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Jin S, Pang W, Zhao L, Zhao Z, Mei S. Review of HPLC-MS methods for the analysis of nicotine and its active metabolite cotinine in various biological matrices. Biomed Chromatogr 2022; 36:e5351. [PMID: 35106788 DOI: 10.1002/bmc.5351] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 11/23/2021] [Accepted: 12/20/2021] [Indexed: 11/11/2022]
Abstract
In recent years, tobacco smoking is a risk factor for a series of diseases including cardiovascular diseases, cerebrovascular diseases, and cancers. Nicotine, the primary component of tobacco smoke, is mainly transformed to its active metabolite cotinine, which is often used as biomarker for tobacco exposure for its higher blood concentration and longer residence time than nicotine. Various analytical methods have been developed for the determination of nicotine and cotinine in biological matrices. This article reviewed the HPLC-MS based methods for nicotine and/or cotinine analysis in various biological matrices. The sample preparation, mass and chromatographic conditions and method validation results of these methods have been summarized and analyzed. Sample was mainly pretreated by protein precipitation and/or extraction. Separation was achieved using methanol and/or acetonitrile:water (with or without ammonium acetate) on C18 columns, and acetonitrile:water (with formic acid, ammonium acetate/formate) on HILIC columns. Nicotine-d3, nicotine-d4 and cotinine-d3 were commonly used internal standards. Other non-deuterated IS were also used such as ritonavir, N-ethylnorcotinine, and milrinone. For both nicotine and cotinine, the calibration range was 0.005-35000 ng/mL, the matrix effect was 75.96% - 126.8% and the recovery was 53% - 124.5%. The two analytes were stable at room temperature for 1-10 days, at -80 °C for up to 6 months, and after 3-6 freeze-thaw cycles. Comedications did not affect nicotine and cotinine analysis.
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Affiliation(s)
- Siyao Jin
- Clinical Research Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, P. R. China.,Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University, Beijing, P. R. China
| | - Wenyuan Pang
- Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University, Beijing, P. R. China.,Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Libo Zhao
- Clinical Research Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, P. R. China.,Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University, Beijing, P. R. China
| | - Zhigang Zhao
- Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University, Beijing, P. R. China
| | - Shenghui Mei
- Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University, Beijing, P. R. China
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2
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Tao XY, Zhang Y, Zhou Y, Liu ZF, Feng XS. Nicotine in Complex Samples: Recent Updates on the Pretreatment and Analysis Method. Crit Rev Anal Chem 2021; 53:1209-1238. [PMID: 34955065 DOI: 10.1080/10408347.2021.2016365] [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: 08/24/2023]
Abstract
Nicotine is a significant evaluation index of tobacco and its related products' quality, but nicotine overdose can pose serious health hazards and cause addiction and dependence, thus it can be seen that it is necessary to find suitable and efficient detection methods to precisely detect nicotine in diverse samples and complex matrices. In this review, an updated summary of the latest trends in pretreatment and analytical techniques for nicotine is provided. We reviewed various sample pretreatment methods, such as solid phase extraction, solid phase microextraction, liquid phase microextraction, QuEChERS, etc., and diverse nicotine assay methods including liquid chromatography, gas chromatography, electrochemical sensors, etc., focusing on the developments since 2015. Furthermore, the recent progress in the applications and applicability of these techniques as well as our prospects for future developments are discussed.HighlightsUpdated pretreatment and analysis methods of nicotine were systematically summarized.Microextraction and automation were main development trends of nicotine pretreatment.The introduction of novel materials added luster to nicotine pretreatment.The evolutions of ion source and mass analyzer were emphasized.
