1
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Zimmerman-Federle H, Ren G, Dowling S, Warren C, Rusyniak D, Avera R, Manicke NE. Plasma drug screening using paper spray mass spectrometry with integrated solid phase extraction. Drug Test Anal 2024. [PMID: 38584344 DOI: 10.1002/dta.3687] [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: 01/08/2024] [Revised: 03/04/2024] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
Drug overdoses have risen dramatically in recent years. We developed a simple nontargeted method using a disposable paper spray cartridge with an integrated solid phase extraction column. This method was used to screen for ~160 fentanyl analogs, synthetic cannabinoids, other synthetic drugs, and traditional drugs of abuse in over 300 authentic overdose samples collected at emergency departments in Indianapolis. A solid phase extraction step was implemented on the paper spray cartridge to enable subnanograms per milliliter synthetic drugs screening in plasma. Analysis was performed on a quadrupole orbitrap mass spectrometer using the sequential window acquisition of all theoretical fragment ion spectra approach in which tandem mass spectrometry was performed using 7 m/z isolation windows in the quadrupole. Calibration curves with isotopically labeled internal standards were constructed for 35 of the most frequently encountered synthetic and traditional illicit drugs by US toxicology labs. Additional qualitative-only drugs in a suspect screening list were also included. Limits of detection in plasma for synthetic cannabinoids ranged from 0.1 to 0.5 and 0.1 to 0.3 ng/mL for fentanyl and its analogs and between 1 and 5 ng/mL for most other drugs. Relative matrix effects were evaluated by determining the variation of the calibration slope in 10 different lots of biofluid and found to be between 3% and 20%. The method was validated on authentic overdose samples collected from two emergency departments in Indianapolis, Indiana, from suspected or known overdoses. Commonly detected synthetic drugs included fentanyl related substances, designer benzodiazepines such as flubromazolam, and the synthetic cannabinoid 5F-PB-22.
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Affiliation(s)
- Hannah Zimmerman-Federle
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Greta Ren
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Sarah Dowling
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Cassandra Warren
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Daniel Rusyniak
- School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Robert Avera
- School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Nicholas E Manicke
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
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2
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Gqamana PP, Zhang YV. High-Throughput Comprehensive Quantitative LC-MS/MS Analysis of Common Drugs and Metabolites (62 Compounds) in Human Urine. Methods Mol Biol 2024; 2737:215-227. [PMID: 38036824 DOI: 10.1007/978-1-0716-3541-4_20] [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] [Indexed: 12/02/2023]
Abstract
In recent years a multitude of LC-MS/MS assays have been widely reported in commercial and clinical literature demonstrating the simultaneous analyses of dozens of drugs of abuse in human samples. The utility of such assays is meant to supplant the indirect detection based on the classical spectral library approach. Direct and simultaneous analysis via LC-MS/MS technology is made possible by fast acquisition rates in multiple reaction monitoring, as well as sensitivity and high selectivity of the technology for each individual analyte in a complex mixture. Hence, unlike immunoassays, which are not well-suited for the analyses of mixtures, and which may also be prone to false positives from potential interferences, quantitative LC-MS/MS analyses are feasible for complex patient mixtures of drugs of abuse. We hereby present a robust clinical LC-MS/MS assay for the simultaneous and semi-quantitative analysis of up to 62 drugs of abuse in human urine, representing major classes that include opiates, benzodiazepines, amphetamines, etc. The assay utilizes dilute and shoot, whereby the sample is diluted ten times in internal standard reagent and thereafter submitted to the LC-MS instrument, i.e., reversed-phase liquid chromatography coupled to the electrospray ionization multiple reaction monitoring analysis, via the TSQ Endura triple-quadrupole instrument. The assay employs stable isotope-labeled internal standards with a linear response in the 30-300 ng/mL range, effectively semi-quantitative, since this analytical range is well within typical immunoassay cutoffs for most drugs.
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Affiliation(s)
- Putuma P Gqamana
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Y Victoria Zhang
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.
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3
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Feliu C, Konecki C, Cazaubon Y, Binet L, Vautier D, Fouley A, Gozalo C, Djerada Z. Development and Validation of a Non-Targeted Screening Method for Most Psychoactive, Analgesic, Anaesthetic, Anti-Diabetic, Anti-Coagulant and Anti-Hypertensive Drugs in Human Whole Blood and Plasma Using High-Resolution Mass Spectrometry. Pharmaceuticals (Basel) 2023; 16:ph16010076. [PMID: 36678573 PMCID: PMC9865759 DOI: 10.3390/ph16010076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/16/2022] [Accepted: 12/30/2022] [Indexed: 01/05/2023] Open
Abstract
(1) Background: In toxicological laboratories, various screening methods can be used to identify compounds involved in intoxication. High-resolution mass spectrometry has been increasingly used in this context for the last years, because of its sensitivity and reliability. Here, we present the development and validation of a screening method that uses liquid chromatography coupled with a high-resolution mass spectrometer. (2) Methods: This method required only 100 µL of whole blood or plasma sample. Pretreatment consisted of a rapid and simple deproteinisation with methanol/acetonitrile and zinc sulphate. This new assay was validated according to international guidelines. (3) Results: To perform the method validation, 53 compounds were selected. The selection criteria were as follows: various chemical structures and therapeutic families (>15), large m/z distribution, positive or negative ionisation mode, and various elution times. The assays showed high selectivity and specificity, with optimal process efficiency. The identification limits, determined using predefined criteria, were established at sub-therapeutic or therapeutic concentrations. Applicability was evaluated using spiked plasma controls and external quality controls. (4) Conclusions: The new method was then successfully applied to routine clinical and forensic samples.
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Affiliation(s)
- Catherine Feliu
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims University Hospital, 51 Rue Cognacq-Jay, CEDEX, 51095 Reims, France
- Correspondence: (C.F.); (Z.D.)
| | - Celine Konecki
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims University Hospital, 51 Rue Cognacq-Jay, CEDEX, 51095 Reims, France
| | - Yoann Cazaubon
- Institute Desbrest of Epidemiology and Public Health, INSERM, Montpellier University, Department of Pharmacology, Montpellier University Hospital, Avenue du Doyen Gaston Giraud, 34090 Montpellier, France
| | - Laurent Binet
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims University Hospital, 51 Rue Cognacq-Jay, CEDEX, 51095 Reims, France
| | - Damien Vautier
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims University Hospital, 51 Rue Cognacq-Jay, CEDEX, 51095 Reims, France
| | - Aurélie Fouley
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims University Hospital, 51 Rue Cognacq-Jay, CEDEX, 51095 Reims, France
| | - Claire Gozalo
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims University Hospital, 51 Rue Cognacq-Jay, CEDEX, 51095 Reims, France
| | - Zoubir Djerada
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims University Hospital, 51 Rue Cognacq-Jay, CEDEX, 51095 Reims, France
- Correspondence: (C.F.); (Z.D.)
