Analysis of Propofol (2,6-Diisopropylphenol) and its Metabolites in One Injection using the DuoSpray Ion Source

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Analysis of Propofol (2,6-Diisopropylphenol) and its Metabolites in One Injection using the DuoSpray Ion Source SCIEX QTRAP 500 LC-MS/MS System and Gerstel, Inc. MultiPurpose Sampler Adrian M. Taylor, 1 J. Larry Campbell, 1 Carmai Seto, 1 Takeo Sakuma 1 and Oscar G. Cabrices. 2 1 SCIEX, Concord, Ontario, Canada; 2 Gerstel, Inc., Linthicum, Maryland, USA. Introduction Propofol (2,6-diisopropylphenol) is a short acting anesthetic drug used most commonly for both the induction and maintenance of general anesthesia. There is an importance for the analysis of propofol in the forensic toxicology setting especially with increased reports of abuse, accidental overdose, suicide and criminal purpose. 1 Propofol rapidly metabolizes in the liver to hydrophilic and inactive compounds, which requires monitoring of both the parent drug and its metabolites. While GC-MS is traditionally used to analyze for the parent drug, it cannot be used to detect the thermally labile metabolites (e.g., glucuronides). Alternatively, an alternative LC-MS/MS approach can monitor both the parent drug and metabolites in a single experiment, providing both financial and time savings. A number of references have described developed LC- MS/MS methods for the analysis of propofol, 2- some methods include the analysis of the metabolites as well. 5-7 This work focused on developing an LC-MS/MS method for highly selective and sensitive quantification of Phase II metabolites (propofol glucuronide, propofol sulphate), Phase I metabolites (-hydroxypropofol, propofol quinone) and parent drug (propofol) in one injection. To accomplish this, we utilizied the triple quadrupole technology of the SCIEX QTRAP 500 LC-MS/MS System operated in Multiple Reaction Monitoring (MRM) mode. In addition to the quantitative aspects of these analyses, an interesting behavior of ion formation (radical anion) for one of the propofol metabolites was observed and will be described. The final developed method utilized the GERSTEL Multi-Purpose Sampler (MPS) 2 XL autosampler equipped with a solid phase extraction (SPE) module to allow automated sample cleanup of human fluid samples and direct injection into the LC that is coupled to a SCIEX QTRAP 500 LC-MS/MS System for quantification of propofol and its metabolites. Figure 1. GERSTEL MPS 2XL multi-purpose sampler configured for On-Line SPE LC-MS/MS with a SCIEX QTRAP 500 LC-MS/MS System for automated sample clean up and LC-MS/MS analysis. Experimental Materials. Standard solutions of propofol (1 mg/ml in methanol; Product No. P-076,), d-17 propofol (100 µg/ml,product No. P-077), and propofol β-d glucuronide (100 µg/ml, Product No. P-82) were purchased from Cerilliant Corporation (Round Rock, TX,). - Hydroxypropofol (1 mg, Cat. # H950770,) was procured from Toronto Research Chemicals (Toronto, ON). Blank serum was spiked with drug mixture stock solutions making concentrations ranging from 5 to 2000 ng/ml to prepare the calibrators; similar solutions with drugs and metaboltes present at 10 and 1000 ng/ml were used as QCs. Samples were obtained from a local hospital that had also been analyzed by GC-MS. These samples were processed in the same way as the calibrators and QCs and analyzed by the developed LC-MS/MS method. RUO-MKT-02-118-A p 1

