Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Bologna, Italy.
Drug Test Anal. 2023 Jan;15(1):128-133. doi: 10.1002/dta.3362. Epub 2022 Sep 2.
Valproic acid (VPA) is a well-known drug prescribed as anti-epileptic. It has a narrow therapeutic range and shows great individual differences in pharmacodynamics and pharmacokinetics. Consequently, the therapeutical drug monitoring (TDM) in patient's plasma is of crucial importance. Liquid chromatography coupled to mass spectrometry (LC-MS/MS) has gained importance in TDM applications for its features of sensitivity, selectivity and rapidity. However, in case of VPA, the LC-MS/MS selectivity could be hampered by the lack of a sufficient number of multiple reaction monitoring (MRM) transitions describing the molecule. In fact, the product ion scan of deprotonated molecules of VPA does not produce any ion and thus most LC-MS/MS methods are based on the detection of the unique MRM transition m/z 143➔143. In this way, the advantages of selectivity in LC-MS cannot be effectively exploited. In the present method, stable analyte adducts were exploited for the determination of VPA in blood. An Acquity HSS C18 column and mobile phases consisting of 5-mM ammonium formate and acetonitrile both added 0.1% formic acid were used. Source worked in negative acquisition mode and parameters were optimized to increase the adduct (m/z 189) and dimer (m/z 287) stability, and their fragmentation were used to increase the selectivity of MRM detection. The method has been validated according to the toxicological forensic guidelines and successfully applied to 10 real blood samples. Finally, the present method showed suitable for the rapid LC-MS/MS detection of VPA in whole blood, demonstrating the possibility to increase specificity by exploiting stable in-source adducts. This should be considered of utmost importance in the case of forensic applications.
丙戊酸(VPA)是一种常用的抗癫痫药物。它的治疗范围较窄,在药效学和药代动力学方面表现出很大的个体差异。因此,患者血浆中的治疗药物监测(TDM)至关重要。液相色谱-质谱联用(LC-MS/MS)因其灵敏度、选择性和快速性而在 TDM 应用中得到重视。然而,在 VPA 的情况下,由于缺乏足够数量的描述分子的多重反应监测(MRM)转换,LC-MS/MS 的选择性可能会受到阻碍。事实上,VPA 去质子分子的产物离子扫描不会产生任何离子,因此大多数 LC-MS/MS 方法都是基于检测独特的 MRM 转换 m/z 143➔143。这样,LC-MS 的选择性优势就无法得到有效利用。在本方法中,利用稳定的分析物加合物来测定血液中的 VPA。采用 Acquity HSS C18 柱和由 5-mM 甲酸铵和乙腈组成的流动相,均添加 0.1%甲酸。源在负采集模式下工作,并对参数进行了优化,以增加加合物(m/z 189)和二聚体(m/z 287)的稳定性,并利用它们的碎片来提高 MRM 检测的选择性。该方法已按照毒理学法医指南进行了验证,并成功应用于 10 个实际血样。最后,本方法适用于全血中 VPA 的快速 LC-MS/MS 检测,证明了通过利用稳定的源内加合物来提高特异性的可能性。这在法医应用中应被视为至关重要。