Analysis of glutathione and glutathione disulfide in human saliva using hydrophilic interaction chromatography with mass spectrometry

Development and validation of a direct HPLC method for the determination of salivary glutathione disulphide using a core shell column and post column derivatization with o-phthalaldehyde

Glutathione disulfide (GSSG) has been monitored in human saliva samples by an optimized and validated method that is based on liquid chromatography coupled to on-line post column derivatization. The analyte was separated from the sample matrix using a 100% aqueous mobile phase through a core-shell reversed phase column. Following optimization of the reaction using Box- Behnken experimental design and validation, GSSG was quantified accurately and selectively in the range of 100-2000 nmol L^-1 with a LOD of 20 nmol L^-1. GSSG was quantified in 15 out of 20 human saliva samples (75%) with a mean value of 860 nmol L^-1 (150-4600 nmol L^-1). Blocking of reduced Glutathione with N-ethylmaleimide ensured stability of the samples for at least 72 h at all temperatures examined.

Tween 20-capped gold nanoparticles for selective extraction of free low-molecular-weight thiols in saliva followed by capillary electrophoresis with contactless conductivity detection

Low-molecular-weight thiols are widely present in human fluids, and are regarded as a kind of potential broad-spectrum evaluation indicators for some clinical diseases. In this work, gold nanoparticles capped with Tween 20 were used for purification and microextraction of the main free thiols (cysteine, homocysteine, glutathione and methionine) in saliva based on Au-S bond formation. Ultrasound further sped up the releasing of the target analytes, and the releasing time needed was only 10 min, and the required sample volume was only 40 µL. The desorption solution could be directly injected for electrophoretic analysis without derivatization, and field-amplified sample stacking of electrophoretic online enrichment technology further improved the detection sensitivity. The synergistic enrichment effect made the enrichment factors of four analytes reach 1119-2067 times. This developed method was applied for the analyses of saliva samples of healthy volunteers. Acceptable sensitivity (LODs: 0.15-1.5 ng mL^-1) and recoveries (97.6-116%) were obtained in the saliva sample matrix. This proposed method provides an alternative for the sensitive detection of low-molecular-weight thiols in noninvasive body fluids, which has potential application prospect in the preliminary noninvasive diagnosis of diabetes, cardiovascular diseases, etc.

Metabolomic signature of brain cancer

Despite advances in surgery and adjuvant therapy, brain tumors represent one of the leading causes of cancer-related mortality and morbidity in both adults and children. Gliomas constitute about 60% of all cerebral tumors, showing varying degrees of malignancy. They are difficult to treat due to dismal prognosis and limited therapeutics. Metabolomics is the untargeted and targeted analyses of endogenous and exogenous small molecules, which charact erizes the phenotype of an individual. This emerging "omics" science provides functional readouts of cellular activity that contribute greatly to the understanding of cancer biology including brain tumor biology. Metabolites are highly informative as a direct signature of biochemical activity; therefore, metabolite profiling has become a promising approach for clinical diagnostics and prognostics. The metabolic alterations are well-recognized as one of the key hallmarks in monitoring disease progression, therapy, and revealing new molecular targets for effective therapeutic intervention. Taking advantage of the latest high-throughput analytical technologies, that is, nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS), metabolomics is now a promising field for precision medicine and drug discovery. In the present report, we review the application of metabolomics and in vivo metabolic profiling in the context of adult gliomas and paediatric brain tumors. Analytical platforms such as high-resolution (HR) NMR, in vivo magnetic resonance spectroscopic imaging and high- and low-resolution MS are discussed. Moreover, the relevance of metabolic studies in the development of new therapeutic strategies for treatment of gliomas are reviewed.

Quantitative SERS Detection of Trace Glutathione with Internal Reference Embedded Au-core/Ag-shell Nanoparticles

Surface-enhanced Raman scattering (SERS) has been widely studied and applied for over three decades. However, reliable SERS detection of molecules with low polarizability is still suffering from poor sensitivity and reproducibility. In this paper, we have reported a new strategy for performing quantitative SERS detection of Raman insensitive Glutathione (GSH), based on GSH-induced replacement of a highly Raman sensitive four-mercaptopyridine (MP) adsorbed on the surface of four-aminothiophenol (ATP) embedded Au-core/Ag-shell particles. This replacement led to a strong decrease of the MP SERS signal, which was used to determine the concentration of GSH. The adoption of GSH-induced Raman probe replacement leads to high sensitivity, while the use of internal reference method provides an improved accuracy of the GSH quantification.

