Potential use of a dried saliva spot (DSS) in therapeutic drug monitoring and disease diagnosis

Biological Fluid Microsampling for Therapeutic Drug Monitoring: A Narrative Review

Therapeutic drug monitoring (TDM) is a specialized area of laboratory medicine which involves the measurement of drug concentrations in biological fluids with the aim of optimizing efficacy and reducing side effects, possibly modifying the drug dose to keep the plasma concentration within the therapeutic range. Plasma and/or whole blood, usually obtained by venipuncture, are the "gold standard" matrices for TDM. Microsampling, commonly used for newborn screening, could also be a convenient alternative to traditional sampling techniques for pharmacokinetics (PK) studies and TDM, helping to overcome practical problems and offering less invasive options to patients. Although technical limitations have hampered the use of microsampling in these fields, innovative techniques such as 3-D dried blood spheroids, volumetric absorptive microsampling (VAMS), dried plasma spots (DPS), and various microfluidic devices (MDS) can now offer reliable alternatives to traditional samples. The application of microsampling in routine clinical pharmacology is also hampered by the need for instrumentation capable of quantifying analytes in small volumes with sufficient sensitivity. The combination of microsampling with high-sensitivity analytical techniques, such as liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS), is particularly effective in ensuring high accuracy and sensitivity from very small sample volumes. This manuscript provides a critical review of the currently available microsampling devices for both whole blood and other biological fluids, such as plasma, urine, breast milk, and saliva. The purpose is to provide useful information in the scientific community to laboratory personnel, clinicians, and researchers interested in implementing the use of microsampling in their routine clinical practice.

Advances and perspectives in the analytical technology for small peptide hormones analysis: A glimpse to gonadorelin

In the last twenty years, we have witnessed an important evolution of bioanalytical approaches moving from conventional lab bench instrumentation to simpler, easy-to-use techniques to deliver analytical responses on-site, with reduced analysis times and costs. In this frame, affinity reagents production has also jointly advanced from natural receptors to biomimetic, abiotic receptors, animal-free produced. Among biomimetic ones, aptamers, and molecular imprinted polymers (MIPs) play a leading role. Herein, our motivation is to provide insights into the evolution of conventional and innovative analytical approaches based on chromatography, immunochemistry, and affinity sensing referred to as peptide hormones. Indeed, the analysis of peptide hormones represents a current challenge for biomedical, pharmaceutical, and anti-doping analysis. Specifically, as a paradigmatic example, we report the case of gonadorelin, a neuropeptide that in recent years has drawn a lot of attention as a therapeutic drug misused in doping practices during sports competitions.

Evaluation of Antipsychotic Drugs' Stability in Oral Fluid Samples

Antipsychotics have narrow therapeutic windows, and their monitoring in biological fluids is therefore important; consequently, stability in those fluids must be investigated during method development and validation. This work evaluates the stability of chlorpromazine, levomepromazine, cyamemazine, clozapine, haloperidol, and quetiapine in oral fluid (OF) samples, using the dried saliva spots (DSS) sampling approach and gas chromatography coupled to tandem mass spectrometry. Since many parameters can influence the stability of the target analytes, design of experiments was adopted to check the crucial factors that affect that stability in a multivariate fashion. The studied parameters were the presence of preservatives at different concentrations, temperature, light, and time. It was possible to observe that antipsychotic stability improved when OF samples in DSS were stored at 4 °C, with a low ascorbic acid concentration, and in the absence of light. With these conditions, chlorpromazine and quetiapine were stable for 14 days, clozapine and haloperidol were stable for 28 days, levomepromazine remained stable for 44 days, and cyamemazine was stable for the entire monitored period (146 days). This is the first study that evaluates the stability of these antipsychotics in OF samples after application to DSS cards.

Saliva Sampling in Therapeutic Drug Monitoring and Physiologically Based Pharmacokinetic Modeling: Review

Therapeutic drug monitoring investigations based on saliva samples can be utilized as an alternative to blood sampling for many advantages. Moreover, the development of physiologically based pharmacokinetic (PBPK) modeling tools can further help to estimate drug exposure from saliva. This review discusses the use of saliva samples and illustrates the applications and examples of PBPK modeling systems for estimating drug exposure from saliva.

Rapid Detection of Amitriptyline in Dried Blood and Dried Saliva Samples with Surface-Enhanced Raman Spectroscopy

There is growing demand for rapid, nondestructive detection of trace-level bioactive molecules including medicines, toxins, biomolecules, and single cells, in a variety of disciplines. In recent years, surface-enhanced Raman scattering has been increasingly applied for such purposes, and this area of research is rapidly growing. Of particular interest is the detection of such compounds in dried saliva spots (DSS) and dried blood spots (DBS), often in medical scenarios, such as therapeutic drug monitoring (TDM) and disease diagnosis. Such samples are usually analyzed using hyphenated chromatography techniques, which are costly and time consuming. Here we present for the first time a surface-enhanced Raman spectroscopy protocol for the detection of the common antidepressant amitriptyline (AMT) on DBS and DSS using a test substrate modified with silver nanoparticles. The validated protocol is rapid and non-destructive, with a detection limit of 95 ppb, and linear range between 100 ppb and 1.75 ppm on the SERS substrate, which covers the therapeutic window of AMT in biological fluids.