Evaluation of phosphatidylethanol by ELISA for detection of excessive alcohol use compared with traditional biomarkers: a case-control study

Abstract

Objective: The highly sensitive chromatographic methods for quantifying phosphatidylethanol (PEth) require high levels of expertice and expensive instrumentation. Enzyme-linked immunosorbent assay (ELISA) kits have been developed for research purposes, but the implementation of PEth immunoassays to screen alcohol consumption has not been applied to the analysis of clinical samples. Our aim was to examine the ELISA method for PEth analysis in clinical samples. Methods: We examined the alterations of the PEth serum levels of 22 male inpatients diagnosed with alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, during alcohol withdrawal (at days 1, 7, and 14) compared to 32 healthy controls using ELISA. All patients were admitted for detoxification treatment at

A narrative review of outcome measures used in drug and alcohol inpatient withdrawal treatment research

“…Measures used to assess craving most frequently used a visual analogue scale, utilised in eight studies [ 10 , 12 , 33 , 34 , 39 , 46 , 59 , 77 ]. The next most frequent measure was the Penn Alcohol Craving Scale (four studies [ 45 , 46 , 89 , 90 ]). Another nine craving orientated measures were used in one study each.…”

“…The most frequent measure, utilised in nine studies, was the self‐reported Subjective Opioid Withdrawal Scale [ 23 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. Other outcome measures included the amount of ancillary or rescue medication used (five studies [ 35 , 39 , 40 , 41 , 42 ]), self‐report via the Clinical Institute Withdrawal Assessment for Alcohol, Revised Version (CIWA‐Ar) (four studies [ 39 , 43 , 44 , 45 ]) or Clinical Institute Withdrawal Assessment for Alcohol (CIWA) (one study [ 46 ]). Clinician report via the Objective Opiate Withdrawal Scale was used in four studies [ 33 , 35 , 42 , 47 ] and self‐report via the Cocaine Selective Severity Assessment in four studies [ 48 , 49 , 50 , 51 ].…”

“…PEth serum levels (indicating chronic heavy drinking), aspartate transaminase, alanine transaminase, gammaglutamyl transferase levels (liver function indicators) and complete blood count [45], plasma neurotrophic factor levels [65], blood protein content, protein thiol content, protein carbonylation, reduced glutathione and total reactive antioxidant potential [51], and blood and urine biomarkers' associated with withdrawal/relapse/clinical scales (i.e., CDT and EtG, cytokines and growth factors, antioxidant enzymes, oxidative stress markers and neurochemical markers) [10].…”

Current evolutions, applications, and challenges of phosphatidylethanol analysis for clinical and forensic purposes

“…Today, liquid chromatography in combination with tandem mass spectrometry (LC–MS/MS) is the method of choice for the analysis of selected analogs of PEth (Helander & Zheng, 2009; Zheng et al, 2011). Although the immunological detection of PEth has been demonstrated using antibodies in fluorescence immunoassay, flow cytometric analysis, and sandwich ELISA followed by optical density measurement, these approaches have not found their way into clinical applications (yet) (Nissinen et al, 2008; Sonmez et al, 2017).…”

“…A lower PEth value does not formally prove abstinence but can be in accordance with a claim of abstinence (Ulwelling & Smith, 2018). To differentiate between moderate and excessive alcohol consumption, several thresholds have been proposed, ranging from 80 to 800 ng/ml (Hafez et al, 2016; Sonmez et al, 2017). However, concentrations between 150 and 221 ng/ml are most often used as the upper cutoff when investigating chronic and excessive alcohol consumption (De Vos et al, 2019; Kummer, Ingels, et al, 2016; Schröck et al, 2016).…”