1
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Pan Y, Wang Q, Chen M, Takao T. Profiling of urinary steroids aided by lithium ion adduction-based ultrahigh-performance liquid chromatography-tandem mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2024; 38:e9719. [PMID: 38500352 DOI: 10.1002/rcm.9719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 03/20/2024]
Abstract
RATIONALE As 3-OH-containing steroids are prone to dehydration by conventional electrospray ionization, reducing detection sensitivity, Li ion adduction-based ultrahigh-performance liquid chromatography-tandem mass spectrometry (UHPLC/MS/MS), developed to prevent dehydration and effectively detect 3-OH steroids, was applied for profiling total and free steroids in urine. METHODS Free urinary steroids were isolated directly from urine by solid-phase extraction (SPE) with 80% acetonitrile. The total steroids were prepared by enzymatic treatment of urine with a cocktail of sulfatase and glucronidase, protein precipitation, and separation with the above SPE. In order to detect as many steroid types as possible, UHPLC/MS/MS (Li method) with Li+ solution added after the column was used for analysis in addition to the conventional method of detecting protonated ions (H method). The 13 3-OH steroids and the remaining 16 steroids were quantified by standard curves prepared using product ion transitions derived from [M + Li]+ and MH+ , respectively. RESULTS Two groups of human urine, male and female urine, were analyzed. 3-OH steroids could be detected with greater sensitivity using the Li method than the conventional method. The absolute amounts of each steroid were normalized based on creatinine levels. The difference between the male and female groups are clearly attributable to sex steroids. CONCLUSIONS Twenty-nine total steroids and 19 free steroids were identified in a limited volume (240 mL) of urine. Of these, 13 3-OH steroids were better detected by Li+ adduction-based UHPLC/MS/MS.
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Affiliation(s)
- Yue Pan
- Institute for Protein Research, Osaka University, Osaka, Japan
| | - Qiuyi Wang
- Institute for Protein Research, Osaka University, Osaka, Japan
| | - Mengyao Chen
- Institute for Protein Research, Osaka University, Osaka, Japan
| | - Toshifumi Takao
- Institute for Protein Research, Osaka University, Osaka, Japan
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2
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Ankarberg-Lindgren C, Becker C, Svala E, Ryberg H. Methodological considerations in determining sex steroids in children: comparison of conventional immunoassays with liquid chromatography-tandem mass spectrometry. Clin Chem Lab Med 2024; 62:85-96. [PMID: 37540832 DOI: 10.1515/cclm-2023-0344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/14/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES In laboratory medicine, external quality assessment (EQA) schemes have become versatile tools for detecting analytical flaws. However, EQA schemes are lacking for pediatric sex steroid levels. We aimed to investigate the suitability of different estradiol and testosterone immunoassays in a pediatric setting in comparison with clinical liquid chromatography-tandem mass spectrometry (LC-MS/MS) assays. METHODS The study was conducted by staff and the advisory group on endocrinology at Equalis, the Swedish provider of EQA schemes for laboratory medicine. The test material consisted of five pooled serum samples from children who were either prepubertal or in puberty. Clinical laboratories enrolled in Equalis EQA schemes for estradiol and testosterone were invited to participate, as were clinical laboratories using LC-MS/MS-assays. Samples were analyzed by either routine immunoassays (n=18) or in-house LC-MS/MS assays (n=3). RESULTS For estradiol, LC-MS/MS assays showed a high degree of conformity with interlaboratory coefficients of variation (CV) below 24.2 %. Reported levels were between 4.9 ± 1.2 and 33.9 ± 1.6 pmol/L (group mean ± standard deviation). The direct immunoassays had lower precision; their CVs were up to 81.4 %. Reported concentrations were between 25.3 ± 18.1 and 45.7 ± 19.4 pmol/L, an overestimation compared to LC-MS/MS. Testosterone LC-MS/MS also showed a high degree of conformity, CVs were below 13.4 %, and reported concentrations were from 0.06 ± 0.00 to 1.00 ± 0.11 nmol/L. The direct immunoassays had a larger discrepancy between results; CVs were up to 95.8 %. Concentrations were between 0.12 ± 0.11 and 0.85 ± 0.23 nmol/L. CONCLUSIONS For the safe diagnosis and determination of sex steroids in children, analysis with mass spectrometry-based methods is recommended.
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Affiliation(s)
- Carina Ankarberg-Lindgren
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Charlotte Becker
- Department of Clinical Chemistry and Pharmacology, University and Regional Laboratories Region Skåne, Malmö, Sweden
| | | | - Henrik Ryberg
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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3
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Visconti G, de Figueiredo M, Strassel O, Boccard J, Vuilleumier N, Jaques D, Ponte B, Rudaz S. Multitargeted Internal Calibration for the Quantification of Chronic Kidney Disease-Related Endogenous Metabolites Using Liquid Chromatography-Mass Spectrometry. Anal Chem 2023; 95:13546-13554. [PMID: 37655548 PMCID: PMC10500547 DOI: 10.1021/acs.analchem.3c02069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023]
Abstract
Accurate quantitative analysis in liquid chromatography-mass spectrometry (LC-MS) benefits from calibration curves generated in the same matrix as the study sample. In the case of endogenous compound quantification, as no blank matrix exists, the multitargeted internal calibration (MTIC) is an attractive and straightforward approach to avoid the need for extensive matrix similarity evaluation. Its principle is to take advantage of stable isotope labeled (SIL) standards as internal calibrants to simultaneously quantify authentic analytes using a within sample calibration. An MTIC workflow was developed for the simultaneous quantification of metabolites related to chronic kidney disease (CKD) using a volumetric microsampling device to collect 20 μL of serum or plasma, followed by a single-step extraction with acetonitrile/water and liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Since a single concentration of internal calibrant is necessary to calculate the study sample concentration, the instrument response function was investigated to determine the best SIL concentration. After validation, the trueness of 16 endogenous analytes in authentic human serum ranged from 72.2 to 116.0%, the repeatability from 1.9 to 11.3%, and the intermediate precision ranged overall from 2.1 to 15.4%. The proposed approach was applied to plasma samples collected from healthy control participants and two patient groups diagnosed with CKD. Results confirmed substantial concentration differences between groups for several analytes, including indoxyl sulfate and cortisone, as well as metabolite enrichment in the kynurenine and indole pathways. Multitargeted methodologies represent a major step toward rapid and straightforward LC-MS/MS absolute quantification of endogenous biomarkers, which could change the paradigm of MS use in clinical laboratories.
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Affiliation(s)
- Gioele Visconti
- School
of Pharmaceutical Sciences, University of
Geneva, CMU −
Rue Michel-Servet 1, 1211 Geneva 4, Switzerland
- Institute
of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU − Rue Michel-Servet 1, 1211 Geneva 4, Switzerland
| | - Miguel de Figueiredo
- School
of Pharmaceutical Sciences, University of
Geneva, CMU −
Rue Michel-Servet 1, 1211 Geneva 4, Switzerland
- Institute
of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU − Rue Michel-Servet 1, 1211 Geneva 4, Switzerland
| | - Oriane Strassel
- School
of Pharmaceutical Sciences, University of
Geneva, CMU −
Rue Michel-Servet 1, 1211 Geneva 4, Switzerland
- Institute
of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU − Rue Michel-Servet 1, 1211 Geneva 4, Switzerland
| | - Julien Boccard
- School
of Pharmaceutical Sciences, University of
Geneva, CMU −
Rue Michel-Servet 1, 1211 Geneva 4, Switzerland
- Institute
of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU − Rue Michel-Servet 1, 1211 Geneva 4, Switzerland
| | - Nicolas Vuilleumier
- Department
of Genetic and Laboratory Medicine, Geneva
University Hospitals (HUG), Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - David Jaques
- Service
of Nephrology, Geneva University Hospitals
(HUG), Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Belén Ponte
- Service
of Nephrology, Geneva University Hospitals
(HUG), Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Serge Rudaz
- School
of Pharmaceutical Sciences, University of
Geneva, CMU −
Rue Michel-Servet 1, 1211 Geneva 4, Switzerland
- Institute
of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU − Rue Michel-Servet 1, 1211 Geneva 4, Switzerland
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4
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Wu J, Li Z, Chen B. Simultaneous measurement of 19 steroid hormones in dried blood spots using ultra-performance liquid chromatography-tandem mass spectrometry. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2023; 15:2006-2015. [PMID: 37057591 DOI: 10.1039/d2ay02009b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
A rapid and accurate ultra-performance liquid chromatography-tandem-mass spectrometry (UPLC-MS/MS) method was developed for the measurement of 19 steroid hormones in dried blood spots and to achieve the highly traceable analysis of steroid hormones in dried blood samples. In this method, a BEH C8 column and UPLC-MS/MS were used for the separation of the steroid hormones. The extraction process was simple and accurate. The distribution ranges of 19 steroid hormones in four healthy individuals (2 males and 2 females) were determined simultaneously by positive ionization mode (ESI+) and negative ionization mode (ESI-) analysis, which were recorded by multiple reaction monitoring (MRM) modes. The linearity of the standard curves of 19 steroid hormones in dried blood spots was good, and the linear correlation coefficients R2 were all ≥0.997. Meanwhile, the matrix effect of the method ranged from 87.1% to 131.3%. Across the analytical range, the inter-assay coefficient of variation (CV) was <12.07% and the intra-assay CV was <18.16%. The spiked recovery was >67.33%. The distribution ranges of 19 steroid hormones in four healthy individuals were in agreement with those in previous reports. A UPLC-MS/MS method for the simultaneous measurement of 19 steroid hormones in dried blood spots was developed to achieve traceable analysis of steroid hormones in dried blood samples.
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Affiliation(s)
- Jie Wu
- College of Chemistry, Beijing University of Chemical Technology, Beijing 100029, China.
| | - Zenghe Li
- College of Chemistry, Beijing University of Chemical Technology, Beijing 100029, China.
| | - Baorong Chen
- Laboratory Diagnosis Department, Beijing Kingmed Diagnostics, Beijing 100103, China.
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Won EJ, Yi A, Ko YJ. Analytical Performance Evaluation for Estradiol using Liquid Chromatography-Tandem Mass Spectrometry. Clin Biochem 2023; 113:59-63. [PMID: 36627012 DOI: 10.1016/j.clinbiochem.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND There is an increased need for the sensitive and accurate measurement of estradiol levels in patients with estradiol-related endocrine disorders. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is a reliable and accurate method for measuring steroid hormone levels. Here, we aimed to establish an LC-MS/MS-based method to quantify estradiol levels without sample derivatization and evaluated its analytical performance. METHODS Sciex Triple Quad 6500 + LC-MS/MS was used for estradiol analysis. We evaluated its analytical performance, including linearity, precision, the lower limit of detection and quantification (LoD and LoQ, respectively), accuracy, and carryover. The estradiol results determined by LC-MS/MS were compared with those obtained using a chemiluminescent microparticle immunoassay. RESULTS The LC-MS/MS output was linear for serum estradiol concentrations in the range of 0.2-10311.6 pmol/L. The intra-laboratory precision (coefficient of variation) was 3.0-10.1 %. The LoD and LoQ were 2.8 and 7.5 pmol/L, respectively. The overall accuracy was within 15 % of bias, and the carryover was within the acceptable range (<1.0 %). The results of the estradiol analysis determined by LC-MS/MS were comparable to those obtained by the chemiluminescent microparticle immunoassay (r2 = 0.9843), although there was a negative bias of - 17.82 (95 % confidence interval, -27.21 to - 8.44). CONCLUSIONS A highly sensitive, derivatization-free LC-MS/MS method was successfully developed in this study. This may be beneficial for estradiol measurements in patients with estradiol-related endocrine disorders.
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Affiliation(s)
- Eun Jeong Won
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Ahram Yi
- Department of Laboratory Medicine, Green Cross Laboratories (GC Labs), Yongin, South Korea
| | - Young Jin Ko
- Department of Laboratory Medicine, College of Medicine, Chosun University, Gwangju, South Korea.
