Mass Spectrometry for Determining if a Mutated Variant of a Target Protein is Present in a Sample

Abstract

A method of mass spectrometry is disclosed for determining if a mutated variant of a target protein is present in a sample. The method comprises subjecting the sample to fragmentation so as to cause said target protein to fragment to form second generation fragment ions, and then mass analysing these fragment ions to obtain spectral data. The method determines if a mutated variant is present in the sample by determining that an ion in the spectral data has a mass to charge ratio that differs from the mass to charge ratio of an ion that would be observed if said target protein was a normal unmutated version of said target protein, and by an amount that corresponds to a mass difference that would be caused by the target protein being a mutated variant of said target protein. This method of analysing second generation fragment ions if a rapid and efficiency method of analysing a sample.

Claims

1. A method of mass spectrometry for determining if a mutated variant of a target protein is present in a sample, comprising: introducing said sample comprising the target protein into a mass spectrometer; subjecting the sample to fragmentation so as to cause said target protein to fragment to form first fragment ions; fragmenting said first fragment ions to form second fragment ions; mass analysing said second fragment ions to obtain first spectral data; and determining that an ion in the first spectral data has a mass to charge ratio that differs from the mass to charge ratio of an ion that would be observed if said target protein was a normal unmutated version of said target protein, and by an amount that corresponds to a mass difference that would be caused by the target protein being a mutated variant of said target protein.

2. The method of claim 1, wherein said sample is, or comprises: blood; whole-blood; diluted blood; or diluted whole blood; and/or wherein the target protein is haemoglobin or a haemoglobin beta chain.

3. The method of claim 1, wherein the target protein is subjected to ionisation prior to said fragmentation step such that target protein ions are fragmented to form the first fragment ions; and optionally wherein the target protein is ionised in an ion source to form the target protein ions.

4. The method of claim 1, wherein said fragmentation is Atmospheric Pressure Electron Capture Dissociation (‘Ap-ECD’); Atmospheric Pressure Electron Transfer Dissociation (‘Ap-ETD’); Electron Capture Dissociation (“ECD”); or Electron Transfer Dissociation (“ETD”).

5. The method of claim 1, wherein the sample is introduced directly into the mass spectrometer; and/or wherein the sample is not subjected to liquid chromatography; and/or wherein the sample is ionised in the mass spectrometer and the sample is not subjected to separation or digestion prior to ionisation and/or fragmentation.

6. The method of claim 1, wherein said step of fragmenting said first fragment ions comprises isolating one of said first fragment ions from the other fragment ions and then fragmenting the isolated ions so as to form the second fragment ions.

7. The method of claim 6, wherein an ion filter is used to perform said step of isolating ions, and wherein the ion filter is set to isolate ions having a mass to charge ratio or ion mobility corresponding to that of a first fragment ion from a non-normal mutated variant of the target protein.

8. The method of claim 6, wherein said target protein is a haemoglobin protein; and wherein the first fragment ion that is isolated and fragmented to form said second fragment ions is a c8 fragment ion derived from a haemoglobin beta chain.

9. The method of claim 1, wherein the step of fragmenting said first fragment ions comprises fragmenting said first fragment ions using Collision Induced Dissociation (“CID”); and/or wherein the isolated ions are fragmented using CID.

10. The method of claim 1, wherein if or when an ion having said mass difference is detected, the ion is considered and/or indicated as being from a non-normal mutated variant of the target protein.

11. The method of claim 1, further comprising using the mass to charge ratio of said ion in the first spectral data to identify the location of the mutation within the protein sequence of the target protein.

12. The method of claim 1, comprising using the value of said mass difference to identify the type of mutation in the sequence of the target protein.

13. The method of claim 1, wherein the mass difference is equivalent the mass difference between two different amino-acids.

14. The method of claim 11, comprising identifying the type of variant of the target protein in the sample, or identifying a disease in the sample, from the location and/or type of mutation.

