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Simple and fast determination of tetrodotoxin in human plasma based on hydrophilic-interaction/ion-exchange mixed-mode solid phase extraction combined with liquid chromatography-ta

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Tiêu đề Simple and fast determination of Tetrodotoxin in human plasma based on hydrophilic-interaction/ion-exchange mixed-mode solid phase extraction combined with liquid chromatography-tandem mass spectrometry
Tác giả Liang Xin, Yan Liang, Shuangshuang Yang, Fengli Jiang, Fan Yu, Meiwei Zhang, Wei Chang, Wei Wang, Chen Yu, Gangyi Liu, Youli Lu
Trường học Shanghai Xuhui Central Hospital/Zhongshan-Xuhui Hospital, Fudan University
Chuyên ngành Clinical Mass Spectrometry, Analytical Chemistry
Thể loại Research Article
Năm xuất bản 2022
Thành phố Shanghai
Định dạng
Số trang 9
Dung lượng 1,87 MB

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Nội dung

In this study, we developed and validated a simple, fast and sensitive LC-MS/MS method for the measurement of tetrodotoxin (TTX) in human plasma. Three HILIC-type solid phase extraction (SPE) carriers (PSA, silica, Siphila i HILIX) with different stationary phase functional groups were compared.

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journalhomepage:www.elsevier.com/locate/chroma

spectroscopy

Liang Xina,b,c,1, Yan Lianga,b,c,1, Shuangshuang Yanga,b,c,1, Fengli Jianga,b,c, Fan Yua,b,c,

Meiwei Zhanga,b,c, Wei Changd, Wei Wangd, Chen Yua,b,c, Gangyi Liua,b,c,∗, Youli Lua,b,c,∗

a Central Laboratory, Shanghai Xuhui Central Hospital/Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China

b Shanghai Engineering Research Center of Phase I Clinical Research & Quality Consistency Evaluation for Drugs, Shanghai, China

c Shanghai Institute of Clinical Mass Spectrometry, Shanghai, China

d Department of Emergency Medicine, Shanghai Xuhui Central Hospital/Zhongshan - Xuhui Hospital, Fudan University, Shanghai, China

a r t i c l e i n f o

Article history:

Received 26 August 2022

Revised 11 October 2022

Accepted 12 October 2022

Available online 18 October 2022

Keywords:

Tetrodotoxin

Hydrophilic-interaction/ion-exchange

Mixed-mode solid phase extraction

LC-MS/MS

Human plasma

a b s t r a c t

Inthisstudy, wedeveloped andvalidatedasimple,fastandsensitiveLC-MS/MSmethodforthe mea-surementoftetrodotoxin(TTX)inhumanplasma.ThreeHILIC-typesolidphaseextraction(SPE)carriers (PSA,silica,SiphilaiHILIX)withdifferentstationaryphasefunctionalgroupswerecompared.TheSiphila

iHILIXSPEplatecontainingmulti-carboxylgroupswasfinallyselectedduetoobviouslybetterextraction recoveryofTTX(about80%ofrecoveryfromplasmasamples)thantheothertwoandnosignificant ma-trixeffectswereobserved,whichwasspeculatedtohavemixed-modesynergisticeffectsofhydrophilic interactionandionexchange.100μLplasmasamplewasprecipitatedrapidlywithacetonitrilecontaining 1%trichloroaceticacid,and filtrateswereloaded ontoSiphilaiHILIX 96well SPEplate.Afterwashed with95%acetonitrile,TTXwaselutedwith200μLof50%acetonitrilecontaining1%trichloroaceticacid

