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Yozgat I, Cakır U, Serdar MA, Sahin S, Sezerman OU, Nemutlu E, Baykal AT, Serteser M. Longitudinal non-targeted metabolomic profiling of urine samples for monitoring of kidney transplantation patients. Ren Fail 2024; 46:2300736. [PMID: 38213228 PMCID: PMC10791079 DOI: 10.1080/0886022x.2023.2300736] [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: 08/29/2023] [Accepted: 12/26/2023] [Indexed: 01/13/2024] Open
Abstract
The assessment of kidney function within the first year following transplantation is crucial for predicting long-term graft survival. This study aimed to develop a robust and accurate model using metabolite profiles to predict early long-term outcomes in patient groups at the highest risk of early graft loss. A group of 61 kidney transplant recipients underwent thorough monitoring during a one-year follow-up period, which included a one-week hospital stay and follow-up assessments at three and six months. Based on their 12-month follow-up serum creatinine levels: Group 2 had levels exceeding 1.5 mg/dl, while Group 1 had levels below 1.5 mg/dl. Metabolites were detected by mass spectrometer and first pre-processed. Univariate and multivariate statistical analyses were employed to identify significant differences between the two groups. Nineteen metabolites were found to differ significantly in the 1st week, and seventeen metabolites in the 3rd month (adjusted p-value < 0.05, quality control (QC) < 30, a fold change (FC) > 1.1 or a FC < 0.91, Variable Influence on Projection (VIP) > 1). However, no significant differences were observed in the 6th month. These distinctive metabolites mainly belonged to lipid, fatty acid, and amino acid categories. Ten models were constructed using a backward conditional approach, with the best performance seen in model 5 for Group 2 at the 1st-week mark (AUC 0.900) and model 3 at the 3rd-month mark (AUC 0.924). In conclusion, the models developed in the early stages may offer potential benefits in the management of kidney transplant patients.
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Affiliation(s)
- Ihsan Yozgat
- Department of Medical Biotechnology, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Ulkem Cakır
- Department of Nephrology, Acibadem University School of Medicine, Istanbul, Turkey
| | | | - Sevgi Sahin
- Department of Nephrology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Osman Ugur Sezerman
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Acibadem University, Istanbul, Turkey
| | - Emirhan Nemutlu
- Faculty of Pharmacy, Department of Analytical Chemistry, Hacettepe University, Ankara, Türkiye
| | - Ahmet Tarik Baykal
- Department of Medical Biochemistry, Faculty of Medicine, Acibadem University, Istanbul, Turkey
| | - Mustafa Serteser
- Department of Medical Biochemistry, Faculty of Medicine, Acibadem University, Istanbul, Turkey
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Shimada T, Kawakami D, Fujita A, Yamamoto R, Hara S, Ito K, Mizushima I, Kitajima S, Iwata Y, Sakai N, Kawano M, Wada T, Sai Y. Validation of an automated sample preparation module directly connected to LC-MS/MS (CLAM-LC-MS/MS system) and comparison with conventional immunoassays for quantitation of tacrolimus and cyclosporin A in a clinical setting. J Pharm Health Care Sci 2024; 10:5. [PMID: 38191469 PMCID: PMC10773076 DOI: 10.1186/s40780-023-00318-6] [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: 07/24/2023] [Accepted: 11/13/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Therapeutic drug monitoring (TDM) systems generally use either liquid chromatography/tandem mass spectrometry (LC-MS/MS) or immunoassay, though both methodologies have disadvantages. In this study, we aimed to evaluate whether a CLAM-LC-MS/MS system, which consists of a sample preparation module directly connected to LC-MS/MS, could be used for clinical TDM work for immunosuppressive drugs in whole blood, which requires a hemolytic process. For this purpose, we prospectively validated this system for clinical measurement of tacrolimus and cyclosporin A in patients' whole blood. The results were also compared with those of commercial immunoassays. METHODS Whole blood from patients treated with tacrolimus or cyclosporin A at the Department of Nephrology and Departments of Rheumatology, Kanazawa University Hospital, from May 2018 to July 2019 was collected with informed consent, and drug concentrations were measured by CLAM-LC-MS/MS and by chemiluminescence immunoassay (CLIA) for tacrolimus and affinity column-mediated immunoassay (ACMIA) for cyclosporin A. Correlations between the CLAM-LC-MS/MS and immunoassay results were analyzed. RESULTS Two hundred and twenty-four blood samples from 80 patients were used for tacrolimus measurement, and 76 samples from 21 patients were used for cyclosporin A. Intra- and inter-assay precision values of quality controls were less than 7%. There were significant correlations between CLAM-LC-MS/MS and the immunoassays for tacrolimus and cyclosporin A (Spearman rank correlation coefficients: 0.861, 0.941, P < 0.00001 in each case). The drug concentrations measured by CLAM-LC-MS/MS were about 20% lower than those obtained using the immunoassays. CLAM-LC-MS/MS maintenance requirements did not interfere with clinical operations. Compared to manual pretreatment, automated pretreatment by CLAM showed lower inter-assay precision values and greatly reduced the pretreatment time. CONCLUSIONS The results obtained by CLAM-LC-MS/MS were highly correlated with those of commercial immunoassay methods. CLAM-LC-MS/MS offers advantages in clinical TDM practice, including simple, automatic pretreatment, low maintenance requirement, and avoidance of interference.
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Affiliation(s)
- Tsutomu Shimada
- Department of Clinical Pharmacokinetics, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
- Department of Hospital Pharmacy, University Hospital, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Daisuke Kawakami
- Shimadzu Corporation, Kyoto, Japan
- Shimadzu Europa GmbH, Duisburg, Germany
| | - Arimi Fujita
- Department of Clinical Pharmacokinetics, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
- Department of Hospital Pharmacy, University Hospital, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | | | - Satoshi Hara
- Department of Rheumatology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Kiyoaki Ito
- Department of Rheumatology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Ichiro Mizushima
- Department of Rheumatology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Shinji Kitajima
- Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Yasunori Iwata
- Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Norihiko Sakai
- Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Mitsuhiro Kawano
- Department of Rheumatology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Takashi Wada
- Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Yoshimichi Sai
- Department of Clinical Pharmacokinetics, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
- Department of Hospital Pharmacy, University Hospital, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
- AI Hospital/Macro Signal Dynamics Research and Development Center, Kanazawa University, Kanazawa, Ishikawa, Japan
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Zhu Z, Zhang Y, Xue J, Kong J, Huang L, Ouyang H, Fu Z, He Y. Fluorescent immunochromatographic test strip for therapeutic drug monitoring of methotrexate with high sensitivity and wide dynamic range. Mikrochim Acta 2023; 190:342. [PMID: 37540283 DOI: 10.1007/s00604-023-05917-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023]
Abstract
As a front-line chemotherapeutic drug for maintenance and consolidation therapy, methotrexate (MTX) has widely been applied to treat various tumors and some inflammatory diseases. However, because of its severe toxicity ascribed to low selectivity, it is necessary to monitor therapeutic drugs in high-dose MTX therapeutic regimens to ensure treatment safety. In this work, we developed a fluorescent immunochromatographic test strip (FITS) for monitoring MTX by employing time-resolved fluorescent microspheres as signal probes. With a competitive immunoassay mode, the FITS for MTX shows a super-wide dynamic range of 10 pM-10 μM, covering the entire clinical therapeutic concentration range of MTX. Therapeutic drug monitoring of MTX can be achieved within 7 min with high specificity, facilitating the timely rescue of drug poisoning led by high-dose MTX treatment. The method was employed for monitoring MTX in the spiked human serum, urine, and milk, showing acceptable recoveries ranging from 94.0 to 110.0%. The established FITS has been applied to MTX detection in serum obtained from high-dose MTX treatment. The results from FITS and enzyme multiplied immunoassay technique showed no significant difference, suggesting its reliability for usage in real biological samples. The device shows promise in point-of-care therapeutic drug monitoring for resource-limited countries and institutes, which significantly facilitates overcoming the lag time between sampling and results.
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Affiliation(s)
- Zhongjie Zhu
- Department of Pharmacy, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Yu Zhang
- College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China
| | - Jinxia Xue
- College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China
| | - Jing Kong
- Department of Pharmacy, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Ling Huang
- Department of Pharmacy, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Hui Ouyang
- College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China
| | - Zhifeng Fu
- College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China.
| | - Yong He
- Department of Pharmacy, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China.
