Single Hair Analysis Monitoring Concept for P4 Implementation

  • Markus R. Baumgartner


P4 medicine is a holistic concept describing man as a complex biological system. With a viewpoint of general healthcare management this concept focuses mainly on prevention and not curative treatment. On the other hand, forensic toxicology investigates (adverse) effects caused by drugs and chemicals in cases with medicolegal consequences. Thus, on a first glance, these two concepts seem to have nothing in common. Hair testing is a young technique among all the analytical tools applied in forensic toxicology. The main advantage of this method is the prolonged time frame represented by a segment of the keratinized part of the hair. This allows long term monitoring of exposure, not only to drugs, but also to environmental influences or situations pertaining to health such as, for example, an on-going stressful situation. Hair metabolomics hast just started; however, the development of new markers will—together with standardized toxicological hair analysis—enable a predictive and preventive monitoring over a controlled time frame. The highly sophisticated techniques currently developed for single hair analysis allow an even deeper insight into hair, incorporation pathways, but also degradation mechanisms. Even today, first experiments have shown that metabolic ratios observed in the hair matrix might provide some evidence for the phenotype of the individual regarding metabolism. A single hair does not only consist of a dead, keratinized part containing mitochondrial DNA (mtDNA). The hair follicle at the bottom end of a plucked hair contains enough nuclear DNA (nuDNA) for complete sequencing. In addition, microscopic examination of the hair follicle is used to determine the state of the hair growth cycle the hair is in. In summary, single hair analysis allows individual characterization and therefore supports personalized assessment and facilitates participatory medicine.