2μLofelutionsolutionwasdirectlyinjectedintoLC-MS/MSandthetotalruntimeonaBEHamide col-umnwas4.5min.Themethodavoidstheevaporationandultrafiltrationprocesseswhichissimpleand timesaving(<30min).TTXandinternalstandard(arginine-15N4)weremonitoredinpositivemodeusing

m/z320.3→162.2(quantificationtransitionforTTX),320.3→284.1(confirmationtransitionforTTX)and 179.2→63.0(transitionforIS),respectively.Themethodwaslinearintherangeof0.1–20ng/mLforTTX withthelowlimitofquantification(S/N >10)of0.1ng/mL;theintra-andinter-assayaccuracieswerein therangeof98.5%-99.8%(relativestandarddeviations,RSDs≤ 5.92%)and98.8–99.5%(RSDs≤ 6.23%), re-spectively.Biasesofspikinganalysiswererangedfrom-7.00%to7.43%forhealthyhumanplasmasamples (RSDs≤ 8.83%)andfrom-5.00%to3.93%forhemolytic,hightriglyceride,highcholesterolandhigh biliru-binplasmasamples(RSDs≤ 6.40%),whichprovedthegoodanti-interferencepropertyofthemethod.The resultsshowedthatthemethodissensitive,accurate,specific,reliable,andcanbeusedtomonitorthe concentrationofTTXinplasmatomeettheneedsofclinicalresearchandpoisoningscreening

© 2022TheAuthors.PublishedbyElsevierB.V ThisisanopenaccessarticleundertheCCBY-NC-NDlicense (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Introduction

Tetrodotoxin (TTX) poses a serious threat to human health in

coastalareaswheremarinefoodisthemainfoodsource[1–2]

In-cidentsoffoodpoisoningcausedbyTTXwerereportedalmost

ev-eryyear[3–7].Comparedtoothermarinetoxins,TTX intoxication

∗ Corresponding authors

E-mail addresses: gyliu@shxh-centerlab.com (G Liu), yllu@shxh-centerlab.com

(Y Lu)

1 These authors are considered as co-first authors

leadstomoreseveresymptomsandhighermortality[8].Thegrade

ofTTX poisoningdependsontheingestedamount,thetime since ingestion,andthehealthstatusbeforepoisoning[9–10].Thereisa strongcorrelationbetweenthesymptomsandthelevelsofTTXin thebloodofvictims[11]

Asa potenttoxin,TTX selectivelyblocksvoltage-gated sodium (NaV)channels,suchasNaV1.1, NaV1.2,NaV1.3,NaV1.6, andNaV1.7 [12–13],whicharewidelydistributedinthehumancentraland pe-ripheralnervoussystem[14],making itaverypromisingdrugfor the treatment ofpain [15–16].The therapeutic doses reportedin currentclinical trialswere 15–45 μg withCmax ofapproximately https://doi.org/10.1016/j.chroma.2022.463567

0021-9673/© 2022 The Authors Published by Elsevier B.V This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

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chro-matographywithfluorescencedetection(LC-FL)[22],mostofthem

are for shellfish orfish tissue samples.Dealing withhuman

bio-logical samplesismuch morechallengingbecausetheamount of

TTXintheurineandplasmaisgenerallyextremelylow.Theliquid

chromatography-tandem mass spectroscopy (LC-MS/MS) method

wasconsideredthemostpopularmethodfortheidentificationand

quantificationofTTXbecauseofitshighsensitivity,selectivity,and

specificity[23–24]

SinceTTX isahighlypolarsubstance,therewouldbepoor

re-tentionontheconventionalreverse-phasecolumnandlow

ioniza-tion efficiencyin massspectrometry [25] Hydrophilicinteraction

liquid chromatography(HILIC) could help to address theseissues

andshowedgoodretentioncapabilityandimprovedionization

ef-ficiencyinLC-MS[26–27].Whileionsuppression(onekindof

ma-trix effect) wasanother challenge in analyzing TTX in biological

samples.Ionsuppressionusuallyresultsfromthecoelutionof

non-detected interferences[28–29].Ingeneral, ionsuppressioncanbe

reduced by samplepreparation, chromatographic separation, and

MSanalysis[30–32]

The most daunting analysis bottleneck is sample preparation

Because its effectiveextractionandenrichment fromcomplicated

human biological samples are challenging [33] The most

popu-lar technique for the cleanup of TTX samples is solid phase

ex-traction (SPE), usually using cation exchange extraction [34–35]