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Fingerprick Microsampling Methods Can Replace Venepuncture for Simultaneous Therapeutic Drug Monitoring of Tacrolimus, Mycophenolic Acid, and Prednisolone Concentrations in Adult Kidney Transplant Patients. Ther Drug Monit 2023; 45:69-78. [PMID: 36097333 DOI: 10.1097/ftd.0000000000001024] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/19/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Kidney transplant patients undergo repeated and frequent venepunctures during allograft management. Microsampling methods that use a fingerprick draw of capillary blood, such as dried blood spots (DBS) and volumetric absorptive microsamplers (VAMS), have the potential to reduce the burden and volume of blood loss with venepuncture. METHODS This study aimed to examine microsampling approaches for the simultaneous measurement of tacrolimus, mycophenolic acid, mycophenolic acid glucuronide (MPAG), and prednisolone drug concentrations compared with standard venepuncture in adult kidney transplant patients. DBS and VAMS were simultaneously collected with venepuncture samples from 40 adult kidney transplant patients immediately before and 2 hours after immunosuppressant dosing. Method comparison was performed using Passing-Bablok regression, and bias was assessed using Bland-Altman analysis. Drug concentrations measured through microsampling and venepuncture were also compared by estimating the median prediction error (MPE) and median absolute percentage prediction error (MAPE). RESULTS Passing-Bablok regression showed a systematic difference between tacrolimus DBS and venepuncture [slope of 1.06 (1.01-1.13)] and between tacrolimus VAMS and venepuncture [slope of 1.08 (1.03-1.13)]. Tacrolimus values were adjusted for this difference, and the corrected values showed no systematic differences. Moreover, no systematic differences were observed when comparing DBS or VAMS with venepuncture for mycophenolic acid and prednisolone. Tacrolimus (corrected), mycophenolic acid, and prednisolone microsampling values met the MPE and MAPE predefined acceptability limits of <15% when compared with the corresponding venepuncture values. DBS and VAMS, collected in a controlled environment, simultaneously measured multiple immunosuppressants. CONCLUSIONS This study demonstrates that accurate results of multiple immunosuppressant concentrations can be generated through the microsampling approach, with a preference for VAMS over DBS.
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Mathieu E, Duterme C, Fage D, Cotton F. Cascadion™ SM Clinical Analyzer: Evaluation of the whole blood immunosuppressants quantification and routine usability. Clin Chim Acta 2023; 539:97-104. [PMID: 36509135 DOI: 10.1016/j.cca.2022.11.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/09/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Liquid chromatography coupled with tandem mass spectrometry (LC- MS/MS) tends to overcome other methods for therapeutic drugs monitoring (TDM) due to its very good analytical performances. Nevertheless, the lack of automation still limits its use in laboratory medicine. The Cascadion SM Clinical Analyzer (Thermo Fisher Scientific) is the first fully automated LC-MS/MS instrument available. We evaluated its immunosuppressant drugs (ISD) assay and the incorporation of such instrument into a core-laboratory. METHODS An extended analytical verification of the Cascadion ISD panel including cyclosporin A, tacrolimus, everolimus and sirolimus was performed. It was compared to the MassTox ISD assay (Chromsystems). Different preanalytical and analytical conditions were tested. Finally, a turnaround-time evaluation and a satisfaction survey of users after 11 months of use in a core-laboratory were performed. RESULTS Precision and linearity results were within the analytical goals fixed. The comparison with the MassTox ISD assay showed results in agreement except for cyclosporin A where a bias of -11.6% was observed, probably due to a greater trueness of the Cascadion method. Additional experiments showed good performances. The random accessibility and the ease of use by non-specialized staff members allowed a wider working time range and a reduction of the turnaround-time of 55%. CONCLUSION The Cascadion ISD Panel held its promises in term of analytical performances, workflow aspects and ease of use by non-specialized staff.
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Affiliation(s)
- Elise Mathieu
- Department of Clinical Chemistry, LHUB-ULB, Université Libre de Bruxelles, Brussels, Belgium.
| | - Cécile Duterme
- Department of Clinical Chemistry, LHUB-ULB, Université Libre de Bruxelles, Brussels, Belgium
| | - David Fage
- Department of Clinical Chemistry, LHUB-ULB, Université Libre de Bruxelles, Brussels, Belgium
| | - Frédéric Cotton
- Department of Clinical Chemistry, LHUB-ULB, Université Libre de Bruxelles, Brussels, Belgium
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A Volumetric Absorptive Microsampling UPLC-MS/MS Method for Simultaneous Quantification of Tacrolimus, Mycophenolic Acid and Creatinine in Whole Blood of Renal Transplant Recipients. Pharmaceutics 2022; 14:pharmaceutics14122547. [PMID: 36559041 PMCID: PMC9788011 DOI: 10.3390/pharmaceutics14122547] [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: 09/19/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Abstract
(1) Background: Continuous monitoring of tacrolimus (TAC), mycophenolic acid (MPA), and creatinine (Cre) after renal transplantation is vitally important. In this study, we developed a new method based on volumetric absorptive microsampling (VAMS) combined with Ultra Performance Liquid Chromatography−Tandem Mass Spectrometry (UPLC-MS/MS) to simultaneously quantify three analytes including TAC, MPA, and Cre in whole blood. (2) Methods: The VAMS-based UPLC-MS/MS assay used a shared extraction and a single injection to simultaneously quantify the included TAC, MPA, and Cre. Development and validation were carried out following the Food and Drug Administration and European Medicines Agency guidelines for the validation of bioanalytical methods. Moreover, clinical validation for the three analytes was performed in both dried blood spot (DBS) and VAMS. Furthermore, a willingness survey was conducted using the system usability scale (SUS) for renal transplant recipients. (3) Results: The assay was successfully validated for all analytes. No interference, carryover, or matrix effects were observed, and extraction recoveries and process efficiencies were >90.00%. Analysis was unaffected by hematocrit (0.20~0.60, L/L) and anticoagulants (EDTA-2K). Dried VAMS samples were stable for 7 days at ambient temperature and stable for at least 1 month at −20 °C. During clinical validation, the measured TAC, corrected MPA, and Cre concentrations of VAMS samples met the analytical standards (95.00%, 88.57%, and 92.50%). When more stringent clinical acceptance criteria were set, the results obtained by VAMS (90.00%, 71.43%, and 85.00%) better than DBS (77.50%, 62.86%, and 70.00%). Compared with DBS, the survey found that renal transplant recipients are more inclined to use VAMS. (4) Conclusions: A robust extraction and UPLC-MS/MS analysis method in VAMS tips was developed and fully validated for the simultaneous quantification of TAC, MPA, and Cre concentrations. This method provides analytical support for the one-sample remote monitoring of both immunosuppressive drug concentrations and renal function in allo-renal recipients. Based on the good consistency between this method and the routine detection of venous blood samples and higher patient satisfaction than DBS, we believe that VAMS sampling can be a better alternative to venous whole-blood sampling.
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Bressán IG, Giménez MI, Llesuy SF. Clinical validation of a liquid chromatography-tandem mass spectrometry method for the quantification of calcineurin and mTOR inhibitors in dried matrix on paper discs. J Mass Spectrom Adv Clin Lab 2022; 25:12-18. [PMID: 35694178 PMCID: PMC9184858 DOI: 10.1016/j.jmsacl.2022.06.002] [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: 01/09/2022] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 11/30/2022] Open
Abstract
The feasibility of DMPD for therapeutic monitoring of four immunosuppressive drugs was clinically validated. More than 40 paired samples per analyte (finger prick on DMPD vs whole blood collected by venipuncture) from different transplant patient types were quantified using LC-MS/MS. Errors at medical decision points and overall bias were not statistically or clinically significant. DMPD is interchangeable with whole blood obtained by venipuncture for samples collected by trained personnel.
Introduction Advances in liquid chromatography coupled to tandem mass spectrometry (LC–MS/MS) have enabled the quantification of immunosuppressants using microsampling techniques. In this context, dried matrix on paper discs (DMPD) could be a useful alternative to conventional venipuncture. Although analytical validation is necessary to establish the suitability of method performance, it is not sufficient to proceed with its implementation into routine clinical practice. Also necessary is that equivalence between sampling methods be demonstrated in a clinical validation study. Objetives To clinically validate a LC-MS/MS method for the quantification of tacrolimus, sirolimus, everolimus and cyclosporin A using DMPD. Methods According to the recommendations of international guidelines, at least 40 whole blood (WB) and DMPD paired samples for each analyte were collected by skilled technicians and analyzed using LC-MS/MS. Results were evaluated in terms of statistical agreement and bias values at medical decision points. Results For all analytes, Passing-Bablok regression analysis revealed that confidence intervals (CIs) for slopes and intercepts included 1 and 0, respectively. It also showed that biases at medical decision points were not clinically relevant. No statistically significant differences between DMPD and WB were found using difference plots and agreement analysis. In this regard, CIs for bias estimators included 0, and more than 95% of the results fell within the limits of agreement. Conclusion The feasibility of the clinical application of simultaneous quantification of tacrolimus, sirolimus, everolimus and cyclosporin A in DMPD was demonstrated. Results showed that this microsampling technique is interchangeable with conventional WB sampling when specimens are collected by trained personnel.
