A Brazilian Rare-Disease Center's Experience with Glucosylsphingosine (lyso-Gb1) in Patients with Gaucher Disease: Exploring a Novel Correlation with IgG Levels in Plasma and a Biomarker Measurement in CSF.

Gaucher disease (GD, OMIM 230800) is one of the most common lysosomal disorders, being caused by the deficient activity of the enzyme acid ß-glucocerebrosidase (Gcase). Three clinical forms of Gaucher's disease (GD) are classified based on neurological involvement. Type 1 (GD1) is non-neuronopathic, while types 2 (GD2) and 3 (GD3) are neuronopathic forms. Gcase catalyzes the conversion of glucosylceramide (GlcCer) into ceramide and glucose. As GlcCer accumulates in lysosomal macrophages, it undergoes deacylation to become glycosylsphingosine (lyso-Gb1), which has shown to be a useful and reliable biomarker for the diagnosis and monitoring of treated and untreated patients with GD. Multiple myeloma (MM) is one of the leading causes of cancer-related death among patients with GD and monoclonal gammopathy of undetermined significance (MGUS) is a non-neoplastic condition that can be a telltale sign of a B clonal proliferation caused by the chronic activation of B cells. This study aimed to quantify Lyso-Gb1 levels in dried blood spots (DBS) and cerebrospinal fluid (CSF) as biomarkers for Gaucher disease (GD) and discuss the association of this biomarker with other clinical parameters. This is a mixed-methods study incorporating both cross-sectional and longitudinal elements within a cohort design with a convenience-sampling strategy. Data collection took place from January 2012 to March 2023. Lyso-Gb1 extraction from DBS involved the use of a methanol-acetonitrile-water mixture, followed by incubation and centrifugation. Analysis was performed using UPLC-MS/MS with MassLynx software version 4.2 and the control group for the DBS measurements included general newborns. CSF Lyso-Gb1 was extracted using ethyl acetate, analyzed by UPLC-MS/MS with a calibration curve, and expressed in pmol/L. Lysosomal activity in CSF was assessed by measuring chitotriosidase (Cht), and other lysosomal enzyme activities were assessed as previously described in the literature. Patients with metachromatic leukodystrophy (MLD) were used as controls. Thirty-two treated patients (twenty-nine GD1 and three GD3, all on ERT except for one GD type on SRT with eliglustat) and three untreated patients (one GD1, one GD2, and one GD3) were included. When analyzing only the treated GD1 group, a significant correlation was found between lyso-Gb1 and age (rho = -0.447, p = 0.001), ChT, and IgG levels (rho = 0.73, p < 0.001; and rho = 0.36, p = 0.03, respectively). Five GD1 patients (three females, mean age 40 years) also had their CSF collected and analyzed. The average measurement of lyso-Gb1 in CSF was 94 pmol/L (range: 57.1-157.9 pmol/L) versus <6.2 pmol/L in the control group (MLD). This is the first time, to the best of our knowledge, that lyso-Gb1 has been associated with IgG levels. While this finding reflects a risk for MGUS or MM and not only chronic plasma B-cell activation, it still requires further studies. Moreover, the analysis of CSF lyso-Gb1 levels in GD1 patients was demonstrated to be significantly higher than the control group. This raises the hypothesis that CSF lyso-Gb1 may serve as a valuable indicator for neurological involvement in GD, providing insights into the potential implications for neurological manifestations in GD, including GD1. The correlation between lyso-Gb1 and ChT levels in treated GD1 patients further underscores the interconnectedness of lysosomal markers and their relevance in monitoring.

Follow-up of pre-motor symptoms of Parkinson's disease in adult patients with Gaucher disease type 1 and analysis of their lysosomal enzyme profiles in the CSF.

BACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disease worldwide. Its classic motor symptoms may be preceded by non-motor symptoms (NMS). Population studies have identified GBA variants as risk factors for idiopathic PD. The increased risk of PD has also been suggested in other Lysosomal Storage Disorders (LSDs). OBJECTIVE: To assess the evolution of the prevalence of NMS compatible with PD in a cohort of South Brazilian adult patients with Gaucher Disease (GD) type 1, already evaluated 3 years ago (2018). Cerebrospinal Fluid (CSF) was collected to assess the levels of LSD enzymes (beta-hexosaminidases, beta-glucuronidase) and biomarker of macrophage activation (chitotriosidase, ChT), compared to controls (metachromatic leukodystrophy, MLD). Cognition was evaluated by the Montreal Cognitive Assessment (MoCA) questionnaire, daytime sleepiness by the Epworth Sleepiness Scale (ESS), depression by Beck´s Inventory, constipation by the Unified Multiple System Atrophy Rating Scale (UMSARS) scale, and REM sleep behavior disorder by the single-question screen. Hyposmia was assessed with Sniffin' Sticks (SST). RESULTS: Nineteen patients completed the follow-up (mean age of the sample was 44 years; range, 26-71). The patient with the highest number of NMS at the baseline (4 including the lowest SST score) was diagnosed with PD four years later. Apart from an improvement in the ESS score, no other statistical significance was found between the number of NMS between the first and second evaluation, nor between patients with one L444P variant (n = 5) and the rest of the cohort. CSF was collected in five patients (mean age of the sample was 40 years, range 30-53. A significant difference was found in the mean CSF activity levels of beta-hexosaminidases and beta-glucuronidase between GD1 and MLD patients. Mean ChT (CSF) was 62 nmol/h/mL in GD patients and 142 in MLD (n = 6) patients. CONCLUSIONS: The patient with the highest number of NMS in our 2018 cohort was the one that developed PD, corroborating with the importance of this longitudinal follow-up. CSF and plasma analysis might allow a better understanding of the neurodegenerative processes connecting PD and the lysosomal environment. Further analysis is needed to understand this relationship.

