A liquid chromatography-mass spectrometry assay for quantification of Exendin[9-39] in human plasma

Exendin(9-39)NH2 : Recommendations for clinical use based on a systematic literature review

AIM

To present an overview of exendin(9-39)NH₂ usage as a scientific tool in humans and provide recommendations for dosage and infusion regimes.

METHODS

We systematically searched the literature on exendin(9-39)NH₂ and included for review 44 clinical studies reporting use of exendin(9-39)NH₂ in humans.

RESULTS

Exendin(9-39)NH₂ binds to the orthosteric binding site of the glucagon-like peptide-1 (GLP-1) receptor with high affinity. The plasma elimination half-life of exendin(9-39)NH₂ after intravenous administration is ~30 minutes, requiring ~2.5 hours of constant infusion before steady-state plasma concentrations can be expected. Studies utilizing infusions with exendin(9-39)NH₂ in humans have applied varying regimens (priming with a bolus or constant infusion) and dosages (continuous infusion rate range 30-900 pmol/kg/min) with subsequent differences in effects. Administration of exendin(9-39)NH₂ in healthy individuals, patients with diabetes, obese patients, and patients who have undergone bariatric surgery significantly increases fasting and postprandial levels of glucose and glucagon, but has inconsistent effects on circulating concentrations of insulin and C-peptide, gastric emptying, appetite sensations, and food intake. Importantly, exendin(9-39)NH₂ induces secretion of all L cell products (ie, in addition to GLP-1, also peptide YY, glucagon-like peptide-2, oxyntomodulin, and glicentin) complicating use of exendin(9-39)NH₂ as a tool to study the isolated effect of GLP-1.

CONCLUSIONS

Exendin(9-39)NH₂ is selective for the GLP-1 receptor, with numerous and complex whole-body effects. To obtain GLP-1 receptor blockade in humans, we recommend an initial high-dose infusion, followed by a continuous infusion rate aiming at a ratio of exendin(9-39)NH₂ to GLP-1 of 2000:1. Highlights Exendin(9-39)NH₂ is a competitive antagonist of the human GLP-1 receptor. Exendin(9-39)NH₂ has been used as a tool to delineate human GLP-1 physiology since 1998. Exendin(9-39)NH₂ induces secretion of GLP-1 and other L cell products. Reported effects of exendin(9-39)NH₂ on insulin levels and food intake are inconsistent. Here, we provide recommendations for the use of exendin(9-39)NH₂ in clinical studies.

Overview, consequences, and strategies for overcoming matrix effects in LC-MS analysis: a critical review

The high-performance liquid chromatography-mass spectrometry (LC-MS) technique is widely applied to routine analysis in many matrices. Despite the enormous application of LC/MS, this technique is subjected to drawbacks called matrix effects (MEs) that could lead to ion suppression or ion enhancement. This phenomenon can exert a deleterious impact on the ionization efficacy of an analyte and subsequently on the important method performance parameters. LC-MS susceptibility to MEs is the main challenge of this technique in the analysis of complex matrices such as biological and food samples. Nowadays, the assessment, estimation, and overcoming of the MEs before developing a method is mandatory in any analysis. Two main approaches including the post-column infusion and post-extraction spike are proposed to determine the degree of MEs. Different strategies can be adopted to reduce or eliminate MEs depending on the complexity of the matrix. This could be done by improving extraction and clean-up methods, changing the type of ionization employed, optimization of liquid chromatography conditions, and using corrective calibration methods. This review article will provide an overview of the MEs as the Achilles heel of the LC-MS technique, the causes of ME occurrence, their consequences, and systemic approaches towards overcoming MEs during LC-MS-based multi-analyte procedures.

[Recent advances in microchip liquid chromatography]

微型化是现代分析仪器发展的重要趋势。微型化液相色谱仪器在提供与常规尺度液相色谱相同甚至更高分离效率的同时,可以有效减少溶剂和样品的消耗;在液相色谱-质谱联用中,低流速进样可以有效提高质谱离子源的离子化效率,提高质谱检测效率;对于极微量样品的分离,微型化的液相色谱可以有效减少样品稀释;液相色谱的微型化还有利于液相色谱仪器整体的模块化和集成化设计。芯片液相色谱是在微流控芯片上制备色谱柱并集成相应的流体控制系统和检测系统。芯片液相色谱是色谱仪器微型化的一种重要方式,受到学术界和产业界的普遍关注,但是这一方式也充满挑战。液相色谱微流控芯片需要在芯片基底材料、芯片色谱柱的结构设计、微流体控制技术、检测器技术等方面做出创新,使微流控芯片系统适配液相色谱分离技术的需要。目前芯片液相色谱领域面临的主要问题在于芯片基底材料的性质难以满足芯片液相色谱进一步微型化和集成化的需求;因此芯片液相色谱在未来的发展中需要着重关注新型微流控芯片基底材料的开发以及微流控芯片通道结构的统一设计。该文着重介绍了芯片液相色谱技术近年来的研究进展,并简要展示了商品化芯片色谱当前的发展情况。

