Direct Analysis of Opioids and Metabolites from Whole Blood Using Ostro Sample Preparation Plates Combined with UPLC-MS/MS for Forensic Toxicology

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Usin Ostro Sample Preparation Plates Combined with UPLC-MS/MS for Forensic Toxicoloy Jonathan P. Danaceau, Erin E. Chambers, and Kenneth J. Fountain Waters Corporation, Milford, MA, USA APPLICATION BENEFITS Analysis of lucuronide metabolites without enzymatic hydrolysis Comprehensive panel of 22 opiate and opioid analesic compounds Rapid and simple sample preparation compared to traditional LLE, SPE, or protein precipitation Removal of endoenous phospholipids Linear response for all analytes and metabolites WATERS SOLUTIONS Ostro Pass-throuh 96-well Plate ACQUITY UPLC BEH Column ACQUITY UPLC System INTRODUCTION The analysis of natural and synthetic opioid drus continues to be an important aspect of forensic toxicoloy. A substantial percentae of arrests and/or deaths are attributed to the misuse or abuse of narcotic pain relievers such as oxycodone and hydrocodone, as well as the illeal opiate, heroin. Forensic laboratories often need to analyze whole blood specimens for the presence of different drus to determine the precise cause of death, in cases of drivin under the influence of drus, or other criminal or research purposes. In the past, opioid analyses were typically conducted by GC/MS after first subjectin the samples to acid or enzymatic hydrolysis to liberate lucuronide metabolites. 1 This step of usin enzymatic hydrolysis to convert lucuronide metabolites to their free form adds time and expense to analysis, and complete and consistent hydrolysis is not always assured. 2 With the advent of modern UPLC /MS/MS techniques, lucuronide metabolites can now be analyzed directly. 3-6 Many sample preparation strateies have been used for whole blood analysis, includin liquid-liquid extraction (LLE) and solid phase extraction (SPE). One of the simplest involves cell lysis followed by protein precipitation. The method presented in this study describes a rapid and straihtforward sample preparation stratey usin Ostro Sample Preparation Plates whereby whole blood samples can be pre-treated to lyse the cells, precipitated with acetonitrile, and eluted usin a simple 96-well format. All sample pre-treatment is conducted within the wells of the Ostro Plate, without the need for centrifuation or sample transfer from individual tubes. Followin sample preparation, 22 opioid drus and metabolites are subsequently analyzed by UPLC-MS/MS. Glucuronide metabolites are directly analyzed, eliminatin the need for enzymatic or chemical hydrolysis. Calibration curves are linear with appropriate limits of detection easily reached. Xevo TQD Mass Spectrometer KEY WORDS Opiates, opioids, UPLC, forensic toxicoloy, whole blood 1

E X P E R IM E N TA L LC conditions System: ACQUITY UPLC Column: ACQUITY UPLC BEH C 18 2.1 x 100 mm, 1.7 μm Column temp.: 30 C Injection volume: Flow rate: Mobile phase A: Mobile phase B: Gradient: MS conditions Mass spectrometer: Ionization mode: (p/n 186002352) 10 μl 0.4 ml/min 0.1% formic acid in MilliQ water 0.1% formic acid in ACN Initial conditions were 2% B. The %B was increased to 52.8% over 6 minutes, then returned to 2% over 0.5 minute. The system was allowed to re-equilibrate for 1.5 minutes. The entire cycle time was 8.0 minutes. Xevo TQD ESI positive Acquisition mode: MRM (see Table 1 Capillary