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Lee CW, Su H, Hsu YW, Su LZ, Wu YH, Hou CY, Shih SY, Shiea J. Rapid Characterization of Undeclared Pharmaceuticals in Herbal Preparations by Ambient Ionization Mass Spectrometry for Emergency Care. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2024; 35:960-971. [PMID: 38616559 PMCID: PMC11066970 DOI: 10.1021/jasms.4c00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 03/12/2024] [Accepted: 04/09/2024] [Indexed: 04/16/2024]
Abstract
In Asia, some herbal preparations have been found to be adulterated with undeclared synthetic medicines to increase their therapeutic efficiency. Many of these adulterants were found to be toxic when overdosed and have been documented to bring about severe, even life-threatening acute poisoning events. The objective of this study is to develop a rapid and sensitive ambient ionization mass spectrometric platform to characterize the undeclared toxic adulterated ingredients in herbal preparations. Several common adulterants were spiked into different herbal preparations and human sera to simulate the clinical conditions of acute poisoning. They were then sampled with a metallic probe and analyzed by the thermal desorption-electrospray ionization mass spectrometry. The experimental parameters including sensitivity, specificity, accuracy, and turnaround time were prudently optimized in this study. Since tedious and time-consuming pretreatment of the sample is unnecessary, the toxic adulterants could be characterized within 60 s. The results can help emergency physicians to make clinical judgments and prescribe appropriate antidotes or supportive treatment in a time-sensitive manner.
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Affiliation(s)
- Chi-Wei Lee
- Institute
of Medical Science and Technology, National
Sun Yat-Sen University, Kaohsiung 804201, Taiwan, ROC
- Rapid
Screening Research Center for Toxicology and Biomedicine, National Sun Yat-Sen University, Kaohsiung 804201, Taiwan, ROC
- Research
Center for Environmental Medicine, Kaohsiung
Medical University, Kaohsiung 80756, Taiwan, ROC
| | - Hung Su
- Department
of Chemistry, National Sun Yat-Sen University, Kaohsiung 804201, Taiwan, ROC
| | - Yi-Wen Hsu
- Institute
of Medical Science and Technology, National
Sun Yat-Sen University, Kaohsiung 804201, Taiwan, ROC
| | - Lin-Zhen Su
- Institute
of Medical Science and Technology, National
Sun Yat-Sen University, Kaohsiung 804201, Taiwan, ROC
| | - Yen-Hung Wu
- Department
of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan, ROC
| | - Chia-Yi Hou
- Department
of Clinical Pathology, Chi-Mei Medical Center, Liouying 73659, Taiwan, ROC
| | - Shu-Yu Shih
- Department
of Emergency Medicine, Chi-Mei Medical Center, Liouying 73659, Taiwan, ROC
| | - Jentaie Shiea
- Department
of Chemistry, National Sun Yat-Sen University, Kaohsiung 804201, Taiwan, ROC
- Department
of Medicinal and Applied Chemistry, Kaohsiung
Medical University, Kaohsiung 80756, Taiwan, ROC
- Rapid
Screening Research Center for Toxicology and Biomedicine, National Sun Yat-Sen University, Kaohsiung 804201, Taiwan, ROC
- Research
Center for Environmental Medicine, Kaohsiung
Medical University, Kaohsiung 80756, Taiwan, ROC
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Mernissi T, Demagny J, Le Guyader M, Renou M, Choukroun G, Kamel S, Liabeuf S, Bodeau S. Quantitative determination of plasma free and total concentrations of antivitamin K drugs using a new sensitive and rapid LC-MS/MS method: Application in hemodialysis patients. Clin Chim Acta 2023; 548:117498. [PMID: 37482192 DOI: 10.1016/j.cca.2023.117498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/11/2023] [Accepted: 07/20/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND AND AIMS Vitamin K antagonists (VKAs) are the first-line anticoagulants used in end stage renal disease. This population experiences a significant variability in their International Normalized Ratio (INR) over time. There is a need for methods allowing the study of the pharmacokinetics of free and total concentrations of VKAs to explain INR variability. MATERIALS AND METHODS We developed and validated a high-performance liquid chromatography-tandem mass spectrometry method allowing the quantification of warfarin and fluindione free and total plasma concentrations. Chromatographic separation was achieved in a raptor biphenyl column and the spectrometry acquisition was set in multiple reaction monitoring mode after negative electrospray ionization. We then applied it in describing the plasma free and total concentrations of VKAs in samples from 50 hemodialysis patients. RESULTS The developed method is rapid, sensitive and specific. Our cohort results showed a correlation between free and total VKA concentrations. The free VKA concentrations tended to be higher in patients with higher INR. Although VKAs are highly albumin-bound drugs, albumin concentration did not totally explain the high inter-individual total VKA concentrations variability. CONCLUSION This opens the door to further studies to understand the factors involved in their variability.
