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Baldwin AE, Hayes N, Ostrander E, Magri R, Sass N, Dos Anjos Mesquita M, Martínez M, Juliani MC, Cabral P, Fleming M. Phosphatidylethanol Levels in Postpartum Women and Their Newborns in Uruguay and Brazil. Alcohol Clin Exp Res 2020; 44:1292-1299. [PMID: 32441809 DOI: 10.1111/acer.14339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/16/2020] [Accepted: 03/27/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is increasing interest in the development of newborn screening tests to identify children at risk of fetal alcohol spectrum disorder (FASD) in order to provide these children with early intervention. Phosphatidylethanol (PEth) has emerged as a potential universal newborn screening candidate. METHODS The aim of this report was to present the results of a study designed to compare PEth levels in 1,140 postpartum women and their newborn infants in Montevideo, Uruguay, and Sao Paulo, Brazil. Self-report alcohol use during pregnancy data was collected, along with both maternal and newborn dried blood spot samples for PEth analysis. RESULTS The average age and parity of the women in the sample were 26 years of age and 2.3 pregnancies. For the Uruguay sample (n = 611), 45.8% of postpartum women had PEth levels ≥ 8 ng/ml with a mean positive PEth of 43.6 ng/ml. In contrast, 86.8% of the newborns had PEth levels ≥ 8 ng/ml, with a mean positive PEth of 77.4 ng/ml. For the Brazil sample (n = 529), 33.2% of women had PEth levels ≥ 8 ng/ml with a mean positive PEth of 31 ng/ml. In contrast, 76.9% of the Brazil newborns had PEth levels ≥ 8 ng/ml and 43.9% with a mean positive PEth of 61.1 ng/ml. PEth levels were significantly higher in newborns compared with their postpartum mothers in both the Uruguay and Brazil samples. Self-reported third-trimester alcohol was 6% in the Uruguay sample and 9.1% in the Brazil sample compared with positive maternal PEth levels in 45.8% and 33.2%, respectively. CONCLUSIONS Clinicians may want to consider newborn PEth screening in high-risk populations where prenatal alcohol use is common. The mechanism underlying significantly higher PEth levels in newborns compared with their mothers is not known.
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Affiliation(s)
- Aileen E Baldwin
- United States Drug Testing Laboratories, Inc., (AEB), Des Plaines, Illinois
| | - Nicole Hayes
- UCLA Counseling and Psychological Services, (NH), University of California Los Angeles, Los Angeles, California
| | - Erika Ostrander
- Department of Psychiatry and Behavioral Sciences, (EO, MF), Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Raquel Magri
- Facultad de Medicina, (RM), Universidad de la República, Montevideo, Uruguay
| | - Nelson Sass
- Universidade Federal de São Paulo, (NS), Clínica Obstétrica da Maternidade Escola de Vila Nova Cachoeirinha, São Paulo, Brazil
| | | | - Monica Martínez
- Facultad de Odontologia, (MM), Universidad de la República, Montevideo, Uruguay
| | | | - Pablo Cabral
- Hospital General de las Fuerzas Armadas de Uruguay, (MCJ, PC), Montevideo, Uruguay
| | - Michael Fleming
- Department of Psychiatry and Behavioral Sciences, (EO, MF), Northwestern University Feinberg School of Medicine, Chicago, Illinois
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2
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Quantitation of Ethyl-β-D-Glucuronide in Human Umbilical Cord Tissue by Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS). Methods Mol Biol 2019. [PMID: 30350294 DOI: 10.1007/978-1-4939-8823-5_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
Abstract
In utero exposure to alcohol may adversely affect the development of the embryo or fetus and result in adverse outcomes known as fetal alcohol spectrum disorders (FASD) which encompass a range of physical, behavioral, and cognitive impairments in the newborn. Since maternal self-reports are often unreliable, biomarkers of gestational alcohol consumption are necessary for accurate identification of exposed newborns at risk. Ethyl-β-D-glucuronide (EtG) is a minor phase II metabolite of ethyl alcohol (ethanol), formed by enzymatic conjugation of ethanol with glucuronic acid in the liver. As a direct biomarker for alcohol, detection of EtG in neonatal biological matrices provides accurate identification of maternal alcohol consumption and fetal alcohol exposure during pregnancy. This chapter describes the quantitation of EtG in human umbilical cord tissue by liquid chromatography tandem mass spectrometry (LC-MS/MS).
