Evaluation and validation of a non-invasive (using fingerprints) drug screening device as a point-of-care tool for the detection of illicit drugs

研究表明，药物滥用与不良预后和治疗结果有关。然而，临床医生在评估精神和心理障碍患者时往往低估了药物滥用问题的存在。对于那些与患有这些疾病的患者一起工作的人来说，假设物质使用的迹象是由于短暂的身体问题或疾病本身，这并不罕见。一个简单的生物学工具，以协助临床医生在识别非法物质尚未确定。有人呼吁在物质滥用可能不是主要诊断的情况下使用非侵入性药物检测设备。重要的是，卫生保健和其他专业人员谁怀疑物质滥用能够确认使用，以发现，以改善治疗结果，并了解更多关于司机这种behavior.We提出了一项研究，以评估实用性的沉积指纹作为一种新的，非侵入性的方法，用于药物检测，有可能在各种各样的设置应用。物质滥用的实验室检测广泛依赖于检测或测量体液或组织中一系列精神活性物质及其代谢物（生物标志物）的能力。检测程序面临的主要挑战之一是可能消费的精神活性物质种类繁多，需要针对这些物质采取具体办法。药物可以在任何体液或组织中检测到，但存在实际限制，这些限制决定了可以使用和使用的样品。生物标志物的选择受被测物质的药代动力学以及在实验室环境中分析的难易程度的影响。这项研究建议旨在探讨在戒毒治疗机构和精神健康服务等临床环境中，使用指纹作为筛查工具来检测滥用药物的可行性。已经有相当多的证据表明，药物及其代谢物可以在人体汗液中检测到。研究已成功鉴别出可卡因及其代谢物[Huestis 1999，Kidwell 2003;Cone 1994; Winhusen 2003，Samyn 2002];阿片类药物[Cone 1994，Kintz 1997，Samyn 2002];安非他明[Samyn 2002];苯二氮卓类药物[Kintz 1996]和美沙酮[Skopp 1996，亨德森1973]。该方案旨在验证分析指纹沉积物中汗液成分用于筛查滥用药物的用途。潜在指纹（LFP）中的汗液可以包含口服摄入的药物及其代谢产物。一种新的药物检测方法能够将LFP与磁性纳米颗粒（NPs）孵育，并且用荧光标记的二次抗体处理的LFP可以通过荧光成像进行表征（Hazarika等人，2008; 2010）。一个主要的研究问题是，非法物质是否可以在一个单一的打印检测，这将是理想的采样目的，以及是否有可能在同一时间检测不同药物类别的药物。拟议的取样将包括一个人在一个专门设计的模板上留下指纹。然后提取指纹并通过液相色谱-串联质谱法（LC-MS/MS）进行分析，以识别药物和药物代谢物。将采集血液和口腔液样本作为配对样本，以测试程序的有效性，并确认器械在临床环境中使用的灵敏度和特异性。

Studies have indicated that substance misuse is associated with poor prognosis and treatment outcome. However, clinicians' often underestimate the presence of substance misuse problems when assessing patients with psychiatric and psychological disorders. It is not unusual for those working with patients who have these conditions to assume that signs of substance use are due to transient physical problems, or the disorder itself. A simple biological tool to assist the clinician in the identification of illicit substances has yet to be identified. There have been calls for a non invasive drug testing device for use in settings where substance misuse may not be the primary diagnosis. It is important that health care and other professionals who suspect substance misuse are able to confirm use in order to discover to improve the treatment outcome and learn more about the drivers for such behaviour.We propose a study to evaluate the utility of deposited fingerprints as a novel, non invasive method for drug testing that has the potential for application in a wide variety of settings. Laboratory testing for substance misuse relies extensively on the ability to detect or measure a range of psychoactive substances and their metabolites in body fluids or tissues (biomarker). One of the major challenges for testing procedures is the wide array of psychoactive substances that may be consumed and the need for specific approaches for them. A drug may be detected in any body fluid or tissue but there are practical limitations that govern which samples can be, and are, used. The choice of biomarker is influenced by the pharmacokinetics of the substance being tested for, and the ease with which it can be analysed in a laboratory setting. This research proposal aims to explore the feasibility of using deposited fingerprints as a screening instrument to detect drugs of abuse in clinical settings such as drug treatment agencies and mental health services. There is already a considerable body of evidence to show that drugs and their metabolites can be detected in human sweat. Studies have successfully indentified cocaine and metabolites [Huestis 1999, Kidwell 2003;Cone 1994; Winhusen 2003, Samyn 2002]; opiates [Cone 1994, Kintz 1997, Samyn 2002]; amphetamines [Samyn 2002]; benzodiazepines [Kintz 1996] and methadone [Skopp 1996, Henderson 1973]. This proposal aims to validate the use of analysing sweat components in fingerprint deposits for to screen for drugs of misuse.The sweat in a latent fingerprint (LFP) can contain orally ingested drugs and their metabolites a new method for drug detection, is able to incubate LFP with magnetic nanoparticles (NPs)and the LFP treated with a fluorescently labeled secondary antibody allows characterization by fluorescence imaging (Hazarika et al, 2008; 2010). A major research question is whether illicit substances can be detected in a single print as would be the ideal for sampling purposes and if it is possible to detect drugs of different drug classes at one time. The proposed sampling would consist of an individual depositing a fingerprint on a specifically designed template. The print will then be extracted and analysed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify drugs and drug metabolites. Blood and oral fluid samples will be collected as paired samples to test the valdidty of the procedure and to confirm sensitivity and specificity of the device for use in clinical settings.