Corrigendum to " Biochemical diagnosis of aromatic-L-amino acid decarboxylase deficiency (AADCD) by assay of AADC activity in plasma using liquid chromatography/tandem mass spectrometry" [32/100888 (2022) page 1-4].

[This corrects the article DOI: 10.1016/j.ymgmr.2022.100888.].

Experience of the NPC Brazil Network with a Comprehensive Program for the Screening and Diagnosis of Niemann-Pick Disease Type C.

Niemann-Pick disease type C (NPC) is a lysosomal disorder caused by impaired cholesterol metabolism. Levels of lysosphingomyelin 509 (LysoSM509) have been shown elevated in dried blood spots (DBS) of NPC and acid sphingomyelinase deficiency patients. In this study, we report our experience using a two-tier approach (1st tier is the quantification of lysoSM509 by ultra-performance liquid chromatography tandem mass spectrometry followed by the 2nd tier with next-generation sequencing of the NPC1 and NPC2 genes). DBS samples from 450 suspected patients were received by the NPC Brazil network. Of these, 33 samples had elevated levels of lysoSM509, and in 25 of them, variants classified as pathogenic, likely pathogenic, or of unknown significance were identified in the NPC1 or NPC2 genes by next-generation sequencing. The quantification of lysoSM509 in DBS as a first-tier test for the diagnosis of NPC followed by molecular analysis of the NPC1 and NPC2 genes almost doubled the detection rate when compared to the performance of chitotriosidase activity as a first-tier biomarker, and it could likely be increased with the addition of a third tier with MLPA of the two genes involved. This strategy seems suitable for the neonatal screening (NBS) of NPC if this disease is eventually adopted by NBS programs.

Biochemical diagnosis of aromatic-L-amino acid decarboxylase deficiency (AADCD) by assay of AADC activity in plasma using liquid chromatography/tandem mass spectrometry.

Aromatic l-amino acid decarboxylase (AADC, EC 4.1.1.28) deficiency is a rare genetic disorder characterized by developmental delay, oculogyric crises, autonomic dysfunction and other problems, caused by biallelic mutations in the DDC gene leading to deficient activity of aromatic l-amino acid decarboxylase, an enzyme involved in the formation of important neurotransmitters, such as dopamine and serotonin. A clinical development program of gene therapy for AADC deficiency is ongoing. An important step for the success of this therapy is the early and precise identification of the affected individuals, but it has been estimated that around 90% of the cases remain undiagnosed. The availability measurement of the AADC activity is mandatory for an accurate biochemical diagnosis. Based on these statements, our objectives were to develop a liquid chromatography tandem mass spectrometry (LC-MS/MS) method suitable for the determination of the AADC activity, and to evaluate its capacity to confirm the deficiency of AADC in potential patients in Brazil. The AADC activities were measured in plasma samples of seven AADC deficient patients and 35 healthy controls, after enzymatic reaction and LC-MS/MS analysis of dopamine, the main reaction product. The results obtained showed clear discrimination between confirmed AADC deficient patients and healthy controls. The method presented here could be incorporated in the IEM laboratories for confirmation of the diagnosis of when a suspicion of AADC deficiency is present due to clinical signs and/or abnormal biomarkers, including when an increased level of 3-O-methyldopa (3-OMD) is found in dried blood spots (DBS) samples from high-risk patients or from newborn screening programs.

Ultrasound-assisted biomass valorization to industrial interesting products: state-of-the-art, perspectives and challenges.

