Elsi Mynttinen1, Niklas Wester2, Tuomas Lilius3,4, Eija Kalso3,5, Bjørn Mikladal6, Ilkka Varjos6, Sami Sainio7, Hua Jiang8, Esko I Kauppinen8, Jari Koskinen2, Tomi Laurila1. 1. Department of Electrical Engineering and Automation, Aalto University, Tietotie 3, 02150 Espoo, Finland. 2. Department of Chemistry and Materials Science, Aalto University, Kemistintie 1, 02150 Espoo, Finland. 3. Department of Pharmacology, University of Helsinki, Haartmaninkatu 8, 00290 Helsinki, Finland. 4. Department of Clinical Pharmacology, University of Helsinki and Helsinki University Hospital, Tukholmankatu 8C, 00290 Helsinki, Finland. 5. Pain Clinic, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2A, 00290 Helsinki, Finland. 6. Canatu Oy, Tiilenlyöjänkuja 9, 01720 Vantaa, Finland. 7. Stanford Synchrotron Radiation Lightsource, SLAC National Accelerator Laboratory, Menlo Park, California 94025, United States. 8. Department of Applied Physics, Aalto University, 02150 Espoo, Finland.
Abstract
Oxycodone is a strong opioid frequently used as an analgesic. Although proven efficacious in the management of moderate to severe acute pain and cancer pain, use of oxycodone imposes a risk of adverse effects such as addiction, overdose, and death. Fast and accurate determination of oxycodone blood concentration would enable personalized dosing and monitoring of the analgesic as well as quick diagnostics of possible overdose in emergency care. However, in addition to the parent drug, several metabolites are always present in the blood after a dose of oxycodone, and to date, there is no electrochemical data available on any of these metabolites. In this paper, a single-walled carbon nanotube (SWCNT) electrode and a Nafion-coated SWCNT electrode were used, for the first time, to study the electrochemical behavior of oxycodone and its two main metabolites, noroxycodone and oxymorphone. Both electrode types could selectively detect oxycodone in the presence of noroxycodone and oxymorphone. However, we have previously shown that addition of a Nafion coating on top of the SWCNT electrode is essential for direct measurements in complex biological matrices. Thus, the Nafion/SWCNT electrode was further characterized and used for measuring clinically relevant concentrations of oxycodone in buffer solution. The limit of detection for oxycodone with the Nafion/SWCNT sensor was 85 nM, and the linear range was 0.5-10 μM in buffer solution. This study shows that the fabricated Nafion/SWCNT sensor has potential to be applied in clinical concentration measurements.
Oxycodone is a strong opioid frequently used as an analgesic. Although proven efficacious in the management of moderate to severe acute pain and cancer pain, use of oxycodone imposes a risk of adverse effects such as addiction, overdose, and death. Fast and accurate determination of oxycodone blood concentration would enable personalized dosing and monitoring of the analgesic as well as quick diagnostics of possible overdose in emergency care. However, in addition to the parent drug, several metabolites are always present in the blood after a dose of oxycodone, and to date, there is no electrochemical data available on any of these metabolites. In this paper, a single-walled carbon nanotube (SWCNT) electrode and a Nafion-coated SWCNT electrode were used, for the first time, to study the electrochemical behavior of oxycodone and its two main metabolites, noroxycodone and oxymorphone. Both electrode types could selectively detect oxycodone in the presence of noroxycodone and oxymorphone. However, we have previously shown that addition of a Nafion coating on top of the SWCNT electrode is essential for direct measurements in complex biological matrices. Thus, the Nafion/SWCNT electrode was further characterized and used for measuring clinically relevant concentrations of oxycodone in buffer solution. The limit of detection for oxycodone with the Nafion/SWCNT sensor was 85 nM, and the linear range was 0.5-10 μM in buffer solution. This study shows that the fabricated Nafion/SWCNT sensor has potential to be applied in clinical concentration measurements.
