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Wang L, Wang X, Li W, Liu J, Yao X, Wei Z, Yun K. Stability of diazepam's phase II metabolites in dried blood spots on filter paper. J Pharm Biomed Anal 2024; 240:115921. [PMID: 38157738 DOI: 10.1016/j.jpba.2023.115921] [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: 11/09/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
Phase II metabolites play an important role in diazepam-related cases. The study aimed to assess the stability of diazepam's phase II metabolites in dried blood spots on filter paper. METHODS A piece of filter paper was spotted with 100 µL of whole blood (added 1% sodium fluoride as needed) obtained from participant who received 5 mg diazepam orally, air dried for 2 h at room temperature, and then stored at different conditions. Whole spots were cut at 0.1 cm from the outer edge of blood spots at post-consumption time-points of prior (zero), 5, 16, 35, 61, 120 days and 1, 1.5 years. Analytes were extracted with methanol/water mixture (8:2, v/v) and determined using HPLC-MS/MS. Decomposition rules were analyzed by a statistical software "SPSS". RESULTS Temazepam glucuronide remained stable (0.5-18.6% loss) at 20 ℃ and at 20 ℃ with 1% sodium fluoride for 16 days, while it was unstable after 5 days at 4 ℃ (21.1-26.2% loss) and - 20 ℃ (28.9 - 34.4% loss). After 35 days, temazepam glucuronide concentrations began to fluctuate significantly under all conditions, and an obvious increase (290.4-355.1%) was observed in 1.5 years. Oxazepam glucuronide was always unstable after 5 days, the percentage loss was even 100% when it was stored for 61 days and 1.5 years. CONCLUSIONS Dried blood spots on ordinary filter paper are recommended to be stored at 20 ℃ or 20 ℃ with 1% sodium fluoride within 16 days. Samples should be analyzed immediately or stored in sterile and dry media.
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Affiliation(s)
- Lele Wang
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Medicine in Shanxi Province, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong 030600, Shanxi, China
| | - Xuezhi Wang
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Medicine in Shanxi Province, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong 030600, Shanxi, China; Department of Pathology, Air Force Medical Center, PLA, 100142, Beijing, China
| | - Wenyue Li
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Medicine in Shanxi Province, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong 030600, Shanxi, China; Guangdong Nantian Institute of Forensic Science, 518003 Shenzhen, Beijing, China
| | - Jiajia Liu
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Medicine in Shanxi Province, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong 030600, Shanxi, China
| | - Xiukun Yao
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Medicine in Shanxi Province, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong 030600, Shanxi, China
| | - Zhiwen Wei
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Medicine in Shanxi Province, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong 030600, Shanxi, China.
| | - Keming Yun
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Medicine in Shanxi Province, Jinzhong 030600, Shanxi, China; Key Laboratory of Forensic Toxicology of Ministry of Public Security, Jinzhong 030600, Shanxi, China.
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Tierney AJ, Williamson KC, Stewart VA, Mace CR. Hematocrit-Independent Sampling Enables White Blood Cell Counts from Patterned Dried Blood Spot Cards. Anal Chem 2024; 96:1993-1999. [PMID: 38266026 DOI: 10.1021/acs.analchem.3c04439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
The accurate and efficient measurement of white blood cell (WBC) counts is vital for monitoring general patient health and can aid in the diagnosis of a range of possible infections or diseases. Even with their importance universally acknowledged, access to WBC counts is largely limited to those with access to phlebotomists and centralized clinical laboratories, which house the instruments that perform the tests. As a result, large populations of people (e.g., those that are home-bound or live in remote locations) lack facile access to testing. Dried blood spot (DBS) cards are often used to bridge these gaps in access to testing by offering the ability to collect blood at home for ambient shipping to laboratories. However, it is well understood that these cards, which are prepared from cellulose cardstocks without further modification, suffer from variabilities in accuracy and precision due to uncontrolled sample spreading and hematocrit effects, which have hindered their use to determine WBC counts. In this paper, we present a method to obtain an accurate WBC count using a patterned dried blood spot (pDBS) card, which comprises collection zones that meter volumes of dried blood. Using an input volume of 75 μL of whole blood, we demonstrate that, unlike the gold standard DBS card (Whatman 903), our pDBS design allows for the collection of replicate zones containing a reproducible, average volume of dried blood (12.1 μL, 7.8% CV) over the range of hematocrits from 25 to 55%. We then used qPCR to quantify the 18S rRNA gene to determine WBC counts from the volumes of blood that are metered in pDBS zones. We observe that WBC counts generated from our method are comparable to those measured with a HemoCue point-of-care WBC analyzer. Our approach to using pDBS cards as a blood collection device has the potential to support at-home sampling and other patient populations that need WBC counts but lack access to clinical facilities.
