases (2010-2015). The names of the tests have been identified. The methods and publications that correlate between the social instruments and the biochemical tests were further investigated. There is a clear need for assays standardization to ensure the use of these biochemical tests as routine biomarkers. FINDINGS Alcohol ingestion can be measured using a breath test. Because alcohol is rapidly eliminated from the circulation, the time for detection by this analysis is in the range of hours. Alcohol consumption can alternatively be detected by direct measurement of ethanol concentration in blood or urine. Several markers have been proposed to extend the interval and sensitivities of detection, including ethyl glucuronide and ethyl sulfate in urine, phosphatidylethanol in blood, and ethyl glucuronide and fatty acid ethyl esters in hair, among others. Moreover, there is a need to correlate the indirect biomarker carbohydrate deficient transferrin, which reflects longer lasting consumption of higher amounts of alcohol, with serum γ-glutamyl transpeptidase, another long term indirect biomarker that is routinely used and standardized in laboratory medicine.
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Affiliation(s)
- Radu M Nanau
- In Vitro Drug Safety and Biotechnology, University of Toronto, Toronto, ON M5G 0A3, Canada.
| | - Manuela G Neuman
- In Vitro Drug Safety and Biotechnology, University of Toronto, Toronto, ON M5G 0A3, Canada.
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON M5G 0A3, Canada.
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Cabarcos P, Álvarez I, Tabernero MJ, Bermejo AM. Determination of direct alcohol markers: a review. Anal Bioanal Chem 2015; 407:4907-25. [DOI: 10.1007/s00216-015-8701-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 03/26/2015] [Accepted: 04/13/2015] [Indexed: 12/15/2022]
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Kummer N, Wille SMR, Di Fazio V, Ramírez Fernández MDM, Yegles M, Lambert WEE, Samyn N. Impact of the Grinding Process on the Quantification of Ethyl Glucuronide in Hair Using a Validated UPLC–ESI–MS-MS Method. J Anal Toxicol 2014; 39:17-23. [DOI: 10.1093/jat/bku108] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cabarcos P, Tabernero MJ, Otero JL, Míguez M, Bermejo AM, Martello S, De Giovanni N, Chiarotti M. Quantification of fatty acid ethyl esters (FAEE) and ethyl glucuronide (EtG) in meconium for detection of alcohol abuse during pregnancy: Correlation study between both biomarkers. J Pharm Biomed Anal 2014; 100:74-78. [PMID: 25137651 DOI: 10.1016/j.jpba.2014.07.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 06/30/2014] [Accepted: 07/23/2014] [Indexed: 10/25/2022]
Abstract
This article presents results from 47 meconium samples, which were analyzed for fatty acid ethyl esters (FAEE) and ethyl glucuronide (EtG) for detection of gestational alcohol consumption. A validated microwave assisted extraction (MAE) method in combination with GC-MS developed in the Institute of Forensic Science (Santiago de Compostela) was used for FAEE and the cumulative concentration of ethyl myristate, ethyl palmitate and ethyl stearate with a cut-off of 600ng/g was applied for interpretation. A simple method for identification and quantification of EtG has been evaluated by ultrasonication followed solid phase extraction (SPE). Successful validation parameters were obtained for both biochemical markers of alcohol intake. FAEE and EtG concentrations in meconium ranged between values lower than LOD and 32,892ng/g or 218ng/g respectively. We have analyzed FAEE and EtG in the same meconium aliquot, enabling comparison of the efficiency of gestational ethanol exposure detection. Certain agreement between the two biomarkers was found as they are both a very specific alcohol markers, making it a useful analysis for confirmation.
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Affiliation(s)
- Pamela Cabarcos
- Institute of Forensic Science, Forensic Toxicology Service, Faculty of Medicine, University of Santiago de Compostela, C/San Francisco s/n, 15782 Santiago de Compostela, Spain.
| | - María Jesús Tabernero
- Institute of Forensic Science, Forensic Toxicology Service, Faculty of Medicine, University of Santiago de Compostela, C/San Francisco s/n, 15782 Santiago de Compostela, Spain
| | - José Luís Otero
- Department of Biostatistics, School of Medicine, University of Santiago de Compostela, Spain
| | - Martha Míguez
- Institute of Forensic Science, Forensic Toxicology Service, Faculty of Medicine, University of Santiago de Compostela, C/San Francisco s/n, 15782 Santiago de Compostela, Spain
| | - Ana María Bermejo
- Institute of Forensic Science, Forensic Toxicology Service, Faculty of Medicine, University of Santiago de Compostela, C/San Francisco s/n, 15782 Santiago de Compostela, Spain
| | - Simona Martello
- Institute of Public Health, Section of Legal Medicine, Catholic University of Sacred Heart, Rome, L.go F. Vito 1, 00168 Rome, Italy
| | - Nadia De Giovanni
- Institute of Public Health, Section of Legal Medicine, Catholic University of Sacred Heart, Rome, L.go F. Vito 1, 00168 Rome, Italy
| | - Marcello Chiarotti
- Institute of Public Health, Section of Legal Medicine, Catholic University of Sacred Heart, Rome, L.go F. Vito 1, 00168 Rome, Italy
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Abstract
Alcohol misuse is associated with significant morbidity and mortality. Although clinical history, examination, and the use of self-report questionnaires may identify subjects with harmful patterns of alcohol use, denial or under-reporting of alcohol intake is common. Existing biomarkers for detecting alcohol misuse include measurement of blood or urine ethanol for acute alcohol consumption, and carbohydrate-deficient transferrin and gamma-glutamyl transferase for chronic alcohol misuse. There is a need for a biomarker that can detect excessive alcohol consumption in the timeframe between 1 day and several weeks. Ethyl glucuronide (EtG) is a direct metabolite of ethanol detectable in urine for up to 90 h and longer in hair. Because EtG has high specificity for excess alcohol intake, it has great potential for use in detecting "binge" drinking. Using urine or hair, this noninvasive marker has a role in a variety of clinical and forensic settings.
