1
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Bonnet-Serrano F, Nakib S, Zientek C, Guignat L, Guibourdenche J, Bertherat J, Menet MC. Urinary Free Cortisol Determination and Interferences Studies Using Liquid Chromatography Coupled to Tandem Mass Spectrometry after On-Line Solid Phase Extraction Based on Turboflow TM Chromatography. Metabolites 2023; 13:1063. [PMID: 37887388 PMCID: PMC10608966 DOI: 10.3390/metabo13101063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/28/2023] Open
Abstract
(1) A 24 h urinary free cortisol (UFF) is one of the first-line exams recommended for the diagnosis of Cushing's syndrome. In a hospital hormonology department, this activity can exceed several hundred dosages per week. The UFF is generally determined via an immunoassay with an automate using a chemiluminescence or electrochemiluminescence detection system. To increase the cortisol concentration in the analyzed sample, the automated analysis is preceded by urine extraction, which does not prevent there from being some interferences due to other steroids with close structures. (2) This paper describes the development of on-line solid phase extraction coupled to liquid chromatography and mass spectrometry for the analysis of urinary free cortisol. The on-line extraction was based on the TurboflowTM chromatography coupled to the analytical column by two valves, easily available for the laboratories. (3) The choice of the Accucore Polar Premium® analytical column made it possible to avoid analytical interferences with exogenous or endogenous molecules having the same SRM transition (363 → 121) as cortisol. (4) The method was fully validated in the range of clinically relevant concentrations from the lower limit of quantification (LLOQ) to 411.75 nmol·L-1.
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Affiliation(s)
- Fidéline Bonnet-Serrano
- Université Paris Cité, 75014 Paris, France; (F.B.-S.); (J.G.); (J.B.)
- Inserm U1016-CNRS UMR8104, 75014 Paris, France
- Hormonology Department, Cochin Hospital, 75014 Paris, France;
| | - Samir Nakib
- Specialized Biochemistry Department, Cochin Hospital, 75014 Paris, France;
| | - Corinne Zientek
- Hormonology Department, Cochin Hospital, 75014 Paris, France;
| | - Laurence Guignat
- Reference Center for Rare Adrenal Diseases, Endocrinology Department, Cochin Hospital, 75014 Paris, France;
| | - Jean Guibourdenche
- Université Paris Cité, 75014 Paris, France; (F.B.-S.); (J.G.); (J.B.)
- Hormonology Department, Cochin Hospital, 75014 Paris, France;
- Inserm U1139, 75006 Paris, France
| | - Jerôme Bertherat
- Université Paris Cité, 75014 Paris, France; (F.B.-S.); (J.G.); (J.B.)
- Inserm U1016-CNRS UMR8104, 75014 Paris, France
- Reference Center for Rare Adrenal Diseases, Endocrinology Department, Cochin Hospital, 75014 Paris, France;
| | - Marie-Claude Menet
- Institut de Chimie Physique, CNRS UMR8000, Université Paris-Saclay, 91400 Orsay, France
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2
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Guo H, Guan J, Wu X, Wei Y, Zhao J, Zhou Y, Li F, Pang HB. Peptide-guided delivery improves the therapeutic efficacy and safety of glucocorticoid drugs for treating acute lung injury. Mol Ther 2023; 31:875-889. [PMID: 36609145 PMCID: PMC10014283 DOI: 10.1016/j.ymthe.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/08/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023] Open
Abstract
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are life-threatening conditions with excessive inflammation in the lung. Glucocorticoids had been widely used for ALI/ARDS, but their clinical benefit remains unclear. Here, we tackled the problem by conjugating prednisolone (PSL) with a targeting peptide termed CRV. Systemically administered CRV selectively homes to the inflamed lung of a murine ALI model, but not healthy organs or the lung of healthy mice. The expression of the CRV receptor, retinoid X receptor β, was elevated in the lung of ALI mice and patients with interstitial lung diseases, which may be the basis of CRV targeting. We then covalently conjugated PSL and CRV with a reactive oxygen species (ROS)-responsive linker in the middle. While being intact in blood, the ROS linker was cleaved intracellularly to release PSL for action. In vitro, CRV-PSL showed an anti-inflammatory effect similar to that of PSL. In vivo, CRV conjugation increased the amount of PSL in the inflamed lung but reduced its accumulation in healthy organs. Accordingly, CRV-PSL significantly reduced lung injury and immune-related side effects elsewhere. Taken together, our peptide-based strategy for targeted delivery of glucocorticoids for ALI may have great potential for clinical translation.
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Affiliation(s)
- Hong Guo
- Department of Pharmaceutics, School of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Jibin Guan
- Department of Pharmaceutics, School of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Xian Wu
- Department of Pharmaceutics, School of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Yushuang Wei
- Department of Pharmaceutics, School of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Jiaqi Zhao
- Department of Pharmaceutics, School of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Yan Zhou
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Faqian Li
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Hong-Bo Pang
- Department of Pharmaceutics, School of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA.
