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Ke P, Stidham RA, Castaneto MS, Forbes AM, Lewis JW, Wegner MD, Mont SL. Updated Adult Human Red Blood Cell Acetylcholinesterase Activity Reference Range with Time-Modified Michel Method. Clin Chem 2024; 70:680-682. [PMID: 38441310 DOI: 10.1093/clinchem/hvae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Pucheng Ke
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Ralph A Stidham
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Marisol S Castaneto
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Adrienne M Forbes
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Jeremy W Lewis
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Matthew D Wegner
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Stephanie L Mont
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
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Ke P, Stidham RA, Castaneto MS, Forbes AM, Fathke RL, Crochet RB, Lewis JW, Wegner MD, Mont SL. Human red blood cell acetylcholinesterase activity: a revisit after fifteen years. Drug Chem Toxicol 2024:1-8. [PMID: 38508709 DOI: 10.1080/01480545.2024.2329752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/06/2024] [Indexed: 03/22/2024]
Abstract
Human red blood cell acetylcholinesterase (RBC-AChE) activity is valuable for detecting potential exposure to cholinesterase inhibiting substances (CIS). A reliable population-based RBC-AChE activity reference range is critical for early and massive clinical and occupational toxicology screening. Previous published studies were often limited to small numbers of subjects, various testing methods, and crude statistical data analyses. We tested 4818 adult subjects with a well-established 17-minute modified Michel method over a 2-year period. We conducted a retrospective data analysis and systematically investigated on the influences to testing values from gender, age, age group, and their combinations and interactions. No significant difference was observed in the testing values between males (mean, medium, interquartile range = 0.76, 0.76, 0.71-0.80 ΔpH/h, respectively) and females (mean, medium, interquartile range = 0.76, 0.76, 0.71-0.81 ΔpH/hour, respectively), when gender was the only factor considered (p = 0.7238). However, with age progression, male testing values exhibited a consistent upward trend, while females did not show any clear patterns. Linear regression analysis of the data revealed that gender, age, and age group more or less affected testing values either as independent variables or with their combinations and interactions. However, more potential factors need to be included to achieve better testing value predictions. We recommend the toxicological testing community to adopt a new set of age group specific RBC-AChE activity reference ranges for males (0.68-0.80, 0.69-0.81, 0.70-0.83, 0.71-0.84, and 0.73-0.87 ΔpH/h for 18-29, 30-39, 40-49, 50-59, and ≥60 years old, respectively) while keeping the current reference range (0.63-0.89 ΔpH/hour) for females.
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Affiliation(s)
- Pucheng Ke
- U.S. Army Public Health Command, West, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA
| | - Ralph A Stidham
- U.S. Army Public Health Command, West, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA
| | - Marisol S Castaneto
- U.S. Army Public Health Command, West, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA
| | - Adrienne M Forbes
- U.S. Army Public Health Command, West, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA
| | - Robert L Fathke
- U.S. Army Public Health Command, West, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA
| | - Robert B Crochet
- U.S. Army Public Health Command, West, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA
| | - Jeremy W Lewis
- U.S. Army Public Health Command, West, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA
| | - Matthew D Wegner
- U.S. Army Public Health Command, West, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA
| | - Stephanie L Mont
- U.S. Army Public Health Command, West, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA
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Ke P, Stidham RA, Forbes AM, Castaneto MS, Wegner MD, Mont SL. A Hidden Gem: Highlighting the Indispensable Capabilities and History of the DoD Cholinesterase Monitoring Program and DoD Cholinesterase Reference Laboratory. Mil Med 2023; 188:220-222. [PMID: 36929418 DOI: 10.1093/milmed/usad079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/13/2023] [Accepted: 03/04/2023] [Indexed: 03/18/2023] Open
Abstract
The DoD Cholinesterase Monitoring Program and Cholinesterase Reference Laboratory have safeguarded U.S. government employees in chemical defense for over five decades. Considering Russia's potential deployment of chemical warfare nerve agents in Ukraine, it is critical to maintain a robust cholinesterase testing program and its efficiency presently and in future.
