Researchers have developed a fast, non-invasive saliva-based test, Paper-Arrow Mass Spectrometry (PA-MS), to detect acetaminophen levels. This technique addresses the urgent need for rapid overdose diagnosis and treatment, promising improved patient care and healthcare efficiency.
A research team from the University of Liverpool has developed an innovative technique to rapidly assess acetaminophen levels using saliva.
In a paper published in the journal BMC Medicine, the team demonstrates the clinical validity of a novel mass spectrometry-based technique that tests acetaminophen levels from a tiny drop of saliva applied to a piece of paper. While generally called acetaminophen (Tylenol) in the United States, the same medicine is known as paracetamol (Panadol) in Europe.
Called Paper-Arrow Mass Spectrometry (PA-MS), the patent-pending technique was found to offer enhanced analytical performance while requiring less time, resources, and clinical involvement than current tests.
Acetaminophen is the most consumed medicine globally and its accessibility contributes to frequent misuse and overdose. Approximately 100,000 cases of acetaminophen overdose are reported in the UK each year, leading to 50,000 hospital admissions due to liver toxicity. If not treated quickly, acetaminophen overdoses can lead to severe outcomes, including liver failure, transplantation, or even death.
N-acetylcysteine (NAC) is a medication that is used to treat acetaminophen overdose and is effective in preventing acute liver injury (ALI), however, it is time-sensitive and most effective if administered within 8 hours.
Study Highlights Saliva as the Preferred Sample Type
The research team tested the technique using both saliva and plasma samples from volunteers who had ingested acetaminophen and saliva was found to be the preferred sample method.
The study is in collaboration with Alder Hey NHS Foundation Trust, Royal Liverpool University Hospitals NHS Foundation Trust, and Liverpool School of Tropical Medicine.
Dr. Simon Maher, an expert in Mass Spectrometry Technologies with the University of Liverpool’s Department of Electrical Engineering and Electronics, said: “This study demonstrates successful testing of the new PA-MS test in a clinical environment and lays the foundation for advancing point-of-care testing across emergency and routine clinical settings. This innovation represents a significant step forward in ambient ionization mass spectrometry techniques, with the potential for broad application in clinical diagnostics.”
Professor Dan Hawcutt, a clinical pharmacologist and Director of Research at Alder Hey Children’s Hospital, and Director of the NIHR Alder Hey Clinical Research Facility, said: “The speed, simplicity, and efficiency of this new technology has the potential to provide faster diagnosis, better patient outcomes, and cost savings for healthcare systems.”
The foundational development of this technology was funded by the EPSRC Healthcare Technologies program and was published in the Royal Society of Chemistry.
Dr. Robert Felstead, Deputy Director of Healthcare Technologies at EPSRC, added: “This research, which was supported by EPSRC, represents a significant breakthrough in the rapid and accurate quantitation of paracetamol. Given the high incidence of paracetamol overdose and its severe consequences, this innovative technology offers a fast, non-invasive, and cost-effective solution that can greatly enhance patient care and outcomes.”
The University of Liverpool is seeking to translate this technology into a bespoke multiplexed diagnostic tool for rapid OD and liver injury assessment.
Reference: “Rapid and non-invasive analysis of paracetamol overdose using paper arrow-mass spectrometry: a prospective observational study” by Yufeng Zhou, Silothabo Dliso, Jennie Craske, Andrea Gill, Louise Bracken, Kiran Landa, Philip Arnold, Laura Walker, Ionela Grasim, Gabrielle Seddon, Tao Chen, Andrew S. Davison, Tung-Ting Sham, Barry Smith, Daniel B. Hawcutt and Simon Maher, 25 November 2024, BMC Medicine.
