Skip to main content
Top
Published in: Clinical Pharmacokinetics 8/2014

01-08-2014 | Short Communication

Why Dried Blood Spots Are an Ideal Tool for CYP1A2 Phenotyping

Authors: Pieter M. M. De Kesel, Willy E. Lambert, Christophe P. Stove

Published in: Clinical Pharmacokinetics | Issue 8/2014

Login to get access

Abstract

Background and Objective

Dried blood spot (DBS) sampling has gained wide interest in bioanalysis during the last decade and has already been successfully applied in pharmacokinetic and phenotyping studies. However, all of the available phenotyping studies used small datasets and did not include a systematic evaluation of DBS-specific parameters. The latter is important since several of these factors still challenge the breakthrough of DBS in routine practice. In this study, caffeine and paraxanthine are determined in capillary DBS, venous DBS, whole blood and plasma for cytochrome P450 (CYP) 1A2 phenotyping. The aim of this study was to explore the usefulness of DBS as a tool for CYP1A2 phenotyping.

Methods

A CYP1A2 phenotyping study was conducted in 73 healthy volunteers who received a 150 mg oral dose of caffeine. Six hours post-administration, caffeine and paraxanthine concentrations and paraxanthine:caffeine molar concentration ratios, i.e., the actual CYP1A2 phenotyping indices, were determined in capillary DBS (obtained by non-volumetric application, direct from the fingertip), venous DBS, whole blood, and plasma. Furthermore, the impact of DBS-specific parameters, including hematocrit, volume spotted, and punch location, was evaluated.

Results

Concentrations of caffeine and paraxanthine in capillary DBS were, respectively, on average 12.7 and 13.8 % lower than those in venous DBS and 31.5 and 33.1 % lower than those in plasma. While these differences were statistically significant (p < 0.001), no significant difference was observed between the paraxanthine:caffeine molar ratios in the distinct evaluated matrices (p ≥ 0.053). This ratio also alleviated the impact of hematocrit and volume spotted.

