The analysis of dried blood spot samples using liquid chromatography tandem mass spectrometry

Assays using dried blood samples have been in use for a number of years particularly for the diagnosis of inborn errors of metabolism. This sampling technique has been greatly helped by the sensitivity and specificity offered by liquid chromatography tandem mass spectrometry because of the limited amount of sample available for analysis. There are advantages for patients to take samples at home but these must be weighed against potential problems with the sampling technique. Some assays appear to work very well whilst others suffer from poor recovery because of adsorption of the analyte onto the filter paper. Some newer strategies including impregnation of the filter paper and filter filtration will be discussed. Calibration of assays and the problems with matrix matching of standards are also important issues that need to be addressed before an assay can be used routinely.     

Nontargeted SWATH acquisition mode for metabolites identification of osthole in rats using ultra-high-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry

Osthole (OST), 7-methoxy-8-isopentenoxycoumarin, is the characteristic constituent found in Cnidium monnieri (L.) Cuss. and possesses excellent pharmacological activities, including anticancer, anti-apoptosis and neuroprotection. In this study, a rapid and reliable method based on ultra-high-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS) and MetabolitePilot2.0™ software with principal component variable grouping (PCVG) filtering was developed to observe probable metabolites of OST firstly. The high resolution mass data were acquired by data-independent acquisition mode (DIA), i.e., sequential window acquisition of all theoretical fragmentation spectra (SWATH), which could significantly improved the hit rate of low-level and trace metabolites. A novel data processing method ‘key product ions (KPIs)’ were employed for metabolites rapid hunting and identification as an assistant tool. A total of 72 metabolites of OST were detected in vitro and in vivo, including 39 metabolites in rat liver microsomes (RLMs), 20 metabolites in plasma, 32 metabolites in bile, 32 metabolites in urine and 37 metabolites in feces. The results showed that mono-oxidation, demethylation, dehydrogenation, sulfate conjugation and glucuronide conjugation were major metabolic reactions of OST. More significant, oxydrolysis, 3,4-epoxide-aldehylation, phosphorylation, S-cysteine conjugation and N-acetylcysteine conjugation were considered as unique metabolic pathways of OST, and phosphorylation, S-cysteine conjugation and N-acetylcysteine conjugation reactions were characterized in rat biological samples for the first time. Preparation of active metabolites will be greatly helpful in elucidating the potential biological mechanism of OST, and the proposed metabolic pathways of it might provide further understanding of the safety and efficacy of simple coumarins.

Osthole (OST), 7-methoxy-8-isopentenoxycoumarin, is the characteristic constituent found in Cnidium monnieri (L.) Cuss. and possesses excellent pharmacological activities, including anticancer, anti-apoptosis and neuroprotection.     

液相色谱串联质谱在检验医学中的应用

尽管色谱和质谱技术已经成为生物医学中的重要技术,但是其在临床实验室中的应用仍然比较少,一般只在少数专业实验室中进行。这是因为与现在普遍应用的临床化学和免疫学分析方法相比,这些技术要求非常熟练的操作,而且经常会出现复杂的故障。随着液相色谱串联质谱(liquid chromatography-tandem mass spectrometry,LC-TMS)技术的出现,该技术在临床检验医学工作中的应用不断扩展。1液相色谱—质谱(liquid chrematography-mass spectrometry,LC-MS)70年代后期及80年代早期HPLC技术的发展,推动了质谱技术的发展。然而,LC-MS的临床应用仍然…     

Measurement of serum testosterone using high-performance liquid chromatography/tandem mass spectrometry.

Low levels of serum testosterone typically found in women and children cannot be reliably measured by immunoassay. We developed a simple and sensitive method using high-performance liquid chromatography/tandem mass spectrometry (HPLC-MS/MS). Sample preparation involved protein precipitation of serum (1.0 mL) with acetonitrile containing the internal standard (testosterone-d3) followed by liquid extraction with methylene chloride. The chromatographic cycle per specimen was 10 min. The performance was evaluated according to the CLSI EP10-A2 protocol. Within- and between-run imprecision was 20.9%, 2.29% and 1.80%, and 1.81%, 3.58% and 2.97% at mean concentrations of 0.17, 14.1 and 28.8 nM, respectively, with no apparent carryover. The method was linear from 0.21 to 53.1 nM and the analytical recovery was 100.5-106.2% across the concentrations tested. There was no interference observed from other steroids that were tested. Correlation using de-identified patient specimens with a commercial HPLC-MS/MS method showed a slope of 0.991, an intercept of -0.017 and a correlation coefficient (R(2)) of 0.998 by linear regression over concentrations ranging from 0.21 to 16.7 nM. In conclusion, we report here an HPLC-MS/MS method suitable for clinical measurement of serum testosterone.     

