1
|
Hastie C, Thompson A, Perkins M, Langford VS, Eddleston M, Homer NZM. Selected Ion Flow Tube-Mass Spectrometry (SIFT-MS) as an Alternative to Gas Chromatography/Mass Spectrometry (GC/MS) for the Analysis of Cyclohexanone and Cyclohexanol in Plasma. ACS Omega 2021; 6:32818-32822. [PMID: 34901631 PMCID: PMC8655936 DOI: 10.1021/acsomega.1c03827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/14/2021] [Indexed: 06/14/2023]
Abstract
Self-poisoning with professional agricultural pesticide products is responsible for about 20% of global suicide, with most cases occurring in South Asia and China. Treatment of severe poisoning involves long-term intensive clinical care and is often unsuccessful. Solvent co-formulants (such as cyclohexanone) also contribute to mortality themselves or via more toxic metabolic products (such as cyclohexanol). Faster detection of co-formulants could aid earlier identification of pesticide poisoning and faster intervention, reducing mortality. Conventional analysis of volatiles in blood uses headspace (HS)-GC/MS. This paper evaluates SIFT-MS, a direct MS technique that provides higher sample throughput than GC/MS, as a potential tool for cyclohexanone and cyclohexanol analysis in plasma. Both instruments were calibrated using a conventional approach prior to analysis of each porcine plasma sample on both instruments. Comparative data were evaluated using Bland-Altman plots, demonstrating that the techniques were in good agreement. Compared with GC/MS, SIFT-MS provides fourfold higher sample throughput and shows great promise as an alternative analytical tool.
Collapse
Affiliation(s)
- Colin Hastie
- Anatune Ltd, Unit 4, Wellbrook Court, Girton
Road, Cambridge CB3 0NA, United Kingdom
| | - Adrian Thompson
- University/BHF Centre for Cardiovascular
Sciences, Queen’s Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom
| | - Mark Perkins
- Anatune Ltd, Unit 4, Wellbrook Court, Girton
Road, Cambridge CB3 0NA, United Kingdom
| | | | - Michael Eddleston
- University/BHF Centre for Cardiovascular
Sciences, Queen’s Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom
| | - Natalie ZM. Homer
- University/BHF Centre for Cardiovascular
Sciences, Queen’s Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom
- Mass
Spectrometry Core, Edinburgh Clinical Research Facility, University/BHF Centre for Cardiovascular Sciences,
Queen’s Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, United
Kingdom
| |
Collapse
|
2
|
Vliegenthart A, Kimmitt RA, Seymour JH, Homer NZ, Clarke JI, Eddleston M, Gray A, Wood DM, Dargan PI, Cooper JG, Antoine DJ, Webb DJ, Lewis SC, Bateman DN, Dear JW. Circulating acetaminophen metabolites are toxicokinetic biomarkers of acute liver injury. Clin Pharmacol Ther 2016; 101:531-540. [PMID: 27770431 PMCID: PMC6099202 DOI: 10.1002/cpt.541] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/15/2016] [Accepted: 10/17/2016] [Indexed: 02/07/2023]
Abstract
Acetaminophen (paracetamol-APAP) is the most common cause of drug-induced liver injury in the Western world. Reactive metabolite production by cytochrome P450 enzymes (CYP-metabolites) causes hepatotoxicity. We explored the toxicokinetics of human circulating APAP metabolites following overdose. Plasma from patients treated with acetylcysteine (NAC) for a single APAP overdose was analyzed from discovery (n = 116) and validation (n = 150) patient cohorts. In the discovery cohort, patients who developed acute liver injury (ALI) had higher CYP-metabolites than those without ALI. Receiver operator curve (ROC) analysis demonstrated that at hospital presentation CYP-metabolites were more sensitive/specific for ALI than alanine aminotransferase (ALT) activity and APAP concentration (optimal CYP-metabolite receiver operating characteristic area under the curve (ROC-AUC): 0.91 (95% confidence interval (CI) 0.83-0.98); ALT ROC-AUC: 0.67 (0.50-0.84); APAP ROC-AUC: 0.50 (0.33-0.67)). This enhanced sensitivity/specificity was replicated in the validation cohort. Circulating CYP-metabolites stratify patients by risk of liver injury prior to starting NAC. With development, APAP metabolites have potential utility in stratified trials and for refinement of clinical decision-making.
Collapse
Affiliation(s)
- Adb Vliegenthart
- Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK
| | - R A Kimmitt
- Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK
| | - J H Seymour
- Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK
| | - N Z Homer
- Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK
| | - J I Clarke
- MRC Centre for Drug Safety Science, Department of Molecular & Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - M Eddleston
- Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK
| | - A Gray
- Emergency Medicine Research Group, Department of Emergency Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - D M Wood
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | - P I Dargan
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | - J G Cooper
- Emergency Department, Aberdeen Royal Infirmary, Aberdeen, UK
| | - D J Antoine
- MRC Centre for Drug Safety Science, Department of Molecular & Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - D J Webb
- Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK
| | - S C Lewis
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - D N Bateman
- Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK
| | - J W Dear
- Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK
| |
Collapse
|