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Affiliation(s)
- Pucheng Ke
- DoD Cholinesterase Reference Laboratory, Joint Base San Antonio-Fort Sam Houston, TX 78234, USA
| | - Ralph A Stidham
- Division of Epidemiology and Disease Surveillance, U.S. Army Public Health Command-Central, Joint Base San Antonio-Fort Sam Houston, TX 78234, USA
| | - Adrienne M Forbes
- DoD Cholinesterase Reference Laboratory, Joint Base San Antonio-Fort Sam Houston, TX 78234, USA
| | - Marisol S Castaneto
- DoD Food Analysis and Diagnostic Laboratory, Joint Base San Antonio-Fort Sam Houston, TX 78234, USA
| | - Matthew D Wegner
- DoD Food Analysis and Diagnostic Laboratory, Joint Base San Antonio-Fort Sam Houston, TX 78234, USA
| | - Stephanie L Mont
- U.S. Army Public Health Command-Central, Joint Base San Antonio-Fort Sam Houston, TX 78234, USA
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Peralt A, Ke P, Castaneto MS. Impact of cannabis-infused edibles on public safety and regulation. J Forensic Sci 2022; 67:2387-2393. [PMID: 36097671 PMCID: PMC9826368 DOI: 10.1111/1556-4029.15135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 01/11/2023]
Abstract
Popularity of cannabis-infused products has bloomed since legalization for recreational use of marijuana started. Consumption of cannabis edibles has steadily increased, as restrictions on recreational cannabis smoking have become tighter. This phenomenon enhanced the possibility of these products crossing the state line. The most psychoactive component of cannabis, ∆9-tetrahydrocannabinol (THC) is infused in "edibles" and linked to physiological and psychological effects. Consumers unfamiliar with these edibles may mistake them for non-THC containing products, causing unintended use or overconsumption. In addition, these cannabis-infused edibles are posing significant health risks. The FDA has recognized the potential dangers and recommended that cannabis remain as a Schedule I substance and illegal at the federal level. However, states maintain control of determining the legality of cannabis related products, and creating guidelines distinguishing cannabis edibles from the non-cannabis containing products. Recently, the State of Maine offers a blueprint for edible regulation that should be implemented in all states that are considering or have legalized marijuana.
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Affiliation(s)
| | - Pucheng Ke
- Department of Defense Food Analysis and Diagnostic LaboratorySan AntonioTexasUSA
| | - Marisol S. Castaneto
- Department of Defense Food Analysis and Diagnostic LaboratorySan AntonioTexasUSA
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Castaneto MS, Huang C, Capps D, Ke P, VanZile M, Calero E. Evaluation of a Highly Efficient Multidrug Biochip Array Technology for a Simultaneous and High-Throughput Urine Drug Screening in Clinical and Toxicological Settings. Ther Drug Monit 2022; 44:683-695. [PMID: 35358108 DOI: 10.1097/ftd.0000000000000981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/21/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND A high-throughput and highly efficient analytical platform for urine drug screening is critical in both clinical and forensic settings. Mass spectrometry (MS) has better sensitivity and specificity than conventional immunoassays (IA); however, not all laboratories have the necessary resources and workforce to operate MS. The goal of this study was to evaluate a multidrug biochip with 20 discrete testing regions (DTRs) for high-throughput urine drug screening (UDS). METHODS The Randox DOA Ultra Urine (DOAULT URN) biochip employs chemiluminescent IA to detect various analytes, including stimulants, hallucinogens, sedatives, narcotics, and dextromethorphan. The verification included the evaluation of the limits of detection (LOD), stability of calibrators and controls, cross-reactivity, carryover, interference, and overall performance. RESULTS LODs < quality control low for each DTR. The reconstituted calibrators were stable for up to 2 weeks at -20°C. Controls were stable for 4-6 hours at 22-25°C, with <20% within-day and ≤23% between-day imprecision. The accuracy of the controls (%bias) was within ±20% of the target concentration, except for dextromethorphan at -23.8%. No interference was observed with common over-the-counter medications. No carryover was detected in the high-concentration samples. Satisfactory cross-reactivity (≥50%) with known analytes produced presumptive positive results, with readings higher than the proposed decision points. The overall biochip performance of 165 confirmed samples showed 98.0% sensitivity, 96.9% specificity, and 97.5% efficiency. CONCLUSIONS The DOAULT URN biochip is a multidrug analyte IA capable of detecting dozens of parent drugs and their metabolites in urine. It offers clinical and forensic laboratories an alternative UDS tool with LODs comparable to those of MS.
