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Romani L, Mannocchi G, Mineo F, Vernich F, Stefani L, Marsella LT, Tittarelli R. Development and Validation of a Fast and Sensitive UPLC-MS/MS Method for Ethyl Glucuronide (EtG) in Hair, Application to Real Cases and Comparison with Carbohydrate-Deficient Transferrin (CDT) in Serum. Int J Mol Sci 2025; 26:1344. [PMID: 39941113 PMCID: PMC11818164 DOI: 10.3390/ijms26031344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2025] [Revised: 01/31/2025] [Accepted: 02/01/2025] [Indexed: 02/16/2025] Open
Abstract
Alcohol is responsible for an ever-increasing number of deaths worldwide, and many road accidents are caused by irresponsible drinking and driving. The use of biomarkers that can support a diagnosis of alcohol abuse is a very important tool that can improve the prevention of many alcohol-related diseases and serious traffic accidents. The main aim of our study was the full validation of a rapid and simple method by ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) to detect ethyl glucuronide in hair (hEtG). The method was successfully applied to n = 171 real hair samples collected from drivers convicted of driving while impaired by alcohol or drugs. A comparison of hEtG and serum Carbohydrate-Deficient Transferrin percentages (% CDT) was also performed to carefully evaluate the data in relation to the specific detection windows of the two different biomarkers. Most of the drivers with hEtG > 30 pg/mg were males in their thirties. None of the hEtG-positives had a serum % CDT above the cutoff (≥2%). Although some researchers suggest caution until solid data are available on the possible effects of interindividual variability that may influence EtG incorporation and metabolism, hEtG is a very useful biomarker of long-term alcohol exposure that shows greater reliability than traditional blood markers.
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Affiliation(s)
- Leonardo Romani
- Laboratory of Forensic Toxicology, Section of Legal Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (L.R.); (F.M.); (F.V.); (L.S.); (L.T.M.); (R.T.)
- PhD School in Medical-Surgical Applied Sciences, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy
| | - Giulio Mannocchi
- Laboratory of Forensic Toxicology, Section of Legal Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (L.R.); (F.M.); (F.V.); (L.S.); (L.T.M.); (R.T.)
| | - Federico Mineo
- Laboratory of Forensic Toxicology, Section of Legal Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (L.R.); (F.M.); (F.V.); (L.S.); (L.T.M.); (R.T.)
| | - Francesca Vernich
- Laboratory of Forensic Toxicology, Section of Legal Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (L.R.); (F.M.); (F.V.); (L.S.); (L.T.M.); (R.T.)
| | - Lucrezia Stefani
- Laboratory of Forensic Toxicology, Section of Legal Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (L.R.); (F.M.); (F.V.); (L.S.); (L.T.M.); (R.T.)
- PhD School in Medical-Surgical Applied Sciences, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy
| | - Luigi Tonino Marsella
- Laboratory of Forensic Toxicology, Section of Legal Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (L.R.); (F.M.); (F.V.); (L.S.); (L.T.M.); (R.T.)
| | - Roberta Tittarelli
- Laboratory of Forensic Toxicology, Section of Legal Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (L.R.); (F.M.); (F.V.); (L.S.); (L.T.M.); (R.T.)
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Odoardi S, Mestria S, Valentini V, Biosa G, Rossi SS. Rapid and Effective Determination of Ethyl Glucuronide in Hair by Micro Extraction by Packed Sorbent (MEPS) and LC-MS/MS. Drug Test Anal 2024. [PMID: 39469804 DOI: 10.1002/dta.3824] [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: 03/29/2024] [Revised: 08/01/2024] [Accepted: 10/15/2024] [Indexed: 10/30/2024]
Abstract
Ethyl glucuronide (EtG) in hair is a reliable biomarker of alcohol consumption habits. Due to its small concentration incorporated into hair, analytical methods sensitive enough to reliably quantify EtG in this matrix are required. Sample preparation is critical in hair analysis, especially for EtG, for which extraction efficiency and matrix effect can strongly influence the results; furthermore, miniaturized methods are sought, to reduce solvent use and times of sample preparation. A micro extraction by packed sorbent (MEPS) procedure coupled to a high-performance liquid chromatography-tandem mass spectrometry method was developed and validated for quantitation of EtG in human hair samples. Fifty milligrams of hair samples were cut into snippets and extracted in water. The cleanup of the extract was carried out by using a MEPS syringe packed with anion exchange sorbent (SAX); all parameters for conditioning, washing, loading and eluting steps were optimized and the eluted aqueous volume was directly injected in the LC-MS/MS system operating in the negative ionization mode. The method was fully validated assessing LOD, LOQ, calibration curve, repeatability, accuracy, matrix effect and carryover. The method was subsequently applied to QCs and authentic hair samples. The developed MEPS method is quick and effective, with low solvent purchase and discard costs, allowing the differentiation between social drinkers and chronic excessive alcohol consumers, according to the cut-offs established by the Society of Hair Testing (SoHT).