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Affiliation(s)
- Touria Mernissi
- MP3CV Laboratory, EA7517, Jules Verne University of Picardie, Amiens, F-80000 Amiens, France; Department of Clinical Pharmacology, Amiens University Medical Center, F-80000 Amiens, France
| | - Julien Demagny
- Department of Hematology, Amiens University Medical Center, F-80000 Amiens, France
| | - Mailys Le Guyader
- Department of Hematology, Amiens University Medical Center, F-80000 Amiens, France
| | - Marianne Renou
- Department of Nephrology, Dialysis and Transplantation, Amiens University Medical Center, F-80000 Amiens, France
| | - Gabriel Choukroun
- MP3CV Laboratory, EA7517, Jules Verne University of Picardie, Amiens, F-80000 Amiens, France; Department of Nephrology, Dialysis and Transplantation, Amiens University Medical Center, F-80000 Amiens, France
| | - Saïd Kamel
- MP3CV Laboratory, EA7517, Jules Verne University of Picardie, Amiens, F-80000 Amiens, France; Department of Biochemistry, Amiens University Medical Center, F-80000 Amiens, France
| | - Sophie Liabeuf
- MP3CV Laboratory, EA7517, Jules Verne University of Picardie, Amiens, F-80000 Amiens, France; Department of Clinical Pharmacology, Amiens University Medical Center, F-80000 Amiens, France
| | - Sandra Bodeau
- MP3CV Laboratory, EA7517, Jules Verne University of Picardie, Amiens, F-80000 Amiens, France; Department of Clinical Pharmacology, Amiens University Medical Center, F-80000 Amiens, France.
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Lee CW, Su H, Shiea J. Potential applications and challenges of novel ambient ionization mass spectrometric techniques in the emergency care for acute poisoning. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Su H, Huang MZ, Shiea J, Lee CW. Thermal desorption ambient ionization mass spectrometry for emergency toxicology. MASS SPECTROMETRY REVIEWS 2022:e21784. [PMID: 35603997 DOI: 10.1002/mas.21784] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/17/2021] [Accepted: 01/21/2022] [Indexed: 06/15/2023]
Abstract
In the emergency department, it is important to rapidly identify the toxic substances that have led to acute poisoning because different toxicants or toxins cause poisoning through different mechanisms, requiring disparate therapeutic strategies and precautions against contraindicating actions, and diverse directions of clinical course monitoring and prediction of prognosis. Ambient ionization mass spectrometry, a state-of-the-art technology, has been proved to be a fast, accurate, and user-friendly tool for rapidly identifying toxicants like residual pesticides on fruits and vegetables. In view of this, developing an analytical platform that explores the application of such a cutting-edge technology in a novel direction has been initiated a research program, namely, the rapid identification of toxic substances which might have caused acute poisoning in patients who visit the emergency department and requires an accurate diagnosis for correct clinical decision-making to bring about corresponding data-guided management. This review includes (i) a narrative account of the breakthrough in emergency toxicology brought about by the advent of ambient ionization mass spectrometry and (ii) a thorough discussion about the clinical implications and technical limitations of such a promising innovation for promoting toxicological tests from tier two-level to tier one level.
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Affiliation(s)
- Hung Su
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Min-Zong Huang
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Jentaie Shiea
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Wei Lee
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
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A novel, rapid and simple UHPLC-MS/MS method for quantification of warfarin in dried blood spots. Anal Biochem 2022; 647:114664. [PMID: 35300971 DOI: 10.1016/j.ab.2022.114664] [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: 10/29/2021] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 11/01/2022]
Abstract
Warfarin is a common first line anticoagulant with a narrow therapeutic window. Because of the large blood volume needed, previous warfarin determination methods were not applicable to small animals, such as mice. To reduce the number of small animals used needed, we developed and validated a sensitive rapid assay for the simultaneous detection of warfarin enantiomers in mouse dried blood spot (DBS) samples. Analytes were extracted by tert-butyl methyl ether and then separated by a chiral Cellulose-1 column with a mobile phase of 75% acetonitrile (containing 0.1% formic acid). The total chromatographic run time was 3 min. Negative mode electrospray ionization was used for MS/MS detection, where the monitored ion transitions were m/z 307.1 → 161.0 and 341.1 → 284.0 for warfarin and coumachlor (internal standard) respectively. The calibration curves were linear with a correlation coefficient of ≥0.994 for both enantiomers over a concentration range of 10-1000 ng/mL. The satisfactory accuracy and adequate reproducibility of both warfarin enantiomers were validated in terms of intra- and interday precision with mouse DBS cards. The samples were stable at room temperature for at least 14 days. The validated method was applied to a pharmacokinetic study in mice.
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Castro TNE, Costa ER, Gonçalves JCS, Estrela RDCE. Pretreatment and non-specific binding in ultrafiltration device: Impact on protease inhibitor quantification. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1146:122127. [PMID: 32371328 DOI: 10.1016/j.jchromb.2020.122127] [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: 10/16/2019] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Ultrafiltration (UF) is used to separate unbound drugs; however, non-specific binding (NSB) may be a limiting factor of this technique. Pretreatment of UF devices has been suggested to reduce NSB. Therefore, the pretreatment methodologies for UF devices were evaluated in order to test their effectiveness in reducing NSB of protease inhibitors (PIs). METHODOLOGY Two PIs (lopinavir-LPV and ritonavir-RTV) were tested. UF devices were pretreated with ultrapure water, Tween-20 or Tween-80. To evaluate the NSB, after UF devices being pretreated, ultrafiltrate solutions containing the analytes at two concentrations (low and high) were used. Samples were quantified by LC-MS/MS. RESULTS UF devices pretreated with Tween-5% had the lowest NSB for both analytes. NSB values varied between 7 and 11% at low concentration 16-34% at high LPV concentration, respectively. For RTV, NSB was approximately 6% for low concentration and 18% for high concentration. Failure to completely remove Tween in UF devices could results in an overestimation of NSB. CONCLUSION Pretreatment of UF device with Tween and subsequent removal proved to be effective in reducing NSB of PI.