Oxycodone is a strong opioid
widely used as an analgesic. As with all opioids, oxycodone can cause
severe adverse effects such as addiction, overdose, and death due
to respiratory depression. In 2017, more than 70 000 drug overdose
deaths occurred in the Unites States alone, 68% of which involved
opioids, including oxycodone.[1] The pharmacokinetic
profile of oxycodone is affected by several factors such as age, sex,
concomitant diseases, and drug–drug interactions.[2] In addition, the plasma concentrations of oxycodone
leading to sufficient analgesia after surgery are highly individual,
the average concentrations ranging between 0.3 and 100 nM,[3] and in cases of overdose, the highest concentrations
found in blood can be over 10 μM.[4] Thus, there is need for a fast and accurate method to assess the
blood concentrations of oxycodone to support safe and efficacious
pain management and enable rapid diagnostics of opioid overdosing.The chemical structures and metabolic pathways of oxycodone and
its oxidative metabolites are shown in Figure . In addition to the parent drug oxycodone,
there are always various metabolites present in the blood after systemic
administration. Oxycodone undergoes extensive oxidative metabolism
by hepatic cytochrome P 450 (CYP) enzymes.[2,5] Oxycodone
is mainly oxidized into noroxycodone by CYP3A enzymes and, to a lesser
extent, to oxymorphone by CYP2D6. From these two, the major metabolite
noroxycodone can reach high blood concentrations but has low affinity
to the μ-opioid receptor and thus does not contribute to oxycodoneanalgesia.[6,7] Similarly, oxymorphone has no significant
role in the overall opioid effect of oxycodone due to very low plasma
concentrations achieved after oxycodone administration.[5] However, oxymorphone has higher activity at the
μ-opioid receptor than the parent drug, and it is also used
as an analgesic by itself.[6,7]
Figure 1
Chemical structures and
metabolic pathways of oxycodone and its
oxidative metabolites. Percentages in the colored diagrams show the
peak plasma concentrations (Cmax) (mol/L)
of noroxycodone, noroxymorphone, and oxymorphone relative to the peak
plasma concentration of oxycodone. These concentrations have been
measured in human plasma after a single dose of oxycodone.[5] Arrows represent the metabolic pathways leading
to oxidation of the molecules by the CYP3A or CYP2D6 enzymes.
Chemical structures and
metabolic pathways of oxycodone and its
oxidative metabolites. Percentages in the colored diagrams show the
peak plasma concentrations (Cmax) (mol/L)
of noroxycodone, noroxymorphone, and oxymorphone relative to the peak
plasma concentration of oxycodone. These concentrations have been
measured in human plasma after a single dose of oxycodone.[5] Arrows represent the metabolic pathways leading
to oxidation of the molecules by the CYP3A or CYP2D6 enzymes.Both noroxycodone and oxymorphone are further oxidatively
metabolized
to noroxymorphone by CYP2D6 and CYP3A, respectively (Figure ). Noroxymorphone can reach
relatively high concentrations in plasma after oral administration
of oxycodone but has no analgesic effect due to poor penetrance through
the blood–brain barrier.[5,8] In addition to the oxidative
metabolites, oxycodone has several reductive metabolites. However,
the main pharmacologic effect of oxycodone seems to be attributed
to the parent drug alone.[5]The gold
standard method for measuring plasma concentrations of
oxycodone and other opioids is high-performance liquid chromatography
(HPLC) often coupled with mass spectrometry,[3,9,10] a method already used for decades.[11] This method provides extreme specificity and
low limits of quantification, but the measurements are time consuming
and laborious and require skilled laboratory personnel. While point-of-care
drug concentration measurements would often aid in clinical decision
making, performing HPLC analysis takes up to a few hours. Electrochemical
methods have been shown to provide fast response time, high sensitivity,
and simple usability in sensor applications. They have also been used
to measure opioid concentrations.[12−17] However, only a few studies on electrochemical detection of oxycodone
have been published,[12] and to our knowledge,
there are currently no reported studies on the electrochemical behavior
of oxycodone together with its main metabolites.Carbon nanomaterials,
including single-walled carbon nanotubes
(SWCNT), have been widely used in electrochemical sensor applications
due to their high conductivity, biocompatibility, good sensitivity,
and fast response time.[18] A considerable
advantage of the SWCNT networks, specifically, is their compatibility
with industrial manufacturing processes, making them a desirable material
for large-scale production of, e.g., disposable sensor strips. In
addition, SWCNTs can be functionalized or otherwise tuned for specific
applications, for example, by selecting appropriate catalysts for
the fabrication.[19] In our previous studies,
we have also shown that the performance of a sensor can be further
improved by combining the exceptional qualities of carbon nanomaterials
with the selective properties of the ion-exchange membrane Nafion.[15,16,20] The Nafion membrane contains
nanosized interconnected hydrophilic channels coated with negatively