液相色谱串联质谱法对原发性醛固酮增多症的诊断价值

目的： 探讨液相色谱串联质谱（LC-MS/MS）检测方法中的卡托普利试验（captopril test，CCT）和生理盐水输注试验（saline infusion test，SIT）对原发性醛固酮增多症（primary aldosteronism，PA）的诊断价值。方法： 选取2018年2月至2019年2月复旦大学附属中山医院内分泌科收治的高血压患者127例，其中111例患者行CCT试验，101例患者行SIT试验。通过LC-MS/MS方法检测患者试验前后血浆醛固酮浓度（PAC）、肾素活性及醛固酮/肾素活性比值（aldosterone/renin ratio，ARR）水平。以手术或螺内酯试验为诊断金标准，采用CCT和SIT的ROC曲线探讨2种试验的诊断指标和最佳诊断截断值。结果： PA患者57例，原发性高血压患者70例。CCT后醛固酮、ARR及醛固酮抑制率的AUC分别为0.876、0.902和0.751；ARR为6.5时，诊断PA的灵敏度为94.2%，特异度为78%；PAC为34.8 pg/mL时，诊断PA的灵敏度为75.5%，特异度为93.2%。SIT后醛固酮、ARR及醛固酮抑制率的AUC分别为0.881、0.823和0.652；PAC为24 pg/mL时，诊断PA的灵敏度为87.2%，特异度为78.8%。结论： CCT后ARR和PAC均可作为PA的诊断指标，诊断截断值为6.5和34.8 pg/mL；SIT试验后PAC为PA诊断指标，诊断截断值为24 pg/mL。     

Determination of L-pipecolic acid in plasma using chiral liquid chromatography-electrospray tandem mass spectrometry.

BACKGROUND: L-pipecolic acid (L-PA), an important biochemical marker for the diagnosis of peroxisomal disorders, is usually determined as the racemate. We developed a chiral liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the analysis of L-PA in plasma. METHODS: We used a narrow bore chiral macrocyclic glycopeptide teicoplanin column for the enantioseparation of D-pipecolic acid (D-PA) and L-PA and interfaced the column directly to the electrospray source of a tandem mass spectrometer. We used phenylalanine-d5 as internal standard added to 50 microL of plasma followed by deproteinization, evaporation, and injection. The analysis was performed in the selected-reaction monitoring mode using two transitions: m/z 130-->m/z 84 for PA, and m/z 171-->m/z 125 for phenylalanine-d5. L-PA eluted at 7 min, and D-PA eluted at 11.7 min, whereas phenylalanine-d5 eluted at 6 min. The turnaround time for the assay was 20 min. RESULTS: Linear calibration curves were obtained in the range of 0.5-80 micromol/L. At a plasma concentration of 1.0 micromol/L, the signal-to-noise ratio was 50:1. The intra- and interassay variations were 3.1-7.9% and 5.7-13%, respectively, at concentrations of 1-50 micromol/L. Mean recoveries of L-PA added to plasma were 95% (5 micromol/L) and 102% (50 micromol/L). The method clearly distinguished between healthy individuals and peroxisomal disease patients. CONCLUSIONS: The novel LC-MS/MS method is simple, rapid, and stereoselective, and uses only 50 microL of plasma, no derivatizing reagents, and a commercially available internal standard. Sample preparation is not complex and is faster than for all other methods.     

