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Xing S, Jiao Y, Salehzadeh M, Soma KK, Huan T. SteroidXtract: Deep Learning-Based Pattern Recognition Enables Comprehensive and Rapid Extraction of Steroid-Like Metabolic Features for Automated Biology-Driven Metabolomics. Anal Chem 2021; 93:5735-5743. [PMID: 33784068 DOI: 10.1021/acs.analchem.0c04834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Despite the vast amount of metabolic information that can be captured in untargeted metabolomics, many biological applications are looking for a biology-driven metabolomics platform that targets a set of metabolites that are relevant to the given biological question. Steroids are a class of important molecules that play critical roles in many physiological systems and diseases. Besides known steroids, there are a large number of unknown steroids that have not been reported in the literature. The ability to rapidly detect and quantify both known and unknown steroid molecules in a biological sample can greatly accelerate a broad range of steroid-focused life science research. This work describes the development and application of SteroidXtract, a convolutional neural network (CNN)-based bioinformatics tool that can recognize steroid molecules in mass spectrometry (MS)-based untargeted metabolomics using their unique tandem MS (MS2) spectral patterns. SteroidXtract was trained using a comprehensive set of standard MS2 spectra from MassBank of North America (MoNA) and an in-house steroid library. Data augmentation strategies, including intensity thresholding and Gaussian noise addition, were created and applied to minimize data overfitting caused by the limited number of standard steroid MS2 spectra. The CNN model embedded in SteroidXtract was further compared with random forest and XGBoost using nested cross-validations to demonstrate its performance. Finally, SteroidXtract was applied in several metabolomics studies to demonstrate its sensitivity, specificity, and robustness. Compared to conventional statistics-driven metabolomics data interpretation, our work offers a novel automated biology-driven approach to interpreting untargeted metabolomics data, prioritizing biologically important molecules with high throughput and sensitivity.
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Affiliation(s)
- Shipei Xing
- Department of Chemistry, Faculty of Science, University of British Columbia, Vancouver Campus, 2036 Main Mall, Vancouver, BC V6T 1Z1, Canada
| | - Yibo Jiao
- Department of Chemistry, Faculty of Science, University of British Columbia, Vancouver Campus, 2036 Main Mall, Vancouver, BC V6T 1Z1, Canada
| | - Melody Salehzadeh
- Department of Zoology, Faculty of Science, University of British Columbia, Vancouver Campus, 6270 University Boulevard, Vancouver, BC V6T 1Z4, Canada
| | - Kiran K Soma
- Department of Zoology, Faculty of Science, University of British Columbia, Vancouver Campus, 6270 University Boulevard, Vancouver, BC V6T 1Z4, Canada.,Department of Psychology, Faculty of Arts, University of British Columbia, Vancouver Campus, 2136 West Mall, Vancouver, BC V6T 1Z4, Canada
| | - Tao Huan
- Department of Chemistry, Faculty of Science, University of British Columbia, Vancouver Campus, 2036 Main Mall, Vancouver, BC V6T 1Z1, Canada
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Analysis of steroids in urine by gas chromatography-capillary photoionization-tandem mass spectrometry. J Chromatogr A 2019; 1598:175-182. [PMID: 31003716 DOI: 10.1016/j.chroma.2019.03.061] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/18/2019] [Accepted: 03/28/2019] [Indexed: 01/19/2023]
Abstract
A new heated capillary photoionization (CPI) ion source design was developed to photoionize analytes inside a transfer capillary between a gas chromatograph (GC) and a mass spectrometer (MS). The CPI setup included a wide, oval-shaped vacuum-ultraviolet (VUV) transparent magnesium fluoride (MgF2) window to maximize photoionization efficiency and thus sensitivity. The source contained a nitrogen housing around the ionization chamber inlet to avoid undesirable hydrolysis and oxidation reactions with ambient air and to maximize the proportion of formed molecular radical cations of analytes. The feasibility of the ion source was studied by analyzing 18 endogenous steroids in urine as their trimethylsilyl (TMS) derivatives with gas chromatography-tandem mass spectrometry (GC-MS/MS). The method was validated and applied to human urine samples. To our best knowledge, this is the first time that a capillary photoionization ion source has been applied for quantitative analysis of biological samples. The GC-CPI-MS/MS method showed good chromatographic resolution (peak half-widths between 3.1 to 5.3 s), acceptable linearity (coefficient of determination between 0.981 to 0.996), and repeatability (relative standard deviation (RSD%) between 5 to 18%). Limits of detection (LOD) were between 2 to 100 pg mL-1 and limits of quantitation (LOQ) were between 0.05 to 2 ng mL-1. In total, 15 steroids were quantified either as a free steroid or glucuronide conjugate from the urine of volunteers. The new CPI source design showed excellent sensitivity for analysis of steroids in complex biological samples.
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Desai R, Harwood DT, Handelsman DJ. Simultaneous measurement of 18 steroids in human and mouse serum by liquid chromatography-mass spectrometry without derivatization to profile the classical and alternate pathways of androgen synthesis and metabolism. CLINICAL MASS SPECTROMETRY (DEL MAR, CALIF.) 2019; 11:42-51. [PMID: 34841072 PMCID: PMC8620903 DOI: 10.1016/j.clinms.2018.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/26/2018] [Accepted: 12/30/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The recently identified alternate, or backdoor, pathway of DHT synthesis provides important novel information on androgen biosynthesis beyond the classical pathway. We report a rapid and versatile liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to simultaneously and accurately quantify key steroids in human or mouse serum involved in either the classical or backdoor androgen synthesis pathways. METHODS Serum (200 µL) fortified with isotopically labelled internal standards underwent liquid-liquid extraction (LLE) with MTBE and extracts were analysed on a LC-MS/MS. The targeted steroids for quantification were testosterone (T), dihydrotestosterone (DHT), 5α-androstane-3α,17β-diol (3α diol), 5α-androstane-3β,17β-diol (3β diol), dehydroepiandrosterone (DHEA), androstenedione (A4), androsterone (AD), estradiol (E2), estrone (E1), progesterone (P4), pregnenolone (P5), androstenediol (Adiol), 17-hydroxyprogesterone (17-OHP4) and 17-hydroxypregnenolone (17-OHP5), corticosterone (B), cortisol (F), allopregnanolone (Allo-P5) and dihydroprogesterone (DHP). RESULTS The limits of quantification (LOQ) were 5 pg/mL for E2 and E1, 25 pg/mL for T, 50 pg/mL for A4 and 0.10 ng/mL for DHT, 17OHP5, P4, P5, AD, Adiol, DHEA, AlloP5 and 0.20 ng/mL for 17OHP4, 3α diol, 3β diol, DHP, 0.25 ng/mL for B and 1 ng/mL for F. Accuracy, precision, reproducibility and recovery were within acceptable limits for bioanalytical method validation. The method is illustrated in human and mouse, male and female serum. CONCLUSIONS The presented method is sufficiently sensitive, specific and reproducible to meet the quality criteria for routine laboratory application for accurate quantitation of 18 steroid concentrations in male and female serum from humans or mice for the purpose of profiling androgen synthesis and metabolism pathways.
