ID: R515 Novelbedsidediagnosticsfor methanolpoisoning...MeTOX - Bedside diagnostics for methanol...

METHODSThestripsareconstructedbasedonthesameprinciplesasaglucosestripfordiabetespatients,whereonedropofbloodfromthefingerdetectsformatebyacolorchange(Fig2).

Fig2Principles andbasic structureMethanol itself isnottoxic,andsymptomsdoes notappear until asufficientamount offormic acid/formatehasbeen developed (approx 10mM)– this usuallytakes 12-24hours after metabolism hasstarted.

KnutErikHovda1,Gaut Gadeholt2,DagJacobsen2

1TheNorwegianCBRNECentreofMedicine,DepartmentofAcuteMedicine,OsloUniversityHospital,Oslo,Norway2DepartmentofAcuteMedicine,OsloUniversityHospital,Oslo,Norway

BACKGROUNDEveryyear,thousandsofpeoplearepoisonedbymethanol,butinspiteofanincreasingnumberofoutbreaksbeingreportedbythemediaandsometimesthemedicalliterature(Fig1),thisislikelyonlytipoftheiceberg.Despiteeffectivetreatment,thelackofawareness,knowledgeandespeciallydiagnosticequipment,leavesthousandsdead,blindorbraindamaged.Methanolpoisoningmostoftenaffectsthepoorestofthepoor– childrenandadults– predominantlyinthelow- andmiddleincomecountries1.Byoftentearingawaytheyoungandhealthymembersofsociety,itincreasesthesocialburden.

Fig1Reported methanol incidents recent years

Inaddressingthemethanolpoisoningproblemworldwide,thereareseveralchallenges:Thedelayfromintaketosymptoms,thevariationofsymptoms,thelackofclinicalexperience,thelimitedavailabilityoftreatmentoptions,theoverwhelmingofresources/lackofcapacity,andthehighmorbidityandmortality.Still,thelackofdiagnosticequipment2 remainsoneofthemajorproblems,asitisdifficulttoidentifyandtreatapoisoningifyoudonotknowwhototreat.Thediagnosticalternativesarefarfromsatisfactorymostplaces3,andmoreorlessnon-existinginthelow- andmiddleincomecountrieswheremostofthepoisoningsactuallyoccurs.Wehavethereforedevelopedapoint-of-carediagnostictool(MeTOXÔ)formeasuringformate4,thetoxicmetaboliteofmethanol.

DISCUSSIONWehavedevelopedasimple,bedsidetoolfordiagnosingmethanolpoisoningandforscreeningmetabolicacidosisofunknownorigin:Nolaboratoryequipmentisneeded.Thesensitivityandspecificityishigh,itisstable,andcanbedisposedafteruse.Thestripismeantasascreeningtooltoeliminatemethanolpoisoningasthecauseinmetabolicacidosisofunknownorigin– averycommonmedicalconditioncausingchallengesinallhealthcaresystems.

TheproductionofMeTOXÔ Generation1isexpectedtostartin2017asanon-for-profitfortheinventors.

Novel bedside diagnostics formethanol poisoning

REFERENCES1RostrupMetal.Plos One2016;11:e01526762HovdaKEetal..Scand JClin LabInvest2015;75(7):610-43KrautJa.ClinToxicol.2015;53(7):589-95.4HovdaKEetal. JAnalToxicol 2005;29(6):586-588

RESULTSTheprototypeisnowfinalized,withtestingrenderingahighsensitivitywithanincreasingcolorreactionwithhigherconcentrationsofformate.Therewerenoinfluenceonthespecificitytestingonanyofthetestedsubstances(i.e.nofalsepositives).Theresultcanbereadwithin2-3minutesfromadisposablestrip.Theshelflifeismorethantwoyearsinroomtemperature(i.e.nocoldstorageorcoldchainduringtransportisnecessary).

Detectable few hours aftermethanol metabolism

(>6hours before symptomsappears)

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ID:R515

DisclosureMeTOXÔ isaregisteredproductownedbyOrphanDiagnostics(www.orphandiagnostics.com).OrphanDiagnosticsisownedbyOsloUniversityHospital/Inven2andtheinnovators.Theinnovatorshavegivenawayallfutureincomeandroyaltiestomaketheproductnon-for-profitandthusreachthelow- andmiddleincomecountriesforaslowcostaspossible.