A high resolution LC-MS targeted method for the concomitant analysis of 11 contraceptive progestins and 4 steroids

In the context of hormonal contraception and hormone replacement therapy (HRT), many women are exposed to exogenous hormones. Current use of hormonal contraception with combined ethinyl estradiol and different progestins bestows a breast cancer relative risk (RR) of 1.2- while combined HRT has a RR of 2. Although these exposures present an important public health issue, little is known about the effects of individual progestins on the breast and other tissues. Increasing availability of large scale biobanks, high throughput analyses and data management tools enable ever expanding, sophisticated population studies. In order to address the impact of distinct progestins on various health indicators, it is desirable to accurately quantify progestins in clinical samples. Here we have developed and validated a high resolution liquid chromatography mass spectrometry (LC-MS) targeted method for the simultaneous quantification of 11 synthetic progestins widely used in oral contraceptives, gestodene, levonorgestrel, etonogestrel, chlormadinone acetate, cyproterone acetate, drospirenone, desacetyl norgestimate, medroxyprogesterone acetate, norethindrone, dienogest, nomegestrol acetate, and 4 endogenous steroid hormones, progesterone, testosterone, androstenedione, and cortisol in blood samples. This highly specific quantitative analysis with high resolution Orbitrap technology detects and quantifies 15 compounds using their internal standard counterparts in a single 12 min LC-MS run. Sensitivity is attained by the use of the instrument in targeted selected ion monitoring mode. Lower limit of quantitation ranges from 2.4 pg/ml for drospirenone to 78.1 pg/ml for chlormadinone acetate. The method provides comprehensive progestin panel measurements with as little as 50 μl of murine or human plasma.

Development of reference intervals for the large intestinal transit of radiopaque markers in dogs

Ten healthy dogs were fed 30 1.5 mm and 10 5 mm radiopaque markers (BIPS, MedID, Grand Rapids) mixed with sufficient quantities of a high fibre diet to meet 25% of their estimated daily caloric requirements. Abdominal radiographs were made at two hour intervals until 90% of the small and large markers had left the colon. The mean residence times (MRT) of each size of marker in the proximal, distal and total colon were calculated using kinetic analysis. The MRT's of the small markers were 4.9 hours (SD 4.4), 7.1 hours (SD 3.3) and 12.0 hours (SD 7.1) respectively. The MRT's of the large markers were not significantly different from the small markers except in the proximal colon where they were significantly shorter (3.2 hours, SD 2.3). Reference colonic filling and colonic transit curves for both sizes of markers were constructed. These may be useful to detect abnormal colonic transit in dogs.