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3
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Determination of 27 Glucocorticoids in Urine by Ultra-High-Performance Liquid Chromatography-Tandem Mass Spectrometry Using UniSprayTM Source. SEPARATIONS 2023. [DOI: 10.3390/separations10030155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
Glucocorticoids (GCs) are a group of the most important and commonly used anti-inflammatory, antiallergenic, and immunosuppressive drugs. Like narcotics, they can be addictive if taken at increasing doses to achieve greater analgesic effects. The purpose of the study was to develop initial and confirmation testing analytical methods that would allow for the identification of glucocorticoid class substances in human urine to be used for routine analyses for the purposes of prosecution in the case of abuse, for clinical toxicology, medical jurisprudence, as well as for routine testing of athletes for the presence of prohibited substances in sports by means of ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) using a new generation ionization source UniSprayTM (U.S). This new method allows for the simultaneous detection of 27 glucocorticoids in human urine using LC-MS/MS. The tests conducted yielded relatively low LOD and LOQ values, ranging from 0.06 ng/mL to 0.14 ng/mL and 0.75 ng/mL for LOD and LOQ, respectively.
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4
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Iannella L, Comunità F, Botrè F, Colamonici C, Curcio D, de la Torre X, Mazzarino M. Urinary excretion profile of prednisolone and prednisone after rectal administration: significance in antidoping analysis. Drug Test Anal 2022; 14:2007-2016. [PMID: 35921255 PMCID: PMC10087643 DOI: 10.1002/dta.3352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022]
Abstract
The rectal administration of glucocorticoids, as well as any injectable, and oral ones, is currently prohibited by the World Anti-Doping Agency when occurs "in competition". A reporting level of 100 ng/mL for prednisolone and 300 ng/mL for prednisone was established to discriminate the allowed and the prohibited administration. Here, the urinary excretion profiles of prednisone and prednisolone were evaluated in five volunteers in therapy with glucocorticoid-based rectal formulations containing prednisone or prednisolone caproate. The urinary levels of the excreted target compounds were determined by LC-MS/MS following the procedure validated and currently in use in our laboratory to detect and quantitate glucocorticoids in urine. Predictably, the excretion trend of the analytes of interest were generally comparable to those obtained after oral administration, even if the excretion profile showed a broad inter-individual variability, with the absorption rate and the systemic bioavailability after rectal administration being strongly influenced by the type of formulations (suppository or rectal cream, in our case) as well as the physiological conditions of the absorption area. Results showed that the target compounds were detectable for at least 30 hours after drug administration. After suppository administration, prednisolone levels reached the maximum after 3 hours from drug administration, and then dropped below the reporting level after 15-21 hours; prednisone reached the maximum after 3 hours from drug administration, and then dropped below the reporting level after 12-15 hours. After cream administration both prednisone and prednisolone levels remained in a concentration below the reporting level throughout the entire monitored period.
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Affiliation(s)
- Loredana Iannella
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Fabio Comunità
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Francesco Botrè
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy.,REDs - Research and Expertise in anti-Doping sciences, ISSUL - Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | | | - Davide Curcio
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Xavier de la Torre
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Monica Mazzarino
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
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5
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Skauby RH, Bergan S, Andersen AM, Vethe NT, Christensen H. In vitro assessments predict that CYP3A4 contributes to a greater extent than CYP3A5 to prednisolone clearance. Basic Clin Pharmacol Toxicol 2021; 129:427-436. [PMID: 34396687 DOI: 10.1111/bcpt.13645] [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: 04/15/2021] [Revised: 07/15/2021] [Accepted: 08/11/2021] [Indexed: 11/28/2022]
Abstract
Because several steroid hormones are metabolized to their respective 6β-hydroxy forms by CYP3A4 and CYP3A5, these isoenzymes have been assumed to metabolize the immunosuppressive drug prednisolone, with conflicting results in the literature with respect to their relative importance. A direct study of the metabolism of prednisolone by microsomal CYP3A4 and CYP3A5 is missing. The aim of this in vitro study was to investigate the relative importance of recombinant CYP3A4 and recombinant CYP3A5 in the metabolism of prednisolone and to compare the extent of formation of 6β-OH-prednisolone by the two enzymes. Through in vitro incubations using rCYP3A4 and rCYP3A5 enzymes, intrinsic clearance (CLint ) of prednisolone was determined by the substrate depletion approach. Formation of the metabolite 6β-OH-prednisolone by rCYP3A4 and rCYP3A5, respectively, were compared. Prednisolone concentrations were measured and its metabolite 6β-OH-prednisolone was identified using a HPLC-MS/MS in-house method. CLint for prednisolone by rCYP3A5 was less than 26% relative to rCYP3A4. Formation of 6β -OH-prednisolone by rCYP3A5 was less than 11% relative to rCYP3A4. The study indicates that 6β-hydroxylation of prednisolone assessed in vitro in recombinant CYP enzymes depends on rCYP3A4 rather than rCYP3A5, and that CYP3A5 may be responsible for the formation of other prednisolone metabolite(s) in addition to 6β-OH-prednisolone.
