A P P L I C AT I O N N O T E Liquid Chromatography/ Mass Spectrometry PerkinElmer, Inc. Waltham, MA A Quantitative SLE LC/TOF MS Method to Detect Multiple Drugs and Drug Metabolites in Urine Introduction Liquid chromatography-mass spectrometry (LC/MS) is commonly used to measure drugs and their concentrations in extracts of biological matrices. Triple quadrupole MS is often employed for targeted quantitative analysis, using multiple reaction monitoring (MRM) mode. Here, the intensity of product ions resulting from the collisionally induced fragmentation of a specified precursor ion is measured. Using MRM mode requires complex method optimization for each compound and the measurement is limited to targeted species. In contrast, time-of-flight (TOF) MS has higher mass resolution than quadrupole MS and allows for post-acquisition data interrogation of drugs and metabolites not originally specified in the experimental method. This latter process is not possible using triple quadrupole MRM data, which only records information on those species originally specified. This study was conducted to evaluate the performance of a quantitative LC/TOF MS method to detect 52 drugs and drug metabolites in human urine. Drug standards in urine were treated with glucuronidase and then prepared using supported liquid extraction (SLE) prior to LC/TOF MS analysis. Heavy isotope labeled internal standards were utilized to normalize for variations in extraction efficiency and instrument response. Experimental Table 1. Liquid Chromatography Parameters. Flexar System: FX-15 UHPLC pump, autosampler, and column oven Mobile phase A Water containing 0.1% Formic acid Mobile phase B Acetonitrile containing 0.1% Formic acid Autosampler needle wash Acetonitrile (2 x 1mL post-injection flushes) Sample injection 10 µL fixed loop, 8 injections Flow rate 0.4 mL/min Column temperature 45 °C Brownlee™ SPP Phenyl-Hexyl column 2.1 x 100 mm, 2.7 µm, p/n N9308485 Pre-column filter 0.5 µm porosity stainless steel Table 2. Liquid Chromatography Gradient. Time (min) %B 0 7 0.8 7 4.8 60 4.9 100 5.9 100 6.0 7 3 min equilibration at 7% B Table 3. Mass Spectrometry. Instrument and Software Parameters PerkinElmer AxION® 2 TOF mass spectrometer Chromera® software Ultraspray™ 2 Dual Probe electrospray source Positive pulse mode 3 spectra per second acquisition rate m/z range 70 to 1250 Drying gas flow: 14 liters per minute at 350 °C Endplate heater: Medium Lockmass mode: 127.0727, 609.2807, Search span 50 mmu Lockmass solution: methanol containing 0.1% Lockmass calibrant concentration: 6 µg/mL each Left ESI probe (lockmass): 20 psi, right probe (column): 80 psi Capillary exit: 90 V, Skimmer: 25 V Extracted ion chromatogram (EIC) tolerance: ± 0.03 u Table 4. Reagents. Reagent Certified reference material (CRM) drug standards Ethanol- and drug-free human urine (OH2040) LC/MS grade water (LC365) LC/MS grade acetonitrile (LC015) 2 Supplier Cerilliant® (Round Rock, TX) Golden West Biologicals® (Temecula, CA) Honeywell Burdick & Jackson® (Muskegon, MI) Honeywell Burdick & Jackson® (Muskegon, MI) LC/MS grade methanol (A 456) Fisher Scientific™ (Pittsburgh, PA) LC/MS grade formic acid (A 117) Fisher Scientific™ (Pittsburgh, PA) Ethyl acetate (E196SK) Fisher Scientific™ (Pittsburgh, PA) Ammonium hydroxide (28%, 338818) Sigma-Aldrich® (St. Louis, MO). Glacial acetic acid (695084) Sigma-Aldrich® (St. Louis, MO). 