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Colombo C, Ceruti D, Succi M, De Leo S, Trevisan M, Moneta C, Fugazzola L. Impact of systemic treatments for advanced thyroid cancer on the adrenal cortex. Eur Thyroid J 2024; 13:e230246. [PMID: 38642580 PMCID: PMC11103760 DOI: 10.1530/etj-23-0246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/16/2024] [Indexed: 04/22/2024] Open
Abstract
Background Fatigue is a frequent adverse event during systemic treatments for advanced thyroid cancer, often leading to reduction, interruption, or discontinuation. We were the first group to demonstrate a correlation between fatigue and primary adrenal insufficiency (PAI). Aim The objective was to assess the entire adrenal function in patients on systemic treatments. Methods ACTH, cortisol and all the hormones produced by the adrenal gland were evaluated monthly in 36 patients (25 on lenvatinib, six on vandetanib, and five on selpercatinib). ACTH stimulation tests were performed in 26 cases. Results After a median treatment period of 7 months, we observed an increase in ACTH values in 80-100% of patients and an impaired cortisol response to the ACTH test in 19% of cases. Additionally, dehydroepiandrosterone sulphate, ∆-4-androstenedione and 17-OH progesterone levels were below the median of normal values in the majority of patients regardless of the drug used. Testosterone in females and oestradiol in males were below the median of normal values in the majority of patients on lenvatinib and vandetanib. Finally, aldosterone was below the median of the normal values in most cases, whilst renin levels were normal. Metanephrines and normetanephrines were always within the normal range. Replacement therapy with cortisone acetate improved fatigue in 14/17 (82%) patients with PAI. Conclusion Our data confirm that systemic treatments for advanced thyroid cancer can lead to impaired cortisol secretion. A reduction in the other hormones secreted by the adrenal cortex has been first reported and should be considered in the more appropriate management of these fragile patients.
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Affiliation(s)
- Carla Colombo
- Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Daniele Ceruti
- Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Massimiliano Succi
- Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Simone De Leo
- Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Matteo Trevisan
- Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Claudia Moneta
- Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Laura Fugazzola
- Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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2
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Luis SA, Chung R, Stefanescu Schmidt AC, Clark JW, Pearson DS. Case 33-2023: An 86-Year-Old Man with Shortness of Breath. N Engl J Med 2023; 389:1602-1613. [PMID: 37888920 DOI: 10.1056/nejmcpc2300908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Affiliation(s)
- Sushil Allen Luis
- From the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (S.A.L.); and the Departments of Radiology (R.C.), Medicine (A.C.S.S., J.W.C.), and Pathology (D.S.P.), Massachusetts General Hospital, and the Departments of Radiology (R.C.), Medicine (A.C.S.S., J.W.C.), and Pathology (D.S.P.), Harvard Medical School - both in Boston
| | - Ryan Chung
- From the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (S.A.L.); and the Departments of Radiology (R.C.), Medicine (A.C.S.S., J.W.C.), and Pathology (D.S.P.), Massachusetts General Hospital, and the Departments of Radiology (R.C.), Medicine (A.C.S.S., J.W.C.), and Pathology (D.S.P.), Harvard Medical School - both in Boston
| | - Ada C Stefanescu Schmidt
- From the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (S.A.L.); and the Departments of Radiology (R.C.), Medicine (A.C.S.S., J.W.C.), and Pathology (D.S.P.), Massachusetts General Hospital, and the Departments of Radiology (R.C.), Medicine (A.C.S.S., J.W.C.), and Pathology (D.S.P.), Harvard Medical School - both in Boston
| | - Jeffrey W Clark
- From the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (S.A.L.); and the Departments of Radiology (R.C.), Medicine (A.C.S.S., J.W.C.), and Pathology (D.S.P.), Massachusetts General Hospital, and the Departments of Radiology (R.C.), Medicine (A.C.S.S., J.W.C.), and Pathology (D.S.P.), Harvard Medical School - both in Boston
| | - Daniel S Pearson
- From the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (S.A.L.); and the Departments of Radiology (R.C.), Medicine (A.C.S.S., J.W.C.), and Pathology (D.S.P.), Massachusetts General Hospital, and the Departments of Radiology (R.C.), Medicine (A.C.S.S., J.W.C.), and Pathology (D.S.P.), Harvard Medical School - both in Boston
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3
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Zuling ET, Debono M, Rab E, Balasubramanian S. Sulfasalazine as a cause of false-positive elevation of urinary normetanephrine in patients with adrenal mass and suspected phaeochromocytoma: a diagnostic challenge. BMJ Case Rep 2023; 16:e253597. [PMID: 37730424 PMCID: PMC10514662 DOI: 10.1136/bcr-2022-253597] [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] [Indexed: 09/22/2023] Open
Abstract
In patients with suspected phaeochromocytoma, biochemical screening of urine or blood for excess secretion catecholamines and/or their metabolites is performed. Elevated levels of catecholamines and metanephrines help in establishing the diagnosis of phaeochromocytoma. In two patients with adrenal lesions who were subjected to biochemical testing significantly elevated urinary normetanephrines appeared to establish the diagnosis of phaeochromocytoma. However, on subsequent investigations, this was demonstrated to be a 'false positive' finding. Both these patients were on sulfasalazine, an anti-inflammatory drug used in inflammatory bowel disease, rheumatoid arthritis and ankylosing spondylitis. Sulfasalazine can cause analytical interference in some assays for urinary normetanephrine and result in spuriously elevated levels, leading to misdiagnosis of phaeochromocytoma. In this report, one patient underwent adrenalectomy and another had conservative management.Although this has been previously reported, increased awareness of the possibility of false-positive results on urinary metanephrines testing is important to reduce the potential for misdiagnosis and unnecessary treatment.
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Affiliation(s)
| | - Miguel Debono
- Department of Diabetes and Endocrinology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Edmund Rab
- Sheffield Laboratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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4
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Eisenhofer G, Pamporaki C, Lenders JWM. Biochemical Assessment of Pheochromocytoma and Paraganglioma. Endocr Rev 2023; 44:862-909. [PMID: 36996131 DOI: 10.1210/endrev/bnad011] [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: 09/28/2022] [Revised: 01/24/2023] [Accepted: 03/29/2023] [Indexed: 03/31/2023]
Abstract
Pheochromocytoma and paraganglioma (PPGL) require prompt consideration and efficient diagnosis and treatment to minimize associated morbidity and mortality. Once considered, appropriate biochemical testing is key to diagnosis. Advances in understanding catecholamine metabolism have clarified why measurements of the O-methylated catecholamine metabolites rather than the catecholamines themselves are important for effective diagnosis. These metabolites, normetanephrine and metanephrine, produced respectively from norepinephrine and epinephrine, can be measured in plasma or urine, with choice according to available methods or presentation of patients. For patients with signs and symptoms of catecholamine excess, either test will invariably establish the diagnosis, whereas the plasma test provides higher sensitivity than urinary metanephrines for patients screened due to an incidentaloma or genetic predisposition, particularly for small tumors or in patients with an asymptomatic presentation. Additional measurements of plasma methoxytyramine can be important for some tumors, such as paragangliomas, and for surveillance of patients at risk of metastatic disease. Avoidance of false-positive test results is best achieved by plasma measurements with appropriate reference intervals and preanalytical precautions, including sampling blood in the fully supine position. Follow-up of positive results, including optimization of preanalytics for repeat tests or whether to proceed directly to anatomic imaging or confirmatory clonidine tests, depends on the test results, which can also suggest likely size, adrenal vs extra-adrenal location, underlying biology, or even metastatic involvement of a suspected tumor. Modern biochemical testing now makes diagnosis of PPGL relatively simple. Integration of artificial intelligence into the process should make it possible to fine-tune these advances.
