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Sun W, Huang A, Wen S, Yang R, Liu X. Temporal Assessment of Protein Stability in Dried Blood Spots. J Proteome Res 2024. [PMID: 38950347 DOI: 10.1021/acs.jproteome.4c00233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
The use of protein biomarkers in blood for clinical settings is limited by the cost and accessibility of traditional venipuncture sampling. The dried blood spot (DBS) technique offers a less invasive and more accessible alternative. However, protein stability in DBS has not been well evaluated. Herein, we deployed a quantitative LC-MS/MS system to construct proteomic atlases of whole blood, DBSs, plasma, and blood cells. Approximately 4% of detected proteins' abundance was significantly altered during blood drying into blood spots, with overwhelming disturbances in cytoplasmic fraction. We also reported a novel finding suggesting a decrease in the level of membrane/cytoskeletal proteins (SLC4A1, RHAG, DSC1, DSP, and JUP) and an increase in the level of proteins (ATG3, SEC14L4, and NRBP1) related to intracellular trafficking. Furthermore, we identified 19 temporally dynamic proteins in DBS samples stored at room temperature for up to 6 months. There were three declined cytoskeleton-related proteins (RDX, SH3BGRL3, and MYH9) and four elevated proteins (XPO7, RAN, SLC2A1, and SLC29A1) involved in cytoplasmic transport as representatives. The instability was governed predominantly by hydrophilic proteins and enhanced significantly with an increasing storage time. Our analyses provide comprehensive knowledge of both short- and long-term storage stability of DBS proteins, forming the foundation for the widespread use of DBS in clinical proteomics and other analytical applications.
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Affiliation(s)
- Weifen Sun
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science Ministry of Justice, Shanghai 200063, China
| | - Ao Huang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science Ministry of Justice, Shanghai 200063, China
- Department of Forensic Science, Medical School of Soochow University, Suzhou 215123, Jiangsu Province, China
| | - Shubo Wen
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science Ministry of Justice, Shanghai 200063, China
- Department of Forensic Science, Medical School of Soochow University, Suzhou 215123, Jiangsu Province, China
| | - Ruicong Yang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science Ministry of Justice, Shanghai 200063, China
- School of Forensic Medicine, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Xiling Liu
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science Ministry of Justice, Shanghai 200063, China
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Guterstam J, Tavic C, Barosso M, Beck O. A multicomponent LC-MS/MS method for drugs of abuse testing using volumetric DBS and a clinical evaluation by comparison with urine. J Pharm Biomed Anal 2024; 243:116075. [PMID: 38457867 DOI: 10.1016/j.jpba.2024.116075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/17/2024] [Accepted: 02/26/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Drug testing commonly use urine as a specimen and immunoassays for screening. The need for supervised urine collection has led to an interest in alternative specimens and a need for using mass spectrometry methods already for screening. In addition, mass spectrometry methods allow for broad multipanel screening which of great value because of the increased number of substances that needs to be covered has increased over time. One alternative specimen of interest for drugs of abuse testing is dried blood spots (DBS) and this work aimed at developing multipanel screening methods based on selected reaction monitoring liquid chromatography - mass spectrometry for both urine and dried finger blood as specimens. MATERIALS AND METHODS The urine method comprised 37 analytes and utilised salted out liquid/liquid extraction in 96-well format, respectively, and the blood method comprised 35 analytes, a 10 µL volumetric DBS device and a two-step solvent extraction procedure. In both cases stable isotope labelled internal standards were used for almost all analytes. RESULTS The methods were validated according to forensic standard. The lowest reporting limits were generally set at 100 ng/mL for urine and 1 ng/mL for blood and the accuracy and imprecision were within limits of 15 and 20%. The methods were applied in a clinical study on patients receiving methadone maintenance treatment for opioid dependence. Methadone was detected in all urine and DBS samples, for urine sometimes below the commonly applied screening cutoff limit of 300 ng/mL. In 20 out of 99 cases no other drug was detected in any specimen. The most commonly other detected substances were pregabalin, amphetamine, alprazolam, zopiclone and THCCOOH. Findings in urine and DBS generally agreed well but more positives were detected in DBS. CONCLUSION Multipanel methods using liquid chromatography - mass spectrometry suitable for clinical drug screening were successfully developed for urine and blood collected by finger-pricking and stored as DBS.
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Affiliation(s)
- Joar Guterstam
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | | | | | - Olof Beck
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden; ABCLabs AB, Solna, Sweden.
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Zailani NNB, Ho PCL. Dried Blood Spots-A Platform for Therapeutic Drug Monitoring (TDM) and Drug/Disease Response Monitoring (DRM). Eur J Drug Metab Pharmacokinet 2023; 48:467-494. [PMID: 37495930 PMCID: PMC10480258 DOI: 10.1007/s13318-023-00846-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 07/28/2023]
Abstract
This review provides an overview on the current applications of dried blood spots (DBS) as matrices for therapeutic drug (TDM) and drug or disease response monitoring (DRM). Compared with conventional methods using plasma/serum, DBS offers several advantages, including minimally invasiveness, a small blood volume requirement, reduced biohazardous risk, and improved sample stability. Numerous assays utilising DBS for TDM have been reported in the literature over the past decade, covering a wide range of therapeutic drugs. Several factors can affect the accuracy and reliability of the DBS sampling method, including haematocrit (HCT), blood volume, sampling paper and chromatographic effects. It is crucial to evaluate the correlation between DBS concentrations and conventional plasma/serum concentrations, as the latter has traditionally been used for clinical decision. The feasibility of using DBS sampling method as an option for home-based TDM is also discussed. Furthermore, DBS has also been used as a matrix for monitoring the drug or disease responses (DRM) through various approaches such as genotyping, viral load measurement, assessment of inflammatory factors, and more recently, metabolic profiling. Although this research is still in the development stage, advancements in technology are expected to lead to the identification of surrogate biomarkers for drug treatment in DBS and a better understanding of the correlation between DBS drug levels and drug responses. This will make DBS a valuable matrix for TDM and DRM, facilitating the achievement of pharmacokinetic and pharmacodynamic correlations and enabling personalised therapy.
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Affiliation(s)
- Nur Nabihah Binte Zailani
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Paul Chi-Lui Ho
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore.
- School of Pharmacy, Monash University Malaysia, Level 5, Building 2, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia.
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Müller IR, Linden G, Charão MF, Antunes MV, Linden R. Dried blood spot sampling for therapeutic drug monitoring: challenges and opportunities. Expert Rev Clin Pharmacol 2023; 16:691-701. [PMID: 37300458 DOI: 10.1080/17512433.2023.2224562] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/08/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The use of dried blood spots (DBS) has gained interest in the field of therapeutic drug monitoring (TDM) due to its potential advantages, such as minimally invasive capillary blood collection, potential stabilization of drugs and metabolites at room or high temperatures, and lower biohazard, allowing for inexpensive storage and transportation. However, there are several drawbacks to the clinical use of DBS in TDM, mostly related to hematocrit (Hct) effects, differences between venous and capillary blood concentrations, among others, that must be evaluated during analytical and clinical method validation. AREA COVERED This review focuses on the most recent publications on the applications of DBS sampling for TDM (2016-2022), with a special focus on the challenges presented by this alternative sampling strategy, as well as the opportunities for clinical applications. Real-life studies presenting clinical applications were reviewed. EXPERT OPINION With the availability of method development and validation guidelines for DBS-based methods in TDM, higher levels of assay validation standardization have been achieved, expanding the clinical applications of DBS sampling in patient care. New sampling devices that overcome the limitations of classical DBS, such as the Hct effects, will further encourage the use of DBS in routine TDM.
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Affiliation(s)
| | - Gabriel Linden
- Laboratory of Analytical Toxicology, Universidade Feevale, Novo Hamburgo, Brazil
| | | | | | - Rafael Linden
- Laboratory of Analytical Toxicology, Universidade Feevale, Novo Hamburgo, Brazil
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Thangavelu MU, Wouters B, Kindt A, Reiss IKM, Hankemeier T. Blood microsampling technologies: Innovations and applications in 2022. ANALYTICAL SCIENCE ADVANCES 2023; 4:154-180. [PMID: 38716066 PMCID: PMC10989553 DOI: 10.1002/ansa.202300011] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 06/23/2024]
Abstract
With the development of highly sensitive bioanalytical techniques, the volume of samples necessary for accurate analysis has reduced. Microsampling, the process of obtaining small amounts of blood, has thus gained popularity as it offers minimal-invasiveness, reduced logistical costs and biohazard risks while simultaneously showing increased sample stability and a potential for the decentralization of the approach and at-home self-sampling. Although the benefits of microsampling have been recognised, its adoption in clinical practice has been slow. Several microsampling technologies and devices are currently available and employed in research studies for various biomedical applications. This review provides an overview of the state-of-the-art in microsampling technology with a focus on the latest developments and advancements in the field of microsampling. Research published in the year 2022, including studies (i) developing strategies for the quantitation of analytes in microsamples and (ii) bridging and comparing the interchangeability between matrices and choice of technology for a given application, is reviewed to assess the advantages, challenges and limitations of the current state of microsampling. Successful implementation of microsampling in routine clinical care requires continued efforts for standardization and harmonization. Microsampling has been shown to facilitate data-rich studies and a patient-centric approach to healthcare and is foreseen to play a central role in the future digital revolution of healthcare through continuous monitoring to improve the quality of life.
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Affiliation(s)
| | - Bert Wouters
- Metabolomics and Analytics CentreLeiden UniversityLeidenThe Netherlands
| | - Alida Kindt
- Metabolomics and Analytics CentreLeiden UniversityLeidenThe Netherlands
| | - Irwin K. M. Reiss
- Department of Neonatal and Pediatric Intensive CareDivision of NeonatologyErasmus MCRotterdamThe Netherlands
| | - Thomas Hankemeier
- Metabolomics and Analytics CentreLeiden UniversityLeidenThe Netherlands
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González-Rubio JM, Domínguez-Morueco N, Pedraza-Díaz S, Cañas Portilla A, Lucena MÁ, Rodriguez A, Castaño A, Esteban-López M. A simple method for direct mercury analysis in dried blood spots (DBS) samples for human biomonitoring studies. ENVIRONMENT INTERNATIONAL 2023; 177:107958. [PMID: 37285712 DOI: 10.1016/j.envint.2023.107958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/22/2023] [Accepted: 05/02/2023] [Indexed: 06/09/2023]
Abstract
Human exposure to mercury can have serious health effects, especially in vulnerable groups such as children and fetuses. The use of dried blood spot (DBS) samples to collect capillary blood greatly facilitates sample collection and fieldwork, being a less invasive alternative to blood collection by venipuncture, needing a small volume of sample, and does not require specialized medical staff. Moreover, DBS sampling reduces logistical and financial barriers related to transport and storage of blood samples. We propose here a novel method to analyze total mercury in DBS samples in a Direct Mercury Analyzer (DMA) that allow the control of the volume of the DBS samples. This method has shown good results in terms of precision (<6% error), accuracy (<10% coefficient of variation) and recovery (75-106%). The applicability of the method in human biomonitoring (HBM) was demonstrated in a pilot study involving 41 adults aged 18-65. Mercury concentrations of DBS samples from capillary blood collected by finger prick (real DBS samples) were determined in the DMA and compared with those determined in whole blood (venous blood) by ICP-MS, the method usually used in HBM. The sampling procedure was also validated by comparison of real DBS samples and DBS generated artificially in the laboratory by depositing venous samples in cellulose cards (laboratory DBS). There were no statistically significant differences in the results obtained using both methodologies (DMA: Geometric Mean (confidence interval 95%) = 3.87 (3.12-4.79) µg/L; ICP-MS: Geometric Mean (confidence interval 95%) = 3.46 (2.80-4.27) µg/L). The proposed method is an excellent alternative to be applied in clinical settings as screening methodology for assessing mercury exposure in vulnerable groups, such us pregnant woman, babies and children.