Nowadays, the application of ultrasound (US) energy for assisting the lignocellulosic biomass and waste materials conversion into value-added products has dramatically increased. In this sense, this review covers theoretical aspects, promising applications, challenges and perspectives about US and its use for biomass treatment. The combination of US energy with a suitable reaction time, temperature and solvent contributes to the destruction of recalcitrant lignin structure, allowing the products to be used in thermochemical and biological process. The main mechanisms related to US propagation and impact on the fragmentation of lignocellulosic materials, selectivity, and yield of conversion treatments are discussed. Moreover, the synergistic effects between US and alternative green solvents with the perspective of industrial applications are investigated. The present survey analysed the last ten years of literature, studying challenges and perspectives of US application in biorefinery. We were aiming to highlight value-added products and some new areas of research.

A single step ultrasound-assisted nitrocellulose synthesis from microcrystalline cellulose.

Nitrocellulose is a nitrated cellulose polymer with a broad application in industry. Depending on the nitrogen content, this polymer can be used for manufacturing explosives, varnishes, clothes, and films, being considered a product of high value-added. In this work, the use of ultrasound was investigated for the intensification of nitrocellulose synthesis from microcrystalline cellulose. The ultrasound-assisted nitrocellulose synthesis (UANS) was carried out using several ultrasound systems, such as baths and cup horns, allowing the evaluation of the frequency (from 20 to 130 kHz) and delivered power (from 23 to 134 W dm-3) to the reaction medium. The following parameters were evaluated: acid mixture (H2SO4, H3PO4, CH2O2 or CH3COOH with HNO3, 2 to 14.4 mol L-1), ultrasound amplitude (10 to 70%) and reaction time (5 to 50 min). Better nitrocellulose yield (nitrogen content of 12.5% was obtained from 1 g of microcrystalline cellulose employing a cup horn system operating at 20 kHz, 750 W of nominal power with 60% of amplitude, 25 mL of acid solution (13.6 mL of 18.4 mol L-1 H2SO4 + 9.2 mL of 14.4 mol L-1 HNO3 + 2.2 mL H2O), at 30 °C for 30 min. At silent conditions (mechanical stirring ranging from 100 to 500 rpm), the nitrogen content was lower than 11.8% which demonstrate the ultrasound effects for nitrocellulose synthesis.

UPLC-ESI/Q-TOF MS/MS Method for Determination of Vildagliptin and its Organic Impurities.

Vildagliptin (VLG) corresponds to a drug used for the treatment of diabetes mellitus. This disease requires continuous treatment, and so the control of impurities present in it is important to assure the quality of this drug. Thus, it is necessary to use sensitive and selective detection techniques and the ultra-performance liquid chromatography is a better option compared with high-performance liquid chromatography because it enhances the separation efficiency with a shorter analysis time and an increased resolution. This research analysis was accomplished by using liquid chromatography/tandem mass spectrometry, and the quantification was performed by using an extracted ion from the VLG drug and its main organic impurities of synthesis. During the validation process, following international standards, the method proved to be linear for the tree substances (R2 = 0.997-0.998) and the analysis of variance showed a non-significant linearity deviation (P > 0.05). Three critical factors were selected to evaluate method robustness with a full factorial experimental design, and the changes in the parameters were found to be not significant for the quantification of VLG and its impurities. The ultra-performance liquid chromatography-tandem mass spectrometry for the determination of impurities in VLG was precise, accurate and robust proving to be effective for analysis in the pharmaceutical industry and to improve the quality, safety and effectiveness of the new drug developed.

An ultrasound-assisted sample preparation method of carbonatite rock for determination of rare earth elements by inductively coupled plasma mass spectrometry.

RATIONALE: A method for the determination of rare earth elements in carbonatite rocks by inductively coupled plasma mass spectrometry (ICP-MS) was developed. METHODS: An alkaline rock, carbonatite, was submitted to ultrasound-assisted extraction (USAE) using an ultrasound bath, a cup horn system or an ultrasound probe. The main USAE parameters were evaluated, such as extraction time (1 to 30 min), extraction temperature (20 to 100°C) and ultrasound amplitude (10 to 100%). For ICP-MS, a desolvation system (APEX-Q) was used to reduce interference in lanthanide determination. To evaluate if the effect of ultrasound improved extraction, experiments were carried out using magnetic stirring (500 rpm) for comparison. RESULTS: The temperature and ultrasound amplitude optimized for the method were 70°C and 40%, respectively, using dilute nitric acid (3% v/v). Quantitative analyte recoveries were obtained using an ultrasound bath (25 kHz/100 W) which allowed for the simultaneous extraction of twelve replicates. CONCLUSIONS: All the results obtained with the use of ultrasound systems were better than those obtained with mechanical stirring. The extracts were suitable for ICP-MS analysis and the results were in agreement with those obtained by the reference method (using wet acid digestion). Based on the results, the use of USAE can be considered an alternative method for sample preparation of carbonatite rocks, under milder conditions, for further ICP-MS analysis.

An in situ pre-concentration method for fluorine determination based on successive digestions by microwave-induced combustion.

