Toxtyper: a complete solution for Clinical Research and Forensic Toxicology

The high demand in clinical research and forensic toxicology for comprehensive, specific, and transferable techniques has led to new developments in the field of Liquid Chromatography-tandem Mass Spectrometry (LC-MS). LC-MSⁿ, combined with library searching, is one of the most promising screening solutions for modern toxicology research.

The Toxtyper holds a high quality spectral library of more than 980 compounds of toxicology research interest with ˜ 3,000 spectra of MS, MS² and MS³ experiments and a smaller targeted library for Drugs of Abuse screening research. The library search module, as part of Brukers' new Toxtyper software package, allows for unambiguous and fast (11-minute duty cycle) drug identification. In addition, the Toxtyper supports the Maurer/Wissenbach/Weber LC-MSⁿ library* containing > 4500 drugs, metabolites, and artifacts.

Different well-established sample preparation methods, such as liquid-liquid extraction (LLE), solid-phase extraction (SPE) or simple protein precipitation, can be used within the Toxtyper workflow and are well-suited for the extraction of a wide range of analytes such as hypnotics, neuroleptics, antidepressants, and many others.

From comprehensive screening to targeted libraries and semi-quantification

Example data demonstrating simultaneous, highly sensitive detection of drugs in human urine. Following simple sample preparation (liquid-liquid-extraction) of 1 mL of urine, the Toxtyper permits detection down to 0.8 ng/ml.

Although drug analysis using immunological methods is fast, it is not always reliable. The available screening tests can easily lead to false positive results. For the confirmation of such immunoassay results,
complex and time-consuming GC-MS analysis has been so far performed by the Stuttgart hospital.

Since March 2017, the Toxtyper system has been used for the screening of drugs and toxins in blood, oral fluid and urine. Without lengthy sample preparation, Toxtyper delivers fast and reliable results that are highly specific and reproducible. Additionally, the Toxtyper achieves a high level of confidence with toxicological analysis before neurological diagnosis of irreversible brain failure.

Case Study

A 34 year old patient with dizziness, nausea and vomiting is admitted to the emergency room.From the anamnesis there is a suspicion of drug consumption, however the patient denies the use of illegal drugs. Urine screening using various immunoassays was negative for Amphetamines, Barbiturates, Benzodiapezepins, Cocaine, Opiates and Cannabis. The Toxtyper identified Mitragynin and several metabolites of Paynanthein and Speciociliantin, which are alkaloids present in leaves and fruits of the Kratom tree. Kratom is used for substitution of Opioids and is not regulated by the German narcotics law.