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Affiliation(s)
- Thales Nascimento E Castro
- Programa de Pós-Graduação em Saúde Pública e Meio Ambiente, Escola Nacional de Saúde Pública Sergio Arouca, FIOCRUZ, Rio de Janeiro, RJ, Brazil; Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Edlaine Rijo Costa
- Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Rita de Cassia Elias Estrela
- Programa de Pós-Graduação em Saúde Pública e Meio Ambiente, Escola Nacional de Saúde Pública Sergio Arouca, FIOCRUZ, Rio de Janeiro, RJ, Brazil; Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
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7
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Gao L, Xue Y, Zhang Z, Tian Y. Enantioseparation of
N‐
acetyl‐glutamine enantiomers by LC–MS/MS and its application to a plasma protein binding study. Biomed Chromatogr 2019; 33:e4559. [DOI: 10.1002/bmc.4559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/12/2019] [Accepted: 04/17/2019] [Indexed: 01/16/2023]
Affiliation(s)
- Lei Gao
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education)China Pharmaceutical University Nanjing China
- Key Laboratory of Drug Consistency EvaluationChina Pharmaceutical University Nanjing China
| | - Yunwen Xue
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education)China Pharmaceutical University Nanjing China
- Key Laboratory of Drug Consistency EvaluationChina Pharmaceutical University Nanjing China
| | - Zunjian Zhang
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education)China Pharmaceutical University Nanjing China
- Key Laboratory of Drug Consistency EvaluationChina Pharmaceutical University Nanjing China
| | - Yuan Tian
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education)China Pharmaceutical University Nanjing China
- Key Laboratory of Drug Consistency EvaluationChina Pharmaceutical University Nanjing China
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8
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Shakleya D, Rahman Z, Faustino PJ. Development and validation of an ultra-high-performance liquid chromatography-tandem mass spectrometry method to determine the bioavailability of warfarin and its major metabolite 7-hydroxy warfarin in rats dosed with oral formulations containing different polymorphic forms. Biomed Chromatogr 2019; 33:e4685. [PMID: 31430835 DOI: 10.1002/bmc.4685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/29/2019] [Accepted: 08/15/2019] [Indexed: 11/12/2022]
Abstract
A simple, sensitive and rapid ultra-high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry method was developed and validated for the quantification of warfarin and 7-hydroxy warfarin in Sprague Dawley (SD) rats. Animals were administered a single dose of warfarin sodium formulations (crystalline and amorphous) at 12 mg/kg via oral gavage and blood was drawn over a 96-h time course. Sample process recoveries, matrix effect and analyte stability were determined. The linearity for warfarin and 7-hydroxy warfarin was from 5 to 2000 ng/mL in blank SD rat plasma. Correlation coefficients (r2 ) for standard calibration curves were >.98 and analytes quantified within ±15% of target at all calibrator concentrations. The average percent accuracy and precision for intra- and inter-day were 93.7%-113.8% and ≤12.1%, respectively, for warfarin and 7-hydroxy warfarin, across the quality control standards (5, 10, 500, 1800 and 2000 ng/mL). Acceptable analytical recovery (>55%) was achieved with process efficiencies >41.5% and matrix effects <139.9% over the analytical range. Both analytes were stable in stock solution, autosampler, benchtop and three cycles of freeze-thaw with percent accuracy ≥90.2% and precision (percent relative standard deviation) ≤14%. The validated method was successfully applied to a pre-clinical bioavailability study of crystalline and amorphous warfarin sodium formulations in SD rats.
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Affiliation(s)
- Diaa Shakleya
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Ziyaur Rahman
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA.,Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Texas A&M University, College Station, TX, USA
| | - Patrick J Faustino
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
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Kislyuk S, Kroonen J, Adams E, Augustijns P, de Witte P, Cabooter D. Development of a sensitive and quantitative UHPLC-MS/MS method to study the whole-body uptake of pharmaceuticals in zebrafish. Talanta 2017; 174:780-788. [PMID: 28738654 DOI: 10.1016/j.talanta.2017.06.075] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/23/2017] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
Abstract
An analytical procedure to measure the whole-body uptake of pharmaceuticals in zebrafish has been developed using state-of-the-art methodologies. A sample preparation procedure for 9 pharmaceuticals displaying a variety in physicochemical properties was developed using 10-day old zebrafish (TG898). For an efficient homogenization of the samples and subsequent recovery of the compounds of interest, different amounts of organic solvents in combination with acidic modifiers were added to zebrafish samples. Samples were subsequently processed using a powerful bath sonicator and centrifuged. Supernatant was then removed and evaporated in a vacuum oven before being reconstituted in a mobile phase-like solvent. Samples were analyzed using ultra-high performance liquid chromatography (UHPLC) on an Acquity BEH C18 column (100 × 2.1mm, dp=1.7µm) coupled to a Waters Xevo TQ-S mass spectrometer. For this purpose, a generic gradient was run, wherein the percentage of acetonitrile was varied from 3% to 82% in 10.5min at a flow rate of 0.41mL/min. Linearity of the method was demonstrated for all compounds (R2 > 0.997) in a practically relevant concentration range. Matrix effects were between 81% and 106%, except for amitriptyline (51%). Using this method, it was demonstrated that a sample pretreatment using 1:2 (v/v) water:methanol in combination with 0.1% formic acid resulted in acceptable recoveries between 74% and 100% for all compounds. Together with the obtained lower limits of quantification of the analytical method (between 0.005 and 1.5ng/mL), this allowed the use of a single zebrafish to study the whole-body uptake of a particular drug, after incubating zebrafish at the maximum tolerated concentration for this drug.
