Simple and sensitive dilute-and-shoot analysis of carotenoids in human plasma

Association of Candidate Single-Nucleotide Polymorphism Genotypes With Plasma and Skin Carotenoid Concentrations in Adults Provided a Lycopene-Rich Juice

BACKGROUND

Carotenoids are fat-soluble phytochemicals with biological roles, including ultraviolet protective functions in skin. Spectroscopic skin carotenoid measurements can also serve as a noninvasive biomarker for carotenoid consumption. Single-nucleotide polymorphisms (SNPs) in metabolic genes are associated with human plasma carotenoid concentrations; however, their relationships with skin carotenoid concentrations are unknown.

OBJECTIVES

The objective of this study was to determine the relationship between 13 candidate SNPs with skin and plasma carotenoid concentrations before and after a carotenoid-rich tomato juice intervention.

METHODS

In this randomized, controlled trial, participants (n = 80) were provided with lycopene-rich vegetable juice providing low (13.1 mg), medium (23.9 mg), and high (31.0 mg) daily total carotenoid doses for 8 wk. Plasma carotenoid concentrations were measured by high-pressure liquid chromatography, and skin carotenoid score was assessed by reflection spectroscopy (Veggie Meter) at baseline and the end-of-study time point. Thirteen candidate SNPs in 5 genes (BCO1, CD36, SCARB1, SETD7, and ABCA1) were genotyped from blood using PCR-based assays. Mixed models tested the effects of the intervention, study time point, interaction between intervention and study time point, and SNP genotype on skin and plasma carotenoids throughout the study. Baseline carotenoid intake, body mass index, gender, and age are covariates in all models.

RESULTS

The genotype of CD36 rs1527479 (P = 0.0490) was significantly associated with skin carotenoid concentrations when baseline and the final week of the intervention were evaluated. Genotypes for BCO1 rs7500996 (P = 0.0067) and CD36 rs1527479 (P = 0.0018) were significant predictors of skin carotenoid concentrations in a combined SNP model.

CONCLUSIONS

These novel associations between SNPs and skin carotenoid concentrations expand on the understanding of how genetic variation affects interindividual variation in skin carotenoid phenotypes in humans. This trial was registered at clinicaltrials.gov as NCT03202043.

Carotenoids in Health as Studied by Omics-Related Endpoints

Carotenoids have been associated with risk reduction for several chronic diseases, including the association of their dietary intake/circulating levels with reduced incidence of obesity, type 2 diabetes, certain types of cancer, and even lower total mortality. In addition to some carotenoids constituting vitamin A precursors, they are implicated in potential antioxidant effects and pathways related to inflammation and oxidative stress, including transcription factors such as nuclear factor κB and nuclear factor erythroid 2-related factor 2. Carotenoids and metabolites may also interact with nuclear receptors, mainly retinoic acid receptor/retinoid X receptor and peroxisome proliferator-activated receptors, which play a role in the immune system and cellular differentiation. Therefore, a large number of downstream targets are likely influenced by carotenoids, including but not limited to genes and proteins implicated in oxidative stress and inflammation, antioxidation, and cellular differentiation processes. Furthermore, recent studies also propose an association between carotenoid intake and gut microbiota. While all these endpoints could be individually assessed, a more complete/integrative way to determine a multitude of health-related aspects of carotenoids includes (multi)omics-related techniques, especially transcriptomics, proteomics, lipidomics, and metabolomics, as well as metagenomics, measured in a variety of biospecimens including plasma, urine, stool, white blood cells, or other tissue cellular extracts. In this review, we highlight the use of omics technologies to assess health-related effects of carotenoids in mammalian organisms and models.

Biochemical Validation of a Self-Administered Carotenoid Intake Screener to Assess Carotenoid Intake in Nonobese Adults

Background

Epidemiological studies have demonstrated an association between carotenoid intake and health. However, an accurate measurement of carotenoid intake is challenging. FFQ is the most commonly used dietary assessment method and is typically composed of 100-200 items. However, the greater participant burden that accompanies a more detailed FFQ provides only a marginal gain in accuracy. Therefore, a brief validated carotenoid intake screener is needed.

Objectives

To conduct secondary analysis evaluating the validity of a newly developed 44-item carotenoid intake screener from The Juice Study: Sensitivity of Skin Carotenoid Status to Detect Change in Intake (NCT03202043) against corresponding plasma carotenoid concentrations (primary) and skin carotenoids (secondary) in nonobese Midwestern American adults.