Can saliva testing replace blood measurements for health monitoring? Insights from a correlation study of salivary and whole blood glutathione in humans

The feasibility of using saliva samples as diagnostic for health status is assessed.

Glutathione metabolism in the HaCaT cell line as a model for the detoxification of the model sensitisers 2,4-dinitrohalobenzenes in human skin

Glutathione (GSH) is the most prominent antioxidant in cells and the co-factor of an important set of enzymes involved in the skin metabolic clearance system, glutathione S-transferases (GST). Here, we describe an LC-MS (liquid chromatography-mass spectroscopy) method to measure GSH and its disulfide form (GSSG) in HaCaT cells and a 3D Reconstructed Human Epidermis (RHE) model. In our assay, the basal level of GSH in both systems was in the low nmol/mg soluble protein range, while the level of GSSG was systematically below our limit of quantification (0.1 μM). We found that 2,4-dinitrohalobenzenes deplete the GSH present in HaCaT cells within the first hour of exposure, in a dose dependent manner. The level of GSH in HaCaT cells treated with a single non-toxic dose of 10 μM of dinitrohalobenzene was also shown to increase after two hours. While cells treated with 1-chloro-2,4-dinitrobenzene (DNCB) and 1-fluoro-2,4-dinitrobenzene (DNFB) repleted GSH to levels similar to untreated control cells within 24h, 1-bromo-2,4-dinitrobenzene (DNBB) seemed to prevent such a repletion and appeared to be the most toxic compound in all assays. A mathematical modelling of experimental results was performed to further rationalise the differences observed between test chemicals. For this purpose the biological phenomena observed were simplified into two sequential events: the initial depletion of the GSH stock after chemical treatment followed by the repletion of the GSH once the chemical was cleared. Activation of the nuclear factor E2-related factor 2 (Nrf2) pathway was observed with all compounds within two hours, and at concentrations less than 10 μM. These data show that GSH depletion and repletion occur rapidly in skin cells and emphasize the importance of conducting kinetic studies when performing in vitro experiments exploring skin sensitization.

[Pharmaceutical analysis of chemicals related with daily life products for safe and secure]

An association between exposure to trace hazardous chemicals such as endocrine disrupting chemicals and an increased incidence of human endocrine disease might be continued to study. The accurate and sensitive analytical methods for determination of various chemicals in human biospecimen such as urine, blood and breast milk have been studied by techniques including chromatography. In order to obtain the safe and secure life, the pharmaceutical analytical approaches might be applicable with the hopes of realizing scientific risk assessment of the chemicals derived from daily life products as regulatory sciences.

Molecular and structural basis of glutathione import in Gram-positive bacteria via GshT and the cystine ABC importer TcyBC of Streptococcus mutans

Glutathione (GSH) protects cells against oxidative injury and maintains a range of vital functions across all branches of life. Despite recent advances in our understanding of the transport mechanisms responsible for maintaining the spatiotemporal homeostasis of GSH and its conjugates in eukaryotes and Gram-negative bacteria, the molecular and structural basis of GSH import into Gram-positive bacteria has remained largely uncharacterized. Here, we employ genetic, biochemical and structural studies to investigate a possible glutathione import axis in Streptococcus mutans, an organism that has hitherto served as a model system. We show that GshT, a type 3 solute binding protein, displays physiologically relevant affinity for GSH and glutathione disulfide (GSSG). The crystal structure of GshT in complex with GSSG reveals a collapsed structure whereby the GS-I-leg of GSSG is accommodated tightly via extensive interactions contributed by the N- and C-terminal lobes of GshT, while the GS-II leg extends to the solvent. This can explain the ligand promiscuity of GshT in terms of binding glutathione analogues with substitutions at the cysteine-sulfur or the glycine-carboxylate. Finally, we show that GshT primes glutathione import via the L-cystine ABC transporter TcyBC, a membrane permease, which had previously exclusively been associated with the transport of L-cystine.

Use of modified Doehlert-type experimental design in optimization of a hybrid electrospray ionization ion trap time-of-flight mass spectrometry technique for glutathione determination

RATIONALE

The capabilities of modified non-spherical Doehlert-type experimental designs to optimize the performance of a hybrid mass spectrometer were investigated in this paper for the first time. The optimization process was completed in three successive steps with groups of variables avoiding any univariable approach. Glutathione (GSH, reduced) was selected as a very interesting analyte since it is considered to be one of the most abundant tripeptides in human organism and its action against xenobiotics and oxidative radicals is well known.

