R esearch A rticle For reprint orders, please contact reprints@future-science.com Salt-assisted LLE combined with field-amplified sample stacking in CE for improved determination of beta blocker drugs in human urine Background: A simple and sensitive CE method was developed and validated for the analysis of some beta blockers in human urine. Methods: In this study, salting-out assisted LLE combined with field-amplified sample stacking method was employed for biological sample clean-up and sensitivity enhancement in CE. Results: Under the optimal conditions good linearity (r2 ≥0.998) was obtained, within 0.025–1 µg/ml for propranolol and metoprolol, and within 0.05–1 µg/ml for carvedilol in urine samples. LODs and LLOQs ranged from 0.005 to 0.015 µg/ml, and from 0.025 to 0.05 µg/ml, respectively. The RSDs of intra- and inter-day analysis of examined compounds were less than 4.0%. The recoveries were in the range of 98–119%. Conclusion: The validated method is successfully applied to determine propranolol, metoprolol and carvedilol in human urine samples obtained from the patients who received these drugs. The beta blockers are an extremely important class of cardiovascular drugs that are mainly used to treat various cardiovascular disorders, such as hypertension and chronic heart failure [1]. They were also recommended as the first-line therapy for hypertension by all Joint National Committees [2]. The use of beta blockers was forbidden by the Medical Commission of the International Olympic Committee because these drugs reduce the cardiac rhythm by blocking the beta-receptors in the heart; this can be useful in sports where aiming is important [3]. For the detection of beta blockers in urine samples, the minimum required performance limit set by the World Anti-doping Agency is 0.5 µg/ml [101,102]. Therefore, quantifications of these drugs in biological fluids are required in therapeutic drug monitoring and doping tests. Different techniques, namely TLC [4], fluorescence [5,6], GC [7,8], GC–MS [9–11], HPLC with UV/fluorescence/photodiode array/ amperometric detection and MS [12–16], capillary zone electrophoresis (CZE) [17] and micellar electrokinetic chromatography [18,19] have been used for the determination of beta blockers in biological fluids. A number of GC and LC methods are compared in Table 1 [8,9,11,20–26]. GC methods usually require a tedious derivatization to improve chromatographic properties and laborintensive pretreatment procedures for obtaining high detection sensitivity. LC is the more popular method, but with some drawbacks such as the matrix effect. Therefore, it has to be coupled with a preconcentration method, such as SPE, LLE and so on. Large amounts of potentially toxic or hazardous solvents are also required for these extractions. In addition, in most cases, MS has been used as a detection system. It is clear that employing MS detection in an analytical setup restricts its routine analysis applications and does not attract more attention due to its high cost. The results of LC–UV methods published after 2010, are comparable and/or better than our findings. However, it should be mentioned that there are some limitations for CE methods when compared with LC methods. Lower sensitivity is usually expected from CE methods. CE is extensively used for routine analysis as an attractive alternative to HPLC because of its small sample requirements [27], high resolving power and short analysis time [28–30]. Therefore, using CE in routine analysis offers a fast method development with low operational costs. The UV/ Vis detector is the most popular detector used in CZE but possesses a relatively high LOD of 10-5–10-6 mol dm-3 due to the detector’s short path length and also due to nanoliter injection volumes [31]. Therefore, for trace analysis applications, the amount of analyte injected into the capillary or the detector sensitivity has to be increased [32]. Detection sensitivity can be improved by using a Z-shaped cell for UV detection to increase the path length of the detector, or by using sensitive 10.4155/BIO.13.303 © 2014 Future Science Ltd Bioanalysis (2014) 6(3), 319–334 Rana Fazeli-Bakhtiyari1,2 , Mohammad Hossein Sorouraddin2 , Mir Ali Farajzadeh2 , Mohammad Hossein Somi1 & Abolghasem Jouyban*3 Biomedical Analysis Lab, Liver & Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2 Department of Analytical Chemistry, Faculty of Chemistry, University of Tabriz, Tabriz, Iran 3 Drug Applied Research Center & Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran *Author for correspondence: Tel.: +98 411 337 9323 Fax: +98 411 336 3231 E-mail: ajouyban@hotmail.com 1 ISSN 1757-6180 319 R esearch A rticle | Key Terms Beta blockers: Popular class of cardiovascular drugs that are mostly used for treatment of hypertension, angina pectoris, cardiac arrhythmias, and so on. Therapeutic drug monitoring: Subspecialty of clinical pharmacy used for measuring drug concentrations in plasma, serum or blood, in order to enhance treatment efficacy, reduce toxicity or assist with diagnosis. Doping tests: Technical analyses to determine the presence or absence of prohibited substances in a biological specimen such as urine, blood, saliva and so on. Capillary zone electrophoresis: Analytical tool in which species are separated based on their charge-to-size ratio in the interior of an electrolyte-filled capillary. Field-amplified sample stacking: Powerful online sample preconcentration method that improves detection sensitivity by using the conductivity difference between sample zone and the capillary zone electrophoresis buffer. Method validation: Process of testing an analytical and bioanalytical method to assess its performance and limitations. In this way, validation is carried out according to US FDA and ICH recommendations. 