Denmark health authority warns on falsified tirzepatide pens
Reported from the analysis, not from a warning notice.
TheCompound Journal
Reporting on incretins, compounding & the peptide supply chain
Method
The Journal’s standing position: a mass that matches is necessary evidence of identity and nowhere near sufficient.
Consider the arithmetic. A peptide of thirty residues built from twenty available amino acids has on the order of ten to the thirty-ninth possible sequences. The number of those sequences with an identical elemental composition — and therefore an identical mass to any achievable precision — is not one. Any permutation of the same residues weighs exactly the same. Any exchange of leucine for isoleucine weighs exactly the same. Any inversion of stereochemistry weighs exactly the same. An intact mass measurement is blind to all of it, by construction rather than by inadequacy.
Suppose a laboratory reports an observed monoisotopic mass within two parts per million of the theoretical value for the labelled peptide. What has been established is that the sample contains a species whose elemental composition is either identical to the target or differs from it in a way that happens to conserve mass to within that tolerance. This is genuinely strong evidence, and it is not identity.
The set of molecules consistent with that observation includes every permutation of the target sequence, every substitution of leucine for isoleucine and vice versa, every inversion of stereochemistry at any of the chiral centres, every migration of aspartate to isoaspartate, and — at tolerances above roughly ten parts per million — every glutamine-for-lysine exchange. It also includes any unrelated molecule of coincidentally matching composition, though in practice the chromatographic retention time excludes most of those.
The proteomics literature has spent two decades formalising exactly this problem under the heading of identification confidence, developing false-discovery-rate frameworks precisely because a matching mass is a weak identifier and a matching fragmentation pattern is a strong one.1 The research-peptide trade has borrowed the instrument from that field and not the epistemology, and the result is a market in which the word confirmed is applied to the weakest available evidence.
Peptide mapping is the standard method by which the primary structure of a peptide or protein product is verified. The material is digested with a protease of defined specificity — trypsin cleaving after lysine and arginine, Lys-C after lysine alone, chymotrypsin after aromatic residues — and the resulting fragments are separated by reversed-phase chromatography with mass detection. Each fragment’s observed mass is matched against the masses predicted from the expected sequence, and the fraction of the chain accounted for is reported as sequence coverage.
A digest that returns every predicted fragment at the predicted mass is a far stronger identity statement than an intact mass, because it constrains the order of residues in a way that an intact measurement does not: a permuted sequence generally produces different cleavage products. It is not complete on its own, because a fragment mass is subject to the same permutation ambiguity in miniature, which is why serious mapping proceeds to a second stage of mass analysis on the fragments themselves.
For synthetic peptides of thirty to forty residues, mapping is straightforward chemistry and unremarkable chromatography, and the reason it does not appear on certificates in this market is cost and turnaround rather than difficulty. The regulatory expectation for a peptide product characterised as a biotechnological article treats structural confirmation of this kind as a matter of routine rather than of specialism.23
Roughly one dalton, roughly sixteen, and zero: the three most consequential things that go wrong with a synthetic peptide, in decreasing order of detectability.
Tandem mass spectrometry selects an ion of a particular mass-to-charge ratio, breaks it, and measures the masses of the pieces. Collision-induced dissociation and its higher-energy variant fragment the peptide predominantly at the amide bonds, producing two complementary series: b ions retaining the N-terminal portion and y ions retaining the C-terminal portion. The mass difference between consecutive members of either series is the residue mass of one amino acid, so reading the series in order reads the sequence.
Electron-transfer dissociation fragments differently, producing c and z ions, and preserves labile modifications that collisional methods tend to strip. Between them the two approaches cover most of what a peptide chemist needs. The nomenclature for these fragment series was fixed decades ago and is stable enough that a spectrum annotated in it can be read by anybody in the field.4
Two limitations should be stated because they are routinely elided. Fragmentation is not uniform along a chain: proline residues and basic residues bias cleavage, and stretches of a sequence can go unrepresented, which is why coverage is reported as a percentage rather than asserted as complete. And leucine and isoleucine remain indistinguishable under collisional fragmentation because their residue masses are identical; separating them requires side-chain fragmentation under specialised conditions, which almost nobody performs outside a research context.
