Gas Chromatography-Tandem Mass Spectrometry Verification of Sulfur Mustard Exposure in Humans through the Conversion of Protein Adducts to Free Sulfur Mustard.

Exposures to sulfur mustard (HD; bis(2-chloroethyll) sulfide) are well-known to result in the formation of adducts with free aspartate and glutamate residues of plasma proteins (Lawrence, R. J., Smith, J. R., and Capacio, B. R. 2008 32, (1), 31-36). A modified version of the analytical method reported previously for the verification of HD exposure has been developed (Lawrence, R. J., Smith, J. R., and Capacio, B. R. 2008 32, (1), 31-36). The method reported herein involves the reaction of hydrochloric acid with HD-adducted plasma proteins, resulting in the simultaneous cleavage and conversion of the adduct to free HD. A water scavenger, 2,2-dimethoxypropane, was added to the mixture to increase the reaction yield. Deuterated (d8) thiodiglycol was added as an internal standard and underwent conversion to deuterated sulfur mustard. The analytes were isolated by hexane liquid-liquid extraction and subsequently analyzed by gas chromatography tandem mass spectrometry (GC-MS-MS). An interday and intraday study was performed to evaluate the accuracy and precision of the method. Individual calibration curves with quality control (QC) standards were prepared on 5 days, and a calibration curve with five sets of QCs was prepared on a single day. All results were within the acceptable limits of the validation criteria. Linearity, limit of detection, and limit of quantitation were also verified for each calibration curve. This highly sensitive (pg/mL limit of detection) method can be used for rapid analysis of a definitive marker of sulfur mustard exposure.

Validation of an ELISA Synthetic Cannabinoids Urine Assay.

BACKGROUND: Synthetic cannabinoids are touted as legal alternatives to cannabis, at least when first released, and routine urine cannabinoid screening methods do not detect these novel psychoactive substances. Synthetic cannabinoids are widely available, are a major public health and safety problem, and a difficult challenge for drug-testing laboratories. We evaluated performance of the National Medical Services (NMS) JWH-018 direct enzyme-linked immunosorbent assay (ELISA) kit to sensitively, selectively, and rapidly screen urinary synthetic cannabinoids. METHODS: The NMS ELISA kit targeting the JWH-018 N-(5-hydroxypentyl) metabolite was used to screen 2492 urine samples with 5 and 10 mcg/L cutoffs. A fully validated liquid chromatography-tandem mass spectrometry method for 29 synthetic cannabinoids markers confirmed all presumptive positive and negative results. Performance challenges at ±25% and ±50% of cutoffs determined intraplate and interplate imprecision around proposed cutoffs. RESULTS: The immunoassay was linear from 1 to 500 mcg/L with intraplate and interplate imprecision of ≤8.2% and <14.0%, respectively. No interferences were present from 93 common drugs of abuse, metabolites, coadministered drugs, over-the-counter medications, or structurally similar compounds, and 19 of 73 individual synthetic cannabinoids (26%) exhibited moderate to high cross-reactivity to JWH-018 N-(5-hydroxypentyl) metabolite. Sensitivity, specificity, and efficiency results were 83.7%, 99.4%, and 97.6%, as well as 71.6%, 99.7%, and 96.4% with the 5 and 10 mcg/L urine cutoffs, respectively. CONCLUSIONS: This high throughput immunoassay exhibited good diagnostic efficiency and documented that the NMS JWH-018 direct ELISA is a viable method for screening synthetic cannabinoids in urine targeting the JWH-018 N-(5-hydroxypentyl) and related analytes. Optimal performance was achieved with a matrix-matched 5 mcg/L urine cutoff.

The Application of a Single-Column GC-MS-MS Method for the Rapid Analysis of Chemical Warfare Agents and Breakdown Products.

The development of one comprehensive gas chromatographic-triple quadrupole mass spectrometric (GC-MS-MS) method for the analysis of nerve agents and their breakdown products can pose a challenge due to significant differences in analyte volatility. Nerve agent breakdown products typically have a low volatility, requiring a derivatization step prior to analysis by gas chromatography (GC). However, nerve agent parent compounds are generally more volatile, which eliminates the need for derivatization and allows for direct analysis. Therefore, the analysis of these analytes is typically performed using separate analytical methods. This may require the use of multiple columns composed of different stationary phases to ensure the most efficient separation. With the wide selection of GC columns and derivatizing agents, it is potentially possible to develop a single-column/analytical method that is suitable for the detection of nerve agents and their breakdown products. We evaluated six nerve agents (tabun, sarin, soman, cyclosarin, VX and Russian VX) and the six corresponding breakdown products (EDPA, IMPA, PMPA, CMPA EMPA and MMPA). Chromatographic separation and multiple-reaction mode electron ionization detection of the nerve agents and silylated breakdown product derivatives were performed using an Agilent 7890 A gas chromatography (GC) equipped with a mid-polarity column, coupled to a 7000 triple quadrupole mass spectrometry system. A fast (12.5 min), highly sensitive (picogram) and selective method was achieved. The feasibility of this method for nerve agent and breakdown product detection in real samples was demonstrated using nerve agent-spiked human plasma at various exposure times (3 min, 1 h and 24 h). Five of the six nerve agents and all six breakdown products were successfully detected. This robust method has utility as a rapid screening tool to identify a specific nerve agent in a potential exposure event by simultaneous detection of the parent and or its corresponding breakdown product in plasma.

