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Peters FT, Wissenbach D. Current state-of-the-art approaches for mass spectrometry in clinical toxicology: an overview. Expert Opin Drug Metab Toxicol 2023; 19:487-500. [PMID: 37615282 DOI: 10.1080/17425255.2023.2252324] [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: 05/16/2023] [Revised: 08/04/2023] [Accepted: 08/23/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Hyphenated mass spectrometry (MS) has evolved into a very powerful analytical technique of high sensitivity and specificity. It is used to analyze a very wide spectrum of analytes in classical and alternative matrices. The presented paper will provide an overview of the current state-of-the-art of hyphenated MS applications in clinical toxicology primarily based on review articles indexed in PubMed (1990 to April 2023). AREAS COVERED A general overview of matrices, sample preparation, analytical systems, detection modes, and validation and quality control is given. Moreover, selected applications are discussed. EXPERT OPINION A more widespread use of hyphenated MS techniques, especially in systematic toxicological analysis and drugs of abuse testing, would help overcome limitations of immunoassay-based screening strategies. This is currently hampered by high instrument cost, qualification requirements for personnel, and less favorable turnaround times, which could be overcome by more user-friendly, ideally fully automated MS instruments. This would help making hyphenated MS-based analysis available in more laboratories and expanding analysis to a large number of organic drugs, poisons, and/or metabolites. Even the most recent novel psychoactive substances (NPS) could be presumptively identified by high-resolution MS methods, their likely presence be communicated to treating physicians, and be confirmed later on.
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Affiliation(s)
- Frank T Peters
- Institute of Forensic Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Daniela Wissenbach
- Institute of Forensic Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
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Zarrouk E, Lenski M, Bruno C, Thibert V, Contreras P, Privat K, Ameline A, Fabresse N. High-resolution mass spectrometry: Theoretical and technological aspects. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Goncalves R, Pelletier R, Couette A, Gicquel T, Le Daré B. Suitability of high-resolution mass spectrometry in analytical toxicology: Focus on drugs of abuse. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fernandes FS, da Silva GS, Hilel AS, Carvalho AC, Remor KVT, Schlindwein AD, Kanis LA, Martins DF, Kviecinski MR. Study of the potential adverse effects caused by the dermal application of Dillenia indica L. fruit extract standardized to betulinic acid in rodents. PLoS One 2019; 14:e0217718. [PMID: 31150479 PMCID: PMC6544281 DOI: 10.1371/journal.pone.0217718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/16/2019] [Indexed: 12/17/2022] Open
Abstract
This study aimed to evaluate the potential adverse effects of the dermal administration of Dillenia indica Linnaeus (D. indica) fruit extract in healthy rodents; the extract was standardized to betulinic acid. In the initial phase, the acute effects were evaluated on the skin application site of a single extract dose. A skin irritation test was performed in male Wistar rats (n = 8/group) receiving the extract (50–150 mg/mL) with betulinic acid (0.5–1.5%, respectively). A photosensitivity test was performed in male BALB/c mice (n = 6/group) receiving the extract (150 mg/mL). Afterwards, other BALB/c mice (n = 20, male:female, 1:1) were used to assess the systemic alterations caused by 14 daily repeated doses (150 mg/mL) by monitoring the effects on mortality, body morphology, behavior, nutrition status, neuromotor reactions, organ morphology and weight, and blood tests. At this time, 0.5 mg/mL clobetasol was used as the positive control. The skin irritation index suggested that negligible skin irritation had occurred, even when the extract was applied to the rat skin at 150 mg/mL. However, the extract acted as a photosensitizer on mouse skin, showing a photosensitizing activity close to that of 10 mg/mL 5-methoxypsoralen. Repeated doses caused no mouse mortality, aggressiveness, piloerection, diarrhea, convulsions, neuromotor alterations or nutrition status changes. The mouse organ weights did not change, and the mice did not have alterations in their blood compositions. Clobetasol caused a reduction in the mononuclear leukocyte numbers. In general, the data suggest that the extract was safe in healthy rodents but indicate that caution should be taken with the photosensitizing activity; in addition, this activity should be further explored as it may be useful for phototherapeutic drug development.
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Affiliation(s)
- Flávia S. Fernandes
- Universidade do Sul de Santa Catarina, Postgraduate Program in Health Sciences, Palhoça, Santa Catarina, Brazil
| | - Gustavo S. da Silva
- Universidade do Sul de Santa Catarina, Postgraduate Program in Health Sciences, Palhoça, Santa Catarina, Brazil
| | - Alexandre S. Hilel
- Universidade do Sul de Santa Catarina, Postgraduate Program in Health Sciences, Palhoça, Santa Catarina, Brazil
| | - Ana C. Carvalho
- Universidade do Sul de Santa Catarina, Postgraduate Program in Health Sciences, Palhoça, Santa Catarina, Brazil
| | - Karina V. T. Remor
- Universidade do Sul de Santa Catarina, Postgraduate Program in Health Sciences, Palhoça, Santa Catarina, Brazil
| | - Aline D. Schlindwein
- Universidade do Sul de Santa Catarina, Postgraduate Program in Health Sciences, Palhoça, Santa Catarina, Brazil
| | - Luiz A. Kanis
- Universidade do Sul de Santa Catarina, Postgraduate Program in Health Sciences, Palhoça, Santa Catarina, Brazil
| | - Daniel F. Martins
- Universidade do Sul de Santa Catarina, Postgraduate Program in Health Sciences, Palhoça, Santa Catarina, Brazil
| | - Maicon R. Kviecinski
- Universidade do Sul de Santa Catarina, Postgraduate Program in Health Sciences, Palhoça, Santa Catarina, Brazil
- * E-mail: ,
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Mass Spectrometry for Research and Application in Therapeutic Drug Monitoring or Clinical and Forensic Toxicology. Ther Drug Monit 2018; 40:389-393. [PMID: 29750739 DOI: 10.1097/ftd.0000000000000525] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This article reviews current applications of various hyphenated low- and high-resolution mass spectrometry techniques in the field of therapeutic drug monitoring and clinical/forensic toxicology in both research and practice. They cover gas chromatography, liquid chromatography, matrix-assisted laser desorption ionization, or paper spray ionization coupled to quadrupole, ion trap, time-of-flight, or Orbitrap mass analyzers.
