scholarly journals Capillary Electrophoresis Hyphenated with Mass Spectrometry for Determination of Inflammatory Bowel Disease Drugs in Clinical Urine Samples

Molecules ◽  
2017 ◽  
Vol 22 (11) ◽  
pp. 1973 ◽  
Author(s):  
Katarína Maráková ◽  
Juraj Piešťanský ◽  
Zuzana Zelinková ◽  
Peter Mikuš
Keyword(s):  
Mass Spectrometry ◽  
Inflammatory Bowel Disease ◽  
Capillary Electrophoresis ◽  
Bowel Disease ◽  
Urine Samples ◽  
Inflammatory Bowel

scholarly journals Profiling of Amino Acids in Urine Samples of Patients Suffering from Inflammatory Bowel Disease by Capillary Electrophoresis-Mass Spectrometry

Molecules ◽  
2019 ◽  
Vol 24 (18) ◽  
pp. 3345 ◽  
Author(s):  
Juraj Piestansky ◽  
Dominika Olesova ◽  
Jaroslav Galba ◽  
Katarina Marakova ◽  
Vojtech Parrak ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Amino Acids ◽  
Inflammatory Bowel Disease ◽  
Capillary Electrophoresis ◽  
Amino Acid ◽  
Bowel Disease ◽  
Urine Samples ◽  
Simultaneous Action ◽  
Relative Standard ◽  
Inflammatory Bowel

Urine represents a convenient biofluid for metabolomic studies due to its noninvasive collection and richness in metabolites. Here, amino acids are valuable biomarkers for their ability to reflect imbalances of different biochemical pathways. An impact of amino acids on pathology, prognosis and therapy of various diseases, including inflammatory bowel disease (IBD), is therefore the subject of current clinical research. This work is aimed to develop a capillary electrophoresis-tandem mass spectrometry (CE-MS/MS) method for the quantification of the 20 proteinogenic amino acids in human urine samples obtained from patients suffering from IBD and treated with thiopurines. The optimized CE-MS/MS method, with minimum sample preparation (just “dilute and shoot”), exhibited excellent linearity for all the analytes (coefficients of determination were higher than 0.99), with inter-day and intra-day precision yielding relative standard deviations in the range of 0.91–15.12% and with accuracy yielding relative errors in the range of 85.47–112.46%. Total analysis time, an important parameter for the sample throughput demanded in routine practice, was shorter in ca. 17% when compared to established CE-MS methods. Favorable performance of the proposed CE-MS/MS method was also confirmed by the comparison with corresponding ultra-high performance liquid chromatography-mass spectrometry (UHPLC-MS) method. Consistent data for the investigated amino acid metabolome were obtained using both methods. For the first time, the amino acid profiling by CE-MS approach was applied on the clinical IBD samples. Here, significant differences observed in the concentration levels of some amino acids between IBD patients undergoing thiopurine treatment and healthy volunteers could result from the simultaneous action of the disease and the corresponding therapy. These findings indicate that amino acids analysis could be a valuable tool for the study of mechanism of the IBD treatment by thiopurines.

scholarly journals Urinary Metabolites Enable Differential Diagnosis and Therapeutic Monitoring of Pediatric Inflammatory Bowel Disease

Metabolites ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 245
Author(s):  
Mai Yamamoto ◽  
Meera Shanmuganathan ◽  
Lara Hart ◽  
Nikhil Pai ◽  
Philip Britz-McKibbin
Keyword(s):  
Mass Spectrometry ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Urinary Metabolites ◽  
Urine Samples ◽  
Therapeutic Monitoring ◽  
Induction Treatment ◽  
Early Management ◽  
Inflammatory Bowel ◽  
Pediatric Ibd