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A New Heart-Cutting Method for a Multiplex Quantitative Analysis of Steroid Hormones in Plasma Using 2D-LC/MS/MS Technique. Molecules 2023; 28:molecules28031379. [PMID: 36771043 PMCID: PMC9921923 DOI: 10.3390/molecules28031379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
The aim of the current research was to develop a simple and rapid mass spectrometry-based assay for the determination of 15 steroid hormones in human plasma in a single run, which would be suitable for a routine practice setting. For this purpose, we designed a procedure based on the 2D-liquid chromatography-tandem mass spectrometry with a minimalistic sample pre-treatment. In our arrangement, the preparation of one sample takes only 10 min and can accommodate 40 samples per hour when tested in series. The following analytical run is 18 min long for all steroid hormones. In addition, we developed an independent analytical run for estradiol, significantly increasing the assay accuracy while taking an additional 10 min to perform an analytical run of a sample. The optimized method was applied to a set of human plasma samples, including chylous. Our results indicate the linearity of the method for all steroid hormones with squared regression coefficients R2 ≥ 0.995, within-run and between-run precision (RSD < 6.4%), and an accuracy of 92.9% to 106.2%. The absolute recovery for each analyzed steroid hormone ranged between 101.6% and 116.5%. The method detection limit for 15 steroid hormones ranged between 0.008 nmol/L (2.88 pg/mL) for aldosterone and 0.873 nmol/L (0.252 ng/mL) for DHEA. For all the analytes, the lowest calibration point relative standard deviation was less than 10.8%, indicating a good precision of the assay within the lowest concentration of interest. In conclusion, in this method article, we describe a simple, sensitive, and cost-effective 2D-LC/MS/MS method suitable for the routine analysis of a complex of steroid hormones allowing high analytical specificity and sensitivity despite minimal sample processing and short throughput times.
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7
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Visconti G, Boccard J, Feinberg M, Rudaz S. From fundamentals in calibration to modern methodologies: A tutorial for small molecules quantification in liquid chromatography-mass spectrometry bioanalysis. Anal Chim Acta 2023; 1240:340711. [PMID: 36641149 DOI: 10.1016/j.aca.2022.340711] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022]
Abstract
Over the last two decades, liquid chromatography coupled to mass-spectrometry (LC‒MS) has become the gold standard to perform qualitative and quantitative analyses of small molecules. When quantitative analysis is developed, an analyst usually refers to international guidelines for analytical method validation. In this context, the design of calibration curves plays a key role in providing accurate results. During recent years and along with instrumental advances, strategies to build calibration curves have dramatically evolved, introducing innovative approaches to improve quantitative precision and throughput. For example, when a labeled standard is available to be spiked directly into the study sample, the concentration of the unlabeled analog can be easily determined using the isotopic pattern deconvolution or the internal calibration approach, eliminating the need for multipoint calibration curves. This tutorial aims to synthetize the advances in LC‒MS quantitative analysis for small molecules in complex matrices, going from fundamental aspects in calibration to modern methodologies and applications. Different work schemes for calibration depending on the sample characteristics (analyte and matrix nature) are distinguished and discussed. Finally, this tutorial outlines the importance of having international guidelines for analytical method validation that agree with the advances in calibration strategies and analytical instrumentation.
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Affiliation(s)
- Gioele Visconti
- School of Pharmaceutical Sciences, University of Geneva, CMU - Rue Michel-Servet 1, 1211, Geneva, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU - Rue Michel-Servet 1, 1211, Geneva, Switzerland
| | - Julien Boccard
- School of Pharmaceutical Sciences, University of Geneva, CMU - Rue Michel-Servet 1, 1211, Geneva, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU - Rue Michel-Servet 1, 1211, Geneva, Switzerland
| | | | - Serge Rudaz
- School of Pharmaceutical Sciences, University of Geneva, CMU - Rue Michel-Servet 1, 1211, Geneva, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU - Rue Michel-Servet 1, 1211, Geneva, Switzerland.
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8
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Rakete S, Schubert T, Vogeser M. Semi-automated serum steroid profiling with tandem mass spectrometry. J Mass Spectrom Adv Clin Lab 2022; 27:40-48. [PMID: 36619216 PMCID: PMC9813517 DOI: 10.1016/j.jmsacl.2022.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/16/2022] Open
Abstract
Objectives Highly selective and sensitive multi-analyte methods for the analysis of steroids are attractive for the diagnosis of endocrine diseases. Commercially available kits are increasingly used for this purpose. These methods involve laborious solid phase extraction, and the respective panels of target analytes are incomplete. We wanted to investigate whether an improvement of kit solutions is possible by introducing automated on-line solid phase extraction (SPE) and combining originally separate analyte panels. Methods Sample preparation was performed using automated on-line SPE on a high-pressure stable extraction column. Chromatographic separation, including isobaric compounds, was achieved using a 0.25 mM ammonium fluoride-methanol gradient on a small particle size biphenyl column. Standard compounds and internal standard mixtures of two panels of a commercially available kit were combined to achieve an optimized and straightforward detection of 15 endogenous steroids. Validation was performed according to the European Medicines Agency (EMA) guidelines with slight modifications. Results Validation was successfully performed for all steroids over a clinically relevant calibration range. Deviations of intra- and inter-assay accuracy and precision results passed the criteria and no relevant matrix effects were detected due to highly effective sample preparation. External quality assessment samples showed the applicability as a routine diagnostic method, which was affirmed by the analyses of anonymized clinical samples. Conclusions It was found possible to complement a commercially available kit for quantitative serum steroid profiling based on isotope dilution LC-MS/MS by implementing automated on-line SPE, thereby improving the practicality and robustness of the measurement procedure.
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Key Words
- A4, Androstendione
- ALDO, Aldosterone
- APCI, Atmospheric pressure chemical ionization
- CAH, Congenital adrenal hyperplasia
- CE, Collision energy
- CE-IVD, Certified in-vitro-diagnostic device
- CV, Coefficient of variation
- DHEA, Dehydro-epiandrosterone
- DHEA-S, Dehydro-epiandrosterone sulfate
- DHT, Dihydrotestosterone
- DOC, 11-deoxycorticosterone
- E, Cortisone
- E2, Estradiol
- EMA, European Medicines Agency
- EQA, External quality assessment
- ESI, Electrospray ionisation
- F, Cortisol
- IVD, In-vitro-diagnostic
- IVDR, EU In vitro Diagnostic Regulation
- LC, Liquid chromatography
- LC–MS/MS, Liquid chromatography tandem mass spectrometry
- LDT, Laboratory developed test
- LLOQ, Lower limit of quantification
- MRM, Multiple reaction monitoring
- On-line solid phase extraction (SPE)
- P4, Progesterone
- QC, Quality control
- Robustness
- S/N, Signal-to-noise ratio
- SID, Stable-isotope dilution
- SPE, Solid phase extraction
- SST, System suitability test
- Serum steroid profiling
- Stable-isotope dilution liquid chromatography-tandem mass spectrometry (SID LC-MS/MS)
- UHPLC, Ultra high performance liquid chromatography
- ULOQ, Upper limit of quantification
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Affiliation(s)
| | | | - Michael Vogeser
- Corresponding author at: Institute of Laboratory Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.
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Dai J, Wang H, Liao Y, Tan L, Sun Y, Song C, Liu W, Qiu X, Ding C. RNA-seq and LC-MS/MS analysis of antiviral effects mediated by cold stress and stress hormone corticosterone in chicken DF-1 cells. Vet Microbiol 2022; 275:109580. [DOI: 10.1016/j.vetmic.2022.109580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/28/2022] [Accepted: 10/01/2022] [Indexed: 11/06/2022]
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Comprehensive Steroid Assay with Non-Targeted Analysis Using Liquid Chromatography Ion Mobility Mass Spectrometry. Int J Mol Sci 2022; 23:ijms232213858. [PMID: 36430339 PMCID: PMC9697045 DOI: 10.3390/ijms232213858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/28/2022] [Accepted: 11/07/2022] [Indexed: 11/12/2022] Open
Abstract
Aldosterone-producing adenomas (APAs) have different steroid profiles in serum, depending on the causative genetic mutation. Ion mobility is a separation technique for gas-phase ions based on their m/z values, shapes, and sizes. Human serum (100 µL) was purified by liquid-liquid extraction using tert-butyl methyl ether/ethyl acetate at 1/1 (v/v) and mixed with deuterium-labeled steroids as the internal standard. The separated supernatant was dried, re-dissolved in water containing 20% methanol, and injected into a liquid chromatography-ion mobility-mass spectrometer (LC/IM/MS). We established a highly sensitive assay system by separating 20 steroids based on their retention time, m/z value, and drift time. Twenty steroids were measured in the serum of patients with primary aldosteronism, essential hypertension, and healthy subjects and were clearly classified using principal component analysis. This method was also able to detect phosphatidylcholine and phosphatidylethanolamine, which were not targeted. LC/IM/MS has a high selectivity for known compounds and has the potential to provide information on unknown compounds. This analytical method has the potential to elucidate the pathogenesis of APA and identify unknown steroids that could serve as biomarkers for APA with different genetic mutations.
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Jia Y, Wang Z, Feng Y, Wang M, Jiang L, Yu Z, Shao X, He G, Liu Y. Validity of the association between five steroid hormones quantification and female infertility conditions: A new perspective for clinical diagnosis. Steroids 2022; 186:109086. [PMID: 35803387 DOI: 10.1016/j.steroids.2022.109086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/25/2022] [Accepted: 07/02/2022] [Indexed: 11/19/2022]
Abstract
Quantification of endogenous steroids and their precursors is essential for diagnosis of a wide range of causes for female infertility. However, immunoassays often overestimate concentrations due to assay interference by other endogenous steroids, especially at low concentrations. In addition, it still lacks of diagnostic reference intervals for five sex steroid hormones, including estradiol (E2), 11-deoxycorticosterone (DOC), 17-hydroxyprogesterone (17-OHP4), pregnenolone (P5) and progesterone (P4), which are crucial for distinguishing between normal individuals and female infertility. Therefore, we developed and validated a reliable and rapid ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for simultaneous determination and quantification of five sex hormones, giving the reference intervals to accurately evaluate and diagnose female infertility. Our results showed that the developed UPLC-MS/MS assay was fast, high throughput, reproducible, specific, accurate, highly sensitive, and fully validated for simultaneous determination of P5, P4, 17-OHP4, DOC and E2 in human follicular fluid. The simple sample preparation procedure in the current study gave reproducible and consistent recoveries. The validation results show that the UPLC-MS/MS assay has acceptable accuracy and precision at low concentrations, which permits their use in clinical study. In addition, our data gave the concentration range of five steroid hormones quantification in patients with female infertility and normal individuals. Our data can be used to accurately evaluate and diagnose female infertility.
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Affiliation(s)
- Yaqin Jia
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin 124221, China
| | - Zhe Wang
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin 124221, China
| | - Yuyi Feng
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin 124221, China
| | - Meixian Wang
- Department of Reproductive and Genetic Medicine Center, Dalian Municipal Women and Children's Medical Center, Dalian 116037, China
| | - Lili Jiang
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin 124221, China
| | - Zhijun Yu
- Department of Reproductive and Genetic Medicine Center, Dalian Municipal Women and Children's Medical Center, Dalian 116037, China
| | - Xiaoguang Shao
- Department of Reproductive and Genetic Medicine Center, Dalian Municipal Women and Children's Medical Center, Dalian 116037, China
| | - Guiyuan He
- Department of Reproductive and Genetic Medicine Center, Dalian Municipal Women and Children's Medical Center, Dalian 116037, China.
| | - Yong Liu
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin 124221, China.
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12
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Zhang Q, Zhan M, Wu H, Feng P, Jin X, Wan Z, Yan J, Zhang P, Ke P, Zhuang J, Zhou J, Han L, Huang X. Simultaneous quantitation of 17 endogenous adrenal corticosteroid hormones in human plasma by UHPLC-MS/MS and their application in congenital adrenal hyperplasia screening. Front Chem 2022; 10:961660. [PMID: 36034654 PMCID: PMC9403142 DOI: 10.3389/fchem.2022.961660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Accurate investigation of adrenal hormone levels plays a vital role in pediatric endocrinology for the detection of steroid-related disorders. This study aims to develop a straightforward, sensitive UHPLC-MS/MS method to quantify 17 endogenous adrenal corticosteroid hormones in human plasma. These hormones are the main ingredients in the synthetic and metabolic pathways of adrenal corticosteroid hormones. Chromatographic separation was achieved on a C18 column before electrospray ionization triple-quadrupole mass spectrometry in multiple reaction monitoring mode with a run time of 7 min. The samples were extracted by liquid-liquid extraction and required no derivatization. Analytical performance was evaluated, including linearity, analytical sensitivity, accuracy, precision, and specificity. Plasma specimens from 32 congenital adrenal hyperplasia (CAH) patients and 30 healthy volunteers were analyzed to further reveal the diagnostic value of multiple steroid hormones in the synthetic and metabolic pathways of adrenal corticosteroid in CAH diagnosis. All hormones were effectively extracted and separated using our method. The method was essentially free from potential interference of isomers or structural analogues. The imprecisions were <10%. The lower limits of quantification varied from 0.05 to 15.0 ng/ml. Good linearity coefficients (r2 > 0.998) were also obtained for most hormones in the required concentration range, except for 21-deoxycortisol (r2 = 0.9967) and androstenediol (r2 = 0.9952). The recoveries for the steroid hormones ranged from 91.7 to 109.8%. We developed the UHPLC-MS/MS method for the simultaneous measurement of steroid hormones. The results showed that measurement of steroid hormones simultaneously could improve the diagnostic efficiency of CAH.