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Affiliation(s)
- Ragnhild Heier Skauby
- Department of Pharmacology, Oslo University Hospital, Norway.,Department of Medical Biochemistry, Oslo University Hospital, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Norway
| | - Stein Bergan
- Department of Pharmacology, Oslo University Hospital, Norway.,Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Norway
| | | | - Nils Tore Vethe
- Department of Pharmacology, Oslo University Hospital, Norway
| | - Hege Christensen
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Norway
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6
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Deventer K, Polet M, Van Gansbeke W, Hooghe F, Van Hoecke H, Van Eenoo P. Investigation of the urinary excretion of prednisolone and metabolites after nasal administration: Relevance to doping control. Drug Test Anal 2021; 13:1897-1905. [PMID: 34081842 DOI: 10.1002/dta.3105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/18/2021] [Accepted: 05/28/2021] [Indexed: 11/08/2022]
Abstract
Glucocorticosteroid use in sport is restricted to non-systemic (nasal/ophtamological/dermatological/intra-articular) use. Systemic use is prohibited because of strong inflammatory suppressing effects. Prednisolone is a GC proven to be very effective in the treatment of nasal congestions and allergic rhinitis and its therapeutic use is allowed. To establish normal urinary concentration ranges for nasally administered prednisolone, an excretion study was performed with Sofrasolone® (nasal-inhaler). Six volunteers were administered a high dose (4.5 mg prednisolone in four gifts over a 9-h period). Samples were analysed using a validated LC-MS/MS method monitoring prednisolone (PRED) and the metabolites prednisone (PREDON), 20β-dihydroprednisolone (20βPRED) and 20α-dihydroprednisolone (20αPRED) in the total fraction (glucuroconjugated and free). Maximum concentrations were 266, 500, 350 and 140 ng/ml for PRED, PREDON, 20βPRED and 20αPRED, respectively. These results show that the current reporting limit of 30 ng/ml in urine can be easily exceeded after therapeutic use. Hence, to avoid false-positive findings related to nasal application, this limit should be increased. To investigate the degree of glucuronidation of PRED and its metabolites also the free fraction was investigated. This shows that PREDON has the highest glucuroconjugation (50%). PRED, 20βPRED and 20αPRED only show less than 20% conjugation.
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Affiliation(s)
- Koen Deventer
- Doping Control Laboratory (DoCoLab), Ghent University (UGent), Ghent, Belgium
| | - Michael Polet
- Doping Control Laboratory (DoCoLab), Ghent University (UGent), Ghent, Belgium
| | - Wim Van Gansbeke
- Doping Control Laboratory (DoCoLab), Ghent University (UGent), Ghent, Belgium
| | - Fiona Hooghe
- Doping Control Laboratory (DoCoLab), Ghent University (UGent), Ghent, Belgium
| | - Helen Van Hoecke
- Department of Head and Skin, Ghent University (UGent), Ghent, Belgium
| | - Peter Van Eenoo
- Doping Control Laboratory (DoCoLab), Ghent University (UGent), Ghent, Belgium
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7
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Ventura R, Daley-Yates P, Mazzoni I, Collomp K, Saugy M, Buttgereit F, Rabin O, Stuart M. A novel approach to improve detection of glucocorticoid doping in sport with new guidance for physicians prescribing for athletes. Br J Sports Med 2021; 55:bjsports-2020-103512. [PMID: 33879477 DOI: 10.1136/bjsports-2020-103512] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 01/13/2023]
Abstract
The systemic effect of glucocorticoids (GCs) following injectable routes of administration presents a potential risk to both improving performance and causing harm to health in athletes. This review evaluates the current GC antidoping regulations defined by the World Anti-Doping Agency and presents a novel approach for defining permitted and prohibited use of glucocorticoids in sport based on the pharmacological potential for performance enhancement (PE) and risk of adverse effects on health. Known performance-enhancing doses of glucocorticoids are expressed in terms of cortisol-equivalent doses and thereby the dose associated with a high potential for PE for any GC and route of administration can be derived. Consequently, revised and substance-specific laboratory reporting values are presented to better distinguish between prohibited and permitted use in sport. In addition, washout periods are presented to enable clinicians to prescribe glucocorticoids safely and to avoid the risk of athletes testing positive for a doping test.
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Affiliation(s)
- Rosa Ventura
- Catalonian Antidoping Laboratory, IMIM, Hospital del Mar Institute for Medical Research, Barcelona, Catalunya, Spain
| | - Peter Daley-Yates
- Clinical Pharmacology & Experimental Medicine, GSK, Brentford, London, UK
| | - Irene Mazzoni
- Science & Medicine Department, World Anti-Doping Agency, Montreal, Quebec, Canada
| | - Katia Collomp
- CIAMS, Université d'Orléans, Orléans, France
- Université Paris-Saclay CIAMS, Orsay, France
- Département des Analyses, AFLD, Chatenay-Malabry, France
| | - Martial Saugy
- REDs, Research and Expertise in antiDoping sciences, University of Lausanne, Lausanne, Switzerland
| | - Frank Buttgereit
- Department of Rheumatology and Clinical Immunology, Charité University Medicine, Berlin, Germany
| | - Olivier Rabin
- Science & Medicine Department, World Anti-Doping Agency, Montreal, Quebec, Canada
| | - Mark Stuart
- International Testing Agency, Lausanne, Switzerland
- Division of Medicine, Centre for Metabolism and Inflammation, University College London, London, UK
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8
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Alahmadi FH, Simpson AJ, Gomez C, Ericsson M, Thörngren JO, Wheelock CE, Shaw DE, Fleming LJ, Roberts G, Riley J, Bates S, Sousa AR, Knowles R, Bansal AT, Corfield J, Pandis I, Sun K, Bakke PS, Caruso M, Chanez P, Dahlén B, Horvath I, Krug N, Montuschi P, Singer F, Wagers S, Adcock IM, Djukanovic R, Chung KF, Sterk PJ, Dahlen SE, Fowler SJ. Medication Adherence in Patients With Severe Asthma Prescribed Oral Corticosteroids in the U-BIOPRED Cohort. Chest 2021; 160:53-64. [PMID: 33610577 DOI: 10.1016/j.chest.2021.02.