5 M ammonium acetate (09691) Sigma-Aldrich® (St. Louis, MO). β-glucuronidase (Patella vulgata, G 8132) Sigma-Aldrich® (St. Louis, MO). Melamine (lockmass low, M 2659) Sigma-Aldrich® (St. Louis, MO). Reserpine (lockmass high, R 0875) Sigma-Aldrich® (St. Louis, MO). Mass spectrometry. The lockmass solution was delivered from the onboard pressurized calibration vials through an 8 cm length of 250 µm ID PEEK tubing to a 0.5 µm porosity stainless steel in-line filter (IDEX, Oak Harbor, WA). Solvent flow was regulated by connecting a 110 cm length of 125 µm PEEK tubing from the filter to provide backpressure. This setup yielded a flow rate of 30 µL/min. The monoisotopic peak was used to generate all EICs except for the di-halogenated compounds lorazepam-D4 and phenazepam-D4. The EICs for these two compounds were generated using the A+2 peaks to avoid interference from higher isotope peaks of their corresponding unlabeled analytes. Sample preparation. ISOLUTE 400 µL 96-well SLE+ and sample collection plates were obtained from Biotage® (Uppsala, Sweden). Isotope labeled internal standards solution in methanol (0.4 mL of 1 µg/mL for each drug except flurazepam) were added to glass vials and dried for 45 min. at room temperature in a Thermo Savant™ SPD2010 SpeedVac system. A concentrated stock (2,000 ng/mL) of 52 analytes was prepared in drug-free urine (Lot #G011704063) using Cerilliant® CRM neat solution stocks. The concentrated stock was spiked into drug-free urine aliquots to produce the final concentration levels, calibrators: 1, 2.5, 5, 10, 25, 50, 100, 250, 500, and 1000 ng/mL (Lot #G011704063), test samples: 5, 10, 25, 100, 250, and 750 ng/mL (Lot #G011611003). 2 mL aliquots of spiked urine were added to vials containing the dried internal standards to yield a final internal standard concentration of 200 ng/mL for all samples. 20 µL of 5 M ammonium acetate, pH 5 and 30 µL of β-glucuronidase (333.3 units/µL) were added to each sample, mixed, and incubated at 40 °C for 30 min. Samples were returned to room temperature, then 20 µL of concentrated ammonium hydroxide was added to each vial and mixed. Four 400 µL aliquots of each sample were added to four consecutive wells of the SLE+ plate on a Supelco® vacuum manifold and a brief pulse of vacuum was applied to load the samples. The samples were incubated for five min. at room temperature and then eluted with two additions of ethyl acetate (600 µL each) which were allowed to flow by gravity, followed by a brief pulse of vacuum. Eluates were dried under a stream of nitrogen at 40 °C for 40 min. with a microplate evaporator (Evaporex® EVX-192, Covina, CA). Each sample well was reconstituted with 350 µL of 5% acetonitrile in water containing 0.1% formic acid and shaken for 10 min. at room temperature at 400 rpm on an incubating microplate shaker (VWR, Radnor, PA). The four wells for each sample were pooled by transferring to a single well of a 2 ml 96-well plate (1.4 mL total volume each) for LC-TOF-MS analysis. Data analysis. Instrument response was expressed as analyte/ IS ratio using the heavy isotope labeled internal standard for each analyte, with the exception of flurazepam which used buprenorphine-D4 as a surrogate IS. Calibration curves were generated from the 10 level calibration samples using a quadratic fit with no weighting