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Gerhardtova I, Cizmarova I, Jankech T, Olesova D, Jampilek J, Parrak V, Nemergutova K, Sopko L, Piestansky J, Kovac A. Implementation of Modern Therapeutic Drug Monitoring and Lipidomics Approaches in Clinical Practice: A Case Study with Colistin Treatment. Pharmaceuticals (Basel) 2024; 17:753. [PMID: 38931420 PMCID: PMC11206893 DOI: 10.3390/ph17060753] [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: 05/09/2024] [Revised: 06/02/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Nowadays, lipidomics plays a crucial role in the investigation of novel biomarkers of various diseases. Its implementation into the field of clinical analysis led to the identification of specific lipids and/or significant changes in their plasma levels in patients suffering from cancer, Alzheimer's disease, sepsis, and many other diseases and pathological conditions. Profiling of lipids and determination of their plasma concentrations could also be helpful in the case of drug therapy management, especially in combination with therapeutic drug monitoring (TDM). Here, for the first time, a combined approach based on the TDM of colistin, a last-resort antibiotic, and lipidomic profiling is presented in a case study of a critically ill male patient suffering from Pseudomonas aeruginosa-induced pneumonia. Implementation of innovative analytical approaches for TDM (online combination of capillary electrophoresis with tandem mass spectrometry, CZE-MS/MS) and lipidomics (liquid chromatography-tandem mass spectrometry, LC-MS/MS) was demonstrated. The CZE-MS/MS strategy confirmed the chosen colistin drug dosing regimen, leading to stable colistin concentrations in plasma samples. The determined colistin concentrations in plasma samples reached the required minimal inhibitory concentration of 1 μg/mL. The complex lipidomics approach led to monitoring 545 lipids in collected patient plasma samples during and after the therapy. Some changes in specific individual lipids were in good agreement with previous lipidomics studies dealing with sepsis. The presented case study represents a good starting point for identifying particular individual lipids that could correlate with antimicrobial and inflammation therapeutic management.
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Affiliation(s)
- Ivana Gerhardtova
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia; (I.G.); (T.J.); (D.O.); (J.J.); (V.P.)
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University Bratislava, Ilkovicova 6, 842 15 Bratislava, Slovakia
| | - Ivana Cizmarova
- Department of Pharmaceutical Analysis and Nuclear Pharmacy, Faculty of Pharmacy, Comenius University Bratislava, Odbojarov 10, 832 32 Bratislava, Slovakia;
- Toxicological and Antidoping Center, Faculty of Pharmacy, Comenius University Bratislava, Odbojarov 10, 832 32 Bratislava, Slovakia
| | - Timotej Jankech
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia; (I.G.); (T.J.); (D.O.); (J.J.); (V.P.)
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University Bratislava, Ilkovicova 6, 842 15 Bratislava, Slovakia
| | - Dominika Olesova
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia; (I.G.); (T.J.); (D.O.); (J.J.); (V.P.)
- Institute of Experimental Endocrinology, Biomedical Research Center SAS, Dubravska cesta 9, 845 10 Bratislava, Slovakia
| | - Josef Jampilek
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia; (I.G.); (T.J.); (D.O.); (J.J.); (V.P.)
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University Bratislava, Ilkovicova 6, 842 15 Bratislava, Slovakia
| | - Vojtech Parrak
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia; (I.G.); (T.J.); (D.O.); (J.J.); (V.P.)
- Clinic of Hematology and Transfusiology, St. Cyril and Methodius Hospital, Antolska 11, 851 07 Bratislava, Slovakia; (K.N.); (L.S.)
| | - Kristina Nemergutova
- Clinic of Hematology and Transfusiology, St. Cyril and Methodius Hospital, Antolska 11, 851 07 Bratislava, Slovakia; (K.N.); (L.S.)
| | - Ladislav Sopko
- Clinic of Hematology and Transfusiology, St. Cyril and Methodius Hospital, Antolska 11, 851 07 Bratislava, Slovakia; (K.N.); (L.S.)
| | - Juraj Piestansky
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia; (I.G.); (T.J.); (D.O.); (J.J.); (V.P.)
- Toxicological and Antidoping Center, Faculty of Pharmacy, Comenius University Bratislava, Odbojarov 10, 832 32 Bratislava, Slovakia
- Department of Galenic Pharmacy, Faculty of Pharmacy, Comenius University Bratislava, Odbojarov 10, 832 32 Bratislava, Slovakia
| | - Andrej Kovac
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia; (I.G.); (T.J.); (D.O.); (J.J.); (V.P.)
- Department of Pharmacology and Toxicology, University of Veterinary Medicine and Pharmacy in Kosice, Komenského 68/73, 041 81 Kosice, Slovakia
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Wang X, Sun Q, Li X, Wang G, Xing B, Li Z. Novel method for determination of colistin sulfate in human plasma by high-performance liquid chromatography-tandem mass spectrometry and its clinical applications in critically ill patients. J Pharmacol Toxicol Methods 2024; 127:107502. [PMID: 38555058 DOI: 10.1016/j.vascn.2024.107502] [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: 01/19/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
Colistin is a last-resort antibiotic used for treating infections caused by carbapenem-resistant Gram-negative bacteria, particularly in critically patients, nevertheless its therapeutic window is narrow, and requires monitoring. A determination method suitable for clinical detection is conducive to ensure its efficacy and safety of patients with severe infection. We developed and validated a concise and accurate high-performance liquid chromatography-tandem mass spectrometry method for the determination of colistin A and B in human plasma. We used a Kinetex C18 column (50 mm × 2.1 mm, 2.6 μm) with acetonitrile (containing 0.1% formic acid) as the protein precipitant and water (containing 0.2% formic acid and 5 mmol/L ammonium formate) - acetonitrile (containing 0.2% formic acid) as the gradient elution. The calibration curves were linear over concentration ranges of 0.06-4.00 μg/mL (colistin A) and 0.1-7.0 μg/mL (colistin B). The precision, accuracy, matrix effect, extraction recovery, and stability were all validated. This method was applied to the therapeutic drug monitoring for 50 critically ill patients. The trough, peak, and average steady-state concentrations of these patients were 0.8 ± 0.4, 1.4 ± 0.5, and 1.0 ± 0.4 μg/mL, respectively. And the concentrations of colistin in human plasma were closely related to the patient's renal function.