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although estimates of suboptimal adherence to oral corticosteroids in asthma range from 30% to 50%, no ideal method for measurement exists; the impact of poor adherence in severe asthma is likely to be particularly high. RESEARCH QUESTIONS What is the prevalence of suboptimal adherence detected by self-reporting and direct measures? Is suboptimal adherence associated with disease activity? STUDY DESIGN AND METHODS Data were included from individuals with severe asthma taking part in the U-BIOPRED (Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes) study and prescribed daily oral corticosteroids. Participants completed the Medication Adherence Report Scale, a five-item questionnaire used to grade adherence on a scale from 1 to 5, and provided a urine sample for analysis of prednisolone and metabolites by liquid chromatography-mass spectrometry. RESULTS Data from 166 participants were included in this study: mean (SD) age, 54.2 (± 11.9) years; FEV1, 65.1% (± 20.5%) predicted; female, 58%; 37% completing the Medication Adherence Report Scale reported suboptimal adherence; and 43% with urinary corticosteroid data did not have detectable prednisolone or metabolites in their urine. Good adherence by both methods was detected in 49 of the 142 (35%) of participants in whom both methods were performed; adherence detection did not match between methods in 53%. Self-reported high adherers had better asthma control and quality of life, whereas directly measured high adherers had lower blood eosinophil levels. INTERPRETATION Low adherence is a common problem in severe asthma, whether measured directly or self-reported. We report poor agreement between the two methods, suggesting some disassociation between self-assessment of medication adherence and regular oral corticosteroid use, which suggests that each approach may provide complementary information in clinical practice.
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Affiliation(s)
- Fahad H Alahmadi
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, and Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, England; Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia
| | - Andrew J Simpson
- Division of Sport, Health and Exercise Science, University of Hull, Hull, England
| | - Cristina Gomez
- The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Division of Physiological Chemistry II, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Ericsson
- The Doping Laboratory, The Department of Laboratory Medicine at the Karolinska University Hospital Huddinge, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - John-Olof Thörngren
- The Doping Laboratory, The Department of Laboratory Medicine at the Karolinska University Hospital Huddinge, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Craig E Wheelock
- Division of Physiological Chemistry II, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden; Department of Respiratory Medicine and Allergy, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Dominic E Shaw
- Respiratory Research Unit, University of Nottingham, Nottingham, England
| | - Louise J Fleming
- National Heart and Lung Institute, Imperial College London, London, England
| | - Graham Roberts
- NIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences and Human Development and Health, Southampton, England
| | - John Riley
- Respiratory Therapeutic Unit, GlaxoSmithKline, Stockley Park, London, England
| | - Stewart Bates
- Respiratory Therapeutic Unit, GlaxoSmithKline, Stockley Park, London, England
| | - Ana R Sousa
- Respiratory Therapeutic Unit, GlaxoSmithKline, Stockley Park, London, England
| | | | - Aruna T Bansal
- Acclarogen Ltd, St John's Innovation Centre, Cambridge, England
| | | | - Ioannis Pandis
- Data Science Institute, South Kensington Campus, Imperial College London, London, England
| | - Kai Sun
- Data Science Institute, South Kensington Campus, Imperial College London, London, England
| | - Per S Bakke
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Massimo Caruso
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Pascal Chanez
- Assistance Publique-Hôpitaux de Marseille, Clinique des Bronches, de l'Allergie et du Sommeil CIC Nord, Aix-Marseille Université, Marseille, France
| | - Barbro Dahlén
- Division of Respiratory Medicine and Allergy, Department of Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Ildiko Horvath
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Norbert Krug
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | | | - Florian Singer
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital University Hospital Bern, University of Bern, Switzerland
| | | | - Ian M Adcock
- National Heart and Lung Institute, Imperial College London, London, England
| | - Ratko Djukanovic
- NIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences and Human Development and Health, Southampton, England
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, England
| | - Peter J Sterk
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sven-Erik Dahlen
- The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Stephen J Fowler
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, and Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, England.
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9
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Stucki M, Voegel CD, Binz TM, Kraemer T, Lavaud A, Voelter K. Systemic detectability of dexamethasone and prednisolone after eye drop application in horses. Equine Vet J 2021; 53:1250-1256. [PMID: 33421187 DOI: 10.1111/evj.13418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/30/2020] [Accepted: 01/03/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Equine sport agencies list steroids as prohibited substances for competing horses. OBJECTIVES The objective of this study was to investigate if the controlled substances dexamethasone and prednisolone are detectable in equine serum and urine samples during and after treatment with eye drops and if this can generate a positive doping test. STUDY DESIGN Prospective cohort study. METHODS The study cohort included 11 horses. One eye of the horses was treated with either dexamethasone (Maxitrol® 0.1%, n = 5 eyes) or prednisolone (Pred forte® 1%, n = 6 eyes) eye drops 3 times daily for 14 days. Dexamethasone and prednisolone concentrations were determined in serum and urine at day 0 (negative control), 1, 7, 14, 15, 17 and 21 using liquid chromatography-tandem mass spectrometry. Blood samples were collected within 2 hours post application. Urine samples were collected during spontaneous urination. RESULTS All serum samples (range: 0.7-43 ng/mL, mean 2.1 ng/mL) and urine samples (range 1.2-5 ng/mL, mean 0.8 ng/mL) showed measurable amounts of dexamethasone during the course of treatment. Concentrations in both serum and urine samples were below limit of detection (LOD) 24 hours after the last dexamethasone treatment (day 15). All serum samples (range 1.1-32.5 ng/mL, mean 6.4 ng/mL) and urine samples (range 3.7-19 ng/mL, mean 4.6 ng/mL) were positive for prednisolone during treatment. Urine samples were below LOD on day 15; serum samples on day 21. CONCLUSIONS Dexamethasone and prednisolone eye drops can induce detectable drug levels in serum and urine samples of horses after a 14-day treatment plan. This can lead to a positive doping result. All samples tested negative (below LOD of the analytical method) for dexamethasone one day and for prednisolone one week after treatment cessation.
