Feasibility of Repurposing the Polyanionic Microbicide, PPCM, for Prophylaxis against HIV Transmission during ART.

HIV-serodiscordant couples wishing to conceive often seek assisted reproduction, during which spermatozoa from infected men are washed to minimize the risk of HIV transmission to partner and fetus. We sought to improve this method by adding a microbicide, PPCM, as an HIV prophylactic. HIV-1 (BaL) inhibition by PPCM appears irreversible and independent of added Ca(2+). Without added Ca(2+), PPCM (≤10 mg/mL, ≤90 min), a stimulus of Ca(2+)-dependent acrosomal loss, has no effect on sperm motility, forward progression, or acrosomal status. PPCM-treated (10 mg/mL) sperm retain their ability to acrosome react when Ca(2+) is added. Sperm DNA integrity/function is unaffected by PPCM (≤10 mg/mL). Adding PPCM (5 mg/mL, 30 min) to washing media reduces infectivity (viral antigen p24 and RNA) of ex-vivo HIV-infected semen by 3-4 Logs compared with washing alone. Sperm washing with appropriate extracellular Ca(2+) levels and PPCM is significantly more effective than washing alone at reducing HIV infectivity.

Direct determination of ethyl glucuronide and ethyl sulfate in postmortem urine specimens using hydrophilic interaction liquid chromatography-electrospray ionization-tandem mass spectrometry.

This work was aimed at developing and validating a hydrophilic interaction chromatography (HILIC)-electrospray ionization (ESI)-ion trap-tandem mass spectrometric method for identification and quantification of ethyl glucuronide (ETG) and ethyl sulfate (ETS) as ethanol biomarkers and at employing this method for analysis of postmortem urine samples. Analytes of interest were separated on a ZIC-HILIC column (150 x 2.1 mm, 3.5 microm) connected to a Thermo Finnigan LCQ Deca Plus liquid chromatographic- tandem mass spectrometric instrument operated in the ESI-selected reaction monitoring mode. Seventy-nine urine case samples were divided into three groups depending on the ethanol concentration found in blood and analyzed by the developed method: group A with postmortem blood ethanol concentrations higher than 200 mg/100 mL; group B with ethanol concentrations in the range 80-200 mg/100 mL; and group C with ethanol concentrations in the range 10-80 mg/100 mL. ETG and ETS had high recoveries of 98-99%, and the HILIC column produced fine, sharp peak shapes and achieved baseline separation in less than 7 min. Both ethanol markers were detected in all groups with overall median concentrations of 100 and 23 mg/L for ETG and ETS, respectively. It can be concluded that the potential for postmortem production of alcohol increased in the low ethanol concentration group as several cases tested negative for both biomarkers in group C. ETG was detected at low concentrations in some cases for which ETS tested negative. Although ETS is stable after being subjected to many stability conditions, the use of ETS as sole evidence of alcohol ingestion may lead to a false-negative result, as we noticed in groups A and C in the present study. The use of ETG is a more reliable ethanol biomarker. Both ethanol biomarkers should be determined in heavily putrefied cases and when the ethanol concentration in postmortem blood is low.

Method for the quantification of diamorphine and its metabolites in pediatric plasma samples by liquid chromatography-tandem mass spectrometry.

