Evaluation of Therapeutic Opioids in Hair of Neonatal and Pediatric Patients.

IF 2.7 3区 医学 Q2 BIOCHEMICAL RESEARCH METHODS
Max Polke, Florian Zapf, Tanja Restin, Thomas Kraemer, Tina M Binz
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引用次数: 0

Abstract

Forensic hair analysis poses a valuable tool for assessing opioid exposure in children and neonates. However, reliable literature data on opioid concentrations in the hair of this population are mostly scarce, making the interpretation of such hair analysis results rather challenging. This noninterventional study aims to address this issue by investigating 118 hair samples of pediatric patients (median age: 50 days) from the University Children's Hospital Zurich. These patients were treated with medically approved novel synthetic opioids (fentanyl, remifentanil, sufentanil, or alfentanil) and traditional opioids (morphine, methadone, and hydromorphone) during their clinical treatment. Quantification of the opioids and selected metabolites was achieved by a previously validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) based method, which showed good sensitivity with lower limits of quantification (LLOQs) ranging from 0.1 to 1 pg/mg hair. Most analytes were successfully detected in patients' hair, with the majority being identified for the first time in this matrix. Significant correlations were found between the opioid concentrations in hair and the administered medication doses, indicating that hair analysis may reflect the extent of opioid exposure in this population. Furthermore, metabolite ratios similar to the ones commonly found in adult hair were identified, which are forensically important to differentiate between active intake of a drug and contamination. The metabolite ratio of β-hydroxyfentanyl to fentanyl was particularly well suited for children and neonatal patients. In conclusion, concentration ranges, metabolite ratios, and dose correlations of the studied opioids in pediatric hair were established, providing insights into opioid incorporation pathways.

阿片类药物治疗新生儿和儿童毛发的评价。
法医毛发分析是评估儿童和新生儿阿片类药物暴露的宝贵工具。然而,关于这一人群头发中阿片类药物浓度的可靠文献数据大多很少,这使得对这种头发分析结果的解释相当具有挑战性。这项非介入性研究旨在通过调查来自苏黎世大学儿童医院的118名儿科患者(中位年龄:50天)的头发样本来解决这一问题。这些患者在临床治疗期间接受医学上批准的新型合成阿片类药物(芬太尼、瑞芬太尼、舒芬太尼或阿芬太尼)和传统阿片类药物(吗啡、美沙酮和氢吗啡酮)治疗。通过液相色谱-串联质谱(LC-MS/MS)方法实现了阿片类药物和选定代谢物的定量,该方法具有良好的灵敏度,定量下限(LLOQs)为0.1至1 pg/mg头发。大多数分析物在患者的头发中被成功检测到,其中大多数是第一次在这个矩阵中被识别出来。头发中的阿片类药物浓度与给药剂量之间存在显著相关性,表明头发分析可能反映该人群中阿片类药物暴露的程度。此外,鉴定出了与成人头发中常见的代谢物比率相似的代谢物比率,这对于区分主动摄入药物和污染具有重要的法医意义。β-羟基芬太尼与芬太尼的代谢物比例特别适合儿童和新生儿患者。总之,我们建立了儿童毛发中阿片类药物的浓度范围、代谢物比率和剂量相关性,为阿片类药物的掺入途径提供了见解。
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来源期刊
Drug Testing and Analysis
Drug Testing and Analysis BIOCHEMICAL RESEARCH METHODS-CHEMISTRY, ANALYTICAL
CiteScore
5.90
自引率
24.10%
发文量
191
审稿时长
2.3 months
期刊介绍: As the incidence of drugs escalates in 21st century living, their detection and analysis have become increasingly important. Sport, the workplace, crime investigation, homeland security, the pharmaceutical industry and the environment are just some of the high profile arenas in which analytical testing has provided an important investigative tool for uncovering the presence of extraneous substances. In addition to the usual publishing fare of primary research articles, case reports and letters, Drug Testing and Analysis offers a unique combination of; ‘How to’ material such as ‘Tutorials’ and ‘Reviews’, Speculative pieces (‘Commentaries’ and ‘Perspectives'', providing a broader scientific and social context to the aspects of analytical testing), ‘Annual banned substance reviews’ (delivering a critical evaluation of the methods used in the characterization of established and newly outlawed compounds). Rather than focus on the application of a single technique, Drug Testing and Analysis employs a unique multidisciplinary approach to the field of controversial compound determination. Papers discussing chromatography, mass spectrometry, immunological approaches, 1D/2D gel electrophoresis, to name just a few select methods, are welcomed where their application is related to any of the six key topics listed below.
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