and unconstrained y-intercept. The upper and lower concentration level of the curves was determined as the range which produced a uniform distribution of residuals at each included level and had an analyte/IS ratio imprecision of ≤ 25 %CV. The resulting calibration curve parameters were used to determine concentration values of the test samples. Percent recovery of test samples was calculated as (average measured concentration / spiked concentration) × 100. Imprecision of test samples (%CV) was calculated as (standard deviation in concentration units / average measured concentration) × 100. The limit of quantitation (LOQ) was determined as the lowest test sample concentration with imprecision of ≤ 25 %CV, recovery between 75% and 125%, and a minimum of seven replicate measurements. Limit of detection (LOD) was estimated as: t99(n – 1) × s LOQ where t99(n – 1) is the one-tailed t-statistic for n – 1 observations at the 99% confidence level and sLOQ is the standard deviation at the LOQ in concentration units. The t99(n – 1) value is 2.998 for eight replicates and 3.143 for seven replicates. Results Figure 1 shows an example LC/TOF MS analysis, the first replicate for the 250 ng/mL calibrator level, with extracted ion chromatograms for all of the drugs and internal standards. The complete dataset was processed to generate calibration curves for each drug or metabolite. The median r2 value for all calibration curves was 0.9937 (range 0.9588 to 0.9986). Two example calibration curves, for flunitrazepam and morphine, are shown in Figure 2. Calibration curves were applied to test samples to determine concentration levels and the resulting data is summarized in Table 5. Recovery values for all analytes at all levels averaged 87.1% (range 66.4 to 121.1%) and imprecision averaged 10.4 %CV (range 2.5 to 23.7 %CV). Limits of detection (LOD) were from 0.9 to 122.7 ng/ml and limits of quantitation (LOQ) ranged from 5 to 250 ng/ ml. The LOD and LOQ were not determined for sufentanil due to recoveries below 75%. Heroin was not detected with this extraction method, however, the heroin metabolite 6-acetylmorphine was detected with an LOQ of 10 ng/mL. LOQs for meprobamate (100 ng/mL), α-hydroxyalprazolam (100 ng/mL) and benzoylecgonine (250 ng/mL) were relatively high with this method and may be improved with changes to the SLE+ extraction protocol. Conclusions The LC/TOF MS method outlined here is capable of simultaneous quantitative measurement of a large number of drugs extracted from human urine. The sample preparation method can readily be automated to streamline laboratory workflows. Modification of the sample preparation protocol may improve detection limits of selected analytes. Figure 1. Example extracted ion chromatogram of the 250 ng/ml calibrator sample. Flunitrazepam Flunitrazepam 0.50.5 Morphine Morphine R² R² = 0.9959 = 0.9959 0.40.4 Analyte/IS Ratio Analyte/IS Ratio Analyte/IS Ratio Analyte/IS Ratio 0.40.4 0.30.3 0.30.3 0.20.2 0.20.2 0.10.1 0.10.1 0.00.0 0 0 R² R² = 0.9898 = 0.9898 5050 ng/mL ng/mL 100 100 0.00.0 0 0 2020 4040 ng/mL ng/mL 6060 Figure 2. Examples of analyte calibration curves. 