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Affiliation(s)
- Ignacio Guillermo Bressán
- Laboratory of Mass Spectrometry, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Department of Chemistry, Instituto Universitario Escuela de Medicina del Hospital Italiano, Buenos Aires, Argentina
- Corresponding author at: Laboratory of Mass Spectrometry, Hospital Italiano de Buenos Aires, Tte. Juan Domingo Perón 4190 (C1181ACH), Buenos Aires, Argentina.
| | - María Isabel Giménez
- Laboratory of Mass Spectrometry, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Department of Clinical Biochemistry, Instituto Universitario Escuela de Medicina del Hospital Italiano, Buenos Aires, Argentina
| | - Susana Francisca Llesuy
- Department of Chemistry, Instituto Universitario Escuela de Medicina del Hospital Italiano, Buenos Aires, Argentina
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Le J, Peng R, Yang SL, Chen JL, Cheng JR, Li Y, Wang ST. Quantification of immunosuppressants from one 3.2 mm dried blood spot by a novel cold-induced phase separation based LC-MS/MS method. Anal Chim Acta 2022; 1210:339889. [DOI: 10.1016/j.aca.2022.339889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/12/2022] [Accepted: 04/28/2022] [Indexed: 11/01/2022]
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Zhang M, Cui X, Li N. Smartphone-based mobile biosensors for the point-of-care testing of human metabolites. Mater Today Bio 2022; 14:100254. [PMID: 35469257 PMCID: PMC9034388 DOI: 10.1016/j.mtbio.2022.100254] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/14/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
Rapid, accurate, portable and quantitative profiling of metabolic biomarkers is of great importance for disease diagnosis and prognosis. The recent development in the optical and electric biosensors based on the smartphone is promising for profiling of metabolites with advantages of rapid, reliability, accuracy, low-cost and multi-analytes analysis capability. In this review, we introduced the optical biosensing platforms including colorimetric, fluorescent and chemiluminescent sensing, and electrochemical biosensing platforms including wired and wireless communication. Challenges and future perspectives desired for reliable, accurate, cost-effective, and multi-functions smartphone-based biosensing systems were also discussed. We envision that such smartphone-based biosensing platforms will allow daily and comprehensive metabolites monitoring in the future, thus unlocking the potential to transform clinical diagnostics into non-clinical self-testing. We also believed that this progress report will encourage future research to develop advanced, integrated and multi-functional smartphone-based Point-of-Care testing (POCT) biosensors for the monitoring and diagnosis as well as personalized treatments of a spectrum of metabolic-disorder related diseases.
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Jiang X, Xu X, Zeng L, Song S, Xu L, Kuang H, Liu L, Xu C. A gold-based immunochromatographic strip for the detection of sirolimus in human whole blood. Analyst 2022; 147:1394-1402. [DOI: 10.1039/d1an02297k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The schematic of a colloidal gold-based immunochromatographic strip for the detection of sirolimus in human whole blood.
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Affiliation(s)
- Xiaoqian Jiang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
- International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Xinxin Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
- International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Lu Zeng
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
- International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Shanshan Song
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
- International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Liguang Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
- International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Hua Kuang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
- International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Liqiang Liu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
- International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Chuanlai Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
- International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
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Tombelli S, Trono C, Berneschi S, Berrettoni C, Giannetti A, Bernini R, Persichetti G, Testa G, Orellana G, Salis F, Weber S, Luppa PB, Porro G, Quarto G, Schubert M, Berner M, Freitas PP, Cardoso S, Franco F, Silverio V, Lopez-Martinez M, Hilbig U, Freudenberger K, Gauglitz G, Becker H, Gärtner C, O'Connell MT, Baldini F. An integrated device for fast and sensitive immunosuppressant detection. Anal Bioanal Chem 2021; 414:3243-3255. [PMID: 34936009 PMCID: PMC8956524 DOI: 10.1007/s00216-021-03847-x] [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: 09/23/2021] [Revised: 11/22/2021] [Accepted: 12/10/2021] [Indexed: 12/17/2022]
Abstract
The present paper describes a compact point of care (POC) optical device for therapeutic drug monitoring (TDM). The core of the device is a disposable plastic chip where an immunoassay for the determination of immunosuppressants takes place. The chip is designed in order to have ten parallel microchannels allowing the simultaneous detection of more than one analyte with replicate measurements. The device is equipped with a microfluidic system, which provides sample mixing with the necessary chemicals and pumping samples, reagents and buffers into the measurement chip, and with integrated thin film amorphous silicon photodiodes for the fluorescence detection. Submicrometric fluorescent magnetic particles are used as support in the immunoassay in order to improve the efficiency of the assay. In particular, the magnetic feature is used to concentrate the antibody onto the sensing layer leading to a much faster implementation of the assay, while the fluorescent feature is used to increase the optical signal leading to a larger optical dynamic change and consequently a better sensitivity and a lower limit of detection. The design and development of the whole integrated optical device are here illustrated. In addition, detection of mycophenolic acid and cyclosporine A in spiked solutions and in microdialysate samples from patient blood with the implemented device are reported.
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Affiliation(s)
- Sara Tombelli
- Institute of Applied Physics "Nello Carrara", CNR-IFAC, Via Madonna del Piano 10, 50019, Sesto Fiorentino, Italy
| | - Cosimo Trono
- Institute of Applied Physics "Nello Carrara", CNR-IFAC, Via Madonna del Piano 10, 50019, Sesto Fiorentino, Italy.
| | - Simone Berneschi
- Institute of Applied Physics "Nello Carrara", CNR-IFAC, Via Madonna del Piano 10, 50019, Sesto Fiorentino, Italy
| | - Chiara Berrettoni
- Institute of Applied Physics "Nello Carrara", CNR-IFAC, Via Madonna del Piano 10, 50019, Sesto Fiorentino, Italy
| | - Ambra Giannetti
- Institute of Applied Physics "Nello Carrara", CNR-IFAC, Via Madonna del Piano 10, 50019, Sesto Fiorentino, Italy
| | - Romeo Bernini
- Institute for Electromagnetic Sensing of the Environment, CNR-IREA, Via Diocleziano 328, 80124, Napoli, Italy
| | - Gianluca Persichetti
- Institute for Electromagnetic Sensing of the Environment, CNR-IREA, Via Diocleziano 328, 80124, Napoli, Italy
| | - Genni Testa
- Institute for Electromagnetic Sensing of the Environment, CNR-IREA, Via Diocleziano 328, 80124, Napoli, Italy
| | - Guillermo Orellana
- Department of Organic Chemistry, Faculty of Chemistry, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Francesca Salis
- Department of Organic Chemistry, Faculty of Chemistry, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Susanne Weber
- Institute of Clinical Chemistry and Pathobiochemistry, Klinikum rechts der Isar, Technische Universität München, Marchioninistrasse 15, 8000, Munich, Germany
| | - Peter B Luppa
- Institute of Clinical Chemistry and Pathobiochemistry, Klinikum rechts der Isar, Technische Universität München, Marchioninistrasse 15, 8000, Munich, Germany
| | - Giampiero Porro
- Datamed Srl, Via Grandi 4/6, 20068 - Peschiera Borromeo, Milan, Italy
| | - Giovanna Quarto
- Datamed Srl, Via Grandi 4/6, 20068 - Peschiera Borromeo, Milan, Italy
| | - Markus Schubert
- Institute for Photovoltaics and Research Center SCoPE, University of Stuttgart, 70569, Stuttgart, Germany
| | - Marcel Berner
- Innovative Pyrotechnik GmbH, Steinwerkstraße 2, 71139, Ehningen, Germany
| | - Paulo P Freitas
- Instituto de Engenharia de Sistemas e Computadores-Microsistemas e Nanotecnologias, R.Alves Redol 9, 1000-027, Lisbon, Portugal
| | - Susana Cardoso
- Instituto de Engenharia de Sistemas e Computadores-Microsistemas e Nanotecnologias, R.Alves Redol 9, 1000-027, Lisbon, Portugal
| | - Fernando Franco
- Instituto de Engenharia de Sistemas e Computadores-Microsistemas e Nanotecnologias, R.Alves Redol 9, 1000-027, Lisbon, Portugal
| | - Vânia Silverio
- Instituto de Engenharia de Sistemas e Computadores-Microsistemas e Nanotecnologias, R.Alves Redol 9, 1000-027, Lisbon, Portugal
| | - Maria Lopez-Martinez
- Instituto de Engenharia de Sistemas e Computadores-Microsistemas e Nanotecnologias, R.Alves Redol 9, 1000-027, Lisbon, Portugal
| | - Urs Hilbig
- Institute for Physical and Theoretical Chemistry, Eberhard Karls University, Auf der Morgenstelle 18, 72076, Tübingen, Germany
| | - Kathrin Freudenberger
- Institute for Physical and Theoretical Chemistry, Eberhard Karls University, Auf der Morgenstelle 18, 72076, Tübingen, Germany
| | - Günter Gauglitz
- Institute for Physical and Theoretical Chemistry, Eberhard Karls University, Auf der Morgenstelle 18, 72076, Tübingen, Germany
| | - Holger Becker
- microfluidic ChipShop GmbH, Stockholmer Str. 20, 07747, Jena, Germany
| | - Claudia Gärtner
- microfluidic ChipShop GmbH, Stockholmer Str. 20, 07747, Jena, Germany
| | - Mark T O'Connell
- Cornel Medical Limited, 17 Church Walk, St Neots, Cambridgeshire, PE19 1JH, UK
| | - Francesco Baldini
- Institute of Applied Physics "Nello Carrara", CNR-IFAC, Via Madonna del Piano 10, 50019, Sesto Fiorentino, Italy
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12
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Dulay MT, Boeser CL, Walker KL, Feider C, Zare RN. Polymer substrate with surface solvent reservoir for polymer-spray mass spectrometric analysis of hydrophilic drugs. TALANTA OPEN 2021. [DOI: 10.1016/j.talo.2021.100048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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13
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Seyfinejad B, Jouyban A. Overview of therapeutic drug monitoring of immunosuppressive drugs: Analytical and clinical practices. J Pharm Biomed Anal 2021; 205:114315. [PMID: 34399192 DOI: 10.1016/j.jpba.2021.114315] [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] [Received: 04/09/2021] [Revised: 07/16/2021] [Accepted: 08/05/2021] [Indexed: 01/04/2023]
Abstract
Immunosuppressant drugs (ISDs) play a key role in short-term patient survival together with very low acute allograft rejection rates in transplant recipients. Due to the narrow therapeutic index and large inter-patient pharmacokinetic variability of ISDs, therapeutic drug monitoring (TDM) is needed to dose adjustment for each patient (personalized medicine approach) to avoid treatment failure or side effects of the therapy. To achieve this, TDM needs to be done effectively. However, it would not be possible without the proper clinical practice and analytical tools. The purpose of this review is to provide a guide to establish reliable TDM, followed by a critical overview of the current analytical methods and clinical practices for the TDM of ISDs, and to discuss some of the main practical aspects of the TDM.
