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Clinical Research









               In contrast, PESI-MS omits chromatography by directly captur-  was immediately centrifugated, while the second was delayed
            ing tiny sample amounts with a needle tip from which electrospray   for 3 h.
                                                         3
            is generated  in  ambient  conditions  by applying  a high  voltage .   Plasma aliquots were thawed in a water ice bath (0°C) for 15
            This simplifies handling immensely, shortens measurement times   min. 10 µl of each plasma sample aliquot was pooled for quality
            to minutes and allows previously impossible application scenar-  control (QC) and split into 20 µl aliquots. From each sample, QC
              4–6
            ios , especially where robust, routine and high-throughput meas-  aliquot and blank a volume of 20 µl were precipitated with 380
            urements are needed. Sample quality control is one such setting   µL extraction solution to a final concentration of 10 mM NH4Ac,
            where metabolomics has shown great scientific promise but has not   70% MeOH and 5% DMSO. Precipitates were frozen at -80°C
            yet entered routine application.                   until measurement within 3 h after thawing of samples. The meas-
               High-quality biospecimens are crucial for reproducible results   urement was split into 3 batches. Blanks and QC were measured
            in *omics or biomedical research, for correct clinical routine di-  repeatedly throughout the sequence. Precipitated extracts were
            agnostics and for successful biobanking. Currently specific types   thawed in 1–2 h sub-batches in water ice baths and precipitates
            of preanalytical issues are tested with specific methods . These   were removed by centrifugation for 5 min at 4°C with 12.000 rpm.
                                                    7
            specific methods are not comprehensive enough to cover the most   Supernatants were kept in a water ice bath until measured
            frequently occurring pre-analytical error sources in one swift meas-  with the DPiMS-2020 (Shimadzu Corporation, Kyoto, Japan). Per
            urement. NMR and MS-based metabolomics has shown great   measurement 10 µl were deposited on a sample plate and all meas-
            capability to detect various pre-analytical errors in one measure-  urements were replicated until at least two valid TIC patterns for
            ment 8–14 . However, costs and complexity precede a wide-spread   each ionization mode were recorded. TIC patterns were defined
            routine application, despite the numerous benefits of metabolomics   as invalid when TIC spiking stopped before at least 30 s of the
            for sample quality control.                        mode were measured (refer to Fig. 1 for invalid TIC pattern ex-
               PESI-MS could overcome this barrier through its unique ad-  ample). For instrument settings refer to Table 1. For each replicate
            vantages and capability to deliver full mass spectra within minutes.   a fresh needle (silicon coated, 18529A1, Shimadzu Corporation,
            In our set-up PESI was coupled to a single-quad mass spectrome-  Kyoto, Japan) and sample plate (11A9722418115OMS, Shimadzu
            ter, purposely omitting and more sophisticated detectors in order   Corporation, Kyoto, Japan) was used.
            to (1) decrease instrument acquisition and maintenance costs, (2)
            increase the instruments robustness and operating usability for per-
                                                                     Table 1. Instrument settings for the PESI measurement.
            sonnel without extensive MS expertise, and (3) decrease measure-
                                                                                  IONIZATION
            ment time per sample.
               In this proof-of-principle study we concentrated on the single,   Needle position  -37 mm
            most common preanalytical issue, the time delay of blood to   Outage time          200 ms
            plasma processing. Our aim was to investigate if PESI-MS is           SAMPLE TAKE
            able to robustly classify time delays of 3 h from immediately pro-
                                                                      Needle position          -46 mm
            cessed sample.
                                                                       Outage time              50 ms
                                                                         Speed                250 mm/s
                                                                                 MEASUREMENTS
                       Materials & Methods                            voltage segment   Electric potential  Time
                                                                       1 – Corona         +4.00 kV     3.6 s
            Plasma preparation and PESI-MS measurement                 2 – neg mode       -4.25 kV    30.0 s
            The study was conducted in adherence to the Declaration of     3 – Corona     -4.50 kV     3.6 s
            Helsinki and was reviewed by the ethical committee of the Medical
                                                                       4 – pos mode       +2.75 kV    30.0 s
            University of Graz, Austria (31–116 ex 18/19, 16.01.2019). Study details
                                                                        m/z range             10-2000 m/z
            are available at https://www.drks.de DRKS-ID: DRKS00024807.
                                                                       Scan speed              5000 u/s
            Blood samples were donated by 50 volunteers (24 female, 26 male,
                               2
            age 18–90, BMI≥ 18.5 kg/m ) and were collected within 3 weeks (for
                                  15
            details refer to Bordag et al 2021 ). From each volunteer one sample





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