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Affiliation(s)
- Sara Odoardi
- Department of Healthcare Surveillance and Bioethics, Forensic Toxicology Laboratory, Università Cattolica del Sacro Cuore F. Policlinico Gemelli IRCCS, Rome, Italy
| | - Serena Mestria
- Department of Healthcare Surveillance and Bioethics, Forensic Toxicology Laboratory, Università Cattolica del Sacro Cuore F. Policlinico Gemelli IRCCS, Rome, Italy
| | - Valeria Valentini
- Department of Healthcare Surveillance and Bioethics, Forensic Toxicology Laboratory, Università Cattolica del Sacro Cuore F. Policlinico Gemelli IRCCS, Rome, Italy
| | - Giulia Biosa
- Department of Healthcare Surveillance and Bioethics, Forensic Toxicology Laboratory, Università Cattolica del Sacro Cuore F. Policlinico Gemelli IRCCS, Rome, Italy
| | - Sabina Strano Rossi
- Department of Healthcare Surveillance and Bioethics, Forensic Toxicology Laboratory, Università Cattolica del Sacro Cuore F. Policlinico Gemelli IRCCS, Rome, Italy
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Unlocking the potential of forensic traces: Analytical approaches to generate investigative leads. Sci Justice 2022; 62:310-326. [PMID: 35598924 DOI: 10.1016/j.scijus.2022.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 11/21/2022]
Abstract
Forensic investigation involves gathering the information necessary to understand the criminal events as well as linking objects or individuals to an item, location or other individual(s) for investigative purposes. For years techniques such as presumptive chemical tests, DNA profiling or fingermark analysis have been of great value to this process. However, these techniques have their limitations, whether it is a lack of confidence in the results obtained due to cross-reactivity, subjectivity and low sensitivity; or because they are dependent on holding reference samples in a pre-existing database. There is currently a need to devise new ways to gather as much information as possible from a single trace, particularly from biological traces commonly encountered in forensic casework. This review outlines the most recent advancements in the forensic analysis of biological fluids, fingermarks and hair. Special emphasis is placed on analytical methods that can expand the information obtained from the trace beyond what is achieved in the usual practices. Special attention is paid to those methods that accurately determine the nature of the sample, as well as how long it has been at the crime scene, along with individualising information regarding the donor source of the trace.
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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: 6.2] [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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Béranger R, Hardy EM, Dexet C, Guldner L, Zaros C, Nougadère A, Metten MA, Chevrier C, Appenzeller BMR. Multiple pesticide analysis in hair samples of pregnant French women: Results from the ELFE national birth cohort. ENVIRONMENT INTERNATIONAL 2018; 120:43-53. [PMID: 30064054 DOI: 10.1016/j.envint.2018.07.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 05/19/2023]
Abstract
BACKGROUND A growing body of evidence suggests that prenatal exposure to pesticides might impair fetal development. Nonetheless, knowledge about pesticide exposure of pregnant women, especially in Europe, is largely restricted to a limited panel of molecules. AIM To characterize the concentration of 140 pesticides and metabolites in hair strands from women in the ELFE French nationwide birth cohort. METHODS Among cohort members who gave birth in northeastern and southwestern France in 2011, we selected those with a sufficient available mass of hair (n = 311). Bundles of hair 9 cm long were collected at delivery. We screened 111 pesticides and 29 metabolites, including 112 selected a priori based on their reported usage or detection in the French environment. The bundles of hair from 47 women were split into three segments to explore the intraindividual variability of the exposure. Intraclass correlation coefficients (ICCs) were computed for the chemicals with a detection frequency >70%. RESULTS We detected a median of 43 chemicals per woman (IQR 38-47). Overall, 122 chemicals (>20 chemical families) were detected at least once, including 28 chemicals detected in 70-100% of hair samples. The highest median concentrations were observed for permethrin (median: 37.9 pg/mg of hair), p-nitrophenol (13.2 pg/mg), and pentachlorophenol (10.0 pg/mg). The ICCs for the 28 chemicals studied ranged from 0.59 to 0.94. CONCLUSION Pregnant women are exposed to multiple pesticides simultaneously from various chemical families, including chemicals suspected to be reproductive toxicants or endocrine disruptors. The ICCs suggest that the intraindividual variability of pesticide concentrations in hair is lower than its interindividual variability.
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Affiliation(s)
- Rémi Béranger
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France.