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Affiliation(s)
- Stanislav Kislyuk
- University of Leuven (KU Leuven), Pharmaceutical Analysis, Department of Pharmaceutical and Pharmacological Sciences, Herestraat 49, 3000 Leuven, Belgium
| | - Jerome Kroonen
- Diagenode Belgium, Rue Bois Saint-Jean 3, 4102 Seraing (Ougrée), Belgium
| | - Erwin Adams
- University of Leuven (KU Leuven), Pharmaceutical Analysis, Department of Pharmaceutical and Pharmacological Sciences, Herestraat 49, 3000 Leuven, Belgium
| | - Patrick Augustijns
- University of Leuven (KU Leuven), Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, Herestraat 49, 3000 Leuven, Belgium
| | - Peter de Witte
- University of Leuven (KU Leuven), Molecular Biodiscovery, Department of Pharmaceutical and Pharmacological Sciences, Herestraat 49, 3000 Leuven, Belgium
| | - Deirdre Cabooter
- University of Leuven (KU Leuven), Pharmaceutical Analysis, Department of Pharmaceutical and Pharmacological Sciences, Herestraat 49, 3000 Leuven, Belgium.
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Ranjbar bandforuzi S, Hadjmohammadi MR. Solvent bar microextraction using a reverse micelle containing extraction phase for the determination of warfarin from human plasma by high-performance liquid chromatography. J Chromatogr A 2017; 1496:1-8. [DOI: 10.1016/j.chroma.2017.03.037] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 03/15/2017] [Accepted: 03/17/2017] [Indexed: 11/25/2022]
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Kumar P, Kumar V, Gupta R. Detection of the anticoagulant drug warfarin by palladium complexes. Dalton Trans 2017; 46:10205-10209. [DOI: 10.1039/c7dt01811h] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This work illustrates the application of palladium complexes in the significant sensing of warfarin, a commercial anticoagulant drug, not only in organic solvents but also in aqueous medium.
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Affiliation(s)
- Pramod Kumar
- Department of Chemistry
- University of Delhi
- Delhi 110 007
- India
| | - Vijay Kumar
- Department of Chemistry
- University of Delhi
- Delhi 110 007
- India
| | - Rajeev Gupta
- Department of Chemistry
- University of Delhi
- Delhi 110 007
- India
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Wei H, Zhang X, Tian X, Wu G. Pharmaceutical applications of affinity-ultrafiltration mass spectrometry: Recent advances and future prospects. J Pharm Biomed Anal 2016; 131:444-453. [PMID: 27668554 DOI: 10.1016/j.jpba.2016.09.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/06/2016] [Accepted: 09/20/2016] [Indexed: 11/17/2022]
Abstract
The immunoaffinity of protein with ligand is broadly involved in many bioanalytical methods. Affinity-ultrafiltration mass spectrometry (AUF-MS), a platform based on interaction of protein-ligand affinity, has been developed to fish out interesting molecules from complex matrixes. Here we reviewed the basics of AUF-MS and its recent applications to pharmaceutical field, i.e. target-oriented discovery of lead compounds from combinatorial libraries and natural product extracts, and determination of free drug concentration in biosamples. Selected practical examples were highlighted to illustrate the advances of AUF-MS in pharmaceutical fields. The future prospects were also presented.