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Key Words
- 17OHP4, 17-hydroxyprogesterone
- 17OHP5, 17hydroxypregnenolone
- 3α diol, 5α-androstane-3α17β-diol
- 3β diol, 5α-androstane-3β17β-diol
- A4, androstenedione
- AD, androsterone
- APPI, atmospheric pressure photoionization
- Adiol, androstenediol
- AlloP5, allopregnanolone
- Androgen
- B, corticosterone
- CSP, Charcoal Stripped Plasma
- DHEA, dehydroepiandrosterone
- DHP, dihydroprogesterone
- DHT, dihydrotestosterone
- Dihydrotestosterone
- E1, estrone
- E2, estradiol
- F, cortisol
- IS, internal standard
- LOD, lower limit of detection
- LOQ, lower limit of quantification
- Liquid chromatography–mass spectrometry
- ME, matrix effect
- MTBE, methyl tert-butyl ether
- NMI, National Measurement Institute
- P4, progesterone
- P5, pregnenolone
- S/N, signal-to-noise ratio
- Steroidogenesis
- T, testosterone
- Testosterone
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Affiliation(s)
- Reena Desai
- ANZAC Research Institute, University of Sydney, Sydney, NSW 2139, Australia
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Taylor DR, Couchman L, Taylor NF. In Reply. Clin Chem 2018; 64:976-977. [DOI: 10.1373/clinchem.2018.289769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Lewis Couchman
- Departments of Clinical Biochemistry (Viapath) and
- Toxicology (Viapath) King's College Hospital NHS Foundation Trust London, United Kingdom SE5 9RS
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Sun Q, Gu J, Stolze BR, Soldin SJ. Atmospheric Pressure Chemical Ionization Is a Suboptimal Ionization Source for Steroids. Clin Chem 2018; 64:974-976. [PMID: 29653936 DOI: 10.1373/clinchem.2018.287029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Qian Sun
- Department of Laboratory Medicine Clinical Center National Institutes of Health Bethesda, MD
| | - Jianghong Gu
- Department of Laboratory Medicine Clinical Center National Institutes of Health Bethesda, MD
| | - Brian R Stolze
- Department of Laboratory Medicine Clinical Center National Institutes of Health Bethesda, MD
| | - Steven J Soldin
- Department of Laboratory Medicine Clinical Center National Institutes of Health Bethesda, MD .,Department of Medicine Division of Endocrinology and Metabolism Georgetown University Washington, DC
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Combination of in situ metathesis reaction with a novel “magnetic effervescent tablet-assisted ionic liquid dispersive microextraction” for the determination of endogenous steroids in human fluids. Anal Bioanal Chem 2018. [DOI: 10.1007/s00216-018-0973-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Pundir S, Wall CR, Mitchell CJ, Thorstensen EB, Lai CT, Geddes DT, Cameron-Smith D. Variation of Human Milk Glucocorticoids over 24 hour Period. J Mammary Gland Biol Neoplasia 2017; 22:85-92. [PMID: 28144768 DOI: 10.1007/s10911-017-9375-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 01/20/2017] [Indexed: 01/09/2023] Open
Abstract
Human milk (HM) contains a complex array of hormones, including members of the glucocorticoid family. The predominant glucocorticoids, cortisol and cortisone may influence the growth and behaviour of the breastfed infant. However, little is understood of the factors regulating the levels of these hormones within HM. The aim of the study was to examine HM cortisol and cortisone concentration, measured in samples collected at each feed during a 24 hour period. Twenty three exclusively breastfeeding mothers collected milk, prior to and after each breastfeeding session over 24 hour period at 3.2(1.60) months. HM cortisol and cortisone levels were measured using high pressure liquid chromatography mass spectroscopy. Cortisone was the predominant glucocorticoid (3.40 ng/ml), and cortisol was detected in all samples (1.62 ng/ml). A positive correlation was found between cortisone and cortisol (r = 0.61, y = 1.93 ± 0.24, p < 0.0001). Cortisol and cortisone concentrations were significantly higher in feeds in the morning (2.97 ng/ml and 4.88 ng/ml), compared to afternoon (1.20 ng/ml and 3.54 ng/ml), evening (0.69 ng/ml and 2.13 ng/ml) and night (1.59 and 3.27 ng/ml). No difference was found between glucocorticoids level of the milk expressed for collection either before or immediately after the breastfeed, or between milk collected from the left or right breast. This study shows that HM glucocorticoid concentrations exhibit a 24 hour pattern, with highest peak levels in the early morning, reflecting the circadian pattern as previously reported in plasma. Thus, HM glucocorticoid concentrations are likely to reflect those in the maternal circulation.
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Affiliation(s)
- Shikha Pundir
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Clare R Wall
- Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Cameron J Mitchell
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Eric B Thorstensen
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Ching T Lai
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - David Cameron-Smith
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
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Stolze BR, Gounden V, Gu J, Elliott EA, Masika LS, Abel BS, Merke DP, Skarulis MC, Soldin SJ. An improved micro-method for the measurement of steroid profiles by APPI-LC-MS/MS and its use in assessing diurnal effects on steroid concentrations and optimizing the diagnosis and treatment of adrenal insufficiency and CAH. J Steroid Biochem Mol Biol 2016; 162:110-6. [PMID: 26721696 PMCID: PMC4917495 DOI: 10.1016/j.jsbmb.2015.12.024] [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: 06/29/2015] [Revised: 12/03/2015] [Accepted: 12/15/2015] [Indexed: 12/12/2022]
Abstract
Our goals were to (1) develop an improved micro-method usable for neonates for steroid profile measurements and a method to measure androsterone, a key steroid in the recently described androgen backdoor pathway together, with dehydroepiandrosterone and (2) to assess if dehydroepiandrosterone diurnal concentration fluctuations exist potentially necessitating strict adherence to time of blood sample draw and requirement of separate time-dependent reference intervals. Liquid chromatography-tandem mass spectrometry was performed with an atmospheric pressure photoionization source [1]. For each sample 50μL (100μL for the backdoor pathway) of serum was deproteinized by adding 75μL (150μL for the backdoor pathway) of acetonitrile containing the internal standards. After centrifugation, 75μL (150μL for the backdoor pathway) of supernatant was diluted with 250μL of water and injected onto a Poroshell 120 EC-C8 column (SB-C8 column for the backdoor pathway). Within-run coefficients of variation ranged from 2.4 to 10.4% and between-day coefficients of variation from 2.9 to 11.2%. Comparison studies yielded correlation coefficient between 0.97 and 1.00 with recoveries of 90% or greater. Our methods analyze a 9 steroid profile and an additional 2 steroid profile (backdoor pathway) with minimal sample volume (usable in neonates optimizing early diagnosis of endocrinopathies and genetic diseases). Low limits of quantitation make these methods ideal for steroid measurement in women and prepubertal children. As diurnal variations of dehydroepiandrosterone and other steroids [2] concentrations are clinically significant we recommend that separate reference intervals be developed for 8 am, 8 pm, and midnight sample draws. The use of this approach in improving the diagnosis of patients with adrenal insufficiency and congenital adrenal hyperplasia is discussed.
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Affiliation(s)
- Brian R Stolze
- Department of Laboratory Medicine, National Institutes of Health, 10 Center Drive, Building 10, Room 2C-306, Bethesda, MD 20814, USA
| | - Verena Gounden
- Department of Laboratory Medicine, National Institutes of Health, 10 Center Drive, Building 10, Room 2C-306, Bethesda, MD 20814, USA
| | - Jianghong Gu
- Department of Laboratory Medicine, National Institutes of Health, 10 Center Drive, Building 10, Room 2C-306, Bethesda, MD 20814, USA
| | - Elizabeth A Elliott
- Department of Laboratory Medicine, National Institutes of Health, 10 Center Drive, Building 10, Room 2C-306, Bethesda, MD 20814, USA
| | - Likhona S Masika
- Department of Laboratory Medicine, National Institutes of Health, 10 Center Drive, Building 10, Room 2C-306, Bethesda, MD 20814, USA
| | - Brent S Abel
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, 10Center Drive, Building 10, Room 6-3940, Bethesda, MD, 20814, USA
| | - Deborah P Merke
- Clinical Center and Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, 10 Center Drive, Building 10, Room 1-2740, Bethesda, MD, 20814, USA
| | - Monica C Skarulis
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, 10Center Drive, Building 10, Room 6-3940, Bethesda, MD, 20814, USA
| | - Steven J Soldin
- Department of Laboratory Medicine, National Institutes of Health, 10 Center Drive, Building 10, Room 2C-306, Bethesda, MD 20814, USA; Department of Medicine, Division of Endocrinology and Metabolism, Georgetown University, 3700 O St NW, Washington, D.C. 20057, USA.