320 Fazeli-Bakhtiyari, Sorouraddin, Farajzadeh, Somi & Jouyban Table 1. Summary of previous chromatographic methods based on GC and LC for determination of selected drugs in urine samples. Analyte Pre-treatment method Analysis method LOQ (ng/ml) LOD (ng/ml) Metoprolol Propranolol Enzymatic hydrolysis LLE [20] SPE-SFE 1.2 3.44 8.4 23.3 ND ND Metoprolol Propranolol Metoprolol Propranolol GC–MS (TMS/TFA derivatives) GC–MS( boronate derivatives) GC–MS [21] Enzymatic hydrolysis SPE Derivatization HF-LPME with in situ derivatization GC–MS 10.8 17.8 30 40 3.6 6.2 GC–MS ND N-ethoxycarbonyl derivatization LLE N-Methyl-N-(trimethylsilyl) trifluoroacetamide derivatization SPE GC–MS ND LC–MS/MS ND Dilution Filteration CM-LPME SPE MLC/FL ND HPLC/DAD UHPLC/UV DLLME HPLC/UV ND 41.4 86.3 44.4 14 Metoprolol Propranolol Metoprolol Propranolol Carvedilol Metoprolol Propranolol Metoprolol Propranolol Propranolol Carvedilol Metoprolol Propranolol Carvedilol Ref. 0.08 0.05 1.8 0.6 20 40 50 19.2 11.8 5 13.8 28.8 14.8 4 [8] [9] [11] [22] [23] [24] [25] [26] CM-LPME: Carrier-mediated liquid-phase microextraction; DAD: Diode array detector; DLLME: Dispersive liquid–liquid microextraction; HF-LPME: Hollow-fiber liquid-phase microextraction; MLC/FL: Micellar LC/fluorimetric detection; ND: No data; SFE: Supercritical fluid extraction; TMS/TFA: Trimethylsilylated/trifluoroacetate. detection techniques, for example, laser induced fluorescence [33], chemiluminescence [34], electrochemical and amperometric detectors [35]. Various preconcentration techniques were investigated to address this limitation. Electrophoresis-based preconcentration methods including field-amplified sample injection [36], large volume sample stacking [37,38], isotachophoretic electrophoresis stacking [36], dynamic pH junction stacking [39–41] and sweeping [42] can all greatly improve the detection limit [43–45]. The injection method in CE is more important and different injection modes can be used. Therefore, selection of the right injection approach can result in significant improvements in performance during any method development [28]. For example, electrokinetic injection provides a large preconcentration potential through sample stacking compared with hydrodynamic injection [46]. Field-amplified sample stacking (FASS) is a phenomenon through which sample ions accumulate at the boundary [47], which separates the low conductivity sample plug and the high conductivity background electrolytes (BGEs) [48,49]. Sample pre-treatment should be considered since Bioanalysis (2014) 6(3) many of the techniques involving stacking are critically dependent on the nature of the solvent from which the analyte is loaded into the capillary [50]. The major challenge in bioanalysis is to separate the analytes from the matrix of the biological samples. Because of this, various types of clean-up procedures are employed to effectively separate the analyte from the endogenous biological material [51,52]. In addition, in biomedical investigations, there is an increasing demand for efficient analytical methods that permit simultaneous separation and quantification of the complex drug matrix with less laboratory work [53]. Protein precipitation (PPT), immiscible LLE, column SPE and dispersive SPE are the most popular sample preparation methods in bioanalysis [54]. PPT is simple but supernatant from PPT contains not only analyte(s) of interest but also a lot of soluble substances (i.e., all endogenous matrix components) that can interfere with the analytical methods [55,56]. LLE and SPE require a large amount of toxic and expensive organic solvents, and are also time-consuming. Therefore, alternative environmentally friendly sample preparation future science group future science group O NH H3C O OH O H3C † HO NH 0.02–0.3 3.10 9.5 O Physicochemical properties calculated using ACDLabs software [103]. CH3 0.02–0.5 1.79 9.5 O OH NH CH3 CH3 0.02–0.16 4.11 7.5 Carvedilol Metoprolol CH3 Propranolol www.future-science.com Therapeutic range (µg/ml) Log P pKa CZE-DAD An Agilent 7100 CE system equipped with a DAD was used. The system was controlled by a personal computer installed with Agilent Chemstation software (Waldbronn, Germany). Molecular structure Instrumentation: Properties Experimental Chemicals & materials Carvedilol, 1-(carbazol-4-yloxy-3-[[2-(Omethoxyphenoxy) ethyl]amino]-2-propranol, metoprolol, 1-(isopropylamino)-3-[4-(2-methoxyethyl)phenoxy]propan-2-ol and propranolol (as hydrochloride), 1-(isopropylamino)-3-(1naphthyloxy)propan-2-ol) were kindly supplied by Salehan Chemi, Alborz Darou and Rouzdarou Pharmaceutical Companies (Tehran, Iran), respectively, (molecular structures, log P, pK a values and therapeutic levels of these drugs are reported in Table 2). Methanol, ethanol, 2-propanol and acetonitrile were purchased from Scharlau (Barcelona, Spain). Phosphoric acid, tris (hydroxymethyl) aminomethane (Tris), sodium chloride, hydrochloric acid, and sodium hydroxide were purchased from Merck Company (Darmstadt, Germany). Deionized water (Shahid Ghazi Company, Tabriz, Iran) was used for preparing the buffer and sample solutions. Table 2. Molecular structures and physicochemical properties of the analytes†. methods are greatly needed. Recently, salting-out extraction, which is a type of homogeneous LLE has received considerable attention by bioanalysts [57]. Salting-out assisted LLE (SALLE) is performed by more polar solvents (such as acetonitrile, acetone and so on), which are water miscible. When an appropriate salting-out agent (e.g., NaCl) is added to a mixture of water and a water-miscible organic solvent, it leads to the separation of the solvent from the bulk aqueous solution and forms a biphasic system, see [56] and the references within. Experimental results demonstrated that SALLE is simple, fast and environmentally