The positively charged guanidinium group of TTX strongly

inter-actswiththesulfonicacidgroupinthestationaryphase,allowing

TTX to be strongly retained on SPE cartridges Onlystrong acids

such ashydrochloricacidcaneluteit,requiringadditionalsolvent

evaporationandresidueredissolutionsteps,whichare both

time-consuming andlabor-intensive Therefore, strongcation exchange

extraction techniques are rarelyused for the detectionof TTX at

present

Another SPEtechnique applied to TTX detectionis the use of

graphitized carboncarriers.However,theTTX recoveriesofurine,

serum, and plasma samples were 43%, 23%, and 20%,

respec-tively [36] Lowrecoveries can be attributedto toxin loss and/or

ion suppression during SPE cleanup The limits of quantification

for serum and plasma samples were 21.8 and 25.4 ng/mL,

re-spectively, which were not sensitive enough for pharmacokinetic

studies Ochi [37]also usedgraphitized carboncarriers and

opti-mized themethod by ion-pair solid-phaseextraction The

differ-encewasthattheuseofion-pairsolventinsampleloading

condi-tionimprovetheretentionofTTXongraphitizedcarbon.Whilethe

methodwasonlyappliedtothedeterminationoftoxinsinbivalve

extracts,therewasnodatatoproveitsrecoveryandmatrixeffect

inhumanbiologicalsamples

Hydrophilic interaction liquidchromatography-solid phase

ex-traction (HILIC-SPE) can be a thirdoption dueto thehydrophilic

nature ofTTX.However, fewattempts havebeenmadetoextract

TTX from plasma using HILIC-SPE technology One reason is the

limitedimpurity removalcapabilityofasingleHILIC-SPE

Consid-eringthis, doubleSPEusingC18-HILIChadbeenusedto improve

theefficiencyofremovingionsuppression[38]

In thisstudy, we attempted to use three HILIC-type SPE

car-riers for samplepreparationto comparetheir extraction

recover-ies and influence on matrix effects A simple and fast SPE

pro-tocol based on hydrophilic-interaction/ion-exchange mixed-mode

1.1 Reagents and materials

TTX(99.5%)waspurchasedfromStandardpharmCo.,Ltd.(New York, USA).Arginine-15N4 (90.4%) waspurchased from TLC Phar-maceutical Standards Ltd (Ontario, Canada) Voglibose(98%) was purchasedfromAltaScientific.Ltd (Tianjin,China).SiphilaiHILIX

96wellplates(30mg/2mL)wereobtainedfromSiphila Technolo-gies Co., Ltd (Tianjin, China) PSA 96 well plates (30 mg/2 mL) and silica 96 well plates (30 mg/2 mL) were obtained from Tu-pLabsCo.,Ltd (Tianjin,China).The linksforthethree SPEplates were shown in the supplementary materials Protein precipita-tion plates (2 mL/well) were obtained from TupLabs Co., Ltd (Tianjin, China).Trichloroaceticacid(TCA, ≥99%)wassuppliedby Sinopharm Chemical Reagent Co., Ltd (Shanghai, China) HPLC-grade acetonitrile (ACN) and methanol were supplied by Merck KGaA (Darmstadt, Germany) HPLC-grade formic acid (FA, 99%) andammoniumformate(98%)weresuppliedbyACS(Wilmington, USA) Water was purified using Simplicity system (Merck KGaA, Darmstadt, Germany) Blank human plasma was obtained from healthydonorswhosignedtheInformedConsentForms

ThestandardstocksolutionsofTTX(100μg/mL)wereprepared

indeionizedwaterandstoredat−80 °Cuntilfurther use Work-ingstandardsolutionswerepreparedbyserialdilutionofstandard stocksolutionsusingdeionizedwaterat5differentpoints(1,2,10,

50,200ng/mL)beforetheywereaddedtohumanblankplasmato create calibration curves withranges from 0.1to 20 ng/mL The same waywas used to make quality control samples (QCs) at 4 differentconcentrationlevels(0.1,0.5,2,10ng/mL)

