Mass Spectrometry Applications in Clinical Diagnostics

Clinical Laboratories utilizes the Mass spectrometry technology for disease screening, diagnosis of disease and metabolic disorders, identifying drug toxicity and poisoning, monitoring of drug therapy and determine advanced biomarkers. Therapeutic monitoring of immunosuppressant drugs using MS is well established. Liquid chromatography-mass spectrometry has become the standard for assay of steroid hormones for diagnosis of endocrine disorders. Vitamin D analysis by Liquid chromatography-mass spectrometry is widely used in the clinical laboratory today. Whereas immunoassays are unable to distinguish between 25-hydroxy vitamins D2 and D3, the Liquid chromatography-mass spectrometry methodologies are able to measure these levels separately so the contribution of each to the total can be determined. The capability of measuring thyroid hormones by tandem Mass spectrometry was developed recently and this has overcome the issues associated with immunoassays. Triple quadrupole MS/MS is the preferred methodology for toxicology screening and for toxic drug quantitation. In newborn and prenatal screening programs, electrospray tandem Mass spectrometry has made possible identification of inborn errors in metabolism or genetic defects so that preventive and medical intervention can be implemented promptly to relieve or treat. The intensive research into metabolomics, the assessment of endogenous metabolites as new disease biomarkers, is another promising applications of MS, which has been demonstrated to be very well suited to discovery and clinical application of metabolite profiles . Another area of increasing interest is the use of automated MALDI-TOF MS for rapid identification of microorganisms in clinical microbiology laboratories.