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4
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Jiao G, Fan X, Wang Y, Weng N, Ouyang L, Wang H, Pan S, Huang D, Han J, Zhang F, Chen W. Dissection of the Active Ingredients and Potential Mechanism of Han-Shi-Yu-Fei-Decoction in Treating COVID-19 Based on In Vivo Substances Profiling and Clinical Symptom-Guided Network Pharmacology. ACS OMEGA 2022; 7:36598-36610. [PMID: 36268464 PMCID: PMC9578366 DOI: 10.1021/acsomega.2c04589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
This work was aimed to elucidate the mechanism of action of Han-Shi-Yu-Fei-decoction (HSYFD) for treating patients with mild coronavirus disease 2019 (COVID-19) based on clinical symptom-guided network pharmacology. Experimentally, an ultra-high performance liquid chromatography technique coupled with quadrupole time-of-flight mass spectrometry method was used to profile the chemical components and the absorbed prototype constituents in rat serum after its oral administration, and 11 out of 108 compounds were identified. Calculatingly, the disease targets of Han-Shi-Yu-Fei symptoms of COVID-19 were constructed through the TCMIP V2.0 database. The subsequent network pharmacology and molecular docking analysis explored the molecular mechanism of the absorbed prototype constituents in the treatment of COVID-19. A total of 42 HSYFD targets oriented by COVID-19 clinical symptom were obtained, with EGFR, TP53, TNF, JAK2, NR3C1, TH, COMT, and DRD2 as the core targets. Enriched pathway analysis yielded multiple COVID-19-related signaling pathways, such as the PI3K/AKT signaling pathway and JAK-STAT pathway. Molecular docking showed that the key compounds, such as 6-gingerol, 10-gingerol, and scopoletin, had high binding activity to the core targets like COMT, JAK2, and NR3C1. Our work also verified the feasibility of clinical symptom-guided network pharmacology analysis of chemical compounds, and provided a possible agreement between the points of views of traditional Chinese medicine and western medicine on the disease.
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Affiliation(s)
- Guangyang Jiao
- Institute
of Chinese Materia Medica, Shanghai University
of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xiangcheng Fan
- Department
of Pharmacy, Changzheng Hospital, (Second Military Medical University), Naval Medical University, Shanghai 200003, China
- Shanghai
Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China
| | - Yejian Wang
- Department
of Pharmacology, Anhui University of Chinese
Medicine, Hefei 230012, Anhui, China
| | - Nan Weng
- Department
of Pharmacy, Changzheng Hospital, (Second Military Medical University), Naval Medical University, Shanghai 200003, China
- School
of Traditional Chinese Material, Shenyang
Pharmaceutical University, Shenyang 11001, China
| | - Luolan Ouyang
- School of
Pharmacy, Shanghai University of Chinese
Medicine, Shanghai 201203, China
| | - Haoqian Wang
- School of
Pharmacy, Shanghai University of Chinese
Medicine, Shanghai 201203, China
| | - Sihan Pan
- School of
Pharmacy, Shanghai University of Chinese
Medicine, Shanghai 201203, China
| | - Doudou Huang
- Institute
of Chinese Materia Medica, Shanghai University
of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jun Han
- Department
of Gastroenterology, Changzheng Hospital, (Second Military Medical
University), Naval Medical University, Shanghai 200003, China
| | - Feng Zhang
- Department
of Pharmacy, Changzheng Hospital, (Second Military Medical University), Naval Medical University, Shanghai 200003, China
- Shanghai
Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China
- Department
of Pharmacology, Anhui University of Chinese
Medicine, Hefei 230012, Anhui, China
| | - Wansheng Chen
- Institute
of Chinese Materia Medica, Shanghai University
of Traditional Chinese Medicine, Shanghai 201203, China
- Department
of Pharmacy, Changzheng Hospital, (Second Military Medical University), Naval Medical University, Shanghai 200003, China
- Shanghai
Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China
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5
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Roadside Drug Testing Approaches. Molecules 2021; 26:molecules26113291. [PMID: 34072538 PMCID: PMC8199318 DOI: 10.3390/molecules26113291] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 01/01/2023] Open
Abstract
The purpose of this review is to present an overview of roadside drug testing, driving enforcement, and drunk/drug driving detection around the world. Drunk and drug driving is a severe problem, not only in the UAE, but also around the world. This has important implications for road safety as drunk or drug driving may increase the chances of a driver’s involvement in a road crash when compared to a drug-free driver. Recently, due to increases in drug-impaired drivers’ crash involvement, many mobile roadside drug testing devices have been introduced to the market. These devices use oral fluid, urine or blood matrices. These are on-the-spot tests, which are easy to use and are applied by law enforcement agencies and the public. Law enforcement agencies most commonly use oral fluid to detect the presence of illicit drugs in drivers. This review discusses all the available devices in the market used by the authorities. It also describes the type of drugs widely abused by drivers along with behavioral testing methods. The different types of matrices used for roadside drug testing are also evaluated. Sample collection, storage, and pre-treatment methods are discussed, followed by the confirmatory analysis of positive samples. This article will significantly help law enforcement agencies compare and evaluate all the reliable roadside testing devices and new emerging confirmatory devices available to them in the market. This will help them make an informed decision on which device to adapt to their individual needs.
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6
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Lee HJ, Kadokami K, Oh JE. Occurrences of microorganic pollutants in the Kumho River by a comprehensive target analysis using LC-Q/TOF-MS with sequential window acquisition of all theoretical fragment ion spectra (SWATH). THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 713:136508. [PMID: 32019012 DOI: 10.1016/j.scitotenv.2020.136508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/02/2020] [Accepted: 01/02/2020] [Indexed: 06/10/2023]
Abstract
In this study, simultaneous identification and semi-quantification of hundreds of micropollutant compounds, including pharmaceutical and personal care products (PPCPs) and pesticides were performed in river and effluent samples from the Kumho River Basin using liquid chromatography quadrupole time-of-flight mass spectrometry (LC-Q-TOF/MS) with sequential window acquisition of all theoretical fragment ion spectra (SWATH). In total, 85 compounds (29 pesticides and 56 PPCPs) were identified. The highest proportions of PPCP residues were detected in the downstream area of the Kumho River, close to the central city. On the other hand, the highest proportions of pesticide residues were observed upstream, near agricultural land and golf courses. Additionally, the highly exposable chemicals were prioritized using a scoring and ranking system based on their concentration and detection frequency. Thus, 20 compounds (7 pesticides and 13 PPCPs) with scores of 200 or higher were defined as highly exposable compounds in Kumho River basin.
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Affiliation(s)
- Heon-Jun Lee
- Department of Civil and Environmental Engineering, Pusan National University, Busan, Republic of Korea
| | - Kiwao Kadokami
- Faculty of Environmental Engineering, The University of Kitakyushu, Kitakyushu, Japan
| | - Jeong-Eun Oh
- Department of Civil and Environmental Engineering, Pusan National University, Busan, Republic of Korea.
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7
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Kang D, Ding Q, Xu Y, Yin X, Guo H, Yu T, Wang H, Xu W, Wang G, Liang Y. Comparative analysis of constitutes and metabolites for traditional Chinese medicine using IDA and SWATH data acquisition modes on LC-Q-TOF MS. J Pharm Anal 2019; 10:588-596. [PMID: 33425453 PMCID: PMC7775849 DOI: 10.1016/j.jpha.2019.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 11/14/2019] [Accepted: 11/14/2019] [Indexed: 01/26/2023] Open
Abstract
Identification of components and metabolites of traditional Chinese medicines (TCMs) employing liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-Q-TOF MS) techniques with information-dependent acquisition (IDA) approaches is increasingly frequent. A current drawback of IDA-MS is that the complexity of a sample might prevent important compounds from being triggered in IDA settings. Sequential window acquisition of all theoretical fragment-ion spectra (SWATH) is a data-independent acquisition (DIA) method where the instrument deterministically fragments all precursor ions within the predefined m/z range in a systematic and unbiased fashion. Herein, the superiority of SWATH on the detection of TCMs’ components was firstly investigated by comparing the detection efficiency of SWATH-MS and IDA-MS data acquisition modes, and sanguisorbin extract was used as a mode TCM. After optimizing the setting parameters of SWATH, rolling collision energy (CE) and variable Q1 isolation windows were found to be more efficient for sanguisorbin identification than the fixed CE and fixed Q1 isolation window. More importantly, the qualitative efficiency of SWATH-MS on sanguisorbins was found significantly higher than that of IDA-MS data acquisition. In IDA mode, 18 kinds of sanguisorbins were detected in sanguisorbin extract. A total of 47 sanguisorbins were detected when SWATH-MS was used under rolling CE and flexible Q1 isolation window modes. Besides, 26 metabolites of sanguisorbins were identified in rat plasma, and their metabolic pathways could be deduced as decarbonylation, oxidization, reduction, methylation, and glucuronidation according to their fragmental ions acquired in SWATH-MS mode. Thus, SWATH-MS data acquisition could provide more comprehensive information for the component and metabolite identification for TCMs than IDA-MS. SWATH was first used to identify components and metabolites of TCMs. Superiority of SWATH on the detection of TCM was firstly investigated. The number of components detected by SWATH was greatly higher than IDA.