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Affiliation(s)
- Graeme Eisenhofer
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Christina Pamporaki
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Jacques W M Lenders
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- Department of Internal Medicine, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands
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5
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Rossi RE, Lavezzi E, Jaafar S, Cristofolini G, Laffi A, Nappo G, Carrara S, Bertuzzi AF, Uccella S, Repici A, Zerbi A, Lania AGA. Urinary 5-Hydroxyindolacetic Acid Measurements in Patients with Neuroendocrine Tumor-Related Carcinoid Syndrome: State of the Art. Cancers (Basel) 2023; 15:4065. [PMID: 37627093 PMCID: PMC10452849 DOI: 10.3390/cancers15164065] [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: 07/06/2023] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Carcinoid syndrome (CS), mostly associated with small intestinal neuroendocrine tumors (SI-NETs) or lung-related NETs, is characterized by symptoms related to hormonal secretion and long-term complications, including carcinoid heart disease (CHD), which is potentially life-threatening. In the early stages of the disease, symptoms are non-specific, which leads to delayed diagnoses. The availability of reliable tumor markers is crucial for a prompt diagnosis and proper management. This review summarizes available evidence on the role of 24 h urinary 5-hydroxyindolacetic acid (24u5HIAA), which is the urinary breakdown metabolite of serotonin, in the diagnosis/follow-up of NET-related CS, with a focus on its potential prognostic role, while eventually attempting to suggest a timeline for its measurement during the follow-up of NET patients. The use of 24u5HIAA is an established biomarker for the diagnosis of NETs with CS since it shows a sensibility and specificity of 100% and 85-90%, respectively. The downside of 24u5-HIAA is represented by the need for 24 h urine collection and the risk of confounding factors (foods and medication), which might lead to false positive/negative results. Moreover, 24u5HIAA is useful in the follow-up of NETs with CS since a shorter double time correlates to a higher risk of disease progression/disease-specific mortality. Furthermore, an elevation in 24u5-HIAA is correlated with a dismal prognosis because it is associated with an increased likelihood of CHD development and disease progression/mortality. Other potentially interesting biochemical markers have been proposed, including plasmatic 5HIAA, although further standardization and prospective studies are required to define their role in the management of NETs. Meanwhile, 24u5HIAA remains the most accurate CS biomarker.
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Affiliation(s)
- Roberta Elisa Rossi
- Gastroenterology and Endoscopy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (R.E.R.); (S.C.); (A.R.)
| | - Elisabetta Lavezzi
- Endocrinology and Diabetology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (E.L.); (S.J.); (G.C.)
| | - Simona Jaafar
- Endocrinology and Diabetology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (E.L.); (S.J.); (G.C.)
| | - Giacomo Cristofolini
- Endocrinology and Diabetology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (E.L.); (S.J.); (G.C.)
| | - Alice Laffi
- Hematology and Oncology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (A.L.); (A.F.B.)
| | - Gennaro Nappo
- Pancreatic Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (G.N.); (A.Z.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy;
| | - Silvia Carrara
- Gastroenterology and Endoscopy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (R.E.R.); (S.C.); (A.R.)
| | - Alexia Francesca Bertuzzi
- Hematology and Oncology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (A.L.); (A.F.B.)
| | - Silvia Uccella
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy;
- Pathology Service, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Alessandro Repici
- Gastroenterology and Endoscopy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (R.E.R.); (S.C.); (A.R.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy;
| | - Alessandro Zerbi
- Pancreatic Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (G.N.); (A.Z.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy;
| | - Andrea Gerardo Antonio Lania
- Endocrinology and Diabetology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (E.L.); (S.J.); (G.C.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy;
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6
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Jimenez C, Chin BB, Noto RB, Dillon JS, Solnes L, Stambler N, DiPippo VA, Pryma DA. Biomarker response to high-specific-activity I-131 meta-iodobenzylguanidine in pheochromocytoma/paraganglioma. Endocr Relat Cancer 2023; 30:e220236. [PMID: 36472300 PMCID: PMC9874967 DOI: 10.1530/erc-22-0236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022]
Abstract
The objective of this study is to present the complete biomarker response dataset from a pivotal trial evaluating the efficacy and safety of high-specific-activity I-131 meta-iodobenzylguanidine in patients with advanced pheochromocytoma or paraganglioma. Biomarker status was assessed and post-treatment responses were analyzed for catecholamines, metanephrines, and serum chromogranin A. Complete biomarker response (normalization) or partial response, defined as at least 50% reduction from baseline if above the normal range, was evaluated at specified time points over a 12-month period. These results were correlated with two other study objectives: blood pressure control and objective tumor response as per RECIST 1.0. In this open-label, single-arm study, 68 patients received at least one therapeutic dose (~18.5 GBq (~500 mCi)) of high-specific-activity I-131 meta-iodobenzylguanidine. Of the patients, 79% and 72% had tumors associated with elevated total plasma free metanephrines and serum chromogranin A levels, respectively. Best overall biomarker responses (complete or partial response) for total plasma free metanephrines and chromogranin A were observed in 69% (37/54) and 80% (39/49) of patients, respectively. The best response for individual biomarkers was observed 6-12 months following the first administration of high-specific-activity I-131 meta-iodobenzylguanidine. Biochemical tumor marker response was significantly associated with both reduction in antihypertensive medication use (correlation coefficient 0.35; P = 0.006) as well as objective tumor response (correlation coefficient 0.36; P = 0.007). Treatment with high-specific-activity I-131 meta-iodobenzylguanidine resulted in long-lasting biomarker responses in patients with advanced pheochromocytoma or paraganglioma that correlated with blood pressure control and objective response rate. ClinicalTrials.gov number: NCT00874614.
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Affiliation(s)
- Camilo Jimenez
- University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Bennett B Chin
- University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Richard B Noto
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | | | - Lilja Solnes
- Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Nancy Stambler
- Progenics Pharmaceuticals, Inc., a Lantheus Company, North Billerica, Massachusetts, USA
| | - Vincent A DiPippo
- Progenics Pharmaceuticals, Inc., a Lantheus Company, North Billerica, Massachusetts, USA
| | - Daniel A Pryma
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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7
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Bal C, Topcuoğlu C, Rıfat Balık A, Yılmaz FM, Erel Ö, Yılmaz G. The effect of acid use as a preservative on the results of biochemical tests measured in 24-h urine. Scandinavian Journal of Clinical and Laboratory Investigation 2022; 82:329-333. [PMID: 35791842 DOI: 10.1080/00365513.2022.2092899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Twenty-four-hour urine measurements play a crucial role in the diagnosis, follow-up and treatment of various diseases. There are different approaches to the collection of urine in patients who need to collect multiple urine samples at a time, especially in hospitals with heavy workloads. In this study, we compared the sodium, potassium, chloride, amylase, calcium, creatinine, phosphorus, microalbumin, protein, magnesium, urea, uric acid, adrenaline, noradrenaline, dopamine, metanephrine, normetanephrine, vanillylmandelic acid, 5-hydroxyindoleacetic acid and homovanillic acid results of 24-h urine samples analyzed immediately without acid addition, which we accepted as the reference and baseline measurement, with the results of the samples analyzed after waiting for 24 h without acid addition, analyzed immediately with acid addition and analyzed after waiting for 24 h with acid addition. Chloride, microalbumin, amylase and protein tests, which are recommended to be measured in the sample without preservatives, are affected by acid addition. Adrenaline, noradrenaline and dopamine, which are the tests recommended to be measured in acid-added urine are degraded in the samples without acid, and the levels of metanephrine and normetanephrine were not significantly degraded in the absence of preservatives.