In recent years, intranasal diamorphine (DIM) has been recommended as an alternative to intravenous administration for the treatment of acute-to-severe pain in children. This provides a rapid and less painful route of administration without decreasing the effectiveness of the analgesic properties. A sensitive technique for the detection and quantitation of DIM and its metabolites is essential because of the low concentrations of DIM and metabolites in children's plasma, which are a result of the low dose of DIM given and the limited sample volume obtained from children (0.25 mL or less). DIM can be easily hydrolyzed to 6-monoacetylmorphine (6-MAM) during sample preparation and extraction, so this must be considered when developing a solid-phase extraction (SPE) method to prevent the hydrolysis of DIM. This work was aimed at validating and developing a liquid chromatography-tandem mass spectrometry (LC-MS-MS) method with electrospray ionization for the identification and quantification of DIM and its metabolites, namely 6-MAM, MOR, M3G, M6G, and NMOR in plasma samples obtained from children who are under treatment for acute-to-severe pain. Following the addition of deuterated internal standards, analytes were extracted by SPE with Bond Elut C(18) cartridges followed by LC-MS-MS analysis. Intraday and interday precision for all analytes were determined at five concentration (1, 5, 25, 50, and 200 ng/mL), and these were found to be 2.5-13.4% and 1.8-15%, respectively. Recoveries of analytes of interest were between 81 and 109%. Calibration curves were linear for all analytes over the concentration range 0.1-50 ng/mL, and correlation coefficients were better than 0.999. Limits of detection and quantitation were 0.08-0.37 ng/mL and 0.28-1.22 ng/mL, respectively. DIM and metabolites were detected in all case samples with the exception of NMOR, which tested negative in all cases. The pharmacokinetics of DIM and its metabolites following INDIM and IVDIM administration in children have been compared for the first time in this study, which confirmed that INDIM can achieve therapeutic plasma concentrations of DIM and its active metabolites, although these are lower than those obtained with IVDIM and occur at later times after administration.

Analysis of ketamine and norketamine in hair samples using molecularly imprinted solid-phase extraction (MISPE) and liquid chromatography-tandem mass spectrometry (LC-MS/MS).

An anti-ketamine molecularly imprinted polymer (MIP) was synthesized and used as the sorbent in a solid-phase extraction protocol to isolate ketamine and norketamine from human hair extracts prior to LC-MS/MS analysis. Under optimised conditions, the MIP was capable of selectively rebinding ketamine, a licensed anaesthetic that is widely misused as a recreational drug, with an apparent binding capacity of 0.13 microg ketamine per mg polymer. The limit of detection (LOD) and lower limit of quantification (LLOQ) for both ketamine and norketamine were 0.1 ng/mg hair and 0.2 ng/mg hair, respectively, when 10 mg hair were analysed. The method was linear from 0.1 to 10 ng/mg hair, with correlation coefficients (R(2)) of better than 0.99 for both ketamine and norketamine. Recoveries from hair samples spiked with ketamine and norketamine at a concentration of 50 ng/mg were 86% and 88%, respectively. The method showed good intra- and interday precisions (<5%) for both analytes. Minimal matrix effects were observed during the LC-MS/MS analysis of ketamine (ion suppression -6.8%) and norketamine (ion enhancement +0.2%). Results for forensic case samples demonstrated that the method successfully detected ketamine and norketamine concentrations in hair samples with analyte concentrations ranging from 0.2 to 5.7 ng/mg and from 0.1 to 1.2 ng/mg, respectively.

Oxycodone-related fatalities in the west of Scotland.

The intent of this study was to review fatalities involving oxycodone in the west of Scotland using a liquid chromatography-electrospray ionization-tandem mass spectrometry method developed for the determination of oxycodone and N- and O-demethylated metabolites in unhydrolyzed postmortem specimens. Ten oxycodone positive postmortem cases were detected, and nine were drug-related fatalities. Five cases were attributed solely to oxycodone intoxication and four to polydrug intoxication. Although there was overlap between blood oxycodone levels in deaths attributed to oxycodone only and those due to polydrug intoxication, lower oxycodone levels (< 1 mg/L) were associated with polydrug intoxication when compared with cases due to oxycodone alone (> 1 mg/L). The role of the parent drug in oxycodone fatalities has been fully studied, but the role of oxycodone metabolites (noroxycodone and oxymorphone) was investigated in this report for the first time. Oxycodone was more commonly detected in blood, urine, and vitreous humor followed by noroxycodone. The ratio between oxycodone and its N-demethylated metabolite was evaluated and found to be useful in determining whether death occurred shortly after drug administration or if there was a significant delay. High parent/metabolite ratios were correlated with short survival times after ingestion. The median ratio of oxycodone/noroxycodone was 2.4 and ranged from 0.7 to 49. Oxycodone prescriptions have risen sharply in Scotland in recent years, and the identification of 10 oxycodone-related deaths in the past 18 months highlights the importance of including this drug in routine laboratory screening and confirmation procedures.