Performance characteristics of an ELISA screening assay for urinary synthetic cannabinoids.

Synthetic cannabinoids are marketed as legal alternatives to cannabis, as routine urine cannabinoid immunoassays do not detect synthetic cannabinoids. Laboratories are challenged to identify these new designer drugs that are widely available and represent a major public health and safety problem. Immunoassay testing offers rapid separation of presumptive positive and negative specimens, prior to more costly and time-consuming chromatographic confirmation. The Neogen SPICE ELISA kit targets JWH-018 N-pentanoic acid as a marker for urinary synthetic cannabinoids. Assay performance was evaluated by analyzing 2469 authentic urine samples with the Neogen immunoassay and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Two immunoassay cut-off concentrations, 5 and 10 µg/L, classified samples as presumptive positive or negative, followed by qualitative LC-MS/MS confirmation for 29 synthetic cannabinoids markers with limits of detection of 0.5-10 µg/L to determine the assay's sensitivity, specificity and efficacy. Challenges at ±25% of each cut-off also were investigated to determine performance around the cut-off and intra- and inter-plate imprecision. The immunoassay was linear from 1 to 250 µg/L (r(2) = 0.992) with intra- and inter-plate imprecision of ≤5.3% and <9%, respectively. Sensitivity, specificity, and efficiency results with the 5 µg/L cut-off were 79.9%, 99.7%, and 97.4% and with the 10 µg/L cut-off 69.3%, 99.8%, and 96.3%, respectively. Cross-reactivity was shown for 18 of 73 synthetic cannabinoids markers evaluated. Good sensitivity, specificity, and efficiency, lack of sample preparation requirements, and rapid semi-automation documented that the Neogen SPICE ELISA kit is a viable method for screening synthetic cannabinoids in urine targeting JWH-018 N-pentanoic acid.

Evaluation of a homogenous enzyme immunoassay for the detection of synthetic cannabinoids in urine.

INTRODUCTION: The recent emergence and widespread availability of many new synthetic cannabinoids support the need for an accurate and high-throughput urine screen for these new designer drugs. We evaluated performance of the immunalysis homogeneous enzyme immunoassay (HEIA) to sensitively, selectively, and rapidly identify urinary synthetic cannabinoids. METHODS: 2443 authentic urine samples were analyzed with the HEIA that targets JWH-018 N-pentanoic acid, and a validated LC-MS/MS method for 29 synthetic cannabinoids and metabolites. Semi-quantitative HEIA results were obtained, permitting performance evaluation at and around three cutoffs (5, 10 and 20 µg/L), and diagnostic sensitivity, specificity and efficiency determination. Performance challenges at ±25 and ±50% of each cutoff level, cross-reactivity and interferences also were evaluated. RESULTS: Sensitivity, specificity, and efficiency of the immunalysis HEIA K2 Spice kit with the manufacturer's recommended 10 µg/L cutoff were 75.6%, 99.6% and 96.8%, respectively, as compared to the reference LC-MS/MS method with limits of detection of 0.1-10 µg/L. Performance at 5 µg/L was 92.2%, 98.1% and 97.4%, and for the 20 µg/L cutoff were 62.9%, 99.7% and 95.4%. Semi-quantitative results for in-house prepared standards were obtained from 2.5-30 µg/L, and documented acceptable linearity from 5-25 µg/L, with inter-day imprecision <30% (n = 17). Thirteen of 74 synthetic cannabinoids evaluated were classified as highly cross-reactive (≥50% at 10 µg/L); 4 showed moderate cross-reactivity (10-50% at 10 µg/L), 30 low cross-reactivity (<10% at 500 µg/L), and 27 <1% cross-reactivity at 500 µg/L. There was no interference from 102 investigated compounds. Only a mixture containing 1000 µg/L each of buprenorphine/norbuprenorphine produced a positive result above our proposed cutoff (5 µg/L) but below the manufacturer's recommended cutoff concentration (10 µg/L). CONCLUSION: The Immunalysis HEIA K2 Spice kit required no sample preparation, had a high-throughput, and acceptable sensitivity, specificity and efficiency, offering a viable method for screening synthetic cannabinoids in urine that cross-react with JWH-018 N-pentanoic acid antibodies.