Journal
CLINICAL CHEMISTRY
Volume 60, Issue 8, Pages 1115-1125Publisher
AMER ASSOC CLINICAL CHEMISTRY
DOI: 10.1373/clinchem.2014.222976
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Funding
- California Association of Toxicologists Research Grant
- University of California-San Diego clinical chemistry fellowship program funding by Roche Diagnostics
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BACKGROUND: High-resolution mass spectrometry (HRMS) has the potential to supplement other drug screening platforms used in toxicology laboratories. HRMS offers high analytical specificity, which can be further enhanced by incorporating a fragment ion for each analyte. The ability to obtain precursor ions and fragment ions using elevated collision energies (MSE) can help improve the specificity of HRMS methods. METHODS: We developed a broad-spectrum screening method on an ultraperformance liquid chromatography TOF mass spectrometer (UPLC-TOF-MS) using the MSE mode. A diverse set of patient samples were subjected to a simple dilute, hydrolyze, and shoot protocol and analyzed in a blind manner. Data were processed with 3 sets of criteria with increasing stringency, and the results were compared with the reference laboratory results. RESULTS: Acombination of retention time match (+/- 0.2 min), a protonated analyte, and fragment ion mass accuracy of +/- 5 ppm produced zero false-positive results. Using these criteria, we confirmed 92% (253/275) of true positives. The positive confirmation rate increased to 98% (270/275) when the requirement for a fragment ion was dropped, but also produced 53 false positives. A total of 136 additional positive drug findings not identified by the reference methods were identified with the UPLC-TOF-MS. CONCLUSIONS: MSE provides a unique way to incorporate fragment ion information without the need of precursor ion selection. A primary limitation of requiring a fragment ion for positive identification was that certain drug classes required high-energy collisions, which formed many fragment ions of low abundance that were not readily detected. (C) 2014 American Association for Clinical Chemistry
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