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Affiliation(s)
- Qiaoxuan Zhang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Min Zhan
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Huihui Wu
- Anhui Prevention and Treatment Center for Occupational Disease, Anhui No. 2 Provincial People’s Hospital, Hefei, China
| | - Pinning Feng
- Department of Laboratory Medicine, Sun Yat-Sen University First Affiliated Hospital, Guangzhou, China
| | - Xing Jin
- The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Zemin Wan
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Jun Yan
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Pengwei Zhang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Peifeng Ke
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Junhua Zhuang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Jiuyao Zhou
- Department of Pharmacology, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liqiao Han
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- *Correspondence: Liqiao Han, ; Xianzhang Huang,
| | - Xianzhang Huang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- *Correspondence: Liqiao Han, ; Xianzhang Huang,
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13
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Adrenal steroids reference ranges in infancy determined by LC-MS/MS. Pediatr Res 2022; 92:265-274. [PMID: 34556810 DOI: 10.1038/s41390-021-01739-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/16/2021] [Accepted: 08/08/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Interpretation of the results of steroid hormone measurements is challenging at early infancy. The liquid chromatography-tandem mass spectrometry (LC-MS/MS) method provides a powerful tool for diagnosing steroidogenesis disorders. We aimed to develop normative data for a 14-steroid panel and four adrenal enzyme activity indices, determined by LC-MS/MS from 3 days to 6 months of age. METHODS Age- and sex-specific plasma steroid concentrations were calculated in 324 healthy full-term neonates and infants (151 females). Percentile curves were devised. Steroid ratios were evaluated as biomarkers of adrenal enzyme activities. The steroid profiles of four patients with adrenal enzyme deficiencies were included to test the diagnostic efficiency. RESULTS Nine steroids showed age, but none showed sex specificity. The concentrations of progestins and androgens were higher at 7-14 days than at 3-7 days. After the first month, adrenal androgen concentrations decreased significantly. Adrenal enzyme activities changed towards increasing cortisol over the first 6 months. There were several-fold differences in diagnostic steroids and related adrenal enzyme activity indices between the patients and the healthy group. CONCLUSIONS The majority of adrenal steroids show age-related variations in the neonatal period and early infancy. Our data will enable accurate interpretation of steroid measurements for etiologic diagnosis of disorders of steroidogenesis. IMPACT LC-MS/MS method is capable of quantitating numerous analytes simultaneously, which provides an integrated picture of adrenal steroidogenesis in a small amount of sample. The development of LC-MS/MS-based normative data of steroid hormones in healthy infants is crucial to differentiate physiologic alterations from steroidogenic defects during the first 3-6 months of infancy. Previous studies had limitations due to the small numbers of samples available by sex and by age groups. Our detailed normative data and percentile curves will enable accurate interpretation of steroid measurements for etiologic diagnosis of disorders of steroidogenesis without the need for further invasive testing.
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14
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Running L, Atilla-Gokcumen GE, Aga DS. Development of a Liquid Chromatography-Mass Spectrometry-Based In Vitro Assay to Assess Changes in Steroid Hormones Due to Exposure to Per- and Polyfluoroalkyl Substances. Chem Res Toxicol 2022; 35:1277-1288. [PMID: 35696490 DOI: 10.1021/acs.chemrestox.2c00116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Per- and poly-fluorinated substances (PFASs) are organic pollutants that have been linked to numerous health effects, including diabetes, cancers, and dysregulation of the endocrine system. This study aims to develop a liquid chromatography with tandem mass spectrometry (LC-MS/MS) assay to measure changes in 17 hormones in H295R cell line (a steroid producing adrenocortical cells) upon exposure to PFASs. Due to the challenges in the analysis of steroid hormones using electrospray ionization MS, a chemical derivatization method was employed to achieve 0.07-2 μg/L detection limits in LC-MS/MS. Furthermore, a 10-fold concentration factor through solid-phase extraction (SPE) allows for consistent sub-parts per billion detections. Optimization of the derivatization conditions showed doubly-derivatized products in some hormone analytes, including progesterone, corticosterone, and cortisol, and gave improved ionization efficiency up to 20-fold higher signal than the singly-derivatized product. The use of SPE for sample cleanup to analyze hormones from cellular media using weak anion exchange sorbent yielded 80-100% recovery for the 17 targeted hormones. The method was validated by exposing H295R cells to two known endocrine disruptors, forskolin and prochloraz, which showed expected changes in hormones. An initial exposure of H295R cells with various PFAS standards and their mixtures at 1 μM showed significant increases in progestogens with some PFAS treatments, which include PFBS, PFHxA, PFOS, PFDA, and PFDS. In addition, modest changes in hormone levels were observed in cells treated with other sulfonated or carboxylated headgroup PFASs. This sensitive LC-MS/MS method for hormone analysis in H295R cells will allow for the investigations of the alterations in the hormone production caused by exposure to various environmental insults in cell-based assays and other in vitro models.
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Affiliation(s)
- Logan Running
- Department of Chemistry, University at Buffalo, The State University of New York (SUNY), Buffalo, New York 14260, United States
| | - G Ekin Atilla-Gokcumen
- Department of Chemistry, University at Buffalo, The State University of New York (SUNY), Buffalo, New York 14260, United States
| | - Diana S Aga
- Department of Chemistry, University at Buffalo, The State University of New York (SUNY), Buffalo, New York 14260, United States
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15
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Functional Nanomaterials Based Opto-Electrochemical Sensors for the Detection of Gonadal Steroid Hormones. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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16
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An LC-APCI +-MS/MS-based method for determining the concentration of neurosteroids in the brain of male mice with different gut microbiota. J Neurosci Methods 2021; 360:109268. [PMID: 34171313 DOI: 10.1016/j.jneumeth.2021.109268] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/14/2021] [Accepted: 06/18/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although the interaction between the gut microbiota and central nervous system (CNS) is well-known, the effects of gut microbiota on different brain regions remain obscure. NEW METHOD In present study, we developed a simple and sensitive high-performance liquid chromatography-tandem mass spectrometry with atmospheric pressure chemical ionization in positive mode (LC-APCI+-MS/MS) for simultaneous detection of 12 analytes in the rodent' brain with different housing conditions RESULTS: The results showed that male mice in XZ group had significantly higher brain levels of dehydroepiandrosterone (DHEA), androstenedione (A4), testosterone (T), progesterone (P), corticosterone (CORT), aldosterone (ALD) and 11-dehydrocorticosterone (11-DHC) than those in SPF group. CORT level was higher in the left prefrontal cortex, whereas ALD and 11-DHC levels were higher in the left hypothalamus than in the right symmetrical areas in both groups. DHEA and CORT levels were highest in the striatum than in the prefrontal cortex, hippocampus, hypothalamus, regardless of the region and group (XZ and SPF). COMPARISON WITH EXISTING METHODS These results demonstrated that the method developed in this study provides, for the first time, direct quantitation of neurosteroids in male mice brain. CONCLUSIONS DHEA levels showed a left-lateralized pattern in the hippocampus and hypothalamus. Mice in the XZ group showed significantly elevated levels of CORT and/or its metabolites, ALD and 11-DHC in brain than mice in the SPF group. Insanitation living conditions increased more diverse gut microbiota.
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17
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Alahmadi FH, Keevil B, Elsey L, George K, Niven R, Fowler SJ. Serum Inhaled Corticosteroid Detection for Monitoring Adherence in Severe Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:4279-4287.e6. [PMID: 34153519 DOI: 10.1016/j.jaip.2021.05.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/15/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Daily inhaled corticosteroids (ICSs) are fundamental to asthma management, but adherence is low. OBJECTIVES To investigate (1) whether LC-MS/MS could be used to detect ICSs in serum and (2) whether serum levels related to markers of disease severity. METHODS We collected blood samples over an 8-hour period from patients with severe asthma prescribed at least 1000 μg daily of beclomethasone dipropionate equivalent. Following baseline sampling, patients were observed taking their usual morning dose. Subsequent blood samples were obtained 1, 2, 4, and 8 hours postinhalation and analyzed by LC-MS/MS. Correlations between serum ICS levels and severity markers were investigated. RESULTS A total of 60 patients were recruited (41 females; 39 prescribed maintenance prednisolone; mean age, 49 ± 12 years; FEV1, 63 ± 20 %predicted). Eight hours postinhalation, all patients using budesonide (n = 10) and beclomethasone dipropionate (15), and all but 1 using fluticasone propionate (28), had detectable serum drug levels. Fluticasone furorate was detected in 2 patients (of 4), ciclesonide in none (of 7). Low adherence by repeat prescription records (<80%) was identified in 43%. Blood ICS levels correlated negatively with exacerbation rate, and (for fluticasone propionate only) positively with FEV1 %predicted. CONCLUSIONS Commonly used ICSs can be reliably detected in the blood at least 8 hours after dosing, and could therefore be used as a measure of adherence in severe asthma. Higher exacerbation rates and poorer lung function (for fluticasone propionate) were associated with lower blood levels.
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Affiliation(s)
- Fahad H Alahmadi
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom; Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia
| | - Brian Keevil
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Lynn Elsey
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Kate George
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Robert Niven
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Stephen J Fowler
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.
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18
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Zhu Y, Han X, Li X, Qin Y, Rang Y, Zhai X, Lu Y. Quantitation of six steroid hormones by ultra-performance liquid chromatography-tandem mass spectrometry in plasma and prefrontal cortex samples from rats with chronic unpredictable mild stress-induced depression. Biomed Chromatogr 2021; 35:e5200. [PMID: 34128243 DOI: 10.1002/bmc.5200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 06/06/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022]
Abstract
Steroid hormones such as glucocorticoids and their metabolites are closely related to mental diseases and neuroendocrine diseases. Quantitative analysis of these substances will help in understanding their roles in related research fields. In this study, an ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed to detect the concentration of corticosterone (CORT) and its metabolites, progesterone (PROG) and testosterone in rat plasma and prefrontal cortex (PFC), and was applied to investigate the changes in hormones in rats with depression induced by chronic unpredictable mild stress (CUMS). The method was shown to be linear in the quantitation range for all analytes. Intra- and inter-day accuracy and precision were between 80% and 120%. Furthermore, we found that the level of CORT in plasma and PFC increased, whereas that of 11-dehydrocorticosterone (11-DHCORT) as well as the ratio of 11-DHCORT and CORT declined in rats with CUMS-induced depression. The trends of these changes in central PFC and peripheral plasma were consistent. In conclusion, this study successfully established an UPLC-MS/MS method for simultaneous measurement of CORT and its metabolites, PROG and testosterone in rat plasma and PFC, and applied it to rats with depression. The method could be further applied to the research of depression and diseases related to these steroid hormones.
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Affiliation(s)
- Ying Zhu
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xuemei Han
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, Hubei, China
| | - Xixuan Li
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanjie Qin
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, Hubei, China
| | - Ying Rang
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, Hubei, China
| | - Xuejia Zhai
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, Hubei, China
| | - Yongning Lu
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, Hubei, China
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19
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Ozeki Y, Tanimura Y, Nagai S, Nomura T, Kinoshita M, Shibuta K, Matsuda N, Miyamoto S, Yoshida Y, Okamoto M, Gotoh K, Masaki T, Kambara K, Shibata H. Development of a New Chemiluminescent Enzyme Immunoassay Using a Two-Step Sandwich Method for Measuring Aldosterone Concentrations. Diagnostics (Basel) 2021; 11:diagnostics11030433. [PMID: 33806394 PMCID: PMC8001557 DOI: 10.3390/diagnostics11030433] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 01/04/2023] Open
Abstract
In the present study, we developed a new chemiluminescent enzyme immunoassay (CLEIA) using a two-step sandwich method to measure aldosterone concentrations. We investigated serum and plasma aldosterone concentrations in 75 blood samples from 27 patients using a radioimmunoassay (RIA) and the CLEIA (with current and newly improved reagents) as well as liquid chromatography-tandem mass spectrometry (LC-MS/MS). Based on the results of the Passing–Bablok regression analysis, the aldosterone levels measured using CLEIA with the new reagents and those measured by LC-MS/MS were found to be significantly correlated (slope, 0.984; intercept, 0.2). However, aldosterone levels varied depending on the measurement method (i.e., CLEIA with the new reagent, CLEIA with the current reagent, and RIA). Aldosterone levels were lower with the improved CLEIA method than with RIA and CLEIA using the current reagent. Therefore, the cutoff values of the screening test as well as those of the confirmatory test for primary aldosteronism (PA) should be adjusted to follow current clinical practice guidelines for PA. The formula that can be used to obtain the aldosterone level (pg/mL) when using CLEIA with the new reagent is 0.765 × RIA (pg/mL) − 33.7. This formula will enable PA cutoff values to be set for provisional screening and confirmatory tests.