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Affiliation(s)
- Xiaoying Wang
- Department of Pharmacy, Beijing Electric Power Hospital of State Grid Co. of China, Capital Medical University Electric Teaching Hospital, Beijing 100073, China
| | - Qiang Sun
- Department of Pharmacy, Beijing Electric Power Hospital of State Grid Co. of China, Capital Medical University Electric Teaching Hospital, Beijing 100073, China
| | - Xiaojing Li
- Department of Pharmacy, Beijing Electric Power Hospital of State Grid Co. of China, Capital Medical University Electric Teaching Hospital, Beijing 100073, China
| | - Genzhu Wang
- Department of Pharmacy, Beijing Electric Power Hospital of State Grid Co. of China, Capital Medical University Electric Teaching Hospital, Beijing 100073, China
| | - Baiqian Xing
- Department of Pharmacy, Beijing Electric Power Hospital of State Grid Co. of China, Capital Medical University Electric Teaching Hospital, Beijing 100073, China
| | - Zhongdong Li
- Department of Pharmacy, Beijing Electric Power Hospital of State Grid Co. of China, Capital Medical University Electric Teaching Hospital, Beijing 100073, China.
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Cafaro A, Conti M, Pigliasco F, Barco S, Bandettini R, Cangemi G. Biological Fluid Microsampling for Therapeutic Drug Monitoring: A Narrative Review. Biomedicines 2023; 11:1962. [PMID: 37509602 PMCID: PMC10377272 DOI: 10.3390/biomedicines11071962] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Therapeutic drug monitoring (TDM) is a specialized area of laboratory medicine which involves the measurement of drug concentrations in biological fluids with the aim of optimizing efficacy and reducing side effects, possibly modifying the drug dose to keep the plasma concentration within the therapeutic range. Plasma and/or whole blood, usually obtained by venipuncture, are the "gold standard" matrices for TDM. Microsampling, commonly used for newborn screening, could also be a convenient alternative to traditional sampling techniques for pharmacokinetics (PK) studies and TDM, helping to overcome practical problems and offering less invasive options to patients. Although technical limitations have hampered the use of microsampling in these fields, innovative techniques such as 3-D dried blood spheroids, volumetric absorptive microsampling (VAMS), dried plasma spots (DPS), and various microfluidic devices (MDS) can now offer reliable alternatives to traditional samples. The application of microsampling in routine clinical pharmacology is also hampered by the need for instrumentation capable of quantifying analytes in small volumes with sufficient sensitivity. The combination of microsampling with high-sensitivity analytical techniques, such as liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS), is particularly effective in ensuring high accuracy and sensitivity from very small sample volumes. This manuscript provides a critical review of the currently available microsampling devices for both whole blood and other biological fluids, such as plasma, urine, breast milk, and saliva. The purpose is to provide useful information in the scientific community to laboratory personnel, clinicians, and researchers interested in implementing the use of microsampling in their routine clinical practice.
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Affiliation(s)
- Alessia Cafaro
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Matteo Conti
- Public Health Department, Imola Local Unit, Regione Emilia-Romagna Healthcare Service, 40026 Imola, Italy
| | - Federica Pigliasco
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Sebastiano Barco
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Roberto Bandettini
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Giuliana Cangemi
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
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Han Y, Li XL, Zhang M, Wang J, Zeng S, Min JZ. Potential use of a dried saliva spot (DSS) in therapeutic drug monitoring and disease diagnosis. J Pharm Anal 2022; 12:815-823. [PMID: 36605582 PMCID: PMC9805949 DOI: 10.1016/j.jpha.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 01/07/2023] Open
Abstract
In recent years, scientific researchers have increasingly become interested in noninvasive sampling methods for therapeutic drug monitoring and disease diagnosis. As a result, dried saliva spot (DSS), which is a sampling technique for collecting dried saliva samples, has been widely used as an alternative matrix to serum for the detection of target molecules. Coupling the DSS method with a highly sensitive detection instrument improves the efficiency of the preparation and analysis of biological samples. Furthermore, dried blood spots, dried plasma spots, and dried matrix spots, which are similar to those of the DSS method, are discussed. Compared with alternative biological fluids used in dried spot methods, including serum, tears, urine, and plasma, saliva has the advantage of convenience in terms of sample collection from children or persons with disabilities. This review aims to provide integral strategies and guidelines for dried spot methods to analyze biological samples by illustrating several dried spot methods. Herein, we summarize recent advancements in DSS methods from June 2014 to March 2021 and discuss the advantages and disadvantages of the key aspects of this method, including sample preparation and method validation. Finally, we outline the challenges and prospects of such methods in practical applications.
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Affiliation(s)
- Yu Han
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, Department of Pharmaceutical Analysis, College of Pharmacy, Yanbian University, Yanji, Jilin, 133002, China
| | - Xi-Ling Li
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, Department of Pharmaceutical Analysis, College of Pharmacy, Yanbian University, Yanji, Jilin, 133002, China
| | - Minghui Zhang
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, Department of Pharmaceutical Analysis, College of Pharmacy, Yanbian University, Yanji, Jilin, 133002, China
| | - Jing Wang
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, Department of Pharmaceutical Analysis, College of Pharmacy, Yanbian University, Yanji, Jilin, 133002, China
| | - Su Zeng
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
- Corresponding author.
| | - Jun Zhe Min
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, Department of Pharmaceutical Analysis, College of Pharmacy, Yanbian University, Yanji, Jilin, 133002, China
- Corresponding author.