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Affiliation(s)
- Behrouz Seyfinejad
- Pharmaceutical Analysis Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran; Student Research Committee, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Abolghasem Jouyban
- Pharmaceutical Analysis Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran; Faculty of Pharmacy, Near East University, PO BOX: 99138 Nicosia, North Cyprus, Mersin 10, Turkey.
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14
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Göksel Y, Zor K, Rindzevicius T, Thorhauge Als-Nielsen BE, Schmiegelow K, Boisen A. Quantification of Methotrexate in Human Serum Using Surface-Enhanced Raman Scattering-Toward Therapeutic Drug Monitoring. ACS Sens 2021; 6:2664-2673. [PMID: 34143600 DOI: 10.1021/acssensors.1c00643] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Therapeutic drug monitoring (TDM) can improve clinical care when using drugs with pharmacokinetic variability and a narrow therapeutic window. Rapid, reliable, and easy-to-use detection methods are required in order to decrease the time of analysis and can also enable TDM in resource-limited settings or even at bedside. Monitoring methotrexate (MTX), an anticancer drug, is critical since it is needed to follow the drug clearance rate and decide how to administer the rescue drug, leucovorin (LV), in order to avoid toxicity and even death. We show that with the optimized nanopillar-assisted separation (NPAS) method using surface-enhanced Raman scattering, we were able to measure MTX in PBS and serum in the linear range of 5-150 μM and confirmed that MTX detection can be carried out even in the presence of LV. Additionally, when NPAS was combined with centrifugal filtration, a quantification limit of 2.1 μM for MTX in human serum sample was achieved. The developed detection method enables fast detection (10 min) and quantification of MTX from human serum (>90% accuracy). Furthermore, we show the potential of the developed method for TDM, when quantifying MTX from clinical samples, collected from patients who are undergoing high-dose MTX therapy.
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Affiliation(s)
- Yaman Göksel
- Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Kongens Lyngby 2800, Denmark
| | - Kinga Zor
- Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Kongens Lyngby 2800, Denmark
- BioInnovation Institute Foundation, Copenhagen N 2200, Denmark
| | - Tomas Rindzevicius
- Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Kongens Lyngby 2800, Denmark
- BioInnovation Institute Foundation, Copenhagen N 2200, Denmark
| | | | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet University Hospital, Copenhagen 2100, Denmark
| | - Anja Boisen
- Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Kongens Lyngby 2800, Denmark
- BioInnovation Institute Foundation, Copenhagen N 2200, Denmark
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15
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Taddeo A, Prim D, Bojescu ED, Segura JM, Pfeifer ME. Point-of-Care Therapeutic Drug Monitoring for Precision Dosing of Immunosuppressive Drugs. J Appl Lab Med 2021; 5:738-761. [PMID: 32533157 DOI: 10.1093/jalm/jfaa067] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/03/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Immunosuppressive drugs (ISD) are an essential tool in the treatment of transplant rejection and immune-mediated diseases. Therapeutic drug monitoring (TDM) for determination of ISD concentrations in biological samples is an important instrument for dose personalization for improving efficacy while reducing side effects. While currently ISD concentration measurements are performed at specialized, centralized facilities, making the process complex and laborious for the patient, various innovative technical solutions have recently been proposed for bringing TDM to the point-of-care (POC). CONTENT In this review, we evaluate current ISD-TDM and its value, limitations, and proposed implementations. Then, we discuss the potential of POC-TDM in the era of personalized medicine, and provide an updated review on the unmet needs and available technological solutions for the development of POC-TDM devices for ISD monitoring. Finally, we provide concrete suggestions for the generation of a meaningful and more patient-centric process for ISD monitoring. SUMMARY POC-based ISD monitoring may improve clinical care by reducing turnaround time, by enabling more frequent measurements in order to obtain meaningful pharmacokinetic data (i.e., area under the curve) faster reaction in case of problems and by increasing patient convenience and compliance. The analysis of the ISD-TDM field prompts the evolution of POC testing toward the development of fully integrated platforms able to support clinical decision-making. We identify 4 major areas requiring careful combined implementation: patient usability, data meaningfulness, clinicians' acceptance, and cost-effectiveness.
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Affiliation(s)
- Adriano Taddeo
- Institute of Life Technologies - School of Engineering, HES-SO//University of Applied Sciences, Western Switzerland, Sion, Switzerland
| | - Denis Prim
- Institute of Life Technologies - School of Engineering, HES-SO//University of Applied Sciences, Western Switzerland, Sion, Switzerland
| | - Elena-Diana Bojescu
- Institute of Life Technologies - School of Engineering, HES-SO//University of Applied Sciences, Western Switzerland, Sion, Switzerland
| | - Jean-Manuel Segura
- Institute of Life Technologies - School of Engineering, HES-SO//University of Applied Sciences, Western Switzerland, Sion, Switzerland
| | - Marc E Pfeifer
- Institute of Life Technologies - School of Engineering, HES-SO//University of Applied Sciences, Western Switzerland, Sion, Switzerland
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16
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Therapeutic drug monitoring of immunosuppressive drugs in hepatology and gastroenterology. Best Pract Res Clin Gastroenterol 2021; 54-55:101756. [PMID: 34874840 DOI: 10.1016/j.bpg.2021.101756] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/11/2021] [Indexed: 01/31/2023]
Abstract
Immunosuppressive drugs have been key to the success of liver transplantation and are essential components of the treatment of inflammatory bowel disease (IBD) and autoimmune hepatitis (AIH). For many but not all immunosuppressants, therapeutic drug monitoring (TDM) is recommended to guide therapy. In this article, the rationale and evidence for TDM of tacrolimus, mycophenolic acid, the mammalian target of rapamycin inhibitors, and azathioprine in liver transplantation, IBD, and AIH is reviewed. New developments, including algorithm-based/computer-assisted immunosuppressant dosing, measurement of immunosuppressants in alternative matrices for whole blood, and pharmacodynamic monitoring of these agents is discussed. It is expected that these novel techniques will be incorporate into the standard TDM in the next few years.
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17
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Antunes NJ, Kipper K, Couchman L, Duncan MA, Holt DW, De Nucci G, Johnston A. Simultaneous quantification of cyclosporin, tacrolimus, sirolimus and everolimus in whole blood by UHPLC-MS/MS for therapeutic drug monitoring. Biomed Chromatogr 2021; 35:e5071. [PMID: 33462848 DOI: 10.1002/bmc.5071] [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] [Received: 10/21/2020] [Revised: 12/30/2020] [Accepted: 01/12/2021] [Indexed: 12/28/2022]
Abstract
The aim of this study was to develop and validate a UHPLC-MS/MS assay to quantify cyclosporin (CYC), tacrolimus (TAC), sirolimus (SIR) and everolimus (EVE) in human whole blood for therapeutic drug monitoring. Analytes were extracted from 50 μL human whole blood by protein precipitation. The separation of the drugs was performed on an Acquity UPLC BEH C18 column. Analytes were eluted with a mobile phase consisting of 2 mM ammonium acetate with 0.1% formic acid (v/v) in deionised water and 2 mM ammonium acetate with 0.1% formic acid (v/v) in methanol at a flow rate of 300 μL/min in gradient elution. The method performance was evaluated by analysing patient blood samples and/or external quality control samples [proficiency testing (PT) scheme]. The method was linear from 23.75 to 1094.0, 1.3 to 42.4, 1.3 to 47.0 and 1.2-41.6 μg/mL for CYC, TAC, SIR and EVE, respectively. The within- and between-assay reproducibility results were ˂ 11%. Results from PT and patient sample quantification were comparable to those obtained previously by an in-house validated method using protein precipitation and liquid-liquid extraction. This method showed good analytical performance for quantifying CYC, TAC, SIR and EVE in whole blood over their respective calibration ranges.
