A liquid chromatography tandem mass spectrometry assay for plasma renin activity using online solid-phase extraction

Background

The plasma renin activity (PRA) assay measures the ability of renin to generate angiotensin I (AngI) from angiotensinogen. It is used to monitor mineralocorticoid therapy and to screen hypertensive individuals for primary aldosteronism (PA).

Methods

Samples were incubated in the presence of protease inhibitors for 6.5 and 24 h. The reaction was stopped by the addition of 2% ammonium hydroxide. AngI was then quantified by liquid chromatography tandem mass spectrometry using online solid-phase extraction (XLC-MS/MS).

Results

This method requires a sample volume of 50 μL and has an inter-assay precision <14% across the working range. A 6.5-h incubation gave a lower limit of quantification (LLOQ) of 0.3 nmol/L/h and this can be reduced to 0.08 nmol/L/h using a 24-h incubation. Comparison to a radioimmunoassay revealed excellent correlation ( r2 = 0.98), but a 37% negative bias. We also found that renin is stable in whole blood for up to 24 h at room temperature. In contrast, storage at 4°C should be avoided as prorenin cryoactivation can affect the PRA result in some patient groups.

Conclusions

We have developed and fully validated a semi-automated XLC-MS/MS method for the measurement of PRA. In addition, a reference range specific to this assay has been defined. We have also demonstrated that renin is stable for up to 24 h at room temperature. This will enable this assay to be extended to samples taken in primary care, potentially increasing the number of hypertensive patients who can be screened for PA.

A cleaner river: long term use of semipermeable membrane devices demonstrate that concentrations of selected organochlorines and PAHs in the Brisbane River estuary, Queensland have reduced substantially over the past decade

We first used semipermeable membrane devices as samplers to evaluate concentrations of organochlorines and PAHs in the Brisbane River in 1998. Here we revisit this work and repeat the study a decade later in the same season (summer), also taking account of results from a similar study involving PAHs in the summer of 2001-2002. The accumulation of organochlorines and most PAHs in the samplers in the recent assessment was substantially less than in the 1998 deployment, suggesting that the ambient concentrations of these chemicals have decreased considerably over the last decade. In all cases there was high reproducibility of the mass of chemicals accumulated in the sampler. We used performance reference compounds in the later deployment, and assuming that the kinetics were similar in both deployment periods, we estimate that the concentration of dieldrin, the organochlorine found at highest concentrations, decreased from approximately 3.9 ng/L to about 1.4 ng/L. The decrease of most other analytes of interest including DDE and DDD was greater, potentially indicating that dieldrin is still entering the Brisbane River through run-off from urban areas where it was used widely for treatment of termites until 1995. DDT use in Australia ceased in the mid 1980s.

Molecular cytogenetic analysis of cervical squamous cell carcinoma cells demonstrates discordant levels of numerical and structural chromosomal instability and identifies 'selected' chromosome rearrangements

The processes underlying the karyotype complexity and heterogeneity characteristic of cervical squamous cell carcinoma (SCC) cells are not well understood, nor is it known which chromosome abnormalities provide a selective advantage. We used molecular cytogenetics to quantify for the first time the prevalence of all chromosomal abnormalities detectable in 8 cervical SCC cell lines. Of 225 rearrangements identified, 118 occurred frequently (> or =70% metaphases) in one or more lines, indicating selection. Most of these selected rearrangements (107; 48% of the total) were included in published lists of abnormalities detected in independent cell stocks (although their significance was not previously recognised), indicating that they arose early in the establishment of the lines and were therefore most likely to have been present in the original tumours. The 8 cell lines showed 4.7- and 11.0-fold variation in levels of numerical and structural chromosomal instability (N-CIN and S-CIN) respectively, as determined by quantifying non-clonal abnormalities. We observed discordance between N-CIN and S-CIN (p = 0.148), with modal chromosome number showing a strong association with N-CIN (p = 0.007) but not with S-CIN (p = 0.602). These data imply that different mechanisms underlie N-CIN and S-CIN in cervical SCC. Despite ongoing S-CIN, newly arisen in vitro rearrangements were infrequently selected, supporting the view that selection is an important determinant of somatic evolution in malignancy. There was a positive association between numbers of non-clonal and clonal rearrangements (p = 0.002 for non-clonal vs. selected rearrangements), suggesting that factors affecting S-CIN determine the total numbers of rearrangements present in established cervical SCC cells.