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Affiliation(s)
- Michael Stucki
- Veterinary Ophthalmology, Equine Clinic, Vetsuisse Faculty Zurich, Zurich, Switzerland
| | - Clarissa D Voegel
- Zurich Institute of Forensic Medicine, Center for Forensic Hair Analytics, University of Zurich, Zurich, Switzerland
| | - Tina M Binz
- Zurich Institute of Forensic Medicine, Center for Forensic Hair Analytics, University of Zurich, Zurich, Switzerland
| | - Thomas Kraemer
- Zurich Institute of Forensic Medicine, Center for Forensic Hair Analytics, University of Zurich, Zurich, Switzerland
| | - Arnold Lavaud
- Veterinary Ophthalmology, Equine Clinic, Vetsuisse Faculty Zurich, Zurich, Switzerland
| | - Katrin Voelter
- Veterinary Ophthalmology, Equine Clinic, Vetsuisse Faculty Zurich, Zurich, Switzerland
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10
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Coll S, Monfort N, Alechaga É, Matabosch X, Pozo OJ, Pérez-Mañá C, Ventura R. Elimination profiles of prednisone and prednisolone after different administration routes: Evaluation of the reporting level and washout periods to ensure safe therapeutic administrations. Drug Test Anal 2020; 13:571-582. [PMID: 33161623 DOI: 10.1002/dta.2966] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 11/02/2020] [Accepted: 11/02/2020] [Indexed: 12/11/2022]
Abstract
Prednisolone (PRED) and prednisone (PSONE) are prohibited in sports competitions when administered by systemic routes, and they are allowed by other routes for therapeutic purposes. There is no restriction of use in out-of-competition periods. The present study aimed to evaluate the urinary excretion of PRED, PSONE, and their most important metabolites after systemic and nonsystemic treatments in order to verify the suitability of the current reporting level of 30 ng/ml used to distinguish allowed and prohibited administrations and to establish washout periods for oral treatments performed in out-of-competition periods. PRED was studied after dermatological administration (5 mg/day for 5 days, n = 6 males) and oral administration (5 mg, n = 6 males; 10 mg, n = 2 males). PSONE was studied after oral administration (10 mg, n = 2 males; 30 mg, n = 1 male and 1 female). Concentrations in urine were measured using an LC-MS/MS method. Concentrations after dermatological treatment were low for all metabolites. After oral administration, concentrations were very high during the first 24 h after administration ranging from 1.6 to 2261 ng/ml and from 4.6 to 908 ng/ml for PRED and PSONE, respectively. Concentrations of most of the metabolites measured were lower than 30 ng/ml from 24 h after all oral administrations. New reporting levels are proposed for PRED and PSONE considering data of our study and other information published after nonsystemic administrations of the compounds. Washout periods of at least 24 h are recommended to ensure no false positives when oral treatments need to be performed in out-of-competition periods.
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Affiliation(s)
- Sergi Coll
- Doping Control Research Group, Catalonian Antidoping Laboratory, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Núria Monfort
- Doping Control Research Group, Catalonian Antidoping Laboratory, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Élida Alechaga
- Doping Control Research Group, Catalonian Antidoping Laboratory, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Xavier Matabosch
- Doping Control Research Group, Catalonian Antidoping Laboratory, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Oscar J Pozo
- Integrative Pharmacology and Systems Neuroscience Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Clara Pérez-Mañá
- Human Pharmacology and Clinical Neurosciences Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Rosa Ventura
- Doping Control Research Group, Catalonian Antidoping Laboratory, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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11
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Othonos N, Marjot T, Woods C, Hazlehurst JM, Nikolaou N, Pofi R, White S, Bonaventura I, Webster C, Duffy J, Cornfield T, Moolla A, Isidori AM, Hodson L, Tomlinson JW. Co-administration of 5α-reductase Inhibitors Worsens the Adverse Metabolic Effects of Prescribed Glucocorticoids. J Clin Endocrinol Metab 2020; 105:5864156. [PMID: 32594135 PMCID: PMC7500580 DOI: 10.1210/clinem/dgaa408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 06/28/2020] [Indexed: 12/20/2022]
Abstract
CONTEXT Glucocorticoids (GCs) are commonly prescribed, but their use is associated with adverse metabolic effects. 