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Affiliation(s)
- Xin-Yue Tao
- School of Pharmacy, China Medical University, Shenyang, China
- Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuan Zhang
- School of Pharmacy, China Medical University, Shenyang, China
| | - Yu Zhou
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhi-Fei Liu
- School of Pharmacy, China Medical University, Shenyang, China
| | - Xue-Song Feng
- School of Pharmacy, China Medical University, Shenyang, China
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3
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Scarpino M, Rosso T, Lanzo G, Lolli F, Bonizzoli M, Lazzeri C, Mannaioni G, Baronti R, Fattapposta F, Grippo A. Severe neurological nicotine intoxication by e-cigarette liquids: Systematic literature review. Acta Neurol Scand 2021; 143:121-130. [PMID: 32866996 DOI: 10.1111/ane.13338] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/27/2020] [Accepted: 08/19/2020] [Indexed: 12/20/2022]
Abstract
Electronic cigarettes are a popular, easily purchased, alternative source of nicotine that is considered safer than conventional tobacco. However, Intentional or accidental exposure to e-liquid substances, mainly nicotine, can lead to serious, potentially fatal toxicity. Emergency and critical care physicians should keep in mind acute intoxication of this poison with a biphasic toxic syndrome. We highlight its potentially fatal outcome and suggest monitoring the adverse effects of nicotine according to a multimodal protocol integrating somatosensory evoked potentials, electroencephalography and neuroimaging data with anamnestic report and toxicological and laboratory data.
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Affiliation(s)
- Maenia Scarpino
- Neurophysiopathology Unit Neuromuscolar Department AOU Careggi Florence Italy
- IRCCS Don Carlo Gnocchi Florence Italy
| | - Tiziana Rosso
- UOC Neurologia Distretto di Asolo Azienda ULSS 2 Marca Trevigiana Treviso Italia
| | - Giovanni Lanzo
- Neurophysiopathology Unit Neuromuscolar Department AOU Careggi Florence Italy
| | - Francesco Lolli
- Biomedical Science Department Mario Serio University of Florence Florence Italy
| | - Manuela Bonizzoli
- Traumatic Intensive Care Unit Neuromuscolar Department AOU Careggi Florence Italy
| | - Chiara Lazzeri
- Traumatic Intensive Care Unit Neuromuscolar Department AOU Careggi Florence Italy
| | - Guido Mannaioni
- Section of Pharmacology and Toxicology Department of Neuroscience, Psychology, Drug Research and Child Health (NEURORFARBA) University Florence Florence Italy
| | - Roberto Baronti
- Laboratory of Clinical Toxicology and Antidoping Azienda USL Toscana Centro Florence Italy
| | | | - Antonello Grippo
- Neurophysiopathology Unit Neuromuscolar Department AOU Careggi Florence Italy
- IRCCS Don Carlo Gnocchi Florence Italy
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4
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Tzortzi A, Kapetanstrataki M, Evangelopoulou V, Behrakis P. A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2248. [PMID: 32230711 PMCID: PMC7177608 DOI: 10.3390/ijerph17072248] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 12/13/2022]
Abstract
Following the recent electronic cigarette (e-cigarette) illness outbreak, the current review aimed to collect all related clinical cases for study and analysis and provide a critical synopsis of the proposed injury mechanism. Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines, e-cigarette-related clinical cases were identified via Google Scholar and PubMed databases. Additionally, references of published case reports and previous review papers were manually searched, revealing 159 publications presenting e-cigarette-related case reports and 19 reports by the Centers for Disease Control and Prevention. 238 individual cases were identified; 53% traumatic injuries due to e-cigarette explosion or self-combustion, 24% respiratory cases, and 12% poisonings. Additional cases pertained to oral, cardiovascular, immunologic, hematologic, allergic reactions, infant complications, and altered medication levels. Case reports were mainly published between 2016-2019 (78%). The oldest case, a lipoid pneumonia, was published in 2012. The current review showed that e-cigarette-related health effects extend beyond the acute lung injury syndrome, including traumatic, thermal injuries and acute intoxications. Physicians should be aware of the distinct clinical presentations and be trained to respond and treat effectively. Regulators and public health authorities should address the regulatory gap regarding electronic nicotine delivery systems (ENDS) and novel tobacco products.
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Affiliation(s)
- Anna Tzortzi
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Street, 10557 Athens, Greece; (V.E.); (P.B.)