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Affiliation(s)
| | | | - Susana Pedraza-Díaz
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Cañas Portilla
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Ángel Lucena
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Rodriguez
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Argelia Castaño
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Esteban-López
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
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Guo X, Zhou L, Wang Y, Suo F, Wang C, Zhou W, Gou L, Gu M, Xu G. Development of a fast and robust liquid chromatography-mass spectrometry-based metabolomics analysis method for neonatal dried blood spots. J Pharm Biomed Anal 2023; 230:115383. [PMID: 37054601 DOI: 10.1016/j.jpba.2023.115383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
Dried blood spot (DBS) samples have been widely used in many fields including newborn screening, with the advantages in transportation, storage and non-invasiveness. The DBS metabolomics research of neonatal congenital diseases will greatly expand the understanding of the disease. In this study, we developed a liquid chromatography-mass spectrometry-based method for neonatal metabolomics analysis of DBS. The influences of blood volume and chromatographic effects on the filter paper on metabolite levels were studied. The levels of 11.11 % metabolites were different between 75 μL and 35 μL of blood volumes used for DBS preparation. Chromatographic effects on the filter paper occurred in DBS prepared with 75 μL whole blood and 6.67 % metabolites had different MS responses when central disks were compared with outer disks. The DBS storage stability study showed that compared with - 80 °C storage, storing at 4 °C for 1 year had obvious influences on more than half metabolites. Storing at 4 °C and - 20 °C for short term (< 14 days) and - 20 °C for longer term (1 year) had less influences on amino acids, acyl-carnitines and sphingomyelins, but greater influences on partial phospholipids. Method validation showed that this method has a good repeatability, intra-day and inter-day precision and linearity. Finally, this method was applied to investigate metabolic disruptions of congenital hypothyroidism (CH), metabolic changes of CH newborns were mainly involved in amino acid metabolism and lipid metabolism.
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Affiliation(s)
- Xingyu Guo
- Zhang Dayu College of Chemistry, Dalian University of Technology, Dalian 116024, China; CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China
| | - Lina Zhou
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China.
| | - Yi Wang
- Center for Genetic Medicine, Maternity and Child Health Care Hospital Affiliated to Xuzhou Medical University, Xuzhou 221009, China
| | - Feng Suo
- Center for Genetic Medicine, Maternity and Child Health Care Hospital Affiliated to Xuzhou Medical University, Xuzhou 221009, China
| | - Chuanxia Wang
- Center for Genetic Medicine, Maternity and Child Health Care Hospital Affiliated to Xuzhou Medical University, Xuzhou 221009, China
| | - Wei Zhou
- Center for Genetic Medicine, Maternity and Child Health Care Hospital Affiliated to Xuzhou Medical University, Xuzhou 221009, China
| | - Lingshan Gou
- Center for Genetic Medicine, Maternity and Child Health Care Hospital Affiliated to Xuzhou Medical University, Xuzhou 221009, China
| | - Maosheng Gu
- Center for Genetic Medicine, Maternity and Child Health Care Hospital Affiliated to Xuzhou Medical University, Xuzhou 221009, China.
| | - Guowang Xu
- Zhang Dayu College of Chemistry, Dalian University of Technology, Dalian 116024, China; CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China; Liaoning Province Key Laboratory of Metabolomics, Dalian 116023, China
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8
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Stachanow V, Neumann U, Blankenstein O, Alder-Baerens N, Bindellini D, Hindmarsh P, Ross RJ, Whitaker MJ, Melin J, Huisinga W, Michelet R, Kloft C. Model-Informed Target Morning 17α-Hydroxyprogesterone Concentrations in Dried Blood Spots for Pediatric Congenital Adrenal Hyperplasia Patients. Pharmaceuticals (Basel) 2023; 16:ph16030464. [PMID: 36986563 PMCID: PMC10051286 DOI: 10.3390/ph16030464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Monitoring cortisol replacement therapy in congenital adrenal hyperplasia (CAH) patients is vital to avoid serious adverse events such as adrenal crises due to cortisol underexposure or metabolic consequences due to cortisol overexposure. The less invasive dried blood spot (DBS) sampling is an advantageous alternative to traditional plasma sampling, especially in pediatric patients. However, target concentrations for important disease biomarkers such as 17α-hydroxyprogesterone (17-OHP) are unknown using DBS. Therefore, a modeling and simulation framework, including a pharmacokinetic/pharmacodynamic model linking plasma cortisol concentrations to DBS 17-OHP concentrations, was used to derive a target morning DBS 17-OHP concentration range of 2-8 nmol/L in pediatric CAH patients. Since either capillary or venous DBS sampling is becoming more common in the clinics, the clinical applicability of this work was shown by demonstrating the comparability of capillary and venous cortisol and 17-OHP concentrations collected by DBS sampling, using a Bland-Altman and Passing-Bablok analysis. The derived target morning DBS 17-OHP concentration range is a first step towards providing improved therapy monitoring using DBS sampling and adjusting hydrocortisone (synthetic cortisol) dosing in children with CAH. In the future, this framework can be used to assess further research questions, e.g., target replacement ranges for the entire day.
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Affiliation(s)
- Viktoria Stachanow
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr 31, 12169 Berlin, Germany
- Graduate Research Training Program, PharMetrX, 12169 Berlin, Germany
| | - Uta Neumann
- Charité-Universitätsmedizin, Freie Universität Berlin, 13353 Berlin, Germany
| | - Oliver Blankenstein
- Charité-Universitätsmedizin, Freie Universität Berlin, 13353 Berlin, Germany
- Labor Berlin, Charité Vivantes GmbH, 13353 Berlin, Germany
| | | | - Davide Bindellini
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr 31, 12169 Berlin, Germany
- Graduate Research Training Program, PharMetrX, 12169 Berlin, Germany
| | - Peter Hindmarsh
- Developmental Endocrinology Research Group, UCL Institute of Child Health, London WC1E 6BT, UK
| | - Richard J Ross
- Department of Oncology and Metabolism, University of Sheffield, Sheffield S10 2TN, UK
| | - Martin J Whitaker
- Department of Oncology and Metabolism, University of Sheffield, Sheffield S10 2TN, UK
| | - Johanna Melin
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr 31, 12169 Berlin, Germany
- Graduate Research Training Program, PharMetrX, 12169 Berlin, Germany
| | - Wilhelm Huisinga
- Institute of Mathematics, Universität Potsdam, 14476 Potsdam, Germany
| | - Robin Michelet
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr 31, 12169 Berlin, Germany
| | - Charlotte Kloft
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr 31, 12169 Berlin, Germany
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Besten-Bertholee DD, Wegner I, Touw DJ, Ter Horst PGJ. Analytical and clinical validation of an LC-MS/MS method for carbamazepine, lamotrigine and levetiracetam in dried blood spots. Eur J Hosp Pharm 2023:ejhpharm-2022-003589. [PMID: 36894298 DOI: 10.1136/ejhpharm-2022-003589] [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: 11/11/2022] [Accepted: 02/28/2023] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVES Therapeutic drug monitoring is performed routinely in patients on anti-epileptic drugs (AEDs) for optimisation and individualisation of therapy. The dried blood spot (DBS) sampling technique is a suitable, more patient-friendly alternative for conventional venous sampling methods. However, before DBS can be used in routine care, data are needed to establish the correlation between standard plasma concentrations obtained from venous puncture and concentrations measured through DBS obtained by finger prick. This study aims to investigate the correlation between carbamazepine, lamotrigine and levetiracetam drug concentrations in venous blood and DBS samples in the same patients at the same time. METHODS Clinical validation was conducted by direct comparison of paired DBS and venous plasma samples. Method agreement was evaluated using Passing-Bablok regression analysis and Bland-Altman plots to provide insight into the relationship between the two analytically validated methods. For Bland-Altman analysis the acceptance limit required by both FDA and EMA guidelines is at least two-thirds (67%) of the paired samples within 80-120% of the mean of both methods. RESULTS Paired samples from 79 patients were studied. For all three AEDs, plasma and DBS concentrations correlated highly (r=0.90 for carbamazepine, r=0.93 for lamotrigine and r=0.93 for levetiracetam), indicating a linear relationship. For carbamazepine and lamotrigine, no proportional or constant bias was revealed. For levetiracetam, concentrations were higher in plasma samples than in DBS (slope 1.21), implying a conversion factor is needed. The acceptance limit was met for carbamazepine and levetiracetam with a value of 72% and 81%, respectively. For lamotrigine, this acceptance limit was not met with a value of 60%. CONCLUSIONS The method was successfully validated and will be used for therapeutic drug monitoring in patients using carbamazepine, lamotrigine and/or levetiracetam.
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Affiliation(s)
| | | | - Daan J Touw
- Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.,Groningen Research Institute of Pharmacy, Section Pharmaceutical Analysis, University of Groningen, Groningen, The Netherlands
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10
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Tang Y, Chen L, Liang X, Dean B, Wang J. Exploring the potential of dried plasma collection cards for liquid chromatography coupled with tandem mass spectrometry quantitation of giredestrant in human plasma. Biomed Chromatogr 2023; 37:e5554. [PMID: 36417291 DOI: 10.1002/bmc.5554] [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: 09/02/2022] [Revised: 10/20/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022]
Abstract
Microsampling technology for dried blood-derived samples provides an advantageous alternative to conventional venous blood for drug quantitation. Unlike conventional whole blood microsampling techniques, Noviplex is a novel, card-based technology for rapid dried plasma spot collection that retains the benefits of microsampling during collection and transportation, while avoiding the disadvantages of using whole blood samples. Giredestrant is a promising small-molecule therapeutic agent under development by Genentech to treat patients with estrogen receptor-positive breast cancer. In this study, we investigated the feasibility of using Noviplex cards for pharmacokinetic analysis of giredestrant levels in human plasma, including optimizing extraction recovery, evaluating in-card stability, and assessing batch precision and accuracy. We found that while the Noviplex card demonstrated levels of sensitivity, extraction recovery, and stability at ambient temperature that meet the requirements of pharmacokinetic analysis for clinical studies, further optimization of the filtration layers within the Noviplex card is necessary to improve filtration efficiency and consistency. This study reveals the possibilities as well as the limitations of the Noviplex card and provides a better understanding of the capabilities and risks of using the Noviplex card for drug quantitation in plasma.
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Affiliation(s)
- Yang Tang
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc., South San Francisco, CA, USA
| | - Liuxi Chen
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc., South San Francisco, CA, USA
| | - Xiaorong Liang
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc., South San Francisco, CA, USA
| | - Brian Dean
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc., South San Francisco, CA, USA
| | - Jianshuang Wang
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc., South San Francisco, CA, USA
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11
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Baillargeon KR, Mace CR. Microsampling tools for collecting, processing, and storing blood at the point-of-care. Bioeng Transl Med 2023; 8:e10476. [PMID: 36925672 PMCID: PMC10013775 DOI: 10.1002/btm2.10476] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/29/2022] [Accepted: 12/07/2022] [Indexed: 01/01/2023] Open
Abstract
In the wake of the COVID-19 global pandemic, self-administered microsampling tools have reemerged as an effective means to maintain routine healthcare assessments without inundating hospitals or clinics. Finger-stick collection of blood is easily performed at home, in the workplace, or at the point-of-care, obviating the need for a trained phlebotomist. While the initial collection of blood is facile, the diagnostic or clinical utility of the sample is dependent on how the sample is processed and stored prior to transport to an analytical laboratory. The past decade has seen incredible innovation for the development of new materials and technologies to collect low-volume samples of blood with excellent precision that operate independently of the hematocrit effect. The final application of that blood (i.e., the test to be performed) ultimately dictates the collection and storage approach as certain materials or chemical reagents can render a sample diagnostically useless. Consequently, there is not a single microsampling tool that is capable of addressing every clinical need at this time. In this review, we highlight technologies designed for patient-centric microsampling blood at the point-of-care and discuss their utility for quantitative sampling as a function of collection material and technique. In addition to surveying methods for collecting and storing whole blood, we emphasize the need for direct separation of the cellular and liquid components of blood to produce cell-free plasma to expand clinical utility. Integrating advanced functionality while maintaining simple user operation presents a viable means of revolutionizing self-administered microsampling, establishing new avenues for innovation in materials science, and expanding access to healthcare.