voltae: Collision enery (ev): for transitions) 1 kv Optimized for individual compounds (see Table 1) Sample description All compounds and internal standards (IS) were purchased from Cerilliant (Round Rock, TX). Complementary, deuterated internal standards were used for all compounds with the exception of hydromorphone-3-lucuronide, codeine- 6-lucuronide, and norbuprenorphine-lucuronide. For these compounds, a deuterated IS with the most similar response was chosen as a surroate. A combined stock solution of all compounds (10 µ/ml; 2.5 µ/ml for fentanyl) was prepared in methanol. Workin solutions were prepared daily with hih standards and QCs in matrix (blood) and performin serial dilutions to achieve the desired concentrations. Calibrator concentrations raned from 5 to 500 n/ml for all analytes except fentanyl, which was prepared at 25% of the concentration of the other analytes (1.25 to 125.00 n/ml). A combined internal standard stock solution (5 µ/ml; 1.25 µ/ml for fentanyl) was prepared in ACN. Sample preparation Whole blood samples were prepared by addin 150 μl of aqueous 0.1 M ZnSO 4 /0.1 M NH 4 CH 3 COOH to the wells of an Ostro Pass-throuh Sample Preparation Plate. 50 μl of whole blood was added to the ZnSO 4 /NH 4 CH 3 COOH solution and mixed briefly (5 s) to lyse the cells. 600 μl of ACN containin internal standards was then added to the prepared samples. After vortexin for 3 minutes, the samples were eluted into a 96-well collection plate, evaporated to dryness under N 2, and reconstituted in 50 μl of 0.1% formic acid in 2% ACN. 10 µl was injected onto the LC/MS/MS system. RESULTS AND DISCUSSION The 22 compounds and metabolites screened, listed in Table 1, constitute a comprehensive panel of natural opiate drus, semi-synthetic opioids, and synthetic narcotic analesic compounds. Most of the compounds are weak bases, with pka values of approximately 8 to 9. They have a wide rane of polarities, with LoP values ranin from -3.48 for morphine-3β-d-lucuronide to 5.0 for methadone. MRM transitions used are also listed in Table 1. With the exception of tramadol and O-desmethyl tramadol, primary and confirmatory MRM transitions are listed alon with their respective collision eneries. Cone voltae (V): Optimized for individual compounds (see Table 1) Data manaement Waters MassLynx Software v4.1 2

Chromatoraphy A representative chromatoram of all compounds from a 50 n/ml calibration standard is shown in Fiure 1. Peak assinments can be found in Table 1. Usin an ACQUITY UPLC BEH C 18 2.1 x 100 mm, 1.7 μm Column, all analytes were analyzed in less than 5.5 minutes with a baseline separation between the critical isomer pairs of morphine-3-lucuronide and hydromorphone-3-lucuronide (compounds 1 and 3), morphine and hydromorphone (compounds 4 and 6), and codeine and hydrocodone (compounds 9 and 13). Total cycle time was 8.0 minutes. 100 15 12,13 % 16,17 7,8,9 0 1,2 3 6 10,11 14 21 4,5 18 19 20 22 Minutes 1.50 2.00 2.50 3.00 3.50 4.00 4.50 5.00 5.50 Fiure 1. Chromatoraphy of opiate and synthetic analesic compounds. Peak assinments are listed in Table 1. Compound RT Formula Molecular mass MRM transitions Cone voltae Collision enery 1 Morphine-3β-D-lucuronide 1.21 C 23 H 27 NO 9 461.17 462.1>286.1, 201.1 58 30, 52 2 Oxymorphone-3β-D-lucuronide 1.21 C 23 H 27 NO 10 477.16 478.1>284.1, 227.1 46 28, 50 3 Hydromorphone-3β-D- lucuronide 1.34 C 23 H 27 NO 9 461.17 462.1>286.1, 185.1 58 28, 56 4 Morphine 1.50 C 17 H 19 