Simultaneous determination of plasma creatinine, uric acid, kynurenine and tryptophan by high-performance liquid chromatography: method validation and in application to the assessment of renal function

Kynurenines and aerobic exercise capacity in chronic kidney disease: A cross-sectional and longitudinal study

BACKGROUND

The causes of reduced aerobic exercise capacity (ExCap) in chronic kidney disease (CKD) are multifactorial, possibly involving the accumulation of tryptophan (TRP) metabolites such as kynurenine (KYN) and kynurenic acid (KYNA), known as kynurenines. Their relationship to ExCap has yet to be studied in CKD. We hypothesised that aerobic ExCap would be negatively associated with plasma levels of TRP, KYN and KYNA in CKD.

METHODS

We included 102 patients with non-dialysis CKD stages 2-5 (CKD 2-3, n = 54; CKD 4-5, n = 48) and 54 healthy controls, age- and sex-matched with the CKD 2-3 group. ExCap was assessed as peak workload during a maximal cycle ergometer test. Plasma KYN, KYNA and TRP were determined by high-performance liquid chromatography. Kidney function was evaluated by glomerular filtration rate (GFR) and estimated GFR. The CKD 2-3 group and healthy controls repeated tests after five years. The association between TRP, KYN, KYNA and ExCap in CKD was assessed using a generalised linear model.

RESULTS

At baseline, there were significant differences between all groups in aerobic ExCap, KYN, KYNA, TRP and KYN/TRP. KYNA increased in CKD 2-3 during the follow-up period. In CKD 2-5, KYNA, KYN/TRP and KYNA/KYN were all significantly negatively associated with ExCap at baseline, whereas KYN and TRP were not. Kynurenines were significantly correlated with GFR (p < 0.001 for all). Including GFR in the statistical model, no kynurenines were independently associated with ExCap at baseline. At follow-up, the increase in KYN and KYN/TRP was related to a decrease in ExCap in CKD 2-3. After adjusting for GFR, increase in KYN/TRP remained an independent significant predictor of a decline in ExCap in CKD 2-3.

CONCLUSION

Aerobic ExCap was inversely associated with plasma levels of kynurenines in CKD at baseline and follow-up.

Efficient and fast detection of uric acid based on a colorimetric sensing method

The uric acid (UA) level is an important physiological indicator of the human body, and its abnormality can lead to a series of diseases. Therefore, the immediate detection of uric acid concentration has broad application prospects. Commonly used methods for the analysis of uric acid include chromatography, high-performance capillary electrophoresis and electrochemical methods. However, these methods have the disadvantages of cumbersome sample pre-treatment, high cost, time-consuming, and the need for experimental instruments and professional operators, which are extremely unfavorable for the detection of uric acid and the diagnosis of related diseases in resource-limited areas. In this study, a portable visualization method was developed for the detection of uric acid using hydrogen peroxide (H2O2) test strips. Uric acid enzyme specifically catalyzes the oxidation of uric acid to produce H2O2, which causes a significant change in the color of the H2O2 test strip. The response has good linearity in the range of 1 ∼ 50 μg mL-1. Thus, it provides a simple, rapid, and cost-effective visualized bioassay for uric acid.

MoS2/S@g-CN Composite Electrode for L-Tryptophan Sensing

L-tryptophan (L-TRP) is an essential amino acid responsible for the establishment and maintenance of a positive nitrogen equilibrium in the nutrition of human beings. Therefore, it is vital to quantify the amount of L-tryptophan in our body. Herein, we report the MoS2/S@g-CN-modified glassy carbon electrode for the electrochemical detection of L-tryptophan (L-TRP). The MoS2/S@g-CN composite was successfully synthesized using an efficient and cost-effective hydrothermal method. The physical and chemical properties of the synthesized composite were analyzed using powder X-ray diffraction (PXRD), scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and energy-dispersive X-ray analysis (EDX). The crystallite size of the composite was calculated as 39.4 nm, with porous balls of MoS2 decorated over the S@g-CN surface. The XPS spectrum confirmed the presence of Mo, S, O, C, and N elements in the sample. The synthesized nanocomposite was further used to modify the glassy carbon (GC) electrode (MoS2/S@g-CN/GC). This MoS2/S@g-CN/GC was used for the electrochemical detection of L-TRP using cyclic voltammetry (CV) and differential pulse voltammetry (DPV) techniques. For the purpose of comparison, the effects of the scanning rate and the concentration of L-TRP on the current response for the bare GC, S@g-CN/GC, MoS2/GC, and MoS2/S@g-CN/GC were studied in detail. The MoS2/S@g-CN-modified GC electrode exhibited a rational limit of detection (LoD) of 0.03 µM and a sensitivity of 1.74 µA/ µMcm2, with excellent stability, efficient repeatability, and high selectivity for L-TRP detection.

