Acidified nitrite

New studies at AACC 2023 Annual Scientific Meeting could change lives, improve drug safety. ANAHEIM, Calif., July 26, 2023 /PRNewswire/ -- Two studies featured today at the 2023 AACC Annual Scientific Meeting & Clinical Lab Expo highlight advances that could boost the accuracy of marijuana tests and provide vital information for addressing the opioid epidemic. The first describes a promising method for determining when urine samples have been tampered with to evade a positive result for marijuana. The second found that more than half of fentanyl samples contained novel psychoactive substances that could heighten the drug's danger. The legalization of marijuana in many states and the emergence of the fentanyl crisis have underscored the need for accurate and reliable drug tests. As marijuana use becomes more prevalent, researchers are focused on improving the detection methods used for legal, medical, and workforce drug tests. For example, many labs want help identifying when urine samples have been manipulated to avoid a positive result for marijuana. Deaths from opioid overdoses have been steadily climbing in the U.S. since 2020, in part due to the spread of the powerful narcotic fentanyl. At the same time, there has been a rise in the prevalence of novel psychoactive substances, which are often added to drugs sold as fentanyl to enhance potency. These substances can raise the risk of overdose and death. "Dilute-and-Shoot" Method Detects Manipulated THC Samples A scientific team led by Yubo Chai, MD/PhD, at the Mayo Clinic in Rochester, Minnesota, devised a method to counteract the drug-masking effects of common adulterants in marijuana tests. The researchers gathered 5 urine samples positive for both delta 8- and 9-THC-COOH, which are active ingredients of cannabis. They treated them with the adulterant nitrite or strong acid adulterants and found that the compounds quickly degraded both of the ingredients and the internal standard. The team then implemented a "dilute-and-shoot" workflow that combines a tandem- mass spectrometry method and liquid chromatography separation system. The system can determine whether a urine sample is truly negative or only appears so because it has been degraded by nitrite. The method was further validated with an additional crop of 12 specimens that contained delta 8-THC-COOH, delta 9-THC-COOH, or both. "Our unique dilute-and-shoot method can separate and quantify delta 8- and 9-THC-COOH," Chai said. "As a result, labs will be able to distinguish between true negative delta 8- and 9-THC-COOH results from specimens adulterated with nitrite, as the latter lack peaks for both the analytes and the internal standard." Chai noted that their study only tested samples adulterated with sodium nitrite. He calls for further work with samples tainted with other compounds such as peroxide and potassium nitrite. Study Sheds Light on "Designer" Substances in Fentanyl In another study, a group led by Gemma Campbell at Aegis Sciences Corp. in Nashville set out to evaluate how common novel psychoactive substances are in fentanyl tests. Studying 200 urine and oral fluid samples gathered from individuals in 30 U.S. states who tested positive for fentanyl, the scientists performed additional testing for designer opioids, benzodiazepines, synthetic marijuana, and other substances. Strikingly, 117 of the samples (58.5%) tested positive for at least one novel psychoactive substance. Almost 38% of the samples tested positive for xylazine, which possesses opioid-like effects but can't be reversed by naloxone, a life-saving medication that blocks the effects of opioid overdose. Nearly half (47%) of the samples contained other designer opioids, and 8% tested positive for designer benzodiazepines, which can prove deadly when combined with opioids outside of medical settings. "The timeliest finding as it relates to the danger of today's illicit drug supply was finding xylazine in 38% of the fentanyl samples," said study scientist Andrew Holt, Pharm.D, at Aegis Sciences Corp. "Depending on where drug testing occurs, an understanding of the other substances present in the illicit drug supply can change the approaches to harm reduction with communities and individuals," he added. About the 2023 AACC Annual Scientific Meeting & Clinical Lab Expo The 2023 AACC Annual Scientific Meeting offers 5 days packed with opportunities to learn about exciting science from July 23-27 in Anaheim, California. Plenary sessions will explore microbiome-directed therapies for undernutrition, big data for practicing precision medicine, healthcare equity, cardiovascular disease in women, and promising sickle cell disease treatments. At the Clinical Lab Expo, more than 900 exhibitors will fill the show floor of the Anaheim Convention Center in Anaheim, California, with displays of the latest diagnostic technology, including but not limited to COVID-19 testing, artificial intelligence, point-of-care, and automation. About the Association for Diagnostics & Laboratory Medicine (ADLM) Dedicated to achieving better health through laboratory medicine, ADLM (formerly AACC) brings together more than 70,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of progressing laboratory science. Since 1948, ADLM has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit . Bill Malone AACC Director, Communications & News Publications (p) 202.835.8756 [email protected] Molly Polen AACC Senior Director, Communications & PR (p) 202.420.7612 (c) 703.598.0472 [email protected] SOURCE ADLM

The nitrate ingested over the course of a person's adult lifetime through the consumption of tap water and bottled water could be a risk factor for prostate cancer, particularly in the case of aggressive tumors and in younger men. The nitrate ingested over the course of a person's adult lifetime through the consumption of tap water and bottled water could be a risk factor for prostate cancer, particularly in the case of aggressive tumours and in younger men. This is the conclusion of a study conducted in Spain and led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation. The findings have been published in Environmental Health Perspectives. The study also suggests that diet plays an important role. The researchers found that eating plenty of fibre, fruit/vegetables and vitamin C could reduce the negative effect of nitrate in drinking water. Ingestion of Waterborne Nitrate and Trihalomethanes The aim of the study was to assess whether there was an association between the ingestion