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Gervasoni J, Schiattarella A, Primiano A, D'Addurno I, Cocci A, Zuppi C, Persichilli S. Simultaneous quantification of 17-hydroxyprogesterone, androstenedione, testosterone and cortisol in human serum by LC-MS/MS using TurboFlow online sample extraction. Clin Biochem 2016; 49:998-1003. [DOI: 10.1016/j.clinbiochem.2016.05.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 05/02/2016] [Accepted: 05/08/2016] [Indexed: 12/23/2022]
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10
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Cha E, Kim S, Kim HJ, Lee KM, Kim KH, Kwon OS, Lee J. Sensitivity of GC-EI/MS, GC-EI/MS/MS, LC-ESI/MS/MS, LC-Ag+CIS/MS/MS, and GC-ESI/MS/MS for analysis of anabolic steroids in doping control. Drug Test Anal 2015; 7:1040-9. [DOI: 10.1002/dta.1906] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/21/2015] [Accepted: 09/21/2015] [Indexed: 01/17/2023]
Affiliation(s)
- Eunju Cha
- Doping Control Center, Korea Institute of Science and Technology; Hwarang-ro 14-gil 5, Seongbuk-gu Seoul 136-791 Korea
- Department of Chemistry, Research Institute for Natural Sciences; Korea University; 145, Anam-ro, Seongbuk-gu Seoul 136-701 Korea
| | - Sohee Kim
- Doping Control Center, Korea Institute of Science and Technology; Hwarang-ro 14-gil 5, Seongbuk-gu Seoul 136-791 Korea
| | - Ho Jun Kim
- Doping Control Center, Korea Institute of Science and Technology; Hwarang-ro 14-gil 5, Seongbuk-gu Seoul 136-791 Korea
| | - Kang Mi Lee
- Doping Control Center, Korea Institute of Science and Technology; Hwarang-ro 14-gil 5, Seongbuk-gu Seoul 136-791 Korea
| | - Ki Hun Kim
- Doping Control Center, Korea Institute of Science and Technology; Hwarang-ro 14-gil 5, Seongbuk-gu Seoul 136-791 Korea
| | - Oh-Seung Kwon
- Doping Control Center, Korea Institute of Science and Technology; Hwarang-ro 14-gil 5, Seongbuk-gu Seoul 136-791 Korea
| | - Jaeick Lee
- Doping Control Center, Korea Institute of Science and Technology; Hwarang-ro 14-gil 5, Seongbuk-gu Seoul 136-791 Korea
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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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Abstract
Estradiol quantitation is useful in the clinical assessment of diseases like hypogonadism, hirsutism, polycystic ovary syndrome (PCOS), amenorrhea, ovarian tumors and for monitoring response in women receiving aromatase inhibitor therapy. Physiologically relevant serum estradiol concentration in women can span across four orders of magnitude. For example, in women undergoing ovulation induction serum estradiol concentration can range between 250-2000 pg/mL whereas aromatase inhibitor therapy can decrease serum estradiol concentration to <5 pg/mL. While high-through-put automated un-extracted (direct) immunoassays accommodate the growing clinical need for estradiol quantitation, are amenable to implementation by most hospital clinical laboratories, they display a significant loss of specificity and accuracy at low concentrations. Most clinical scenarios (example: estradiol monitoring in fertility treatments) place a modest demand on accuracy and precision of the assay in use but accurate quantitation of estradiol in certain clinical scenarios (pediatric and male patients and for monitoring aromatase inhibitor therapy) can be challenging using currently available immunoassays since the direct immunoassays are prone to issues with sub-optimal accuracy and specificity due to cross reactivity with estradiol conjugates and metabolites. In this review we discuss the bases for the evolution of estradiol assays from extracted (indirect) radio-immunoassays to direct immunoassays to liquid-chromatography tandem mass spectrometry (LC-MS/MS) based assays, discuss technical factors relevant for development and optimization of a LC-MS/MS assay for estradiol and present the details and performance characteristics of an ultra-sensitive LC-MS/MS estradiol assay with a limit of quantitation of 0.2 pg/mL.
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Affiliation(s)
- Hemamalini Ketha
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, United States
| | - Adam Girtman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, United States
| | - Ravinder J Singh
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, United States.
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Deme P, Upadhyayula VVR. Ultra performance liquid chromatography atmospheric pressure photoionization high resolution mass spectrometric method for determination of multiclass pesticide residues in grape and mango juices. Food Chem 2014; 173:1142-9. [PMID: 25466136 DOI: 10.1016/j.foodchem.2014.11.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 10/29/2014] [Accepted: 11/01/2014] [Indexed: 11/29/2022]
Abstract
A novel analytical method was developed for determination of organochlorine, synthetic pyrethroid, organophosphate and carbamate pesticide residues in fruit juices using ultra performance liquid chromatography-atmospheric pressure photoionization-high resolution mass spectrometry (UPLC-APPI-HRMS). The analytes were extracted from fruit juices by dispersive solid-phase extraction using multi-walled carbon nanotubes (MWCNTs). The analysis was carried out in full scan mode using dual ionization mode of APPI in the mass range of 100-650 units. The limit of detection and limit of quantification values for the pesticides were in the range of 0.025-0.15 ng mL(-1) and 0.1-0.5 ng mL(-1) respectively. The matrix effect of the method was found to be low and extraction recoveries were in the range of 60-110%. Some of the real fruits juice samples showed the presence of some pesticides in the range of 6.5-24.8 ng L(-1).
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Affiliation(s)
- Pragney Deme
- National Centre for Mass Spectrometry, Indian Institute of Chemical Technology, Tarnaka, Hyderabad 500007, Telangana, India
| | - Vijayasarathi V R Upadhyayula
- National Centre for Mass Spectrometry, Indian Institute of Chemical Technology, Tarnaka, Hyderabad 500007, Telangana, India.
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Normal phase-liquid chromatography-tandem mass spectrometry with atmospheric pressure photoionization for the purity assessment of 17β-estradiol. Anal Bioanal Chem 2014; 407:3147-57. [DOI: 10.1007/s00216-014-8189-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 09/09/2014] [Accepted: 09/12/2014] [Indexed: 10/24/2022]
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Wilton JH, Titus MA, Efstathiou E, Fetterly GJ, Mohler JL. Androgenic biomarker prof|ling in human matrices and cell culture samples using high throughput, electrospray tandem mass spectrometry. Prostate 2014; 74:722-31. [PMID: 24847527 PMCID: PMC4335642 DOI: 10.1002/pros.22792] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
UNLABELLED BACKGROUND. A high throughput, high pressure liquid chromatographic (HPLC) method with triple quadrupole mass spectral detection (LC/MS/MS) was validated for the measurement of 5 endogenous androgens in human plasma and serum and applied to various in vivo and in vitro study samples to pursue a better understanding of the interrelationship of the androgen axis, intracrine metabolism, and castration-recurrent prostate cancer (CaP). METHODS A Shimadzu HPLC system interfaced with a Sciex QTRAP 5500 mass spectrometer with electrospray ionization was used with in line column-switching. Samples were liquid/liquid extracted and chromatographed on a Luna C18(2) column at 60°C with a biphasic gradient using a 15-min run time. RESULTS The method was validated for five androgens in human plasma and serum, and applied to four sets of samples. Plasma (n=188) and bone marrow aspirate (n=129) samples from patients with CaP, who received abiraterone acetate plus prednisone for up to 945 days(135 weeks), had undetectable androgens after 8 weeks of treatment. Plasma dehydroepiandrosterone(DHEA) concentrations were higher in African Americans than Caucasian Americans with newly diagnosed CaP. Analysis of prostate tumor tissue homogenates demonstrated reproducible testosterone (T) and dihydrotestosterone (DHT) concentrations with a minimal sample size of 1.0–2.0 mg of tissue. Finally, cell pellet and media samples from the LNCaP C4-2 cell line showed conversion of T to DHT. CONCLUSION The proposed LC/MS/MS method was validated for quantitation of five endogenous androgens in human plasma and serum, and effectively profiles androgens in clinical specimens and cell culture samples.
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Affiliation(s)
- John H. Wilton
- PK/PD Core Resource, Roswell Park Cancer Institute, Buffalo, New York
- Correspondence to: John H. Wilton, PhD, PK/PD Core Resource, CGP L1-140, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY.
| | - Mark A. Titus
- Department of Urology, Roswell Park Cancer Institute, Buffalo, New York
| | - Eleni Efstathiou
- David H. Koch Center, M.D. Anderson Cancer Center, University of Texas, Houston, Texas
| | | | - James L. Mohler
- Department of Urology, Roswell Park Cancer Institute, Buffalo, New York
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Abstract
17-Hydroxyprogesterone (17-OHP) is an intermediate steroid in the adrenal biosynthetic pathway from cholesterol to cortisol and is the substrate for steroid 21-hydroxylase. An inherited deficiency of 21-hydroxylase leads to greatly increased serum concentrations of 17-OHP, while the absence of cortisol synthesis causes an increase in adrenocorticotrophic hormone. The classical congenital adrenal hyperplasia (CAH) presents usually with virilisation of a girl at birth. Affected boys and girls can have renal salt loss within a few days if aldosterone production is also compromised. Diagnosis can be delayed in boys. A non-classical form of congenital adrenal hyperplasia (NC-CAH) presents later in life usually with androgen excess. Moderately raised or normal 17-OHP concentrations can be seen basally but, if normal and clinical suspicion is high, an ACTH stimulation test will show 17-OHP concentrations (typically >30 nmol/L) above the normal response. NC-CAH is more likely to be detected clinically in females and may be asymptomatic particularly in males until families are investigated. The prevalence of NC-CAH in women with androgen excess can be up to 9% according to ethnic background and genotype. Mutations in the 21-hydroxylase genes in NC-CAH can be found that have less deleterious effects on enzyme activity. Other less-common defects in enzymes of cortisol synthesis can be associated with moderately elevated 17-OHP. Precocious puberty, acne, hirsutism and subfertility are the commonest features of hyperandrogenism. 17-OHP is a diagnostic marker for CAH but opinions differ on the role of 17OHP or androstenedione in monitoring treatment with renin in the salt losing form. This review considers the utility of 17-OHP measurements in children, adolescents and adults.