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Affiliation(s)
- Dian Kang
- Key Lab of Drug Metabolism & Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Tongjiaxiang 24, Nanjing, 210009, PR China
| | - Qingqing Ding
- Department of Geriatric Oncology, First Affiliated Hospital of Nanjing Medical University (Jiangsu People's Hospital), No. 300 Guangzhou Road, Nanjing, 210029, PR China
| | - Yangfan Xu
- Key Lab of Drug Metabolism & Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Tongjiaxiang 24, Nanjing, 210009, PR China
| | - Xiaoxi Yin
- Key Lab of Drug Metabolism & Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Tongjiaxiang 24, Nanjing, 210009, PR China
| | - Huimin Guo
- Key Lab of Drug Metabolism & Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Tongjiaxiang 24, Nanjing, 210009, PR China
| | - Tengjie Yu
- Key Lab of Drug Metabolism & Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Tongjiaxiang 24, Nanjing, 210009, PR China
| | - He Wang
- Key Lab of Drug Metabolism & Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Tongjiaxiang 24, Nanjing, 210009, PR China
| | - Wenshuo Xu
- Key Lab of Drug Metabolism & Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Tongjiaxiang 24, Nanjing, 210009, PR China
| | - Guangji Wang
- Key Lab of Drug Metabolism & Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Tongjiaxiang 24, Nanjing, 210009, PR China
| | - Yan Liang
- Key Lab of Drug Metabolism & Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Tongjiaxiang 24, Nanjing, 210009, PR China
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8
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Vasiljevic T, Gómez-Ríos GA, Li F, Liang P, Pawliszyn J. High-throughput quantification of drugs of abuse in biofluids via 96-solid-phase microextraction-transmission mode and direct analysis in real time mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2019; 33:1423-1433. [PMID: 31063263 DOI: 10.1002/rcm.8477] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/05/2019] [Accepted: 04/14/2019] [Indexed: 06/09/2023]
Abstract
RATIONALE The workload of clinical laboratories has been steadily increasing over the last few years. High-throughput (HT) sample processing allows scientists to spend more time undertaking matters of critical thinking rather than laborious sample processing. Herein we introduce a HT 96-solid-phase microextraction (SPME) transmission mode (TM) system coupled to direct analysis in real time (DART) mass spectrometry (MS). METHODS Model compounds (opioids) were extracted from urine and plasma samples using a 96-SPME-TM device. A standard voltage and pressure (SVP) DART source was used for all experiments. Examination of SPME-TM performance was done using high-resolution mass spectrometry (HRMS) in full scan mode (100-500 m/z), whereas quantitation of opioids was performed using triple quadrupole MS in multiple reaction monitoring mode and by using a matrix-matched internal standard correction method. RESULTS Thirteen points (0.5 to 200 ng mL-1 ) were used to establish a calibration curve. Low limits of quantitation (LOQ) were obtained (0.5 to 25 ng mL-1 ) for matrices used. Acceptable accuracy (71.4-129.4%) and repeatability (1.1-24%) were obtained for validation levels tested (0.5, 30 and 90 ng mL-1 ). In less than 1.5 hours, 96 samples were extracted, desorbed and processed using the 96-SPME-TM system coupled to DART-MS. CONCLUSIONS A rapid HT method for detection of opioids in urine and plasma samples was developed. This study demonstrated that ambient ionization mass spectrometry coupled to robust sample preparation methods such as SPME-TM can rapidly and efficiently screen/quantify target analytes in a HT context.
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Affiliation(s)
- Tijana Vasiljevic
- Department of Chemistry, University of Waterloo, Ontario, N2L 3G1, Canada
| | - Germán Augusto Gómez-Ríos
- Department of Chemistry, University of Waterloo, Ontario, N2L 3G1, Canada
- Restek Corporation, Bellefonte, Pennsylvania, 16823, USA
| | - Frederick Li
- Ionsense, Inc., Saugus, Massachusetts, 01906, USA
| | - Paul Liang
- Ionsense, Inc., Saugus, Massachusetts, 01906, USA
| | - Janusz Pawliszyn
- Department of Chemistry, University of Waterloo, Ontario, N2L 3G1, Canada
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9
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10
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Rasmussen NN, Barker A, Strathmann FG. Lowering the Bar for Mass Spectrometry: A Comparison between Immunoassay and Rapid Time-of-Flight for Presumptive Screening of Drugs in Urine. J Appl Lab Med 2018; 2:535-542. [PMID: 33636881 DOI: 10.1373/jalm.2017.024166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/14/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Immunoassay-based techniques and creatinine quantification have historically been the methods of choice for urine drug screening. Positive presumptive drug screen results are reflexed to more specific, confirmatory testing using gas or liquid chromatography coupled to mass spectrometry. False positives and false negatives with immunoassay techniques are common problems that have substantial down-stream consequences for patient care, laboratory operations, and total costs. METHODS The final workflow included rapid enzymatic hydrolysis, rapid liquid chromatographic methods, and time-of-flight mass spectrometry for detection. In total, 84 drugs and metabolites were included and reported qualitatively using 11 isotopically labeled internal standards selected to represent compound classes, retention time, and expected abundances to control for method inefficiencies and matrix suppression/enhancement. The method performance validation included 420 individual urine specimens. RESULTS Of the 420 samples screened by immunoassay, 117 failed to confirm by mass spectrometry and were immunoassay false positives. None of these 117 samples screened positive on the liquid chromatography time-of-flight mass spectrometry (LC-TOF-MS) assay. The LC-TOF-MS method failed to detect 1 sample in each of the following classes: buprenorphine, ethanol markers, and opiates owing to concentrations below the established cutoffs. Out of 579 samples, 275 (47.4%) screened positive by LC-TOF-MS for nicotine and at least 2 of its metabolites. Quantitative creatinine comparison to an existing Jaffe method yielded a slope of 0.91 and a correlation coefficient of 0.96. CONCLUSIONS We investigated whether immunoassay-based drug screening and creatinine quantification could be sufficiently replaced by a rapid LC-TOF-MS screen with higher specificity and accuracy than existing methods. The LC-LC-TOF-MS method is a sensitive and more specific way to screen for drugs, providing creatinine quantification and potential novel specimen validity testing with the inclusion of nicotine metabolites.