Validation of an enzyme-linked immunosorbent assay screening method and a liquid chromatography-tandem mass spectrometry confirmation method for the identification and quantification of ketamine and norketamine in urine samples from Malaysia.

An ELISA and a liquid chromatography-tandem mass spectrometry (LC-MS-MS) confirmation method were developed and validated for the identification and quantitation of ketamine and its major metabolite norketamine in urine samples. The Neogen ketamine microplate ELISA was optimized with respect to sample and enzyme conjugate volumes and the sample preincubation time before addition of the enzyme conjugate. The ELISA kit was validated to include an assessment of the dose-response curve, intra- and interday precision, limit of detection (LOD), and cross-reactivity. The sensitivity and specificity were calculated by comparison to the results from the validated LC-MS-MS confirmation method. An LC-MS-MS method was developed and validated with respect to LOD, lower limit of quantitation (LLOQ), linearity, recovery, intra- and interday precision, and matrix effects. The ELISA dose-response curve was a typical S-shaped binding curve, with a linear portion of the graph observed between 25 and 500 ng/mL for ketamine. The cross-reactivity of 200 ng/mL norketamine to ketamine was 2.1%, and no cross-reactivity was detected with 13 common drugs tested at 10,000 ng/mL. The ELISA LOD was calculated to be 5 ng/mL. Both intra- (n = 10) and interday (n = 50) precisions were below 5.0% at 25 ng/mL. The LOD for ketamine and norketamine was calculated statistically to be 0.6 ng/mL. The LLOQ values were also calculated statistically and were 1.9 ng/mL and 2.1 ng/mL for ketamine and norketamine, respectively. The test linearity was 0-1200 ng/mL with correlation coefficient (R(2)) > 0.99 for both analytes. Recoveries at 50, 500, and 1000 ng/mL range from 97.9% to 113.3%. Intra- (n = 5) and interday (n = 25) precisions between extracts for ketamine and norketamine were excellent (< 10%). Matrix effects analysis showed an average ion suppression of 5.7% for ketamine and an average ion enhancement of 13.0% for norketamine for urine samples collected from six individuals. A comparison of ELISA and LC-MS-MS results demonstrated a sensitivity, specificity, and efficiency of 100%. These results indicated that a cutoff value of 25 ng/mL ketamine in the ELISA screen is particularly suitable and reliable for urine testing in a forensic toxicology setting. Furthermore, both ketamine and norketamine were detected in all 34 urine samples collected from individuals socializing in pubs by the Royal Malaysian Police. Ketamine concentrations detected by LC-MS-MS ranged from 22 to 31,670 ng/mL, and norketamine concentrations ranged from 25 to 10,990 ng/mL. The concentrations of ketamine and norketamine detected in the samples are most ikely indicative of ketamine abuse.

A new tent trap for sampling exophagic and endophagic members of the Anopheles gambiae complex.