1.2 Sample pretreatment

Onehundred microlitersofhumanplasmasample(calibration curves, QCs or real samples) and 10μL arginine-15N4 (internal standard,IS,100 ng/mL) workingsolution weremixedand trans-ferredto96wellproteinprecipitationplate,then700μLof 1%TCA-ACNwasaddedforproteinprecipitation.Afterfilteringwitha pos-itivepressuredevice,allfiltratesweretransferredtoSiphilaiHILIX

96 well SPE plate, which was previously activated with 1 mL of methanolandequilibratedwith1mLACN.Washoncewith200μL

of95%ACNandelutewith200μLof1%TCA-50%ACN.2μLof elu-tionsolutionwasdirectlyinjectedintoLC-MS/MS

1.3 LC-MS/MS analysis

The LC-MS/MS system consisted of a triple quadrupole mass spectrometer 6500 system (SCIEX, USA) and an ExionLC system (SCIEX,USA).Datawasacquiredandstatisticallycalculatedby An-alyst1.6.3(SCIEX,USA)

TTXandISweremonitoredusingmultiplereactionmonitoring (MRM)inpositivemode withthetransitionsofm/z 320.3→162.2 (quantification transition for TTX), 320.3→284.1 (confirmation transitionforTTX)and179.2→63.0(transitionforIS),respectively Ionsourceparameterswerealsooptimized:550°Csource temper-ature,60psiionsourcegas1,70psiionsourcegas2,30psicurtain gas,4000Vionsprayvoltage,120/43Vdeclusteringpotential,and 49/27eVcollisionenergy

2

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Fig 1 Effects of ammonium formate (a) and formic acid (b) concentration in mobile phase for TTX

Chromatographic separation was performed on an ACQUITY

UPLC BEH Amide column (50×2.1 mm, 1.7 μm, Waters, USA) at

room temperature The mobile phase consisted of (A) deionized

waterand(B)ACN,bothcontaining10μmol/Lammoniumformate

and 0.01% FA The following gradient program was used [mobile

phaseB]:85–55%at0–2min;held55%at2–3min;55–85%at3–

3.01min;held85%at3.01–4.5minwithaflowrateof0.5mL/min

1.4 Method validation

The lower limit of quantification (LLOQ), linearity,

inter/intra-batch accuracy and precision, matrix effect, extraction recovery,

specificity,andinterferenceoftheestablishedmethodwere

inves-tigated accordingto the U.S foodand drugadministration(FDA)

bioanalyticalmethodvalidationguidelines[39]

2 Results and discussion

2.1 Development of chromatography and mass spectrometry method

TTX is difficult toretain on reversed-phase columns [26], and

mostrecentreportsusedanamidecolumnwithalengthof10cm

toimprovetheretentionof10TTXanalogs[37].Here,anACQUITY

UPLCBEHC18Amide column(50×2.1mm,1.7μm,Waters,USA)