friendly [55]. In the present work, SALLE-FASS-CE-diode array detector (DAD) was employed for biological sample clean-up and sensitivity enhancement in CE (using beta blocker drugs as model analytes). The effects of chemical parameters (e.g., buffer ionic strength, pH and buffer additives) and instrumental parameters (e.g., applied voltage and temperature) were investigated. After that, sample electrokinetic injection parameters in FASS were investigated to achieve improved sensitivity. Finally, method validation was performed according to US FDA guideline and then applied to analyze the selected drugs concentrations in urine samples. | R esearch A rticle O Improved determination of beta blocker drugs in human urine 321 R esearch A rticle | Fazeli-Bakhtiyari, Sorouraddin, Farajzadeh, Somi & Jouyban Electrophoresis and preconcentration experiments were performed in uncoated fused-silica capillary 50 µm I.D. and 375 µm O.D. (64.5 cm total length, 56 cm effective length). When a new capillary was used, the capillary was washed with sodium hydroxide solution (1.0 M) for 30 min, deionized water (30 min) and running buffer (30 min). The experiments were performed after prewashing with sodium hydroxide solution (0.1 M) followed by deionized water and then running buffer for 2 min at each step. The BGE solution consisted of 30 mM Tris and phosphate buffer at pH 2.2 containing 15% (v/v) methanol as organic modifier. It should be noted that pH of the buffer was adjusted to 2.2 with concentrated phosphoric acid before addition of the organic solvent. Injection was performed electrokinetically. The injection time, the injection voltage and the preinjection water plug were investigated. All BGE and sample solutions were filtered through a 0.20 µm pore size PTFE filter (Chromafil, Germany). Capillaries were thermostated at 25˚C and the applied voltage was +25 kV. Online UV detection was performed at 195 and 214 nm where the selected drugs showed sufficient absorbance responses. A Metrohm model 827 pH meter (Herisau, Switzerland) was used to measure buffer and urine solution pH. agent/extraction solvent) was added to the solution and vortexed for 1 min. The salting out effect was used to induce phase separation by addition of NaCl (1 g) to increase the ionic strength. The mixture was again vortexed for 1 min. After centrifugation at 4000 rpm for 5 min, 1 ml of organic phase supernatant was removed from the urine sample. Next, 0.2 ml of the collected organic phase was removed and evaporated to dryness under a gentle N2 stream. Subsequently, the dry residue-containing enriched analytes was reconstituted in 0.1 ml of deionized water and then analyzed by CZE-DAD. The total sample preparation time was 18 min; including extraction time (2 min), centrifugation time (5 min), solvent evaporation time (~10 min) and residue reconstitution time (1 min). Standard urine samples collection Urine samples were obtained from patients receiving the drugs who had signed consent forms approved by the ethics committee, Tabriz University of Medical Sciences. Samples were collected in polypropylene tubes and stored at -20°C until analysis. where Ccoll and C 0 are the concentration of analyte in the collected phase and the initial concentration of analyte within the sample, respectively. Ccoll was calculated from calibration curves plotted by direct injection of standard solutions. Vcoll and Vaq are also the volumes of the collected phase and sample phase, respectively. It should be noted here that EFs and ER% of each analyte was calculated based on starting with 4 ml urine and extracting the analytes into 1 ml (Table 3). If whole volumes of the collected phase (i.e., 1 ml) are evaporated and reconstituted in 0.1 ml, higher EFs could be obtained, but the matrixinduced interferences are also enriched. In order to avoid any matrix effect and reduce evaporation time, a portion of the collected phase was removed, dried and reconstituted in 0.1 ml. The proposed method was validated with different urine samples collected at different times of day and the same matrix effect was observed. Extraction Assay Calculation of enrichment factor & extraction recovery The enrichment factor (EF) and extraction recovery (ER%) were obtained by the following equations: EF = Ccoll C0 Equation 1 ER% = EF # Vcoll # 100 Vaq Equation 2 solutions & biologic samples A stock solution of three beta blockers (each 1000 mg/l) was prepared in methanol and kept in a refrigerator at 4°C. Working standard solutions were prepared daily by appropriate dilutions of the stock solution with deionized water. Spiked urine samples were also prepared daily by dilution of the stock solution by drug-free urine samples. It should be noted that the method was developed using standard solutions of the three drugs and spiked urine samples were used for validation studies. Real procedure The pH of urine sample was adjusted to 11.3 by adding drops of 6 mol/l NaOH solution. 