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Affiliation(s)
- Ceylan Bal
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
| | - Canan Topcuoğlu
- Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Rıfat Balık
- Department of Medical Biochemistry, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Fatma Meriç Yılmaz
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
| | - Özcan Erel
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
| | - Gülsen Yılmaz
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
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Fang JM, Li J, Shi J. An update on the diagnosis of gastroenteropancreatic neuroendocrine neoplasms. World J Gastroenterol 2022; 28:1009-1023. [PMID: 35431496 PMCID: PMC8968521 DOI: 10.3748/wjg.v28.i10.1009] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/26/2021] [Accepted: 02/10/2022] [Indexed: 02/06/2023] Open
Abstract
Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) arise from neuroendocrine cells found throughout the gastrointestinal tract and islet cells of the pancreas. The incidence and prevalence of GEP-NENs have been increasing each year due to higher awareness, improved diagnostic modalities, and increased incidental detection on cross-sectional imaging and endoscopy for cancer screening and other conditions and symptoms. GEP-NENs are a heterogeneous group of tumors and have a wide range in clinical presentation, histopathologic features, and molecular biology. Clinical presentation most commonly depends on whether the GEP-NEN secretes an active hormone. The World Health Organization recently updated the classification of GEP-NENs to introduce a distinction between high-grade neuroendocrine tumors and neuroendocrine carcinomas, which can be identified using histology and molecular studies and are more aggressive with a worse prognosis compared to high-grade neuroendocrine tumors. As our understanding of the biology of GEP-NENs has grown, new and improved diagnostic modalities can be developed and optimized. Here, we discuss clinical features and updates in diagnosis, including histopathological analysis, biomarkers, molecular techniques, and radiology of GEP-NENs. We review established diagnostic tests and discuss promising novel diagnostic tests that are currently in development or require further investigation and validation prior to broad utilization in patient care.
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Affiliation(s)
- Jiayun M Fang
- Department of Pathology & Clinical Labs, University of Michigan, Ann Arbor, MI 48109, United States
| | - Jay Li
- Medical Scientist Training Program, University of Michigan, Ann Arbor, MI 48109, United States
| | - Jiaqi Shi
- Department of Pathology & Clinical Labs, University of Michigan, Ann Arbor, MI 48109, United States
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9
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OUP accepted manuscript. Clin Chem 2022; 68:724-726. [DOI: 10.1093/clinchem/hvac025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/31/2022] [Indexed: 11/14/2022]
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10
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Li H, Zhang G, Wang W, Jiao LL, Chen CB, Huo JR, Wu W. Detection of catecholamine metabolites in urine based on ultra-high-performance liquid chromatography-tandem mass spectrometry. Biomed Chromatogr 2021; 36:e5280. [PMID: 34788895 DOI: 10.1002/bmc.5280] [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: 08/23/2021] [Revised: 10/15/2021] [Accepted: 11/04/2021] [Indexed: 11/09/2022]
Abstract
The excretion of neurotransmitter metabolites in normal individuals is of great significance for health monitoring. A rapid quantitative method was developed with ultra-performance liquid chromatography-tandem mass spectrometry. The method was further applied to determine catecholamine metabolites vanilymandelic acid (VMA), methoxy hydroxyphenyl glycol (MHPG), dihydroxy-phenyl acetic acid (DOPAC), and homovanillic acid (HVA) in the urine. The urine was collected from six healthy volunteers (20-22 years old) for 10 consecutive days. It was precolumn derivatized with dansyl chloride. Subsequently, the sample was analyzed using triple quadrupole mass spectrometry with an electrospray ion in positive and multireaction monitoring modes. The method was sensitive and repeatable with the recoveries 92.7-104.30%, limits of detection (LODs) 0.01-0.05 μg/mL, and coefficients no less than 0.9938. The excretion content of four target compounds in random urine samples was 0.20 ± 0.086 μg/mL (MHPG), 1.27 ± 1.24 μg/mL (VMA), 3.29 ± 1.36 μg/mL (HVA), and 1.13 ± 1.07 μg/mL (DOPAC). In the urine, the content of VMA, the metabolite of norepinephrine and adrenaline, was more than MHPG, and the content of HVA, the metabolite of dopamine, was more than DOPAC. This paper detected the levels of catecholamine metabolites and summarized the characteristics of excretion using random urine samples, which could provide valuable information for clinical practice.
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Affiliation(s)
- Hui Li
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Guolei Zhang
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Wei Wang
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Li-Li Jiao
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Chang-Bao Chen
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Jing-Rui Huo
- Cangzhou Nanobody Technology Innovation Center, Cangzhou Medical College, Cangzhou, China
| | - Wei Wu
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
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11
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Moncer F, Adhoum N, Catak D, Monser L. Electrochemical sensor based on MIP for highly sensitive detection of 5-hydroxyindole-3-acetic acid carcinoid cancer biomarker in human biological fluids. Anal Chim Acta 2021; 1181:338925. [PMID: 34556226 DOI: 10.1016/j.aca.2021.338925] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/24/2021] [Accepted: 08/07/2021] [Indexed: 12/23/2022]
Abstract
An electrochemically synthetized nano-sensor based on molecularly imprinted polypyrrole (MIPPy) was successfully developed for the detection of 5-hydroxyindole-3-acetic acid (5-HIAA) in human biological fluids namely serum, urine, and plasma. The imprinted glassy carbon electrode was prepared by electropolymerisation of pyrrole via cyclic voltammetry (C.V). After completely leaching the imprinted molecules from the polymeric network, complementary cavities are created. The developed MIPPy sensor, under optimized conditions, shows a high sensitivity towards the target molecule (LOQ = 5 × 10-11 M). Moreover, it presents a wide linear response in the range of 5 × 10-11 - 5 × 10-5 M (R2 > 0.999) with a detection limit of 15 × 10-12 M. In order to evaluate the selectivity of the MIPPy film, several structural analogues and compounds forming the real matrices were tested. The obtained results show an excellent recovery rate (between 98.86 and 101.52%) proving the promising application of the proposed nano-sensor in the detection of 5-HIAA in human biological fluids without any significant interference recorded.
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Affiliation(s)
- Fatma Moncer
- EcoChimie Laboratory, Department of Chemical and Biological Engineering, National Institute of Applied Sciences and Technology, Carthage University, Tunisia; Laboratory of Electrochemistry, Materials, and Environment, UR16ES02, Preparatory School for Engineering Studies, Kairouan University, Tunisia.
| | - Nafaâ Adhoum
- Laboratory of Electrochemistry, Materials, and Environment, UR16ES02, Preparatory School for Engineering Studies, Kairouan University, Tunisia
| | - Darmin Catak
- National Centre for Nano Fabrication and Characterization, DTU Nanolab, Technical University of Denmark, Denmark
| | - Lotfi Monser
- EcoChimie Laboratory, Department of Chemical and Biological Engineering, National Institute of Applied Sciences and Technology, Carthage University, Tunisia; Laboratory of Electrochemistry, Materials, and Environment, UR16ES02, Preparatory School for Engineering Studies, Kairouan University, Tunisia.