A review of zeolitic imidazolate frameworks (ZIFs) as electrochemical sensors for important small biomolecules in human body fluids

Small biomolecules play a critical role in the fundamental processes that sustain life and are essential for the proper functioning of the human body. The detection of small biomolecules has garnered significant interest in various fields, including disease diagnosis and medicine. Electrochemical techniques are commonly employed in the detection of critical biomolecules through the principle of redox reactions. It is also a very convenient, cheap, simple, fast, and accurate measurement method in analytical chemistry. Zeolitic imidazolate frameworks (ZIFs) are a unique type of metal-organic framework (MOF) composed of porous crystals with extended three-dimensional structures. These frameworks are made up of metal ions and imidazolate linkers, which form a highly porous and stable structure. In addition to their many advantages in other applications, ZIFs have emerged as promising candidates for electrochemical sensors. Their large surface area, pore diameter, and stability make them ideal for use in sensing applications, particularly in the detection of small molecules and ions. This review summarizes the critical role of small biomolecules in the human body, the standard features of electrochemical analysis, and the utilization of various types of ZIF materials (including carbon composites, metal-based composites, ZIF polymer materials, and ZIF-derived materials) for the detection of important small biomolecules in human body fluids. Lastly, we provide an overview of the current status, challenges, and future outlook for research on ZIF materials.

Colorimetric and visual determination of uric acid based on decolorization of manganese dioxide nanosheet dispersions

Serum levels of uric acid (UA) play an important role in the prevention of diseases. Developing a rapid and accurate way to detect UA is still a meaningful task. Hence, positively charged manganese dioxide nanosheets (MnO₂NSs) with an average latter size of 100 nm and an ultra-thin thickness of below 1 nm have been prepared. They can be well dispersed in water and form stable yellow-brown solutions. The MnO₂NSs can be decomposed by UA via redox reaction, leading to a decline of a characteristic absorption peak (374 nm) and a color fading of MnO₂NSs solution. On this basis, an enzyme-free colorimetric sensing system for the detection of UA has been developed. The sensing system shows many advantages, including a wide linear range of 0.10-50.0 μmol/L, a limit of quantitation (LOQ) of 0.10 μmol/L, a low limit of detection (LOD) of 0.047 μmol/L (3σ/m), and rapid response without need of strict time control. Moreover, a simple and convenient visual sensor for UA detection has also been developed by adding an appropriate amount of phthalocyanine to provide a blue background color, which helps to increase visual discrimination. Finally, the strategy has been successfully applied to detect UA in human serum and urine samples.

Identification of Biomarkers for the Diagnosis of Sepsis-Associated Acute Kidney Injury and Prediction of Renal Recovery in the Intensive Care Unit

PURPOSE

Acute kidney injury (AKI) following sepsis is associated with higher mortality; however, reliable biomarkers for AKI development and recovery remain to be elucidated.

MATERIALS AND METHODS

Patients with sepsis admitted to the medical intensive care unit (ICU) of Severance Hospital between June 2018 and May 2019 were prospectively analyzed. Patients were divided into those with and without AKI within 48 hours. Patients with septic AKI were subdivided into AKI-recovery and non-recovery groups based on whether their kidney injury recovered within 7 days.