5α-reductase inhibitors (5α-RI) are also frequently prescribed, mainly to inhibit testosterone conversion to dihydrotestosterone. However, they also prevent the inactivation of GCs. OBJECTIVE We hypothesized that 5α-RI may worsen the adverse effects of GCs. DESIGN Prospective, randomized study. PATIENTS A total of 19 healthy male volunteers (age 45 ± 2 years; body mass index 27.1 ± 0.7kg/m2). INTERVENTIONS Participants underwent metabolic assessments; 2-step hyperinsulinemic, euglycemic clamp incorporating stable isotopes, adipose tissue microdialysis, and biopsy. Participants were then randomized to either prednisolone (10 mg daily) or prednisolone (10 mg daily) plus a 5α-RI (finasteride 5 mg daily or dutasteride 0.5 mg daily) for 7 days; metabolic assessments were then repeated. MAIN OUTCOME MEASURES Ra glucose, glucose utilization (M-value), glucose oxidation, and nonesterified fatty acids (NEFA) levels. RESULTS Co-administration of prednisolone with a 5α-RI increased circulating prednisolone levels (482 ± 96 vs 761 ± 57 nmol/L, P = 0.029). Prednisolone alone did not alter Ra glucose (2.55 ± 0.34 vs 2.62 ± 0.19 mg/kg/minute, P = 0.86), M-value (3.2 ± 0.5 vs 2.7 ± 0.7 mg/kg/minute, P = 0.37), or glucose oxidation (0.042 ± 0.007 vs 0.040 ± 0.004 mmol/hr/kg/minute, P = 0.79). However, co-administration with a 5α-RI increased Ra glucose (2.67 ± 0.16 vs 3.05 ± 0.18 mg/kg/minute, P < 0.05) and decreased M-value (4.0 ± 0.5 vs 2.6 ± 0.4 mg/kg/minute, P < 0.05), and oxidation (0.043 ± 0.003 vs 0.036 ± 0.002 mmol/hr/kg, P < 0.01). Similarly, prednisolone did not impair insulin-mediated suppression of circulating NEFA (43.1 ± 28.9 vs 36.8 ± 14.3 μmol/L, P = 0.81), unless co-administered with a 5α-RI (49.8 ± 8.6 vs 88.5 ± 13.5 μmol/L, P < 0.01). CONCLUSIONS We have demonstrated that 5α-RIs exacerbate the adverse effects of prednisolone. This study has significant translational implications, including the need to consider GC dose adjustments, but also the necessity for increased vigilance for the development of adverse effects.
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Affiliation(s)
- Nantia Othonos
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
| | - Thomas Marjot
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Conor Woods
- Department of Endocrinology, Naas General Hospital, Kildare and Tallaght Hospital, Dublin, Ireland
| | - Jonathan M Hazlehurst
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - Nikolaos Nikolaou
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
| | - Riccardo Pofi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Sarah White
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
| | - Ilaria Bonaventura
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Craig Webster
- Department of Pathology, University Hospitals Birmingham, NHS Foundation Trust, Birmingham, UK
| | - Joanne Duffy
- Department of Pathology, University Hospitals Birmingham, NHS Foundation Trust, Birmingham, UK
| | - Thomas Cornfield
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
| | - Ahmad Moolla
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
| | - Jeremy W Tomlinson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
- Correspondence and Reprint Requests: Professor Jeremy Tomlinson, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford OX3 7LJ, UK, E-mail:
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12
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Iannella L, Botrè F, Colamonici C, Curcio D, Ciccarelli C, Mazzarino M, Torre X. Carbon isotopic characterization of prednisolone and prednisone pharmaceutical formulations: Implications in antidoping analysis. Drug Test Anal 2020; 12:1587-1598. [DOI: 10.1002/dta.2876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Loredana Iannella
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana Rome Italy
- Dipartimento di Chimica e Tecnologia del Farmaco “Sapienza” Università di Roma Rome Italy
| | - Francesco Botrè
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana Rome Italy
- Dipartimento di Medicina Sperimentale “Sapienza” Università di Roma Rome Italy
| | | | - Davide Curcio
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana Rome Italy
| | | | - Monica Mazzarino
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana Rome Italy
| | - Xavier Torre
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana Rome Italy
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13
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Iannella L, Botrè F, Colamonici C, Curcio D, Torre X. Development and validation of a method to confirm the exogenous origin of prednisone and prednisolone by GC‐C‐IRMS. Drug Test Anal 2019; 11:1615-1628. [DOI: 10.1002/dta.2715] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/04/2019] [Accepted: 10/05/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Loredana Iannella
- Laboratorio AntidopingFederazione Medico Sportiva Italiana Rome Italy
- Dipartimento di Chimica e Tecnologia del Farmaco“Sapienza” Università di Roma Rome Italy
| | - Francesco Botrè
- Laboratorio AntidopingFederazione Medico Sportiva Italiana Rome Italy
- Dipartimento di Medicina Sperimentale“Sapienza” Università di Roma Rome Italy
| | | | - Davide Curcio
- Laboratorio AntidopingFederazione Medico Sportiva Italiana Rome Italy
| | - Xavier Torre
- Laboratorio AntidopingFederazione Medico Sportiva Italiana Rome Italy
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14
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Mazzarino M, Piantadosi C, Comunità F, Torre X, Botrè F. Urinary excretion profile of prednisone and prednisolone after different administration routes. Drug Test Anal 2019; 11:1601-1614. [DOI: 10.1002/dta.2733] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/02/2019] [Accepted: 11/04/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Monica Mazzarino
- Laboratorio Antidoping Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197 Rome Italy
| | - Chiara Piantadosi
- Laboratorio Antidoping Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197 Rome Italy