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Affiliation(s)
- John W Honour
- Institute of Women’s Health, University College London, London, UK
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17
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Abstract
Testosterone, the most abundant androgen in men, is a steroid hormone that is synthesized predominantly by the testes. In women, minor amounts are synthesized in the ovaries. Androgen precursors are also produced and secreted from the adrenal glands in both sexes, where they undergo peripheral conversion to testosterone. Circulating concentrations are approximately 15-25 times higher in adult men compared to women. Maintenance of these levels is necessary for development and maintenance of secondary sexual characteristics, libido, growth, prevention of osteoporosis, and most importantly in men, spermatogenesis. Most testosterone circulates tightly bound to sex hormone-binding globulin (SHBG) or weakly bound to albumin. A minor amount circulates as free testosterone, and it is believed that this is the metabolically active fraction. Measurement of free testosterone is important in the diagnosis of many diseases, most importantly disorders of androgen deficiency in men (i.e., hypogonadism) and androgen excess in women (i.e., polycystic ovary syndrome and hirsutism). Many methodologies are available for free testosterone measurement including the reference methods (equilibrium dialysis and ultrafiltration), analog immunoassay, and calculated free testosterone based on measurement of total testosterone, SHBG, and albumin. Moreover, measurement of bioavailable testosterone, a combination of albumin-bound and free testosterone, also has clinical utility and can be measured by selective protein precipitation or calculation. In this review, the advantages and limitations of each of these methods will be discussed in the context of clinical utility and implementation into a routine hospital laboratory. Furthermore, up and coming methodologies for free testosterone measurement, including liquid chromatography-tandem mass spectrometry, will also be discussed.
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Analysis of anabolic steroids in urine by gas chromatography–microchip atmospheric pressure photoionization-mass spectrometry with chlorobenzene as dopant. J Chromatogr A 2013; 1312:111-7. [DOI: 10.1016/j.chroma.2013.08.098] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 08/01/2013] [Accepted: 08/29/2013] [Indexed: 01/25/2023]
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19
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Chang LC, Chiu TC, Lee SS, Kuo CH, Chang TC. Simultaneous Separation of Four Types of Steroid Hormones by Micellar Electrokinetic Chromatography with Cetyltrimethylammonium Bromide. J CHIN CHEM SOC-TAIP 2013. [DOI: 10.1002/jccs.200800087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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20
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Keski-Rahkonen P, Huhtinen K, Desai R, Harwood DT, Handelsman DJ, Poutanen M, Auriola S. LC-MS analysis of estradiol in human serum and endometrial tissue: Comparison of electrospray ionization, atmospheric pressure chemical ionization and atmospheric pressure photoionization. JOURNAL OF MASS SPECTROMETRY : JMS 2013; 48:1050-1058. [PMID: 24078246 DOI: 10.1002/jms.3252] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 07/08/2013] [Accepted: 07/09/2013] [Indexed: 06/02/2023]
Abstract
Accurate measurement of estradiol (E2) is important in clinical diagnostics and research. High sensitivity methods are critical for specimens with E2 concentrations at low picomolar levels, such as serum of men, postmenopausal women and children. Achieving the required assay performance with LC-MS is challenging due to the non-polar structure and low proton affinity of E2. Previous studies suggest that ionization has a major role for the performance of E2 measurement, but comparisons of different ionization techniques for the analysis of clinical samples are not available. In this study, female serum and endometrium tissue samples were used to compare electrospray ionization (ESI), atmospheric pressure chemical ionization (APCI) and atmospheric pressure photoionization (APPI) in both polarities. APPI was found to have the most potential for E2 analysis, with a quantification limit of 1 fmol on-column. APCI and ESI could be employed in negative polarity, although being slightly less sensitive than APPI. In the presence of biological background, ESI was found to be highly susceptible to ion suppression, while APCI and APPI were largely unaffected by the sample matrix. Irrespective of the ionization technique, background interferences were observed when using the multiple reaction monitoring transitions commonly employed for E2 (m/z 271 > 159; m/z 255 > 145). These unidentified interferences were most severe in serum samples, varied in intensity between ionization techniques and required efficient chromatographic separation in order to achieve specificity for E2.
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Affiliation(s)
- Pekka Keski-Rahkonen
- ANZAC Research Institute, University of Sydney, Sydney, NSW 2139, Australia; School of Pharmacy, University of Eastern Finland, 70211, Kuopio, Finland
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21
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Suominen T, Haapala M, Takala A, Ketola RA, Kostiainen R. Neurosteroid analysis by gas chromatography–atmospheric pressure photoionization–tandem mass spectrometry. Anal Chim Acta 2013; 794:76-81. [DOI: 10.1016/j.aca.2013.07.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 07/19/2013] [Accepted: 07/24/2013] [Indexed: 12/23/2022]
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22
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Methlie P, Hustad S, Kellman R, Almås B, Erichsen MM, Husebye ES, Løvås K. Multisteroid LC-MS/MS assay for glucocorticoids and androgens, and its application in Addison's disease. Endocr Connect 2013; 2:125-136. [PMID: 23825158 PMCID: PMC3845685 DOI: 10.1530/ec-13-0023] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Liquid chromatography-mass spectrometry (LC-MS/MS) offers superior analytical specificity compared to immunoassays, but is not available in many regions and hospital due to expensive instrumentation and tedious sample preparation. Thus, we developed an automated, high-throughput LC-MS/MS assay for simultaneous quantification of 10 endogenous and synthetic steroids targeting diseases of the hypothalamo-pituitary-adrenal-axis and gonads. METHODS Deuterated internal standards were added to 85µl serum and processed by liquid-liquid-extraction. Cortisol, cortisone, prednisolone, prednisone, 11-deoxycortisol, dexamethasone, testosterone, androstenedione and progesterone were resolved by ultra-high pressure chromatography on a reversed-phase column in 6.1 minutes, and detected by triple-quadrupole MS. The method was used to assess steroid profiles in women with Addison's disease (AD, n=156) and blood donors (BD, n=102). RESULTS Precisions ranged 4.5-10.1% RSD, accuracies 95-108%, and extraction recoveries 60-84%. The method was practically free of matrix effects and robust to individual differences in serum composition. Most postmenopausal AD women had extremely low androstenedione below 0.14 nmol/L and median testosterone 0.15 nmol/L [interquartile range 0.00-0.41], considerably lower than postmenopausal BD (1.28 nmol/L [0.96-1.64] and 0.65 nmol/L [0.56-1.10], respectively). AD women in fertile years had androstenedione 1.18 nmol/L [0.71-1.76] and testosterone 0.44 nmol/L [0.22-0.63], approximately half of levels found in BD of corresponding age. CONCLUSION This LC-MS/MS assay provides highly sensitive and specific assessments of glucocorticoids and androgens with low sample volumes, and is suitable for endocrine laboratories and research. Its utility was demonstrated in a large cohort of women with AD, and the data suggest that women with AD are particularly androgen deficient after menopause.
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Affiliation(s)
- Paal Methlie
- Department of Clinical ScienceUniversity of BergenN-5021, BergenNorway
- The Hormone LaboratoryHaukeland University HospitalN-5021, BergenNorway
- Correspondence should be addressed to P Methlie Email
| | - Steinar Hustad
- Department of Clinical ScienceUniversity of BergenN-5021, BergenNorway
| | - Ralf Kellman
- The Hormone LaboratoryHaukeland University HospitalN-5021, BergenNorway
| | - Bjørg Almås
- The Hormone LaboratoryHaukeland University HospitalN-5021, BergenNorway
| | | | - Eystein S Husebye
- Department of Clinical ScienceUniversity of BergenN-5021, BergenNorway
- Department of MedicineHaukeland University HospitalBergen, N-5021Norway
| | - Kristian Løvås
- Department of Clinical ScienceUniversity of BergenN-5021, BergenNorway
- Department of MedicineHaukeland University HospitalBergen, N-5021Norway
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23
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Fanelli F, Gambineri A, Mezzullo M, Vicennati V, Pelusi C, Pasquali R, Pagotto U. Revisiting hyper- and hypo-androgenism by tandem mass spectrometry. Rev Endocr Metab Disord 2013; 14:185-205. [PMID: 23619762 DOI: 10.1007/s11154-013-9243-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Modern endocrinology is living a critical age of transition as far as laboratory testing and biochemical diagnosis are concerned. Novel liquid chromatography-tandem mass spectrometry (LC-MS/MS) assays for steroid measurement in biological fluids have abundantly demonstrated their analytical superiority over immunometric platforms that until now have dominated the world of steroid hormones determination in clinical laboratories. One of the most useful applications of LC-MS/MS is in the hypogonadism and hyperandrogenism field: LC-MS/MS has proved particularly suitable for the detection of low levels of testosterone typical of women and children, and in general more reliable in accurately determining hypogonadal male levels. This technique also offers increased informative power by allowing multi-analytical profiles that give a more comprehensive picture of the overall hormonal asset. Several LC-MS/MS methods for testosterone have been published in the last decade, some of them included other androgen or more comprehensive steroid profiles. LC-MS/MS offers the concrete possibility of achieving a definitive standardization of testosterone measurements and the generation of widely accepted reference intervals, that will set the basis for a consensus on the diagnostic value of biochemical testing. The present review is aimed at summarizing technological advancements in androgen measurements in serum and saliva. We also provide a picture of the state of advancement of standardization of testosterone assays, of the redefinition of androgen reference intervals by novel assays and of studies using LC-MS/MS for the characterization and diagnosis of female hyperandrogenism and male hypogonadism.