BACKGROUND: Mosquito sampling methods are essential for monitoring and evaluating malaria vector control interventions. In urban Dar es Salaam, human landing catch (HLC) is the only method sufficiently sensitive for monitoring malaria-transmitting Anopheles. HLC is labour intensive, cumbersome, hazardous, and requires such intense supervision that is difficulty to sustain on large scales. METHODS: Novel tent traps were developed as alternatives to HLC. The Furvela tent, designed in Mozambique, incorporates a CDC Light trap (LT) components, while two others from Ifakara, Tanzania (designs A and B) require no electricity or moving parts. Their sensitivity for sampling malaria vectors was compared with LT and HLC over a wide range of vector abundances in rural and urban settings in Tanzania, with endophagic and exophagic populations, respectively, using randomised Latin-square and cross- over experimental designs. RESULTS: The sensitivity of LTs was greater than HLC while the opposite was true of Ifakara tent traps (crude mean catch of An. gambiae sensu lato relative to HLC = 0.28, 0.65 and 1.30 for designs A, B and LT in a rural setting and 0.32 for design B in an urban setting). However, Ifakara B catches correlated far better to HLC (r2 = 0.73, P < 0.001) than any other method tested (r2 = 0.04, P = 0.426 and r2 = 0.19, P = 0.006 for Ifakara A and LTs respectively). Only Ifakara B in a rural setting with high vector density exhibited constant sampling efficiency relative to HLC. The relative sensitivity of Ifakara B increased as vector densities decreased in the urban setting and exceeded that of HLC at the lowest densities. None of the tent traps differed from HLC in terms of the proportions of parous mosquitoes (P >or= 0.849) or An. gambiae s.l. sibling species (P >or= 0.280) they sampled but both Ifakara A and B designs failed to reduce the proportion of blood-fed mosquitoes caught (Odds ratio [95% Confidence Interval] = 1.6 [1.2, 2.1] and 1.0 [0.8, 1.2], P = 0.002 and 0.998, respectively), probably because of operator exposure while emptying the trap each morning. CONCLUSION: The Ifakara B trap may have potential for monitoring and evaluating a variety of endophagic and exophagic Afrotropical malaria vectors, particularly at low but epidemiologically relevant population densities. However, operator exposure to mosquito bites remains a concern so additional modifications or protective measures will be required before this design can be considered for widespread, routine use.

Clinical observations and seven-and-one-half-year follow-up of patients using an integrative holistic approach for treating chronic sinusitis.

CONTEXT: Despite the widespread popularity of alternative medical approaches to respiratory and allergic disorders, there is a lack of scientific substantiation of their benefits. OBJECTIVE: Assessment of the therapeutic benefit of an integrative holistic approach to the treatment of chronic sinusitis. DESIGN: Patients began a 5-month program consisting of 5 evening sessions of 2 hours each in October of 1999. SETTING: The program was held in the offices of one of the authors (WSS). PATIENTS: Ten patients of an allergist-immunologist specialist (WSS), symptomatic despite aggressive conventional treatment for their chronic sinusitis, were recruited to participate in an integrative holistic medical education and treatment program consisting of 5 sessions and evaluated at a 1-year follow-up. Sessions consisted of education in lifestyle and indoor-air modification, nasal hygiene, and treatment with fluconazole. Eight of 9 subjects were located and provided feedback 7 years and 6 months later, in June 2007. MAIN OUTCOME MEASURES: Health-related quality of life (QOL) was assessed using the short-form QOL survey (SF-12) and rhinitis QOL by the Rhinitis Quality of Life Questionnaire (RQLQ). RESULTS: No significant differences emerged in the SF-12 or mini-RQLQ scores comparing visit 2 with visit 1. Statistically significant improvement for physical and mental subscales of the SF-12 emerged comparing the results of visit 4 with visit 2 after the addition offluconazole treatment to the regimen, persisting through an additional year of follow-up. Feedback at 7.5 years confirmed marked long-term improvement in chronic sinusitis symptoms compared to their pre-study condition.

Nitric oxide-dependent human acrosomal loss induced by PPCM (SAMMA) and by nitric oxide donors occurs by independent pathways: basis for synthesis of an improved contraceptive microbicide.