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Affiliation(s)
- Keith R Baillargeon
- Department of Chemistry, Laboratory for Living Devices Tufts University Medford Massachusetts USA
| | - Charles R Mace
- Department of Chemistry, Laboratory for Living Devices Tufts University Medford Massachusetts USA
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12
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Influence of Age and Sex on the Pharmacokinetics of Midazolam and the Depth of Sedation in Pediatric Patients Undergoing Minor Surgeries. Pharmaceutics 2023; 15:pharmaceutics15020440. [PMID: 36839762 PMCID: PMC9963644 DOI: 10.3390/pharmaceutics15020440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/23/2022] [Accepted: 01/09/2023] [Indexed: 02/03/2023] Open
Abstract
Whether age and sex influence the depth of sedation and the pharmacokinetics of midazolam is currently unknown. The influence of age and sex was investigated in 117 children (2 to 17 years) who required intravenous sedation for minor surgery (0.05 mg/kg). Plasma concentrations and sedation effects were simultaneously measured. The measured concentrations were analyzed using a two-compartment model with first-order elimination. Among the age ranges, significant differences were found (p < 0.05) between the volume of distribution (Vd) of the first compartment (V1) and that of the second (V2). With respect to sex, differences in V2 were found between age groups. At the administered dose, in patients younger than 6 years, a profound sedative effect (40-60 BIS) was observed for up to 120 min, while in older children, the effect lasted only half as long. The differences found in the Vd and bispectral index (BIS) in patients younger than 6 years compared to older patients may be due to immature CYP3A activity and body fat content; furthermore, the Vd varies with age due to changes in body composition and protein binding. Patients younger than 6 years require intravenous (IV) doses <0.05 mg/kg of midazolam for deep sedation. Dosage adjustments according to age group are suggested.
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A Validated UHPLC-MS/MS Method to Quantify Eight Antibiotics in Quantitative Dried Blood Spots in Support of Pharmacokinetic Studies in Neonates. Antibiotics (Basel) 2023; 12:antibiotics12020199. [PMID: 36830110 PMCID: PMC9952362 DOI: 10.3390/antibiotics12020199] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Conduction of pharmacokinetic (PK) study in pediatric patients is challenging due to blood sampling limits. The dried blood spots (DBS) method represents a potential matrix for microsampling in support of PK studies in children. Herein, we used the Capitainer® qDBS device to develop a DBS method that can collect an exact 10 µL volume of blood on a paper card. This DBS method was developed to simultaneously quantify the concentrations of eight antibiotics, including sulbactam, tazobactam, ampicillin, meropenem, cefotaxime, cefoperazone, piperacillin, and metronidazole using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). METHODS The prepared DBS samples were extracted in methanol containing acetaminophen as the internal standard at 20 °C on a block bath shaker at 500 rpm for 30 min. The extracted antibiotics were eluted on an Acquity UPLC HSS T3 column (2.1 × 50 mm, 1.8 µm) using gradient elution with a total chromatographic run time of 6.5 min. The precursor and product ions of the analytes were detected by use of the multiple reaction monitoring (MRM) mode. RESULTS No interfering peaks at the respective retention times of the analytes were observed in DBS samples. The lower limits of quantification (LLOQ) for the antibiotics were between 0.25 and 2.0 μg/mL, and satisfactory accuracies (intra/inter-assay bias -16.7 to +13.6%) and precisions (intra/inter-assay coefficient of variations 1.5-15.6%) were obtained for the analytes. As a proof of concept, the method was applied to DBS samples obtained from neonatal patients treated with ampicillin and piperacillin/sulbactam. CONCLUSIONS The DBS method is simple and robust, and it can be used in children with limited blood sampling.
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Identification of host biomarkers from dried blood spots for monitoring treatment response in extrapulmonary tuberculosis. Sci Rep 2023; 13:599. [PMID: 36635313 PMCID: PMC9837114 DOI: 10.1038/s41598-022-26823-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/20/2022] [Indexed: 01/14/2023] Open
Abstract
There is a lack of objective tools for monitoring treatment response in extrapulmonary tuberculosis (EPTB). This study aimed to explore the utility of inflammatory biomarkers from the dry blood spots (DBS) as a tool for monitoring treatment response in EPTB. In a prospective cohort study, 40 inflammatory biomarkers were investigated in DBS samples from 105 EPTB cases using a Luminex platform. The samples were taken before, and, at the end of the 2nd and 6th months of treatment. A total of 11 inflammatory host biomarkers changed significantly with treatment in all EPTB patients. CXCL9/MIG, CCL20, CCL23, CXCL10/IP-10, CXCL1, CXCL2, and CXCL8 significantly declined in our cohort of EPTB (48 TB pleuritis and 57 TB lymphadenitis) patients at both time points. A biosignature consisting of MIG, CCL23, and CXCL2, corresponded with the treatment response in 81% of patients in the 2nd month and 79% of patients at the end of treatment. MIG, CCL23, IP-10, and CXCL2 changed significantly with treatment in all patients including those showing partial clinical response at the 2nd month of treatment. The changes in the levels of inflammatory biomarkers in the DBS correspond with the treatment success and can be developed as a routine test in low-resource settings.
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15
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Schork NJ, Beaulieu-Jones B, Liang WS, Smalley S, Goetz LH. Exploring human biology with N-of-1 clinical trials. CAMBRIDGE PRISMS. PRECISION MEDICINE 2023; 1:e12. [PMID: 37255593 PMCID: PMC10228692 DOI: 10.1017/pcm.2022.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/12/2022] [Accepted: 12/26/2022] [Indexed: 06/01/2023]
Abstract
Studies on humans that exploit contemporary data-intensive, high-throughput 'omic' assay technologies, such as genomics, transcriptomics, proteomics and metabolomics, have unequivocally revealed that humans differ greatly at the molecular level. These differences, which are compounded by each individual's distinct behavioral and environmental exposures, impact individual responses to health interventions such as diet and drugs. Questions about the best way to tailor health interventions to individuals based on their nuanced genomic, physiologic, behavioral, etc. profiles have motivated the current emphasis on 'precision' medicine. This review's purpose is to describe how the design and execution of N-of-1 (or personalized) multivariate clinical trials can advance the field. Such trials focus on individual responses to health interventions from a whole-person perspective, leverage emerging health monitoring technologies, and can be used to address the most relevant questions in the precision medicine era. This includes how to validate biomarkers that may indicate appropriate activity of an intervention as well as how to identify likely beneficial interventions for an individual. We also argue that multivariate N-of-1 and aggregated N-of-1 trials are ideal vehicles for advancing biomedical and translational science in the precision medicine era since the insights gained from them can not only shed light on how to treat or prevent diseases generally, but also provide insight into how to provide real-time care to the very individuals who are seeking attention for their health concerns in the first place.
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Affiliation(s)
- N. J. Schork
- Department of Quantitative Medicine, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
- Net.bio Inc., Los Angeles, CA, USA
| | - B. Beaulieu-Jones
- Net.bio Inc., Los Angeles, CA, USA
- University of Chicago, Chicago, IL, USA
| | | | - S. Smalley
- Net.bio Inc., Los Angeles, CA, USA
- The University of California Los Angeles, Los Angeles, CA, USA
| | - L. H. Goetz
- Department of Quantitative Medicine, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
- Net.bio Inc., Los Angeles, CA, USA
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Green JM, Barry F, Burton P, Beauchemin J, Huentelman MJ, Deoni SCL, Lewis CR. At-home dried blood spot (DBS) collection to increase population heterogeneity representation in pediatric research: An ECHO study. Front Pediatr 2023; 11:1059107. [PMID: 36937973 PMCID: PMC10020170 DOI: 10.3389/fped.2023.1059107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/31/2023] [Indexed: 03/06/2023] Open
Abstract
Self-collection of dried blood samples (DBS) in the participant's home provides an alternative to university/hospital visits for research and has the potential to improve the representation of population heterogeneity in research. This study aimed to assess the feasibility of guardian and/or self-DBS collection in healthy youth in the lab and home. Guardians/youth [N = 140; females = 63; M age = 8.73, SD age = 3.56] who enrolled in a longitudinal study of typical development were asked during a lab visit to provide a DBS. Upon providing a sample, the participants were asked if they would be willing to self-collect in the home and return the sample via the post office. Of those asked to provide a sample in the lab, 82% consented and 18% declined, with a significant difference in age but no significant difference in sex, ethnicity, race, or family income. Of those who provided a sample in the lab, 75% were willing to self-collect DBS in the home, with no significant difference in demographic variables between them. We report a quality assessment and DNA extraction results from a subset of samples. The results demonstrate a high feasibility of DBS collection from healthy youth for research purposes both in the laboratory and in the home across different demographic variables. Developmental researchers should consider including this approach in their studies to increase population heterogeneity representation.
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Affiliation(s)
- Joseph M. Green
- School of Life Sciences, Arizona State University, Tempe, AZ, United States
| | - Fatoumata Barry
- Rhode Island Hospital, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Phoebe Burton
- Rhode Island Hospital, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Jennifer Beauchemin
- Rhode Island Hospital, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Matthew J. Huentelman
- Neurogenomics, Translational Genomics Research Institute, Phoenix, AZ, United States
| | - Sean C. L. Deoni
- Rhode Island Hospital, Warren Alpert Medical School, Brown University, Providence, RI, United States
- Department of Pediatrics, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Candace R. Lewis
- School of Life Sciences, Arizona State University, Tempe, AZ, United States
- Neurogenomics, Translational Genomics Research Institute, Phoenix, AZ, United States
- Correspondence: Candace R. Lewis
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17
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Francke MI, Peeters LEJ, Hesselink DA, Kloosterboer SM, Koch BCP, Veenhof H, de Winter BCM. Best Practices to Implement Dried Blood Spot Sampling for Therapeutic Drug Monitoring in Clinical Practice. Ther Drug Monit 2022; 44:696-700. [PMID: 35607881 PMCID: PMC9467683 DOI: 10.1097/ftd.0000000000000994] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/27/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sampling of blood at home to determine the concentration of drugs or other compounds can be effective in limiting hospital-based sampling. This could lower hospital visits and patient burden, improve the quality of life, and reduce health care costs. Dried blood spot (DBS) microsampling is often used for this purpose, wherein capillary blood, obtained by pricking the heel or finger, is used to measure different analytes. Although DBS has several advantages over venous blood sampling, it is not routinely implemented in clinical practice. To facilitate the bench to bedside transition, it is important to be aware of certain challenges that need to be considered and addressed. RESULTS Here, important considerations regarding the implementation of DBS in clinical practice, the choice of patients, blood sampling, transport, and laboratory analysis are discussed. In addition, we share our experience and provide suggestions on how to deal with these problems in a clinical setting.
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Affiliation(s)
- Marith I. Francke
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam
| | - Laura E. J. Peeters
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam
- Division of Vascular Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam
| | - Dennis A. Hesselink
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam
| | - Sanne M. Kloosterboer
- Department of Child- and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam; and
| | - Birgit C. P. Koch
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam
| | - Herman Veenhof
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Woo S, Rosli N, Choi S, Kwon HJ, Yoon YA, Ahn S, Lee JY, Hong SP, Jeong JS. Development of Certified Reference Material for Amino Acids in Dried Blood Spots and Accuracy Assessment of Disc Sampling. Anal Chem 2022; 94:10127-10134. [PMID: 35802862 PMCID: PMC9310008 DOI: 10.1021/acs.analchem.2c01349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
![]()
To achieve the measurement reliability of amino acids
used as diagnostic
markers in clinical fields, establishing a reference measurement system
is required, in which certified reference materials (CRMs) are an
essential step in the hierarchy of measurement traceability. This
study describes the development of dried blood spot (DBS) CRMs for
amino acid analysis with complete measurement traceability to the
International System of Units (SI). Six essential amino acids—proline,
valine, isoleucine, leucine, phenylalanine, and tyrosine—were
analyzed using isotope-dilution liquid chromatography–mass
spectrometry (ID-MS). For minimizing measurement bias and uncertainty
overestimation, whole spots with 50 μL of whole blood were adopted
in the certification. The between-spot homogeneities by whole spot
sampling were lower than 2.1%. The relative expanded uncertainties
of the six amino acids in the developed DBS CRMs were lower than 5.7%
at 95% confidence. The certified values are traceable to SI through
both gravimetric preparation and the primary method in certification,
ID-MS. Comparison among DBS testing laboratories revealed discrepancies
between the whole spot and disc sampling methods. The actual sampling
volume was accurately estimated by weighing, which revealed the possibility
of underestimation in routine DBS testing. The candidate CRMs can
support the standardization of DBS testing for amino acids through
the qualification and validation of many kinds of measurement procedures
to compensate the measurement bias caused by matrix-specific sampling
error.
