Bioanalysis of Stress Biomarkers through Sensitive HILIC-MS/MS Method: A Stride toward Accurate Quantification of MDA, ACR, and CTA.

Quantifying reactive aldehyde biomarkers, such as malondialdehyde, acrolein, and crotonaldehyde, is the most preferred approach to determine oxidative stress. However, reported analytical methods lack specificity for accurately quantifying these aldehydes as certain methodologies may produce false positive results due to harsh experimental conditions. Thus, in this research work, a novel HILIC-MS/MS method with endogenous histidine derivatization is developed, which proves to have higher specificity and reproducibility in quantifying these aldehydes from the biological matrix. To overcome the reactivity of aldehyde, endogenous histidine is used for its derivatization. The generated adduct is orthogonally characterized by NMR and LC-HRMS. The method employed a hydrophilic HILIC column and multiple reaction monitoring (MRM) to accurately quantify these reactive aldehydes. The developed method is an unequivocal solution for quantifying stress in in vivo and in vitro studies.

Cell-Engineered Recombinant α-Synuclein: A Gage R&R Validated Protocol.

α-Synuclein (α-Syn) misfolding and its presence in Lewy bodies are observed in almost all Parkinson's disease (PD) patients. Basic biomedical research would benefit from a quick, low-cost approach to purifying α-Syn and developing in vitro and in vivo models for PD. Several research groups utilize PFF-based models, yet the production of α-Syn PFFs is inconsistent, resulting in nonconclusive findings. Some research laboratories prepare recombinant α-Syn (r α-Syn) by molecular cloning to overexpress α-Syn with various purifying techniques. Laboratory-to-laboratory protocols cause considerable variability and sometimes contradictory findings. PD researchers spend more on protein than solving α-Syn's riddles. This article uncovered a novel method for expressing and purifying r α-Syn validated through gage reproducibility and repeatability (Gage R&R). For the production of r α-Syn, we have employed the ability of a high-cell-density-based expression system to overexpress protein in BL21(DE3). A simple, high-throughput, nonchromatographical purification protocol has been devised to facilitate research with higher reproducibility, which was validated through Gage R&R. A crossover experimental design was utilized, and the purified protein was characterized using orthogonal high-end analytical methods, which displayed higher similarity between the isolated r α-Syn. Batch-to-batch variability was the least for produced protein and hence can be utilized for exploring the iceberg of PD.

Inter-software and inter-scan variability in measurement of epicardial adipose tissue: a three-way comparison of a research-specific, a freeware and a coronary application software platform.

OBJECTIVES: Epicardial adipose tissue (EAT) is a proposed marker of cardiovascular risk; however, clinical application may be limited by variability in post-processing software platforms. We assessed inter-vendor agreement of EAT volume (EATv) and attenuation on both contrast-enhanced (CE) and non-contrast CT (NCT) using a standard coronary CT reporting software (Vitrea), an EAT research-specific software (QFAT) and a freeware imaging software (OsiriX). METHODS: Seventy-six consecutive patients undergoing simultaneous CE and NCT had complete volumetric EAT measurement. Between-software, within-software NCT vs. CE, and inter- and intra-observer agreement were evaluated with analysis by ANOVA (with post hoc adjustment), Bland-Altman with 95% levels of agreement (LoA) and intraclass correlation coefficient (ICC). RESULTS: Mean EATv (freeware 53 ± 31 mL vs. research 93 ± 43 mL vs. coronary 157 ± 64 mL) and attenuation (freeware - 72 ± 25 HU vs. research - 75 ± 3 HU vs. coronary - 61 ± 10 HU) were significantly different between all vendors (ANOVA p < 0.001). EATv was consistently higher in NCT vs. CE for all software packages, with most reproducibility found in research software (bias 26 mL, 95% LoA: 2 to 56 mL), compared to freeware (bias 11 mL 95% LoA: - 46 mL to 69 mL) and coronary software (bias 10 mL 95% LoA: - 127 to 147 mL). Research software had more comparable NCT vs. CE attenuation (- 75 vs. - 72 HU) compared to freeware (- 72 vs. - 57 HU) and coronary (- 61 vs. - 39 HU). Excellent inter-observer agreement was seen with research (ICC 0.98) compared to freeware (ICC 0.73) and coronary software (ICC 0.75) with narrow LoA on Bland-Altman analysis. CONCLUSION: There are significant inter-vendor differences in EAT assessment. Our study suggests that research-specific software has better agreement and reproducibility compared to freeware or coronary software platforms. KEY POINTS: • There are significant differences between EAT volume and attenuation values between software platforms, regardless of scan type. • Non-contrast scans routinely have higher mean EAT volume and attenuation; however, this finding is only consistently seen with research-specific software. • Of the three analyzed packages, research-specific software demonstrates the highest reproducibility, agreement, and reliability for both inter-scan and inter-observer agreement.

