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Application Mass Spectrometry in Clinical Chemistry

Application Mass Spectrometry in Clinical Chemistry. Contents. Application of MS in Laboratory Medicine Simultaneous Analysis Prospect of Future. Application of MS in Laboratory Medicine . Application of MS in Laboratory Medicine . 1. Biochemical genetics

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Application Mass Spectrometry in Clinical Chemistry

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  1. Application Mass Spectrometry in Clinical Chemistry

  2. Contents Application of MS in Laboratory Medicine Simultaneous Analysis Prospect of Future

  3. Application of MS in Laboratory Medicine

  4. Application of MS in Laboratory Medicine 1. Biochemical genetics 2. Therapeutic Drug monitoring 3. Biomarkers for certain disorders 4. Clinical proteomics 5. Clinical microbiology

  5. Therapeutic Drug monitoring(TDM) • Immunoassays(IA) • HPLC • LC/MS/MS

  6. Immunoassays(IA)

  7. Usage of the instruments for TDM KAQACL in 2011

  8. Cyclosporine TDM 및 약물남용검사 신빙도조사 결과보고(2007)

  9. Mass Spectrometry

  10. 검사법비교

  11. Conventional method vs Mass spectrometry

  12. Immunoassays(IA) : Disadvantage 1. 구조가 유사한 compounds (e.g., prodrugs and drug metabolites) 의 교차-반응에 의한 간섭 1) 간 기능이상 또는 신장기능장애환자에서 더욱 심화 ⇒ 광범위한 수준의 대사물 누적이 발생 2. Human anti-animal antibody 에 의한 간섭효과 1) 치료나 영상촬영을 위한 mouse monoclonal antibody 사용증가에 따른 human anti-mouse anti body (HAMA)에 의해잘 인지되지 않음 2) 특히 two-site mouse monoclonal antibody-based 측정법에서 양성과 음성 간섭을 모두 유발 3. 감도 범위가 한정적이다. 1) 어린아이 간이식 수술 후 tacrolimus의경우 IA로측정할때 낮은 감도로 인해 측정이 안 될 수도 있음.

  13. LC/MS/MS: Advantage 1. Specific (no cross reactivity) 2. Metabolites 3. Cost-effective (?)

  14. Cost-effective

  15. Yearly Costs Calculations experienced in the authors’ laboratory. Based on 15,000 samples analyzed per year. Prices in Euros including VAT. Apparatus costs for the LC-MS/MS are based on 250,000 euro for purchase and 50,000 euro depreciation per year during 5 years. Ther Drug Monit Volume 31, Number 1, February 2009

  16. Conventional method vs Mass spectrometry • Automation • TAT • Method development

  17. Simultaneous Analysis

  18. Unknown Drug Scanning

  19. Antiepileptic Drugs 1. Primidone 2. Gabapentin 3. Carbamazepine 4. Oxcarbazepine 5. Zonisamide 6. Levetiracetam 7. Lamotrigine 8. Phenytoin 9. Topiramte

  20. MRM chromatogram

  21. Prospect of Future

  22. Test evolution • Tests often evolve through this spectrum – New esoteric testing will grow substantially with the maturation of genomics and proteomics – What’s esoteric today may be POCT tomorrow with advances in technology, new therapeutic options, and new care models

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