The alcohol biomarker phosphatidylethanol (PEth) – test performance and experiences from routine analysis and external quality assessment

References

• Helander A, Beck O, Jones AW. Laboratory testing for recent alcohol consumption: comparison of ethanol, methanol, and 5-hydroxytryptophol. Clin Chem. 1996;42(4):618–624. doi: 10.1093/clinchem/42.4.618.
   PubMed Web of Science ®Google Scholar
• Whitfield JB, Hensley WJ, Bryden D, et al. Some laboratory correlates of drinking habits. Ann Clin Biochem. 1978;15(6):297–303. doi: 10.1177/000456327801500171.
   PubMed Web of Science ®Google Scholar
• Whitehead TP, Clarke CA, Whitfield AG. Biochemical and haematological markers of alcohol intake. Lancet. 1978;1(8071):978–981. doi: 10.1016/s0140-6736(78)90261-1.
   PubMed Web of Science ®Google Scholar
• Helander A, Wielders J, Anton R, et al. Standardisation and use of the alcohol biomarker carbohydrate-deficient transferrin (CDT). Clin Chim Acta. 2016;459:19–24. doi: 10.1016/j.cca.2016.05.016.
   PubMed Web of Science ®Google Scholar
• Helander A, Beck O. Ethyl sulfate: a metabolite of ethanol in humans and a potential biomarker of acute alcohol intake. J Anal Toxicol. 2005;29(5):270–274. doi: 10.1093/jat/29.5.270.
   PubMed Web of Science ®Google Scholar
• Isaksson A, Walther L, Hansson T, et al. Phosphatidylethanol in blood (B-PEth): a marker for alcohol use and abuse. Drug Test Anal. 2011;3(4):195–200. doi: 10.1002/dta.278.
   PubMed Web of Science ®Google Scholar
• Gnann H, Engelmann C, Skopp G, et al. Identification of 48 homologues of phosphatidylethanol in blood by LC-ESI-MS/MS. Anal Bioanal Chem. 2010;396(7):2415–2423. doi: 10.1007/s00216-010-3458-5.
   PubMed Web of Science ®Google Scholar
• Helander A, Zheng Y. Molecular species of the alcohol biomarker phosphatidylethanol in human blood measured by LC-MS. Clin Chem. 2009;55(7):1395–1405. doi: 10.1373/clinchem.2008.120923.
   PubMed Web of Science ®Google Scholar
• Stenton J, Walther L, Hansson T, et al. Inter individual variation and factors regulating the formation of phosphatidylethanol. Alcohol Clin Exp Res. 2019;43(11):2322–2331. doi: 10.1111/acer.14195.
   PubMed Web of Science ®Google Scholar
• Helander A, Böttcher M, Dahmen N, et al. Elimination characteristics of the alcohol biomarker phosphatidylethanol (PEth) in blood during alcohol detoxification. Alcohol Alcohol. 2019;54(3):251–257. doi: 10.1093/alcalc/agz027.
   PubMed Web of Science ®Google Scholar
• Hansson P, Caron M, Johnson G, et al. Blood phosphatidylethanol as a marker of alcohol abuse: levels in alcoholic males during withdrawal. Alcohol Clin Exp Res. 1997;21(1):108–110. doi: 10.1097/00000374-199702000-00015.
   PubMed Web of Science ®Google Scholar
• Helander A, Hansson T. [National harmonization of the alcohol biomarker PEth]. Läkartidningen. 2013;110:1747–1748.
   PubMedGoogle Scholar
• Varga A, Hansson P, Johnson G, et al. Normalization rate and cellular localization of phosphatidylethanol in whole blood from chronic alcoholics. Clin Chim Acta. 2000;299(1-2):141–150. doi: 10.1016/s0009-8981(00)00291-6.
   PubMed Web of Science ®Google Scholar
• Isaksson A, Walther L, Alling C, et al. [Phosphatidylethanol in blood (B-PEth) - a new marker of alcohol abuse]. Läkartidningen. 2009;106:1094–1098.
   PubMedGoogle Scholar
• Isaksson A, Walther L, Hansson T, et al. High-throughput LC-MS/MS method for determination of the alcohol use biomarker phosphatidylethanol in clinical samples by use of a simple automated extraction procedure - preanalytical and analytical conditions. J Appl Lab Med. 2018;2(6):880–892. doi: 10.1373/jalm.2017.024828.
   PubMedGoogle Scholar
• Berg T, Eliassen E, Jørgenrud B, et al. Determination of phosphatidylethanol 16:0/18:1 in whole blood by 96-well supported liquid extraction and UHPLC-MS/MS. J Clin Lab Anal. 2019;33(1):e22631. doi: 10.1002/jcla.22631.
   PubMed Web of Science ®Google Scholar
• Zheng Y, Beck O, Helander A. Method development for routine liquid chromatography-mass spectrometry measurement of the alcohol biomarker phosphatidylethanol (PEth) in blood. Clin Chim Acta. 2011;412(15-16):1428–1435. doi: 10.1016/j.cca.2011.04.022.