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HPLC Determination of Colistin in Human Urine Using Alkaline Mobile Phase Combined with Post-Column Derivatization: Validation Using Accuracy Profiles. Molecules 2022; 27:molecules27113489. [PMID: 35684427 PMCID: PMC9181871 DOI: 10.3390/molecules27113489] [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] [Received: 04/26/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 12/10/2022] Open
Abstract
In this study, the development, validation, and application of a new liquid chromatography post-column derivatization method for the determination of Colistin in human urine samples is demonstrated. Separation of Colistin was performed using a core–shell C18 analytical column in an alkaline medium in order (i) to be compatible with the o-phthalaldehyde-based post-column derivatization reaction and (ii) to obtain better retention of the analyte. The Colistin derivative was detected spectrofluorometrically (λext/λem = 340/460 nm) after post-column derivatization with o-phthalaldehyde and N-acetyl cysteine. The post-column derivatization parameters were optimized using the Box–Behnken experimental design, and the method was validated using the total error concept. The β-expectation tolerance intervals did not exceed the acceptance criteria of ±15%, meaning that 95% of future results would be included in the defined bias limits. The limit of detection of the method was adequate corresponding to 100 nmol·L−1. The mean analytical bias (expressed as relative error) in the spiking levels was suitable, being in the range of −2.8 to +2.5% for both compounds with the percentage relative standard deviation lower than 3.4% in all cases. The proposed analytical method was satisfactorily applied to the analysis of the drug in human urine samples.
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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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Cao H, Li L, Wang S, Guo H, Ren W, Li Y, Huang J. Dried plasma spot-based liquid chromatography-tandem mass spectrometry for the quantification of methotrexate in human plasma and its application in therapeutic drug monitoring. J Sep Sci 2022; 45:1153-1161. [PMID: 34981894 DOI: 10.1002/jssc.202100700] [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: 09/05/2021] [Revised: 12/31/2021] [Accepted: 01/01/2022] [Indexed: 11/06/2022]
Abstract
Methotrexate, a folic acid antitumor drug, is widely used to treat childhood acute lymphoblastic leukemia. Therapeutic drug monitoring is crucial for adjusting the dosage of methotrexate according to its plasma concentration and reducing adverse effects. Micro-sampling strategies, like dried plasma spot, is an attractive but underutilized method that has the desired features of easy collection, storage, and transport, and overcomes known hematocrit issues in dried blood spot analysis. This study describes a dried plasma spot-based liquid chromatography-tandem mass spectrometry method for quantification of methotrexate. The assay showed good linearity over 30-2000 ng/mL (R2 ≥ 0.995) as well as excellent precision (0.6-9.3%) and accuracy (89.2-108.3%). Methotrexate was extracted from dried plasma spot and wet plasma samples with recoveries greater than 92.1%, and no significant matrix effect was observed. A comparison of dried plasma spot and wet plasma concentrations was assessed in 27 patients treated with methotrexate and Passing-Bablok regression coefficients showed that no significant difference between the two methods. Bland-Altman plots showed similar agreement between the methods, indicating that the proposed dried plasma spot sampling method is an effective way to monitor the concentration of methotrexate in human plasma. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Haiwei Cao
- Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, 130061, PR China
| | - Li Li
- Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, 130061, PR China
| | - Shaomin Wang
- Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, 130061, PR China
| | - Haiyang Guo
- Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, 130061, PR China
| | - Wenbo Ren
- Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, 130061, PR China
| | - Yanyan Li
- Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, 130061, PR China
| | - Jing Huang
- Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, 130061, PR China
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Mead A, Gillard N, Robert C, Pierret G, Henrottin J, Richez P, Pelligand L. Determination of colistin in luminal and parietal intestinal matrices of chicken by ultra-high-performance liquid chromatography-tandem mass spectrometry. J Vet Pharmacol Ther 2021; 44:982-985. [PMID: 34614207 PMCID: PMC9293311 DOI: 10.1111/jvp.13022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
Justification for continued use of colistin in veterinary medicine, for example medicated water, relies on pharmacokinetic/pharmacodynamic (PK/PD) studies that require accurate measurement of colistin content in the digestive tract. A method for the detection and quantification of colistin in poultry intestinal material was developed and validated. Colistin is not absorbed after oral administration, and the biophase is the gastrointestinal tract. Extraction of colistin from the matrix was achieved using solid‐phase extraction with a methanol:water (1:2; v/v) solution. Polymyxin B was used as an internal standard. Colistin A and colistin B, the main components of colistin, were separated, detected and measured using ultra‐high‐performance liquid chromatography coupled with tandem mass spectrometry (UHPLC‐MS/MS). The method was validated for linearity/quadraticity between 1.1 (LOQ) and 56.7 mg/kg. Mean accuracy was between 82.7% and 107.7% with inter‐ and intra‐day precision lower than 13.3% and 15% respectively. Freeze–thaw, long‐term and bench storage were validated. Incurred samples following colistin treatment in poultry at the approved clinical dose of 75,000 IU/kg in drinking water and oral gavage were quantifiable and in line with expected intestinal transit times. The method is considered appropriately accurate and precise for the purposes of pharmacokinetic analysis in the gastrointestinal tract.