Figure 2. Maestro Sequence Scheduler with Prep Ahead coupled to Analyst Software MS acquisition software. Instrumentation All automated SPE and injections were performed using a dualhead MPS 2XL multi-purpose sampler with the GERSTEL SPE Option as shown in Figure 3. Automated sample preparation utilized Phenomenex Strata-X strong cation exchange cartridges modified to be accommodated by the SPE module. All analyses were performed using an Agilent 1260 HPLC pump with a 2.1 x 50 mm Inertsil Ph-3, 2-µm, phenyl column (GL Sciences, Tokyo, Japan) and a SCIEX QTRAP 500 LC-MS/MS System. Sample pretreatment The automated SPE sample cleanup was programmed using Maestro software coupled to Analyst 1.6.1 Software. Enabling the Prep Ahead functionality in Maestro allowed high-throughput just in time sample preparation for analysis (Figure 3). The automated SPE-LC-MS/MS serum cleanup and analysis method included the following steps: Figure 3. GERSTEL Multi-Purpose Sampler (MPS) 2XL - equipped with an SPE module Automated SPE Prep Sequence: Addition of 500 µl 0.05% NH OH to elution vial 1 st Conditioning: MeOH 2 nd Conditioning: H 2 O Added 500 µl of the sample to the SPE cartridge Wash: 95:5 H 2 0/MeOH (2% NH OH) 1 st Elution: 500 µl AcN/MeOH (75:25) 2 nd Elution: 500 µl AcN/MeOH (75:25 2%FA) Mixed the sample in the elution vial for 10 seconds RUO-MKT-02-118-A p 2

LC Conditions: LC column: 2.1 x 50 mm Inertsil Ph-3, 2-µm, phenyl column, GL Sciences, Tokyo, Japan. Mobile Phase A: 95% water + 5% acetonitrile + 1 mm ammonium acetate Mobile Phase B: 95% acetonitrile + 5 % water + 1 mm ammonium acetate Time (min) Flow (ml/min) %B 0.00 0. 10 1.00 0. 10 5.00 0. 100 6.00 0. 100 6.10 0. 10 7.50 0. 10 Injection volume: 50 µl Column temperature: 0 C MS Conditions SCIEX QTRAP 500 LC-MS/MS system Operation: DuoSpray Ion Source Negative mode Temperature: 50 o C Ion Source Gas 1: 0 Current: -3 Curtain Gas: 25 CAD: High switch at 3.5 minutes to allow the LC effluent to run through the heated nebulizer probe of the DuoSpray ionization source for the rest of the LC gradient. MRM Transitions and Ion Source Conditions Compound Q1 Q3 Ionization Propofol Sulfate 1 257 80 TurboIonSpray Probe Propofol Sulfate 2 257 227 TurboIonSpray Probe Propofol Glucuronide 1 353 113 TurboIonSpray Probe Propofol Glucuronide 2 353 177 TurboIonSpray Probe Propofol 1 177 15 Heated Propofol 2 177 161 Heated -Hydroxypropofol 1 192 13 Heated -Hydroxypropofol 2 192 177 Heated 2,6-Diisopropyl-phenyl isopropyl ether 1 219 177 Heated 2,6-Diisopropyl-phenyl isopropyl ether 2 219 191 Heated 3,3,5,5 -Tetraiso-propyldiphenol 1 352 307 Heated 3,3,5,5 -Tetraiso-propyldiphenol 2 352 337 Heated d-17 Propofol 1 19 15 Heated d-17 Propofol 2 19 17 Heated The effluent from the Inertsil Ph-3, 2-µm, 2.1 x 50 mm column was sent to Port of a Valco injection/diverter valve via 1/16 OD, 0.005 red PEEK tubing. This valve is a standard integrated part of the QTRAP 000 system. Port 3 was connected to the TurboIonSpray probe, and Port 5 was connected to the Heated Probe via red PEEK tubing (as short as possible). The MRM experiment consisted of 2 periods. The first period involves the use of TurboIonSpray ; electrospray ionization (ESI) probe, and the second period was dedicated to Heated. During the method acquisition, the valve was switched to allow effluent from the LC column to flow through the TurboIonSpray probe of the DuoSpray ionization source from 0 to 3.5 minutes of the LC-MS/MS method. The valve was then programmed to Results and Discussion In the development of the LC-MS/MS method, the mass spectrometric conditions of the parent propofol drug were first investigated. The aim of these experiments was to identify which ionization mode Electrospray Ionization (ESI) or Atmospheric Pressure Chemical Ionization (APCI) - gives the best sensitivity for the compound. After direct infusion of a propofol standard with electrospray analysis in both positive and negative mode, the Q1 scans (Figure ) showed little activity in positive mode for protonated propofol at m/z 179 or in negative mode for the deprotonated propofol at m/z 177. RUO-MKT-02-118-A p 3