charged sulfonic groups and thus only allows cationic molecules, including
opioids, through while practically blocking anions from the electrode
surface. This is a particularly advantageous property for electrochemical
sensors applied in biological matrices, since many of the interfering
molecules, such as ascorbic acid and uric acid, are in anionic form
at the physiological pH. Thus, coating the electrode with a Nafion
membrane not only increases the selectivity of the electrode but also
enables detection of analytes in complex biological matrices.In this work, we investigated the use of a plain SWCNT electrode
as well as a SWCNT electrode coated with a thin Nafion layer for selective
detection of oxycodone in the presence of its two metabolites noroxycodone
and oxymorphone. These metabolites were selected based on their high
relative concentration (noroxycodone), analgesic activity (oxymorphone),
and availability. Differential pulse voltammetry (DPV) was selected
for the appropriate electrochemical method, since it provides a low
signal-to-noise ratio and a response time of just a few minutes. The
electrochemical behavior of oxycodone, noroxycodone, and oxymorphone
was studied on both plain and Nafion-coated SWCNT electrodes. Due
to its better applicability in real clinical samples,[15,16] the Nafion/SWCNT electrode was further characterized and applied
in measuring clinically relevant concentrations of oxycodone in buffer
solution. Both electrode types were then shown to be able to detect
oxycodone in the presence of its two main metabolites, while the Nafion
coating was seen to improve the sensitivity toward oxycodone. These
results show that the SWCNT/Nafion has potential to be applied in
further studies for selective detection of oxycodone in clinical concentration
measurements.
Materials and Methods
Preparation of Nafion/SWCNT
Electrode
The SWCNT networks
were synthesized by aerosol chemical vapor deposition (CVD), using
the process described in more detail in refs (21) and (22). Briefly, in this thermal
high-temperature floating catalyst CVD, iron nanoparticles are first
produced in a carbon monoxide atmosphere in a laminar flow reactor.
In these conditions, the formed iron acts as a catalyst to decompose
the carbon monoxide, leading to nucleation and growth of SWCNTs. The
SWCNTs are collected onto a membrane filter, resulting in a sheet
of SWCNT network.A piece of the received SWCNT network was
cut from the filter paper and press transferred by hand onto a glass
slide (Thermo Scientific, ISO 8037-1) with dimensions of 1 ×
2 cm. The glass slide was precleaned by immersing in acetone (AnalaR
NOMRAPUR, Merck) and ethanol (99.5 wt %, Altia, Finland). After press
transferring, the filter paper was removed and the network densified
with a drop of ethanol which was allowed to dry at room temperature.
Silver contact pads were painted with conductive silver paint (Electrolube)
and allowed to dry for at least 1 h. A piece of conductive copper
tape (Ted Pella, Inc.) was placed at the end of the contact pad to
enable a robust connection point for the electrode leads.Finally,
the electrode was covered with polytetrafluoroethylene
film (PTFE, Saint-Gobain Performance Plastics CHR 2255-2) with a 3
mm hole to isolate the working electrode area and to attach the SWCNT
network onto the glass substrate. The film was allowed to adhere to
the glass surface overnight. The following day, the electrode was
coated with 2.5 wt % Nafion, diluted from 5 wt % NafionD-520 solution
(Alfa Aesar) with 94 wt % ethanol (Altia, Finland). The coating was
done with a mechanical dip coater by immersing the electrode into
the solution for 5 s and allowing to dry for 30 s before detaching
from the holder. The prepared electrode was dried in ambient air overnight
before measurements.
Electrochemistry Equipment and Measurement
Parameters
All electrochemical measurements were done with
a three-electrode
system with a CH Instrument (CHI630E) potentiostat. Ag/AgCl (+0.199
V vs standard hydrogen electrode, Radiometer Analytical) was used
as a reference and platinum wire as the counter electrode. The potential
window was from −0.4 to 1.3 V, pulse amplitude 50 mV, step
potential 4 mV and pulse period 0.2 s. Phosphate-buffered saline (PBS
0.01 M, pH 7.4) was used as the electrolyte. All solutions were purged
with N2 for at least 10 min prior to the measurements,
and deoxygenation was continued throughout the measurements.The prepared Nafion/SWCNT electrodes were always measured the following
day after Nafion coating if not stated otherwise. Before starting
the measurements, the electrodes were allowed to swell in PBS for
30 min. Background signals were collected with DPV at least five times
or until the stability of the background was satisfactory so that
two consecutive backgrounds were overlapping. An additional background
with a 5 min accumulation time was measured if an accumulation time
was applied in the analyte measurements as well. In the OXC concentration
series measurements, to improve background stability the samples were
cycled approximately 20 times with DPV in PBS solution. In addition,
three consecutive backgrounds with a 5 min accumulation time were
recorded to determine the values for the limit of detection (LOD),
keeping the electrodes in PBS for 5 min between each measurement.