wasusedtoseparate TTXfromitsinterferences,whichperformed

better compared with an ACQUITY UPLC BEH C18 HILIC column

(50×2.1 mm, 1.7μm, Waters,USA) The retention times forTTX

andISontheamidecolumnwere2.41minand2.31min,

respec-tively,withatotalanalysistimeof4.5min

The pHvalue andthe concentration ofammonium formate in

the mobile phase were considered to have significant effects on

retentiontimeandpeakarea[37].Therefore,differentFAand

am-moniumformateconcentrationsweretestedunderthesame

sepa-rationconditions.Itwasobservedthattheretentiontimeandpeak

areaofTTXincreasedwiththedecreaseofFA(from0.05%to0.01%,

v:v)(seeFig.1a)andammoniumformateminimizedtheretention

timeshiftbetweenpuresolventandmatrixsamplesbutdecreased

the peakarea ofTTX (Fig.1b).In thisstudy,10μmol per literof

ammonium formateand0.01%FA(v:v)were usedinbothmobile

phasestoacquirebettersensitivityandmakethepeaksmore

sta-ble.Thevariationof56consecutiveinjectionspreparedbyplasma

sampleswastested(seeFig.S1)andthemeanretentiontimewas

2.42±0.1min(2.37–2.47min),whichindicatedthatthe

chromato-graphicseparationconditionsperformedwellwithexcellent

repro-ducibility MS/MS parameters for TTX and IS were optimized by

directinfusionofindividualstandardsolutions.Thequantifierand

confirmationproductionforTTXwerem/z162.2and284.1,

respec-tively, although the mostabundant product ionwas observed as

[M+H –H2O]+ion(m/z302.2).Thelatterhashigherbaselineand

strongerinterferenceinplasmasamples

2.2 Selection and optimization of SPE

In the beginning, MCX and WCX cation exchange SPE plates (Waters,USA)weretestedtocleanuptheplasmasamplesand pu-rify TTX Itwas found that theWCX plate can hardly retain TTX duringloading,andtheMCXplatecanhardlyeluteTTXusing or-ganic solventcontainingmoderate acids likefomic acid oracetic acid.Strongacidlikehydrochloricacidwasn’ttried onMCXplate duetoits damagetoliquidchromatographyandmass spectrome-try,evenifitcanbedriedup,poorpeakshapesandseverematrix effectmightnotbeavoided

In turn, three differentHILIC-type SPE plates were attempted

to separate TTX from the plasma matrix PSA plate containing polyamidematerial,silica platecontainingsilica gelmaterial,and SiphilaiHILIXplatecontainingmulti-carboxylmaterialwere com-pared The flow charts of comparisonand optimizationfor three differentHILIC-SPEwereshowninFig.2.Alltheloading,washing, andelutionsampleswere collectedandanalyzedto calculatethe lossorrecoveryofTTX

HILIC-typeSPEusually requires highconcentrationsoforganic solvents as loading solutions and water is used as a strong elu-ent [40] In this study, pure ACN and ACN containing 1%TCA, 5%TCA, and 2%FA were investigated respectively as loading solu-tions, which also acted as protein precipitating agents, denatur-ingplasmaproteinsandreleasingTTX.100μLofstandardsolution (prepared bydeionized water)andplasmasamples were precipi-tated with700μL ofloading solutions in 96-well protein precip-itation platesrespectively andthen all filtrates were loaded onto three different SPE plates, which were previously activated with methanolandequilibratedwithACN.TheresultsshowedTTXwas moststronglyretainedontheSiphilaiHILIXSPEplateduring sam-ple loading ACNwas the optimalloading solvent and facilitated theretentionofTTXonSPEplates,followedby2%FA-ACN, 1%TCA-ACN, and5%TCA-ACN(Fig.3) Theloss ofTTX inplasmasamples were lessthan that instandard solution samples duringloading, whichmightbeduetothepoorbufferingcapacityofstandard so-lutionsamplescomparedwithplasma

TofurtherinvestigatethelossandrecoveryofTTXduring wash-ingandelutionsteps,200μLof95%ACNwasusedforwashing fol-lowed by 200μL of 1%TCA-50%ACNfor elution In the 2%FA-ACN andACN loadinggroups, due to thelow recoveriesafter elution, another200μLof5%TCA-ACNwasusedforfurtherelutionto im-provetherecovery.TheresultswereshowninFig.4

Different retention and elution capabilities of TTX were ob-served on the same SPEplate underdifferent loading conditions duringwashingandelution.SiphilaiHILIX wasthemostdistinct andoptimalone(Fig.4a) Inthe1%TCA-ACNloadinggroup, wash-ingwith95%ACNresultedinalossof18%TTX,whileelutionwith 1% TCA-50% ACN resulted in the recovery of 80% TTX inplasma samples While during the same loading and washing steps, the corresponding standard solution samples would lose even more, withless than 30% TTX recovered by elution Inthe 5%TCA-ACN loading group, both the loading and washing steps resulted in

