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Ziegler A, Sæves I, Almaas R. Differences in bile acid profiles between cholestatic diseases - Development of a high throughput assay for dried bloodspots. Clin Chim Acta 2024:119864. [PMID: 38992821 DOI: 10.1016/j.cca.2024.119864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 07/01/2024] [Accepted: 07/08/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Cholestasis causes accumulation of bile acids (BAs) and changes the circulating bile acid profile. Quantification of circulating BAs in dried bloodspots (DBS) may demonstrate obstruction of bile flow and altered bile acid metabolism in the liver. High sample throughput enables rapid screening of cholestatic diseases. MATERIALS AND METHODS Ultra high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS) was used for optimizing separation and detection of the primary unconjugated BAs cholic acid (CA) and chenodeoxycholic acid (CDCA); the secondary unconjugated BAs ursodeoxycholic acid (UDCA), hyodeoxycholic acid (HDCA) and deoxycholic acid (DCA), as well as the glycine- and taurine- conjugated variants of CA, CDCA, DCA and UDCA. Donor blood was obtained to prepare DBS calibrators and quality controls for method development and validation. RESULTS We developed a quantitative bile acid assay with a run-time of two minutes, and one-step sample preparation of 3.2 mm DBS discs. Validation results demonstrated overall good performance and was considered fit for purpose. Children with Alagille syndrome, Aagenaes syndrome and alpha-1 antitrypsin deficiency had increased BAs in DBS from newborn screening samples compared with age matched controls, and had different bile acids profiles. CONCLUSION We propose that our high throughput assay allows bile acid profiling in DBS that can be a valuable assessment tool for early screening of cholestasis in children. Assaying BAs in dried bloodspots is key for early detection of cholestasis, and provides transferability to a newborn screening setting.
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Affiliation(s)
- Anders Ziegler
- Department of Pediatric Research, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway; Department of Newborn Screening, Oslo University Hospital, Forskningsveien 2B, 0373 Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ingjerd Sæves
- Department of Newborn Screening, Oslo University Hospital, Forskningsveien 2B, 0373 Oslo, Norway
| | - Runar Almaas
- Department of Pediatric Research, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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2
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Boffel L, Van Mensel A, Pauwels J, Den Hond E, Bessems J, Van Uytfanghe K, Stove CP. Self-Sampling by Adolescents at Home: Assessment of the Feasibility to Successfully Collect Blood Microsamples by Inexperienced Individuals. AAPS J 2024; 26:75. [PMID: 38955903 DOI: 10.1208/s12248-024-00947-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/13/2024] [Indexed: 07/04/2024] Open
Abstract
Blood microsampling has increasingly attracted interest in the past decades as a more patient-centric sampling approach, offering the possibility to collect a minimal volume of blood following a finger or arm prick at home. In addition to conventional dried blood spots (DBS), many different devices allowing self-sampling of blood have become available. Obviously, the success of home-sampling can only be assured when (inexperienced) users collect samples of good quality. Therefore, the feasibility of six different microsampling devices to collect capillary blood by inexperienced adolescents at home was evaluated. Participants (n = 95) were randomly assigned to collect blood (dried or liquid) at different time points using four of six different self-sampling devices (i.e., DBS, Mitra volumetric absorptive microsampling (VAMS), Capitainer B, Tasso M20, Minicollect tube and Tasso+ serum separator tube (SST)). The quality of the samples was visually inspected and analytically determined. Moreover, the participants' satisfaction was assessed via questionnaires. Although a majority succeeded based on the visual inspection, the success rate differed largely between the different devices. In general, the lowest success rate was obtained for the Minicollect tubes, although there is an opportunity and need for improvement for the other self-sampling devices as well. Hence, this also emphasizes the importance to assess the quality of samples collected by the target population prior to study initiation. In addition, visual classification by a trained individual was confirmed based on assessment of the analytical variability between replicates. Finally, self-sampling at home was overall (very) positively received by the participants.
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Affiliation(s)
- Laura Boffel
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ottergemsesteenweg 46, Ghent, B-9000, Belgium
| | | | - Janne Pauwels
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Jos Bessems
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Katleen Van Uytfanghe
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ottergemsesteenweg 46, Ghent, B-9000, Belgium
| | - Christophe P Stove
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ottergemsesteenweg 46, Ghent, B-9000, Belgium.
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3
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Dvořák M, Kubáň P. Automated analyses of dried blood spots collected by volumetric microsampling devices. Anal Chim Acta 2024; 1310:342718. [PMID: 38811137 DOI: 10.1016/j.aca.2024.342718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Dried blood spot (DBS) sampling on cellulose cards suffers from varying blood haematocrit levels and from chromatographic effects, which have a direct impact on quantitative DBS analyses. Commercial volumetric microsampling devices were, therefore, introduced to mitigate these effects, however, these devices are not compatible with automated DBS processing systems and must be processed manually. RESULTS Capillary electrophoresis (CE) instruments use fused-silica (FS) capillaries for precise and accurate liquid handling as well as for injection, separation, and quantitative analyses of liquid samples. These inherent features of an Agilent 7100 CE instrument were employed for the automated processing (elution and homogenization) of DBSs collected by hemaPEN® volumetric devices (2.74 μL of capillary blood per spot). The hemaPEN® samples were processed directly in CE vials by consecutive transfers of 56 μL of methanol and 14 μL of deionized water through the FS capillary in a sequence of 39 DBSs with repeatability of the liquid transfers better than 1.4 %. The resulting DBS eluates were homogenized by a quick air flush through the capillary and analyzed by the same capillary and CE instrument. Creatinine was selected as a clinically relevant model analyte and its endogenous concentrations in DBSs were determined by CE with capacitively coupled contactless conductivity detection (CE-C4D) in a background electrolyte solution consisting of 50 mM acetic acid and 0.1 % (v/v) Tween 20 (pH 3.0). The overall repeatability of the automated DBS processing and CE-C4D analyses of 39 DBSs was ≤7.1 % (peak areas) and ≤0.6 % (migration times), the calibration curve was linear in the 25-500 μM range (R2 = 0.9993) and covered all endogenous blood creatinine levels, the limit of detection was 5.0 μM, and sample throughput was >12 DBSs per hour. DBS ageing for 60 days and varying blood haematocrit levels (20-70 %) did not affect creatinine quantitative results (≤6.9 % for peak areas). Inter-capillary and inter-instrument repeatability was ≤7.7 % (peak areas) and ≤3.4 % (migration times) and demonstrated an excellent transferability of the proposed analytical concept among laboratories. SIGNIFICANCE AND NOVELTY This contribution is the first-ever report on the use of a single off-the-shelf analytical instrument for fully automated analyses of DBSs collected by commercial volumetric microsampling devices and holds great promise for future unmanned quantitative DBS analyses.
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Affiliation(s)
- Miloš Dvořák
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200, Brno, Czech Republic
| | - Pavel Kubáň
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200, Brno, Czech Republic.
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4
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Couacault P, Avella D, Londoño‐Osorio S, Lorenzo AS, Gradillas A, Kärkkäinen O, Want E, Witting M. Targeted and untargeted metabolomics and lipidomics in dried blood microsampling: Recent applications and perspectives. ANALYTICAL SCIENCE ADVANCES 2024; 5:e2400002. [PMID: 38948320 PMCID: PMC11210747 DOI: 10.1002/ansa.202400002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 07/02/2024]
Abstract
Blood microsampling (BµS) offers an alternative to conventional methods that use plasma or serum for profiling human health, being minimally invasive and cost effective, especially beneficial for vulnerable populations. We present a non-systematic review that offers a synopsis of the analytical methods, applications and perspectives related to dry blood microsampling in targeted and untargeted metabolomics and lipidomics research in the years 2022 and 2023. BµS shows potential in neonatal and paediatric studies, therapeutic drug monitoring, metabolite screening, biomarker research, sports supervision, clinical disorders studies and forensic toxicology. Notably, dried blood spots and volumetric absorptive microsampling options have been more extensively studied than other volumetric technologies. Therefore, we suggest that a further investigation and application of the volumetric technologies will contribute to the use of BµS as an alternative to conventional methods. Conversely, we support the idea that harmonisation of the analytical methods when using BµS would have a positive impact on its implementation.
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Affiliation(s)
- Pauline Couacault
- Metabolomics and Proteomics CoreHelmholtz Zentrum MünchenNeuherbergGermany
| | - Dennisse Avella
- Afekta Technologies Ltd.KuopioFinland
- School of PharmacyFaculty of Health SciencesUniversity of Eastern FinlandKuopioFinland
| | - Sara Londoño‐Osorio
- Centro de Metabolómica y Bioanálisis (CEMBIO)Facultad de FarmaciaUniversidad San Pablo‐CEUCEU UniversitiesUrbanización MontepríncipeBoadilla del MonteMadridSpain
| | - Ana S. Lorenzo
- Department of MetabolismDigestion and ReproductionImperial College LondonLondonUK
| | - Ana Gradillas
- Centro de Metabolómica y Bioanálisis (CEMBIO)Facultad de FarmaciaUniversidad San Pablo‐CEUCEU UniversitiesUrbanización MontepríncipeBoadilla del MonteMadridSpain
| | - Olli Kärkkäinen
- Afekta Technologies Ltd.KuopioFinland
- School of PharmacyFaculty of Health SciencesUniversity of Eastern FinlandKuopioFinland
| | - Elizabeth Want
- Department of MetabolismDigestion and ReproductionImperial College LondonLondonUK
| | - Michael Witting
- Metabolomics and Proteomics CoreHelmholtz Zentrum MünchenNeuherbergGermany
- Chair of Analytical Food ChemistryTUM School of Life SciencesTechnical University of MunichFreising‐WeihenstephanGermany
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Meikopoulos T, Gika H, Theodoridis G, Begou O. Detection of 26 Drugs of Abuse and Metabolites in Quantitative Dried Blood Spots by Liquid Chromatography-Mass Spectrometry. Molecules 2024; 29:975. [PMID: 38474487 DOI: 10.3390/molecules29050975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/11/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
A method was developed for the determination of 26 drugs of abuse from different classes, including illicit drugs in quantitative dried blood spots (qDBSs), with the aim to provide a convenient method for drug testing by using only 10 μL of capillary blood. A satisfactory limit of quantification (LOQ) of 2.5 ng/mL for 9 of the compounds and 5 ng/mL for 17 of the compounds and a limit of detection (LOD) of 0.75 ng/mL for 9 of the compounds and 1.5 ng/mL for 17 of the compounds were achieved for all analytes. Reversed-phase liquid chromatography was applied on a C18 column coupled to MS, providing selective detections with both +ESI and -ESI modes. Extraction from the qDBS was performed using AcN-MeOH, 1:1 (v/v), with recovery ranging from 84.6% to 106%, while no significant effect of the hematocrit was observed. The studied drugs of abuse were found to be stable over five days under three different storage conditions (at ambient temperature 21 °C, at -20 °C, and at 35 °C), thus offering a highly attractive approach for drug screening by minimally invasive sampling for individuals that could find application in forensic toxicology analysis.
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Affiliation(s)
- Thomas Meikopoulos
- Laboratory of Analytical Chemistry, Department of Chemistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- BIOMIC_Auth, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
| | - Helen Gika
- BIOMIC_Auth, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
- Laboratory of Forensic Medicine & Toxicology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Georgios Theodoridis
- Laboratory of Analytical Chemistry, Department of Chemistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- BIOMIC_Auth, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
- ThetaBiomarkers, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), Balkan Center, 10th Km Thessaloniki-Thermi Rd., P.O. Box 8318, 57001 Thessaloniki, Greece
| | - Olga Begou
- BIOMIC_Auth, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
- ThetaBiomarkers, Center for Interdisciplinary Research, and Innovation (CIRI-AUTH), Balkan Center, 10th Km Thessaloniki-Thermi Rd., P.O. Box 8318, 57001 Thessaloniki, Greece
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6
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Tuma C, Schick A, Pommerening N, Braun H, Thevis M. Effects of an Individualized vs. Standardized Vitamin D Supplementation on the 25(OH)D Level in Athletes. Nutrients 2023; 15:4747. [PMID: 38004144 PMCID: PMC10675819 DOI: 10.3390/nu15224747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Vitamin D is crucial to the health and performance of athletes. Although the exact vitamin D requirements for athletes have not been established, maintaining a 25(OH)D level of at least 40 ng/mL is considered beneficial. This randomized controlled intervention study aimed to determine whether an individual loading dose formula for vitamin D supplementation is more effective than standardized supplementation and suitable enough for athletes to meet a target value of 40 ng/mL. In a 10-week supplementation study conducted during the winter months in Germany, 90 athletes with insufficient vitamin D levels (25(OH)D < 30 ng/mL) were randomly assigned to receive either a universal dose of 2000 IU/day of vitamin D or a loading dose of 4000 IU/day, followed by a maintenance dose of 1000 IU/day. The total 25(OH)D concentration was measured from dried blood spots at three time points: at baseline, at the computed date of 40 ng/mL, and after the 10-week period. Additionally, a vitamin-D-specific questionnaire was issued. On the day when 25(OH)D blood concentrations of 40 ng/mL were calculated to prevail, the individualized group had a significantly higher 25(OH)D level than the standardized group (41.1 ± 10.9 ng/mL vs. 32.5 ± 6.4 ng/mL, p < 0.001). This study demonstrated that the examined formula is suitable enough for athletes to achieve a 25(OH)D concentration of 40 ng/mL. This indicates that a personalized approach is more effective than a one-size-fits-all approach in restoring adequate vitamin D levels in athletes.
