Recent advances in on-site mass spectrometry analysis for clinical applications

A Miniature Orthogonal Injection Ion Funnel (MO-IF) Providing Enhanced Performance for the Miniature Mass Spectrometer

The sensitivity of the miniature mass spectrometer (mini-MS) is largely restricted by the ion transmission in rough vacuum region. Even though various "in-line" ion transfer devices have improved mini-MS sensitivity, the severe dynamic gas is still weakening the efficiency of ion transmission in this region. Inspired by the "off-axis" ion funnel design in the lab-scale mass spectrometers, a miniature orthogonal injection ion funnel (MO-IF) was developed in this study for the mini-MS with a continuous atmospheric pressure interface. Capable of directing injected ions by 90° and then transport them forward to the downstream skimmer, the MO-IF enabled the separation of ions from the dynamic gas flow jetted out of the inlet capillary. The key factors were optimized for the MO-IF, including the effects of RF amplitude, DC electric fields, and the position of the repeller. Under optimized conditions, the MO-IF minimized the negative effects of dynamic gas and improved the ion transmission efficiency by ∼2-fold in comparison with the in-line injection ion funnel. As a result, a lower limit of detection of 0.5 ng/mL were obtained with good linearity for hypaconitine. Additionally, the MO-IF further decreased the buffer gas pressure in the second vacuum chamber and improved the mass resolution by 1.1-1.5 times at different scan rates.

Determination of amino acid metabolic diseases from dried blood spots with a rapid extraction method coupled with nanoelectrospray ionization mass spectrometry

In this work, a rapid extraction method of methanol/water (95:5 v/v) with 0.1% formic acid was developed for extraction of amino acids from dried blood spots (DBS) for inherited metabolic diseases (IMDs). The combination of this extraction procedure with nanoelectrospray ionization mass spectrometry (nESI-MS) was used for the rapid analysis of amino acids. This approach with eliminating the chromatographic separation required only 2 min for the extraction of amino acids from DBS, which simplified the configuration and improved the timeliness. Dependence of the sensitivity on the operating parameters was systematically investigated. The LOD of 91.2-262.5 nmol/L and LOQ of 304-875 nmol/L which were lower than the cut-off values were obtained for amino acids within DBS. The accuracy was determined to be 93.82%-103.07% and the precision was determined to be less than 8.30%. The effectiveness of this method was also compared with the gold standard method (e.g., LC-MS/MS). The desalination mechanism was explored with interference mainly originated from the blood. These findings indicated that the rapid extraction procedure coupled with nESI-MS is capable of screening indicators for IMDs in complex biological samples.

One-step online analysis of antibiotics in highly saline seawater by nano-based slug-flow microextraction

The transition to mass spectrometry (MS) in the analysis of antibiotics in the marine environment is highly desirable, particularly in the enhancement of sensitivity for high-salinity (3.5 wt%) seawater samples. However, the persistence of complex operational procedures poses substantial challenges to this transition. In this study, a rapid method for the online analysis of antibiotics in seawater samples via nano-electrospray ionization (nESI) MS based on slug-flow microextraction (SFME) has been proposed. Comparisons with other methods, complex laboratory setups for sample processing are now seamlessly integrated into a single online step, completing the entire process, including desalination and detection, SFME-nESI-MS provides faster results in less than 2 min while maintaining sensitivity comparable to that of other detection methods. Using SFME-nESI, six antibiotics in high-salinity (3.5 wt%) seawater samples have been determined in both positive and negative ion modes. The proposed method successfully detected clarithromycin, ofloxacin, and sulfadimidine in seawater within a linear range of 1-1000 ng mL-1 and limit of detection (LOD) of 0.23, 0.06, and 0.28 ng mL-1, respectively. The method recovery was from 92.8% to 107.3%, and the relative standard deviation was less than 7.5%. In addition, the response intensity of SFME-nESI-treated high-salinity (3.5 wt%) samples surpassed that of untreated medium-salinity (0.35 wt%) samples by two to five orders of magnitude. This advancement provides an exceptionally simplified protocol for the online rapid, highly sensitive, and quantitative determination of antibiotics in high-salinity (3.5 wt%) seawater.