RESULTS

A total of 84 patients were enrolled. The baseline creatinine (2.9 mg/dL vs. 0.8 mg/dL vs. 1.2 mg/dL, p<0.001), Charlson Comorbidity Index (4.5 vs. 2.0 vs. 3.0, p=0.002), Sequential Organ Failure Assessment (10.0 vs. 6.5 vs. 8.0, p<0.001), and Acute Physiology and Chronic Health Evaluation II scores (32.0 vs. 21.5 vs. 30.5, p=0.004) were higher in the non-recovery AKI group compared to the non-AKI and AKI-recovery groups. The Kaplan-Meier curves revealed that non-recovery from AKI was associated with lower survival (p<0.001). High-lactate (p≤0.05) and kynurenine levels (p≤0.05) were associated with non-recovery of renal function following AKI. The areas under the curve for predicting non-recovery from AKI were 0.693 and 0.721 for lactate and kynurenine, respectively. The survival rate was lower in the high-kynurenine (p=0.040) and high-lactate (p=0.010) groups.

CONCLUSION

The mortality of patients who recovered from AKI was comparable to that of patients without AKI. Lactate and kynurenine could be useful biomarkers for the diagnosis and recovery of AKI following sepsis.

A Flexible Dual-Analyte Electrochemical Biosensor for Salivary Glucose and Lactate Detection

Electrochemical biosensors have been widely applied in the development of metabolite detection systems for disease management. However, conventional intravenous and fingertip blood tests are invasive and cannot track dynamic trends of multiple metabolites. Among various body fluids, saliva can be easily accessed and is regarded as a promising candidate for non-invasive metabolite detection. Recent works on the development of electrochemical biosensors for monitoring salivary metabolites have demonstrated high sensitivity and wide linear range. However, most of this research has been focused on salivary detection of a single metabolite. Here, we present a dual-channel electrochemical biosensor for simultaneous detection of lactate and glucose in saliva based on a flexible screen-printed electrode with two working electrodes. The sensitivities of glucose and lactate channels were 18.7 μA/(mM·cm²) and 21.8 μA/(mM·cm²), respectively. The dual-channel biosensor exhibited wide linear ranges of 0-1500 μM for the glucose channel and 0-2000 μM for the lactate channel and the cross-talk between the two detection channels was negligible, which made it adequately suitable for sensing low-level salivary metabolites. Such attractive characteristics demonstrate the potential of this dual-analyte biosensor in the development of wearable devices for monitoring disease progression and fitness.

Enzyme-free fluorescence determination of uric acid and trace Hg(II) in serum using Si/N doped carbon dots

A new fluorescence probe method for the detection of Hg(II) in serum was established, which has the detection limit of 3.57 nM and quantification limit of 5 nM, based on the electrostatic induced agglomeration quenching and complexation between Hg(II) and silicon-nitrogen-doped carbon nanodots (Si/N-CDs). Furthermore, the fluorescence probe also showed the satisfactory results in the determination of Hg(II) in human serum. Subsequently, take advantage of the uric acid (UA) to recover the fluorescence of the Si/N-CDs-Hg(II) complex probe, another enzyme-free ways to determine UA was developed. The complex probe can selectively detect the UA content in the 0.5-30 μM range, and its detection limit can reach 0.14 μM, which has successfully detected the UA in total serum, and the results were no significant difference comparing with the controls.

Development of a Novel Sensor Based on Polypyrrole Doped with Potassium Hexacyanoferrate (II) for Detection of L-Tryptophan in Pharmaceutics

This study describes the development of a new sensor with applicability in the determination and quantification of yjr essential amino acid (AA) L-tryptophan (L-TRP) from pharmaceutical products. The proposed sensor is based on a carbon screen-printed electrode (SPCE) modified with the conductor polymer polypyrrole (PPy) doped with potassium hexacyanoferrate (II) (FeCN). For the modification of the SPCE with the PPy doped with FeCN, the chronoamperometry (CA) method was used. For the study of the electrochemical behavior and the sensitive properties of the sensor when detecting L-TRP, the cyclic voltammetry (CV) method was used. This developed electrode has shown a high sensibility, a low detection limit (LOD) of up to 1.05 × 10−7 M, a quantification limit (LOQ) equal to 3.51 × 10−7 M and a wide linearity range between 3.3 × 10−7 M and 1.06 × 10−5 M. The analytical performances of the device were studied for the detection of AA L-TRP from pharmaceutical products, obtaining excellent results. The validation of the electroanalytical method was performed by using the standard method with good results.