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Affiliation(s)
- Yoshinori Ozeki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Yukie Tanimura
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Satoshi Nagai
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Takuya Nomura
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Mizuki Kinoshita
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Kanako Shibuta
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Naoki Matsuda
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Shotaro Miyamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Mitsuhiro Okamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Koro Gotoh
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Takayuki Masaki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Kengo Kambara
- FUJIFILM Wako Pure Chemical Corporation, Amagasaki City 661-0963, Hyogo, Japan;
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
- Correspondence: ; Tel.: +81-97-586-5793
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20
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Holmboe SA, Jasuja R, Lawney B, Priskorn L, Joergensen N, Linneberg A, Jensen TK, Skakkebæk NE, Juul A, Andersson AM. Free testosterone and cardiometabolic parameters in men: comparison of algorithms. Endocr Connect 2021; 10:220-229. [PMID: 33544092 PMCID: PMC7983478 DOI: 10.1530/ec-20-0552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/04/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Calculating the free testosterone level has gained increasing interest and different indirect algorithms have been suggested. The objective was to compare free androgen index (FAI), free testosterone estimated using the linear binding model (Vermeulen: cFTV) and the binding framework accounting for allosterically coupled SHBG monomers (Zakharov: cFTZ) in relation to cardiometabolic conditions. DESIGN A prospective cohort study including 5350 men, aged 30-70 years, participating in population-based surveys (MONICA I-III and Inter99) from 1982 to 2001 and followed until December 2012 with baseline and follow-up information on cardiometabolic parameters and vital status. RESULTS Using age-standardized hormone levels, FAI was higher among men with baseline cardiometabolic conditions, whereas cFTV and cFTZ levels were lower compared to men without these conditions as also seen for total testosterone. Men in highest quartiles of cFTV or cFTZ had lower risk of developing type 2 diabetes (cFTV: HR = 0.74 (0.49-1.10), cFTZ: HR = 0.59 (0.39-0.91)) than men in lowest quartile. In contrast, men with highest levels of FAI had a 74% (1.17-2.59) increased risk of developing type 2 diabetes compared to men in lowest quartile. CONCLUSION The association of estimated free testosterone and the studied outcomes differ depending on algorithm used. cFTV and cFTZ showed similar associations to baseline and long-term cardiometabolic parameters. In contrast, an empiric ratio, FAI, showed opposite associations to several of the examined parameters and may reflect limited clinical utility.
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Affiliation(s)
- Stine A Holmboe
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
- The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ravi Jasuja
- Research Program in Men’s Health: Aging and Metabolism, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Brian Lawney
- Research Program in Men’s Health: Aging and Metabolism, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lærke Priskorn
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
- The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Niels Joergensen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
- The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Allan Linneberg
- Centre for Clinical Research and Prevention, Frederiksberg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tina Kold Jensen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
- The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Niels Erik Skakkebæk
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
- The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
- The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
- The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Correspondence should be addressed to A-M Andersson:
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21
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Cresta F, Arcuri L, Bianchin S, Castellani C, Casciaro R, Cavedagna TM, Maghnie M, Barco S, Cangemi G. A case of interference in testosterone, DHEA-S and progesterone measurements by second generation immunoassays. Clin Chem Lab Med 2021; 59:e275-e277. [PMID: 33544463 DOI: 10.1515/cclm-2020-1786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/07/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Federico Cresta
- Cystic Fibrosis Center Genoa, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Luca Arcuri
- Cystic Fibrosis Center Genoa, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Silvia Bianchin
- Cystic Fibrosis Center Genoa, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Carlo Castellani
- Cystic Fibrosis Center Genoa, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Rosaria Casciaro
- Cystic Fibrosis Center Genoa, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Mohamad Maghnie
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, University of Genoa, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Sebastiano Barco
- Central Laboratory of Analyses, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Giuliana Cangemi
- Central Laboratory of Analyses, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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22
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Alahmadi F, Peel A, Keevil B, Niven R, Fowler SJ. Assessment of adherence to corticosteroids in asthma by drug monitoring or fractional exhaled nitric oxide: A literature review. Clin Exp Allergy 2020; 51:49-62. [PMID: 33190234 PMCID: PMC7839457 DOI: 10.1111/cea.13787] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 09/07/2020] [Accepted: 09/24/2020] [Indexed: 01/13/2023]
Abstract
Background Although the efficacy of corticosteroid treatment in controlling asthma is widely accepted, its effectiveness is undermined by poor adherence. However, the optimal method for measuring adherence to asthma therapy remains unclear. Objective To perform a review of the literature reporting biological, objective methods for assessing adherence to inhaled or oral corticosteroids in asthma; we included studies reporting direct measurement of exogenous corticosteroids in blood, or the effect of adherence on exhaled nitric oxide. Design We searched three databases MEDLINE (using both PubMed and Ovid), the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Web of Science for articles published between January 1975 and July 2020. Quality of the studies was assessed using the National Institute of Health checklist. Results From 2850 screened articles, 26 fulfilled the inclusion criteria. Measurement of blood prednisolone with or without cortisol was used in eight studies as a measure of oral corticosteroid adherence, and fractional exhaled nitric oxide (FeNO) in 17 studies for inhaled corticosteroid adherence. Inhaled corticosteroids were measured directly in the blood in one study. By direct measurement of drug levels in the blood, adherence rates to oral corticosteroids ranged from 47% to 92%, although the performance and timing of the test were often not known, making interpretation of findings and serum prednisolone concentrations difficult. FeNO is generally lower in adherent than non‐adherent patients, but no absolute cut‐off can be proposed based on the available data. However, a fall in FeNO following supervised inhaled corticosteroid dosing could indicate previous poor adherence. Conclusions and Clinical Relevance Despite prednisolone and cortisol levels commonly being used as adherence markers in clinical practice, further work is required to assess the influence of the dose and timing on blood levels. The promising findings of FeNO suppression testing should be explored in further prospective studies.
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Affiliation(s)
- Fahad Alahmadi
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester and Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Unit and Manchester University NHS Foundation Trust, Manchester, UK.,Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia
| | - Adam Peel
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Brian Keevil
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester and Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Unit and Manchester University NHS Foundation Trust, Manchester, UK
| | - Rob Niven
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester and Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Unit and Manchester University NHS Foundation Trust, Manchester, UK
| | - Stephen J Fowler
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester and Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Unit and Manchester University NHS Foundation Trust, Manchester, UK
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23
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Ankarberg-Lindgren C, Andersson MX, Dahlgren J. Determination of estrone sulfate, testosterone, androstenedione, DHEAS, cortisol, cortisone, and 17α-hydroxyprogesterone by LC-MS/MS in children and adolescents. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 80:672-680. [DOI: 10.1080/00365513.2020.1829699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Carina Ankarberg-Lindgren
- Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mats X. Andersson
- Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Biological and Environmental Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Jovanna Dahlgren
- Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Endocrinology, Region Västra Götaland, Queen Silvia Children´s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
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24
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Jairaj C, O'Leary N, Doolin K, Farrell C, McCarthy A, McAuliffe FM, O'Grady-Walshe A, Sheehan J, O'Keane V. The hypothalamic-pituitary-adrenal axis in the perinatal period: Its relationship with major depressive disorder and early life adversity. World J Biol Psychiatry 2020; 21:552-563. [PMID: 32216569 DOI: 10.1080/15622975.2020.1740318] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: Effects of major depressive disorder and early life adversity (ELA) on the maternal HPA axis in the perinatal period were examined.Methods: Four groups of women (n = 127) were recruited, with the perinatal groups being compared during pregnancy (Preg) and at two months postpartum (PP) - [1] Depressed during pregnancy (Depressed-Preg/PP), [2] Prior history of depression but euthymic during pregnancy (History-Preg/PP), [3] Healthy pregnant women (Control-Preg/PP), and [4] Healthy non-pregnant women (Non-pregnant Control). Serial saliva samples were collected over the course of a day and waking and evening cortisol, total cortisol output and the cortisol awakening response were examined.Results: There were no HPA axis differences among the three groups during pregnancy. A history of ELA, regardless of comorbid depression, was associated with higher evening cortisol levels during pregnancy (p = 0.015). Women in the Depressed-PP group had had higher evening cortisol levels compared to the History-PP group (p < 0.017).Conclusions: Evening cortisol measures are a potential marker for both ELA and depression, with higher levels during pregnancy being associated with ELA and higher levels postpartum being associated with antenatal depression.
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Affiliation(s)
- Chaitra Jairaj
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Niamh O'Leary
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Kelly Doolin
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Chloe Farrell
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Anthony McCarthy
- Perinatal Mental Health Service, National Maternity Hospital, Dublin, Ireland
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Ann O'Grady-Walshe
- Perinatal Mental Health Service, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - John Sheehan
- Perinatal Mental Health Service, Rotunda Hospital, Dublin, Ireland
| | - Veronica O'Keane
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.,Trinity Centre for Health Sciences, Tallaght Hospital, Dublin, Ireland
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25
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The Potential of Steroid Profiling by Mass Spectrometry in the Management of Adrenocortical Carcinoma. Biomedicines 2020; 8:biomedicines8090314. [PMID: 32872281 PMCID: PMC7555975 DOI: 10.3390/biomedicines8090314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 12/23/2022] Open
Abstract
Radiological and endocrinological work up of adrenal neoplasms is aimed at distinguishing between frequent non-functioning adenomas and rare but very aggressive adrenocortical carcinoma (ACC). Relevant research has addressed the identification of molecular, genetic and hormonal markers that could have clinical significance for malignancy, as well as a prognostic value. Regarding endocrine aspects, attention has been paid to the pattern of steroid secretion that can be affected by altered steroidogenic pathway in ACC. The advent of mass spectrometry techniques has overcome many limitations usually associated with immunoassays, allowing the determination of both common and rarely measured steroids in a single analysis with high specificity and sensitivity. Indeed, mass spectrometry strategies may be able to identify an individualized steroid profile of ACC, allowing a rapid diagnosis and a specific follow-up. In this review, insights, strengths and limitations of mass spectrometry-based approaches in steroid profiling, as well as of immunoassay in steroid measurements, will be specifically discussed. Moreover, the latest findings on steroid profiling by mass spectrometry-based techniques, the most promising analytical tool, will be summarized to evaluate if steroid profiling might be the clue for solving the clinical dilemma in differentiating ACC from non-functioning adrenocortical adenomas (ACA).
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26
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Karsli T, Jain VG, Mhanna M, Wu Q, Pepkowitz SH, Chandler DW, Shekhawat PS. Assessment of adrenal function at birth using adrenal glucocorticoid precursor to product ratios to predict short-term neonatal outcomes. Pediatr Res 2020; 87:767-772. [PMID: 31645056 DOI: 10.1038/s41390-019-0629-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 10/10/2019] [Accepted: 10/12/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Most neonatal outcomes in neonates are related to normal adrenal gland function. Assessment of adrenal function in a sick preterm neonate remains a challenge, thus we hypothesized that adrenal steroid precursors to their product ratios have a direct relationship with neonatal outcomes. METHODS We studied demographics of pregnancy and neonatal outcomes in 99 mother-infant pairs (24-41 weeks) and assayed 7 glucocorticoid precursors in the cortisol biosynthesis/degradation pathway. We correlated antenatal factors and short-term neonatal outcomes with these precursors and their ratios to assess maturity of individual enzymes. RESULTS We found no correlation between cortisol levels with antenatal factors and outcomes. Antenatal steroid use impacted several cortisol precursors. 17-OH pregnenolone-to-cortisol ratio at birth was the best predictor of short-term neonatal outcomes, such as hypotension, RDS, IVH and PDA. A cord blood 17-OH pregnenolone:cortisol ratio of <0.21 predicts which neonate will have a normal outcome with a high sensitivity and specificity. CONCLUSIONS Maternal factors and antenatal steroids impact neonatal adrenal function and leads to maturation of adrenal function. 17-OH pregnenolone:cortisol ratio and not cortisol is the best predictor of adrenal function. Adrenal function can be assessed by evaluating the profile of adrenal steroids.
