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Shahinfar S, Maibach H. Enigma of Intramuscular Triamcinolone Acetonide (Kenalog ®) Efficacy. Clin Pharmacokinet 2023; 62:1189-1199. [PMID: 37598107 DOI: 10.1007/s40262-023-01297-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 08/21/2023]
Abstract
Triamcinolone acetonide is a glucocorticosteroid used in standard clinical practice for its anti-inflammatory properties. Although it can be given via different routes of administration, the intramuscular route is unique compared with other corticosteroids-its effects remain potent over a longer period of time. We summarize the existing literature on the pharmacokinetic and pharmacodynamic mechanisms of intramuscular triamcinolone acetonide (Kenalog®). The fascinating nature of the purported efficacy of triamcinolone acetonide may be attributed to differing binding mechanisms, low solubility in blood, a low renal clearance rate, and various metabolites and other yet defined effects on skin. The enigma of the purported efficacy of triamcinolone acetonide may lie in the fact that it has a unique nature of having a long-term effect on dermatologic disease using a seemingly low dose compared with other routes of administration and other corticosteroids. Possible reasons for this may be binding differences at the intramuscular site, low solubility due to acetonide esters, a slow rate of absorption from the injected site, and a low renal clearance rate. There is still much to be learned about its mechanism of action, which may be of clinical and therapeutic significance.
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Affiliation(s)
- Sheeva Shahinfar
- Texas A&M University School of Medicine, 8447 Riverside Pkwy, Bryan, TX, 77807, USA.
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2
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Zhao P, Qi Y. Development of a UPLC-ESI-MS/MS method for the determination of triamcinolone acetonide in human plasma and evaluation of its bioequivalence after a single intramuscular injection in healthy volunteers. Front Pharmacol 2023; 14:1223112. [PMID: 37497115 PMCID: PMC10367002 DOI: 10.3389/fphar.2023.1223112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/03/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction: Triamcinolone acetonide (TA) is commonly used in the treatment of various inflammatory conditions. To ensure its efficacy and safety, it is important to accurately determine its concentration in human plasma and evaluate its bioequivalence. In this study, an efficient ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (UPLC-ESI-MS/MS) method was developed for the quantification of TA in human plasma after a single intramuscular injection. The internal standard used in this method was cortisone acetate (CA). Methods: TA and CA were extracted from plasma using ethyl acetate and N-hexane (4:1, v/v), separated on a C18 reverse-phase column with a mobile phase of acetonitrile-water containing 1% formic acid (55:45, v/v), and analyzed by UPLC-ESI-MS/MS. Multiple-reaction monitoring was performed using the transitions m/z 435.4→397.3 for TA and m/z 403.4→163.1 for CA. Results: The developed UPLC-ESI-MS/MS method demonstrated linearity over a concentration range of 0.53-21.20 ng/mL, with a lower limit of quantification of 0.53 ng/mL. The intra- and inter-run precision values ranged from 3.007% to 9.960% and 3.528% to 11.26%, respectively. The intra- and inter-run accuracy ranges were -1.962% to -6.577% and -3.371% to 0.348%, respectively. The matrix effect, extraction recovery, and stability of TA all met the acceptance criteria recommended by the National Medical Products Administration (NMPA) for bioassays. In healthy volunteers who received a single intramuscular injection of 80 mg of either the test or reference formulation of TA, various pharmacokinetic parameters were determined. C max was found to be 8.616 ± 1.232 and 8.285 ± 1.218 ng/mL for the test and reference formulations, respectively. T max was approximately 1.833 ± 0.243 and 1.861 ± 0.230 h. The t 1/2 was calculated to be 181.249 ± 78.585 and 201.782 ± 83.551 h. AUC 0-720 was 835.642 ± 297.209 and 830.684 ± 331.168 ng h/mL, AUC 0-∞ was 991.859 ± 355.939 and 1018.665 ± 420.769 ng h/mL for the test and reference formulations, respectively. The average relative bioavailability of TA, determined using AUC 0-720, was 105.4 ± 26.9%. Bioequivalence was evaluated through variance analysis and a double unilateral test, and the 90% confidence intervals of AUC 0-720, C max, and AUC 0-∞ were 92.8%-113.4%, 99.1%-109.1%, and 89.7%-110.9%, respectively (all p > 0.05). Discussion: These results met the bioequivalence criteria set by the NMPA, indicating that the developed UPLC-ESI-MS/MS method accurately determined TA concentrations in the plasma of healthy Chinese volunteers and that the test and reference formulations exhibited bioequivalence in these individuals.
