Use of Dried Blood Spot Specimens to Monitor Patients with Inherited Metabolic Disorders

Monitoring of patients with inherited metabolic disorders (IMDs) using dried blood spot (DBS) specimens has been routinely used since the inception of newborn screening (NBS) for phenylketonuria in the 1960s. The introduction of flow injection analysis tandem mass spectrometry (FIA−MS/MS)...

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Main Authors: Stuart J. Moat, Roanna S. George, Rachel S. Carling
Format: Article
Language:English
Published: MDPI AG 2020-03-01
Series:International Journal of Neonatal Screening
Subjects:
Online Access:https://www.mdpi.com/2409-515X/6/2/26
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author Stuart J. Moat
Roanna S. George
Rachel S. Carling
author_facet Stuart J. Moat
Roanna S. George
Rachel S. Carling
author_sort Stuart J. Moat
collection DOAJ
description Monitoring of patients with inherited metabolic disorders (IMDs) using dried blood spot (DBS) specimens has been routinely used since the inception of newborn screening (NBS) for phenylketonuria in the 1960s. The introduction of flow injection analysis tandem mass spectrometry (FIA−MS/MS) in the 1990s facilitated the expansion of NBS for IMDs. This has led to increased identification of patients who require biochemical monitoring. Monitoring of IMD patients using DBS specimens is widely favoured due to the convenience of collecting blood from a finger prick onto filter paper devices in the patient’s home, which can then be mailed directly to the laboratory. Ideally, analytical methodologies with a short analysis time and high sample throughput are required to enable results to be communicated to patients in a timely manner, allowing prompt therapy adjustment. The development of ultra-performance liquid chromatography (UPLC−MS/MS), means that metabolic laboratories now have the capability to routinely analyse DBS specimens with superior specificity and sensitivity. This advancement in analytical technology has led to the development of numerous assays to detect analytes at low concentrations (pmol/L) in DBS specimens that can be used to monitor IMD patients. In this review, we discuss the pre-analytical, analytical and post-analytical variables that may affect the final test result obtained using DBS specimens used for monitoring of patients with an IMD.
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spelling doaj.art-f531424bed4e40bab12b933a71cc86892022-12-21T23:56:54ZengMDPI AGInternational Journal of Neonatal Screening2409-515X2020-03-01622610.3390/ijns6020026ijns6020026Use of Dried Blood Spot Specimens to Monitor Patients with Inherited Metabolic DisordersStuart J. Moat0Roanna S. George1Rachel S. Carling2Department of Medical Biochemistry, Immunology & Toxicology, University Hospital of Wales, Cardiff CF14 4XW, UKDerriford Combined Laboratory, University Hospitals Plymouth NHS Trust, Plymouth PL6 8DH, UKBiochemical Sciences, Viapath, Guys & St Thomas’ NHSFT, London SE1 7EH, UKMonitoring of patients with inherited metabolic disorders (IMDs) using dried blood spot (DBS) specimens has been routinely used since the inception of newborn screening (NBS) for phenylketonuria in the 1960s. The introduction of flow injection analysis tandem mass spectrometry (FIA−MS/MS) in the 1990s facilitated the expansion of NBS for IMDs. This has led to increased identification of patients who require biochemical monitoring. Monitoring of IMD patients using DBS specimens is widely favoured due to the convenience of collecting blood from a finger prick onto filter paper devices in the patient’s home, which can then be mailed directly to the laboratory. Ideally, analytical methodologies with a short analysis time and high sample throughput are required to enable results to be communicated to patients in a timely manner, allowing prompt therapy adjustment. The development of ultra-performance liquid chromatography (UPLC−MS/MS), means that metabolic laboratories now have the capability to routinely analyse DBS specimens with superior specificity and sensitivity. This advancement in analytical technology has led to the development of numerous assays to detect analytes at low concentrations (pmol/L) in DBS specimens that can be used to monitor IMD patients. In this review, we discuss the pre-analytical, analytical and post-analytical variables that may affect the final test result obtained using DBS specimens used for monitoring of patients with an IMD.https://www.mdpi.com/2409-515X/6/2/26inherited metabolic disordersmonitoringtreatment rangesdried blood spotshaematocritcertified reference materialprecisionaccuracybias
spellingShingle Stuart J. Moat
Roanna S. George
Rachel S. Carling
Use of Dried Blood Spot Specimens to Monitor Patients with Inherited Metabolic Disorders
International Journal of Neonatal Screening
inherited metabolic disorders
monitoring
treatment ranges
dried blood spots
haematocrit
certified reference material
precision
accuracy
bias
title Use of Dried Blood Spot Specimens to Monitor Patients with Inherited Metabolic Disorders
title_full Use of Dried Blood Spot Specimens to Monitor Patients with Inherited Metabolic Disorders
title_fullStr Use of Dried Blood Spot Specimens to Monitor Patients with Inherited Metabolic Disorders
title_full_unstemmed Use of Dried Blood Spot Specimens to Monitor Patients with Inherited Metabolic Disorders
title_short Use of Dried Blood Spot Specimens to Monitor Patients with Inherited Metabolic Disorders
title_sort use of dried blood spot specimens to monitor patients with inherited metabolic disorders
topic inherited metabolic disorders
monitoring
treatment ranges
dried blood spots
haematocrit
certified reference material
precision
accuracy
bias
url https://www.mdpi.com/2409-515X/6/2/26
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