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Affiliation(s)
- Sangji Woo
- Biometrology Group, Division of Chemical and Biological Metrology, Korea Research Institute of Standards and Science, 267 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea.,Department of Oriental Pharmaceutical Sciences, College of Pharmacy, KyungHee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 16954, Republic of Korea
| | - Nordiana Rosli
- Biometrology Group, Division of Chemical and Biological Metrology, Korea Research Institute of Standards and Science, 267 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea.,Department of Bio-Analytical Science, University of Science and Technology, 217 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea.,Training Division Ministry of Health Malaysia, Level 6 Menara Prisma, Presint 3, 62675 Putrajaya, Malaysia
| | - Seohyun Choi
- Biometrology Group, Division of Chemical and Biological Metrology, Korea Research Institute of Standards and Science, 267 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea.,Department of Bio-Analytical Science, University of Science and Technology, 217 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
| | - Ha-Jeong Kwon
- Biometrology Group, Division of Chemical and Biological Metrology, Korea Research Institute of Standards and Science, 267 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
| | - Young Ahn Yoon
- Department of Laboratory Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang Univerisity College of Medicine, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do 130-701, Republic of Korea
| | - Sunhyun Ahn
- Seoul Clinical Laboratories, 13, Heungdeok 1-ro, Giheung-gu, Yongin-si, Gyeonggi-do 34113, Republic of Korea
| | - Ji Youn Lee
- Biometrology Group, Division of Chemical and Biological Metrology, Korea Research Institute of Standards and Science, 267 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
| | - Seon-Pyo Hong
- Department of Oriental Pharmaceutical Sciences, College of Pharmacy, KyungHee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 16954, Republic of Korea
| | - Ji-Seon Jeong
- Biometrology Group, Division of Chemical and Biological Metrology, Korea Research Institute of Standards and Science, 267 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea.,Department of Bio-Analytical Science, University of Science and Technology, 217 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
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19
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Rodríguez-Saldaña V, Basu N. Comparison and Agreement of Toxic and Essential Elements Between Venous and Capillary Whole Blood. Biol Trace Elem Res 2022; 200:3088-3096. [PMID: 34545473 DOI: 10.1007/s12011-021-02931-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/14/2021] [Indexed: 11/30/2022]
Abstract
For practical and ethical reasons, there is an interest in the use of capillary blood as an alternative to classical human biomonitoring methods that use venipuncture. However, with the exception of Pb, few elements have been studied in detail to understand potential differences in measures between capillary and venous blood. To increase our understanding of the agreement in concentrations of select toxic metal(loid)s and essential minerals in venous and capillary whole blood. Concentrations of As, Pb, Cd, Mn, Cu, Fe, and Se were measured with Inductively Coupled Plasma-Mass Spectrometry in venous and capillary whole blood samples obtained from 49 healthy adult members of the McGill University community in 2016. Measured concentrations of all elements were similar to values reported in background populations. There were strong correlations (i.e., p < 0.001) in measures taken for all these elements between capillary and venous blood. Using Bland-Altman, a deeper investigation of the agreement between the measures found relatively good agreement for blood As, Pb, Cu, and Fe. For blood Cd, Mn, and Se, the agreement between the measures taken in capillary and venous blood was less consistent, though more research is needed to determine if the method can be improved and/or if there are real differences. For the seven elements under investigation, there was relatively good correlation and agreement in measures taken between capillary and venous blood from the same individual. Further research is needed to confirm these findings (particularly from more diverse population groups), expand the number of elements analyzed, and explore the utility of capillary sampling in biomonitoring programs that take samples using traditional venipuncture methods.
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Affiliation(s)
- Verónica Rodríguez-Saldaña
- Faculty of Agricultural and Environmental Sciences, McGill University, Ste-Anne-de-Bellevue, Montreal, Québec, Canada
| | - Niladri Basu
- Faculty of Agricultural and Environmental Sciences, McGill University, Ste-Anne-de-Bellevue, Montreal, Québec, Canada.
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20
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Samsonova JV, Saushkin NY, Osipov AP. Dried Blood Spots technology for veterinary applications and biological investigations: technical aspects, retrospective analysis, ongoing status and future perspectives. Vet Res Commun 2022; 46:655-698. [PMID: 35771305 PMCID: PMC9244892 DOI: 10.1007/s11259-022-09957-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/13/2022] [Indexed: 11/25/2022]
Abstract
Dried Blood Spots (DBS) technology has become a valuable tool in medical studies, however, in veterinary and biological research DBS technology applications are still limited. Up-to-date no review has comprehensively integrated all the evidence existing across the fields, technologies and animal species. In this paper we summarize the current applications of DBS technology in the mentioned areas, and provide a scope of different types of dried sample carriers (cellulose and non-cellulose), sampling devices, applicable methods for analyte extraction and detection. Mammals, birds, insects and other species are represented as the study objects. Besides the blood, the review considers a variety of specimens, such as milk, saliva, tissue samples and others. The main applications of dried samples highlighted in the review include epidemiological surveys and monitoring for infections agents or specific antibodies for disease/vaccination control in households and wildlife. Besides the genetic investigations, the paper describes detection of environmental contaminants, pregnancy diagnosis and many other useful applications of animal dried samples. The paper also analyses dried sample stability and storage conditions for antibodies, viruses and other substances. Finally, recent developments and future research for DBS technology in veterinary medicine and biological sciences are discussed.
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Affiliation(s)
- Jeanne V Samsonova
- Faculty of Chemistry, Lomonosov Moscow State University, Moscow, Russia.
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21
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Samsonova JV, Saushkin NY, Osipov AP. Dried Samples of Biological Fluids on Porous Membranes as a Promising Sample Preparation Method for Biomedical and Veterinary Diagnostics. JOURNAL OF ANALYTICAL CHEMISTRY 2022. [DOI: 10.1134/s1061934822040104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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22
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Anderson M, Dockendorf MF, McIntosh I, Xie I, Breidinger S, Meng D, Ren S, Zhong W, Zhang L, Roadcap B, Bateman KP, Stone J, Woolf E. An Investigation of Instability in Dried Blood Spot Samples for Pharmacokinetic Sampling in Phase 3 Trials of Verubecestat. AAPS J 2022; 24:52. [PMID: 35384529 DOI: 10.1208/s12248-022-00683-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 01/19/2022] [Indexed: 11/30/2022] Open
Abstract
In-clinic dried blood spot (DBS) pharmacokinetic (PK) sampling was incorporated into two phase 3 studies of verubecestat for Alzheimer's disease (EPOCH [NCT01739348] and APECS [NCT01953601]), as a potential alternative to plasma PK sampling for improved logistical feasibility and decreased blood volume burden. However, an interim PK analysis revealed verubecestat concentrations in DBS samples declined with time to assay in both trials. An investigation revealed wide variation in implementation practices for DBS sample handling procedures resulting in insufficient desiccation which caused verubecestat instability. High-resolution mass spectrometry evaluations of stressed and aged verubecestat DBS samples revealed the presence of two hydrolysis degradants. To minimize instability, new DBS handling procedures were implemented that provided additional desiccant and minimized the time to analysis. Both verubecestat hydrolysis products were previously discovered and synthesized during active pharmaceutical ingredient stability characterization. A liquid chromatography-mass spectrometry assay to quantitate the dominant verubecestat degradant in DBS samples was developed and validated. The application of this method to stressed and aged verubecestat DBS samples confirmed that degradant concentrations accounted for the observed decreases in the verubecestat concentration. Furthermore, after increasing desiccant amounts, degradant concentrations accounted for approximately 7% of the verubecestat concentration in DBS clinical samples, indicating that issues with sample handling were minimized with new storage and shipping conditions. This case study illustrates the challenges with employing new sampling techniques in large, global trials, and the importance of anticipating and mitigating implementation risks.
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Affiliation(s)
- Melanie Anderson
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA.
| | - Marissa F Dockendorf
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Ian McIntosh
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Iris Xie
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Sheila Breidinger
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Dongfang Meng
- Process Chemistry, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Sumei Ren
- SM PR&D, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Wendy Zhong
- Analytical Research & Development, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Li Zhang
- Analytical Research & Development, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Brad Roadcap
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Kevin P Bateman
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Julie Stone
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Eric Woolf
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
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23
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Koutsimpani-Wagner A, Quartucci C, Rooney JPK, Bose-O'Reilly S, Rakete S. Mercury biomonitoring in German adults using volumetric absorptive microsampling. ENVIRONMENTAL MONITORING AND ASSESSMENT 2022; 194:315. [PMID: 35355133 PMCID: PMC8969040 DOI: 10.1007/s10661-022-09962-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/19/2022] [Indexed: 06/09/2023]
Abstract
Mercury (Hg) is a global pollutant and a danger to human health. Human biomonitoring of Hg using a dried blood matrix instead of venous blood sampling for exposure assessment is of growing interest. This study aims to develop, validate, and evaluate the application of volumetric absorptive microsampling (VAMS) for Hg biomonitoring in humans. Sampling, drying, and storage conditions were evaluated during method development. Storage in pre-cleaned glass vials after drying for 2 h in a desiccator ensured analyte stability for at least 4 weeks. Sixty-eight paired capillary VAMS and venous blood samples from volunteers in Munich, Germany, were used for method validation. Hg levels in VAMS and venous blood samples were determined by direct mercury analysis. The limits of detection and quantitation for VAMS were 0.18 and 0.61 µg/l, respectively. However, sensitivity could be improved by using two microsamples for analysis instead of one. Hg levels in VAMS samples correlated very well with Hg levels in venous blood samples (R2 = 0.958). Furthermore, VAMS showed a high accuracy (median recovery: 117%) and precision (median relative standard deviation: 8.7%), especially for Hg concentrations above 1.0 µg/l. In fact, accuracy and precision of VAMS improved with increasing Hg concentrations. In conclusion, VAMS in combination with direct mercury analysis is an accurate and viable alternative for human biomonitoring of Hg.
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Affiliation(s)
- Anastasia Koutsimpani-Wagner
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 5, 80336, Munich, Germany
| | - Caroline Quartucci
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 5, 80336, Munich, Germany
- Institute for Occupational Health and Product Safety, Bavarian Health and Food Safety Authority, Environmental Health, Munich, Germany
| | - James P K Rooney
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 5, 80336, Munich, Germany
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Stephan Bose-O'Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 5, 80336, Munich, Germany
- Department of Public HealthInstitute of Public Health, Medical Decision Making and Health Technology AssessmentMedical Informatics and Technology, Health Services Research and Health Technology Assessment, UMIT - Private University for Health Sciences, Hall i.T., Austria
| | - Stefan Rakete
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 5, 80336, Munich, Germany.