Trend in creatinine determining methods: Conventional methods to molecular-based methods

Renal failure (RF) disease is ranked as one of the most prevalent diseases with severe morbidity and mortality. Early diagnosis of RF leads to subsequent control of disease to reduce the poor prognosis. The level of sera creatinine is considered as a significant biomarker for kidney biofunction, which is routinely detected by the Jaffe reaction. The normal range for creatinine in the blood may be 0.84-1.21 mg/dL. Low accuracy, insufficient sensitivity, explosive and toxicity of picric acid, and pseudo-interaction with nonspecific elements such as ammonium ions in the Jaffe method lead to the development of various techniques for precise detection of creatinine such as spectroscopic, electrochemical, and chromatography approaches and sensors based on enzymes, molecular imprinted polymer and nanoparticles, etc. Based on previously established results, they are trying to construct sensors with high accuracy, optimum sensitivity, acceptable linear/calibration range, and limit of detection, which are small in size and applicable by the patient him/herself (point-of-care testing). By comparing the results of research, a molecularly imprinted electrochemiluminescence-based sensor with linear/calibration range of 5-1 mMconcentration of creatinine and the detection limit of 0.5 nM has the best detectable resolution with 2 million measurable points. In this paper, we will review the recently developed methods for measuring creatinine concentration and renal biofunction.

A 3D electrochemical biosensor based on Super-Aligned Carbon NanoTube array for point-of-care uric acid monitoring

Uric acid analysis is extremely important for gout prognosis, diagnosis and treatment. Previous technologies either lack specificity or exhibit poor performance, and thus could not meet the need of Point-of-Care (POC) uric acid monitoring. Here we present for the first time, a novel electrochemical biosensor based on 3D Super-Aligned Carbon NanoTube (SACNT) array to facilitate POC uric acid monitoring. The working electrode of the biosensor is composed of an orderly 3D SACNT array immobilized with uricase through a precipitation and crosslinking procedure. Such biosensor possesses a higher enzyme density, significantly larger contact area with reactants and could maintain the intact SACNT structure and its excellent conductivity after modification. The developed 3D SACNT array electrochemical biosensor benefits from high specific surface area, high electro-catalytic activity and large contact area with analytes, and demonstrates high sensitivity of 518.8 μA/(mM⋅cm²), wide linear range of 100-1000 μM and low limit of detection of 1 μM for uric acid. Dynamic uric acid monitoring has been achieved using the presented biosensor. And the obtained results in serum samples had no significant difference compared with those obtained using the FDA-approved electrochemical analyzer (Paired T-test, p > 0.05). These demonstrated that the technology can potentially be applied in POC monitoring of other biomolecules to improve prognosis, diagnosis and treatment outcomes of metabolic diseases.

Improved ultra-high performance liquid chromatographic method for simultaneous determination of five gout-related metabolites in human serum

Creatinine and purines are gout-related metabolites commonly quantified by liquid chromatography coupled with ultraviolet and mass spectrometry. However, the high cost of liquid chromatography coupled with mass spectrometry hindered its extensive use in ordinary hospitals and clinical laboratories. Using the traditional liquid chromatography method, the full separation of these metabolites in complex biological samples is still not achieved. In this study, an improved ultra-high-performance liquid chromatography with ultraviolet spectroscopy method was reported for quantitative determination of five gout-related metabolites (i.e., creatinine, uric acid, hypoxanthine, xanthine, and inosine) in human serum within 10 min. A UHPLC system equipped with a hydrophilic C18 column was used to improve separation, shorten analysis time, and increase analysis throughput. The performance of the method was validated by evaluating linearity (squared correlation coefficient > 0.9991), recovery (92.8-100.0%, with relative standard deviation < 4.7%), accuracy (relative errors < 14.6%), precision (0.2-4.1% for intraday and 2.1-7.3% for interday) and stability (-14.1 to 8.3% in autosampler for 12 h and -13.3 to 2.2% for freeze-thaw cycles). This method was successfully applied to quantify gout-related metabolites in serum samples of healthy controls and gout patients, which was expected to be used in the clinical investigation of gout at different stages.