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Affiliation(s)
- Chiara Tuma
- Institute of Biochemistry/Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany (M.T.)
- German Research Centre of Elite Sports (Momentum), German Sport University Cologne, 50933 Cologne, Germany
| | - Arne Schick
- Institute of Biochemistry/Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany (M.T.)
| | - Nele Pommerening
- Institute of Biochemistry/Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany (M.T.)
| | - Hans Braun
- Institute of Biochemistry/Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany (M.T.)
- German Research Centre of Elite Sports (Momentum), German Sport University Cologne, 50933 Cologne, Germany
| | - Mario Thevis
- Institute of Biochemistry/Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany (M.T.)
- European Monitoring Center for Emerging Doping Agents, 50933 Cologne, Germany
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7
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Chhonker YS, Aldhafiri WN, Soni D, Trivedi N, Steinbronn C, Johnson C, Karita HCS, Paasche-Orlow MK, Barnabas R, Arnold SL, Murry DJ. Simultaneous LC-MS/MS method for the quantitation of Azithromycin, Hydroxychloroquine and its metabolites in SARS-CoV-2(-/ +) populations using dried blood spots. Sci Rep 2023; 13:16428. [PMID: 37777555 PMCID: PMC10542348 DOI: 10.1038/s41598-023-43185-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 09/20/2023] [Indexed: 10/02/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to a global pandemic of coronavirus disease 2019 (COVID-19). Early in the pandemic, efforts were made to test the SARS-CoV-2 antiviral efficacy of repurposed medications that were already approved and available for other indications, including hydroxychloroquine (HCQ) and azithromycin (AZI). To reduce the risk of SARS-CoV-2 exposure for clinical-trial study participants and to conform with lockdowns and social distancing guidelines, biospecimen collection for HCQ and AZI included at-home dried blood spot (DBS) collection rather than standard venipuncture by trained clinicians. In this study, we developed and validated the first sensitive and selective simultaneous LC-MS/MS method to accurately quantitate the concentration of HCQ, HCQ metabolites (Desethylchloroquine [DCQ], Bisdesethylchloroquine [BDCQ], Monodesethylhydroxychloroquine [DHCQ]) and AZI extracted from DBS. The validated method was successfully applied for the quantification of over 2000 DBS specimens to evaluate the pharmacokinetic profile of AZI, HQC, and its metabolites. This new method has a small sample volume requirement (~ 10 µL), results in high sensitivity (1 ng/mL), and would facilitate remotely conducted therapeutic drug monitoring.
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Affiliation(s)
- Yashpal S Chhonker
- Clinical Pharmacology Laboratory, Department of Pharmacy Practice and Science, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, 68198-6025, USA.
| | - Wafaa N Aldhafiri
- Clinical Pharmacology Laboratory, Department of Pharmacy Practice and Science, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, 68198-6025, USA
| | - Dhruvkumar Soni
- Clinical Pharmacology Laboratory, Department of Pharmacy Practice and Science, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, 68198-6025, USA
| | - Neerja Trivedi
- Clinical Pharmacology Laboratory, Department of Pharmacy Practice and Science, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, 68198-6025, USA
| | - Claire Steinbronn
- Department of Pharmaceutics, University of Washington, Seattle, WA, 98195, USA
| | - Christine Johnson
- Department of Medicine, University of Washington, Seattle, WA, 98195, USA
| | | | | | - Ruanne Barnabas
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Samuel L Arnold
- Department of Pharmaceutics, University of Washington, Seattle, WA, 98195, USA
- Department of Medicine, University of Washington, Seattle, WA, 98195, USA
| | - Daryl J Murry
- Clinical Pharmacology Laboratory, Department of Pharmacy Practice and Science, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, 68198-6025, USA.
- Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
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8
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Johannsen C, Mrsa A, Halvorsen TG, Reubsaet L. Smart sampling as the "Spot-on" Method for LC-MS protein analysis from dried blood spots. J Sep Sci 2023; 46:e2300394. [PMID: 37582644 DOI: 10.1002/jssc.202300394] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/17/2023]
Abstract
This perspective explores the feasibility of smart sampling with dried blood spots for the determination of proteins and peptides from human biomatrices using liquid chromatography coupled to mass spectrometry for clinical purposes. The focus is on innovative approaches to transform filter paper from a mere sample carrier to an active element in sample preparation, with the aim of reducing the need for extensive and intensive sample preparation in the conventional sense. Specifically, we discuss the use of modified cellulose to integrate sample preparation at an early stage of sample handling. The use of paper immobilized with either trypsin or monoclonal antibodies for protein digestion and affinity clean-up is discussed as a potential benefit of starting sample preparation instantly at the moment of sampling to optimize time efficiency and enable faster analysis, diagnosis, and follow-up of patients.
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Affiliation(s)
- Christina Johannsen
- Section of Pharmaceutical Chemistry, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Ago Mrsa
- Section of Pharmaceutical Chemistry, Department of Pharmacy, University of Oslo, Oslo, Norway
| | | | - Léon Reubsaet
- Section of Pharmaceutical Chemistry, Department of Pharmacy, University of Oslo, Oslo, Norway
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9
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Lee KC, Wan KX, Barricklow J, Lim CN, Clarke S, Potts D, Holmes K, Gonzalez P, Kavetska O. Using Mitra sampling to support first-in-human pharmacokinetic evaluations for PF-07059013. Bioanalysis 2023; 15:1083-1094. [PMID: 37584365 DOI: 10.4155/bio-2023-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
Aim: A sensitive and selective method for the determination of PF-07059013 in dried blood collected by Mitra™ tips was developed and qualified from 50 to 50,000 ng/ml. Materials & methods: PF-07059013 is isolated from 10 μl of human dried blood by extraction with methanol and analyzed by HPLC-MS/MS. Results & conclusions: In addition to routine validation elements, impact of hematocrit and Mitra tip's lot-to-lot variation on assay accuracy were evaluated. The qualified method was used in one clinical study with excellent performance. Correlation coefficient between blood concentrations obtained from liquid-incurred blood samples and dried-incurred blood samples is 0.95. Clinical Trial Registration: NCT04323124 (ClinicalTrials.gov).
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Affiliation(s)
| | | | | | | | - Stephen Clarke
- York Bioanalytical Solutions, Upper Poppleton, York, YO26 6QR, UK
| | - Daniel Potts
- York Bioanalytical Solutions, Upper Poppleton, York, YO26 6QR, UK
| | - Kevin Holmes
- York Bioanalytical Solutions, Upper Poppleton, York, YO26 6QR, UK
| | - Pilar Gonzalez
- York Bioanalytical Solutions, Upper Poppleton, York, YO26 6QR, UK
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10
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Daousani C, Karalis V, Loukas YL, Schulpis KH, Alexiou K, Dotsikas Y. Dried Blood Spots in Neonatal Studies: A Computational Analysis for the Role of the Hematocrit Effect. Pharmaceuticals (Basel) 2023; 16:1126. [PMID: 37631041 PMCID: PMC10459320 DOI: 10.3390/ph16081126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/29/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Dried blood spot (DBS) microsampling is extensively employed in newborn screening (NBS) and neonatal studies. However, the impact of variable neonatal hematocrit (Ht) values on the results can be a source of analytical error, and the use of fixed Ht for calibration (Htcal) is not representative of all neonatal subpopulations. A computational approach based on neonatal demographics was developed and implemented in R® language to propose a strategy using correction factors to address the Ht effect in neonatal DBS partial-spot assays. A rational "tolerance level" was proposed for the Ht effect contribution to the total analytical error and a safe Ht range for neonatal samples, where the correction of concentrations can be omitted. Furthermore, an "alert zone" for a false positive or negative result in NBS was proposed, where the Ht effect has to be considered. Results point toward the use of Htcal values closely representative of populations under analysis and an acceptable level of percentage relative error can be attributed to the Ht effect, diminishing the probability of correction. Overall, the impact of the Ht effect on neonatal studies is important and future work may further investigate this parameter, correlated to other clinical variables potentially affecting results.
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Affiliation(s)
- Chrysa Daousani
- Laboratory of Pharmaceutical Analysis, Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis, 157 84 Athens, Greece
| | - Vangelis Karalis
- Laboratory of Biopharmaceutics-Pharmacokinetics, Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis, 157 84 Athens, Greece
| | - Yannis L. Loukas
- Laboratory of Pharmaceutical Analysis, Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis, 157 84 Athens, Greece
| | | | | | - Yannis Dotsikas
- Laboratory of Pharmaceutical Analysis, Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis, 157 84 Athens, Greece
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11
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Dvořák M, Moravčík O, Kubáň P. Capillary Electrophoresis with Interchangeable Cartridges for Versatile and Automated Analyses of Dried Blood Spot Samples. Anal Chem 2023; 95:11823-11830. [PMID: 37505089 PMCID: PMC10413327 DOI: 10.1021/acs.analchem.3c02474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023]
Abstract
A novel concept for highly versatile automated analyses of dried blood spot (DBS) samples by commercial capillary electrophoresis (CE) is presented. Two interchangeable CE cartridges with different fused-silica capillaries were used for the DBS elutions and the DBS eluate analyses, respectively. The application of one CE cartridge with a wide-bore capillary reduced DBS processing times to a minimum (1-2 min per sample) while fitting the other CE cartridge with a narrow-bore capillary served for highly efficient CE analyses. A comprehensive investigation of major variables affecting liquid handling in CE (capillary length, internal diameter, and temperature) was carried out with the aim of optimizing both procedures and enabling their maximum flexibility. The application of two CE cartridges also enabled the employment of CE detectors with different instrumental set-ups and/or principles as was demonstrated by the optical detection of nonsteroidal anti-inflammatory drugs (NSAIDs) and the conductivity detection of amino acids (AAs). The presented methods were optimized for the automated CE analyses of 36 DBS samples formed by a volumetric collection of 5 μL of capillary blood onto Whatman 903 discs and processed by direct in-vial elution using the CE instrument. The precision of liquid transfers for the automated DBS elutions was better than 0.9% and the precision of CE analyses did not exceed 5.1 and 12.3% for the determination of NSAIDs and AAs, respectively. Both methods were linear (R2 ≥ 0.996) over the therapeutic (NSAIDs) and the endogenous (AAs) concentration ranges, had limits of quantification below the typical analyte concentrations in human blood, and achieved sample throughputs of more than 6 DBSs per hour.
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Affiliation(s)
- Miloš Dvořák
- Institute
of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200 Brno, Czech Republic
| | - Ondrej Moravčík
- Institute
of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200 Brno, Czech Republic
- Faculty
of Science, Department of Chemistry, Masaryk
University, Kamenice
5, CZ-62500 Brno, Czech Republic
| | - Pavel Kubáň
- Institute
of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200 Brno, Czech Republic
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Moravčík O, Dvořák M, Kubáň P. Autonomous capillary electrophoresis processing and analysis of dried blood spots for high-throughput determination of uric acid. Anal Chim Acta 2023; 1267:341390. [PMID: 37257961 DOI: 10.1016/j.aca.2023.341390] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/28/2023] [Accepted: 05/16/2023] [Indexed: 06/02/2023]
Abstract
A new set-up for fully autonomous and high-throughput capillary electrophoresis (CE) analyses of dried blood spot (DBS) samples is presented. The DBS samples were prepared by collecting exactly 5 μL of capillary blood from a finger-prick onto a pre-punched DBS disc in a disposable plastic CE vial and by in-vial blood drying. The vials with the DBS samples were then loaded into a commercial CE instrument for a fully unmanned sample processing and analysis. A fused-silica capillary of the CE instrument was first used for the transfer of 100 μL of elution solvent to each vial, in-vial DBS elution, and in-vial eluate homogenization. The same capillary was also used for at-line injection, separation, and selective analysis of the resulting eluates. Novel CE sequences were tailor-programmed for consecutive processing and analyses of multiple DBSs, which facilitated a fully autonomous determination of uric acid with a throughput of 240 DBS samples per day (24 h). The presented analytical protocol (using 100 μm i. d./30 cm capillary; 30 mM 2-(N-morpholino)-ethanesulfonic acid, 30 mM l-histidine, and 30 μM cetyltrimethylammonium bromide background electrolyte solution; and UV detection at 292 nm) provided excellent precision at endogenous and spiked uric acid concentrations with RSD values of peak areas below 3.2%. Calibration curves were linear over the 33.3 - 1200 μM range (R2 better than 0.998), limits of detection and quantification in the original capillary blood were 10 and 33.3 μM, respectively, and were well below the uric acid clinical range (140-420 μM). The stability of uric acid in DBS samples stored at laboratory temperature for up to 2 months was also excellent demonstrating less than a 4.2% decrease in uric acid concentrations. The actual set-up might thus be highly attractive for clinical subjects and laboratories because it is minimally invasive and requires minimum intervention from laboratory staff.