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Huang X, Liu X, Wang Y, Zhang J. Determination of polymyxin B in dried blood spots using LC-MS/MS for therapeutic drug monitoring. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1192:123131. [DOI: 10.1016/j.jchromb.2022.123131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
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Baillargeon K, Brooks JC, Miljanic PR, Mace CR. Patterned Dried Blood Spot Cards for the Improved Sampling of Whole Blood. ACS MEASUREMENT SCIENCE AU 2022; 2:31-38. [PMID: 35211698 PMCID: PMC8855418 DOI: 10.1021/acsmeasuresciau.1c00031] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Indexed: 06/12/2023]
Abstract
Dried blood spot (DBS) cards perform many functions for sampling blood that is intended for subsequent laboratory analysis, which include: (i) obviating the need for a phlebotomist by using fingersticks, (ii) enhancing the stability of analytes at ambient or elevated environmental conditions, and (iii) simplifying the transportation of samples without a cold chain. However, a significant drawback of standard DBS cards is the potential for sampling bias due to unrestricted filling caused by the hematocrit of blood, which often limits quantitative or reproducible measurements. Alternative microsampling technologies have minimized or eliminated this bias by restricting blood distribution, but these approaches deviate from clinical protocols and present a barrier to broad adoption. Herein, we describe a patterned dried blood spot (pDBS) card that uses wax barriers to control the flow and restrict the distribution of blood to provide enhanced sampling. These patterned cards reproducibly fill four replicate extraction zones independent of the hematocrit effect. We demonstrate a 3-fold improvement in accuracy for the quantitation of hemoglobin using pDBS cards compared to unpatterned cards. Patterned cards also facilitate the near quantitative recovery (ca. 95%) of sodium with no evidence of a statistically significant difference between dried and liquid blood samples. Similarly, the recovery of select amino acids was conserved in comparison to a recent report with improved intercard precision. We anticipate that this approach presents a viable method for preparing and storing samples of blood in limited resource settings while maintaining current clinical protocols for processing and analyzing dried blood spots.
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Dried matrix spots: an evolving trend in the toxicological field. Forensic Sci Med Pathol 2022; 18:86-102. [PMID: 35171452 DOI: 10.1007/s12024-021-00434-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 10/19/2022]
Abstract
Dried matrix spot (DMS) is a sampling technique, primarily used to analyze blood to diagnose metabolic diseases in newborns. As this technique has several advantages, DMS has started to be employed for other purposes using other biological matrices and increasingly in toxicology over the last decade. The aim of this work was to review the analytical methods using DMS which can be applied to drugs of abuse and which have been published since 2010. Three different databases were searched, using dried, spots, and drugs of abuse as the descriptors and using a snowball search. After applying the exclusion criteria, 39 papers remained. The most common publications were related to the use of blood, which corresponded to 77% of the papers, followed by urine and oral fluid, which corresponded to 13 and 10% of the papers, respectively. The selected studies covered different illicit drugs, sample sizes of 5 to 250 µL and spot sizes ranging from 3 to 18 mm in diameter. This review also examined the extraction techniques and the methods employed to analyze various biological matrices and drugs of abuse, mostly by liquid-extraction and liquid chromatography-tandem mass spectrometry. The benefits of DMS include: a simple sample pretreatment, better stability than liquid matrices, a simple extraction procedure, lower costs, and environmental benefits. DMS appears to be a promising technique in the field of toxicology and provides new perspectives for use in forensic laboratories.
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Developing a Nationwide Infrastructure for Therapeutic Drug Monitoring of Targeted Oral Anticancer Drugs: The ON-TARGET Study Protocol. Cancers (Basel) 2021; 13:cancers13246281. [PMID: 34944899 PMCID: PMC8699239 DOI: 10.3390/cancers13246281] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 12/28/2022] Open
Abstract
Simple Summary Relationships between drug concentrations in blood and efficacy and/or toxicity have been reported for up to 80% of oral anticancer drugs (OADs). Most OADs exhibit highly variable drug concentrations at the approved dose. This may result in a significant proportion of patients with suboptimal drug concentrations. Therapeutic Drug Monitoring (TDM), which is dose optimization based on measured drug concentrations, can be used to personalize drug dosing with the overall goal to improve the benefit-risk ratio of anticancer drug treatment. The ON-TARGET study aims to investigate the feasibility of TDM in patients receiving either axitinib or cabozantinib for the treatment of renal-cell carcinoma with the main objective to improve severe tyrosine kinase inhibitor associated toxicity. Additionally, the feasibility of volumetric absorptive microsampling (VAMS), a novel minimally invasive and easy to handle blood sampling technique, for TDM sample collection is investigated. Abstract Exposure-efficacy and/or exposure-toxicity relationships have been identified for up to 80% of oral anticancer drugs (OADs). Usually, OADs are administered at fixed doses despite their high interindividual pharmacokinetic variability resulting in large differences in drug exposure. Consequently, a substantial proportion of patients receive a suboptimal dose. Therapeutic Drug Monitoring (TDM), i.e., dosing based on measured drug concentrations, may be used to improve treatment outcomes. The prospective, multicenter, non-interventional ON-TARGET study (DRKS00025325) aims to investigate the potential of routine TDM to reduce adverse drug reactions in renal cell carcinoma patients receiving axitinib or cabozantinib. Furthermore, the feasibility of using volumetric absorptive microsampling (VAMS), a minimally invasive and easy to handle blood sampling technique, for sample collection is examined. During routine visits, blood samples are collected and sent to bioanalytical laboratories. Venous and VAMS blood samples are collected in the first study phase to facilitate home-based capillary blood sampling in the second study phase. Within one week, the drug plasma concentrations are measured, interpreted, and reported back to the physician. Patients report their drug intake and toxicity using PRO-CTCAE-based questionnaires in dedicated diaries. Ultimately, the ON-TARGET study aims to develop a nationwide infrastructure for TDM for oral anticancer drugs.
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Yue X, Liu W, Liu Y, Shen M, Zhai Y, Ma Z, Cao Z. Development, validation, and clinical application of an FIA-MS/MS method for the quantification of lysophosphatidylcholines in dried blood spots. J Clin Lab Anal 2021; 36:e24099. [PMID: 34788474 PMCID: PMC8761423 DOI: 10.1002/jcla.24099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 12/04/2022] Open
Abstract
Background Lysophosphatidylcholine (LPC) plays pivotal roles in several physiological processes and their disturbances are closely associated with various disorders. In this study, we described the development and validation of a reliable and simple flow injection analysis–tandem mass spectrometry (FIA‐MS/MS)‐based method using dried blood spots (DBS) for quantification of four individual LPC (C20:0, C22:0, C24:0, and C26:0). Methods Lysophosphatidylcholines were extracted from 3.2 mm DBS with 85% methanol containing 60 ng/ml internal standard using a rapid (30 min) and simple procedure. The analytes and the internal standard were directly measured by triple quadrupole tandem mass spectrometry in multiple reactions monitoring mode via positive electrospray ionization. Results Method validation results showed good linearity ranging from 50 to 2000 ng/ml for each LPC. Intra‐ and inter‐day precision and accuracy were within the acceptable limits at four quality control levels. Recovery was from 70.5% to 107.0%, and all analytes in DBS were stable under assay conditions (24 h at room temperature and 72 h in autosampler). The validated method was successfully applied to assessment of C20:0‐C26:0LPCs in 1900 Chinese neonates. C26:0‐LPC levels in this study were consistent with previously published values. Conclusion We propose a simple FIA‐MS/MS method for analyzing C20:0‐C26:0LPCs in DBS, which can be used for first‐tier screening.
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Affiliation(s)
- Xiaofei Yue
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.,Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Wei Liu
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.,Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Ying Liu
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.,Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Min Shen
- Reference Laboratory, Medical System Biotechnology Co., Ltd, Ningbo, Zhejiang, China
| | - Yanhong Zhai
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.,Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Zhijun Ma
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.,Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Zheng Cao
- Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.,Beijing Maternal and Child Health Care Hospital, Beijing, China.,Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
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Kleijne VD, Kohler I, C Heijboer A, Ackermans MT. Solutions for hematocrit bias in dried blood spot hormone analysis. Bioanalysis 2021; 13:1293-1308. [PMID: 34470479 DOI: 10.4155/bio-2021-0119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Over the last years, dried blood spot (DBS) sampling has gained significant interest due to development of analytical techniques combined with DBS, the simplicity and low cost of the method. Despite its wide use, DBS sampling can lead to inaccurate results due to the impact of the hematocrit (Hct) on the analysis. Some analytes have shown to be hardly impacted by Hct values. However, in other cases, a significant impact of Hct is observed, which requires the use of alternative approaches to circumvent this issue. This review describes the possible impact of Hct-related bias in DBS sampling in the context of hormone analysis and discusses the different methodologies that can be used to overcome this bias to ensure accurate results.
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Affiliation(s)
- Vera de Kleijne
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Isabelle Kohler
- Division of BioAnalytical Chemistry, Amsterdam Institute of Molecular & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Center for Analytical Sciences Amsterdam, Amsterdam, The Netherlands
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands
| | - Mariëtte T Ackermans
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Lin SY, Peng YF, Huang CF, Kuo CH, Tang SC, Jeng JS. Measurement of Dabigatran Concentration Using Finger Prick Dried Blood Spot Sample Collection. Front Pharmacol 2021; 12:679431. [PMID: 34122105 PMCID: PMC8187780 DOI: 10.3389/fphar.2021.679431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/12/2021] [Indexed: 12/04/2022] Open
Abstract
Background and Purpose: Real-world laboratory monitoring of dabigatran activity is challenging. The purpose of the present study was to demonstrate the feasibility and accuracy of finger prick sampling with dried blood spot (fpDBS) cards in measuring the dabigatran concentration. Material and Methods: Patients >20 years of age with atrial fibrillation and receiving dabigatran therapy for more than 7 days were included in the study. Peak and trough dabigatran concentrations were collected by simultaneous finger prick and venous puncture. The dabigatran concentration was measured by ultra-high performance liquid chromatography with tandem mass spectrometry. Our previously developed post-column infused internal standard (PCI-IS) method was applied to estimate the blood spot volume on fpDBS and to calibrate the drug concentration. Deming regression was used to analyze the correlation between dabigatran concentration on fpDBS cards and in plasma samples, followed by Bland–Altman analysis to compare the bias between two sampling techniques. Results: A total of 33 patients were enrolled and contributed 66 plasma and 55 fpDBS dabigatran samples. The average patient age was 74.6 ± 7.9 years, mean creatinine clearance 58.1 ± 18.3 mL/min, and CHA2DS2-VASc score 3.5 ± 1.6 points. The dabigatran concentration ranged from 41.8–1421.7 ng/mL. The plasma and DBS dabigatran concentrations correlated well (r = 0.98), and the conversion factor for fpDBS to plasma dabigatran concentration was 1.28. The Bland–Altman analysis showed that 94.5% of the fpDBS-predicted concentration fell within 20% of bias. Conclusions: The study showed that fpDBS measurement of dabigatran concentration is reliable and can be applied in clinical scenarios.
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Affiliation(s)
- Shin-Yi Lin
- Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Fong Peng
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Fen Huang
- Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ching-Hua Kuo
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sung-Chun Tang
- Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jiann-Shing Jeng
- Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
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Comparison of different preparation techniques of dried blood spot quality controls in newborn screening for congenital adrenal hyperplasia. PLoS One 2021; 16:e0252091. [PMID: 34015037 PMCID: PMC8136632 DOI: 10.1371/journal.pone.0252091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/07/2021] [Indexed: 11/19/2022] Open
Abstract
In newborn screening, samples suspected for congenital adrenal hyperplasia (CAH), a potentially lethal inborn error of steroid biosynthesis, need to be confirmed using liquid chromatography-tandem mass spectrometry. Daily quality controls (QCs) for the 2nd-tier CAH assay are not commercially available and are therefore generally prepared within the laboratory. For the first time, we aimed to compare five different QC preparation approaches used in routine diagnostics for CAH on the concentrations of cortisol, 21-deoxycortisol, 11-deoxycortisol, 4-androstenedione and 17-hydroxyprogesterone in dried blood spots. The techniques from Prep1 to Prep5 were tested at two analyte concentrations by spiking aliquots of a steroid-depleted blood, derived from washed erythrocyte suspension and steroid-depleted serum. The preparation processes differed in the sequence of the preparation steps and whether freeze-thaw cycles were used to facilitate blood homogeneity. The five types of dried blood spot QCs were assayed and quantitated in duplicate on five different days using a single calibration row per day. Inter-assay variations less than 15% and concentrations within ±15% of the nominal values were considered acceptable. Results obtained by means of the four dried blood spot QC preparation techniques (Prep1, Prep2, Prep4 and Prep5) were statistically similar and remained within the ±15% ranges in terms of both reproducibility and nominal values. However, concentration results for Prep3 (spiking prior to three freeze-thaw cycles) were significantly lower than the nominal values in this setting, with differences exceeding the ±15% range in many cases despite acceptable inter-assay variations. These findings have implications for the in-house preparation of QC samples in laboratory developed tests for CAH, including 2nd-tier assays in newborn screening.
