Validation of an Automated Method to Remove

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Shahana Wahab Huq 1, Richard Thomas 2, Agnes Cua 2, Seyed Sadjadi 1 1 Phenomenex, 411 Madrid Avenue, Torrance, CA 951 2 Precision Toxicology, 33 Bunker Hill Street, San Diego, CA 9219 Validation of an Automated Method to Remove β-glucuronidase from Hydrolyzed Pain Management Urine Sample PO387315_W_2

Abstract The escalating abuse of pain medicines has mandated that health care providers and practitioners routinely perform urine drug testing. Most laboratories opt for a dilute-andshoot approach, along with enzymatic hydrolysis that requires no sample cleanup. The addition of extra protein as a result of hydrolysis using β-glucuronidase to the urine can result in fouling of the LC column and loss of productivity. In this work, we present an automated method that uses an Impact Protein Precipitation 96-well plate to remove a majority of the proteins from hydrolyzed urine.

Intrduction The gradual dependence and addiction of pain medication has made pain management and monitoring one of the fastest growing clinical market segments today. The escalating abuse of pain medicines has mandated that health care providers and practitioners routinely perform urine drug testing using a reliable approach that is fast and cost effective. To meet the demand for a large accrual of samples, most laboratories adopt a dilute-and-shoot approach that requires virtually no sample cleanup. However, the samples must undergo some form of hydrolysis procedure to de-conjugate the metabolized compounds back to their native form. An enzymatic procedure using β-glucuronidase is the most readily accepted form of hydrolysis. However, the addition of extra protein to the urine can result in plugging or otherwise fouling (Figure 1) of the LC column1. The continuous increase in system pressure resulting from denatured enzyme within the column will reduce the column and assay performance. In this work, we present a validated procedure that uses an Impact Protein Precipitation 96-well plate to remove the enzyme (and other proteins) from urine (Figure 2). To increase productivity and accuracy, we utilized a Tecan Freedom EVO 1 Liquid Handling System (or similar) in conjunction with a Kinetex 2.6 µm Phenyl-Hexyl 5 x 4.6 mm core-shell HPLC column. The chromatographic conditions were adequately efficient to accommodate fifty one (51) pain panel compounds in less then six (6) minutes.

Experimental Conditions HPLC Column: Kinetex 2.6 µm Phenyl-Hexyl Dimensions: 5 x 4.6 mm Part No.: B-4495-E Mobile Phase: A:.1 % Formic Acid in water B:.1 % Formic Acid in water methanol Gradient: Time (min) % B. 5 5.5 95 6. 95 6.1 5 6.5 5 Flow Rate: 1. ml/min Injection Volume: 5 µl Instrument: Shimadzu XR Detection: MS/MS, AB SCIEX QTRAP 65 (Positive Ionization) Sample Preparation Automation: Tecan Freedom EVO 1 with MultiChannel Arm 96 (MCA96) Note: Additional equilibration time is included in the acquisition method Sample Preparation Sample Hydrolysis Procedure A 5 μl sample of urine was diluted with 1 μl acetate buffer (ph 4.5-4.8) and 2 μl β-glucuronidase, 1 6 units (DR21, www.campbellscience.com) in a 96-well collection plate. The samples were vortexed for 1-15 seconds and then incubated in a water bath at 63 C for 3 minutes. Dilute-and-Shoot Protocol The hydrolyzed samples were sealed and centrifuged for 1 minutes at 2 rpm (or the maximum possible speed by the centrifuge). The supernatant was then transferred to a LC/MS/MS for analysis. Protein Precipitation A 1 μl volume of the hydrolyzed sample was loaded directly to an Impact (2 ml Square Well Filter Plate, Part No. CE-7565) Protein Precipitation 96-well plate that had been pre-loaded with 4 μl methanol. The plate was sealed and then vortexed for 2 minutes at the maximum possible speed. A vacuum of 2-7 of Hg was applied for 2-3 minutes until filtrate was collected. The resulting extract was then evaporated to dryness and reconstituted in starting mobile phase before being transferred for LC/ MS/MS analysis.