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Affiliation(s)
- Ondrej Moravčík
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200, Brno, Czech Republic; Faculty of Science, Department of Chemistry, Masaryk University, Kamenice 5, CZ-62500, Brno, Czech Republic
| | - Miloš Dvořák
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200, Brno, Czech Republic
| | - Pavel Kubáň
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200, Brno, Czech Republic.
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Thangavelu MU, Wouters B, Kindt A, Reiss IKM, Hankemeier T. Blood microsampling technologies: Innovations and applications in 2022. ANALYTICAL SCIENCE ADVANCES 2023; 4:154-180. [PMID: 38716066 PMCID: PMC10989553 DOI: 10.1002/ansa.202300011] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 06/23/2024]
Abstract
With the development of highly sensitive bioanalytical techniques, the volume of samples necessary for accurate analysis has reduced. Microsampling, the process of obtaining small amounts of blood, has thus gained popularity as it offers minimal-invasiveness, reduced logistical costs and biohazard risks while simultaneously showing increased sample stability and a potential for the decentralization of the approach and at-home self-sampling. Although the benefits of microsampling have been recognised, its adoption in clinical practice has been slow. Several microsampling technologies and devices are currently available and employed in research studies for various biomedical applications. This review provides an overview of the state-of-the-art in microsampling technology with a focus on the latest developments and advancements in the field of microsampling. Research published in the year 2022, including studies (i) developing strategies for the quantitation of analytes in microsamples and (ii) bridging and comparing the interchangeability between matrices and choice of technology for a given application, is reviewed to assess the advantages, challenges and limitations of the current state of microsampling. Successful implementation of microsampling in routine clinical care requires continued efforts for standardization and harmonization. Microsampling has been shown to facilitate data-rich studies and a patient-centric approach to healthcare and is foreseen to play a central role in the future digital revolution of healthcare through continuous monitoring to improve the quality of life.
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Affiliation(s)
| | - Bert Wouters
- Metabolomics and Analytics CentreLeiden UniversityLeidenThe Netherlands
| | - Alida Kindt
- Metabolomics and Analytics CentreLeiden UniversityLeidenThe Netherlands
| | - Irwin K. M. Reiss
- Department of Neonatal and Pediatric Intensive CareDivision of NeonatologyErasmus MCRotterdamThe Netherlands
| | - Thomas Hankemeier
- Metabolomics and Analytics CentreLeiden UniversityLeidenThe Netherlands
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Meikopoulos T, Begou O, Theodoridis G, Gika H. Ceramides biomarkers determination in quantitative dried blood spots by UHPLC-MS/MS. Anal Chim Acta 2023; 1255:341131. [PMID: 37032061 DOI: 10.1016/j.aca.2023.341131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/10/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023]
Abstract
A method was developed for the analysis of four ceramide species; namely C16:0, C18:0, C24:0 and C24:1 in quantitative Dried Blood Samples (qDBS) by LC-MS/MS and validated with the aim to give prominence to an interesting application of at-home blood microsampling for health monitoring. Ceramides, being key-role metabolites implicated in regulation of diverse cellular processes have been considered as emerging biomarkers for different disease states, such as cardiovascular diseases, type 2 diabetes and others. Here, Capitainer device was utilized to provide accurate and consistent volumes of samples, ideal for accurate determinations. The method requires a 10 μL sample offering duplicate analysis by device, is quick and enables the sample collection by distance as it was proved that ceramides under study were stable at various conditions, including RT. Intra and inter-day accuracy of the determination were estimated between 87.6% - 113% and 90.6% -113%, respectively, while intra- and inter-day precision were calculated from 0.2% to 9.9% %RSD and 0.1% - 8.0% %RSD, respectively. The data acquired by ten healthy individuals indicated that circulating ceramides are at higher levels in whole blood taken from the fingertip in comparison to the reported values in plasma or serum.
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15
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Stacchini C, Botrè F, de la Torre X, Mazzarino M. Capillary blood as a complementary matrix for doping control purposes. Application to the definition of the individual longitudinal profile of IGF-1. J Pharm Biomed Anal 2023; 227:115274. [PMID: 36774791 DOI: 10.1016/j.jpba.2023.115274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 01/27/2023]
Abstract
We present a novel procedure to monitor the fluctuations of the levels of IGF-1 in capillary blood in the framework of doping control analysis. Being an endogenous hormone, direct methods are not applicable, so the most effective way to detect the intake of the exogenous hormone would be based on the longitudinal monitoring of the athlete. We have therefore followed the individual variability, in four subjects (two males and two females), of the levels of IGF-1 in capillary blood samples collected three times per day for five days, then once a week for at least two months. Analyses were performed by liquid chromatography coupled to tandem mass spectrometry following a bottom-up approach. The whole protocol, from the sample collection to the instrumental analysis, was validated according to the World Anti-Doping Agency's guidelines and ISO17025. The analytical protocol showed to be fit for purpose in terms of sensitivity (LOD 25 ng/mL and LOI 35 ng/mL), selectivity (no interferences were detected at the retention time of IGF-1 and the internal standard), and repeatability (CV<10%). The linearity was confirmed in the range of 50-1000 ng/mL (correlation coefficient R2 >0.995, with a % relative bias of the experimental concentration of the different calibrators used for the estimation of the linearity lower than 20% for the lowest level and than 15% for the other levels). Stability studies were also performed, also to establish the optimal conditions for transport and storage: samples were stable at 4 °C for up to 72 h and at -20 °C and -80 °C for up to three months. Our preliminary results indicate that, in all subjects, the levels of IGF-1 did not present significant circadian fluctuations and remained stable during the entire period of the study (2-3 months, depending on the subject). The stability over time of IGF-1 levels in capillary blood indicates the possibility of detecting the intake of the non-endogenous hormone based on a longitudinal approach, as it is modeled in the framework of the endocrinological module of the athlete biological passport.
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Affiliation(s)
- Carlotta Stacchini
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti 1, 00197 Rome, Italy; Dipartimento Chimica e Tecnologia del Farmaco "Sapienza" Università di Roma, Piazzale Aldo Moro 5, 00161 Rome, Italy
| | - Francesco Botrè
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti 1, 00197 Rome, Italy; REDs - Research and Expertise on Doping in Sport, ISSUL - Institute of Sport Sciences, University of Lausanne, Synathlon - Quartier Centre, 1015 Lausanne, Switzerland.
| | - Xavier de la Torre
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti 1, 00197 Rome, Italy
| | - Monica Mazzarino
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti 1, 00197 Rome, Italy
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Stachanow V, Neumann U, Blankenstein O, Alder-Baerens N, Bindellini D, Hindmarsh P, Ross RJ, Whitaker MJ, Melin J, Huisinga W, Michelet R, Kloft C. Model-Informed Target Morning 17α-Hydroxyprogesterone Concentrations in Dried Blood Spots for Pediatric Congenital Adrenal Hyperplasia Patients. Pharmaceuticals (Basel) 2023; 16:ph16030464. [PMID: 36986563 PMCID: PMC10051286 DOI: 10.3390/ph16030464] [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: 02/15/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Monitoring cortisol replacement therapy in congenital adrenal hyperplasia (CAH) patients is vital to avoid serious adverse events such as adrenal crises due to cortisol underexposure or metabolic consequences due to cortisol overexposure. The less invasive dried blood spot (DBS) sampling is an advantageous alternative to traditional plasma sampling, especially in pediatric patients. However, target concentrations for important disease biomarkers such as 17α-hydroxyprogesterone (17-OHP) are unknown using DBS. Therefore, a modeling and simulation framework, including a pharmacokinetic/pharmacodynamic model linking plasma cortisol concentrations to DBS 17-OHP concentrations, was used to derive a target morning DBS 17-OHP concentration range of 2-8 nmol/L in pediatric CAH patients. Since either capillary or venous DBS sampling is becoming more common in the clinics, the clinical applicability of this work was shown by demonstrating the comparability of capillary and venous cortisol and 17-OHP concentrations collected by DBS sampling, using a Bland-Altman and Passing-Bablok analysis. The derived target morning DBS 17-OHP concentration range is a first step towards providing improved therapy monitoring using DBS sampling and adjusting hydrocortisone (synthetic cortisol) dosing in children with CAH. In the future, this framework can be used to assess further research questions, e.g., target replacement ranges for the entire day.
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Affiliation(s)
- Viktoria Stachanow
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr 31, 12169 Berlin, Germany
- Graduate Research Training Program, PharMetrX, 12169 Berlin, Germany
| | - Uta Neumann
- Charité-Universitätsmedizin, Freie Universität Berlin, 13353 Berlin, Germany
| | - Oliver Blankenstein
- Charité-Universitätsmedizin, Freie Universität Berlin, 13353 Berlin, Germany
- Labor Berlin, Charité Vivantes GmbH, 13353 Berlin, Germany
| | | | - Davide Bindellini
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr 31, 12169 Berlin, Germany
- Graduate Research Training Program, PharMetrX, 12169 Berlin, Germany
| | - Peter Hindmarsh
- Developmental Endocrinology Research Group, UCL Institute of Child Health, London WC1E 6BT, UK
| | - Richard J Ross
- Department of Oncology and Metabolism, University of Sheffield, Sheffield S10 2TN, UK
| | - Martin J Whitaker
- Department of Oncology and Metabolism, University of Sheffield, Sheffield S10 2TN, UK
| | - Johanna Melin
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr 31, 12169 Berlin, Germany
- Graduate Research Training Program, PharMetrX, 12169 Berlin, Germany
| | - Wilhelm Huisinga
- Institute of Mathematics, Universität Potsdam, 14476 Potsdam, Germany
| | - Robin Michelet
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr 31, 12169 Berlin, Germany
| | - Charlotte Kloft
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr 31, 12169 Berlin, Germany
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Zanchetta M, Posocco B, Gagno S, Poetto AS, Orleni M, Canil G, Guardascione M, Puglisi F, Toffoli G. A fast and validated LC-MS/MS method to quantify lenvatinib in dried blood spot. J Pharm Biomed Anal 2023; 226:115255. [PMID: 36682207 DOI: 10.1016/j.jpba.2023.115255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 01/16/2023]
Abstract
A new LC-MS/MS method for the quantification of lenvatinib (LENVA) in venous Dried Blood Spot (DBS) samples has been presented. This method is characterized by a short run time (4 min), requires a volumetric sampling of 10 µL and extraction of the entire spot to avoid hematocrit (Hct) and spot volume effects. The quantification method was successfully validated in the range of 5.00-2000 ng/mL on two different DBS filter papers (Whatman 31 ET CHR and Whatman 903) according to European Medicines Agency (EMA) and Food and Drug Administration (FDA) guidelines, European Bioanalysis Forum (EBF), and International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT) recommendations. During the validation process, the following parameters were evaluated: recovery (≥ 77% for both filter papers), absence of matrix effect, process efficiency (close to 72% for Whatman 31 ET CHR and close to 77% for Whatman 903), Hct effect (CV ≤ 6.3% and accuracy within 96-112%), linearity (r ≥ 0.998 for Whatman 31 ET CHR and r ≥ 0.999 for Whatman 903), intra- and inter-day precision (CV ≤ 8.8%) and accuracy (92.8-108%), selectivity and sensitivity, reproducibility with incurred samples reanalysis (ISR), and stability. This method was applied to quantify venous DBS samples from patients with hepatocellular carcinoma treated with LENVA enrolled in a cross-validation study (CRO-2018-83). A good correlation between LENVA plasma concentration determined by standard procedure and the new developed DBS LENVA method (R2 ≥ 0.996) has been observed.