Hierarchical superstructure aerogels for in situ biofluid metabolomics

High-throughput biofluid metabolomics analysis for screening life-threatening diseases is urgently needed. However, the high salt content of biofluid samples, which introduces severe interference, can greatly limit the analysis throughput. Here, a new 3-D interconnected hierarchical superstructure, namely a "plasmonic gold-on-silica (Au/SiO2) double-layered aerogel", integrating distinctive features of an upper plasmonic gold aerogel with a lower inert silica aerogel was successfully developed to achieve in situ separation and storage of inorganic salts in the silica aerogel, parallel enrichment of metabolites on the surface of the functionalized gold aerogel, and direct desorption/ionization of enriched metabolites by the photo-excited gold aerogel for rapid, sensitive, and comprehensive metabolomics analysis of human serum/urine samples. By integrating all these unique advantages into the hierarchical aerogel, multifunctional properties were introduced in the SALDI substrate to enable its effective utilization in clinical metabolomics for the discovery of reliable metabolic biomarkers to achieve unambiguous differentiation of early and advanced-stage lung cancer patients from healthy individuals. This study provides insight into the design and application of superstructured nanomaterials for in situ separation, storage, and photoexcitation of multi-components in complex biofluid samples for sensitive analysis.

Solid phase microextraction device coupled with miniature mass spectrometry and mathematical model of its ion chronogram

Modern solid phase microextraction (SPME) device linked with mass spectrometry (SPME-MS) has evolved from producing ion chronogram as flat noisy signal to as unimodal-like signal. We designed a SPME device, which is closer in morphology to LC column, linked it with a miniature mass spectrometer (SPME-Mini MS), and proposed a mathematical model that elution of compound from the SPME device is equivalent to overlay of elution of the compound from the infinite LC columns with the lengths between 0 and the length of the device and it can generate an ion chronogram as right-skew unimodal signal. Rhodamine B as analyte was used for experimental verification and its unimodal signal was used to fit the parameters of a computer simulation program based on the model. The experimental results and simulations empirically cross-confirmed that SPME-Mini MS can generate ion chronogram as clean right-skew unimodal signal. Furthermore, the SPME-Mini MS system was used for quantitative analysis of psychotropic drugs (i.e. risperidone and aripiprazole) in artificial urine. The results preliminarily demonstrated that the system can utilize area under unimodal signal for quantitative analysis and has potential to be applied for on-site, fast and accurate quantification of drugs and other compounds.

Mass spectrometry for neurosurgery: Intraoperative support in decision-making

Ambient ionization mass spectrometry was proved to be a powerful tool for oncological surgery. Still, it remains a translational technique on the way from laboratory to clinic. Brain surgery is the most sensitive to resection accuracy field since the balance between completeness of resection and minimization of nerve fiber damage determines patient outcome and quality of life. In this review, we summarize efforts made to develop various intraoperative support techniques for oncological neurosurgery and discuss difficulties arising on the way to clinical implementation of mass spectrometry-guided brain surgery.

Determination of indoxyl sulfate by spectrofluorimetric method in human plasma through extraction with deep eutectic solvent

A rapid and efficient analytical method was established to quantify indoxyl sulfate (IS) in plasma through extraction technique with a deep eutectic solvent (DES) and spectrofluorimetric method. DES (choline chloride: urea) was mixed with plasma samples for the extraction of IS, followed by the addition of dipotassium hydrogen phosphate (K2HPO4) solution to form an aqueous two-phase system. The fluorescence intensity of IS which was first extracted to the DES-rich-phase and then back-extracted into the salt-rich-phase, was measured by spectrofluorimetric method. Some key factors such as pH, centrifugation speed and time, the volume ratio of DES/salt, and salt concentration were optimized. Under the optimized conditions, the suggested method had a dynamic range between 20 and 160 µg/mL with a coefficient of determination (R2) of 0.99. Precision (relative standard deviation) was less than 15% and accuracy (% relative recovery) was ± 15% at the nominal concentration level. In addition, results showed that IS levels in real samples were higher than 40 µg/mL which was compatible with reported IS levels in end-stage renal disease (ESRD) patients. Overall, all the results reflect the fact that the presented analytical method can potentially be used for the determination of IS in real plasma samples.

