Free and conjugated 3-methoxy-4-hydroxyphenylglycol in human urine: peripheral origin of glucuronide

Urinary metabolite variation is associated with pathological progression of the post-hepatitis B cirrhosis patients

Cirrhosis is a common and terminal outcome of many chronic liver conditions. A urinary metabonomic study using gas chromatography-mass spectrometry (GC-MS) and ultra performance liquid chromatography time-of-flight mass spectrometry (UPLC-TOFMS) was carried out to elucidate the pathophysiological basis of posthepatitis B cirrhosis in 63 posthepatitis B cirrhosis patients and 31 health controls. Urinary metabolic profile and corresponding differential metabolites associated with Child-Pugh (CP) grading of liver function were characterized, in addition to the blood routine, liver, and renal function tests. Multivariate statistical tools including principal component analysis (PCA) and orthogonal partial least-squares-discriminant analysis (OPLS-DA) were employed in the metabolite analysis along with a univariate statistical method, Wilcoxon-Mann-Whitney test. The alterations of differential metabolites contributing to the intergroup variation between healthy controls and cirrhotic patients, and among cirrhosis of CP grade A, B and C were also investigated. Six metabolites, α-hydroxyhippurate, tyrosine-betaxanthin, 3-hydroxyisovalerate, canavaninosuccinate, estrone, and glycoursodeoxycholate, were significantly altered among cirrhotic patients with CP A, B, and C, reflecting abnormal metabolism of amino acid, bile acids, hormones, and intestinal microbial metabolism. The results show that dynamic alteration of urinary metabolome, characterized by the changes of a panel of the differential metabolite markers, is indicative of an exacerbated liver function, highlighting their diagnostic and prognostic potential for the liver cirrhosis development.

Rapid and sensitive determination of catecholamines and the metabolite 3-methoxy-4-hydroxyphen-ethyleneglycol using HPLC following novel extraction procedures

In the present study assays were improved for the determination of free catecholamines and 3-methoxy-4-hydroxyphenethyleneglycol (MHPG), the major metabolite of peripheral and central noradrenaline. The compounds were extracted by a fluid phase extraction: a diphenyl boric acid method for the purification of catecholamines and an ethyl acetate extraction for MHPG were used, respectively. High-performance liquid chromatography with electrochemical detection was employed for quantitative analysis. In previous studies, significant differences between plasma concentrations of these substances in normal volunteers and hospital patients were demonstrated. Therefore, we established valid reference values for a hospital population. Blood and urine samples of 59 patients without disorders and medication affecting catecholamine synthesis and metabolism or the activity of the sympatho-adrenal system were collected and analyzed for free and total (free plus conjugated) MHPG, noradrenaline (NA), adrenaline (A) and dopamine (DA); total MHPG was assayed after enzymatic hydrolysis of conjugates. Our data clearly demonstrate that these methods are sensitive, specific, rapid, and can easily be standardized. The intra- and inter-assay precision were high (CV 2.6-5.3% and 4.3-6.9% for plasma, CV 3.8-4.9% and 5.1-8.2% for urine, respectively). For plasma, the mean concentrations +/- SD were determined to be 20.82+/-4.70 pmol/ml for free MHPG, 68.43+/-16.21 pmol/ml for total MHPG, 2.11+/-0.24 pmol/ml for NA and 0.31+/-0.08 pmol/ml for A. For 24h-urine the mean concentrations +/-SD were determined to be 0.44+/-0.13 mmol/24h for free MHPG, 8.79+/-2.13 mmol/24h for total MHPG, 169.8+/-58.25 nmol/24h for NA, 62.19+/-21.79 nmol/24h for A and 757.2+/-382.6 nmol/24h for DA. In summary, these novel and rapid methods can clearly be employed in a routine clinical setting.