Compensate for or Minimize Matrix Effects? Strategies for Overcoming Matrix Effects in Liquid Chromatography-Mass Spectrometry Technique: A Tutorial Review

In recent decades, mass spectrometry techniques, particularly when combined with separation methods such as high-performance liquid chromatography, have become increasingly important in pharmaceutical, bio-analytical, environmental, and food science applications because they afford high selectivity and sensitivity. However, mass spectrometry has limitations due to the matrix effects (ME), which can be particularly marked in complex mixes, when the analyte co-elutes together with other molecules, altering analysis results quantitatively. This may be detrimental during method validation, negatively affecting reproducibility, linearity, selectivity, accuracy, and sensitivity. Starting from literature and own experience, this review intends to provide a simple guideline for selecting the best operative conditions to overcome matrix effects in LC-MS techniques, to obtain the best result in the shortest time. The proposed methodology can be of benefit in different sectors, such as pharmaceutical, bio-analytical, environmental, and food sciences. Depending on the required sensitivity, analysts may minimize or compensate for ME. When sensitivity is crucial, analysis must try to minimize ME by adjusting MS parameters, chromatographic conditions, or optimizing clean-up. On the contrary, to compensate for ME analysts should have recourse to calibration approaches depending on the availability of blank matrix. When blank matrices are available, calibration can occur through isotope labeled internal standards and matrix matched calibration standards; conversely, when blank matrices are not available, calibration can be performed through isotope labeled internal standards, background subtraction, or surrogate matrices. In any case, an adjusting of MS parameters, chromatographic conditions, or a clean-up are necessary.

Comparison of ELISA and HPLC-MS methods for the determination of exenatide in biological and biotechnology-based formulation matrices

The development of biotechnology-based active pharmaceutical ingredients, such as GLP-1 analogs, brought changes in type 2 diabetes treatment options. For better therapeutic efficiency, these active pharmaceutical ingredients require appropriate administration, without the development of adverse effects or toxicity. Therefore, it is required to develop several quantification methods for GLP-1 analogs products, in order to achieve the therapeutic goals, among which ELISA and HPLC arise. These methods are developed, optimized and validated in order to determine GLP-1 analogs, not only in final formulation of the active pharmaceutical ingredient, but also during preclinical and clinical trials assessment. This review highlights the role of ELISA and HPLC methods that have been used during the assessment for GLP-1 analogs, especially for exenatide.

Peptidomic analysis of endogenous plasma peptides from patients with pancreatic neuroendocrine tumours

RATIONALE

Diagnosis of pancreatic neuroendocrine tumours requires the study of patient plasma with multiple immunoassays, using multiple aliquots of plasma. The application of mass spectrometry based techniques could reduce the cost and amount of plasma required for diagnosis.

METHODS

Plasma samples from two patients with pancreatic neuroendocrine tumours were extracted using an established acetonitrile-based plasma peptide enrichment strategy. The circulating peptidome was characterised using nano and high flow rate liquid chromatography/mass spectrometry (LC/MS) analyses. To assess the diagnostic potential of the analytical approach, a large sample batch (68 plasmas) from control subjects, and aliquots from subjects harbouring two different types of pancreatic neuroendocrine tumour (insulinoma and glucagonoma), were analysed using a 10-min LC/MS peptide screen.

RESULTS

The untargeted plasma peptidomics approach identified peptides derived from the glucagon prohormone, chromogranin A, chromogranin B and other peptide hormones and proteins related to control of peptide secretion. The glucagon prohormone derived peptides that were detected were compared against putative peptides that were identified using multiple antibody pairs against glucagon peptides. Comparison of the plasma samples for relative levels of selected peptides showed clear separation between the glucagonoma and the insulinoma and control samples.

CONCLUSIONS

The combination of the organic solvent extraction methodology with high flow rate analysis could potentially be used to aid diagnosis and monitor treatment of patients with functioning pancreatic neuroendocrine tumours. However, significant validation will be required before this approach can be clinically applied.