In general, a 5 min accumulation time was used in all measurements
unless stated otherwise. All measurements were repeated with at least
three electrodes.
Characterization of the SWCNT Network
The physical
and chemical structure of the SWCNT network was characterized with
transmission electron microscopy (TEM) and X-ray absorption spectroscopy
(XAS). The samples for TEM imaging were prepared by press transferring
a piece of the SWCNT network on a S147AH Au TEM grid with holey carbon
films (Agar Scientific). Analysis was conducted with a double-aberration-corrected
electron microscope JEOL 2200FS (JEOL, Japan) with a Gatan 4k ×
4k Ultrascan 4000 CCD camera for the digital recording of the high-resolution
TEM (HRTEM) images. The microscope was operated at 200 kV with a field-emission
electron gun.For XAS analysis, SWCNT samples were similarly
prepared on a highly conductive (<0.005 Ω cm–1) boron-doped Si ⟨100⟩ wafer (Sieger Wafer, Germany).
The spectra were recorded at the Stanford Synchrotron Radiation Lightsource
(SSRL) according to the protocol described in more detail in ref (17). The X-ray energies used
for carbon (C 1s), oxygen (O 1s), and iron (Fe 2p) were from 260 to
350, 520 to 580, and 695 to 735 eV, respectively. Total electron yield
(TEY) mode was used for data collection, the drain current being amplified
by a Keithley picoammeter. For determining the sheet resistance of
the SWCNT network, four-point probe measurements were carried out
on a Hewlett-Packard 3458A multimeter attached to a Jandel RM3000
multiheight probe.
Characterization of Nafion/SWCNT Electrodes
The concentration
of the Nafion solution to be used for coating was determined by comparing
the performance of 2.5% and 5% Nafion. SWCNT electrodes were coated
with both concentrations and measured in 5 μM OXC in PBS with
DPV. The thickness of the 2.5% Nafion coatings was measured with a
contact profilometer (Dektak 6M) from three electrodes. Prior to analysis,
the SWCNT/Nafion film was cut along the inner circumference of the
PTFE film with a 3 mm biopsy punch (Agar). After this cutting step,
the PTFE film was removed, leaving the active area of the electrode
intact on the glass substrate for analysis.In order to optimize
the accumulation time, 5 μM oxycodone was measured with the
Nafion/SWCNT electrode with 0, 5, 10, and 15 min accumulation times.
The stability of the electrode signal was determined by measuring
six sequential scans in 5 μM oxycodone. The electrode was kept
in PBS for 6.75 min between each scan. The relative standard deviation
(RSD) was calculated for the oxycodone signal.A long-term stability
test was conducted by measuring three electrodes
in 5 μM oxycodone in PBS at 1, 8, 15, and 22 days after coating.
The RSD value was calculated for the average peak currents at each
time point. The difference between the average peak currents at each
time point with respect to the average peak current at time point
1 was calculated. The electrode-to-electrode reproducibility was also
determined by calculating the RSD value for the oxycodone signal from
the three electrodes measured at time point 1. All RSD values were
calculated from peak current values without background subtraction.
Detection of Oxycodone and Metabolites
Oxycodone hydrochloride
powder and noroxycodone hydrochloride powder were purchased from Toronto
Research Chemicals, Canada. In addition, oxymorphone hydrochloride
was received from Professor Jari Yli-Kauhaluoma, synthesized at the
University of Helsinki. The purity of oxymorphone was checked with
a mass spectrometer and found to be 77%. The measurements with oxymorphone
have been added here as tentative results and are discussed as such,
since further studies with pure oxymorphone should be conducted for
more detailed analysis.For the measurements with oxycodone,
noroxycodone, and oxymorphone, the analytes were measured first with
both plain and Nafion-coated SWCNT electrodes in 10 μM concentration.