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Affiliation(s)
| | - Chihyon Huang
- Department of Pathology, Tripler Army Medical Center, Honolulu, Hawaii
| | - Duriza Capps
- Department of Pathology, Tripler Army Medical Center, Honolulu, Hawaii
| | - Pucheng Ke
- Army Medical Department Student Detachment, 187th Medical Battalion, Medical Professional Training Brigade, Joint Base San Antonio- Fort Sam Houston, Texas
| | - Michael VanZile
- Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland; and
| | - Eva Calero
- Department of Pathology and Area Laboratory Services, Brooke Army Medical Center, Joint Base San Antonio- Fort Sam Houston, Texas
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Presley BC, Castaneto MS, Logan BK, Jansen-Varnum SA. Metabolic profiling of synthetic cannabinoid 5F-ADB and identification of metabolites in authentic human blood samples via human liver microsome incubation and ultra-high-performance liquid chromatography/high-resolution mass spectrometry. Rapid Commun Mass Spectrom 2020; 34:e8908. [PMID: 32710798 DOI: 10.1002/rcm.8908] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 06/11/2023]
Abstract
RATIONALE Indazole carboxamide synthetic cannabinoids, a prevalent class of recreational drugs, are a major clinical, forensic and public health challenge. One such compound, 5F-ADB, has been implicated in fatalities worldwide. Understanding its metabolism and distribution facilitates the development of laboratory assays to substantiate its consumption. Synthetic cannabinoid metabolites have been extensively studied in urine; studies identifying metabolites in blood are limited and no data on the metabolic stability (half-life, clearance and extraction ratio) of 5F-ADB have been published prior to this report. METHODS The in vitro metabolism of 5F-ADB was elucidated via incubation with human liver microsomes for 2 h at 37°C. Samples were collected at multiple time points to determine its metabolic stability. Upon identification of metabolites, authentic forensic human blood samples underwent liquid-liquid extraction and were screened for metabolites. Extracts were analyzed via ultra-high-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UHPLC/QTOFMS) operated in positive electrospray ionization mode. RESULTS Seven metabolites were identified including oxidative defluorination (M1); carboxypentyl (M2); monohydroxylation of the fluoropentyl chain (M3.1/M3.2) and indazole ring system (M4); ester hydrolysis (M5); and ester hydrolysis with oxidative defluorination (M6). The half-life (3.1 min), intrinsic clearance (256.2 mL min-1 kg-1 ), hepatic clearance (18.6 mL min-1 kg-1 ) and extraction ratio (0.93) were determined for the first time. In blood, M1 was present in each sample as the most abundant substance; two samples contained M5; one contained 5F-ADB, M1 and M5. CONCLUSIONS 5F-ADB is rapidly metabolized in HLM. 5F-ADB, M1 and M5 are pharmacologically active at the cannabinoid receptors (CB1 /CB2 ) and M1 and M5 may contribute to a user's impairment profile. The results demonstrate that it is imperative that synthetic cannabinoid assays screen for pharmacologically active metabolites, especially for drugs with short half-lives. The authors propose that M1 and M5 are appropriate markers to include in laboratory blood tests screening for 5F-ADB.