  1. 1.
    Hood L, Balling R, Auffray C (2012) Revolutionizing medicine in the 21st century through systems approaches. Biotechnol J 7(8):992–1001CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Flores M, Glusman G, Brogaard K, Price ND, Hood L (2013) P4 medicine: how systems medicine will transform the healthcare sector and society. Per Med 10(6):565–576CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Hood L, Flores M (2012) A personal view on systems medicine and the emergence of proactive P4 medicine: predictive, preventive, personalized and participatory. N Biotechnol 29(6):613–624CrossRefPubMedGoogle Scholar
  4. 4.
  5. 5.
    Hood L (2013) Systems biology and p4 medicine: past, present, and future. Rambam Maimonides Med J 4(2):e0012CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Smarr L (2012) Quantifying your body: a how-to guide from a systems biology perspective. Biotechnol J 7(8):980–991CrossRefPubMedGoogle Scholar
  7. 7.
    Snyderman R (2012) Personalized health care: from theory to practice. Biotechnol J 7(8):973–979CrossRefPubMedGoogle Scholar
  8. 8.
    The Forensic Toxicology Council (2010) Briefing: What is Forensic Toxicology? Available via DIALOG. Accessed 17 Nov 2016
  9. 9.
    Desharnais B, Mireault P, Skinner CD (2015) Postmortem identification of metabolizer type: a proteomics approach. Paper presented at the 53rd TIAFT meetings, Florence, 30 August–4 September 2015Google Scholar
  10. 10.
    Pragst F, Balikova MA (2006) State of the art in hair analysis for detection of drug and alcohol abuse. Clin Chim Acta 370(1–2):17–49CrossRefPubMedGoogle Scholar
  11. 11.
    Baumgartner MR (2014) Nails: an adequate alternative matrix in forensic toxicology for drug analysis? Bioanalysis 6(17):2189–2191CrossRefPubMedGoogle Scholar
  12. 12.
    Lee DY, Kim E, Choi MH (2015) Technical and clinical aspects of cortisol as a biochemical marker of chronic stress. BMB Rep 48(4):209–216CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Nielsen KL, Telving R, Andreasen MF, Hasselstrøm JB, Johannsen M (2016) A metabolomics study of retrospective forensic data from whole blood samples of humans exposed to 3,4-methylenedioxymethamphetamine: a new approach for identifying drug metabolites and changes in metabolism related to drug consumption. J Proteome Res 15(2):619–627CrossRefPubMedGoogle Scholar
  14. 14.
    Thieme D, Schmid D, Sachs H (2007) Individual variations of amitriptyline biotransformation examined in scalp hair samples. Forensic Sci Med Pathol 3(2):119–123CrossRefPubMedGoogle Scholar
  15. 15.
    Madry MM, Rust KY, Guglielmello R, Baumgartner MR, Kraemer T (2012) Metabolite to parent drug concentration ratios in hair for the differentiation of tramadol intake from external contamination and passive exposure. Forensic Sci Int 223(1–3):330–334CrossRefPubMedGoogle Scholar
  16. 16.
    Fisichella M, Steuer AE, Kraemer T, Baumgartner MR (2014) O18: Chiral analysis of methadone and its main metabolite EDDP in hair: incorporation depending on hair colour and metabolizer status. Toxicol Anal Clin 26:S12Google Scholar
  17. 17.
    Chata C, Hardy EM, Grova N, Appenzeller BM (2016) Influence of pesticide physicochemical properties on the association between plasma and hair concentration. Anal Bioanal Chem 408(13):3601–3612CrossRefPubMedGoogle Scholar
  18. 18.
    Müller A, Jungen H, Iwersen-Bergmann S, Sterneck M, Andresen-Streichert H (2013) Analysis of cyclosporin a in hair samples from liver transplanted patients. Ther Drug Monit 35(4):450–458CrossRefPubMedGoogle Scholar
  19. 19.
    Favretto D, Tucci M, Monaldi A, Ferrara SD, Miolo G (2014) A study on photodegradation of methadone, EDDP, and other drugs of abuse in hair exposed to controlled UVB radiation. Drug Test Anal 6(Suppl 1):78–84CrossRefPubMedGoogle Scholar
  20. 20.
    Pötsch L, Skopp G (1996) Stability of opiates in hair fibers after exposure to cosmetic treatment. Forensic Sci Int 81(2–3):95–102CrossRefPubMedGoogle Scholar
  21. 21.
    Kerekes I, Yegles M (2013) Coloring, bleaching, and perming: influence on EtG content in hair. Ther Drug Monit 35(4):527–529CrossRefPubMedGoogle Scholar
  22. 22.
    Sulek K, Han TL, Villas-Boas SG, Wishart DS, Soh SE, Kwek K, Gluckman PD, Chong YS, Kenny LC, Baker PN (2014) Hair metabolomics: identification of fetal compromise provides proof of concept for biomarker discovery. Theranostics 4(9):953–959CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Rust KY, Baumgartner MR, Dally AM, Kraemer T (2012) Prevalence of new psychoactive substances: A retrospective study in hair. Drug Test Anal 4(6):402–408CrossRefPubMedGoogle Scholar
  24. 24.
    Thieme D, Sachs H (2007) Examination of a long-term clozapine administration by high resolution segmental hair analysis. Forensic Sci Int 166(2–3):110–114CrossRefPubMedGoogle Scholar
  25. 25.
    Thieme D, Baumer C, Sachs H, Teske J (2013) Screening and long-term retrospection for psychoactive drugs in presumptive drug-facilitated crimes using segmented single hairs. Drug Test Anal 9–10:736–740CrossRefGoogle Scholar
  26. 26.
    Duvivier WF, van Putten MR, van Beek TA, Nielen MW (2016) (Un)targeted scanning of locks of hair for drugs of abuse by direct analysis in real time-high-resolution mass spectrometry. Anal Chem 88(4):2489–2496CrossRefPubMedGoogle Scholar
  27. 27.
    Cuypers E, Flinders B, Boone CM, Bosman IJ, Lusthof KJ, Van Asten AC, Tytgat J, Heeren RM (2016) Consequences of decontamination procedures in forensic hair analysis using metal-assisted secondary ion mass spectrometry analysis. Anal Chem 88(6):3091–3097CrossRefPubMedGoogle Scholar
  28. 28.
    Flinders B, Cuypers E, Zeijlemaker H, Tytgat J, Heeren RM (2015) Preparation of longitudinal sections of hair samples for the analysis of cocaine by MALDI-MS/MS and TOF-SIMS imaging. Drug Test Anal 7(10):859–865CrossRefPubMedGoogle Scholar
  29. 29.
    Kamata T, Shima N, Sasaki K, Matsuta S, Takei S, Katagi M, Miki A, Zaitsu K, Nakanishi T, Sato T, Suzuki K, Tsuchihashi H (2015) Time-course mass spectrometry imaging for depicting drug incorporation into hair. Anal Chem 87(11):5476–5481CrossRefPubMedGoogle Scholar
  30. 30.
    Poetzsch M, Baumgartner MR, Steuer AE, Kraemer T (2015) Segmental hair analysis for differentiation of tilidine intake from external contamination using LC-ESI-MS/MS and MALDI-MS/MS imaging. Drug Test Anal 7(2):143–149CrossRefPubMedGoogle Scholar
  31. 31.
    Poetzsch M, Steuer AE, Roemmelt AT, Baumgartner MR, Kraemer T (2014) Single hair analysis of small molecules using MALDI-triple quadrupole MS imaging and LC-MS/MS: investigations on opportunities and pitfalls. Anal Chem 86(23):11758–11765CrossRefPubMedGoogle Scholar
  32. 32.
    Porta T, Grivet C, Kraemer T, Varesio E, Hopfgartner G (2011) Single hair cocaine consumption monitoring by mass spectrometric imaging. Anal Chem 83(11):4266–4272CrossRefPubMedGoogle Scholar
  33. 33.
    Haines AM, Linacre A (2016) A rapid screening method using DNA binding dyes to determine whether hair follicles have sufficient DNA for successful profiling. Forensic Sci Int 262:190–195CrossRefPubMedGoogle Scholar
  34. 34.
    McNevin D, Wilson-Wilde L, Robertson J, Kyd J, Lennard C (2005) Short tandem repeat (STR) genotyping of keratinised hair. Forensic Sci Int 153(2–3):237–246CrossRefPubMedGoogle Scholar
  35. 35.
    Schmidt C (2014) Leroy Hood looks forward to P4 medicine: predictive, personalized, preventive, and participatory. J Natl Cancer Inst 106(12)Google Scholar
  36. 36.
    Stalder T, Steudte-Schmiedgen S, Alexander N, Klucken T, Vater A, Wichmann S, Kirschbaum C, Miller R (2017) Stress-related and basic determinants of hair cortisol in humans: A meta-analysis. Psychoneuroendocrinology 77:261–274Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Zurich Institute of Forensic Medicine, University of ZurichZürichSwitzerland

Personalised recommendations