15. The method of claim 1, wherein the target protein is mass analysed in a precursor ion mode without first being fragmented; wherein if said ion having said mass difference is detected in the first spectral data, a related precursor ion detected in said precursor ion mode is considered and/or indicated as being a mutated precursor ion from a non-normal mutated variant of the target protein; wherein the method determines whether or not the precursor ions contain a precursor ion corresponding to an unmutated version of the mutated precursor ion; and wherein if the method determines that the precursor ions contain both said mutated precursor ion and said unmutated version of the precursor ion, then the variant is determined to be a heterozygous variant; or wherein if the method determines that the precursor ions contain said mutated precursor ion and not said unmutated version of the precursor ion, then the variant is determined to be a homozygous variant.

16. The method of claim 1, wherein if said ion having said mass difference is detected in the first spectral data, the first fragment ion that is fragmented to produce the second spectral data is considered and/or indicated as being a mutated first fragment ion from a non-normal mutated variant of the target protein; and wherein the method determines whether or not the first fragment ions contain a fragment ion corresponding to an unmutated version of the mutated first fragment ion; and wherein if the method determines that the first fragment ions contain both said mutated first fragment ion and said unmutated version of the mutated first fragment ion, then the variant is determined to be a heterozygous variant; and/or wherein if the method determines that the first fragment ions contain said mutated first fragment ion and not said unmutated version of the mutated first fragment ion, then the variant is determined to be a homozygous variant

17. A mass spectrometer for determining if a mutated variant of a target protein is present in a sample, comprising: a device arranged and configured to receive said sample comprising the target protein; at least one fragmentation device; a mass analyser; a processor; and a control system arranged and configured to: subject the sample to fragmentation in the at least one fragmentation device so as to cause said target protein to fragment to form first fragment ions; fragment said first fragment ions in said at least one fragmentation device so as to form second fragment ions; mass analyse said second fragment ions in said mass analyser so as to obtain first spectral data; and control the processor to determine that an ion in the first spectral data has a mass to charge ratio that differs from the mass to charge ratio of an ion that would be observed if said target protein was a normal unmutated version of said target protein, and by an amount that corresponds to a mass difference that would be caused by the target protein being a mutated variant of said target protein.

18. A method of mass spectrometry comprising: introducing a blood sample into a mass spectrometer system; and using Electron Capture Dissociation (“ECD”) or Electron Transfer Dissociation (“ETD”) to subject said sample to fragmentation so as to cause haemoglobin proteins to fragment to form first fragment ions.

19. The method of claim 18, wherein said ECD is Atmospheric Pressure Electron Capture Dissociation (‘Ap-ECD’); and said ETD is Atmospheric Pressure Electron Transfer Dissociation (‘Ap-ETD’).

20. The method of claim 18, wherein the step of introducing the blood sample into the mass spectrometer system comprises introducing the blood sample directly into the mass spectrometer system; and/or wherein the blood sample is not subjected to liquid chromatography; or wherein the blood sample is ionised in the mass spectrometer system and the blood sample is not subjected to separation or digestion prior to ionisation.

21. The method of claim 18, wherein the blood sample introduced into the mass spectrometer system is, or comprises, whole blood; and/or wherein said blood sample comprises, or is, a diluted blood sample.

22. The method of claim 18, wherein the step of using ECD or ETD to subject said sample to fragmentation comprises using said ECD or ETD to subject said sample to in-source fragmentation so as to cause the haemoglobin proteins to fragment to form the first fragment ions.

23. The method of claim 18, comprising mass analysing said first fragment ions to obtain first spectral data; and determining whether or not ions in the first spectral data are at mass to charge ratios corresponding to the mass to charge ratios that these ions would be detected at if the haemoglobin in the blood sample was normal, unmutated haemoglobin; and optionally, further comprising providing an indication that the haemoglobin in the blood sample is normal unmutated haemoglobin if the ions in the first spectral data are at mass to charge ratios corresponding to the mass to charge ratios that the ions would be detected at if the haemoglobin in the blood sample was normal unmutated haemoglobin.

