The role of liquid chromatography-tandem mass spectrometry in the clinical laboratory

Novel methodologies in metabolic profiling with a focus on molecular diagnostic applications

The metabolome contains all the biological end points of genomic, transcriptomic and proteomic perturbations, also including the influence of gut microbiota and the environment, giving a direct picture of an organism's ongoing metabolic state. Metabolomics thus has the potential to be an effective tool for early diagnosis of disease, and also to be a predictor of treatment response and survival. In recent years, the development of instrumental systems has enabled more comprehensive coverage of the metabolome. Advances in mass spectrometry and chromatography have particularly improved both the efficiency of nontargeted metabolic profiling as well as the sensitivity and reliability of targeted analyses. Mass spectrometric techniques are also increasingly becoming accepted as a routine diagnostic tool in clinical laboratories. This review summarizes the most recent advances and current challenges in metabolomics, with a focus on mass spectrometric methods utilized in biomarker research, highlighted with selected examples.

Digging deeper into the field of the small cell lung cancer tumor marker ProGRP: a method for differentiation of its isoforms

In this paper, we have used a newly developed immunocapture and LC-MS method to demonstrate for the first time the presence of protein isoforms 1 and 3 of the small cell lung cancer (SCLC) marker progastrin-releasing peptide (ProGRP) in sera. In addition, the method allows for indirect determination of the relative presence of the other known isoform of ProGRP, also known as ProGRP isoform 2. This new method is able to determine total ProGRP as a marker in sera at clinically relevant levels and to differentiate between isoforms at the low-pM level through combining selective sample preparation by immunoextraction, tryptic digestion, and separation followed by detection with LC-SRM-MS of the signature peptides, NLLGLIEAK (total ProGRP), LSAPGSQR (ProGRP isoform 1), and DLVDSLLQVLNVK (ProGRP isoform 3), with accuracies ≤ 25% for lower limit of quantification (LLOQ) and precisions ≤ 33%. By analyzing serum samples from four patients diagnosed with SCLC using the here described new and fully validated method, the ability is shown to both determine total ProGRP concentration and to differentiate between ProGRP isoforms 1 and 3 in one single run. Quantification of various ProGRP isoforms in one single run may be helpful for further understanding of the underlying biochemical processes in SCLC and differentiation of small cell lung cancer.

Quantification of citrulline by parallel fragmentation monitoring--a novel method using graphitized carbon nanoparticles and MALDI-TOF/TOF mass spectrometry

BACKGROUND

Selected reaction monitoring (SRM) is a reliable mass spectrometry (MS)-based technique for quantification of small molecules. However, it is not applicable to matrix-assisted laser desorption/ionization time-of-flight/time-of-flight tandem MS (MALDI-TOF/TOF MS) instruments. This work presents a novel comparable MALDI-TOF/TOF MS technique, "Parallel Fragmentation Monitoring" (PFM), for high-throughput quantification of citrulline.

METHOD

Calibrator/sample solutions were spiked with internal standard that was a stable isotopic analog with 1 mass unit heavier than citrulline. Both citrulline and internal standard were isolated and fragmented in parallel by MALDI-TOF/TOF MS in the presence of graphitized carbon nanoparticles as matrix. The ratio of the peak intensities of the selected fragment of citrulline to that of internal standard was used to calibrate/calculate the concentrations of citrulline in samples.

RESULTS

Linear calibration curves were obtained in the range of 10-250 μmol/l citrulline with correlation coefficients ≥0.997. Stored calibration curve and batch-specific calibration curve produced highly similar measurement values. Within- and between-day CVs were 3.1-8.7% and 3.5-10.6%, respectively, illustrating the reliability and robustness of PFM.

CONCLUSION

Using citrulline for proof-of-concept, we have developed the PFM technique with tremendous potential for high-throughput quantification of amino acids and other small molecules.

Challenges in the development of bioanalytical liquid chromatography-mass spectrometry method with emphasis on fast analysis

The development of bioanalytical methods has become more and more challenging over the past years due to very demanding requirements in terms of method reliability, sensitivity, speed of analysis and sample throughput. LC-MS/MS has established itself as a method of choice for routine analysis of biological materials. A development of such method consists of several steps including sample preparation and clean-up step, efficient chromatographic separation, sensitive and selective detection of analytes in complex matrices, a choice of convenient data processing and calibration approach and finally method validation. Each of these steps has its own constraints and challenges, which are discussed in detail in this review. Novel and modern approaches in sample preparation, chromatography and detection are especially emphasized. Attention is paid to proper calibration approach and matrix effects that can seriously affect method accuracy and precision.

SPE–MS analysis of absorption, distribution, metabolism and excretion assays: a tool to increase throughput and steamline workflow

In an effort to create faster and more efficient bioanalytical methods for drug development, many investigators have evaluated a variety of SPE–MS systems. Over the past 15 years online systems have evolved from run times of >1.5 min/sample to <10 s/sample. High-throughput SPE–MS methods for in vitro absorption, distribution, metabolism and excretion screening assays have been described by several laboratories and shown to produce results comparable to conventional LC–MS/MS systems. While quantitative analysis of small molecules in biological matrixes holds many challenges, for several applications SPE–MS methods have achieved comparable results to LC–MS/MS with the benefit of 10–30-times the throughput. Based on its distinct advantages of throughput and streamlined workflow efficiencies, SPE–MS is a useful tool for the analysis of many in vitro absorption, distribution, metabolism and excretion assays and in vivo bioanalytical studies. Further development of SPE–MS methods and analysis workflows has the potential to expand the capabilities of this technology for other challenging bioanalytical applications.

Sample preparation for measurement of plasma mycophenolic acid concentrations using chromatographically functionalized magnetic micro-particles

Utilizing chromatographically modified magnetic micro-particles is an innovative principle of sample preparation for quantitative analysis of small molecules in complex biomedical samples by liquid chromatography tandem mass spectrometry. Since no vacuum or pressure has to be applied-in contrast to cartridge based solid phase extraction protocols-the principle's main characteristics are potentially straightforward automation and a high extraction performance (in terms of µg of extraction material per µL of sample). Following first descriptions of the approach, this article reports, the validation of a magnetic particle-based, analytical method for the quantification of the immunosuppressant mycophenolic acid in plasma. This sample preparation technology has shown a good performance for this clinically relevant analyte. As a result, we conclude that further work towards the implementation of this technology in a multi- analyte approach on robotic systems, aiming towards a fully automated process, is justified.