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3
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Detection of in utero ethanol exposure via ethyl glucuronide and ethyl sulfate analysis in umbilical cord and placenta. Forensic Toxicol 2018. [DOI: 10.1007/s11419-018-0439-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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4
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Swortwood MJ, Bartock SH, Scheidweiler KB, Shaw S, Filis P, Douglas A, O’Shaughnessy PJ, Soffientini U, Lucendo-Villarin B, Iredale JP, Hay DC, Fowler PA, Huestis MA. Quantification of ethyl glucuronide, ethyl sulfate, nicotine, and its metabolites in human fetal liver and placenta. Forensic Toxicol 2017. [DOI: 10.1007/s11419-017-0389-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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5
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Quifer-Rada P, Chiva-Blanch G, Jáuregui O, Estruch R, Lamuela-Raventós RM. A discovery-driven approach to elucidate urinary metabolome changes after a regular and moderate consumption of beer and nonalcoholic beer in subjects at high cardiovascular risk. Mol Nutr Food Res 2017; 61. [PMID: 28608394 DOI: 10.1002/mnfr.201600980] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 05/24/2017] [Accepted: 05/30/2017] [Indexed: 01/15/2023]
Abstract
SCOPE The aim of this work was to study the urinary metabolomics changes of participants that consumed beer, nonalcoholic beer (na-beer), and gin. METHODS AND RESULTS Thirty-three males at high cardiovascular risk between 55 and 75 years old participated in an open, randomized, crossover, controlled trial with three nutritional interventions consisting of beer, na-beer, and gin for 4 wk. Diet and physical activity was monitored throughout the study and compliance was assessed by measurement of urinary isoxanthohumol. Metabolomic analysis was performed in urine samples by LC coupled to an LTQ-Orbitrap mass spectrometer combined with univariate and multivariate statistical analysis. Ten metabolites were identified. Eight were exogenous metabolites related to beer, na-beer, or gin consumption, but two of them were related to endogenic changes: hydroxyadipic acid linked to fatty acid oxidation, and 4-guanidinobutanoic acid, which correlated with a decrease in urinary creatinine. Plasmatic acylcarnitines were quantified by targeted MS. A regular and moderate consumption of beer and na-beer decreased stearoylcarnitine concentrations. CONCLUSION Humulinone and 2,3-dihydroxy-3-methylvaleric acid showed to be potential biomarkers of beer and na-beer consumption. Moreover, the results of this trial provide new evidence that the nonalcoholic fraction of beer may increase fatty oxidation.
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Affiliation(s)
- Paola Quifer-Rada
- Department of Nutrition, Food Science and Gastronomy-XARTA-INSA-UB, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.,CIBEROBN del Instituto de Salud Carlos III, ISCIII, Madrid, Spain
| | - Gemma Chiva-Blanch
- Department of Internal Medicine, Hospital Clinic, Institute of Biomedical Investigation August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Cardiovascular Research Center (CSIC-ICCC), Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Olga Jáuregui
- Scientific and Technological Center of University of Barcelona (CCiTUB), Barcelona, Spain
| | - Ramon Estruch
- Department of Internal Medicine, Hospital Clinic, Institute of Biomedical Investigation August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Rosa M Lamuela-Raventós
- Department of Nutrition, Food Science and Gastronomy-XARTA-INSA-UB, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.,CIBEROBN del Instituto de Salud Carlos III, ISCIII, Madrid, Spain
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6
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Abstract
Fetal alcohol spectrum disorder (FASD) is a major public health issue that encompass an array of physical, neurological, and behavioral effects due to alcohol consumption during pregnancy. The classical biomarkers of FASD that are currently used lack sensitivity and specificity, and as such there is an opportunity through the use of novel metabolomics analysis to identify new biomarkers to identify those at risk for FASD, which could more effectively aid in early intervention. The focus of this minireview is to identify current work that is being done in the field of metabolomics in FASD in utero, and to highlight promising metabolites that could act as biomarkers in the future. We will conclude with suggestions for further research, as there is a large gap of knowledge in this particular area of metabolomics.
