The metabolism of CGS—15873 in man using stable isotope pattern recognition techniques

Approaches for the rapid identification of drug metabolites in early clinical studies

Understanding the metabolism of a novel drug candidate in drug discovery and drug development is as important today as it was 30 years ago. What has changed in this period is the technology available for proficient metabolite characterization from complex biological sources. High-efficiency chromatography, sensitive MS and information-rich NMR spectroscopy are approaches that are now commonplace in the modern laboratory. These advancements in analytical technology have led to unequivocal metabolite identification often being performed at the earliest opportunity, following the first dose to man. For this reason an alternative approach is to shift from predicting and extrapolating possible human metabolism from in silico and nonclinical sources, to actual characterization at steady state within early clinical trials. This review provides an overview of modern approaches for characterizing drug metabolites in these early clinical studies. Since much of this progress has come from technology development over the years, the review is concluded with a forward-looking perspective on how this progression may continue into the next decade.

Performance of human mass balance studies with stable isotope-labeled drug and continuous flow-isotope ratio mass spectrometry: a progress report

We propose performing human mass balance studies by administering stable isotope labeled (13C or 15N) drug and quantitating excess (above background) 13C or 15N in urine, serum, and feces by continuous flow-isotope ratio mass spectrometry (CF-IRMS). Theoretical calculations and empirical data (dynamic range, linearity, sensitivity, precision, accuracy) are presented to establish that commercially available CF-IRMS instruments can quantitate stable isotope labeled (one or two 15N or 13C labels) drug concentrations of 1.0 microg/mL or greater in urine, serum (15N), or feces. More than two 13C labels may be necessary to quantitate 1.0 microg/mL of drug in serum. Three volunteers received 650 mg of 15N13C2-acetaminophen, and urine was collected for 72 hours. Percent of administered label recovered in urine from the three subjects was 97.4, 78.9, and 95.4 for 13C and 90.3, 77.0, and 90.6 for 15N. Fecal recovery of label for one subject was 0.9% (13C2) and 1.1% (15N). Serum pharmacokinetic values obtained by counting 13C or 15N in one subject were as expected for acetaminophen. This method appears to be promising, and further validation is ongoing.

Biomedical and biochemical applications of liquid chromatography-mass spectrometry

This review centres on the application of various LC-MS and LC-MS-MS techniques to the study and solution of practical problems in biomedical research. For this purpose it covers a selection of publications in this area included in the MEDLINE database for the period 1991-mid-1994. As shown herein, LC-MS is increasingly gaining in importance in the biomedical field, especially after the revolution brought about by the introduction of the new liquid-phase atmospheric pressure ionization (API) techniques, such as electrospray (ES) and ionspray. The information in this database shows that thermospray (TS), which clearly dominated LC-MS coupling in the 1980s, is on a downward trend relative to the more modern API techniques which will certainly dominate this application field in the present decade. Studies on drug metabolism, therapeutic drug monitoring and pharmacology have been traditionally carried out by GC-MS. However, LC-MS has lately been replacing classical GC-MS techniques in many of these applications. For instance, LC-ES-MS has greatly facilitated the application of both qualitative and quantitative LC-MS methods to highly polar molecules. This is possible without the need to resort to elaborate sample handling and derivatization procedures for relatively high-molecular-mass compounds such as drug conjugates, biosynthetic and natural peptides and therapeutic proteins obtained by recombinant DNA technology, all of them formerly totally inaccessible to the standard GC-MS or LC-MS methods. With regard to studies on metabolism and biochemical phenomena of endogenous compounds, LC-ES-MS is also becoming very strong in the analysis of structural biopolymers such as peptides, proteins, glycoproteins and glycolipids, and also lower molecular mass compounds such as fatty acids, vitamins, steroids and nucleic acids. For example, structural verification of post-translational modifications in proteins can be efficiently obtained in the time frame of an LC run and suitable MS methods for the location of glycopeptide-containing fractions in proteolytic digests of glycoproteins have been developed. Interesting examples are also shown of the use of LC-MS in clinical studies and the determination of biological markers of disease.