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Affiliation(s)
- Natalie E Walsham
- Department of Clinical Biochemistry, University Hospital Lewisham, London, United Kingdom
| | - Roy A Sherwood
- Department of Clinical Biochemistry, King's College Hospital NHS Foundation Trust, London, United Kingdom.
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Crunelle CL, Yegles M, Nuijs ALNV, Covaci A, De Doncker M, Maudens KE, Sabbe B, Dom G, Lambert WE, Michielsen P, Neels H. Hair ethyl glucuronide levels as a marker for alcohol use and abuse: a review of the current state of the art. Drug Alcohol Depend 2014; 134:1-11. [PMID: 24239414 DOI: 10.1016/j.drugalcdep.2013.10.008] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 10/07/2013] [Accepted: 10/13/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND Ethyl glucuronide (EtG) is a minor alcohol metabolite that has been proposed as a stable marker in hair to detect and quantify alcohol consumption over long time periods. METHODS We provide an outline of currently available techniques for EtG hair sample analysis and highlight the pitfalls related to data interpretation. The literature of EtG analysis has been reviewed from January 1980 up to August 2013. In addition, we present an overview of the clinical and forensic studies which have used EtG quantification in hair as a marker for alcohol consumption/abstinence and we provide suggestions for future research. RESULTS EtG is a stable marker in hair that can be used to detect and quantify alcohol consumption over long time periods. This alcohol metabolite remains in hair after complete elimination of alcohol. Currently, there are three main analytical techniques used to quantify EtG in hair: gas chromatography-mass spectrometry (GC-MS), gas chromatography-tandem mass spectrometry (GC-MS/MS), and liquid chromatography-tandem mass spectrometry (LC-MS/MS). No standardized protocols are yet available for the analysis of EtG levels in hair samples, and the current protocols vary in sample preparation and extraction procedures. Variables such as hair length, cosmetic treatment, gender, and pathophysiological conditions influence the final results and should be taken into account. CONCLUSIONS EtG quantification in hair is a useful tool for the objective detection of alcohol consumption over extended time periods, but care should be taken when interpreting the results.
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Affiliation(s)
- Cleo L Crunelle
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium; Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium.
| | - Michel Yegles
- Laboratoire National de Santé - Toxicologie, Université du Luxembourg, 162a, av. Faiencerie, L1511, Luxembourg
| | | | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium
| | - Mireille De Doncker
- Toxicology Laboratory, ZNA Stuivenberg, Lange Beeldekenstraat 267, B2060 Antwerp, Belgium
| | - Kristof E Maudens
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium
| | - Bernard Sabbe
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium; Psychiatric Hospital Sint-Norbertus, Stationstraat 22, B2570 Duffel, Belgium
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium; Psychiatric Centre Alexian Brothers, Provinciesteenweg 408, B2530 Boechout, Belgium
| | - Willy E Lambert
- Laboratory of Toxicology, Ghent University, Harelbekestraat 72, B9000 Gent, Belgium
| | - Peter Michielsen
- Department of Gastroenterology and Hepatology, University Hospital Antwerp, Wilrijkstraat 10, B2650 Antwerp, Belgium
| | - Hugo Neels
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium; Toxicology Laboratory, ZNA Stuivenberg, Lange Beeldekenstraat 267, B2060 Antwerp, Belgium
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Vincenti M, Salomone A, Gerace E, Pirro V. Application of mass spectrometry to hair analysis for forensic toxicological investigations. MASS SPECTROMETRY REVIEWS 2013; 32:312-32. [PMID: 23165962 DOI: 10.1002/mas.21364] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 08/22/2012] [Accepted: 08/22/2012] [Indexed: 05/22/2023]
Abstract
The increasing role of hair analysis in forensic toxicological investigations principally owes to recent improvements of mass spectrometric instrumentation. Research achievements during the last 6 years in this distinctive application area of analytical toxicology are reviewed. The earlier state of the art of hair analysis was comprehensively covered by a dedicated book (Kintz, 2007a. Analytical and practical aspects of drug testing in hair. Boca Raton: CRC Press and Taylor & Francis, 382 p) that represents key reference of the present overview. Whereas the traditional organization of analytical methods in forensic toxicology divided target substances into quite homogeneous groups of drugs, with similar structures and chemical properties, the current approach often takes advantage of the rapid expansion of multiclass and multiresidue analytical procedures; the latter is made possible by the fast operation and extreme sensitivity of modern mass spectrometers. This change in the strategy of toxicological analysis is reflected in the presentation of the recent literature material, which is mostly based on a fit-for-purpose logic. Thus, general screening of unknown substances is applied in diverse forensic contexts than drugs of abuse testing, and different instrumentation (triple quadrupoles, time-of-flight analyzers, linear and orbital traps) is utilized to optimally cope with the scope. Other key issues of modern toxicology, such as cost reduction and high sample throughput, are discussed with reference to procedural and instrumental alternatives.
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Affiliation(s)
- Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia A. Bertinaria, Orbassano, Turin, Italy.
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