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Braal CL, Lam MH, Rienks T, van Tilborg CJ, Heuts W, Heijns JB, Bos MEMM, Mathijssen RHJ, de Bruijn P, Koolen SLW. Quantification of ribociclib in dried blood spots by LC-MS/MS: Method development and clinical validation. J Pharm Biomed Anal 2021; 201:114118. [PMID: 34000578 DOI: 10.1016/j.jpba.2021.114118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/28/2021] [Accepted: 05/01/2021] [Indexed: 11/19/2022]
Abstract
A reliable, specific, selective and robust liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed for the determination of ribociclib in both dried blood spot (DBS) samples and potassium EDTA plasma. DBS samples were obtained simultaneously with a plasma sample in advanced breast cancer patients treated with ribociclib. A 6 mm disk from the central part of the dried blood spot sample was punched, followed by extraction of ribociclib using liquid-liquid extraction spiked with ribociclib-d6 as internal standard. Concentrations of ribociclib in DBS samples were correlated with corresponding plasma concentrations. From the blood sample also hematocrit was determined. The method was validated for selectivity, sensitivity, precision, lower limit of detection, linearity, stability and accuracy according to the food and drug administration (FDA) guideline. The within- and between-run precisions were ≤10.6 and ≤1.07 %, respectively; while the average accuracy ranged from 100 to 103 %. The influence of hematocrit on validation parameters was tested in the range of 0.20 - 0.40 L/L. No influence of hematocrit on validation parameters was observed. Regression analysis and a Bland-Altman plot indicated correlation between the results obtained from DBS and plasma samples. A strong correlation (R2 >0.97) between DBS samples and plasma concentration from 17 breast cancer patients was found. A number of 12 out of 17 processed DBS samples (71 %) fell inside the acceptable range of 20 % difference of simultaneously obtained plasma samples. The lower limit of quantification in DBS is 10.0 ng/mL and linearity was demonstrated up to 1000 ng/mL. In conclusion, the newly developed assay met the required standard for validation. The methods were used to study ribociclib disposition in patients with advanced breast cancer.
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Affiliation(s)
- C Louwrens Braal
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
| | - Mei H Lam
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Tineke Rienks
- Department of Medical Oncology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands
| | - Claudia J van Tilborg
- Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Wendy Heuts
- Department of Internal Medicine, Laurentius Hospital, Roermond, The Netherlands
| | - Joan B Heijns
- Department of Medical Oncology, Amphia Hospital, Breda, The Netherlands
| | - Monique E M M Bos
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Ron H J Mathijssen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Peter de Bruijn
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Stijn L W Koolen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands; Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands
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Clinical Validation of a Dried Blood Spot Assay for 8 Antihypertensive Drugs and 4 Active Metabolites. Ther Drug Monit 2021; 42:460-467. [PMID: 31593031 DOI: 10.1097/ftd.0000000000000703] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Drug nonadherence is one of the major challenges faced by resistant hypertension patients, and identification of this problem is needed for optimizing pharmacotherapy. Dried blood spot (DBS) sampling is a minimally invasive method designed to detect and determine the degree of nonadherence. In this study, a DBS method for qualifying 8 antihypertensive drugs (AHDs) and 4 active metabolites was developed and validated using ultra high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). METHOD The DBS assay was validated analytically and clinically, in accordance with FDA requirements. Analytical validation was accomplished using UHPLC-MS/MS. For clinical validation, paired peak and trough levels of DBS and plasma samples were simultaneously collected and comparatively analyzed using Deming regression and Bland-Altman analyses. All concentrations below the set lower limit were excluded. Deming regression analysis was used to predict comparison bias between the collected plasma and DBS samples, with DBS concentrations corrected accordingly. RESULTS The UHPLC-MS/MS method for simultaneously measuring 8 AHDs and their metabolites in DBS, was successfully validated. With Deming regression no bias was observed in N = 1; constant bias was seen in N = 6 and proportional bias in N = 11 of the AHDs and metabolites. After correction for bias, only one metabolite (canrenone) met the 20% acceptance limit for quantification, after Bland-Altman analyses. In addition, amlodipine, valsartan, and [enalaprilate] met the 25% acceptance limit. CONCLUSIONS A novel DBS assay for simultaneously qualifying and quantifying 8 AHDs and their metabolites, has been successfully developed and validated. The DBS assay is therefore a suitable method to detect drug nonadherence. However, with the exception of canrenone, the interchangeable use of plasma and DBS sampling to interpret drug quantities should be avoided.
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Dilo A, Daali Y, Desmeules J, Chalandon Y, Uppugunduri CRS, Ansari M. Comparing Dried Blood Spots and Plasma Concentrations for Busulfan Therapeutic Drug Monitoring in Children. Ther Drug Monit 2021; 42:111-117. [PMID: 31348116 DOI: 10.1097/ftd.0000000000000673] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Busulfan (Bu) is one of the conditioning regimen components for pediatric hematopoietic stem cell transplantation. Bu therapeutic drug monitoring (TDM) is essential for a successful treatment outcome and toxicity evasion. Dried blood spot (DBS) sampling is a rapid and simple method for Bu TDM, compared with conventional plasma sampling. This study evaluated the feasibility of using the DBS method for Bu TDM. The hematocrit (Hct) and conditioning day were also examined for their impact on the DBS method's performance. METHODS Venous blood collected from 6 healthy volunteers was diluted, using their plasma into 4 samples of varying Hct values. Each sample was spiked with Bu calibrators (300, 600, and 1400 ng/mL), prepared using DBS and dried plasma spot (DPS) sampling and analyzed using a validated liquid-chromatography tandem-mass spectrometry method. Clinical blood samples (n = 153) from pediatric patients (n = 15) treated with Bu (mainly from doses 1, 2, 5, and 9) were used to prepare paired volumetric DBS and DPS samples. A Bland-Altman plot and Deming regression were used to define the agreement between the paired DBS and DPS measurements. Passing-Bablok regression analyses investigated the effects of Hct and conditioning day on the linearity between both methods. RESULTS In vitro analyses showed good agreement between DBS and DPS measurements, with a mean difference of -5.4% and a 95% confidence interval on the limits of agreement of -15.3% to 4.6%. Clinical samples showed good correlation (Pearson correlation coefficient = 0.96; slope = 1.00) between the DBS and DPS methods. The DBS method met the clinical acceptance limits for clinical samples, with a bias <±20%. Bland-Altman plots showed good agreement, with only 5.8% of paired measurements exceeding the limits of agreement (±1.96 SD), although within its 95% confidence interval. Hct observations ranged from 21.7% to 34.7% and did not affect Bu concentrations measured from DBS in either the in vitro or in vivo studies. CONCLUSIONS These results show that DBS is a useful method for Bu TDM, provided samples are analyzed on the collection day. DBS sampling offers advantages over traditional plasma sampling in infants and younger children because only small volumes of blood are required.
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Affiliation(s)
- Ana Dilo
- Clinical Pharmacology and Toxicology Unit, Geneva University Hospitals, University of Geneva
| | - Youssef Daali
- Clinical Pharmacology and Toxicology Unit, Geneva University Hospitals, University of Geneva
| | - Jules Desmeules
- Clinical Pharmacology and Toxicology Unit, Geneva University Hospitals, University of Geneva
| | - Yves Chalandon
- Division of Hematology, Department of Oncology, Geneva University Hospitals
| | - Chakradhara R S Uppugunduri
- Onco-Hematology Unit, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals; and.,CANSEARCH Research Laboratory, Department of Paediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Marc Ansari
- Onco-Hematology Unit, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals; and.,CANSEARCH Research Laboratory, Department of Paediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Dried Blood Spot Technique Applied in Therapeutic Drug Monitoring of Anticancer Drugs: a Review on Conversion Methods to Correlate Plasma and Dried Blood Spot Concentrations. Pharm Res 2021; 38:759-778. [PMID: 33846903 DOI: 10.1007/s11095-021-03036-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/25/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Anticancer drugs are notoriously characterized by a low therapeutic index, the introduction of therapeutic drug monitoring (TDM) in oncologic clinical practice could therefore be fundamental to improve treatment efficacy. In this context, an attractive technique to overcome the conventional venous sampling limits and simplify TDM application is represented by dried blood spot (DBS). Despite the significant progress made in bioanalysis exploiting DBS, there is still the need to tackle some challenges that limit the application of this technology: one of the main issues is the comparison of drug concentrations obtained from DBS with those obtained from reference matrix (e.g., plasma). In fact, the use of DBS assays to estimate plasma concentrations is highly dependent on the chemical-physical characteristics of the measured analyte, in particular on how these properties determine the drug partition in whole blood. METHODS In the present review, we introduce a critical investigation of the DBS-to-plasma concentration conversion methods proposed in the last ten years and applied to quantitative bioanalysis of anticancer drugs in DBS matrix. To prove the concordance between DBS and plasma concentration, the results of statistical tests applied and the presence or absence of trends or biases were also considered.
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Iqbal M, Ullah Z, Ezzeldin E, Khalil NY, Al-Shakliah NS, Alrasheed A, Ahmad I, Albehlal L. A simple and sensitive HILIC-based UHPLC-MS/MS method for quantifying of rivaroxaban in dried blood spots: Application in comparison with the plasma sample method. J Pharm Biomed Anal 2021; 198:114023. [PMID: 33744464 DOI: 10.1016/j.jpba.2021.114023] [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: 12/02/2020] [Revised: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
Rivaroxaban, indicated for the treatment of atrial fibrillation, deep vein thrombosis, pulmonary embolism, and coronary or peripheral artery disease, is one of the most frequently used direct oral anticoagulants. Therapeutic drug monitoring [TDM] is essential to minimize bleeding and thrombosis during personalized rivaroxaban treatment. An efficient and reliable analytical technique is required to quatify the rivaroxaban during its therapeutic indication. Dried blood spots (DBSs) sampling is a convenient bioanalytical method with minimal invasive blood drawing, long-term stability, and low shipment and storage costs. Therfore, DBS sampling technique is growing rapidly for TDM of drugs in medical care. This study developed an ultra high performance liquid chromatography-tandem mass spectrometry method of quantitating rivaroxaban in DBSs samples using the isotopic labeled analog (rivaroxaban-d4) as an internal standard (IS). Rivaroxaban and IS were separated on an Acquity HILIC column and eluted with a mobile-phase composition of acetonitrile and 20 mM ammonium acetate in the ratio of 95:5 at a flow rate of 0.3 mL/min. The precursor-to-product ion transitions of 436.03 ˃ 144.9 for rivaroxaban and 440.04 ˃ 144.9 for IS were used to quantify in multiple reaction monitoring mode. The method was accurate and precise in the 2.06-1000 ng/mL calibration range without hematocrit and blood spot volume effects. Rivaroxaban was stable in DBSs samples under different anticipated storage and temperature conditions. We observed good correlation between the plasma concentration and the DBSs concentration, indicating that the proposed DBSs method is suitable for monitoring the rivaroxaban concentration using a simple and convenient sample collection procedure.