Effect of reserpine on 3-methoxy-4-hydroxyphenylethyleneglycol and 3,4-dihydroxyphenylacetic acid in the hippocampus of depression-model rats: an in vivo microdialysis study

Using in vivo microdialysis, we examined the effect of intraperitoneal injection of reserpine (2 mg/kg) on hippocampal 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) and 3,4-dihydroxy-phenylacetic acid (DOPAC), two major metabolites of catecholamine. Responses were examined serially for 12 h in the hippocampus of walking-stress-induced depression-model rats, recovery rats and control rats. Control rats showed a rapid rise followed by a gradual fall of free and total MHPG and a delayed increase of DOPAC in response to reserpine. Depression-model rats showed a significantly blunted biphasic response of free and total MHPG as well as blunted monophasic response of DOPAC compared with control rats. Recovery rats also exhibited a blunted fall response of MHPG. Our findings suggest that the vesicle membrane in the central noradrenaline (NA) neurons could be hyposensitive to reserpine in the depression-model rats.

A simplified routine assay for urinary 3-methoxy-4-hydroxyphenylglycol

Urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) level may provide us with a biochemical index for central noradrenergic activity. Previous methods for assaying MHPG in urine often lacked specificity, sensitivity, cost-effectiveness or convenience. We now describe a simplified routine assay for urinary MHPG by high-pressure liquid chromatography using electrochemical detection. For convenience and cost-effectiveness within a typical batch assay of total MHPG, 0.5 mL of urine sample, 50 microL of glusulase and 4 micrograms iso-vanillyl alcohol (internal standard) were used to hydrolyze conjugated MHPG at 37 degrees C overnight. Alternatively, for a same-day operation, it is efficient to hydrolyze the sample at 50 degrees C for 3 hours. Each sample was separated isocratically on a reversed-phase column (Ultracarb 5 ODS) at 25 degrees C with the flow rate at 1 mL/min. Intra- and inter-assay coefficients of variation were found to be 4.0% (n = 10) and 5.0% (n = 27), respectively, for MHPG at a mean concentration of 1.9 mg/L. Sulfatase or glucuronidase can be substituted for glusulase to obtain either sulfate- or glucuronide-conjugated MHPG. This procedure requires smaller sample amounts and less preparation time without compromising sensitivity and reproducibility.

Reward dependence is positively related to urinary monoamines in normal men

According to Cloninger, three major personality dimensions, novelty seeking, harm avoidance, and reward dependence, are dependent on central monoaminergic systems. This study examined the relationship between the urinary levels of different monoamines and the above personality dimensions. Fifty normal men answered the Tridimensional Personality Questionnaire (TPQ); their levels of dopamine, norepinephrine, epinephrine, normetanephrine, metanephrine, 3-methoxy-4-hydroxyphenylglycol, vanilmandelic acid, homovanilic acid, and serotonin metabolite 5-hydroxyindolacetic acid were measured in urine on two consecutive nights. Significant and positive correlations were found between reward dependence, 3-methoxy-4-hydroxyphenylglycol, and epinephrine (r = .50 and r = .51, respectively). Monoamine levels explained 44% of the variance of reward dependence. Cluster analysis identified three groups of subjects presenting specific patterns of monoamine excretion. The TPQ scores could discriminate among subjects belonging to these clusters. These results point out a narrow relationship between urinary monoamine excretion and the basic personality dimension of reward dependence.

The impact of gender on alpha-methyl-para-tyrosine mediated changes in prolactin secretion and 6-hydroxymelatonin sulfate excretion

