1
|
Yu KW, Li BL, Yuan YS, Liao JM, Li WK, Dong H, Ke PF, Jin X, Chen L, Zhao JJ, Wang H, Cao SW, Chen WY, Huang XZ, Zhao BB, Kang CM. A modified LC-MS/MS method for the detection of whole blood tacrolimus and its clinical value in Chinese kidney transplant patients. Heliyon 2022; 8:e10214. [PMID: 36042743 PMCID: PMC9420483 DOI: 10.1016/j.heliyon.2022.e10214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/12/2022] [Accepted: 08/03/2022] [Indexed: 11/26/2022] Open
Abstract
Background For patients who treated with tacrolimus after kidney transplant, therapeutic drug monitoring is essential to improve their prognosis. However, previous detection methods have limitations, such as the overestimation and unacceptable bias in the immunoassays. Precision medicine has been challenged. The liquid chromatography-tandem mass spectrometry (LC-MS/MS) method is recognized as the gold standard due to its accuracy and specificity, but lack of throughput and complex process limits its clinical application. Therefore, an accurate, simple and high throughput method for tacrolimus monitoring is needed for clinical practice. Methods A modified LC-MS/MS method was introduced and validated. Whole blood samples were prepared by a one-step protein precipitation method. Chromatographic separation was achieved using a Phenomenex Kinetex 2.6 μm XB-C18 2.1 × 50 mm column with a total run time of 3.5 min to avoid matrix effect. An electrospray ionization source (ESI) was used in positive ion multiple reaction monitoring (MRM) mode for mass spectrometric detection. In order to protect the mass spectrometer, only part of the sample after LC separation was allowed to enter the mass spectrum, through a two HPLC systems coupled one mass spectrometry design. In this way, the instrument throughput is also improved and realizing the detection of 2 samples within 3.5 min and carried out a shorter analyzing time for each sample of 1.75 min. Additionally, we calculated tacrolimus-intrapatient variant (Tac-IPV) based on this modified method and assessed the prognostic value of Tac-IPV in Chinese kidney transplant patients. Results The LC-MS/MS was modified by streamlining the procedure and increasing the throughput. The method proved to be accurate and reproducible with all performance parameters suitably meeting the clinical requirements over a calibration ranged from 0.37 to 42.90 ng/mL. Parameters such as linearity, limit of quantification (LoQ) and dilution integrity were validated with a clinical reportable range from 0.37 to 343.20 ng/mL, which was particularly useful for high drug concentrations patients (rare but very serious). Both cross-contamination and matrix effects were negligible. Clinical data of 83 patients showed that Tac-IPV was associated with poor kidney transplant outcome in Chinese (Hazard Ratio (HR) = 3.96, 4.75; 95% Cl: 1.10–14.21, 1.23–18.36; P < 0.05). Conclusions This modified LC-MS/MS method possessed high throughput and simple sample preparation, allowing it to meet daily clinical needs. At the same time, Tac-IPV based on this modified LC-MS/MS had excellent prognostic value in kidney transplantation. These advantages have great significance for the individualized treatment of Chinese kidney transplant patients and broad application of Tac-IPV.