Figure 1. Number of injections vs. backpressure for dilute-and-shoot samples Premature Column Death After Only 15 Injections 4 Backpressure (bar) 35 3 25 2 15 1 2 4 6 8 1 12 14 # of Injections

Figure 2. Number of injections vs. backpressure for protein precipitated samples Stable Backpressure After Cleanup with Impact 96-Well Plate 4 35 Backpressure (bar) 3 25 2 15 1 5 1 15 2 25 3 35 4 45 5 # of Injections

Figure 3. LC/MS/MS analysis of 51 compounds in less than 6 minutes LC/MS/MS Method Development 7.e7 6.5e7 6.e7 5.5e7 5.e7 4.5e7 Intensity, cps 4.e7 3.5e7 3.e7 2.5e7 2.e7 1.5e7 1.e7 5.e6..2.4.6.8 1. 1.2 1.4 1.6 1.8 2. 2.2 2.4 2.6 2.8 3. 3.2 3.4 3.6 3.8 4. min

Figure 4. Calibration curve for benzodiazepines α-oh-alprazolam Clonazepam 15 15 Quant ratio 1 5 Quant ratio 1 5 5 1 15 Conc [ng/ml] 5 1 15 Conc [ng/ml]

Figure 5. Calibration curve for opiates 15 Hydrocodone 15 Hydromorphone Quant ratio 1 5 Quant ratio 1 5 5 1 15 Conc [ng/ml] 5 1 15 Conc [ng/ml]

Figure 6. Calibration curve for amphetamines 25 Amphetamine 25 Methamphetamine 2 2 Quant ratio 15 1 5 Quant ratio 15 1 5 5 1 15 2 25 Conc [ng/ml] 5 1 15 2 25 Conc [ng/ml]

Figure 7. Calibration curve for analgesics Buprenorphine Norbuprenorphine 4 6 Quant ratio 3 2 1 Quant ratio 4 2 1 2 3 4 Conc [ng/ml] 2 4 6 Conc [ng/ml]

Figure 8. Lower and upper limits of quantitation (ng/ml) Drug Name LLOQ ULOQ 6-MAM 2.5 5 a-oh-alprazolam 5 1 Alprazolam 5 1 Amitriptyline 1 2 Amphetamine 1 2 Benzoylecgonine 5 1 Buprenorphine 1.5 3 Carisoprodol 1 2 Clonazepam 5 1 Codeine 1 2 Cyclobenzaprine 1 2 EDDP 1 2 Fentanyl.5 1 Hydrocodone 5 1 Hydromorphone 5 1 Lorazepam 5 1 MDMA 1 2 Meperidine 5 1 Meprobamate 1 2 Figure 8. Lower and upper limits of quantitation (ng/ml) Drug Name LLOQ ULOQ Temazepam 5 1 Tramadol 5 1 Butalbital 12.5 25 Phenobarbital 12.5 25 Tapentadol 5 1 Methylphenidate 5 1 Desipramine 5 1 Imipramine 5 1 7-Aminoclonazepam 5 1 Duloxetine 25 1 Zolpidem 5 1 MDPV 5 1 Mephedrone 5 1 Methylone 5 1 Gaba 8 16 Sovaldi 1 2 THCA 12.5 5 Methadone 1 2 Methamphetamine 1 2 Morphine 5 1 Naloxone 1 2 Norbuprenorphine 2.5 5 Nordiazepam 5 1 Norfentanyl.5 1 Norhydrocodone 1 2 Noroxycodone 5 1 Nortriptyline 1 2 Oxazepam 5 1 Oxycodone 5 1 Oxymorphone 5 1 Phencyclidine 2.5 5 Propoxyphene 1 2

