Abstract
Tetrodotoxin (TTX) is a powerful sodium channel blocker found in puffer fish and some marine animals. Cases of TTX poisoning most often result from puffer fish ingestion. Diagnosis is mainly from patient’s signs and symptoms or the detection of TTX in the leftover food. If leftover food is unavailable, the determination of TTX in the patient’s urine and/or plasma is essential to confirm the diagnosis. Although various methods for the determination of TTX have been published, most of them are for food tissue samples. Dealing with human urine and blood samples is much more challenging. Unlike in food, the amount of toxin in the urine and blood of a patient is generally extremely low; therefore a very sensitive method is required to detect it. In this regard, mass spectrometry (MS) methods are the best choice. Since TTX is a very polar compound, there will be lack of retention on conventional reverse-phase columns; use of ion pair reagent or hydrophilic interaction liquid chromatography (HILIC) can help solve this problem. The problem of ion suppression is another challenge in analyzing polar compound in biological samples. This review will discuss different MS methods and their pros and cons.
Highlights
Tetrodotoxin (TTX), a puffer fish toxin named after the fish’s order name Tetraodontiformes, is a potent neurotoxin
In this report we only focus on analytical methods for the determination of TTX in human urine and blood
LC-mass spectrometry (MS)/MS for TTX determination in human urine and blood requires a simple sample preparation when compared with gas chromatography-mass spectrometry (GC-MS) and provides a better limit of detection when compared with HPLC-FLD or HPLC-ultra violet (UV) methods
Summary
Tetrodotoxin (TTX), a puffer fish toxin named after the fish’s order name Tetraodontiformes, is a potent neurotoxin It is of low molecular weight, with a unique structure (Figure 1), only relatively recently determined in 1964 [1,2,3]. From 1993 to 2006, 10 incidents of puffer fish poisoning were reported in Hong Kong [9] which involved 23 persons with 1 fatality. Leftover food is sometimes not available, either because it has not been brought with the patient to the hospital or because it has been discarded Under such conditions, the detection of TTX in patient’s urine or blood is essential to confirm the diagnosis of TTX poisoning. In order to eliminate the effect of dehydration and variations in urinary output, creatinine adjustment should be made for all urine samples
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