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Affiliation(s)
- Martina Zanchetta
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini 2, 33081 Aviano, Italy; Department of Chemical and Pharmaceutical Sciences, University of Trieste, via Licio Giorgieri 1, 34127 Trieste, Italy
| | - Bianca Posocco
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini 2, 33081 Aviano, Italy.
| | - Sara Gagno
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini 2, 33081 Aviano, Italy.
| | - Ariana Soledad Poetto
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini 2, 33081 Aviano, Italy; Doctoral School in Pharmacological Sciences, University of Padua, Lgo Meneghetti 2, 35131 Padova, Italy
| | - Marco Orleni
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini 2, 33081 Aviano, Italy; Doctoral School in Pharmacological Sciences, University of Padua, Lgo Meneghetti 2, 35131 Padova, Italy
| | - Giovanni Canil
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini 2, 33081 Aviano, Italy
| | - Michela Guardascione
- Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini 2, 33081 Aviano, Italy
| | - Fabio Puglisi
- Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini 2, 33081 Aviano, Italy; Department of Medicine (DAME), University of Udine, via Palladio 8, 33100 Udine, Italy
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini 2, 33081 Aviano, Italy
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18
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Shen G, Moua KTY, Perkins K, Johnson D, Li A, Curtin P, Gao W, McCune JS. Precision sirolimus dosing in children: The potential for model-informed dosing and novel drug monitoring. Front Pharmacol 2023; 14:1126981. [PMID: 37021042 PMCID: PMC10069443 DOI: 10.3389/fphar.2023.1126981] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/14/2023] [Indexed: 04/07/2023] Open
Abstract
The mTOR inhibitor sirolimus is prescribed to treat children with varying diseases, ranging from vascular anomalies to sporadic lymphangioleiomyomatosis to transplantation (solid organ or hematopoietic cell). Precision dosing of sirolimus using therapeutic drug monitoring (TDM) of sirolimus concentrations in whole blood drawn at the trough (before the next dose) time-point is the current standard of care. For sirolimus, trough concentrations are only modestly correlated with the area under the curve, with R 2 values ranging from 0.52 to 0.84. Thus, it should not be surprising, even with the use of sirolimus TDM, that patients treated with sirolimus have variable pharmacokinetics, toxicity, and effectiveness. Model-informed precision dosing (MIPD) will be beneficial and should be implemented. The data do not suggest dried blood spots point-of-care sampling of sirolimus concentrations for precision dosing of sirolimus. Future research on precision dosing of sirolimus should focus on pharmacogenomic and pharmacometabolomic tools to predict sirolimus pharmacokinetics and wearables for point-of-care quantitation and MIPD.
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Affiliation(s)
- Guofang Shen
- Department of Hematologic Malignancies Translational Sciences, City of Hope, and Department of Hematopoietic Cell Transplantation, City of Hope Medical Center, Duarte, CA, United States
| | - Kao Tang Ying Moua
- Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA, United States
| | - Kathryn Perkins
- Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA, United States
| | - Deron Johnson
- Clinical Informatics, City of Hope Medical Center, Duarte, CA, United States
| | - Arthur Li
- Division of Biostatistics, City of Hope, Duarte, CA, United States
| | - Peter Curtin
- Department of Hematologic Malignancies Translational Sciences, City of Hope, and Department of Hematopoietic Cell Transplantation, City of Hope Medical Center, Duarte, CA, United States
| | - Wei Gao
- Division of Engineering and Applied Science, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA, United States
| | - Jeannine S. McCune
- Department of Hematologic Malignancies Translational Sciences, City of Hope, and Department of Hematopoietic Cell Transplantation, City of Hope Medical Center, Duarte, CA, United States
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Besten-Bertholee DD, Wegner I, Touw DJ, Ter Horst PGJ. Analytical and clinical validation of an LC-MS/MS method for carbamazepine, lamotrigine and levetiracetam in dried blood spots. Eur J Hosp Pharm 2023:ejhpharm-2022-003589. [PMID: 36894298 DOI: 10.1136/ejhpharm-2022-003589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/28/2023] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVES Therapeutic drug monitoring is performed routinely in patients on anti-epileptic drugs (AEDs) for optimisation and individualisation of therapy. The dried blood spot (DBS) sampling technique is a suitable, more patient-friendly alternative for conventional venous sampling methods. However, before DBS can be used in routine care, data are needed to establish the correlation between standard plasma concentrations obtained from venous puncture and concentrations measured through DBS obtained by finger prick. This study aims to investigate the correlation between carbamazepine, lamotrigine and levetiracetam drug concentrations in venous blood and DBS samples in the same patients at the same time. METHODS Clinical validation was conducted by direct comparison of paired DBS and venous plasma samples. Method agreement was evaluated using Passing-Bablok regression analysis and Bland-Altman plots to provide insight into the relationship between the two analytically validated methods. For Bland-Altman analysis the acceptance limit required by both FDA and EMA guidelines is at least two-thirds (67%) of the paired samples within 80-120% of the mean of both methods. RESULTS Paired samples from 79 patients were studied. For all three AEDs, plasma and DBS concentrations correlated highly (r=0.90 for carbamazepine, r=0.93 for lamotrigine and r=0.93 for levetiracetam), indicating a linear relationship. For carbamazepine and lamotrigine, no proportional or constant bias was revealed. For levetiracetam, concentrations were higher in plasma samples than in DBS (slope 1.21), implying a conversion factor is needed. The acceptance limit was met for carbamazepine and levetiracetam with a value of 72% and 81%, respectively. For lamotrigine, this acceptance limit was not met with a value of 60%. CONCLUSIONS The method was successfully validated and will be used for therapeutic drug monitoring in patients using carbamazepine, lamotrigine and/or levetiracetam.
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Affiliation(s)
| | | | - Daan J Touw
- Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.,Groningen Research Institute of Pharmacy, Section Pharmaceutical Analysis, University of Groningen, Groningen, The Netherlands
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Dvořák M, Maršala R, Kubáň P. In-vial dried urine spot collection and processing for quantitative analyses. Anal Chim Acta 2023; 1254:341071. [PMID: 37005033 DOI: 10.1016/j.aca.2023.341071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023]
Abstract
Analysis of dried urine spots (DUSs) is becoming an emerging technique in clinical, toxicological, and forensic chemistry due to the fully non-invasive collection, facile transportation, and simple storage of DUS samples. Correct DUS collection and elution is of the utmost importance because inadequate DUS sampling/processing may have direct consequences on quantitative DUS analyses and these aspects were, for the first time, comprehensively investigated in this contribution. Various groups of endogenous and exogenous species were selected as model analytes and their concentrations were monitored in DUSs collected on standard cellulose-based sampling cards. Strong chromatographic effects were observed for most analytes having a crucial impact on their distribution within the DUSs during sampling. Concentrations of target analytes were up to 3.75-fold higher in the central DUS sub-punch in comparison to the liquid urine. Consequently, substantially reduced concentrations of these analytes were determined in peripheral DUS sub-punches demonstrating that sub-punching, often applied to dried material spots, is not acceptable for quantitative DUS analyses. Hence, a simple, rapid, and user-friendly procedure was suggested, which employed an in-vial collection of a known urine volume on a pre-punched sampling disc (using a low-cost micropipette designed for patient-centric clinical sampling) and in-vial processing of the whole DUS. Excellent accuracy (0.20%) and precision (0.89%) of liquid transfers were achieved by the micropipette, which was also applied to remote DUS collection by laic and expert users. The resulting DUS eluates were analysed by capillary electrophoresis (CE) for the determination of endogenous urine species. The CE results demonstrated no significant differences between the two user groups, elution efficiencies of 88-100% (in comparison to the liquid urine), and precision better than 5.5%.
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Affiliation(s)
- Miloš Dvořák
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200, Brno, Czech Republic
| | - Richard Maršala
- Faculty of Science, Department of Chemistry, Masaryk University, Kamenice 5, CZ-62500, Brno, Czech Republic
| | - Pavel Kubáň
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200, Brno, Czech Republic.
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21
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Tuma C, Thomas A, Braun H, Thevis M. Quantification of 25-hydroxyvitamin D 2 and D 3 in Mitra® devices with volumetric absorptive microsampling technology (VAMS®) by UHPLC-HRMS for regular vitamin D status monitoring. J Pharm Biomed Anal 2023; 228:115314. [PMID: 36870118 DOI: 10.1016/j.jpba.2023.115314] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023]
Abstract
The numbers of vitamin D inadequacies has reportedly increased in the general population, especially in the Northern hemisphere. However, routine measurement of 25(OH) vitamin D is usually associated with a substantial effort due to the requirement of a venous blood sample taken by medical professionals. Thus, the objective of this work is to develop and validate an easy and minimal-invasive method, using a microsampling technique for autonomous blood collections by medically untrained individuals. The assay enables a simplified monitoring of the vitamin D-status in both, risk group and normal population throughout the year. For this purpose, a simple methanol extraction without derivatization combined with a UHPLC-HRMS method was developed to quantify 25(OH)D2 and 25(OH)D3 in capillary blood. For sample collection, a 20 μl Mitra® device with VAMS® technology is used. By employing the six-fold deuterium-labelled 25(OH)D3 as internal standard, the validated assay provides accurate (<10%) and precise (<11%) results. With a LOQ of 5 ng/ml, the approach also proved sensitive enough to adequately identify potential vitamin D deficiencies (< 12 ng/ml), and proof-of-concept analyses of authentic VAMS® samples (n = 20) yielded test results in the expected blood concentration range. Implementing VAMS® sampling for vitamin D-status monitoring enables a higher frequency due to a simplified, straightforward, and time-effective sample collection. VAMS® assures accurate sample volumes because of its absorptive capacities and, thus, area bias and homogeneity issues associated with conventional DBS are avoided. Regular monitoring of 25(OH)D status throughout the year supports people in high-risk groups for vitamin D-deficiency by early identifying inadequacies and, thus, preventing adverse health consequences.
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Affiliation(s)
- Chiara Tuma
- Institute of Biochemistry/ Center of Preventive Doping Research, German Sport University Cologne, Cologne, Germany; German Research Centre of Elite Sports (momentum), German Sport University Cologne, Cologne, Germany
| | - Andreas Thomas
- Institute of Biochemistry/ Center of Preventive Doping Research, German Sport University Cologne, Cologne, Germany
| | - Hans Braun
- Institute of Biochemistry/ Center of Preventive Doping Research, German Sport University Cologne, Cologne, Germany; German Research Centre of Elite Sports (momentum), German Sport University Cologne, Cologne, Germany
| | - Mario Thevis
- Institute of Biochemistry/ Center of Preventive Doping Research, German Sport University Cologne, Cologne, Germany; European Monitoring Center for Emerging Doping Agents, Cologne, Germany.
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Deprez S, Van Uytfanghe K, Stove CP. Liquid chromatography-tandem mass spectrometry for therapeutic drug monitoring of immunosuppressants and creatinine from a single dried blood spot using the Capitainer® qDBS device. Anal Chim Acta 2023; 1242:340797. [PMID: 36657891 DOI: 10.1016/j.aca.2023.340797] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/12/2022] [Accepted: 01/02/2023] [Indexed: 01/09/2023]
Abstract
In recent years, a lot of attention has been given to a more patient-centric therapeutic drug monitoring (TDM) of immunosuppressant drugs (tacrolimus, sirolimus, everolimus and cyclosporin A) by the use of microsampling techniques. By adopting Dried Blood Spots (DBS) after a finger prick, instead of conventional venous blood draws, follow-up can (partially) be established from patients' homes. Despite the many advantages of DBS, one of the major disadvantages associated with this technique is the well described hematocrit (hct) effect. In order to overcome the hct area bias, different strategies have been proposed, amongst which the use of dried blood sampling techniques based on the volumetric collection of blood. The aim of this study was to evaluate the use of the Capitainer® qDBS (quantitative Dried Blood Spot) device for the combined TDM of four immunosuppressants and creatinine from a single qDBS. The set-up of an adequate sample preparation allowing both immunosuppressants and creatinine quantification was one of the key challenges in the method development due to device-specific interferences. Liquid chromatography tandem-mass spectrometry methods for the quantification of tacrolimus, sirolimus, everolimus, cyclosporin A and creatinine from qDBS (10 μL) were developed and validated based on international guidelines, also taking into account DBS-specific parameters. The methods proved to be accurate and reproducible, with absolute biases below 10% and within-run CVs (%) below 8% over a calibration range from 1 to 50 ng/mL for tacrolimus, sirolimus and everolimus, 20-1500 ng/mL for cyclosporin A, and 15-700 μmol/L for creatinine. Reproducible (CV < 15%) IS-compensated relative recovery values were obtained, showing no hematocrit-dependence (compared to a hct of 0.37), except for cyclosporin A at higher hct values. Application on venous blood left-over patient samples showed good agreement between the results of Capitainer® qDBS and whole blood with 98% (47/48), 93% (41/44), 89% (41/46), 88% (38/43) and 89% (116/131) of the samples lying within 20% of the whole blood result for tacrolimus, sirolimus, everolimus, cyclosporin A and plasma/serum for creatinine, respectively. For creatinine a blood/plasma ratio of 0.85 was found and used to convert qDBS results to plasma/serum results. As a next step, capillary finger prick samples will need to demonstrate the clinical applicability of the method in a real life setting.