A rapid discriminative hydrogen-deuterium exchange and LC-HRMS/MS strategy for primary and higher order structural mapping of therapeutic proteins: a case study using filgrastim.

A vast number of therapeutic proteins are approved and available on the market. However, there are very limited analytical approaches available for the rapid determination of primary and higher-order structures which can be utilized for counterfeit identification. In the present study, filgrastim biosimilar products from different manufacturers were considered for developing discriminative orthogonal analytical techniques to determine structural variations. The developed intact mass analytical method and peptide mapping through LC-HRMS were able to differentiate three biosimilars based on deconvoluted mass and possible structural modification, respectively. Another structural attribute employed was charge heterogeneity through isoelectric focusing, which provides a snapshot of the presence of charge variants/impurities and was able to differentiate various marketed formulations of filgrastim. These three techniques can certainly differentiate the products that contain counterfeit drugs due to their capability concerning selectivity. Additionally, a unique HDX technique on LC-HRMS was developed, which can determine the labile hydrogen exposed to deuterium exchange in a specified time. HDX aids in identifying the workup process or changes in the host cell in the counterfeit product by differentiating the protein based on its higher-order structure.

Hyphenated liquid chromatography - diode array detection - charged aerosol detection - high resolution - multistage mass spectrometry with online hydrogen/deuterium exchange: One stop solution for pharmaceutical impurity profiling.

Hyphenation of different analytical techniques has always been advantageous in structural characterization as it saves time, money and resources. In the pharmaceutical sector, chromatography-based impurity profiling, including identification, characterization, and quantification in drug substances or finished products, is of utmost importance to comply with quality, patient safety and regulatory requirements. These impurities are monitored using LC-UV/DAD and identified and/or characterized using HRMS and MS/MS. LC analysis usually yields the area percent purity of the targeted peak, however, this is not sufficient for pharmaceutical purposes; where the regulatory requirement is to report impurities in percent weight by weight. Unfortunately, the non-availability of impurity standards and relative response factors at an early stage of drug development, risks the product quality due to the inability of the method to differentiate percent purity, and percent weight by weight. Hence, there is a need for a distinctive way of determining the relative response factor. In the current study, a unique hyphenation has been employed by integrating LC with DAD, CAD, and HRMSn with hydrogen-deuterium exchange. The LC flow, post-DAD detection has been diverted to CAD with an inverse gradient for relative response factor determination and MS Orbitrap for exact mass, and MSn fragmentation. A separate infusion pump has been incorporated to infuse D2O on a need basis, which can perform partial hydrogen deuterium exchange for determining the number of labile hydrogens in the impurity structure. This hyphenation has been validated with four model compounds and a total of nineteen chromatographic peaks. The technique provides ample information for their qualitative analysis along with percent weight-by-weight values, which fulfils the regulatory requirements and can be used as one-stop solution for impurity profiling.

Extrinsic hyaluronic acid induction differentially modulates intracellular glutamine metabolism in breast cancer stem cells.