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Affiliation(s)
- Pengfei Zhao
- Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, China
| | - Ying Qi
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
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3
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Investigation of the Excretion of Triamcinolone Acetonide and Its Metabolite. SEPARATIONS 2023. [DOI: 10.3390/separations10030164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Triamcinolone acetonide (TA) is a synthetic corticosteroid commonly used in medical practice to treat various skin conditions, including eczema, dermatitis, and allergies. It is a highly potent derivative of triamcinolone, with a strength that is about eight times greater than prednisone. Although it is sometimes used by athletes, it is important to note that the World Anti-Doping Agency (WADA) prohibits the use of glucocorticoids in competition when administered via injection, oral (including oromucosal, such as buccal, gingival, or sublingual), or rectal routes. However, they are allowed if administered otherwise, such as via inhalation or topical application to the skin. Anti-doping laboratories generally report Adverse Analytical Findings (AAF) for glucocorticoid group substances when their estimated concentration exceeds 30 ng/mL, with some exceptions such as triamcinolone acetonide, which has a reporting limit of 15 ng/mL. It is important to note that this only applies to the parent compound of specified metabolites. To address interpretation issues that can arise with other glucocorticoids, such as budesonide, the authors of this study investigated whether similar issues occur with triamcinolone acetonide. Specifically, they examined whether therapeutic doses of the commonly used medication Previsone could result in anti-doping rule violations due to the presence of triamcinolone acetonide and its metabolites in urine. The study involved ten healthy volunteers, and the analytical procedure was developed using liquid/liquid extraction, hydrolysis, and LC/MS/MS analysis. The results of the study showed that topical administration of therapeutic doses of Previsone does not pose a threat of anti-doping rules violation, as the excretion of the parent compound does not exceed the reporting limit in urine. Additionally, the concentration of 6β-hydroxy Triamcinolone acetonide was also well below the reporting limit.
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Thiebot P, Magny R, Bertolo L, Langrand J, Mimoun M, Houzé P, Labat L. Identification de corticoïdes dans un produit lipolytique vendu sur internet et promu par deux influenceuses. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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5
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Bijlsma L, Celma A, Castiglioni S, Salgueiro-González N, Bou-Iserte L, Baz-Lomba JA, Reid MJ, Dias MJ, Lopes A, Matias J, Pastor-Alcañiz L, Radonić J, Turk Sekulic M, Shine T, van Nuijs ALN, Hernandez F, Zuccato E. Monitoring psychoactive substance use at six European festivals through wastewater and pooled urine analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 725:138376. [PMID: 32298891 DOI: 10.1016/j.scitotenv.2020.138376] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 06/11/2023]
Abstract
The consumption of psychoactive substances is considered a growing problem in many communities. Moreover, new psychoactive substances (NPS) designed as (legal) substitutes to traditional illicit drugs are relatively easily available to the public through e-commerce and retail shops, but there is little knowledge regarding the extent and actual use of these substances. This study aims to gain new and complementary information on NPS and traditional illicit drug use at six music festivals across Europe by investigating wastewater and pooled urine. Samples were collected, between 2015 and 2018, at six music festivals across Europe with approximately 465.000 attendees. Wastewater samples were also collected during a period not coinciding with festivals. A wide-scope screening for 197 NPS, six illicit drugs and known metabolites was applied using different chromatography-mass spectrometric strategies. Several illicit drugs and in total 21 different NPS, mainly synthetic cathinones, phenethylamines and tryptamines, were identified in the samples. Ketamine and the traditional illicit drugs, such as amphetamine-type stimulants, cannabis and cocaine were most abundant and/or frequently detected in the samples collected, suggesting a higher use compared to NPS. The analyses of urine and wastewater is quick and a high number of attendees may be monitored anonymously by analysing only a few samples which allows identifying the local profiles of use of different drugs within a wide panel of psychoactive substances. This approach contributes to the development of an efficient surveillance system which can provide timely insight in the trends of NPS and illicit drugs use.