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Affiliation(s)
- Sigrid Deprez
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium
| | - Katleen Van Uytfanghe
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium; Ref4U - Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium
| | - Christophe P Stove
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium.
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23
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Ryšavá L, Dorazilová J, Dvořák M, Sedláček P, Vojtová L, Kubáň P. Fully soluble polymeric foams for in-vial dried blood spot collection and analysis of acidic drugs by capillary electrophoresis. Anal Chim Acta 2023; 1241:340793. [PMID: 36657868 DOI: 10.1016/j.aca.2023.340793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/16/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
Polymeric foams tailor-made of polyvinylpyrrolidone (PVP) and carboxymethylcellulose/oxidized 6-carboxycellulose (CMC07/OC) composite were proposed as suitable sorbents for the collection and analysis of dried blood spots (DBSs). The PVP and CMC07/OC foams were easy to prepare, enabled collection of minute volumes of capillary blood, and blood drying at ambient temperature. The resulting foams were prepared as small porous discs with uniform dimensions (approx. 6 × 3 mm) and were fully soluble in aqueous solutions. The DBSs were formed in standard capillary electrophoresis (CE) vials fitted with the soluble foam discs and enabled the direct in-vial DBS processing and at-line analysis by CE. The DBSs were pretreated with a simple process, which involved a complete dissolution of the foam disc in an acidic solution and a simultaneous hollow fiber liquid-phase microextraction (HF-LPME) in one step. The complete solubility of the foam disc with the DBS served for a quantitative transfer of all blood components into the eluate and a nearly exhaustive HF-LPME of target analytes, whereas the blood matrix and the polymeric foam components were efficiently retained by the organic solvent impregnated in the walls of the HF. The suitability of the PVP and CMC07/OC foams for the collection and the direct analysis of DBSs was demonstrated by the HF-LPME/CE determination of model acidic drugs (warfarin, ibuprofen, naproxen, ketoprofen, and diclofenac) at therapeutically relevant concentrations. Repeatability of the analytical method was better than 8.1% (RSD), extraction recoveries ranged from 70 to 99% (for PVP foam), calibration curves were linear over two orders of magnitude (R2 higher than 0.9991), and limits of detection were less than 44 μg/L (for concentrations in undiluted capillary blood). The soluble polymeric foams exhibited non-significant variations in analyte concentrations for DBSs prepared from blood samples with different hematocrit levels and for aged DBSs (less than 9.2%), moreover, they outperformed standard DBS sampling devices in terms of sample pretreatment time and extraction recovery.
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Affiliation(s)
- Lenka Ryšavá
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200, Brno, Czech Republic; Institute of Food Science and Biotechnology, Faculty of Chemistry, Brno University of Technology, Purkyňova 118, CZ-61200, Brno, Czech Republic
| | - Jana Dorazilová
- Central European Institute of Technology, Advanced Biomaterials, Brno University of Technology, Purkyňova 656/123, CZ-612 00, Brno, Czech Republic
| | - Miloš Dvořák
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200, Brno, Czech Republic
| | - Petr Sedláček
- Institute of Physical and Applied Chemistry, Faculty of Chemistry, Brno University of Technology, Purkyňova 118, CZ-61200, Brno, Czech Republic
| | - Lucy Vojtová
- Central European Institute of Technology, Advanced Biomaterials, Brno University of Technology, Purkyňova 656/123, CZ-612 00, Brno, Czech Republic
| | - Pavel Kubáň
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200, Brno, Czech Republic.
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Deprez S, Stove CP. Dried blood microsampling-assisted therapeutic drug monitoring of immunosuppressants: An overview. J Chromatogr A 2023; 1689:463724. [PMID: 36592482 DOI: 10.1016/j.chroma.2022.463724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
In the field of solid organ transplantation, chemotherapy and autoimmune disorders, treatment with immunosuppressant drugs requires intensive follow-up of the blood concentrations via therapeutic drug monitoring (TDM) because of their narrow therapeutic window and high intra- and inter-subject variability. This requires frequent hospital visits and venepunctures to allow the determination of these analytes, putting a high burden on the patients. In the context of patient-centric thinking, it is becoming increasingly established that at least part of these conventional blood draws could be replaced by microsampling, allowing home-sampling and increasing the quality of life for these patients. In this review we discuss the published methods - mostly using liquid chromatography coupled to tandem mass spectrometry - that have utilized (volumetric) dried blood samples as an alternative for conventional liquid whole blood for the TDM of immunosuppressant drugs. Furthermore, some pre-analytical considerations using DBS or volumetric alternatives are considered, as well as the applicability on clinical samples. The implementation status in clinical practice is also discussed, including (1) the cost-effectiveness of this approach compared to venepuncture, (2) the availability of multiplexed methods, (3) the status of harmonization and (4) patient perception. A brief perspective on potential future developments for the dried blood-based TDM of immunosuppressant drugs is provided, by considering how obstacles for the implementation of these strategies into clinical practice might be overcome.
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Affiliation(s)
- Sigrid Deprez
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - Christophe P Stove
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium.
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A simple and rapid HPLC-MS/MS method for therapeutic drug monitoring of amikacin in dried matrix spots. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1220:123592. [PMID: 36890098 DOI: 10.1016/j.jchromb.2023.123592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/22/2022] [Accepted: 01/02/2023] [Indexed: 01/09/2023]
Abstract
Individualized treatment of amikacin under the guidance of therapeutic drug monitoring (TDM) is important to reduce the occurrence of toxicity and improve clinical efficacy. In the present study, we developed and validated a simple and high-throughput liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to determine the concentration of amikacin in dried matrix spots (DMS) which the matrix is serum. DMS samples were obtained by spotting volumetric blood onto Whatman 903® cards. Samples were punched into 3 mm diameter discs and extracted with 0.2 % formic acid in water. The HILIC column (2.1 mm × 100 mm, 3.0 µm) under gradient elution was applied, and the analysis time was 3 min per injection. The mass spectrometry transitions were m/z 586.3 → 163.0 for amikacin and m/z 591.4 → 163.1 for D5-amikacin. Full validation was conducted for DMS method, and the method was applied for the amikacin TDM and compared with serum method. The linearity was ranged from 0.5 to 100 mg/L. Both within-run and between-run accuracy and precision of DMS ranged from 91.8 % to 109.6 % and 3.6 % to 14.2 %, respectively. The matrix effect was 100.5 %-106.5 % of DMS method. Amikacin remained stable in DMS for at least 6 days at room temperature, 16 days at 4 °C, 86 days at -20 °C and -70 °C. A good agreement between the DMS method and serum method has been shown in Bland-Altman plots and Passing-Bablok regression. All of the results demonstrated that the DMS methods can be a favorable replacement for amikacin TDM.
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Volumetric Absorptive Microsampling to Enhance the Therapeutic Drug Monitoring of Tacrolimus and Mycophenolic Acid: A Systematic Review and Critical Assessment. Ther Drug Monit 2023:00007691-990000000-00082. [PMID: 36728554 DOI: 10.1097/ftd.0000000000001066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/23/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Volumetric absorptive microsampling (VAMS) is an emerging technique that may support multisample collection to enhance therapeutic drug monitoring in solid organ transplantation. This review aimed to assess whether tacrolimus and mycophenolic acid can be reliably assayed using VAMS and to identify knowledge gaps by providing granularity to existing analytical methods and clinical applications. METHODS A systematic literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed, Embase, and Scopus databases were accessed for records from January 2014 to April 2022 to identify scientific reports on the clinical validation of VAMS for monitoring tacrolimus and mycophenolic acid concentrations. Data on the study population, sample sources, analytical methods, and comparison results were compiled. RESULTS Data from 12 studies were collected, including 9 studies pertaining to tacrolimus and 3 studies on the concurrent analysis of tacrolimus and mycophenolic acid. An additional 14 studies that provided information relevant to the secondary objectives (analytical validation and clinical application) were also included. The results of the clinical validation studies generally met the method agreement requirements described by regulatory agencies, but in many cases, it was essential to apply correction factors. CONCLUSIONSS Current evidence suggests that the existing analytical methods that use VAMS require additional optimization steps for the analysis of tacrolimus and mycophenolic acid. The recommendations put forth in this review can help guide future studies in achieving the goal of improving the care of transplant recipients by simplifying multisample collection for the dose optimization of these drugs.
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Jain A, Morris M, Lin EZ, Khan SA, Ma X, Deziel NC, Godri Pollitt KJ, Johnson CH. Hemoglobin normalization outperforms other methods for standardizing dried blood spot metabolomics: A comparative study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 854:158716. [PMID: 36113793 DOI: 10.1016/j.scitotenv.2022.158716] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 06/15/2023]
Abstract
Dried blood spot (DBS) metabolomics has numerous applications in newborn health screening, exposomics, and biomonitoring of environmental chemicals in pregnant women and the elderly. However, accurate metabolite quantification is hindered by several challenges: notably the "hematocrit effect" and unknown blood-spotting volumes. Different techniques have been employed to overcome these issues but there is no consensus on the optimal normalization method for DBS metabolomics, and in some cases no normalization is used. We compared five normalization methods (hemoglobin (Hb), specific gravity (SG), protein, spot weight, potassium (K+)) to unnormalized data, and assessed sex-related differences in the DBS metabolome in 21 adults (group 1, n = 10 males, n = 11 females). The performance of each normalization method was evaluated using multiple criteria: (a) reduction of intragroup variation (pooled median absolute deviation, pooled estimate of variance, pooled coefficient of variation, NMDS and principal component analysis), (b) effect on differential metabolic analysis (dendrogram, heatmap, p-value distribution), and (c) influence on classification accuracy (partial least squares discriminant analysis, sparse partial least squares discriminant analysis error rates, receiver operating curve, random forest out of bag error rate). Our results revealed that Hb normalization outperformed all the other methods based on the three criteria and 13 different parameters; the performance of Hb was further demonstrated in an independent group of DBS from 18 neonates (group 2, n = 9 males, n = 9 females). Furthermore, we showed that SG and Hb are correlated in adults (rs = 0.86, p < 0.001), and validated this relationship in an independent group of 18 neonates and infants (group 3) (rs = 0.84, p < 0.001). Using the equation, SG = -0.4814Hb2 + 2.44Hb + 0.005, SG can be used as a surrogate for normalization by Hb. This is the first comparative study to concurrently evaluate multiple normalization methods for DBS metabolomics which will serve as a robust methodological platform for future environmental epidemiological studies.
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Affiliation(s)
- Abhishek Jain
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Montana Morris
- Yale University School of Medicine, New Haven, CT, United States
| | - Elizabeth Z Lin
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Sajid A Khan
- Division of Surgical Oncology, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Krystal J Godri Pollitt
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Caroline H Johnson
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States.
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28
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Krützmann ME, Martini RR, de Souza Guterres F, Kohlrausch R, Wagner SC, Mattevi VS, Torriani MS, Fogliatto LM, Linden R, Antunes MV. Volumetric dried blood microsampling for monitoring imatinib mesylate therapy: Method development and clinical application in patients with chronic myeloid leukemia. J Pharm Biomed Anal 2023; 222:115108. [DOI: 10.1016/j.jpba.2022.115108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/29/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022]
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29
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Jacobs CM, Kunz M, Mahfoud F, Wagmann L, Meyer MR. Closing the gap - development of an analytical methodology using volumetric absorptive microsampling of finger prick blood followed by LC-HRMS/MS for adherence monitoring of antihypertensive drugs. Anal Bioanal Chem 2023; 415:167-177. [PMID: 36318313 PMCID: PMC9816235 DOI: 10.1007/s00216-022-04394-9] [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: 08/24/2022] [Revised: 10/06/2022] [Accepted: 10/19/2022] [Indexed: 01/07/2023]
Abstract
Volumetric absorptive microsampling (VAMS), an emerging microsampling technique, is a promising tool for adherence monitoring. This study focused on development of an analytical methodology to improve VAMS-based strategies for adherence assessment by analyzing angiotensin-converting-enzyme (ACE) inhibitors, loop diuretics, a potassium-sparing diuretic, and a thiazide diuretic. Development included sample preparation, chromatographic conditions, mass spectrometry settings, validation, and demonstrating proof of concept. Quantification of analytes, by name furosemide, hydrochlorothiazide, lisinopril, torasemide, and the active metabolites, canrenone, enalaprilat, and ramiprilat in finger prick blood (FPB), was validated based on international guidelines. Selectivity, carryover, and within/between-run accuracy and precision were in accordance with the recommendations. The matrix effect was evaluated at three different hematocrit levels (HT: 20%, 40%, 60%) and the coefficients of variation did not exceed 15%. Dilution integrity (1:10 and 1:20) was given for all analytes except lisinopril, yet for lisinopril, the therapeutic range was already covered by the calibration range. Long-term stability in VAMS tips was tested for 2 weeks at 24 °C in the dark and revealed no degradation of analytes. The proof of concept was performed by analyzing 35 intakes of ACE-inhibitors and diuretics in 18 VAMS and matched plasma samples. Hereby, determined concentration in FPB and plasma cannot be used interchangeably, and thus specific reference ranges for whole blood must be established. Nevertheless, the VAMS-based strategy was shown to be suitable for assessing adherence of all classes of antihypertensive drugs used in the guidelines to manage hypertension.