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Affiliation(s)
- Tijen Karsli
- Department of Pediatrics (Neonatology), East Carolina University, Greenville, NC, USA
| | - Viral G Jain
- Perinatal Research Institute, Division of Neonatology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Maroun Mhanna
- Department of Pediatrics (Neonatology), MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Qiang Wu
- Department of Biostatistics, East Carolina University, Greenville, NC, USA
| | | | | | - Prem S Shekhawat
- Department of Pediatrics (Neonatology), MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
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27
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Yuan TF, Le J, Wang ST, Li Y. An LC/MS/MS method for analyzing the steroid metabolome with high accuracy and from small serum samples. J Lipid Res 2020; 61:580-586. [PMID: 31964762 PMCID: PMC7112139 DOI: 10.1194/jlr.d119000591] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/17/2020] [Indexed: 11/20/2022] Open
Abstract
Analyzing global steroid metabolism in humans can shed light on the etiologies of steroid-related diseases. However, existing methods require large amounts of serum and lack the evaluation of accuracy. Here, we developed an LC/MS/MS method for the simultaneous quantification of 12 steroid hormones: testosterone, pregnenolone, progesterone, androstenedione, corticosterone, 11-deoxycortisol, cortisol, 17-hydroxypregnenolone, 17-hydroxyprogesterone, dehydroepiandrosterone, estriol, and estradiol. Steroids and spiked internal standards in 100 μl serum were extracted by protein precipitation and liquid-liquid extraction. The organic phase was dried by evaporation, and isonicotinoyl chloride was added for steroid derivatization, followed by evaporation under nitrogen and redissolution in 50% methanol. Chromatographic separation was performed on a reverse-phase PFP column, and analytes were detected on a triple quadrupole mass spectrometer with ESI. The lower limits of quantification ranged from 0.005 ng/ml for estradiol to 1 ng/ml for cortisol. Apparent recoveries of steroids at high, medium, and low concentrations in quality control samples were between 86.4% and 115.0%. There were limited biases (−10.7% to 10.5%) between the measured values and the authentic values, indicating that the method has excellent reliability. An analysis of the steroid metabolome in pregnant women highlighted the applicability of the method in clinical serum samples. We conclude that the LC/MS/MS method reported here enables steroid metabolome analysis with high accuracy and reduced serum consumption, indicating that it may be a useful tool in both clinical and scientific laboratory research.
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Affiliation(s)
- Teng-Fei Yuan
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Juan Le
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shao-Ting Wang
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
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28
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Tandem mass spectrometry in the clinical laboratory: A tutorial overview. CLINICAL MASS SPECTROMETRY 2020. [DOI: 10.1016/j.clinms.2019.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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29
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Dasenaki M, Papatzani M, Gounari E, Magnisali P, Papadopoulou-Marketou N, Kanaka-Gantenbein C, Moutsatsou P, Thomaidis NS. Simultaneous Determination of Free Cortisol, Cortisone and their Tetrahydrometabolites in Urine by Single Solvent Extraction and Liquid Chromatography–Tandem Mass Spectrometry. ANAL LETT 2019. [DOI: 10.1080/00032719.2019.1602629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Marilena Dasenaki
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Papatzani
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Gounari
- Pediatric Intensive Care, King’s College Hospital NHS Foundation Trust, London, UK
| | - Paraskevi Magnisali
- Department of Clinical Biochemistry, Medical School National and Kapodistrian University of Athens University Hospital “ATTIKO”, Athens, Greece
| | - Nektaria Papadopoulou-Marketou
- Division of Endocrinology Diabetes and Metabolism First, Department of Paediatrics, National and Kapodistrian University of Athens, Agia Sophia Children’s Hospital, Athens, Greece
- Department of Endocrinology, Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
| | - Christina Kanaka-Gantenbein
- Division of Endocrinology Diabetes and Metabolism First, Department of Paediatrics, National and Kapodistrian University of Athens, Agia Sophia Children’s Hospital, Athens, Greece
| | - Paraskevi Moutsatsou
- Department of Clinical Biochemistry, Medical School National and Kapodistrian University of Athens University Hospital “ATTIKO”, Athens, Greece
| | - Nikolaos S. Thomaidis
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
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30
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Yiğit Ş, Türkmen M, Tuncer O, Taşkın E, Güran T, Abacı A, Çatlı G, Tarım Ö. Neonatal adrenal insufficiency: Turkish Neonatal and Pediatric Endocrinology and Diabetes Societies consensus report. TURK PEDIATRI ARSIVI 2019; 53:S239-S243. [PMID: 31236037 PMCID: PMC6568299 DOI: 10.5152/turkpediatriars.2018.01822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It is difficult to make a diagnosis of adrenal insufficiency in the newborn, because the clinical findings are not specific and the normal serum cortisol level is far lower compared to children and adults. However, dehydratation, hyperpigmentation, hypoglycemia, hyponatremia, hyperkalemia and metabolic acidosis should suggest the diagnosis of adrenal insufficiency. Hypotension which does not respond to vasopressors should especially be considered a warning. If the adrenocorticotropin hormone level measured simultaneously with a low serum cortisol level is 2-fold higher than the upper normal limit of the reference range, a diagnosis of primary adrenal insufficiency is definite. Even if the serum cortisol level is normal, a diagnosis of relative adrenal insufficiency can be made with clinical findings, if the patient is under heavy stress. The serum cortisol level should be measured using the method of ‘high pressure liquid chromatography’ or ‘LC mass spectrometry’. Adrenal steroid biosynthesis can be evaluated more specifically and sensitively with ‘steroid profiling’. Rennin and aldosterone levels may be measured in addition to serum electrolytes for the diagnosis of mineralocorticoid insufficiency. Adrenocorticotropic hormone stimulation test may be used to confirm the diagnosis and elucidate the etiology. In suspicious cases, treatment can be initiated without waiting for the adrenocorticotropic hormone stimulation test. In schock which does not respond to vasopressors, intravenous hydrocortisone at a dose of 50-100 mg/m2 or a glucocorticoid drug at an equivalent dose should be initiated. In maintanence treatment, the physiological secretion rate of hydrocortisone is 6 mg/m2/day (15 mg/m2/day in the newborn). The replacement dose should be adjusted with clinical follow-up and by monitoring growth rate, weight gain and blood pressure. Fludrocortisone (0,1 mg tablet) is given for mineralocorticoid treatment (2x0,5-1 tablets). A higher dose may be needed in the neonatal period and in patients with aldosterone resistance. If hyponatremia persists, oral NACl may be added to treatment. In the long-term follow-up, patients should carry an identification card and the glucocorticoid dose should be increased 3-10-fold in cases of stress.
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Affiliation(s)
- Şule Yiğit
- Division of Neonatology, Department of Pediatrics, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Münevver Türkmen
- Division of Neonatology, Department of Pediatrics, Adnan Menderes University, Faculty of Medicine, Aydın, Turkey
| | - Oğuz Tuncer
- Division of Neonatology, Department of Pediatrics, Van Yüzüncü Yıl University, Faculty of Medicine, Van, Turkey
| | - Erdal Taşkın
- Division of Neonatology, Department of Pediatrics, Fırat University, Faculty of Medicine, Elazığ, Turkey
| | - Tülay Güran
- Division of Pediatric Endocrinology, Department of Pediatrics, Marmara University, Faculty of Medicine, İstanbul, Turkey
| | - Ayhan Abacı
- Division of Pediatric Endocrinology Dokuz, Department of Pediatrics, Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Gönül Çatlı
- Division of Pediatric Endocrinology, Department of Pediatrics, İzmir Katip Çelebi University, Faculty of Medicine, İzmir, Turkey
| | - Ömer Tarım
- Division of Pediatric Endocrinology, Department of Pediatrics, Uludağ University, Faculty of Medicine, Bursa, Turkey
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Kotłowska A, Szefer P. Recent Advances and Challenges in Steroid Metabolomics for Biomarker Discovery. Curr Med Chem 2019; 26:29-45. [PMID: 29141530 DOI: 10.2174/0929867324666171113120810] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 03/01/2017] [Accepted: 03/20/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Steroid hormones belong to a group of low-molecular weight compounds which are responsible for maintenance of various body functions, thus, their accurate assessment is crucial for evaluation of biosynthetic defects. The development of reliable methods allowing disease diagnosis is essential to improve early detection of various disorders connected with altered steroidogenesis. Currently, the field of metabolomics offers several improvements in terms of sensitivity and specificity of the diagnostic methods when opposed to classical diagnostic approaches. The combination of hyphenated techniques and pattern recognition methods allows to carry out a comprehensive assessment of the slightest alterations in steroid metabolic pathways and can be applied as a tool for biomarker discovery. METHODS We have performed an extensive literature search applying various bibliographic databases for peer-reviewed articles concentrating on the applications of hyphenated techniques and pattern recognition methods incorporated into the steroid metabolomic approach for biomarker discovery. RESULTS The review discusses strengths, challenges and recent developments in steroidbased metabolomics. We present methods of sample collection and preparation, methods of separation and detection of steroid hormones in biological material, data analysis, and interpretation as well as examples of applications of steroid metabolomics for biomarker discovery (cancer, mental and central nervous system disorders, endocrine diseases, monitoring of drug therapy and doping control). CONCLUSION Information presented in this review will be valuable to anyone interested in the application of metabolomics for biomarker discovery with a special emphasis on disorders of steroid hormone synthesis and metabolism.
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Affiliation(s)
- Alicja Kotłowska
- Department of Food Sciences, Faculty of Pharmacy, Medical University of Gdansk, Al. Gen. J. Hallera 107, 80-416 Gdansk, Poland
| | - Piotr Szefer
- Department of Food Sciences, Faculty of Pharmacy, Medical University of Gdansk, Al. Gen. J. Hallera 107, 80-416 Gdansk, Poland
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Ahmed KEM, Frøysa HG, Karlsen OA, Blaser N, Zimmer KE, Berntsen HF, Verhaegen S, Ropstad E, Kellmann R, Goksøyr A. Effects of defined mixtures of POPs and endocrine disruptors on the steroid metabolome of the human H295R adrenocortical cell line. CHEMOSPHERE 2019; 218:328-339. [PMID: 30476764 DOI: 10.1016/j.chemosphere.2018.11.057] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
The presence of environmental pollutants in our ecosystem may impose harmful health effects to wildlife and humans. Several of these toxic chemicals have a potential to interfere with the endocrine system. The adrenal cortex has been identified as the main target organ affected by endocrine disrupting chemicals. The aim of this work was to assess exposure effects of defined and environmentally relevant mixtures of chlorinated, brominated and perfluorinated chemicals on steroidogenesis, using the H295R adrenocortical cell line model in combination with a newly developed liquid chromatography tandem mass spectrometry (LC-MS/MS) method. By using this approach, we could simultaneously analyze 19 of the steroids in the steroid biosynthesis pathway, revealing a deeper insight into possible disruption of steroidogenesis. Our results showed a noticeable down-regulation in steroid production when cells were exposed to the highest concentration of a mixture of brominated and fluorinated compounds (10,000-times human blood values). In contrast, up-regulation was observed with estrone under the same experimental condition, as well as with some other steroids when cells were exposed to a perfluorinated mixture (1000-times human blood values), and the mixture of chlorinated and fluorinated compounds. Interestingly, the low concentration of the perfluorinated mixture alone produced a significant, albeit small, down-regulation of pregnenolone, and the total mixture a similar effect on 17-hydroxypregnenolone. Other mixtures resulted in only slight deviations from the control. Indication of synergistic effects were noted when we used a statistical model to improve data interpretation. A potential for adverse outcomes of human exposures is indicated, pointing to the need for further investigation into these mixtures.
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Affiliation(s)
| | - Håvard G Frøysa
- Department of Mathematics, University of Bergen, P.O. Box 7803, N-5020 Bergen, Norway.
| | - Odd André Karlsen
- Department of Biological Sciences, University of Bergen, P.O. Box 7803, N-5020 Bergen, Norway.
| | - Nello Blaser
- Department of Mathematics, University of Bergen, P.O. Box 7803, N-5020 Bergen, Norway.
| | - Karin Elisabeth Zimmer
- Department of Basic Sciences and Aquatic Medicine, Faculty of Veterinary Medicine, Norwegian University of Life Sciences (NMBU), P.O. Box 8146 Dep. N-0033, Oslo, Norway.
| | - Hanne Friis Berntsen
- Department of Production Animal Clinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences (NMBU), P.O. Box 8146 Dep. N-0033, Oslo, Norway; Department of Administration, Lab Animal Unit, National Institute of Occupational Health, P.O. Box 5330 Majorstuen, N-0304, Oslo, Norway.
| | - Steven Verhaegen
- Department of Production Animal Clinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences (NMBU), P.O. Box 8146 Dep. N-0033, Oslo, Norway.
| | - Erik Ropstad
- Department of Production Animal Clinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences (NMBU), P.O. Box 8146 Dep. N-0033, Oslo, Norway.
| | - Ralf Kellmann
- Hormone Laboratory, Haukeland University Hospital, N-5021 Bergen, Norway.
| | - Anders Goksøyr
- Department of Biological Sciences, University of Bergen, P.O. Box 7803, N-5020 Bergen, Norway.
