Researchers develop new saliva test to rapidly identify paracetamol overdose

A research team led by the University of Liverpool has developed an innovative new technique that can rapidly assess paracetamol levels from saliva.

In a paper published in the journal BMC Medicine, the team demonstrates the clinical validity of a new mass spectrometry technology-based technique that can test a tiny drop of saliva on a piece of paper for levels of paracetamol. The team tested the technique using both saliva and plasma samples from volunteers who had ingested paracetamol and saliva was found to be the preferred sample method.

Called Paper-Arrow Mass Spectrometry (PA-MS), the patent-pending technique was found to offer enhanced analytical performance while requiring less time, resources, and clinical involvement than current clinical tests.

Paracetamol is the most consumed medicine globally and its accessibility contributes to frequent misuse and overdose. Approximately 100,000 cases of paracetamol overdose are reported in the UK each year, leading to 50,000 hospital admissions due to liver toxicity. If not treated quickly, paracetamol overdoses can lead to severe outcomes, including liver failure, transplantation, or even death.

N-acetylcysteine (NAC) is a medication that is used to treat paracetamol overdose and is effective in preventing acute liver injury (ALI), however, it is time sensitive and most effective if administered within 8 hours.

The study is in collaboration with Alder Hey NHS Foundation Trust, Royal Liverpool University Hospitals NHS Foundation Trust, and Liverpool School of Tropical Medicine.

Dr Simon Maher, an expert in Mass Spectrometry Technologies with the University of Liverpool’s Department of Electrical Engineering and Electronics, said, “This study demonstrates successful testing of the new PA-MS test in a clinical environment and lays the foundation for advancing point-of-care testing across emergency and routine clinical settings. This innovation represents a significant step forward in ambient ionization mass spectrometry techniques, with the potential for broad application in clinical diagnostics.”

The foundational development of this technology was supported by the Engineering and Physical Sciences Research Council (EPSRC) Healthcare Technologies program and was published previously in the Royal Society of Chemistry.

The University of Liverpool is seeking to translate this technology into a bespoke multiplexed diagnostic tool for rapid OD and liver injury assessment.

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