This was done to determine the oxidizing functional groups in the
molecules and to assign them to corresponding oxidation peaks as well
as to compare the electrochemical behavior of the analytes on the
two electrode types.The concentration series for oxycodone
were measured with 0.5,
1, 2.5, 5, 7.5, and 10 μM with Nafion/SWCNT. The analyte was
injected with a pipet into the 50 mL electrochemical cell from a 1
mM stock solution. After each injection, the solution was mixed slightly
with the pipet for 30 s, and the measurement was started after a 5
min accumulation time. Four electrodes were measured and kept in PBS
between the measurements. The linear range was plotted by taking the
average of the peak currents for each electrode at each concentration
point with the standard deviations as error bars. The LOD value was
calculated with the formula LOD = 3.3 × σ/s, where σ is the standard deviation of three consecutive background
currents (μA, at the oxidation potential of oxycodone and without
background correction) and s is the sensitivity of
the electrode (μA/μM). The value was calculated as the
average of four electrodes.To assess the capability of the
electrodes to selectively detect
oxycodone in the presence of the metabolites, all analytes were measured
in relevant concentration ratios based on the average plasma concentrations
given in ref (5) and
discussed in the Introduction. The percentages
of the metabolites were rounded up slightly and adjusted to a 5 μM
oxycodone reference concentration. Thus, 5 μM oxycodone, 3.75
μM noroxycodone, and 250 nM oxymorphone were measured separately
with both plain and Nafion-coated SWCNT electrodes. The selectivity
of the electrodes was further assessed by measuring 5 μM oxycodone
first alone and then 5 μM oxycodone in the presence of 3.75
μM noroxycodone and 250 nM oxymorphone.
Results and Discussion
Characterization
of the SWCNT Network
The SWCNT networks
from the same batch have been extensively characterized in our previous
work by Raman spectroscopy, UV–vis, and X-ray-photoelectron
microscopy (XPS) as well as TEM and XAS.[17] Briefly, in Raman spectroscopy analysis, the low Id/Ig ratio of
0.102 ± 0.003 confirmed the presence of a low amount of amorphous
carbon and a small number of defects. The results also showed radial
breathing modes corresponding to SWCNT diameters in the range of 1.2–2.1
nm, whereas a mean diameter of 2.1 nm was found with UV–vis
analysis. The XPS survey found 71.7 ± 0.2 atom % carbon, 8.7
± 0.2 atom % oxygen, and 0.1 ± 0.01 atom % iron as well
as 19.5 ± 0.3 atom % Si. From these elements, Si and most of
the oxygen are likely due to the partially exposed Si wafer with native
oxide.Figure A shows a TEM image from the SWCNT networks prepared in this work.
In the HRTEM micrograph in Figure B, both individual and bundled SWCNTs can be seen as
well as typical catalyst particles encapsulated in a few layers of
carbon.
Figure 2
Characterization of the SWCNT network. (A) TEM image and (B) HRTEM
image of the SWCNT network. (C) C 1s, (D) O 1s, and (E) Fe 2p XAS
spectra of the SWCNT.
Characterization of the SWCNT network. (A) TEM image and (B) HRTEM
image of the SWCNT network. (C) C 1s, (D) O 1s, and (E) Fe 2p XAS
spectra of the SWCNT.The surface chemistry
of the SWCNT network was also further studied
with XAS and peaks assigned according to an extensive literature survey.[23−33]Figure C, 2D, and 2E show the XAS spectra
for the C 1s, O 1s, and Fe 2p of the SWCNT, respectively. The C 1s
spectrum indicates highly sp2-bound carbon (sp2 π* at 285.5 eV) with a clear long-range order (exciton at
291.9 eV) and a relatively small oxygen surface loading, consistent
with EDS analysis of previous work.[17] However,
the C 1s spectra also show peaks likely attributed to ketone/aldehyde
and carboxyl groups. In Figure D, the contributions of C–O bonds and possible oxidized
Fe is heavily convoluted by the partially exposed native oxide of
Si in the O 1s spectrum. Nevertheless, the spectrum suggests the presence
of aldehyde, ketone, and carboxyl functional groups on the SWCNT,
as seen in ref (17). The Fe 2p spectrum shown in Figure E also closely matches that of previous work, where
the iron is expected to be bonded to carbon and oxygen (indicating
the presence of a mix of iron carbide[34] and iron oxide seen as the higher energy peaks of the Fe 2p LII
and LIII spectra) and metallic iron (as the lower energy peaks of
the Fe 2p LII and LIII spectra). The results of the characterization
from the previous and this work are summarized in Table .