24. The method of claim 18, comprising mass analysing said first fragment ions to obtain first spectral data; and determining from the first spectral data if an ion is present at a mass to charge ratio corresponding to the mass to charge ratio that an ion would be detected at only if the haemoglobin in the blood sample was of a mutated non-normal variant; and optionally, further comprising providing an indication that the haemoglobin in the blood sample is a mutated variant of haemoglobin.

25. The method of claim 18, further comprising fragmenting at least some of said first fragment ions to form second fragment ions.

26. The method of claim 25, wherein said step of fragmenting at least some of said first fragment ions comprises isolating one of said first fragment ions from the other fragment ions and then fragmenting the isolated ions so as to form the second fragment ions.

27. The method of claim 26, wherein said first fragment ion that is isolated and fragmented to form said second fragment ions is a c8 fragment ion derived from a haemoglobin beta chain.

28. The method of claim 25, wherein the step of fragmenting at least some of said first fragment ions comprises fragmenting at least some of said first fragment ions using Collision Induced Dissociation (“CID”); and/or wherein the isolated ions are fragmented using CID.

29. The method of claim 25, comprising mass analysing the second fragment ions to obtain second spectral data; and determining from the second spectral data if an ion is present at a mass to charge ratio corresponding to the mass to charge ratio that an ion would be detected at only if the haemoglobin in the blood sample was of a non-normal mutated variant.

30. The method of claim 29, comprising determining that an ion in the second spectral data has a mass to charge ratio that differs from the mass to charge ratio of an ion that would be observed if normal unmutated haemoglobin had been analysed, and by an amount that corresponds to a mass difference that would be caused by the analysed haemoglobin being a non-normal variant or that would be caused by a mutation/substitution of an amino-acid of normal haemoglobin for another amino-acid.

31. The method of claim 30, wherein the mass difference is 30 Da; and/or wherein the mass difference corresponds to a mutation of Glutamic Acid to Valine; and/or wherein the mass difference is a mass difference that would arise if the haemoglobin in the blood sample was from a patient having sickle cell disease.

32. The method of claim 30, comprising using the value of said mass difference to identify the type of mutation in the haemoglobin sequence.

33. The method of claim 29, wherein the method further comprises using the mass to charge ratio of said ion in the second spectral data to identify the location of the mutation within the haemoglobin sequence.

34. The method of claim 32, comprising identifying a type of haemoglobin variant in the blood sample or a blood disease in the blood sample from the location and/or type of mutation; and/or identifying from the location and type of mutation that the blood sample was taken from a patient having sickle cell disease.

35. The method of claim 30, wherein the blood sample is mass analysed in a precursor ion mode without prior fragmentation; wherein if said ion having said mass difference is detected, a related precursor ion detected in said precursor ion mode is considered and/or indicated as being a mutated precursor ion from a non-normal mutated variant of haemoglobin; wherein the method determines whether or not the precursor ions contain a precursor ion corresponding to an unmutated version of the mutated precursor ion; and wherein if the method determines that the precursor ions contain both said mutated precursor ion and said unmutated version of the precursor ion, then the variant is determined to be a heterozygous variant; or wherein if the method determines that the precursor ions contain said mutated precursor ion and not said unmutated version of the precursor ion, then the variant is determined to be a homozygous variant.

36. The method of claim 30, wherein if said ion having said mass difference is detected, the first fragment ion that is fragmented to produce the second spectral data is considered and/or indicated as being a mutated first fragment ion from a non-normal mutated variant of haemoglobin; and wherein the method determines whether or not the first fragment ions contain a fragment ion corresponding to an unmutated version of the mutated first fragment ion; wherein if the method determines that the first fragment ions contain both said mutated first fragment ion and said unmutated version of the mutated first fragment ion, then the haemoglobin variant is determined to be a heterozygous variant; and/or wherein if the method determines that the first fragment ions contain said mutated first fragment ion and not said unmutated version of the mutated first fragment ion, then the haemoglobin variant is determined to be a homozygous variant

37. A method of identifying a type of haemoglobin variant in a blood sample or a blood disease in a blood sample comprising a method as claimed in claim 1.