Conclusions

Using the largest DBS-based phenotyping study to date, we have demonstrated that CYP1A2 phenotyping in capillary DBS is a valid and convenient alternative for the classical plasma-based approach. Additionally, we have provided an objective basis as to why DBS are an ideal tool for CYP1A2 phenotyping.
Appendix
Available only for authorised users
Literature
2.
go back to reference Edelbroek PM, van der Heijden J, Stolk LM. Dried blood spot methods in therapeutic drug monitoring: methods, assays, and pitfalls. Ther Drug Monit. 2009;31(3):327–36.PubMedCrossRef Edelbroek PM, van der Heijden J, Stolk LM. Dried blood spot methods in therapeutic drug monitoring: methods, assays, and pitfalls. Ther Drug Monit. 2009;31(3):327–36.PubMedCrossRef
3.
go back to reference Li W, Tse FL. Dried blood spot sampling in combination with LC–MS/MS for quantitative analysis of small molecules. Biomed Chromatogr. 2010;24(1):49–65.PubMedCrossRef Li W, Tse FL. Dried blood spot sampling in combination with LC–MS/MS for quantitative analysis of small molecules. Biomed Chromatogr. 2010;24(1):49–65.PubMedCrossRef
4.
go back to reference Meesters RJ, Hooff GP. State-of-the-art dried blood spot analysis: an overview of recent advances and future trends. Bioanalysis. 2013;5(17):2187–208.PubMedCrossRef Meesters RJ, Hooff GP. State-of-the-art dried blood spot analysis: an overview of recent advances and future trends. Bioanalysis. 2013;5(17):2187–208.PubMedCrossRef
5.
go back to reference Stove CP, Ingels AS, De Kesel PM, Lambert WE. Dried blood spots in toxicology: from the cradle to the grave? Crit Rev Toxicol. 2012;42(3):230–43.PubMedCrossRef Stove CP, Ingels AS, De Kesel PM, Lambert WE. Dried blood spots in toxicology: from the cradle to the grave? Crit Rev Toxicol. 2012;42(3):230–43.PubMedCrossRef
6.
go back to reference Ingels AS, Hertegonne K, Lambert WE, Stove CP. Feasibility of following up gamma-hydroxybutyric acid concentrations in sodium oxybate (Xyrem®)-treated narcoleptic patients using dried blood spot sampling at home: an exploratory study. CNS Drugs. 2013;27(3):233–7.PubMedCrossRef Ingels AS, Hertegonne K, Lambert WE, Stove CP. Feasibility of following up gamma-hydroxybutyric acid concentrations in sodium oxybate (Xyrem®)-treated narcoleptic patients using dried blood spot sampling at home: an exploratory study. CNS Drugs. 2013;27(3):233–7.PubMedCrossRef
7.
go back to reference Ashley EA, Stepniewska K, Lindegardh N, Annerberg A, Tarning J, McGready R, et al. Comparison of plasma, venous and capillary blood levels of piperaquine in patients with uncomplicated falciparum malaria. Eur J Clin Pharmacol. 2010;66(7):705–12.PubMedCentralPubMedCrossRef Ashley EA, Stepniewska K, Lindegardh N, Annerberg A, Tarning J, McGready R, et al. Comparison of plasma, venous and capillary blood levels of piperaquine in patients with uncomplicated falciparum malaria. Eur J Clin Pharmacol. 2010;66(7):705–12.PubMedCentralPubMedCrossRef
8.
go back to reference Mohammed BS, Cameron GA, Cameron L, Hawksworth GH, Helms PJ, Mclay JS. Can finger-prick sampling replace venous sampling to determine the pharmacokinetic profile of oral paracetamol? Brit J Clin Pharmacol. 2010;70(1):52–6.CrossRef Mohammed BS, Cameron GA, Cameron L, Hawksworth GH, Helms PJ, Mclay JS. Can finger-prick sampling replace venous sampling to determine the pharmacokinetic profile of oral paracetamol? Brit J Clin Pharmacol. 2010;70(1):52–6.CrossRef
10.
go back to reference De Kesel PM, Sadones N, Capiau S, Lambert WE, Stove CP. Hemato-critical issues in quantitative analysis of dried blood spots: challenges and solutions. Bioanalysis. 2013;5(16):2023–41.PubMedCrossRef De Kesel PM, Sadones N, Capiau S, Lambert WE, Stove CP. Hemato-critical issues in quantitative analysis of dried blood spots: challenges and solutions. Bioanalysis. 2013;5(16):2023–41.PubMedCrossRef