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Affiliation(s)
| | - Adam Barker
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT.,Department of Pathology, University of Utah, Salt Lake City, UT
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11
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Enders JR, Smith JP, Feng S, Strickland EC, McIntire GL. Analytical Considerations When Developing an LC-MS/MS Method for More than 30 Analytes. J Appl Lab Med 2017; 2:543-554. [PMID: 33636886 DOI: 10.1373/jalm.2017.024174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/13/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND While validation of analytical (LC-MS/MS) methods has been documented in any number of articles and reference texts, the optimal design and subsequent validation of a method for over 30 analytes presents special challenges. Conventional approaches to calibration curves, controls, and run time are not tenable in such methods. This report details the practical aspects of designing and implementing such a method in accordance with College of American Pathologists validation criteria. METHODS Conventional criteria were followed in the design and validation of a method for 34 analytes and 15 internal standards by LC-MS/MS. These criteria are laid out in a standard operating procedure, which is followed without exception and is consistent with College of American Pathologists criteria. RESULTS The method presented herein provides quality results and accurate medication monitoring. The method was optimized to negate interferences (both from within the method and from potential concomitant compounds), increase throughput, and provide reproducible quality quantification over relevant analyte concentrations ranges. CONCLUSIONS The method was designed primarily with quality and accurate medication monitoring in mind. The method achieves these goals by use of novel approaches to calibration curves and controls that both improve performance and minimize risk (financial and operational). As automation and LC-MS/MS equipment continue to improve, it is expected that more methods like this one will be developed.
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Affiliation(s)
- Jeffrey R Enders
- Research and Development Department, Ameritox, LLC, Greensboro, NC 27409
| | - Jeremy P Smith
- Research and Development Department, Ameritox, LLC, Greensboro, NC 27409
| | - Sheng Feng
- Research and Development Department, Ameritox, LLC, Greensboro, NC 27409
| | - Erin C Strickland
- Research and Development Department, Ameritox, LLC, Greensboro, NC 27409
| | - Gregory L McIntire
- Research and Development Department, Ameritox, LLC, Greensboro, NC 27409
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12
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DiBattista A, Rampersaud D, Lee H, Kim M, Britz-McKibbin P. High Throughput Screening Method for Systematic Surveillance of Drugs of Abuse by Multisegment Injection–Capillary Electrophoresis–Mass Spectrometry. Anal Chem 2017; 89:11853-11861. [DOI: 10.1021/acs.analchem.7b03590] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Alicia DiBattista
- Department
of Chemistry and Chemical Biology, McMaster University, Hamilton L8S 4L8, Canada
| | | | - Howard Lee
- Seroclinix Corporation, Mississauga, ON L4W 5B9, Canada
| | - Marcus Kim
- Agilent Technologies Inc., Mississauga, ON L5N 5M4, Canada
| | - Philip Britz-McKibbin
- Department
of Chemistry and Chemical Biology, McMaster University, Hamilton L8S 4L8, Canada
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13
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Michely JA, Meyer MR, Maurer HH. Paper Spray Ionization Coupled to High Resolution Tandem Mass Spectrometry for Comprehensive Urine Drug Testing in Comparison to Liquid Chromatography-Coupled Techniques after Urine Precipitation or Dried Urine Spot Workup. Anal Chem 2017; 89:11779-11786. [DOI: 10.1021/acs.analchem.7b03398] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Julian A. Michely
- Department of Experimental and Clinical
Toxicology, Institute of Experimental and Clinical Pharmacology and
Toxicology, Saarland University, Homburg, Saar D-66421, Germany
| | - Markus R. Meyer
- Department of Experimental and Clinical
Toxicology, Institute of Experimental and Clinical Pharmacology and
Toxicology, Saarland University, Homburg, Saar D-66421, Germany
| | - Hans H. Maurer
- Department of Experimental and Clinical
Toxicology, Institute of Experimental and Clinical Pharmacology and
Toxicology, Saarland University, Homburg, Saar D-66421, Germany
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Kwong TC, Magnani B, Moore C. Urine and oral fluid drug testing in support of pain management. Crit Rev Clin Lab Sci 2017; 54:433-445. [PMID: 28990451 DOI: 10.1080/10408363.2017.1385053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In recent years, the abuse of opioid drugs has resulted in greater prevalence of addiction, overdose, and deaths attributable to opioid abuse. The epidemic of opioid abuse has prompted professional and government agencies to issue practice guidelines for prescribing opioids to manage chronic pain. An important tool available to providers is the drug test for use in the initial assessment of patients for possible opioid therapy, subsequent monitoring of compliance, and documentation of suspected aberrant drug behaviors. This review discusses the issues that most affect the clinical utility of drug testing in chronic pain management with opioid therapy. It focuses on the two most commonly used specimen matrices in drug testing: urine and oral fluid. The advantages and disadvantages of urine and oral fluid in the entire testing process, from specimen collection and analytical methodologies to result interpretation are reviewed. The analytical sensitivity and specificity limitations of immunoassays used for testing are examined in detail to draw attention to how these shortcomings can affect result interpretation and influence clinical decision-making in pain management. The need for specific identification and quantitative measurement of the drugs and metabolites present to investigate suspected aberrant drug behavior or unexpected positive results is analyzed. Also presented are recent developments in optimization of test menus and testing strategies, such as the modification of the standard screen and reflexed-confirmation testing model by eliminating some of the initial immunoassay-based tests and proceeding directly to definitive testing by mass spectrometry assays.
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Affiliation(s)
- Tai C Kwong
- a Department of Pathology and Laboratory Medicine , University of Rochester Medical Center , Rochester , NY , USA
| | - Barbarajean Magnani
- b Department of Pathology and Laboratory Medicine , Tufts Medical Center , Boston , MA , USA
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Gehrie EA, Keiser A, Haglock-Adler CJ, Strathmann F, Booth GS. Detecting Pharmaceuticals in the Red Blood Cell Inventory of a Hospital Blood Bank. J Pediatr 2017; 189:227-231.e1. [PMID: 28669612 DOI: 10.1016/j.jpeds.2017.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/22/2017] [Accepted: 06/05/2017] [Indexed: 01/13/2023]
Abstract
We tested 220 red blood cell units for the presence of pharmaceuticals; 15 units (6.8%) were confirmed to contain low concentrations of opiates, benzodiazepines, stimulants, or barbiturates. Further study is needed to determine whether these drugs, which are not prohibited in donated blood by current Food and Drug Administration standards, could mediate adverse reactions in children.
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Affiliation(s)
- Eric A Gehrie
- Department of Pathology, Johns Hopkins University, Baltimore, MD
| | - Amaris Keiser
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD
| | | | | | - Garrett S Booth
- Department of Pathology, Johns Hopkins University, Baltimore, MD.
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Michely JA, Meyer MR, Maurer HH. Power of Orbitrap-based LC-high resolution-MS/MS for comprehensive drug testing in urine with or without conjugate cleavage or using dried urine spots after on-spot cleavage in comparison to established LC-MS n or GC-MS procedures. Drug Test Anal 2017; 10:158-163. [PMID: 28755512 DOI: 10.1002/dta.2255] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 11/12/2022]
Abstract
Reliable, sensitive, and comprehensive urine screening procedures by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-mass spectrometry (LC-MS) with low or high resolution (HR) are of high importance for drug testing, adherence monitoring, or detection of toxic compounds. Besides conventional urine sampling, dried urine spots are of increasing interest. In the present study, the power of LC-HR-MS/MS was investigated for comprehensive drug testing in urine with or without conjugate cleavage or using dried urine spots after on-spot cleavage in comparison to established LC-MSn or GC-MS procedures. Authentic human urine samples (n = 103) were split in 4 parts. One aliquot was prepared by precipitation (UP), one by UP with conjugate cleavage (UglucP), one spot on filter paper cards and prepared by on-spot cleavage followed by liquid extraction (DUSglucE), and one worked-up by acid hydrolysis, liquid-liquid extraction, and acetylation for GC-MS analysis. The 3 series of LC-HR-MS/MS results were compared among themselves, to corresponding published LC-MSn data, and to screening results obtained by conventional GC-MS. The reference libraries used for the 3 techniques contained over 4500 spectra of parent compounds and their metabolites. The number of all detected hits (770 drug intakes) was set to 100%. The LC-HR-MS/MS approach detected 80% of the hits after UP, 89% after UglucP, and 77% after DUSglucE, which meant over one-third more hits in comparison to the corresponding published LC-MSn results with ≤49% detected hits. The GC-MS approach identified 56% of all detected hits. In conclusion, LC-HR-MS/MS provided the best screening results after conjugate cleavage and precipitation.