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Affiliation(s)
- Allison J Tierney
- Department of Chemistry, Tufts University, Medford, Massachusetts 02155, United States
| | - Kim C Williamson
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, United States
| | - V Ann Stewart
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, United States
| | - Charles R Mace
- Department of Chemistry, Tufts University, Medford, Massachusetts 02155, United States
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3
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Lehner AF, Rebolloso S, Calle PP, Ingerman K, Lewbart GA, Muñoz-Pérez JP, Valle CA, Buchweitz JP. Dried blood spot analysis for elements of nutritional concern as demonstrated in studies of Galápagos land iguanas (Conolophus species). J Trace Elem Med Biol 2024; 81:127322. [PMID: 37890447 DOI: 10.1016/j.jtemb.2023.127322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Dried blood spot (DBS) technology is valuable in providing simple means of storing blood samples from wildlife with small blood volumes. Methods designed for heavy metal analysis on DBS become more useful if extended to elements of nutritional significance. PURPOSE (1) Development of procedures for measuring Mn, Fe, Co, Cu, Zn, Se and Mo in DBS; (2) use the designed methods in health assessments of Galápagos land iguanas (Conolophus species). PROCEDURES Elements were measured by inductively coupled plasma/mass spectrometry (ICP-MS) following acid digestion of whole blood or DBS from the same animal for direct comparison. Study animals comprised free-ranging iguanas from separate islands in the Galápagos archipelago. MAIN FINDINGS DBS spikes (Mn, Fe, Co, Cu, Zn, Se and Mo) demonstrated accuracy to ∼100 ppb; reporting limits were set there except for Fe and Zn which were set at 1000 ppb. Plasma samples - generally preferable for nutritional element diagnostics - were submitted from Galápagos land iguanas along with DBS as part of a large-scale health assessment. In plasma versus DBS concentration comparisons, Fe, Cu, Se and Mn correlated well with R^2 values of 0.799, 0.818, 0.896 and 0.899, respectively, and slopes ranging 0.88 - 1.3. Co and Zn showed greater scatter. Mo had insufficient points above its reporting limit and offered advantages for toxicity assessments. Bland-Altman diagrams showed flat scatter between 2x standard deviation boundaries with no undue trends except for Mn which had few points above its reporting limit. Bias, defined as the average difference [DBS - plasma] divided by the average value, was relatively low throughout, with values of - 19.3 % (Fe), - 48.7 % (Co), - 19.6 % (Cu), - 6.9 % (Zn), - 21.4 % (Se) and + 40.7 % (Mn). Normal distribution assessment of iguana Cu, Zn, Se and Fe plasma values showed unanticipated divergences between two species. CONCLUSIONS The DBS approach for nutritional element analysis offers a suitable methodology for determining crucial elements Mn, Fe, Co, Cu, Zn, Se, and Mo in veterinary samples. Analyses of samples from Conolophus species revealed interesting divergences particularly for Cu, Zn, Se and Fe, elements generally associated with defense against oxidative stress.
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Affiliation(s)
- Andreas F Lehner
- Michigan State University Veterinary Diagnostic Laboratory, Toxicology Section, Michigan State University, East Lansing, MI, 48910.
| | - Sarah Rebolloso
- Michigan State University Veterinary Diagnostic Laboratory, Toxicology Section, Michigan State University, East Lansing, MI, 48910
| | - Paul P Calle
- Wildlife Conservation Society, Zoological Health Program, Bronx, NY 10460
| | - Karen Ingerman
- Wildlife Conservation Society, Zoological Health Program, Bronx, NY 10460
| | - Gregory A Lewbart
- North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607; Colegio de Ciencias Biológicas y Ambientales COCIBA and Galápagos Science Center GSC, Universidad San Francisco de Quito, Quito, Ecuador
| | - Juan Pablo Muñoz-Pérez
- Colegio de Ciencias Biológicas y Ambientales COCIBA and Galápagos Science Center GSC, Universidad San Francisco de Quito, Quito, Ecuador; Faculty of Science and Engineering, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Carlos A Valle
- Colegio de Ciencias Biológicas y Ambientales COCIBA and Galápagos Science Center GSC, Universidad San Francisco de Quito, Quito, Ecuador
| | - John P Buchweitz
- Michigan State University Veterinary Diagnostic Laboratory, Toxicology Section, Michigan State University, East Lansing, MI, 48910; Department of Pathobiology & Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI, 48824
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Zailani NNB, Ho PCL. Dried Blood Spots-A Platform for Therapeutic Drug Monitoring (TDM) and Drug/Disease Response Monitoring (DRM). Eur J Drug Metab Pharmacokinet 2023; 48:467-494. [PMID: 37495930 PMCID: PMC10480258 DOI: 10.1007/s13318-023-00846-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 07/28/2023]
Abstract
This review provides an overview on the current applications of dried blood spots (DBS) as matrices for therapeutic drug (TDM) and drug or disease response monitoring (DRM). Compared with conventional methods using plasma/serum, DBS offers several advantages, including minimally invasiveness, a small blood volume requirement, reduced biohazardous risk, and improved sample stability. Numerous assays utilising DBS for TDM have been reported in the literature over the past decade, covering a wide range of therapeutic drugs. Several factors can affect the accuracy and reliability of the DBS sampling method, including haematocrit (HCT), blood volume, sampling paper and chromatographic effects. It is crucial to evaluate the correlation between DBS concentrations and conventional plasma/serum concentrations, as the latter has traditionally been used for clinical decision. The feasibility of using DBS sampling method as an option for home-based TDM is also discussed. Furthermore, DBS has also been used as a matrix for monitoring the drug or disease responses (DRM) through various approaches such as genotyping, viral load measurement, assessment of inflammatory factors, and more recently, metabolic profiling. Although this research is still in the development stage, advancements in technology are expected to lead to the identification of surrogate biomarkers for drug treatment in DBS and a better understanding of the correlation between DBS drug levels and drug responses. This will make DBS a valuable matrix for TDM and DRM, facilitating the achievement of pharmacokinetic and pharmacodynamic correlations and enabling personalised therapy.