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Affiliation(s)
- Cathy M. Jacobs
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Germany
| | - Michael Kunz
- Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Saarland University, Homburg, Germany
| | - Felix Mahfoud
- Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Saarland University, Homburg, Germany ,Institute for Medical Engineering and Science, MIT, Cambridge, MA USA
| | - Lea Wagmann
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Germany
| | - Markus R. Meyer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Germany
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30
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Øverbø J, Aziz A, Zaman K, Julin CH, Qadri F, Stene-Johansen K, Biswas R, Islam S, Bhuiyan TR, Haque W, Sandbu S, Dembinski JL, Dudman S. Stability and Feasibility of Dried Blood Spots for Hepatitis E Virus Serology in a Rural Setting. Viruses 2022; 14:v14112525. [PMID: 36423134 PMCID: PMC9692628 DOI: 10.3390/v14112525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 11/16/2022] Open
Abstract
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. In many low-income countries it causes large outbreaks and disproportionally affects pregnant women and their offspring. Surveillance studies to find effective preventive interventions are needed but are hampered by the lack of funding and infrastructure. Dried blood spots (DBS) offer an easier and more robust way to collect, transport, and store blood samples compared to plasma/serum samples, and could ease some of the barriers for such studies. In this study we optimize an HEV IgG ELISA for DBS samples and validate it on 300 paired DBS and plasma samples collected in rural areas of Bangladesh from participants in a HEV vaccine study. We demonstrate that HEV IgG in blood stored as DBS is stable for two months at up to 40 °C, and for five freeze-thaw cycles. The specificity was 97% and the overall sensitivity of the DBS assay was 81%. The sensitivity was higher in samples from vaccinated participants (100%) compared to previously infected participants (59%), reflecting a positive correlation between IgG titer and sensitivity. We found a strong correlation between DBS and plasma samples with an r2 of 0.90, but with a higher degree of difference between individual paired samples. Our study shows that DBS offers a stable alternative to plasma/serum for HEV IgG measurements and can facilitate serological studies, particularly in resource limited areas.
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Affiliation(s)
- Joakim Øverbø
- Norwegian Institute of Public Health, NO-0213 Oslo, Norway
- Department of Microbiology, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway
- Correspondence: (J.Ø.); (S.D.)
| | - Asma Aziz
- Department of Microbiology, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
- International Vaccine Institute, Seoul 08826, Republic of Korea
| | - K. Zaman
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | | | - Firdausi Qadri
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | | | - Rajib Biswas
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | - Shaumik Islam
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | | | - Warda Haque
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | - Synne Sandbu
- Norwegian Institute of Public Health, NO-0213 Oslo, Norway
| | | | - Susanne Dudman
- Department of Microbiology, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway
- Oslo University Hospital, NO-0424 Oslo, Norway
- Correspondence: (J.Ø.); (S.D.)
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31
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Francke MI, van Domburg B, Bouarfa S, van de Velde D, Hellemons ME, Manintveld OC, Last-Koopmans S, Mulder MB, Hesselink DA, de Winter BCM. The clinical validation of a dried blood spot method for simultaneous measurement of cyclosporine A, tacrolimus, creatinine, and hematocrit. Clin Chim Acta 2022; 535:131-139. [PMID: 36007582 DOI: 10.1016/j.cca.2022.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Marith I Francke
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Erasmus MC Transplant Institute, University Medical Center, Rotterdam, the Netherlands; Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Bart van Domburg
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Samah Bouarfa
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; School of Pharmacy, Utrecht University, Utrecht, the Netherlands
| | - Daan van de Velde
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Merel E Hellemons
- Erasmus MC Transplant Institute, University Medical Center, Rotterdam, the Netherlands; Department of Pulmonary Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Olivier C Manintveld
- Erasmus MC Transplant Institute, University Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Suzanne Last-Koopmans
- Department of Hematology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Midas B Mulder
- Erasmus MC Transplant Institute, University Medical Center, Rotterdam, the Netherlands; Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Dennis A Hesselink
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Erasmus MC Transplant Institute, University Medical Center, Rotterdam, the Netherlands
| | - Brenda C M de Winter
- Erasmus MC Transplant Institute, University Medical Center, Rotterdam, the Netherlands; Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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32
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Bioanalytical method validation and sample analysis for nirmatrelvir in dried blood collected using the Tasso-M20 device. Bioanalysis 2022; 14:1305-1315. [PMID: 36541270 DOI: 10.4155/bio-2022-0167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aim: A sensitive and selective method for the determination of nirmatrelvir in dried human blood collected by Tasso-M20 was developed and validated from 20.0 to 20,000 ng/ml. Materials & methods: Nirmatrelvir and its stable-labeled internal standard were isolated from approximately 20 μl of blood dried on one volumetric absorptive pad inside the Tasso-M20 device by extraction with methanol, followed by dilution of the supernatant. The extracts were analyzed by high-performance liquid chromatography coupled with tandem mass spectrometric detection. Results & conclusion: The method was fully validated. Hematocrit levels do not impact assay accuracy. Stabilities to cover sample drying and storage at a variety of conditions were conducted. The validated method was used in multiple clinical studies with excellent performance.
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33
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Simeoli R, Cairoli S, Decembrino N, Campi F, Dionisi Vici C, Corona A, Goffredo BM. Use of Antibiotics in Preterm Newborns. Antibiotics (Basel) 2022; 11:antibiotics11091142. [PMID: 36139921 PMCID: PMC9495226 DOI: 10.3390/antibiotics11091142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 11/16/2022] Open
Abstract
Due to complex maturational and physiological changes that characterize neonates and affect their response to pharmacological treatments, neonatal pharmacology is different from children and adults and deserves particular attention. Although preterms are usually considered part of the neonatal population, they have physiological and pharmacological hallmarks different from full-terms and, therefore, need specific considerations. Antibiotics are widely used among preterms. In fact, during their stay in neonatal intensive care units (NICUs), invasive procedures, including central catheters for parental nutrition and ventilators for respiratory support, are often sources of microbes and require antimicrobial treatments. Unfortunately, the majority of drugs administered to neonates are off-label due to the lack of clinical studies conducted on this special population. In fact, physiological and ethical concerns represent a huge limit in performing pharmacokinetic (PK) studies on these subjects, since they limit the number and volume of blood sampling. Therapeutic drug monitoring (TDM) is a useful tool that allows dose adjustments aiming to fit plasma concentrations within the therapeutic range and to reach specific drug target attainment. In this review of the last ten years’ literature, we performed Pubmed research aiming to summarize the PK aspects for the most used antibiotics in preterms.
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Affiliation(s)
- Raffaele Simeoli
- Division of Metabolic Diseases and Drug Biology, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy
| | - Sara Cairoli
- Division of Metabolic Diseases and Drug Biology, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy
| | - Nunzia Decembrino
- Neonatal Intensive Care Unit, University Hospital “Policlinico-San Marco” Catania, Integrated Department for Maternal and Child’s Health Protection, 95100 Catania, Italy
| | - Francesca Campi
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus-Newborn-Infant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Carlo Dionisi Vici
- Division of Metabolic Diseases and Drug Biology, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy
| | - Alberto Corona
- ICU and Accident & Emergency Department, ASST Valcamonica, 25043 Breno, Italy
| | - Bianca Maria Goffredo
- Division of Metabolic Diseases and Drug Biology, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy
- Correspondence: ; Tel.: +39-0668592174; Fax: + 39-0668593009
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Dried blood spots in clinical lipidomics: optimization and recent findings. Anal Bioanal Chem 2022; 414:7085-7101. [PMID: 35840669 DOI: 10.1007/s00216-022-04221-1] [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: 04/05/2022] [Revised: 06/15/2022] [Accepted: 07/05/2022] [Indexed: 11/01/2022]
Abstract
Dried blood spots (DBS) are being considered as an alternative sampling method of blood collection that can be used in combination with lipidomic and other omic analysis. DBS are successfully used in the clinical context to collect samples for newborn screening for the measurement of specific fatty acid derivatives, such as acylcarnitines, and lipids from whole blood for diagnostic purposes. However, DBS are scarcely used for lipidomic analysis and investigations. Lipidomic studies using DBS are starting to emerge as a powerful method for sampling and storage in clinical lipidomic analysis, but the major research work is being done in the pre- and analytical steps and procedures, and few in clinical applications. This review presents a description of the impact factors and variables that can affect DBS lipidomic analysis, such as the type of DBS card, haematocrit, homogeneity of the blood drop, matrix/chromatographic effects, and the chemical and physical properties of the analyte. Additionally, a brief overview of lipidomic studies using DBS to unveil their application in clinical scenarios is also presented, considering the studies of method development and validation and, to a less extent, for clinical diagnosis using clinical lipidomics. DBS combined with lipidomic approaches proved to be as effective as whole blood samples, achieving high levels of sensitivity and specificity during MS and MS/MS analysis, which could be a useful tool for biomarker identification. Lipidomic profiling using MS/MS platforms enables significant insights into physiological changes, which could be useful in precision medicine.
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35
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Samsonova JV, Saushkin NY, Osipov AP. Dried Blood Spots technology for veterinary applications and biological investigations: technical aspects, retrospective analysis, ongoing status and future perspectives. Vet Res Commun 2022; 46:655-698. [PMID: 35771305 PMCID: PMC9244892 DOI: 10.1007/s11259-022-09957-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/13/2022] [Indexed: 11/25/2022]
Abstract
Dried Blood Spots (DBS) technology has become a valuable tool in medical studies, however, in veterinary and biological research DBS technology applications are still limited. Up-to-date no review has comprehensively integrated all the evidence existing across the fields, technologies and animal species. In this paper we summarize the current applications of DBS technology in the mentioned areas, and provide a scope of different types of dried sample carriers (cellulose and non-cellulose), sampling devices, applicable methods for analyte extraction and detection. Mammals, birds, insects and other species are represented as the study objects. Besides the blood, the review considers a variety of specimens, such as milk, saliva, tissue samples and others. The main applications of dried samples highlighted in the review include epidemiological surveys and monitoring for infections agents or specific antibodies for disease/vaccination control in households and wildlife. Besides the genetic investigations, the paper describes detection of environmental contaminants, pregnancy diagnosis and many other useful applications of animal dried samples. The paper also analyses dried sample stability and storage conditions for antibodies, viruses and other substances. Finally, recent developments and future research for DBS technology in veterinary medicine and biological sciences are discussed.
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Affiliation(s)
- Jeanne V Samsonova
- Faculty of Chemistry, Lomonosov Moscow State University, Moscow, Russia.
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36
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Bressán IG, Giménez MI, Llesuy SF. Clinical validation of a liquid chromatography-tandem mass spectrometry method for the quantification of calcineurin and mTOR inhibitors in dried matrix on paper discs. J Mass Spectrom Adv Clin Lab 2022; 25:12-18. [PMID: 35694178 PMCID: PMC9184858 DOI: 10.1016/j.jmsacl.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 11/30/2022] Open
Abstract
The feasibility of DMPD for therapeutic monitoring of four immunosuppressive drugs was clinically validated. More than 40 paired samples per analyte (finger prick on DMPD vs whole blood collected by venipuncture) from different transplant patient types were quantified using LC-MS/MS. Errors at medical decision points and overall bias were not statistically or clinically significant. DMPD is interchangeable with whole blood obtained by venipuncture for samples collected by trained personnel.
