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New saliva test may detect alcohol, GHB poisonings

Methanol, ethanol, ethylene glycol, 1,3-propandiol and -hydroxybutyric acid can be recovered and detected in human saliva through the use of a polydimenthylsiloxane oral sampler, according to a study published in the Journal of Breath Research.

“In communities and regions without recourse to gold standard pathology services, or in cases where the number of patients runs into the hundreds, clinical teams may be forced to treat their patients symptomatically without recourse to reliable diagnosis,” Laura Criado-Garcia, BSc, of the department of analytical chemistry at the Institute of Fine Chemistry and Nanochemistry, University of Cordoba, in Spain, and colleagues wrote. “Other complications arise when intoxication from sedatives, such as γ-hydroxybutyric acid (GHB) taken intentionally or through malicious administration, is mistaken for ethanol abuse or, more seriously, is masked by ethanol consumption.”

With the purpose of developing a faster point-of-care toxicity screening for methanol, ethanol, ethylene glycol, 1,3-propandiol and GHB, the researchers expanded on an earlier study of saliva analysis to profile methanol intoxication, using an active membrane to recover ethanol and methanol from human saliva with determination by thermal desorption-gas chromatography-differential mobility spectrometry (TD-GC-DMS).

The researchers added methanol, ethanol, ethylene glycol, 1,3-propandiol and GHB to fresh saliva samples collected from three healthy adult male nonsmokers who were recruited at Loughborough University in the United Kingdom. The passive drool approach was used to collect two samples of approximately 10 cm³ in saliva from each participant. Once the chemicals were added to the saliva, the researchers used a polydimenthylsiloxane oral sampler to extract the methanol, ethanol, ethylene glycol, 1,3-propandiol and GHB.

According to the researchers, the compounds were recovered by thermal desorption, isolated by gas chromatography and detected with differential mobility spectrometry, operating with a programmed dispersion field. The researchers determined that in vivo saliva sampling with thermal desorption gas chromatography could provide a semi-quantitative diagnostic screen over the toxicity threshold concentration ranges of 100 mg dm^-3 to 3 g dm^-3.

“This represents a potentially useful methodological advance in the rapid assessment of alcohol toxicity and, embodied within a TD-GC-DMS or a TD-GC-[ion mobility spectrometry], it provides a workable approach for a rapid screen and evaluation protocol for alcohols present at toxic levels from a single noninvasive sample,” Criado-Garcia and colleagues wrote. “This has not been possible previously and has the potential for the development of point-of-care toxicity assessment in emergency room settings. Indeed, this study, in concert with others, is developing the concept of extending volatile biomarker measurement from the breath to the range of excretory routes.” – by Jason Laday

Disclosure: The authors report no relevant financial disclosures.