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Parr MK, Wüst B, Teubel J, Joseph JF. Splitless hyphenation of SFC with MS by APCI, APPI, and ESI exemplified by steroids as model compounds. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1091:67-78. [DOI: 10.1016/j.jchromb.2018.05.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/07/2018] [Accepted: 05/14/2018] [Indexed: 01/10/2023]
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Drotleff B, Hallschmid M, Lämmerhofer M. Quantification of steroid hormones in plasma using a surrogate calibrant approach and UHPLC-ESI-QTOF-MS/MS with SWATH-acquisition combined with untargeted profiling. Anal Chim Acta 2018; 1022:70-80. [DOI: 10.1016/j.aca.2018.03.040] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/16/2018] [Accepted: 03/20/2018] [Indexed: 11/16/2022]
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LC-MS/MS based profiling and dynamic modelling of the steroidogenesis pathway in adrenocarcinoma H295R cells. Toxicol In Vitro 2018; 52:332-341. [PMID: 30017865 DOI: 10.1016/j.tiv.2018.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/22/2018] [Accepted: 07/06/2018] [Indexed: 12/17/2022]
Abstract
Endocrine disrupting chemicals have been reported to exert effects directly on enzymes involved in steroid biosynthesis. Here, we present a new liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for profiling the steroid metabolome of H295R human adrenocarcinoma cells. Our method can simultaneously analyse 19 precursors, intermediates and end-products, representing the adrenal steroid biosynthesis pathway. In order to obtain better insights into the processes of steroidogenesis, we investigated the dose-response relationship of forskolin, an activator of adenylate cyclase, on steroid production in H295R cells. We observed that 1.5 μM forskolin stimulated steroid production at approximately 50% of the maximum rate for most steroids. Hence, we studied the time course for steroid synthesis over 72 h in H295R cells that were stimulated with forskolin. At 24 h, we observed a peak in steroid levels for the intermediate metabolites, such as progesterone and pregnenolone, while end-products such as testosterone and cortisol continued to increase until 72 h. Finally, we show how global data provide a unique basis to develop a comprehensive, dynamic model for steroidogenesis using first order kinetics. The timeline data made it possible to estimate all reaction rate constants of the network. We propose this method as a unique and sensitive screening tool to identify effects on adrenal steroidogenesis by endocrine disrupting compounds.
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Honour JW, Conway E, Hodkinson R, Lam F. The evolution of methods for urinary steroid metabolomics in clinical investigations particularly in childhood. J Steroid Biochem Mol Biol 2018; 181:28-51. [PMID: 29481855 DOI: 10.1016/j.jsbmb.2018.02.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/21/2018] [Accepted: 02/21/2018] [Indexed: 12/15/2022]
Abstract
The metabolites of cortisol, and the intermediates in the pathways from cholesterol to cortisol and the adrenal sex steroids can be analysed in a single separation of steroids by gas chromatography (GC) coupled to MS to give a urinary steroid profile (USP). Steroids individually and in profile are now commonly measured in plasma by liquid chromatography (LC) coupled with MS/MS. The steroid conjugates in urine can be determined after hydrolysis and derivative formation and for the first time without hydrolysis using GC-MS, GC-MS/MS and liquid chromatography with mass spectrometry (LC-MS/MS). The evolution of the technology, practicalities and clinical applications are examined in this review. The patterns and quantities of steroids changes through childhood. Information can be obtained on production rates, from which children with steroid excess and deficiency states can be recognised when presenting with obesity, adrenarche, adrenal suppression, hypertension, adrenal tumours, intersex condition and early puberty, as examples. Genetic defects in steroid production and action can be detected by abnormalities from the GC-MS of steroids in urine. New mechanisms of steroid synthesis and metabolism have been recognised through steroid profiling. GC with tandem mass spectrometry (GC-MS/MS) has been used for the tentative identification of unknown steroids in urine from newborn infants with congenital adrenal hyperplasia. Suggestions are made as to areas for future research and for future applications of steroid profiling. As routine hospital laboratories become more familiar with the problems of chromatographic and MS analysis they can consider steroid profiling in their test repertoire although with LC-MS/MS of urinary steroids this is unlikely to become a routine test because of the availability, cost and purity of the internal standards and the complexity of data interpretation. Steroid profiling with quantitative analysis by mass spectrometry (MS) after chromatography now provides the most versatile of tests of adrenal function in childhood.
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Affiliation(s)
- John W Honour
- Institute for Women's Health, University College London, 74 Huntley Street, London, WC1E 6AU, UK.
| | - E Conway
- Clinical Biochemistry, HSL Analytics LLP, Floor 2, 1 Mabledon Place, London, WC1H 9AX, UK
| | - R Hodkinson
- Clinical Biochemistry, HSL Analytics LLP, Floor 2, 1 Mabledon Place, London, WC1H 9AX, UK
| | - F Lam
- Clinical Biochemistry, HSL Analytics LLP, Floor 2, 1 Mabledon Place, London, WC1H 9AX, UK
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Konieczna L, Belka M, Okońska M, Pyszka M, Bączek T. New 3D-printed sorbent for extraction of steroids from human plasma preceding LC-MS analysis. J Chromatogr A 2018. [PMID: 29523348 DOI: 10.1016/j.chroma.2018.02.040] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In recent years, there has been an increasing worldwide interest in the use of alternative sample preparation methods that are proceeded by separation techniques. Fused deposition modeling (FDM) is a 3D printing technique that is based the consecutive layering of softened/melted thermoplastic materials. In this study, a group of natural steroids and sexual hormones - namely, aldosterone, cortisol, β-estradiol, testosterone, dihydrotestosterone, and synthetic methyltestosterone and betamethasone - were separated and determined using an optimized high-performance liquid chromatography coupled to mass spectrometry (LC-MS) method in positive ionization mode. 3D-printed sorbents were selected as the pre-concentration technique because they are generally low cost, fast, and simple to make and automate. Furthermore, the use of 3D-printed sorbents helps to minimize potential errors due to their repeatability and reproducibility, and their ability to eliminate carry over by using one printed sorbent for a single extraction of steroids from biological matrices. The extraction procedure was optimized and the parameters influencing 3D-printed Layfomm 60® based sorbent and LC-MS were studied, including the type of extraction solvent used, sorption and desorption times, temperature, and the salting-out effect. To demonstrate this method's applicability for biological sample analysis, the SPME-LC-MS method was validated for its ability to simultaneously quantify endogenous steroids. This evaluation confirmed good linearity and an R2 that was between 0.9970 and 0.9990. The recovery rates for human plasma samples were 86.34-93.6% for the studied steroids with intra- and inter-day RSDs of 1.44-7.42% and 1.44-9.46%, respectively. To our knowledge, this study is the first time that 3D-printed sorbents have been used to extract trace amounts of endogenous low-molecular-weight compounds, such as steroids, from biological samples, such as plasma.
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Affiliation(s)
- Lucyna Konieczna
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, al. gen. J. Hallera 107, 80-416 Gdańsk, Poland
| | - Mariusz Belka
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, al. gen. J. Hallera 107, 80-416 Gdańsk, Poland
| | - Magdalena Okońska
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, al. gen. J. Hallera 107, 80-416 Gdańsk, Poland
| | - Magdalena Pyszka
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, al. gen. J. Hallera 107, 80-416 Gdańsk, Poland
| | - Tomasz Bączek
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, al. gen. J. Hallera 107, 80-416 Gdańsk, Poland.
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Lindner JM, Suhr AC, Grimm SH, Möhnle P, Vogeser M, Briegel J. The dynamics of a serum steroid profile after stimulation with intravenous ACTH. J Pharm Biomed Anal 2017; 151:159-163. [PMID: 29346086 DOI: 10.1016/j.jpba.2017.12.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 12/19/2017] [Accepted: 12/21/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Stimulation with intravenous adrenocorticotropic hormone (ACTH) is a widely used diagnostic procedure to characterize the adrenocortical function. Currently, the response of serum cortisol, mainly quantified by immunoassays, is the only established read-out of this test. By using liquid chromatography coupled with mass spectrometry (LC-MS/MS) simultaneous determination of several steroids that respond to ACTH stimulation is now possible. The aim of this study was to further characterize the typical effect of exogenous ACTH (250 mg) on a LC-MS/MS-serum steroid profile. METHODS A set of 36 paired samples (pre-/post-IV-ACTH) was investigated (age range 22-58, 26 female and 10 male individuals). Serum steroid profiling was performed using a LC-MS/MS method covering cortisol, cortisone, corticosterone, 11-deoxycortisol, 17-OH-progesterone and 11-deoxycorticosterone. RESULTS The concentrations of all measured steroids increased after stimulation with ACTH, except for cortisone. Serum corticosterone, 11-deoxycorticosterone and 11-deoxycortisol showed markedly more pronounced relative increases compared to cortisol. The strongest response was observed for corticosterone (15-fold median relative increase, compared to 1.4-fold median increase of cortisol). CONCLUSION Serum steroid profiling using LC-MS/MS after stimulation with IV ACTH demonstrates highly dynamic response patterns. Further studies should address in particular serum corticosterone as a potential novel marker of biochemical stress response.
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Affiliation(s)
- Johanna M Lindner
- Institute of Laboratory Medicine, University Hospital, LMU Munich, Germany.
| | | | - Stefanie H Grimm
- Institute of Laboratory Medicine, University Hospital, LMU Munich, Germany
| | - Patrick Möhnle
- Department of Anesthesiology, University Hospital, LMU Munich, Germany
| | - Michael Vogeser
- Institute of Laboratory Medicine, University Hospital, LMU Munich, Germany
| | - Josef Briegel
- Department of Anesthesiology, University Hospital, LMU Munich, Germany
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Karsli T, Strickland D, Livingston J, Wu Q, Mhanna MJ, Shekhawat PS. Assessment of neonatal adrenal size using high resolution 2D ultrasound and its correlation with birth demographics and clinical outcomes. J Matern Fetal Neonatal Med 2017; 32:377-383. [PMID: 28889777 DOI: 10.1080/14767058.2017.1378340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Assessment of adrenal function in a sick neonate remains a challenge in spite of major advances in neonatal care. We used 2D ultrasound of adrenal glands to assess maturity of adrenal glands in extremely preterm infants and sick term and near term infants. STUDY DESIGN We collected demographics details of 99 mother-infants pairs (24-41 weeks) and obtained 2D ultrasound scans of adrenal glands in first week of life to measure adrenal volume, fetal zone size, and adrenal to kidney ratios. Relationship between adrenal measurements, antenatal factors, and postnatal outcomes were studied. RESULTS We reported normative adrenal gland volume data during gestation from 80 appropriate for gestational age (AGA) infants. In a binary analysis, adrenal size was significantly related to gender, race, intrauterine growth restriction (IUGR), maternal chorioamnionitis, and maternal hypertension. Linear regression analysis showed that fetal zone is significantly related to not only gestational age but also chorioamnionitis and later development of intraventricular hemorrhage (IVH). Adrenal volume likewise is also related to gestational age, preeclampsia, and IVH. CONCLUSIONS Antenatal maternal factors and uterine environment affects adrenal growth and development thus postnatal high resolution 2D US scan of adrenal glands can provide useful information to predict outcomes. This information can complement hormone and adrenocorticotrophic hormone (ACTH) stimulation assays.
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Affiliation(s)
- Tijen Karsli
- a Department of Pediatrics , Greenville , NC , USA
| | - Diana Strickland
- b Department of Obstetrics and Gynecology , Greenville , NC , USA
| | | | - Qiang Wu
- c Department of Biostatistics , East Carolina University , Greenville , NC , USA
| | - Maroun J Mhanna
- d Department of Pediatrics, Division of Neonatology , Case Western Reserve University, MetroHealth Medical Center , Cleveland , OH , USA
| | - Prem S Shekhawat
- d Department of Pediatrics, Division of Neonatology , Case Western Reserve University, MetroHealth Medical Center , Cleveland , OH , USA
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Travers S, Martinerie L, Bouvattier C, Boileau P, Lombès M, Pussard E. Multiplexed steroid profiling of gluco- and mineralocorticoids pathways using a liquid chromatography tandem mass spectrometry method. J Steroid Biochem Mol Biol 2017; 165:202-211. [PMID: 27339652 DOI: 10.1016/j.jsbmb.2016.06.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/28/2016] [Accepted: 06/17/2016] [Indexed: 11/24/2022]
Abstract
Serum steroid assays are major tools in the clinical evaluation of adrenal disorders. The main adrenal steroids are routinely measured with immunoassays. However, chromatographic methods are known to offer better specificity. We report a liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay for simultaneous quantification of 15 adrenal steroids targeting the mineralo- and gluco-corticosteroid pathways. Serum steroids combined with deuterated internal standards were extracted using successive protein precipitation and solid phase extraction steps. Cortisol, cortisone, 11-deoxycortisol, 17-hydroxyprogesterone, 21-deoxycortisol, progesterone, 11-deoxycorticosterone, corticosterone, 11-dehydrocorticosterone, 18-hydroxycorticosterone, 18-hydroxy-11-deoxycorticosterone, aldosterone, dehydroepiandrosterone sulfate, testosterone and androstenedione were resolved in fourteen minutes using a BEH C18 column coupled to a methanol-ammonium formate gradient. Detection was performed using multiple reaction monitoring quantitation. Routinely determined steroid levels by immunoassays were compared to those measured by LC-MS/MS. This method was applied to assess steroid profiles in congenital adrenal hyperplasia (CAH) patients with 21-hydroxylase deficiency. Low quantification limits depending on each steroid (ranging from 0.015ng/mL for aldosterone to 20ng/mL for DHEAS) are adapted to the clinical use. Recoveries of steroids range from 64% for 21-deoxycortisol to 101% for cortisol and are fully corrected by internal standards. A good linearity with R>0.989 is obtained for each compound. The inter-day variation coefficients ranged from 4.7% for cortisol to 16.3% for 11-deoxycorticosterone. The immunoassay for cortisol (Immulite 2000, Siemens) showed acceptable agreement with LC-MS/MS (bias +7.2%). However, Bland-Altman plots revealed large negative bias for aldosterone (-33.4%, AldoCT, CisBio international), for 17-hydroxyprogesterone at concentrations below 2ng/mL (-74.1%, OHP-CT MP Biomedical), for androstenedione (-80.3%, RIA D4, Beckman Coulter) and for 11-deoxycortisol (-125.3%, Diasource Immunoassays). Finally, the analysis of samples from 21-hydroxylase defective patients demonstrated the potential usefulness of multiplexed steroid profiling for the diagnosis and/or monitoring of different forms of congenital adrenal hyperplasia. This LC-MS/MS method provides highly sensitive and specific assessments of mineralo- and glucocorticoids pathways from a small volume sample and is therefore a promising potent tool for clinical and experimental endocrine studies.
