Dried Blood Spots—A Platform for Therapeutic Drug Monitoring (TDM) and Drug/Disease Response Monitoring (DRM)

Abstract

This review provides an overview on the current applications of dried blood spots (DBS) as matrices for therapeutic drug (TDM) and drug or disease response monitoring (DRM). Compared with conventional methods using plasma/serum, DBS offers several advantages, including minimally invasiveness, a small blood volume requirement, reduced biohazardous risk, and improved sample stability. Numerous assays utilising DBS for TDM have been reported in the literature over the past decade, covering a wide range of therapeutic drugs. Several factors can affect the accuracy and reliability of the DBS sampling method, including haematocrit (HCT), blood volume, sampling paper and chromatographic effects. It is crucial to evaluate the correlation between DBS concentrations and conventional plasma/serum concentrations, as the latter has traditionally been used for clinical decision. The feasibility of using DBS sampling method as an option for home-based TDM is also discussed. Furthermore, DBS has also been used as a matrix for monitoring the drug or disease responses (DRM) through various approaches such as genotyping, viral load measurement, assessment of inflammatory factors, and more recently, metabolic profiling. Although this research is still in the development stage, advancements in technology are expected to lead to the identification of surrogate biomarkers for drug treatment in DBS and a better understanding of the correlation between DBS drug levels and drug responses. This will make DBS a valuable matrix for TDM and DRM, facilitating the achievement of pharmacokinetic and pharmacodynamic correlations and enabling personalised therapy.

Diagnostic Value of Menstrual Blood Lipidomics in Endometriosis: A Pilot Study

“…This technique offers several advantages for screening purposes. The use of DBS enables easy collection, storage, and transportation of blood samples, as the dried spots on filter paper are stable at room temperature for extended periods [45]. This characteristic simplifies sample handling logistics and allows for decentralized sample collection, making it feasible to conduct screening programs in remote areas or community settings without sophisticated laboratory infrastructure [46].…”

Targeted and untargeted metabolomics and lipidomics in dried blood microsampling: Recent applications and perspectives

“…BµS is not yet used in routine TDM workflow, but several studies show an increasing interest in this type of microsampling devices. 45 Indeed, microsampling devices need a small amount of blood, most analytes are stable even at ambient temperature, and since the sample is dry it is less biohazardous than wet blood. 1 Furthermore, since TDM requires repeated sampling in short intervals, BµS are of great interest.…”

“… 1 Furthermore, since TDM requires repeated sampling in short intervals, BµS are of great interest. In the last 2 years, BµS has been studied in the monitoring of immunosuppressant drugs used after organ transplantation like tacrolimus and the associate biomarker creatinine, 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 anti‐cancer such as PARP and kinase inhibitors, 55 , 56 , 57 , 58 antibiotics in children and neonates, 59 , 60 , 61 anti‐tuberculosis drugs 62 and anti‐fungal medication. 63 …”