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Affiliation(s)
- Brandon C Presley
- Department of Chemistry, Temple University, 1901 N. 13 St., Philadelphia, PA, 19122, USA
| | - Marisol S Castaneto
- Department of Pathology, Tripler Army Medical Center, 1 Jarrett White Rd., Honolulu, HI, 96859, USA
| | - Barry K Logan
- The Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA, 19090, USA
| | - Susan A Jansen-Varnum
- Department of Chemistry, Temple University, 1901 N. 13 St., Philadelphia, PA, 19122, USA
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Presley BC, Castaneto MS, Logan BK, Jansen-Varnum SA. Assessment of synthetic cannabinoid FUB-AMB and its ester hydrolysis metabolite in human liver microsomes and human blood samples using UHPLC-MS/MS. Biomed Chromatogr 2020; 34:e4884. [PMID: 32415732 DOI: 10.1002/bmc.4884] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/15/2020] [Accepted: 05/11/2020] [Indexed: 12/18/2022]
Abstract
FUB-AMB, an indazole carboxamide synthetic cannabinoid recreational drug, was one of the compounds most frequently reported to governmental agencies worldwide between 2016 and 2019. It has been implicated in intoxications and fatalities, posing a risk to public health. In the current study, FUB-AMB was incubated with human liver microsomes (HLM) to assess its metabolic fate and stability and to determine if its major ester hydrolysis metabolite (M1) was present in 12 authentic forensic human blood samples from driving under the influence of drug cases and postmortem investigations using UHPLC-MS/MS. FUB-AMB was rapidly metabolized in HLM, generating M1 that was stable through a 120-min incubation period, a finding that indicates a potential long detection window in human biological samples. M1 was identified in all blood samples, and no parent drug was detected. The authors propose that M1 is a reliable marker for inclusion in laboratory blood screens for FUB-AMB; this metabolite may be pharmacologically active like its precursor FUB-AMB. M1 frequently appears in samples in which the parent drug is undetectable and can point to the causative agent. The results suggest that it is imperative that synthetic cannabinoid laboratory assay panels include metabolites, especially known or potential pharmacologically active metabolites, particularly for compounds with short half-lives.
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Affiliation(s)
- Brandon C Presley
- Department of Chemistry, Temple University, Philadelphia, Pennsylvania, USA
| | | | - Barry K Logan
- The Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, Willow Grove, Pennsylvania, USA
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Kim VJ, Okano CK, Osborne CR, Frank DM, Meana CT, Castaneto MS. Can synthetic urine replace authentic urine to "beat" workplace drug testing? Drug Test Anal 2018; 11:331-335. [PMID: 30194711 DOI: 10.1002/dta.2497] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/16/2018] [Accepted: 08/31/2018] [Indexed: 11/06/2022]
Abstract
Synthetic urine (SU), which was primarily utilized by drug testing laboratories as a matrix for quality control preparations, is now commercially sold and can be used to "fool" a positive drug test. To determine if SU can pass as authentic urine, we challenged Army urine drug testing specimen accessioning and testing procedures using eight different commercial SU products. Adulteration (Sciteck AdultaCheck® 6) and Onsite SU (Synthetic UrineCheck™) test strips were also evaluated. Five of the eight SU were identified by physical observation. All SU products screened negative in the drug immunoassay and additionally passed the specimen validity testing (SVT) as authentic urine. Furthermore, SU was not detected as adulterated with the adulteration test strips (Sciteck AdultaCheck® 6) but was successfully detected as SU with the On-site synthetic urine (Synthetic UrineCheck™). To deter SU use, direct observation, as utilized by the military, may be recommended during the collection process.
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Affiliation(s)
- Victor J Kim
- Tripler Army Medical Center Forensic Toxicology Drug Testing Laboratory, Honolulu, Hawaii, USA
| | - Catherine K Okano
- Tripler Army Medical Center Forensic Toxicology Drug Testing Laboratory, Honolulu, Hawaii, USA
| | - Caroline R Osborne
- Tripler Army Medical Center Forensic Toxicology Drug Testing Laboratory, Honolulu, Hawaii, USA
| | - Deanna M Frank
- Tripler Army Medical Center Forensic Toxicology Drug Testing Laboratory, Honolulu, Hawaii, USA
| | - Christopher T Meana
- Naval Criminal Investigative Service, Hawaii Field Office, Honolulu, Hawaii, USA
| | - Marisol S Castaneto
- Tripler Army Medical Center Forensic Toxicology Drug Testing Laboratory, Honolulu, Hawaii, USA
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Wohlfarth A, Castaneto MS, Zhu M, Pang S, Scheidweiler KB, Kronstrand R, Huestis MA. Pentylindole/Pentylindazole Synthetic Cannabinoids and Their 5-Fluoro Analogs Produce Different Primary Metabolites: Metabolite Profiling for AB-PINACA and 5F-AB-PINACA. AAPS J 2015; 17:660-77. [PMID: 25721194 PMCID: PMC4406957 DOI: 10.1208/s12248-015-9721-0] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 01/15/2015] [Indexed: 01/10/2023] Open
Abstract