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Affiliation(s)
- Nur Nabihah Binte Zailani
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Paul Chi-Lui Ho
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore.
- School of Pharmacy, Monash University Malaysia, Level 5, Building 2, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia.
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5
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Lemaitre F, Budde K, Van Gelder T, Bergan S, Lawson R, Noceti O, Venkataramanan R, Elens L, Moes DJAR, Hesselink DA, Pawinski T, Johnson-Davis KL, De Winter BCM, Pattanaik S, Brunet M, Masuda S, Langman LJ. Therapeutic Drug Monitoring and Dosage Adjustments of Immunosuppressive Drugs When Combined With Nirmatrelvir/Ritonavir in Patients With COVID-19. Ther Drug Monit 2023; 45:191-199. [PMID: 35944126 DOI: 10.1097/ftd.0000000000001014] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT Nirmatrelvir/ritonavir (Paxlovid) consists of a peptidomimetic inhibitor (nirmatrelvir) of the SARS-CoV-2 main protease and a pharmacokinetic enhancer (ritonavir). It is approved for the treatment of mild-to-moderate COVID-19. This combination of nirmatrelvir and ritonavir can mediate significant and complex drug-drug interactions (DDIs), primarily due to the ritonavir component. Indeed, ritonavir inhibits the metabolism of nirmatrelvir through cytochrome P450 3A (CYP3A) leading to higher plasma concentrations and a longer half-life of nirmatrelvir. Coadministration of nirmatrelvir/ritonavir with immunosuppressive drugs (ISDs) is particularly challenging given the major involvement of CYP3A in the metabolism of most of these drugs and their narrow therapeutic ranges. Exposure of ISDs will be drastically increased through the potent ritonavir-mediated inhibition of CYP3A, resulting in an increased risk of adverse drug reactions. Although a decrease in the dosage of ISDs can prevent toxicity, an inappropriate dosage regimen may also result in insufficient exposure and a risk of rejection. Here, we provide some general recommendations for therapeutic drug monitoring of ISDs and dosing recommendations when coadministered with nirmatrelvir/ritonavir. Particularly, tacrolimus should be discontinued, or patients should be given a microdose on day 1, whereas cyclosporine dosage should be reduced to 20% of the initial dosage during the antiviral treatment. Dosages of mammalian target of rapamycin inhibitors (m-TORis) should also be adjusted while dosages of mycophenolic acid and corticosteroids are expected to be less impacted.
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Affiliation(s)
- Florian Lemaitre
- Department of Pharmacology, Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET-UMR S 1085, Rennes, France
- INSERM, Centre d'Investigation Clinique 1414, Rennes, France
| | - Klemens Budde
- Department of Nephrology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Teun Van Gelder
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, the Netherlands
| | - Stein Bergan
- Department of Pharmacology, Oslo University Hospital and Department of Pharmacy, University of Oslo, Norway
| | - Roland Lawson
- University of Limoges, Inserm U1248, Pharmacology & Transplantation, Limoges, France
| | - Ofelia Noceti
- National Center for Liver Transplantation and Liver Diseases, Army Forces Hospital, Montevideo, Uruguay
| | - Raman Venkataramanan
- Department of Pharmaceutical Sciences, School of Pharmacy and Department of Pathology, Starzl Transplantation Institute, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Laure Elens
- Integrated Pharmacometrics, Pharmacogenetic and Pharmacokinetics Research Group (PMGK), Louvain Drug for Research Institute (LDRI), Catholic University of Louvain (UCLouvain), Brussels, Belgium
| | - Dirk Jan A R Moes
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, the Netherlands
| | - Dennis A Hesselink
- Erasmus MC Transplant Institute, University Medical Center, Rotterdam, the Netherlands
| | - Tomasz Pawinski
- Department of Drug Chemistry, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland
| | | | - Brenda C M De Winter
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Smita Pattanaik
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, INDIA
| | - Mercè Brunet
- Pharmacology and Toxicology Laboratory, Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, CIBERehd, Spain
| | - Satohiro Masuda
- Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Himeji Dokkyo University, Japan; and
| | - Loralie J Langman
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