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Affiliation(s)
- L Bijlsma
- Research Institute for Pesticides and Water, University Jaume I, Castellón, Spain.
| | - A Celma
- Research Institute for Pesticides and Water, University Jaume I, Castellón, Spain
| | - S Castiglioni
- Istituto di Ricerche Farmacologiche Mario Negri -IRCCS, , Milan, Italy
| | | | - L Bou-Iserte
- Department of Inorganic and Organic Chemistry, University Jaume I, Castellón, Spain
| | - J A Baz-Lomba
- Norwegian Institute for Water Research, Oslo, Norway
| | - M J Reid
- Norwegian Institute for Water Research, Oslo, Norway
| | - M J Dias
- Instituto Nacional de Medicina Legal e Ciencias Forenses, Lisbon, Portugal
| | - A Lopes
- Egas Moniz, Cooperativa de Ensino Superior, Lisbon, Portugal
| | - J Matias
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | | | - J Radonić
- University of Novi Sad, Faculty of Technical Sciences, Novi Sad, Serbia
| | - M Turk Sekulic
- University of Novi Sad, Faculty of Technical Sciences, Novi Sad, Serbia
| | - T Shine
- TICTAC Communications Ltd., London, United Kingdom
| | - A L N van Nuijs
- Toxicological Centre, University of Antwerp, Antwerp, Belgium
| | - F Hernandez
- Research Institute for Pesticides and Water, University Jaume I, Castellón, Spain
| | - E Zuccato
- Istituto di Ricerche Farmacologiche Mario Negri -IRCCS, , Milan, Italy
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6
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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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Coll S, Monfort N, Alechaga É, Matabosch X, Pérez-Mañá C, Ventura R. Additional studies on triamcinolone acetonide use and misuse in sports: Elimination profile after intranasal and high-dose intramuscular administrations. Steroids 2019; 151:108464. [PMID: 31344406 DOI: 10.1016/j.steroids.2019.108464] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/08/2019] [Accepted: 07/14/2019] [Indexed: 12/16/2022]
Abstract
Triamcinolone acetonide (TA) is a glucocorticoid (GC) widely used in sports medicine. GCs are prohibited in sports competitions by oral, intramuscular (IM), intravenous and rectal administrations, and they are allowed by other routes considered of local action such as intranasal administration (INT). We examined the urinary profiles of TA and its metabolites after INT and high-dose IM administrations. We also measured concentrations of TA and cortisol (CORT) in plasma following IM administration. TA was administered to healthy volunteers using INT route (220 μg/day for 3 days, n = 4 males and 4 females) or IM route (single dose of 40 mg, n = 4 males and 4 females and single dose 80 mg, n = 4 males). Urine and plasma samples were collected before and after administration at different time periods, and were analysed by liquid chromatography-tandem mass spectrometry. TA concentrations in urine were constant during 23 days after IM injection (range 1.4-129.0 ng/mL), and were very low after INT administration (range 0.0-3.5 ng/mL). For 6β-hydroxy-triamcinolone, the main TA metabolite, higher concentrations were detected (0.0-93.7 ng/mL and 15.7-973.9 ng/mL after INT and IM administrations, respectively). On the other hand, TA was detected in all plasma samples collected during 23 days after IM administration (range 0.2-5.7 ng/mL). CORT levels were largely suppressed after IM injection, and were recovered in a dose-dependent manner. In view of the results obtained, we propose a reporting level of 5 ng/mL for TA to distinguish forbidden from allowed TA administrations in sports. We also suggest that other GCs with faster urinary elimination from the body should be considered for IM therapies in out-of-competition rather than TA, in order to reduce the possibility of reporting false adverse analytical findings.
