Quantification of phosphatidylethanol 16:0/18:1, 18:1/18:1, and 16:0/16:0 in venous blood and venous and capillary dried blood spots from patients in alcohol withdrawal and control volunteers

Kummer, Natalie; Ingels, Ann Sofie; Wille, Sarah M. R.; Hanak, Catherine; Verbanck, Paul; Lambert, Willy E.; Samyn, Nele; Stove, Christophe

doi:10.1007/s00216-015-9169-1

Cited by 70 publications

(52 citation statements)

References 34 publications

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“…Research staff in our study were trained by a short instructional video on collection. PEth levels from one study demonstrated consistency in measurements between capillary-DBS, whole blood, or venous-DBS (Kummer et al, 2016) allowing for multiple routes of blood collection, and PEth can be assayed as soon as 60 minutes after alcohol consumption (Gnann et al, 2012). Finally, unlike whole blood venipuncture, PEth does not continue to increase after DBS collection in individuals that had an elevated BAC at time of blood draw (Schrock et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Cut-Point Levels of Phosphatidylethanol to Identify Alcohol Misuse in a Mixed Cohort Including Critically Ill Patients

Afshar

Burnham

Joyce

et al. 2017

Alcohol Clin Exp Res

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Background Although alcohol misuse is associated with deleterious outcomes in critically ill patients, its detection by either self-report or examination of biomarkers is difficult to obtain consistently. Phosphatidylethanol (PEth) is a direct alcohol biomarker that can characterize alcohol consumption patterns; however, its diagnostic accuracy in identifying misuse in critically ill patients is unknown. Methods PEth values were obtained in a mixed cohort comprised of 122 individuals from medical and burn intensive care units (n=33), alcohol detoxification unit (n=51), and healthy volunteers (n=38). Any alcohol misuse and severe misuse were referenced by AUDIT and AUDIT-C scores separately. Mixed effects logistic regression analysis was performed and the discrimination of PEth was evaluated using the area under the receiver operating characteristic (ROC) curve. Results The area under the ROC curve for PEth was 0.927 (95% CI: 0.877, 0.977) for any misuse and 0.906 (95% CI: 0.850, 0.962) for severe misuse defined by AUDIT. By AUDIT-C, the area under the ROC curves were 0.948 (95% CI: 0.910, 0.956) for any misuse and 0.913 (95% CI: 0.856, 0.971) for severe misuse. The PEth cut-points of ≥ 250 ng/mL and ≥ 400 ng/mL provided optimal discrimination for any misuse and severe misuse, respectively. The positive predictive value for ≥ 250 ng/mL was 88.7% (95% CI: 77.5%, 95.0%) and negative predictive value was 86.7% (95% CI: 74.9%, 93.7%). PEth ≥ 400 ng/mL achieved similar values and similar results were shown for AUDIT-C. In a subgroup analysis of critically ill patients only, test characteristics were similar to the mixed cohort. Conclusions PEth is a strong predictor and has good discrimination for any and severe alcohol misuse in a mixed cohort that includes critically ill patients. Cut-points at 250 ng/mL for any, and 400 ng/mL for severe, are favorable. External validation will be required to establish these cut-points in critically ill patients.

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Section: Discussionmentioning

confidence: 99%

Cut-Point Levels of Phosphatidylethanol to Identify Alcohol Misuse in a Mixed Cohort Including Critically Ill Patients

Afshar

Burnham

Joyce

et al. 2017

Alcohol Clin Exp Res

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“…DBS proved to be advantageous concerning the analyte's stability: While the DBS is drying, enzymatic activity is stopped and ethanol evaporates, preventing metabolic post‐sampling formation or degradation of PEth . Furthermore, the possibility of minimally invasive fingertip sampling to obtain capillary DBS has attracted research attention . Contrary to the blood sampling by venipuncture, healthcare professionals such as nurses or doctors are not needed for the capillary DBS sampling.…”

Section: Introductionmentioning

confidence: 99%

“…11 Furthermore, the possibility of minimally invasive fingertip sampling to obtain capillary DBS has attracted research attention. 12 Contrary to the blood sampling by venipuncture, healthcare professionals such as nurses or doctors are not needed for the capillary DBS sampling.…”

Section: Introductionmentioning

confidence: 99%

Monitoring of direct alcohol markers in alcohol use disorder patients during withdrawal treatment and successive rehabilitation