Development of a High-Throughput Mass Spectrometry-Based SARS-CoV-2 Immunoassay

The serious impact of the Covid-19 pandemic underscores the need for rapid, reliable, and high-throughput diagnosis methods for infection. Current analytical methods, either point-of-care or centralized detection, are not able to satisfy the requirements of patient-friendly testing, high demand, and reliability of results. Here, we propose a two-point separation on-demand diagnostic strategy that uses laser desorption/ionization time-of-flight mass spectrometry (LDI-TOF MS) and adopts a stable yet cleavable ionic probe as a mass reporter. The use of this reporter enables ultrasensitive, interruptible, storable, restorable, and high-throughput on-demand detection. We describe a demonstration of the concept whereby we (i) design and synthesize a laser-cleavable reporter (DTPA), (ii) conjugate the reporter onto an antibody and verify the function of the conjugate, (iii) detect with good turnaround and high sensitivity the conjugated reporter, (iv) analyze quantitatively by using a laser-cleavable internal standard, and (v) identify negative and positive samples containing the spike protein. The protocol has excellent sensitivity (amol for the SARS-CoV-2 Spike S1 subunit antibody) without any amplification. This strategy is also applicable for the detection of other disease antigens besides SARS-CoV-2.

Real-Time and Online Monitoring of Hazardous Volatile Organic Compounds in Environmental Water by an Unmanned Shipborne Mass Spectrometer System

Hazardous volatile organic compounds (VOCs) are one of the critical concerns in environmental water due to their toxicity to aquatic organisms and drinking water. Therefore, rapid detection of hazardous VOCs in environmental water is highly needed as many analytical methods are limited to on-site monitoring. In this work, we designed a novel unmanned shipborne mass spectrometer (US-MS) system for the real-time and online monitoring of hazardous VOCs in environmental water. The US-MS system consists of a miniaturized mass spectrometer, an automatic sampling device, a robust unmanned ship, and other monitoring and control devices. Along with the navigation route of the US-MS system, environmental water was continuously introduced into the MS system for the online and real-time detection of hazardous VOCs via a liquid/gas exchange membrane. Analytical performances of the US-MS system were investigated by a mixture of 10 VOCs showing low limits of detection (LODs: 0.31-1.26 ng/mL), good reproducibility (RSDs: 2.93-11.03%, n = 7), and excellent quantitative ability (R2 > 0.99). Furthermore, on-site detection and online monitoring of hazardous volatile contaminants such as benzene, chloroprene, and toluene in different aquatic environments such as rivers and lakes were successfully demonstrated, showing excellent field applicability of the US-MS system. Overall, the newly developed US-MS system could perform on-site, online, and real-time monitoring of complex VOCs in environmental water, showing good performances and versatile applications in water analysis.

Advances in Imaging Mass Spectrometry for Biomedical and Clinical Research

Imaging mass spectrometry (IMS) allows for the untargeted mapping of biomolecules directly from tissue sections. This technology is increasingly integrated into biomedical and clinical research environments to supplement traditional microscopy and provide molecular context for tissue imaging. IMS has widespread clinical applicability in the fields of oncology, dermatology, microbiology, and others. This review summarizes the two most widely employed IMS technologies, matrix-assisted laser desorption/ionization (MALDI) and desorption electrospray ionization (DESI), and covers technological advancements, including efforts to increase spatial resolution, specificity, and throughput. We also highlight recent biomedical applications of IMS, primarily focusing on disease diagnosis, classification, and subtyping.

Mass Spectrometry Analysis for Clinical Applications: A Review

Mass spectrometry (MS) has become an attractive analytical method in clinical analysis due to its comprehensive advantages of high sensitivity, high specificity and high throughput. Separation techniques coupled MS detection (e.g., LC-MS/MS) have shown unique advantages over immunoassay and have developed as golden criterion for many clinical applications. This review summarizes the characteristics and applications of MS, and emphasizes the high efficiency of MS in clinical research. In addition, this review also put forward further prospects for the future of mass spectrometry technology, including the introduction of miniature MS instruments, point-of-care detection and high-throughput analysis, to achieve better development of MS technology in various fields of clinical application. Moreover, as ambient ionization mass spectrometry (AIMS) requires little or no sample pretreatment and improves the flux of MS, this review also summarizes its potential applications in clinic.

Mass spectrometry-based proteomics as an emerging tool in clinical laboratories

Mass spectrometry (MS)-based proteomics have been increasingly implemented in various disciplines of laboratory medicine to identify and quantify biomolecules in a variety of biological specimens. MS-based proteomics is continuously expanding and widely applied in biomarker discovery for early detection, prognosis and markers for treatment response prediction and monitoring. Furthermore, making these advanced tests more accessible and affordable will have the greatest healthcare benefit.This review article highlights the new paradigms MS-based clinical proteomics has created in microbiology laboratories, cancer research and diagnosis of metabolic disorders. The technique is preferred over conventional methods in disease detection and therapy monitoring for its combined advantages in multiplexing capacity, remarkable analytical specificity and sensitivity and low turnaround time.Despite the achievements in the development and adoption of a number of MS-based clinical proteomics practices, more are expected to undergo transition from bench to bedside in the near future. The review provides insights from early trials and recent progresses (mainly covering literature from the NCBI database) in the application of proteomics in clinical laboratories.