4 ml of this solution was transferred into a 10 ml test tube. Then, 2 ml acetonitrile (protein precipitating 322 Bioanalysis (2014) 6(3) validation The validation studies were carried out according to FDA recommendations [58]. The calibration, linearity, LOD, LLOQ, ULOQ, intra- and interday precisions, accuracy, recovery, selectivity, future science group Improved determination of beta blocker drugs in human urine stability (room temperature and freeze–thaw) and robustness were investigated for each analyte. The mean of three calibration curves that were constructed on three nonconsecutive days were used for linearity studies. All experiments were replicated three times. LLOQ and ULOQ terms are defined as the lowest and highest concentration level of calibration curve, while the CV% of three replications should be less than 20 and 15%, respectively. Also, LODs and LOQs were calculated from the S/N ratio as three and ten, respectively, for each drug. For evaluating the inter-and intra- day precisions five spiked urine samples in the low, medium and high concentrations of each drug were analyzed by the developed method on five different days. The accuracy of method was also examined by computing relative errors (%) using the following equation: RE(%) = 100 # c calulated conc. - nominal conc. m nominal conc. Equation 3 The relative recoveries were determined for five human urine samples spiked with three different concentrations of the examined compounds. In the present study, selectivity of the developed method was studied by analyzing urine samples spiked with some other coadministered cardiovascular drugs for potential interferences. To assess room temperature stability, spiked urine samples were left at ambient temperature for 12 h. The freeze–thaw stability was also assessed after three 12-h freeze– thaw cycles. Furthermore, the robustness of the method was evaluated by partial varying of some effective parameters in FASS method in three levels, such as running buffer concentration and its pH, separation temperature and voltage. Results & discussion Development of separation conditions Effects of pH, buffer type and concentration, buffer additives, separation temperature and voltage were investigated using a one-factor-ata-time approach for the baseline separation of beta blockers. In order to find the most suitable buffer composition, three BGE systems (acetate, phosphate and tris-phosphate) in low pH was tried. Best separation for the three beta blockers was achieved when using the tris-phosphate. The pH of buffer plays an important role in the separation since it determines the extent of ionization of each analyte [59]. Therefore, the choice of a proper pH is very important to optimize the separation in CZE. The effect of buffer pH future science group | R esearch A rticle Table 3. Quantitative results of salting-out assisted LLE–fieldamplified sample stacking-CE-diode array detector for the selected drugs in urine samples. Parameter Propranolol Metoprolol Carvedilol Linear range (µg/ml) Slope Slope standard errors Intercept Intercept standard errors Correlation coefficient (r2) Number of data points LOD (µg/ml) LOQ (µg/ml) LLOQ (µg/ml) EFextraction ± SD 0.025–1 0.023 0.001 1.3 0.2 0.998 5 0.008 0.025 0.025 2.8 ± 0.09 0.025–1 0.024 0.002 0.8 0.4 0.999 5 0.005 0.016 0.025 3.2 ± 0.07 0.050–1 0.010 0.002 0.4 0.3 0.999 5 0.015 0.050 0.050 1.4 ± 0.03 EFsample preparation ± SD 5.5 ± 0.2 6.4 ± 0.1 2.74 ± 0.05 SEF ER% ± SD 200 69.2 ± 2.3 200 79.5 ± 1.8 100 34.3 ± 0.7 EF: Enrichment factor; ER%: Extraction recovery; SEF: Sensitivity enhancement factor. was evaluated with 30 mM tris-phosphate buffer at pH values varying from 2.2 to 3.7. In this investigated pH range basic amino alcohols are fully protonated and migrate under reduced electroosmotic flow. Best resolution was achieved at pH 2.2. Furthermore, the buffer concentration effect was studied in the concentrations of 20, 30, 40, 60 and 80 mM. The observed currents for these ionic strengths were 17.5, 22.5, 27.5, 37.5 and 47.5 µA, respectively. According to these results, by increasing buffer ionic strength, current in the capillary was increased and baseline noise was observed. As a result, 30 mM Tris-phosphate was finally chosen as CZE buffer. Furthermore, the separation voltage and temperature effect was investigated by performing runs at increasing voltages (i.e., 20, 25, 27 and 30 kV) and temperatures (i.e., 20, 25, 27 and 30°C). The viscosity of BGE decreases as temperature increases, so runtime can be reduced by increasing the voltage and temperature until a deterioration in resolution is observed. According to the results obtained, 25 kV and 25°C were the optimal voltage and temperature, respectively. The effect of organic solvent present in the BGE was also investigated with some solvents such as methanol, ethanol, 2-propanol and acetonitrile. Addition of the organic solvent resulted in the reduction of the sphere of hydration of the analytes. As a consequence, the difference in charge-to-size ratio increased, resulting in a better resolution of the analytes [60]. For all solvents, no significant difference was observed in lower percentage (5%) but in www.future-science.com 323 R esearch A rticle | Fazeli-Bakhtiyari, Sorouraddin, Farajzadeh, Somi & Jouyban higher level baseline noise was increased except for methanol. As well as in the aqueous-organic buffer system, the mobility decreases with an increase in organic solvent content of the buffer [61]. On the one hand, separation selectivity was significantly increased with increasing the percentage of methanol (from 0 to 15%) and on the other hand, migration time became longer. Therefore, 30 mM Tris-phosphate buffer (pH 2.2) containing 15% methanol was selected as the optimum buffer solution. Under optimum conditions migration order was; propranolol, metoprolol and carvedilol, and total runtime was less than 16 min. The obtained results indicated that the detection limits of the selected drugs are too high (10 mg/l), therefore it is necessary to employ suitable preconcentration methods in order to improve the poor sensitivity of the method. A Diluted buffer (tenfold dilution) Acetonitril:water (30:70) Methanol:water (30:70) Water Development of FASS The possibility of application of FASS for detection limit enhancement of beta blockers in CE was investigated. Therefore, we studied the influence of FASS parameters (the sample matrix composition, water plug injection time, sample injection time and voltage) on the introduced sample amount in this method. Low buffer concentration, pure water, binary solvent mixtures such as methanol:water (30:70) and acetonitrile:water (30:70) were