Immunoassay screening in urine for synthetic cannabinoids – an evaluation of the diagnostic efficiency
| Autor: | Bjoern Moosmann, Melanie Pegoro, Christian Schlögl, Reinhard Mielke, David Janele, Ralf Zehnle, Hanna Jechle, Verena Angerer, Volker Auwärter, Georg Weinfurtner, Harald Ertl, Stefan Gerl, Matthias Wagner, Florian Franz, Matthias Friedl |
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| Rok vydání: | 2017 |
| Předmět: |
Spectrometry
Mass Electrospray Ionization medicine.medical_specialty medicine.drug_class Clinical Biochemistry Population Analytical chemistry Structural diversity Diagnostic accuracy Urine 01 natural sciences 03 medical and health sciences 0302 clinical medicine Tandem Mass Spectrometry Internal medicine Synthetic cannabinoids medicine Humans education Retrospective Studies Immunoassay education.field_of_study medicine.diagnostic_test Cannabinoids business.industry 010401 analytical chemistry Biochemistry (medical) Ms analysis General Medicine 0104 chemical sciences Substance Abuse Detection Designer drug business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Clinical Chemistry and Laboratory Medicine (CCLM). 55 |
| ISSN: | 1437-4331 1434-6621 |
| DOI: | 10.1515/cclm-2016-0831 |
| Popis: | Background:The abuse of synthetic cannabinoids (SCs) as presumed legal alternative to cannabis poses a great risk to public health. For economic reasons many laboratories use immunoassays (IAs) to screen for these substances in urine. However, the structural diversity and high potency of these designer drugs places high demands on IAs regarding cross-reactivity of the antibodies used and detection limits.Methods:Two retrospective studies were carried out in order to evaluate the capability of two homogenous enzyme IAs for the detection of currently prevalent SCs in authentic urine samples. Urine samples were analyzed utilizing a ‘JWH-018’ kit and a ‘UR-144’ kit. The IA results were confirmed by an up-to-date liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) screening method covering metabolites of 45 SCs.Results:The first study (n=549) showed an 8% prevalence of SCs use (LC-MS/MS analysis) among inpatients of forensic-psychiatric clinics, whereas all samples were tested negative by the IAs. In a second study (n=200) the combined application of both IAs led to a sensitivity of 2% and a diagnostic accuracy of 51% when applying the recommended IA cut-offs. Overall, 10 different currently prevalent SCs were detected in this population. The results can be explained by an insufficient cross-reactivity of the antibodies towards current SCs in combination with relatively high detection limits of the IAs.Conclusions:In light of the presented study data it is strongly recommended not to rely on the evaluated IA tests for SCs in clinical or forensic settings. For IA kits of other providers similar results can be expected. |
| Databáze: | OpenAIRE |
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