23.2 237.2 26.1 0.0 160 165 170 175 180 185 190 195 20 205 210 215 20 25 230 235 20 25 250 150 15 Da m/z, 212.9 232.1 171.0 23.9 157.0 19.0 27.1 17.1 0.0 160 165 170 175 180 185 190 195 20 205 210 215 20 25 230 235 20 25 250 150 15 Da m/z, 175.0 179.2 193.2 189.2 0.0 160 165 170 175 180 185 190 195 20 205 210 215 20 25 230 235 20 25 250 150 15 Da m/z, 0.0 160 165 170 175 180 185 190 195 20 205 210 215 20 25 230 235 20 25 250 150 15 Da m/z, 5 5 105.1 16.7 17.1 175.0 Positive Mode 23.0 235.0 Not much activity around m/z = 179 Positive Mode 95.0 137.2 Loss of C 3 H 6 Loss of C 3 H 6 3.0 179.2 91.2 19.2 0. 0 10 20 30 0 50 60 70 80 90 10 10 120 130 10 150 160 170 180 190 1.2 107.0109.0 17.2 151.2 121.0 161.2 135.2 7.2 81.0 105.2 m/z, Da Max. 69.2cps. Max. 2.cps. -MS2(17.12) CE(-30): 0.20to2.03minfromSample2(Porpofol 10ng_uLat 7uL_minto0uL_minMeoH+H2O) of Propofol ne. -Q1: 0.03to1.871minfromSample1(Propofol 1ng_uLinfusedat 7uL_min) of propofol negms.wi f (TurboSpray) 8e6 Negative Mode 231.0 650 6 0 Negative Mode 161.0 50 6e6 e6 Not much activity around m/z = 177 5 0 50 2e6 23.0 3 0 Mechanism confirmed by high resolution QTOF, elemental composition 0 350 O - 250 2 0 50 0 - CH - CH 15.1 50 0 19.1 132.9 158.9 20 30 0 50 60 70 80 90 10 10 120 130 10 150 160 170 180 1.0 92.6 65.2 8.9 17.0 10 13.3 Figure. Positive (top) and negative (bottom) ion mode TurboIonSpray Q1 spectra of propofol: 1 ng/µl solution infused Figure 6. Heated Collision Induced Dissociation (CID) tandem mass spectrum of Propofol: positive (top) and negative (bottom) ion mode; 100 ng/µl x 7 µl added to 0. ml/min of LC flow 58.5 78.9 6.9 m/z, Da In APCI mode using the Heated, the expected ions were present in the Q1 scans for both positive and negative ion mode, with the negative ion mode producing the higher and cleaner signal (Figure 5). 2e6 8e6 6e6 e6 17.2 MH + Positive Mode The mechanisms taking place in the negative ion mode MS/ MS experiments of propofol were confirmed by the high resolution accurate mass of the fragment ions obtained by the use of the SCIEX TripleTOF 5600+ LC-MS/MS system in TOF-MS/MS mode. Figure 7 shows the formula of the fragment ion at m/z 161.097 with the molecular formula being calculated asc 11 H 13 O which is consistent with the loss of CH. 2e6 163.2 173.2 21.2 178.2 191.2 51.2 -Q1: 0. 0to0.252minfromSample1(Porpofol 10ng_uLat 7uL_minto0uL_minMeoH+H2O) of Propofol neghnq1.wi f (Heate. Max. 6.2e6cps. O - 176.9 [M-H] - Negative Mode 178.1 It appears that 2 isopropyl groups attached to 2 and 6 positions affect the acidity of the phenol group, making it less acidic than phenol. 175.1 161.0 Figure 5. Positive (top) and negative ion mode Heated Q1 spectra of Propofol: 100 ng/µl x 7 µl/min Propofol added to 0. ml/min LC flow Product ion experiments were performed to investigate the fragmentation of deprotonated propofol, to aid in the elucidation of metabolites (Figure 6). For example, protonated propofol (Figure 6, Top spectrum) fragments to lose the isopropyl side chains. If the hydroxylated metabolite of propofol forms similar fragments that are 16 Da greater than isopropyl group loss, then it can be postulated that metabolism occurred on the side chain. Such experiments were performed both in positive and negative modes to give different permutations to help derive the structures and also determine the MRM transitions to use in the final method. Figure 7. Heated ; Negative ion mode CID tandem TripleTOF mass spectrum of Propofol. Propofol fragment ion at m/z 161.09720 is due to loss of CH, as opposed to loss of O which would produce 328.7 ppm error. Figure 8 shows the fragment ion at m/z 15.065 as having a formula of C 10 H 9 O consistent with a further loss of a CH. RUO-MKT-02-118-A p