Recumbent Exercise Bicycle for Low-Impact Rehabilitation of Obese Individuals

It is often difficult for persons who are extremely overweight to find exercise systems that are accessible and safe to use. Seating is required to handle heavier loads of up to 500 lbs. and provide safe access to the exercise unit. Additionally, the exercise should not cause additional pain or possible damage if the person needs to suddenly stop. A multidisciplinary team of undergraduate engineers participated in a training course to interview a non-technical customer to determine design requirements and then underwent a rigorous design process to implement the best solution. Mechanical analysis was performed to determine the best solution for the concept, materials, and resistance. An exercise machine with a rotating chair was selected as the best solution. The chair rotates 90 degrees so that the user can sit down without having to step onto the machine. Once the user sits, the chair can then rotate 90 degrees until the chair is in the exercise position; in either position the chair locks into position for stability. This particular concept uses a bicyle exercise. This exercise minimizes impact on the knees, which is a safety issue for patients with knee problems. A sitting position for this exercise eliminates the stability issue raised with a standing exercise, where there is worry of falling. This exercise is beneficial for cardiovascular exercise. Resistance is implemented using a magnet. Fluid resistance and fly-wheel resistance would create too much momentum which was not desired by the customer. Electrical analysis was performed to determine the best method to sense heart rate, speed, and computer interface. Wired handles were selected to monitor the heart rate. These are hand held and are much easier to use than a chest strap. An optical sensor was used to sense speed. It was placed near the center of the wheel and rotations were indicated by a tab to break the connection in the sensor. This method was selected over a Hall effect sensor because it is a much simpler sensing method that does not require an addition magnetic component that is not too accurate a low speeds. The computer interface was a Motorola HC12s since it had the necessary I/O interfaces and was low cost. A custom interface was created with seven segment displays to show the heart rate and time of exercise. The system was then developed, tested, and delivered to the customer for use. This project was supported by Grant No. 0607883 from the National Science Foundation.

Persistence of improvement in insulin sensitivity following a dietary weight loss programme

AIM

Short-term dietary weight loss can improve insulin resistance but long-term studies are lacking. We sought to quantify the degree to which maintenance of weight loss after a short-term dietary intervention was associated with persistent metabolic benefits.

METHODS

Fifty-seven insulin-resistant obese subjects had insulin-mediated glucose disposal quantified through the steady-state plasma glucose (SSPG) test, and associated metabolic risk markers quantified at baseline, after a 16-week dietary weight loss intervention, and in 25 subjects, at follow-up of 28.8 +/- 13 months. Changes in metabolic variables over time were analysed and correlation with weight loss ascertained. Those with greatest vs. least long-term SSPG response (responders vs. non-responders) were compared. Multivariate analysis was performed for predictors of persistent SSPG response.

RESULTS

At follow-up, the 25 subjects who returned for metabolic testing had, on average, maintained their weight loss. Insulin-mediated glucose disposal remained significantly improved vs. baseline, as did plasma triglyceride and HDL cholesterol (HDL-C) concentrations, and improvement correlated with total amount of weight lost. Comparison of SSPG responders to non-responders showed no difference in amount of weight lost and SSPG change during the 16-week dietary intervention; however, SSPG non-responders regained 2.6% of weight lost, whereas responders lost an additional 1.5% at follow-up (p < 0.05 vs. non-responders). Non-responders had baseline characteristics consistent with more severe insulin resistance, including higher fasting plasma glucose (p = 0.03). Long-term SSPG change was independently predicted by both total weight loss (p = 0.005) and baseline fasting plasma glucose (p = 0.007).

CONCLUSIONS

Improvement in insulin sensitivity is maintained for 2-3 years following dietary weight loss if weight is not regained. Triglyceride and HDL-C concentrations also remain improved over time, consistent with improvement in insulin sensitivity. Fasting glucose and weight regain predict less long-term response in insulin sensitivity. These results highlight the potential long-term benefits of weight loss and importance of preventing weight regain among high-risk individuals.