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Affiliation(s)
- Erin M Goldberg
- a Department of Human Nutritional Sciences, University of Manitoba, St. Boniface Hospital Research Center, Winnipeg, MB R2H 2A6, Canada
| | - Michel Aliani
- a Department of Human Nutritional Sciences, University of Manitoba, St. Boniface Hospital Research Center, Winnipeg, MB R2H 2A6, Canada.,b Departments of Physiology and Pathophysiology, and The Canadian Centre for Agri-Food Research in Health and Medicine (CCARM), St. Boniface Hospital Research Center, Winnipeg, MB R2H 2A6, Canada
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7
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Ferraguti G, Ciolli P, Carito V, Battagliese G, Mancinelli R, Ciafrè S, Tirassa P, Ciccarelli R, Cipriani A, Messina MP, Fiore M, Ceccanti M. Ethylglucuronide in the urine as a marker of alcohol consumption during pregnancy: Comparison with four alcohol screening questionnaires. Toxicol Lett 2017; 275:49-56. [DOI: 10.1016/j.toxlet.2017.04.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/19/2017] [Accepted: 04/24/2017] [Indexed: 10/19/2022]
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8
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Bager H, Christensen LP, Husby S, Bjerregaard L. Biomarkers for the Detection of Prenatal Alcohol Exposure: A Review. Alcohol Clin Exp Res 2017; 41:251-261. [PMID: 28098942 DOI: 10.1111/acer.13309] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 12/03/2016] [Indexed: 01/06/2023]
Abstract
Alcohol exposure during pregnancy can cause adverse effects to the fetus, because it interferes with fetal development, leading to later physical and mental impairment. The most common clinical tool to determine fetal alcohol exposure is maternal self-reporting. However, a more objective and useful method is based on the use of biomarkers in biological specimens alone or in combination with maternal self-reporting. This review reports on clinically relevant biomarkers for detection of prenatal alcohol exposure (PAE). A systematic search was performed to ensure a proper overview in existing literature. Studies were selected to give an overview on clinically relevant neonatal and maternal biomarkers. The direct biomarkers fatty acid ethyl esters (FAEEs), ethyl glucuronide (EtG), ethyl sulfate, and phosphatidylethanol (PEth) were found to be the most appropriate biomarkers in relation to detection of PAE. To review each biomarker in a clinical context, we have compared the advantages and disadvantages of each biomarker, in relation to its window of detectability, ease of collection, and the ease and cost of analysis of each biomarker. The biomarkers PEth, FAEEs, and EtG were found to be applicable for detection of even low levels of alcohol exposure. Meconium is an accessible matrix for determination of FAEEs and EtG, and blood an accessible matrix for determination of PEth.
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Affiliation(s)
- Heidi Bager
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark
| | - Lars Porskjaer Christensen
- Department of Chemical Engineering, Biotechnology and Environmental Technology, University of Southern Denmark, Odense M, Denmark
| | - Steffen Husby
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark
| | - Lene Bjerregaard
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark
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9
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Heier C, Xie H, Zimmermann R. Nonoxidative ethanol metabolism in humans-from biomarkers to bioactive lipids. IUBMB Life 2016; 68:916-923. [PMID: 27714979 PMCID: PMC5324703 DOI: 10.1002/iub.1569] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 09/19/2016] [Indexed: 12/21/2022]
Abstract
Ethanol is a widely used psychoactive drug whose chronic abuse is associated with organ dysfunction and disease. Although the prevalent metabolic fate of ethanol in the human body is oxidation a smaller fraction undergoes nonoxidative metabolism yielding ethyl glucuronide, ethyl sulfate, phosphatidylethanol and fatty acid ethyl esters. Nonoxidative ethanol metabolites persist in tissues and body fluids for much longer than ethanol itself and represent biomarkers for the assessment of ethanol intake in clinical and forensic settings. Of note, the nonoxidative reaction of ethanol with phospholipids and fatty acids yields bioactive compounds that affect cellular signaling pathways and organelle function and may contribute to ethanol toxicity. Thus, despite low quantitative contributions of nonoxidative pathways to overall ethanol metabolism the resultant ethanol metabolites have important biological implications. In this review we summarize the current knowledge about the enzymatic formation of nonoxidative ethanol metabolites in humans and discuss the implications of nonoxidative ethanol metabolites as biomarkers of ethanol intake and mediators of ethanol toxicity. © 2016 IUBMB Life, 68(12):916-923, 2016.