38. A mass spectrometer comprising: a device arranged and adapted to receive a blood sample; an Electron Capture Dissociation (“ECD”) device or an Electron Transfer Dissociation (“ETD”) device; and a control system arranged and adapted: (i) to subject said sample to fragmentation using said ECD device or said ETD device so as to cause haemoglobin proteins to fragment to form first fragment ions.

39. A method of mass spectrometry comprising: introducing a blood sample directly into a mass spectrometer system; and using Atmospheric Pressure Electron Capture Dissociation (“Ap-ECD”) or Atmospheric Pressure Electron Transfer Dissociation (“Ap-ETD”) to subject said sample to in-source fragmentation so as to cause haemoglobin proteins to fragment to form first fragment ions; fragmenting at least some of said first fragment ions to form second fragment ions; and using said first fragment ions and/or said second fragment ions to identify the location of haemoglobin sequence mutations.

40. The method claim 39, wherein the step of fragmenting said at least some of the first fragment ions comprises fragmenting at least some of said first fragment ions using Collision Induced Dissociation (“CID”).

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0169] Various embodiments of the present invention will now be described, by way of example only, and with reference to the accompanying drawings in which:

[0170] FIG. 1 shows a simplified workflow according to an embodiment of the present invention;

[0171] FIGS. 2A-2C show MS precursor ion spectra for blood samples containing normal (AA), heterozygote (AS) and homozygote (SS) variants of haemoglobin;

[0172] FIGS. 3A-3C show fragment ion spectra for blood samples containing normal (AA), heterozygote (AS) and homozygote (SS) variants of haemoglobin, obtained by switching on a UV lamp in an MS mode;

[0173] FIG. 4 shows the sequence for a haemoglobin beta chain and three possible mutations of the amino-acids; and

[0174] FIGS. 5A-5C show fragment ion spectra for blood samples containing normal (AA), heterozygote (AS) and homozygote (SS) variants of haemoglobin, obtained by CID dissociation of a fragment ion observed in FIGS. 3A-3C.

DETAILED DESCRIPTION

[0175] A simplified workflow according to an embodiment of the present invention is shown in FIG. 1. The workflow comprises diluting the blood sample taken from a patient and introducing the diluted blood sample directly into a mass spectrometer. The ratio of dilution of blood to water in this example is 1:500, although other dilutions may of course be used. Components or molecules in the diluted blood sample are then ionised within the mass spectrometer. In a first mode, the resulting ions are then subjected to Atmospheric Pressure Electron Capture Dissociation (“Ap-ECD”), or Atmospheric Pressure Electron Transfer Dissociation (“Ap-ETD”), so as to dissociate the ions to form first fragment ions, e.g. to dissociate ions derived from haemoglobin proteins to form first fragment ions. The resulting spectra may be used to putatively determine the location of a mutation, as will be described further below in relation to FIGS. 3A-3C.

[0176] In a second mode, MS/MS analysis may be performed. This may be performed by selectively transmitting a first fragment ion having a particular mass to charge ratio (or range of mass to charge ratios) and then fragmenting that ion by Collisionally Induced Dissociation (CID). The resulting spectra may be used to accurately determine the location of a mutation, as will be described further below in relation to FIGS. 5A-5C.

[0177] The above-described workflow does not involve the relatively time consuming steps of HPLC and sample digestion, and does not require complex workflows. The simplified workflow is relatively fast, only requiring approximately a minute or less per stage. Furthermore, the procedure may be performed using a small, low-cost bench-top instrument.