used as sample matrices and a mixture of these drugs (10 mg/l each) was prepared and injected (5 kV for 5 s). Figure 1A shows that the highest sensitivity can be obtained when pure water was employed as sample matrix. When the sample is prepared in a lower conductivity matrix (than that of the buffer), the analytes will experience a high field zone in the sample plug, causing faster migration of B Propranolol Metoprolol Carvedilol 80 400 Peak area (a.u.) Peak area (a.u.) 500 300 200 100 0 C Metroprolol 20 Propranolol Metoprolol Carvedilol Carvedilol 0 D 1 3 5 Water plug injection time (s) Propranolol Metoprolol Carvedilol 1500 Peak area (a.u.) Peak area (a.u.) 40 0 Propanolol 1200 900 600 300 0 60 1200 900 600 300 0 5 10 15 20 Injection time (s) 25 30 5 10 Injection voltage (kV) 12 Figure 1. Optimization of the injection parameters for field-amplified sample stacking. Separation conditions: uncoated fused-silica capillary, 64.5 cm (effective length 56 cm) × 50 µm I.D.; BGE: 30 mM Tris-phosphate (pH 2.2) containing 15% of methanol; UV detection at 195 nm; temperature, 25°C; applied voltage, 25 kV. Optimization of (A) sample matrix composition; sample solution: 10 mg/l of each drug injected at 5 kV for 5 s; (B) water plug injection time; sample solution: 1 mg/l of each drug injected at 5 kV for 5 s after preliminary pressure injection of water; (C) sample injection time; sample solution: 1 mg/l of each drug injected at 5 kV after preliminary pressure injection of water (50 mbar for 1 s); and (D) injection voltage; sample solution: 1 mg/l of each drug injected for 25 s after preliminary pressure injection of water (50 mbar for 1 s). The error bars indicate the maximum and minimum of three determinations. 324 Bioanalysis (2014) 6(3) future science group Improved determination of beta blocker drugs in human urine the analytes until they reach the boundary of the BGE zone. When the analytes pass the boundary between the sample and the buffer, they experience a loss in velocity and stack a sharp band because of the significant decrease of the field strength in the electrophoresis buffer [47]. In general, a pre-injection plug can provide a trap in which the analytes are collected prior to being separated in the BGE; consequently, the stacking efficiency becomes larger [62]. Furthermore, the influence of the hydrodynamic injection of water plug prior to electrokinetic sample injection (5 s at +5 kV) was studied. The obtained results presented in Figure 1B, indicate that the peak areas increase with increasing the injection time from 0 to 1 s and then decrease thereafter. Hence, a short plug of water (50 mbar × 1 s) was selected for subsequent experiments. Here, we employed electrokinetic injection for sample introduction in CE because of its ability to concentrate the sample in CE capillary. Therefore, the effect of injection time and voltage on peak areas of the three beta blockers was tested. Injection time and voltage were varied from 5 to 30 s and 5 to 12 kV, respectively. Longer injection times and A higher injection voltages resulted in greater peak areas [41]. As shown in Figure 1C & D, a significant increase in the peak areas was observed with increasing injection time in the range of 5–25 s and injection voltage within 5–10 kV. Therefore, 25 s and 10 kV were chosen as injection time and voltage, respectively. Under obtained FASS-CE conditions (i.e., 30 mM Tris-phosphate, 15% v/v methanol, pH 2.2, pure water as the sample solution and electrokinetic injection with 10 kV for 25 s after preliminary pressure injection of water for 1 s) linearity was assessed within 25–5000 ng/ ml. The standard electropherogram of the selected drugs are displayed in Figure 2A & B. Comparing Figure 2A & D, reveals that FASS is strongly affected by the matrix effect, since the concentration of the analytes in Figure 2D is a quarter of those in Figure 2A , however, the peak heights are 1/20 of the standard solutions. It should be added that although a ten-times diluted (1 mg/l) concentration of the standard solutions was used in FASS-CE-DAD method and a sensitivity enhancement factor of 200-, 200- and 100-fold was achieved for propranolol, metoprolol and carvedilol, respectively. The sensitivity C 12 118 98 2 3 78 58 1 38 18 Absorbance (mAU) Absorbance (mAU) 138 -2 0 2 4 B 6 8 10 12 14 16 18 Migration time (min) 98 78 58 38 18 -2 0 2 4 6 8 10 12 14 16 18 Migration time (min) 8 6 4 2 8 10 12 14 16 Migration time (min) 8 10 12 14 16 Migration time (min) D Absorbance (mAU) 118 10 0 138 Absorbance (mAU) | R esearch A rticle 16 14 12 10 8 6 4 2 0 Figure 2. Typical electrophoregrams. Using (A) water samples spiked with 1 mg/l of selected drugs obtained under optimal field-amplified sample stacking-CE-diode array detector (DAD) (sample solution injected at 10 kV for 25 s after preliminary pressure injection of water [50 mbar for 1 s]); (B) water samples spiked with 10 mg/l of selected drugs obtained under optimal capillary zone electrophoresis-DAD (sample solution injected at 5 kV for 5 s); (C) blank human urine; and (D) blank human urine spiked with 250 ng/ml of selected drugs obtained under optimal salting-out assisted LLE–field-amplified sample stacking-CE-DAD. Separation conditions are the same as in Figure 1. Peaks: (1) propranolol; (2) metoprolol; and (3) carvedilol. future science group www.future-science.com 325 R esearch A rticle | Fazeli-Bakhtiyari, Sorouraddin, Farajzadeh, Somi & Jouyban enhancement factor values were calculated for each drug using the following equation: SEFheight = Height with field amplified sample injection # dilution Height with conventional injection Equation 4 Method validation Linearity & calibration curves Method validation is a process that demonstrates whether the method will successfully meet or exceed the minimum standards recommended