Whereas non-fluoropentylindole/indazole synthetic cannabinoids appear to be metabolized preferably at the pentyl chain though without clear preference for one specific position, their 5-fluoro analogs' major metabolites usually are 5-hydroxypentyl and pentanoic acid metabolites. We determined metabolic stability and metabolites of N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-pentyl-1H-indazole-3-carboxamide (AB-PINACA) and 5-fluoro-AB-PINACA (5F-AB-PINACA), two new synthetic cannabinoids, and investigated if results were similar. In silico prediction was performed with MetaSite (Molecular Discovery). For metabolic stability, 1 μmol/L of each compound was incubated with human liver microsomes for up to 1 h, and for metabolite profiling, 10 μmol/L was incubated with pooled human hepatocytes for up to 3 h. Also, authentic urine specimens from AB-PINACA cases were hydrolyzed and extracted. All samples were analyzed by liquid chromatography high-resolution mass spectrometry on a TripleTOF 5600+ (AB SCIEX) with gradient elution (0.1% formic acid in water and acetonitrile). High-resolution full-scan mass spectrometry (MS) and information-dependent acquisition MS/MS data were analyzed with MetabolitePilot (AB SCIEX) using different data processing algorithms. Both drugs had intermediate clearance. We identified 23 AB-PINACA metabolites, generated by carboxamide hydrolysis, hydroxylation, ketone formation, carboxylation, epoxide formation with subsequent hydrolysis, or reaction combinations. We identified 18 5F-AB-PINACA metabolites, generated by the same biotransformations and oxidative defluorination producing 5-hydroxypentyl and pentanoic acid metabolites shared with AB-PINACA. Authentic urine specimens documented presence of these metabolites. AB-PINACA and 5F-AB-PINACA produced suggested metabolite patterns. AB-PINACA was predominantly hydrolyzed to AB-PINACA carboxylic acid, carbonyl-AB-PINACA, and hydroxypentyl AB-PINACA, likely in 4-position. The most intense 5F-AB-PINACA metabolites were AB-PINACA pentanoic acid and 5-hydroxypentyl-AB-PINACA.
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Affiliation(s)
- Ariane Wohlfarth
- />Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Boulevard, Baltimore, Maryland 21224 USA
| | - Marisol S. Castaneto
- />Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Boulevard, Baltimore, Maryland 21224 USA
| | - Mingshe Zhu
- />Department of Biotransformation, Bristol-Myers Squibb, Research and Development, Princeton, New Jersey 08543 USA
| | | | - Karl B. Scheidweiler
- />Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Boulevard, Baltimore, Maryland 21224 USA
| | - Robert Kronstrand
- />Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, 58758 Linköping, Sweden
- />Division of Drug Research, Linköping University, 58185 Linköping, Sweden
| | - Marilyn A. Huestis
- />Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Boulevard, Baltimore, Maryland 21224 USA
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Castaneto MS, Barnes AJ, Concheiro M, Klette KL, Martin TA, Huestis MA. Biochip array technology immunoassay performance and quantitative confirmation of designer piperazines for urine workplace drug testing. Anal Bioanal Chem 2015; 407:4639-48. [DOI: 10.1007/s00216-015-8660-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 03/16/2015] [Accepted: 03/24/2015] [Indexed: 11/29/2022]
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Castaneto MS, Wohlfarth A, Pang S, Zhu M, Scheidweiler KB, Kronstrand R, Huestis MA. Identification of AB-FUBINACA metabolites in human hepatocytes and urine using high-resolution mass spectrometry. Forensic Toxicol 2015. [DOI: 10.1007/s11419-015-0275-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Castaneto MS, Wohlfarth A, Desrosiers NA, Hartman RL, Gorelick DA, Huestis MA. Synthetic cannabinoids pharmacokinetics and detection methods in biological matrices. Drug Metab Rev 2015; 47:124-74. [PMID: 25853390 DOI: 10.3109/03602532.2015.1029635] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Synthetic cannabinoids (SC), originally developed as research tools, are now highly abused novel psychoactive substances. We present a comprehensive systematic review covering in vivo and in vitro animal and human pharmacokinetics and analytical methods for identifying SC and their metabolites in biological matrices. Of two main phases of SC research, the first investigated therapeutic applications, and the second abuse-related issues. Administration studies showed high lipophilicity and distribution into brain and fat tissue. Metabolite profiling studies, mostly with human liver microsomes and human hepatocytes, structurally elucidated metabolites and identified suitable SC markers. In general, SC underwent hydroxylation at various molecular sites, defluorination of fluorinated analogs and phase II metabolites were almost exclusively glucuronides. Analytical methods are critical for documenting intake, with different strategies applied to adequately address the continuous emergence of new compounds. Immunoassays have different cross-reactivities for different SC classes, but cannot keep pace with changing analyte targets. Gas chromatography and liquid chromatography mass spectrometry assays - first for a few, then numerous analytes - are available but constrained by reference standard availability, and must be continuously updated and revalidated. In blood and oral fluid, parent compounds are frequently present, albeit in low concentrations; for urinary detection, metabolites must be identified and interpretation is complex due to shared metabolic pathways. A new approach is non-targeted HRMS screening that is more flexible and permits retrospective data analysis. We suggest that streamlined assessment of new SC's pharmacokinetics and advanced HRMS screening provide a promising strategy to maintain relevant assays.