[0178] FIGS. 2A-2C show MS spectra for precursor ions from three different blood samples. FIG. 2A shows an MS spectra for ions from a normal (AA) blood sample. The most intense peak 2 shown in the spectrum is due to ions from the alpha chain (ions having a charge state of 18+ and having an average molecular weight of 15126 Da) and the second most intense peak 4 is due to beta chain ions (ions having a charge state of 19+ and having an average molecular weight of 15867 Da). As the blood sample is a normal sample (AA), both beta chains are unmodified and appear at the same mass to charge ratio.

[0179] FIG. 2B shows an MS spectra for ions from a heterozygous (AS) blood sample, i.e. a sample in which one of the beta chains is mutated and one of the beta chains is not mutated. The spectrum shows an ion peak 2 due to the alpha chain and an ion peak 4 due to the non-mutated beta chain (beta A) at the same locations as the alpha and beta chain peaks in FIG. 2A. However, the non-mutated beta chain peak 4 in FIG. 2B has a lower intensity than that in FIG. 2A, because the blood sample analysed to produce FIG. 2B does not contain only non-mutated beta chains but also includes mutated beta chains. FIG. 2B shows an ion peak 6 corresponding to the mutated beta chain (beta S), which has an approximately similar intensity to peak 4 shown in FIG. 2B for the non-mutated beta chain (beta A). The ion peak 6 is due to ions having a charge state of 19+ and having an average molecular weight of 15837 Da.

[0180] FIG. 2C shows an MS spectra for ions from a homozygous (SS) blood sample, i.e. a sample in which both of the beta chains are mutated. The spectrum shows an ion peak 2 due to the alpha chain at substantially the same location and intensity as the alpha chain peaks in FIGS. 2A and 2B. The spectrum of FIG. 2C includes only a single beta chain peak 6 that is located at the same location as the mutated beta chain (beta S) peak shown in FIG. 2B. The beta chain peak 6 in FIG. 2C has a higher intensity than that in FIG. 2B (and the substantially same intensity as the non-mutated beta chain 4 in FIG. 2A), because the blood sample analysed to produce FIG. 2C contains only mutated beta chains and no non-mutated beta chains. The ion peak 6 in FIG. 2C is due to ions having a charge state of 19+ and having an average molecular weight of 15837 Da.

[0181] It can be seen by comparing FIGS. 2A-2C that the mutation in the beta chain in the AS and SS variants (FIGS. 2B and 2C) causes the beta chain to decrease in mass by 30 Da, as compared to an non-mutated beta chain (FIG. 2A). However, the location of the mutation has not been determined precisely and so is not directly indicative of whether the mutation is problematic or not (e.g. whether or not the mutation is symptomatic in the patient). It may therefore be desirable to use the technique described in relation to FIG. 1 to determine the location of the mutation more accurately.

[0182] FIGS. 3A-3C show fragment ion spectra obtained for the three different blood samples analysed in FIGS. 2A-2C, respectively. The fragment ion spectra were obtained by switching on an Atmospheric Pressure Electron Capture Dissociation (“Ap-ECD”) ultra-violet lamp whilst in a MS mode of operation. The light from the lamp may generate photoelectrons, e.g. via the ionization of a supplementary acetone flow within the ion source. The photoelectrons may then react with the multiply charged analyte ions, thereby generating Electron Capture Dissociation (ECD) type fragment ions. Several ‘c’ type fragment ions are generated.

[0183] FIG. 3A shows the spectrum for the normal (AA) blood sample. In this example, the c8 fragment ion has a mass to charge ratio of 952 and is derived from a normal beta chain (beta A). A c8 ion exists in only one form for the normal (AA) blood sample, at a mass to charge ratio of 952.

[0184] FIG. 3B shows the spectrum for the heterozygous (AS) blood sample. As in FIG. 3A, the spectrum shows a c8 fragment ion having a mass to charge ratio of 952, which is derived from a normal beta chain (beta A). The spectrum of FIG. 3B also shows a c8 fragment having a mass to charge ratio of 922 and which is derived from a mutated beta chain (beta S).

