Institute of Forensic Medicine, Forensic Toxicology and Chemistry, University of Bern, Bühlstrasse 20, 3012 Bern, Switzerland; Graduate School for Cellular and Biomedical Sciences (GCB), University of Bern, c/o Theodor Kocher Institute, Freiestrasse 1, 3012 Bern, Switzerland.
Institute of Forensic Medicine, Forensic Toxicology and Chemistry, University of Bern, Bühlstrasse 20, 3012 Bern, Switzerland.
Alcohol. 2018 Dec;73:1-7. doi: 10.1016/j.alcohol.2018.03.003. Epub 2018 Mar 20.
Phosphatidylethanol (PEth) is an alcohol biomarker formed from phosphatidylcholine (PC) by the enzyme phospholipase D (PLD) in the presence of ethanol. A drinking study revealed individual differences in maximum PEth levels after drinking to a targeted blood alcohol concentration (BAC) of 0.1%. This seemed to be due to different PLD activities in the tested persons. Furthermore, post-sampling formation of PEth occurred in blood samples, still containing alcohol. Therefore, a standardized in vitro test for measuring individual PEth formation rates was developed. Two PLD inhibitors were tested for their potency to inhibit post-sampling PEth formation. PEth-negative blood samples were collected from a volunteer. Ethanol was added in different concentrations (0.01-0.3% BAC) directly after blood sampling. The specimens were incubated at 37 °C. Aliquots were taken at the start of the incubation, and every hour until 8 h after start of incubation, and one sample was taken on subsequent days over 1 week. PEth 16:0/18:1 and PEth 16:0/18:2 were determined by online SPE-LC-MS/MS. Furthermore, this test system was applied to blood samples of 12 volunteers. For the inhibition tests, fresh blood (spiked with 0.1% ethanol) was spiked with 30, 300, 3000, or 30,000 nM of either halopemide or 5-fluoro-2-indolyl-deschlorohalopemide (FIPI), and incubated at 37 °C. PEth concentrations were determined hourly over 5 h on the first day and once on day 2 and day 3. PEth formation was linear in the first 7 h of incubation and dependent on the alcohol concentration. The formation rates of PEth 16:0/18:1 were 0.002 μmol L h (0.01% BAC), 0.016 μmol L h (0.1% BAC), 0.025 μmol L h (0.2% BAC), and 0.029 μmol L h (0.3% BAC). For PEth 16:0/18:2, the formation rates were 0.002 μmol L h (0.01% BAC), 0.019 μmol L h (0.1% BAC), 0.025 μmol L h (0.2% BAC), and 0.030 μmol L h (0.3% BAC). Maximum concentrations reached 431 ng/mL (PEth 16:0/18:1) and 496 ng/mL (PEth 16:0/18:2) at 0.3% BAC after 3 days. Maximum velocity (v) was not reached under these conditions. PEth formation in blood of the 12 volunteers ranged between 0.011 and 0.025 μmol L h for PEth 16:0/18:1 and between 0.014 and 0.021 μmol L h for PEth 16:0/18:2. PEth formation in human blood was inhibited by halopemide in a concentration-dependent manner. However, a complete inhibition was not achieved by the applied maximum concentration of 30,000 nM. FIPI showed a better inhibition of PEth formation. A complete inhibition could be achieved by a concentration of 30,000 nM for the first 24 h (for PEth 16:0/18:1) and for 48 h (for PEth 16:0/18:2). Formation of PEth was found to be dependent on the BAC. As a consequence, it is essential to inhibit PLD activity after blood collection to avoid post-sampling formation of PEth in blood samples with a positive BAC. Inhibition of PEth formation was more effective using FIPI, compared to halopemide.
磷脂酰乙醇(PEth)是在存在乙醇的情况下由磷脂酶 D(PLD)从磷脂酰胆碱(PC)形成的醇生物标志物。一项饮酒研究表明,在饮酒至目标血液酒精浓度(BAC)为 0.1%后,个体的最大 PEth 水平存在差异。这似乎是由于测试人员中不同的 PLD 活性所致。此外,在含有酒精的血液样本中仍会发生采样后的 PEth 形成。因此,开发了一种标准化的体外试验来测量个体 PEth 形成率。测试了两种 PLD 抑制剂以抑制采样后的 PEth 形成。从志愿者中采集阴性 PEth 的血样。在采血后直接加入不同浓度(0.01-0.3% BAC)的乙醇。将标本在 37°C 下孵育。在孵育开始时、每小时直到孵育开始后 8 小时以及随后一周内每天的一个样本取一个等分试样。通过在线 SPE-LC-MS/MS 测定 PEth 16:0/18:1 和 PEth 16:0/18:2。此外,该测试系统还应用于 12 名志愿者的血液样本。对于抑制试验,新鲜血液(用 0.1%乙醇加标)用 30、300、3000 或 30,000nM 的 halopemide 或 5-氟-2-吲哚基-deschlorohalopemide(FIPI)加标,并在 37°C 下孵育。在第一天的前 5 小时和第二天和第三天的一个时间点每小时测定 PEth 浓度。在孵育的前 7 小时内,PEth 形成呈线性,并且依赖于酒精浓度。PEth 16:0/18:1 的形成率为 0.002μmol L h(0.01% BAC)、0.016μmol L h(0.1% BAC)、0.025μmol L h(0.2% BAC)和 0.029μmol L h(0.3% BAC)。对于 PEth 16:0/18:2,形成率分别为 0.002μmol L h(0.01% BAC)、0.019μmol L h(0.1% BAC)、0.025μmol L h(0.2% BAC)和 0.030μmol L h(0.3% BAC)。在 3 天后达到 0.3% BAC 时,最大浓度达到 431ng/mL(PEth 16:0/18:1)和 496ng/mL(PEth 16:0/18:2)。在这些条件下未达到最大速度(v)。12 名志愿者的血液中 PEth 16:0/18:1 的形成率在 0.011 到 0.025μmol L h 之间,PEth 16:0/18:2 的形成率在 0.014 到 0.021μmol L h 之间。 halopemide 以浓度依赖性方式抑制人血液中的 PEth 形成。然而,应用的最大浓度 30,000nM 并未完全抑制。FIPI 显示出更好的抑制 PEth 形成的作用。在第一个 24 小时内(PEth 16:0/18:1)和 48 小时内(PEth 16:0/18:2),通过 30,000nM 的浓度可实现完全抑制。发现 PEth 的形成取决于 BAC。因此,在血液采集后抑制 PLD 活性以避免在阳性 BAC 的血液样本中发生采样后的 PEth 形成是至关重要的。与 halopemide 相比,使用 FIPI 抑制 PEth 形成的效果更好。