   PubMed Web of Science ®Google Scholar
• Skråstad RB, Spigset O, Aamo TO, et al. Stability of phosphatidylethanol 16:0/18:1 in freshly drawn, authentic samples from healthy volunteers. J Anal Toxicol. 2021;45(4):417–421. doi: 10.1093/jat/bkaa082.
   PubMed Web of Science ®Google Scholar
• Lakso H, Wuolikainen A, Sundkvist A, et al. Long-term stability of the alcohol consumption biomarker phosphatidylethanol in erythrocytes at -80 °C. Clin Mass Spectrom. 2019;11:37–41. doi: 10.1016/j.clinms.2018.12.002.
   PubMedGoogle Scholar
• Dumitrascu C, van de Lavoir MCA, Neels H, et al. Stability of phosphatidylethanol 16:0/18:1 in authentic and spiked whole blood. Drug Test Anal. 2021;13(6):1219–1222. doi: 10.1002/dta.2995.
   PubMed Web of Science ®Google Scholar
• Beck O, Mellring M, Löwbeer C, et al. Measurement of the alcohol biomarker phosphatidylethanol (PEth) in dried blood spots and venous blood-importance of inhibition of post-sampling formation from ethanol. Anal Bioanal Chem. 2021;413(22):5601–5606. doi: 10.1007/s00216-021-03211-z.
   PubMed Web of Science ®Google Scholar
• Beck O, Kenan Moden N, Seferaj S, et al. Study of measurement of the alcohol biomarker phosphatidylethanol (PEth) in dried blood spot (DBS) samples and application of a volumetric DBS device. Clin Chim Acta. 2018;479:38–42. doi: 10.1016/j.cca.2018.01.008.
   PubMed Web of Science ®Google Scholar
• Kummer N, Ingels AS, Wille SM, et al. Quantification of phosphatidylethanol 16:0/18:1, 18:1/18:1, and 16:0/16:0 in venous blood and venous and capillary dried blood spots from patients in alcohol withdrawal and control volunteers. Anal Bioanal Chem. 2016;408(3):825–838. doi: 10.1007/s00216-015-9169-1.
   PubMed Web of Science ®Google Scholar
• Javors MA, Hill-Kapturczak N, Roache JD, et al. Characterization of the pharmacokinetics of phosphatidylethanol 16:0/18:1 and 16:0/18:2 in human whole blood after alcohol consumption in a clinical laboratory study. Alcohol Clin Exp Res. 2016;40(6):1228–1234. doi: 10.1111/acer.13062.
   PubMed Web of Science ®Google Scholar
• Neumann J, Beck O, Helander A, et al. Performance of PEth compared with other alcohol biomarkers in subjects pfesenting for occupational and pre-employment medical examination. Alcohol Alcohol. 2020;55(4):401–408. doi: 10.1093/alcalc/agaa027.
   PubMed Web of Science ®Google Scholar
• Skråstad RB, Aamo TO, Andreassen TN, et al. Quantifying alcohol consumption in the general population by analysing phosphatidylethanol concentrations in whole blood: results from 24,574 subjects included in the HUNT4 study. Alcohol Alcohol. 2023;58(3):258–265. doi: 10.1093/alcalc/agad015.
   PubMed Web of Science ®Google Scholar
• Herzog J, Skopp G, Musshoff F, et al. Formation of phosphatidylethanol and ethylglucuronide after low to moderate alcohol consumption in volunteers with a previous three-week alcohol abstinence. Alcohol Alcohol. 2023. doi: 10.1093/alcalc/agad025.
   PubMed Web of Science ®Google Scholar
• Aboutara N, Jungen H, Szewczyk A, et al. PEth 16:0/18:1 and 16:0/18:2 after consumption of low doses of alcohol - a contribution to cutoff discussion. Drug Test Anal. 2023;15(1):104–114. doi: 10.1002/dta.3376.
   PubMed Web of Science ®Google Scholar
• Hasken JM, Marais AS, de Vries MM, et al. Assessing the sensitivity and specificity of phosphatidylethanol (PEth) cutoffs to identify alcohol exposed pregnancies. Curr Res Toxicol. 2023;4:100105. doi: 10.1016/j.crtox.2023.100105.
   PubMedGoogle Scholar
• Erim Y, Böttcher M, Dahmen U, et al. Urinary ethyl glucuronide testing detects alcohol consumption in alcoholic liver disease patients awaiting liver transplantation. Liver Transpl. 2007;13(5):757–761. doi: 10.1002/lt.21163.
   PubMed Web of Science ®Google Scholar
• Faulkner CS, White CM, Manatsathit W, et al. Positive blood phosphatidylethanol concentration is associated with unfavorable waitlist-related outcomes for patients medically appropriate for liver transplantation. Alcohol Clin Exp Res. 2022;46(4):581–588. doi: 10.1111/acer.14786.
   PubMed Web of Science ®Google Scholar
• Helander A. [Biomarkers can detect early-stage alcohol problems]. Läkartidningen. 2011;108:2291–2295.