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Affiliation(s)
- Marisol S Castaneto
- Department of Chemistry and Drug Metabolism, National Institute on Drug Abuse, NIH , Baltimore, MD , USA
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Castaneto MS, Gorelick DA, Desrosiers NA, Hartman RL, Pirard S, Huestis MA. Synthetic cannabinoids: epidemiology, pharmacodynamics, and clinical implications. Drug Alcohol Depend 2014; 144:12-41. [PMID: 25220897 PMCID: PMC4253059 DOI: 10.1016/j.drugalcdep.2014.08.005] [Citation(s) in RCA: 415] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/04/2014] [Accepted: 08/05/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Synthetic cannabinoids (SC) are a heterogeneous group of compounds developed to probe the endogenous cannabinoid system or as potential therapeutics. Clandestine laboratories subsequently utilized published data to develop SC variations marketed as abusable designer drugs. In the early 2000s, SC became popular as "legal highs" under brand names such as Spice and K2, in part due to their ability to escape detection by standard cannabinoid screening tests. The majority of SC detected in herbal products have greater binding affinity to the cannabinoid CB1 receptor than does Δ(9)-tetrahydrocannabinol (THC), the primary psychoactive compound in the cannabis plant, and greater affinity at the CB1 than the CB2 receptor. In vitro and animal in vivo studies show SC pharmacological effects 2-100 times more potent than THC, including analgesic, anti-seizure, weight-loss, anti-inflammatory, and anti-cancer growth effects. SC produce physiological and psychoactive effects similar to THC, but with greater intensity, resulting in medical and psychiatric emergencies. Human adverse effects include nausea and vomiting, shortness of breath or depressed breathing, hypertension, tachycardia, chest pain, muscle twitches, acute renal failure, anxiety, agitation, psychosis, suicidal ideation, and cognitive impairment. Long-term or residual effects are unknown. Due to these public health consequences, many SC are classified as controlled substances. However, frequent structural modification by clandestine laboratories results in a stream of novel SC that may not be legally controlled or detectable by routine laboratory tests. METHODS We present here a comprehensive review, based on a systematic electronic literature search, of SC epidemiology and pharmacology and their clinical implications.
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Affiliation(s)
- Marisol S Castaneto
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD, United States; Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, United States
| | - David A Gorelick
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Nathalie A Desrosiers
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD, United States; Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, United States
| | - Rebecca L Hartman
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD, United States; Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, United States
| | - Sandrine Pirard
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD, United States
| | - Marilyn A Huestis
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD, United States.
