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He Z, Dai H, Shen J, Huang Y, Liu J, Yan R, Zhang F, Yan S. Development and evaluation of a candidate reference measurement procedure for detecting 17α-hydroxyprogesterone in dried blood spots using isotope dilution liquid chromatography tandem mass spectrometry. Anal Bioanal Chem 2024; 416:4635-4645. [PMID: 38949681 PMCID: PMC11294408 DOI: 10.1007/s00216-024-05411-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 07/02/2024]
Abstract
17α-Hydroxyprogesterone (17α-OHP) quantification in dried blood spots (DBS) is essential for newborn screening for congenital adrenal hyperplasia (CAH), which is challenging due to its low physiological concentration. The high false-positive rates of immunoassays necessitate the development of more accurate methods. Liquid chromatography tandem mass spectrometry (LC-MS/MS) offers increased specificity and sensitivity, yet standardized procedures for 17α-OHP measurement are required for clinical application. A candidate reference measurement procedure (cRMP) using isotope dilution LC-MS/MS was developed for 17α-OHP quantification in DBS. By utilizing stable isotope-labeled D8-17α-OHP as an internal standard, the cRMP was optimized, covering sample preparation, calibration, and LC-MS/MS analysis. The method performance was validated across several parameters, including precision, accuracy, specificity, detection limits, and matrix effects. Clinical applicability was further assessed through the establishment of reference intervals for healthy newborns. The developed cRMP exhibited a linear range of 1.00 to 80.00 ng/mL for 17α-OHP, with detection and quantification limits of 0.14 ng/mL and 0.52 ng/mL, respectively. Inter- and intraday precision demonstrated coefficients of variation within 1.27 to 5.69%. The recovery rates and matrix effects were well within acceptable limits, ensuring method reliability. Clinical application showed distinct reference intervals for healthy newborns that were unaffected by sex but influenced by weight and gestational age. This method significantly enhances CAH diagnostic accuracy in newborns, providing a valuable tool for clinical laboratories and improving newborn screening program standardization and traceability.
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Affiliation(s)
- Ziyun He
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, China
- College of Laboratory Medicine, Zunyi Medical University, Zunyi, 563000, China
| | - Haibing Dai
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, China
- College of Laboratory Medicine, Zunyi Medical University, Zunyi, 563000, China
| | - Jian Shen
- Guangzhou Fenghua Biotech Co., Ltd., Guangzhou, 510730, China
| | - Yanjie Huang
- Guangdong Provincial Institute of Metrology, South China National Centre of Metrology, Guangzhou, 510405, China
| | - Jinsong Liu
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, China
- College of Laboratory Medicine, Zunyi Medical University, Zunyi, 563000, China
| | - Renqing Yan
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, China
- College of Laboratory Medicine, Zunyi Medical University, Zunyi, 563000, China
| | - Feng Zhang
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, China
- College of Laboratory Medicine, Zunyi Medical University, Zunyi, 563000, China
| | - Shengkai Yan
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, China.
- College of Laboratory Medicine, Zunyi Medical University, Zunyi, 563000, China.
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17-α Hydroxyprogesterone Caproate Immunology, a Special Focus on Preterm Labor, Preeclampsia, and COVID-19. REPRODUCTIVE MEDICINE 2022. [DOI: 10.3390/reprodmed3030019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
17-α hydroxyprogesterone caproate (17-OHPC) could alter the immune response and inflammation, specifically affecting the risk of preterm labor and preeclampsia. However, the exact immune and inflammatory effects of 17-OHPC remain hard to be identified. The current literature on 17-OHPC immune effects is limited and more research is needed to identify these mechanistic pathways. Further, coronavirus disease 2019 (COVID-19) infection in pregnancy involves heightened immune response, widespread inflammation and high rates of preterm labor and preeclampsia. Since the pathogenesis of preterm labor, preeclampsia and COVID-19 involves inflammation and altered immune response, it is important to explore the possible immune effects of 17-OHPC in pregnant women with COVID-19. This commentary article will explain the immune effects of 17-OHPC and their implications in preterm labor, preeclampsia and COVID-19.
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