Figure 9. Method Precision for High Conc. Analyte Conc. (ng/ml) Within-Run Precision (%) Within-Laboratory Precision (%) Interday Precision (%) Intraday Precision (%) 6-MAM 25 1.67 2.15 1.15.73 a-oh-alprazolam 5 2.68 3.53 2.33.4 Alprazolam 5 2.62 2.41 1.2 1.57 Amitriptyline 1 7.29 8.23 2.64 2.75 Amphetamine 1 3.2 2.79 1.49 2.16 Benzoylecgonine 5 2.17 3.47 2.95 1.17 Buprenorphine 15 12.23 12.23 6.12 6.12 Carisoprodol 1 6.19 15.9 12.3 6.17 Clonazepam 5 3.37 3.95 2.55 1.49 Codeine 1 3.19 4.84 3.78 1.5 EDDP 1 5.79 9.73 5.34 5.72 Fentanyl 5 3.16 4.46 2.88 1.26 Hydrocodone 5 2.36 2.31.82.96 Hydromorphone 5 1.99 3.52 3.18 1.3 Lorazepam 5 3.4 3.59 1.22.46 MDMA 1 1.91 2.99 2.27.39 Meperidine 5 3.4 3.52 2.52 1.79 Meprobamate 1 6.25 6.23 3.38 3.34 Methadone 1 5.29 9.87 4.8 9.61 Methamphetamine 1 2.84 6.29 4.94 2.66 Morphine 5 1.63 2.78 2.28.38 Naloxone 1 2.92 2.61.6 1.45 Norbuprenorphine 25 5.89 5.48 3.14 3.81 Nordiazepam 5 2.63 2.41.99.41 Norfentanyl 5 2.49 2.67 1.93 1.67 Norhydrocodone 1 1.75 1.58.68 1.2 Nortriptyline 1 3.54 3.38 2.9 2.35 Oxazepam 5 2.92 2.76.38.88 Oxycodone 5 3.29 3.47 2.4 2.11 Oxymorphone 5 1.73 2.4 1.92.96 PCP 25 5.4 8.56 1.27 6.8 Propoxyphene 1 8.76 14.67 1.16 5.95 Temazepam 5 2.91 3.87 1.8 1.81 Tramadol 5 1.74 2.77 2.39 1.3 Butalbital 125 2.12 4.31 1.36 3.99 Phenobarbital 125 4.57 6.79 4.88 1.18 Desipramine 5 2.95 2.98 1.71 1.65 Imipramine 5 2.64 4.68 3.79.78 7-Aminoclonazepam 5 2.92 3.58 2.38 1.16 Zolpidem 5 3.6 3.73 2.61 1.5 MDPV 5 3.1 3.48 2.43 1.69 Gaba 8 2.84 3.7 2.23 1.9 THCA 25 1.37 5.56 5.19 1.46

Figure 1. Method Precision for Low Conc. Analyte Conc. (ng/ml) Within-Run Precision (%) Within-Laboratory Precision (%) Interday Precision (%) Intraday Precision (%) 6-MAM 25 4.31 6.15 4.21 1.24 a-oh-alprazolam 5 2.32 5.58 4.95 1.12 Alprazolam 5 2.92 5.62 4.96 1.23 Amitriptyline 1 5.8 8.8 3.62 4.3 Amphetamine 1 3.27 13.93 13.38 2.8 Benzoylecgonine 5 3.26 6.27 5.37.45 Buprenorphine 15 16.6 15.38 4.33 6.33 Carisoprodol 1 1.31 17.58 13.72 3.8 Clonazepam 5 4.92 5.15 3.6 3.26 Codeine 1 3.14 4.28 3.29 1.53 EDDP 1 5.64 5.94 4.1 3.56 Fentanyl 5 4.47 4.47 Hydrocodone 5 2.57 11.19 1.85 1 Hydromorphone 5 2.93 5.4 4.38 1.55 Lorazepam 5 3 4.27 2.66 1.48 MDMA 1 1.8 2.95 2.6 1.14 Meperidine 5 2.61 5.2 4.49 1.34 Meprobamate 1 8.75 15.31 3.13 12.16 Methadone 1 5.76 6.93 3.38 5.13 Methamphetamine 1 2.66 3.99 3.27 1.34 Morphine 5 3.29 5.1 4.21 1.84 Naloxone 1 3.57 3.51 1.85 1.97 Norbuprenorphine 25 14.14 14.38 7.62 7.16 Nordiazepam 5 3.49 5.3 3.63 Norfentanyl 5 2.16 3.28 2.68 1.2 Norhydrocodone 1 3.75 3.56 2.22 2.5 Nortriptyline 1 4.92 5.7 4.46 3.41 Oxazepam 5 2.79 9.64 8.95 2.28 Oxycodone 5 3.1 4.54 3.55 1.26 Oxymorphone 5 3.55 4.95 4.14 2.28 PCP 25 9.8 8.29 3.35 4 Propoxyphene 1 12.18 13.32 4.36 6.94 Temazepam 5 2.32 4.63 3.53 1.9 Tramadol 5 2.97 4.75 4.14 1.84 Butalbital 125 5.8 6.28 3.68 5.22 Phenobarbital 125 6.79 4.88 1.18 Methylphenidate 5 4.77 5.1 3.42 3.7 Desipramine 5 3.66 4.96 3.77 1.73 Imipramine 5 3 7.5 6.46 1 7-Aminoclonazepam 5 2.72 11.62 11.31.45 Zolpidem 5 3.16 5.2 4.5 1.79 MDPV 5 2.97 4.33 3.54 1.61 Gaba 8 1.98 5.19 4.97 1.29 THCA 25 2.68 7.67 6.8 2.37