METHODS

In particular, a tandem technique based on sequential ion management by an ion trap followed by a time-of-flight mass analyzer (ITTOFMS) was introduced commercially in recent years and investigated for glutathione determination. Glutathione was injected in a stream of a typical mobile phase used in liquid chromatography (LC) and analyzed after electrospray ionization (ESI) in tandem MS.

RESULTS

The three main steps of the LC/MS system, namely the LC mobile phase, the ESI interface and the MS analyzer, were independently optimized in terms of maximum sensitivity. In this context quadratic models were found and their prediction power was evaluated. A calibration study was performed at default and optimum conditions in order to quantitatively estimate the sensitivity enhancement of the employed technique for this analyte. Satisfactory precision (RSD 5.7%) and detectability (LOD 0.07 µmol L(-1) ) were achieved.

CONCLUSIONS

The results highlighted the possibilities offered by the employment of multifactorial optimization towards the improvement of performance of tandem mass spectrometry techniques.

A Hg(2+)-mediated label-free fluorescent sensing strategy based on G-quadruplex formation for selective detection of glutathione and cysteine

A novel label-free fluorescent strategy for the detection of glutathione (GSH) and cysteine (Cys) is presented. The system consists of two single stranded DNA (ssDNA) with thymine-thymine (T-T) mismatches and used Hg(2+) as a mediator, and N-methyl mesoporphyrin IX (NMM) as the signal reporter. The assay is based on the competitive reaction of Hg(2+) with GSH/Cys and T-T mismatched double stranded DNA (dsDNA). In the absence of the target, two ssDNA containing T-T mismatches react with Hg(2+) to form a T-Hg(2+)-T dsDNA structure in the solution, which hampers the formation of a G-quadruplex structure. However, in the presence of the target, GSH/Cys reacts with Hg(2+) to keep DNA probes in a free single state, resulting in the effective formation of a G-quadruplex structure of the DNA probe (GP). Subsequently, due to the strong interaction between the G-quadruplex structure and NMM, fluorescence was greatly enhanced. This fluorescence strategy does not require any chemical modification, making the assay convenient and cost-effective. This method exhibited a linear relationship between peak fluorescence intensity and concentration of GSH in the range of 10-400 nM with a limit of detection (LOD) of 9.6 nM. A linear range for Cys detection was obtained in the concentration range of 10-500 nM with an LOD of 10 nM. Moreover, the proposed method worked well for the analysis of complex biological samples.

Direct glutathione quantification in human blood by LC-MS/MS: comparison with HPLC with electrochemical detection

Glutathione plays a central role in the defence against oxidative damage and in signaling pathways. Upon oxidation the reduced glutathione (GSH) is transformed to glutathione disulfide (GSSG). The concentration of GSH and GSSG in whole blood samples and their ratios is useful indicator of the oxidative stress status and/or disease risk. Here we describe a liquid-chromatographic method coupled with tandem mass spectrometry (LC-MS/MS) and we present the results of its comparison with a high-performance liquid-chromatographic method with electrochemical detection (HPLC-ECD). The method performed well in terms of validation parameters, i.e. linear range (0.01-50μM for both GSH and GSSG), precision (intra- and inter-day coefficients of variation were less than 10% for both GSH and GSSG), accuracy (bias% varied between -2.1 and 7.9% for both analytes), quantification limits (LLOQs were 0.5μM and 0.0625μM for GSH and GSSG respectively). Furthermore the LC-MS/MS method showed a good agreement with the HPLC-ECD assay. However, major benefits of LC-MS/MS are the improved selectivity, precision and accuracy, the higher sensitivity and the unaltered capacity of detection with time in contrast to ECD.

Separation technique for the determination of highly polar metabolites in biological samples

Metabolomics is a new approach that is based on the systematic study of the full complement of metabolites in a biological sample. Metabolomics has the potential to fundamentally change clinical chemistry and, by extension, the fields of nutrition, toxicology, and medicine. However, it can be difficult to separate highly polar compounds. Mass spectrometry (MS), in combination with capillary electrophoresis (CE), gas chromatography (GC), or high performance liquid chromatography (HPLC) is the key analytical technique on which emerging "omics" technologies, namely, proteomics, metabolomics, and lipidomics, are based. In this review, we introduce various methods for the separation of highly polar metabolites.