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Fig 2 The flow charts of comparison and optimization for three different HILIC-SPE

moreloss ofTTX,about60%forplasmasamplesandeven higher

for standard solution samples (>80%) In the 2%FA-ACN loading

group, no significant TTX loss wasobserved for plasmasamples

afterwashingwith95%ACN,andtherecovery wasabout22%after

elution with 1%TCA-ACN Comparedto the two TCA-ACN loading

groups, thetotal recoveryofTTX inplasmasampleswasreduced

throughouttheSPE,so anadditional5%TCA-ACNelutionwas

per-formed to look for the lost TTX and the total recovery was

in-creasedto60%aftertheadditionalelution.Thiswasquitedifferent

from the total recovery of standard solution samples which was

closeto100%.ThetotalrecoveryofTTXinplasmasampleswas

sig-nificantlylower intheACNloadinggroup,nomatter inthe

load-ingandwashingsolutions,ortheelutedandtwice-elutedsamples,

whiletherecovery ofstandardsolutionsampleswasnearly 100%

In the 2%FA-ACN and ACNloading groups, the lower recovery of

TTX fromplasmasamplescomparedtostandardsolutionsamples

maybeduetotheincompletereleaseofTTXfromplasmaproteins

upon precipitation of thesetwo loading solutions Similarresults

were observed whenusingPSAandsilica plates(Fig.4b and4c)

Strong acids such asTCA inthe precipitatingagent maybe

nec-essaryforthereleaseofTTX fromplasmaproteins.ExcessiveTCA

resulted in weak retentionof TTX onSPE, whichmay be related

to the decreased polarity of theTTX-TCA conjugates inthe

pres-enceof ionpairssolvents, thus reducing theretentionof TTXon

HILIC-typeSPEplates

TheresultsshowedthattheretentioncapacityamongSiphilai HILIX,PSA,andsilicaSPEwerequitedifferent.ComparedtoSiphila

iHILIX,PSAandsilicahadweakerretentionofTTX underalmost all loadingconditions.It wasspeculatedthat both SiphilaiHILIX and silica may have two interaction modes: hydrophilic interac-tionandionexchange.SomeSiOH-containingsilica materialshad beenshowntohavecation-exchangeproperties[41].Whileinour study,wefoundthattheionexchangeeffectofsilicaSPEmightbe veryweak whichcouldbe easilyinhibitedby TCAorFA In addi-tiontohydrophilicinteraction,SiphilaiHILIXmayalsoretainpolar basiccompounds through cation-exchangeinteraction which was similarorevenstrongertothat ofweak cation-exchangematerial with carboxylic acid moieties [42] It seemed that PSA had only

a purehydrophilic effecton TTX,andretention wastheweakest Among the three HILIC materials, Siphilai HILIX wasconsidered

tohavebettersynergisticeffectofhydrophilicinteractionandion exchange,whichwassuitablefortheretentionofTTX

After optimizing the loading conditions,the washing solvents wereselected among95%ACN, 98%ACN, andACN No significant differencewasobserved,so95%ACNwaschosenbecauseithadthe strongestcleaningcapability.Theelutionsolventremained 1%TCA-50%ACN,which had no obviousion suppression orenhancement effects on TTX Since stable isotope labeled TTX is very expen-sive and difficult to obtain, we used the reported voglibose and theavailable arginine-15N4 ascandidateinternal standardsinthis

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Fig 3 The loss of TTX under different sample loading conditions on three HILIC-SPE plates

Table 1

The major validation parameters for TTX and IS in human plasma

Spiked conc (ng/mL)

TTX Intra-assay ( n = 6) Inter-assay ( n = 6 × 3) Extraction recovery ( n = 6) IS-normalized MF ( n = 6) Mean accuracy (%) RSD (%) Mean accuracy (%) RSD (%) Mean (%) RSD (%) Mean (%) RSD (%)