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Affiliation(s)
- Han Wei
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
| | - Xiaojian Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Xin Tian
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Guanghua Wu
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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13
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Lee CW, Su H, Wu KD, Shiea J, Wu DC, Chen BH, Shin SJ. Rapid point-of-care identification of oral medications in gastric lavage content by ambient mass spectrometry in the emergency room. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2016; 30:1295-1303. [PMID: 27173111 DOI: 10.1002/rcm.7557] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 03/10/2016] [Accepted: 03/10/2016] [Indexed: 06/05/2023]
Abstract
RATIONALE Acute poisoning should be handled with high efficiency in order to minimize morbidity and mortality in the emergency room. Unfortunately, history-taking and physical examination are not always reliable. Mis-swallowing of oral medications is common in the pediatric group. This study aimed at developing a rapid point-of-care ambient mass spectrometric method for the early identification of ingested oral medications in gastric lavage content. METHODS Four different types of oral medications that are most commonly mis-swallowed by children were diluted to different concentrations. Each of these chemical solutions was mixed with human gastric lavage content. A direct metallic sampling probe was dipped into the solution. It was then inserted promptly into the thermal desorption electrospray ionization source to carry out ionization and subsequent mass spectrometric analysis of the medications. The corresponding compounds were identified through matching of the obtained mass spectrometric data with those provided by well-established databases. RESULTS Since no pretreatment of the specimen was required, the sampling step, and the subsequent thermal desorption electrospray ionization and mass spectrometric detection of the medications were completed within 30 s. Mass spectra were obtained for four different kinds of oral medication. The limit-of-detection of the four tested oral medications in gastric lavage content is at sub-ppm level, which is sensitive enough for emergency medicine applications since the quantities of medications ingested by pediatric patients are usually much higher. CONCLUSIONS Thermal desorption electrospray ionization mass spectrometry, with informational support provided by an online mass spectral database, allows for early point-of-care identification of mis-swallowed oral medications in the evacuated gastric lavage contents obtained from gastric lavage of patients in the emergency room, and it is promising in providing important toxicological information to ensure the appropriateness of the subsequent medical management. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Chi-Wei Lee
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung Su
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Kun-Da Wu
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Jentaie Shiea
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Center for Stem Cell Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Deng-Chyang Wu
- Center for Stem Cell Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Bai-Hsiun Chen
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shyi-Jang Shin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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14
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Alshogran OY, Ocque AJ, Leblond FA, Pichette V, Nolin TD. Validation and Application of a Simple UHPLC-MS-MS Method for the Enantiospecific Determination of Warfarin in Human Urine. J Chromatogr Sci 2016; 54:554-60. [PMID: 26657732 PMCID: PMC4885390 DOI: 10.1093/chromsci/bmv186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 09/20/2015] [Indexed: 11/14/2022]
Abstract
A simple and rapid liquid chromatographic-tandem mass spectrometric method has been developed and validated for the enantiospecific determination of R- and S-warfarin in human urine. Warfarin enantiomers were extracted from urine using methyl tert-butyl ether. Chromatographic separation of warfarin enantiomers and the internal standard d5-warfarin was achieved using a Astec Chirobiotic V column with gradient mobile phase at a flow rate of 400 µL/min over 10 min. Detection was performed on a TSQ Quantum Ultra triple quadrupole mass spectrometer equipped with a heated electrospray ionization source. Analytes were detected in negative ionization mode using selected reaction monitoring. Calibration curves were linear with a correlation coefficient of ≥0.996 for both enantiomers over a concentration range of 5-500 ng/mL. The intra- and interday accuracy and precision for both analytes were within ±9.0%. Excellent extraction efficiency and negligible matrix effects were observed. The applicability of the method was demonstrated by successful measurement of warfarin enantiomers in urine of patients with kidney disease. The method is simple, accurate and reproducible and is currently being used to support warfarin pharmacokinetic studies.
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Affiliation(s)
- Osama Y Alshogran
- Center for Clinical Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrew J Ocque
- Center for Clinical Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, 208 Salk Pavillion, 335 Sutherland Drive, Pittsburgh, PA 15260, USA
| | - François A Leblond
- Service de Néphrologie et Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada
| | - Vincent Pichette
- Service de Néphrologie et Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada Département de Pharmacologie, Université de Montréal, Montréal, QC, Canada
| | - Thomas D Nolin
- Center for Clinical Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, 208 Salk Pavillion, 335 Sutherland Drive, Pittsburgh, PA 15260, USA
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15
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Beesoon S, Martin JW. Isomer-Specific Binding Affinity of Perfluorooctanesulfonate (PFOS) and Perfluorooctanoate (PFOA) to Serum Proteins. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2015; 49:5722-31. [PMID: 25826685 DOI: 10.1021/es505399w] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA) are among the most prominent contaminants in human serum, and these were historically manufactured as technical mixtures of linear and branched isomers. The isomers display unique pharmacokinetics in humans and in animal models, but molecular mechanisms underlying isomer-specific PFOS and PFOA disposition have not previously been studied. Here, ultrafiltration devices were used to examine (i) the dissociation constants (Kd) of individual PFOS and PFOA isomers with human serum albumin (HSA) and (ii) relative binding affinity of isomers in technical mixtures spiked to whole calf serum and human serum. Measurement of HSA Kd's demonstrated that linear PFOS (Kd=8(±4)×10(-8) M) was much more tightly bound than branched PFOS isomers (Kd range from 8(±1)×10(-5) M to 4(±2)×10(-4) M). Similarly, linear PFOA (Kd=1(±0.9)×10(-4) M) was more strongly bound to HSA compared to branched PFOA isomers (Kd range from 4(±2)×10(-4) M to 3(±2)×10(-4) M). The higher binding affinities of linear PFOS and PFOA to total serum protein were confirmed when both calf serum and human serum were spiked with technical mixtures. Overall, these data provide a mechanistic explanation for the longer biological half-life of PFOS in humans, compared to PFOA, and for the higher transplacental transfer efficiencies and renal clearance of branched PFOS and PFOA isomers, compared to the respective linear isomer.