Hydrophilic interaction liquid chromatography (HILIC)--a powerful separation technique

Hydrophilic interaction liquid chromatography (HILIC) provides an alternative approach to effectively separate small polar compounds on polar stationary phases. The purpose of this work was to review the options for the characterization of HILIC stationary phases and their applications for separations of polar compounds in complex matrices. The characteristics of the hydrophilic stationary phase may affect and in some cases limit the choices of mobile phase composition, ion strength or buffer pH value available, since mechanisms other than hydrophilic partitioning could potentially occur. Enhancing our understanding of retention behavior in HILIC increases the scope of possible applications of liquid chromatography. One interesting option may also be to use HILIC in orthogonal and/or two-dimensional separations. Bioapplications of HILIC systems are also presented.

Cadmium exposure route affects antioxidant responses in the mayfly Centroptilum triangulifer

Aquatic organisms accumulate metals directly from water and from their diets. Exposure to metals is known to generate oxidative stress in living organisms and this stress may be ameliorated via activation of antioxidant enzymes and non-enzymatic antioxidants. To determine if antioxidant physiology is dependent on Cd exposure route in the mayfly Centroptilum triangulifer, we exposed larvae to environmentally relevant concentrations of Cd from isolated dissolved or dietary exposure routes to achieve comparable tissue concentrations. Dissolved Cd had no effect on the antioxidant enzymes examined. However, dietary Cd significantly suppressed catalase and superoxide dismutase activities, and decreased concentrations of the reduced (active) form of glutathione in C. triangulifer larvae. These findings suggest that dietary Cd is potentially more toxic than aqueously derived Cd in this mayfly. We further examined the effect of dietary Cd tissue loading rates on antioxidant enzyme suppression and found that absolute tissue load appeared more important than loading rate. These results may help explain why insects are routinely unresponsive to dissolved metal exposures in the laboratory, yet highly responsive to metal pollution in nature.

Absolute quantification of free glutathione and cysteine in aquatic insects using isotope dilution and selected reaction monitoring

A simple and robust isotope dilution mass spectrometry-based assay was developed for the determination of free cysteine and glutathione (GSH) in aquatic insects. Several experimental parameters were evaluated and optimized to provide specific and sensitive detection of both compounds by in situ derivatization with N-ethylmaleimide followed by acid alkylation quenching and reverse-phased liquid chromatography coupled with selected reaction monitoring. For both targets, the assay was evaluated over a concentration range of 0.313 to 320 μM and was demonstrated to have a quantitative dynamic range spanning nearly three orders of magnitude, with lower limits of quantification being 0.330 μM for GSH and 0.370 μM for cysteine. Additionally, measurements were observed to be highly reproducible over the course of several days. When applied to the analysis of four different species of insects, large biological variation between and within species was observed. Different feeding regimens were also tested within two species of insects but statistical comparisons revealed no significant difference in the levels of either compound.

Development and validation of a hydrophilic interaction chromatography-tandem mass spectrometry for quantification of nicotine and its metabolites in human maternal and cord sera

A selective and sensitive HILIC-MS/MS method for the simultaneous quantification of nicotine and its metabolites in human maternal and cord sera was developed and validated. After solid-phase extraction, LC separation was achieved on a hydrophilic interaction chromatography. The validated method is capable of selective identification as well as accurate and sensitive quantification. Analyte recovery ranged from 86.2 to 107.7% and intra- and inter-day assay precision were less than 15% relative standard deviation. This sensitive HILIC-MS/MS method can be used to determine nicotine and its metabolic profile in smokers. This validated method is useful for the determination of nicotine and its metabolites in human serum in future studies of the effects of nicotine exposure on neonatal outcome.