PPCM (previously designated sulfuric acid-modified mandelic acid [SAMMA]) is a contraceptive microbicide in preclinical development. Its contraceptive activity is attributable in part to its ability to promote premature acrosomal loss. Prior studies showed that PPCM-induced human acrosomal loss (PAL) is Ca(2+)-dependent. This study was carried out to determine transduction elements downstream from Ca(2+) entry. PAL is inhibited by inhibitors selective for endothelial-type nitric oxide synthase. PAL is completely inhibited by 0.1 microM ODQ (soluble guanylate cyclase inhibitor). PAL is inhibited by protein kinase G inhibitors with selectivity for the type II isotype. Several inhibitors of the nitric oxide/cyclic guanosine monophosphate (cGMP)/protein kinase G pathway induce Ca(2+)-dependent acrosomal loss when added alone. These responses are inhibited by nifedipine, a blocker of Ca(v1.x) voltage-dependent channels. Acrosomal loss induced by the nitric oxide donor SNAP (SNAL) does not require added Ca(2+). Sperm production of nitric oxide is increased by PPCM, an effect inhibited by nitro-L-arginine (nitric oxide synthase inhibitor). Although inhibited by ODQ, SNAL and acrosomal loss induced by other nitric oxide donors are unaffected by KT5823 (protein kinase G inhibitor). Unlike PAL, SNAL is partially inhibited by KT5720 (protein kinase A inhibitor) and genistein (protein tyrosine kinase inhibitor). Acrosomal loss response to PPCM and SNAP added in combination suggests that these agents act by independent mechanisms. A PPCM derivative was synthesized, in which a nitric oxide donor was esterified to PPCM (NOSPPA-23). NOSPPA-23 induces acrosomal loss with or without added Ca(2+). The ED(50) of NOSPPA-23 (4.8 nM) in the presence of Ca(2+) is 35-fold less than that of PPCM. These findings suggest the following: 1) elements responsible for PAL include endothelial nitric oxide synthase, soluble guanylate cyclase, and type II protein kinase G; 2) the resting state of the nitric oxide/cGMP/protein kinase G pathway is a determinant of acrosomal status; 3) PPCM and nitric oxide donors induce acrosomal loss via nitric oxide, but through independent pathways; and 4) covalent attachment of a nitric oxide donor to PPCM provides synergistic efficacy as a stimulus of acrosomal loss. Further studies with this novel prototype as an improved contraceptive microbicide are warranted.

Differential Sensitivity of Lactobacillus spp. to Inhibition by Candidate Topical Microbicides.

Preclinical evaluation of vaginal microbicides includes screening against lactobacilli. However, there is no consensus regarding the species to be tested. This study was carried out to determine if results with one species would apply to other species, and to evaluate the utility of turbidometry as a screening tool. One current (PPCM; previously designated sulfuric acid-modified mandelic acid, SAMMA) and two former (cellulose sulfate, CS; and polystyrene sulfonate, PSS) candidate microbicides were evaluated. Bacterial growth was measured turbidometrically and by direct cell count. No microbicide affected Lact. gasseri, measured by either method. Apparent inhibition of Lact. jensenii by CS, PSS, and PPCM, and of Lact. crispatus by CS, occurred with turbidometric measurement. This was not substantiated with direct cell count. PSS and PPCM inhibited Lact. crispatus and Lact. acidophilus with both methods. These findings agree with results from vaginal isolates, which included Lact. gasseri, jensenii, acidophillus, crispatus, rhamnosis, casei, and paracasei. We conclude that sensitivities of similar lactobacilli to at least three microbicides are different. A single species is inadequate for screening vaginal products. Turbidometric evaluation is a sensitive, but not specific, screening method. We recommend that this method be used to screen candidate microbicides against several species of prevalent Lactobacillus species as an initial measure of microbicide safety evaluation.

Comparison of nonhydrolysis and hydrolysis methods for the determination of buprenorphine metabolites in urine by liquid chromatography-tandem mass spectrometry.

A highly sensitive and selective method for the direct determination of buprenorphine (BUP), norbuprenorphine (NBUB), buprenorphine-3-glucuronide, and norbuprenorphine-3-glucuronide in urine was developed and validated. Analytes of interest were extracted by solid-phase extraction on Bond Elut C18, followed by liquid chromatography-electrospray ionization tandem mass spectrometry analysis using a Synergy Polar RP column. Gradient elution was based on a mobile phase consisting of 10 mM ammonium formate adjusted to pH 3 and acetonitrile. Acceptance criteria for linearity, precision, and recovery were achieved for all analytes. Intraday and interday precisions were better than 12% and 14%, respectively. Calibration curves were linear for BUP and its metabolites over the concentration range of 5-250 ng/mL, and correlation coefficients (R(2)) were better than 0.999. Limits of detection and lower limits of quantification were 0.2-0.4 and 0.7-1.2 ng/mL, respectively. Recoveries were in the range of 76-96%. No interference was detected with other common drugs. The described method was compared with an in-house hydrolysis method using 21 real urine case samples. BUP and NBUP were detected using both methods, with higher concentrations obtained using the direct method. Both methods were linear with correlation coefficients of 0.994 and 0.986 for total BUP and total NBUP, respectively. The comparison between the direct detection of BUP and its metabolites with the analysis of total BUP and total NBUP using the hydrolysis method is reported for the first time in this work.