in the FDA guideline for accuracy, precision, selectivity, specificity, stability and robustness [63]. Calibration was performed in blank urine samples spiked with five different concentrations of each drug. As mentioned in the previous section, 4 ml of these solutions were subjected to SALLE method before FASS-CE analysis. Linearity was tested within 25–5000 ng/ml for standard calibration curve and 25–1000 ng/ml for matrix calibration curves. Higher concentrations were not tested as this linear range was wide enough for clinical applications. Mean of regression equations, correlation coefficients of calibration curves constructed on three different days and corresponding validation parameters (i.e., linear range, LOD, LOQ and LLOQ ) are listed in Table 3. Precision & accuracy Intra- and inter-day precision (expressed as RSD%) along with accuracy (expressed as RE%) of the method were determined as described in the experimental section. All RSD% values were less than 4.0% and acceptable range of accuracy was obtained (Table 4). These results indicate that the developed method is both accurate and precise. Recovery Relative recoveries (expressed as RR%) of the tested drugs from spiked urine samples were measured at three concentrations – high (500 ng/ml), medium (250 ng/ml) and low (50 ng/ml). The obtained results are presented in Table 5. The calculated recoveries are in range of 98% (for propranolol) to 119% (for carvedilol). Selectivity & specificity The proposed method showed adequate peak separation for the selected drugs. Representative electropherograms for blank urine sample and spiked urine with concentration of 250 ng/ml of drugs are shown in Figure 2C & D. No interference was observed from urine matrix. But it should be noted that matrix-induced migration time shifts were observed when analyzing urine samples. Therefore, shift in migration times is controlled by ana lysis of QC samples that were prepared in the same manner as the test samples. The selectivity of the method for the selected drugs was also tested by analysis of some other cardiovascular drugs (e.g., amiloride, amiodarone, atenolol, diltiazem, furosemide, hydrochlorothiazide, losartan, verapamil, sotalol and nifedipine) and most commonly used drugs such as acetaminophen, diazepam and salicylic acid. Among the tested drugs, acetaminophen, furosemide and hydrochlorthiazide are acidic drugs and there are no positive charge to be analyzed using our developed method. Selectivity tests were performed using urine samples with a 500 ng/ml concentration of each drug. According to the results obtained (Table 6), only diltiazem was found to be interfered with carvedilol, which could be considered as a restriction parameter for the developed method. Stability The analyzed drugs showed reliable stability behavior when stored at room temperature Table 4. Precision and accuracy of the method for determination of the studied drugs in urine samples. Drug Nominal concentration (ng/ml) (n = 5) Intra-assay precision (RSD%) (n = 5) Inter-assay precision Accuracy (RE%) (RSD%) (n = 5) Propranolol 50 250 500 50 250 500 50 250 500 2.5 1.2 0.7 2.3 1.3 0.3 3.6 1.6 3.2 4.0 0.4 0.5 0.1 1.3 0.1 2.2 0.7 0.6 Metoprolol Carvedilol 326 Bioanalysis (2014) 6(3) -1.7 3.0 5.8 15.1 2.0 2.3 19.3 7.2 1.6 future science group Improved determination of beta blocker drugs in human urine | R esearch A rticle Table 5. Relative recoveries obtained by salting-out assisted LLE–field-amplified sample stacking-CE-diode array detector in urine samples spiked at 50, 250 and 500 ng/ml. Drug Nominal concentration (ng/ml) (n = 5) Found concentration (ng/ml) ± SD (n = 5) Relative recovery (RR%) ± SD Propranolol 50 250 500 50 250 500 50 250 500 49± 2 257± 1 529 ± 2 58 ± (<0.5) 255± 3 511 ± (<0.5) 60 ± 1 268 ± 2 508 ± 3 98 ± 4 103 ± (<0.5) 106 ± 1 115 ± (<0.5) 102 ± 1 102 ± (<0.5) 119 ± 6 107 ± 1 102 ± 1 Metoprolol Carvedilol (25 ± 2.0°C) for 12 h and over three freeze–thaw cycles. Results are summarized in Table 7. RE% values for LLOQ and higher concentration were below 18 and 6%, respectively. Robustness Robustness testing was carried out by making small changes in effective chemical (i.e., running buffer concentration and its pH) and instrumental parameters (i.e., separation temperature and voltage). The results are shown in Table 8. As can be seen, there is no significant difference in the obtained data and indicating that the reported method is a robust method. Comparison of the proposed method with other methods For a number of GC methods [8,9,11,20,21] cited in Table 1, more sophisticated instrumentations, longer pretreatment time and the limited number of quantified analytes could be considered as restriction factors when compared with the proposed method especially in routine analysis. Lower LOD and LOQ of these methods could be considered as their advantages. It should be noted that the proposed method provided better and/or comparable LOD values with the work of Hartonen and Riekkola [21]. Comparing LC methods listed in Table 1, LC–MS/MS method employs highly sophisticated instrumentation with slightly higher LOD values for some beta blockers including three investigated drugs [22]. The micellar LC with fluorescence detection of metoprolol and propranolol is a simple method, however produced higher LOD values in comparison with the proposed CE method [23]. The HPLC/DAD method coupled with carrier-mediated liquid-phase microextraction produced similar LOD for propranolol with our proposed method [24]. The main advantages of future science group the proposed method are simple pretreatment procedure and more analytes detected by CE method. The reported UHPLC/UV with SPE was reported for determinations of some analytes in urine including the beta blockers investigated in this work. However, the reported LODs