Journal of Clinical Toxicology
Open Access
ISSN: 2161-0495
ISSN: 2161-0495
Roda E*, Lonati D, Buscaglia E, Papa P, Rocchi L, Locatelli CA and Coccini T
toxicological data combined with their widespread abuse generated great concern in the international scientific community. Objective: Inside the Italian National Early Warning System (NEWS), clinical urine specimens were collected from patients (n=202) admitted to the Emergency Departments (April 2011-January 2013) for clinically suspected abuse of any kind of unknown new psychoactive substances, to measure synthetic cathinones demonstrating the consistency and reliability of the employed screening assays as useful tools to detect these drugs, with the ultimate objective to advance patients care and management. Methods: Screening analyses were performed using two specific ELISA assays, targeting Mephedrone/ methcathinone and MDPV (LOD 0.40 and 20.0 ng/ml, respectively). Data were then compared to determinations gained by LC-MS (LOD 5 ng/ml). Results: (i) Mephedrone/methcathinone: 195/202 samples gave values <7 ng/ml by screening ELISA assay and tested negative by LC-MS. Seven specimens showed concentrations >16 ng/ml (above the upper limit of the standard curve) by screening immunoassay, and only 4 of them resulted positive by LC-MS; (ii) MDPV: 162/167 samples gave values ≤ 60 ng/ml by screening ELISA and tested negative by LC-MS. Five samples showed concentration above the upper limit of the standard curve (>850 ng/ml). Among these, 3/5 samples were confirmed positive by LC-MS (2 for butylone and MDPV, 1 for pentedrone and MDPV). Discussion and conclusion: These results emphasize a good overall match between data obtained by the two analytical methods, showing disagreement in few cases concerning positive results; no false negatives were detected by ELISA screening, suggesting the promising usefulness of this reliable tool as first approach in the emergency setting to rapidly detect synthetic cathinones, allowing the clinician to improve differential diagnosis, aiding real-time patient care and management.