Rare Diseases Symptoms Automatic Extraction
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The use of mass spectrometry to analyze dried blood spots.
[phenylketonuria]
Dried
blood
spots
(
DBS
)
typically
consist
in
the
deposition
of
small
volumes
of
capillary
blood
onto
dedicated
paper
cards
.
Comparatively
to
whole
blood
or
plasma
samples
,
their
benefits
rely
in
the
fact
that
sample
collection
is
easier
and
that
logistic
aspects
related
to
sample
storage
and
shipment
can
be
relatively
limited
,
respectively
,
without
the
need
of
a
refrigerator
or
dry
ice
.
Originally
,
this
approach
has
been
developed
in
the
sixties
to
support
the
analysis
of
phenylalanine
for
the
detection
of
phenylketonuria
in
newborns
using
bacterial
inhibition
test
.
In
the
nineties
tandem
mass
spectrometry
was
established
as
the
detection
technique
for
phenylalanine
and
tyrosine
.
DBS
became
rapidly
recognized
for
their
clinical
value
:
they
were
widely
implemented
in
pediatric
settings
with
mass
spectrometric
detection
,
and
were
closely
associated
to
the
debut
of
newborn
screening
(
NBS
)
programs
,
as
a
part
of
public
health
policies
.
Since
then
,
sample
collection
on
paper
cards
has
been
explored
with
various
analytical
techniques
in
other
areas
more
or
less
successfully
regarding
large
-scale
applications
.
Moreover
,
in
the
last
5
years
a
regain
of
interest
for
DBS
was
observed
and
originated
from
the
bioanalytical
community
to
support
drug
development
(
e
.
g
.
,
PK
studies
)
or
therapeutic
drug
monitoring
mainly
.
Those
recent
applications
were
essentially
driven
by
improved
sensitivity
of
triple
quadrupole
mass
spectrometers
.
This
review
presents
an
overall
view
of
all
instrumental
and
methodological
developments
for
DBS
analysis
with
mass
spectrometric
detection
,
with
and
without
separation
techniques
.
A
general
introduction
to
DBS
will
describe
their
advantages
and
historical
aspects
of
their
emergence
.
A
second
section
will
focus
on
blood
collection
,
with
a
strong
emphasis
on
specific
parameters
that
can
impact
quantitative
analysis
,
including
chromatographic
effects
,
hematocrit
effects
,
blood
effects
,
and
analyte
stability
.
A
third
part
of
the
review
is
dedicated
to
sample
preparation
and
will
consider
off-line
and
on-line
extractions
;
in
particular
,
instrumental
designs
that
have
been
developed
so
far
for
DBS
extraction
will
be
detailed
.
Flow
injection
analysis
and
applications
will
be
discussed
in
section
IV
.
The
application
of
surface
analysis
mass
spectrometry
(
DESI
,
paper
spray
,
DART
,
APTDCI
,
MALDI
,
LDTD-APCI
,
and
ICP
)
to
DBS
is
described
in
section
V
,
while
applications
based
on
separation
techniques
(
e
.
g
.
,
liquid
or
gas
chromatography
)
are
presented
in
section
VI
.
To
conclude
this
review
,
the
current
status
of
DBS
analysis
is
summarized
,
and
future
perspectives
are
provided
.
©
2014
Wiley
Periodicals
,
Inc
.
Mass
Spec
Rev
9999
:
1
-
78
,
2014
.
Diseases
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"second section"
symptom
phenylketonuria
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