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Affiliation(s)
- Julian A Michely
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical, Pharmacology and Toxicology, Saarland University, Homburg, Saar, Germany
| | - Markus R Meyer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical, Pharmacology and Toxicology, Saarland University, Homburg, Saar, Germany
| | - Hans H Maurer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical, Pharmacology and Toxicology, Saarland University, Homburg, Saar, Germany
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Helfer AG, Michely JA, Weber AA, Meyer MR, Maurer HH. Liquid chromatography-high resolution-tandem mass spectrometry using Orbitrap technology for comprehensive screening to detect drugs and their metabolites in blood plasma. Anal Chim Acta 2017; 965:83-95. [DOI: 10.1016/j.aca.2017.03.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 02/06/2017] [Accepted: 03/02/2017] [Indexed: 01/30/2023]
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Andra SS, Austin C, Patel D, Dolios G, Awawda M, Arora M. Trends in the application of high-resolution mass spectrometry for human biomonitoring: An analytical primer to studying the environmental chemical space of the human exposome. ENVIRONMENT INTERNATIONAL 2017; 100:32-61. [PMID: 28062070 PMCID: PMC5322482 DOI: 10.1016/j.envint.2016.11.026] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 11/23/2016] [Accepted: 11/27/2016] [Indexed: 05/05/2023]
Abstract
Global profiling of xenobiotics in human matrices in an untargeted mode is gaining attention for studying the environmental chemical space of the human exposome. Defined as the study of a comprehensive inclusion of environmental influences and associated biological responses, human exposome science is currently evolving out of the metabolomics science. In analogy to the latter, the development and applications of high resolution mass spectrometry (HRMS) has shown potential and promise to greatly expand our ability to capture the broad spectrum of environmental chemicals in exposome studies. HRMS can perform both untargeted and targeted analysis because of its capability of full- and/or tandem-mass spectrum acquisition at high mass accuracy with good sensitivity. The collected data from target, suspect and non-target screening can be used not only for the identification of environmental chemical contaminants in human matrices prospectively but also retrospectively. This review covers recent trends and advances in this field. We focus on advances and applications of HRMS in human biomonitoring studies, and data acquisition and mining. The acquired insights provide stepping stones to improve understanding of the human exposome by applying HRMS, and the challenges and prospects for future research.
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Affiliation(s)
- Syam S Andra
- Exposure Biology, Senator Frank R. Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Christine Austin
- Exposure Biology, Senator Frank R. Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Dhavalkumar Patel
- Exposure Biology, Senator Frank R. Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Georgia Dolios
- Exposure Biology, Senator Frank R. Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mahmoud Awawda
- Exposure Biology, Senator Frank R. Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Manish Arora
- Exposure Biology, Senator Frank R. Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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Doyle K, Strathmann FG. Cost and Efficacy Assessment of an Alternative Medication Compliance Urine Drug Testing Strategy. PAIN MEDICINE 2017; 18:307-315. [PMID: 28204701 DOI: 10.1093/pm/pnw165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective This study investigates the frequency at which quantitative results provide additional clinical benefit compared to qualitative results alone. A comparison between alternative urine drug screens and conventional screens including the assessment of cost-to-payer differences, accuracy of prescription compliance or polypharmacy/substance abuse was also included. Setting and Methods In a reference laboratory evaluation of urine specimens from across the United States, 213 urine specimens with provided prescription medication information (302 prescriptions) were analyzed by two testing algorithms: 1) conventional immunoassay screen with subsequent reflexive testing of positive results by quantitative mass spectrometry; and 2) a combined immunoassay/qualitative mass-spectrometry screen that substantially reduced the need for subsequent testing. Results The qualitative screen was superior to immunoassay with reflex to mass spectrometry in confirming compliance per prescription (226/302 vs 205/302), and identifying non-prescription abuse (97 vs 71). Pharmaceutical impurities and inconsistent drug metabolite patterns were detected in only 3.8% of specimens, suggesting that quantitative results have limited benefit. The percentage difference between the conventional testing algorithm and the alternative screen was projected to be 55%, and a 2-year evaluation of test utilization as a measure of test order volume follows an exponential trend for alternative screen test orders over conventional immunoassay screens that require subsequent confirmation testing. Conclusion Alternative, qualitative urine drug screens provide a less expensive, faster, and more comprehensive evaluation of patient medication compliance and drug abuse. The vast majority of results were interpretable with qualitative results alone indicating a reduced need to automatically reflex to quantitation or provide quantitation for the majority of patients. This strategy highlights a successful approach using an alternative strategy for both the laboratory and physician to align clinical needs while being mindful of costs.
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Affiliation(s)
- Kelly Doyle
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA.,Department of Pathology, Primary Children’s Hospital, Salt Lake City, Utah, USA.,Intermountain Healthcare Central Laboratory, Murray, Utah, USA
| | - Frederick G Strathmann
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA.,ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah, USA
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Bidny S, Gago K, Chung P, Albertyn D, Pasin D. Simultaneous Screening and Quantification of Basic, Neutral and Acidic Drugs in Blood Using UPLC-QTOF-MS. J Anal Toxicol 2016; 41:181-195. [DOI: 10.1093/jat/bkw118] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Grant RP. Design and utility of open-access liquid chromatography tandem mass spectrometry in quantitative clinical toxicology and therapeutic drug monitoring. Trends Analyt Chem 2016. [DOI: 10.1016/j.trac.2016.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Telving R, Hasselstrøm JB, Andreasen MF. Targeted toxicological screening for acidic, neutral and basic substances in postmortem and antemortem whole blood using simple protein precipitation and UPLC-HR-TOF-MS. Forensic Sci Int 2016; 266:453-461. [PMID: 27458995 DOI: 10.1016/j.forsciint.2016.07.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/29/2016] [Accepted: 07/05/2016] [Indexed: 11/26/2022]
Abstract
A broad targeted screening method based on broadband collision-induced dissociation (bbCID) ultra-performance liquid chromatography high-resolution time-of-flight mass spectrometry (UPLC-HR-TOF-MS) was developed and evaluated for toxicological screening of whole blood samples. The acidic, neutral and basic substances covered by the method were identified in postmortem and antemortem whole blood samples from forensic autopsy cases, clinical forensic cases and driving under the influence of drugs (DUID) cases by a reverse target database search. The screening method covered 467 substances. Validation was performed on spiked whole blood samples and authentic postmortem and antemortem whole blood samples. For most of the basic drugs, the established cut-off limits were very low, ranging from 0.25ng/g to 50ng/g. The established cut-off limits for most neutral and acidic drugs, were in the range from 50ng/g to 500ng/g. Sample preparation was performed using simple protein precipitation of 300μL of whole blood with acetonitrile and methanol. Ten microliters of the reconstituted extract were injected and separated within a 13.5min UPLC gradient reverse-phase run. Positive electrospray ionization (ESI) was used to generate the ions in the m/z range of 50-1000. Fragment ions were generated by bbCID. Identification was based on retention time, accurate mass, fragment ion(s) and isotopic pattern. A very sensitive broad toxicological screening method using positive electrospray ionization UPLC-HR-TOF-MS was achieved in one injection. This method covered basic substances, substances traditionally analyzed in negative ESI (e.g., salicylic acid), small highly polar substances such as beta- and gamma-hydroxybutyric acid (BHB and GHB, respectively) and highly non-polar substances such as amiodarone. The new method was shown to combine high sensitivity with a very broad scope that has not previously been reported in toxicological whole blood screening when using only one injection.