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Affiliation(s)
- Sergi Coll
- IMIM (Hospital del Mar Medical Research Institute), Doping Control Research Group, Catalonian Antidoping Laboratory, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Núria Monfort
- IMIM (Hospital del Mar Medical Research Institute), Doping Control Research Group, Catalonian Antidoping Laboratory, Barcelona, Spain
| | - Élida Alechaga
- IMIM (Hospital del Mar Medical Research Institute), Doping Control Research Group, Catalonian Antidoping Laboratory, Barcelona, Spain
| | - Xavier Matabosch
- IMIM (Hospital del Mar Medical Research Institute), Doping Control Research Group, Catalonian Antidoping Laboratory, Barcelona, Spain
| | - Clara Pérez-Mañá
- Hospital Universitari Germans Trias i Pujol (HUGTP-IGTP), Department of Clinical Pharmacology, Badalona, Spain; Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain; IMIM (Hospital del Mar Medical Research Institute), Human Pharmacology and Clinical Neurosciences Research Group, Barcelona, Spain
| | - Rosa Ventura
- IMIM (Hospital del Mar Medical Research Institute), Doping Control Research Group, Catalonian Antidoping Laboratory, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
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8
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Coll S, Matabosch X, Llorente-Onaindia J, Carbó ML, Pérez-Mañá C, Monfort N, Monfort J, Ventura R. Elimination profile of triamcinolone hexacetonide and its metabolites in human urine and plasma after a single intra-articular administration. Drug Test Anal 2019; 11:1589-1600. [PMID: 31087549 DOI: 10.1002/dta.2614] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 11/11/2022]
Abstract
Triamcinolone hexacetonide (THA) is a synthetic glucocorticoid (GC) used by intra-articular (IA) administration. GCs are prohibited in sports competitions by systemic routes, and they are allowed by other routes considered of local action (IA administration, among others). The aim of the present work was to study the metabolic profile of THA in urine and plasma following IA administration. Eight patients (4 males and 4 females) with knee osteoarthritis received an IA dose of THA (40 mg) in the knee joint. Spot urine and plasma samples were collected before injection and at different time periods up to day 23 and 10 post-administration, respectively. The samples were analysed by liquid chromatography-tandem mass spectrometry. Neither THA nor specific THA metabolites were detected in urine. Triamcinolone acetonide (TA) and 6β-hydroxy-triamcinolone acetonide were the main urinary metabolites. Maximum concentrations wereobtained between 24 and 48 h after administration. Using the reporting level of 30 ng/mL to distinguish allowed from forbidden administrations of GCs, a large number of false adverse analytical findings would be reported up to day 4. On the other hand, TA was detected in all plasma samples collected up to day 10 after administration. THA was also detected in plasma but at lower concentrations. The detection of plasma THA would be an unequivocal proof to demonstrate IA use of THA. A reversible decrease was observed in plasma concentrations of cortisol in some of the patients, indicating a systemic effect of the drug.
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Affiliation(s)
- Sergi Coll
- IMIM (Hospital del Mar Medical Research Institute), Catalonian Antidoping Laboratory, Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Xavier Matabosch
- IMIM (Hospital del Mar Medical Research Institute), Catalonian Antidoping Laboratory, Barcelona, Spain
| | - Jone Llorente-Onaindia
- IMIM (Hospital del Mar Medical Research Institute), Cell Research on Inflammation and Cartilage Group, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Rheumatology Department, Barcelona, Spain
| | - Marcel Li Carbó
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Clara Pérez-Mañá
- Hospital Universitari Germans Trias i Pujol (IGTP), Department of Clinical Pharmacology, Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Nuria Monfort
- IMIM (Hospital del Mar Medical Research Institute), Catalonian Antidoping Laboratory, Barcelona, Spain
| | - Jordi Monfort
- IMIM (Hospital del Mar Medical Research Institute), Cell Research on Inflammation and Cartilage Group, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Rheumatology Department, Barcelona, Spain
| | - Rosa Ventura
- IMIM (Hospital del Mar Medical Research Institute), Catalonian Antidoping Laboratory, Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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Kim Y, Jeon M, Min H, Son J, Lee J, Kwon OS, Moon MH, Kim KH. Development of a multi-functional concurrent assay using weak cation-exchange solid-phase extraction (WCX-SPE) and reconstitution with a diluted sample aliquot for anti-doping analysis. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2018; 32:897-905. [PMID: 29572989 DOI: 10.1002/rcm.8119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/09/2018] [Accepted: 03/13/2018] [Indexed: 06/08/2023]