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Affiliation(s)
- Flaminia Fanelli
- Endocrinology Unit, Department of Medical and Surgical Sciences, and Center for Applied Biomedical Sciences, S.Orsola - Malpighi Hospital, University Alma Mater Studiorum, Via Massarenti 9, 40138, Bologna, Italy
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24
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Rhea JM, French D, Molinaro RJ. Direct total and free testosterone measurement by liquid chromatography tandem mass spectrometry across two different platforms. Clin Biochem 2013; 46:656-64. [DOI: 10.1016/j.clinbiochem.2013.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 01/11/2013] [Accepted: 01/12/2013] [Indexed: 10/27/2022]
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25
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Serum concentrations of DHEA, DHEAS, 17α-hydroxyprogesterone, Δ4-androstenedione and testosterone in children determined by TurboFlow-LC–MS/MS. Clin Chim Acta 2013; 419:95-101. [DOI: 10.1016/j.cca.2013.01.019] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 01/21/2013] [Accepted: 01/28/2013] [Indexed: 11/22/2022]
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26
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Administration of dehydroepiandrosterone (DHEA) increases serum levels of androgens and estrogens but does not enhance short-term memory in post-menopausal women. Brain Res 2012; 1483:54-62. [PMID: 22985672 DOI: 10.1016/j.brainres.2012.09.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 09/04/2012] [Accepted: 09/08/2012] [Indexed: 11/20/2022]
Abstract
The current study examines the effect of administering dehydroepiandrosterone (DHEA) on short-term memory. This experiment used a double-blind placebo-controlled cross-over design to explore the effects of a four week regimen of 50 mg oral DHEA on performance on the digit span, verbal span, and modified Sternberg (Oberauer) tasks. The results demonstrate that the current regimen of drug administration significantly increases serum levels of DHEA, DHEAS, testosterone and estrone and substantially alters the patterns of correlations among the serum levels of these hormones. Despite this substantial change in the hormonal milieu, DHEA administration produced no beneficial effects on cognitive performance in the digit span, verbal span, or modified Sternberg paradigm tasks. Ancillary analyses of the relation between hormone levels and cognitive performance demonstrated a strong positive correlation between DHEA levels and performance on digit span forward/backward and verbal span forward in the placebo drug condition, but not in the DHEA condition. We interpret the juxtaposition of the null results of DHEA administration and the correlation of DHEA levels and performance in the placebo condition to indicate that the referenced correlations arise because a third variable (i.e., age) is associated with both performance and DHEA levels. Additional analyses supported this hypothesis.
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27
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Rannulu NS, Cole RB. Novel fragmentation pathways of anionic adducts of steroids formed by electrospray anion attachment involving regioselective attachment, regiospecific decompositions, charge-induced pathways, and ion-dipole complex intermediates. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2012; 23:1558-1568. [PMID: 22733166 DOI: 10.1007/s13361-012-0422-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 05/16/2012] [Accepted: 05/17/2012] [Indexed: 06/01/2023]
Abstract
The analysis of several bifunctional neutral steroids, 5-α-pregnane diol (5-α-pregnane-3α-20βdiol), estradiol (3,17α-dihydroxy-1,3,5(10)-estratriene), progesterone (4-pregnene-3,20-dione), lupeol (3β-hydroxy-20(29)-lupene), pregnenolone (5-pregnen-3β-ol-20-one), and pregnenolone acetate (5-pregnen-3β-ol-20-one acetate) was accomplished by negative ion electrospray mass spectrometry (ESI-MS) employing adduct formation with various anions: fluoride, bicarbonate, acetate, and chloride. Fluoride yielded higher abundances of anionic adducts and more substantial abundances of deprotonated molecules compared with other investigated anions. Collision-induced dissociation (CID) of precursor [M + anion](-) adducts of these steroids revealed that fluoride adduct [M + F](-) precursors first lose HF to produce [M - H](-) and then undergo consecutive decompositions to yield higher abundances of structurally-informative product ions than the other tested anions. In addition to charge-remote fragmentations, the majority of CID pathways of estradiol are deduced to occur via charge-induced fragmentation. Most interestingly, certain anions exhibit preferential attachment to a specific site on these bifunctional steroid molecules, which we are calling "regioselective anion attachment." Regioselective anion attachment is evidenced by subsequent regiospecific decomposition. Regioselective attachment of fluoride (and acetate) anions to low (and moderate) acidity functional groups of pregnenolone, respectively, is demonstrated using deuterated compounds. Moreover, the formation of unique intermediate ion-dipole complexes leading to novel fragmentation pathways of fluoride adducts of pregnenolone acetate, and bicarbonate adducts of d(4)-pregnenolone, are also discussed.
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Affiliation(s)
- Nalaka S Rannulu
- Department of Chemistry, University of New Orleans, New Orleans, LA 70148, USA
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28
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The development and validation of a turbulent flow chromatography–tandem mass spectrometry method for the endogenous steroid profiling of equine serum. J Chromatogr B Analyt Technol Biomed Life Sci 2012; 905:1-9. [DOI: 10.1016/j.jchromb.2012.06.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 06/15/2012] [Accepted: 06/16/2012] [Indexed: 11/20/2022]
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29
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Molenaar N, Bijkerk RM, Beishuizen A, Hempen CM, de Jong MFC, Vermes I, van der Sluijs Veer G, Girbes ARJ, Groeneveld ABJ. Steroidogenesis in the adrenal dysfunction of critical illness: impact of etomidate. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2012; 16:R121. [PMID: 22781364 PMCID: PMC3580698 DOI: 10.1186/cc11415] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 07/10/2012] [Indexed: 12/15/2022]
Abstract
Introduction This study was aimed at characterizing basal and adrenocorticotropic hormone (ACTH)-induced steroidogenesis in sepsis and nonsepsis patients with a suspicion of critical illness-related corticosteroid insufficiency (CIRCI), taking the use of etomidate-inhibiting 11β-hydroxylase into account. Method This was a prospective study in a mixed surgical/medical intensive care unit (ICU) of a university hospital. The patients were 62 critically ill patients with a clinical suspicion of CIRCI. The patients underwent a 250-μg ACTH test (n = 67). ACTH, adrenal steroids, substrates, and precursors (modified tandem mass spectrometry) also were measured. Clinical characteristics including use of etomidate to facilitate intubation (n = 14 within 72 hours of ACTH testing) were recorded. Results At the time of ACTH testing, patients had septic (n = 43) or nonseptic critical illness (n = 24). Baseline cortisol directly related to sepsis and endogenous ACTH, independent of etomidate use. Etomidate was associated with a lower baseline cortisol and cortisol/11β-deoxycortisol ratio as well as higher 11β-deoxycortisol, reflecting greater 11β-hydroxylase inhibition in nonsepsis than in sepsis. Cortisol increases < 250 mM in exogenous ACTH were associated with relatively low baseline (HDL-) cholesterol, and high endogenous ACTH with low cortisol/ACTH ratio, independent of etomidate. Although cortisol increases with exogenous ACTH, levels were lower in sepsis than in nonsepsis patients, and etomidate was associated with diminished increases in cortisol with exogenous ACTH, so that its use increased, albeit nonsignificantly, low cortisol increases to exogenous ACTH from 38% to 57%, in both conditions. Conclusions A single dose of etomidate may attenuate stimulated more than basal cortisol synthesis. However, it may only partly contribute, particularly in the stressed sepsis patient, to the adrenal dysfunction of CIRCI, in addition to substrate deficiency.
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30
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Jonklaas J, Holst JP, Verbalis JG, Pehlivanova M, Soldin SJ. Changes in steroid concentrations with the timing of corticotropin stimulation testing in participants with adrenal sufficiency. Endocr Pract 2012; 18:66-75. [PMID: 21856601 DOI: 10.4158/ep11085.or] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine whether the time of day at which corticotropin stimulation testing is performed influences the steroid concentrations observed in persons with normal adrenal function. METHODS In this retrospective, secondary analysis, participants with normal adrenal function were studied to determine whether the time of corticotropin stimulation testing influenced results. Participants consisted of 2 groups: healthy volunteers who were not suspected of having adrenal insufficiency and patients being tested for adrenal insufficiency as part of their standard of care who were subsequently shown to have normal adrenal function on the basis of a peak cortisol value of at least 20 μg/dL. A high-dose corticotropin stimulation test was performed in all participants. Baseline, peak, and delta steroid concentrations were documented after corticotropin injection. Steroid concentrations were measured by tandem mass spectrometry. Multivariate analyses adjusted for patient age, sex, and baseline steroid concentrations. RESULTS With progression through the day for the time of testing, the baseline cortisol concentration decreased, while the peak and delta cortisol concentration increased (P values: <.001, .007, .007, respectively). For 11-deoxycortisol, the baseline decreased, while peak and delta values increased with later testing (P values: .017, .012, .02, respectively). Peak aldosterone concentrations increased according to their baseline values (P<.001), but were unaffected by time. Peak and delta dehydroepiandrosterone concentrations increased with time (P = .015 and .021, respectively). Referring to the various criteria for adequate steroid responses to corticotropin available in the literature, the time-related differences in this small group of patients were insufficient to draw different conclusions about results of testing. CONCLUSIONS Cortisol, 11-deoxycortisol, and dehydroepiandrosterone values were most influenced by testing times. In patients with borderline adrenal function who are tested at different times of the day, the modest differences we observed may be sufficient to affect conclusions about whether adrenal insufficiency is present.