Figure 11. Matrix effect summary Compound % Matrix Effect Compound % Matrix Effect Compound % Matrix Effect 6-MAM 97.39 MDMA 15.72 Oxymorphone 16.48 a-oh-alprazolam 15.88 Meperidine 1.88 PCP 96.62 Alprazolam 13.71 Meprobamate 19.15 Propoxyphene 94.88 Amitriptyline 11.26 Methadone 14.77 Temazepam 12.66 Amphetamine 13.66 Methamphetamine 96.82 Tramadol 12.9 Benzoylecgonine 17.37 Morphine 98.97 Butalbital 95.53 Buprenorphine 118.52 Naloxone 16.81 Phenobarbital 97.9 Carisoprodol 113.79 Norbuprenorphine 12.84 Methylphenidate 11.19 Clonazepam 88.85 Nordiazepam 11.99 Desipramine 1.38 Codeine 11.88 Norfentanyl 14.61 Imipramine 99.75 EDDP 98.41 Norhydrocodone 15.19 7-Aminoclonazepam 12.89 Fentanyl 12.21 Nortriptyline 12.4 Zolpidem 19.61 Hydrocodone 98.5 Oxazepam 13.37 Gaba 98.58 Hydromorphone 13.56 Oxycodone 1.4 THCA 9.26

Results and Discussion 1. The presence of additional protein (β-glucuronidase) in a urine sample can denature in the column during a normal chromatographic run. The resulting fouling will quickly plug the HPLC column and render it useless (Figure 1). However, removal of the protein from the samples by a simple precipitation procedure can enhance the longevity of the column (Figure 2). 2. The protein precipitation method evaluated here produced good chromatographic separation of the compounds (Figure 3) with acceptable calibration parameters (Figures 4-7). 3. In addition, great method precision was achieved at both low and high quantitation levels (Figures 9-1). 4. The method produced minimal matrix effect despite a simple sample preparation procedure from an inherently dirty sample matrix (Figure 11).

Conclusion Performing protein precipitation after enzymatic hydrolysis provides cleaner extracts and extends the HPLC column lifetime. Fifty one (51) compounds and fourteen (14) deuterated analogs were efficiently and quickly resolved in 6 minutes using a Kinetex Phenyl-Hexyl core-shell HPLC column. The sample preparation proved to be robust requiring no method development. This method produced excellent calibration range. The calculated matrix effect results for all the evaluated analytes fell within acceptable limits. This bioanalytical method is proven to be suitable for a wide range of acidic, basic, and neutral compounds.

References 1. S Huq, S Sadjadi, and S Countryman, Removal of Beta-Glucuronidase Enzyme from Urine Post-Hydrolysis to Improve Assay Performance and Column Lifetime. Mass Spec Application for Clinical Laboratory Conference, 213 Trademarks Kinetex is a registered trademark and Impact is a trademark of Phenomenex. Shimadzu is a registered trademark of Shimadzu Corp. Freedom EVO is a registered trademark and MultiChannel Arm is a trademark of Tecan Group Ltd. API 5 is a registered trademark of AB SCIEX Pte. Ltd. AB SCIEX is being used under license. 215 Phenomenex, Inc. All rights reserved.