Spermicidal activity of the safe natural antimicrobial peptide subtilosin.

Bacterial vaginosis (BV), a condition affecting millions of women each year, is primarily caused by the gram-variable organism Gardnerella vaginalis. A number of organisms associated with BV cases have been reported to develop multidrug resistance, leading to the need for alternative therapies. Previously, we reported the antimicrobial peptide subtilosin has proven antimicrobial activity against G. vaginalis, but not against the tested healthy vaginal microbiota of lactobacilli. After conducting tissue sensitivity assays using an ectocervical tissue model, we determined that human cells remained viable after prolonged exposures to partially-purified subtilosin, indicating the compound is safe for human use. Subtilosin was shown to eliminate the motility and forward progression of human spermatozoa in a dose-dependent manner, and can therefore be considered a general spermicidal agent. These results suggest subtilosin would be a valuable component in topical personal care products aimed at contraception and BV prophylaxis and treatment.

Stability of benzodiazepines and cocaine in blood spots stored on filter paper.

Previous studies have shown that drug concentrations in blood can change during storage, especially at room temperature, but even labile drugs such as cocaine may be stable in dried blood spots (DBS). A new method has been developed for the analysis of hydrolytically labile drugs in blood spots on filter paper in order to assess their degradation during a storage period of one month. The drugs selected included flunitrazepam, temazepam, oxazepam, lorazepam, nitrazepam, diazepam, and cocaine. A Guthrie card 903 was spotted with 100 microL of blood containing the drugs at concentrations of 1000 ng/mL and left overnight to dry at room temperature. The filter paper was suspended in extraction buffer for 1 h with ultrasonication. Drugs were then extracted from the buffer by solid-phase extraction using Clean Screen((R)) columns and analyzed by liquid chromatography-tandem mass spectrometry. Method validation showed that all calibration curves were linear over the concentration range 5-200 ng/spot with correlation coefficients of 0.994-0.999. Interday and intraday precisions at three concentrations (10, 50, and 100 ng/spot) were 1.6-18.3% and 2.8-14.7%, respectively. Limits of detection were 0.29-0.74 ng/spot, and lower limits of quantitation were 0.99-2.46 ng/spot. Recoveries of all analytes were in the range 81-106%. DBS were stored in duplicate at room temperature, 4 degrees C, and -20 degrees C for up to one month. Degradation of the drugs in DBS at all storage conditions was less than for the corresponding liquid blood samples stored under similar conditions and more than 80% of each analyte could be recovered from the samples.

Tires as larval habitats for mosquitoes (Diptera: Culicidae) in southern Manitoba, Canada.

In 2003, a survey at waste management grounds and tire dealerships was conducted to determine the species composition of mosquitoes in tires in southern Manitoba, Canada. Over 25% of the 1,142 tires sampled contained a total of 32,474 mosquito larvae and pupae. Culex restuans made up at least 95% of the larvae collected for each month of the summer. Culiseta inornata and Culex tarsalis reached their greatest numbers in July and August, respectively, though they were never abundant. Ochlerotatus triseriatus was also found but never reached more than 1% of the total larvae collected in any given month. Mosquito prevalence was more than three times greater in August (36.1%) than in June (11.7%). Orientation affected prevalence of mosquitoes in tires: 31.4% of vertical tires (tires standing on their treads) contained mosquitoes, whereas mosquitoes were found in only 18.9% of horizontal tires (tires parallel to the ground). Tires in the eastern region of Manitoba contained mosquitoes more often (61.7%), irrespective of date, than Winnipeg (25.9%), the central region (29.1%), or the western region (19.8%). Mosquito prevalence was similar across three size categories of tires, car tires (18.8%), truck tires (19.8%), and semi-trailer tires (26.7%), though tractor tires (47.8%) contained significantly more mosquitoes than tires in the other categories.