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Affiliation(s)
- Muzaffar Iqbal
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, PO Box No. 2457, Riyadh, Saudi Arabia; Bioavailability Unit, Central Lab, College of Pharmacy, King Saud University, PO Box No. 2457, Riyadh, Saudi Arabia.
| | - Zabih Ullah
- Scientific Research Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; Department of Pharmacy, College of Dentistry and Pharmacy, Buraydah Colleges, Alqassim, Saudi Arabia
| | - Essam Ezzeldin
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, PO Box No. 2457, Riyadh, Saudi Arabia; Bioavailability Unit, Central Lab, College of Pharmacy, King Saud University, PO Box No. 2457, Riyadh, Saudi Arabia
| | - Nasr Y Khalil
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, PO Box No. 2457, Riyadh, Saudi Arabia
| | - Nasser S Al-Shakliah
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, PO Box No. 2457, Riyadh, Saudi Arabia
| | | | - Ishtiaque Ahmad
- Scientific Research Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Luluh Albehlal
- Scientific Research Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Loo RL, Lu Q, Carter EM, Liu S, Clark S, Wang Y, Baumgartner J, Tang H, Chan Q. A feasibility study of metabolic phenotyping of dried blood spot specimens in rural Chinese women exposed to household air pollution. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:328-344. [PMID: 32709935 DOI: 10.1038/s41370-020-0252-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 07/01/2020] [Accepted: 07/15/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Exposure-response studies and policy evaluations of household air pollution (HAP) are limited by current methods of exposure assessment which are expensive and burdensome to participants. METHODS We collected 152 dried blood spot (DBS) specimens during the heating and non-heating seasons from 53 women who regularly used biomass-burning stoves for cooking and heating. Participants were enrolled in a longitudinal study in China. Untargeted metabolic phenotyping of DBS were generated using ultra-high performance liquid chromatography coupled with mass spectrometry to exemplify measurement precision and assessment for feasibility to detect exposure to HAP, evaluated by season (high pollution vs. low pollution) and measured personal exposure to fine particulate matter <2.5 μm diameters (PM2.5) and black carbon (BC) in the 48-h prior to collecting the DBS specimen. RESULTS Metabolites e.g., amino acids, acyl-carnitines, lyso-phosphorylcholines, sphinganine, and choline were detected in the DBS specimens. Our approach is capable of detecting the differences in personal exposure to HAP whilst showing high analytical reproducibility, coefficient of variance (CV) <15%, meeting the U.S. Food and Drug Administration criteria. CONCLUSIONS Our results provide a proof of principle that high-resolution metabolic phenotypic data can be generated using a simple DBS extraction method thus suitable for exposure studies in remote, low-resource settings where the collection of serum and plasma is logistically challenging or infeasible. The analytical run time (19 min/specimen) is similar to most global phenotyping methods and therefore suitable for large-scale application.
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Affiliation(s)
- Ruey Leng Loo
- Centre for Computational and Systems Medicine, Institute of Health Futures, Murdoch University, Perth, WA, Australia
- Australian National Phenome Centre, Murdoch University, Perth, WA, Australia
| | - Qinwei Lu
- State Key Laboratory of Genetic Engineering, Zhongshan Hospital and School of Life Sciences, Human Phenome Institute, Metabonomics and Systems Biology Laboratory at Shanghai International Centre for Molecular Phenomics, Fudan University, Shanghai, China
| | - Ellison M Carter
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, CO, USA
| | - Si Liu
- State Key Laboratory of Genetic Engineering, Zhongshan Hospital and School of Life Sciences, Human Phenome Institute, Metabonomics and Systems Biology Laboratory at Shanghai International Centre for Molecular Phenomics, Fudan University, Shanghai, China
- CAS Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Centre for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences (CAS), Wuhan, China
| | - Sierra Clark
- Institute for Health and Social Policy and Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Yulan Wang
- Singapore Phenome Centre, Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, Singapore, Singapore
| | - Jill Baumgartner
- Institute for Health and Social Policy and Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Huiru Tang
- State Key Laboratory of Genetic Engineering, Zhongshan Hospital and School of Life Sciences, Human Phenome Institute, Metabonomics and Systems Biology Laboratory at Shanghai International Centre for Molecular Phenomics, Fudan University, Shanghai, China.
- CAS Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Centre for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences (CAS), Wuhan, China.
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
- MRC Centre for Environment and Health, Imperial College London, London, UK.
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Beck O, Mellring M, Löwbeer C, Seferaj S, Helander A. Measurement of the alcohol biomarker phosphatidylethanol (PEth) in dried blood spots and venous blood-importance of inhibition of post-sampling formation from ethanol. Anal Bioanal Chem 2021; 413:5601-5606. [PMID: 33590314 PMCID: PMC8410693 DOI: 10.1007/s00216-021-03211-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 11/29/2022]
Abstract
Phosphatidylethanol (PEth) is a group of phospholipids formed in cell membranes following alcohol consumption by action of the enzyme phospholipase D (PLD). PEth measurement in whole blood samples is established as a specific alcohol biomarker with clinical and forensic applications. However, in blood specimens containing ethanol, formation of PEth may continue after sampling leading to falsely elevated concentrations. This study evaluated the use of dried blood spot (DBS) and microsampling specimens to avoid post-sampling formation of PEth. Filter paper cards and three commercial devices for volumetric microsampling of finger-pricked blood were assessed, using PEth-negative and PEth-positive whole blood fortified with 2 g/L ethanol. PEth (16:0/18:1) was measured by LC–MS/MS. Post-sampling formation of PEth occurred in wet blood and in the volumetric devices, but not filter paper cards, when stored at room temperature for 48 h. Addition of an inhibitor of PLD, sodium metavanadate (NaVO3), eliminated post-sampling formation during storage and drying. In conclusion, the present study confirmed previous observations that PEth can be formed in blood samples after collection, if the specimen contains ethanol. The results further demonstrated that post-sampling formation of PEth from ethanol also occurred with commercial devices for volumetric dried blood microsampling. In order for a PEth result not to be questioned, it is recommended to use a PLD inhibitor, whether venous blood is collected in a vacutainer tube or finger-pricked blood is obtained using devices for dried blood microsampling.
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Affiliation(s)
- Olof Beck
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | | | - Christian Löwbeer
- SYNLAB Medilab, 183 34, Täby, Sweden.,Department of Laboratory Medicine, Karolinska Institutet, 141 86, Stockholm, Sweden
| | - Sabina Seferaj
- Department of Clinical Pharmacology, Karolinska University Laboratory, 141 86, Stockholm, Sweden
| | - Anders Helander
- Department of Laboratory Medicine, Karolinska Institutet, 141 86, Stockholm, Sweden. .,Department of Clinical Pharmacology, Karolinska University Laboratory, 141 86, Stockholm, Sweden.
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Broberg K, Svensson J, Grahn K, Assarsson E, Åberg M, Selander J, Enroth S. Evaluation of 92 cardiovascular proteins in dried blood spots collected under field-conditions: Off-the-shelf affinity-based multiplexed assays work well, allowing for simplified sample collection. Bioessays 2021; 43:e2000299. [PMID: 33586222 DOI: 10.1002/bies.202000299] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/10/2021] [Accepted: 01/20/2021] [Indexed: 11/11/2022]
Abstract
Workplace-collected blood spots deposited on filter paper were analysed with multiplexed affinity-based protein assays and found to be suitable for proteomics analysis. The protein extension assay (PEA) was used to characterize 92 proteins using 1.2 mm punches in repeated samples collected from 20 workers. Overall, 97.8% of the samples and 91.3% of the analysed proteins passed quality control. Both within and between spot correlations using six replicates from the same individual were above 0.99, suggesting that comparable levels are obtained from multiple punches from the same spot and from consecutive spots. Protein levels from dried blood and wet serum from the same individuals were compared and the majority of the analysed proteins were found to be significantly correlated. These results open up for simplified sample collection of blood in field conditions for proteomic analysis, but also highlight that not all proteins can be robustly measured from dried whole blood.
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Affiliation(s)
- Karin Broberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Johanna Svensson
- Department of Medical Sciences, Clinical Chemistry, Science for Life Laboratory (SciLifeLab) Uppsala, Uppsala University, Uppsala, Sweden
| | - Karin Grahn
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eva Assarsson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Mikael Åberg
- Department of Medical Sciences, Clinical Chemistry, Science for Life Laboratory (SciLifeLab) Uppsala, Uppsala University, Uppsala, Sweden
| | - Jenny Selander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Enroth
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory (SciLifeLab) Uppsala, Uppsala University, Uppsala, Sweden
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40
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Carpentieri D, Colvard A, Petersen J, Marsh W, David-Dirgo V, Huentelman M, Pirrotte P, Sivakumaran TA. Mind the Quality Gap When Banking on Dry Blood Spots. Biopreserv Biobank 2021; 19:136-142. [PMID: 33567235 DOI: 10.1089/bio.2020.0131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Dry blood spots (DBS) offer many advantages over other blood banking protocols due to the reduction of time and equipment needed for collection and the ease of processing, storage, and shipment. In addition, the sample size makes it a very attractive method when considering the banking of small pediatric samples. On that note, the Centers for Disease Control and Prevention (CDC) preanalytical standards for DBS are commonly used in the worldwide mass spectrometry-based inborn errors of metabolism screening programs. However, these guidelines may not apply for analytes and protocols not included in these programs. In fact, the availability of leftover samples and the ongoing interest in protocols outside this scenario are providing us with new DBS biobanking insights. Herein, we review the literature for indicators that should be considered in the design of prospective fit for purpose DBS biobanks, especially for those focused mostly on pediatric and OMIC platforms.
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Affiliation(s)
- David Carpentieri
- Department of Pathology and Laboratory Medicine, Clinical Genomics, Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - Amber Colvard
- Department of Pathology, Clinical Genomics, Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - Jackie Petersen
- Department of Pathology, Clinical Genomics, Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - William Marsh
- Department of Biorepository, Mayo Clinic, Phoenix, Arizona, USA
| | - Victoria David-Dirgo
- Collaborative Center for Translational Mass Spectrometry, The Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Matt Huentelman
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Patrick Pirrotte
- Collaborative Center for Translational Mass Spectrometry, The Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - T A Sivakumaran
- Department of Pathology, Clinical Genomics, Phoenix Children's Hospital, Phoenix, Arizona, USA
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41
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Measuring thiamine status in dried blood spots. Clin Chim Acta 2020; 509:52-59. [DOI: 10.1016/j.cca.2020.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 11/23/2022]
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Dittakavi S, Jat RK, Mullangi R. A Validated DBS Method for Quantitation of a Novel Mutant IDH1/2 Inhibitor, Vorasidenib Using 10 μL Mice Blood: Application to a Pharmacokinetic Study in Mice. CURR PHARM ANAL 2020. [DOI: 10.2174/1573412915666190802163644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Vorasidenib is a pan-IDH inhibitor, undergoing clinical trials for the treatment
of acute myeloid leukemia.
Methods:
In this paper, we present the data of method validation to quantify vorasidenib in the mice
blood mice using dried blood spot (DBS) method on LC-MS/MS as per FDA bioanalytical method validation
guideline. Using methanol (enriched with internal standard) as an extraction solvent followed by
sonication, vorasidenib was extracted from DBS quality control samples, calibration curve samples and
pharmacokinetic study samples. Baseline separation of vorasidenib and the IS in a 2.0 μL injected sample
was accomplished by delivering 0.2% formic acid and acetonitrile (25:75, v/v) at a constant flowrate
(1.00 mL/min) on a C18 column. The total run time was 2.0 min. Using the transition pair of m/z
415.4→260.4 for vorasidenib and m/z 583.1→186.1 for the IS, the quantitation was performed. The
method linearity range was 1.00-3008.00 ng/mL.
Results:
The recovery of vorasidenib ranged between 71.28%-78.14% across the tested concentrations.
No matrix effect was seen. Intra- and inter-day precisions were ≤7.23% and intra- and inter-accuracies
ranged between 97.1%-107%. Vorasidenib was stable for three freeze/thaw cycles, up to 7 days at room
temperature and for one month at -80°C. Following intravenous and oral administration of vorasidenib
to mice, it was quantifiable up to 72 h. The oral bioavailability was 51.6%.
Conclusions:
All the validation parameters met the acceptance criteria as specified in the FDA regulatory
guideline. The results suggest that validated DBS method can be used for pharmacokinetic studies in
mice to characterize the pharmacokinetic parameters of vorasidenib post intravenous and oral administration.
