Definitive EtG/EtS LC-MS/MS Analysis:

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Definitive / LC- Analysis: A Rugged 4-Min Method for High-Throughput Labs By Justin Steimling and Frances Carroll Abstract Methods for monitoring alcohol consumption biomarkers and are generally limited by poor retention and coelution with matrix interferences, as well as by long analysis times and short column lifetimes. The dilute-and-shoot / LC- analysis developed here using the novel Raptor / column easily resolves and from matrix interferences, providing consistent, accurate results for high-throughput labs testing human urine samples for alcohol consumption. Introduction Ethyl glucuronide () and ethyl sulfate () are important biomarkers of alcohol use. The detection of these metabolites has proven advantageous for zero tolerance treatment programs and abstinence enforcement, where information regarding recent alcohol consumption is required. The analysis of and offers many advantages for abstinence monitoring, including a threeday detection window, good stability in properly stored specimens, and analytical specificity. However, and are both polar compounds, which makes them difficult to retain via reversed-phase chromatography. Both compounds are also very sensitive to matrix interferences, so accurate results can be difficult to obtain if retention is not sufficient to resolve and from the sample matrix. If matrix suppression occurs, low limits of detection may not be met. More important, if coeluting matrix components are isobaric to the compounds of interest, then accurate quantitation may be impossible. Typical methods for / analysis have several shortfalls: poor retention and resolution of and from matrix components, long run times that limit sample throughput, and short column lifetimes. In this study, a simple dilute-and-shoot method was developed, validated, and applied to patient samples for / LC- analysis in human urine. The method was developed and stringently tested on a Raptor / column, which features a novel stationary phase that was developed specifically for this critical application. This column was selected because it provides the retention characteristics that are needed to consistently elute the target analytes away from matrix interferences. In addition, it is rugged and long-lasting, which is beneficial to high-throughput labs. Figure 1: Structures of and O O O CH 3 O OH OH OH S H 3 C O OH OH O Experimental Standard and Preparation Human urine (alcohol free) was fortified with and in order to prepare calibration standards and QC samples. The concentration of calibration standards ranged from 50 5,000 ng/ml for both analytes. Four QC levels were prepared at 50, 150, 750, and 4,000 ng/ml. Aliquots (50 µl) of urine were diluted with 950 µl of the working internal standard (100 ng/ml -d5 and 25 ng/ml -d5 in 0.1% formic acid in water). s were vortexed at 3,500 rpm for 10 seconds to mix followed by centrifugation at 3,000 rpm for 5 minutes at 10 C. Additional double blanks were extracted for column equilibration.

LC- Analysis In order to ensure good response, peak shape, and retention time consistency, the analytical column was conditioned prior to use with 30 matrix injections that were run through the full gradient program. parameters for / LC- analysis are shown below and the analyte transitions are given in Table I. Analytical column: Raptor /, 2.7 µm, 100 mm x 2.1 mm (cat.# 9325A12) Guard column: UltraShield U precolumn filter, 0.2 µm frit (cat.# 25809) Mobile phase Mobile phase Gradient %B 0.00 5 2.50 35 2.51 5 4.00 5 Flow rate: 0.5 ml/min Injection volume: 10 µl Column temp.: 35 C Ion mode: Negative ESI Table I: Analyte Transitions Analyte Precursor Ion Product Ion Product Ion -d5 225.9 84.9 220.8 84.9 74.8 -d5 129.7 97.7 124.7 96.8 79.7 Results and Discussion Chromatographic Performance A fast, four-minute / LC- analysis was obtained from the direct (dilute-and-shoot) injection of supernatant (Figure 2). Both and are clearly resolved from matrix interferences, making accurate peak identification an easy task. As shown in Figure 3, low levels of quantitation can be obtained because matrix interferences are avoided. Figure 2: Even with a fast, four-minute analysis time, the Raptor / column provides good retention of the target analytes so they elute well away from potential matrix interferences. Peaks tr (min) Precursor Ion Product Ion Product Ion 1. Ethyl-β-D-glucuronide-d5 0.86 225.9 84.9-2. Ethyl-β-D-glucuronide 0.87 220.8 84.9 74.8 3. Ethyl sulfate-d5 2.14 129.7 97.7-4. Ethyl sulfate 2.17 124.7 96.8 79.7 LC_CF0704 Column Raptor / (cat.# 9325A12) Guard Column: UltraShield U precolumn filter, 0.2 µm frit (cat.# 25809) Diluent: Conc.: 0.1% Formic acid in water A 500 ng/ml standard was prepared in urine. 50 µl of the standard was diluted with 950 µl of a working internal standard (25 ng/ml -d5/100 ng/ml -d5 in 0.1% formic acid in water). The sample was vortexed at 3,500 rpm for 10 seconds to mix. The sample was then centrifuged at 3,000 rpm for 5 minutes at 10 C. The autosampler needle was adjusted to inject from the supernatant. Ion Notes Reference Standards Ethyl-β-D-glucuronide (cat.# 34101) Ethyl-β-D-glucuronide-d5 (cat.# 34102) Ethyl sulfate sodium salt (cat.# 34103) Ethyl sulfate-d5 sodium salt (cat.# 34104) www.restek.com 2