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16
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Zhao H, Zhang Y, Guo Y, Shi S. Identification of major α-glucosidase inhibitors in Radix Astragali and its human microsomal metabolites using ultrafiltration HPLC–DAD–MSn. J Pharm Biomed Anal 2015; 104:31-7. [DOI: 10.1016/j.jpba.2014.09.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 09/15/2014] [Accepted: 09/20/2014] [Indexed: 11/15/2022]
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17
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Computational design of an enantioselective molecular imprinted polymer for the solid phase extraction of S-warfarin from plasma. J Chromatogr A 2014; 1338:9-16. [DOI: 10.1016/j.chroma.2014.02.055] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 02/14/2014] [Accepted: 02/18/2014] [Indexed: 11/17/2022]
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18
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Lomonaco T, Ghimenti S, Piga I, Onor M, Melai B, Fuoco R, Di Francesco F. Determination of total and unbound warfarin and warfarin alcohols in human plasma by high performance liquid chromatography with fluorescence detection. J Chromatogr A 2013; 1314:54-62. [PMID: 24054125 DOI: 10.1016/j.chroma.2013.08.091] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 08/23/2013] [Accepted: 08/25/2013] [Indexed: 10/26/2022]
Abstract
Two analytical procedures are presented for the determination of the total content and unbound fraction of both warfarin and warfarin alcohols in human plasma. Chromatographic separation was carried out in isocratic conditions at 25°C on a C-18 reversed-phase column with a mobile phase consisting of a 70% buffer phosphate 25mM at pH=7, 25% methanol and 5% acetonitrile at a flow rate of 1.2mL/min. Fluorescence detection was performed at 390nm (excitation wavelength 310nm). Neither method showed any detectable interference or matrix effect. Inter-day recovery of the total warfarin and warfarin alcohols at a concentration level of 1000ng/mL was 89±3% and 73±3%, respectively, whereas for their unbound fraction (at a concentration level of 10ng/mL) was 66±8% and 90±7%, respectively. The intra- and inter-day precision (assessed as relative standard deviation) was <10% for both methods. The limits of detection were 0.4 and 0.2ng/mL for warfarin and warfarin alcohols, respectively. The methods were successfully applied to a pooled plasma sample obtained from 69 patients undergoing warfarin therapy.
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Affiliation(s)
- Tommaso Lomonaco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Italy
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19
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Maddison J, Somogyi AA, Jensen BP, James HM, Gentgall M, Rolan PE. The pharmacokinetics and pharmacodynamics of single dose (R)- and (S)-warfarin administered separately and together: relationship to VKORC1 genotype. Br J Clin Pharmacol 2013; 75:208-16. [PMID: 22616655 DOI: 10.1111/j.1365-2125.2012.04335.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIMS 1) To determine the pharmacokinetics and pharmacodynamics of (R)- and (S)-warfarin given alone and in combination and 2) to determine whether the relative potency of (R)- and (S)-warfarin is dependent on VKORC1 genotype. METHODS A three way crossover study was conducted in which 17 healthy male subjects stratified by VKORC1 1173 C>T genotype and all CYP2C9 1*/1* received (R)-warfarin 80 mg, (S)-warfarin 12.5 mg and rac-warfarin sodium 25 mg. Plasma (R)- and (S)-warfarin unbound and total concentrations and prothrombin time were determined at multiple time points to 168 h. RESULTS Pharmacokinetic parameters for (R)- and (S)-warfarin were similar to the literature. (R)-warfarin 80 mg alone resulted in a mean AUC(PT) (0,168 h) of 3550 s h (95% CI 3220, 3880). Rac-warfarin sodium 25 mg containing (S)-warfarin 11.7 mg produced a greater effect on AUC(PT) (0,168 h) than (S)-warfarin 12.5 mg (mean difference 250 s.h, 95% CI 110, 380, P < 0.002) given alone. In a mixed effects model the ratio of response between (R)- and (S)-warfarin (AUC(PT((R)-warfarin)) : AUC(PT((S)-warfarin))) was 1.21 fold higher (95% CI 1.05, 1.41, P < 0.02) in subjects of VKORC1 TT genotype compared with the CC genotype. CONCLUSIONS (R)-warfarin has a clear PD effect and contributes to the hypoprothrombinaemic effect of rac-warfarin. VKORC1 genotype is a covariate of the relative R/S potency relationship. Prediction of drug interactions with warfarin needs to consider effects on (R)-warfarin PK and VKORC1 genotype.
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Affiliation(s)
- John Maddison
- Department of Geriatric Medicine, Royal Adelaide Hospital, Adelaide, Australia.