3 Table 5. Summary of Method Performance Parameters. Calibration Curve Analyte Lower Benzodiazepines % Recovery Upper r2 LOD LOQ 5 10 25 100 81.1 103.1 105.3 88.6 85.1 81.0 86.9 92.3 105.3 87.9 86.6 83.2 96.4 106.8 92.0 92.7 78.5 92.2 92.1 105.5 84.1 91.5 93.1 94.2 93.4 84.3 85.4 86.0 100.9 83.2 121.1 84.4 103.4 98.8 97.5 84.7 84.7 80.9 88.9 83.3 98.2 73.7 93.2 103.2 83.0 79.5 75.6 81.0 79.4 76.7 86.6 75.2 78.7 82.3 77.3 97.3 77.0 79.1 91.0 81.9 84.2 84.6 80.7 96.3 83.3 84.1 77.7 75.8 82.0 86.3 76.1 82.6 78.6 75.5 68.7 72.8 71.9 83.9 97.1 72.8 74.6 82.0 76.4 81.3 85.5 88.9 78.1 97.5 86.1 75.2 74.2 81.3 80.3 77.5 97.2 72.7 66.4 77.9 80.2 80.6 87.2 91.6 80.8 92.9 89.5 80.2 78.6 86.5 89.0 80.3 94.7 79.4 73.9 85.6 91.5 88.7 101.0 7-Aminoclonazepam Alprazolam Clonazepam Diazepam Flunitrazepam Flurazepam Lorazepam Midazolam Nitrazepam Nordiazepam Oxazepam 5 1 2.5 1 1 1 1 1 1 2.5 1 100 25 50 50 100 250 250 25 50 100 100 0.9930 0.9697 0.9952 0.9953 0.9959 0.9986 0.9945 0.9765 0.9908 0.9961 0.9928 4.0 2.6 2.4 1.8 1.0 1.0 2.8 2.2 3.6 1.5 2.3 10 5 5 5 5 5 5 5 5 5 10 Phenazepam Temazepam α-Hydroxyalprazolam 1 1 5 100 100 100 0.9944 0.9903 0.9908 1.9 2.4 39.4 5 5 100 2.5 1 10 1 1 1 1 1 nd 1 2.5 1 1 2.5 5 1 1 1 1 2.5 1 2.5 1 1 1 50 50 250 50 50 25 50 50 nd 50 50 25 25 50 25 50 50 100 50 100 50 25 50 50 50 0.9932 0.9982 0.9767 0.9950 0.9936 0.9735 0.9983 0.9985 nd 0.9962 0.9835 0.9917 0.9865 0.9898 0.9794 0.9930 0.9945 0.9984 0.9951 0.9945 0.9904 0.9668 0.9962 0.9977 0.9985 2.4 2.1 4.5 1.3 2.0 2.2 1.6 1.0 nd 1.3 1.9 1.6 1.2 1.7 2.4 2.0 1.2 2.7 2.2 1.9 2.0 2.2 4.7 1.6 10 10 10 5 5 5 5 5 nd 5 5 5 5 5 10 5 5 25 10 10 5 5 25 5 5 100 1 10 1 1 5 2.5 250 1000 25 50 50 50 100 100 0.9755 0.9753 0.9941 0.9719 0.9941 0.9895 0.9981 0.9900 3.3 122.7 2.7 4.1 2.2 2.4 3.5 3.2 5 250 10 10 5 10 10 10 10 5 1 50 2.5 250 100 25 1000 25 0.9588 0.9986 0.9955 0.9963 0.9937 6.9 0.9 1.2 19.1 1.6 10 5 5 100 10 % CV 250 750 97.9 100.0 98.8 101.1 5 10 25 100 16.4 15.7 8.3 8.4 7.7 6.6 17.0 9.3 21.0 7.6 8.7 9.8 11.9 5.5 6.8 5.5 9.3 9.8 5.6 11.4 8.7 6.8 11.4 18.5 17.4 14.4 8.1 7.8 18.2 17.5 19.6 11.7 15.2 18.7 8.8 10.5 8.3 12.4 14.0 8.1 7.1 15.8 11.1 17.6 18.0 13.6 9.0 9.4 9.1 18.3 8.8 12.3 9.1 11.9 8.9 6.7 4.5 18.8 4.5 8.6 7.7 3.7 2.5 10.9 17.0 13.2 9.5 14.5 13.7 16.9 10.2 11.7 5.8 18.9 15.1 14.6 9.3 15.7 13.4 10.9 7.4 10.1 8.4 8.8 8.2 9.3 7.8 11.0 9.2 7.7 12.8 8.1 9.1 14.5 11.4 7.5 8.9 3.6 5.6 8.0 5.3 10.3 6.8 4.6 6.8 15.7 4.8 6.4 7.8 3.7 4.7 23.7 12.7 11.8 9.3 11.5 14.8 4.6 9.2 13.3 12.6 2.5 8.7 9.4 11.0 6.0 15.9 6.7 10.0 22.1 9.5 8.0 18.8 2.9 2.8 7.3 7.2 3.5 3.6 10.8 10.3 250 750 n <8 4.5 3.9 5.4 9.0 Opioids 6-Acetylmorphine Acetyl fentanyl Acetyl norfentanyl Buprenorphine Codeine Dihydrocodeine EDDP Fentanyl Heroin Hydrocodone Hydromorphone Meperidine Methadone Morphine Naloxone Naltrexone Norbuprenorphine Norfentanyl Normeperidine Norpropoxyphene Oxycodone Oxymorphone Propoxyphene Sufentanil Tramadol 67.5 9.2 85.3 95.8 96.5 93.3 12.4 7 10.2 5 5 3.9 13.5 7 7 Stimulants Amphetamine Benzoylecgonine Cocaine MDA MDEA MDMA Methamphetamine Phentermine 72.9 78.5 93.5 89.6 87.3 88.8 83.4 80.4 102.0 94.3 86.0 93.2 81.9 94.2 78.4 103.9 77.1 77.6 109.8 76.1 83.8 68.9 75.1 81.0 77.7 71.4 73.6 108.5 96.9 95.5 11.3 103.0 18.5 16.9 15.7 109.2 99.9 11.1 17.1 15.1 5.0 13.3 Others Carisoprodol Cyclobenzaprine Dextromethorphan Meprobamate Phencyclidine 110.0 95.5 96.8 103.4 97.2 107.0 S amples with fewer than 8 replicates are indicated in bold with the number of replicates listed in the last column (n<8) nd = not detected For research use only. 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