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Pigliasco F, Cafaro A, Simeoli R, Barco S, Magnasco A, Faraci M, Tripodi G, Goffredo BM, Cangemi G. A UHPLC-MS/MS Method for Therapeutic Drug Monitoring of Aciclovir and Ganciclovir in Plasma and Dried Plasma Spots. Biomedicines 2021; 9:biomedicines9101379. [PMID: 34680495 PMCID: PMC8533239 DOI: 10.3390/biomedicines9101379] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 01/06/2023] Open
Abstract
The role of therapeutic drug monitoring (TDM) of valaciclovir (VA)/aciclovir (A) and valganciclovir/ganciclovir (VG/G) in critically ill patients is still a matter of debate. More data on the dose–concentration relationship might therefore be useful, especially in pediatrics where clinical practice is not adequately supported by robust PK studies. We developed and validated a new liquid chromatography-tandem mass spectrometry (LC-MS/MS) micro-method to simultaneously quantify A and G from plasma and dried plasma spots (DPS). The method was based on rapid organic extraction from DPS and separation on a reversed-phase C-18 UHPLC column after addition of deuterated internal standards. Accurate analyte quantification using SRM detection was then obtained using a Thermo Fisher Quantiva triple-quadrupole MS coupled to an Ultimate 3000 UHPLC. It was validated following international (EMA) guidelines for bioanalytical method validation and was tested on samples from pediatric patients treated with A, VG, or G for cytomegalovirus infection following solid organ or hematopoietic stem cell transplantation. Concentrations obtained from plasma and DPS were compared using Passing–Bablok and Bland–Altman statistical tests. The assay was linear over wide concentration ranges (0.01–20 mg/L) in both plasma and DPS for A and G, suitable for the expected therapeutic ranges for both Cmin and Cmax, accurate, and reproducible in the absence of matrix effects. The results obtained from plasma and DPS were comparable. Using an LC-MS/MS method allowed us to obtain a very specific, sensitive, and rapid quantification of these antiviral drugs starting from very low volumes (50 μL) of plasma samples and DPS. The stability of analytes for at least 30 days allows for cost-effective shipment and storage at room temperature. Our method is suitable for TDM and could be helpful for improving knowledge on PK/PD targets of antivirals in critically ill pediatric patients.
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Affiliation(s)
- Federica Pigliasco
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (F.P.); (A.C.); (G.T.); (G.C.)
| | - Alessia Cafaro
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (F.P.); (A.C.); (G.T.); (G.C.)
| | - Raffaele Simeoli
- Department of Pediatric Specialties, Division of Metabolic Biochemistry, Children’s Hospital Bambino Gesù, IRCCS, 00165 Rome, Italy; (R.S.); (B.M.G.)
| | - Sebastiano Barco
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (F.P.); (A.C.); (G.T.); (G.C.)
- Correspondence: ; Tel.: +39-01056363289
| | - Alberto Magnasco
- Pediatric Nephrology, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy;
| | - Maura Faraci
- Hematopoietic Stem Cell Unit, Department of Pediatric Hematology and Oncology, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy;
| | - Gino Tripodi
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (F.P.); (A.C.); (G.T.); (G.C.)
| | - Bianca Maria Goffredo
- Department of Pediatric Specialties, Division of Metabolic Biochemistry, Children’s Hospital Bambino Gesù, IRCCS, 00165 Rome, Italy; (R.S.); (B.M.G.)
| | - Giuliana Cangemi
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (F.P.); (A.C.); (G.T.); (G.C.)
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Mukai Y, Yoshida Y, Yoshida T, Kondo T, Inotsume N, Toda T. Simultaneous Quantification of BCR-ABL and Bruton Tyrosine Kinase Inhibitors in Dried Plasma Spots and Its Application to Clinical Sample Analysis. Ther Drug Monit 2021; 43:386-393. [PMID: 33065614 DOI: 10.1097/ftd.0000000000000825] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/29/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Recent reports highlight the importance of therapeutic drug monitoring (TDM) of BCR-ABL and Bruton tyrosine kinase inhibitors (TKIs); thus, large-scale studies are needed to determine the target concentrations of these drugs. TDM using dried plasma spots (DPS) instead of conventional plasma samples is a promising approach. This study aimed to develop and validate a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the simultaneous quantification of BCR-ABL and Bruton TKIs for further TDM studies. METHODS A 20-μL aliquot of plasma was spotted onto a filter paper and dried completely. Analytes were extracted from 2 DPS using 250 μL of solvent. After cleanup by supported liquid extraction, the sample was analyzed by LC-MS/MS. Applicability of the method was examined using samples of patients' DPS transported by regular mail as a proof-of-concept study. The constant bias and proportional error between plasma and DPS concentrations were assessed by Passing-Bablok regression analysis, and systematic errors were evaluated by Bland-Altman analysis. RESULTS The method was successfully validated over the following calibration ranges: 1-200 ng/mL for dasatinib and ponatinib, 2-400 ng/mL for ibrutinib, 5-1000 ng/mL for bosutinib, and 20-4000 ng/mL for imatinib and nilotinib. TKI concentrations were successfully determined for 93 of 96 DPS from clinical samples. No constant bias between plasma and DPS concentrations was observed for bosutinib, dasatinib, nilotinib, and ponatinib, whereas there were proportional errors between the plasma and DPS concentrations of nilotinib and ponatinib. Bland-Altman plots revealed that significant systematic errors existed between both methods for bosutinib, nilotinib, and ponatinib. CONCLUSIONS An LC-MS/MS method for the simultaneous quantification of 6 TKIs in DPS was developed and validated. Further large-scale studies should be conducted to assess the consistency of concentration measurements obtained from plasma and DPS.
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Affiliation(s)
- Yuji Mukai
- Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido. Dr. Yuji Mukai is now with the Department of Pharmacy, University of Tsukuba Hospital, Ibaraki
| | - Yuka Yoshida
- Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido. Dr. Yuji Mukai is now with the Department of Pharmacy, University of Tsukuba Hospital, Ibaraki
| | | | - Takeshi Kondo
- Department of Hematology, Blood Disorders Center, Aiiku Hospital, Hokkaido; and
| | - Nobuo Inotsume
- Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido. Dr. Yuji Mukai is now with the Department of Pharmacy, University of Tsukuba Hospital, Ibaraki
- Nihon Pharmaceutical University, Saitama, Japan
| | - Takaki Toda
- Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido. Dr. Yuji Mukai is now with the Department of Pharmacy, University of Tsukuba Hospital, Ibaraki
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Peng C, Zuo S, Qiu Y, Fu S, Peng L. Determination of Colistin in Contents Derived from Gastrointestinal Tract of Feeding Treated Piglet and Broiler. Antibiotics (Basel) 2021; 10:422. [PMID: 33921200 PMCID: PMC8070394 DOI: 10.3390/antibiotics10040422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/03/2021] [Accepted: 04/08/2021] [Indexed: 11/16/2022] Open
Abstract
Colistin is considered as the last-resort treatment for multiantibiotic-resistant Gram-negative bacterial infections in humans. However, the oral administration of colistin to livestock and poultry results in the introduction of large amounts of colistin to the surrounding environment via urine and feces, potentially inducing the prevalence of colistin-resistant bacteria and the impact on the ecological environment. We established a quantitative mass spectrometry (MS) based method to measure colistin in contents recovered from the gastrointestinal segments of piglets and broilers, as well as colistin in feces from the animals. The mean recoveries of colistin from different matrices were between 73.2% and 103.9%. The quantitation limit values for different matrices ranged from 0.37 to 1.85 ng/g. In colistin-treated swine samples, the highest concentration of colistin was detected in feces samples at a level of 1248.3 ng/g. However, the highest concentration of colistin in broiler samples was around 4882.9 ng/g, which was found in the contents derived from broilers' ceca. The employment of the proposed method to assess colistin in animals' gastrointestinal tracts might help to understand the colistin absorption in animals' guts and the potential impact of colistin on the emergence of resistant bacteria in animals' gut flora and the ecological environment.