11.
go back to reference Denniff P, Spooner N. The effect of hematocrit on assay bias when using DBS samples for the quantitative bioanalysis of drugs. Bioanalysis. 2010;2(8):1385–95.PubMedCrossRef Denniff P, Spooner N. The effect of hematocrit on assay bias when using DBS samples for the quantitative bioanalysis of drugs. Bioanalysis. 2010;2(8):1385–95.PubMedCrossRef
12.
go back to reference O’Mara M, Hudson-Curtis B, Olson K, Yueh Y, Dunn J, Spooner N. The effect of hematocrit and punch location on assay bias during quantitative bioanalysis of dried blood spot samples. Bioanalysis. 2011;3(20):2335–47.PubMedCrossRef O’Mara M, Hudson-Curtis B, Olson K, Yueh Y, Dunn J, Spooner N. The effect of hematocrit and punch location on assay bias during quantitative bioanalysis of dried blood spot samples. Bioanalysis. 2011;3(20):2335–47.PubMedCrossRef
13.
go back to reference Arranz MJ, de Leon J. Pharmacogenetics and pharmacogenomics of schizophrenia: a review of last decade of research. Mol Psychiatry. 2007;12(8):707–47.PubMedCrossRef Arranz MJ, de Leon J. Pharmacogenetics and pharmacogenomics of schizophrenia: a review of last decade of research. Mol Psychiatry. 2007;12(8):707–47.PubMedCrossRef
14.
go back to reference Magnusson MO, Dahl ML, Cederberg J, Karlsson MO, Sandstrom R. Pharmacodynamics of carbamazepine-mediated induction of CYP3A4, CYP1A2, and Pgp as assessed by probe substrates midazolam, caffeine, and digoxin. Clin Pharmacol Ther. 2008;84(1):52–62.PubMedCrossRef Magnusson MO, Dahl ML, Cederberg J, Karlsson MO, Sandstrom R. Pharmacodynamics of carbamazepine-mediated induction of CYP3A4, CYP1A2, and Pgp as assessed by probe substrates midazolam, caffeine, and digoxin. Clin Pharmacol Ther. 2008;84(1):52–62.PubMedCrossRef
15.
go back to reference Tantcheva-Poor I, Zaigler M, Rietbrock S, Fuhr U. Estimation of cytochrome P-450 CYP1A2 activity in 863 healthy Caucasians using a saliva-based caffeine test. Pharmacogenetics. 1999;9(2):131–44.PubMed Tantcheva-Poor I, Zaigler M, Rietbrock S, Fuhr U. Estimation of cytochrome P-450 CYP1A2 activity in 863 healthy Caucasians using a saliva-based caffeine test. Pharmacogenetics. 1999;9(2):131–44.PubMed
16.
go back to reference Zanger UM, Schwab M. Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacol Ther. 2013;138(1):103–41.PubMedCrossRef Zanger UM, Schwab M. Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacol Ther. 2013;138(1):103–41.PubMedCrossRef
17.
go back to reference Kalow W, Tang BK. The use of caffeine for enzyme assays—a critical appraisal. Clin Pharmacol Ther. 1993;53(5):503–14.PubMedCrossRef Kalow W, Tang BK. The use of caffeine for enzyme assays—a critical appraisal. Clin Pharmacol Ther. 1993;53(5):503–14.PubMedCrossRef
18.
go back to reference Fuhr U, Jetter A, Kirchheiner J. Appropriate phenotyping procedures for drug metabolizing enzymes and transporters in humans and their simultaneous use in the “cocktail” approach. Clin Pharmacol Ther. 2007;81(2):270–83.PubMedCrossRef Fuhr U, Jetter A, Kirchheiner J. Appropriate phenotyping procedures for drug metabolizing enzymes and transporters in humans and their simultaneous use in the “cocktail” approach. Clin Pharmacol Ther. 2007;81(2):270–83.PubMedCrossRef
19.
go back to reference Perera V, Gross AS, McLachlan AJ. Measurement of CYP1A2 activity: a focus on caffeine as a probe. Curr Drug Metab. 2012;13(5):667–78.PubMedCrossRef Perera V, Gross AS, McLachlan AJ. Measurement of CYP1A2 activity: a focus on caffeine as a probe. Curr Drug Metab. 2012;13(5):667–78.PubMedCrossRef
20.
go back to reference de Boer T, Wieling J, Meulman E, Reuvers M, Renkema G, den Daas I, et al. Application of dried blood spot sampling combined with LC–MS/MS for genotyping and phenotyping of CYP450 enzymes in healthy volunteers. Biomed Chromatogr. 2011;25(10):1112–23.PubMedCrossRef de Boer T, Wieling J, Meulman E, Reuvers M, Renkema G, den Daas I, et al. Application of dried blood spot sampling combined with LC–MS/MS for genotyping and phenotyping of CYP450 enzymes in healthy volunteers. Biomed Chromatogr. 2011;25(10):1112–23.PubMedCrossRef