Miniature mass spectrometers and their potential for clinical point-of-care analysis

Mass spectrometry (MS) has become a powerful technique for clinical applications with high sensitivity and specificity. Different from conventional MS diagnosis in laboratory, point-of-care (POC) analyses in clinics require mass spectrometers and analytical procedures to be friendly for novice users and applicable for on-site clinical diagnosis. The recent decades have seen the progress in the development of miniature mass spectrometers, providing a promising solution for clinical POC applications. In this review, we report recent advances of miniature mass spectrometers and their exploration in clinical applications, mainly including the rapid analysis of illegal drugs, on-site monitoring of therapeutic drugs, and detection of biomarkers. With improved analytical performance, miniature mass spectrometers are also expected to apply to more and more clinical applications. Some promising POC analyses that can be performed by miniature mass spectrometers in the future are discussed. Lastly, we also provide our perspectives on the challenges in technical development of miniature mass spectrometers for clinical POC analysis.

High-Throughput and Rapid Screening of Drugs of Abuse in Saliva by Multi-Segment Injection Using Solid-Phase Microextraction-Automated Microfluidic Open Interface-Mass Spectrometry

There is great demand for analytical methods capable of providing high-throughput and rapid screening, especially for anti-doping and clinical point-of-care applications. In this work, automated microfluidic open interface-mass spectrometry (MOI-MS) was used for coupling with high-throughput, automated solid-phase microextraction (SPME) to achieve this objective. The design of the MOI-MS interface provides a continuous and stable electrospray fluid flow to the MS without introducing any bubble, a feature that we exploit to introduce the concept of multi-segment injection for the determination of multiple samples in a single MS run. By eliminating the need to start a new MS run between sample assays, the developed approach provides significantly simplified protocols controlled by programmed software and increased reproducibility. Furthermore, the biocompatible SPME device, which utilizes coating consisting of hydrophilic-lipophilic balanced particles embedded in a polyacrylonitrile (PAN) binder, can be directly used for biological sample analysis, as the PAN acts as both a binder and a matrix-compatible barrier, thus enabling the enrichment of small molecules while eliminating interferences associated with the presence of interfering macromolecules. The above design was employed to develop a fast, quantitative method capable of analyzing drugs of abuse in saliva samples in as little as 75 s per sample. The findings indicate that the developed method provides good analytical performance, with limits of detection ranging between 0.05 and 5 ng/mL for analysis of 16 drugs of abuse, good calibration linear correlation coefficients (R2 ≥ 0.9957), accuracy between 81 and 120%, and excellent precision (RSD% < 13%). Finally, a proof-of-concept experiment was performed to demonstrate the method's suitability for real-time analysis in anti-doping applications.

Development and application of a miniature mass spectrometer with continuous sub-atmospheric pressure interface and integrated ionization source

For the miniature mass spectrometer (MS) with a continuous atmospheric pressure interface (CAPI), the gas in the multi-stage chambers directly affects the performance of the instrument. In this study, a sealed ionization chamber is designed to couple with a conventional mini CAPI-MS. In this configuration, the gas environment in the first ionization chamber can be flexibly changed to regulate the gas conditions throughout the entire instrument. By studying the effect of gas pressure on the performance of the instrument, we found that the instrument shows some unique advantages when the first ionization chamber is under sub-atmospheric pressure (SAP) conditions, such as reducing the load of the vacuum pump by 40%, achieving pump-free injection for gas and liquid samples, and improving the resolution by a factor of 2 without loss of detection sensitivity. Therefore, we propose a new integrated interface called continuous sub-atmospheric pressure interface (CSAPI) for building a miniature ion trap mass spectrometer. The CSAPI specially integrates sample introduction, gas/ions interface, and ionizations, including electrospray ionization (ESI) and secondary electrospray ionization (SESI), making this system more convenient for non-professional handlers to rapidly identify or monitor target analytes in gaseous- and solution-phase samples. We also use this system to study gas composition to further improve performance, being able to achieve a 5-fold sensitivity and 2-fold resolution improvement. At last, some custom applications of the current CSAPI-MS platform are explored and demonstrated, including real-time monitoring of chemical reactions in solution and long-distance sampling and analysis of dried Chinese herbs. In conclusion, this study provides a new approach to constructing a complete, versatile and practical miniature MS instrument.