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Affiliation(s)
- Chun Peng
- School of Animal Science and Nutritional Engineering, Wuhan Polytechnic University, Changqing Garden, Hankou, Wuhan 430023, China; (C.P.); (S.Z.); (Y.Q.); (S.F.)
| | - Sanling Zuo
- School of Animal Science and Nutritional Engineering, Wuhan Polytechnic University, Changqing Garden, Hankou, Wuhan 430023, China; (C.P.); (S.Z.); (Y.Q.); (S.F.)
| | - Yinsheng Qiu
- School of Animal Science and Nutritional Engineering, Wuhan Polytechnic University, Changqing Garden, Hankou, Wuhan 430023, China; (C.P.); (S.Z.); (Y.Q.); (S.F.)
| | - Shulin Fu
- School of Animal Science and Nutritional Engineering, Wuhan Polytechnic University, Changqing Garden, Hankou, Wuhan 430023, China; (C.P.); (S.Z.); (Y.Q.); (S.F.)
| | - Lijuan Peng
- School of Food Science and Engineering, Wuhan Polytechnic University, Changqing Garden, Hankou, Wuhan 430023, China
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12
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Pharmacokinetics of colistin in cerebrospinal fluid after intraventricular administration alone in intracranial infections. Int J Antimicrob Agents 2021; 57:106281. [PMID: 33465459 DOI: 10.1016/j.ijantimicag.2021.106281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/12/2020] [Accepted: 01/09/2021] [Indexed: 11/20/2022]
Abstract
The aim of this study was to investigate the pharmacokinetics of colistin in cerebrospinal fluid (CSF) after intraventricular (IVT) administration of colistin methanesulfonate (CMS) for central nervous system (CNS) infections caused by multidrug-resistant Gram-negative bacteria. Ten patients with CNS infection were treated with CMS (active substance colistin equivalent to 100 000 units, every 24 h) by IVT administration. After 3 days of treatment, the concentration of colistin in the CSF was determined by selective ultra-performance liquid chromatography (UPLC) at 2, 4, 6, 8, 12 and 24 h after CMS administration. A pharmacokinetic analysis was performed using Phoenix WinNonlin. Following IVT administration of CMS, the estimated colistin apparent CSF half-life (t1/2) was 10.46 ± 6.98 h, the average peak colistin concentration (Cmax) was 16.95 ± 7.39 μg/mL and the average time to peak concentration (Tmax) was 4.6 ± 0.97 h. The measured trough concentration (Cmin; colistin concentration in CSF at 24 h after administration of CMS) was 1.12-8.33 μg/mL and the average Cmin was 2.91 ± 2.11 μg/mL. CSF concentrations of colistin were above the minimum inhibitory concentration (MIC) of 0.5 μg/mL at 24 h after IVT administration in all patients. Microbiological cure was observed in all patients. In conclusion, this is the first study of colistin pharmacokinetics in CSF after IVT administration alone in patients with CNS infection. It provides essential data for designing relatively safe and effective CMS dosing regimens.
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13
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A review of recent advances in microsampling techniques of biological fluids for therapeutic drug monitoring. J Chromatogr A 2020; 1635:461731. [PMID: 33285415 DOI: 10.1016/j.chroma.2020.461731] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022]
Abstract
Conventional sampling of biological fluids often involves a bulk quantity of samples that are tedious to collect, deliver and process. Miniaturized sampling approaches have emerged as promising tools for sample collection due to numerous advantages such as minute sample size, patient friendliness and ease of shipment. This article reviews the applications and advances of microsampling techniques in therapeutic drug monitoring (TDM), covering the period January 2015 - August 2020. As whole blood is the gold standard sampling matrix for TDM, this article comprehensively highlights the most historical microsampling technique, the dried blood spot (DBS), and its development. Advanced developments of DBS, ranging from various automation DBS, paper spray mass spectrometry (PS-MS), 3D dried blood spheroids and volumetric absorptive paper disc (VAPD) and mini-disc (VAPDmini) are discussed. The volumetric absorptive microsampling (VAMS) approach, which overcomes the hematocrit effect associated with the DBS sample, has been employed in recent TDM. The sample collection and sample preparation details in DBS and VAMS are outlined and summarized. This review also delineates the involvement of other biological fluids (plasma, urine, breast milk and saliva) and their miniaturized dried matrix forms in TDM. Specific features and challenges of each microsampling technique are identified and comparison studies are reviewed.
