Identification of NTBC metabolites in urine from patients with hereditary tyrosinemia type 1 using two different mass spectrometric platforms: triple stage quadrupole and LTQ-Orbitrap

Long-Term Outcomes and Practical Considerations in the Pharmacological Management of Tyrosinemia Type 1

Tyrosinemia type 1 (TT1) is a rare metabolic disease caused by a defect in tyrosine catabolism. TT1 is clinically characterized by acute liver failure, development of hepatocellular carcinoma, renal and neurological problems, and consequently an extremely poor outcome. This review showed that the introduction of 2-(2-nitro-4-trifluoromethylbenzoyl)-1,3-cyclohexanedione (NTBC) in 1992 has revolutionized the outcome of TT1 patients, especially when started pre-clinically. If started early, NTBC can prevent liver failure, renal problems, and neurological attacks and decrease the risk for hepatocellular carcinoma. NTBC has been shown to be safe and well tolerated, although the long-term effectiveness of treatment with NTBC needs to be awaited. The high tyrosine concentrations caused by treatment with NTBC could result in ophthalmological and skin problems and requires life-long dietary restriction of tyrosine and its precursor phenylalanine, which could be strenuous to adhere to. In addition, neurocognitive problems have been reported since the introduction of NTBC, with hypothesized but as yet unproven pathophysiological mechanisms. Further research should be done to investigate the possible relationship between important clinical outcomes and blood concentrations of biochemical parameters such as phenylalanine, tyrosine, succinylacetone, and NTBC, and to develop clear guidelines for treatment and follow-up with reliable measurements. This all in order to ultimately improve the combined NTBC and dietary treatment and limit possible complications such as hepatocellular carcinoma development, neurocognitive problems, and impaired quality of life.

LC-MS/MS study of the degradation processes of nitisinone and its by-products

Nitisinone (2-(2-nitro-4-trifluoromethylbenzoyl)-1,3-cyclohexanedione, NTBC) was the first synthetically produced triketone herbicide. However, its unsatisfactory herbicidal properties, negative impact on the natural environment and the high cost of synthesis have hindered its commercialization as a plant protection agent. Nevertheless, NTBC has become the medical treatment of choice for a rare hereditary metabolic disease -hepatorenal tyrosinemia. Literature review shows that most research on nitisinone focuses on its medical applications, while there are neither in-depth studies of its stability nor its degradation pathways. Therefore, the aim of our study was to employ liquid chromatography coupled with mass spectrometry (LC-MS/MS) to determine the stability of NTBC in different experimental conditions (pH of solution, temperature, time of incubation, ultraviolet radiation), identify its degradation products and determine the stability of the latter. Electrospray ionization (ESI) in the negative ion mode was used as an ionization method and the analytes were detected by multiple reaction monitoring. We show that nitisinone stability increases with increasing pH of the solution. At pH similar to that of gastric juice in the human stomach, two major products of NTBC degradation are formed: 2-amino-4-(trifluoromethyl)benzoic acid (ATFA) and 2-nitro-4-(trifluoromethyl)benzoic acid (NTFA), which show considerable stability under studied conditions. The results of these studies shed new light on the properties of NTBC, therefore contributing to better understanding of possible risks and benefits of its medical application.

Dissipation and metabolism of tebufenozide in cabbage and soil under open field conditions in South China

The novel nonsteroidal ecdysone agonist tebufenozide is capable of controlling a wide range of lepidopteran pests. However its intensive use in vegetables has raised concerns towards the safety of food and environment. Here, we developed an easy and reliable method to analyze tebufenozide in cabbage and soil by reversed-phase high performance liquid chromatography (HPLC). The average recoveries of tebufenozide ranged from 72.01% to 101.10% with the relative standard deviations (RSD)<6%, and the LOD and LOQ were 0.02µgg^-1 and 0.05µgg^-1, respectively. According to the dissipation study, the half-lives of tebufenozide were 2.96 and 4.08 d in cabbage and 4.95-7.70d in soil, respectively. The final residues were determined below the maximum residue limit (MRL) (0.5mgkg^-1) after a pre-harvest interval (PHI) of 7d. Moreover, its major metabolites were identified by liquid chromatography tandem mass spectrometry (LC-MS/MS) on LTQ-Orbitrap XL, which leading to the first report of the degradation pathway of tebufenozide in cabbage. The present study is expected to provide basic data for the use guidance and safety evaluation of tebufenozide in agricultural crops and environment.

Comparison of plasma and dry blood spots as samples for the determination of nitisinone (NTBC) by high-performance liquid chromatography-tandem mass spectrometry. Study of the stability of the samples at different temperatures

Tyrosinemia is an inborn error of metabolism characterized by the accumulation of tyrosine as well as toxic by-products. NTBC or nitisinone is a drug currently used for the treatment of tyrosinemia that avoids the formation of these toxic substances. This paper presents the determination of NTBC in plasma and dry blood spots by high-performance liquid chromatography (HPLC) coupled to tandem mass spectrometry. The concentration of NTBC in matched plasma-dry blood spots was compared and the study of degradation of NTBC in plasma and dry spots at different temperatures is presented.

METHOD

For sample preparation, plasma proteins were precipitated with acetonitrile and 3-mm discs were extracted with methanol. ESI(+) was used as inozation method and the analytes were detected by multiple reaction monitoring using the transitions 330>218 for NTBC and 340>228 for mesotrione, used as internal standard.

RESULTS

There is good correlation between concentrations obtained in dry blood spots and plasma (r(2)=0.83), although values are 2.4 times higher in plasma samples. NTBC in plasma is stable at least for 45 days frozen at -30°C and refrigerated at 4°C. However, it shows slow decomposition at room temperature, approximately 30% after 45 days. The method shows good precision, accuracy and linearity and the detection limit is 50 nmol/L and paper samples are appropriate for the monitorization of NTBC.