Extraction recovery ( n = 6) Extraction recovery ( n = 6)

study,bothofwhichshowedsimilarchromatographicbehaviorto

TTXontheamidecolumn

The performance ofthe two candidateinternal standards was

further compared inplasmamatrix Post-columninjection

exper-iment wasusedto investigatethe differentmatrixeffects ofTTX

and the two candidate internal standards in pure solvent and

plasma samples It was found that TTX wasbarely enhanced or

inhibited by plasma matrix,arginine-15N4 was slightlyenhanced,

whilevoglibose wasseverelyenhanced (Fig.5).Bycomparingthe

recoveries, itcan be foundthat both arginine-15N4 andvoglibose

had similarextraction recoveriesas TTX.Therefore, arginine-15N4

wasfinallyselectedasISinthisstudy(seeTable1)

2.3 Method validation

After determining the optimization of SPE conditions,

valida-tionwasattemptedtoinvestigatethepracticabilityofthepresent

method The method displayed excellent linearity of TTX with

1/x asweighting factor,and R value was higherthan 0.999 over

a 200-fold linear dynamic range (0.1–20 ng/mL) with the LLOQ (signal-to-noiseratio,S/N >10)ofabout0.1ng/mL.Moreover, spike-recoverystudiesassessed forfourdifferentQCs(at0.1,0.5, 2,and

10ng/mL,n =6) atthreeconsecutivedays.The intra- and inter-assay accuracies (%) were 98.5%−99.8% and98.8%−99.5%, respec-tively, calculated by comparing measured concentrations to the-oretically spiked concentrations.The intra- and inter-assay preci-sioninvestigatedintermsofrelativestandarddeviations(RSDs%), were≤ 5.92%and≤ 6.23%,respectively.Theresultswere summa-rizedinTable1,whichshowedacceptable accuracyandprecision forplasmaTTX inthe investigatedconcentration range The vali-dationofthemethodselectionprovedthatsampleswereprepared wellbySiphilaiHILIX.Therepresentativechromatogramsofblank samplesand LLOQ samplesatconcentration of0.1ng/mL of TTX and10ng/mLofISwereshowninFig.6.Noobviousinterferences coelutingwiththeTTXandtheISwasobservedandthebaselines

ofnoisewereacceptable.TheLLOQwasabout0.3ng/mLfor con-firmationtransition (m/z 320.3→284.1) accordingto thecriterion

ofS/N >10,indicatingthatthemethodinthisstudywouldbe

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suit-Fig 4 The recoveries of TTX in each step on three HILIC-SPE plates under different sample loading conditions a Siphila i HILIX SPE, b Silica, c PSA

6

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Fig 5 Plasma matrix effect of a TTX, b arginine- 15 N 4 and c voglibose

Fig 6 The representative chromatograms of blank, LLOQ (0.1 ng/mL) of a TTX and b IS (10 ng/mL)

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Plasma5 −1.43 5.90 −7.00 4.07