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14
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A fluorescent artificial receptor with specific imprinted cavities to selectively detect colistin. Anal Bioanal Chem 2020; 412:7417-7428. [PMID: 32812120 DOI: 10.1007/s00216-020-02873-5] [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] [Received: 04/20/2020] [Revised: 06/29/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
A novel and facile fluorescent artificial receptor on the basis of the molecularly imprinted polymer-coated graphene quantum dots was engineered successfully to detect colistin. The colistin imprinted graphene quantum dots (CMIP-GQDs) was synthesized by vinyl-based radical polymerization between functional monomers and crosslinker at around the template molecule on the surface of graphene quantum dots. The size of bare, CNIP-GQDs, and CMIP-GQDs was about 4.8 ± 0.6 nm, 18.4 ± 1.7 nm, and 19.7 ± 1.3 nm, respectively. The CMIP-GQDs, which showed the strong fluorescence emission at 440 nm with the excitation wavelength fixed at 380 nm, had excellent selectivity and specificity to rapidly recognize and detect colistin. The linear range of fluorescence quenching of this fluorescent artificial receptor for detection colistin was 0.016-2.0 μg mL-1 with a correlation coefficient (R2) of 0.99919, and the detection limit was 7.3 ng mL-1 in human serum samples. The designed receptor was successfully applied to detect colistin in human serum samples and it achieved excellent recoveries shifted from 93.8 to 105%. Graphical abstract.
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15
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Zabidi MS, Abu Bakar R, Musa N, Wan Yusuf WN. Analytical methodologies for measuring colistin levels in pharmacokinetic studies. J LIQ CHROMATOGR R T 2020. [DOI: 10.1080/10826076.2020.1783291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mohd Shafie Zabidi
- Department of Pharmacology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Ruzilawati Abu Bakar
- Department of Pharmacology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Nurfadhlina Musa
- Human Genome Centre, School of Medical Sciences, Health Campus Universiti Sains Malaysia, Kelantan, Malaysia
| | - Wan Nazirah Wan Yusuf
- Department of Pharmacology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
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16
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Dagla I, Tsarbopoulos A, Gikas E. Design of experiments guided multivariate calibration for the quantitation of injectable colistimethate sodium by ultra performance liquid chromatography - High resolution mass spectrometry. Talanta 2020; 220:121406. [PMID: 32928422 DOI: 10.1016/j.talanta.2020.121406] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 11/15/2022]
Abstract
Colistimethate sodium (CMS) is a widely administrated old-generation prodrug for the treatment of the life-threatening infections caused by multi-resistant Gram-negative bacteria. Until now, the quality control procedure of the CMS commercial products is based on microbiological assays. The aim of the study is the development of a chemical analysis methodology based on liquid chromatography - mass spectrometry (LC-MS) that could be used for the quality control of CMS products. The careful optimization of the LC and QToF-MS parameters was deemed crucial, as CMS is known to be a very complex mixture. Thus, a two stage Design of Experiments (DoE) pipeline has been followed, aiming towards the separation of the mixture components. According to the DoE results, a baseline-resolved chromatogram revealing more than 20 compounds was achieved. The separation was performed using a Waters Acquity BEH C8 column employing gradient elution. The mobile phase consisted of aq. ammonium formate 0.005 M (pH 6) (solvent A) and methanol/acetonitrile 79/21 (v/v) (solvent B). A second optimization experiment for the MS signal was employed in order to achieve maximum sensitivity. The singly charged signals were monitored for the validation in the positive ion mode. The calibration curve range was 50-110 μg mL-1, corresponding to the 80-120% of the nominal CMS amount in the commercial products. Due to the complexity of the CMS chromatograms and the corresponding spectrum of each chromatographic peak, untargeted and targeted approaches were performed employing the MZmine software. Furthermore, apart from the classical univariate statistical analysis, partial least squares regression (PLS-R) model was also employed, as the variables were more than the observations. The developed methodology has been employed to analyze several batches and inconsistences have been discovered.
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Affiliation(s)
- Ioanna Dagla
- Laboratory of Pharmaceutical Analysis, Division of Pharmaceutical Chemistry, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistiomiopolis, Zografou, 157 71, Athens, Greece
| | - Anthony Tsarbopoulos
- Laboratory of Pharmacology, Department of Descriptive-Functional Studies, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evagelos Gikas
- Laboratory of Analytical Chemistry, School of Chemistry, National and Kapodistrian University of Athens, Panepistiomiopolis, Zografou, 157 71, Athens, Greece.
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17
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Bassetti M, Peghin M, Mesini A, Castagnola E. Optimal Management of Complicated Infections in the Pediatric Patient: The Role and Utility of Ceftazidime/Avibactam. Infect Drug Resist 2020; 13:1763-1773. [PMID: 32606826 PMCID: PMC7305847 DOI: 10.2147/idr.s209264] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/11/2020] [Indexed: 12/19/2022] Open
Abstract
Antimicrobial resistance poses a substantial threat to global public health. The pursuit of new antibiotics has decreased and very few options have been investigated for the treatment of complicated multidrug-resistant Gram-negative (MDR-GN) infections in adult population and even less in pediatric patients. Ceftazidime-avibactam (CAZ-AVI) is novel cephalosporin/β-lactamase inhibitor (BL-BLI) combination with broad antibacterial spectrum. The aim of this review is to describe the current and future role CAZ-AVI in the pediatric population with suspected or confirmed MDR-GN infections.