The effect of low and high molecular weight hyaluronic acid on glutamine metabolism in luminal and basal breast cancer and cancer stem cells is being investigated. In luminal cell lines (MCF-7), HA enhances the intracellular utilization of gln in redox metabolism and decreases its use in TCA. On the contrary, in MDAMB-231 cells, HA induces the uptake of gln to be utilized in anaplerosis rather than ROS maintenance. However, in MCF-7 CSCs, HA induces up-regulation of xCT, further, it uses gln-derived glutamate for the exchange of cystine, thus maintaining ROS levels through xCT. MDA-MB-231 CSCs reduce the secretion of glutamate in response to HA and decrease the gln flux towards reductive carboxylation. Conclusively, our study demonstrated that although the uptake of gln is enhanced by HA, it is differentially utilized intracellularly in breast cancer cells. This study could significantly influence the therapeutics involving HA and Gln in breast cancer.

Agreement Between iFR and Other Non-Hyperaemic Pressure Ratios in Severe Aortic Stenosis.

BACKGROUND: Instantaneous wave-free ratio (iFR) can reliably assess the physiological significance of coronary artery disease (CAD). Previous studies have demonstrated its interchangeability with other non-hyperaemic pressure ratios (NHPR), but there is no data exploring whether this association is maintained in patients with severe aortic stenosis (AS). METHODS: Forty-two patients (67 lesions) with severe AS were recruited and underwent invasive pressure-wire assessment. Data were extracted to calculate iFR, resting Pd/Pa, diastolic pressure ratios (DPR and dPR), and Diastolic Hyperaemia-Free Ratio (DFR). iFR was then compared with other NHPR to determine agreement and accuracy. RESULTS: Mean aortic gradient and dimensionless index were 44.3 ± 11.6 mmHg and 0.23 ± 0.04, respectively. Of the 67 vessels, 57% were LAD, 15% LCx, 13% RCA and 12% other. There was strong positive correlation between iFR and all other NHPR, including Pd/Pa (r = 0.91, p < 0.001), DPR (r = 0.99, p < 0.001), dPR (r = 0.97, p < 0.001) and DFR (r = 0.98, p < 0.001). While Bald-Altman analysis demonstrated that Pd/Pa and DFR were numerically different from iFR, ROC analyses demonstrated iFR ≤0.89 was accurately identified by all NHPRs; Pd/Pa (AUC = 0.965, 95% CI [0.928-0.994]), DPR (AUC = 1.000, 95% CI [1.000-1.000]), dPR (AUC = 0.974, 95% CI [0.937-1.000]), DFR (AUC = 0.989, 95% CI [0.968-1.000]). CONCLUSION: In patients with severe AS, all the included NHPR in this analysis accurately predicted iFR < 0.89. These data should reassure clinicians that use of alternative NHPR to iFR is reasonable when assessing the physiological significance of CAD in patients with severe AS.

LC-HRMS studies on ruxolitinib degradation: a comprehensive approach during drug development.

Ruxolitinib, a kinase inhibitor, was subjected to stress studies as described in the ICH Q1A(R2) guidelines. Solution state hydrolytic and solid state oxidative and thermal stress studies were carried out to understand its degradation behaviour. The drug showed significant instability in the hydrolytic condition in comparison with other conditions. HPLC and UHPLC methods were developed for the separation of the drug and its hydrolytic degradation products. Mass fragmentation pathway of the drug was established as the first step of the LC-MS characterization of the degradation products. MS/MS analysis of the drug and MS3 of selected fragments were achieved through QTOF and QTRAP by varying the collision energy and performing an H/D exchange. LC-MS/MS QTOF studies were subsequently carried out on stress samples and the structures of the degradation products were identified through comparison of the drug fragmentation pathways. The four hydrolytic products viz. 4-(1H-pyrazol-4-yl)-7H-pyrrolo[2,3-d]pyrimidine, 3-(4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl)-3-cyclopentylpropanoic acid, 3-(4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl)-3-cyclopentylpropanamide, and 3-(4-(6-amino-5-formylpyrimidin-4-yl)-1H-pyrazol-1-yl)-3-cyclopentylpropanenitrile were formed under acidic and basic conditions. The degradation pathway was delineated through a mechanistic explanation. The in silico tools preADMET and Protox-II predictor were used to compare the toxicity of the impurities with respect to the drug.

A new rat model of treatment-naive quiescent choroidal neovascularization induced by human VEGF165 overexpression.