[0185] FIG. 3C shows the spectrum for the homozygous (SS) blood sample. The c8 fragment ion having a mass to charge ratio of 952 that is shown in FIGS. 3A and 3B is missing, because such a fragment would be derived from a normal beta chain (beta A), which is not present in the homozygous (SS) blood sample. However, the spectrum of FIG. 3C shows the c8 fragment ion having a mass to charge ratio of 922, which is derived from the mutated beta chain (beta S), and which is also shown in FIG. 3B.

[0186] It can be seen by comparing FIGS. 3A-3C that the mutation in the beta chain in the AS and SS variants (FIGS. 3B and 3C) causes c8 fragment ions to be observed at a mass to charge ratio that is 30 Da lower than the c8 fragment ion from a non-mutated beta chain (FIG. 3A). A mass shift of 30 Da may be attributed to either a Threonine to Alanine mutation, or a Glutamic Acid to Valine mutation in the beta chain sequence. Within the beta chain sequence, three different possibilities exist for such a mutation, as shown in FIG. 4.

[0187] FIG. 4 shows the amino-acid sequence for a non-mutated beta chain, together with the above-described three different possible mutations that would give rise to a 30 Da mass shift. At position 4 in the beta chain there is shown a potential mutation of Threonine to Alanine (T-A mutation), and at position 7 there is shown a potential mutation of Glutamic Acid to Valine (E-V mutation). These two mutations are “non-listed” and are not thought to be clinically significant. At position 6 in the beta chain there is shown a potential mutation of Glutamic Acid to Valine (E-V mutation). This mutation is known to cause sickle cell disease in homozygous cases, and may be asymptomatic in heterozygous cases. FIG. 4 also shows how the mutations would affect the b- and y-fragment ions.

[0188] The spectra in FIGS. 2B-2C and FIGS. 3B-3C show the putative location of the mutation, i.e. at the beta chain. However, it may be desirable to determine the precise location of the mutation in the AS and SS forms in order to determine if the mutation is clinically significant. This may be achieved by performing the second mode described above in relation to FIG. 1. In this mode, c8 fragment ions observed in the experiments of FIGS. 3A-3C may be selected and isolated. The isolated c8 fragment ion may then be subjected to Collisionally Induced Dissociation (CID) so as to produce sequence ions, as shown in the spectra of FIGS. 5A-5C. The sequence ions may then be used to determine the location of the mutation, and hence whether the mutation is clinically significant or not.

[0189] FIG. 5A shows the spectrum obtained by CID fragmentation of the c8 ion observed in FIG. 3A, i.e. for a normal (AA) blood sample. The b6 ion in this spectrum appears at its expected mass for a non-mutated sample. Referring back to FIG. 4, this indicates that the Glutamic Acid to Valine (E-V) mutation at position 6 in the beta chain has not occurred and that the patient providing this sample does not have sickle cell disease. The y2 and b4 ions in this spectrum also appear at their expected masses for a non-mutated sample. Again referring to FIG. 4, this indicates that the clinically insignificant Threonine to Alanine (T-A) mutation at position 4 in the beta chain has not occurred, and that the clinically insignificant Glutamic Acid to Valine (E-V) mutation at position 7 in the beta chain has not occurred.

[0190] FIG. 5B shows the spectrum obtained by isolating the c8 ions observed at a mass to charge ratio of around 922 in FIG. 3B, and then fragmenting these ions by CID, i.e. fragmenting the mutated c8 ions for the heterozygous (AS) blood sample. The b6 ion in this spectrum is located at a mass 30 Da below its expected mass for a non-mutated sample. Referring back to FIG. 4, this indicates that the Glutamic Acid to Valine (E-V) mutation at position 6 in the beta chain has occurred, indicating that the sample is either homozygous or heterozygous. It may be determined that the sample is a heterozygous sample by determining that both mutated an unmutated beta chains are present (e.g. from the MS spectrum shown in FIG. 2B). Alternatively, or additionally, it may be determined that the sample is a heterozygous sample by determining that c8 fragment ions having a mass to charge ratio of around 952 are generated in the first generation fragment ions (i.e. determining that the non-mutated c8 fragment ions shown in FIG. 3B are generated). Alternatively, or additionally, the sample may be determined to be heterozygous by fragmenting the first generation ions and detecting the presence of product ions generated from the fragmentation of unmutated c8 ions, i.e. from c8 ions at m/z 952. Data is not shown for this, but it would essentially correspond to that shown in FIG. 5A. Alternatively, or additionally, it may be determined that the sample is heterozygous, rather than homozygous, by determining that the mass shift in the b6 ions indicate a mutation and that the intensity of the b6 ion peak is below a threshold value.