and LOQs were higher or comparable with our findings. The latest work from our group reported the analysis of HPLC/UV method coupled with dispersive liquid–liquid microextraction for two cardiovascular drugs in plasma and urine samples. The reported LOD for carvedilol was better than CE method. As an overall aspect, higher sensitivity and lower LOD and LOQ values are expected from GC and/or LC methods in comparison with CE methods. However, as reported above, in some cases, our obtained results for CE are better than chromatographic findings. Considering Table 6. Investigation of the interference effect of other drugs with the studied drugs in urine samples using the proposed method. Drug Retention time (min) Overlap Acetaminophen Amiloride Amiodarone Atenolol Carvedilol Diazepam Diltiazem Furosemide Hydrochlorothiazide Losartan Metoprolol Nifedipine Propranolol Salicylic acid Sotalol Verapamil No peak No peak No peak 14.13 15.49 17.09 15.65 No peak No peak No peak 14.83 No peak 13.8 17.04 14.03 16.69 ND ND ND No Diltiazem No Carvedilol ND ND ND No ND No No No No ND: No data. www.future-science.com 327 R esearch A rticle | Fazeli-Bakhtiyari, Sorouraddin, Farajzadeh, Somi & Jouyban Table 7. Stability data for three beta blockers in urine samples obtained by proposed salting-out assisted LLE–field-amplified sample stacking-CE-diode array detector method. Drug Propranolol Metoprolol Carvedilol Nominal concentration (ng/ml) (n = 3) Room temperature stability Freeze–thaw stability Found concentration (ng/ml) ± SD Accuracy (RE%) Recovery (%) ± SD Found concentration (ng/ml) ± SD Accuracy (RE%) Recovery (%) ± SD 50 250 500 50 250 48 ± 1 257 ± 3 529 ± 4 59 ± 4 255 ± 10 -4 3 6 18 2 96 ± 3 103 ± 1 106 ± 1 118 ± 8 102 ± 4 51 ± 2 256 ± 2 530 ± 4 57 ± 3 248 ± 2 2 2 6 14 -1 102 ± 3 102 ± 1 106 ± 1 114 ± 6 99 ± 1 500 50 250 500 510 ± 4 55 ± 3 262 ± 3 508 ± 5 2 10 5 2 102 ± 1 110 ± 6 105 ± 1 102 ± 1 512 ± 2 55 ± 2 260 ± 5 503 ± 6 2.4 10 4 1 102 ± 1 110 ± 4 104 ± 2 101 ± 1 CE-based methods (Table 9), three FASS-CE methods [17,64,65] were reported for determination of one beta blocker in urine samples with higher and/or comparable LOD values. Methods reported in references [64,65] used more sensitive detection with simple dilution for metoprolol, and propranolol [17] was analyzed after head space-solid-phase microextraction extraction method, which is comparable with our method, but it is applied for one drug. CE-based methods without FASS used more sensitive detectors and produced higher and/or comparable LODs [53,66]. It should be noted that these LODs were achieved with sensitive detectors that are not actually commercially available and are difficult to fabricate in-house. Even MS and LIF coupled to CE are not as ‘routine’ as the CE-DAD is, which makes the developed method quite attractive, considering that the SALLE is quite simple yet effective and FASS requires no ‘add-ons’ to the CE instrument. CE-UV methods with SPE and/or LLE also produced higher LOD values and analyzed a single beta blocker [67–69]. Two CE–MS methods listed in Table 9 produced higher and/or lower LOD values. The capillary electrochromatography-ESI-MS [70] produced better LOD using a capillary electrochromatography column, which are fragile and expensive, and the data was validated in standard solution. The CE–TOF-MS [71] that employed a microextraction pretreatment procedure interestingly produced higher LOD value when compared with our LOD. Application to real samples The described method has been applied to the urine samples of patients under cardiovascular treatment with propranolol, metoprolol or carvedilol. Those patients also receiving other Table 8. Evaluation of method robustness for extraction and analysis of three beta blockers in spiked urine samples with salting-out assisted LLE–field-amplified sample stacking-CE-diode array detector. Drug Level Nominal concentration (ng/ml) (n = 3) Found concentration Accuracy (ng/ml) ± SD (n = 3) (RE%) Recovery (%) ± SD Propranolol 1 2 3 1 2 3 1 2 3 500 500 500 500 500 500 500 500 500 532 ± 4 532 ± 4 528 ± 5 515 ± 7 511 ± 3 511 ± 4 496 ± 20 502 ± 10 496 ± 4 106 ± 1 106 ± 1 106 ± 1 103 ± 1 102 ± 1 102 ± 1 99 ± 4 100 ± 2 99 ± 1 Metoprolol Carvedilol 6 6 6 3 2.2 2 -1 0 -1 Level 1: pH = 2.00, separation temperature and voltage: 24°C and 24.5 kV, buffer concentration: 28 mM. Level 2: pH = 2.20, separation temperature and voltage: 25°C and 25 kV, buffer concentration: 30 mM. Level 3: pH = 2.40, separation temperature and voltage: 26°C and 25.5 kV, buffer concentration: 32 mM. 328 Bioanalysis (2014) 6(3) future science group Improved determination of beta blocker drugs in human urine | R esearch A rticle Table 9. Comparison of the proposed salting-out assisted LLE–field-amplified sample stacking-CE-diode array detector method with other CE methods used in quantification and determination of the studied drugs in urine. Drug CE type Sample preparation Sample stacking method Validation LOD (µmol/l) Metoprolol Metoprolol Propranolol Metoprolol CE-ECL CE-ECL CE-AD CE-ECL CE-EC CE-DAD CZE-DAD Dilution Dilution Filtration /dilution Dilution FASS FASS ND ND No method validation No method validation No method validation No method validation [64] SPE HS-SPME-ultrasonic back extraction SPE PPT with methanol Filtration Enzymatic hydrolysis LLE DLLME SALLE ND FASS No stability, selectivity test No method validation 0.1† 0.4† 0.05 0.03 0.02 0.1 0.03 ND ND Yes No method validation [68] ND No method validation 0.1 0.0006† 0.001† 0.74 ND FASS No method validation Yes Propranolol Propranolol Carvedilol Metoprolol Propranolol Carvedilol CZE-UV pCEC–ESI-MS Metoprolol Carvedilol Metoprolol Propranolol CE–TOF-MS CZE-DAD CZE-DAD 1.87 0.04 0.02 0.03 Ref. [65] [66] [53] [67] [17] [69] [70] [71] This work The validation of these data has been carried out with