- Institute of Public Health, The American College of Greece, 17B Ipitou Street, 10557 Athens, Greece
| | - Melpo Kapetanstrataki
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Street, 10557 Athens, Greece; (V.E.); (P.B.)
| | - Vaso Evangelopoulou
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Street, 10557 Athens, Greece; (V.E.); (P.B.)
| | - Panagiotis Behrakis
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Street, 10557 Athens, Greece; (V.E.); (P.B.)
- Institute of Public Health, The American College of Greece, 17B Ipitou Street, 10557 Athens, Greece
- Pulmonary Department, Athens Medical Center, Distomou 5-7, Marousi, 15125 Athens, Greece
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5
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A case of complex suicide due to acute nicotine intoxication caused by cigarette ingestion. Int J Legal Med 2019; 134:997-1002. [DOI: 10.1007/s00414-019-02228-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
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6
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Maessen GC, Wijnhoven AM, Neijzen RL, Paulus MC, van Heel DAM, Bomers BHA, Boersma LE, Konya B, van der Heyden MAG. Nicotine intoxication by e-cigarette liquids: a study of case reports and pathophysiology. Clin Toxicol (Phila) 2019; 58:1-8. [PMID: 31286797 DOI: 10.1080/15563650.2019.1636994] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: Electronic cigarettes (e-cigarettes), the smokeless alternative to conventional tobacco cigarettes, have become increasingly popular. E-cigarettes vaporise e-liquid, a solution of highly concentrated nicotine, propylene glycol (PG) and vegetable glycerine (VG). With the popularity of e-cigarettes, e-liquid refills have become easily accessible and several cases of intoxication due to the ingestion of e-liquid have been reported. We provide an overview of these cases, their pathophysiology and patients' characteristics.Methods: We carried out a retrospective evaluation of the scientific literature reporting on cases of liquid nicotine intoxication, using the following inclusion criteria: (1) the article is or contains a case report, (2) describes an intoxication with e-liquid, (3) the substance contains nicotine, and (4) intake is oral, intravenous or subcutaneous.Results: We found 26 case reports describing a total of 31 patients who suffered from e-liquid intoxication. All intoxications up to the age of six were reported as unintentional, whereas nearly all cases from ages 13 to 53 were due to suicide attempts. The three most prevalent symptoms of e-liquid intoxication were tachycardia, altered mental status and vomiting. Eleven cases resulted in the death of the patient. In the survivors, the highest plasma concentration of nicotine was 800 µg L-1, while the lowest concentration in the non-survivors was 1600 µg L-1.Conclusions: There is a mismatch between the generally accepted lethal oral nicotine dose of 60 mg, resulting in approximately 180 µg L-1 plasma concentration, and the 4.4- to 8.9-fold higher lethal plasma concentrations we found in cases of e-liquid intoxication. In these severe intoxications, plasma cotinine concentration does not act as a more reliable indicator of nicotine intoxication than nicotine itself. The ages of the patients display a bimodal distribution. In patients above the age of 10, intoxication results mainly from suicide attempts rather than accidental ingestion. The role of PG and VG in e-liquid intoxications is remarkably unclear. However, the similarity across nicotine and PG toxicity symptoms leads us to believe a cumulative effect cannot be excluded.