   PubMedGoogle Scholar
• Reisfield GM, Teitelbaum SA, Jones JT, et al. Blood phosphatidylethanol (PEth) concentrations following intensive use of an alcohol-based hand sanitizer. J Anal Toxicol. 2023;46(9):979–990. doi: 10.1093/jat/bkab115.
   PubMed Web of Science ®Google Scholar
• Reisfield GM, Teitelbaum SA, Jones JT, et al. Blood phosphatidylethanol concentrations following regular exposure to an alcohol-based mouthwash. J Anal Toxicol. 2021;45(9):950–956. doi: 10.1093/jat/bkaa147.
   PubMed Web of Science ®Google Scholar
• Thurfjell Å, Sandlund C, Adami J, et al. General practitioners’ experiences of phosphatidylethanol in treatment of hypertension: a qualitative study. BJGP Open. 2023:BJGPO.2023.0037. doi: 10.3399/BJGPO.2023.0037.
   PubMedGoogle Scholar
• Hill-Kapturczak N, Dougherty DM, Roache JD, et al. Differences in the synthesis and elimination of phosphatidylethanol 16:0/18:1 and 16:0/18:2 after acute doses of alcohol. Alcohol Clin Exp Res. 2018;42(5):851–860. doi: 10.1111/acer.13620.
   PubMed Web of Science ®Google Scholar
• Schröck A, Thierauf-Emberger A, Schürch S, et al. Phosphatidylethanol (PEth) detected in blood for 3 to 12 days after single consumption of alcohol-a drinking study with 16 volunteers. Int J Legal Med. 2017;131(1):153–160. doi: 10.1007/s00414-016-1445-x.
   PubMed Web of Science ®Google Scholar
• Stöth F, Kotzerke E, Thierauf-Emberger A, et al. Can PEth be detected with a cutoff of 20 ng/mL after single alcohol consumption? J Anal Toxicol. 2023;46(9):e232–e238. doi: 10.1093/jat/bkac069.
   PubMed Web of Science ®Google Scholar
• Gnann H, Weinmann W, Thierauf A. Formation of phosphatidylethanol and its subsequent elimination during an extensive drinking experiment over 5 days. Alcohol Clin Exp Res. 2012;36(9):1507–1511. doi: 10.1111/j.1530-0277.2012.01768.x.
   PubMed Web of Science ®Google Scholar
• Helander A, Hermansson U, Beck O. Dose-response characteristics of the alcohol biomarker phosphatidylethanol (PEth)-a study of outpatients in treatment for reduced drinking. Alcohol Alcohol. 2019;54(6):567–573. doi: 10.1093/alcalc/agz064.
   PubMed Web of Science ®Google Scholar
• Stöth F, Weinmann W, Soravia LM, et al. Evaluation of phosphatidylethanol elimination in alcohol use disorder patients undergoing withdrawal treatment. Alcohol Alcohol. 2023;58(3):266–273. doi: 10.1093/alcalc/agad010.
   PubMed Web of Science ®Google Scholar
• Helander A, Peter O, Zheng Y. Monitoring of the alcohol biomarkers PEth, CDT and EtG/EtS in an outpatient treatment setting. Alcohol Alcohol. 2012;47(5):552–557. doi: 10.1093/alcalc/ags065.
   PubMed Web of Science ®Google Scholar
• Hodson L, Skeaff CM, Fielding BA. Fatty acid composition of adipose tissue and blood in humans and its use as a biomarker of dietary intake. Prog Lipid Res. 2008;47(5):348–380. doi: 10.1016/j.plipres.2008.03.003.
   PubMed Web of Science ®Google Scholar
• Alling C, Gustavsson L, Kristensson-Aas A, et al. Changes in fatty acid composition of major glycerophospholipids in erythrocyte membranes from chronic alcoholics during withdrawal. Scand J Clin Lab Invest. 1984;44(4):283–289. doi: 10.3109/00365518409083809.
   PubMed Web of Science ®Google Scholar
• Aboutara N, Jungen H, Szewczyk A, et al. Analysis of six different homologues of phosphatidylethanol from dried blood spots using liquid chromatography-tandem mass spectrometry. Drug Test Anal. 2021;13(1):140–147. doi: 10.1002/dta.2910.
   PubMed Web of Science ®Google Scholar
• Hahn JA, Murnane PM, Vittinghoff E, et al. Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: an individual patient data meta-analysis. Alcohol Clin Exp Res. 2021;45(6):1166–1187. doi: 10.1111/acer.14611.
   PubMed Web of Science ®Google Scholar
• Årving A, Hilberg T, Sovershaev M, et al. Falsely low phosphatidylethanol may be associated with biomarkers of haemolytic disease. Basic Clin Pharmacol Toxicol. 2023;132(2):223–230. doi: 10.1111/bcpt.13814.
   PubMed Web of Science ®Google Scholar
• Ulwelling W, Smith K. The PEth blood test in the security environment: what it is; why it is important; and interpretative guidelines. J Forensic Sci. 2018;63(6):1634–1640. doi: 10.1111/1556-4029.13874.
   PubMed Web of Science ®Google Scholar
• GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2018;392(10152):1015–1035. doi: 10.1016/S0140-6736(18)31310-2.
   PubMed Web of Science ®Google Scholar