Rates of pediatric Crohn’s disease (CD) and ulcerative colitis (UC) are increasing globally. Differentiation of these inflammatory bowel disease (IBD) subtypes however can be challenging when relying on invasive endoscopic approaches. We sought to identify urinary metabolic signatures of pediatric IBD at diagnosis, and during induction treatment. Nontargeted metabolite profiling of urine samples from CD (n = 18) and UC (n = 8) in a pediatric retrospective cohort study was performed using multisegment injection-capillary electrophoresis-mass spectrometry. Over 122 urinary metabolites were reliably measured from pediatric IBD patients, and unknown metabolites were identified by tandem mass spectrometry. Dynamic changes in sum-normalized urinary metabolites were also monitored following exclusive enteral nutrition (EEN) or corticosteroid therapy (CS) in repeat urine samples collected over 8 weeks. Higher urinary excretion of indoxyl sulfate, hydroxyindoxyl sulfate, phenylacetylglutamine, and sialic acid were measured in CD as compared to UC patients, but lower threonine, serine, kynurenine, and hypoxanthine (p < 0.05). Excellent discrimination of CD from UC was achieved based on the urinary serine:indoxylsulfate ratio (AUC = 0.972; p = 3.21 × 10−5). Urinary octanoyl glucuronide, pantothenic acid, and pyridoxic acid were also identified as specific dietary biomarkers of EEN in pediatric IBD patients who achieved clinical remission. This work may complement or replace existing strategies in the diagnosis and early management of children with IBD.

Advocating for Patients With Inflammatory Bowel Disease: How to Navigate the Prior Authorization Process

2019 ◽  
Vol 25 (10) ◽  
pp. 1621-1628 ◽  
Author(s):  
Shubha Bhat ◽  
Toni Zahorian ◽  
Regine Robert ◽  
Francis A Farraye
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Prior Authorization ◽  
Treatment Pathways ◽  
Treatment Delays ◽  
Manage Health Care ◽  
Inflammatory Bowel ◽  
Step Therapy ◽  
Care Costs

Abstract In an effort to manage health care costs and avoid improper medication use, prior authorizations (PAs) have become a standard stipulation required by payers in the determination of medication coverage. For gastroenterologists managing patients, especially those with inflammatory bowel disease (IBD), the PA process is time-consuming and further complicated by 2 additional factors: step therapy requirements and failure of payers to recognize updated IBD treatment pathways. These factors often lead to PA denials and cause treatment delays, which in turn can lead to disease progression, ongoing patient suffering, and ultimately an increase in both direct and indirect total costs. In this manuscript, the PA process, PA models, tips and available resources to navigate the PA process, and future advocacy efforts are discussed with the intent to help gastroenterology practices optimize PA outcomes and improve the care provided to patients with IBD and other gastrointestinal disorders.

Characterization of sulfasalazine's interference in the measurement of conjugated bilirubin by the Ektachem slide method.

1989 ◽  
Vol 35 (8) ◽  
pp. 1760-1762 ◽  
Author(s):  
D W Franquemont ◽  
J L Sutphen ◽  
D A Herold ◽  
D E Bruns
Keyword(s):  
Inflammatory Bowel Disease ◽  
Human Serum ◽  
Bowel Disease ◽  
Multilayer Film ◽  
Total Bilirubin ◽  
Inflammatory Bowel ◽  
Film Analyzer ◽  
Conjugated Bilirubin

Abstract We describe the cases of four patients who were taking sulfasalazine for inflammatory bowel disease, whose conjugated bilirubin concentrations in serum exceeded their corresponding total bilirubin concentrations as measured with a multilayer film analyzer, the Ektachem 400. Sulfasalazine added to pooled human serum at therapeutic concentrations increased the apparent conjugated bilirubin, as measured with the Ektachem, in a linear and dose-related fashion. Measured unconjugated bilirubin was simultaneously decreased to values less than -3 mg/L. The same interference occurred on the Ektachem 700, but an algorithm prevented the instrument from reporting the results. The major metabolites of sulfasalazine in blood did not interfere with analysis for those fractions of bilirubin. Sulfasalazine's strong absorbance at 400 nm explains its interference with determination of conjugated bilirubin in this instrument.

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