Prolactin (PRL) and melatonin (ML) secretion are mediated by dopamine (DA) and norepinephrine (NE), respectively. Alpha-methyl-para-tyrosine (AMPT) inhibits the production of CNS catecholamines (CA). The purpose of the study is to determine: (1) if AMPT inhibition of ML has the same gender-dependent effect as on PRL secretion; (2) if there is a post AMPT-induced NE depletion mood change in men and/or women. In a randomized, double-blind cross-over fashion, five healthy young males and five females were either given five doses of AMPT 1 g (active) or promethazine 50 mg (placebo) over a 28 h period, separated by 4-6 weeks. The PRL and ML concentrations were collected at regular intervals via an indwelling venous catheter and concurrently, two 12 h urinary 6-hydroxymelatonin sulfate (6-MS) measurements were made. Mood and anxiety states of subjects at baseline and post drug were assessed with appropriate rating scales at regular intervals. Light exposure beginning at dusk and lasting until dawn was controlled to no more than 200 lux during all phases of the study. The PRL secretion showed a significant interaction of drug x time (p = .0001) in women and a non-significant trend (p = .056) in men. No difference in PRL secretion was found between the two genders in the placebo condition, whereas the PRL secretion was significantly higher in the AMPT condition in women when compared to men (df 17,119, F = 1.9, p = .021). Total 24 h urinary 6-MS secretion highly correlated with ML secretion expressed as area under the curve (AUC) during both active and placebo experiments (r = 0.8, p < .01) and (r = 0.86, p < or = .01), respectively. The ANOVA reveals a significant interaction of drug x time for 6-SM excretion. There was no gender difference in AMPT suppression of 6-MS excretion. No mood changes were detected in men or women. We conclude that urinary 6-MS is a reliable indirect measure of the degree of AMPT-induced decrease in CNS NE activity as part of overall AMPT-induced reduction of central catecholamine activities. The pre and post AMPT-induced changes in 6-MS are not gender dependent, dissimilar to the AMPT-induced changes in PRL secretion. Therefore, 6-MS, in addition to PRL, should be measured when applying the AMPT paradigm in future research.

Assay of urinary free and conjugated 3-methoxy-4-hydroxyphenylethyleneglycol by high-performance liquid chromatography with amperometric detection

The aim of this study was to develop an analytical method for free and conjugated 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) in urine. After hydrolysis of the conjugated forms, the urinary MHPG was purified by solid-phase extraction on anion exchanger and eluted with a water-methanol (1:1, v/v) mixture. After addition of ethyl acetate to the eluate and back-extraction into acetic acid, the aqueous phase was separated on a C18 column by HPLC and detected amperometrically. The results obtained from forty healthy human subjects were compared with the literature values. The precision and accuracy of the assay were studied using 4-methoxy-3-hydroxyphenylethyleneglycol (iso-MHPG) as internal standard.

The influence of total sleep deprivation on urinary excretion of catecholamine metabolites in major depression

To elucidate the influence of total sleep deprivation (TSD) on catecholaminergic neurotransmission, which is assumed to be disturbed in depression, 9 depressive patients collected consecutive 24-h urine samples prior to (baseline), during (TSD) and following total sleep deprivation (post-TSD). Urine samples were analysed for total MHPG (3-methoxy-4-hydroxyphenylglycol), conjugates of MHPG (glucuronide and sulfate), excretion of HVA (homovanillic acid) and VMA (3-methoxy-4-hydroxymandelic acid). TSD increased the urinary excretion of MHPG-sulfate as a marker of the central norepinephrine metabolism and the excretion rates of VMA and HVA as indices of the peripheral catecholamine metabolism. Patients with higher VMA values prior to TSD reacted worse, and the VMA increase due to TSD was positively correlated with the response. The results demonstrate that TSD, besides acting as a stimulus on the peripheral sympathetic nervous system, influences central nervous noradrenergic neurotransmission, as reflected by the increase of MHPG-sulfate.

Effect of diet on urinary excretion of unconjugated catecholamines and some of their metabolites in healthy control subjects and depressed patients

The effect of a low-monoamine diet on the 24-h urinary excretion of unconjugated catecholamines and some of their metabolites was investigated. Total (unconjugated and conjugated) 3-methoxy-4-hydroxy-phenylglycol excretion was 15% to 20% lower under the low-monoamine diet, both when calculated per 24 h and per creatinine excretion. No effect on the concentrations of unconjugated urinary catecholamines, unconjugated vanillylmandelic acid, or total normetanephrine was observed. It is concluded that, for diagnosis of neural crest tumors, no dietary restrictions are necessary, provided analytical methods such as presented are used. When 24-h urines are analysed for MHPG, however, as in psychiatric studies, dietary effects must be taken into account, especially when small differences in excretion are expected.