Flow injection analysis vs. ultra high performance liquid chromatography coupled with tandem mass spectrometry for determination of imatinib in human plasma

BackgroundThe aim of this study was to develop, validate and compare flow injection analysis (FIA) and ultra-high-performance liquid chromatography (LC)/tandem mass spectrometry methods for the determination of imatinib in plasma from patients with chronic myeloid leukemia.MethodsThe plasma for analysis by both methods was deproteinated by methanol containing d8-imatinib. The separation was achieved on a 1.7 μm C18 column with a linear gradient (4 mM ammonium formiate and acetonitrile, pH 3.2). FIA was performed at flow rate of 0.03 mL/min (0.1% formic acid in methanol). Multiple reaction monitoring mode on the tandem mass spectrometer (API 4000, AB Sciex) in positive ESI were used for detection.ResultsThe total analysis times were 3.2 (LC) and 0.75 min (FIA). Both methods were successfully validated and applied to the plasma patients samples. The limits of quantification were 4.1 and 30.8 ng/mL; imprecisions were less than 5.7% and recovery ranged between 93 and 105%, for the LC and FIA, respectively. The methods revealed an agreement with a mean difference of 1.46 ng/mL (SD 28.95 ng/mL).ConclusionsThe high-throughput methods that were developed are suitable for the therapeutic drug monitoring of imatinib in plasma. They can be used in routine clinical practice.     

A robust liquid chromatography tandem mass spectrometry method for total plasma homocysteine determination in clinical practice.

BACKGROUND: Total plasma homocysteine has emerged as an independent risk factor for vascular disease. To meet increasing requests by clinicians for this homocysteine determination, a rapid assay for a routine use has been developed. METHODS: A robust, stable, isotope-dilution liquid chromatography tandem mass spectrometry (LC/MS/MS) method is described, including all the practical details and analytical performance results. RESULTS: The method allows homocysteine quantitation over a linear working range up to 100 micromol/L, with the limit of quantification estimated at a low value of 0.09 micromol/L. Total analytical imprecision is less than 4%. Accuracy was assessed by measuring the homocysteine concentration in a serum Standard Reference Material. CONCLUSIONS: The method was demonstrated to be quick, reliable and cheap after 1 year of use on a time-shared instrument in our hospital unit.     

同位素稀释液相色谱串联质谱法测定血清可替宁

目的 建立一种同位素稀释液相色谱串联质谱(ID-LC/MS/MS)测定血清可替宁的方法,以评价不同吸烟状况健康人的吸烟暴露水平分布状况.方法 以[D3]-可替宁作内标,乙腈沉淀蛋白、离心后吸取上清液、氮气挥干、流动相重组,液相分离后进人串联质谱分析;然后,采用多离子反应监测模式,以标准品制作标准曲线,结合同位素内标法定量建立同位素稀释液相色谱串联质谱法.用以对0 68、48.42、94.34、250.95、287.04 μg/L 5个水平血清样本进行5次重复分析,每次每种血清重复分析3份,以考察方法的精密度;同时测定与评价血清样本添加不同浓度标准品的加样回收率和样本在常温、4℃、-80℃保存的稳定性,以及2010年10月至12月期间94名健康志愿者在不同吸烟状况下的血清可替宁分布情况.并用Mann-Whitney U检验分析60名非吸烟、14名戒烟与20名吸烟健康志愿者血清可替宁含量的差异.结果 用ID-LC/MS/MS检测血清可替宁在本试验条件下分离良好,无内源性物质的干扰,具有较好的特异性;血清可替宁、内标峰面积比与可替宁浓度的线性相关系数≥0.9993;测定5个水平血清样本的总变异系数(CV)分别为4.71％、1.40％、1.98％、1.10％和1.03％;批内CV分别为2.19％、0.78％、0.75％、0.65％和0.67％,ID-LC/MS/MS的检测限(LOD)和定量限(LOQ)分别为0.013和0.050 μg/L,具有较高的灵敏度;3次试验的加样回收率范围为99.22％ ～ 102.67％;样本在常温条件下放置2d、4 ℃放置7d以及-80℃冻存保存3个月测定结果的准确度为99.28％～ 100.87％,批间CV均＜5％.检测94名健康人血清可替宁水平呈偏态和尖态分布(偏度2.71,峰度6.65),其中,20名吸烟者的可替宁浓度为116.40 (63.17 ～241.12) μg/L,14名已成烟者为0.67 (0.15～0.95) μg/L,60名非吸烟者为0.22 (0.15 ～0.42) μg/L;已戒烟者(Z=-2.12,P＜0.05)和吸烟者(Z=-6.67,P＜0.001)血清可替宁浓度分别显著高于非吸烟者.结论 建立的ID-LC/MS/MS测定血清可替宁方法操作简便、特异、灵敏,可望在吸烟暴露水平评价及暴露与疾病发生危险的研究中提供有效技术平台.     