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Affiliation(s)
- Jacqueline Jonklaas
- Division of Endocrinology, Georgetown University Medical Center, Washington, DC 20007, USA.
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31
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Koren L, Ng ESM, Soma KK, Wynne-Edwards KE. Sample preparation and liquid chromatography-tandem mass spectrometry for multiple steroids in mammalian and avian circulation. PLoS One 2012; 7:e32496. [PMID: 22384262 PMCID: PMC3288106 DOI: 10.1371/journal.pone.0032496] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 01/27/2012] [Indexed: 12/12/2022] Open
Abstract
Blood samples from wild mammals and birds are often limited in volume, allowing researchers to quantify only one or two steroids from a single sample by immunoassays. In addition, wildlife serum or plasma samples are often lipemic, necessitating stringent sample preparation. Here, we validated sample preparation for simultaneous liquid chromatography--tandem mass spectrometry (LC-MS/MS) quantitation of cortisol, corticosterone, 11-deoxycortisol, dehydroepiandrosterone (DHEA), 17β-estradiol, progesterone, 17α-hydroxyprogesterone and testosterone from diverse mammalian (7 species) and avian (5 species) samples. Using 100 µL of serum or plasma, we quantified (signal-to-noise (S/N) ratio ≥ 10) 4-7 steroids depending on the species and sample, without derivatization. Steroids were extracted from serum or plasma using automated solid-phase extraction where samples were loaded onto C18 columns, washed with water and hexane, and then eluted with ethyl acetate. Quantitation by LC-MS/MS was done in positive ion, multiple reaction-monitoring (MRM) mode with an atmospheric pressure chemical ionization (APCI) source and heated nebulizer (500°C). Deuterated steroids served as internal standards and run time was 15 minutes. Extraction recoveries were 87-101% for the 8 analytes, and all intra- and inter-run CVs were ≤ 8.25%. This quantitation method yields good recoveries with variable lipid-content samples, avoids antibody cross-reactivity issues, and delivers results for multiple steroids. Thus, this method can enrich datasets by providing simultaneous quantitation of multiple steroids, and allow researchers to reimagine the hypotheses that could be tested with their volume-limited, lipemic, wildlife samples.
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Affiliation(s)
- Lee Koren
- Department of Comparative Biology & Experimental Medicine, Faculty of Veterinary Medicine, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Ella S. M. Ng
- Department of Comparative Biology & Experimental Medicine, Faculty of Veterinary Medicine, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Kiran K. Soma
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katherine E. Wynne-Edwards
- Department of Comparative Biology & Experimental Medicine, Faculty of Veterinary Medicine, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
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Becker S, Kortz L, Helmschrodt C, Thiery J, Ceglarek U. LC–MS-based metabolomics in the clinical laboratory. J Chromatogr B Analyt Technol Biomed Life Sci 2012; 883-884:68-75. [DOI: 10.1016/j.jchromb.2011.10.018] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 10/13/2011] [Accepted: 10/14/2011] [Indexed: 10/16/2022]
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Abstract
Quantification of endogenous hormonal steroids and their precursors is essential for diagnosing a wide range of endocrine disorders. Historically, these analyses have been carried out using immunoassay, but such methods are problematic, especially for low-concentration analytes, due to assay interference by other endogenous steroids. MS offers improved specificity over immunoassay and can be highly sensitive. GC–MS, with use of stable isotopically labeled internal standards, is considered the ‘gold standard’ method for serum steroid analysis. GC–MS is the method of choice for profiling steroid metabolites in urine, but these techniques are not appropriate for routine use in clinical laboratories owing to a need for extensive sample preparation, as well as analytical expertise. LC–MS/MS compares well to GC–MS in terms of accuracy, precision and sensitivity, but allows simplified sample preparation. While most publications have featured only one or a limited number of steroids, we consider that steroid paneling (which we propose as the preferred term for multitargeted steroid analysis) has great potential to enable clinicians to make a definitive diagnosis. It is adaptable for use in a number of matrices, including serum, saliva and dried blood spots. However, LC–MS/MS-based steroid analysis is not straightforward, and understanding the chemical and analytical processes involved is essential for implementation of a robust clinical service. This article discusses specific challenges in the measurement of endogenous steroids using LC–MS/MS, and provides examples of the benefits it offers.
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Stangl B, Hirshman E, Verbalis J. Administration of dehydroepiandrosterone (DHEA) enhances visual-spatial performance in postmenopausal women. Behav Neurosci 2011; 125:742-52. [PMID: 21942436 PMCID: PMC3715689 DOI: 10.1037/a0025151] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The current article examines the effect of administering dehydroepiandrosterone (DHEA) on visual-spatial performance in postmenopausal women (N = 24, ages 55-80). The concurrent reduction of serum DHEA levels and visual-spatial performance in this population, coupled with the documented effects of DHEA's androgenic metabolites on visual-spatial performance, suggests that DHEA administration may enhance visual-spatial performance. The current experiment used a double-blind, placebo-controlled crossover design in which 50 mg of oral DHEA was administered daily in the drug condition to explore this hypothesis. Performance on the Mental Rotation, Subject-Ordered Pointing, Fragmented Picture Identification, Perceptual Identification, Same-Different Judgment, and Visual Search tasks and serum levels of DHEA, DHEAS, testosterone, estrone, and cortisol were measured in the DHEA and placebo conditions. In contrast to prior experiments using the current methodology that did not demonstrate effects of DHEA administration on episodic and short-term memory tasks, the current experiment demonstrated large beneficial effects of DHEA administration on Mental Rotation, Subject-Ordered Pointing, Fragmented Picture Identification, Perceptual Identification, and Same-Different Judgment. Moreover, DHEA administration enhanced serum levels of DHEA, DHEAS, testosterone, and estrone, and regression analyses demonstrated that levels of DHEA and its metabolites were positively related to cognitive performance on the visual-spatial tasks in the DHEA condition.
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Affiliation(s)
- Bethany Stangl
- National Institutes of Health, National Institute of Alcohol Abuse and Alcoholism, USA
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Soldin OP, Makambi KH, Soldin SJ, O'Mara DM. Steroid hormone levels associated with passive and active smoking. Steroids 2011; 76:653-9. [PMID: 21396948 PMCID: PMC3635532 DOI: 10.1016/j.steroids.2011.02.042] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2010] [Revised: 02/23/2011] [Accepted: 02/24/2011] [Indexed: 11/19/2022]
Abstract
CONTEXT Cigarette tobacco smoke is a potent environmental contaminant known to adversely affect health including fertility and pregnancy. OBJECTIVE To examine the associations between second-hand cigarette tobacco-smoke exposure, or active smoking and serum concentrations of steroid hormones using tandem mass spectrometry. DESIGN Healthy women (18-45 y) from the general community in the Metropolitan Washington, DC were recruited at the follicular stage of their menstrual cycle. Participants were assigned to one of three study groups: active smokers (N=107), passive smokers (N=86), or non-smokers (N=100). Classifications were based on a combination of self-reporting and serum cotinine concentrations. METHODS Serum androgens, estrogens, progestins, androstenedione, aldosterone, cortisol, corticosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), 11-deoxycortisol and 25-hydroxy-vitamin D3 (25-OHVitD3) and cotinine were measured by isotope dilution tandem mass spectrometry (LC/MS/MS) (API-5000). Kruskal-Wallis tests were used to assess median differences among the three groups, with Dunn's multiple comparison test for post hoc analysis. RESULTS Serum estrone, estradiol, and estriol concentrations were lower in active and passive smokers than in non-smokers. The three study groups differed significantly in serum concentrations of 16-OHE1, aldosterone and 25-OHVitD3, as well as in the ratios of many of the steroids. Pair-wise comparison of the groups demonstrated significant differences in hormone concentrations between (i) smokers and non-smokers for aldosterone: (ii) passive smokers and non-smokers for aldosterone, progesterone and estriol. Moreover, for smokers and passive smokers, there were no significant differences in these hormone concentrations. CONCLUSIONS Smoke exposure was associated with lower than normal median steroid hormone concentrations. These processes may be instrumental in explaining some adverse effects of tobacco smoke on female health and fertility.