Urinary MHPG sulfate as a marker of central norepinephrine metabolism: a commentary

Measurement of total (free + conjugated) 3 methoxy-4-hydroxyphenylglycol (MHPG) in urine has long been used to assess the metabolism of central norepinephrine (NE). However, available data indicate that total MHPG is not a sensitive marker because the portion of urinary MHPG which derives from brain NE is less than was previously assumed. Several arguments support the view that central MHPG excretion is best represented by the urinary MHPG sulfate fraction. Accordingly, a new strategy has been introduced in last years, involving the separate determination of sulfate and glucuronide conjugates of MHPG as respective markers of central and peripheral NE metabolism. Various biochemical and pharmacological data obtained in healthy subjects and in patients with mental diseases support this hypothesis.

Rapid non-enzymatic HPLC determination of total MHPG in human plasma

We have previously reported a method for the determination of total 3-methoxy-4-hydroxy phenylethylene glycol (MHPG) in brain, based on a simple acid-catalyzed hydrolysis. Now we extend this procedure to the determination of plasma total MHPG. The method involves the deproteinization of plasma with perchloric acid, followed by 3 minutes of an acid-catalyzed step. The hydrolysates are injected into the HPLC system, using a formic acid/methanol eluent with fluorimetric detection. Sample detection limit is below 1 ng MHPG/mL of plasma. This procedure has been used for the determination of plasma total MHPG from 109 healthy individuals of both sexes. Mean value was: 5.4 + 2.3 ng total MHPG/mL of plasma (means +/- S.D., N = 109). No sex differences were observed, and a slight correlation with age (r = 0.24, p less than 0.02) has been found. Plasma-free MHPG was also determined in a subgroup of 15 randomly chosen individuals (3.0 +/- 1.2 ng free MHPG/mL plasma, means +/- S.D.). A significant correlation was obtained with plasma total MHPG (r = 0.77, p less than 0.001, N = 15). The main advantage of the present method lays in its simplicity, since no enzymatic hydrolysis or extraction procedures are needed, being its reliability fully proven through 109 plasma total MHPG determinations.

Gas-liquid chromatographic method for routine detection of plasma sulfo-, gluco-, and free 3-methoxy-4-hydroxyphenylglycol

A revised method is described for detection of human plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) using gas-liquid chromatography and electron capture detection. This method has comparable sensitivity and reproducibility as HPLC methods with amperometric detection but is less expensive. The extraction and detection of an internal standard of 3-ethoxy-4-hydroxyphenylglycol (EHPG) is identical to MHPG, making quantitation easier than with electrochemical detection. Techniques for measuring the sulfo-, gluco-, and free plasma MHPG fractions are described, and normal adult values are reported.

Determination of urinary 3-methoxy-4-hydroxyphenylethylene glycol and its conjugates by high-performance liquid chromatography with electrochemical and ultraviolet absorbance detection

A simple method for the determination in urine of the norepinephrine metabolite 3-methoxy-4-hydroxyphenylethylene glycol (MHPG) and its conjugated derivatives is described. After an extraction procedure similar to that described by Gaertner and Wiatr [J. Clin. Chem. Clin. Biochem., 18 (1980) 579] isocratic high-performance liquid chromatographic separation is performed. MHPG can be detected by either electrochemical or absorbance detection (278 nm). Free MHPG is determined directly, whereas MHPG sulphate and MHPG glucuronide are determined after enzymic hydrolysis. Since total MHPG, which represents the sum of these substances, is determined separately, a comparison of the results allows the effectiveness of the hydrolysis of the MHPG derivatives for each urine sample to be determined. For quantitation, the method of adding standard amounts of MHPG is used.