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Affiliation(s)
- Matteo Bassetti
- Infectious Diseases Clinic, Department of Medicine University of Udine and Azienda Sanitaria Universitaria Integrata, Udine, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Maddalena Peghin
- Infectious Diseases Clinic, Department of Medicine University of Udine and Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Alessio Mesini
- Division of Infectious Diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Elio Castagnola
- Division of Infectious Diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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18
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da Silva ACC, de Lima Feltraco Lizot L, Bastiani MF, Venzon Antunes M, Brucker N, Linden R. Dried plasma spots for therapeutic monitoring of amikacin: Validation of an UHPLC-MS/MS assay and pharmacokinetic application. J Pharm Biomed Anal 2020; 184:113201. [DOI: 10.1016/j.jpba.2020.113201] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/20/2020] [Accepted: 02/22/2020] [Indexed: 01/20/2023]
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19
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Qi B, Gijsen M, Van Brantegem P, De Vocht T, Deferm N, Abza GB, Nauwelaerts N, Wauters J, Spriet I, Annaert P. Quantitative determination of colistin A/B and colistin methanesulfonate in biological samples using hydrophilic interaction chromatography tandem mass spectrometry. Drug Test Anal 2020; 12:1183-1195. [PMID: 32336034 DOI: 10.1002/dta.2812] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/10/2020] [Accepted: 04/23/2020] [Indexed: 12/12/2022]
Abstract
Colistin (polymyxin E) is a polycation antibiotic which is increasingly used (administered as colistin methanesulfonate, CMS) as a salvage therapy in critically ill patients with multidrug resistant Gram-negative infections. Even though colistin has been used for more than 50 years, its metabolic fate is poorly understood. One of the current challenges for studying the pharmacokinetics (PK) is the precise and accurate determination of colistin in in vitro and in vivo studies. In the present study, we developed and validated a series of sensitive and robust liquid chromatography tandem mass spectrometry (LC-MS/MS) methods for analysing biological samples obtained from in vitro and in vivo disposition assays. After a zinc acetate-mediated precipitation, hydrophilic-lipophilic-balanced solid phase extraction (HLB-SPE) was used for the extraction of colistin. The compounds were retained on a hydrophilic interaction liquid chromatography (HILIC) column and were detected by MS/MS. CMS was quantified by determining the produced amount of colistin during acidic hydrolysis. The developed methods are sensitive with lower limits of quantification varying between 0.009 μg/mL and 0.071 μg/mL for colistin A, and 0.002 μg/mL to 0.013 μg/mL for colistin B. The intra- and inter-day precision and accuracy were within ±15%. Calibration curves of colistin were linear (0.063 μg/mL to 8.00 μg/mL) within clinically relevant concentration ranges. Zinc acetate-mediated precipitation and the use of a HILIC column were found to be essential. The developed methods are sensitive, accurate, precise, highly efficient and allow monitoring colistin and CMS in biological samples without the need for an internal standard.
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Affiliation(s)
- Bing Qi
- Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
| | - Matthias Gijsen
- Clinical Pharmacology and Pharmacotherapy, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium.,Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
| | - Pieter Van Brantegem
- Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
| | - Tom De Vocht
- Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
| | - Neel Deferm
- Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
| | - Getahun B Abza
- Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
| | - Nina Nauwelaerts
- Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
| | - Joost Wauters
- KU Leuven Department of Microbiology and Immunology, Clinical Infectious and Inflammatory Disorders, Leuven, Belgium.,Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Isabel Spriet
- Clinical Pharmacology and Pharmacotherapy, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium.,Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
| | - Pieter Annaert
- Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
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20
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Ruggiero C, Ramirez S, Ramazzotti E, Mancini R, Muratori R, Raggi MA, Conti M. Multiplexed therapeutic drug monitoring of antipsychotics in dried plasma spots by LC-MS/MS. J Sep Sci 2020; 43:1440-1449. [PMID: 32077627 DOI: 10.1002/jssc.201901200] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/31/2020] [Accepted: 02/01/2020] [Indexed: 01/19/2023]
Abstract
In this work, a convenient method for the therapeutic monitoring of seven common antipsychotic drugs in "dried plasma spot" samples has been developed. It is based on the liquid chromatography tandem mass spectrometry technique, operating in multiple reaction monitoring mode, and a straightforward procedure for the simultaneous extraction of all antipsychotics in a single step, with high extraction yield. The method was fully validated with proper accuracy, precision, selectivity and sensitivity, for all the drugs. Limits of quantification were 0.12, 1.09, 1.46, 1.47, 5.70, 1.32, 1.33 µg/L for haloperidol, aripiprazole, olanzapine, quetiapine, clozapine, risperidone, and paliperidone, respectively. Accuracy, intra- and interday precision values were <10% for all drugs at all concentration levels examined. The method was tested in the analysis of 30 plasma samples from real patients for each drug. The proposed analytical approach, by combining practical and logistical advantages of microsampling with liquid chromatography tandem mass spectrometry analytical performance, could offer an ideal strategy for accurate and timely therapeutic drug monitoring of antipsychotic drugs in most clinical settings, even in remote centers and/or in out-patient settings, bringing so many potential improvements in psychiatric patient care.
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Affiliation(s)
- Carla Ruggiero
- LUM Metropolitan Laboratory, AUSL Bologna, Bologna, Italy
| | | | | | - Rita Mancini
- LUM Metropolitan Laboratory, AUSL Bologna, Bologna, Italy
| | | | | | - Matteo Conti
- LUM Metropolitan Laboratory, AUSL Bologna, Bologna, Italy
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21
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Patel D, Namdev KK, Verma K, Gururani R, Tiwari A, Kumar P, Dewangan RP, Wabaidur SM, Sharma S, Dwivedi J. HPLC-UV and spectrofluorimetric methods for simultaneous estimation of fluticasone furoate and vilanterol in rabbit plasma: A pharmacokinetic study. J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1132:121842. [PMID: 31669821 DOI: 10.1016/j.jchromb.2019.121842] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 11/24/2022]
Abstract
Fluticasone furoate (FF) and vilanterol trifenatate (VT) is a widely prescribed combination in the management of asthma and chronic obstructive pulmonary disease. In the present study, two quantitative methods based on HPLC-UV and spectrofluorimetric analysis had been developed and validated for simultaneous estimation of FF and VT in rabbit plasma using baclomethasone as internal standard (ISTD). Analytes and ISTD were separated from plasma using simple step of protein precipitation with acetonitrile. Chromatographic separation was achieved on Spherisorb S5 ODS2 (250 mm × 4.6 mm, 5.0 µm) column using mobile phase that constitute acetonitrile-0.01% glacial acetic acid in water (70:30, v/v) and then detected on a UV detector at 235 nm wavelength. Spectrofluorimetric detection was performed using absorption/emission wavelength (λabs/em) of 286/352 nm and 362/407 nm for FF and VT, respectively. For both analytes, linearity ranged from 4-200 ng/mL to 10-200 ng/mL using HPLC-UV and spectrofluorimetric method, respectively. Methods were validated as per FDA recommendations. Statistical analysis revealed that these detection methods are statistically insignificant difference and can be used interchangeably without any bias. Further, these methods were applied in pharmacokinetic study for simultaneous estimation of FF and VT in rabbit plasma.