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Affiliation(s)
- Offie P Soldin
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.
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Cole RB, Rannulu NS. Regioselective anion attachment leading to regiospecific decompositions of bifunctional steroids in negative ion electrospray tandem mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2011; 25:558-562. [PMID: 21259365 DOI: 10.1002/rcm.4884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Konkle ATM, McCarthy MM. Developmental time course of estradiol, testosterone, and dihydrotestosterone levels in discrete regions of male and female rat brain. Endocrinology 2011; 152:223-35. [PMID: 21068160 PMCID: PMC3033055 DOI: 10.1210/en.2010-0607] [Citation(s) in RCA: 207] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The prevailing view of sexual differentiation of mammalian brain is that androgen synthesized in the fetal and neonatal testis and aromatized centrally during a perinatal sensitive period is the sole source of brain estradiol and the primary determinant of sex differences. Subregions of the diencephalon are among the most sexually dimorphic in the brain, and there are well-established sex differences in the amount of testosterone and estradiol measured in the hypothalamus and preoptic area during the perinatal period. We previously reported unexpectedly high estradiol in the hippocampus and cortex of both male and female newborn rat. This prompted a thorough investigation of the developmental profile of steroids in the rat brain using RIA to quantify the level of estradiol, testosterone, and dihydrotestosterone in discrete subregions of the brain from embryonic d 19 to adulthood. Plasma estradiol levels from individual animals were assessed when sufficient sample was available. A significant sex difference in hypothalamic testosterone prior to birth was consistent with previous findings. Postnatally, there was a distinct pattern of changing steroid concentrations in each brain region, and these were unrelated to circulating steroid. Removal of the gonads and adrenals at birth did not significantly reduce steroids in any brain region assayed 3 d later. Aromatase activity was detectable in all brain areas at birth, and the difference in activity level paralleled the observed regional differences in estradiol content. Based on these findings, we propose that steroidogenesis in the brain, independent of peripherally derived precursors, may play a critical role in mammalian brain development of both sexes, beyond the establishment of sex differences.
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Affiliation(s)
- Anne T M Konkle
- FAculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada K1N 6N5.
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Feasibility of gas chromatography–microchip atmospheric pressure photoionization-mass spectrometry in analysis of anabolic steroids. J Chromatogr A 2010; 1217:8290-7. [DOI: 10.1016/j.chroma.2010.10.074] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 09/13/2010] [Accepted: 10/18/2010] [Indexed: 12/14/2022]
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Shushan B. A review of clinical diagnostic applications of liquid chromatography-tandem mass spectrometry. MASS SPECTROMETRY REVIEWS 2010; 29:930-944. [PMID: 20949635 DOI: 10.1002/mas.20295] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Liquid chromatography coupled with tandem mass spectrometry (LC/MS/MS) technology is emerging as a complementary method to traditional methodology used for clinical applications. Enhanced specificity and high-throughput capabilities are providing significant benefits to clinical diagnostic laboratories conducting routine analyses. This technology is expected to expand rapidly as scientists focus on more complicated challenges that can be solved efficiently by adding LC/MS/MS to their arsenal of techniques.
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Affiliation(s)
- Bori Shushan
- Clinical Mass Spec Consultants, Toronto, ON, Canada, M4W 2W6.
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Vesper HW, Botelho JC. Standardization of testosterone measurements in humans. J Steroid Biochem Mol Biol 2010; 121:513-9. [PMID: 20302935 DOI: 10.1016/j.jsbmb.2010.03.032] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 01/26/2010] [Accepted: 03/08/2010] [Indexed: 11/24/2022]
Abstract
Testosterone levels are used primarily for the diagnosis of hypogonadism in men and androgen excess in women. Current studies suggest that serum testosterone measurements may be indicated in a wide range of diseases and conditions. Translation of testosterone levels outside of the reference ranges into clinical treatment, appropriate cut offs for clinical guidelines and epidemiological studies with public health impact pose challenges due to the measurement variability among assays and in assay sensitivity. While introducing mass spectrometry technology can overcome some of these challenges and help to improve measurements, it faces variability issues similar to those observed with immunoassays that need to be addressed. To overcome these problems in testosterone testing, the Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences (CDC/NCEH/DLS) started a steroid hormone standardization project. Their objective was to create testosterone measurement results that are traceable to one accuracy basis, thus allowing measurements to be comparable across methods, time, and location. CDC/NCEH/DLS conducts activities to standardize and improve testosterone assays and laboratory measurements by establishing metrological traceability to a higher order reference method and material. In addition, the standardization effort includes pre- and post-analytical challenges, such as test selection, interpretation, and establishing reference ranges to improve the translation of standardized results into clinical guidelines and public health assessments. CDC is conducting these standardization activities in collaboration with the clinical, laboratory, and research communities.
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Affiliation(s)
- Hubert W Vesper
- Centers for Disease Control and Prevention, Division of Laboratory Sciences, 4770 Buford Highway, MS F25, Atlanta, GA 30341, United States.
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Ceglarek U, Werner M, Kortz L, Körner A, Kiess W, Thiery J, Kratzsch J. Preclinical challenges in steroid analysis of human samples. J Steroid Biochem Mol Biol 2010; 121:505-12. [PMID: 20302937 DOI: 10.1016/j.jsbmb.2010.03.039] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 03/02/2010] [Accepted: 03/08/2010] [Indexed: 11/25/2022]
Abstract
Preclinical challenges in the analysis of steroid hormones are primarily determined by biological factors involved in the physiology and pathophysiology of hormone secretion. Major biologically influencing factors like age, sex, pubertal stage, pregnancy, phase of the menstruation, and diurnal rhythm have to be considered in the definition of reference ranges for steroids and their clinical interpretation. Hitherto, in clinical routine laboratories steroids were mainly determined by direct immunoassays applied on automated platforms, which are simple, rapid and cheap if a high number of samples are measured. However, technical factors like cross-reactivity of related steroid metabolites or limited analytical ranges have to be taken in account and may impair accuracy and precision of these direct methods. The actual development of mass spectrometry based analytical platforms for the determination of single steroid or steroid patterns seems to be an alternative analytical approach combining multi-parametric analysis, high sensitivity and specificity as well simple sample pre-treatment, robustness and low running costs for steroid analysis. This short review will give an overview about biological influencing factors and technical disturbing factors of routinely used immunoassay for the analysis of steroids. The application of LC-MS/MS as an alternative routine high-throughput platform for steroid analysis and its perspective role in the standardization and harmonisation of steroid measurements in clinical routine application will be discussed.
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Affiliation(s)
- Uta Ceglarek
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Paul List-Str.13-15, Germany
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Lih FB, Titus MA, Mohler JL, Tomer KB. Atmospheric pressure photoionization tandem mass spectrometry of androgens in prostate cancer. Anal Chem 2010; 82:6000-7. [PMID: 20560527 PMCID: PMC2928567 DOI: 10.1021/ac100460x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Androgen deprivation therapy is the most common treatment option for advanced prostate cancer. Almost all prostate cancers recur during androgen deprivation therapy, and new evidence suggests that androgen receptor activation persists despite castrate levels of circulating androgens. Quantitation of tissue levels of androgens is critical to understanding the mechanism of recurrence of prostate cancer during androgen deprivation therapy. A liquid chromatography atmospheric pressure photoionization tandem mass spectrometric method was developed for quantitation of tissue levels of androgens. Quantitation of the saturated keto-steroids dihydrotestosterone and 5-alpha-androstanedione required detection of a novel parent ion, [M + 15](+). The nature of this parent ion was explored, and the method was applied to prostate tissue and cell culture with comparison to results achieved using electrospray ionization.
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Affiliation(s)
- Fred Bjørn Lih
- National Institute of Environmental Health Sciences/National Institutes of Health/Department of Health and Human Services, Research Triangle Park, North Carolina 27709-2233, USA
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Agreement of immunoassay and tandem mass spectrometry in the analysis of cortisol and free t4: interpretation and implications for clinicians. Int J Anal Chem 2010; 2010. [PMID: 20706537 PMCID: PMC2913524 DOI: 10.1155/2010/234808] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 04/29/2010] [Indexed: 12/02/2022] Open
Abstract
Objective. To quantify differences in results obtained by immunoassays (IAs) and tandem mass spectrometry (MSMS) for cortisol and free thyroxine (FT4). Design & Patients. Cortisol was measured over 60 minutes following a standard ACTH stimulation test (n = 80); FT4 was measured over time in two cohorts of pregnant (n = 57), and nonpregnant (n = 28) women. Measurements. Samples were analyzed with both IA and MSMS. Results. Results for cortisol by the two methods tended to agree, but agreement weakened over the 60-minute test and was worse for higher (more extreme) concentrations. The results for FT4 depended on the method. IA measurements tended to agree with MSMS measurements when values fell within “normal levels”, but agreement was not constant across trimester in pregnant women and was poorest for the extreme (low/high) concentrations. Correlations between MSMS measurements and the difference between MSMS and IA results were strong and positive (0.411 < r < 0.823; all P < .05). Conclusions. IA and MSMS provide different measures of cortisol and FT4 at extreme levels, where clinical decision making requires the greatest precision. Agreement between the methods is inconsistent over time, is nonlinear, and varies with the analyte and concentrations. IA-based measurements may lead to erroneous clinical decisions.