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Affiliation(s)
- Natalicia J Antunes
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil.,Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Analytical Services International (ASI) Ltd, St George's-University of London, London, UK
| | - Karin Kipper
- Analytical Services International (ASI) Ltd, St George's-University of London, London, UK.,Institute of Chemistry, University of Tartu, Tartu, Estonia
| | - Lewis Couchman
- Analytical Services International (ASI) Ltd, St George's-University of London, London, UK.,Pharmaceutical Sciences Clinical Academic Group, King's College London, London, UK
| | - Marie-Anne Duncan
- Analytical Services International (ASI) Ltd, St George's-University of London, London, UK
| | - David W Holt
- Analytical Services International (ASI) Ltd, St George's-University of London, London, UK
| | - Gilberto De Nucci
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Atholl Johnston
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Analytical Services International (ASI) Ltd, St George's-University of London, London, UK
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18
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Gönel A, Kirhan I. Effects of Broad Spectrum Antibiotics on Measurement of Immunosuppressant Drugs. Antiinflamm Antiallergy Agents Med Chem 2021; 20:101-105. [PMID: 32208127 DOI: 10.2174/1871523019666200324111436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/07/2020] [Accepted: 02/19/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Antibiotics used parenterally can affect blood drug level measurements, as measured in diagnostic tests. OBJECTIVE To investigate the effect of six different antibiotics commonly used in intensive care units on tacrolimus, sirolimus, everolimus and cyclosporin A levels measured by mass spectrometry. METHODS Ampicillin + sulbactam (AB1, IV, 1 g), imipenem + cilastatin sodium (AB2, IV, 500 mg), piperacillin + tazobactam (AB3, 4.5 g, IV), ertapenem (AB4, IV, 1 g), meropenem trihydrate (AB5, 500 mg, IV) and ceftriaxone (AB6, 1 g, IV) antibiotics were used for the interference assay. Measurements were performed on the Shimadzu 8045 (Japan) LC-MS/MS instrument. Bias values were calculated. RESULTS The least affected immunosuppressant was cyclosporine A (between -6.88% and 3.40%). The most affected were everolimus and sirolimus. Ertapenem caused negative interference on the level of everolimus at the rate of -27.34% and sirolimus at the rate of -26.79%. Piperacillin + tazobactam and imipenem + cilastatin sodium caused positive interferences on sirolimus at the rate of 24.24% and 22.73%, respectively. Ampicillin + sulbactam, meropenem trihydrate and ceftriaxone affected the sirolimus levels at lower rates (-4.49%, 5.93% and 9.86%). Everolimus levels deviated at the rate of -11.21% to -16.99% due to imipenem + cilastatin sodium, meropenem trihydrate and ceftriaxone. CONCLUSION This study demonstrated the potential of antibiotic use affecting immunosuppressant levels. Antibiotic interference, especially in transplant patients, may cause erroneous immunosuppression, increasing the likelihood of rejection.
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Affiliation(s)
- Ataman Gönel
- Department of Medicinal Biochemistry, Medicine Faculty, Harran University, Sanliurfa, Turkey
| | - Idris Kirhan
- Department of Internal Medicine, Medicine Faculty, Harran University, Sanliurfa, Turkey
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19
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Weber S, Tombelli S, Giannetti A, Trono C, O'Connell M, Wen M, Descalzo AB, Bittersohl H, Bietenbeck A, Marquet P, Renders L, Orellana G, Baldini F, Luppa PB. Immunosuppressant quantification in intravenous microdialysate - towards novel quasi-continuous therapeutic drug monitoring in transplanted patients. Clin Chem Lab Med 2020; 59:935-945. [PMID: 33554521 DOI: 10.1515/cclm-2020-1542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/06/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Therapeutic drug monitoring (TDM) plays a crucial role in personalized medicine. It helps clinicians to tailor drug dosage for optimized therapy through understanding the underlying complex pharmacokinetics and pharmacodynamics. Conventional, non-continuous TDM fails to provide real-time information, which is particularly important for the initial phase of immunosuppressant therapy, e.g., with cyclosporine (CsA) and mycophenolic acid (MPA). METHODS We analyzed the time course over 8 h of total and free of immunosuppressive drug (CsA and MPA) concentrations measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 16 kidney transplant patients. Besides repeated blood sampling, intravenous microdialysis was used for continuous sampling. Free drug concentrations were determined from ultracentrifuged EDTA-plasma (UC) and compared with the drug concentrations in the respective microdialysate (µD). µDs were additionally analyzed for free CsA using a novel immunosensor chip integrated into a fluorescence detection platform. The potential of microdialysis coupled with an optical immunosensor for the TDM of immunosuppressants was assessed. RESULTS Using LC-MS/MS, the free concentrations of CsA (fCsA) and MPA (fMPA) were detectable and the time courses of total and free CsA comparable. fCsA and fMPA and area-under-the-curves (AUCs) in µDs correlated well with those determined in UCs (r≥0.79 and r≥0.88, respectively). Moreover, fCsA in µDs measured with the immunosensor correlated clearly with those determined by LC-MS/MS (r=0.82). CONCLUSIONS The new microdialysis-supported immunosensor allows real-time analysis of immunosuppressants and tailor-made dosing according to the AUC concept. It readily lends itself to future applications as minimally invasive and continuous near-patient TDM.
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Affiliation(s)
- Susanne Weber
- Institute of Clinical Chemistry and Pathobiochemistry, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Sara Tombelli
- Institute of Applied Physics "Nello Carrara", National Research Council, Sesto Fiorentino (FI), Italy
| | - Ambra Giannetti
- Institute of Applied Physics "Nello Carrara", National Research Council, Sesto Fiorentino (FI), Italy
| | - Cosimo Trono
- Institute of Applied Physics "Nello Carrara", National Research Council, Sesto Fiorentino (FI), Italy
| | | | - Ming Wen
- Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Ana B Descalzo
- Department of Organic Chemistry, Universidad Complutense de Madrid, Madrid, Spain
| | - Heike Bittersohl
- Institute of Clinical Chemistry and Pathobiochemistry, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Andreas Bietenbeck
- Institute of Clinical Chemistry and Pathobiochemistry, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Pierre Marquet
- U1248 IPPRITT, INSERM, University of Limoges, Limoges, CHU Limoges, France
| | - Lutz Renders
- Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,German Centre for Infection Research (DZIF), Munich, Germany
| | - Guillermo Orellana
- Department of Organic Chemistry, Universidad Complutense de Madrid, Madrid, Spain
| | - Francesco Baldini
- Institute of Applied Physics "Nello Carrara", National Research Council, Sesto Fiorentino (FI), Italy
| | - Peter B Luppa
- Institute of Clinical Chemistry and Pathobiochemistry, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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20
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Rapid determination of tacrolimus and sirolimus in whole human blood by direct coupling of solid-phase microextraction to mass spectrometry via microfluidic open interface. Anal Chim Acta 2020; 1144:53-60. [PMID: 33453797 DOI: 10.1016/j.aca.2020.11.056] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 12/29/2022]
Abstract
Immunosuppressive drugs are administered to decrease immune system activity (e.g. of patients undergoing solid organ transplant). Concentrations of immunosuppressive drugs (ISDs) in circulating blood must be closely monitored during the period of immunosuppression therapy due to adverse effects that take place when concentration levels fall outside of the very narrow therapeutic concentration range of these drugs. This study presents the rapid determination of four relevant immunosuppressive drugs (tacrolimus, sirolimus, everolimus, and cyclosporine A) in whole human blood by directly coupling solid-phase microextraction to mass spectrometry via the microfluidic open interface (Bio-SPME-MOI-MS/MS). The BioSPME-MOI-MS/MS method offers ≤ 10% imprecision of in-house prepared quality controls over a 10-day period, ≤ 10% imprecision of ClinCal® Recipe calibrators over a three-day period, and single total turnaround time of ∼ 60 min (4.5 min for high throughput). The limits of quantification were determined to be 0.8 ng mL-1 for tacrolimus, 0.7 ng mL-1 sirolimus, 1.0 ng mL-1 for everolimus, and 0.8 ng mL-1 for cyclosporine. The limits of detection were determined to be 0.3 ng mL-1 for tacrolimus, 0.2 ng mL-1 for sirolimus, 0.3 ng mL-1 for everolimus, and 0.3 ng mL-1 for cyclosporine A. The R2 values for all analytes were above 0.9992 with linear dynamic range from 1.0 mL-1 to 50.0 ng mL-1 for tacrolimus, sirolimus, and everolimus while from 2.5 ng mL-1 to 500.0 ng mL-1 for cyclosporine A. To further evaluate the performance of the present method, 95 residual whole blood samples of tacrolimus and sirolimus from patients undergoing immunosuppression therapy were used to compare the Bio-SPME-MOI-MS/MS method against a clinically validated reference method based on chemiluminescent microparticle immunoassay, showing acceptable results. Our results demonstrated that Bio-SPME-MOI-MS/MS can be considered as a suitable alternative to existing methods for the determination of immunosuppressive drugs in whole blood providing faster analysis, better selectivity and sensitivity, and a wider dynamic range than current existing approaches.