| | - Emilie M Hardy
- Human Biomonitoring Research Unit, Department of Population Health, Luxembourg Institute of Health, Esch sur Alzette, Luxembourg
| | - Célia Dexet
- Human Biomonitoring Research Unit, Department of Population Health, Luxembourg Institute of Health, Esch sur Alzette, Luxembourg
| | - Laurence Guldner
- Univ Rennes, Inserm, EHESP, Irset - UMR_S 1085, F-35000 Rennes, France
| | - Cécile Zaros
- INSERM, Joint Unit INED-INSERM-EFS, Paris, France
| | - Alexandre Nougadère
- European Food Safety Authority (EFSA), Scientific Committee and Emerging Risks Unit (SCER), Parma, Italy
| | - Marie-Astrid Metten
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Cécile Chevrier
- Univ Rennes, Inserm, EHESP, Irset - UMR_S 1085, F-35000 Rennes, France
| | - Brice M R Appenzeller
- Human Biomonitoring Research Unit, Department of Population Health, Luxembourg Institute of Health, Esch sur Alzette, Luxembourg
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Fosen JT, Høiseth G, Sempio C, Giarratana N, Enger A, Mørland J, Morini L. Hair EtG: Alterations in segment levels accompanying hair growth. Drug Test Anal 2018; 11:112-118. [DOI: 10.1002/dta.2474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/27/2018] [Accepted: 07/30/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Jan Toralf Fosen
- Department of Forensic Sciences; Oslo University Hospital; Oslo Norway
| | - Gudrun Høiseth
- Department of Forensic Sciences; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine, University of Oslo; Oslo Norway
- Center for Psychopharmacology; Diakonhjemmet Hospital; Oslo Norway
| | - Cristina Sempio
- Department of Public Health, Experimental and Forensic Medicine; University of Pavia; Pavia Italy
| | - Nefele Giarratana
- Department of Public Health, Experimental and Forensic Medicine; University of Pavia; Pavia Italy
| | - Asle Enger
- Trasoppklinikken; Oslo Norway
- Department of Addiction Treatment; Oslo University Hospital; Oslo Norway
| | - Jørg Mørland
- Institute of Clinical Medicine, University of Oslo; Oslo Norway
- Norwegian Institute of Public Health; Oslo Norway
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine; University of Pavia; Pavia Italy
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Małkowska A, Bamburowicz-Klimkowska M, Łukasik M, Grucza K, Szutowski M, Kwiatkowska D. The influence of caffeine on ethyl glucuronide levels in rat serum and in rat hair. Pharmacol Rep 2018; 70:831-836. [PMID: 32002974 DOI: 10.1016/j.pharep.2018.02.002] [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: 08/18/2017] [Revised: 01/09/2018] [Accepted: 02/01/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ethanol and caffeine are the most widely used psychoactive substances in the world, with an observed steady increase in the combined consumption of alcohol and caffeine. Specific signs of ethanol-caffeine interactions have been reported both in humans and in animals. The metabolic effects of these interactions have not been fully elucidated. There are no published reports on the influence of caffeine on ethyl glucuronide (EtG) formation. EtG is a direct metabolite of ethanol and is very often used as a biomarker of alcohol consumption. Here, we investigated the influence of caffeine on the formation of EtG in rat plasma and EtG incorporation into the hair. METHODS Studies were conducted on three male Wistar rat groups, each receiving either ethanol at 3 g/kg/day, ethanol (at the same dose) with caffeine at 3 mg/kg/day, or caffeine at 3 mg/kg/day for four weeks. EtG and caffeine levels were evaluated in hair and in blood after the last administration. RESULTS Blood EtG levels after the administration of ethanol together with caffeine were significantly higher than after the administration of ethanol alone. EtG levels in rat hair in the ethanol-and-caffeine group were also higher than in the ethanol-only group, but the difference was not statistically significant. CONCLUSION This study shows the possible effect of ethanol and caffeine co-administration on EtG formation. Caffeine stimulates EtG synthesis resulting in increased blood and, possibly, hair levels of this metabolite. However, the role of these changes in estimating alcohol consumption requires further studies.
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Affiliation(s)
- Anna Małkowska
- Department of Applied Toxicology, Faculty of Pharmacy, Medical University of Warsaw, Warszawa, Poland.
| | | | - Marcin Łukasik
- Department of Applied Toxicology, Faculty of Pharmacy, Medical University of Warsaw, Warszawa, Poland
| | - Krzysztof Grucza
- Department of Applied Toxicology, Faculty of Pharmacy, Medical University of Warsaw, Warszawa, Poland.,Department of Anti-Doping Research, Institute of Sport - National Research Institute, Warszawa, Poland
| | - Mirosław Szutowski
- Department of Applied Toxicology, Faculty of Pharmacy, Medical University of Warsaw, Warszawa, Poland
| | - Dorota Kwiatkowska
- Department of Anti-Doping Research, Institute of Sport - National Research Institute, Warszawa, Poland
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8
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Appenzeller BMR, Hardy EM, Grova N, Chata C, Faÿs F, Briand O, Schroeder H, Duca RC. Hair analysis for the biomonitoring of pesticide exposure: comparison with blood and urine in a rat model. Arch Toxicol 2016; 91:2813-2825. [PMID: 28011991 PMCID: PMC5515982 DOI: 10.1007/s00204-016-1910-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 12/06/2016] [Indexed: 12/01/2022]
Abstract
Urine and plasma have been used to date for the biomonitoring of exposure to pollutants and are still the preferred fluids for this purpose; however, these fluids mainly provide information on the short term and may present a high level of variability regarding pesticide concentrations, especially for nonpersistent compounds. Hair analysis may provide information about chronic exposure that is averaged over several months; therefore, this method has been proposed as an alternative to solely relying on these fluids. Although the possibility of detecting pesticides in hair has been demonstrated over the past few years, the unknown linkage between exposure and pesticides concentration in hair has limited the recognition of this matrix as a relevant tool for assessing human exposure. Based on a rat model in which there was controlled exposure to a mixture of pesticides composed of lindane, β-hexachlorocyclohexane, β-endosulfan, p,p′-DDT, p,p′-DDE, dieldrin, pentachlorophenol, diazinon, chlorpyrifos, cyhalothrin, permethrin, cypermethrin, propiconazole, fipronil, oxadiazon, diflufenican, trifluralin, carbofuran, and propoxur, the current work demonstrates the association between exposure intensity and resulting pesticide concentration in hair. We also compared the results obtained from a hair analysis to urine and plasma collected from the same rats. Hair, blood, and urine were collected from rats submitted to 90-day exposure by gavage to the aforementioned mixture of common pesticides at different levels. We observed a linear relationship between exposure intensity and the concentration of pesticides in the rats’ hair (RPearson 0.453–0.978, p < 0.01). A comparison with results from urine and plasma samples demonstrated the relevance of hair analysis and, for many chemicals, its superiority over using fluids for differentiating animals from different groups and for re-attributing animals to their correct groups of exposure based on pesticide concentrations in the matrix. Therefore, this study strongly supports hair analysis as a reliable tool to be used during epidemiological studies to investigate exposure-associated adverse health effects.