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Castaneto MS, Scheidweiler KB, Gandhi A, Wohlfarth A, Klette KL, Martin TM, Huestis MA. Quantitative urine confirmatory testing for synthetic cannabinoids in randomly collected urine specimens. Drug Test Anal 2014; 7:483-93. [PMID: 25231213 DOI: 10.1002/dta.1709] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 07/25/2014] [Accepted: 08/01/2014] [Indexed: 11/11/2022]
Abstract
Synthetic cannabinoid intake is an ongoing health issue worldwide, with new compounds continually emerging, making drug testing complex. Parent synthetic cannabinoids are rarely detected in urine, the most common matrix employed in workplace drug testing. Optimal identification of synthetic cannabinoid markers in authentic urine specimens and correlation of metabolite concentrations and toxicities would improve synthetic cannabinoid result interpretation. We screened 20 017 randomly collected US military urine specimens between July 2011 and June 2012 with a synthetic cannabinoid immunoassay yielding 1432 presumptive positive specimens. We analyzed all presumptive positive and 1069 negative specimens with our qualitative synthetic cannabinoid liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, which confirmed 290 positive specimens. All 290 positive and 487 randomly selected negative specimens were quantified with the most comprehensive urine quantitative LC-MS/MS method published to date; 290 specimens confirmed positive for 22 metabolites from 11 parent synthetic cannabinoids. The five most predominant metabolites were JWH-018 pentanoic acid (93%), JWH-N-hydroxypentyl (84%), AM2201 N-hydroxypentyl (69%), JWH-073 butanoic acid (69%), and JWH-122 N-hydroxypentyl (45%) with 11.1 (0.1-2,434), 5.1 (0.1-1,239), 2.0 (0.1-321), 1.1 (0.1-48.6), and 1.1 (0.1-250) µg/L median (range) concentrations, respectively. Alkyl hydroxy and carboxy metabolites provided suitable biomarkers for 11 parent synthetic cannabinoids; although hydroxyindoles were also observed. This is by far the largest data set of synthetic cannabinoid metabolites urine concentrations from randomly collected workplace drug testing specimens rather than acute intoxications or driving under the influence of drugs. These data improve the interpretation of synthetic cannabinoid urine test results and suggest suitable urine markers of synthetic cannabinoid intake.
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Affiliation(s)
- Marisol S Castaneto
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, NIH, Baltimore, MD, USA.,Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, USA
| | - Karl B Scheidweiler
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, NIH, Baltimore, MD, USA
| | - Adarsh Gandhi
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, NIH, Baltimore, MD, USA
| | - Ariane Wohlfarth
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, NIH, Baltimore, MD, USA
| | - Kevin L Klette
- Drug Testing and Program Policy, Office of the Under Secretary of Defense (Personnel and Readiness), Personnel Risk Reduction, Washington, DC, USA
| | - Thomas M Martin
- Drug Testing and Program Policy, Office of the Under Secretary of Defense (Personnel and Readiness), Personnel Risk Reduction, Washington, DC, USA
| | - Marilyn A Huestis
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, NIH, Baltimore, MD, USA
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15
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Spinelli E, Barnes AJ, Young S, Castaneto MS, Martin TM, Klette KL, Huestis MA. Performance characteristics of an ELISA screening assay for urinary synthetic cannabinoids. Drug Test Anal 2014; 7:467-74. [DOI: 10.1002/dta.1702] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 07/14/2014] [Accepted: 07/15/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Eliani Spinelli
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug AbuseNational Institutes of Health Baltimore MD 21224 USA
- School of PharmacyFluminense Federal University (CAPES Foundation – BEX 1534/12‐2) Rio de Janeiro Brazil
| | - Allan J. Barnes
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug AbuseNational Institutes of Health Baltimore MD 21224 USA
| | - Sheena Young
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug AbuseNational Institutes of Health Baltimore MD 21224 USA
| | - Marisol S. Castaneto
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug AbuseNational Institutes of Health Baltimore MD 21224 USA
| | - Thomas M. Martin
- Drug Testing and Program Policy, Office of the Under Secretary of Defense (Personnel & Readiness)Personel Risk Reduction Washington DC USA
| | - Kevin L. Klette
- Drug Testing and Program Policy, Office of the Under Secretary of Defense (Personnel & Readiness)Personel Risk Reduction Washington DC USA