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21
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Caminati G, Procacci P. Mounting evidence of FKBP12 implication in neurodegeneration. Neural Regen Res 2020; 15:2195-2202. [PMID: 32594030 PMCID: PMC7749462 DOI: 10.4103/1673-5374.284980] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/18/2020] [Accepted: 03/24/2020] [Indexed: 12/25/2022] Open
Abstract
Intrinsically disordered proteins, such as tau or α-synuclein, have long been associated with a dysfunctional role in neurodegenerative diseases. In Alzheimer's and Parkinson's' diseases, these proteins, sharing a common chemical-physical pattern with alternating hydrophobic and hydrophilic domains rich in prolines, abnormally aggregate in tangles in the brain leading to progressive loss of neurons. In this review, we present an overview linking the studies on the implication of the peptidyl-prolyl isomerase domain of immunophilins, and notably FKBP12, to a variety of neurodegenerative diseases, focusing on the molecular origin of such a role. The involvement of FKBP12 dysregulation in the aberrant aggregation of disordered proteins pinpoints this protein as a possible therapeutic target and, at the same time, as a predictive biomarker for early diagnosis in neurodegeneration, calling for the development of reliable, fast and cost-effective detection methods in body fluids for community-based screening campaigns.
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Affiliation(s)
- Gabriella Caminati
- Department of Chemistry “Ugo Schiff”, University of Florence, Sesto Fiorentino, Italy
- Center for Colloid and Surface Science (CSGI), University of Florence, Sesto Fiorentino, Italy
| | - Piero Procacci
- Department of Chemistry “Ugo Schiff”, University of Florence, Sesto Fiorentino, Italy
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22
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Antunes NJ, Ince N, Raymond J, Kipper K, Couchman L, Holt DW, De Nucci G, Johnston A. Quantification of mycophenolic acid in human plasma by liquid chromatography with time-of-flight mass spectrometry for therapeutic drug monitoring. Biomed Chromatogr 2020; 35:e5011. [PMID: 33119895 DOI: 10.1002/bmc.5011] [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: 07/14/2020] [Revised: 10/08/2020] [Accepted: 10/21/2020] [Indexed: 11/07/2022]
Abstract
This study presents, for the first time, the development and validation of a liquid chromatography and time-of-flight mass-spectrometry (LC-TOF-MS) based assay to quantify mycophenolic acid (MPA) in patient samples as part of a routine therapeutic drug monitoring service. MPA was extracted from 50 μl human plasma by protein precipitation, using sulindac as internal standard (IS). Separation was obtained on a Luna™ Omega polar C18 column kept at 40°C. The mobile phase consisted of a mixture of acetonitrile-deionized water (50:50, v/v) with 0.1% formic acid at a flow rate of 350 μl/min. Analyte and IS were monitored on a TOF-MS using a Jet-Stream™ (electrospray) interface running in positive mode. Assay performance was evaluated by analysing patient plasma (N = 69) and external quality assessment (N = 6) samples. The retention times were 2.66 and 2.18 min for MPA and IS, respectively. The lower limit of quantification of MPA was 0.1 μg/ml. The within- and between-assay reproducibility results ranged from 1.81 to 10.72%. Patient and external quality assessment sample results were comparable with those obtained previously by an in-house validated LC-MS/MS method. This method showed satisfactory analytical performance for the determination of MPA in plasma over the calibration range of 0.1-15.0 μg/ml.
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Affiliation(s)
- Natalicia J Antunes
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Analytical Services International Ltd, St George's University of London, London, UK
| | - Nina Ince
- Analytical Services International Ltd, St George's University of London, London, UK
- Department of Chemistry, University of Surrey, Guildford, UK
| | - Jason Raymond
- Analytical Services International Ltd, St George's University of London, London, UK
- Department of Chemistry, University of Surrey, Guildford, UK
| | - Karin Kipper
- Analytical Services International Ltd, St George's University of London, London, UK
- Institute of Chemistry, University of Tartu, Tartu, Estonia
| | - Lewis Couchman
- Analytical Services International Ltd, St George's University of London, London, UK
- Pharmaceutical Sciences Clinical Academic Group, King's College London, London, UK
| | - David W Holt
- Analytical Services International Ltd, St George's University of London, London, UK
| | - Gilberto De Nucci
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil
| | - Atholl Johnston
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Analytical Services International Ltd, St George's University of London, London, UK
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Tuzimski T, Petruczynik A. Review of Chromatographic Methods Coupled with Modern Detection Techniques Applied in the Therapeutic Drugs Monitoring (TDM). Molecules 2020; 25:E4026. [PMID: 32899296 PMCID: PMC7504794 DOI: 10.3390/molecules25174026] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/29/2020] [Accepted: 08/30/2020] [Indexed: 12/15/2022] Open
Abstract
Therapeutic drug monitoring (TDM) is a tool used to integrate pharmacokinetic and pharmacodynamics knowledge to optimize and personalize various drug therapies. The optimization of drug dosing may improve treatment outcomes, reduce toxicity, and reduce the risk of developing drug resistance. To adequately implement TDM, accurate and precise analytical procedures are required. In clinical practice, blood is the most commonly used matrix for TDM; however, less invasive samples, such as dried blood spots or non-invasive saliva samples, are increasingly being used. The choice of sample preparation method, type of column packing, mobile phase composition, and detection method is important to ensure accurate drug measurement and to avoid interference from matrix effects and drug metabolites. Most of the reported procedures used liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) techniques due to its high selectivity and sensitivity. High-performance chromatography with ultraviolet detection (HPLC-UV) methods are also used when a simpler and more cost-effective methodology is desired for clinical monitoring. The application of high-performance chromatography with fluorescence detection (HPLC-FLD) with and without derivatization processes and high-performance chromatography with electrochemical detection (HPLC-ED) techniques for the analysis of various drugs in biological samples for TDM have been described less often. Before chromatographic analysis, samples were pretreated by various procedures-most often by protein precipitation, liquid-liquid extraction, and solid-phase extraction, rarely by microextraction by packed sorbent, dispersive liquid-liquid microextraction. The aim of this article is to review the recent literature (2010-2020) regarding the use of liquid chromatography with various detection techniques for TDM.
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Affiliation(s)
- Tomasz Tuzimski
- Department of Physical Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland
| | - Anna Petruczynik
- Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland
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Ates HC, Roberts JA, Lipman J, Cass AEG, Urban GA, Dincer C. On-Site Therapeutic Drug Monitoring. Trends Biotechnol 2020; 38:1262-1277. [PMID: 33058758 DOI: 10.1016/j.tibtech.2020.03.001] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 12/13/2022]
Abstract
Recent technological advances have stimulated efforts to bring personalized medicine into practice. Yet, traditional application fields like therapeutic drug monitoring (TDM) have remained rather under-appreciated. Owing to clear dose-response relationships, TDM could improve patient outcomes and reduce healthcare costs. While chromatography-based routine practices are restricted due to high costs and turnaround times, biosensors overcome these limitations by offering on-site analysis. Nevertheless, sensor-based approaches have yet to break through for clinical TDM applications, due to the gap between scientific and clinical communities. We provide a critical overview of current TDM practices, followed by a TDM guideline to establish a common ground across disciplines. Finally, we discuss how the translation of sensor systems for TDM can be facilitated, by highlighting the challenges and opportunities.
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Affiliation(s)
- H Ceren Ates
- Freiburg Centre for Interactive Materials and Bioinspired Technologies - FIT, University of Freiburg, 79110 Freiburg, Germany; Department of Microsystems Engineering - IMTEK, Laboratory for Sensors, University of Freiburg, 79110 Freiburg, Germany
| | - Jason A Roberts
- Centre of Clinical Research, Faculty of Medicine, The University of Queensland, 4072, Brisbane, Queensland, Australia; Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, 4029, Brisbane, Queensland, Australia; Department of Pharmacy, Royal Brisbane and Women's Hospital, 4029, Brisbane, Queensland, Australia; Centre for Translational Anti-infective Pharmacodynamics, School of Pharmacy, The University of Queensland, 4102, Brisbane, Queensland, Australia; Division of Anaesthesiology Critical Care Emergency and Pain Medicine, University of Montpellier, Nîmes University Hospital, 34090, Nîmes, France
| | - Jeffrey Lipman
- Centre of Clinical Research, Faculty of Medicine, The University of Queensland, 4072, Brisbane, Queensland, Australia; Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, 4029, Brisbane, Queensland, Australia; Division of Anaesthesiology Critical Care Emergency and Pain Medicine, University of Montpellier, Nîmes University Hospital, 34090, Nîmes, France
| | - Anthony E G Cass
- Department of Chemistry and Institute of Biomedical Engineering, Imperial College London, SW7 2AZ, London, UK
| | - Gerald A Urban
- Freiburg Centre for Interactive Materials and Bioinspired Technologies - FIT, University of Freiburg, 79110 Freiburg, Germany; Freiburg Materials Research Centre - FMF, University of Freiburg, 79104 Freiburg, Germany
| | - Can Dincer
- Freiburg Centre for Interactive Materials and Bioinspired Technologies - FIT, University of Freiburg, 79110 Freiburg, Germany; Department of Microsystems Engineering - IMTEK, Laboratory for Sensors, University of Freiburg, 79110 Freiburg, Germany. @imtek.de
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Sheikholeslami MN, Vosough M, Esfahani HM. On the performance of multivariate curve resolution to resolve highly complex liquid chromatography–full scan mass spectrometry data for quantification of selected immunosuppressants in blood and water samples. Microchem J 2020. [DOI: 10.1016/j.microc.2019.104298] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Gong ZS, Wu ZH, Xu SX, Han WN, Jiang XM, Liu HP, Yan-Li, Wei-Hu, Yan-Wang. A high-throughput LC-MS/MS method for the quantification of four immunosu- ppressants drugs in whole blood. Clin Chim Acta 2019; 498:21-26. [PMID: 31351928 DOI: 10.1016/j.cca.2019.07.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/28/2019] [Accepted: 07/23/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Immunoassays and liquid chromatography tandem mass spectrometry (LC-MS/MS) are two major methods for therapeutic drug monitoring (TDM) of immunosuppressant drugs. Compared to the relatively limited analytical performance and cross reactivities of immunoassays, the LC-MS/MS method is considered as a gold standard; however, the lack of systematic evaluation and standardization needs to be addressed. METHODS A LC-MS/MS method for the determination of cyclosporine A, sirolimus, tacrolimus, and everolimus was developed. One-step protein precipitation was used to prepare blood samples. The newly developed method was systematically evaluated and validated according to the standard guidelines. RESULTS The quantitative method for four immunosuppressant drugs in human whole blood was validated according to the guidelines. The lower limits of the measuring interval (LLMI) for cyclosporine A, sirolimus, tacrolimus, and everolimus were 5, 0.5, 0.5, and 0.5 ng/mL, respectively. Linear correlation coefficients were all >0.999. Internal standard-normalized (IS-normalized) matrix correction factor was within the range 0.88-1.17. The average spiked recoveries of five replicates for the four immunosuppressant drugs were in the range 87.4-109.6%. CONCLUSION An LC-MS/MS method combined with one-step protein precipitation was developed, providing short sample preparation and chromatographic run time, thus allowing easy clinical diagnosis.