Vascular endothelial growth factor (VEGF) is a crucial stimulator for choroidal neovascularization (CNV). Our aim was to develop a reproducible and valid treatment-naive quiescent CNV (i.e. without signs of exudation and with normal visual acuity) rat model by subretinal injection of an adeno-associated virus (AAV)-VEGFA165 vector. The CNV development was longitudinally followed up in vivo by scanning laser ophthalmoscopy/optical coherence tomography, fluorescein and Indocyanine Green angiographies and ex vivo by electron microscopy (EM) and immunohistochemistry. In total, 57 eyes were analysed. In vivo, a quiescent CNV was observed in 93% of the eyes 6 weeks post-transduction. In EM, CNV vessels with few fenestrations, multi-layered basement membranes and bifurcation of endothelial cells were observed sharing the human CNV features. Human VEGF overexpression, multi-layered retinal pigment epithelium (RPE) (RPE65) and macrophages/activated microglia (Iba1) were also detected. In addition, 19 CNV eyes were treated for up to 3 weeks with bevacizumab. The retinal and CNV lesion thickness decreased significantly in bevacizumab-treated CNV eyes compared with untreated CNV eyes 1 week after the treatment. In conclusion, our experimental CNV resembles those seen in patients suffering from treatment-naive quiescent CNV in wet age-related macular degeneration (AMD), and responds to short-term treatment with bevacizumab. Our new model can, therefore, be used to test the long-term effect of new drugs targeting CNV under precisely-defined conditions.

Masked Hypertension: A Systematic Review.

BACKGROUND: Masked phenomenon, Masked Hypertension (MHT) and Masked Uncontrolled Hypertension (MUCH) is a well-defined clinical entity. However, many aspects of MHT/MUCH remain unclear. METHODS: We systematically reviewed the published literature on MHT/MUCH from 1 January 2000 to 31 June 2018 with a particular focus on epidemiology, clinical significance, evaluation and management. Meta-analyses were performed with respect to prevalence, clinical significance and diagnostic agreement between home blood pressure (HBP) and ambulatory BP (ABP) measurements. RESULTS: The overall weighted-mean prevalence of masked phenomenon was 11% [9,14]; MHT 10% [9,11]; and MUCH 13% [8,17]. The weighted-mean prevalence when expressed as a proportion of patients with normal office BP was 32% [25,40]; MHT 28% [15,41]; and MUCH 43% [29,57]. The prevalence of masked phenomenon determined by ABP (11% [8,14]) and HBP (13% [9,16]), was similar. However, ABP appeared to have a greater sensitivity, i.e. proportion of patients diagnosed as having MHT/MUCH was greater with ABP than with HBP (22% v 16%, p<0.05), when both methodologies were applied to the same cohort of patients. The prevalence of MHT was influenced by ethnicities and comorbidities, and in case of MUCH by anti-hypertensive treatment. MHT/MUCH was associated with increased risk of fatal and non-fatal cardiac/cerebrovascular events (relative risk [RR] 2.09 [1.80, 2.44]), and the risk was comparable to sustained hypertension (SHT) (RR 2.26 [1.84, 2.78]). The increased risk occurred regardless of the method of out of office BP assessment; the relative risks for ABP and HBP were 2.38 [1.90, 2.98] and 1.90 [1.57, 2.29] respectively. The diagnostic agreement between ABP and HBP was only modest, kappa = 0.46 [0.40, 0.52], even though the percentage agreement was 83%. The evidence for the management of MHT was scant. CONCLUSIONS: MHT/MUCH is a common BP phenotype with a risk profile similar to that of SHT. Therefore, high risk patients should undergo out of office BP assessment, probably both by HBP and ABP, to confirm diagnosis and be considered for treatment.

Staggering shifts to rebalance night medical registrar workload.