Determination of glutathione and glutathione disulfide in human whole blood using HPLC with coulometric detection: A comparison with fluorescence detection

We describe a relatively simple method for the determination of glutathione (GSH) and glutathione disulfide (GSSG) in human whole blood. We have used an HPLC with coulometric electrochemical detection for the simultaneous measurement of GSH and GSSG. Diluted and filtered trichloroacetic acid extracts were injected directly into the HPLC system and were eluted isocratically on a Polaris 5u C18-A, 250 × 4.6 mm analytical column. Glutathione in samples extracted with trichloroacetic acid and diluted with 1.0 mMhydrochloric acid was stable at 4 °C for at least 8 h. The analytical performance of this method is satisfactory: the intra-assay and inter-assay coefficients of variation were below 10%. Quantitative recoveries from spiked whole blood samples were at intervals 91.6–97.6% for GSH and 85.0–104.4% for GSSG. The linear range is 5.0–2000.0 μmol/l, with a detection limit of 2.1 μmol/l (signal-to-noise ratio = 3) for GSH and 2.0–250.0 μmol/l, with a detection limit of 0.9 μmol/l for GSSG.

A new strategy for ionization enhancement by derivatization for mass spectrometry

Liquid chromatography-mass spectrometry (LC-MS) using atmospheric pressure ionization is drastically different from hitherto available analytical methods used to detect polar analytes. The electrospray ionization (ESI) and atmospheric pressure chemical ionization (APCI) sources of MS have contributed to the advancement of LC-MS and LC-MS/MS techniques for the analysis of biological samples. However, one major obstacle is the weak ionization of some analytes in the ESI and APCI techniques. In this review, we introduce high-sensitivity methods using several derivatization reagents for ionization enhancement. We also present an overview of chemical derivatization methods that have been applied to small molecules, such as amino acids and steroids, in biological samples.

Manganese bioconcentration in aquatic insects: Mn oxide coatings, molting loss, and Mn(II) thiol scavenging

Streams below mountaintop removal-valley fill coal mining operations often have elevated Mn concentrations, but it remains unclear if Mn plays a role in biodiversity reduction. We examined various aspects of aqueous Mn interactions with aquatic insects exposed to environmentally relevant Mn concentrations, revealing complex behavior. First, Mn accumulation rates varied widely among 9 species. A significant percentage of total Mn accrued (mean 74%, range 24-95%) was associated with the cuticle, predominantly in the form of Mn-oxides, and to a lesser degree Mn(II). Mn II is also absorbed into tissues, possibly through calcium transporters. Increased ambient calcium concentrations decreased both adsorbed and absorbed Mn accumulation from solution. Though species showed similar Mn efflux rate constants (0.032-0.072 d(-1)), the primary mode of Mn loss was through molting. Both adsorbed and absorbed Mn is lost during the molt. Subcellular compartmentalization studies revealed an overwhelming tendency for internalized Mn to associate with the heat stable cytosolic protein fraction. After short dissolved Mn exposures, intracellular glutathione and cysteine levels were markedly reduced relative to controls. These findings suggest that Mn exposure results in transient physiological stress in aquatic insects which is likely relieved, in part, during the molting process.

Chromatographic and mass spectrometric analysis of glutathione in biological samples

Biological thiol compounds are classified into high-molecular-mass protein thiols and low-molecular-mass free thiols. Endogenous low-molecular-mass thiol compounds, namely, reduced glutathione (GSH) and its corresponding disulfide, glutathione disulfide (GSSG), are very important molecules that participate in a variety of physiological and pathological processes. GSH plays an essential role in protecting cells from oxidative and nitrosative stress and GSSG can be converted into the reduced form by action of glutathione reductase. Measurement of GSH and GSSG is a useful indicator of oxidative stress and disease risk. Many publications have reported successful determination of GSH and GSSG in biological samples. In this article, we review newly developed techniques, such as liquid chromatography coupled with mass spectrometry and tandem mass spectrometry, for identifying GSH bound to proteins, or for localizing GSH in bound or free forms at specific sites in organs and in cellular locations.

Clinical assay of four thiol amino acid redox couples by LC-MS/MS: utility in thalassemia