hemolytic plasma −3.53 4.28 −2.50 3.86

high triglyceride plasma 0.90 4.80 −4.67 2.92

high cholesterol plasma −3.67 3.10 −2.50 6.40

high bilirubin plasma −5.00 4.95 3.93 2.37

able forthe identification andquantification of TTX at poisoned

concentrationlevels

Theextractionrecoverywasassessedbycomparingthepeak

ar-easofspikedplasmasampleswiththoseofpost-extractionspiked

samples at three QC levels The quantitative matrix factors were

evaluated by comparing the peak areasof post-extraction spiked

samplesfromsixsourcesattwoQClevelswiththoseofneat

stan-dard solutions.The methoddemonstratedexcellent extraction

re-coveryforTTX,rangingfrom80.8%to81.5%atthreedifferent

con-centrations(RSDs≤ 6.78%).ThemeanISnormalizedmatrixfactor

of samples from sixsources at two levels were 0.979 and 0.968

respectively,whichindicatednosignificantionsuppressionor

en-hancementexistedbytheoptimizedmethod(Table1).Thelost

ex-tractionrecoveryofTTXwasmainlyinthewashingstep,asshown

inFig.4a,whichwasspeculatedtobeimprovedbyincreasingthe

amountofSPEpackedmaterialorreducingthewashingvolume

Good specificity means that the analytical method can

differ-entiate between thetarget analyteand interferingsubstances for

samples from different sources and the bias and precision were

acceptable Ten blank human plasma samples including samples

fromsixhealthyvolunteersandpooledblankhumanplasma

sam-ples mixingwithhigh concentrationsofhemoglobin,triglyceride,

cholesterol, andbilirubinwerepreparedandinvestigatedby

spik-ing analysis In detail, working standard solutions of TTX were

spikedtotheabove10blankplasmasamplestomakeQCsatLLOQ

andHigh concentration levels(0.1, 10ng/mL) TheQCs were

pre-treatedandanalyzed.ThebiasesandRSDswerelisted inTable2

The biases oftarget value were ranged from−7.00%to 7.43% for

healthy humanplasmasamples(RSDs ≤ 8.83%)andfrom−5.00%

to3.93%forhemolytic,hightriglyceride,highcholesterolandhigh

bilirubinplasmasamples (RSDs≤ 6.40%),whichproved thegood

anti-interferencepropertyofthemethod

Saxitoxin and its approximately 60 natural analogues, which

are also potent andspecific voltage-gated sodium channel

block-ersandshare thesame bindingsiteasthat of TTX[43,44], also

cause paralysis and even death inextreme cases In our

supple-mentalstudy,gonyautoxin5(GTX5)waspurchasedforinterference

test sinceits retentiontime wasclosest toTTX onamide column

[45,37].Underthe optimizedLCandSPEconditionsdescribedin

this study, the retention time of GTX5 was2.53 min which was

closetoTTX(seeFig.S2).Nointerferenceswereobservedbetween

theTTXandGTX5MRMtransitions.Therefore,webelievethat

sax-itoxin and its analogues may not interfere the detection of TTX

Besides, in a preliminary study, the total recovery of GTX5 from

plasma samples wasabout 70% according to the peak area ratio

of spiked plasmasamples and neat standard solutions which

in-dicated that the describedmethod in our studymay be suitable

for quantitation of these compounds after optimization.In

addi-tion, the analogs of TTX like 4,9-anhydro TTX, 4–epi TTX andso

on,usuallyhavesimilarchemicalstructuresandlowertoxic

equiv-3 Conclusions

An LC-MS/MS method had been developed and validated for thequantitationofTTXinhumanplasma.Thismethodused multi-carboxylgroupSPEmaterialsanddidnotrequireevaporationand ultrafiltrationsteps Comparedwithprevious reports,the method was highly sensitive, simple, and rapid in sample pre-treatment andhadshortchromatographictime.Themethodpresentedinthis papershowedwidelinearity,lowLLOQ, goodprecisionand accu-racy,andhighrecoverycharacteristicswhichwell satisfiedthe re-quirementsofpharmacokineticstudyandclinicaldiagnosisofTTX

Credit authorship contribution statement Liang Xin:Conceptualization,Investigation,Methodology, Writ-ing OriginalDraft.Yan Liang:DataCuration,Investigation, Writ-ing Original Draft Shuangshuang Yang: Methodology, Data Curation, Visualization Fengli Jiang: Investigation, Methodology

Fan Yu: Investigation, Validation Meiwei Zhang: Data curation, Methodology Wei Chang: Funding acquisition Wei Wang: Data curation, Validation Chen Yu: Supervision Gangyi Liu: Formal analysis,Project administration,Writing Review&Editing.Youli Lu: Funding acquisition, Formal analysis, Project administration, Writing Review&Editing

Declaration of Competing Interest

Theauthorsdeclarethattheyhavenoknowncompeting finan-cialinterestsorpersonalrelationshipsthatcouldhaveappearedto influencetheworkreportedinthispaper

Data Availability

Datawillbemadeavailableonrequest

Acknowledgments

ThisresearchwasfundedbytheInnovationFundofScienceand Technology Commission of Shanghai Municipality (20Y11900800) andtheGeneralProjectofMedicalResearchFundofXuhuiDistrict, Shanghai(SHXH202121)

Supplementary materials

Supplementary material associated with this article can be found,intheonlineversion,atdoi:10.1016/j.chroma.2022.463567

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