Current evolutions, applications, and challenges of phosphatidylethanol analysis for clinical and forensic purposes

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Abstract
Phosphatidylethanols (PEth) are a group of abnormal phospholipids which are formed within the human body in the presence of ethanol. As PEth accumulates in red blood cells, which prolongs its detectability, it became popular as a direct alcohol biomarker. When alcohol is consumed regularly, PEth concentrations in the human blood reach an equilibrium (plateau) between formation and degradation which is representative of drinking habits. A wide range of applications has been demonstrated for PEth, whereby in most studies it could provide advancements regarding accuracy and precision when compared to already established alcohol biomarkers (carbohydrate‐deficient transferrin, gamma‐glutamyltransferase, and ethyl glucuronide). Although PEth has been the focus of many research projects all around the world, the final breakthrough from the research laboratory into the clinical mass market is still ongoing. In this overview article, we discuss the evolution of PEth analysis, its applications, and the associated challenges. The main reasons that hinder the use of PEth in the mass market were identified as (a) the lack of implementing a uniform reference measurement system, which should ensure that every single PEth result is comparable and/or (b) ensuring good laboratory practice dedicated to PEth analysis, which should guarantee that every result obtained by an individual laboratory is correct. These challenges regarding PEth analytics must be carefully addressed in the near future before the implementation of common cut‐off values and international guidelines can take place.This article is categorized under: Toxicology > Alcohol Toxicology > Analytical Toxicology Toxicology > Drug Analysis

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