of waterborne nitrate and trihalomethanes (THMs) and the risk of prostate cancer. Nitrate and THMs are two of the most common contaminants in drinking water. The nitrate present in the water comes from agricultural fertilisers and manure from intensive livestock farming; it is washed into aquifers and rivers by rainfall. "Nitrate is a compound that is a part of nature, but we have altered its natural cycle," explained Cristina Villanueva, an ISGlobal researcher specialised in water pollution. The new study looked at whether long-term exposure to nitrite throughout adulthood could lead to cancer. THMs are by-products of water disinfection -- i.e. chemical compounds formed after drinking water is disinfected, usually with chlorine. Unlike nitrate, for which the only route of entry is ingestion, THMs can also be inhaled and absorbed through the skin while showering, swimming in pools or washing dishes. Long-term exposure to THMs has been associated with an increased risk of bladder cancer, but evidence of the relationship between THMs and other types of cancer is, to date, very limited. Prostate Cancer and Long-Term Exposure to Nitrate and THMs in Drinking Water To evaluate the possible association between prostate cancer and long-term exposure to nitrate and THMs in drinking water, a research team led by ISGlobal studied 697 cases of prostate cancer in Spanish hospitals between 2008 and 2013 (including 97 aggressive tumours), as well as a control group made up of 927 men aged 38-85 years who had not been diagnosed with cancer at the time of the study. The average nitrate and trihalomethanes to which each participant had been exposed since the age of 18 was estimated based on where they had lived and the type (tap water, bottled water or, in some cases, well water) and amount of water they had drunk throughout their lives. Estimates were made on the basis of available data from drinking water controls carried out by municipalities or concessionary companies, from analyses of bottled water of the most widely distributed brands, and from measurements taken in different Spanish locations supplied by groundwater. The findings showed that the higher the nitrate intake, the greater the association with prostate cancer. Participants with higher waterborne nitrate ingestion (lifetime average of more than 14 mg per day) were 1.6 times more likely to develop low-grade or medium-grade prostate cancer and nearly 3 times more likely to develop an aggressive prostate tumour than participants with lower nitrate intakes (lifetime average of less than 6 mg per day). "It has been suggested that aggressive prostate cancers, which are associated with a worse prognosis, have different underlying aetiological causes than slow-growing tumours with an indolent course, and our findings confirm this possibility," explained ISGlobal researcher Carolina Donat-Vargas, lead author of the study. "The risks associated with waterborne nitrate ingestion are already observed in people who consume water with nitrate levels below the maximum level allowed by European directives, which is 50 mg of nitrate per litre of water." Drinking Water Does Not Imply Getting Cancer The authors noted that this study simply provides the first evidence of the association, which will need to be confirmed through further research. Therefore, there is still a long way to go before we can assert a causal relationship. "Being exposed to nitrates through drinking water does not mean that you are going to develop prostate cancer," commented Donat-Vargas. "Our hope is that this study, and others, will encourage a review of the levels of nitrate that are allowed in water, in order to ensure that there is no risk to human health." While the ingestion of waterborne THMs was not associated with prostate cancer, THM concentrations in residential tap water were associated with the development of these tumours, suggesting that inhalation and dermal exposure may play a significant role in total exposure. Further studies properly quantifying exposure to THMs via multiple routes are needed to draw firm conclusions. Fibre, Fruit, Vegetables and Vitamin C to Prevent Prostate Cancer Participants also completed a food frequency questionnaire, which provided individual dietary information. A striking finding of the study was that the association between ingested nitrate and prostate cancer were only observed in men with lower intakes of fibre, fruit/vegetables and vitamin C. "Antioxidants, vitamins and polyphenols in fruits and vegetables may inhibit the formation of nitrosamines -- compounds with carcinogenic potential -- in the stomach," explained Donat-Vargas. "Moreover, vitamin C has shown significant anti-tumour activity. And fibre, for its part, benefits the intestinal bacteria, which protect against food-derived toxicants, including nitrosamines." In participants with lower intakes of fibre (≤11 g/day), higher nitrate intake increased the likelihood of prostate cancer by a factor of 2.3. However, in those with higher intakes of fibre (>11 g/day), higher nitrate intake was not associated with an increased likelihood of prostate cancer. The research team hopes that this study will help to raise awareness of the potential environmental and human health impacts of pollutants in water, and to persuade authorities to ensure more rigorous control of this natural resource. Among the measures proposed by the authors of the study to reduce nitrate levels are "putting an end to the indiscriminate use of fertilisers and pesticides," and encouraging the adoption of diets that prioritise the health of the planet by reducing the consumption of animal-based foods, especially meat. Prostate Cancer: The Most Common Cancer in Spanish Men Prostate cancer appears to be on the rise worldwide. It is currently the most common cancer in Spanish men, among whom it accounts for 22% of all tumours diagnosed. However, its causes remain largely unknown, and it is one of the few cancers for which the International Agency for Research on Cancer (IARC) has not identified a clear carcinogenic agent. The currently recognised risk factors -- age, ethnicity and family history -- are non-modifiable. However, it is suspected that certain environmental exposures may contribute to the development of prostate cancer, especially in its advanced-stage and more aggressive forms. Therefore, it is vitally important to continue exploring the environmental factors that may contribute to the development of this cancer, so that action can be taken to prevent it.