Methods

Healthy adults (n = 83; 25 men and 58 women) aged 18-65 y (mean age, 32 ± 12 y) with a BMI (in kg/m2) of 18.5-29.9 (mean BMI, 25 ± 3) were recruited between 25 April 2018 and 28 March 2019. Participants completed the carotenoid intake screener weekly during the 8-wk parent study. Plasma carotenoid concentrations were assessed at weeks 0, 4, and 8 using HPLC. Skin carotenoids were assessed weekly using pressure-mediated reflection spectroscopy (RS). Correlation matrices from mixed models were used to determine the correlation between carotenoid intake and plasma and skin carotenoids over time.

Results

The total carotenoid intake, as determined by the carotenoid intake screener, correlated with both the plasma total carotenoid concentration (r = 0.52; P < 0.0001) and the RS-assessed skin carotenoid concentration (r = 0.43; P < 0.0001). Correlations between reported intake and plasma concentrations of α-carotene (r = 0.40; P = 0.0002), cryptoxanthin (r = 0.28; P = 0.0113), and lycopene (r = 0.33; P = 0.0022) were also observed.

Conclusions

The results of this study demonstrate an acceptable relative validity of the carotenoid intake screener to assess total carotenoid intake in adults classified as those having a healthy body or those with overweight.

Sensitivity of Pressure-Mediated Reflection Spectroscopy to Detect Changes in Skin Carotenoids in Adults Without Obesity in Response to Increased Carotenoid Intake: A Randomized Controlled Trial

BACKGROUND

The sensitivity of commercially available devices to detect changes in skin carotenoids is not known.

OBJECTIVES

We aimed to determine the sensitivity of pressure-mediated reflection spectroscopy (RS) to detect changes in skin carotenoids in response to increasing carotenoid intake.

METHODS

Nonobese adults were randomly assigned to a control (water; n = 20; females = 15 (75%); mean age: 31 ± 3 (SE) y; mean BMI: 26 ± 1 kg/m²) or one of 3 carotenoid intake levels: 1) LOW - 13.1 mg; n = 22; females = 18(82%); age: 33 ± 3 y; BMI: 25 ± 1 kg/m²; 2) MED - 23.9 mg; n = 22; females = 17 (77%); age: 30 ± 2 y; BMI: 26 ± 1 kg/m²); or 3) HIGH - 31.0 mg; n = 19; females = 9 (47%); age: 33 ± 3 y; BMI: 24 ± 1 kg/m². A commercial vegetable juice was provided daily to ensure that the additional carotenoid intake was achieved. Skin carotenoids (RS intensity [RSI]) were measured weekly. Plasma carotenoid concentrations were assessed at wk 0, 4, and 8. Mixed models were used to test the effect of treatment, time, and their interaction. Correlation matrices from mixed models were used to determine the correlation between plasma and skin carotenoids.

RESULTS

A correlation was observed between skin and plasma carotenoids (r = 0.65; P < 0.001). Skin carotenoids were greater than baseline starting at week 1 in the HIGH (290 ± 20 vs. 321 ± 24 RSI; P ≤ 0.01), week 2 in the MED (274 ± 18 vs. 290 ± 23 RSI; P ≤ 0.03), and week 3 in the LOW (261 ± 18 vs. 288 ± 15 RSI; P ≤ 0.03). Compared with control, differences in skin carotenoids were observed starting at week 2 in the HIGH ([268 ± 16 vs. 338 ± 26 RSI; P ≤ 0.01] except for week 3 [287 ± 20 vs. 335 ± 26 RSI; P = 0.08]) and week 6 in the MED (303 ± 26 vs. 363 ± 27 RSI; P ≤ 0.03). No differences were observed between the control and LOW.

CONCLUSIONS

These findings demonstrate that RS can detect changes in skin carotenoids in adults without obesity when daily carotenoid intake is increased by 13.1 mg for a minimum of 3 wk. However, a minimum difference in intake of 23.9 mg of carotenoids is needed to detect group differences. This trial was registered at ClinicalTrials.gov as NCT03202043.