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20
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Lorenzo MP, Villaseñor A, Ramamoorthy A, Garcia A. Optimization and validation of a capillary electrophoresis laser-induced fluorescence method for amino acids determination in human plasma: application to bipolar disorder study. Electrophoresis 2013; 34:1701-9. [PMID: 23512402 DOI: 10.1002/elps.201200632] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 02/06/2013] [Accepted: 02/07/2013] [Indexed: 11/05/2022]
Abstract
Quantitative and qualitative analysis of amino acids in biofluids offers relevant information in diagnosis of diseases, evaluation of nutritional state, and in elucidating metabolic influences on physiology. A simple, rapid, and robust procedure in terms of sample treatment, separation, and quantitation based on CE-LIF has been optimized for use in human plasma samples. Time required for derivatization was 15 min and analysis time was 35 min. 4-Fluoro-7-nitro-2,1,3-benzoxadiazole (NBD-F) was the labeling agent used for obtaining fluorescent derivatives. Electrophoretic conditions were: 175 mM borate buffer at pH 10.25 prepared with 12.5 mM β-cyclodextrin. The voltage applied was +21 kV. Fourteen amino acids could be quantified: L-proline, L-phenylalanine, L-leucine, L-isoleucine, L-ornithine, D-ornithine, L-glutamine, L-alanine, L-threonine, glycine, L-serine, D-serine, taurine and L-glutamate. With this chiral CE-LIF method, L- and D-amino acids are adequately separated. The method was validated for a representative group of amino acids in human plasma: L-proline, L-isoleucine, L-ornithine, L-glutamine, L-alanine L-threonine, glycine, L-serine, D-serine, and glutamate. The method has been successfully applied to human plasma from patients with bipolar disorder, all of whom were taking lithium as a mood stabilizer. Eleven amino acids were quantified in plasma from nine patients, aged 24-55 years. The results were in accordance to published values for the bipolar patients. The method is useful particularly in studies where plasma amino acid levels can be used as biomarkers for diagnosis of diseases, evaluating the disease progression, and monitoring response to drug therapy.
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Affiliation(s)
- Ma Paz Lorenzo
- Center for Metabolomics and Bioanalysis (CEMBIO), Facultad de Farmacia, Universidad CEU San Pablo, Campus Montepríncipe, Madrid, Spain
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21
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Jensen BP, Chin PKL, Roberts RL, Begg EJ. Influence of adult age on the total and free clearance and protein binding of (R)- and (S)-warfarin. Br J Clin Pharmacol 2013; 74:797-805. [PMID: 22380743 DOI: 10.1111/j.1365-2125.2012.04259.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Hepatic drug clearance is thought to be reduced with age. However for highly protein bound drugs, which are cleared by capacity-limited metabolism, studies on total clearance have been conflicting. The hypothesis that protein binding decreases with age has been used to explain this. Warfarin is a highly protein bound drug, which is cleared by capacity-limited metabolism. There are conflicting or little data on the relationship between adult age and total and free clearance and protein binding of (R)- and (S)-warfarin. WHAT THIS STUDY ADDS In a clinical study of 72 patients (18-89 years) on warfarin therapy, both total and free clearance of (R)-warfarin decreased with age. For (S)-warfarin there was a stronger signal of a decrease in free than total clearance. Protein binding was found not to correlate with age for (R)- and (S)-warfarin. In an ex vivo study, in which warfarin was spiked to plasma samples from 60 healthy subjects (19-87 years), no correlation between protein binding and age was found. These data support the hypothesis that hepatic drug clearance decreases with age. This should be taken into consideration when individualizing dosing, particularly in the elderly. AIMS To test the hypothesis that the clearance (CL) of warfarin, a very highly protein bound drug with capacity-limited metabolism, decreases with age. METHODS In a clinical study, a steady-state blood sample was taken from 72 patients (18-89 years) on routine treatment with warfarin. Concentrations of (R)- and (S)-warfarin were determined in plasma (total) and ultrafiltrate (free) by LC-MS/MS. Total and free CL and protein binding were determined and regressed against age and other covariates. In an ex vivo study, warfarin was spiked to plasma samples from 60 healthy subjects (19-87 years) and protein binding was regressed against age and other covariates. RESULTS For (R)-warfarin a significant decrease with age was found for both total and free CL (P < 0.001). For (S)-warfarin there was a stronger signal of a decrease with age in free CL (P= 0.005) vs. total CL (P= 0.045). The decrease in CL of (R)- and (S)-warfarin was 0.3-0.5% per year. Other covariates influencing CL were lean body weight for both (R)- and (S)-warfarin and CYP2C9 genotype and blood sampling time for (S)-warfarin. Protein binding of (R)- and (S)-warfarin was not found to change significantly with age in either the clinical or the spiked samples, despite a slight decrease in albumin concentration with age. CONCLUSIONS These data support the hypothesis that the CL of (R)- and (S)-warfarin decreases with age. More accurate information was gained when measuring free CL for (S)-warfarin. Warfarin protein binding did not change significantly with age.
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Affiliation(s)
- Berit Packert Jensen
- Clinical Pharmacology, Department of Medicine, University of Otago-Christchurch, New Zealand.