NO 3 285.14 286.2>201.1, 165.1 54 28, 34 5 Oxymorphone 1.61 C 17 H 19 NO 4 301.13 302.1>227.1, 242.1 44 28, 24 6 Hydromorphone 1.76 C 17 H 19 NO 3 285.13 286.2>185.1, 157.1 66 32, 42 7 Codeine-6β-D-lucuronide 2.00 C 24 H 29 NO 9 475.18 476.2>300.2, 165.2 60 36, 40 8 Dihydrocodeine 2.07 C 18 H 23 NO 3 301.17 302.2>199.1, 128.1 52 34, 58 9 Codeine 2.14 C 18 H 21 NO 3 299.15 300.2>215.2, 165.1 54 26, 38 10 Oxycodone 2.37 C 18 H 21 NO 4 315.15 316.2>256.2, 241.1 44 26, 26 11 6-Acetylmorphone (6-AM) 2.41 C 19 H 21 NO 4 327.15 328.2>165.1, 211.1 60 26, 36 12 O-desmethyl tramadol 2.46 C 15 H 23 NO 2 249.17 250.2>58.0 26 18 13 Hydrocodone 2.50 C 18 H 21 NO 3 299.15 300.2>199.1, 171.0 60 30, 44 14 Norbuprenorphine-lucuronide 2.83 C 31 H 43 NO 10 589.29 590.3>414.3, 101.0 70 34, 54 15 Tramadol 3.21 C 16 H 25 NO 2 263.19 264.2>58.0 24 16 16 Normeperedine 3.58 C 14 H 19 NO 2 233.10 234.1>160.1, 188.2 36 12, 18 17 Meperidine 3.60 C 15 H 21 NO 2 247.16 248.2>174.1, 220.2 48 22, 20 18 Norbuprenorphine 3.77 C 25 H 35 NO 4 413.26 414.3>101.0, 187.2 66 42, 34 19 Fentanyl 4.29 C 22 H 28 N 2 O 336.22 337.2>188.2, 105.1 48 22, 38 20 Buprenorphine 4.55 C 29 H 41 NO 4 467.30 468.3>101.0, 396.3 72 40, 48 21 Propoxyphene 5.18 C 22 H 29 NO 2 339.30 340.3>266.2, 143.1 22 8, 32 22 Methadone 5.25 C 21 H 27 NO 309.20 310.2>105.0, 223.1 32 22, 28 Table 1. Chemical properties and MS conditions of test compounds. 3

t Recovery For this application, evaporation of the oranic eluate and reconstitution in a hih aqueous solution (2% ACN) was necessary to prevent solvent effects that, otherwise, would interfere with the chromatoraphy of the lucuronide metabolites. Fiure 2 shows the averae recovery of all compounds from whole blood usin the Ostro Pass-throuh protocol detailed above. With the exception of the three earliest elutin lucuronide metabolites, all compounds demonstrated recoveries of 60% or reater, and the majority of compounds were recovered at 80% or reater. 120% Fentanyl 125% 100% 80% 60% 40% 20% 0% Fiure 2. Recovery of opioid compounds from whole blood usin Ostro Pass-throuh Sample Preparation Plates. Bars represent the mean recovery from whole blood samples (N=4). 4

Linearity and sensitivity The whole blood extraction method described herein was evaluated for linearity. Calibration standards were prepared in urine at concentrations ranin from 5 to 500 n/ml (1.25 to 125.00 n/ml for fentanyl). Table 2 summarizes the R 2 values, % deviations, and %CVs for all of the compounds. The averae deviation of all calibration points from the curve was less than 2% for all compounds, and mean %CV values were less than 10% for all but three compounds. Individually, >93% of all calibrators were within 15% of their nominal concentration and >95% of the %CVs for individual calibration points (N=3) were less than 15%. Individual R 2 values were all reater than 0.973, and all but 2 were reater than 0.98. In addition to the ood linearity seen over the calibration rane, all compounds demonstrated excellent sensitivity. At 5 n/ml, the UPLC-MS/MS sinal for oxymorphone-3-lucuronide, the least sensitive compound, was at least 20x reater than that of a blank extracted whole blood sample. In most cases, the sinal for this low calibrator well exceeded 100x the method blank sinal. Accuracy Compound R 2 Mean S.D. Mean S.D. 1 Morphine-3-β-d-lucuronide 0.985 99.7 4.9 9.6% 4.6% 2 Oxymorphone-3-b-d-lucuronide 0.983 100.7 4.7 8.4% 6.6% 3 Hydromorphone-3-b-d-lucuronide 