Figure 8. Heated ; Negative ion mode CID tandem TripleTOF mass spectrum of Propofol. Propofol fragment ion at m/z 15.06599 is due to loss of 2 x CH Investigation into the mass spectrometric conditions of - hydroxypropofol was also performed A negative mode infusion in Q1 produced an intense ion at m/z 192. From the product ion experiment performed on this precursor ion (Figure 9) it was proposed that the -hydroxypropofol undergoes re-arrangement or in-source fragmentation to lose 2 hydrogen atoms, forming a stable 2,6-diisopropyl benzoquinone radical anion. Figure 10. DuoSpray Ion Source. Use of a source capable of providing both electrospray and heated nebulizer ionizations in one analytical run. During the LC method development, a number of columns were investigated; the Inertsil Phenyl column from GL Sciences was found to provide the best separation of the compounds. The use of either acetonitrile or methanol as mobile phase constituents was also investigated, and the use of methanol was demonstrated to retain polar Phase II metabolites much better than acetonitrile. Sample preparation consisted of an automated preparation in which the Phenomenex Strata-X Strong Anion Exchange Solid Phase Extraction cartridges were modified to be accommodated by the Gerstel Multi-Purpose Sampler (MPS) 2XL. The automated sample clean-up procedure included firstly adding 0.05% NH OH to the elution vial to aid in propofol mass spectrometric detection. Figure 9. Negative ion mode Heated Q1 Spectrum of - Hydroxypropofol (top) and Negative ion mode Heated Collision Dissociation tandem mass spectrum of ions at m/z 192 (middle) and m/z 193 (bottom). Phase II metabolites are easily detected in the negative ion mode using a nebulizer-assisted electrospray whereas the less polar parent molecule and -hydroxy propofol are better ionized using the negative ion mode APCI. Therefore, for the final method a source capable of providing both ionization methods in one analytical run was used - DuoSpray Ion Source (Figure 10). The LC-MS/MS conditions on the SCIEX QTRAP 500 LC- MS/MS system involved the use of the DuoSpray Ion Source. A built-in diverter valve allowed switching between directing LC eluent to either the TurboIonSpray probe or the Heated Probe. For the first 3.5 minutes of the method the LC eluent was directed to the TurboIonSpray probe after which the valve was switched to allow the LC effluent to run through the Heated probe of the DuoSpray ionization source for the rest of the LC gradient. The MS method consisted of 2 periods; the first monitored the elution of the propofol glucuronide and propofol sulfate in electrospray ionization mode up until 3.5 minutes. The second period, from 3.5 to 7.5 minutes, monitored the parent and Phase I metabolites in Heated ionization mode. RUO-MKT-02-118-A p 5

Figure 11. Propofol Calibration Curve - Spiked Serum Figure 1. Propofol Quinone Calibration Curves - Spiked Serum Figures 11 through 1 show the linearity for propofol and metabolites. Linearity was achieved between 5-2000 ng/ml for most analytes. Recoveries and %RSDs reported to be greater than 85% and less than 15%, respectively, in most cases. Figure 12. Propofol Glucuronide Calibration Curves - Spiked Serum A comparison of the LC-MS/MS method with a GC-MS method for propofol analysis showed good correlation (Figures 15 and 16). However, the LC-MS/MS method had the added benefit of being able to determine propofol glucuronide concentration from the same experiment. Figure 16 shows the excellent correlation between the LC-MS/MS and GC-MS experiments, with near equivalent amounts of propofol measured in each individual sample (on average within ~17%). Figure 13. -Hydroxpropofol Calibration Curves - Spiked Serum Figure 15. LC-MS/MS Analysis Provides Propofol and Propofol Glucuronide Concentration Determinations from Serum Samples from the Same Injection RUO-MKT-02-118-A p 6