Comparison of molecularly imprinted solid-phase extraction (MISPE) with classical solid-phase extraction (SPE) for the detection of benzodiazepines in post-mortem hair samples.

This preliminary study compares the benzodiazepine results for 10 post-mortem scalp hair samples using a classical solid-phase extraction (SPE) and a molecularly imprinted solid-phase extraction (MISPE) system. The hair samples selected for testing were from drug-related deaths where a positive benzodiazepine blood result was obtained. Samples were decontaminated with 0.1% sodium dodecyl sulfate, distilled water and dichloromethane, incubated overnight in methanol/25% aqueous ammonium hydroxide (20:1), extracted by SPE or MISPE and subsequently analysed by liquid chromatography-tandem mass spectrometry (LC-MS-MS). Both extraction methods detected diazepam, nordiazepam, oxazepam, temazepam and nitrazepam in the samples. Diazepam was detected in a greater number of samples using MISPE due to both its lower limit of detection (LOD) and higher extraction recovery as a result of excellent molecular recognition of the template (diazepam) imparted by the imprinting process. The selective recognition of two diazepam analogues, nordiazepam and oxazepam, was demonstrated using MISPE since they were also detected in a greater number of samples. In contrast, another diazepam analogue, temazepam, was detected in a greater number of samples using SPE since the LOD using this extraction was lower than with MISPE. Nitrazepam was detected in one sample using both extraction methods. Overall the MISPE and SPE hair results were in good qualitative agreement. For the samples, where both extraction methods detected nordiazepam, temazepam and oxazepam, the concentrations were always higher for SPE. This is probably due to the MIP procedure producing extracts with fewer matrix interferences than the extracts produced using the classical SPE method. MISPE could be used as a complementary method to classical SPE for the analysis of benzodiazepine positive hair samples collected from chronic users.

SAMMA, a mandelic acid condensation polymer, inhibits dendritic cell-mediated HIV transmission.

SAMMA, a mandelic acid condensation polymer, exhibits a broad antimicrobial activity against several sexually transmitted pathogens including human immunodeficiency virus (HIV). Here we demonstrated that SAMMA suppressed HIV transmission by dendritic cells (DCs), one of the first target cells for primary infection. The greatest inhibitory effect was achieved when SAMMA was present during the co-culture with target cells. The inhibitory effect of SAMMA on DC-mediated HIV transmission was not due to cytotoxicity. Analysis of the level of DC-associated HIV p24 antigen revealed that SAMMA prevented HIV internalization by DCs when the virus was pre-incubated with the compound. In contrast, pre-incubation of DCs with SAMMA followed by wash-off did not affect the amount of cell-associated HIV p24 antigen. In addition, SAMMA blocked HIV glycoprotein-mediated cell-cell fusion. This study suggests that SAMMA prevents HIV infection through multiple mechanisms.

Method for quantification of opioids and their metabolites in autopsy blood by liquid chromatography-tandem mass spectrometry.

A method using liquid chromatography-electrospray ionization-tandem mass spectrometry was developed and validated for the determination of morphine, codeine, hydromorphone, dihydrocodeine, oxycodone, buprenorphine, and naloxone with their metabolites morphine-3-glucuronide, morphine-6-glucuronide, normorphine, 6-acetylmorphine, 6-acetylcodeine, codeine-6-glucuronide, norcodeine, hydromorphine-3-glucuronide, dihydrocodeine-6-glucuronide, dihydromorphine, dihydromorphine-3-glucuronide, dihydromorphine-6-glucuronide, oxymorphone, norbuprenorphine, buprenorphine-3-glucuronide, norbuprenorphine-3-glucuronide, and naloxone-3-glucuronide in human whole blood. Polar metabolites (glucuronides) and other analytes were extracted by SPE using Bond Elut C18. Chromatographic separation was performed on a Phenomenex Synergi reversed-phase column with gradient elution based on a mobile phase consisting of 10mM ammonium formate adjusted to pH 3 and acetonitrile. Intraday and interday precision for all analytes were between 0.6% and 13.8%, and recoveries were between 80.3% and 101.4%. Calibration curves were linear for all analytes over the concentration range 5-400 ng/mL, and correlation coefficients (R(2)) were better than 0.999. Limits of detection and quantitation were 0.16-1.2 ng/mL and 0.5-4.09 ng/mL, respectively. The method described consolidates previous work on opioids and their metabolites published in the literature and is the first to include the detection of naloxone-3-glucuronide. The method has been applied in routine postmortem cases after opiate overdose with the threefold purpose of providing interpretive information on the cause and type of death (rapid, sub-acute, or delayed death) and to distinguish heroin, morphine, and codeine users.