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Direct measurement of serum free testosterone by ultrafiltration followed by liquid chromatography tandem mass spectrometry. Clin Biochem 2010; 43:490-6. [DOI: 10.1016/j.clinbiochem.2009.12.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 11/13/2009] [Accepted: 12/06/2009] [Indexed: 11/17/2022]
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Schwarz E, Liu A, Randall H, Haslip C, Keune F, Murray M, Longo N, Pasquali M. Use of steroid profiling by UPLC-MS/MS as a second tier test in newborn screening for congenital adrenal hyperplasia: the Utah experience. Pediatr Res 2009; 66:230-5. [PMID: 19390483 DOI: 10.1203/pdr.0b013e3181aa3777] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Newborn screening allows the diagnosis of congenital adrenal hyperplasia (CAH) before symptoms appear, preventing the severe and potentially life-threatening crisis associated with this disease in infancy. Traditional screening by enzyme immunoassay results in a large number of false positives. To reduce the number of unnecessary tests, anxiety to families and physicians, and the burden to the newborn screening follow-up program, we implemented a second-tier test for CAH using steroid profiling by an ultra-performance liquid chromatography-tandem mass spectrometry. We measured three steroids: 17-hydroxyprogesterone, androstenedione, and cortisol and correlated them with the age of infant at the time of sample collection and birth weight. Both age at collection and birth weight affected the levels of adrenal steroids, but the use of appropriate cut offs and analyte ratios allowed the identification of infants with CAH. This approach was effective in identifying infants with CAH, with both salt-wasting and simple virilizing forms, while reducing the false-positive rate from 2.6 to 0.09%.
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Affiliation(s)
- Elisabeth Schwarz
- ARUP Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, Utah 84108, USA.
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Bowden JA, Colosi DM, Stutts WL, Mora-Montero DC, Garrett TJ, Yost RA. Enhanced Analysis of Steroids by Gas Chromatography/Mass Spectrometry using Microwave-Accelerated Derivatization. Anal Chem 2009; 81:6725-34. [DOI: 10.1021/ac900663c] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- John A. Bowden
- Department of Chemistry, University of Florida, PO Box 117200, Gainesville, Florida 32611, and Biomedical Mass Spectrometry Laboratory, University of Florida, Department of Medicine, PO Box 100322, Gainesville, Florida 32610
| | - Dominic M. Colosi
- Department of Chemistry, University of Florida, PO Box 117200, Gainesville, Florida 32611, and Biomedical Mass Spectrometry Laboratory, University of Florida, Department of Medicine, PO Box 100322, Gainesville, Florida 32610
| | - Whitney L. Stutts
- Department of Chemistry, University of Florida, PO Box 117200, Gainesville, Florida 32611, and Biomedical Mass Spectrometry Laboratory, University of Florida, Department of Medicine, PO Box 100322, Gainesville, Florida 32610
| | - Diana C. Mora-Montero
- Department of Chemistry, University of Florida, PO Box 117200, Gainesville, Florida 32611, and Biomedical Mass Spectrometry Laboratory, University of Florida, Department of Medicine, PO Box 100322, Gainesville, Florida 32610
| | - Timothy J. Garrett
- Department of Chemistry, University of Florida, PO Box 117200, Gainesville, Florida 32611, and Biomedical Mass Spectrometry Laboratory, University of Florida, Department of Medicine, PO Box 100322, Gainesville, Florida 32610
| | - Richard A. Yost
- Department of Chemistry, University of Florida, PO Box 117200, Gainesville, Florida 32611, and Biomedical Mass Spectrometry Laboratory, University of Florida, Department of Medicine, PO Box 100322, Gainesville, Florida 32610
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Abstract
BACKGROUND New high-performance liquid chromatography/tandem mass spectrometry (LC-MS/MS) methods are among the most successful approaches to improve specificity problems inherent in many immunoassays. CONTENT We emphasize problems with immunoassays for the measurement of steroids and review the emerging role of LC-MS/MS in the measurement of clinically relevant steroids. The latest generation of tandem mass spectrometers has superior limits of quantification, permitting omission of previously employed derivatization steps. The measurement of steroid profiles in the diagnosis and treatment of congenital adrenal hyperplasia, adrenal insufficiency, chronic pelvic pain and prostatitis, oncology (breast cancer), and athletes has important new applications. CONCLUSIONS LC-MS/MS now affords the specificity, imprecision, and limits of quantification necessary for the reliable measurement of steroids in human fluids, enhancing diagnostic capabilities, particularly when steroid profiles are available.
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Affiliation(s)
- Steven J Soldin
- Department of Medicine, Georgetown University, Washington, DC 20007, USA.
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Rauh M. Steroid measurement with LC-MS/MS in pediatric endocrinology. Mol Cell Endocrinol 2009; 301:272-81. [PMID: 19007847 DOI: 10.1016/j.mce.2008.10.007] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Revised: 10/10/2008] [Accepted: 10/11/2008] [Indexed: 11/21/2022]
Abstract
The liquid chromatography-tandem mass spectrometry (LC-MS/MS) is an increasingly common tool in the clinical laboratory. Established applications include routine assays for detecting inborn errors of metabolism and for monitoring therapeutic drugs and steroids. Steroid profiling is a very effective method for distinguishing almost all steroid related disorders. It allows accurate diagnosis and is very useful in many clinical situations. Most methods for the determination of steroid hormones are based on immunoassays, which are rapid and easy to perform. However, the reliability of steroid immunoassays has been shown to be doubtful because of the lack of specificity and of matrix effects. Immunological methods, especially direct assays, often overestimate true steroid values. This is of particular importance in the newborn period and in early infancy. Problems with steroid immunoassays have further been reported for female patients or when analysing different media, e.g. saliva. Patient follow-up over time or between laboratories, as well as longitudinal studies are extremely difficult. In contrast to immunoassays, which allow the measurement of only a single steroid at a time, LC-MS/MS has the advantage that a wide spectrum of steroid hormones can be measured simultaneously. The applicability for clinical samples and problems in pediatric endocrinology will be discussed.
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Affiliation(s)
- Manfred Rauh
- Kinder- und Jugendklinik, Universitätsklinikum Erlangen, Loschgestr, 15, 91054 Erlangen, Germany.
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Ceglarek U, Kortz L, Leichtle A, Fiedler GM, Kratzsch J, Thiery J. Rapid quantification of steroid patterns in human serum by on-line solid phase extraction combined with liquid chromatography–triple quadrupole linear ion trap mass spectrometry. Clin Chim Acta 2009; 401:114-8. [DOI: 10.1016/j.cca.2008.11.022] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Revised: 11/21/2008] [Accepted: 11/21/2008] [Indexed: 11/24/2022]
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Soldin OP, Sharma H, Husted L, Soldin SJ. Pediatric reference intervals for aldosterone, 17alpha-hydroxyprogesterone, dehydroepiandrosterone, testosterone and 25-hydroxy vitamin D3 using tandem mass spectrometry. Clin Biochem 2009; 42:823-7. [PMID: 19318024 DOI: 10.1016/j.clinbiochem.2009.01.015] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Revised: 01/20/2009] [Accepted: 01/23/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To determine age and sex-specific pediatric reference intervals for aldosterone, 17alpha-hydroxyprogesterone, dehydroepiandrosterone, testosterone, and 25-hydroxy vitamin D(3). BACKGROUND AND DESIGN Reference intervals were determined for neonates and children 0-18 years of age. The study was conducted at both Children's National Medical Center and Georgetown University using outpatient blood samples obtained between January 1, 2004 and June 30, 2008. METHODS Serum samples were analyzed using isotope dilution liquid chromatography tandem mass spectrometry (LC/MS/MS) with deuterium-labeled internal standards at Children's National Medical Center and Georgetown University Medical Center Bioanalytical Core Laboratory. RESULTS AND CONCLUSIONS This is the first study to provide pediatric reference intervals of steroid hormones for children from birth to 18 years of age using LC/MS/MS. Reference intervals were established for aldosterone, 17alpha-hydroxyprogesterone, dehydroepiandrosterone, testosterone, and 25-hydroxy vitamin D(3). All the analytes exhibited at least some age dependence. Sex differences between early and late childhood and adolescence were found for 17alpha-hydroxyprogesterone and testosterone. Seasonal differences were apparent for 25-hydroxy vitamin D(3).
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Affiliation(s)
- Offie P Soldin
- Department of Oncology, Georgetown University Medical Center, USA.
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