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Akinloye A, Eniayewu O, Adeagbo B, Bolaji O, Olagunju A. Validation and Clinical Application of a Liquid Chromatography-Ultraviolet Detection Method to Quantify Dolutegravir in Dried Blood Spots. Ther Drug Monit 2022; 44:430-437. [PMID: 34629444 PMCID: PMC7612724 DOI: 10.1097/ftd.0000000000000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/09/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dolutegravir is currently the preferred component of first-line antiretroviral therapy. To facilitate clinical pharmacology studies in key populations, quantitative analytical methods compatible with microsampling and adaptable to resource-limited settings are desirable. The authors developed and validated a liquid chromatography-ultraviolet detection method to quantify dolutegravir in dried blood spots (DBS). METHODS Calibration standards and quality control samples were prepared by spotting 50 μL of dolutegravir-spiked whole blood on each circle of DBS cards. Three spots (two 6-mm punches/spot) were extracted with methanol. Chromatographic separation was achieved with gradient elution of acetonitrile/potassium phosphate monobasic buffer (pH 5) on a reverse-phase C18 column (flow rate, 1 mL/min) using pioglitazone as the internal standard. UV detection was performed at 260 nm. In the clinical pharmacokinetic study, DBS from finger prick was collected from participants (n = 10) at 8 time points over 12 hours postdosing, with paired plasma at 1 and 12 hours. The method was used to quantify dolutegravir, estimating pharmacokinetic parameters. Agreement between DBS and plasma concentrations was evaluated using linearity and Bland-Altman plots. RESULTS The method was validated over the concentration range of 0.4-10 mcg/mL, accuracy was 102.4%-114.8%, and precision was 3.4%-14.7%. The mean recovery was 42.3% (%CV: 8.3). The mean (±SD) dolutegravir concentration in DBS was 37.5% (±3.8%) lower than that in the plasma. DBS-derived and measured plasma concentrations showed strong correlation with linearity (R2 = 0.9804) and Bland-Altman plots. Means (%CV) of area under curve, Cmax, and C24 from the DBS-derived plasma concentration were 37.8 (23.2) mcg·h/mL, 2.7 (24.7) mcg/mL, and 1.34 (31.6) mcg/mL, respectively. CONCLUSIONS The application of this simple, accurate, and precise method will expand opportunities for clinical assessment of dolutegravir in resource-limited settings.
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Affiliation(s)
- Abdulafeez Akinloye
- Department of Pharmaceutical Chemistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Oluwasegun Eniayewu
- Department of Pharmaceutical Chemistry, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Pharmaceutical and Medicinal Chemistry, University of Ilorin, Ilorin, Nigeria
| | - Babatunde Adeagbo
- Department of Pharmaceutical Chemistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Oluseye Bolaji
- Department of Pharmaceutical Chemistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Adeniyi Olagunju
- Department of Pharmaceutical Chemistry, Obafemi Awolowo University, Ile-Ife, Nigeria
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Grignani P, Manfredi A, Monti MC, Moretti M, Morini L, Visonà SD, Fattorini P, Previderè C. GENETIC INDIVIDUAL IDENTIFICATION FROM DRIED URINE SPOTS (DUS): A COMPLEMENTARY TOOL TO DRUG MONITORING AND ANTI DOPING TESTING. Drug Test Anal 2022; 14:1234-1243. [PMID: 35195361 PMCID: PMC9540579 DOI: 10.1002/dta.3243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/04/2022] [Accepted: 02/21/2022] [Indexed: 11/29/2022]
Abstract
The collection of liquid biological matrices onto paper cards (dried matrix spots [DMS]) is becoming an alternative sampling strategy. The stability over time of molecules of interest for therapeutic, sport drug monitoring, and forensic toxicology on DMS has been recently investigated representing a reliable alternative to conventional analytical techniques. When a tampering of a urine sample in drug monitoring or doping control cases is suspected, it could be relevant to know whether genetic profiles useful for individual identification could be generated from urine samples spotted onto paper (dried urine spot [DUS]). To understand the influence of sex, storage conditions, and time on the quality and quantity of the DNA, five female and ten male urine samples were dispensed onto Whatman 903 paper and sampled after different storage conditions over time, from 1 to 12 weeks. Direct PCR was performed starting from 2‐mm punches collected from each spot amplifying a panel of markers useful for individual identification. The female DUS stored in different conditions produced genetic profiles fully matching the reference samples. The same result was obtained for the male DUS but using urine 30X concentrated by centrifugation instead of the original samples. Our data show that this approach is valid for genetic individual identification of urine samples spotted onto paper cards up to 12 weeks after deposition and could be easily incorporated in anti‐doping or drug screening protocols to help on the suspicion of evidence tampering or to solve questions on the reliability of samples collection.