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Affiliation(s)
- Rasmus Telving
- Section for Forensic Chemistry, Department of Forensic Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark
| | - Jørgen Bo Hasselstrøm
- Section for Forensic Chemistry, Department of Forensic Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark
| | - Mette Findal Andreasen
- Section for Forensic Chemistry, Department of Forensic Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark.
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Helfer AG, Michely JA, Weber AA, Meyer MR, Maurer HH. LC-HR-MS/MS standard urine screening approach: Pros and cons of automated on-line extraction by turbulent flow chromatography versus dilute-and-shoot and comparison with established urine precipitation. J Chromatogr B Analyt Technol Biomed Life Sci 2016; 1043:138-149. [PMID: 27381570 DOI: 10.1016/j.jchromb.2016.06.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 05/31/2016] [Accepted: 06/20/2016] [Indexed: 11/19/2022]
Abstract
Comprehensive urine screening for drugs and metabolites by LC-HR-MS/MS using Orbitrap technology has been described with precipitation as simple workup. In order to fasten, automate, and/or simplify the workup, on-line extraction by turbulent flow chromatography and a dilute-and-shoot approach were developed and compared. After chromatographic separation within 10min, the Q-Exactive mass spectrometer was run in full scan mode with positive/negative switching and subsequent data dependent acquisition mode. The workup approaches were validated concerning selectivity, recovery, matrix effects, process efficiency, and limits of identification and detection for typical drug representatives and metabolites. The total workup time for on-line extraction was 6min, for the dilution approach 3min. For comparison, the established urine precipitation and evaporation lasted 10min. The validation results were acceptable. The limits for on-line extraction were comparable with those described for precipitation, but lower than for dilution. Thanks to the high sensitivity of the LC-HR-MS/MS system, all three workup approaches were sufficient for comprehensive urine screening and allowed fast, reliable, and reproducible detection of cardiovascular drugs, drugs of abuse, and other CNS acting drugs after common doses.
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Affiliation(s)
- Andreas G Helfer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg (Saar), Germany
| | - Julian A Michely
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg (Saar), Germany
| | - Armin A Weber
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg (Saar), Germany
| | - Markus R Meyer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg (Saar), Germany
| | - Hans H Maurer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg (Saar), Germany.
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Krasowski MD, Savage J, Ehlers A, Maakestad J, Schmidt GA, La'ulu S, Rasmussen NN, Strathmann FG, Genzen JR. Ordering of the Serum Angiotensin-Converting Enzyme Test in Patients Receiving Angiotensin-Converting Enzyme Inhibitor Therapy: An Avoidable but Common Error. Chest 2016. [PMID: 26225637 DOI: 10.1378/chest.15-1061] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Serum angiotensin-converting enzyme (ACE) levels may be decreased by use of ACE inhibitor (ACEI) medication. In this study, we determined how often ACE levels were measured in patients receiving ACEI therapy. METHODS ACE levels analyzed over a 54-month preintervention time period at an academic medical center were reviewed retrospectively for tests performed during ACEI therapy. These data were compared with a large, deidentified dataset of ACE levels measured at a national reference laboratory; in vitro studies of ACEI inhibition; and liquid chromatography time-of-flight mass spectrometry detection of lisinopril in a subset of clinical specimens. RESULTS Over a 54-month period, 1,292 patients had ACE levels measured, with 108 patients (8.4%) receiving ACEI therapy at the time of testing. ACE levels measured for patients receiving ACEI therapy were substantially lower. In general, clinical teams did not recognize a medication effect on ACE levels. Introduction of a warning prompt in the electronic health record reduced the ordering of ACE levels in patients receiving ACEIs by > 60% in a 17-month postintervention time period. The deidentified dataset of ACE levels at a reference laboratory showed a bimodal distribution, with a peak of very low ACE levels. Using liquid chromatography time-of-flight mass spectrometry, the presence of lisinopril was confirmed in a subset of specimens with low ACE activity. In vitro studies of two different ACE assays showed significant inhibition of activity at clinically relevant concentrations. CONCLUSIONS Assessment of ACE activity is often measured for patients receiving ACEIs, potentially leading to low ACE concentrations and inaccurate interpretations.
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Affiliation(s)
- Matthew D Krasowski
- Department of Pathology and the Department of Internal Medicine, University of Iowa, Iowa City, IA.
| | - Johanna Savage
- Department of Pathology and the Department of Internal Medicine, University of Iowa, Iowa City, IA
| | - Alexandra Ehlers
- Department of Pathology and the Department of Internal Medicine, University of Iowa, Iowa City, IA
| | - Jon Maakestad
- Department of Pathology and the Department of Internal Medicine, University of Iowa, Iowa City, IA
| | - Gregory A Schmidt
- Department of Pathology and the Department of Internal Medicine, University of Iowa, Iowa City, IA
| | - Sonia La'ulu
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT
| | | | - Frederick G Strathmann
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT; Department of Pathology, University of Utah, Salt Lake City, UT
| | - Jonathan R Genzen
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT; Department of Pathology, University of Utah, Salt Lake City, UT
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Fletcher CM, Sleeman R. Rapid identification of seized controlled substances and related compounds by tandem mass spectrometry without chromatography. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2016; 30:908-916. [PMID: 26969933 DOI: 10.1002/rcm.7514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/29/2015] [Accepted: 01/19/2016] [Indexed: 06/05/2023]
Abstract
RATIONALE This study demonstrates the capability of using tandem mass spectrometry (MS/MS) for the identification of substances of abuse and related compounds without the need for chromatography. The elimination of chromatography is not only cost-effective because of reduced sample work-up and consumables, but also reduces the environmental impact of solvents. METHODS Two chromatography-free techniques were used to screen for a large suite of compounds using a rapid, inexpensive technique: a thermal desorber coupled to a tandem mass spectrometer operated in selected reaction monitoring (SRM) mode. First, questioned materials in solution were introduced via an autosampler; and secondly, the materials were introduced directly by means of disposable toothpicks. The results were compared with those obtained by gas chromatography/mass spectrometry (GC/MS). RESULTS MS/MS was shown to be capable of the identification of the same drugs within the samples as the conventional method of GC/MS, but with better sensitivity and shorter analysis times. Presented herein is an automated screening method based on an algorithm containing more than 60 precursor ion/product ion 'transitions' (i.e. 30+ compounds simultaneously; two precursor/product ion transitions per analyte), requiring less than 2 min for identification using an autosampler or instantaneously by means of manual sample introduction. Therefore, by eliminating chromatography, a higher laboratory throughput is achievable with simplified sample preparation. CONCLUSIONS An inexpensive, rapid and reliable method was successfully developed for the identification of controlled substances within unknown matrices using MS/MS without any chromatographic separation. This technique could be further validated with reference to an increasing database of MS/MS spectra to help to identify an expanding suite of compounds. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Carl M Fletcher
- Physical Sciences, University of Kent at Canterbury, Canterbury, Kent, CT2 7NZ, UK
| | - Richard Sleeman
- Mass Spec Analytical Ltd, Building 20F, Golf Course Lane, Filton, Bristol, BS34 7RP, UK
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Marin SJ, Doyle K, Chang A, Concheiro-Guisan M, Huestis MA, Johnson-Davis KL. One Hundred False-Positive Amphetamine Specimens Characterized by Liquid Chromatography Time-of-Flight Mass Spectrometry. J Anal Toxicol 2015; 40:37-42. [PMID: 26342055 DOI: 10.1093/jat/bkv101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Some amphetamine (AMP) and ecstacy (MDMA) urine immunoassay (IA) kits are prone to false-positive results due to poor specificity of the antibody. We employed two techniques, high-resolution mass spectrometry (HRMS) and an in silico structure search, to identify compounds likely to cause false-positive results. Hundred false-positive IA specimens for AMP and/or MDMA were analyzed by an Agilent 6230 time-of-flight (TOF) mass spectrometer. Separately, SciFinder (Chemical Abstracts) was used as an in silico structure search to generate a library of compounds that are known to cross-react with AMP/MDMA IAs. Chemical formulas and exact masses of 145 structures were then compared against masses identified by TOF. Compounds known to have cross-reactivity with the IAs were identified in the structure-based search. The chemical formulas and exact masses of 145 structures (of 20 chemical formulas) were compared against masses identified by TOF. Urine analysis by HRMS correlates accurate mass with chemical formulae, but provides little information regarding compound structure. Structural data of targeted antigens can be utilized to correlate HRMS-derived chemical formulas with structural analogs.