standard solutions and the urine samples were used to demonstrate the potential application of the method on urine. AD: Amperometric detection; CE-EC: CE-electrochemical; CZE: Capillary zone electrophoresis; DAD: Diode array detector; ECL: Electrochemiluminescence detection; FASS: Field-amplified sample stacking; HS-SPME: Head space-solid phase microextraction; ND: No data; pCEC: Pressure-assisted capillary electrochromatography; PPT: Protein precipitation; SALLE: Salting-out assisted LLE extraction. † drugs (e.g., furosemide, spironolactone, lactulose, pantoprazole, albumin, metronidazole, warfarin, heparin, ceftriaxone, metconazole, losartan and so on) presented in Table 10. Also electrophoregrams of two patients (numbers 1 and 3) are shown in Figure 3A–D. The results were confirmed with a simple experiment such as the standard addition method. For this purpose, two different real samples were spiked with 100, 250 and 500 ng/ml of selected drugs. Urine samples were collected from healthy people: before drug administration and in 3 h (sample 1) and 6 h (sample 2) periods after an oral dose of 40 mg of propranolol. The concentration of propranolol was calculated as 67 ± 1 and 150 ±(<0.5) ng/ ml. According to the obtained results, good relative recoveries in the range of 92–114% were obtained, which indicates that there were low matrix effects in the analyzed samples (Table 11). Conclusion SALLE-FASS-CE method is suitable for screening and quantifying the prescribed beta blockers in human urine. SALLE was used to reduce the Table 10. Determination of the target drugs in patients urine samples by the proposed method (results given as mean results). N Gender Administered drugs Intake time Sampling time Concentration (µg/l) 1 F 9 am 11 pm 22 2 F 9 pm 6 am 66 3 M 9 am 12 am 111 4 M 9 am 11 am 272 5 F Metoprolol 25 mg Furosemide, spironolactone, lactulose, pantoprazole, albumin, metronidazole Metoprolol 50 mg Warfarin Propranolol 20 mg Furosemide, spironolactone, lactulose, heparin, albumin, pantoprazole Propranolol 20 mg Furosemide, ceftriaxone, metconazole, spironolactone, lactulose Carvedilol 6.25 mg Losartan 9 am 10 am LLOQ> future science group www.future-science.com 329 Fazeli-Bakhtiyari, Sorouraddin, Farajzadeh, Somi & Jouyban Absorbance (mAU) R esearch A rticle | 2.5 1.5 A 0.5 -0.5 Absorbance (mAU) Metoprolol 8 B 9 10 11 12 13 14 15 16 15 16 Migration time (min) 2.5 1.5 Propranolol 0.5 -0.5 C 8 D 9 10 11 12 13 14 Migration time (min) Figure 3. Electropherograms of propranolol and metoprolol in two real samples analyzed by salting-out assisted LLE-field-amplified sample stacking-CE-diode array detector. (A) Blank human urine spiked with 50 ng/ml metoprolol; (B) patient number 1; (C) patient number 3; (D) blank human urine spiked with 100 ng/ml propranolol obtained under optimal salting-out assisted LLE–field-amplified sample stacking-CE-diode array detector. Separation conditions are as in Figure 1. matrix effect in FASS method. Sample matrix was the most important parameter in sample stacking and highest sensitivity was observed when pure water was used as sample matrix. In addition, injecting a short plug of water before sample introduction resulted in greater peak areas. Therefore, sensitivity enhanced by 200-fold for propranolol and metoprolol, and 100-fold for carvedilol. Validation results were satisfactory in terms of accuracy, precision, selectivity, specificity, Table 11. Relative recoveries obtained by salting-out assisted LLE-field-amplified sample stacking-CE-diode array detector method in real samples (sample 1) spiked at 100, 250, and 500 ng/ml. Real sample Drug Concentration added (ng/ml) Concentration found ± SD (ng/ml) Relative recovery (%) ± SD (n = 3) Sample 1 Propranolol Sample 1 Metoprolol Sample 1 Carvedilol Sample 2 Propranolol NA 100 250 500 NA 100 250 500 NA 100 250 500 NA 100 250 500 67 ± 1 162 ± 2 297 ± 4 529 ± 1 N.D. 95 ± 4 252 ± 8 512 ± 9 N.D. 105 ± 2 240 ± 14 515 ± 12 150 ± (<0.5) 264 ± 1 389 ± (<0.5) 641 ± 2 ND 95 ± 2 92 ± 1 92 ± (<0.5) ND 95 ± 4 101 ± 3 102 ± 2 ND 105 ± 2 96 ± 6 103 ± 2 ND 114 ± 1 95 ± (<0.5) 98 ± (<0.5) Analytes contents of samples were subtracted. NA: Not added; ND: Not detected. 330 Bioanalysis (2014) 6(3) future science group Improved determination of beta blocker drugs in human urine stability and robustness. The presented method is a promising method for routine laboratory ana lysis when compared with the other methods. Finally, this method was successfully applied to determine these drugs in patient samples. Future perspective The validated method is applicable in bioanalytical laboratories for routine low level drug ana lysis without the need for a laborious and timeconsuming sample preparation method. In addition, this method could be used for drug abuse detection in competition antidoping testing. Acknowledgements The authors would like to thank the Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences (Tabriz, Iran) for providing analytical facilities. | R esearch A rticle Financial & competing interests disclosure The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript. Ethical conduct of research The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved. Executive summary Aim In this study, salting-out assisted LLE combined with field-amplified sample stacking in CE method has been developed for the sensitivity enhancement of three beta blocker drugs in human urine. Procedure Spike urine sample with selected drugs. Keep at room temperature for 20 min and adjust pH to 11.3. Add 2 ml acetonitrile to 4 ml spiked urine sample and vortex-mix for 1 min. Add 1 g NaCl and vortex-mix for 1 min and then centrifugation for 5 min at 4000 rpm. Remove 0.2 ml of the supernatant and solvent evaporation under a gentle N2 stream. 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