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Affiliation(s)
- Pierangela Grignani
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - Alessandro Manfredi
- Department of Medicine, Surgery and Health, University of Trieste, Trieste, Italy
| | - Maria Cristina Monti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - Matteo Moretti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - Silvia Damiana Visonà
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - Paolo Fattorini
- Department of Medicine, Surgery and Health, University of Trieste, Trieste, Italy
| | - Carlo Previderè
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
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8
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Peck Palmer OM, Dasgupta A. Review of the Preanalytical Errors That Impact Therapeutic Drug Monitoring. Ther Drug Monit 2021; 43:595-608. [PMID: 33928931 DOI: 10.1097/ftd.0000000000000901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/06/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Preanalytical errors comprise the majority of testing errors experienced by clinical laboratories and significantly impact the accuracy of therapeutic drug monitoring (TDM). METHODS Specific preanalytical factors in sample timing, collection, transport, processing, and storage that lead to errors in TDM were reviewed. We performed a literature search using several scientific databases including PubMed, ScienceDirect, Scopus, Web of Science, and ResearchGate for human studies published in the English language from January 1980 to February 2021, reporting on TDM and the preanalytical phase. RESULTS Blood collection errors (ie, wrong anticoagulant/clot activator used, via an intravenous line, incorrect time after dosing) delay testing, cause inaccurate results, and adversely impact patient care. Blood collected in lithium heparin tubes instead of heparin sodium tubes produce supertoxic lithium concentrations, which can compromise care. Specimens collected in serum separator gel tubes cause falsely decreased concentrations due to passive absorption into the gel when samples are not processed and analyzed quickly. Dried blood spots are popular for TDM as they are minimally invasive, allowing for self-sampling and direct shipping to a clinical laboratory using regular mail. However, blood collection techniques, such as trauma to the collection site, filter paper fragility, and hematocrit (Hct) bias, can adversely affect the accuracy of the results. Volumetric absorptive microsampling is a potential alternative to dried blood spot that offers fast, volume-fixed sampling, low pain tolerance, and is not susceptible to Hct concentrations. CONCLUSIONS The identification of preanalytical factors that may negatively impact TDM is critical. Developing workflows that can standardize TDM practices, align appropriate timing and blood collection techniques, and specimen processing will eliminate errors.
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Affiliation(s)
- Octavia M Peck Palmer
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
| | - Amitava Dasgupta
- Department of Pathology and Laboratory Medicine, University of Texas McGovern Medical School at Houston, Texas
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9
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Dried Blood Spot in Toxicology: Current Knowledge. SEPARATIONS 2021. [DOI: 10.3390/separations8090145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Dried Blood Spot (DBS) is becoming very popular in various medical fields, especially in toxicology. Nowadays it is commonly used in newborn screening for inherited or congenital diseases. This paperwork is based on a review of available literature. DBS is simple and rapid, it does not require trained medical staff to collect the samples. Specimens can be easily and safely transported to the laboratory. DBS provides an opportunity for roadside testing and rather quick results. Venous blood spot, collected from a finger or a heel, is put on the special paper card, which can result in a different distribution of blood and concentration of detecting substances. Marking multiple substances from one spot is extremely challenging, but due to further advancements in this area, it is only a matter of time until it becomes possible and all the disadvantages vanish. DBS is certain to develop and become even more worldwide used.
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10
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Moretti M, Freni F, Carelli C, Previderé C, Grignani P, Vignali C, Cobo-Golpe M, Morini L. Analysis of Cannabinoids and Metabolites in Dried Urine Spots (DUS). Molecules 2021; 26:molecules26175334. [PMID: 34500772 PMCID: PMC8434267 DOI: 10.3390/molecules26175334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 12/02/2022] Open
Abstract
Dried urine spots (DUS) represent a potential alternative sample storage for forensic toxicological analysis. The aim of the current study was to develop and validate a liquid chromatographic tandem mass spectrometric procedure for the detection and quantitative determination of cannabinoids and metabolites in DUS. A two-step extraction was performed on DUS and urine samples. An LC-MS/MS system was operated in multiple reaction monitoring and positive polarization mode. The method was checked for sensitivity, specificity, linearity, accuracy, precision, recovery, matrix effects and carryover. The method was applied to 70 urine samples collected from healthy volunteers and drug addicts undergoing withdrawal treatment. The method was successfully developed for DUS. LODs lower than 2.0 ng/mL were obtained for all the monitored substances. All the validation parameters fulfilled the acceptance criteria either for DUS or urine. Among the real samples, 45 cases provided positive results for at least one compound. A good quali-quantitative agreement was obtained between DUS and urine. A good stability of THC, THCCOOH and THCCOOH-gluc was observed after a 24 h storage, in contrast to previously published results. DUS seems to provide a good alternative storage condition for urine that should be checked for the presence of cannabinoids and metabolites.
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Affiliation(s)
- Matteo Moretti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Francesca Freni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Claudia Carelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Carlo Previderé
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Pierangela Grignani
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Claudia Vignali
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
| | - Maria Cobo-Golpe
- Servizo de Toxicología, Instituto de Ciencias Forenses, Universidade de Santiago de Compostela, San Francisco s/n, 27002 Santiago de Compostela, Spain;
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 12, 27100 Pavia, Italy; (M.M.); (F.F.); (C.C.); (C.P.); (P.G.); (C.V.)