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Affiliation(s)
- Stephanie J Marin
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108-1221, USA
| | - Kelly Doyle
- ARUP Laboratories, Inc., 500 Chipeta Way, Salt Lake City, UT 84108-1221, USA Department of Pathology, University of Utah Health Science Center, Salt Lake City, UT, USA
| | | | - Marta Concheiro-Guisan
- National Institute on Drug Abuse, Baltimore, MD, USA Department of Sciences, City University of New York, John Jay College, New York, NY, USA
| | | | - Kamisha L Johnson-Davis
- ARUP Laboratories, Inc., 500 Chipeta Way, Salt Lake City, UT 84108-1221, USA Department of Pathology, University of Utah Health Science Center, Salt Lake City, UT, USA
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Helfer AG, Michely JA, Weber AA, Meyer MR, Maurer HH. Orbitrap technology for comprehensive metabolite-based liquid chromatographic–high resolution-tandem mass spectrometric urine drug screening – Exemplified for cardiovascular drugs. Anal Chim Acta 2015; 891:221-33. [DOI: 10.1016/j.aca.2015.08.018] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 07/20/2015] [Accepted: 08/08/2015] [Indexed: 10/23/2022]
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Eckart K, Röhrich J, Breitmeier D, Ferner M, Laufenberg-Feldmann R, Urban R. Development of a new multi-analyte assay for the simultaneous detection of opioids in serum and other body fluids using liquid chromatography–tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 1001:1-8. [DOI: 10.1016/j.jchromb.2015.06.028] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 06/24/2015] [Accepted: 06/28/2015] [Indexed: 10/23/2022]
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Woźniakiewicz A, Wietecha-Posłuszny R, Woźniakiewicz M, Nowak J, Kościelniak P. Development of the MAE/UHPLC-MS-TOF method for determination of benzodiazepines in human bio-fluids for toxicological analysis. J Pharm Biomed Anal 2015; 108:97-101. [DOI: 10.1016/j.jpba.2015.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 02/03/2015] [Accepted: 02/05/2015] [Indexed: 11/28/2022]
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McMillin GA, Marin SJ, Johnson-Davis KL, Lawlor BG, Strathmann FG. A hybrid approach to urine drug testing using high-resolution mass spectrometry and select immunoassays. Am J Clin Pathol 2015; 143:234-40. [PMID: 25596249 DOI: 10.1309/ajcpmjkbc6vja1sp] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES The major objective of this research was to propose a simplified approach for the evaluation of medication adherence in chronic pain management patients, using liquid chromatography time-of-flight (TOF) mass spectrometry, performed in parallel with select homogeneous enzyme immunoassays (HEIAs). We called it a "hybrid" approach to urine drug testing. METHODS The hybrid approach was defined based on anticipated positivity rates, availability of commercial reagents for HEIAs, and assay performance, particularly analytical sensitivity and specificity for drug(s) of interest. Subsequent to implementation of the hybrid approach, time to result was compared with that observed with other urine drug testing approaches. RESULTS Opioids, benzodiazepines, zolpidem, amphetamine-like stimulants, and methylphenidate metabolite were detected by TOF mass spectrometry to maximize specificity and sensitivity of these 37 drug analytes. Barbiturates, cannabinoid metabolite, carisoprodol, cocaine metabolite, ethyl glucuronide, methadone, phencyclidine, propoxyphene, and tramadol were detected by HEIAs that performed adequately and/or for which positivity rates were very low. Time to result was significantly reduced compared with the traditional approach. CONCLUSIONS The hybrid approach to urine drug testing provides a simplified and analytically specific testing process that minimizes the need for secondary confirmation.
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Affiliation(s)
- Gwendolyn A. McMillin
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT
| | - Stephanie J. Marin
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT
| | - Kamisha L. Johnson-Davis
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT
| | | | - Frederick G. Strathmann
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT
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Marin SJ, Sawyer JC, He X, Johnson-Davis KL. Comparison of Drug Detection by Three Quadrupole Time-of-Flight Mass Spectrometry Platforms. J Anal Toxicol 2014; 39:89-95. [DOI: 10.1093/jat/bku134] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Roemmelt AT, Steuer AE, Poetzsch M, Kraemer T. Liquid chromatography, in combination with a quadrupole time-of-flight instrument (LC QTOF), with sequential window acquisition of all theoretical fragment-ion spectra (SWATH) acquisition: systematic studies on its use for screenings in clinical and forensic toxicology and comparison with information-dependent acquisition (IDA). Anal Chem 2014; 86:11742-9. [PMID: 25329363 DOI: 10.1021/ac503144p] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Forensic and clinical toxicological screening procedures are employing liquid chromatography-tandem mass spectrometry (LC-MS/MS) techniques with information-dependent acquisition (IDA) approaches more and more often. It is known that the complexity of a sample and the IDA settings might prevent important compounds from being triggered. Therefore, data-independent acquisition (DIA) methods should be more suitable for systematic toxicological analysis (STA). The DIA method sequential window acquisition of all theoretical fragment-ion spectra (SWATH), which uses Q1 windows of 20-35 Da for data-independent fragmentation, was systematically investigated for its suitability for STA. Quality of SWATH-generated mass spectra were evaluated with regard to mass error, relative abundance of the fragments, and library hits. With the Q1 window set to 20-25 Da, several precursors pass Q1 at the same time and are fragmented, thus impairing the library search algorithms to a different extent: forward fit was less affected than reverse fit and purity fit. Mass error was not affected. The relative abundance of the fragments was concentration dependent for some analytes and was influenced by cofragmentation, especially of deuterated analogues. Also, the detection rate of IDA compared to SWATH was investigated in a forced coelution experiment (up to 20 analytes coeluting). Even using several different IDA settings, it was observed that IDA failed to trigger relevant compounds. Screening results of 382 authentic forensic cases revealed that SWATH's detection rate was superior to IDA, which failed to trigger ∼10% of the analytes.