| Element of the identity claim | Certificates stating it (of 20) |
|---|---|
| A mass spectrometric identity test was performed | 14 |
| Both observed and theoretical mass given | 8 |
| Instrument or analyser class named | 6 |
| Ionisation source or mode named | 5 |
| A spectrum reproduced in the document | 5 |
| Charge state of the reported ion stated | 4 |
| Monoisotopic or average convention stated | 3 |
| An acceptance tolerance stated | 3 |
| Peptide mapping or MS/MS performed | 1 |
| Counts are of the most recent certificate supplied to the Journal by each of the twenty companies in the dossier programme as at the last quarterly cycle. A company is credited where the element appears anywhere on the document or on an attached laboratory report. No inference about material quality should be drawn from a documentary count. | |
Where a peptide map is performed, the headline output is a coverage figure: the percentage of residues in the expected sequence accounted for by identified fragments. Ninety-five per cent coverage sounds close to complete and is worth interrogating, because the five per cent that is missing is not randomly located. Very short fragments elute in the solvent front and are lost. Very hydrophobic fragments retain on the column. Regions between closely spaced cleavage sites produce peptides too small to identify unambiguously.
The consequence is that the uncovered fraction tends to sit in the same places for a given protease and a given sequence, which means a laboratory reporting ninety-five per cent coverage in run after run has ninety-five per cent coverage of a specific ninety-five per cent. A second digest with a different enzyme is the conventional remedy, and a report that used two orthogonal proteases is doing something a report using one cannot.
For a reader assessing a document, the useful questions are which enzyme, what coverage, and whether the uncovered residues are identified. A map that names the missing stretch has told you where the residual uncertainty lives. A map that reports a percentage alone has told you a number whose meaning depends on information it withheld — which is, in a different guise, the same complaint this department makes about purity figures reported without a gradient.
Follow a mass spectrum through the market and its meaning changes at every step. A laboratory issues a report to whoever submitted the sample, stating what was observed on a named instrument on a named date. The submitter — a vendor, in most cases — extracts a figure and a verdict onto a certificate of analysis for the lot. A reseller reproduces the certificate, or a portion of it. A listing page distils the whole chain into a phrase: identity verified.
Nothing dishonest need happen at any step for the final phrase to support far more than the original report does. The instrument’s resolving power is lost at step two. The convention behind the theoretical mass is lost at step two or three. The date, the batch and the submitter’s identity survive unevenly. By the time the claim reaches a buyer it has become a property of the product rather than a record of a measurement on one vial from one lot on one day.
This is the structural reason the Journal reports identity claims by asking for the underlying laboratory report rather than the certificate. When a supplier supplies it, the claim usually holds up and often turns out to be stronger than the certificate suggested. When a supplier cannot locate it, that is itself information about how far back the documentary chain reaches, and we report that too, without inferring anything about the material.
The uncomfortable conclusion of all this is not that identity testing in this market is worthless. It is that identity testing here is doing considerably less work than the language attached to it suggests, and that the shortfall is documentary rather than analytical. The instruments are capable. The laboratories are competent. What is missing is six lines on a page, and the reason they are missing is that nobody has ever declined a purchase for want of them.
Selected from correspondence received on this article. Writers are identified by initial, surname and city, verified before printing. Replies are from the desk that filed the piece or from the standards editor. Write to letters@compoundjournal.com.
A small defence of the linear MALDI instrument. It is fast, it tolerates dirty samples, and for a synthesis chemist checking that a chain has grown by the residue intended it is entirely fit for purpose. The problem is not the instrument. It is printing its output on a release document.
— K. Oyibo, Benin City
This is the same objection a reader made about the twelve-minute purity gradient two years ago, and it was right then as well. The criticism is of the use, not the tool.
You give the glutamine-to-lysine difference as 0.036 daltons and say it needs an orbital trap. In practice you also need the two species to be chromatographically separated or present in a sensible ratio, because at one per cent of the parent intensity the minor peak sits on the shoulder of the isotope envelope regardless of resolving power.
— J. Halloway, Dundee
Yes, and this is the more useful statement of the problem. Resolving power is necessary and not sufficient; dynamic range and separation matter as much. We have added a sentence to the table note.
Reported from the analysis, not from a warning notice.
We submitted vials for endotoxin determination and report the results, the method and the laboratory, because a pyrogen figure without a method is as empty as a purity…
A reminder that a purity figure is the output of a method, and that methods differ.
The result is unremarkable. What the report omits is not.
Almost nothing in the standard management repertoire has been tested in a randomised trial in this specific population. We say what is extrapolated and from where.
What adding GIP activity does, on the current evidence, and what remains unresolved.