- Correspondence:
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11
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Roxhed N, Bendes A, Dale M, Mattsson C, Hanke L, Dodig-Crnković T, Christian M, Meineke B, Elsässer S, Andréll J, Havervall S, Thålin C, Eklund C, Dillner J, Beck O, Thomas CE, McInerney G, Hong MG, Murrell B, Fredolini C, Schwenk JM. Multianalyte serology in home-sampled blood enables an unbiased assessment of the immune response against SARS-CoV-2. Nat Commun 2021; 12:3695. [PMID: 34140485 PMCID: PMC8211676 DOI: 10.1038/s41467-021-23893-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 05/21/2021] [Indexed: 12/18/2022] Open
Abstract
Serological testing is essential to curb the consequences of the COVID-19 pandemic. However, most assays are still limited to single analytes and samples collected within healthcare. Thus, we establish a multianalyte and multiplexed approach to reliably profile IgG and IgM levels against several versions of SARS-CoV-2 proteins (S, RBD, N) in home-sampled dried blood spots (DBS). We analyse DBS collected during spring of 2020 from 878 random and undiagnosed individuals from the population in Stockholm, Sweden, and use classification approaches to estimate an accumulated seroprevalence of 12.5% (95% CI: 10.3%-14.7%). This includes 5.4% of the samples being IgG+IgM+ against several SARS-CoV-2 proteins, as well as 2.1% being IgG-IgM+ and 5.0% being IgG+IgM- for the virus' S protein. Subjects classified as IgG+ for several SARS-CoV-2 proteins report influenza-like symptoms more frequently than those being IgG+ for only the S protein (OR = 6.1; p < 0.001). Among all seropositive cases, 30% are asymptomatic. Our strategy enables an accurate individual-level and multiplexed assessment of antibodies in home-sampled blood, assisting our understanding about the undiagnosed seroprevalence and diversity of the immune response against the coronavirus.
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Affiliation(s)
- Niclas Roxhed
- Micro and Nanosystems, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, Stockholm, Sweden.
- MedTechLabs, BioClinicum, Karolinska University Hospital, Solna, Sweden.
| | - Annika Bendes
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Matilda Dale
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Cecilia Mattsson
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Leo Hanke
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Tea Dodig-Crnković
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Murray Christian
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Birthe Meineke
- Science for Life Laboratory, Karolinska Institutet, Department of Medical Biochemistry and Biophysics, Division of Genome Biology, Solna, Sweden
- Ming Wai Lau Centre for Reparative Medicine, Stockholm node, Karolinska Institutet, Solna, Sweden
| | - Simon Elsässer
- Science for Life Laboratory, Karolinska Institutet, Department of Medical Biochemistry and Biophysics, Division of Genome Biology, Solna, Sweden
- Ming Wai Lau Centre for Reparative Medicine, Stockholm node, Karolinska Institutet, Solna, Sweden
| | - Juni Andréll
- Science for Life Laboratory, Department of Biochemistry and Biophysics, Stockholm University, Solna, Sweden
| | - Sebastian Havervall
- Division of Internal Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Danderyd, Sweden
| | - Charlotte Thålin
- Division of Internal Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Danderyd, Sweden
| | - Carina Eklund
- Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden
| | - Joakim Dillner
- Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden
| | - Olof Beck
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia E Thomas
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Gerald McInerney
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Mun-Gwan Hong
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Ben Murrell
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Claudia Fredolini
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Jochen M Schwenk
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden.
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12
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Lee J, Jeong JS, Kim W, Kim SY, Lee SJ, Baek SK, Lee JH, Jeong EJ, Nam SY, Yu WJ. Serial blood sampling effects in rat embryo-fetal development studies for toxicokinetics. Regul Toxicol Pharmacol 2021; 123:104930. [PMID: 33891998 DOI: 10.1016/j.yrtph.2021.104930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/11/2021] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
Serial blood sampling for toxicokinetics is generally conducted in regulatory embryo-fetal development (EFD) studies in rats. EFD studies are designed to detect the potential adverse effects of pharmaceuticals on pregnant females and their fetuses; this information is useful for understanding the relationships between systemic exposure levels and toxicity profiles. However, additional satellite pregnant females are needed for toxicokinetics because comprehensive information regarding the potential impact of serial blood sampling on pregnant females is scarce. Here, in this study, we investigated the potential impact of serial blood sampling in pregnant female rats using a typical EFD study design. Additionally, we investigated the additional endpoints (clinical pathology, organ weights, and histopathology) that were deemed likely to be sensitive to blood sampling. Results indicated that serial blood sampling in pregnant females induced physiological adaptive changes and did not affect the general endpoints in EFD studies. Nevertheless, inclusion of satellite groups in EFD studies may be a more prudent approach considering the physiological changes in pregnant females and potential off-target effects of candidate pharmaceuticals. These results provide background information on the impact of serial blood sampling in pregnant females and will be useful to design the regulatory EFD studies.
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Affiliation(s)
- Jinsoo Lee
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea; College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Ji-Seong Jeong
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Woojin Kim
- Toxicological Pathology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Sang Yun Kim
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Seung-Jin Lee
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Sang-Ki Baek
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Jae-Hwan Lee
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Eun Ju Jeong
- Chemical Risk Assessment Research Committee, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Sang-Yoon Nam
- College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Wook-Joon Yu
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea.
