Is Mass Spectrometry Used in Clinical Applications?

From pharmaceutical development to food contamination detection, mass spectrometry (MS) is used across a wide range of industries. The analytical tool measures the mass-to-charge ratio (m/z) of molecules in a sample, with data used to calculate precise weights and concentrations. New developments and advances continue to expand the relevance of mass spectrometry across a wide range of industries, including clinical applications and laboratory medicine. Below, we explore some of the key uses for the analytical tool.

Illicit drug detection

The highly sensitive nature of mass spectrometry makes it the method of choice for measuring laboratory analytes, particularly illicit drugs. It’s the gold-standard in drug analysis, using the mass to charge ratio (m/z) of ions to calculate the precise molecular mass of illicit drugs such as heroin, cocaine, ketamine, methadone and amphetamines.

Immunoassays

The wide analytical range and impressive specificity of mass spectrometry makes it a useful immunoassay tool. Multiple hormones can be detected and measured during the same analysis, giving MS time and cost saving advantages over other techniques.

Biochemical genetics

Mass spectrometry is well established in the biochemical genetics field and is used to detect multiple inherited metabolic disorders in babies, including phenylketonuria (PKU), sickle cell disease and congenital hypothyroidism. Tandem mass spectrometry (MS/MS) has significantly expanded the screening panel for metabolic disorders, with the incorporation of an acylcarnitine profile allowing analysts to detect fatty acid oxidation disorders (FAOD) and organic acid disorders (OAD) caused by enzyme malfunction. In just two minutes MS/MS can analyse around 20 metabolites in a single blood-spot specimen, making it a highly efficient clinical analysis tool.

Olympic drug testing

Mass spectrometry has been a cornerstone of Olympic doping analysis for decades. New advances in mass spectrometry have made it even harder to evade detection, with a study published by the American Chemical Society introducing a new drug detection method called ion mobility-mass spectrometry.

“As the world awaits the upcoming Olympic games, a new method for detecting doping compounds in urine samples could level the playing field for those trying to keep athletics clean. Now, scientists report an approach using ion mobility-mass spectrometry to help regulatory agencies detect existing dopants and future 'designer compounds,” reads the abstract.

Liquid chromatography-mass spectrometry (LC–MS)

Combining the large-scale analysis benefits of mass spectrometry (MS) with the precise separation capabilities of high-performance liquid chromatography (HPLC), LC–MS has set a new benchmark for analytical chemistry in clinical applications. Charis Lam explores how the method is used to de-formulate complex samples in ‘What’s in my LC/MS spectra?