Peters Frank T, Wissenbach Daniela
Institute of Forensic Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Expert Opin Drug Metab Toxicol. 2023 Jul-Dec;19(8):487-500. doi: 10.1080/17425255.2023.2252324. Epub 2023 Sep 1.
Hyphenated mass spectrometry (MS) has evolved into a very powerful analytical technique of high sensitivity and specificity. It is used to analyze a very wide spectrum of analytes in classical and alternative matrices. The presented paper will provide an overview of the current state-of-the-art of hyphenated MS applications in clinical toxicology primarily based on review articles indexed in PubMed (1990 to April 2023).
A general overview of matrices, sample preparation, analytical systems, detection modes, and validation and quality control is given. Moreover, selected applications are discussed.
A more widespread use of hyphenated MS techniques, especially in systematic toxicological analysis and drugs of abuse testing, would help overcome limitations of immunoassay-based screening strategies. This is currently hampered by high instrument cost, qualification requirements for personnel, and less favorable turnaround times, which could be overcome by more user-friendly, ideally fully automated MS instruments. This would help making hyphenated MS-based analysis available in more laboratories and expanding analysis to a large number of organic drugs, poisons, and/or metabolites. Even the most recent novel psychoactive substances (NPS) could be presumptively identified by high-resolution MS methods, their likely presence be communicated to treating physicians, and be confirmed later on.
联用质谱（MS）已发展成为一种具有高灵敏度和特异性的强大分析技术。它用于分析经典和替代基质中种类繁多的分析物。本文将主要基于PubMed（1990年至2023年4月）索引的综述文章，概述联用质谱在临床毒理学中的应用现状。
给出了基质、样品制备、分析系统、检测模式以及验证和质量控制的总体概述。此外，还讨论了选定的应用。
联用质谱技术的更广泛应用，特别是在系统毒理学分析和药物滥用检测中，将有助于克服基于免疫分析的筛查策略的局限性。目前，这受到仪器成本高、人员资质要求以及周转时间不太理想的阻碍，而更用户友好、理想情况下完全自动化的质谱仪器可以克服这些问题。这将有助于使更多实验室能够进行基于联用质谱的分析，并将分析扩展到大量有机药物、毒物和/或代谢物。即使是最新的新型精神活性物质（NPS）也可以通过高分辨率质谱方法进行初步鉴定，将其可能的存在告知治疗医生，并随后进行确认。