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13
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Moretti M, Manfredi A, Freni F, Previderé C, Osculati AMM, Grignani P, Tronconi L, Carelli C, Vignali C, Morini L. A comparison between two different dried blood substrates in determination of psychoactive substances in postmortem samples. Forensic Toxicol 2021; 39:385-393. [PMID: 33488834 PMCID: PMC7812343 DOI: 10.1007/s11419-020-00567-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/20/2020] [Indexed: 11/01/2022]
Abstract
Purpose Whatman™ 903 cards represent a valid type of support for collection, storage, and analysis of dried blood spots (DBS). Whatman™ FTA (Flinders Technology Associates) are a type of cards soaked in chemicals that cause denaturation of proteins, while preserving DNA and ensuring the safe handling of DBS; to date, these cards are still rarely employed in forensic toxicology. The aim of this study was to analyze several psychoactive substances on not-dried blood on the two different cards and to compare the qualitative and quantitative results. Methods Twenty cardiac postmortem blood samples were collected and deposed on Whatman™ 903 and Whatman™ FTA cards. Spots and not-dried blood were analyzed following our validated and previously published liquid chromatography-mass spectrometry methods. Results We were able to identify: eight drugs of abuse and their metabolites (15 cases), five benzodiazepines and their metabolites (3 cases), six antidepressants (6 cases) and two antipsychotics (3 cases). We observed a perfect qualitative correspondence and a general good quantitative correlation between data obtained from not-dried blood and the two different DBS cards, except for alprazolam, diazepam, desmethyldiazepam, fluoxetine and sertraline, that showed a lower concentration on FTA. Additional experiments suggest that the chemicals, adsorbed on FTA, are not the cause of the loss of signal observed for the substances previously mentioned and that methanol should be preferred as extraction solvent. Conclusions This study proved that FTA cards are a good and a hazard-free alternative sample storage method for analysis of several psychoactive substances in postmortem blood. Supplementary Information The online version contains supplementary material available at 10.1007/s11419-020-00567-2.
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Affiliation(s)
- Matteo Moretti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Alessandro Manfredi
- Department of Medicine, Surgery and Health, University of Trieste, Piazzale Europa 1, Trieste, Italy
| | - Francesca Freni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Carlo Previderé
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Antonio Marco Maria Osculati
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy.,Legal Medicine Operative Unit, IRCCS Fondazione Mondino, Pavia, Via Mondino 2, 27100 Pavia, PV Italy
| | - Pierangela Grignani
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Livio Tronconi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy.,Legal Medicine Operative Unit, IRCCS Fondazione Mondino, Pavia, Via Mondino 2, 27100 Pavia, PV Italy
| | - Claudia Carelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Claudia Vignali
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, Pavia, Italy
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14
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Pharmacologic Treatment of Transplant Recipients Infected With SARS-CoV-2: Considerations Regarding Therapeutic Drug Monitoring and Drug-Drug Interactions. Ther Drug Monit 2020; 42:360-368. [PMID: 32304488 PMCID: PMC7188032 DOI: 10.1097/ftd.0000000000000761] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
COVID-19 is a novel infectious disease caused by the severe acute respiratory distress (SARS)-coronavirus-2 (SARS-CoV-2). Several therapeutic options are currently emerging but none with universal consensus or proven efficacy. Solid organ transplant recipients are perceived to be at increased risk of severe COVID-19 because of their immunosuppressed conditions due to chronic use of immunosuppressive drugs (ISDs). It is therefore likely that solid organ transplant recipients will be treated with these experimental antivirals.
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15
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Chan WS, Wong GF, Hung CW, Wong YN, Fung KM, Lee WK, Dao KL, Leung CW, Lo KM, Lee WM, Cheung BKK. Interpol review of toxicology 2016-2019. Forensic Sci Int Synerg 2020; 2:563-607. [PMID: 33385147 PMCID: PMC7770452 DOI: 10.1016/j.fsisyn.2020.01.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/23/2020] [Indexed: 12/13/2022]
Abstract
This review paper covers the forensic-relevant literature in toxicology from 2016 to 2019 as a part of the 19th Interpol International Forensic Science Managers Symposium. The review papers are also available at the Interpol website at: https://www.interpol.int/content/download/14458/file/Interpol%20Review%20.Papers%202019.pdf.