greater than 85% and less than 15%, respectively, in most cases. A good correlation to GC-MS results was shown for the propofol concentrations but with the added benefit of being able to determine metabolite concentrations from the same LC-MS/MS injection. Acknowledgements Figure 16. Analysis of Propofol: GC-MS cross validation. 9 real serum samples have been tested with this method to compare LC-MS/MS with a GC-MS method. Slope of 1.1 and correlation coefficient is 0.9195. Matrix effects were evaluated at 1000 ng/ml using one lot of serum. % accuracy differences were 5. and 7.0 % for propofol and propofol glucuronide respectively and recoveries were determined to be greater than 85 % for all compounds. Conclusions A forensic LC-MS/MS method has been developed for the analysis of Propofol and its metabolites. Propofol glucuronide and sulphate are ionized much better with TurboIonSpray than with Heated Heater nebulizer provides better sensitivity for propofol, -hydroxypropofol and propofol dimer than the standard TurboIonSpray source; propofol specifically by a factor of ~10 times. For the final method a source capable of providing both ionizations in one analytical run was utilized; the DuoSpray Ion Source. Automated On-Line SPE cleanup of samples was performed using Strata-X SPE cartridges, modified to enable automated extraction of serum samples on the Gerstel dual-head MPS 2XL multi-purpose sampler. The Gerstel dual-head MPS 2XL multi-purpose sampler serves as both the sample clean up module as well as the LC autosampler allowing direct injection of the cleaned up sample on to the LC column. Phenyl columns provide efficient separation of the polar Phase I and II metabolites and the parent drug. Linearity was achieved between 5-2000 ng/ml for most analytes. Recoveries and %RSDs reported to be The authors would like to acknowledge Fred D. Foster (Gerstel) for his assistance in preparing samples and Warren Walsh (Sick Kids Hospital, Toronto, ON, Canada) for providing the propofol samples. References 1. Kirby R.R., Colaw J.M., Douglas M.M. Death from propofol: accident, suicide, or murder? Anesth Analg. 2009; 108():1182-118. 2. Bajpai L., Varshney M., Seubert C.N., Dennis D.M. A new method for the quantitation of propofol in human plasma: efficient solid-phase extraction and liquid chromatography/apci-triple quadrupole mass spectrometry detection. J Chromatogr B Analyt Technol Biomed Life Sci. 200; 810(2):291-296. 3. Beaudry F., Guénette S.A., Winterborn A., Marier J.F., Vachon P. Development of a rapid and sensitive LC- ESI/MS/MS assay for the quantification of propofol using a simple off-line dansyl chloride derivatization reaction to enhance signal intensity. J Pharm Biomed Anal. 2005; 39(3-):11-17.. Vlase L., Popa D-S., Siserman C., Zaharia D. Highthroughput toxicological analysis of propofol in human whole blood by LC-MS. Rom J Leg Med 2011;19: 15-150 5. Cohen S., Lhuillier F., Mouloua Y., Vignal B., Favetta P., Guitton J. Quantitative measurement of propofol and in main glucuroconjugate metabolites in human plasma using solid phase extraction-liquid chromatography-tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2007; 85(1-2):165-172. 6. Thieme D., Sachs H., Schelling G., Hornuss C. Formation of the N-methylpyridinium ether derivative of propofol to improve sensitivity, specificity and reproducibility of its detection in blood by liquid chromatography-mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2009; 877(31):055-058. 7. Lee S.Y., Park N.H., Jeong E-K., Wi J-W., Kim C-J., Kim J.Y., In M.K., Hong J. Comparison of GC-MS and LC-MS RUO-MKT-02-118-A p 7

methods for the analysis of propofol and its metabolites in urine. J. Chrom B 2012; 900: 1-10 For Research Use Only. Not for use in diagnostic procedures. 201 SCIEX. The trademarks mentioned herein are the property of AB Sciex Pte. Ltd. or their respective owners. AB SCIEX is being used under license. Document number: RUO-MKT-02-118-A