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Affiliation(s)
- Simon Travers
- Inserm, U1185, Le Kremlin-Bicêtre, F-94276, France; Fac Med Paris-Sud, Univ. Paris-Sud, Université Paris Saclay, UMR-S 1185, Le Kremlin-Bicêtre, F-94276, France; Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital de Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, F-94275, France
| | - Laetitia Martinerie
- Inserm, U1185, Le Kremlin-Bicêtre, F-94276, France; Service d'Endocrinologie Pédiatrique, Hôpital Robert Debré, Assistance Publique Hôpitaux de Paris, Paris, F-75019, France; PremUp Foundation, Paris, F-75005, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, F-75019, France
| | - Claire Bouvattier
- Fac Med Paris-Sud, Univ. Paris-Sud, Université Paris Saclay, UMR-S 1185, Le Kremlin-Bicêtre, F-94276, France; Département d'Endocrinologie Pédiatrique, Hôpital de Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, F-94275, France; Centre de référence des maladies rares du développement sexuel, Le Kremlin Bicêtre, F-94275, France
| | - Pascal Boileau
- PremUp Foundation, Paris, F-75005, France; Service de Réanimation Néonatale, CH Poissy St-Germain en-Laye, Poissy, F-78303, France; EA 7285, UFR des Sciences de la Santé, Simone Veil. Université Versailles St-Quentin en Yvelines, Montigny le Bretonneux F-78180, France
| | - Marc Lombès
- Inserm, U1185, Le Kremlin-Bicêtre, F-94276, France; Fac Med Paris-Sud, Univ. Paris-Sud, Université Paris Saclay, UMR-S 1185, Le Kremlin-Bicêtre, F-94276, France; PremUp Foundation, Paris, F-75005, France; Service d'Endocrinologie et Maladies de la Reproduction, Hôpital de Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, F-94275, France; UMS 32, Institut Biomédical de Bicêtre, Le Kremlin-Bicêtre F-94276, France
| | - Eric Pussard
- Inserm, U1185, Le Kremlin-Bicêtre, F-94276, France; Fac Med Paris-Sud, Univ. Paris-Sud, Université Paris Saclay, UMR-S 1185, Le Kremlin-Bicêtre, F-94276, France; Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital de Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, F-94275, France; UMS 32, Institut Biomédical de Bicêtre, Le Kremlin-Bicêtre F-94276, France.
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Kim B, Lee MN, Park HD, Kim JW, Chang YS, Park WS, Lee SY. Dried blood spot testing for seven steroids using liquid chromatography-tandem mass spectrometry with reference interval determination in the Korean population. Ann Lab Med 2016; 35:578-85. [PMID: 26354345 PMCID: PMC4579101 DOI: 10.3343/alm.2015.35.6.578] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 02/03/2015] [Accepted: 07/27/2015] [Indexed: 11/19/2022] Open
Abstract
Background Conventional screening for congenital adrenal hyperplasia (CAH) using immunoassays generates a large number of false-positive results. A more specific liquid chromatography-tandem mass spectrometry (LC-MS/MS) method has been introduced to minimize unnecessary follow-ups. However, because of limited data on its use in the Korean population, LC-MS/MS has not yet been incorporated into newborn screening programs in this region. The present study aims to develop and validate an LC-MS/MS method for the simultaneous determination of seven steroids in dried blood spots (DBS) for CAH screening, and to define age-specific reference intervals in the Korean population. Methods We developed and validated an LC-MS/MS method to determine the reference intervals of cortisol, 17-hydroxyprogesterone, 11-deoxycortisol, 21-deoxycortisol, androstenedione, corticosterone, and 11-deoxycorticosterone simultaneously in 453 DBS samples. The samples were from Korean subjects stratified by age group (78 full-term neonates, 76 premature neonates, 89 children, and 100 adults). Results The accuracy, precision, matrix effects, and extraction recovery were satisfactory for all the steroids at three concentrations; values of intra- and inter-day precision coefficients of variance, bias, and recovery were 0.7-7.7%, -1.5-9.8%, and 49.3-97.5%, respectively. The linearity range was 1-100 ng/mL for cortisol and 0.5-50 ng/mL for other steroids (R2>0.99). The reference intervals were in agreement with the previous reports. Conclusions This LC-MS/MS method and the reference intervals validated in the Korean population can be successfully applied to analyze seven steroids in DBS for the diagnosis of CAH.
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Affiliation(s)
- Borahm Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Na Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung Doo Park
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Won Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun Sil Chang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Soon Park
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Youn Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Wang Q, Mesaros C, Blair IA. Ultra-high sensitivity analysis of estrogens for special populations in serum and plasma by liquid chromatography-mass spectrometry: Assay considerations and suggested practices. J Steroid Biochem Mol Biol 2016; 162:70-9. [PMID: 26767303 PMCID: PMC4931956 DOI: 10.1016/j.jsbmb.2016.01.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 12/15/2015] [Accepted: 01/04/2016] [Indexed: 11/24/2022]
Abstract
Estrogen measurements play an important role in the clinical evaluation of many endocrine disorders as well as in research on the role of hormones in human biology and disease. It remains an analytical challenge to quantify estrogens and their metabolites in specimens from special populations including older men, children, postmenopausal women and women receiving aromatase inhibitors. Historically, immunoassays have been used for measuring estrogens and their metabolites in biological samples for risk assessment. However, the lack of specificity and accuracy of immunoassay-based methods has caused significant problems when interpreting data generated from epidemiological studies and across different laboratories. Stable isotope dilution (SID) methodology coupled with liquid chromatography-selected reaction monitoring-mass spectrometry (LC-SRM/MS) is now accepted as the 'gold-standard' to quantify estrogens and their metabolites in serum and plasma due to improved specificity, high accuracy, and the ability to monitor multiple estrogens when compared with immunoassays. Ultra-high sensitivity can be obtained with pre-ionized derivatives when using triple quadruple mass spectrometers in the selected reaction monitoring (SRM) mode coupled with nanoflow LC. In this review, we have examined the special issues related to utilizing ultra-high sensitivity SID LC-SRM/MS-based methodology to accurately quantify estrogens and their metabolites in the serum and plasma from populations with low estrogen levels. The major issues that are discussed include: sample preparation for both unconjugated and conjugated estrogens, derivatization, chromatographic separation, matrix effects, and assay validation.
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Affiliation(s)
- Qingqing Wang
- Center of Excellence in Environmental Toxicology and Penn SRP Center, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA 19104, United States; Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA 19104, United States; Department of Pharmacology and Toxicology, Beijing Institute of Radiation Medicine, Beijing 100850, China
| | - Clementina Mesaros
- Center of Excellence in Environmental Toxicology and Penn SRP Center, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA 19104, United States; Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA 19104, United States
| | - Ian A Blair
- Center of Excellence in Environmental Toxicology and Penn SRP Center, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA 19104, United States; Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA 19104, United States.
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Marcos J, Pozo OJ. Current LC-MS methods and procedures applied to the identification of new steroid metabolites. J Steroid Biochem Mol Biol 2016; 162:41-56. [PMID: 26709140 DOI: 10.1016/j.jsbmb.2015.12.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 11/25/2015] [Accepted: 12/11/2015] [Indexed: 12/31/2022]
Abstract
The study of the metabolism of steroids has a long history; from the first characterizations of the major metabolites of steroidal hormones in the pre-chromatographic era, to the latest discoveries of new forms of excretions. The introduction of mass spectrometers coupled to gas chromatography at the end of the 1960's represented a major breakthrough for the elucidation of new metabolites. In the last two decades, this technique is being complemented by the use of liquid chromatography-mass spectrometry (LC-MS). In addition of becoming fundamental in clinical steroid determinations due to its excellent specificity, throughput and sensitivity, LC-MS has emerged as an exceptional tool for the discovery of new steroid metabolites. The aim of the present review is to provide an overview of the current LC-MS procedures used in the quest of novel metabolic products of steroidal hormones and exogenous steroids. Several aspects regarding LC separations are first outlined, followed by a description of the key processes that take place in the mass spectrometric analysis, i.e. the ionization of the steroids in the source and the fragmentation of the selected precursor ions in the collision cell. The different analyzers and approaches employed together with representative examples of each of them are described. Special emphasis is placed on triple quadrupole analyzers (LC-MS/MS), since they are the most commonly employed. Examples on the use of precursor ion scan, neutral loss scan and theoretical selected reaction monitoring strategies are also explained.
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Affiliation(s)
- Josep Marcos
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain; Toxicology Department, Labco Diagnostics, Verge de Guadalupe 18, 08950 Esplugues de Llobregat, Spain
| | - Oscar J Pozo
- Bioanalysis Research Group, IMIM, Hospital del Mar, Doctor Aiguader 88, 08003 Barcelona, Spain.
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Zhao XE, Yan P, Wang R, Zhu S, You J, Bai Y, Liu H. Sensitive determination of cholesterol and its metabolic steroid hormones by UHPLC-MS/MS via derivatization coupled with dual ultrasonic-assisted dispersive liquid-liquid microextraction. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2016; 30 Suppl 1:147-154. [PMID: 27539430 DOI: 10.1002/rcm.7634] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
RATIONALE Quantitative analysis of cholesterol and its metabolic steroid hormones plays a vital role in diagnosing endocrine disorders and understanding disease progression, as well as in clinical medicine studies. Because of their extremely low abundance in body fluids, it remains a challenging task to develop a sensitive detection method. METHODS A hyphenated technique of dual ultrasonic-assisted dispersive liquid-liquid microextraction (dual-UADLLME) coupled with microwave-assisted derivatization (MAD) was proposed for cleansing, enrichment and sensitivity enhancement. 4'-Carboxy-substituted rosamine (CSR) was synthesized and used as derivatization reagent. An ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method was developed for determination of cholesterol and its metabolic steroid hormones in the multiple reaction monitoring mode. RESULTS Parameters of dual-UADLLME, MAD and UHPLC-MS/MS were all optimized. Satisfactory linearity, recovery, repeatability, accuracy and precision, absence of matrix effect and extremely low limits of detection (LODs, 0.08-0.15 pg mL(-1) ) were achieved. CONCLUSIONS Through the combination of dual-UADLLME and MAD, a determination method for cholesterol and its metabolic steroid hormones in human plasma, serum and urine samples was developed and validated with high sensitivity, selectivity, accuracy and perfect matrix effect results. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Xian-En Zhao
- Shandong Provincial Key Laboratory of Life-Organic Analysis and Key Laboratory of Pharmaceutical Intermediates and Analysis of Natural Medicine, College of Chemistry and Chemical Engineering, Qufu Normal University, Qufu, 273165, Shandong, China
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, Institute of Analytical Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing, 100871, China
| | - Ping Yan
- Shandong Provincial Key Laboratory of Life-Organic Analysis and Key Laboratory of Pharmaceutical Intermediates and Analysis of Natural Medicine, College of Chemistry and Chemical Engineering, Qufu Normal University, Qufu, 273165, Shandong, China
- Hospital of University, Qufu Normal University, Qufu, 273165, Shandong, China
| | - Renjun Wang
- Shandong Provincial Key Laboratory of Life-Organic Analysis and Key Laboratory of Pharmaceutical Intermediates and Analysis of Natural Medicine, College of Chemistry and Chemical Engineering, Qufu Normal University, Qufu, 273165, Shandong, China
- College of Life Science, Qufu Normal University, Qufu, 273165, Shandong, China
| | - Shuyun Zhu
- Shandong Provincial Key Laboratory of Life-Organic Analysis and Key Laboratory of Pharmaceutical Intermediates and Analysis of Natural Medicine, College of Chemistry and Chemical Engineering, Qufu Normal University, Qufu, 273165, Shandong, China
| | - Jinmao You
- Shandong Provincial Key Laboratory of Life-Organic Analysis and Key Laboratory of Pharmaceutical Intermediates and Analysis of Natural Medicine, College of Chemistry and Chemical Engineering, Qufu Normal University, Qufu, 273165, Shandong, China
| | - Yu Bai
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, Institute of Analytical Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing, 100871, China
| | - Huwei Liu
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, Institute of Analytical Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing, 100871, China
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Qian X, Zhan Q, Lv L, Zhang H, Hong Z, Li Y, Xu H, Chai Y, Zhao L, Zhang G. Steroid hormone profiles plus α-fetoprotein for diagnosing primary liver cancer by liquid chromatography tandem mass spectrometry. Clin Chim Acta 2016; 457:92-8. [PMID: 27060391 DOI: 10.1016/j.cca.2016.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 03/28/2016] [Accepted: 03/31/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Primary liver cancer (PLC) is one of the most common malignant tumors world-wide but its pathogenesis is unclear. We suggest that steroid hormones may offer diagnostic information for PLC. METHODS Using liquid chromatography (UPLC) and tandem mass spectrometry (MS/MS), we quantified 7 endogenous steroids in 66 PLC human serum samples, 59 liver cirrhosis (LC) samples, and 65 healthy volunteers (HV). Data were assessed chemometrically and with Mann-Whitney U tests and partial least squares discriminant analysis (PLS-DA). RESULTS For PLC patients, androgens were low and estrogen was high. PLS-DA analysis discriminated between healthy subjects and cancer patients using (estrone+estradiol)/testosterone ratios. Moreover, cirrhosis patients were also distinguished with receiver operating characteristic curves indicating the specificity and sensitivity of our current approach. CONCLUSIONS Steroid hormone profiling by UPLC-MS/MS may be promising for early diagnosis of PLC but investigations with more patients and steroids are required to confirm the utility of these biomarkers for clinical applications.
