Blood levels of phosphatidylethanol in pregnant women reporting positive alcohol ingestion, measured by an improved LC-MS/MS analytical method

Kwak, Ho-Seok; Han, Ji Yoon; Ahn, Hyun Kyong; Kim, Min-Hyoung; Ryu, Hyun-Mee; Kim, Moon-Young; Chung, Hee-Jung; Cho, Dong-Hee; Shin, Chan-Young; Velázquez-Armenta, E. Yadira; Nava-Ocampo, Alejandro A

doi:10.3109/15563650.2012.744997

Cited by 31 publications

(18 citation statements)

References 20 publications

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“…Because the nonpolar part of PEths tends to interact very strongly with the nonpolar hydrocarbon phase of a reversed phase column, the use of a more polar phase (i.e. C8 [14,18,20], C4 [7,15] or phenyl [16]) instead of a C18 phase allows to decrease the retention of PEths [14]. The use of less polar solvents, such as tetrahydrofuran (index polarity = 4.0), isopropanol (index polarity = 3.9) or methanol (index polarity = 5.1) instead of acetonitrile (index polarity = 5.8) also improved the elution of PEths using a reversed phase column.…”

Section: Methods Validationmentioning

confidence: 99%

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Quantification of phosphatidylethanol 16:0/18:1, 18:1/18:1, and 16:0/16:0 in venous blood and venous and capillary dried blood spots from patients in alcohol withdrawal and control volunteers

et al. 2015

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Section: Methods Validationmentioning

confidence: 99%

“…The most used extraction technique is a liquid-liquid extraction (LLE) with hexane [5][6][7][11][12][13][14][15][16][17] (or heptane [8]) after stepwise addition of blood to isopropanol and the internal standard (IS) solution. Some methods added water [6], borate buffer pH 9 [5] or sodium acetate buffer pH 5 [15] to dilute the blood.…”

Section: Introductionmentioning

confidence: 99%

Quantification of phosphatidylethanol 16:0/18:1, 18:1/18:1, and 16:0/16:0 in venous blood and venous and capillary dried blood spots from patients in alcohol withdrawal and control volunteers

et al. 2015

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“…The sensitivity of PEth in liquid blood specimens varies from 53% to 100% (reviewed by (Viel et al, 2012) likely due to variations in alcohol consumption patterns between the studies and the methods for estimation of alcohol use. To date, , only one small-scale study has been conducted in pregnant women (Kwak et al, 2012). A study conducted among women of reproductive age demonstrated that PEth was detectable in 93% of subjects averaging >2 drinks/day, but only in 53% of subjects drinking ≤1 drink/day (Steward et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

The Validity of Phosphatidylethanol in Dried Blood Spots of Newborns for the Identification of Prenatal Alcohol Exposure

Bakhireva

Leeman

Savich³

et al. 2014

Alcoholism Clin & Exp Res

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Background Accurate identification of prenatal alcohol exposure (PAE) in the newborn period offers an opportunity for early identification of children at risk for future neurocognitive problems and the implementation of interventional approaches earlier in life. PAE newborn screening by measuring phosphatidylethanol in dried blood spot (PEth-DBS) cards is feasible, logistically easier, and more cost-efficient compared to other biomarkers. However, the sensitivity and specificity of this method have yet to be established. Methods This prospective cohort study examined validity of PEth-DBS among 28 infants with PAE and 32 controls relative to maternal self-report and other biomarkers. Pregnant women were recruited from a University of New Mexico clinic and followed to early postpartum period. The composite index, which was based on self-reported measures of alcohol use and allowed to classify subjects into PAE and control groups, was the criterion measure used to estimate sensitivity and specificity of PEth-DBS. Results The study included large proportions of patients representing ethnic minorities (7.4% American Indian, 81.7% Hispanic/Latina), low education (54.2%

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“…Further, homologues 16:0/18:2 (PLPEth) and 18:0/18:2 are found frequently as well in both alcoholics and social drinkers [16]. Analysis is best performed by LC-MS/ MS methods and LOQs reported ranges start from 3,1 nmol/L to 30 ng/ml [14,16,17]. Research has focused on cut-off levels to differentiate between abstainers, social drinkers and alcoholics [14].…”

Section: Phosphatidylethanol (Peth)mentioning

confidence: 99%

Direct biomarkers to determine alcohol consumption during pregnancy, which one to use?