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Affiliation(s)
- Brice M R Appenzeller
- Human Biomonitoring Research Unit, Department of Population Health, Luxembourg Institute of Health, 29 Rue Henri Koch, 4354, Esch-sur Alzette, Luxembourg.
| | - Emilie M Hardy
- Human Biomonitoring Research Unit, Department of Population Health, Luxembourg Institute of Health, 29 Rue Henri Koch, 4354, Esch-sur Alzette, Luxembourg
| | - Nathalie Grova
- Human Biomonitoring Research Unit, Department of Population Health, Luxembourg Institute of Health, 29 Rue Henri Koch, 4354, Esch-sur Alzette, Luxembourg
| | - Caroline Chata
- Human Biomonitoring Research Unit, Department of Population Health, Luxembourg Institute of Health, 29 Rue Henri Koch, 4354, Esch-sur Alzette, Luxembourg
| | - François Faÿs
- Human Biomonitoring Research Unit, Department of Population Health, Luxembourg Institute of Health, 29 Rue Henri Koch, 4354, Esch-sur Alzette, Luxembourg.,Competence Center in Methodology and Statistics, Luxembourg Institute of Health, 29 Rue Henri Koch, 4354, Esch-sur Alzette, Luxembourg
| | - Olivier Briand
- French Ministry of Agriculture, Agrifood, and Forestry, Paris, France
| | - Henri Schroeder
- Unit Research Animal and Functionality of Animal Products (URAFPA), French National Institute for Agricultural Research (INRA) UC340, University of Lorraine, Nancy, France
| | - Radu-Corneliu Duca
- Human Biomonitoring Research Unit, Department of Population Health, Luxembourg Institute of Health, 29 Rue Henri Koch, 4354, Esch-sur Alzette, Luxembourg
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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: 51] [Impact Index Per Article: 5.7] [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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Bertol E, Vaiano F, Boscolo-Berto R, Fioravanti A, Palumbo D, Catalani V, Mari F, Patussi V, Serpelloni G. Alcohol, caffeine, and nicotine consumption in adolescents: hair analysis versus self-report. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 43:341-349. [PMID: 27588338 DOI: 10.1080/00952990.2016.1216556] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Clinical reliability of self-reported data for alcohol, caffeine, and nicotine consumptions is lacking, particularly in adolescents. OBJECTIVES To compare a self-report questionnaire and hair analysis to assess the reliability and effectiveness of the self-report. METHODS A cross-sectional study on 14-15-year-old Italian students (n = 874, 38% males, 62% females) was performed comparing self-reported data to hair analysis. The latter quantified hair concentrations of caffeine, nicotine, cotinine, ethyl glucuronide (EtG), and fatty acid ethyl esters (FAEEs) using mass spectrometry. RESULTS Concordance between self-report and hair testing ranged from good to poor across substances and levels of use: poor for heavy alcohol intake (EtG: k = 0.36, 20 positive cases by hair analysis, false negative by self-report, 2.3% of total sample; FAEE k = 0.31, 25 positive cases, 2.9% of total sample); fair to poor for active smokers (k = 0.40, 125 positive cases, 14.3% of total sample); and moderate for caffeine (k = 0.57, 56 positive cases, 6.4% of total sample). CONCLUSIONS Epidemiological studies on alcohol, caffeine, and nicotine consumption in adolescents may benefit from the inclusion of toxicological analysis on hair samples to overcome the under-reporting phenomenon of questionnaires and detect more cases of problematic substance use.
