Franz, Florian and Angerer, Verena and Jechle, Hanna and Pegoro, Melanie and Ertl, Harald and Weinfurtner, Georg and Janele, David and Schloegl, Christian and Friedl, Matthias and Gerl, Stefan and Mielke, Reinhard and Zehnle, Ralf and Wagner, Matthias and Moosmann, Bjoern and Auwaerter, Volker (2017) Immunoassay screening in urine for synthetic cannabinoids - an evaluation of the diagnostic efficiency. CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 55 (9). pp. 1375-1384. ISSN 1434-6621, 1437-4331
Full text not available from this repository. (Request a copy)Abstract
Background: The abuse of synthetic cannabinoids (SCs) as presumed legal alternative to cannabis poses a great risk to public health. For economic reasons many laboratories use immunoassays (IAs) to screen for these substances in urine. However, the structural diversity and high potency of these designer drugs places high demands on IAs regarding cross-reactivity of the antibodies used and detection limits. Methods: Two retrospective studies were carried out in order to evaluate the capability of two homogenous enzyme IAs for the detection of currently prevalent SCs in authentic urine samples. Urine samples were analyzed utilizing a 'JWH-018' kit and a 'UR-144' kit. The IA results were confirmed by an up-to-date liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) screening method covering metabolites of 45 SCs. Results: The first study (n = 549) showed an 8% prevalence of SCs use (LC-MS/MS analysis) among inpatients of forensic-psychiatric clinics, whereas all samples were tested negative by the IAs. In a second study (n = 200) the combined application of both IAs led to a sensitivity of 2% and a diagnostic accuracy of 51% when applying the recommended IA cut-offs. Overall, 10 different currently prevalent SCs were detected in this population. The results can be explained by an insufficient cross-reactivity of the antibodies towards current SCs in combination with relatively high detection limits of the IAs. Conclusions: In light of the presented study data it is strongly recommended not to rely on the evaluated IA tests for SCs in clinical or forensic settings. For IA kits of other providers similar results can be expected.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ENZYME-IMMUNOASSAY; US MILITARY; ORAL FLUID; PREVALENCE; VALIDATION; ELISA; SPECIMENS; SPICE; ASSAY; METABOLITES; abstinence control; drug screening; immunoassay; LC-MS/MS; synthetic cannabinoids; urine analysis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Klinische Chemie und Laboratoriumsmedizin Medicine > Abteilung für Forensische Psychiatrie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:15 |
| Last Modified: | 19 Feb 2019 14:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/1343 |
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