Collapse
Affiliation(s)
- Ke-Wei Yu
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China
| | - Bing-Ling Li
- Guangzhou KingMed Center for Clinical Laboratory Co., Ltd., KingMed College of Laboratory Medical of Guangzhou Medical University, Guangzhou, Guangdong 510120, China
| | - Ying-Shi Yuan
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China
| | - Jia-Min Liao
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China
| | - Wei-Kang Li
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China
| | - Heng Dong
- Guangzhou KingMed Center for Clinical Laboratory Co., Ltd., KingMed College of Laboratory Medical of Guangzhou Medical University, Guangzhou, Guangdong 510120, China
| | - Pei-Feng Ke
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China
| | - Xing Jin
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China
| | - Lu Chen
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China
| | - Jing-Jing Zhao
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Heng Wang
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China
| | - Shun-Wang Cao
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China
| | - Wei-Ye Chen
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China
| | - Xian-Zhang Huang
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China.,Department of Laboratory Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, China
| | - Bei-Bei Zhao
- Guangzhou KingMed Center for Clinical Laboratory Co., Ltd., KingMed College of Laboratory Medical of Guangzhou Medical University, Guangzhou, Guangdong 510120, China
| | - Chun-Min Kang
- Department of Laboratory Medicine, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, China.,Department of Laboratory Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, China
| |
Collapse
|
2
|
Shiraiwa K, Suzuki Y, Tanaka K, Kawano M, Iwasaki T, Matsumoto A, Tanaka R, Tatsuta R, Tsumura H, Itoh H. Development of a High-Throughput Quantification Method for Pazopanib Using Ultra-Performance Liquid Chromatography-Tandem Mass Spectrometry and Its Clinical Application in Patients With Soft Tissue Tumors. Ther Drug Monit 2021; 43:416-421. [PMID: 33009287 DOI: 10.1097/ftd.0000000000000821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 08/03/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pazopanib is widely used to treat renal cell carcinomas and soft tissue tumors in Japan. Pazopanib has significant therapeutic efficacy but it is associated with frequent severe adverse effects. Therapeutic drug monitoring (TDM) may help to prevent adverse effects. A more convenient and rapid pazopanib assay is desirable for the application of TDM in clinical settings. In this study, the authors developed a high-throughput method for quantifying pazopanib in human plasma using ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). METHODS After a simple solid-phase extraction step using a 96-well plate, pazopanib was analyzed by UHPLC-MS/MS in the positive electrospray ionization mode. RESULTS The novel method fulfilled the requirements of the US Food and Drug Administration and the European Medicines Agency guidelines for assay validation, and the lower limit of quantification was 0.5 mcg/mL. The calibration curves were linear over the concentration range of 0.5-100 mcg/mL. The average recovery rate was 102.0% ± 3.9% (mean ± SD). The precision was below 5.0%, and the accuracy was within 12.0% for all quality control levels. Matrix effect varied between 90.9% and 97.1%. This assay was successfully applied to TDM of pazopanib trough concentrations in 3 patients treated with the drug for soft tissue tumors. CONCLUSIONS The authors succeeded in developing a novel high-throughput UHPLC-MS/MS method for quantifying pazopanib in human plasma. This method can be applied to TDM of patients receiving pazopanib in clinical settings.
Collapse
Affiliation(s)
- Ken Shiraiwa
- Department of Clinical Pharmacy, Oita University Hospital, Yufu-shi, Oita, Japan; and
| | - Yosuke Suzuki
- Department of Clinical Pharmacy, Oita University Hospital, Yufu-shi, Oita, Japan; and
| | - Kazuhiro Tanaka
- Department of Orthopaedic Surgery, Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
| | - Masanori Kawano
- Department of Orthopaedic Surgery, Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
| | - Tatsuya Iwasaki
- Department of Orthopaedic Surgery, Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
| | - Asami Matsumoto
- Department of Clinical Pharmacy, Oita University Hospital, Yufu-shi, Oita, Japan; and
| | - Ryota Tanaka
- Department of Clinical Pharmacy, Oita University Hospital, Yufu-shi, Oita, Japan; and
| | - Ryosuke Tatsuta
- Department of Clinical Pharmacy, Oita University Hospital, Yufu-shi, Oita, Japan; and
| | - Hiroshi Tsumura
- Department of Orthopaedic Surgery, Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
| | - Hiroki Itoh
- Department of Clinical Pharmacy, Oita University Hospital, Yufu-shi, Oita, Japan; and
| |
Collapse
|
3
|
Chavant A, Jourdil JF, Jouve T, Christians U, Fonrose X, Stanke-Labesque F. A simple and easy-to-perform liquid chromatography-mass spectrometry method for the quantification of tacrolimus and its metabolites in human whole blood. Application to the determination of metabolic ratios in kidney transplant patients. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1173:122698. [PMID: 33878532 DOI: 10.1016/j.jchromb.2021.122698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/22/2021] [Accepted: 04/01/2021] [Indexed: 11/23/2022]