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Affiliation(s)
- Christoph Heier
- Institute of Molecular Biosciences, University of GrazAustria
| | - Hao Xie
- Institute of Molecular Biosciences, University of GrazAustria
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10
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Concheiro M, Lendoiro E, de Castro A, Gónzalez-Colmenero E, Concheiro-Guisan A, Peñas-Silva P, Macias-Cortiña M, Cruz-Landeira A, López-Rivadulla M. Bioanalysis for cocaine, opiates, methadone, and amphetamines exposure detection during pregnancy. Drug Test Anal 2016; 9:898-904. [PMID: 27595432 DOI: 10.1002/dta.2087] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 09/01/2016] [Accepted: 09/01/2016] [Indexed: 01/13/2023]
Abstract
Drug exposure during pregnancy constitutes a major legal issue and a public health concern. Drug and metabolite determination in biological matrices from mother and newborn is an objective indication of prenatal drug exposure. However, limited data are available regarding the interpretation of these analytical results in terms of window of detection and degree of exposure. We collected paired maternal hair, meconium, placenta, and umbilical cord from 727 mother-newborn dyads. We analyzed these specimens by liquid chromatography-tandem mass spectrometry for the determination of cocaine, opioids, methadone, and amphetamines, and compared the analytical results from the four different matrices. The cases were divided in non-exposure, low, and frequent exposure, based on maternal hair concentrations and segmental analysis by trimesters. For cocaine, 62 cases tested positive in hair, 9 in meconium, 6 in placenta and 7 in umbilical cord. In the case of opioids, 14 maternal hair cases were positive, 11 meconium and umbilical cord and 9 placenta samples. For methadone, 11 cases were positive in hair, 9 in meconium and 6 in placenta and umbilical cord. For amphetamines, 18 cases were positive according to maternal hair, but all meconium, placenta, and umbilical cord tested negative. Maternal hair was the most sensitive specimen to detect drug exposure during pregnancy. Meconium, placenta, and umbilical cord tested positive if hair concentrations showed frequent drug use during the whole pregnancy, especially during the third trimester. Meconium, placenta, and umbilical cord also tested positive for morphine and metabolites, if this drug was administered during labour and delivery. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Marta Concheiro
- John Jay College of Criminal Justice, City University of New York, New York, USA
| | - Elena Lendoiro
- Sección de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ana de Castro
- Sección de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Ana Concheiro-Guisan
- Sección de Neonatología, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Patricia Peñas-Silva
- Sección de Ginecología y Obstetricia, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Manuel Macias-Cortiña
- Sección de Ginecología y Obstetricia, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Angelines Cruz-Landeira
- Sección de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Manuel López-Rivadulla
- Sección de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
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11
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Abstract
Fetal alcohol-spectrum disorders (FASDs) are a collection of physical and neurobehavioral disabilities caused by prenatal exposure to alcohol. To prevent or mitigate the costly effects of FASD, we must identify mothers at risk for having a child with FASD, so that we may reach them with interventions. Identifying mothers at risk is beneficial at all time points, whether prior to pregnancy, during pregnancy, or following the birth of the child. In this review, three approaches to identifying mothers at risk are explored: using characteristics of the mother and her pregnancy, using laboratory biomarkers, and using self-report assessment of alcohol-consumption risk. At present, all approaches have serious limitations. Research is needed to improve the sensitivity and specificity of biomarkers and screening instruments, and to link them to outcomes as opposed to exposure. Universal self-report screening of all women of childbearing potential should ideally be incorporated into routine obstetric and gynecologic care, followed by brief interventions, including education and personalized feedback for all who consume alcohol, and referral to treatment as indicated. Effective biomarkers or combinations of biomarkers may be used during pregnancy and at birth to determine maternal and fetal alcohol exposure. The combination of self-report and biomarker screening may help identify a greater proportion of women at risk for having a child with FASD, allowing them to access information and treatment, and empowering them to make decisions that benefit their children.