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Kočová Vlčková H, Pilařová V, Svobodová P, Plíšek J, Švec F, Nováková L. Current state of bioanalytical chromatography in clinical analysis. Analyst 2018; 143:1305-1325. [DOI: 10.1039/c7an01807j] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Chromatographic methods have become popular in clinical analysis in both routine and research laboratories.
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Affiliation(s)
- H. Kočová Vlčková
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
| | - V. Pilařová
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
| | - P. Svobodová
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
| | - J. Plíšek
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
| | - F. Švec
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
| | - L. Nováková
- Deparment of Analytical Chemistry
- Faculty of Pharmacy in Hradec Králové
- Charles University
- Hradec Králové
- Czech Republic
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Busardò FP, Pacifici R, Pichini S. Mass spectrometry vs. immunoassay in clinical and forensic toxicology: qui modus in rebus est? Clin Chem Lab Med 2017; 55:e236-e237. [PMID: 28672772 DOI: 10.1515/cclm-2017-0418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 05/13/2017] [Indexed: 12/27/2022]
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Caspar AT, Kollas AB, Maurer HH, Meyer MR. Development of a quantitative approach in blood plasma for low-dosed hallucinogens and opioids using LC-high resolution mass spectrometry. Talanta 2017; 176:635-645. [PMID: 28917801 DOI: 10.1016/j.talanta.2017.08.063] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/18/2017] [Accepted: 08/19/2017] [Indexed: 11/28/2022]
Abstract
The WHO annually reports an increasing abuse of new psychoactive substances (NPS), which are a heterogeneous group of synthetic drugs and are consumed as substitute for controlled drugs of abuse. In this work, we focused on highly potent derivatives such those of phenethylamine (2C), N-2-methoxybenzyl phenethylamine (NBOMes), lysergic acid diethylamide (LSD), and fentanyl. Severe to fatal intoxications were described due to their high potency. Therefore, they have to be taken at very low doses resulting in low blood concentration in the low ng/mL range, which is a challenge for reliable analytical detection and quantification. The aim of this work was therefore to design a simple, robust, and fast method for simultaneous detection and quantification of multiple substances of the different classes in human blood plasma using liquid chromatography (LC) high resolution (HR) mass spectrometry (MS) with alternating HR full-scan (HRFS) MS and "All-ions fragmentation" (AIF) MS. The paper contains results of the method validation according to the EMA guideline, including intra-/interday accuracy and precision, matrix effects, storage and benchtop analyte stability as well as selectivity and carryover. All validation criteria were fulfilled for most tested compounds except for the NBOMe derivatives, one out of ten 2C-derivatives and butyryl fentanyl, which failed at accuracy and/or precision or at the acceptance criteria for matrix effect. Reasons for this are discussed and solutions presented. Despite some limitations, the HRFS + AIFMS analysis allowed detection of most of the analytes down to 0.1ng/mL, seamless integration of new or unexpected analytes, identification and quantification with no limitations on the number of monitored compounds, and reevaluation of the acquired data also concerning metabolism studies using group-indicating fragment ions.
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Affiliation(s)
- Achim T Caspar
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Germany
| | - Andreas B Kollas
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Germany
| | - Hans H Maurer
- 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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Ott M, Berbalk K, Plecko T, Wieland E, Shipkova M. Detection of drugs of abuse in urine using the Bruker Toxtyper™: Experiences in a routine clinical laboratory setting. CLINICAL MASS SPECTROMETRY 2017. [DOI: 10.1016/j.clinms.2017.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Remane D, Wissenbach DK, Peters FT. Recent advances of liquid chromatography–(tandem) mass spectrometry in clinical and forensic toxicology — An update. Clin Biochem 2016; 49:1051-71. [DOI: 10.1016/j.clinbiochem.2016.07.010] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/04/2016] [Accepted: 07/17/2016] [Indexed: 12/21/2022]
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Maurer HH, Meyer MR. High-resolution mass spectrometry in toxicology: current status and future perspectives. Arch Toxicol 2016; 90:2161-2172. [PMID: 27369376 DOI: 10.1007/s00204-016-1764-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 06/14/2016] [Indexed: 10/21/2022]
Abstract
This paper reviews high-resolution mass spectrometry (HRMS) approaches using time-of-flight or Orbitrap techniques for research and application in various toxicology fields, particularly in clinical toxicology and forensic toxicology published since 2013 and referenced in PubMed. In the introduction, an overview on applications of HRMS in various toxicology fields is given with reference to current review articles. Papers concerning HRMS in metabolism, screening, and quantification of pharmaceuticals, drugs of abuse, and toxins in human body samples are critically reviewed. Finally, a discussion on advantages as well as limitations and future perspectives of these methods is included.
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Affiliation(s)
- H H Maurer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Saarland University, 66421, Homburg, Saar, Germany.
| | - Markus R Meyer
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany
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