Portable mass spectrometry system: instrumentation, applications, and path to 'omics analysis

Mass spectrometry (MS) is an information rich analytical technique and plays a key role in various 'omics studies. Standard mass spectrometers are bulky and operate at high vacuum, which hinder their adoption by the broader community and utility in field applications. Developing portable mass spectrometers can significantly expand the application scope and user groups of MS analysis. This review discusses the basics and recent advancements in the development of key components of portable mass spectrometers including ionization source, mass analyzer, detector, and vacuum system. Further, major areas where portable mass spectrometers are applied are also discussed. Finally, a perspective on the further development of portable mass spectrometers including the potential benefits for 'omics analysis is provided.

Micro-tapered aperture nebulization ionization for versatile mass spectrometry analysis

The bloom of new ionization sources is promoting the prosperity and application of mass spectrometry analysis. In this study, we introduced a new (high) voltage-free ionization method termed micro-tapered aperture nebulization ionization (MANI), which only requires the use of a common micro-tapered aperture atomizer to operate. It is found that liquid nebulization on this type of atomizer can induce ionization of the dissolved analytes in the droplets without the assistance of additional voltage and gas. By assembling the commercially available atomizer module into a 3D-printed chamber, a compact MANI source was constructed and then characterized. This source has a high ion yield and satisfactory quantitative performance, and it is preferably used to analyze aqueous solutions. Furthermore, it exhibits broad applicability and can be easily extended to multiple applications, including liquid extraction surface analysis of solid samples and direct analysis of gaseous analytes via secondary spray ionization. In short, the MANI source is a simple, safe, green, and versatile tool that can assist mass spectrometers to perform routine and diverse analysis.

Measurement of lipid flux to advance translational research: evolution of classic methods to the future of precision health

Over the past 70 years, the study of lipid metabolism has led to important discoveries in identifying the underlying mechanisms of chronic diseases. Advances in the use of stable isotopes and mass spectrometry in humans have expanded our knowledge of target molecules that contribute to pathologies and lipid metabolic pathways. These advances have been leveraged within two research paths, leading to the ability (1) to quantitate lipid flux to understand the fundamentals of human physiology and pathology and (2) to perform untargeted analyses of human blood and tissues derived from a single timepoint to identify lipidomic patterns that predict disease. This review describes the physiological and analytical parameters that influence these measurements and how these issues will propel the coming together of the two fields of metabolic tracing and lipidomics. The potential of data science to advance these fields is also discussed. Future developments are needed to increase the precision of lipid measurements in human samples, leading to discoveries in how individuals vary in their production, storage, and use of lipids. New techniques are critical to support clinical strategies to prevent disease and to identify mechanisms by which treatments confer health benefits with the overall goal of reducing the burden of human disease.

Personalized tracking of how lipid (fat) metabolism changes over time could lead to improvements in the diagnosis and treatment of several diseases. Elizabeth Parks and colleagues from the University of Missouri, Columbia, USA, discuss the ways in which researchers use stable isotope labeling to monitor the kinetics of fatty acids and other lipids in the body. Usually, lipid quantities are measured only at a single timepoint, however the tracking of lipid turnover over time provides further diagnostic information. Aided by new techniques such as high-throughput mass spectrometry and machine learning, researchers are now able to continuously map total lipid contents in individual patients. The transition of measurements of lipid flux from the research laboratory to the doctor’s office will likely play a role in a new era of precision medicine.

Molecular network strategy in multi-omics and mass spectrometry imaging

Human physiological activities and pathological changes arise from the coordinated interactions of multiple molecules. Mass spectrometry (MS)-based multi-omics and MS imaging (MSI)-based spatial omics are powerful methods used to investigate molecular information related to the phenotype of interest from homogenated or sliced samples, including the qualitative, relative quantitative and spatial distributions. Molecular network strategy provides efficient methods to help us understand and mine the biological patterns behind the phenotypic data. It illustrates and combines various relationships between molecules, and further performs the molecule identification and biological interpretation. Here, we describe the recent advances of network-based analysis and its applications for different biological processes, such as, obesity, central nervous system diseases, and environmental toxicology.