LC-MS/MS assay for the determination of a novel D-peptide antagonist of CXCR4 in rat plasma and its application to a preclinical pharmacokinetic study

DV1 is a potent and selective D-peptide antagonist of CXCR4 and being developed as a novel drug candidate molecule. For preclinical pharmacokinetic study of DV1, we established an efficient and reliable liquid chromatography coupled to tandem mass spectrometric (LC-MS/MS) method for the assay of DV1 in rat plasma. Plasma samples were acidified by formic acid and then their protein content precipitated by acetonitrile. Sample separation was processed with a C18 column (4.6 mm × 100 mm, 5 μm) and washed by a water-acetonitrile gradient mobile phase containing 0.1% (v/v) formic acid at a flow rate of 0.4 mL/min. The mass spectrometer was operated in the multiple reaction monitoring mode and positive electrospray ionization. The assay had a good linearity over the range of 10-10000 ng/mL (r>0.998) for DV1. The adsorption of the peptide was diminished by organic additives during the quantitative procedure. The intra- and inter-day precision was 1.9-9.8% and the accuracy was 91.2-110.0%. No significant variation was observed under the optimized conditions. The recovery was above 52% with low matrix effects. The method was successfully applied to a pharmacokinetic study of DV1 after subcutaneous injection at dose of 10 mg/kg in rats. The half-life and AUC_inf of DV1 were calculated as 8.7 h and 35,553 ng/mL·h, respectively. It is the first report on the quantitative analysis and pharmacokinetic characterization of a D-peptide targeted CXCR4, which should be useful for further preclinical studies and development of this and other peptide therapeutics.

Population pharmacokinetics of exendin-(9-39) and clinical dose selection in patients with congenital hyperinsulinism

AIMS

Congenital hyperinsulinism (HI) is the most common cause of persistent hypoglycaemia in infants and children. Exendin-(9-39), an inverse glucagon-like peptide 1 (GLP-1) agonist, is a novel therapeutic agent for HI that has demonstrated glucose-raising effect. We report the first population pharmacokinetic (PopPK) model of the exendin-(9-39) in patients with HI and propose the optimal dosing regimen for future clinical trials in neonates with HI.

METHODS

A total of 182 pharmacokinetic (PK) observations from 26 subjects in three clinical studies were included for constructing the PopPK model using first order conditional estimation (FOCE) with interaction method in nonlinear mixed-effects modelling (NONMEM). Exposure metrics (area under the curve [AUC] and maximum plasma concentration [C_max ]) at no observed adverse effect levels (NOAELs) in rats and dogs were determined in toxicology studies.

RESULTS

Observed concentration-time profiles of exendin-(9-39) were described by a linear two-compartmental PK model. Following allometric scaling of PK parameters, age and creatinine clearance did not significantly affect clearance. The calculated clearance and elimination half-life for adult subjects with median weight of 69 kg were 11.8 l h^-1 and 1.81 h, respectively. The maximum recommended starting dose determined from modelling and simulation based on the AUC_0-last at the NOAEL and predicted AUC_0-inf using the PopPK model was 27 mg kg^-1  day^-1 intravenously.

CONCLUSIONS

This is the first study to investigate the PopPK of exendin-(9-39) in humans. The final PopPK model was successfully used with preclinical toxicology findings to propose the optimal dosing regimen of exendin-(9-39) for clinical studies in neonates with HI, allowing for a more targeted dosing approach to achieve desired glycaemic response.

Development of bioanalytical assays for variegin, a peptide-based bivalent direct thrombin inhibitor

AIM

Variegin is an anticoagulant peptide that will be tested in porcine models of percutaneous coronary intervention. We developed three bioanalytical assays for variegin quantitation and utilized these methods to evaluate pharmacokinetics of variegin in pigs. Results & methodology: The LC-MS/MS, thrombin amidolytic and modified thrombin time assays had a quantitation range of 21.6-5541.7, 10.8-5541.7 and 5.4-5541.7 nM in human plasma, respectively. The elimination half-lives obtained using the LC-MS/MS, modified thrombin time and thrombin amidolytic assays were 52.3 ± 4.4, 50.4 ± 5.9 and 67.7 ± 6.3 min, respectively.

CONCLUSION

We developed three bioanalytical assays for a novel direct thrombin inhibitor, variegin. The thrombin time assay is optimized for variegin quantitation during future porcine studies and clinical trials.