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Affiliation(s)
- Elisabetta Bertol
- a Department of Health Science , University of Florence , Florence , Italy
| | - Fabio Vaiano
- a Department of Health Science , University of Florence , Florence , Italy
| | - Rafael Boscolo-Berto
- b Forensic Toxicology and Antidoping , University Hospital of Padova , Padova , Italy
| | - Alessia Fioravanti
- a Department of Health Science , University of Florence , Florence , Italy
| | - Diego Palumbo
- a Department of Health Science , University of Florence , Florence , Italy
| | - Valeria Catalani
- a Department of Health Science , University of Florence , Florence , Italy
| | - Francesco Mari
- a Department of Health Science , University of Florence , Florence , Italy
| | - Valentino Patussi
- c Regional Alcoholic Center, Toscana Region, Alcohol Unit, AOU Careggi , Florence , Italy
| | - Giovanni Serpelloni
- d University of Florence, Unit of Research and Innovation in Forensic Toxicology and Neuroscience of Addiction , Florence , Italy
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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: 2.9] [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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Beckmann M, Paslakis G, Böttcher M, Helander A, Erim Y. Integration of Clinical Examination, Self-Report, and Hair Ethyl Glucuronide Analysis for Evaluation of Patients With Alcoholic Liver Disease Prior to Liver Transplantation. Prog Transplant 2016; 26:40-6. [DOI: 10.1177/1526924816632120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Context: A large proportion of liver transplants (LTXs) are performed due to alcoholic liver disease (ALD) in the final stage of organ insufficiency. In order to list patients for LTX, transplant centers commonly require 6 months abstinence from alcohol. However, significant differences have been reported between alcohol intake as indicated by self-report and biochemical markers of alcohol. Objective: In the present study, the usefulness of ethyl glucuronide analysis in hair (hETG) was examined during the evaluation procedure before listing patients with ALD for an LTX. Design: Cross-sectional survey. Setting: Psychosomatic evaluation. Patients: Seventy patients with ALD prior to listing for an LTX. Interventions: According to clinical assessment before listing patients with ALD (n = 233) for an LTX, hETG analysis was only performed in the patients who were assumed to deny or underreport their alcohol consumption (n = 70). Main Outcome Measures: The analysis of hETG by liquid chromatography–mass spectrometry, clinical interview. Results: By hETG analyses, 27 (38.6%) of the 70 patients tested positive for ongoing alcohol consumption. Conclusions: Selective use of hETG based on the clinical interview rather than widespread screening is a possible way to detect excessive alcohol consumption in patients with ALD in the transplant setting. The primary evaluation of a patient’s situation in its entirety should remain the superordinate standard procedure. An interdisciplinary approach to transplant candidates with an ALD is asked for.
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Affiliation(s)
- Mingo Beckmann
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Essen, Essen, Germany
| | - Georgios Paslakis
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital of Erlangen, Germany
| | | | - Anders Helander
- Department of Laboratory Medicine, Karolinska Institutet and Karolinska University Laboratory, Stockholm, Sweden
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Essen, Essen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital of Erlangen, Germany
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13
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Fosen JT, Morini L, Sempio C, Ganss R, Mørland J, Høiseth G. Levels of Hair Ethyl Glucuronide in Patients with Decreased Kidney Function: Possibility of Misclassification of Social Drinkers. Alcohol Clin Exp Res 2016; 40:451-6. [DOI: 10.1111/acer.12970] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/23/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Jan Toralf Fosen
- Division of Forensic Sciences; Norwegian Institute of Public Health; Oslo Norway
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine; University of Pavia; Pavia Italy
| | - Cristina Sempio
- Department of Public Health, Experimental and Forensic Medicine; University of Pavia; Pavia Italy
| | - Rudiger Ganss
- Division of Internal Medicine; Department of Nephrology; Akershus University Hospital; Lørenskog Norway
| | - Jørg Mørland
- Division of Forensic Sciences; Norwegian Institute of Public Health; Oslo Norway
| | - Gudrun Høiseth
- Division of Forensic Sciences; Norwegian Institute of Public Health; Oslo Norway
- Center for psychopharmacology; Diakonhjemmet Hospital; Oslo Norway
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L Crunelle C, Cappelle D, Yegles M, De Doncker M, Michielsen P, Dom G, van Nuijs ALN, Maudens KE, Covaci A, Neels H. Ethyl glucuronide concentrations in hair: a controlled alcohol-dosing study in healthy volunteers. Anal Bioanal Chem 2015; 408:2019-25. [PMID: 26549114 DOI: 10.1007/s00216-015-9117-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/20/2015] [Accepted: 10/13/2015] [Indexed: 01/28/2023]
Abstract
Ethyl glucuronide (EtG) is a minor phase II metabolite of alcohol that accumulates in hair. It has been established as a sensitive marker to assess the retrospective consumption of alcohol over recent months using a cut-off of ≥7 pg/mg hair to assess repeated alcohol consumption. The primary aim was to assess whether amounts of alcohol consumed correlated with EtG concentrations in hair. Additionally, we investigated whether the current applied cut-off value of 7 pg/mg hair was adequate to assess the regular consumption of low-to-moderate amounts of alcohol. A prospective controlled alcohol-dosing study in 30 healthy individuals matched on age and gender. Individuals were instructed to drink no alcohol (N = 10), 100 g alcohol per week (N = 10) or 150 g alcohol per week (N = 10) for 12 consecutive weeks, before and after which hair was collected. Throughout the study, compliance to daily alcohol consumption was assessed by analyzing urine EtG three times weekly. Participants in the non-drinking group had median EtG concentrations of 0.5 pg/mg hair (interquartile range (IQR) 1.7 pg/mg; range < 0.21-4.5 pg/mg). Participants consuming 100 and 150 g alcohol per week showed median EtG concentrations of 5.6 pg/mg hair (IQR 4.7 pg/mg; range 2.0-9.8 pg/mg) and 11.3 pg/mg hair (IQR 5.0 pg/mg; range 7.7-38.9 pg/mg), respectively. Hair EtG concentrations between the three study groups differed significantly from one another (p < 0.001). Hair EtG concentrations can be used to differentiate between repeated (low-to-moderate) amounts of alcohol consumed over a long time period. For the assessment of repeated alcohol use, we propose that the current cut-off of 7 pg/mg could be re-evaluated.