Molecularly imprinted solid-phase extraction of diazepam and its metabolites from hair samples.

An anti-diazepam, molecularly imprinted polymer (MIP) has been synthesized and used to extract diazepam and other benzodiazepines from hair samples via a molecularly imprinted solid-phase extraction (MISPE) protocol. Optimum retention of diazepam on the MIP columns was achieved using an apolar solvent, and the binding capacity of the polymer toward diazepam was found to be 110 ng of diazepam/mg of polymer. The recovery of a 50 ng diazepam standard spiked into blank hair was 93%, with good precision (RSD = 1.5%). The LOD and LOQ of diazepam in spiked hair samples were 0.09 and 0.14 ng/mg, respectively. The MISPE method was demonstrated to be applicable to the analysis of diazepam metabolites and other benzodiazepine drugs, in addition to diazepam itself. The application of the extraction method to postmortem hair samples yielded results that were in good agreement with the corresponding ELISA data (from blood samples) and data arising from the analysis of the same blood samples using a validated in-house SPE-LC-MS-MS method.

ACIDFORM inactivates herpes simplex virus and prevents genital herpes in a mouse model: optimal candidate for microbicide combinations.

The acidic vaginal milieu is presumed to inactivate pathogens but is neutralized by semen. This notion fostered the development of acid-buffering products, such as ACIDFORM (developed by Program for Topical Prevention of Conception and Disease, Rush University, and licensed by Instead), as microbicides. However, the extent and mechanism of protective activity provided by buffering gels is not known. Exposure of herpes simplex virus (HSV) to pH 4.5 or lower irreversibly inactivated HSV and reduced HSV yields by at least 90%; exposure to pH 5.0 had little or no effect. Pretreatment of HSV-2 with pH 3.5-4.5 triggered proteolysis, disrupting the HSV particle and resulting in a reduction in binding and invasion. ACIDFORM protected 21 (81%) of 26 mice from genital herpes, compared with 3 (12%) of 25 mice who received a placebo gel. ACIDFORM retained significant activity if mice were challenged with HSV delivered in seminal fluid. These findings suggest that ACIDFORM offers considerable protection against HSV and may be an optimal candidate for developing combination microbicides.

LC/MS/MS analysis of quaternary ammonium drugs and herbicides in whole blood.

Quaternary ammonium drugs (atracurium, bretylium, edrophonium, ipratropium, mivacurium, neostigmine, pancuronium and rocuronium) and herbicides (difenzoquat, diquat and paraquat) in human whole blood were analysed by LC/MS/MS with positive electrospray ionisation (ESI), following extraction with Bond Elut LRC-CBA cartridges. Internal standards were benzyldimethylphenylammonium chloride monohydrate and ethyl viologen for drug and herbicide analysis, respectively. Ion-pair chromatography used heptafluorobutyric acid (15 mM)-ammonium formate (20 mM) buffer adjusted to pH 3.30 with formic acid and a linear gradient from 5 to 90% methanol run over 18 min. Recoveries ranged from 79.7 to 105.1%, detection limits were between 3.6 and 20.4 ng/ml and the intra- and inter-day precisions were less than 18.6% at a concentration of 10 ng/ml. The method was applied to a case of accidental paraquat poisoning in which the concentration of paraquat in blood was 0.64 mg/l, which is within the range associated with fatal paraquat poisoning.