Researchers develop new saliva test to rapidly identify paracetamol overdose

In a paper published in the journal BMC Medicine, the team demonstrate 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.

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 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 research 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.

The study is in collaboration with Alder Hey Children’s NHS Foundation Trust, Royal Liverpool University Hospital, 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 ionisation mass spectrometry techniques, with the potential for broad application in clinical diagnostics.”

Professor Dan Hawcutt, a clinical pharmacologist and Director of Research at Alder Hey Children's NHS Foundation Trust, and Director of the NIHR Alder Hey Clinical Research Facility, said: “The speed, simplicity, and efficiency of this new technology has the potential to provide faster diagnosis, better patient outcomes, and cost savings for healthcare systems.” 

The paper `Rapid and non-invasive analysis of paracetamol overdose using paper arrow-mass spectrometry: a prospective observational study’ is published in BMC Medicine.

The foundational development of this technology was funded by EPSRC Healthcare Technologies programme and was published in the Royal Society of Chemistry (`Emergency diagnosis made easy: matrix removal and analyte enrichment from raw saliva using paper-arrow mass spectrometry - Analyst’).

Dr Robert Felstead, Deputy Director of Healthcare Technologies at EPSRC, added: “This research, which was supported by EPSRC, represents a significant breakthrough in the rapid and accurate quantitation of paracetamol. Given the high incidence of paracetamol overdose and its severe consequences, this innovative technology offers a fast, non-invasive and cost-effective solution that can greatly enhance patient care and outcomes.”

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

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

To find out more about the technology please visit:  liverpool.portals.in-part.com/68d94829-55a1-4f33-b553-3ece52599e75