A new strategy based on successive digestions by microwave-induced combustion (MIC) in the same reaction vessel with a single absorbing solution was proposed. As a proof of concept, F was determined by ion-selective electrode (ISE) in seafood digests. Samples were pressed as pellets (up to 0.7 g) and combusted in closed quartz vessels pressurized with oxygen. Sequential digestions were each performed (up to 4 combustion cycles) in the same vessel and using the same absorbing solution. In each cycle, a new filter paper, igniter and sample pellet (0.7 g of sample) were used. Ammonium hydroxide solutions (10-100 mmol L-1) were evaluated for F absorption. Accuracy of the proposed method was evaluated using certified reference material of oyster tissue (NIST 1566a) and also by comparison of results after pyrohydrolysis method. Up to 3 digestion cycles (total mass of 2.1 g) could be used with 50 mmol L-1 NH4OH as absorbing solution. Results were in agreement with those obtained using pyrohydrolysis and also with certified reference value; the coefficient of variation after 3 cycles was below 5%, which was considered as suitable for F determination even at low concentration. The residual carbon in digests was lower than 25 mg L-1, allowing F determination by ISE virtually free of interferences due to dissolved organic matter. The limit of quantification (LOQ) for F was 1.3 µg g-1 (using 2.1 g of seafood), which is almost 4 times lower than the LOQ obtained using the reference method (pyrohydrolysis). Contrary to the reference method, this relatively low LOQ allowed the determination of F in all the seafood samples analysed. Taking into account that only 6 mL of diluted NH4OH solution (50 mmol L-1) were used and the suitable LOQ, the proposed sequential digestion MIC method can be recommended for further F determination in trace levels in seafood, even using a low-cost technique such as ISE, instead of other, more powerful techniques, such as ion chromatography.

Determination of inorganic contaminants in carbon nanotubes by plasma-based techniques: Overcoming the limitations of sample preparation.

In this work, sample preparation of carbon nanotubes (CNTs) for further determination of inorganic contaminants was investigated using a microwave-assisted wet digestion single reaction chamber system (MAWD-SRC). Analytes (Al, As, Ca, Cd, Co, Cr, Fe, La, Mg, Mo, Ni, Pb and Zn) were determined in CNTs by inductively coupled plasma optical emission spectrometry (ICP-OES) and inductively coupled plasma mass spectrometry (ICP-MS, except for Al, Ca, Fe and Mg). Method parameters were evaluated, as the mass of CNT (25-300 mg), the temperature (220-270 °C) and the time (35-75 min) of irradiation program. The accuracy was evaluated by using a certified reference material (CRM) of CNT and also by comparison of the results with those obtained using neutron activation analysis (NAA) and high resolution continuum source graphite furnace atomic absorption spectrometry with direct solid sampling (DSS-HR-CS-GF AAS). Quantitative recoveries for all elements were obtained using 275 mg of CNTs, 6 mL of 14.4 mol L-1 HNO3 and 0.5 mL of 30% H2O2 with an irradiation program of 65 min (35 min at 270 °C). No statistical difference was observed between the results obtained after the decomposition of CNTs by MAWD-SRC with those obtained by NAA and DSS-HR-CS-GF AAS. No difference was also observed for the results using the proposed method and the values for the CRM of CNT. The use of MAWD-SRC showed good performance for CNTs digestion using relatively high sample mass (up to 275 mg), contributing to low limits of quantification (LOQs) and overcoming the current limitations of sample preparation. To the best knowledge of the authors, this work reports the highest sample mass feasible to be decomposed using wet digestion for CNTs among the methods proposed in literature.

Capillary zone electrophoresis method to assay tipranavir capsules and identification of oxidation product and organic impurity by quadrupole-time of flight mass spectrometry.

Tipranavir (TPV) is one of the most recently developed protease inhibitors (PI) and it is specially recommended for treatment-experienced patients who are resistant to other PI drugs. In this work, a simple and friendly environmental CZE stability-indicating method to assay TPV capsules was developed and two TPV organic impurities were identified by high resolution mass spectrometry (HRMS). The optimized analytical conditions were: background electrolyte composed of sodium borate 50mM, pH 9.0 and 5% of methanol; voltage + 28kV; hydrodynamic injection of 5s (100mbar), detection wavelength 240nm, at 25°C. The separation was achieved in a fused silica capillary with 50µm × 40cm (inner diameter × effective length), using furosemide as internal standard. All the validation parameters were met and the method was specific, even in the presence of degradation products and impurities. Oxidation was indicated as the main degradation pathway among those evaluated in this study (acidic, alkaline, thermal, photolytic and oxidative) and it showed a second order degradation kinetic, under the conditions used in this study. The main oxidation product and an organic impurity detected in the standard were characterized by Q-TOF, and both of them correspond to oxidation products of TPV.