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Affiliation(s)
- Zi-Shan Gong
- Department of Precision Instrument and Opto-Electronics Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Zhong-Hao Wu
- Department of Precision Instrument and Opto-Electronics Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Shu-Xin Xu
- Suzhou Biomedical Engineering Tianjiin Engineering Technology Research Institute Chinese Academy of Sciences, Tianjin 300399, China
| | - Wen-Nian Han
- Suzhou Biomedical Engineering Tianjiin Engineering Technology Research Institute Chinese Academy of Sciences, Tianjin 300399, China
| | - Xiao-Mei Jiang
- Department of Precision Instrument and Opto-Electronics Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Hai-Pei Liu
- Department of Precision Instrument and Opto-Electronics Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Yan-Li
- Suzhou Biomedical Engineering Tianjiin Engineering Technology Research Institute Chinese Academy of Sciences, Tianjin 300399, China
| | - Wei-Hu
- Suzhou Biomedical Engineering Tianjiin Engineering Technology Research Institute Chinese Academy of Sciences, Tianjin 300399, China
| | - Yan-Wang
- Department of Precision Instrument and Opto-Electronics Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China.
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Rigo-Bonnin R, Alía P, Canalias F. Measurement uncertainty and metrological traceability of whole blood cyclosporin A mass concentration results obtained by UHPLC-MS/MS. Clin Chem Lab Med 2019; 56:1458-1468. [PMID: 29688884 DOI: 10.1515/cclm-2018-0120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/21/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Traceable and accurate results of cyclosporine A (CsA) mass concentrations in whole blood are required to ensure the monitoring of immunosuppressive therapy in transplant recipients. Metrological traceability and measurement uncertainty can allow ensuring reliability and comparability of these results over time and space. In this study, we provide a practical and detailed example of how the traceability and uncertainty of mass concentration of CsA results, obtained using an ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) procedure, can be described and estimated. METHODS Traceability was described mainly according to ISO 17511 and information obtained from certificates facilitated with the manufacturer's calibrators. Uncertainty estimation was performed using the bottom-up and top-down approaches. For the bottom-up approach, the most relevant sources of uncertainty were identified and later used to estimate the standard, combined and expanded uncertainties. For the top-down approach, expanded uncertainty was estimated directly using intralab quality control data mainly. RESULTS Mass concentration of CsA results was traceable to the manufacturer's product calibrators used to calibrate the UHPLC-MS/MS procedure. The expanded uncertainties estimated by the bottom-up and top-down approaches were 7.4% and 7.2%, respectively. CONCLUSIONS After performing the bottom-up and top-down approaches, we observed that their results were quite similar. This fact would confirm that the top-down approach could be sufficient for estimating uncertainty of CsA mass concentrations in whole blood results in clinical laboratories. Finally, we hope that this study can help and motivate clinical laboratories to describe metrological traceability and to perform measurement uncertainty studies based on the simpler top-down approach.
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Affiliation(s)
- Raül Rigo-Bonnin
- Laboratori Clínic, IDIBELL, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain, Phone: +34932607543, Fax: +34932607546
| | - Pedro Alía
- Laboratori Clínic, IDIBELL, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Francesca Canalias
- Laboratori de Referència d'Enzimologia Clínica, Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Gönel A, Koyuncu I. False Immunosuppressant Measurement by LC-MS/MS Method Due to Radiopaque Agents. Comb Chem High Throughput Screen 2019; 22:129-134. [PMID: 31038053 DOI: 10.2174/1386207322666190418125307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/25/2019] [Accepted: 04/11/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND Although liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) is preferred as a reliable method, some molecules in the blood matrix may lead to false positive or false negative results. False positive or negative results show the direction of the deviation rate from the target value. AIM The aim of this study was to investigate the effect of seven different radiopaque agents on four immunosuppressant drugs. METHODS Every agent coded with RM1 to RM7 was added to control materials containing tacrolimus, everolimus, sirolimus, and cyclosporine A drugs. Measurements were performed using an LC-MS/MS instrument. Bias values were calculated to detect the deviation rates. RESULTS All RMs led to false negative results in the tacrolimus and cyclosporine A levels at a rate of -19.77% (95% CI, -27.16 to 12.52) to -44.45% (95% CI, -49.20 to -39.69). The smallest deviations were seen in the everolimus levels with the administration of RM6 (gadodiamide) and in the sirolimus levels with RM1 (gadobutrol) at the rates of 4.04% (95% CI, -11.36 to -3.17) and 2.11% (95% CI, -7.18 to 7.11), respectively. The most affected drug by RM4 (gadopentetate dimeglumine salt) was sirolimus at the rate of 114.01% (95% CI, 97.31 - 130.76). RM5 (gadodiamide) interfered cyclosporine A at the most. The highest deviations were observed with the administration of RM3 (iohexol) in the everolimus and sirolimus levels at the rates of 153.72% (95% CI, 142.44 to 164.78) and 171.41% (95% CI, 157.91 to 184.97), respectively. CONCLUSION Radiopaque agents interfered the measurement of immunosuppressant drugs. Especially, everolimus and sirolimus levels were affected due to using iohexol. The choice of gadodiamide or ioversol is important to reduce the risk of interference for everolimus measurement. The blood samples should be obtained for measurement of drug levels before contrast-enhanced imaging.
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Affiliation(s)
- Ataman Gönel
- Department of Biochemistry, Harran University Faculty of Medicine, Sanliurfa, Turkey
| | - Ismail Koyuncu
- Department of Biochemistry, Harran University Faculty of Medicine, Sanliurfa, Turkey
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Yang J, Wang K, Xu H, Yan W, Jin Q, Cui D. Detection platforms for point-of-care testing based on colorimetric, luminescent and magnetic assays: A review. Talanta 2019; 202:96-110. [PMID: 31171232 DOI: 10.1016/j.talanta.2019.04.054] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/03/2019] [Accepted: 04/20/2019] [Indexed: 12/14/2022]
Abstract
Along with the considerable potential and increasing demand of the point-of-care testing (POCT), corresponding detection platforms have attracted great interest in both academic and practical fields. The first few generations of conventional detection devices tend to be costly, complicated to operate and hard to move on account of early limitations in the level of technological development and relatively high requirement of performance. Owing to the requirements for rapidity, simplicity, accuracy and cost controlling in the POCT, reader systems are urgently needed to be developed, upgraded and modified constantly, realizing on-site testing and healthcare management without a specific place or cumbersome operation. Accordingly, numerous rapid detection platforms with diverse size and performance have emerged such as bench-top apparatuses, handheld devices and intelligent detection devices. This review discusses various devices developed mainly for the detection of lateral flow test strips (LFTSs) or microfluidic strips in the POCT and summarizes these devices by size and portability. Furthermore, on the basis of various detection methods and diverse probes usually containing specific nanoparticles composites, three most common aspects of detection rationale in the POCT are selected to elaborate each kind of detection platforms in this paper: colorimetric assay, luminescent detection and magnetic signal detection. Herein, we focus on their structures, detection mechanisms and assay results, accompany with discussions and comments on the performances, costs and potential application, as well as advantages and limitations of each technique. In addition, perspectives on the future advances of detection platforms and some conclusions are proposed.