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Affiliation(s)
- Annika C Montag
- Department of Pediatrics, Division of Dysmorphology and Teratology, University of California San Diego, San Diego, CA, USA
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12
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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: 32] [Impact Index Per Article: 4.0] [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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13
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Gerace E, Landucci E, Totti A, Bani D, Guasti D, Baronti R, Moroni F, Mannaioni G, Pellegrini-Giampietro DE. Ethanol Toxicity During Brain Development: Alterations of Excitatory Synaptic Transmission in Immature Organotypic Hippocampal Slice Cultures. Alcohol Clin Exp Res 2016; 40:706-16. [DOI: 10.1111/acer.13006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/08/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Elisabetta Gerace
- Department of Health Sciences; Section of Clinical Pharmacology and Oncology; University of Florence; Florence Italy
| | - Elisa Landucci
- Department of Health Sciences; Section of Clinical Pharmacology and Oncology; University of Florence; Florence Italy
| | - Arianna Totti
- Department of Health Sciences; Section of Clinical Pharmacology and Oncology; University of Florence; Florence Italy
| | - Daniele Bani
- Department of Experimental & Clinical Medicine; Section of Anatomy & Histology; Research Unit of Histology & Embryology; University of Florence; Florence Italy
| | - Daniele Guasti
- Department of Experimental & Clinical Medicine; Section of Anatomy & Histology; Research Unit of Histology & Embryology; University of Florence; Florence Italy
| | - Roberto Baronti
- Clinical Toxicology Laboratory; Local Health Service; Florence Italy
| | - Flavio Moroni
- Department of Neuroscience, Psychology, Drug Research and Child Health (NeuroFarBa); Section of Pharmacology and Toxicology; University of Florence; Florence Italy
| | - Guido Mannaioni
- Department of Neuroscience, Psychology, Drug Research and Child Health (NeuroFarBa); Section of Pharmacology and Toxicology; University of Florence; Florence Italy
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14
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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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15
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Abstract
Consumption of drugs of abuse, tobacco and alcohol throughout pregnancy is a serious public health problem and results in an important economic cost to the health system. Drug and/or metabolites determination in biological matrices from mother and newborn is an objective measure of in utero drug exposure. We reviewed methods published for the determination of in utero drug exposure from 2007 to 2014, with special focus on meconium, placenta, umbilical cord and newborn hair. Accurate bioanalytical procedures are essential to obtain high-quality data to perform interventions and to establish correlations between analytical measures and clinical outcomes. We included a brief overview of clinical implications of in utero drug exposure to better understand the importance of this serious health issue.
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16
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Placental Fatty Acid ethyl esters are elevated with maternal alcohol use in pregnancies complicated by prematurity. PLoS One 2015; 10:e0126552. [PMID: 25978403 PMCID: PMC4433254 DOI: 10.1371/journal.pone.0126552] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/03/2015] [Indexed: 11/30/2022] Open
Abstract
The accumulation of fatty acid ethyl esters (FAEEs) in meconium of term newborns has been described as one potential biomarker of maternal alcohol use during pregnancy. FAEEs accumulate in multiple alcohol-exposed fetal tissues and in the placenta. Limited research has focused on the identification of the premature newborn exposed to alcohol in utero. We hypothesized that maternal alcohol use occurs in a significant proportion of premature deliveries and that this exposure can be detected as elevated placental FAEEs. The goals of this study were to 1) determine the prevalence of maternal alcohol use in the premature newborn and 2) investigate whether placental FAEEs could identify those newborns with fetal alcohol exposure. This prospective observational study evaluated 80 placentas from 80 women after premature delivery. Subjects were interviewed for alcohol intake and placental FAEEs were quantified via GC/MS. Receiver Operator Characteristic (ROC) Curves were generated to evaluate the ability of placental FAEEs to predict maternal drinking during pregnancy. Adjusted ROC curves were generated to adjust for gestational age, maternal smoking, and illicit drug use. 30% of the subjects admitted to drinking alcohol during pregnancy and approximately 14% answered questions indicative of problem drinking (designated AUDIT+). The specific FAEEs ethyl stearate and linoleate, as well as combinations of oleate + linoleate + linolenate (OLL) and of OLL + stearate, were significantly (p<0.05) elevated in placentas from AUDIT+ pregnancies. Adjusted ROC Curves generated areas under the curve ranging from 88–93% with negative predictive values of 97% for AUDIT+ pregnancies. We conclude that nearly one third of premature pregnancies were alcohol-exposed, and that elevated placental FAEEs hold great promise to accurately determine maternal alcohol use, particularly heavy use, in pregnancies complicated by premature delivery.