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12
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Becker A, Schalin-Jäntti C, Itkonen O. Comparison of Serum and Urinary 5-Hydroxyindoleacetic Acid as Biomarker for Neuroendocrine Neoplasms. J Endocr Soc 2021; 5:bvab106. [PMID: 34195530 PMCID: PMC8237842 DOI: 10.1210/jendso/bvab106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Indexed: 11/19/2022] Open
Abstract
CONTEXT Patients with serotonin-secreting neuroendocrine neoplasms (NENs) have increased serum 5-hydroxyindoleacetic acid (5HIAA) concentrations. Serum 5HIAA thus serves as a biomarker in NEN. OBJECTIVE To evaluate an improved tandem mass spectrometric serum 5HIAA assay for diagnosis and follow-up of NEN in a clinical cohort. DESIGN A retrospective study during 2016-2018 at the Diagnostic Center and Department of Endocrinology at Helsinki University Hospital, Finland. METHODS Detailed patient data was obtained from 116 patients. Serum 5HIAA was analyzed by 2 different liquid chromatography with tandem mass spectrometry (LC-MS/MS) assays with samples prepared either by protein precipitation or solid phase extraction. Twenty-four-hour urine 5HIAA samples (n = 33) were analyzed by amperometric LC, and the results were compared. Specificity and sensitivity were calculated by receiver operating characteristic (ROC) analysis. RESULTS We achieved 5 to10 000 nmol/L linearity and ≤2.5% variation with our new serum 5HIAA assay. In ROC analysis, the area under curve was 85% by serum assays [upper reference limit (URL) value 123 nmol/L] and 88% by the 24-h urine 5HIAA assay (URL value of 47.1 µmol), respectively. A difference (P < 0.001) between patients with active NEN and patients in remission was found by all 5HIAA assays. CONCLUSION Serum 5HIAA by LC-MS/MS after protein precipitation performs equally well for the diagnosis of NEN as urinary 5HIAA LC assay. The outcome and sensitivity for serum and 24-h urine assays are convergent. Due to much more reliable and convenient sampling, we recommend serum instead of 24-h urine 5HIAA for diagnosis and follow-up of NEN patients.
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Affiliation(s)
- Anna Becker
- HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Camilla Schalin-Jäntti
- Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Outi Itkonen
- HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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13
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Spada F, Rossi RE, Kara E, Laffi A, Massironi S, Rubino M, Grimaldi F, Bhoori S, Fazio N. Carcinoid Syndrome and Hyperinsulinemic Hypoglycemia Associated with Neuroendocrine Neoplasms: A Critical Review on Clinical and Pharmacological Management. Pharmaceuticals (Basel) 2021; 14:ph14060539. [PMID: 34199977 PMCID: PMC8228616 DOI: 10.3390/ph14060539] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 02/05/2023] Open
Abstract
The carcinoid syndrome (CS) and hyperinsulinemic hypoglycemia (HH) represent two of the most common clinical syndromes associated with neuroendocrine neoplasms (NENs). The former is mainly related to the serotonin secretion by a small bowel NEN, whereas the latter depends on an insulin hypersecretion by a pancreatic insulinoma. Both syndromes/conditions can affect prognosis and quality of life of patients with NENs. They are often diagnosed late when patients become strongly symptomatic. Therefore, their early detection and management are a critical step in the clinical management of NEN patients. A dedicated and experienced multidisciplinary team with appropriate therapeutic strategies is needed and should be encouraged to optimize clinical outcomes. This review aims to critically analyze clinical features, evidence and treatment options of CS and HH and therefore to improve their management.
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Affiliation(s)
- Francesca Spada
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO) IRCCS, via G. Ripamonti 435, 20141 Milano, Italy; (F.S.); (A.L.); (M.R.)
| | - Roberta E. Rossi
- Hepatology and Hepato-Pancreatic-Biliary Surgery and Liver Transplantation, Fondazione IRCCS, Istituto Nazionale Tumori (INT), via G. Venezian 1, 20133 Milano, Italy; (R.E.R.); (S.B.)
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, via Festa del Perdono 7, 20122 Milano, Italy
| | - Elda Kara
- Endocrinology and Metabolism Unit, University Hospital S. Maria della Misericordia, Piazzale Santa Maria della Misericordia, 15, 33100 Udine, Italy; (E.K.); (F.G.)
| | - Alice Laffi
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO) IRCCS, via G. Ripamonti 435, 20141 Milano, Italy; (F.S.); (A.L.); (M.R.)
| | - Sara Massironi
- Division of Gastroenterology, San Gerardo Hospital, Bicocca School of Medicine, University of Milano Bicocca, 20126 Milano, Italy;
| | - Manila Rubino
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO) IRCCS, via G. Ripamonti 435, 20141 Milano, Italy; (F.S.); (A.L.); (M.R.)
| | - Franco Grimaldi
- Endocrinology and Metabolism Unit, University Hospital S. Maria della Misericordia, Piazzale Santa Maria della Misericordia, 15, 33100 Udine, Italy; (E.K.); (F.G.)
| | - Sherrie Bhoori
- Hepatology and Hepato-Pancreatic-Biliary Surgery and Liver Transplantation, Fondazione IRCCS, Istituto Nazionale Tumori (INT), via G. Venezian 1, 20133 Milano, Italy; (R.E.R.); (S.B.)
| | - Nicola Fazio
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO) IRCCS, via G. Ripamonti 435, 20141 Milano, Italy; (F.S.); (A.L.); (M.R.)
- Correspondence: ; Tel.: +39-025-748-9258
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14
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Ahn J, Park JY, Kim G, Jin SM, Hur KY, Lee SY, Kim JH. Urinary Free Metanephrines for Diagnosis of Pheochromocytoma and Paraganglioma. Endocrinol Metab (Seoul) 2021; 36:697-701. [PMID: 34107605 PMCID: PMC8258320 DOI: 10.3803/enm.2020.925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/12/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Pheochromocytoma and paraganglioma (PPGL) is diagnosed through biochemical confirmation of excessive catecholamines in urine and plasma. Recent technological developments have allowed us to measure urinary free metanephrines; however, the diagnostic accuracy of these new methods and the diagnostic cutoff values have not been evaluated. METHODS This is a retrospective study of 595 subjects, including 71 PPGL cases and 524 controls. PPGL was based on pathological confirmation. Subjects with no evidence of PPGL over 2 years were included in the control group. RESULTS Urinary free metanephrines yielded similar area under the curve (AUC) to urinary fractionated metanephrines and plasma free metanephrines. However, urinary free normetanephrine yielded a better AUC than did urinary fractionated normetanephrine. The optimal cutoff for urinary free metanephrine and normetanephrine corrected for urinary creatinine yielded 97.2% sensitivity and 98.1% specificity. CONCLUSION Urinary free metanephrines are a reliable method for diagnosing PPGL in Asian populations compared with existing biochemical methods.
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Affiliation(s)
- Jiyeon Ahn
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang,
Korea
| | - Ji Yun Park
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, 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
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
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15
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Stabilization of urinary biogenic amines measured in clinical chemistry laboratories. Clin Chim Acta 2020; 514:24-28. [PMID: 33333038 DOI: 10.1016/j.cca.2020.12.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 02/06/2023]
Abstract
Urinary 5-hydroxyindoleacetic acid (5-HIAA), vanillylmandelic (VMA), homovanillic acid (HVA), catecholamines and metanephrines are produced in excess by catecholamine-producing tumors. These biogenic amines are unstable at low or high pH and require hydrochloric acid (HCl) to prevent their degradation. However, HCl addition may result in very low pH causing degradation or deconjugation of several metabolites. This study evaluated the buffering properties of sodium citrate to stabilize all biogenic amines. The metabolite concentrations were measured by LC-MS/MS or by a coulometric assay in 22 urine samples collected native and with HCl or sodium citrate. We studied the effect of pH, time (48 h, four weeks) and storage temperature at 22 °C, 4 °C, and -20 °C. We found that catecholamines degradation was prevented by HCl and citrate and that 5-HIAA was degraded in 5 out of 22 samples collected with HCl. All biogenic amines were efficiently stabilized by citrate for four weeks at 22 °C, except epinephrine (48 h at 4 °C, or four weeks at -20 °C). Sodium citrate did not cause quantification or analytical artefacts concerns. In conclusion, sodium citrate is a non-hazardous alternative to HCl for patients to send unfrozen urine samples to the laboratory which may safely store the sample for four weeks.