Increasing Vegetable Intake Decreases Urinary Acidity and Bone Resorption Marker in Overweight and Obese Adults: An 8-Week Randomized Controlled Trial

BACKGROUND

Controlled intervention trials are needed to confirm a positive association from epidemiological studies between vegetable consumption and bone health.

OBJECTIVE

We investigated whether providing vegetables at the Dietary Guidelines for Americans (DGA) recommended amount affects excretion of acid and calcium in urine and bone turnover markers in serum in adults with low vegetable intake.

METHODS

In total, 102 adults (19 males and 83 females, age 18-65 y, BMI ≥25 kg/m2) consuming ≤1 serving of vegetables (128 g raw leafy or 64 g cooked vegetables) per d were recruited in a 2-arm, parallel, randomized, controlled, and community-based 8-wk feeding intervention trial. The 2 arms included a vegetable intervention (VI) during which participants received extra vegetables (∼270 g/d) and an attention control (CON) group that conducted only the testing visits. Measurements included nutrient intake, plasma carotenoids, and bone-related markers in serum and urine. Differences between CON and VI at week 8 were tested using the ANCOVA with baseline values as a covariate.

RESULTS

Compared with CON, carotenoid intake (mean ± SD) was higher (6.4 ± 3.4 compared with 2.0 ± 1.2 mg/d) (P < 0.01) and dietary potential renal acid load was lower (20 ± 13 compared with 3.4 ± 14 mEq/d) (P < 0.01) in VI. Compared with CON at week 8, urine titratable acid and Mg were 24 and 26% lower, respectively, while urine pH was 3% greater (P < 0.05) and serum C-terminal telopeptide of type I collagen (CTX) was 19% lower in VI. There were no group differences in serum concentrations of propeptide of type 1 procollagen and tartrate-resistant acid phosphatase or urinary excretion of deoxypyridinoline and CTX.

CONCLUSIONS

Consumption of vegetables at the DGA-recommended amount by adults with low vegetable intake potentially benefits bone health. This trial was registered at clinicaltrials.gov as NCT02585102.

Impact of Protein-Enriched Plant Food Items on the Bioaccessibility and Cellular Uptake of Carotenoids

Carotenoids are lipophilic pigments which have been associated with a number of health benefits, partly related to antioxidant effects. However, due to their poor solubility during digestion, carotenoid bioavailability is low and variable. In this study, we investigated the effect of frequently consumed proteins on carotenoid bioaccessibility and cellular uptake. Whey protein isolate (WPI), soy protein isolate (SPI), sodium caseinate (SC), gelatin (GEL), turkey and cod, equivalent to 0/10/25/50% of the recommended dietary allowance (RDA, approx. 60g/d), were co-digested gastro-intestinally with carotenoid-rich food matrices (tomato and carrot juice, spinach), and digesta further studied in Caco-2 cell models. Lipid digestion, surface tension and microscopic visualization were also carried out. Co-digested proteins positively influenced the micellization of carotenes (up to 3-fold, depending on type and concentration), especially in the presence of SPI (p < 0.001). An increased cellular uptake was observed for xanthophylls/carotenes (up to 12/33%, p < 0.001), which was stronger for matrices with an initially poor carotenoid micellization (i.e., tomato juice, p < 0.001), similar to what was encountered for bioaccessibility. Turkey and cod had a weaker impact. Significant interactions between carotenoids, lipids and proteins were observed during digestion. Co-digested proteins generally improved lipid digestion in all matrices (p < 0.001), especially for carrot juice, though slight decreases were observed for GEL. Protein impact on the surface tension was limited. In conclusion, proteins generally improved both carotenoid bioaccessibility and cellular uptake, depending on the matrices and carotenoid-type (i.e., carotene vs. xanthophylls), which may be relevant under specific circumstances, such as intake of carotenoid-rich food items low in lipids.