同位素稀释液相色谱串联质谱法测定血清葡萄糖

目的 建立一种使用同位素稀释液相色谱串联质谱法(ID-LC/MS/MS)测定血清葡萄糖的候选参考方法.方法 以[~(13)C_6]葡萄糖为内标,用重量法准确地与血清混合,除去蛋白后在碱性条件下与1-苯基-3-甲基-5-吡唑酮反应,用LC/MS/MS测定葡萄糖和内标衍生产物,以包括法定量.结果 血清葡萄糖测定的批内、批间和总变异系数的平均值分别为0.36%(范围0.28%-0.42%)、0.47%(范围0.20%-0.67%)和0.61%(范围0.42%-0.76%).加样回收试验的回收率范围为99.0%-100.9%.分析参考物质SRM 965a,测定结果与认定值的平均偏差为-0.20%(范围-0.39%-+0.11%).结论 建立了ID-LC/MS/MS法测定血清葡萄糖的方法,方法准确、精密、简便,可望作为血清葡萄糖测定的参考方法.     

同位素稀释液相色谱串联质谱法测定血清睾酮

目的建立一种用同位素稀释液相色谱串联质谱法(ID-LC/MS/MS)测定血清睾酮的候选参考方法。方法以[16,17,17-d3]睾酮为内标,用重量法准确地与血清混合,用乙酸乙酯-正己烷混合溶剂提取,以羟丙基-β-环糊精水溶液对提取液作净化处理,用液相色谱串联质谱分析,质谱选择离子监测模式检测睾酮与内标的特定碎片离子,用包括法定量。结果血清睾酮测定的批内、批间和总变异系数(CV)的均值(范围)为0.84%(0.22%~2.00%)、1.01%(0.48%~2.37%)和1.37%(0.53%~3.09%)。参考物质ERM DA-345a和NIST SRM 971测定结果与认定值的平均偏差范围为-2.0%~+1.8%。结论用ID-LC/MS/MS建立了血清睾酮的测定方法,方法准确、精密、简便,有望作为血清睾酮测定的参考方法。     

Identification of the cytochrome P450 enzymes involved in the oxidative metabolism of trantinterol using ultra high-performance liquid chromatography coupled with tandem mass spectrometry

Trantinterol is a novel β₂-adrenoceptor agonist used for the treatment of asthma. This study aimed to identify the cytochrome P450 enzymes responsible for the metabolism of trantinterol to form 4-hydroxylamine trantinterol (M1) and tert-butyl hydroxylated trantinterol (M2), which was achieved using the chemical inhibition study, followed by the metabolism study of trantinterol in a panel of recombinant CYPs, as well as the kinetic study with the appropriate cDNA-expressed P450 enzymes. A highly selective and sensitive ultra high-performance liquid chromatography tandem mass spectrometry method was developed and validated for the simultaneous determination of M1 and M2. The inhibition study suggested that CYP2C19 and CYP3A4/5 were involved in the formation of M1 and M2, and CYP2D6 only contributed to the formation of M1. Assays with cDNA-expressed CYP enzymes further showed that the relative contributions of P450 isoforms were 2C19 > 3A4 > 2D6 > 2E1 for the formation of M1, and 3A4 > 2C19 > 2D6 for the formation of M2. The enzyme kinetic analysis was then performed in CYP2C19, CYP2D6 and CYP3A4. The kinetic parameters were determined and normalized with respect to the human hepatic microsomal P450 isoform concentrations. All the results support the conclusion that CYP3A4 and CYP2C19 are the major enzymes responsible for formation of M1 and M2, while CYP2D6 and CYP2E1 also engaged to a lesser degree. The results imply that potential drug–drug interactions may be noticed when trantinterol is used with CYP2C19 and CYP3A4 inducers or inhibitors, and we should pay attention to this phenomenon in clinical study.

The first report on the characterization of the main CYP450 enzymes and the kinetic study involved in trantinterol metabolism.     