21.
go back to reference Daali Y, Samer C, Deglon J, Thomas A, Chabert J, Rebsamen M, et al. Oral flurbiprofen metabolic ratio assessment using a single-point dried blood spot. Clin Pharmacol Ther. 2012;91(3):489–96.PubMedCrossRef Daali Y, Samer C, Deglon J, Thomas A, Chabert J, Rebsamen M, et al. Oral flurbiprofen metabolic ratio assessment using a single-point dried blood spot. Clin Pharmacol Ther. 2012;91(3):489–96.PubMedCrossRef
22.
go back to reference Bosilkovska M, Deglon J, Samer C, Walder B, Desmeules J, Staub C, et al. Simultaneous LC–MS/MS quantification of P-glycoprotein and cytochrome P450 probe substrates and their metabolites in DBS and plasma. Bioanalysis. 2014;6(2):151–64.PubMedCrossRef Bosilkovska M, Deglon J, Samer C, Walder B, Desmeules J, Staub C, et al. Simultaneous LC–MS/MS quantification of P-glycoprotein and cytochrome P450 probe substrates and their metabolites in DBS and plasma. Bioanalysis. 2014;6(2):151–64.PubMedCrossRef
23.
go back to reference Donzelli M, Derungs A, Serratore MG, Noppen C, Nezic L, Krahenbuhl S, et al. The Basel cocktail for simultaneous phenotyping of human cytochrome P450 isoforms in plasma, saliva and dried blood spots. Clin Pharmacokinet. 2014;53(3):271–82.PubMedCrossRef Donzelli M, Derungs A, Serratore MG, Noppen C, Nezic L, Krahenbuhl S, et al. The Basel cocktail for simultaneous phenotyping of human cytochrome P450 isoforms in plasma, saliva and dried blood spots. Clin Pharmacokinet. 2014;53(3):271–82.PubMedCrossRef
24.
go back to reference De Kesel PM, Lambert WE, Stove CP. CYP1A2 phenotyping in dried blood spots and microvolumes of whole blood and plasma. Bioanalysis. In Press. De Kesel PM, Lambert WE, Stove CP. CYP1A2 phenotyping in dried blood spots and microvolumes of whole blood and plasma. Bioanalysis. In Press.
27.
go back to reference Capiau S, Stove VV, Lambert WE, Stove CP. Prediction of the hematocrit of dried blood spots via potassium measurement on a routine clinical chemistry analyzer. Anal Chem. 2013;85(1):404–10.PubMedCrossRef Capiau S, Stove VV, Lambert WE, Stove CP. Prediction of the hematocrit of dried blood spots via potassium measurement on a routine clinical chemistry analyzer. Anal Chem. 2013;85(1):404–10.PubMedCrossRef
28.
go back to reference Perera V, Gross AS, Xu H, McLachlan AJ. Pharmacokinetics of caffeine in plasma and saliva, and the influence of caffeine abstinence on CYP1A2 metrics. J Pharm Pharmacol. 2011;63(9):1161–8.PubMedCrossRef Perera V, Gross AS, Xu H, McLachlan AJ. Pharmacokinetics of caffeine in plasma and saliva, and the influence of caffeine abstinence on CYP1A2 metrics. J Pharm Pharmacol. 2011;63(9):1161–8.PubMedCrossRef
29.
go back to reference Dewitte K, Fierens C, Stockl D, Thienpont LM. Application of the Bland–Altman plot for interpretation of method-comparison studies: a critical investigation of its practice. Clin Chem. 2002;48(5):799–801.PubMed Dewitte K, Fierens C, Stockl D, Thienpont LM. Application of the Bland–Altman plot for interpretation of method-comparison studies: a critical investigation of its practice. Clin Chem. 2002;48(5):799–801.PubMed
30.
go back to reference Rainey PM. Relation between serum and whole-blood ethanol concentrations. Clin Chem. 1993;39(11):2288–92.PubMed Rainey PM. Relation between serum and whole-blood ethanol concentrations. Clin Chem. 1993;39(11):2288–92.PubMed
31.