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Affiliation(s)
- Gerdinique C Maessen
- Honours Program CRU + Bachelor, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anjali M Wijnhoven
- Honours Program CRU + Bachelor, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rosalie L Neijzen
- Honours Program CRU + Bachelor, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michelle C Paulus
- Honours Program CRU + Bachelor, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Dayna A M van Heel
- Honours Program CRU + Bachelor, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bart H A Bomers
- Honours Program CRU + Bachelor, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lucie E Boersma
- Honours Program CRU + Bachelor, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Burak Konya
- Honours Program CRU + Bachelor, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marcel A G van der Heyden
- Department of Medical Physiology, Division of Heart & Lungs, University Medical Center Utrecht, Utrecht, The Netherlands
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7
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Govindarajan P, Spiller HA, Casavant MJ, Chounthirath T, Smith GA. E-Cigarette and Liquid Nicotine Exposures Among Young Children. Pediatrics 2018; 141:peds.2017-3361. [PMID: 29686144 DOI: 10.1542/peds.2017-3361] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To investigate exposures to liquid nicotine (including electronic cigarette devices and liquids) among children <6 years old in the United States and evaluate the impact of legislation requiring child-resistant packaging for liquid nicotine containers. METHODS Liquid nicotine exposure data from the National Poison Data System for January 2012 through April 2017 were analyzed. RESULTS There were 8269 liquid nicotine exposures among children <6 years old reported to US poison control centers during the study period. Most (92.5%) children were exposed through ingestion and 83.9% were children <3 years old. Among children exposed to liquid nicotine, 35.1% were treated and released from a health care facility, and 1.4% were admitted. The annual exposure rate per 100 000 children increased by 1398.2% from 0.7 in 2012 to 10.4 in 2015, and subsequently decreased by 19.8% from 2015 to 8.3 in 2016. Among states without a preexisting law requiring child-resistant packaging for liquid nicotine containers, there was a significant decrease in the mean number of exposures during the 9 months before compared with the 9 months after the federal child-resistant packaging law went into effect, averaging 4.4 (95% confidence interval: -7.1 to -1.7) fewer exposures per state after implementation of the law. CONCLUSIONS Pediatric exposures to liquid nicotine have decreased since January 2015, which may, in part, be attributable to legislation requiring child-resistant packaging and greater public awareness of risks associated with electronic cigarette products. Liquid nicotine continues to pose a serious risk for young children. Additional regulation of these products is warranted.
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Affiliation(s)
- Preethi Govindarajan
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,Rutgers New Jersey Medical School, Newark, New Jersey
| | - Henry A Spiller
- Central Ohio Poison Center, Columbus, Ohio.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; and
| | - Marcel J Casavant
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,Central Ohio Poison Center, Columbus, Ohio.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; and
| | - Thitphalak Chounthirath
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Gary A Smith
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; .,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; and.,Child Injury Prevention Alliance, Columbus, Ohio
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8
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Chun LF, Moazed F, Calfee CS, Matthay MA, Gotts JE. Pulmonary toxicity of e-cigarettes. Am J Physiol Lung Cell Mol Physiol 2017; 313:L193-L206. [PMID: 28522559 PMCID: PMC5582932 DOI: 10.1152/ajplung.00071.2017] [Citation(s) in RCA: 194] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 04/24/2017] [Accepted: 05/16/2017] [Indexed: 01/31/2023] Open
Abstract
Electronic cigarettes (e-cigarettes or e-cigs) are designed to heat and aerosolize mixtures of vegetable glycerin, propylene glycol, nicotine, and flavoring additives, thus delivering nicotine by inhalation in the absence of combustion. These devices were originally developed to facilitate smoking cessation and have been available in the United States for over a decade. Since 2010, e-cig use has expanded rapidly, especially among adolescents, despite a paucity of short- and long-term safety data. Patterns of use have shifted to include never smokers and many dual users of e-cigs and combustible tobacco products. Over the last several years, research into the potential toxicities of e-cig aerosols has grown exponentially. In the interim, regulatory policymakers across the world have struggled with how to regulate an increasingly diverse array of suppliers and products, against a backdrop of strong advocacy from users, manufacturers, and tobacco control experts. Herein we provide an updated review of the pulmonary toxicity profile of these devices, summarizing evidence from cell culture, animal models, and human subjects. We highlight the major gaps in our current understanding, emphasize the challenges confronting the scientific and regulatory communities, and identify areas that require more research in this important and rapidly evolving field.
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Affiliation(s)
- Lauren F Chun
- Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Farzad Moazed
- Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Carolyn S Calfee
- Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Michael A Matthay
- Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Jeffrey E Gotts
- Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, California
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