Abstract
RATIONALE In addition to the development of adequate screening methods for multiple compounds, the World Anti-Doping Agency (WADA) requires anti-doping laboratories to analyze prohibited substances and their metabolites from various classes. This task presents a difficult challenge for all agencies and interests involved in the field of doping control. METHODS A screening method is reported in which hybrid sample preparation was performed using a combination of weak cation-exchange solid-phase extraction (WCX-SPE) and the 'Dilute and Shoot' strategy in order to take advantage of both the methodologies. Target substances were extracted using a WCX cartridge and reconstituted with a diluted sample aliquot that included 20% of an untreated urine sample. The target substances were further analyzed by high-performance liquid chromatography/triple quadrupole mass spectrometry (LC/MS). RESULTS The SPE procedure was optimized using a cartridge-washing step, elution conditions, and elution volume. The cartridge-washing step, which was performed using 10% methanol, improved the overall recovery of target substances. Since the recovery was observed to vary according to the pH of the eluting solution, we applied an elution step using both an acid and a basic organic solvent to achieve complementary recovery. Reconstitution of the diluted aliquot sample was performed to recover the polar substances. CONCLUSIONS The method was validated and applied to real samples in accordance with the external quality assessment scheme of WADA and to the previously reported samples that had provided positive test results. This novel method using hybrid sample preparation and LC/MS could be useful to screen multiple classes of the 264 targeted substances in anti-doping analysis.
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Affiliation(s)
- Yongseok Kim
- Doping Control Center, Korea Institute of Science and Technology, Hwarang-ro 14-gil 5, Seongbuk-gu, Seoul, 02792, Republic of Korea
- Department of Chemistry, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Mijin Jeon
- Doping Control Center, Korea Institute of Science and Technology, Hwarang-ro 14-gil 5, Seongbuk-gu, Seoul, 02792, Republic of Korea
| | - Hophil Min
- Doping Control Center, Korea Institute of Science and Technology, Hwarang-ro 14-gil 5, Seongbuk-gu, Seoul, 02792, Republic of Korea
| | - Junghyun Son
- Doping Control Center, Korea Institute of Science and Technology, Hwarang-ro 14-gil 5, Seongbuk-gu, Seoul, 02792, Republic of Korea
| | - Jaeick Lee
- Doping Control Center, Korea Institute of Science and Technology, Hwarang-ro 14-gil 5, Seongbuk-gu, Seoul, 02792, Republic of Korea
| | - Oh-Seung Kwon
- Doping Control Center, Korea Institute of Science and Technology, Hwarang-ro 14-gil 5, Seongbuk-gu, Seoul, 02792, Republic of Korea
| | - Myeong Hee Moon
- Department of Chemistry, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Ki Hun Kim
- Doping Control Center, Korea Institute of Science and Technology, Hwarang-ro 14-gil 5, Seongbuk-gu, Seoul, 02792, Republic of Korea
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Chen TT, Tseng YC, Huang TY, Chang-Chien GP, Hsu MC. Elimination profile of triamcinolone in urine following oral administration. Drug Test Anal 2017; 10:860-864. [PMID: 29155490 DOI: 10.1002/dta.2343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 09/17/2017] [Accepted: 11/05/2017] [Indexed: 12/29/2022]
Abstract
Triamcinolone (T) is a glucocorticoid commonly used to relieve inflammation and treat arthritis, severe allergies, and asthma; however, it is banned by the World Anti-Doping Agency in competition for athletes when administered orally, intravenously, intramuscularly, or rectally. The minimum required performance limit (MRPL) for urinary T is 30 ng/mL. However, the data about the urinary excretion of T after oral administration is limited. We investigate the elimination profile and determine whether single-dose administration of T would cause a positive doping result. Twelve healthy volunteers received a single-dose of 4-mg T rally, and urine samples were collected for 24 hours. A validated liquid chromatography-tandem mass spectrometry method was used to determine urinary T levels. Non-compartmental modeling was used to estimate the pharmacokinetic parameters. All the urinary T concentrations were much higher than the MRPL. The peak urinary T concentration was 3211.4 ± 860.3 ng/mL (mean ± SD), time to peak concentration was 1.7 ± 0.9 hours, and the estimated elimination half-life was 4.4 ± 2.8 hours. About 27.76% of the consumed dose was eliminated via urine within 24 hours of intake. After a single-dose oral administration, urinary T concentrations still exceeded the MRPL after 24 hours. This information could be useful for limiting the misuse of T. Athletes should be aware when using T in competition and acquire approval for a therapeutic use exemption prior to use. Moreover, the elimination profile of orally administered T may be crucial information for distinguishing different dosage routes.
