A novel fully-automated method to measure steroids in serum by liquid chromatography-tandem mass spectrometry

Evolution of LC-MS/MS in clinical laboratories

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has attracted significant attention in clinical practice owing to its numerous advantages. However, the widespread adoption of this technique is hindered by certain limitations, such as inappropriate analyte selection, low levels of automation, and a lack of specific reference intervals and quality control programs. This review comprehensively summarizes the current challenges associated with LC-MS/MS and proposes potential resolutions. The principle of utility should guide the selection of biomarkers, prioritizing their practical value over sheer quantity. To achieve full-process automation, methodological innovation is crucial for developing high-throughput equipment. Establishing reference intervals for mass spectrometry-based assays across multiple centers and diverse populations is essential for accurate result interpretation. Additionally, the development of commercial quality control materials assumes pivotal importance in ensuring assay reliability and reproducibility. Harmonization and standardization efforts should focus on the development of reference methods and materials for the clinical use of LC-MS/MS. In the future, commercial assay kits and laboratory-developed tests (LDTs) are expected to coexist in clinical laboratories, each offering distinct advantages. The collaborative efforts of diverse professionals is vital for addressing the challenges associated with the clinical application of LC-MS/MS. The anticipated advancements include simplification, increased automation, intelligence, and the standardization of LC-MS/MS, ultimately facilitating its seamless integration into clinical routines for both technicians and clinicians.

Rapid and Simultaneous Determination of Anabolic Andro-Genic Steroids in Livestock and Poultry Meat Using One-Step Solid-Phase Extraction Coupled with UHPLC-MS/MS

Anabolic androgenic steroids (AASs) are usually illegally added to animal feed because they can significantly promote animal growth and increase carcasses' leanness, which threatens the safety of animal-derived foods and indirectly hazards human health. This study aimed to establish an ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method for the simultaneous detection of twelve AAS residues in livestock and poultry meat. The homogenized samples were extracted with acetonitrile containing 1% acetic acid (v/v) and purified using the one-step extraction column. After concentration using nitrogen, the residues were redissolved in acetonitrile and then quantified with an external standard method using UHPLC-MS/MS. The results showed that the above-mentioned method had a satisfactory linear correlation (R2 ≥ 0.9903) with a concentration range of 1-100 μg/L, and the limits of detection (LODs) and quantification (LOQs) were 0.03-0.33 μg/kg and 0.09-0.90 μg/kg, respectively. With the intraday and interday precision less than 15%, the average recoveries of pork, beef, lamb, and chicken, at different spiked levels, ranged from 68.3 to 93.3%, 68.0 to 99.4%, 71.6 to 109.8%, and 70.5 to 97.7%, respectively. Overall, the established method is validated, precise, and capable of the high-throughput determination of the residues of twelve AASs in livestock and poultry meat.

Derivatized versus non-derivatized LC-MS/MS techniques for the analysis of estrogens and estrogen-like endocrine disruptors in human plasma

Bisphenols, parabens, alkylphenols and triclosan are anthropogenic substances with a phenolic group that have been introduced to the environment in recent decades. As they possess hormone-like effects, they have been termed endocrine disruptors (EDs), and can interfere with steroid pathways in organisms. To evaluate the potential impact of EDs on steroid biosynthesis and metabolism, sensitive and robust methods enabling the concurrent measurement of EDs and steroids in plasma are needed. Of crucial importance is the analysis of unconjugated EDs, which possess biological activity. The aim of the study was to develop and validate LC-MS/MS methods with and without a derivatization step for the analysis of unconjugated steroids (estrone-E1, estradiol-E2, estriol-E3, aldosterone-ALDO) and different groups of EDs (bisphenols, parabens, nonylphenol-NP and triclosan-TCS), and compare these methods on a set of 24 human plasma samples using Passing-Bablok regression analysis. Both methods were validated according to FDA and EMA guidelines. The method with dansyl chloride derivatization allowed 17 compounds to be measured: estrogens (E1, E2, E3), bisphenols (bisphenol A-BPA, BPS, BPF, BPAF, BPAP, BPZ, BPP), parabens (methylparaben-MP, ethylparaben-EP, propylparaben-PP, butylparaben-BP, benzylparaben-BenzylP), TCS and NP, with lower limits of quantification (LLOQs) between 4 and 125 pg/mL. The method without derivatization enabled 15 compounds to be analyzed: estrogens (E1, E2, E3), ALDO, bisphenols (BPA, BPS, BPF, BPAF, BPAP, BPZ), parabens (MP, EP, PP, BP, BenzylP) with LLOQs between 2 and 63 pg/mL, and NP and BPP in semiquantitative mode. Adding 6 mM ammonium fluoride post column into mobile phases in the method without derivatization achieved similar or even better LLOQs than the method with the derivatization step. The uniqueness of the methods lies in the simultaneous determination of different classes of unconjugated (bioactive) fraction of EDs together with selected steroids (estrogens + ALDO in the method without derivatization), which provides a useful tool for evaluating the relationships between EDs and steroid metabolism.