| | - Fabio Comunità
- Laboratorio Antidoping Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197 Rome Italy
| | - Xavier Torre
- Laboratorio Antidoping Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197 Rome Italy
| | - Francesco Botrè
- Laboratorio Antidoping Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197 Rome Italy
- Dipartimento di Medicina Sperimentale“Sapienza” Università di Roma Viale Regina Elena 324, 00161 Rome Italy
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15
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Gaudl A, Kratzsch J, Ceglarek U. Advancement in steroid hormone analysis by LC-MS/MS in clinical routine diagnostics - A three year recap from serum cortisol to dried blood 17α-hydroxyprogesterone. J Steroid Biochem Mol Biol 2019; 192:105389. [PMID: 31158444 DOI: 10.1016/j.jsbmb.2019.105389] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/21/2019] [Accepted: 05/30/2019] [Indexed: 12/12/2022]
Abstract
Steroid analysis by LC-MS/MS in daily clinical routine diagnostics requires high-throughput conditions including fast chromatographic separation. Hereby, signal interferences may occur due to limited specificity in complex biologic matrices. During the last three years of routine steroid analysis in our laboratory and roughly 50,000 measurements, about 1% was affected by interferences, mainly serum cortisol (>90%) and dried blood 17α-hydroxyprogesterone (17-OHP). To overcome specificity problems, enhanced chromatography, ionization polarity switching, and detection via two-stage fragmentation (MS3) using a quadrupole linear ion trap were investigated in our study. Signal interferences of serum cortisol were eliminated by applying a protocol for automated method switching without changing the basic high-throughput LC-MS/MS setup. This approach includes negative ionization and extended chromatography from 4 to 6.6 min using the fourfold column length. From 9 samples affected by cortisol interference using the high-throughput method, 8 could be reliably analyzed applying the method switching protocol. Moreover, the applicability of the high-throughput method as second tier analysis in congenital adrenal hyperplasia (CAH) diagnostics from dried blood was verified with 100% diagnostic specificity. In addition, the combination of fast LC and MS3 detection enables specific quantitation of 17-OHP from dried blood spots on a screening time scale. This approach may be an alternative to the newborn screening for CAH by immunoassay due to its higher specificity, reducing the number of false positive results by 90%. In this work we recap experiences from three years of clinical routine steroid analysis via LC-MS/MS and present a unique analytical setup that enables both high-throughput and enhanced resolution analysis of steroid hormones in serum and dried blood.
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Affiliation(s)
- Alexander Gaudl
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Liebigstraße 27a, 04103 Leipzig, Germany.
| | - Jürgen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Liebigstraße 27a, 04103 Leipzig, Germany.
| | - Uta Ceglarek
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Liebigstraße 27a, 04103 Leipzig, Germany.
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16
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The availability of drug by liposomal drug delivery : Individual kinetics and tissue distribution of encapsulated and released drug in mice after administration of PEGylated liposomal prednisolone phosphate. Invest New Drugs 2018; 37:890-901. [PMID: 30547315 PMCID: PMC6736927 DOI: 10.1007/s10637-018-0708-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 11/30/2018] [Indexed: 12/14/2022]
Abstract
Lately, the usefulness of liposomal drug delivery systems has been debated. To better understand the underlying pharmacokinetics of the targeted drug delivery by liposomes, individual encapsulated and non-encapsulated drug concentrations in blood, tumor, liver, spleen and kidneys were quantified after i.v. administration of liposomal prednisolone phosphate in mice. Kinetic analysis shows that the tumor influx of encapsulated drug is not dominant compared to the uptake by the other tissues. Further, from a quantitative point of view, the availability of non-encapsulated drug in the tumor tissue after liposomal delivery is not pronounced as compared to the other tissues studied. However, drug release in the tumor seems more extended than in the other tissues and the non-encapsulated drug concentration decreases more slowly in the tumor than in the liver and spleen. The spleen shows a high affinity for the uptake of encapsulated drug as well as the release of drug from the liposomes. Subsequently, released drug in the spleen, and possibly also in other tissues, is probably quickly redistributed towards the blood and other tissues. This also impairs the drug delivery effect of the liposomes. In contrast to the released drug in the central circulation, liver and spleen, the released drug concentration in the tumor remains at a fairly constant level likely due to the extended release kinetics from the liposomes. These extended release characteristics in the tumor most probably contribute to the beneficial effect. Nevertheless, it should be noted that larger released drug concentrations are formed in healthy tissues.