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16
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Fanciulli G, Ruggeri RM, Grossrubatscher E, Calzo FL, Wood TD, Faggiano A, Isidori A, Colao A. Serotonin pathway in carcinoid syndrome: Clinical, diagnostic, prognostic and therapeutic implications. Rev Endocr Metab Disord 2020; 21:599-612. [PMID: 32152781 DOI: 10.1007/s11154-020-09547-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Carcinoid syndrome represents the most common functional syndrome that affects patients with neuroendocrine neoplasms. Its clinical presentation is really heterogeneous, ranging from mild and often misdiagnosed symptoms to severe manifestations, that significantly worsen the patient's quality of life, such as difficult-to-control diarrhoea and fibrotic complications. Serotonin pathway alteration plays a central role in the pathophysiology of carcinoid syndrome, accounting for most clinical manifestations and providing diagnostic tools. Serotonin pathway is complex, resulting in production of biologically active molecules such as serotonin and melatonin, as well as of different intermediate molecules and final metabolites. These activities require site- and tissue-specific catalytic enzymes. Variable expression and activities of these enzymes result in different clinical pictures, according to primary site of origin of the tumour. At the same time, the biochemical diagnosis of carcinoid syndrome could be difficult even in case of typical symptoms. Therefore, the accuracy of the diagnostic methods of assessment should be improved, also attenuating the impact of confounding factors and maybe considering new serotonin precursors or metabolites as diagnostic markers. Finally, the prognostic role of serotonin markers has been only evaluated for its metabolite 5-hydroxyindole acetic acid but, due to heterogeneous and biased study designs, no definitive conclusions have been achieved. The most recent progress is represented by the new therapeutic agent telotristat, an inhibitor of the enzyme tryptophan hydroxylase, which blocks the conversion of tryptophan in 5-hydroxy-tryptophan. The present review investigates the clinical significance of serotonin pathway in carcinoid syndrome, considering its role in the pathogenesis, diagnosis, prognosis and therapy.
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Affiliation(s)
- Giuseppe Fanciulli
- Department of Medical, Surgical and Experimental Sciences, University of Sassari - Endocrine Unit, AOU Sassari, Sassari, Italy
| | - Rosaria M Ruggeri
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Messina, Italy
| | | | - Fabio Lo Calzo
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy
| | - Troy D Wood
- Department of Chemistry, University at Buffalo, Buffalo, NY, USA
| | | | - Andrea Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy
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17
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Zhang Y, Li L, Gao Y, Wang X, Sun L, Ji W, Ozaki Y. Nitrosonaphthol reaction-assisted SERS assay for selective determination of 5-hydroxyindole-3-acetic acid in human urine. Anal Chim Acta 2020; 1134:34-40. [DOI: 10.1016/j.aca.2020.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 12/29/2022]
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18
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Corcuff JB, Ducint D, Brossaud J. What do you need to know about mass spectrometry? A brief guide for endocrinologists. ANNALES D'ENDOCRINOLOGIE 2020; 81:118-123. [PMID: 32340850 DOI: 10.1016/j.ando.2020.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/06/2020] [Indexed: 10/24/2022]
Abstract
In routine hormonology, liquid chromatography mass spectrometry (LCMS) is now an established technique for androgen, urinary cortisol and metanephrine assay. It has the undeniable advantage of great analytical specificity, but with sensitivity that clearly depends on financial investment in a very high-end spectrometer. We describe the general principles of LCMS and the routine applications so far developed in hormonology. The purpose is to familiarise endocrinologists with the techniques under development and their pros and cons.
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Affiliation(s)
- Jean-Benoît Corcuff
- Laboratoire d'hormonologie, hôpital Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France; Nutrition et neurobiologie intégrée, UMR 1286, université de Bordeaux, 33076 Bordeaux, France; Groupe de biologie spécialisée, societé française de medecine nucléaire, 5, rue Ponscarme 75013, Paris, France.
| | - Dominique Ducint
- Plateau technique de mesures physiques, hôpital Pellegrin, CHU de Bordeaux, 33600 Bordeaux, France.
| | - Julie Brossaud
- Laboratoire d'hormonologie, hôpital Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France; Nutrition et neurobiologie intégrée, UMR 1286, université de Bordeaux, 33076 Bordeaux, France; Groupe de biologie spécialisée, societé française de medecine nucléaire, 5, rue Ponscarme 75013, Paris, France.
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19
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Longitudinal relationship of amino acids and indole metabolites with long-term body mass index and cardiometabolic risk markers in young individuals. Sci Rep 2020; 10:6399. [PMID: 32286421 PMCID: PMC7156759 DOI: 10.1038/s41598-020-63313-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/24/2020] [Indexed: 02/06/2023] Open
Abstract
Amino acid metabolites in biofluids are associated with high body mass index (BMI) and cardiometabolic abnormalities. However, prospective investigations regarding these associations are few, particularly among young individuals. Moreover, little is presently known about the impact of long-term high BMI. Using data from the DOrtmund Nutritional and Anthropometric Longitudinally Designed study (111 males and 107 females), we prospectively investigated relations between repeatedly measured urinary levels of 33 metabolites and (1) previously identified long-term BMI trajectory groups from childhood into late adolescence and (2) cardiometabolic risk markers in late adolescence–young adulthood, in sex-specific linear mixed regression models. Males with long-term overweight had lower indole-3-acetic acid when compared to others. Further, methionine, isoleucine, tryptophan, xanthurenic acid, and indole-3-carboxaldehyde were negatively associated with C-reactive protein (CRP), but 5-hydroxyindole-3-acetic acid was positively associated with CRP. No associations were observed in females. Long-term overweight from childhood into late adolescence is associated with decreased urinary levels of gut bacteria-derived indole-3-acetic acid, and several urinary amino acids, including gut bacteria-derived indole-3-carboxaldehyde are associated with elevated CRP later on in life. Taken together, our data suggest that indole metabolites, and their gut bacteria producers play potentially important roles in overweight-related inflammation.
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20
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Gade AK, Olariu E, Douthit NT. Carcinoid Syndrome: A Review. Cureus 2020; 12:e7186. [PMID: 32257725 PMCID: PMC7124884 DOI: 10.7759/cureus.7186] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 03/05/2020] [Indexed: 02/06/2023] Open
Abstract
Carcinoid syndrome (CS) is a paraneoplastic syndrome caused by the release of serotonin and other substances from well-differentiated neuroendocrine tumors (NETs). The hallmark symptoms of carcinoid syndrome are flushing and diarrhea; atypical signs and symptoms can include wheezing, abdominal pain, valvular heart disease, telangiectasias, pellagra, and the complications of mesenteric fibrosis, including ureteral obstruction, bowel obstruction, and bowel ischemia. These symptoms are mediated by the release of serotonin (5-HT), histamine, kallikrein, prostaglandins, and tachykinins. The diagnosis of CS requires these symptoms and corresponding elevations in lab tests. Treatment options include surgery and medical management with somatostatin analogs.
