Revolutionize clinical lab with liquid chromatography mass spectrometry

Where health is a concern, mass spectrometry provides high reliability and confidence.

Historically, the success of mass spectrometry (MS), which is extensively used as an analytical instrument in pharma and chemical industries, has played a prominent role in the field of clinical testing to overcome various analytical and economic factors. For two decades, development of MS technology, when coupled with LC (liquid chromatography), has made it the technique of choice for analyzing various analytes of interest in clinical labs because of its high specificity, the separation capabilities of the LC, and its wide dynamic range.

Clinical laboratories use LCMS technology for disease screening, diagnoses of diseases and metabolic disorders, monitoring of drug therapy, identifying drug toxicity and poisoning, and discovering new biomarkers. Therapeutic monitoring of immunosuppressant drugs using LCMS is also well established. Limitations of immunoassays, such as nonspecific binding of the antibody and cross-reactivity with metabolites that often result in overestimation, have made the more accurate LCMS methodologies the assays of choice. LCMS has become the standard for assay of steroid hormones for the diagnosis of endocrine disorders. Vitamin D analysis by LCMS is widely used in clinical laboratories today. Whereas immunoassays are unable to distinguish between 25-hydroxy vitamins D2 and D3, the LCMS methodologies can measure these levels separately so the contribution of each to the total can be determined. The capability of measuring thyroid hormones by tandem MS was developed recently, and this has overcome the issues associated with immunoassays. Triple-quadrupole MS/MS is the preferred methodology for toxicology screening and toxic-drug quantitation. In newborn and prenatal screening programs, electrospray tandem MS has made it possible to identify inborn errors in metabolism, or genetic defects, so that preventive and medical intervention can be implemented promptly to relieve or treat the disease. The intensive research into metabolomics, the assessment of endogenous metabolites as new disease biomarkers, is another promising application of MS, which has been demonstrated to be very well suited to the discovery and clinical application of metabolite profiles.

Despite the rapid advances made in the application of LCMS to clinical assays, there are relatively few instruments employed in routine diagnostic labs, compared to the traditional clinical analyzer systems, which are based upon biochemicals and immunoassays. The advantages of LCMS are many, including no costly analyte-specific reagents (ASRs); the ability to determine many analytes in a single run with the same low cost of analysis whether one or many analytes are determined; high specificity and sensitivity, especially for small-molecule analytes in comparison to immunoassays; and relatively rapid assay development amenable to homebrew.

Today, LCMS has made a cutting edge over other techniques for routine estimation of vitamins, hormones, and other biomarkers. Varied types of sample analysis using LCMS have increased their implication in the healthcare industry. The cost of such advanced analytical techniques is prohibitive but due to the advantages of ultra-high sensitivity and capability to handle heavy workloads, the returns on investment are recovered easily by clinical laboratories through high profits, higher confidence, and efficient services to patients. New horizons and trends indicate a bright future for LCMS in revolutionizing the healthcare industry.