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug AbuseNational Institutes of Health Baltimore MD 21224 USA
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16
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Ellefsen KN, Anizan S, Castaneto MS, Desrosiers NA, Martin TM, Klette KL, Huestis MA. Validation of the only commercially available immunoassay for synthetic cathinones in urine: Randox Drugs of Abuse V Biochip Array Technology. Drug Test Anal 2014; 6:728-38. [PMID: 24659527 DOI: 10.1002/dta.1633] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 01/24/2014] [Accepted: 02/08/2014] [Indexed: 11/09/2022]
Abstract
Deterrence of synthetic cathinone abuse is hampered by the lack of a high-throughput immunoassay screen. The Randox Drugs of Abuse V (DOA-V) Biochip Array Technology contains two synthetic cathinone antibodies: Bath Salt I (BSI) targets mephedrone/methcathinone and Bath Salt II (BSII) targets 3',4'-methylenedioxypyrovalerone (MDPV)/3',4'-methylenedioxy-α-pyrrolidinobutiophenone (MDPBP). We evaluated DOA-V synthetic cathinones performance and conducted a full validation on the original assay with calibrators reconstituted in water, and the new assay with calibrators prepared in lyophilized urine; both utilized the same antibodies and were run on the fully automated Evidence® Analyzer. We screened 20 017 authentic military urine specimens and confirmed positives by liquid chromatography-tandem mass spectrometry (LC-MS/MS) for 28 synthetic cathinones. Limits of detection (LOD) for the original and new assays were 0.35 and 0.18 (BSI), and 8.5 and 9.2 µg/L (BSII), respectively. Linearity was acceptable (R(2) >0.98); however, a large negative bias was observed with in-house prepared calibrators. Intra-assay imprecision was <20% BSI-II, while inter-assay imprecision was 18-42% BSI and <22% BSII. Precision was acceptable for Randox controls. Cross-reactivities of many additional synthetic cathinones were determined. Authentic drug-free negative urine pH <4 produced false positive results for BSI (6.3 µg/L) and BSII (473 µg/L). Oxidizing agents reduced BSI and increased BSII results. Sensitivity, specificity, and efficiency of 100%, 52.1%, and 53.0% were obtained at manufacturer's proposed cut-offs (BSI 5 µg/L, BSII 30 µg/L). Performance improved if cut-off concentrations increased (BSI 7.5 µg/L, BSII 40 µg/L); however, there were limited confirmed positive specimens. Currently, this is the first and only fully validated immunoassay for preliminary detection of synthetic cathinones in urine. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Kayla N Ellefsen
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, NIH, Baltimore, MD, USA; Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, USA
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Abstract
OBJECTIVE Methamphetamine (MAMP) use, distribution, and manufacture remain a serious public health and safety problem in the United States, and children environmentally exposed to MAMP face a myriad of developmental, social, and health risks, including severe abuse and neglect necessitating child protection involvement. It is recommended that drug-endangered children receive medical evaluation and care with documentation of overall physical and mental conditions and have urine drug testing. The primary aim of this study was to determine the best biological matrix to detect MAMP, amphetamine (AMP), methylenedioxymethamphetamine (MDMA), methylenedioxyamphetamine (MDA), and 3,4-methylenedioxyethylamphetamine (MDEA) in environmentally exposed children. METHODS Ninety-one children, environmentally exposed to household MAMP intake, were medically evaluated at the Child and Adolescent Abuse Resource and Evaluation Diagnostic and Treatment Center at the University of California, Davis Children's Hospital. MAMP, AMP, MDMA, MDA, and MDEA were quantified in urine and oral fluid (OF) by gas chromatography mass spectrometry and in hair by liquid chromatography tandem mass spectrometry. RESULTS Overall drug detection rates in OF, urine, and hair were 6.9%, 22.1%, and 77.8%, respectively. Seventy children (79%) tested positive for 1 or more drugs in 1 or more matrices. MAMP was the primary analyte detected in all 3 biological matrices. All positive OF (n = 5), and 18 of 19 positive urine specimens also had a positive hair test. CONCLUSIONS Hair analysis offered a more sensitive tool for identifying MAMP, AMP, and MDMA environmental exposure in children than urine or OF testing. A negative urine or hair test does not exclude the possibility of drug exposure, but hair testing provided the greatest sensitivity for identifying drug-exposed children.
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Affiliation(s)
| | - Allan J. Barnes
- Chemistry and Drug Metabolism, NIDA-IRP, NIH, Baltimore, MD, USA
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