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Affiliation(s)
- Sreekanth Dittakavi
- Drug Metabolism and Pharmacokinetics, Jubilant Biosys, 2nd Stage, Industrial Suburb, Yeshwanthpur, Bangalore-560 022, India
| | - Rakesh Kumar Jat
- Shri Jagdish Prasad Jhabarmal Tibrewala University, Jhunjhunu-Churu Road, Chudela, Jhunjhunu- 333001, Rajasthan, India
| | - Ramesh Mullangi
- Drug Metabolism and Pharmacokinetics, Jubilant Biosys, 2nd Stage, Industrial Suburb, Yeshwanthpur, Bangalore-560 022, India
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43
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Veenhof H, Koster RA, Brinkman R, Senturk E, Bakker SJL, Berger SP, Akkerman OW, Touw DJ, Alffenaar JWC. Performance of a web-based application measuring spot quality in dried blood spot sampling. Clin Chem Lab Med 2020; 57:1846-1853. [PMID: 31373896 DOI: 10.1515/cclm-2019-0437] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/15/2019] [Indexed: 02/07/2023]
Abstract
Background The dried blood spot (DBS) method allows patients and researchers to collect blood on a sampling card using a skin-prick. An important issue in the application of DBSs is that samples for therapeutic drug monitoring are frequently rejected because of poor spot quality, leading to delayed monitoring or missing data. We describe the development and performance of a web-based application (app), accessible on smartphones, tablets or desktops, capable of assessing DBS quality at the time of sampling by means of analyzing a picture of the DBS. Methods The performance of the app was compared to the judgment of experienced laboratory technicians for samples obtained in a trained and untrained setting. A robustness- and user test were performed. Results In a trained setting the app yielded an adequate decision in 90.0% of the cases with 4.1% false negatives (insufficient quality DBSs incorrectly not rejected) and 5.9% false positives (sufficient quality DBSs incorrectly rejected). In an untrained setting this was 87.4% with 5.5% false negatives and 7.1% false positives. A patient user test resulted in a system usability score of 74 out of 100 with a median time of 1 min and 45 s to use the app. Robustness testing showed a repeatability of 84%. Using the app in a trained and untrained setting improves the amount of sufficient quality samples from 80% to 95.9% and 42.2% to 87.9%, respectively. Conclusions The app can be used in trained and untrained setting to decrease the amount of insufficient quality DBS samples.
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Affiliation(s)
- Herman Veenhof
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Remco A Koster
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Science Department - LC-MS/MS, PRA Health Sciences, Assen, The Netherlands
| | | | - Enes Senturk
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stefan P Berger
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Onno W Akkerman
- Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Daan J Touw
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan-Willem C Alffenaar
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Faculty of Medicine and Health, School of Pharmacy, University of Sydney, Sydney, Australia.,Westmead Hospital, Sydney, Australia
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Matos ALS, Moreira JPDL, Luiz RR, da Silva EP, Rodacki M, Gómez JFB, Zajdenverg L. Comparison of glucose measurement on dried blood spots versus plasma samples in pregnant women with and without anemia. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2020; 64:454-461. [PMID: 32267357 PMCID: PMC10522073 DOI: 10.20945/2359-3997000000229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 12/09/2019] [Indexed: 11/23/2022]
Abstract
Objective Compare the concordance degree between plasma glucose and glucose measurements on Dried Blood Spots (DBS) during pregnancy. Subjects and methods Glucose measurement was performed in pregnant women after a fast of 8-12 hours. Venous blood was collected with sodium fluoride, the plasma was separated, and glucose measured by the enzymatic oxidase glucose method. Capillary blood samples were collected and analyzed by DBS. For statistics, the paired Student's t test, interclass correlation coefficient (ICC), graphic approach of Altman and Bland, and survival - concordance plot were used. Results 307 pregnant women were evaluated, 88.6% without diabetes and 11.4% with previous diabetes. The glucose ranged from 66 to 190 mg/dL [3.66 to 10.55 mmol/L] in plasma and from 53 to 166 mg/dL [2.94 to 9.21 mmol/L] in DBS. The glucose average values were 88.1 ± 12 mg/dL [4.98 ± 0.67 mmol/L] in plasma and 89.2 ±11,5 mg/dL, [4.95 ± 0.64 mmol/L] in DBS - p-value = 0.084. The ICC value was moderate (0.510), and Pearson's correlation coefficient was r = 0.507 p < 0.001. Altman and Bland's graph showed that difference between the values obtained by both methods is -24.62 to 22.3 mg/dL [-1.37 to 1.24 mmol/L]. Significant fixed bias (-1,16 average difference) and proportional bias (r = 0.056; p = 0.33) were not observed. Anemia was associated with differences between plasma glucose and DBS measurements (p = 0.031). Conclusion Capillary glucose in DBS correlates with plasma glucose; however, the methods do not present good concordance. The presence of anemia worsens this result.
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Affiliation(s)
- Ana Lígia Soares Matos
- Maternidade EscolaUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilMaternidade Escola, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Jessica Pronestino de Lima Moreira
- Instituto de Estudos de Saúde ColetivaUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilInstituto de Estudos de Saúde Coletiva (IESC), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Ronir Raggio Luiz
- Instituto de Estudos de Saúde ColetivaUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilInstituto de Estudos de Saúde Coletiva (IESC), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Evelise Pochmann da Silva
- Maternidade EscolaUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilMaternidade Escola, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Melanie Rodacki
- Departamento de Medicina InternaUnidade de Diabetes e NutrologiaUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilDepartamento de Medicina Interna, Unidade de Diabetes e Nutrologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | | | - Lenita Zajdenverg
- Departamento de Medicina InternaUnidade de Diabetes e NutrologiaUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilDepartamento de Medicina Interna, Unidade de Diabetes e Nutrologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
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Giving patients choices: AstraZeneca's evolving approach to patient-centric sampling. Bioanalysis 2020; 12:957-970. [PMID: 32716627 DOI: 10.4155/bio-2020-0105] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This paper shares experiences and learning from introducing patient-centric sampling (PCS) into AstraZeneca trials. Through two case studies we show how modeling approaches can assist pharmacokinetic (PK) bridging studies accounting for blood partitioning and hematocrit and how reduced PK sampling schedules, profiles constructed from composite data (plasma & dry blood) and combined assays (PK & pharmacodynamic) can all reduce patient sampling burden without impacting study outcomes. Following sharing some clinical operational challenges, we finally highlight some key requirements for implementing a patient-centric sampling strategy such as collaborative working across organizational silos, continuous patient engagement throughout the study life cycle and accepting that if the aim is to give patient choice, then one solution (device, procedure and design) will not fit all.
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Pimenta FC, Moiane B, Lessa FC, Venero AKL, Moura I, Larson S, Massora S, Chaúque A, Tembe N, Mucavele H, Verani JR, Whitney CG, Sigaúque B, Carvalho MGS. Dried blood spots for Streptococcus pneumoniae and Haemophilus influenzae detection and serotyping among children < 5 years old in rural Mozambique. BMC Pediatr 2020; 20:326. [PMID: 32615947 PMCID: PMC7331148 DOI: 10.1186/s12887-020-02209-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/16/2020] [Indexed: 11/26/2022] Open
Abstract
Background Dried blood spots (DBS) have been proposed as potentially tool for detecting invasive bacterial diseases. Methods We evaluated the use of DBS for S. pneumoniae and H. influenzae detection among children in Mozambique. Blood for DBS and nasopharyngeal (NP) swabs were collected from children with pneumonia and healthy aged < 5 years. Bacterial detection and serotyping were performed by quantitative PCR (qPCR) (NP and DBS; lytA gene for pneumococcus and hpd for H. influenzae) and culture (NP). Combined detection rates were compared between children with pneumonia and healthy. Results Of 325 children enrolled, 205 had pneumonia and 120 were healthy. Pneumococci were detected in DBS from 20.5 and 64.2% of children with pneumonia and healthy, respectively; NP specimens were positive for pneumococcus in 80.0 and 80.8%, respectively. H. influenzae was detected in DBS from 22.9% of children with pneumonia and 59.2% of healthy; 81.4 and 81.5% of NP specimens were positive for H. influenzae, respectively. Conclusion DBS detected pneumococcal and H. influenzae DNA in children with pneumonia and healthy. Healthy children were often DBS positive for both bacteria, suggesting that qPCR of DBS specimens does not differentiate disease from colonization and is therefore not a useful diagnostic tool for children.
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Affiliation(s)
- Fabiana C Pimenta
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA.
| | - Benild Moiane
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Fernanda C Lessa
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA
| | | | - Iaci Moura
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA
| | | | - Sergio Massora
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Alberto Chaúque
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Nelson Tembe
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Helio Mucavele
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Jennifer R Verani
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA
| | - Cynthia G Whitney
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA
| | - Betuel Sigaúque
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Maria G S Carvalho
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA
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Thevis M, Knoop A, Schaefer MS, Dufaux B, Schrader Y, Thomas A, Geyer H. Can dried blood spots (DBS) contribute to conducting comprehensive SARS-CoV-2 antibody tests? Drug Test Anal 2020; 12:994-997. [PMID: 32386354 PMCID: PMC7272963 DOI: 10.1002/dta.2816] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 05/05/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany.,European Monitoring Center for Emerging Doping Agents, Cologne, Germany
| | - Andre Knoop
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Maximilian S Schaefer
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, USA.,Department of Anaesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | | | - Yvonne Schrader
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Andreas Thomas
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Hans Geyer
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany.,European Monitoring Center for Emerging Doping Agents, Cologne, Germany
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Fluispotter, a novel automated and wearable device for accurate volume serial dried blood spot sampling. Bioanalysis 2020; 12:665-681. [PMID: 32489105 DOI: 10.4155/bio-2020-0048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: A novel automated serial dried blood spot (DBS) sampler, 'Fluispotter', was tested for its sampling performance. Materials & methods: An LC-MS/MS method was developed for the analysis of cortisol in DBS samples serially spotted by Fluispotter. The cortisol concentrations in 148 paired DBS and plasma samples were compared across a hematocrit (HCT) range of 22-55%. Results: The interassay accuracy and precision were <10%. Overall assay bias was negligible across the HCTs tested when analyzing the whole-spot DBS samples. The accuracy and precision of the blood volume in 10 μl DBS samples spotted by Fluispotters and micropipettes were within 3%. Deming regression and Bland-Altman analysis showed a good agreement of DBS-predicted and measured plasma cortisol. Conclusion: The Fluispotter performed serial sampling with high accuracy and precision of the sample blood volume.
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Predictability of Capillary Blood Spot Toward Venous Whole Blood Sampling for Therapeutic Drug Monitoring of Tacrolimus in Solid Organ Transplant Recipients. Eur J Drug Metab Pharmacokinet 2020; 44:729-741. [PMID: 31006833 DOI: 10.1007/s13318-019-00553-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Therapeutic drug monitoring (TDM) of tacrolimus in whole blood obtained from venipuncture is routinely practiced. Dried blood spotting (DBS) may act as a suitable alternative for tacrolimus TDM due to relative ease of sampling and processing. The objective of this literature review was to provide a critical evaluation on the feasibility (i.e., accuracy and precision) of DBS for predicting tacrolimus whole blood concentrations in solid organ transplant recipients. A comprehensive systematic literature search using PubMed, Scopus, EMBASE, and Google Scholar was conducted. The primary objective was to extract the bias and precision data from the identified papers. In addition, the collection, storage, and analysis protocols were also summarized. Both adult and pediatric data were included. The reported bias data (primarily based on individual concentrations) in the majority of studies were within acceptable limits (< 15%). However, the precision data were not consistently reported. The area under the concentration-time curve of tacrolimus derived from DBS appeared to be a better predictor of whole blood compared to single concentrations based on a limited number of studies. No apparent differences in prediction were observed between pediatric and adult patients. Small sample sizes and the lack of complete description of the study population were common limitations. DBS is a promising approach for tacrolimus TDM. However, in order for DBS to become a useful substitute for tacrolimus whole blood monitoring in solid organ transplant patients, further systematic studies with sufficient power and comprehensive prediction error analyses are required.
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Londhe V, Rajadhyaksha M. Opportunities and obstacles for microsampling techniques in bioanalysis: Special focus on DBS and VAMS. J Pharm Biomed Anal 2020; 182:113102. [DOI: 10.1016/j.jpba.2020.113102] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/31/2019] [Accepted: 01/07/2020] [Indexed: 12/31/2022]
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