The development of speciation methods enabling quantification and identification of elemental species has largely been driven by the need to differentiate between species of the same element which may be more toxic or less toxic, or essential to nutrition, often depending on the concentration. Examples of relevance to healthcare include inorganic arsenic, arsenobetaine and arsenocholine; chromium (VI) and chromium (III) and methylmercury and inorganic mercury in a variety of matrices such as food/supplements, biological tissues and clinical and environmental samples. Regulators and legislators are increasingly aware that the toxicity, environmental impact and health benefits of certain trace elements are more dependent on the amount and identity of their chemical forms than on the total concentration. However, most existing regulations are based on total element amount, although a few refer to element species. This is, to a large extent, owing to the limited availability of toxicological data, which demands ‘fit-for-purpose’ speciation methods. Such methods will become invaluable tools to support emerging regulation and human risk assessment. For speciation analysis applied to healthcare, approaches combining a high-resolution separation method, either offline or online, with element-specific detectors have been used for many years. However, it was not until the late 1980s that speciation researchers could have access to the detection power needed to measure low parts-per-billion and parts-per-trillion levels of elemental species in environmental, food and bioclinical samples. Since then, highperformance liquid chromatography–inductively coupled plasma (ICP)–mass spectrometry (MS) techniques have become the centrepiece of most elemental speciation work in this area. Also, the multielement and multi-isotope detection capability of ICP-MS enabled for the first time monitoring of the degree of species transformation (through isotope ratio measurements), which is a challenge associated with most sample preparation procedures. It was mainly in the 1990s when Lobinski and other speciation experts stressed the need to use the combination of elemental and molecular MS and other complementary techniques for elemental species identification over previously reported retention time identification by ICP-MS detection. Today, speciation scientists are more aware of the potential and challenges of this combined approach and, especially, of the power of accurate mass measurement and have, therefore, used it successfully in many applications of speciation analysis to healthcare. Relevant examples include the identification of multiple selenium metabolites of relevance to cancer research and nutrition in food/ supplements, cancer cell lines and biological fluids and tissues, the identification of organoarsenic species (e.g. arsenosugars and arsenolipids) in food and arsenosugars and methylated arsenic species in urine. The introduction of new concepts, technologies and needs in modern clinical chemistry, such as understanding the role of metalloproteins in health and disease or the impact of metallodrugs in disease diagnosis or treatment, has led to major progress in healthcare elemental speciation but also to an increased number of analytical challenges. The possibility of measuring metal-to-sulfur ratios using interference-reducing ICP-MS opened a new door to the quantification and characterisation of metalloproteins and Published in the special issue Speciation Analysis in Healthcare with Guest Editor Heidi Goenaga Infante.
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