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17
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Phungpanya C, Chaipuang A, Machan T, Watla-iad K, Thongpoon C, Suwantong O. Synthesis of prednisolone molecularly imprinted polymer nanoparticles by precipitation polymerization. POLYM ADVAN TECHNOL 2018. [DOI: 10.1002/pat.4428] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Chalida Phungpanya
- School of Science; Mae Fah Luang University; Chiang Rai 57100 Thailand
- Center of Chemical Innovation for Sustainability; Mae Fah Luang University; Chiang Rai 57100 Thailand
| | - Angkana Chaipuang
- School of Science; Mae Fah Luang University; Chiang Rai 57100 Thailand
- Center of Chemical Innovation for Sustainability; Mae Fah Luang University; Chiang Rai 57100 Thailand
| | - Theeraphan Machan
- School of Science; Mae Fah Luang University; Chiang Rai 57100 Thailand
- Center of Chemical Innovation for Sustainability; Mae Fah Luang University; Chiang Rai 57100 Thailand
| | - Kanchana Watla-iad
- School of Science; Mae Fah Luang University; Chiang Rai 57100 Thailand
- Center of Chemical Innovation for Sustainability; Mae Fah Luang University; Chiang Rai 57100 Thailand
| | - Chalermporn Thongpoon
- Program of Chemistry, Faculty of Science and Technology; Pibulsongkram Rajabhat University; Phitsanulok 65000 Thailand
| | - Orawan Suwantong
- School of Science; Mae Fah Luang University; Chiang Rai 57100 Thailand
- Center of Chemical Innovation for Sustainability; Mae Fah Luang University; Chiang Rai 57100 Thailand
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18
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Remane D, Wissenbach DK, Peters FT. Recent advances of liquid chromatography–(tandem) mass spectrometry in clinical and forensic toxicology — An update. Clin Biochem 2016; 49:1051-71. [DOI: 10.1016/j.clinbiochem.2016.07.010] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/04/2016] [Accepted: 07/17/2016] [Indexed: 12/21/2022]
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19
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Marcos J, Pozo OJ. Current LC-MS methods and procedures applied to the identification of new steroid metabolites. J Steroid Biochem Mol Biol 2016; 162:41-56. [PMID: 26709140 DOI: 10.1016/j.jsbmb.2015.12.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 11/25/2015] [Accepted: 12/11/2015] [Indexed: 12/31/2022]
Abstract
The study of the metabolism of steroids has a long history; from the first characterizations of the major metabolites of steroidal hormones in the pre-chromatographic era, to the latest discoveries of new forms of excretions. The introduction of mass spectrometers coupled to gas chromatography at the end of the 1960's represented a major breakthrough for the elucidation of new metabolites. In the last two decades, this technique is being complemented by the use of liquid chromatography-mass spectrometry (LC-MS). In addition of becoming fundamental in clinical steroid determinations due to its excellent specificity, throughput and sensitivity, LC-MS has emerged as an exceptional tool for the discovery of new steroid metabolites. The aim of the present review is to provide an overview of the current LC-MS procedures used in the quest of novel metabolic products of steroidal hormones and exogenous steroids. Several aspects regarding LC separations are first outlined, followed by a description of the key processes that take place in the mass spectrometric analysis, i.e. the ionization of the steroids in the source and the fragmentation of the selected precursor ions in the collision cell. The different analyzers and approaches employed together with representative examples of each of them are described. Special emphasis is placed on triple quadrupole analyzers (LC-MS/MS), since they are the most commonly employed. Examples on the use of precursor ion scan, neutral loss scan and theoretical selected reaction monitoring strategies are also explained.
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Affiliation(s)
- Josep Marcos
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain; Toxicology Department, Labco Diagnostics, Verge de Guadalupe 18, 08950 Esplugues de Llobregat, Spain
| | - Oscar J Pozo
- Bioanalysis Research Group, IMIM, Hospital del Mar, Doctor Aiguader 88, 08003 Barcelona, Spain.
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20
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Matabosch X, Pozo OJ, Pérez-Mañá C, Papaseit E, Segura J, Ventura R. Detection and characterization of prednisolone metabolites in human urine by LC-MS/MS. JOURNAL OF MASS SPECTROMETRY : JMS 2015; 50:633-642. [PMID: 25800201 DOI: 10.1002/jms.3571] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 01/07/2015] [Accepted: 01/07/2015] [Indexed: 06/04/2023]
Abstract
Glucocorticosteroids are prohibited in sports when used by systemic administrations (e.g. oral), whereas they are allowed using other administration ways. Strategies to discriminate between administrations routes have to be developed by doping control laboratories. For this reason, the metabolism of prednisolone (PRED) was studied using liquid chromatography coupled to tandem mass spectrometry. A single oral (10 mg) dose of PRED was administered to two healthy male volunteers. Urine samples were collected up to 6 days after administration. Samples were hydrolyzed with β-glucuronidase and subjected to liquid-liquid extraction with ethyl acetate in alkaline conditions. The extracts were analyzed by liquid chromatography coupled to tandem mass spectrometry. Precursor ion scan methods (m/z 77, 91, 105, 121, 147 and 171) in positive ionization and neutral loss scan methods (76 and 94 Da) in negative ionization modes were applied for the open detection of PRED metabolites. Using these methods, PRED parent compound plus 20 metabolites were detected. PRED and 11 metabolites were characterized by comparison with standards of the compounds (PRED, prednisone, 20β-dihydro-PRED and 20α-dihydro-PRED, 20β-dihydro-prednisone and 20α-dihydro-prednisone, 6β-hydroxy-PRED and 6α-hydroxy-PRED, 20β isomers and 20α isomers of 6β,11β,17α,20,21-pentahydroxypregnan-1,4-diene-3-one, 6α,11β,17α,20β,21-pentahydroxypregnan-1,4-diene-3-one and Δ(6) -PRED). Using mass spectrometric data, feasible structures were proposed for seven of the remaining nine detected metabolites, including several 6-hydroxy-metabolites. Eleven of the characterized metabolites have not been previously described. Maximum excretion rates for PRED metabolites were achieved in first 24 h; however, most of the metabolites were still detectable in the last collected samples (day 6).
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Affiliation(s)
- Xavier Matabosch
- Bioanalysis Research Group, IMIM, Institut Hospital del Mar d'Investigacions Mèdiques, Doctor Aiguader 88, 08003, Barcelona, Spain
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