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Affiliation(s)
- Jinchuan Yang
- Department of Instrument Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai Engineering Research Center for Intelligent diagnosis and treatment instrument, Key Laboratory of Thin Film and Microfabrication (Ministry of Education), Shanghai, 200240, PR China.
| | - Kan Wang
- Department of Instrument Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai Engineering Research Center for Intelligent diagnosis and treatment instrument, Key Laboratory of Thin Film and Microfabrication (Ministry of Education), Shanghai, 200240, PR China.
| | - Hao Xu
- School of Naval Architecture, Ocean & Civil Engineering, Shanghai Jiao Tong University, Shanghai 200240, PR China.
| | - Wenqiang Yan
- Department of Instrument Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai Engineering Research Center for Intelligent diagnosis and treatment instrument, Key Laboratory of Thin Film and Microfabrication (Ministry of Education), Shanghai, 200240, PR China.
| | - Qinghui Jin
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai, 200050, PR China; Faculty of Electrical Engineering and Computer Science, Ningbo University, Ningbo, 315211, PR China.
| | - Daxiang Cui
- Department of Instrument Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai Engineering Research Center for Intelligent diagnosis and treatment instrument, Key Laboratory of Thin Film and Microfabrication (Ministry of Education), Shanghai, 200240, PR China.
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Bonazza G, Tartaggia S, Toffoli G, Polo F, Daniele S. Voltammetric behaviour of the anticancer drug irinotecan and its metabolites in acetonitrile. Implications for electrochemical therapeutic drug monitoring. Electrochim Acta 2018. [DOI: 10.1016/j.electacta.2018.09.094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Salis F, Descalzo AB, Benito-Peña E, Moreno-Bondi MC, Orellana G. Highly Fluorescent Magnetic Nanobeads with a Remarkable Stokes Shift as Labels for Enhanced Detection in Immunoassays. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2018; 14:e1703810. [PMID: 29665269 DOI: 10.1002/smll.201703810] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/30/2018] [Indexed: 06/08/2023]
Abstract
Fluorescence immunoassays are popular for achieving high sensitivity, but they display limitations in biological samples due to strong absorption of light, background fluorescence from matrix components, or light scattering by the biomacromolecules. A powerful strategy to overcome these problems is introduced here by using fluorescent magnetic nanobeads doped with two boron-dipyrromethane dyes displaying intense emission in the visible and near-infrared regions, respectively. Careful matching of the emission and absorption features of the dopants leads to a virtual Stokes shift larger than 150 nm achieved by an intraparticle Förster resonance energy transfer (FRET) process between the donor and the acceptor dyes. Additionally, the magnetic properties of the fluorescent beads allow preconcentration of the sample. To illustrate the usefulness of this approach to increase the sensitivity of fluorescence immunoassays, the novel nanoparticles are employed as labels for quantification of the widely used Tacrolimus (FK506) immunosuppressive drug. The FRET-based competitive inhibition immunoassay yields a limit of detection (LOD) of 0.08 ng mL-1 , with a dynamic range (DR) of 0.15-2.0 ng mL-1 , compared to a LOD of 2.7 ng mL-1 and a DR between 4.1 and 130 ng mL-1 for the immunoassay carried out with direct excitation of the acceptor dye.
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Affiliation(s)
- Francesca Salis
- Department of Organic Chemistry, Faculty of Chemistry, Complutense University of Madrid (UCM), 28040, Madrid, Spain
| | - Ana B Descalzo
- Department of Organic Chemistry, Faculty of Chemistry, Complutense University of Madrid (UCM), 28040, Madrid, Spain
| | - Elena Benito-Peña
- Department of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid (UCM), 28040, Madrid, Spain
| | - María C Moreno-Bondi
- Department of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid (UCM), 28040, Madrid, Spain
| | - Guillermo Orellana
- Department of Organic Chemistry, Faculty of Chemistry, Complutense University of Madrid (UCM), 28040, Madrid, Spain
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32
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Salmaninejad A, Gowhari A, Hosseini S, Aslani S, Yousefi M, Bahrami T, Ebrahimi M, Nesaei A, Zal M. Genetics and immunodysfunction underlying Behçet's disease and immunomodulant treatment approaches. J Immunotoxicol 2018; 14:137-151. [PMID: 28693405 DOI: 10.1080/1547691x.2017.1346008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Behçet's disease (BD) is a chronic autoimmune condition primarily prevalent in populations along the Mediterranean Sea. The exact etiology of BD has not been fully explained yet, but the disease occurrence is associated with a genetic factor, human leukocyte antigen (HLA)-B51 antigen. Among the various immunodysfunctions that are found in BD, patients are increased neutrophil motility and superoxide production, as well as elevated production of tumor necrosis factor (TNF)-α and decreased production of interleukin (IL)-10. Elevated levels of inflammatory cytokines like IL-1 and IL-17 in BD have been found associated with aberrant expression of microRNA. Gene polymorphisms in BD patients have been observed in molecules involved in responses to pathogens that can ultimately modulate the host antimicrobial response. Moreover, several single nucleotide polymorphisms (SNPs) have been reported in genes encoding chemokines and adhesion molecules; many of these changes manifest as increases in vascular inflammation and vascular damage. Lastly, genetic and epigenetic changes have been suggested as involved in the pathogenesis of BD. Modifications in DNA methylation have been found in BD patient monocytes and lymphocytes, leading to adverse function of these cells. This review presents a comprehensive compilation of the literature with regard to the immunodysfunction underlying BD, as well as of the genetics, newly described clinical specifications and novel treatment strategies using immunomodulants based on the current understanding of BD.
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Affiliation(s)
- Arash Salmaninejad
- a Drug Applied Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.,b Medical Genetics Research Center, Student Research Committee, Department of Medical Genetics, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran.,c Rheumatology Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Arezoo Gowhari
- d Department of Immunology, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Seyedmojtaba Hosseini
- b Medical Genetics Research Center, Student Research Committee, Department of Medical Genetics, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Saeed Aslani
- c Rheumatology Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Meysam Yousefi
- b Medical Genetics Research Center, Student Research Committee, Department of Medical Genetics, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Tayyeb Bahrami
- e Genetics Research Center , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Masoume Ebrahimi
- f Department of Biology, Faculty of Sciences , University of Guilan , Rasht , Iran
| | - Abolfazl Nesaei
- g Department of Basic Sciences , Gonabad University of Medical Sciences , Gonabad , Iran
| | - Masoud Zal
- h Department of Medical Genetics , Shahid Beheshti University of Medical Sciences , Tehran , Iran
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Glahn-Martínez B, Benito-Peña E, Salis F, Descalzo AB, Orellana G, Moreno-Bondi MC. Sensitive Rapid Fluorescence Polarization Immunoassay for Free Mycophenolic Acid Determination in Human Serum and Plasma. Anal Chem 2018; 90:5459-5465. [DOI: 10.1021/acs.analchem.8b00780] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Bettina Glahn-Martínez
- Department of Analytical Chemistry, Faculty of Chemistry, Universidad Complutense de Madrid, Av. Complutense s/n, 28040 Madrid, Spain
| | - Elena Benito-Peña
- Department of Analytical Chemistry, Faculty of Chemistry, Universidad Complutense de Madrid, Av. Complutense s/n, 28040 Madrid, Spain
| | - Francesca Salis
- Department of Organic Chemistry, Faculty of Chemistry, Universidad Complutense de Madrid, Av. Complutense s/n, 28040 Madrid, Spain
| | - Ana B. Descalzo
- Department of Organic Chemistry, Faculty of Chemistry, Universidad Complutense de Madrid, Av. Complutense s/n, 28040 Madrid, Spain
| | - Guillermo Orellana
- Department of Organic Chemistry, Faculty of Chemistry, Universidad Complutense de Madrid, Av. Complutense s/n, 28040 Madrid, Spain
| | - María C. Moreno-Bondi
- Department of Analytical Chemistry, Faculty of Chemistry, Universidad Complutense de Madrid, Av. Complutense s/n, 28040 Madrid, Spain
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Development of a fast HPLC-DAD method for simultaneous quantitation of three immunosuppressant drugs in whole blood samples using intelligent chemometrics resolving of coeluting peaks in the presence of blood interferences. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1073:69-79. [DOI: 10.1016/j.jchromb.2017.12.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 10/15/2017] [Accepted: 12/08/2017] [Indexed: 12/23/2022]
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35
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Zhang Y, Zhang R. Recent advances in analytical methods for the therapeutic drug monitoring of immunosuppressive drugs. Drug Test Anal 2017; 10:81-94. [DOI: 10.1002/dta.2290] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/12/2017] [Accepted: 08/16/2017] [Indexed: 01/24/2023]
Affiliation(s)
- Yu Zhang
- Department of Chemistry and Biochemistry; Texas Tech University; Lubbock TX, 79409, USA
| | - Rui Zhang
- Department of Chemistry and Biochemistry; Texas Tech University; Lubbock TX, 79409, USA
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Mišľanová C, Príbojová J, Valachovičová M, Žilinská Z. Determination of Immunosuppressive Pharmaceuticals in Whole Blood Following Kidney Transplantation by High-performance Liquid Chromatography–Tandem Mass Spectrometry. ANAL LETT 2017. [DOI: 10.1080/00032719.2017.1297452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Csilla Mišľanová
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - Jana Príbojová
- Faculty of Nursing and Professional Health Studies, Slovak Medical University, Bratislava, Slovakia
| | - Martina Valachovičová
- Faculty of Nursing and Professional Health Studies, Slovak Medical University, Bratislava, Slovakia
| | - Zuzana Žilinská
- Department of Urology with Kidney Transplant Centre, University Hospital, Bratislava, Slovakia
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