0.986 100.8 8.3 8.2% 3.8% 4 Morphine 0.986 101.0 7.4 10.0% 2.9% 5 Oxymorphone 0.989 98.9 6.5 5.7% 3.3% 6 Hydromorphone 0.988 99.4 8.1 4.6% 2.1% 7 Codeine-6-β-d-lucuronide 0.973 99.8 13.5 6.5% 4.2% 8 Dihydrocodeine 0.984 99.8 11.4 7.0% 2.2% 9 Codeine 0.979 101.1 14.1 4.3% 2.2% 10 Oxycodone 0.986 99.0 12.4 4.4% 3.6% 11 6-Acetylmorphone (6-AM) 0.984 100.4 7.1 11.7% 3.4% 12 O-desmethyl Tramadol 0.990 100.3 6.7 5.2% 2.6% 13 Hydrocodone 0.990 100.5 6.8 5.5% 4.8% 14 Norbuprenorphine-lucuronide 0.989 101.0 7.4 11.1% 6.9% 15 Tramadol 0.988 100.5 10.2 3.4% 1.9% 16 Normeperedine 0.995 100.4 4.9 4.2% 2.6% 17 Meperidine 0.994 100.3 6.4 4.2% 2.3% 18 Norbuprenorphine 0.989 100.5 7.6 6.6% 4.4% 19 Fentanyl 0.992 99.6 5.8 5.2% 2.3% 20 Buprenorphine 0.994 100.3 5.5 5.5% 2.3% 21 Propoxyphene 0.990 100.5 7.5 4.2% 1.7% 22 Methadone 0.994 100.3 6.3 2.8% 0.4% Table 2. Accuracy and coefficients of variation (%CV) from opiate calibration curves prepared usin a simple sample dilution protocol. The concentrations of fentanyl and norfentanyl were 1 /4 that of the other compounds. %CV 5

CONCLUSIONS The method presented in this study demonstrates the use of Ostro Pass-throuh Sample Preparation Plates combined with UPLC-MS/MS for the analysis of 22 opioid compounds and metabolites of interest in whole blood samples. All compounds were analyzed in less than 5.5 minutes with complete resolution of all isobaric compound pairs. The use of Ostro Pass-throuh Sample Preparation Plates allowed for rapid, in-well cell lysis and protein precipitation, followed by elution into a 96-well collection plate. This procedure resulted in improved throuhput compared to protein precipitation in individual tubes, with the added benefit of removin endoenous phospholipid compounds. All analytes demonstrated ood linearity over the entire calibration rane, and the method was sensitive for reliable detection at the lowest curve points. References 1. Goldberer BA, Cone EJ. Confirmatory tests for drus in the workplace by as chromatoraphy-mass spectrometry. Journal of Chromatoraphy A. 1994; 674(1-2): 73-86. 2. Wan P, et al. Incomplete recovery of prescription opioids in urine usin enzymatic hydrolysis of lucuronide metabolites. Journal of Analytical Toxicoloy. 2006; 30(8): 570-575. 3. Gustavsson E, et al. Validation of direct injection electrospray LC-MS/MS for confirmation of opiates in urine dru testin. Journal of Mass Spectrometry. 2007; 42(7): 881-889. 4. Murphy CM, Huestis MA. LC ESI-MS/MS analysis for the quantification of morphine, codeine, morphine-3-β-d-lucuronide, morphine-6-β-dlucuronide, and codeine-6-β-d-lucuronide in human urine. Journal of Mass Spectrometry. 2005; 40(11): 1412-1416. 5. Edinboro L, Backer RC, Poklis A. Direct analysis of opiates in urine by liquid chromatoraphy-tandem mass spectrometry. Journal of Analytical Toxicoloy. 2005; 29(7): 704-710. 6. French D, Wu A, Lynch K. Hydrophilic interaction LC MS/MS analysis of opioids in urine: sinificance of lucuronide metabolites. Bioanalysis. 2011; 3(23): 2603-2612. Waters, The Science of What s Possible, ACQUITY UPLC, Xevo, and MassLynx are reistered trademarks of Waters Corporation. Ostro is a trademarks of Waters Corporation. All other trademarks are the property of their respective owners. 2014 Waters Corporation. Produced in the U.S.A. November 2014 720004673EN AW-PDF Waters Corporation 34 Maple Street Milford, MA 01757 U.S.A. T: 1 508 478 2000 F: 1 508 872 1990 www.waters.com