BACKGROUND: Lone night medical registrars, particularly those working at busy urban hospitals have high workloads and low job satisfaction. Handover of pending referrals from day staff can contribute to further delays in providing care with increased risks for patient safety. AIM: To evaluate the impact of a staggered roster for daytime medical registrar on the workload of night registrar. METHODS: Prospective data were collected of the night medical registrar workload over a 6-month period. The first 3 months included standard shifts from 1330 to 2130 hours with two registrars. The second 3 months followed the introduction of a staggered shift for one registrar to 1530 hour-midnight, providing a 3-h overlap with the night registrar commencing at 2100 hour. Parameters recorded included the number of total admissions, pending admissions, referrals from emergency department, ward reviews and Medical Emergency Team (MET) calls/CODE Blues. Data from weekends and public holidays were not recorded. RESULTS: During the standard rostering period, the average number of medical admissions completed per night shift was 8.66 (n = 60, SD = 3.58). With staggered shifts, the average number was significantly reduced at 6.38 (n = 65, SD = 2.74, P = 0.000057). In addition, there was greater number of ward reviews conducted by the night registrar in the staggered roster period, potentially reflecting greater time availability and reduction in MET calls/codes. CONCLUSION: Rearranging medical registrar shifts can result in significant reduction in night medical registrar workload. It may also have other potential benefits in terms of increased capacity for ward reviews and reduced MET calls/codes.

Is reproducibility inside the bag? Special issue fundamentals and applications of sonochemistry ESS-15.

In this paper we report our most recent attempts to tackle a notorious problem across several scientific activities from the ultrasonics sonochemical perspective: reproducibility of results. We provide experimental results carried out in three different laboratories, using the same ingredients: ultrasound and a novel cavitation reactor bag. The main difference between the experiments is that they are aimed at different applications, KI liberation and MB degradation; and exfoliation of two nanomaterials: graphene and molybdenum disulfide. Iodine liberation rates and methylene blue degradation were higher for the cases where a cavitation intensification bag was used. Similarly, improved dispersion and more polydisperse exfoliated layers of nanomaterials were observed in the intensified bags compared to plain ones. The reproducibility of these new experiments is compared to previous experimental results under similar conditions. Our main conclusion is that despite knowing and understanding most physicochemical phenomena related to the origins and effects of cavitation, there is still a long path towards reproducibility, both in one laboratory, and compared across different laboratories. As emphasized in the sonochemical literature, the latter clearly illustrates the complexity of cavitation as nonlinear phenomenon, whose quantitative estimation represents a challenging aspect. We also provide a list of procedural steps that can help improving reproducibility and scale-up efforts.

Electrocardiographic characteristics in individuals with cocaine use disorder.

BACKGROUND AND OBJECTIVES: Chronic cocaine use has been linked to several abnormalities in cardiac functioning. The objective of this study was to further characterize baseline heart rate and electrocardiograph (ECG) profiles of individuals with cocaine use disorder (CUD) by evaluating demographic and drug use variables that may impact cardiovascular profiles. METHODS: Participants with CUD (n = 335, primarily African-American males) provided demographic and drug use data and ECG profiles (eg, heart rate, PR Interval, QRS, and QTc) were obtained via 12-lead ECG. RESULTS: Forty-eight percent and ten percent of cocaine users met criteria for sinus bradycardia (heart rate ≤60) and severe bradycardia (heart rate ≤50), respectively. Females had significantly higher heart rate (p = .020, d = .30) and QTc (p < .001, d = .75) and significantly lower QRS (p = .002, d = .42) in comparison to males. Those who were cocaine positive had higher QTc (p = .025, d = .26) with a higher prevalence of bradycardia (chi-square = 3.91, p = .048) than those who were negative. Cocaine users who also used alcohol had significantly lower PR Interval (p = .003, d = .36), QRS (p = .014, d = .29), and QTc (p = .037, d = .25) than those who denied alcohol use. CONCLUSIONS: These findings characterize the baseline heart rate and ECG profiles of individuals with CUD, confirm previous reports of cocaine-induced alterations in cardiovascular function, and demonstrate factors impacting cardiovascular profiles. SCIENTIFIC SIGNIFICANCE: While exploratory, these results suggest the presence of bradycardia may serve as a useful biomarker for initiating therapy for individuals with CUD and averting potential adverse cardiovascular events. Future prospective studies are needed to assess this possibility. (Am J Addict 2017;26:221-227).