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New saliva test can 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.

The research was supported by the Engineering and Physical Sciences Research Council (EPSRC) and 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. 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 is a medication that is used to treat paracetamol overdose and is effective in preventing acute liver injury. However, it is time sensitive and most effective if administered within eight 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 Hospital, 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.”

  • Zhou Y, Dliso S, Craske J, et al. Rapid and non-invasive analysis of paracetamol overdose using paper arrow-mass spectrometry: a prospective observational study. BMC Med. 2024;22(1):553. Published 2024 Nov 25. doi:10.1186/s12916-024-03776-3

 

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