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Affiliation(s)
- Ajay K Gade
- Internal Medicine, Brookwood Baptist Medical Center, Birmingham, USA
| | - Eva Olariu
- Internal Medicine, Brookwood Baptist Health, Birmingham, USA
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21
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Mourguet M, Lajaunie R, Schouler M, Godart M, Bonnet D, Riffaud L, Lamant L, Alric L, Rossi B. Je t’ai dans la peau, mais tu nous empoissonnes la vie. Rev Med Interne 2020; 41:210-213. [DOI: 10.1016/j.revmed.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/07/2019] [Indexed: 10/25/2022]
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22
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Pinto LC, Kramer CK, Camargo JL, Canani LH, Gross JL, Leitão CB. No effect of acidification or freezing on urinary metanephrine levels. J Endocrinol Invest 2020; 43:53-56. [PMID: 31228104 DOI: 10.1007/s40618-019-01076-9] [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: 02/20/2019] [Accepted: 06/14/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Urinary metanephrine is a reliable method to estimate catecholamine secretion. Traditionally, urinary metanephrines are collected into chilled containers containing hydrochloric acid (HCl) and most laboratories freeze urinary samples before analysis. It is uncertain if these pre-analytic procedures alter metanephrine values. AIM To evaluate if acidifying and freezing urine samples affect the accuracy of urinary metanephrine measurements. METHODS Random urine samples from healthy individuals were collected. Urine samples were distributed into two containers: with HCl 50% homogenized with urine to obtain pH < 2, and without HCl. Each container was divided again into aliquots for immediate measurement or freezing. One aliquot with acid (group 1) and another without acid (group 2) were sent immediately to the laboratory for testing (HPLC), while the other two aliquots, one with acid (group 3) and another without it (group 4) were frozen for 3 months at - 20 °C. Bland-Altman's test was used to analyze inter-assay agreement between measurements. RESULTS A total of 15 individuals were included (mean age 27.5 ± 5.9 years, 8 male and 14 white). No difference was observed on mean urinary metanephrine/creatinine ratio between groups: group 1: 0.23 ± 0.11, group 2: 0.22 ± 0.07, group 3: 0.25 ± 0.13, group 4: 0.25 ± 0.15 mg/g creatinine; P > 0.05 for all the comparisons). Bland-Altman's analysis showed agreement between the standard method (group 1) and the experimental method (group 4). CONCLUSION Measurement of urinary metanephrines by HPLC method is not influenced by sample acidification nor freezing at - 20 °C for 3 months.
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Affiliation(s)
- L C Pinto
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Prédio 12, 4° Andar, Porto Alegre, RS, 90035-003, Brazil.
| | - C K Kramer
- Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, Canada
| | - J L Camargo
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Prédio 12, 4° Andar, Porto Alegre, RS, 90035-003, Brazil
| | - L H Canani
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Prédio 12, 4° Andar, Porto Alegre, RS, 90035-003, Brazil
| | - J L Gross
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Prédio 12, 4° Andar, Porto Alegre, RS, 90035-003, Brazil
| | - C B Leitão
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Prédio 12, 4° Andar, Porto Alegre, RS, 90035-003, Brazil
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23
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Vázquez-Manjarrez N, Weinert CH, Ulaszewska MM, Mack CI, Micheau P, Pétéra M, Durand S, Pujos-Guillot E, Egert B, Mattivi F, Bub A, Dragsted LO, Kulling SE, Manach C. Discovery and Validation of Banana Intake Biomarkers Using Untargeted Metabolomics in Human Intervention and Cross-sectional Studies. J Nutr 2019; 149:1701-1713. [PMID: 31240312 DOI: 10.1093/jn/nxz125] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/17/2019] [Accepted: 05/14/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Banana is one of the most widely consumed fruits in the world. However, information regarding its health effects is scarce. Biomarkers of banana intake would allow a more accurate assessment of its consumption in nutrition studies. OBJECTIVES Using an untargeted metabolomics approach, we aimed to identify the banana-derived metabolites present in urine after consumption, including new candidate biomarkers of banana intake. METHODS A randomized controlled study with a crossover design was performed on 12 healthy subjects (6 men, 6 women, mean ± SD age: 30.0 ± 4.9 y; mean ± SD BMI: 22.5 ± 2.3 kg/m2). Subjects underwent 2 dietary interventions: 1) 250 mL control drink (Fresubin 2 kcal fiber, neutral flavor; Fresenius Kabi), and 2) 240 g banana + 150 mL control drink. Twenty-four-hour urine samples were collected and analyzed with ultra-performance liquid chromatography coupled to a quadrupole time-of-flight MS and 2-dimensional GC-MS. The discovered biomarkers were confirmed in a cross-sectional study [KarMeN (Karlsruhe Metabolomics and Nutrition study)] in which 78 subjects (mean BMI: 22.8; mean age: 47 y) were selected reflecting high intake (126-378 g/d), low intake (47.3-94.5 g/d), and nonconsumption of banana. The confirmed biomarkers were examined singly or in combinations, for established criteria of validation for biomarkers of food intake. RESULTS We identified 33 potentially bioactive banana metabolites, of which 5 metabolites, methoxyeugenol glucuronide (MEUG-GLUC), dopamine sulfate (DOP-S), salsolinol sulfate, xanthurenic acid, and 6-hydroxy-1-methyl-1,2,3,4-tetrahydro-β-carboline sulfate, were confirmed as candidate intake biomarkers. We demonstrated that the combination of MEUG-GLUC and DOP-S performed best in predicting banana intake in high (AUCtest = 0.92) and low (AUCtest = 0.87) consumers. The new biomarkers met key criteria establishing their current applicability in nutrition and health research for assessing the occurrence of banana intake. CONCLUSIONS Our metabolomics study in healthy men and women revealed new putative bioactive metabolites of banana and a combined biomarker of intake. These findings will help to better decipher the health effects of banana in future focused studies. This study was registered at clinicaltrials.gov as NCT03581955 and with the Ethical Committee for the Protection of Human Subjects Sud-Est 6 as CPP AU 1251, IDRCB 2016-A0013-48; the KarMeN study was registered with the German Clinical Trials Register (DRKS00004890). Details about the study can be obtained from https://www.drks.de.
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Affiliation(s)
- Natalia Vázquez-Manjarrez
- Human Nutrition Unit, INRA, Université Clermont Auvergne, Clermont-Ferrand, France.,Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Christoph H Weinert
- Department of Safety and Quality of Fruit and Vegetables, Max Rubner-Institut, Karlsruhe, Germany
| | - Maria M Ulaszewska
- Department of Food Quality and Nutrition, Fondazione Edmund Mach, Research and Innovation Centre, San Michele all'Adige, Italy
| | - Carina I Mack
- Department of Safety and Quality of Fruit and Vegetables, Max Rubner-Institut, Karlsruhe, Germany
| | - Pierre Micheau
- Human Nutrition Unit, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Mélanie Pétéra
- Human Nutrition Unit, Plateforme d'Exploration du Métabolisme MetaboHUB, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Stephanie Durand
- Human Nutrition Unit, Plateforme d'Exploration du Métabolisme MetaboHUB, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Estelle Pujos-Guillot
- Human Nutrition Unit, Plateforme d'Exploration du Métabolisme MetaboHUB, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Björn Egert
- Department of Safety and Quality of Fruit and Vegetables, Max Rubner-Institut, Karlsruhe, Germany
| | - Fulvio Mattivi
- Department of Food Quality and Nutrition, Fondazione Edmund Mach, Research and Innovation Centre, San Michele all'Adige, Italy.,Centre of Agriculture Food Environment, University of Trento, San Michele all'Adige, Italy
| | - Achim Bub
- Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Karlsruhe, Germany
| | - Lars Ove Dragsted
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Sabine E Kulling
- Department of Safety and Quality of Fruit and Vegetables, Max Rubner-Institut, Karlsruhe, Germany
| | - Claudine Manach
- Human Nutrition Unit, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
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Ewang-Emukowhate M, Nair D, Caplin M. The role of 5-hydroxyindoleacetic acid in neuroendocrine tumors: the journey so far. INTERNATIONAL JOURNAL OF ENDOCRINE ONCOLOGY 2019. [DOI: 10.2217/ije-2019-0001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
5-Hydroxyindole acetic acid (5-HIAA) is a surrogate marker for serotonin measurement and one of the first biochemical markers used in neuroendocrine tumors. In this review, we give a brief history of 5-HIAA and its precursor serotonin. We discuss its clinical utility and diagnostic performance in small intestinal neuroendocrine tumor and describe the challenges encountered during its analysis, historically performed in urine. The introduction of blood-based assays will help overcome some of the issues associated with its measurement in urine. The diagnostic performance of serum and plasma 5-HIAA has been shown to be comparable to that of urine 5-HIAA. Thus, analysis in either serum or plasma will provide a practical and convenient alternative to urine.