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Affiliation(s)
- Cleo L Crunelle
- Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610, Antwerp, Wilrijk, Belgium
| | - Delphine Cappelle
- Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610, Antwerp, Wilrijk, Belgium.
| | - Michel Yegles
- Laboratoire National de Santé, Service de Toxicologie, Dudelange, Luxembourg
| | | | - Peter Michielsen
- Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium
| | - Alexander L N van Nuijs
- Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610, Antwerp, Wilrijk, Belgium
| | - Kristof E Maudens
- Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610, Antwerp, Wilrijk, Belgium
| | - Adrian Covaci
- Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610, Antwerp, Wilrijk, Belgium
| | - Hugo Neels
- Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610, Antwerp, Wilrijk, Belgium
- Toxicology and TDM Laboratory, ZNA Stuivenberg, Antwerp, Belgium
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15
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Wurst FM, Thon N, Yegles M, Schrück A, Preuss UW, Weinmann W. Ethanol Metabolites: Their Role in the Assessment of Alcohol Intake. Alcohol Clin Exp Res 2015; 39:2060-72. [DOI: 10.1111/acer.12851] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 07/22/2015] [Indexed: 01/12/2023]
Affiliation(s)
- Friedrich M. Wurst
- Paracelsus Medical University; Salzburg Austria
- Center for Interdisciplinary Addiction Research; University of Hamburg; Hamburg Germany
| | | | - Michel Yegles
- Service de Toxicologie; Laboratoire National de Sante; Luxembourg Luxembourg
| | - Alexandra Schrück
- Institute of Forensic Medicine; University of Bern; Bern Switzerland
| | - Ulrich W. Preuss
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine; University of Halle; Halle Germany
| | - Wolfgang Weinmann
- Institute of Forensic Medicine; University of Bern; Bern Switzerland
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16
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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: 5.1] [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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17
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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: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bossers L, Paul R, Berry A, Kingston R, Middendorp C, Guwy A. An evaluation of washing and extraction techniques in the analysis of ethyl glucuronide and fatty acid ethyl esters from hair samples. J Chromatogr B Analyt Technol Biomed Life Sci 2014; 953-954:115-9. [DOI: 10.1016/j.jchromb.2014.01.049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/25/2014] [Accepted: 01/29/2014] [Indexed: 01/07/2023]
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Sterneck M, Yegles M, Rothkirch von G, Staufer K, Vettorazzi E, Schulz KH, Tobias N, Graeser C, Fischer L, Nashan B, Andresen-Streichert H. Determination of ethyl glucuronide in hair improves evaluation of long-term alcohol abstention in liver transplant candidates. Liver Int 2014; 34:469-76. [PMID: 23829409 DOI: 10.1111/liv.12243] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 05/28/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Prior to listing patients for Orthotopic liver transplantation (OLT) an abstention period of 6 months is required. Ethyl glucuronide in the hair is a new reliable marker for the assessment of alcohol consumption. Here, the diagnostic value of determining the ethyl glucuronide concentration in the hair of liver transplant candidates was evaluated. METHODS In 63 transplant candidates with alcoholic liver cirrhosis and 25 control patients with cirrhosis of other aetiologies alcohol markers, i.e. hEtG, urine EtG, blood ethanol, methanol and carbohydrate deficient transferrin were determined in parallel to an interview with a psychologist. RESULTS A total of 19 (30%) transplant candidates admitted alcohol consumption within the last 6 months, while 39/63 (62%) were positive for at least one alcohol marker. In 52% of the 44 candidates denying alcohol consumption, abstention was disproved by detecting at least one positive alcohol marker, in 83% of cases by a positive hEtG result. In the control patients stating abstention from alcohol all hEtG tests were negative. No impact of renal or liver function on hEtG results was detected. A specificity of 98% and a positive predictive value of 92% were calculated for testing hEtG in proximal hair segment and applying a cut-off of 30 pg/mg. CONCLUSIONS In 52% of patients denying alcohol consumption within the last 6 months, alcohol abstention was disproved, in 83% of cases by hEtG testing. Therefore, hEtG is a promising new marker for the evaluation of long-term alcohol abstention in liver transplant candidates.
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Affiliation(s)
- Martina Sterneck
- Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg - Eppendorf, Hamburg, Germany
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20
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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: 8.9] [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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Wurst FM, Thon N, Weinmann W, Yegles M, Preuss U. [What ethanol metabolites as biological markers tell us about alcohol use]. Wien Med Wochenschr 2013; 164:25-33. [PMID: 24322386 DOI: 10.1007/s10354-013-0254-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 11/12/2013] [Indexed: 01/12/2023]
Abstract
Alcohol and tobacco related disorders are the two leading and most expensive causes of illness in central Europe. In addition to self reports and questionnaires, biomarkers are of relevance in diagnosis and therapy of alcohol use disorders. Traditional biomarkers such as gamma glutamyl transpeptidase or mean corpuscular volume are indirect biomarkers and are subject to influence of age, gender and non alcohol related diseases, among others.Direct ethanol metabolites such as ethyl glucuronide (EtG), ethyl sulphate (EtS) and phosphatidylethanol (PEth) are direct metabolites of ethanol, that are positive after intake of ethyl alcohol. They represent useful diagnostic tools for identifying alcohol use even more accurately than traditional biomarkers. Each of these drinking indicators remains positive in serum and urine for a characteristic time spectrum after the cessation of ethanol intake--EtG and EtS in urine up to 7 days, EtG in hair for months after ethanol has left the body. Applications include clinical routine use, emergency room settings, proof of abstinence in alcohol rehabilitation programs, driving under influence offenders, workplace testing, assessment of alcohol intake in the context of liver transplantation and fetal alcohol syndrome.