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16
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Lampič K, Trontelj J, Prosen H, Drobne D, Šmid A, Vovk T. Determination of 6-thioguanine and 6-methylmercaptopurine in dried blood spots using liquid chromatography-tandem mass spectrometry: Method development, validation and clinical application. Clin Chim Acta 2019; 499:24-33. [DOI: 10.1016/j.cca.2019.08.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 02/08/2023]
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17
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Lauwers M, Croubels S, De Baere S, Sevastiyanova M, Romera Sierra EM, Letor B, Gougoulias C, Devreese M. Assessment of Dried Blood Spots for Multi-Mycotoxin Biomarker Analysis in Pigs and Broiler Chickens. Toxins (Basel) 2019; 11:toxins11090541. [PMID: 31540490 PMCID: PMC6784198 DOI: 10.3390/toxins11090541] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 11/30/2022] Open
Abstract
Dried blood spots (DBSs), a micro-sampling technique whereby a drop of blood is collected on filter paper has multiple advantages over conventional blood sampling regarding the sampling itself, as well as transportation and storage. This is the first paper describing the development and validation of a method for the determination of 23 mycotoxins and phase I metabolites in DBSs from pigs and broiler chickens using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The targeted mycotoxins belong to groups for which the occurrence in feed is regulated by the European Union, namely, aflatoxins, ochratoxin A and several Fusarium mycotoxins, and to two groups of unregulated mycotoxins, namely Alternaria mycotoxins and Fusarium mycotoxins (enniatins and beauvericin). The impact of blood haematocrit, DBS sampling volume and size of the analysed DBS disk on the validation results was assessed. No effects of variation in size of the analysed disk, haematocrit and spotted blood volume were observed for most mycotoxins, except for the aflatoxins and β-zearalanol (BZAL) at the lowest haematocrit (26%) level and for the enniatins (ENNs) at the lowest volume (40 µL). The developed method was transferred to an LC-high resolution mass spectrometry instrument to determine phase II metabolites. Then, the DBS technique was applied in a proof-of-concept toxicokinetic study including a comparison with LC-MS/MS data from plasma obtained with conventional venous blood sampling. A strong correlation (r > 0.947) was observed between plasma and DBS concentrations. Finally, DBSs were also applied in a pilot exposure assessment study to test their applicability under field conditions.
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Affiliation(s)
- Marianne Lauwers
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
- Innovad Global, Postbaan 69, 2910 Essen, Belgium.
| | - Siska Croubels
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
| | - Siegrid De Baere
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
| | | | | | - Ben Letor
- Innovad Global, Postbaan 69, 2910 Essen, Belgium.
| | | | - Mathias Devreese
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
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18
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Dried Blood Spot Self-Sampling by Guardians of Children With Epilepsy Is Feasible: Comparison With Plasma for Multiple Antiepileptic Drugs. Ther Drug Monit 2019; 41:509-518. [DOI: 10.1097/ftd.0000000000000605] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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19
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Wójtowicz A, Majda A, Zapotoczny S, Wietecha-Posłuszny R. Direct analysis from dried blood spot card surfaces with direct probe mass spectrometry - Evaluation study. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2019; 33:1148-1152. [PMID: 30919500 DOI: 10.1002/rcm.8447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 06/09/2023]
Abstract
RATIONALE The Direct Probe Mass Spectrometry (DIPMS) method allows successful analysis of powders, solid and liquid samples. The potential of direct surface analysis could find further application in the examination of surfaces with good absorption properties such as Dried Blood Spot (DBS) cards that constitute a great alternative to the classical blood collection method directly from veins. METHODS DIPMS was performed with the ionization carried out under atmospheric pressure in an Atmospheric Pressure Chemical Ionization source. Direct analysis of diazepam solutions in methanol and after their deposition onto a DBS card was conducted. Subsequently, images of the DBS cards with and without blood samples were acquired using Scanning Electron Microscopy (SEM). RESULTS Direct quantitative analysis of diazepam liquid samples by DIPMS was successfully performed. Linear correlation between the concentration of diazepam and the peak intensity with a R2 coefficient of 0.937 was obtained. However, the method failed when the analysis was conducted directly from the surface of the DBS cards and no diazepam peak was observed in the mass spectrum. The SEM images confirmed the good absorption properties of DBS cards and the absence of blood components on the surface. CONCLUSIONS DIPMS is an excellent technique for the rapid, direct analysis of powders, solid and liquid samples; however, the potential of the method is limited when samples are deposited on surfaces with good absorption properties such as DBS cards.
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Affiliation(s)
- Anna Wójtowicz
- Faculty of Chemistry, Jagiellonian University, Gronostajowa St. 2, 30-387, Kraków, Poland
| | - Alicja Majda
- Faculty of Chemistry, Jagiellonian University, Gronostajowa St. 2, 30-387, Kraków, Poland
| | - Szczepan Zapotoczny
- Faculty of Chemistry, Jagiellonian University, Gronostajowa St. 2, 30-387, Kraków, Poland
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Lenk G, Ullah S, Stemme G, Beck O, Roxhed N. Evaluation of a Volumetric Dried Blood Spot Card Using a Gravimetric Method and a Bioanalytical Method with Capillary Blood from 44 Volunteers. Anal Chem 2019; 91:5558-5565. [DOI: 10.1021/acs.analchem.8b02905] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Gabriel Lenk
- KTH Royal Institute of Technology Stockholm, Department of Micro and Nanosystems, 10044 Stockholm, Sweden
| | - Shahid Ullah
- Karolinska University Hospital, Clinical Pharmacology, 14186 Stockholm, Sweden
| | - Göran Stemme
- KTH Royal Institute of Technology Stockholm, Department of Micro and Nanosystems, 10044 Stockholm, Sweden
| | - Olof Beck
- Karolinska University Hospital, Clinical Pharmacology, 14186 Stockholm, Sweden
| | - Niclas Roxhed
- KTH Royal Institute of Technology Stockholm, Department of Micro and Nanosystems, 10044 Stockholm, Sweden
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