Abstract
Tacrolimus is the cornerstone of immunosuppressive therapy in solid organ transplantation and its blood concentrations are routinely monitored. Tacrolimus is extensively metabolized into metabolites that are supposed to be nephrotoxic. Yet, few analytical methods have been described to simultaneously quantify tacrolimus and its main metabolites. We developed and validated a simple liquid chromatography-mass spectrometry method for the quantification of tacrolimus and its three desmethylated metabolites, 13-O, 15-O, and 31-O-desmethylated tacrolimus (M-I, M-III, and M-II respectively) in human whole blood. Protein precipitation of 50 µL of whole blood with 100 µL methanol and zinc sulfate was used as a single-extraction procedure. Tacrolimus and its metabolites were quantified using electrospray ionization-triple quadrupole mass spectrometry in combination with selected reaction monitoring detection in the positive ionization mode. The method was validated following FDA recommendations. This method was precise (intra- and inter-assay coefficients of variation: 2.88-7.81% and 3.96-12.10% for low and high levels of internal quality controls, respectively) and accurate (intra- and inter-assay biases: -1.67-10.30%, and -0.77--9.36%, respectively). In adult kidney transplant patients who were treated with tacrolimus prolonged release formulation, the median (10th-90th percentiles) trough concentrations (n = 16) of tacrolimus, M-I, and M-III were 5.85 (3.37-7.09), 0.100 (0.037-0.168), 0.051 (0.03-0.104), respectively. M-II was measured in only 2 trough samples. The metabolic ratios M-I/tacrolimus and M-III/tacrolimus were 0.017 (0.009-0.027) and 0.009 (0.006-0.015) when measured on trough concentration and 0.022 (0.011-0.037) and 0.008 (0.006-0.015) when measured on area under the curves 0-24 h. This method is a suitable and easy-to-perform tool for future pharmacokinetic-pharmacodynamics studies investigating the importance of tacrolimus and its metabolites blood exposure for solid organ graft survival.
Collapse
Affiliation(s)
- Anaëlle Chavant
- Laboratory of Pharmacology-pharmacogenetics and Toxicology- Grenoble-Alpes University Hospital, F-38043 Grenoble, France
| | - Jean-François Jourdil
- Laboratory of Pharmacology-pharmacogenetics and Toxicology- Grenoble-Alpes University Hospital, F-38043 Grenoble, France
| | - Thomas Jouve
- Laboratory of Pharmacology-pharmacogenetics and Toxicology- Grenoble-Alpes University Hospital, F-38043 Grenoble, France; Univ. Grenoble Alpes, F-38041 Grenoble, France; Nephrology, Dialysis, Apheresis and Transplantation Department, Grenoble University Hospital, France
| | - Uwe Christians
- iC42 Clinical Research and Development, Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Xavier Fonrose
- Laboratory of Pharmacology-pharmacogenetics and Toxicology- Grenoble-Alpes University Hospital, F-38043 Grenoble, France
| | - Françoise Stanke-Labesque
- Laboratory of Pharmacology-pharmacogenetics and Toxicology- Grenoble-Alpes University Hospital, F-38043 Grenoble, France; Univ. Grenoble Alpes, F-38041 Grenoble, France; INSERM U1300, HP2, F-38041 Grenoble, France.
| |
Collapse
|
4
|
Watanabe T, Tanaka R, Ono H, Suzuki Y, Tatsuta R, Itoh H. Sensitive, wide-range and high-throughput quantification of cyclosporine in whole blood using ultra-performance liquid chromatography coupled to tandem mass spectrometry and comparison with an antibody-conjugated magnetic immunoassay. Biomed Chromatogr 2021; 35:e5128. [PMID: 33780006 DOI: 10.1002/bmc.5128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/17/2021] [Accepted: 03/25/2021] [Indexed: 12/25/2022]
Abstract
Because either trough or peak concentration at 2 h after administration is measured in routine therapeutic drug monitoring for cyclosporine A (CyA), a quantification method with a wide-range calibration curve capable of simultaneously measuring both concentrations is required. We developed a sensitive, wide-range and high-throughput quantification method for CyA in whole blood using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), and compared patients' blood CyA levels measured by UPLC-MS/MS and antibody-conjugated magnetic immunoassay (ACMIA). Whole blood samples were prepared by solid-phase extraction using Oasis HLB μElution plate. The UPLC-MS/MS assay showed excellent linearity over a wide calibration range of 5-2500 ng/mL. Within-batch accuracy and precision as well as batch-to-batch accuracy and precision fulfilled the criteria of US Food and Drug Administration guidelines. The blood CyA concentrations measured by the UPLC-MS/MS assay correlated strongly with those measured by ACMIA. A Bland-Altman plot showed a fixed error between CyA concentrations measured by the two methods, and the concentrations measured by the UPLC-MS/MS method were consistently lower than those measured by ACMIA. We have succeeded to develop a sensitive, wide-range and high-throughput quantification method for CyA in whole blood using UPLC-MS/MS.