Introduction Advances in liquid chromatography coupled to tandem mass spectrometry (LC–MS/MS) have enabled the quantification of immunosuppressants using microsampling techniques. In this context, dried matrix on paper discs (DMPD) could be a useful alternative to conventional venipuncture. Although analytical validation is necessary to establish the suitability of method performance, it is not sufficient to proceed with its implementation into routine clinical practice. Also necessary is that equivalence between sampling methods be demonstrated in a clinical validation study. Objetives To clinically validate a LC-MS/MS method for the quantification of tacrolimus, sirolimus, everolimus and cyclosporin A using DMPD. Methods According to the recommendations of international guidelines, at least 40 whole blood (WB) and DMPD paired samples for each analyte were collected by skilled technicians and analyzed using LC-MS/MS. Results were evaluated in terms of statistical agreement and bias values at medical decision points. Results For all analytes, Passing-Bablok regression analysis revealed that confidence intervals (CIs) for slopes and intercepts included 1 and 0, respectively. It also showed that biases at medical decision points were not clinically relevant. No statistically significant differences between DMPD and WB were found using difference plots and agreement analysis. In this regard, CIs for bias estimators included 0, and more than 95% of the results fell within the limits of agreement. Conclusion The feasibility of the clinical application of simultaneous quantification of tacrolimus, sirolimus, everolimus and cyclosporin A in DMPD was demonstrated. Results showed that this microsampling technique is interchangeable with conventional WB sampling when specimens are collected by trained personnel.
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Affiliation(s)
- Ignacio Guillermo Bressán
- Laboratory of Mass Spectrometry, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Department of Chemistry, Instituto Universitario Escuela de Medicina del Hospital Italiano, Buenos Aires, Argentina
- Corresponding author at: Laboratory of Mass Spectrometry, Hospital Italiano de Buenos Aires, Tte. Juan Domingo Perón 4190 (C1181ACH), Buenos Aires, Argentina.
| | - María Isabel Giménez
- Laboratory of Mass Spectrometry, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Department of Clinical Biochemistry, Instituto Universitario Escuela de Medicina del Hospital Italiano, Buenos Aires, Argentina
| | - Susana Francisca Llesuy
- Department of Chemistry, Instituto Universitario Escuela de Medicina del Hospital Italiano, Buenos Aires, Argentina
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Soenen R, Stove C, Capobianco A, De Schutter H, Dobbelaere M, Mahjor T, Follens M, Lambert J, Grine L. Promising Tools to Facilitate the Implementation of TDM of Biologics in Clinical Practice. J Clin Med 2022; 11:jcm11113011. [PMID: 35683398 PMCID: PMC9181069 DOI: 10.3390/jcm11113011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 02/04/2023] Open
Abstract
Therapeutic drug monitoring (TDM) of biologics—encompassing the measurement of (trough) concentrations and anti-drug antibodies—is emerging as a valuable tool for clinical decision making. While this strategy needs further validation, attention on its implementation into the clinic is warranted. Rapid testing and easy sampling are key to its implementation. Here, we aimed to evaluate the feasibility and volunteers’ perception of home microsampling for quantification of adalimumab (ADM) concentrations in psoriasis patients. In addition, we compared lateral flow testing (LFT) with enzyme-linked immunosorbent assay (ELISA). Patients participating in the SUPRA-A study (clinicaltrials.gov NCT04028713) were asked to participate in a substudy where volumetric absorptive microsampling (VAMS) was performed at home. At three time points, whole blood and corresponding serum samples were collected for ADM measurement using an in-house ELISA. In addition, the patients’ perspective on microsampling was evaluated via a questionnaire. LFT-obtained ADM concentrations agreed very well with ELISA results (Pearson’s correlation = 0.95 and R2 = 0.89). ADM concentrations determined in both capillary (via finger prick) and corresponding venous blood VAMS samples correlated strongly with serum concentrations (Pearson’s correlation = 0.87). Our preliminary data (n = 7) on rapid testing and home-based microsampling are considered promising with regard to TDM implementation for adalimumab, warranting further research.
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Affiliation(s)
- Rani Soenen
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium; (R.S.); (L.G.)
- Dermatology Research Unit, University Ghent, 9000 Ghent, Belgium; (A.C.); (H.D.S.); (M.D.); (T.M.); (M.F.)
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Christophe Stove
- Department of Bioanalysis, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Alessio Capobianco
- Dermatology Research Unit, University Ghent, 9000 Ghent, Belgium; (A.C.); (H.D.S.); (M.D.); (T.M.); (M.F.)
| | - Hanne De Schutter
- Dermatology Research Unit, University Ghent, 9000 Ghent, Belgium; (A.C.); (H.D.S.); (M.D.); (T.M.); (M.F.)
| | - Marie Dobbelaere
- Dermatology Research Unit, University Ghent, 9000 Ghent, Belgium; (A.C.); (H.D.S.); (M.D.); (T.M.); (M.F.)
| | - Tahmina Mahjor
- Dermatology Research Unit, University Ghent, 9000 Ghent, Belgium; (A.C.); (H.D.S.); (M.D.); (T.M.); (M.F.)
| | - Merel Follens
- Dermatology Research Unit, University Ghent, 9000 Ghent, Belgium; (A.C.); (H.D.S.); (M.D.); (T.M.); (M.F.)
| | - Jo Lambert
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium; (R.S.); (L.G.)
- Dermatology Research Unit, University Ghent, 9000 Ghent, Belgium; (A.C.); (H.D.S.); (M.D.); (T.M.); (M.F.)
- Correspondence:
| | - Lynda Grine
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium; (R.S.); (L.G.)
- Dermatology Research Unit, University Ghent, 9000 Ghent, Belgium; (A.C.); (H.D.S.); (M.D.); (T.M.); (M.F.)
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Mainero Rocca L, L'Episcopo N, Gordiani A, Staderini A. Direct multiclass desorption electrospray ionization-tandem mass spectrometry method for the analysis of sleep inducers and ototoxic drugs in dried blood spots. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2022; 36:e9265. [PMID: 35128730 DOI: 10.1002/rcm.9265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
RATIONALE An unconventional and innovative approach for the quantitative determination of 11 ototoxic and narcoleptic drugs in whole blood is described. The multiclass method allows the inclusion of the most widespread drugs on the market (antihistamines, antidepressants, antihypertensives, anxiolytics, opioids, Z-drugs) responsible for 10% of occupational accidents. METHODS The developed procedure involved the use of the desorption electrospray ionization (DESI) interface for the direct analysis of dried blood spots (DBS). All the issues strictly connected to the chemical-physical characteristics of DBS and DESI (sample inhomogeneity, DBS support, DESI geometry and solvent) were carefully evaluated and innovative strategies were applied. Haematocrit was managed using a small and measured volume of blood (2 μL) with analysis of the entire DBS. RESULTS The proposed method was fully validated in terms of limits of detection, limits of quantitation (LOQs; between 60 pg/mm2 and 1.6 ng/mm2 ), linearity (one order of magnitude starting from LOQs) and inter- and intra-day precision (on three levels, with relative standard deviation values not exceeding 17%). Accuracy was calculated by comparison with an ultrahigh-performance liquid chromatography-tandem mass spectrometry method (suitable also as a confirmatory method). CONCLUSIONS Results showed a surprising sensitivity, demonstrating that this procedure could be suitable for applications in various fields, e.g. forensic analysis. Moreover, as a collateral benefit, it was discovered that the method is able to analyse very light traces left on plastic and glass surfaces by detached dried blood.
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Affiliation(s)
- Lucia Mainero Rocca
- Chemical Agents Laboratory, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Nunziata L'Episcopo
- Chemical Agents Laboratory, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Andrea Gordiani
- Chemical Agents Laboratory, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Alessandro Staderini
- Chemical Agents Laboratory, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
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Samsonova JV, Saushkin NY, Osipov AP. Dried Samples of Biological Fluids on Porous Membranes as a Promising Sample Preparation Method for Biomedical and Veterinary Diagnostics. JOURNAL OF ANALYTICAL CHEMISTRY 2022. [DOI: 10.1134/s1061934822040104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Verougstraete N, Stove V, Verstraete AG, Stove CP. Therapeutic Drug Monitoring of Tyrosine Kinase Inhibitors Using Dried Blood Microsamples. Front Oncol 2022; 12:821807. [PMID: 35392223 PMCID: PMC8980857 DOI: 10.3389/fonc.2022.821807] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/01/2022] [Indexed: 12/14/2022] Open
Abstract
Therapeutic drug monitoring (TDM) of tyrosine kinase inhibitors (TKIs) is not yet performed routinely in the standard care of oncology patients, although it offers a high potential to improve treatment outcome and minimize toxicity. TKIs are perfect candidates for TDM as they show a relatively small therapeutic window, a wide inter-patient variability in pharmacokinetics and a correlation between drug concentration and effect. Moreover, most of the available TKIs are susceptible to various drug-drug interactions and medication adherence can be checked by performing TDM. Plasma, obtained via traditional venous blood sampling, is the standard matrix for TDM of TKIs. However, the use of plasma poses some challenges related to sampling and stability. The use of dried blood microsamples can overcome these limitations. Collection of samples via finger-prick is minimally invasive and considered convenient and simple, enabling sampling by the patients themselves in their home-setting. The collection of small sample volumes is especially relevant for use in pediatric populations or in pharmacokinetic studies. Additionally, working with dried matrices improves compound stability, resulting in convenient and cost-effective transport and storage of the samples. In this review we focus on the different dried blood microsample-based methods that were used for the quantification of TKIs. Despite the many advantages associated with dried blood microsampling, quantitative analyses are also associated with some specific difficulties. Different methodological aspects of microsampling-based methods are discussed and applied to TDM of TKIs. We focus on sample preparation, analytics, internal standards, dilution of samples, external quality controls, dried blood spot specific validation parameters, stability and blood-to-plasma conversion methods. The various impacts of deviating hematocrit values on quantitative results are discussed in a separate section as this is a key issue and undoubtedly the most widely discussed issue in the analysis of dried blood microsamples. Lastly, the applicability and feasibility of performing TDM using microsamples in a real-life home-sampling context is discussed.
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Affiliation(s)
- Nick Verougstraete
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.,Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Veronique Stove
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Alain G Verstraete
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Christophe P Stove
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
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Babu M, Pavithran K. Therapeutic Drug Monitoring as a Tool for Therapy Optimization. Drug Metab Lett 2022; 15:DML-EPUB-122284. [PMID: 35382721 DOI: 10.2174/1872312815666220405122021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/21/2022] [Accepted: 02/09/2022] [Indexed: 11/22/2022]
Abstract
The use of pharmacotherapy for improving healthcare in society is increasing. A vast majority of patients have either received subtherapeutic treatment (which could result from low pharmacokinetic) or experienced adverse effects due to the toxic levels of the drug. The medicines used to treat chronic conditions, such as epilepsy; cardiovascular diseases; and oncological, neurological, and psychiatric disorders, require routine monitoring. New targeted therapies suggest an individualized treatment that can slowly move practitioners away from the concept of a one-size-fits-all-fixed-dosing approach. Therapeutic drug use can be monitored based on pharmacokinetic, pharmacodynamic, and pharmacometric methods. Based on the experiences of therapeutic drug monitoring of various agents across the globe, we can look ahead to the possible developments of therapeutic drug monitoring in India.
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Affiliation(s)
- Merin Babu
- Department of Medical Oncology, Amrita Institute of Medical Sciences and Research Centre Amrita Vishwa Vidyapeetham, Ponekkara P.O, Kochi, Kerala, India
| | - Keechilat Pavithran
- Department of Medical Oncology, Amrita Institute of Medical Sciences and Research Centre Amrita Vishwa Vidyapeetham, Ponekkara P.O, Kochi, Kerala, India
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Biagini D, Antoni S, Ghimenti S, Bonini A, Vivaldi F, Angelucci C, Riparbelli C, Cuttano A, Fuoco R, Di Francesco F, Lomonaco T. Methodological aspects of dried blood spot sampling for the determination of isoprostanoids and prostanoids. Microchem J 2022. [DOI: 10.1016/j.microc.2022.107212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Dvořák M, Miró M, Kubáň P. Automated Sequential Injection-Capillary Electrophoresis for Dried Blood Spot Analysis: A Proof-of-Concept Study. Anal Chem 2022; 94:5301-5309. [PMID: 35319181 DOI: 10.1021/acs.analchem.1c05130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A hyphenated analytical platform that enables fully automated analyses of dried blood spots (DBSs) is proposed by the at-line coupling of sequential injection (SI) to capillary electrophoresis (CE). The SI system, exploited herein for the first time for unattended DBS handling, serves as the "front end" mesofluidic platform for facilitating exhaustive elution of the entire DBS by flow programming. The DBS eluates are thus free from hematocrit and nonhomogeneity biases. The SI pump transfers the resulting DBS eluates into CE sample vials through an internal port of the CE instrument and homogenizes the eluates, whereupon the eluted blood compounds are automatically injected, separated, and quantified by the CE instrument. The SI and CE are commercially available off-the-shelf instruments and are interconnected through standard nuts, ferrules, and tubing without additional instrumental adjustments. They are controlled by dedicated software and are synchronized for a fully autonomous operation. The direct determination of endogenous (potassium and sodium) and exogenous (lithium as a model drug) inorganic cations in DBS samples has been used for the proof-of-concept demonstration. The hyphenated SI-CE platform provides excellent precision of the analytical method with relative standard deviation (RSD) values of peak areas below 1.5 and 3.5% for intraday and interday analyses, respectively, of the endogenous concentrations of the two inorganic cations. For the determination of lithium, calibration is linear in a typical clinical range of the drug (R2 better than 0.9993 for 2-20 mg/L), RSD values of peak areas are below 4.5% (in the entire calibration range), the limit of detection (0.4 mg/L) and the limit of quantification (1.3 mg/L) are well below the drug's minimum therapeutic concentration (4 mg/L), and total analysis time is shorter than 5 min. The SI-CE platform reflects the actual trends in the automation of analytical methods, offers rapid and highly flexible DBS elution/analysis processes, and might thus provide a general solution to modern clinical analysis as it can be applied to a broad range of analytes and dried biological materials.