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Affiliation(s)
- Friedrich Martin Wurst
- Universitätsklinik für Psychiatrie und Psychotherapie II, Christian-Doppler-Klinik, Salzburger Landeskliniken, Paracelsus Medical University (PMU), Ignaz-Harrer-Straße 79, 5020, Salzburg, Österreich,
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22
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Yaldiz F, Daglioglu N, Hilal A, Keten A, Gülmen MK. Determination of ethyl glucuronide in human hair by hydrophilic interaction liquid chromatography–tandem mass spectrometry. J Forensic Leg Med 2013; 20:799-802. [DOI: 10.1016/j.jflm.2013.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 06/10/2013] [Accepted: 06/27/2013] [Indexed: 10/26/2022]
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23
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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: 52] [Impact Index Per Article: 4.3] [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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24
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Kim J, In S, Park Y, Park M, Kim E, Lee S. Quantitative analysis of propofol-glucuronide in hair as a marker for propofol abuse. Anal Bioanal Chem 2013; 405:6807-14. [DOI: 10.1007/s00216-013-7105-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 05/27/2013] [Accepted: 05/29/2013] [Indexed: 01/08/2023]
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25
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Lee SY, You IJ, Kim MJ, Kwon SH, Hong SI, Kim JH, Jang MH, Oh SM, Chung KH, Lee SY, Jang CG. The abuse potential of oxethazaine: Effects of oxethazaine on drug-seeking behavior and analysis of its metabolites in plasma and hair in animal models. Pharmacol Biochem Behav 2013; 105:98-104. [DOI: 10.1016/j.pbb.2013.01.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 01/28/2013] [Accepted: 01/31/2013] [Indexed: 10/27/2022]
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Detecting alcohol abuse: traditional blood alcohol markers compared to ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs) measurement in hair. Forensic Sci Med Pathol 2013; 9:471-7. [PMID: 23504201 DOI: 10.1007/s12024-013-9416-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2013] [Indexed: 01/04/2023]
Abstract
Alcohol abuse is a common problem in society; however, the technical capabilities of evaluating individual alcohol consumption using objective biomarkers are rather limited at present. In recent years research has focused on alcohol markers using hair analysis but data on performance and reliable cut-off values are still lacking. In this study 169 candidates were tested to compare traditional biomarkers, such as carbohydrate-deficient-transferrin (CDT), gamma glutamyl transferase (GGT), aspartate amino transferase, alanine amino transferase and the mean corpuscular volume of the erythrocytes, with alcohol markers detectable in hair such as ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs). This study revealed that EtG, GGT and CDT showed the best results, demonstrating areas under the curve calculated from receiver operating characteristics of 0.941, 0.943 and 0.899 respectively. The lowest false-negative and false-positive rates were obtained by using a combined interpretation system for hair EtG and FAEEs. All markers demonstrated only low to moderate correlations. Optimum cut-off values for differentiation between social and chronic excessive drinking calculated for hair EtG and FAEEs were 28 pg/mg and 0.675 ng/mg, respectively. The critical values published in the "Consensus on Alcohol Markers 2012" by the Society of Hair Testing were confirmed.
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27
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Ethyl glucuronide concentration in hair for detecting heavy drinking and/or abstinence: a meta-analysis. Int J Legal Med 2012; 127:611-9. [DOI: 10.1007/s00414-012-0809-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 12/05/2012] [Indexed: 11/26/2022]
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28
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Schräder J, Rothe M, Pragst F. Ethyl glucuronide concentrations in beard hair after a single alcohol dose: evidence for incorporation in hair root. Int J Legal Med 2012; 126:791-9. [DOI: 10.1007/s00414-012-0729-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 06/12/2012] [Indexed: 11/29/2022]
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29
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Małkowska A, Szutowski M, Dyr W. Deposition of ethyl glucuronide in WHP rat hair after chronic ethanol intake. Pharmacol Rep 2012; 64:586-93. [DOI: 10.1016/s1734-1140(12)70854-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 12/29/2011] [Indexed: 11/30/2022]
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30
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Appenzeller BM, Tsatsakis AM. Hair analysis for biomonitoring of environmental and occupational exposure to organic pollutants: State of the art, critical review and future needs. Toxicol Lett 2012; 210:119-40. [DOI: 10.1016/j.toxlet.2011.10.021] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 10/04/2011] [Accepted: 10/11/2011] [Indexed: 11/28/2022]
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Wright TH, Ferslew KE. Biotransformation of ethanol to ethyl glucuronide in a rat model after a single high oral dosage. Alcohol 2012; 46:159-64. [PMID: 22019193 DOI: 10.1016/j.alcohol.2011.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 07/14/2011] [Accepted: 07/15/2011] [Indexed: 12/01/2022]
Abstract