Wassenaar¹,

Koch²

2015

J Appl Bioanal

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BackgroundAlcohol consumption during pregnancy, even probably social alcohol consumption, can lead to (severe) fetal damage, such as fetal alcohol syndrome (FAS) or fetal alcohol spectrum disorder (FASD). In order to diagnose a child with FAS or FASD, maternal alcohol consumption during pregnancy needs to be proven. This makes the diagnosis of FAS and FASD a difficult one since self-reported questionnaires underreport the use of alcohol and are therefore biased [1]. Further, research regarding the harmful effects of alcohol during pregnancy is mostly performed with such questionnaires, so results of this kind of research is doubtful. Implementation of a reliable objective marker for alcohol detection would therefore be invaluable. Alcohol markers can be divided into two categories: direct and indirect biomarkers. Indirect biomarkers such as liver enzymes and carbohydrate deficient transferrin, are neither specific nor sensitive enough to be used for detection of alcohol consumption during pregnancy (beyond the scope of this article). Direct biomarkers are chemically derived from ethanol and are way more reliable to detect alcohol consumption during pregnancy. Three biomarkers can be used to detect alcohol in pregnant women: Fatty Acid Ethyl Esters (FAEE), ethyl glucuronide (EtG) / ethyl sulfate (EtS) and phosphatidylethanol (PEth) [2]. Fatty Acid Ethyl Esters (FAEE)FAEE are produced by an enzymatic esterification of ethanol with free endogenous fatty acids, triglycerides, lipoproteins and phospholipids by means of two enzymes, FAEE synthase and acyl-CoA/ethanol O-acyl-transferase (AEAT). The FAEE group has more than 20 different compounds including ethyl laurate (E12), ethyl myristate (E14), ethyl palmitate (E16), ethyl palmitoleate (E16:1), ethyl stearate (E18), ethyl oleate (E18:1), ethyl linoleate (E18:3), ethyl arachidonate (E20:4) and ethyl docosahexanoate (E22:6). All have a lipophilic character. In addition, they are stable at neutral pH. FAEE do not cross the placenta into the fetal circulation, and because they can be detected in fetal matrices, must be produced in the fetus itself from the ethanol which crosses the placenta [2]. FAEE can be measured in blood for 24-44 hours, so it is still, such as ethanol in blood and breathing air, only a snapshot of the alcohol exposition to a child. For chronic exposition hair or meconium can be used. Newborn's hair will cover the last 16 weeks of pregnancy and meconium the last 20-24 weeks of pregnancy, the latter also having a greater ease of collection. Meconium comprises the neonates first several bowel movements, identified most commonly by its dark green-black color and lack of odor. Meconium formation begins at approximately 12 weeks of gestation (i.e. at the end of the first trimester), when fetal swallowing of amniotic fluid is initiated [2]. FAEE can be quantified in meconium by means of gas chromatography coupled with either flame ionization or mass spectrometry (GC-MS). MS allows measurement of lower levels, which makes MS in favor of FID when quantifyi...

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Blood levels of phosphatidylethanol in pregnant women reporting positive alcohol ingestion, measured by an improved LC-MS/MS analytical method

Abstract: PEth-16:0/18:1 was detected in pregnant women at 4-6 weeks after their last low-to-moderate alcohol ingestion, and therefore appears to be a reliable biomarker of prenatal alcohol exposure to study the teratogenicity of alcohol at these exposure levels.

Cited by 31 publications

References 20 publications

Quantification of phosphatidylethanol 16:0/18:1, 18:1/18:1, and 16:0/16:0 in venous blood and venous and capillary dried blood spots from patients in alcohol withdrawal and control volunteers

Quantification of phosphatidylethanol 16:0/18:1, 18:1/18:1, and 16:0/16:0 in venous blood and venous and capillary dried blood spots from patients in alcohol withdrawal and control volunteers

The Validity of Phosphatidylethanol in Dried Blood Spots of Newborns for the Identification of Prenatal Alcohol Exposure

Direct biomarkers to determine alcohol consumption during pregnancy, which one to use?

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