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Affiliation(s)
- Mfon Ewang-Emukowhate
- Neuroendocrine Tumour Unit, Royal Free NHS Foundation Trust, London, NW3 2QG, UK
- Department of Clinical Biochemistry, Royal Free NHS Foundation Trust, London, UK, NW3 2QG, UK
| | - Devaki Nair
- Department of Clinical Biochemistry, Royal Free NHS Foundation Trust, London, UK, NW3 2QG, UK
| | - Martyn Caplin
- Neuroendocrine Tumour Unit, Royal Free NHS Foundation Trust, London, NW3 2QG, UK
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Lopez AG, Fraissinet F, Lefebvre H, Brunel V, Ziegler F. Pharmacological and analytical interference in hormone assays for diagnosis of adrenal incidentaloma. ANNALES D'ENDOCRINOLOGIE 2019; 80:250-258. [DOI: 10.1016/j.ando.2018.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 09/27/2018] [Accepted: 11/19/2018] [Indexed: 12/19/2022]
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Calanchini M, Tadman M, Krogh J, Fabbri A, Grossman A, Shine B. Measurement of urinary 5-HIAA: correlation between spot versus 24-h urine collection. Endocr Connect 2019; 8:1082-1088. [PMID: 31265996 PMCID: PMC6652243 DOI: 10.1530/ec-19-0269] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/01/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND The 24-h urinary output of 5-hydroxyindoleacetic acid (5-HIAA) is used to monitor disease progression and treatment responses of neuroendocrine neoplasms (NENs). Several conditions are required for 5-HIAA assay, involving urine collection/preservation and food/drug restrictions. AIM To evaluate the correlation between 5-HIAA concentration in a spot urine sample and the output in a 24-h urine collection, and whether spot urine specimens can replace 24-h collection. METHODS Patients with NENs or symptoms suggestive of NENs were asked to provide a separate spot urine at the end of the 24-h urine collection for 5-HIAA assessment. The upper reference limit for 24-h urinary 5-HIAA was 40 µmol/24 h. 5-HIAA measurements in spot urine samples were corrected for variation in urine flow rate by expressing results as a ratio to creatinine concentration. RESULTS We included 136 paired urinary samples for 5-HIAA assessment from 111 patients (100 NENs). The correlation between 5-HIAA values measured in 24-h and spot urines was r = +0.863 (P < 0.001) and r = +0.840 (P < 0.001) including only NEN patients. Using the 24-h urinary 5-HIAA as reference method, the AUC on ROC analysis for spot urinary 5-HIAA was 0.948 (95% CI, 0.914-0.983; P < 0.001), attaining a sensitivity of 83% and specificity of 95% using 5.3 mol/mmol as cut-off for the spot urine. The AUC among NEN patients alone was 0.945 (95% CI, 0.904-0.987; P < 0.001). CONCLUSIONS The ratio of 5-HIAA to creatinine in a spot urine could replace the measurement of 5-HIAA output in a 24-h urine collection, especially for follow-up of patients with known elevated 5-HIAA levels.
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Affiliation(s)
- Matilde Calanchini
- Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
- Endocrinology & Metabolism Unit, CTO A. Alesini Hospital ASL Roma 2, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Correspondence should be addressed to M Calanchini:
| | - Michael Tadman
- Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
| | - Jesper Krogh
- Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
| | - Andrea Fabbri
- Endocrinology & Metabolism Unit, CTO A. Alesini Hospital ASL Roma 2, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Ashley Grossman
- Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
| | - Brian Shine
- Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
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Thai PK, O'Brien JW, Banks APW, Jiang G, Gao J, Choi PM, Yuan Z, Mueller JF. Evaluating the in-sewer stability of three potential population biomarkers for application in wastewater-based epidemiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 671:248-253. [PMID: 30928753 DOI: 10.1016/j.scitotenv.2019.03.231] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/21/2019] [Accepted: 03/15/2019] [Indexed: 05/21/2023]
Abstract
Endogenous chemicals specific to human metabolism have been suggested to be good candidates for markers of population size in wastewater-based epidemiology (WBE). So far, creatinine is the only endogenous chemical to be assessed against the criteria of in-sewer stability. This study thus aimed to evaluate the fate of three other endogenous compounds, 5-hydroxy indole acetic acid (5-HIAA), cortisol and androstenedione, under different sewer conditions using laboratory-scale sewer reactors. The results showed that while all compounds were stable in wastewater only (i.e. without biofilm), cortisol and androstenedione degraded quickly in sewers with the presence of sewer biofilms. The degradation followed first-order kinetics similar to that of creatinine. In contrast, 5-HIAA was relatively stable in sewer reactors. This study also recognised the impact of wastewater pH on the detectability of 5-HIAA using a LC-MS/MS direct injection method. In samples acidified to pH 2, the method did not allow routine detection/quantification of 5-HIAA whereas in non-acidified samples the method was sufficiently sensitive for routine quantification of 5-HIAA. The stability of 5-HIAA in sewers and the possibility to measure it using a simple and rapid analytical method corroborate that 5-HIAA may be a suitable biomarker for estimation of population size in WBE.
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Affiliation(s)
- Phong K Thai
- The University of Queensland, Queensland Alliance for Environmental Health Sciences (QAEHS), 20 Cornwall Street, Woolloongabba, QLD 4102, Australia.
| | - Jake W O'Brien
- The University of Queensland, Queensland Alliance for Environmental Health Sciences (QAEHS), 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Andrew P W Banks
- The University of Queensland, Queensland Alliance for Environmental Health Sciences (QAEHS), 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Guangming Jiang
- The University of Queensland, Advanced Water Management Centre, St Lucia, QLD 4072, Australia
| | - Jack Gao
- The University of Queensland, Queensland Alliance for Environmental Health Sciences (QAEHS), 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Phil M Choi
- The University of Queensland, Queensland Alliance for Environmental Health Sciences (QAEHS), 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Zhiguo Yuan
- The University of Queensland, Advanced Water Management Centre, St Lucia, QLD 4072, Australia
| | - Jochen F Mueller
- The University of Queensland, Queensland Alliance for Environmental Health Sciences (QAEHS), 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
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Al Alwi SAS, Al-Assari F, Al-Kindi M, Mula-Abed WA, Hassan N. Effect of dietary status on plasma-fractionated metanephrines in healthy individuals measured by Elisa. J Immunoassay Immunochem 2019; 40:448-457. [PMID: 31211630 DOI: 10.1080/15321819.2019.1629591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Pheochromocytoma is a rare tumor that typically originates in the adrenal glands, often causing the over-production of catecholamines. The aim of this study was to determine whether dietary status could affect the concentration of plasma-fractionated metanephrines. This study was conducted at the Chemical Pathology Laboratory, Royal Hospital, Oman. Three plasma samples were collected from each participant (16 male and 16 female) over three consecutive days (day one: dietary restriction,day two: excess intake of restricted foods, day three: random sample following the typical diet for each participant). Samples were collected and centrifuged to obtain the plasma, which was then stored at -20°C prior to analysis. Metanephrine and normetanephrine concentrations were measured by comparative ELISA. Plasma metanephrine and normetanephrine measured under the three different dietary conditions for each individual were not significantly different and within normal range. Pearson correlation coefficient analysis of plasma concentration of metanephrines within individual patients under the three dietary conditions revealed positive correlation. We found no significant effect of dietary status on plasma metanephrine or normetanephrine concentration. Therefore, samples taken under any dietary condition may be used to determine plasma MN and NMN concentration. However, dietary restrictions in the diagnosis of Pheochromocytoma need further investigations.