CuBTC metal organic framework-based dispersive solid phase extraction of cyclosporine and tacrolimus from plasma samples prior to determination by high performance liquid chromatography-tandem mass spectrometry

Immunosuppressive drugs are prescribed to reduce the immune system of persons who are undergoing organ transplants. The concentration of these drugs in blood and plasma samples must be accurately and precisely determined during immunosuppressive therapy due to their significant side effects. In this study, a metal organic framework-based dispersive solid phase extraction method was developed for the extraction of tacrolimus and cyclosporine from plasma samples before their determination by high performance liquid chromatography-tandem mass spectrometry. For this purpose, CuBTC metal organic framework nanoparticles were prepared by a hydrothermal approach and they were used as the sorbent in the extraction procedure. The adsorbed analytes were eluted by a suitable organic solvent and then more concentrated by evaporation of the eluate. All of the effective parameters of the method including sorbent amount, adsorption time, eluent type, desorption time, eluent volume, and sample solution pH were studied and optimized. They were obtained 5 mg, 5 min, acetone, 5 min, 300 μL, and 5, respectively. Under optimal conditions, the developed method was validated and the data showed that the linear range, the limit of detection, the limit of quantification, the coefficient of determination, the enrichment factor, and relative standard deviation values were 1-1000 ng mL^-1, 0.30 ng mL^-1, 0.5 ng mL^-1, 0.99, 15.6, and 5.8 % for tacrolimus and 0.8-500 ng mL^-1, 0.25 ng mL^-1, 0.4 ng mL^-1, 0.99, 17, and 5.6 % for cyclosporine, respectively. Finally, the method was successfully used in the determination of the studied drugs in plasma samples.

Determination of a Serum 25-Hydroxyvitamin D Reference Ranges in Japanese Adults Using Fully Automated Liquid Chromatography-Tandem Mass Spectrometry

BACKGROUND

Despite an increasing interest in vitamin D status, a reference range of the nutrient has not been fully established. This is partly due to a paucity of standardized measuring systems with high throughput. In addition, the range may vary by populations and may change with modernization of lifestyles.

OBJECTIVES

This study aims to calculate the current reference concentration of 25-hydroxyvitamin D (25(OH)D) among healthy people living in an urban area in Japan.

METHODS

A newly developed fully automated liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) system was used to measure serum 25(OH)D concentrations. Reproducibility was assessed by measuring standardized samples. Accuracy was validated by comparing with commercially available immunoassays. Then, mass screening was conducted targeting participants who received medical checkups in Tokyo from April 2019 to March 2020, and the reference ranges were calculated.

RESULTS

The coefficients of variations of interoperator and interday reproducibility were 4.1%-8.5% and 3.7%-8.0% for 25-hydroxyvitamin D₂ (25(OH)D2) and 4.7%-7.0% and 4.0%-6.9% for 25-hydroxyvitamine D3, respectively. The measured total 25(OH)D concentrations correlated well with those measured by immunoassays. In total, 5518 participants were measured for 25(OH)D concentrations, among whom 98% showed inadequate concentrations (<30 ng/mL). The reference ranges of total 25(OH)D for female, male, and total participants were 7-30 ng/mL, 5-27 ng/mL, and 6-29 ng/mL, respectively. After excluding those with abnormal renal and liver function, the range was 6-30 ng/mL.

CONCLUSIONS

The high prevalence of vitamin D insufficiency among seemingly healthy population may be attributed to lifestyle characteristics of people living in urban areas of Japan, including spending less time outdoors and lower intake of traditional foods. Longitudinal follow-up and mass screenings targeting different population will help elucidate reasons for discrepancies between official guidelines and the observed concentrations, to which the well-validated measurement system is essential.