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Affiliation(s)
- Miloš Dvořák
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200 Brno, Czech Republic
| | - Manuel Miró
- FI-TRACE group, Department of Chemistry, University of the Balearic Islands, Carretera de Valldemossa, km 7.5, E-07122 Palma de Mallorca, Spain
| | - Pavel Kubáň
- Institute of Analytical Chemistry of the Czech Academy of Sciences, Veveří 97, CZ-60200 Brno, Czech Republic
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Huang X, Liu X, Wang Y, Zhang J. Determination of polymyxin B in dried blood spots using LC-MS/MS for therapeutic drug monitoring. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1192:123131. [DOI: 10.1016/j.jchromb.2022.123131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
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Märtson AG, Edwina AE, Kim HY, Knoester M, Touw DJ, Sturkenboom MGG, Alffenaar JWC. Therapeutic Drug Monitoring of Ganciclovir: Where Are We? Ther Drug Monit 2022; 44:138-147. [PMID: 34610621 PMCID: PMC8746890 DOI: 10.1097/ftd.0000000000000925] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Ganciclovir is the mainstay of therapy for the prophylaxis and treatment of Cytomegalovirus. However, therapy with this antiviral agent is hindered by side effects such as myelosuppression, which often leads to therapy cessation. Underdosing, as an attempt to prevent side effects, can lead to drug resistance and therapy failure. Therapeutic drug monitoring (TDM) has been used to overcome these problems. The purpose of this narrative review was to give an overview of ganciclovir TDM, available assays, population pharmacokinetic models, and discuss the current knowledge gaps. METHODS For this narrative review, a nonsystematic literature search was performed on the PubMed database in April 2021. The following search terms were used: ganciclovir, valganciclovir, pharmacokinetics, pharmacodynamics, population pharmacokinetics, therapeutic drug monitoring, bioassay, liquid chromatography coupled with tandem mass spectrometry, liquid chromatography, chromatography, spectrophotometry, and toxicity. In addition, the reference lists of the included articles were screened. RESULTS The most common bioanalysis method identified was liquid chromatography coupled with tandem mass spectrometry. There are different models presenting ganciclovir IC50; however, establishing a pharmacokinetic/pharmacodynamic target for ganciclovir based on preclinical data is difficult because there are no studies combining dynamic drug exposure in relation to inhibition of viral replication. The data on ganciclovir TDM show large interindividual variability, indicating that TDM may play a role in modifying the dose to reduce toxicity and prevent treatment failure related to low concentrations. The main hurdle for implementing TDM is the lack of robust data to define a therapeutic window. CONCLUSIONS Although the pharmacokinetics (PK) involved is relatively well-described, both the pharmacodynamics (PD) and pharmacokinetic/pharmacodynamic relationship are not. This is because the studies conducted to date have mainly focused on estimating ganciclovir exposure, and owing to the limited therapeutic options for CMV infections, future studies on ganciclovir are warranted.
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Affiliation(s)
- Anne-Grete Märtson
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Angela E. Edwina
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Hannah Yejin Kim
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia
- Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Camperdown, NSW, Australia
| | - Marjolein Knoester
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; and
| | - Daan J. Touw
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Pharmaceutical Analysis, Groningen Research Institute of Pharmacy, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Marieke G. G. Sturkenboom
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jan-Willem C. Alffenaar
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia
- Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Camperdown, NSW, Australia
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Anibaletto Dos Santos AL, Cezimbra da Silva AC, Feltraco Lizot LDL, Schneider A, Meireles YF, Hahn RZ, Pagnussat LR, Nonnenmacher JL, Hahn SR, Linden R. Development and validation of an assay for the measurement of gentamicin concentrations in dried blood spots using UHPLC-MS/MS. J Pharm Biomed Anal 2022; 208:114448. [PMID: 34740086 DOI: 10.1016/j.jpba.2021.114448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 01/06/2023]
Abstract
Gentamicin sulfate (GEN) is an aminoglycoside antibiotic with a narrow therapeutic range of plasma concentrations. The collection of venous blood represents a significant burden for patients, especially in neonatology. Dried blood spots (DBS) obtained from capillary blood can be an alternative for drug measurements in this particular population. This study aimed to develop and validate an assay for the quantification of GEN in DBS using UHPLC-MS/MS. Total GEN concentrations were obtained by adding the individual concentrations of the GEN forms C1, C1a, and C2. The assay used a DBS disk containing approximately 17 μL of blood for GEN quantitation in the range of 0.1-40 mg L-1. Measurement accuracy for total GEN was in the range of 102.6-108.6%, inter-assay precision was 11.3-13.1% and intra-assay precision was 9.1-12.8.% GEN was stable for 21 days at - 20 and 8 °C, but only for 24 h at room temperature. Blood Hct affected the accuracy within acceptable limits (93.8-95% at Hct% of 30, 104.3-113% at Hct% of 50). Blood spotted volume did not affect GEN measurement accuracy. Concentrations of GEN in DBS obtained after heel pricks were correlated to plasma levels in a small cohort of neonatal patients. However, percentual differences between estimated plasma concentrations and actual plasma levels presented values between - 64-35.3% (average difference of - 1.9%). The use of DBS for the measurement of GEN concentrations can increase access to TDM of this antibiotic due to the ease of sample collection and the facilitated specimen transportation logistics when testing is not available onsite.
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Affiliation(s)
- Ana Laura Anibaletto Dos Santos
- Analytical Toxicology Laboratory, Universidade Feevale, Novo Hamburgo, RS, Brazil; Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Brazil
| | - Anne Caroline Cezimbra da Silva
- Analytical Toxicology Laboratory, Universidade Feevale, Novo Hamburgo, RS, Brazil; Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Brazil
| | - Lilian de Lima Feltraco Lizot
- Analytical Toxicology Laboratory, Universidade Feevale, Novo Hamburgo, RS, Brazil; Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Brazil
| | - Anelise Schneider
- Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Brazil
| | | | - Roberta Zilles Hahn
- Analytical Toxicology Laboratory, Universidade Feevale, Novo Hamburgo, RS, Brazil
| | | | | | | | - Rafael Linden
- Analytical Toxicology Laboratory, Universidade Feevale, Novo Hamburgo, RS, Brazil; Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Brazil.
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Volumetric absorptive microsampling as a suitable tool to monitor tyrosine kinase inhibitors. J Pharm Biomed Anal 2022; 207:114418. [PMID: 34655987 DOI: 10.1016/j.jpba.2021.114418] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/09/2021] [Accepted: 10/02/2021] [Indexed: 01/03/2023]
Abstract
Therapeutic drug monitoring (TDM) of tyrosine kinase inhibitors (TKIs) shows significant potential in guiding personalized anticancer treatment. Dried blood microsampling could be a valuable alternative for traditional plasma sampling to provide TDM results faster and to reach a wider audience. Sample collection is easy and patient friendly as only a small volume of blood is collected via a fingerprick. This enables the possibility of home sampling by the patients themselves. Therefore, an LC-MS/MS method was developed and validated for the quantification of bosutinib, dasatinib, gilteritinib, ibrutinib, imatinib, midostaurin, nilotinib and ponatinib in dried blood samples collected via volumetric absorptive microsampling (VAMS). A VAMS device collects a fixed volume of blood (± 10 µL), irrespective of the sample's hematocrit (Hct). During method validation, special attention was paid to the possible impact of Hct (range 0.18-0.55) on matrix effect (ME), robustness of the extraction, and accuracy of the method. The method was successfully validated based on international guidelines in terms of calibration curves, precision (within-run CV 2.20-14.8%; between-run CV 2.40-12.3%), accuracy (within-run bias 0.34-12.5%; between-run bias -0.15 to 16.2%), carry-over and selectivity. IS-compensated ME and recovery were Hct independent and no significant impact of Hct on the accuracy of the TKI quantifications was observed. All TKIs were stable in VAMS samples stored at -20 °C, 4 °C and room temperature for at least 4 weeks and for 2 days at 60 °C (except ibrutinib). Lastly, we demonstrated a good agreement between liquid blood obtained from patients on TKI treatment and VAMS samples prepared from that venous blood. As this implies that there is no methodological impact of liquid versus dried blood analysis, the presented method can be applied in clinical follow-up studies for determining TKIs in (capillary) VAMS samples with varying Hct levels.
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Chiu HH, Tsai YJ, Lo C, Liao HW, Lin CH, Tang SC, Kuo CH. Development of an LC-MS/MS method to simultaneously quantify therapeutic mAbs and estimate hematocrit values in dried blood spot samples. Anal Chim Acta 2022; 1189:339231. [PMID: 34815034 DOI: 10.1016/j.aca.2021.339231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/25/2021] [Accepted: 10/28/2021] [Indexed: 01/14/2023]
Abstract
Recently, monoclonal antibody (mAb) therapy has gained increasing attention in the medical field due to its high specificity. Dried blood spots (DBSs) have been used in various clinical fields due to their unique characteristics, such as easy transportation, low invasiveness, and home sampling. However, hematocrit (HCT)-associated issues may lead to inaccurate quantification; moreover, the HCT value is required for converting the drug concentration from DBS to plasma. To simultaneously measure HCT levels and quantify mAb concentrations in DBS samples, this study used volumetrically applied 15 μL DBS, and combined protein G purification and ethanol precipitation approaches as the sample preparation method. Sixty-two clinical samples were used to investigate the HCT estimation ability by using hemoglobin (Hb) peptides. Four mAbs, bevacizumab, trastuzumab, nivolumab and tocilizumab, were selected to demonstrate our method, and pembrolizumab was used as the internal standard. The optimized method could measure four mAbs and Hb peptides simultaneously within 11 min. Moreover, a correlation study revealed that the correlation coefficient for the Hb peptides and the HCT value was larger than 0.9. The HCT estimation results revealed that for over 90% of the real DBS samples the HCT could be obtained within ±20% estimation error acceptance criteria. The method was validated in terms of accuracy and precision for the four mAbs. The developed method was further applied to simultaneously quantify mAb concentrations and estimate HCT values in six patient DBS samples to demonstrate its clinical applicability. It is believed that this newly developed method could facilitate various clinical studies and provide benefits for mAb therapies in clinical fields.
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Affiliation(s)
- Huai-Hsuan Chiu
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; The Metabolomics Core Laboratory, Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan
| | - Yun-Jung Tsai
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; The Metabolomics Core Laboratory, Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan
| | - Chiao Lo
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiao-Wei Liao
- Department of Pharmacy, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Department of Medical Oncology, National Taiwan University Cancer Center Hospital, Taipei, Taiwan
| | - Sung-Chun Tang
- Stroke Center and Department of Neurology, National Taiwan University Hospital, Taiwan
| | - Ching-Hua Kuo
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; The Metabolomics Core Laboratory, Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
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Boffel L, Heughebaert L, Lambrecht S, Luginbühl M, Stove CP. In-depth evaluation of automated non-contact reflectance-based hematocrit prediction of dried blood spots. Analyst 2022; 147:5445-5454. [DOI: 10.1039/d2an01642g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Using the automated CAMAG® DBS-MS 500 HCT system, a UV-Vis-based hematocrit prediction calibration model was succesfully set up and applied on both an independent instrument and an independent set of venous DBS samples.
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Affiliation(s)
- Laura Boffel
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - Liesl Heughebaert
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - Stijn Lambrecht
- Laboratory of Clinical Chemistry and Hematology, Ghent University Hospital, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Marc Luginbühl
- CAMAG, Sonnenmattstrasse 11, CH-4132 Muttenz, Switzerland
| | - Christophe P. Stove
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
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Rodríguez-Saldaña V, Basu N. The performance of dried blood spots for the assessment of lead exposure: A narrative review with a systematic search. Microchem J 2022. [DOI: 10.1016/j.microc.2021.106930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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