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Affiliation(s)
- Ting-Ting Chen
- Department of Health and Leisure Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | | | - Tai-Yuan Huang
- Department of Orthopedic Surgery, Yuan's General Hospital, Kaohsiung, Taiwan
| | - Guo-Ping Chang-Chien
- Super Micro Mass Research & Technology Center, Cheng Shiu University, Kaohsiung, Taiwan
| | - Mei-Chich Hsu
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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11
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Li H, Ai L, Fan S, Wang Y, Sun D. Rapid determination of 18 glucocorticoids in serum using reusable on-line SPE polymeric monolithic column coupled with LC-quadrupole/orbitrap high-resolution mass spectrometer. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1065-1066:79-86. [DOI: 10.1016/j.jchromb.2017.09.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 05/25/2017] [Accepted: 09/17/2017] [Indexed: 12/15/2022]
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12
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Proposal of 5-methoxy- N -methyl- N -isopropyltryptamine consumption biomarkers through identification of in vivo metabolites from mice. J Chromatogr A 2017; 1508:95-105. [DOI: 10.1016/j.chroma.2017.06.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 05/31/2017] [Accepted: 06/03/2017] [Indexed: 02/07/2023]
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13
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Santer V, Del Río Sancho S, Lapteva M, Kalia YN. Targeted intracorneal delivery-Biodistribution of triamcinolone acetonide following topical iontophoresis of cationic amino acid ester prodrugs. Int J Pharm 2017; 525:43-53. [PMID: 28414134 DOI: 10.1016/j.ijpharm.2017.04.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 10/19/2022]
Abstract
The aim was to investigate intracorneal iontophoresis of biolabile triamcinolone acetonide (TA) amino acid ester prodrugs (TA-AA). Arginine and lysine esters of TA (TA-Arg and TA-Lys, respectively) were synthesized and characterized; quantification was performed by HPLC-UV and UHPLC-MS/MS. The aqueous solubility of the prodrugs (at pH 5.5) was ∼1000-fold greater than TA. Anodal iontophoresis (10min at 3mA/cm2) of TA-AA was investigated using isolated porcine cornea. Although no statistically significant difference was observed in total intracorneal delivery of TA (468.25±59.70 and 540.85±79.16nmolTA/cm2, for TA-Arg and TA-Lys, respectively), the different susceptibilities of the prodrugs to hydrolysis influenced intracorneal biodistribution. Quantification of TA in twenty-five 40μm thick corneal lamellae revealed significantly deeper penetration of TA following TA-Lys iontophoresis. Its superior resistance to hydrolysis enabled sustained electromigration into the deeper cornea suggesting judicious prodrug selection might enable targeted regioselective drug delivery. The intracorneal biodistribution following anodal iontophoresis of TA-Arg (2.3mM; 10min, 3mA/cm2) was visualized by full field optical coherence tomography providing qualitative confirmation of the extensive intracorneal penetration of TA. Short duration iontophoresis of TA-AA prodrugs may improve deep corneal bioavailability and efficacy in vivo, constituting a "single-shot" treatment option for corneal allograft rejection.
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Affiliation(s)
- Verena Santer
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, CMU, 1 rue Michel Servet, 1211 Geneva 4, Switzerland
| | - Sergio Del Río Sancho
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, CMU, 1 rue Michel Servet, 1211 Geneva 4, Switzerland
| | - Maria Lapteva
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, CMU, 1 rue Michel Servet, 1211 Geneva 4, Switzerland
| | - Yogeshvar N Kalia
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, CMU, 1 rue Michel Servet, 1211 Geneva 4, Switzerland.