Ethyl glucuronide (EtG) is a minor ethanol metabolite that confirms the absorption and metabolism of ethanol after oral or dermal exposure. Human data suggest that maximum blood EtG (BEtG) concentrations are reached between 3.5 and 5.5h after ethanol administration. This study was undertaken to determine if the Sprague-Dawley (SD) rat biotransforms ethanol to EtG after a single high oral dose of ethanol. SD rats (male, n=6) were gavaged with a single ethanol dose (4 g/kg), and urine was collected for 3 h in metabolic cages, followed by euthanization and collection of heart blood. Blood and urine were analyzed for ethanol and EtG by gas chromatography and enzyme immunoassay. Blood and urine ethanol concentrations were 195±23 and 218±19 mg/dL, whereas BEtG and urine EtG (UEtG) concentrations were 1,363±98 ng equivalents/mL and 210±0.29 mg equivalents/dL (X ± standard error of the mean [S.E.M.]). Sixty-six male SD rats were gavaged ethanol (4 g/kg) and placed in metabolic cages to determine the extent and duration of ethanol to EtG biotransformation and urinary excretion. Blood and urine were collected up to 24 h after administration for ethanol and EtG analysis. Maximum blood ethanol, urine ethanol, and UEtG were reached within 4 h, whereas maximum BEtG was reached 6 h after administration. Maximum concentrations were blood ethanol, 213±20 mg/dL; urine ethanol, 308±34 mg/dL; BEtG, 2,683±145 ng equivalents/mL; UEtG, 1.2±0.06 mg equivalents/mL (X±S.E.M.). Areas under the concentration-time curve were blood ethanol, 1,578 h*mg/dL; urine ethanol, 3,096 h*mg/dL; BEtG, 18,284 h*ng equivalents/mL; and UEtG, 850 h*mg equivalents/dL. Blood ethanol and BEtG levels were reduced to below limits of detection (LODs) within 12 and 18 h after ethanol administration. Urine ethanols were below LOD at 18 h, but UEtG was still detectable at 24h after administration. Our data prove that the SD rat biotransforms ethanol to EtG and excretes both in the urine and suggest that it is similar to that of the human.
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Affiliation(s)
- Trista H Wright
- Section of Toxicology, East Tennessee State University, Johnson City, TN 37614, USA.
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Kronstrand R, Brinkhagen L, Nyström FH. Ethyl glucuronide in human hair after daily consumption of 16 or 32g of ethanol for 3 months. Forensic Sci Int 2012; 215:51-5. [DOI: 10.1016/j.forsciint.2011.01.044] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 12/29/2010] [Accepted: 01/30/2011] [Indexed: 10/18/2022]
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Cabarcos P, Hassan HM, Tabernero MJ, Scott KS. Analysis of ethyl glucuronide in hair samples by liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS). J Appl Toxicol 2012; 33:638-43. [DOI: 10.1002/jat.1791] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 11/15/2011] [Accepted: 11/15/2011] [Indexed: 11/08/2022]
Affiliation(s)
- Pamela Cabarcos
- Institute of Legal Medicine, Forensic Toxicology Service; Faculty of Medicine; C/San Francisco s/n 15782; Santiago de Compostela; Spain
| | - Huda M. Hassan
- Forensic Medicine and Science; University of Glasgow; Glasgow; G12 8 QQ; UK
| | - María Jesús Tabernero
- Institute of Legal Medicine, Forensic Toxicology Service; Faculty of Medicine; C/San Francisco s/n 15782; Santiago de Compostela; Spain
| | - Karen S. Scott
- Forensic Medicine and Science; University of Glasgow; Glasgow; G12 8 QQ; UK
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Kelly AT, Mozayani A. An overview of alcohol testing and interpretation in the 21st century. J Pharm Pract 2012; 25:30-6. [PMID: 22215644 DOI: 10.1177/0897190011431149] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Ethanol analysis is the most commonly carried out drug testing in a forensic toxicology laboratory. Determination of blood alcohol concentration (BAC) is needed in a multitude of situations, including in postmortem analysis, driving under the influence (DUI) and drug-facilitated sexual assault (DFSA) cases, workplace drug monitoring, and probation investigations. These analyses are carried out by direct measurement of ethanol concentrations as well as of metabolic by-products, such as ethyl glucuronide (EtG) and ethyl sulfate (EtS). This review article will discuss pharmacokinetics, including absorption, distribution, and elimination of ethanol, methods for the detection of ethanol, the effect of ethanol on human performance, the role of alcohol in injuries and fatalities, and information regarding the interactions that may occur between alcohol and other drugs. Finally, an explanation will be given on how to interpret alcohol levels as well as the extrapolation and calculation of blood alcohol levels at times prior to sample collection.
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Affiliation(s)
- Anna T Kelly
- Harris County Institute of Forensic Sciences, Houston, TX 77054, USA
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Hastedt M, Herre S, Pragst F, Rothe M, Hartwig S. Workplace Alcohol Testing Program by Combined Use of Ethyl Glucuronide and Fatty Acid Ethyl Esters in Hair. Alcohol Alcohol 2011; 47:127-32. [DOI: 10.1093/alcalc/agr148] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Diagnostic performance of ethyl glucuronide in hair for the investigation of alcohol drinking behavior: a comparison with traditional biomarkers. Int J Legal Med 2011; 126:243-50. [DOI: 10.1007/s00414-011-0619-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 08/31/2011] [Indexed: 10/17/2022]
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Chemometric evaluation of nine alcohol biomarkers in a large population of clinically-classified subjects: pre-eminence of ethyl glucuronide concentration in hair for confirmatory classification. Anal Bioanal Chem 2011; 401:2153-64. [DOI: 10.1007/s00216-011-5314-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 08/03/2011] [Accepted: 08/03/2011] [Indexed: 11/27/2022]
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