Diagnostic screening for spermine synthase deficiency by liquid chromatography tandem mass spectrometry

BackgroundSnyder–Robinson syndrome is an X-linked genetic disorder characterized by intellectual disability, facial asymmetry, thickened lower lip, long hands with hyper extendable fingers, slow speech, and hyposcoliosis. The disorder is caused by a mutation in the spermine synthase (SMS) gene. The SMS gene encodes an enzyme involved in polyamine metabolism. Specifically, individuals with Snyder–Robinson have lack or have diminished capability to covert spermidine to spermine.MethodsWe developed a liquid chromatography tandem mass spectrometry (LC–MS/MS) based screen for Snyder–Robinson syndrome.ResultsSince individuals with Snyder–Robinson syndrome have diminished capacity to convert spermidine to spermine, we utilize this characteristic as a screening metric. Spermine to spermidine ratios were measured by LC–MS/MS in both normal controls and individuals with Snyder–Robinson syndrome. Polyamine ratios in subjects with Snyder–Robinson syndrome (n = 20) were significantly different from controls (n = 11) and carriers (n = 5), with p values of 0.0001 and 0.0075, respectively.ConclusionsWe developed an effective LC–MS/MS diagnostic test for Snyder–Robinson syndrome.     

Discovery of potential therapeutic targets for non-small cell lung cancer using high-throughput metabolomics analysis based on liquid chromatography coupled with tandem mass spectrometry

Lung cancer is a severe health problem and threatens a patient''s quality of life. The metabolites present in biological systems are expected to be key mediators and the changes in these metabolites play an important role in promoting health. Metabolomics can unravel the global metabolic changes and identify significant biological pathways involved in disease development. However, the role of metabolites in lung cancer is still largely unknown. In the present study, we developed a liquid chromatography coupled with tandem mass spectrometry method for biomarker discovery and identification of non-small cell lung cancer (NSCLC) from metabolomics data sets and aimed to investigate the metabolic profiles of NSCLC samples to identify potential disease biomarkers and to reveal the pathological mechanism. After cell metabolite extraction, the metabolic changes in NSCLC cells were characterized and targeted metabolite analysis was adopted to offer a novel opportunity to probe into the relationship between differentially regulated cell metabolites and NSCLC. Quantitative analysis of key enzymes in the disturbed pathways by proteomics was employed to verify metabolomic pathway changes. A total of 13 specific biomarkers were identified in NSCLC cells related with metabolic disturbance of NSCLC morbidity, which were involved in 4 vital pathways, namely glycine, serine and threonine metabolism, aminoacyl-tRNA biosynthesis, tyrosine metabolism and sphingolipid metabolism. The proteomics analysis illustrated the obvious fluctuation of the expression of the key enzymes in these pathways, including the downregulation of 3-phosphoglycerate dehydrogenase, phosphoserine phosphatase, tyrosinase and argininosuccinic acid catenase. NSCLC occurrence is mainly related to amino acid and fatty acid metabolic alteration. These findings highlight that the metabolome can provide information on the molecular profiles of cells, which can aid in investigating the metabolite changes to reveal the pathological mechanism.

High-throughput metabolomics can discover potential therapeutic targets for non-small cell lung cancer.     

同位素稀释液相色谱串联质谱法测定血清总甘油

目的 建立同位素稀释液相色谱串联质谱测定血清总甘油的方法.方法 以[13C3]-甘油作内标,用氢氧化钾异丙醇溶液水解血清甘油酯为游离甘油,将游离甘油转化为苯甲酸酯,用同位素稀释液相色谱串联质谱(LC/MS/MS)分离检测,用标准曲线法定量.结果 甘油/内标峰面积比与甘油浓度(0.565～4.517 mmol/L)线性相关系数大于0.999 9;测定不同浓度血清总甘油批内变异系数(CV)平均为0.52%(范围0.21%～2.62%),总CV平均为1.15%(范围0.62%～2.00%);分析国际和国家标准物质,测定值与认证值的偏倚小于1%(-0.20%～1.06%).结论 建立同位素稀释液相色谱串联质谱测定血清总甘油方法,方法特异、精密、准确,可望用作血清总甘油测定参考方法.