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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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Bioanalytical techniques in discrimination between therapeutic and abusive use of drugs in sport. Bioanalysis 2016; 8:965-80. [DOI: 10.4155/bio.15.253] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The discrimination between therapeutic and abusive use of drugs in sports is performed using threshold concentrations or reporting levels, and the detection of the substances in a sample is only reported as an adverse analytical finding when the concentration exceeds the threshold or the reporting level. In this paper, the strategies of discrimination and the analytical methods used for the main groups of substances where the distinction is needed (β-2 agonists, ephedrines, glucocorticoids and morphine) will be reviewed. Nowadays, LC–MS is the method of choice for the analysis of these substances and, in most of the cases, a simple dilution of the urine sample is performed before the chromatographic analysis.
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Derivatization of steroids in biological samples for GC–MS and LC–MS analyses. Bioanalysis 2015; 7:2515-36. [DOI: 10.4155/bio.15.176] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The determination of steroids in biological samples is essential in different areas of knowledge. MS combined with either GC or LC is considered the best analytical technique for specific and sensitive determinations. However, due to the physicochemical properties of some steroids, and the low concentrations found in biological samples, the formation of a derivative prior to their analysis is required. In GC–MS determinations, derivatization is needed for generating volatile and thermally stable compounds. The improvement in terms of stability and chromatographic retention are the main reasons for selecting the derivatization agent. On the other hand, derivatization is not compulsory in LC–MS analyses and the derivatization is typically used for improving the ionization and therefore the overall sensitivity achieved.
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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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Matabosch X, Pozo OJ, Pérez-Mañá C, Papaseit E, Marcos J, Segura J, Ventura R. Evaluation of the reporting level to detect triamcinolone acetonide misuse in sports. J Steroid Biochem Mol Biol 2015; 145:94-102. [PMID: 25260353 DOI: 10.1016/j.jsbmb.2014.09.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 09/04/2014] [Accepted: 09/21/2014] [Indexed: 11/16/2022]
Abstract
Triamcinolone acetonide (TA) is prohibited in sport competitions using systemic administrations (e.g., intramuscular, IM), and it is allowed by other routes (e.g., intranasal, IN, or topical, TOP). A reporting level of 30 ng/mL is used to discriminate between forbidden and allowed administrations. We examined urinary profiles of TA metabolites after TOP, IN and IM administrations to evaluate the suitability of the current reporting level and to define the best criteria to discriminate between these administrations. TA was administered to healthy volunteers by different routes: a single IM dose (n=2), IN doses for three days (n=6), and TOP doses for five days followed by a single IM dose (n=8). Urine samples were collected at different time intervals and they were analyzed by liquid chromatography-tandem mass spectrometry to measure TA and eight metabolites. After TOP and IN administrations, concentrations of the metabolites were significantly lower (p<0.05) than after IM administrations. Concentrations of TA after IM administration were lower than 30 ng/mL for all volunteers (range 0.7-29.7 ng/mL), and they were lower than 5 ng/mL after multiple IN or TOP doses (0.1-3.6 ng/mL and 0-1.7 ng/mL, respectively). For 6β-hydroxy-TA, the main TA metabolite, greater concentrations were obtained: 10.7-469.1 ng/mL, 2.2-90.6 ng/mL and 0-57.2 ng/mL after IM, IN and TOP administrations, respectively. These results suggest that the current reporting level is not suitable to detect forbidden IM administration of TA. A lower concentration of the parent drug or the use of specific metabolites could discriminate IM from TOP or IN administrations.
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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
| | - Oscar J Pozo
- Bioanalysis Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Clara Pérez-Mañá
- Human Pharmacology and Neurosciences Research Group, IMIM, Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
| | - Esther Papaseit
- Human Pharmacology and Neurosciences Research Group, IMIM, Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
| | - Josep Marcos
- Bioanalysis Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Jordi Segura
- Bioanalysis Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Rosa Ventura
- Bioanalysis Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain.
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Detection and characterization of betamethasone metabolites in human urine by LC-MS/MS. Drug Test Anal 2014; 7:663-72. [DOI: 10.1002/dta.1770] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 09/22/2014] [Accepted: 11/27/2014] [Indexed: 11/07/2022]
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