Biogenic amines and their metabolites in body fluids of normal, psychiatric and neurological subjects

The biogenic monoamines and their metabolites have been isolated, identified and quantified in human body fluids over the past forty years using a wide variety of chromatographic separation and detection techniques. This review summarizes the results of those studies on normal, psychiatric and neurological subjects. Tables of normal values and the methods used to obtain them should prove to be useful as a reference source for benchmark amine and metabolite concentrations and for successful analytical procedures for their chromatographic separation, detection and quantification. Summaries of the often contradictory results of the application of these methods to psychiatric and neurological problems are presented and may assist in the assessment of the validity of the results of experiments in this field. Finally, the individual, environmental and the methodological factors affecting the concentrations of the amines and their metabolites are discussed.

Urinary free and conjugated catecholamines and metabolites in autistic children

Urinary catecholamines (DA, NE, E) and their main metabolites (HVA, DOPAC, MHPG) were analyzed both as free and conjugates in eight children diagnosed as autistic according to DSM-III criteria and eight normal children. Significant differences appeared for the urinary excretion of both DA and NE and their respective metabolites: Autistic children showed low DA, high HVA, high NE, low MHPG urinary levels. These results are consistent with previous findings on altered catecholamine metabolism in autistic children. They suggest that autistic behaviors might be related to an abnormal functional imbalance among monoamines either at a molecular level or at a system level. Furthermore, they emphasize the special interest of urinary assays in pediatric research.

The evaluation of 4-hydroxy-3-methoxyphenylglycol sulfate as a possible marker of central norepinephrine turnover. Studies in healthy volunteers and depressed patients

Much evidence indicates that urinary 4-hydroxy-3-methoxyphenylethyleneglycol (MHPG) is an insensitive measure of central norepinephrine metabolism. This conclusion, however, seems to apply mainly to total urinary MHPG, since previous findings point to the possibility that the major proportion of urinary MHPG sulfate originates in the CNS, while most urinary MHPG glucuronide originates in peripheral organs. To examine this hypothesis, experiments were performed by which we altered MHPG turnover in man at two different stages: firstly, strong physical exercise (ergometer) increased the urinary excretion rate of MHPG glucuronide and not that of MHPG-sulfate; secondly, ethanol (l g/kg), which is known to block the metabolism of MHPG to vanilmandelic acid in the liver, increases the urinary excretion rate of the glucuronide and not that of sulfate. Both experiments indicate that alteration of peripheral norepinephrine turnover changes the urinary excretion of MHPG glucuronide only and not that of sulfate, thus providing strong, albeit indirect, evidence for a primarily central origin of MHPG sulfate. Preliminary experiments in 32 depressed patients showed little difference in both MHPG fractions compared with healthy controls, apart from a slightly reduced excretion rate of glucuronide. These findings fail to provide any evidence of central, and only small changes in peripheral norepinephrine metabolism in depression.

Quantitation of total MHPG in the rat brain using a non enzymatic hydrolysis procedure. Effects of drugs

An acid-catalyzed procedure has been used to hydrolyze MHPG-sulfate in homogenates of rat brain. The samples (in 0.4 mol/L perchloric acid) are treated for 3 min. at 100 degrees C in a water bath and aliquots are injected into a reversed phase HPLC system. Detection is achieved fluorimetrically. The absolute detection limit for MHPG is 150 pg, which allows the reliable determination of either free or total MHPG in rat brain in concentrations down to 15 ng/g, using the described procedure. The concentration of total MHPG found in the brains of saline-treated rats are 101 +/- 21 ng/g (mean +/- S.D.) which is in a good accordance with the concentration value for the same samples obtained using a GC-MS method (115 +/- 19 ng/g). Rats treated with clonidine (300 micrograms/Kg, i.p.) or yohimbine (10 mg/Kg, i.p.) showed brain concentrations of total MHPG of 68 +/- 22 ng/g and 299 +/- 85 ng/g, respectively. The utility of this method for the analysis of brain regions or brain nuclei (e.g. locus coeruleus) is also shown.