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Affiliation(s)
- Xian Qian
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Qi Zhan
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Lei Lv
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Hai Zhang
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Zhanying Hong
- Department of Pharmaceutical Analysis, School of Pharmacy, Second Military Medical University, Shanghai 200433, China
| | - Yunqing Li
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Hao Xu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, MI 48109-1065, USA
| | - Yifeng Chai
- Department of Pharmaceutical Analysis, School of Pharmacy, Second Military Medical University, Shanghai 200433, China
| | - Liang Zhao
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Guoqing Zhang
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
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Jeanneret F, Tonoli D, Rossier MF, Saugy M, Boccard J, Rudaz S. Evaluation of steroidomics by liquid chromatography hyphenated to mass spectrometry as a powerful analytical strategy for measuring human steroid perturbations. J Chromatogr A 2015. [PMID: 26195035 DOI: 10.1016/j.chroma.2015.07.008] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This review presents the evolution of steroid analytical techniques, including gas chromatography coupled to mass spectrometry (GC-MS), immunoassay (IA) and targeted liquid chromatography coupled to mass spectrometry (LC-MS), and it evaluates the potential of extended steroid profiles by a metabolomics-based approach, namely steroidomics. Steroids regulate essential biological functions including growth and reproduction, and perturbations of the steroid homeostasis can generate serious physiological issues; therefore, specific and sensitive methods have been developed to measure steroid concentrations. GC-MS measuring several steroids simultaneously was considered the first historical standard method for analysis. Steroids were then quantified by immunoassay, allowing a higher throughput; however, major drawbacks included the measurement of a single compound instead of a panel and cross-reactivity reactions. Targeted LC-MS methods with selected reaction monitoring (SRM) were then introduced for quantifying a small steroid subset without the problems of cross-reactivity. The next step was the integration of metabolomic approaches in the context of steroid analyses. As metabolomics tends to identify and quantify all the metabolites (i.e., the metabolome) in a specific system, appropriate strategies were proposed for discovering new biomarkers. Steroidomics, defined as the untargeted analysis of the steroid content in a sample, was implemented in several fields, including doping analysis, clinical studies, in vivo or in vitro toxicology assays, and more. This review discusses the current analytical methods for assessing steroid changes and compares them to steroidomics. Steroids, their pathways, their implications in diseases and the biological matrices in which they are analysed will first be described. Then, the different analytical strategies will be presented with a focus on their ability to obtain relevant information on the steroid pattern. The future technical requirements for improving steroid analysis will also be presented.
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Affiliation(s)
- Fabienne Jeanneret
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, 1211 Geneva 4, Switzerland; Human Protein Sciences Department, University of Geneva, 1211 Geneva 4, Switzerland; Swiss Centre for Applied Human Toxicology, Geneva, Switzerland
| | - David Tonoli
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, 1211 Geneva 4, Switzerland; Human Protein Sciences Department, University of Geneva, 1211 Geneva 4, Switzerland; Swiss Centre for Applied Human Toxicology, Geneva, Switzerland
| | - Michel F Rossier
- Swiss Centre for Applied Human Toxicology, Geneva, Switzerland; Institut Central (ICHV), Hôpital du Valais, Sion, Switzerland
| | - Martial Saugy
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Epalinges, Switzerland
| | - Julien Boccard
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, 1211 Geneva 4, Switzerland
| | - Serge Rudaz
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, 1211 Geneva 4, Switzerland; Swiss Centre for Applied Human Toxicology, Geneva, Switzerland.
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Wieacker I, Peter M, Borucki K, Empting S, Roehl FW, Mohnike K. Therapy monitoring in congenital adrenal hyperplasia by dried blood samples. J Pediatr Endocrinol Metab 2015; 28:867-71. [PMID: 25781526 DOI: 10.1515/jpem-2014-0303] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 01/29/2015] [Indexed: 11/15/2022]
Abstract
Careful monitoring of the therapy is crucial for patients with congenital adrenal hyperplasia (CAH) in order to prevent the effects of increased androgen production as well as life-threatening salt-wasting crisis. The key metabolite, 17α-hydroxyprogesterone (17-OHP) can be detected in serum, saliva or dried blood. In clinical practice there are challenges due to discomfort of venous blood sampling and complicated retrieval of saliva during infancy. Furthermore, the immunoassay method is limited in its specificity due to cross-reactions. In this observational study we prospectively examined over a period of 5 years, 20 patients with CAH due to 21-hydroxylase deficiency using standard immunoassays for serum samples (radioimmunoassay and enzyme immunoassay) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) in dried blood spots. Bland-Altman plots show goodness of agreement between both the methods for the desirable therapeutic concentration range of 17-OHP. LC-MS/MS is characterized by a high accuracy in the therapeutic concentration range of 17-OHP <100 nmol/L (r=0.91). Dried blood samples are convenient and reliable specimen for 17-OHP measured by LC-MS/MS. This method could be used for home monitoring of hydrocortisone replacement therapy both in salt-waster and simple virilizer CAH.
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Cho YT, Su H, Wu WJ, Wu DC, Hou MF, Kuo CH, Shiea J. Biomarker Characterization by MALDI-TOF/MS. Adv Clin Chem 2015; 69:209-54. [PMID: 25934363 DOI: 10.1016/bs.acc.2015.01.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Mass spectrometric techniques frequently used in clinical diagnosis, such as gas chromatography-mass spectrometry, liquid chromatography-mass spectrometry, ambient ionization mass spectrometry, and matrix-assisted laser desorption ionization/time-of-flight mass spectrometry (MALDI-TOF/MS), are discussed. Due to its ability to rapidly detect large biomolecules in trace amounts, MALDI-TOF/MS is an ideal tool for characterizing disease biomarkers in biologic samples. Clinical applications of MS for the identification and characterization of microorganisms, DNA fragments, tissues, and biofluids are introduced. Approaches for using MALDI-TOF/MS to detect various disease biomarkers including peptides, proteins, and lipids in biological fluids are further discussed. Finally, various sample pretreatment methods which improve the detection efficiency of disease biomarkers are introduced.
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Affiliation(s)
- Yi-Tzu Cho
- Department of Cosmetic Applications and Management, Yuh-Ing Junior College of Health Care & Management, Kaohsiung, Taiwan
| | - Hung Su
- Department of Chemistry, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Wen-Jeng Wu
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Deng-Chyang Wu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Center for Stem Cell Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Feng Hou
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chao-Hung Kuo
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Center for Stem Cell Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jentaie Shiea
- Department of Chemistry, National Sun Yat-sen University, Kaohsiung, Taiwan; Center for Stem Cell Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Peitzsch M, Dekkers T, Haase M, Sweep FCGJ, Quack I, Antoch G, Siegert G, Lenders JWM, Deinum J, Willenberg HS, Eisenhofer G. An LC-MS/MS method for steroid profiling during adrenal venous sampling for investigation of primary aldosteronism. J Steroid Biochem Mol Biol 2015; 145:75-84. [PMID: 25312486 DOI: 10.1016/j.jsbmb.2014.10.006] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/28/2014] [Accepted: 10/08/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Steroid profiling for diagnosis of endocrine disorders featuring disordered production of steroid hormones is now possible from advances in liquid chromatography with tandem mass spectrometry (LC-MS/MS). Adrenal venous (AV) measurements of aldosterone and cortisol are a standard practice in the clinical work-up of primary aldosteronism, but do not yet take advantage of steroid profiling. METHODS A novel LC-MS/MS based method was developed for simultaneous measurement of 15 adrenal steroids: aldosterone, corticosterone, 11-deoxycorticosterone, progesterone, pregnenolone, cortisone, cortisol, 11-deoxycortisol, 17-hydroxyprogesterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone-sulfate, 21-deoxycortisol, 18-oxocortisol and 18-hydroxycortisol. These were compared in peripheral venous (pV) and AV plasma from 70 patients undergoing AV sampling with and without cosyntropin stimulation. Aldosterone and cortisol levels measured by LC-MS/MS were compared with those measured by immunoassay. RESULTS Reproducibility of measurements with coefficients of variation ≤10% as well as analytical sensitivity sufficient to measure low pV levels particularly of aldosterone demonstrate the utility of the assay for profiling adrenal steroids in primary aldosteronism. Method comparisons indicated assay and concentration dependent differences of cortisol and aldosterone concentrations measured by immunoassay and LC-MS/MS. Median AV/pV ratios of 11-deoxycortisol (53.0), 17-hydroxyprogesterone (33.4), pregnenolone (62.4), androstenedione (40.6) and dehydroepiandrosterone (33.3) were 2.9- to, 5.4-fold larger than those for cortisol (11.6), with additionally generally larger increases than for cortisol with than without cosyntropin stimulation. CONCLUSION Our LC-MS/MS assay, in addition to improvements over existing immunoassay measurements of aldosterone and cortisol, offers profiling of 13 other adrenal steroids, providing a potentially useful method for the clinical work-up of patients with primary aldosteronism. In particular, the larger AV/pV ratios of several steroids compared to cortisol suggest more sensitive alternatives to the latter for assessing positioning of AV sampling catheters.
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Affiliation(s)
- Mirko Peitzsch
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany.
| | - Tanja Dekkers
- Department of General Internal Medicine, Radboud University Medical Center, Geert Grooteplein 8, 6525 Nijmegen, The Netherlands
| | - Matthias Haase
- Heinrich-Heine-University of Dusseldorf, Medical Faculty, Division for Specific Endocrinology, Moorenstrasse 5, 40225 Dusseldorf, Germany; Department of Medicine III, University Hospital Carl Gustav Carus, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Fred C G J Sweep
- Department of Laboratory Medicine, Radboud University Medical Center, Geert Grooteplein 10, 6525 Nijmegen, The Netherlands
| | - Ivo Quack
- Heinrich-Heine-University of Dusseldorf, Medical Faculty, Department of Nephrology, Moorenstrasse 5, 40225 Dusseldorf, Germany
| | - Gerald Antoch
- Heinrich-Heine-University of Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstrasse 5, 40225 Dusseldorf, Germany
| | - Gabriele Siegert
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Jacques W M Lenders
- Department of General Internal Medicine, Radboud University Medical Center, Geert Grooteplein 8, 6525 Nijmegen, The Netherlands; Department of Medicine III, University Hospital Carl Gustav Carus, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Jaap Deinum
- Department of General Internal Medicine, Radboud University Medical Center, Geert Grooteplein 8, 6525 Nijmegen, The Netherlands
| | - Holger S Willenberg
- Heinrich-Heine-University of Dusseldorf, Medical Faculty, Division for Specific Endocrinology, Moorenstrasse 5, 40225 Dusseldorf, Germany; Department of Medicine III, University Hospital Carl Gustav Carus, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Graeme Eisenhofer
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany; Department of Medicine III, University Hospital Carl Gustav Carus, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
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