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22
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Development of a chiral micellar electrokinetic chromatography-tandem mass spectrometry assay for simultaneous analysis of warfarin and hydroxywarfarin metabolites: application to the analysis of patients serum samples. J Chromatogr A 2012; 1271:207-16. [PMID: 23246089 DOI: 10.1016/j.chroma.2012.11.046] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 11/14/2012] [Accepted: 11/19/2012] [Indexed: 11/22/2022]
Abstract
The enantioseparation of warfarin (WAR) along with the five positional and optical isomers is challenging because of the difficulty to simultaneously separate and quantitate these chiral compounds. Currently, no effective chiral CE-MS methods exist for the simultaneous enantioseparation of WAR and all its hydroxylated metabolites in a single run. Polymeric surfactants (aka. molecular micelles) are particularly compatible with micellar electrokinetic chromatography-mass spectrometry (MEKC-MS) because they have a wider elution window for enantioseparation and do not interfere with the MS detection of chiral drugs. Using polysodium N-undecenoyl-L,L-leucylvalinate (poly-L,L-SULV) as a chiral pseudophase in MEKC-MS baseline separation of WAR, its five metabolites along with the internal standard was obtained in 45 min. This is in comparison to 100 min required for separation of the same mixture with packed column CEC-MS using a vancomycin chiral stationary phase. Serum samples were extracted with mixed-mode anion-exchange (MAX) cartridge with recoveries of greater than 85.2% for all WAR and hydroxywarfarin (OH-WAR) metabolites. Utilizing the tandem MS and multiple reaction monitoring mode, the MEKC-MS/MS method was used to simultaneously generate calibration curves over a concentration range from 2 to 5000 ng/mL for R- and S-warfarin, 5 to 1000 ng/mL for R- and S-6-, 7-, 8- and 10-OH-WAR and 10 to 1000 ng/mL for R and S-4'-OH-WAR. For the first time, the limits of detection and quantitation for most WAR metabolites by MEKC-MS/MS were found to be at levels of 2 and 5 ng/mL, respectively. The method was successfully applied for the first time to analyze WAR and its metabolites in plasma samples of 55 patients undergoing WAR therapy, demonstrating the potential of chiral MEKC-MS/MS method to accurately quantitate with high sensitivity.
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23
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Rosengren AM, Karlsson BCG, Nicholls IA. Monitoring the distribution of warfarin in blood plasma. ACS Med Chem Lett 2012; 3:650-2. [PMID: 24900525 DOI: 10.1021/ml300112e] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 06/20/2012] [Indexed: 02/02/2023] Open
Abstract
Warfarin is an anticoagulant drug extensively used in the treatment and prevention of thrombotic disorders. Previous studies have shown that warfarin binds extensively to blood plasma proteins and that only a small fraction of the drug is unbound and thus available for therapeutic function. Both warfarin's narrow therapeutic window and the susceptibility of anticoagulant function to patient-dependent factors necessitate regular monitoring. In this study, we have shown that the lifetimes for each of the various bound and free forms of the drug in blood plasma can be quantified in situ by time-correlated single-photon counting fluorescence spectroscopy over the clinically significant concentration range. A relationship between the blood coagulation and the distribution of fluorescence lifetimes was observed. The in situ detection of clinically relevant concentrations of warfarin in its respective bound and unbound forms could provide a prognostic tool for use in patient treatment.
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Affiliation(s)
- Annika M. Rosengren
- Bioorganic and Biophysical Chemistry
Laboratory, School of Natural Sciences, Linnæus University, SE-391 82 Kalmar, Sweden
- SensiKal AB, Öltappargränd
10, SE-393 64 Kalmar, Sweden
| | - Björn C. G. Karlsson
- Bioorganic and Biophysical Chemistry
Laboratory, School of Natural Sciences, Linnæus University, SE-391 82 Kalmar, Sweden
- SensiKal AB, Öltappargränd
10, SE-393 64 Kalmar, Sweden
| | - Ian A. Nicholls
- Bioorganic and Biophysical Chemistry
Laboratory, School of Natural Sciences, Linnæus University, SE-391 82 Kalmar, Sweden
- SensiKal AB, Öltappargränd
10, SE-393 64 Kalmar, Sweden
- Department of Chemistry, Uppsala University, SE-751 23 Uppsala, Sweden
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Responsiveness to low-dose warfarin associated with genetic variants of VKORC1, CYP2C9, CYP2C19, and CYP4F2 in an Indonesian population. Eur J Clin Pharmacol 2012; 69:395-405. [DOI: 10.1007/s00228-012-1356-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 07/11/2012] [Indexed: 02/04/2023]
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25
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Kennedy MA, Joyce PR, Begg EJ. Institutional Profile: The Carney Centre for Pharmacogenomics: a New Zealand focus for personalized medicine research. Pharmacogenomics 2012; 13:865-8. [DOI: 10.2217/pgs.12.55] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The integration of genetics and genomics with pharmacology and clinical medicine has enriched our understanding of all of these disciplines and is steadily providing a more complete picture of the etiology, pathophysiology and treatment of disease. To capitalize on this new knowledge requires the ability to evaluate the underlying evidence base and to test the utility of any proposed pharmacogenetic or genomic approaches to personalized medicine, within local or regional healthcare structures. The Carney Centre for Pharmacogenomics is now in its eighth year of operation, and although small by international standards, it has proven to be a valuable focus for research, training and dissemination of such knowledge in New Zealand and beyond. By focusing predominantly on research and training, the center has raised awareness about the value and limitations of pharmacogenetics and pharmacogenomic approaches.
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Affiliation(s)
- Martin A Kennedy
- Carney Centre for Pharmacogenomics & Department of Pathology, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
| | - Peter R Joyce
- Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
| | - Evan J Begg
- Carney Centre for Pharmacogenomics & Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
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