Simultaneous analysis of twelve biogenic amine metabolites in plasma, cerebrospinal fluid and urine by capillary column gas chromatography-high-resolution mass spectrometry with selected-ion monitoring

A procedure is described for the simultaneous determination of twelve acidic and alcoholic metabolites of trace and catecholic biogenic amines in plasma, cerebrospinal fluid and urine by capillary column gas chromatography--high-resolution mass spectrometry. Protein precipitation with sulphosalicylic acid, derivatization with two different reagent systems, final sample clean-up with a buffer wash and a program for automatically changing the reference mass of the mass spectrometer to suit each group of compounds as they are eluted from the column, are the main novel features of the procedure. A brief description of the synthesis of the deuterium-labelled internal standards is provided. The procedure is applied to biological samples and a comparison to reported values is given.

Sulfate and glucuronide conjugates of 3-methoxy-4-hydroxyphenylglycol (MHPG) in urine of depressed patients: central and peripheral influences

A number of arguments support the hypothesis that changes in urinary levels of MHPG sulfate and MHPG glucuronide respectively reflect central and peripheral norepinephrine metabolism (NE) in man. In this line, the daily excretion of both conjugates was determined in 36 depressed women comparatively to 23 healthy women in order to assess the extent and the central or peripheral location of their possible NE dysfunction. About 80% of the patients suffering from depression (6 endogenous, 19 neurotic, 11 reactive depressions) exhibited a central NE defect, as evidenced by low MHPG sulfate, and many of them had probably also diminished sympathetic activity, as suggested by low MHPG glucuronide. Clinical symptoms possibly related to the psychic state (mood alteration) or associated to sympathetic changes (anxiety, motor activity) respectively altered sulfate or glucuronide excretion. Sulfate (S) and glucuronide (G) MHPG excretions were significantly correlated in healthy subjects (r = 0.53, p = 0.01), thus supporting the concept of the functional link between central NE activity and sympathetic function. Such a correlation was not found in depressive patients. However the lack of significant changes in the mean ratio S/G in the patient sub-groups suggests that as in normal subjects, central and peripheral NE activity are linked in depressed patients, but other factors may also modify sympathetic function. Taken together our data show that the separate assay of sulfate and glucuronide MHPG provides a better picture of NE dysfunction in depression than total MHPG measurement.

Glucuronide and sulfate catecholamine conjugates in rat and human plasma

We have developed a method to selectively estimate free, glucuronidated and sulfated catecholamines (epinephrine [E], norepinephrine [NE], dopamine [DA]) in a single plasma sample. The method incorporates the first step of the catecholamine radioenzymatic assay and the selective enzymatic hydrolysis of conjugates by glucuronidase or sulfatase preparations. The method has been applied to rat and human plasma with a view to determine the relative importance of either conjugate (sulfate or glucuronide) toward free catecholamines. No previous reports were available for the concentration of either conjugate in rat plasma or the level of glucuronide conjugate in human plasma. Both sulfate and glucuronide conjugate of the three catecholamines were found in rat and human plasma, at different levels. Sulfate conjugates predominated in man and glucuronides in rat. In human, hand immersion in ice water for three minutes, which increased free catecholamine levels in the first minutes of the test, elicited too a delayed increase of glucuronide levels at the 30th minute (except for DA glucuronide which was already elevated at the third minute). As to the sulfates, only E sulfate was increased at the 10th minute. Our results suggest that glucuronidation may be an important pathway for catecholamine metabolism in man at rest or under sympathetic stimulation. In rat, our data point out the influence of blood sampling conditions (dietary, catheterization, decapitation) on the studied compounds and suggest that the nearest conditions from basal state may be fulfilled in sucrose-fed catheterized rats. The predominance of glucuronides in rat plasma agrees with previous metabolic reports.