Figure 3: Low levels of quantitation can be met with this / LC- analysis method because matrix interferences are avoided. (50 ng/ml LLOQ sample) Peaks Precursor Ion Product Ion Product Ion 1. Ethyl-β-D-glucuronide 220.8 84.9 74.8 2. Ethyl sulfate 124.7 96.8 79.7 S:N > 25:1 S:N > 5:1 LC_CF0705 Column Raptor / (cat.# 9325A12) Guard Column: UltraShield U precolumn filter, 0.2 µm frit (cat.# 25809) Diluent: 0.1% Formic acid in water Conc.: A 50 ng/ml standard was prepared in urine. 50 µl of the standard was diluted with 950 µl of a working internal standard (25 ng/ml -d5/100 ng/ml -d5 in 0.1% formic acid in water). The sample was vortexed at 3,500 rpm for 10 seconds to mix. The sample was then centrifuged at 3,000 rpm for 5 minutes at 10 C. The autosampler needle was adjusted to inject from the supernatant. Ion Notes Reference Standards Ethyl-β-D-glucuronide (cat.# 34101) Ethyl-β-D-glucuronide-d5 (cat.# 34102) Ethyl sulfate sodium salt (cat.# 34103) Ethyl sulfate-d5 sodium salt (cat.# 34104) 3 www.restek.com

Column Robustness After 1,000 sample injections on a Raptor / column, all chromatographic peaks maintained the initial peak shape, retention time, and response (Figure 4). The maximum system pressure also remained at the same level, indicating no column clogging had occurred. This demonstrates the reliability of the column and method, which is particularly beneficial for high-throughput laboratories that need to minimize downtime for column changes. Figure 4: Rugged Raptor / columns provide reliable results for / LC- analysis allowing more samples to be analyzed between column changes. Peaks Precursor Ion Product Ion Product Ion 1. Ethyl-β-D-glucuronide-d5 225.9 84.9-2. Ethyl-β-D-glucuronide 220.8 84.9 74.8 3. Ethyl sulfate-d5 129.7 97.7-4. Ethyl sulfate 124.7 96.8 79.7 Injection 1 Injection 1,000 LC_CF0706 Column Raptor / (cat.# 9325A12) Guard Column: UltraShield U precolumn filter, 0.2 µm frit (cat.# 25809) Diluent: 0.1% Formic acid in water Conc.: A 500 ng/ml QC sample was prepared in urine. 50 µl of the sample was diluted with 950 µl of a working internal standard (25 ng/ml -d5/100 ng/ml -d5 in 0.1% formic acid in water). The sample was vortexed at 3,500 rpm for 10 seconds to mix. The sample was then centrifuged at 3,000 rpm for 5 minutes at 10 C. The autosampler needle was adjusted to inject from the supernatant. Ion Notes Reference Standards Ethyl-β-D-glucuronide (cat.# 34101) Ethyl-β-D-glucuronide-d5 (cat.# 34102) Ethyl sulfate sodium salt (cat.# 34103) Ethyl sulfate-d5 sodium salt (cat.# 34104) www.restek.com 4