go back to reference Chiou WL. The phenomenon and rationale of marked dependence of drug concentration on blood sampling site. Implications in pharmacokinetics, pharmacodynamics, toxicology and therapeutics (Part II). Clin Pharmacokinet. 1989;17(4):275–90.PubMedCrossRef Chiou WL. The phenomenon and rationale of marked dependence of drug concentration on blood sampling site. Implications in pharmacokinetics, pharmacodynamics, toxicology and therapeutics (Part II). Clin Pharmacokinet. 1989;17(4):275–90.PubMedCrossRef
32.
go back to reference Holub M, Tuschl K, Ratschmann R, Strnadova KA, Muhl A, Heinze G, et al. Influence of hematocrit and localisation of punch in dried blood spots on levels of amino acids and acylcarnitines measured by tandem mass spectrometry. Clin Chim Acta. 2006;373(1–2):27–31.PubMedCrossRef Holub M, Tuschl K, Ratschmann R, Strnadova KA, Muhl A, Heinze G, et al. Influence of hematocrit and localisation of punch in dried blood spots on levels of amino acids and acylcarnitines measured by tandem mass spectrometry. Clin Chim Acta. 2006;373(1–2):27–31.PubMedCrossRef
33.
go back to reference Ingels AS, De Paepe P, Anseeuw K, Van Sassenbroeck D, Neels H, Lambert W, et al. Dried blood spot punches for confirmation of suspected gamma-hydroxybutyric acid intoxications: validation of an optimized GC–MS procedure. Bioanalysis. 2011;3(20):2271–81.PubMedCrossRef Ingels AS, De Paepe P, Anseeuw K, Van Sassenbroeck D, Neels H, Lambert W, et al. Dried blood spot punches for confirmation of suspected gamma-hydroxybutyric acid intoxications: validation of an optimized GC–MS procedure. Bioanalysis. 2011;3(20):2271–81.PubMedCrossRef
34.
go back to reference Mess JN, Taillon MP, Cote C, Garofolo F. Dried blood spot on-card derivatization: an alternative form of sample handling to overcome the instability of thiorphan in biological matrix. Biomed Chromatogr. 2012;26(12):1617–24.PubMedCrossRef Mess JN, Taillon MP, Cote C, Garofolo F. Dried blood spot on-card derivatization: an alternative form of sample handling to overcome the instability of thiorphan in biological matrix. Biomed Chromatogr. 2012;26(12):1617–24.PubMedCrossRef
35.
go back to reference Vu DH, Koster RA, Alffenaar JW, Brouwers JR, Uges DR. Determination of moxifloxacin in dried blood spots using LC–MS/MS and the impact of the hematocrit and blood volume. J Chromatogr B Analyt Technol Biomed Life Sci. 2011;879(15–16):1063–70.PubMedCrossRef Vu DH, Koster RA, Alffenaar JW, Brouwers JR, Uges DR. Determination of moxifloxacin in dried blood spots using LC–MS/MS and the impact of the hematocrit and blood volume. J Chromatogr B Analyt Technol Biomed Life Sci. 2011;879(15–16):1063–70.PubMedCrossRef
36.
go back to reference Dobrinas M, Cornuz J, Oneda B, Kohler Serra M, Puhl M, Eap CB. Impact of smoking, smoking cessation, and genetic polymorphisms on CYP1A2 activity and inducibility. Clin Pharmacol Ther. 2011;90(1):117–25.PubMedCrossRef Dobrinas M, Cornuz J, Oneda B, Kohler Serra M, Puhl M, Eap CB. Impact of smoking, smoking cessation, and genetic polymorphisms on CYP1A2 activity and inducibility. Clin Pharmacol Ther. 2011;90(1):117–25.PubMedCrossRef
37.
go back to reference Han XM, Ou-Yang DS, Lu PX, Jiang CH, Shu Y, Chen XP, et al. Plasma caffeine metabolite ratio (17X/137X) in vivo associated with G-2964A and C734A polymorphisms of human CYP1A2. Pharmacogenetics. 2001;11(5):429–35.PubMedCrossRef Han XM, Ou-Yang DS, Lu PX, Jiang CH, Shu Y, Chen XP, et al. Plasma caffeine metabolite ratio (17X/137X) in vivo associated with G-2964A and C734A polymorphisms of human CYP1A2. Pharmacogenetics. 2001;11(5):429–35.PubMedCrossRef
Metadata
Title
Why Dried Blood Spots Are an Ideal Tool for CYP1A2 Phenotyping
Authors
Pieter M. M. De Kesel
Willy E. Lambert
Christophe P. Stove
Publication date
01-08-2014
Publisher
Springer International Publishing
Published in
Clinical Pharmacokinetics / Issue 8/2014
Print ISSN: 0312-5963
Electronic ISSN: 1179-1926
DOI
https://doi.org/10.1007/s40262-014-0150-5

Other articles of this Issue 8/2014

Clinical Pharmacokinetics 8/2014 Go to the issue