Table 1
Summary
of Characterization Results
of This and Previous Work[17]
Sheet resistance
Raman Id/Ig
UV–vis
XPS
EDS
XAS
88 Ω/sq
0.102 ± 0.003
mean SWCNT diameter 2.1 nm
C 71.7 ± 0.2
catalyst particles: C and Fe
highly sp2-bound carbon with clear long-range order
O 8.7 ± 0.2
SWCNT sidewall: C
ketone/aldehydeand carboxyl peaks
detected
Sia 19.5 ± 0.3
iron particles, iron carbide,
and iron oxide
Fe 0.1 ± 0.01
Most of the detected oxygen and
all silicon from the native oxide of the silicon wafer substrate.
Most of the detected oxygen and
all silicon from the native oxide of the silicon wafer substrate.
Characterization of the
Nafion/SWCNT Electrode
The
thickness of the 2.5% dip-coated Nafion membrane measured with profilometry
was found to be thickest in the center and thinnest near the edges
of the PTFE film. The thickness in the center was 980 ± 48 nm
and around 200 nm close to the cut edge.Extensive electrochemical
characterization of Nafion/SWCNT electrodes has been provided in ref (16) and the behavior of Nafion
studied in ref (20). It has been shown that Nafion selectively lets through and enriches
positively charged molecules while effectively blocking molecules
with negative charge. In addition, Nafion significantly reduces the
matrix effects in biological samples, thus enabling direct detection
of analytes in untreated real samples.For the oxycodone measurements,
the concentration of 2.5% Nafion
was selected as the most suitable. With 2.5% Nafion, a higher sensitivity
toward oxycodone was found compared to 5% (Figure A). A 5 min accumulation time was found to
be sufficient for achieving a clear signal for oxycodone without compromising
the fast nature of the measurement (Figure B).
Figure 3
Characterization of the Nafion/SWCNT electrode.
(A) Nafion concentration.
5 μM oxycodone with SWCNT with 2.5% Nafion and 5% Nafion. (B)
Accumulation time. 5 μM oxycodone measured with SWCNT 2.5% Nafion
with accumulation times 0, 5, 10, and 15 min.
Characterization of the Nafion/SWCNT electrode.
(A) Nafion concentration.
5 μM oxycodone with SWCNT with 2.5% Nafion and 5% Nafion. (B)
Accumulation time. 5 μM oxycodone measured with SWCNT 2.5% Nafion
with accumulation times 0, 5, 10, and 15 min.
Electrochemical Behavior of Oxycodone and Metabolites
Figure shows the
DPV curves for 10 μM oxycodone, noroxycodone, and oxymorphone
measured with a plain SWCNT electrode (Figure A) and Nafion/SWCNT (Figure B). The color bars highlight the oxidation
peaks tentatively assigned to two different functional groups, also
indicated with corresponding colored circles in the chemical structures
of oxycodone and the metabolites. Interestingly, although these analytes
only differ from each other by one functional group, both electrode
types give different responses to each molecule.
Figure 4
Suggested electrochemical
behavior of oxycodone and metabolites.
10 μM oxycodone (blue), 10 μM noroxycodone (green), and
10 μM oxymorphone (red) measured with (A) a plain SWCNT electrode
with no accumulation time and (B) a Nafion/SWCNT electrode with 5
min accumulation time. Color bars highlight the oxidation peaks, tentatively
assigned to two different functional groups, also indicated with corresponding
colored circles in the chemical structures of oxycodone and the metabolites.
Suggested electrochemical
behavior of oxycodone and metabolites.