A 'Dilute and Shoot' Liquid Chromatography-Mass Spectrometry Method for Multiclass Drug Analysis in Pre-Cut Dried Blood Spots

Drugs able to affect the auditory and nervous systems and consumed by workers to treatdifferent pathologies can represent a possible source of risk in the work environment. All the target compounds involved in the presented project show ototoxic and/or narcoleptic side effects and, for these reasons, occupational safety organizations have recognized them as potential causes of work injuries. A multiclass method for the analysis of 15 drugs among the most widespread worldwide (belonging to nine different classes including antihistamines, beta-blockers, antidepressants, Z-drugs and opioids), was developed and validated. This study describes a rapid, sensitive and effective method to analyse these substances in whole blood using tailored pre-cut dried blood spots. Detection was achieved with a triple quadrupole mass spectrometer after an easy and simple 'dilute and shoot' solubilisation followed by an UPLC separation. All the issues linked to the use of the dried blood spots and whole blood, such as haematocrit variability, volumetric evaluation and sample carrier choice were carefully studied and managed during method development. From the validation study results it emerged that this approach can be deemed successful thanks to its few pg µL-1 LOQs, good linear intervals, absolute recoveries of no less than 75%, an almost negligible matrix effect and accuracy and precision in line with the European and American guidelines for validation. All the obtained goals have been specifically pursued in order to encourage method diffusion as a primary prevention intervention, even in small private workplaces.

Application of Dried Blood Spot Cards combined with liquid chromatography-tandem mass spectrometry to determine eight fat-soluble micronutrients in human blood

The analysis of the fat-soluble vitamins A and E and lipid micronutrients in blood, such as carotenoids, is an important parameter to monitor the micronutrient status in humans. Although the potential of dried blood spot (DBS) cards, the use of this technique for blood sampling and subsequent analysis of these fat-soluble micronutrients has been poorly or not studied. An analytical method based on DBS cards (FTA® DMPK-A) combined with liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) has been developed and validated for the determination of carotenoids (lutein, zeaxanthin, β-cryptoxanthin and β-carotene), tocopherols (α-tocopherol, γ-tocopherol and δ-tocopherol) and all-trans-retinol in human blood. Under optimum DBS card extraction conditions, the extraction recoveries of the studied compounds were higher than 72%, the sample matrix effect lower than 17%, and the detection limits at hundred nM concentration levels. The developed method was applied to the analysis of human blood, and the concentration ranges obtained fell within the expected ranges previously reported in healthy adults. Moreover, the influence of hematocrit effect was investigated in a range of 25-55% in order to compare the obtained results to those reported in the literature for the analysis of plasma samples. This method represents an improvement over current techniques reported in the literature due to the use of a non-invasive blood collection method, and moreover, this methodology was for the first time 1) validated for the analysis of all-trans-retinol, tocopherols and carotenoids, and 2) applied for the determination of tocopherols in human blood samples.

Concurrent validity of skin carotenoid status as a concentration biomarker of vegetable and fruit intake compared to multiple 24-h recalls and plasma carotenoid concentrations across one year: a cohort study

Background

Biological markers of vegetable and fruit (VF) intake are needed both for nutrition surveillance and for the evaluation of nutrition interventions. Optically assessed skin carotenoid status (SCS) has been proposed as a marker of intake but there are few published validity studies to date. Therefore, the objective of the study was to examine the concurrent validity of multiple methods of assessing VF intake cross-sectionally and seasonally over one year and to discuss the relative merits and limitations of each method.

Methods

Fifty-two 40–60 y old women completed a 1-year longitudinal study that included 1) SCS assessment using resonance Raman spectroscopy (RRS) and using pressure-mediated reflection spectroscopy (RS) at 12 timepoints, 2) thirty-six 24-h recalls using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24; total 1866 recalls), and 3) plasma carotenoid concentrations measured every 3 months. Pearson correlation coefficients and mixed linear models were used to estimate pairwise correlations between RRS, RS, ASA24, and plasma carotenoids.

Results

RS and RRS were strongly correlated at baseline and over the year (r = 0.86 and 0.76; respectively, P < 0.001). RS was strongly correlated with plasma carotenoids at baseline (r = 0.70) and moderately across the year (r = 0.65), as was RRS (r = 0.77 and 0.69, respectively, all P < 0.001). At baseline, self-reported VF was weakly correlated with RRS (r = 0.33; P = 0.016), but not with RS or plasma carotenoids. Across the year, self-reported VF intake was weakly correlated with both RS (r = 0.37; P = 0.008), RRS (r = 0.37; P = 0.007), and with plasma carotenoids (r = 0.36; P < 0.008).

Conclusions

SCS as measured by RS and RRS is moderately to strongly correlated with plasma carotenoid concentrations both cross-sectionally and longitudinally, indicating that it can be a powerful tool to assess carotenoid-rich VF intake in populations.

Clinical trial registry

This trial was registered at ClinicalTrials.gov as NCT01674296.