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Affiliation(s)
- Durgawati Patel
- Department of Chemistry, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India
| | - Kuldeep Kumar Namdev
- Department of Chemistry, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India
| | - Kanika Verma
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India
| | - Ritika Gururani
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India
| | - Akansha Tiwari
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India
| | - Puspendra Kumar
- KIET School of Pharmacy, KIET Group of Institutions, Ghaziabad, Uttar Pradesh 201206, India
| | - Rikeshwer Prasad Dewangan
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - Saikh Mohammad Wabaidur
- Department of Chemistry, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India; Advanced Materials Research Chair, Department of Chemistry, King Saud University, Riyadh, Saudi Arabia
| | - Swapnil Sharma
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India.
| | - Jaya Dwivedi
- Department of Chemistry, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India.
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22
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Mesini A, Loy A, Gattorno M, Moscatelli A, Bandettini R, Faraci M, Cangemi G, Castagnola E. Colistin Area Under the Time-Concentration in Children Treated With Intravenous Loading Dose and Maintenance Therapy. Clin Infect Dis 2019; 66:808-809. [PMID: 29020309 DOI: 10.1093/cid/cix757] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Alessio Mesini
- Infectious Diseases Unit, University of Genoa, S. Martino Hospital
| | - Anna Loy
- Istituto Giannina Gaslini, Children's Hospital Genoa, Italy
| | - Marco Gattorno
- Istituto Giannina Gaslini, Children's Hospital Genoa, Italy
| | | | | | - Maura Faraci
- Istituto Giannina Gaslini, Children's Hospital Genoa, Italy
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23
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Nation RL. Dose Suggestions for Intravenous Colistin in Pediatric Patients: Caution Required. Clin Infect Dis 2019; 66:810-811. [PMID: 29211826 DOI: 10.1093/cid/cix1048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Roger L Nation
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia
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24
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LC-MS/MS-Based Quantification of 9 Antiepileptic Drugs From a Dried Sample Spot Device. Ther Drug Monit 2019; 41:331-339. [DOI: 10.1097/ftd.0000000000000600] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Barco S, Castagnola E, Mesini A, Tripodi G, Cangemi G. Potential pitfalls in LC-MS/MS quantification of colistin for therapeutic drug monitoring of patients treated with colistimethate. J Pharm Biomed Anal 2019; 170:193-195. [PMID: 30928894 DOI: 10.1016/j.jpba.2019.03.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 03/12/2019] [Indexed: 11/17/2022]
Abstract
Starting from a warning of possible artificially high plasma colistin concentrations observed in clinical samples in our recently published LC-MS/MS method, we reviewed our analytical assay and demonstrated, for the first time, that caution must be paid to ionization conditions employed in the MS system. The artefact reported here demonstrates that additional experiments should be performed in the course of validation of LC-MS/MS methods to be used in samples containing both colistin and colistimethate.
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Affiliation(s)
- Sebastiano Barco
- Central Laboratory of Analyses, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Elio Castagnola
- Infectious Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Alessio Mesini
- Infectious Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Gino Tripodi
- Central Laboratory of Analyses, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Giuliana Cangemi
- Central Laboratory of Analyses, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
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26
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Dagla I, Karkoula E, Baira E, Tsarbopoulos A, Gikas E. Analytical methodologies used for the determination of colistin in biological fluids. Is it still a challenge? J Pharm Biomed Anal 2019; 164:777-788. [DOI: 10.1016/j.jpba.2018.11.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/16/2018] [Accepted: 11/17/2018] [Indexed: 10/27/2022]
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27
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An Improved LC-ESI-MS/MS Method to Quantify Pregabalin in Human Plasma and Dry Plasma Spot for Therapeutic Monitoring and Pharmacokinetic Applications. Ther Drug Monit 2018; 40:610-619. [DOI: 10.1097/ftd.0000000000000541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Clinical application of microsampling versus conventional sampling techniques in the quantitative bioanalysis of antibiotics: a systematic review. Bioanalysis 2018; 10:407-423. [DOI: 10.4155/bio-2017-0269] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Conventional sampling techniques for clinical pharmacokinetic studies often require the removal of large blood volumes from patients. This can result in a physiological or emotional burden, particularly for neonates or pediatric patients. Antibiotic pharmacokinetic studies are typically performed on healthy adults or general ward patients. These may not account for alterations to a patient’s pathophysiology and can lead to suboptimal treatment. Microsampling offers an important opportunity for clinical pharmacokinetic studies in vulnerable patient populations, where smaller sample volumes can be collected. This systematic review provides a description of currently available microsampling techniques and an overview of studies reporting the quantitation and validation of antibiotics using microsampling. A comparison of microsampling to conventional sampling in clinical studies is included.
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29
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Cangemi G, Mesini A, Castagnola E. Reply to Magréault et al. Clin Infect Dis 2018; 66:809-810. [DOI: 10.1093/cid/cix1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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30
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A simple, rapid and stability indicating validated method for quantification of lamotrigine in human plasma and dry plasma spot using LC-ESI–MS/MS: Application in clinical study. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1072:362-369. [DOI: 10.1016/j.jchromb.2017.11.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/19/2017] [Accepted: 11/30/2017] [Indexed: 11/21/2022]
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31
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An on-spot internal standard addition approach for accurately determining colistin A and colistin B in dried blood spots using ultra high-performance liquid chromatography–tandem mass spectrometry. J Pharm Biomed Anal 2017; 145:783-793. [DOI: 10.1016/j.jpba.2017.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 08/01/2017] [Accepted: 08/02/2017] [Indexed: 12/16/2022]
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32
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Barco S, Castagnola E, Moscatelli A, Rudge J, Tripodi G, Cangemi G. Volumetric adsorptive microsampling-liquid chromatography tandem mass spectrometry assay for the simultaneous quantification of four antibiotics in human blood: Method development, validation and comparison with dried blood spot. J Pharm Biomed Anal 2017; 145:704-710. [DOI: 10.1016/j.jpba.2017.07.033] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 07/26/2017] [Accepted: 07/27/2017] [Indexed: 12/01/2022]
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