[0191] The y2 and b4 ions in the spectrum of FIG. 5B appear at their expected masses for a non-mutated sample, indicating that the clinically insignificant Threonine to Alanine (T-A) mutation at position 4 in the beta chain and the clinically insignificant Glutamic Acid to Valine (E-V) mutation at position 7 in the beta chain have not occurred.

[0192] FIG. 5C shows the spectrum obtained by isolating the c8 ions observed at a mass to charge ratio of around 922 in FIG. 3C, and then fragmenting these ions by CID, i.e. fragmenting the mutated c8 ions for the homozygous (AS) blood sample. The b6 ion in this spectrum is located at a mass 30 Da below its expected mass for a non-mutated sample. Referring back to FIG. 4, this indicates that the Glutamic Acid to Valine (E-V) mutation at position 6 in the beta chain has occurred, indicating that the sample is either homozygous or heterozygous. It may be determined that the sample is a homozygous sample by determining that only the mutated beta chain, and not the unmutated beta chain, is present (e.g. from the MS spectrum shown in FIG. 2C). Alternatively, or additionally, it may be determined that the sample is a homozygous sample by determining that c8 fragment ions having a mass to charge ratio of around 952 are not generated in the first generation fragment ions (i.e. determining that the non-mutated c8 fragment ions shown in FIGS. 3A and 3B are not generated). Alternatively, or additionally, it may be determined that the sample is homozygous, rather than heterozygous, by determining that the mass shift in the b6 ions indicate a mutation and that the intensity of the b6 ion peak is above a threshold value. The y2 and b4 ions in this spectrum appear at their expected masses for a non-mutated sample, indicating that the “non-listed” Threonine to Alanine (T-A) mutation at position 4 in the beta chain and the “non-listed” Glutamic Acid to Valine (E-V) mutation at position 7 in the beta chain have not occurred.

[0193] Accordingly, once a 30 Da mass shift has been detected by the methods used to obtain the spectra in FIGS. 2A-2C or 3A-3C, thus flagging a potential mutation listed as being of clinical interest, the technique of FIGS. 5A-5C may be used to identify the location of the mutation and whether the mutation is actually a mutation of clinical significance.

[0194] Although the present invention has been described with reference to various embodiments, it will be understood by those skilled in the art that various changes in form and detail may be made without departing from the scope of the invention as set forth in the accompanying claims.

[0195] For example, the approach described above may detect haemoglobin variants by detecting the location of a mass shift that is expected to occur if that variant is present. Alternatively, the above-described approach may be applied to detecting other clinically significant variants by detecting the location of a mass shift that is expected to occur if that variant is present. For example, the technique may be used to detect Hb Lepores or, for example, to detect any of the conditions listed below:

TABLE-US-00001 Symptoms Name Mutation (homozygote or heterozygote) Hb S β6 (Glu to Val) Sickle Cell Disease or asymptomatic Hb C β6 (Glu to Lys) Mild anaemia or asymptomatic Hb E β26 (Glu to Lys) Thalassemia minor or mild microcytosis Hb D-Punjab β121 (Glu to Gln) Mild anaemia or asymptomatic Hb O-Arab β121 (Glu to Lys) Mild anaemia or asymptomatic

[0196] Although the embodiments described above relate to detecting variants of haemoglobin, the invention may be used to detect variants of other proteins in blood or other biological samples.