10 μM oxycodone (blue), 10 μM noroxycodone (green), and
10 μM oxymorphone (red) measured with (A) a plain SWCNT electrode
with no accumulation time and (B) a Nafion/SWCNT electrode with 5
min accumulation time. Color bars highlight the oxidation peaks, tentatively
assigned to two different functional groups, also indicated with corresponding
colored circles in the chemical structures of oxycodone and the metabolites.When measured without the Nafion coating, several
oxidation peaks
can be seen for each analyte. The first peak around 0.5 V is visible
for oxymorphone but not for oxycodone or noroxycodone. Since the only
functional group that is found in oxymorphone but is lacking from
oxycodone and noroxycodone is the phenol, this oxidation peak can
most probably be attributed to this group. In fact, we have seen this
peak at a lower positive potential in our previous work with morphine,[16] and it has also been assigned to a similar phenol
group in morphine by Garrido et al.[13]Similarly, the second peak at 0.75 V is common to oxycodone and
oxymorphone but is not seen for noroxycodone, making the tertiary
amine a probable source for this peak. The third peak, on the other
hand, is well defined at about 1.0 V for all three molecules, which
suggests that it could be due to further oxidation of the secondary
amine. It has been shown in several studies that a tertiary amine
frequently gives two separate oxidation peaks on carbon-based electrodes.[12,16,17,35,36] However, based on these voltammograms, it
is also possible that the third peak could be due to oxidation of
the hydroxyl group in the amine ring.[12] Moreover, Garrido et al.[37] also assigned
an oxidation peak for codeine at higher potentials for the methoxy
group, which is also present in both oxycodone and noroxycodone.Thus, due to the complex nature of the oxidation processes of oxycodone,
it is not possible to make definite conclusions only based on voltammetric
measurements alone. To confirm these suggestions for the peak assignments,
further experiments involving collecting reaction products should
be done.When Nafion is applied onto the electrode, the current
response
changes significantly. The peak for the phenol group is clearly enhanced
and shifted by about 50 mV to a more positive potential. The other
two peaks are similarly shifted but with about 200 mV.On the
basis of this data, it seems that the order of the peaks
is preserved also when using Nafion, since the middle peak (highlighted
in light turquoise in Figure ) still remains to be well defined only for oxycodone and
oxymorphone and not for noroxycodone.We have previously seen
that with this material combination addition
of Nafion either blocks or shifts the oxidation signal from the tertiary
amine in codeine-like molecules.[16] Although
the results shown in Figure B are not conclusive, they would suggest that Nafion is indeed
shifting the oxidation peaks related to both amine and hydroxyl groups.
This might be purely due to a mass transfer effect introduced by the
Nafion layer. However, it is also possible that the sulfonic groups
of Nafion somehow interact or even react with some of the oxidizing
groups in these molecules, thus altering their electrochemical behavior.
In pH 7.4, the amine groups in the molecules are protonated and all
three molecules are mainly in their cationic form (the pKa values for the amine groups are about 8.8, 9.5, and
8.2 for oxycodone, noroxycodone, and oxymorphone, respectively). Thus,
it is likely that these cations interact with the sulfonic groups
in Nafion also contributing to the enrichment behavior seen in Figure B. However, confirming
the exact mechanisms of these interactions would require thorough
investigations that are out of the scope of this paper.
Concentration
Series for Oxycodone
The results from
the oxycodone concentration series are shown in Figure . In Figure A, the average peak currents (n =
4) are plotted against potential, and Figure B shows the average peak currents as a function
of concentration. The error bars show the standard deviation between
electrodes (n = 4). The linear range for oxycodone
was 0.5–10 μM (i = 0.053cOXC + 0.179, r = 0.999),
and the limit of detection was 85 nM.
Figure 5
Concentration series for oxycodone. (A)
Oxycodone with concentrations
0.5, 1, 2.5, 5, 7.5, and 10 μM with an accumulation time of
5 min. (B) Average oxidation peak currents as a function of oxycodone
concentration. Error bars show the standard deviations of the peak
currents (n = 4).
Concentration series for oxycodone. (A)
Oxycodone with concentrations
0.5, 1, 2.5, 5, 7.5, and 10 μM with an accumulation time of
5 min. (B) Average oxidation peak currents as a function of oxycodone
concentration. Error bars show the standard deviations of the peak
currents (n = 4).
Stability of the Sensor Structure
From the signal stability
study, the RSD for the 5 μM oxycodone signal was found to be
2.3% (Figure A). For
the electrode reproducibility, the RSD value for three electrodes
at time point 1 was 10%. However, the electrodes seemed to be stabilized
over time, since the RSD value was decreased down to 3.8% by day 22
after coating. The long-term stability of the electrodes was also
found to be noticeably high, the RSD for the average peak currents
between each time point being only 2.6%. Figure B shows the differences of the average values
in the oxycodone peak current relative to day 1 in percentages as
a function of days after coating. These results are quite satisfactory,
especially considering the complex behavior of Nafion in aqueous solutions.