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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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18
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Pesek JJ, Matyska MT, Dang A. Analysis of ethyl glucuronide and ethyl sulfate using aqueous normal-phase chromatography with mass spectrometry. J Sep Sci 2015; 38:1515-20. [DOI: 10.1002/jssc.201401307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 02/05/2015] [Accepted: 02/05/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Joseph J. Pesek
- Department of Chemistry; San Jose State University; San Jose CA USA
| | - Maria T. Matyska
- Department of Chemistry; San Jose State University; San Jose CA USA
| | - Andy Dang
- Department of Chemistry; San Jose State University; San Jose CA USA
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19
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Fu J, Liu H, Xing H, Sun H, Ma Z, Wu B. Comparative analysis of glucuronidation of ethanol in treeshrews, rats and humans. Xenobiotica 2014; 44:1067-73. [DOI: 10.3109/00498254.2014.926573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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20
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Kurogi K, Davidson G, Mohammed YI, Williams FE, Liu MY, Sakakibara Y, Suiko M, Liu MC. Ethanol sulfation by the human cytosolic sulfotransferases: a systematic analysis. Biol Pharm Bull 2013. [PMID: 23207770 DOI: 10.1248/bpb.b12-00547] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Ethyl sulfate, a minor and direct ethanol metabolite in adult human body, has been implicated as a biomarker for alcohol consumption and in utero exposure to ethanol. To understand better the physiological relevance of the sulfation of ethanol, it is important to clarify the cytosolic sulfotransferase (SULT) enzymes that are responsible for ethanol sulfation. The present study aimed to identify the major ethanol-sulfating human SULTs and to investigate the sulfation of ethanol under the metabolic setting. A systematic analysis revealed four ethanol-sulfating SULTs, SULT1A1, SULT1A2, SULT1A3, and SULT1C4, among the eleven human SULT enzymes previously prepared and purified. A metabolic labeling study demonstrated the generation and release of ethyl [(35)S]sulfate in a concentration-dependent manner by HepG2 human hepatoma cells labeled with [(35)S]sulfate in the presence of different concentrations of ethanol. Cytosol or S9 fractions of human lung, liver, and small intestine were examined to verify the presence of ethanol-sulfating activity in vivo. Of the three human organs, the small intestine displayed the highest activity.
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Affiliation(s)
- Katsuhisa Kurogi
- Department of Pharmacology, College of Pharmacy and Pharmaceutical Sciences, The University of Toledo, Toledo, OH 43614, USA
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Matlow J, Lubetsky A, Aleksa K, Berger H, Koren G. The transfer of ethyl glucuronide across the dually perfused human placenta. Placenta 2013; 34:369-73. [DOI: 10.1016/j.placenta.2012.12.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 12/17/2012] [Accepted: 12/28/2012] [Indexed: 12/20/2022]
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Joya X, Friguls B, Ortigosa S, Papaseit E, Martínez S, Manich A, Garcia-Algar O, Pacifici R, Vall O, Pichini S. Determination of maternal-fetal biomarkers of prenatal exposure to ethanol: A review. J Pharm Biomed Anal 2012; 69:209-22. [DOI: 10.1016/j.jpba.2012.01.006] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 01/05/2012] [Accepted: 01/07/2012] [Indexed: 12/19/2022]
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Jones J, Jones M, Plate C, Lewis D. The Detection of 1-Palmitoyl-2-oleoyl-<i>sn</i>-glycero-3-phosphoethanol and Ethyl Glucuronide in Human Umbilical Cord. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ajac.2012.312106] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Determination of ethyl glucuronide in nails by liquid chromatography tandem mass spectrometry as a potential new biomarker for chronic alcohol abuse and binge drinking behavior. Anal Bioanal Chem 2011; 402:1865-70. [PMID: 22193819 DOI: 10.1007/s00216-011-5609-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 11/17/2011] [Accepted: 11/24/2011] [Indexed: 10/14/2022]
Abstract
A liquid chromatography tandem mass spectrometry method for ethyl glucuronide (EtG) detection and quantification in nails was developed and fully validated. Nails were extracted in 700 μL double-distilled water. EtG-d(5) was used as an internal standard. Reversed-phase separation was obtained with an isocratic mobile phase composed of 0.1% formic acid and acetonitrile (99:1) for 10 min. Quantification was performed by multiple reaction monitoring of two transitions per compound (EtG and internal standard). The assay was linear from 10 to 500 pg/mg. Validation parameters were studied at three different quality control levels (10, 50, and 300 pg/mg). Intraday, interday, and total imprecision had a coefficient of variation of less than 9.5%. Ion suppression and ion enhancement were negligible (less than 20%). No carryover was detected. The method was applied to several real cases, among teetotalers, social drinkers, and heavy drinkers. A questionnaire, together with the informed consent form, was given to all the participants in order to evaluate alcohol intake in the one month before sample collection. Nail EtG levels in a social drinker were much higher than the concentrations of EtG in hair provided by the same subject, thus suggesting potential high sensitivity in evaluating both chronic excessive alcohol consumption and binge drinking habits.
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