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Affiliation(s)
| | - Fatma Al-Assari
- a Chemical Pathology Laboratory , Royal Hospital , Muscat , Oman
| | - Manal Al-Kindi
- a Chemical Pathology Laboratory , Royal Hospital , Muscat , Oman
| | | | - Nurudeen Hassan
- b Faculty of Health Sport and Science , University of South Wales , Pontypridd , UK
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Grouzmann E, Centeno C, Eugster PJ. Quantification of vanillylmandelic acid, homovanillic acid and 5-hydroxyindoleacetic acid in urine using a dilute-and-shoot and ultra-high pressure liquid chromatography tandem mass spectrometry method. Clin Chem Lab Med 2019; 56:1533-1541. [PMID: 29708876 DOI: 10.1515/cclm-2017-1120] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/27/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) are biomarkers for the diagnosis and follow-up of neuroblastoma, whereas urinary 5-hydroxyindoleacetic acid (5-HIAA) is used to assess a carcinoid tumor. These analytes are conventionally analyzed in a single run by chromatography (LC) coupled with electrochemical detection (LC-ECD) using commercial kits. A rapid dilute-and-shoot LC tandem mass spectrometry (LC-MS/MS) assay was validated in order to replace the LC-ECD method and therefore improve analytical specificity and throughput. METHODS Sample preparation was carried out by dilution of the urine sample with a solution containing the deuterated internal standards. The separation was achieved on an ultra-high pressure LC system with MS detection using a triple quadrupole mass spectrometer. The method was validated according to the current EMA and FDA guidelines. RESULTS The full chromatographic run was achieved in 8 min. The method validation showed excellent linearity (r2>0.999 for all three analytes), precision (CV <15%), negligible matrix effect (recoveries >90%), low carryover (<1%) and LLOQ of 0.25, 0.4 and 0.4 μM for VMA, HVA and 5-HIAA, respectively. Deming fits and Bland-Altman analyses showed no significant differences between the values obtained between the two assays. CONCLUSIONS The LC-MS/MS method proposed in this study is fast and robust, and the simple sample preparation saves time and avoids the additional costs of dedicated kits used for the LC-ECD assays by switching to LC-MS/MS. Additionally, the near-perfect correlation observed herein between both assays allows the previously established reference ranges to be maintained.
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Affiliation(s)
- Eric Grouzmann
- Laboratoire des Catecholamines et Peptides, Service de Pharmacologie Clinique, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Catherine Centeno
- Laboratoire des Catecholamines et Peptides, Service de Pharmacologie Clinique, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Philippe J Eugster
- Laboratoire des Catecholamines et Peptides, Service de Pharmacologie Clinique, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Plenis A, Olędzka I, Kowalski P, Miękus N, Bączek T. Recent Trends in the Quantification of Biogenic Amines in Biofluids as Biomarkers of Various Disorders: A Review. J Clin Med 2019; 8:E640. [PMID: 31075927 PMCID: PMC6572256 DOI: 10.3390/jcm8050640] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 04/30/2019] [Accepted: 05/06/2019] [Indexed: 01/10/2023] Open
Abstract
Biogenic amines (BAs) are bioactive endogenous compounds which play a significant physiological role in many cell processes like cell proliferation and differentiation, signal transduction and membrane stability. Likewise, they are important in the regulation of body temperature, the increase/decrease of blood pressure or intake of nutrition, as well as in the synthesis of nucleic acids and proteins, hormones and alkaloids. Additionally, it was confirmed that these compounds can be considered as useful biomarkers for the diagnosis, therapy and prognosis of several neuroendocrine and cardiovascular disorders, including neuroendocrine tumours (NET), schizophrenia and Parkinson's Disease. Due to the fact that BAs are chemically unstable, light-sensitive and possess a high tendency for spontaneous oxidation and decomposition at high pH values, their determination is a real challenge. Moreover, their concentrations in biological matrices are extremely low. These issues make the measurement of BA levels in biological matrices problematic and the application of reliable bioanalytical methods for the extraction and determination of these molecules is needed. This article presents an overview of the most recent trends in the quantification of BAs in human samples with a special focus on liquid chromatography (LC), gas chromatography (GC) and capillary electrophoresis (CE) techniques. Thus, new approaches and technical possibilities applied in these methodologies for the assessment of BA profiles in human samples and the priorities for future research are reported and critically discussed. Moreover, the most important applications of LC, GC and CE in pharmacology, psychology, oncology and clinical endocrinology in the area of the analysis of BAs for the diagnosis, follow-up and monitoring of the therapy of various health disorders are presented and critically evaluated.
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Affiliation(s)
- Alina Plenis
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, Hallera 107, 80-416 Gdańsk, Poland.
| | - Ilona Olędzka
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, Hallera 107, 80-416 Gdańsk, Poland.
| | - Piotr Kowalski
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, Hallera 107, 80-416 Gdańsk, Poland.
| | - Natalia Miękus
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, Hallera 107, 80-416 Gdańsk, Poland.
- Department of Animal and Human Physiology, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland.
| | - Tomasz Bączek
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, Hallera 107, 80-416 Gdańsk, Poland.
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Godoy-Reyes TM, Costero AM, Gaviña P, Martínez-Máñez R, Sancenón F. Colorimetric detection of normetanephrine, a pheochromocytoma biomarker, using bifunctionalised gold nanoparticles. Anal Chim Acta 2019; 1056:146-152. [DOI: 10.1016/j.aca.2019.01.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 12/17/2018] [Accepted: 01/03/2019] [Indexed: 01/30/2023]
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Xie Z, Lorkiewicz P, Riggs DW, Bhatnagar A, Srivastava S. Comprehensive, robust, and sensitive UPLC-MS/MS analysis of free biogenic monoamines and their metabolites in urine. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1099:83-91. [PMID: 30248561 PMCID: PMC6398444 DOI: 10.1016/j.jchromb.2018.09.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 09/05/2018] [Accepted: 09/11/2018] [Indexed: 01/03/2023]
Abstract
Biogenic monoamines, including catecholamines and serotonin are important hormones and neurotransmitters. Abnormal urinary levels of biogenic monoamines and their metabolites are associated with smoking, neuroendocrine tumors, as well as neurological and cardiovascular diseases. Measurements of free biogenic monoamines and their metabolites have been challenging because of low concentrations in complex biological matrices. Current methods require extensive enrichment and removal of interfering substances and can analyze only basic or acidic compounds in a single run. We developed a simple and robust dilute-and-shoot method capable of measuring 10 analytes, including free biogenic monoamines and their metabolites in human urine. The assay enables sensitive measurements of analytes within expected sample concentration ranges. To assess the assay's efficacy, we measured urinary levels of free biogenic monoamines and their metabolites in 255 non-smokers and 191 smokers. Our data show that while smokers had significantly higher urinary levels of free catecholamines and metanephrines, there was a decrease in levels of biogenic amine metabolites synthesized through the monoamine oxidase pathway - homovanillic acid and vanillylmandelic acid. The method could be used for high throughput measurement of the range of free biogenic amines and their metabolites in urine under a variety of different conditions.
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Affiliation(s)
- Zhengzhi Xie
- American Heart Association - Tobacco Regulation and Addiction Center, Superfund Research Center and Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, 580 South Preston Street, Louisville, KY, 40202, United States of America
| | - Pawel Lorkiewicz
- American Heart Association - Tobacco Regulation and Addiction Center, Superfund Research Center and Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, 580 South Preston Street, Louisville, KY, 40202, United States of America; Department of Chemistry, University of Louisville, 2320 S. Brook St., Louisville, KY, 40292, United States of America
| | - Daniel W Riggs
- American Heart Association - Tobacco Regulation and Addiction Center, Superfund Research Center and Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, 580 South Preston Street, Louisville, KY, 40202, United States of America
| | - Aruni Bhatnagar
- American Heart Association - Tobacco Regulation and Addiction Center, Superfund Research Center and Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, 580 South Preston Street, Louisville, KY, 40202, United States of America
| | - Sanjay Srivastava
- American Heart Association - Tobacco Regulation and Addiction Center, Superfund Research Center and Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, 580 South Preston Street, Louisville, KY, 40202, United States of America.
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