Linearity Using linear 1/x weighted regression for and, both compounds showed good linearity with r 2 values of 0.999 or greater over a calibration range of 50 5,000 ng/ml. Accurate calibration down to 50 ng/ml allows low-level positive results to be reported with confidence. Accuracy & Precision Precision and accuracy analyses were performed on three different days. The method accuracy was demonstrated to be within 6.3% of the nominal concentration for all QC levels for both and. The was 1.28 9.19% and 4.01 6.82% for intra- and interrun, respectively, at the QC LLOQ. The was 0.675 7.78% and 1.00 4.99% for intra- and inter-run, respectively, at the QC low, mid, and high levels, indicating good method precision for / LC- analysis (Table II). Table II: Accuracy and Precision of QC s Analyte Conc. (ng/ml) QC LLOQ (50 ng/ml) Accuracy (%) Conc. (ng/ml) QC Low (150 ng/ml) Accuracy (%) Conc. (ng/ml) QC Mid (750 ng/ml) Accuracy (%) Conc. (ng/ml) QC High (4,000 ng/ml) Accuracy (%) 51.2 102 6.82 143 95.2 4.99 749 99.8 3.68 3,949 98.7 2.04 46.9 93.7 4.01 143 95.6 1.42 762 102 1.00 3,958 98.9 1.59 Selectivity Complex biological matrices, such as urine, can vary across patients. All samples analyzed in this study contained the isobaric interference for shown in Figure 2. However, the sample shown in Figure 5 contained an unusual isobaric interference for. When overlaid with an LLOQ standard, this sample demonstrated the exceptional retention of the Raptor / column, which allowed even less common and more closely eluting matrix interferences to be resolved, preventing the reporting of false positives. Figure 5: Even closely eluting matrix interferences are well resolved on the Raptor / column (overlay of LLOQ standard and patient sample with interference). = Patient sample = 50 ng/ml standard Peaks Precursor Ion Product Ion 1. Ethyl-β-D-glucuronide 220.8 74.8 Column Raptor / (cat.# 9325A12) Guard Column: UltraShield U precolumn filter, 0.2 µm frit (cat.# 25809) Diluent: 0.1% Formic acid in water Conc.: 50 µl of the sample or standard was diluted with 950 µl of a working internal standard (25 ng/ml -d5/100 ng/ml -d5 in 0.1% formic acid in water). The sample was vortexed at 3,500 rpm for 10 seconds to mix. The sample was then centrifuged at 3,000 rpm for 5 minutes at 10 C. The autosampler needle was adjusted to inject from the supernatant. Ion Notes LC_CF0707 Reference Standards Ethyl-β-D-glucuronide (cat.# 34101) Ethyl-β-D-glucuronide-d5 (cat.# 34102) Ethyl sulfate sodium salt (cat.# 34103) Ethyl sulfate-d5 sodium salt (cat.# 34104) 5 www.restek.com

Effect s prepared in matrix show approximately 80% () and 100% () of the signal obtained when samples are prepared in solvent across all QC levels, demonstrating that matrix effect is minimal. The sensitivity and consistency of the response at the LLOQ is only possible because retention on the Raptor / column was optimized so that elutes outside the zones of matrix suppression (Figure 6). Because the optimal elution time was established here during method development, clinical labs adopting the method can be confident that matrix suppression has already been minimized. This, in combination with the established calibration range and LLOQ demonstrates that the method provides excellent sensitivity for, which is generally harder to detect at low levels than. Figure 6: elutes outside the matrix suppression zones (double blank injection with post-column infusion). (overlay of 5,000 ng/ml standard) Peaks Precursor Ion Product Ion Product Ion 1. Ethyl-β-D-glucuronide 220.8 84.9 74.8 double blank injection with post-column infusion. LC_CF0708 Column Raptor / (cat.# 9325A12) Guard Column: UltraShield U precolumn filter, 0.2 µm frit (cat.# 25809) Conc.: 50 µl of urine was diluted with 950 µl of 0.1% formic acid in water. The sample was vortexed at 3,500 rpm for 10 seconds to mix. The sample was then centrifuged at 3,000 rpm for 5 minutes at 10 C. The autosampler needle was adjusted to inject from the supernatant. A post-column infusion of 1,000 ng/ml was made. Ion www.restek.com 6

Analysis The robustness of the method was further tested by monitoring five patient samples with positive results for both and in the lower end of the linear range across multiple instrument platforms and nine lots of Raptor / columns. The precision of the results (n=9) was found to range from 3.24 11.2% for both analytes over multiple days and sample preparations, indicating excellent robustness and ease of method transfer (Table III). High-throughput labs in particular will benefit from implementing this rugged / LC- analysis method as highly consistent performance is seen across a wide range of scenarios. Table III: Inter-Run Precision of Patient s Across Multiple Platforms and Nine Column Lots Patient Concentration (ng/ml) Concentration (ng/ml) A 216 6.13 78.0 3.56 B 1,167 4.81 300 3.24 C 98.2 9.76 82.4 4.01 D 319 8.33 233 3.63 E 247 11.2 163 8.70 Conclusion It was demonstrated that the Raptor / column is excellent for the rapid and accurate analysis of and in human urine. Isobaric matrix interferences are easily resolved, preventing issues with peak identification and quantitation. In addition, superior sensitivity for is achieved because it elutes outside the zones of matrix suppression that are typically observed with dilute-andshoot assays. With a fast and simple sample preparation procedure and only four minutes of chromatographic analysis time, the / LC- method established here provides accurate, high-throughput monitoring of alcohol consumption. 7 www.restek.com

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