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Affiliation(s)
- Andreas T Roemmelt
- Department of Forensic Pharmacology & Toxicology, Zurich Institute of Forensic Medicine, University of Zurich , Zurich, Switzerland
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33
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Future applications of high-resolution MS to meet the demands for pain management drug testing. Bioanalysis 2014; 6:2839-53. [DOI: 10.4155/bio.14.163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Urine specimens submitted for pain management drug testing often contain multiple psychotherapeutic drugs, in addition to opioids. Immunoassay-based screen-and-confirm approaches typically used for clinical drug testing have limited sensitivity to detect therapeutic concentrations of many drugs prescribed in pain management and do not differentiate between drugs in the same class. In addition, screening for all the various illicit and prescription drugs that may be present in the pain management population requires as many as 10–20 individual immunoassays. High-resolution MS approaches have the potential to transform the way clinical drug testing is performed for pain management.
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Yuan C, Chen D, Wang S. Drug confirmation by mass spectrometry: Identification criteria and complicating factors. Clin Chim Acta 2014; 438:119-25. [PMID: 25182671 DOI: 10.1016/j.cca.2014.08.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 08/06/2014] [Accepted: 08/19/2014] [Indexed: 11/27/2022]
Abstract
Drug confirmation by mass spectrometry coupled with chromatography is essential to toxicology, doping control, pain management, and workplace drug testing. High confidence in this technology is due to its superior specificity and sensitivity. However, there are challenges associated with drug confirmation, and proper setup and validation of these assays are important in assuring high-quality results. In this article, assay parameters required for drug confirmation are summarized based on recent scientific publications, various established guidelines, and our own practical experience. Factors affecting the result quality and correct results interpretation are critically reviewed. Several emerging technologies and their potential applications are briefly explored.
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Affiliation(s)
- Chao Yuan
- Department of Clinical Pathology, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Derrick Chen
- Department of Clinical Pathology, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Sihe Wang
- Department of Clinical Pathology, Cleveland Clinic, Cleveland, OH 44195, USA.
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Strathmann FG, Schulte S, Goerl K, Petron DJ. Blood-based biomarkers for traumatic brain injury: Evaluation of research approaches, available methods and potential utility from the clinician and clinical laboratory perspectives. Clin Biochem 2014; 47:876-88. [DOI: 10.1016/j.clinbiochem.2014.01.028] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 01/05/2014] [Accepted: 01/23/2014] [Indexed: 01/06/2023]
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36
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Detection of Neonatal Drug Exposure Using Umbilical Cord Tissue and Liquid Chromatography Time-of-Flight Mass Spectrometry. Ther Drug Monit 2014; 36:119-24. [DOI: 10.1097/ftd.0b013e3182a0d18c] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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A screening method for 30 drugs in hair using ultrahigh-performance liquid chromatography time-of-flight mass spectrometry. Ther Drug Monit 2013; 35:288-95. [PMID: 23666579 DOI: 10.1097/ftd.0b013e3182884528] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objectives of this study were to develop and to validate a qualitative screening method that met the new Society of Hair Testing (SoHT) guideline criteria for thresholds. METHODS Extraction of 20 mg hair was performed by a previously validated procedure using overnight incubation in a mixture of methanol:acetonitrile:formiate buffer pH 3 (10:10:80). Analysis was performed on an Agilent 6540 quadrupole time-of-flight mass spectrometer in combination with an Agilent 1290 Infinity ultrahigh-performance liquid chromatography system. Separation was achieved with a 12-minute linear gradient chromatography on a high-strength silica T3 column at acidic conditions. An in-house database containing 30 compounds from the groups amphetamines, opiates, opioids, cocaine, benzodiazepines, and other sedatives including 6 deuterated internal standards was built by analyzing solutions from certified standards. Data were extracted using mass accuracy of ± 10 ppm, retention time deviation of ± 0.15 minutes, and area of ≥ 30,000 counts. Identification was based on scoring of retention time, accurate mass measurement, and isotopic pattern. Validation included selectivity, repeatability of analyte area, and the scoring parameters at the proposed thresholds and a method comparison with the present liquid chromatography-mass spectrometry-mass spectrometry method using 50 authentic hair samples. A daily cutoff calibrator was used to identify positive samples. RESULTS All cutoffs could be met with imprecisions of less than 5% for most parameters and analytes. Hair from drug-free subjects did not produce any positive results and the method comparison agreed in more than 90% of the cases. CONCLUSIONS We conclude that the developed method meets the criteria of the new SoHT guidelines for screening cutoffs. Even though no thresholds have been suggested for benzodiazepines, we conclude that thresholds between 0.05 and 0.1 ng/mg should be sufficient to determine regular use of these substances.
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McMillin GA, Slawson MH, Marin SJ, Johnson-Davis KL. Demystifying Analytical Approaches for Urine Drug Testing to Evaluate Medication Adherence in Chronic Pain Management. J Pain Palliat Care Pharmacother 2013; 27:322-39. [DOI: 10.3109/15360288.2013.847889] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Tsai IL, Weng TI, Tseng YJ, Tan HKL, Sun HJ, Kuo CH. Screening and confirmation of 62 drugs of abuse and metabolites in urine by ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry. J Anal Toxicol 2013; 37:642-51. [PMID: 24084874 DOI: 10.1093/jat/bkt083] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
An ultra-high-performance liquid chromatography--quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS) method for the screening and confirmation of 62 drugs of abuse and their metabolites in urine was developed in this study. The most commonly abused drugs, including amphetamines, opioids, cocaine, benzodiazepines (BZDs) and barbiturates, and many other new and emerging abused drugs, were selected as the analytes for this study. Urine samples were diluted 5-fold with deionized water before analysis. Using a superficially porous micro-particulate column and an acetic acid-based mobile phase, 54 basic and 8 acidic analytes could be detected within 15 and 12 min in positive and negative ionization modes, respectively. The MS collision energies for the 62 analytes were optimized, and their respective fragmentation patterns were constructed in the in-house library for confirmatory analysis. The coefficients of variation of the intra- and inter-day precision of the analyte responses all were <17.39%. All analytes, except barbital, showed matrix effects of 77-121%. The limits of detection of the 62 analytes were between 2.8 and 187.5 ng/mL, which were lower than their respective cut-off concentrations (20-500 ng/mL). Ten urine samples from patients undergoing methadone treatment were analyzed by the developed UHPLC-QTOF-MS method, and the results were compared with the immunoassay method.
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Affiliation(s)
- I-Lin Tsai
- 1School of Pharmacy, College of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei 100, Taiwan
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Chittamma A, Marin SJ, Williams JA, Clark C, McMillin GA. Detection of In Utero Marijuana Exposure by GC-MS, Ultra-Sensitive ELISA and LC-TOF-MS Using Umbilical Cord Tissue. J Anal Toxicol 2013; 37:391-4. [DOI: 10.1093/jat/bkt052] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Roman M, Ström L, Tell H, Josefsson M. Liquid chromatography/time-of-flight mass spectrometry analysis of postmortem blood samples for targeted toxicological screening. Anal Bioanal Chem 2013; 405:4107-25. [DOI: 10.1007/s00216-013-6798-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 01/26/2013] [Accepted: 01/28/2013] [Indexed: 10/27/2022]
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