Collapse
Affiliation(s)
- Takuma Watanabe
- Department of Clinical Pharmacy, Oita University Hospital, Yufu, Oita, Japan
| | - Ryota Tanaka
- Department of Clinical Pharmacy, Oita University Hospital, Yufu, Oita, Japan
| | - Hiroyuki Ono
- Department of Clinical Pharmacy, Oita University Hospital, Yufu, Oita, Japan
| | - Yosuke Suzuki
- Department of Medication Use Analysis and Clinical Research, Meiji Pharmaceutical University, Tokyo, Japan
| | - Ryosuke Tatsuta
- Department of Clinical Pharmacy, Oita University Hospital, Yufu, Oita, Japan
| | - Hiroki Itoh
- Department of Clinical Pharmacy, Oita University Hospital, Yufu, Oita, Japan
| |
Collapse
|
5
|
Simultaneous quantification method for 5-FU, uracil, and tegafur using UPLC-MS/MS and clinical application in monitoring UFT/LV combination therapy after hepatectomy. Sci Rep 2021; 11:3132. [PMID: 33542452 PMCID: PMC7862254 DOI: 10.1038/s41598-021-82908-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 12/07/2020] [Indexed: 12/22/2022] Open
Abstract
Combination therapy of tegafur/uracil (UFT) and leucovorin (LV) is widely used to treat colorectal cancers. Although this therapy has a significant therapeutic effect, severe adverse effects occur frequently. Therapeutic drug monitoring (TDM) may help to prevent adverse effects. A useful assay that can quantitate plasma levels of 5-FU, uracil, and tegafur simultaneously for TDM has been desired, but such a method is not currently available. In this study, we aimed to develop a sensitive method for simultaneous quantification of 5-FU, uracil, and tegafur in human plasma using ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS). After preparing plasma samples by protein precipitation and liquid extraction, 5-FU, uracil, and tegafur were analyzed by UPLC-MS/MS in negative electrospray ionization mode. Validation was performed according to US Food and Drugs Administration guidance. The calibration curves were linear over concentration ranges of 2–500 ng/mL for 5-FU, 20–5000 ng/mL for uracil, and 200–50,000 ng/mL for tegafur. The corresponding average recovery rates were 79.9, 80.9, and 87.8%. The method provides accuracy within 11.6% and precision below 13.3% for all three analytes. Matrix effects of 5-FU, uracil, and tegafur were higher than 43.5, 84.9, and 100.2%, respectively. This assay was successfully applied to assess the time courses of plasma 5-FU, uracil, and tegafur concentrations in two patients with colorectal liver metastasis who received UFT/LV therapy after hepatectomy. In conclusion, we succeeded to develop a sensitive and robust UPLC-MS/MS method for simultaneous quantification of 5-FU, uracil, and tegafur in human plasma. This method is potentially useful for TDM in patients receiving UFT/LV combination therapy.
Collapse
|
6
|
Zhang Z, Zhang Y, Yu H, Rong S, Gao H, Meng L, Dai J, Pan H, Chang D. Spherical carrier amplification strategy for electrochemical immunosensor based on polystyrene-gold nanorods @L-cysteine/MoS2 for determination of tacrolimus. Talanta 2020; 220:121321. [DOI: 10.1016/j.talanta.2020.121321] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/11/2020] [Accepted: 06/22/2020] [Indexed: 12/11/2022]
|