Luginbühl

Weinmann

Butzke

et al. 2019

Drug Testing and Analysis

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Direct and indirect biomarkers are widely applied for the determination of alcohol consumption. They help to assess past or present alcohol consumption. Depending on the window of detection and sensitivity of the investigated marker, punctual alcohol consumption may remain undetected. In this study, different sampling strategies for the intermediary long‐term marker phosphatidylethanol (PEth) are evaluated and compared to the determination of the short‐term markers ethyl glucuronide (EtG) and ethyl sulfate (EtS) in urine. Samples from 19 patients undergoing alcohol use disorder treatment were collected during the withdrawal treatment and successive rehabilitation (33 ± 26 days (range: 3–74 days)). With liquid chromatography–tandem mass spectrometry (LC–MS/MS) EtG and EtS in urine, PEth in blood, PEth in dried blood spot (DBS) from venous blood, and PEth in DBS from capillary blood were quantified and compared. The use of volumetric capillary DBS, prepared from 20 μL of blood, provided the same results as the use of venous DBS (95% ± 10%, R2 0.9899 for PEth 16:0/18:1). Capillary DBS sampling has the advantage that it can be performed without venipuncture. The use of PEth in DBS proved to prevent post‐sampling degradation, providing a longer detection in comparison to PEth in liquid blood, which only showed 67% ± 24% of the PEth DBS 16:0/18:1 concentration. When compared with EtG and EtS in urine, PEth monitoring proved to be advantageous for the detection of relapse situations, as the accumulation of PEth in blood prolongs the detectability. In conclusion, volumetric capillary DBS sampling for PEth is a simple and useful tool for compliance monitoring, and avoids hematocrit issues.

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“…Also in the context of driving license regranting programs, in which drivers with a history of alcohol abuse are followed up, DBS sampling may be beneficial. We recently demonstrated this for phosphatidylethanol (PEth), a direct alcohol marker that is used to monitor alcohol consumption during the past few weeks: capillary concentrations of PEth were equivalent to those found in venous blood, demonstrating that capillary DBS are a valid alternative for venous blood for this purpose 66 . Since the sampling procedure does not require dedicated staff and PEth outperforms indirect markers like carbohydrate-deficient transferrin (CDT), capillary DBS sampling offers a promising avenue for routine follow-up of drivers with a history of alcohol abuse.…”

Section: Toxicologymentioning

confidence: 99%

Opening the toolbox of alternative sampling strategies in clinical routine: A key-role for (LC-)MS/MS

Velghe

Capiau

Stove

2016

TrAC Trends in Analytical Chemistry

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Alternative sampling strategies such as dried blood sampling, liquid microsampling and the sampling of oral fluid, hair, meconium, interstitial fluid, sweat, exhaled breath condensate and sputum offer interesting opportunities for many applications in clinical routine. Here, we provide an overview of different applications, with special attention to the pivotal role of LC-MS/MS in facilitating analysis of the collected matrices. Covered clinical fields include newborn screening, endocrinology, therapeutic drug monitoring, phenotyping, toxicology, proteomics and metabolomics. Furthermore, specific advantages, challenges and limitations of each alternative sampling strategy are discussed, along with recent advances and future trends that may contribute to routine implementation of these sampling strategies. Given the development of many recent potentially valuable clinical applications, the possibility of home sampling and the opportunity to obtain information that is hard to procure using traditional sampling, a well-balanced role for alternative sampling strategies can be envisaged in patient healthcare in the (near) future.

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Quantification of phosphatidylethanol 16:0/18:1, 18:1/18:1, and 16:0/16:0 in venous blood and venous and capillary dried blood spots from patients in alcohol withdrawal and control volunteers

Abstract: To refer to or to cite this work, please use the citation to the published version:Kummer N., Ingels A-S., Wille S. M.R., Hanak C. , Verbanck P. , Lambert W., Samyn N., Stove C.

Cited by 70 publications

References 34 publications

Cut-Point Levels of Phosphatidylethanol to Identify Alcohol Misuse in a Mixed Cohort Including Critically Ill Patients

Cut-Point Levels of Phosphatidylethanol to Identify Alcohol Misuse in a Mixed Cohort Including Critically Ill Patients

Monitoring of direct alcohol markers in alcohol use disorder patients during withdrawal treatment and successive rehabilitation

Opening the toolbox of alternative sampling strategies in clinical routine: A key-role for (LC-)MS/MS

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