Figure 6
Stability
of the sensor. (A) Electrode signal stability; 5 μM
oxycodone measured with one SWCNT 2.5% Nafion 6 times in a row. (B)
Long-term stability. Three electrodes measured in 5 μM oxycodone
after storing for 1, 8, 15, and 22 days after coating. Data shows
the differences in the average values in the oxycodone peak current
relative to day 1 in percentages as a function of days after coating.
Stability
of the sensor. (A) Electrode signal stability; 5 μM
oxycodone measured with one SWCNT 2.5% Nafion 6 times in a row. (B)
Long-term stability. Three electrodes measured in 5 μM oxycodone
after storing for 1, 8, 15, and 22 days after coating. Data shows
the differences in the average values in the oxycodone peak current
relative to day 1 in percentages as a function of days after coating.
Simultaneous Detection of Oxycodone and Metabolites
The DPV curves for 5 μM oxycodone, 3.75 μM noroxycodone,
and 250 nM oxymorphone are shown in Figure measured separately with an electrode without
(Figure A) and with
Nafion (Figure B).
On the basis of these measurements, it would seem that both electrode
types would be able to selectively detect oxycodone in the presence
of its two metabolites (3.75 μM noroxycodone and 250 nM oxymorphone).
In fact, this assumption is confirmed in Figure C and 7D, where oxycodone
is first measured alone and then simultaneously with the two metabolites
with plain SWCNT (Figure C) and Nafion/SWCNT (Figure D).
Figure 7
Oxycodone and metabolites without and with 2.5% Nafion;
5 μM
oxycodone (blue), 3.75 μM noroxycodone (green), and 250 nM oxymorphone
(red) without Nafion (A) and with Nafion (B); 5 μM oxycodone
(blue) and 5 μM oxycodone in the presence of the two metabolites,
3.75 μM noroxycodone and 250 nM oxymorphone (black dash), without
Nafion (C) and with Nafion (D).
Oxycodone and metabolites without and with 2.5% Nafion;
5 μM
oxycodone (blue), 3.75 μM noroxycodone (green), and 250 nM oxymorphone
(red) without Nafion (A) and with Nafion (B); 5 μM oxycodone
(blue) and 5 μM oxycodone in the presence of the two metabolites,
3.75 μM noroxycodone and 250 nM oxymorphone (black dash), without
Nafion (C) and with Nafion (D).As can be seen from Figure A and 7B, it could be argued that when
applying the electrode in real patient samples, oxycodone could be
detected in the presence of the two metabolites even without the Nafion.
The clinically relevant concentrations of oxycodone are typically
well below 5 μM; for example, Lalovic et al. found the average
peak plasma concentration of oxycodone to be around 0.12 μM
after a single 15 mg oral dose.[5] Thus,
in most clinical situations, it is likely that the concentrations
of oxycodone metabolites are below the detection limit of the electrode
presented in this paper. However, addition of Nafion clearly increases
the oxidation signal for oxycodone and thus improves the detection
limit of the sensor. In addition, Nafion gives significant advantages
when measuring in real samples as it filters out interferents and
greatly reduces the matrix effects, enabling direct measurements in
unprocessed biological samples.[15,16]
Conclusions
We developed a disposable, mass-producible Nafion-coated single-walled
carbon nanotube sensor and demonstrated, for the first time, selective
detection of oxycodone in the presence of its two major metabolites.
The electrochemical behavior of oxycodone, noroxycodone, and oxymorphone
was compared between a plain and a Nafion-coated SWCNT electrode.
The Nafion membrane was seen to significantly affect the oxidation
of these three analytes. With the Nafion/SWCNT electrode, a limit
of detection of 85 nM and a linear range of 0.5–10 μM
were achieved for oxycodone in buffer solution. In addition, both
plain and Nafion-coated SWCNT electrodes were found to be able to
detect oxycodone in the presence of its two metabolites noroxycodone
and oxymorphone. However, the use of the Nafion membrane greatly enhanced
the oxidation current for oxycodone, making the Nafion/SWCNT hybrid
a preferable choice for detection of oxycodone in real samples. Thus,
the Nafion/SWCNT electrode has real potential to be applied in a point-of-care
device, aiding healthcare professionals in personalized dosing of
oxycodone and other opioids.
Authors: Kristiina Cajanus; Mikko Neuvonen; Outi Koskela; Mari A Kaunisto; Pertti J Neuvonen; Mikko Niemi; Eija Kalso Journal: Clin Pharmacol Ther Date: 2017-08-24 Impact factor: 6.875