The total concentrations of four sulfur amino acid (SAA) metabolite redox couples (reduced and oxidized forms of homocysteine, cysteine, glutathione, and cysteinylglycine) in human blood are assayed with a simple and sensitive method by liquid chromatography-electrospray positive ionization-tandem mass spectrometry. To prevent ex vivo thiol oxidation, iodoacetamide (IAM) is used immediately following the blood draw. To selectively enrich for S-carboxyamidomethylated SAA, and other cationic amino acids metabolites, proprietary strong cation-exchange solid phase extraction tips are used. Analytes are further derivatized with isopropylchloroformate (IPCF) to esterify the amino and the carboxylic groups. Double derivatization with IAM and IPCF improves the reverse phase liquid chromatography separation of SAA metabolites. The use of detection mode of multiple-reaction monitoring (MRM) allows sensitive and specific simultaneous detection of SAA. The internal standards used to account for the matrix effects of human plasma and erythrocytes were plant glutathione analogue, homoglutathione, and stable isotopes of cystine and homocystine. The method was validated for its linearity, accuracy, and precision. Excellent linearity of detection (r(2)>0.98) was observed over relevant ranges for plasma and erythrocyte samples, and the limits of detection were established to be between 5 and 20nM. Relative standard deviations were <9% for within-day variations and <15% for between-day variations. The method was used to assess thiol redox states in plasma and erythrocytes isolated from healthy subjects and thalassemia patients.

Dynamics of glutathione and ophthalmate traced with 2H-enriched body water in rats and humans

We developed a LC-MS-MS assay of the (2)H labeling of free glutathione (GSH) and bound glutathione [GSSR; which includes all DTT-reducible forms, primarily glutathione disulfide (GSSG) and mixed disulfides with proteins] and ophthalmate (an index of GSH depletion) labeled from (2)H-enriched body water. In rats whose body water was 2.5% (2)H enriched for up to 31 days, GSH labeling follows a complex pattern because of different rates of labeling of its constitutive amino acids. In rats infused with [(13)C(2),(15)N-glycine]glutathione, the rate of appearance of plasma GSH was 2.1 micromol.min(-1).kg(-1), and the half-life of plasma GSH/GSSR was 6-8 min. In healthy humans whose body fluids were 0.5% (2)H enriched, the (2)H labeling of GSH/GSSR and ophthalmate can be precisely measured after 4 h, with GSH being more rapidly labeled than GSSR. Since plasma GSH/GSSR derives mostly from liver, this technique opens the way to 2) probe noninvasively the labeling pattern and redox status of the liver GSH system in humans and 2) assess the usefulness of ophthalmate as an index of GSH depletion.

Simultaneous determination of reduced glutathione, glutathione disulphide and glutathione sulphonamide in cells and physiological fluids by isotope dilution liquid chromatography-tandem mass spectrometry

A stable isotope dilution liquid chromatography tandem mass spectrometry (LC-MS/MS) method was developed and validated for simultaneously quantifying glutathione (GSH), glutathione disulphide (GSSG) and glutathione sulphonamide (GSA) from biological samples. GSA is a selective product of the reaction of GSH with hypochlorous acid and a potential biomarker of myeloperoxidase activity. GSH was detected as the N-ethylmaleimide alkylated adduct, as formation of this species prevented GSH oxidation occurring during sample processing. Synthesised stable isotope analogues were used as internal standards to accurately quantify each target species. The limit of quantification was determined as being 0.1pmol for each species and excellent linearity was observed over relevant concentration ranges for biological samples. Relative standard deviations were <5% for within-day variation and <10% for between-day variation, except at the lower limit of quantification where they remained <20%. Accuracy was between 82% and 113%. We could detect GSA in neutrophils and endothelial cells treated with hypochlorous acid and in bronchoalveolar lavage fluid from children with cystic fibrosis. This is the first time GSA has been quantified in clinical material and suggests it is formed in vivo. The assay can now be used for investigating GSA as a biomarker of myeloperoxidase activity in inflammatory conditions, and is also applicable to measuring GSH:GSSG molar ratios as a general index of oxidative stress.

Bioanalytical hydrophilic interaction chromatography: recent challenges, solutions and applications

Hydrophilic interaction chromatography (HILIC) has, in recent years, been shown to be an important supplement to reversed-phase liquid chromatography for polar analytes. HILIC, in conjunction with tandem mass spectrometry (MS/MS), has been steadily gaining acceptance in the analysis of polar compounds from complex biological matrices. This hyphenated technique offers the advantages of improved sensitivity by employing high organic content in the mobile phase, shortened sample preparation time with direct injection of the organic-solvent extracts of biological samples and the potential for ultra-fast analysis because of low-column backpressure. This article reviews recent challenges presented by HILIC, advancements in the better understanding of retention characteristics of analytes with different mobile- and stationary-phase compositions and solutions to ion suppression and interference problems encountered in HILIC–MS/MS assays. Applications of HILIC–MS/MS are summarized, including those for pharmacokinetic studies, metabolic studies, therapeutic drug monitoring and clinical diagnostics.