An optimal method for measuring biomarkers: colorimetric optical image processing for determination of creatinine concentration using silver nanoparticles

Creatinine concentration is one of the important elements in the body for diagnosing kidney failure, muscular dystrophy, glomerular filtration rate, and diabetic nephropathy. The disadvantages of recently introduced analytical techniques, such as Jaffe's, spectroscopic, colorimetric, and chromatographic methods, for quantifying creatinine in urine involve toxicity, the high cost, interference, and the complexity of the design. In this paper, we designed and fabricated a new colorimetric assay for the measurement of creatinine concentration based on color differentiation generated by mixing different concentrations of creatinine with synthesized silver nanoparticles (AgNPs) coated with polyvinylpyrrolidone (PVP) and polyvinyl alcohol (PVA). An isolated box is designed for the uniform optical imaging of solutions, the captured images are processed in real time, and the quantitative and qualitative results are displayed. For colorimetric processing, a variety of color systems, such as RGB (red, green, blue), CMYK (cyan, magenta, yellow, black), and grayscale (Gr), have been evaluated, indicating that the combination of green (G) and grayscale (Gr) provides the best results for this experiment. TEM analysis and spectroscopy were used to confirm the results of the experiment. Linear range and limit of detection (LOD) were obtained for AgNPs/PVP 0.03-1 mg/dl and 0.024 mg/dl and for AgNPs/PVA 0.01-1 mg/dl and 0.014 mg/dl, respectively, indicating the superiority of our proposed method over recently introduced methods. In this experiment, the detectable resolution with AgNPs/PVP is 40, while it is 71 with AgNPs/PVA. The designed system is simple to use, small in size, and cost-effective for measuring creatinine concentration, while it can be used as a portable system.

Recent Trends in the Quantification of Biogenic Amines in Biofluids as Biomarkers of Various Disorders: A Review

Biogenic amines (BAs) are bioactive endogenous compounds which play a significant physiological role in many cell processes like cell proliferation and differentiation, signal transduction and membrane stability. Likewise, they are important in the regulation of body temperature, the increase/decrease of blood pressure or intake of nutrition, as well as in the synthesis of nucleic acids and proteins, hormones and alkaloids. Additionally, it was confirmed that these compounds can be considered as useful biomarkers for the diagnosis, therapy and prognosis of several neuroendocrine and cardiovascular disorders, including neuroendocrine tumours (NET), schizophrenia and Parkinson's Disease. Due to the fact that BAs are chemically unstable, light-sensitive and possess a high tendency for spontaneous oxidation and decomposition at high pH values, their determination is a real challenge. Moreover, their concentrations in biological matrices are extremely low. These issues make the measurement of BA levels in biological matrices problematic and the application of reliable bioanalytical methods for the extraction and determination of these molecules is needed. This article presents an overview of the most recent trends in the quantification of BAs in human samples with a special focus on liquid chromatography (LC), gas chromatography (GC) and capillary electrophoresis (CE) techniques. Thus, new approaches and technical possibilities applied in these methodologies for the assessment of BA profiles in human samples and the priorities for future research are reported and critically discussed. Moreover, the most important applications of LC, GC and CE in pharmacology, psychology, oncology and clinical endocrinology in the area of the analysis of BAs for the diagnosis, follow-up and monitoring of the therapy of various health disorders are presented and critically evaluated.

A validated surrogate analyte LC–MS/MS assay for quantitation of endogenous kynurenine and tryptophan in human plasma

Aim: Indoleamine 2,3-dioxygenase (IDO) and tryptophan 2,3-dioxygenase (TDO) catalyze the initial and rate-controlling step of tryptophan metabolism through the kynurenine pathway, which plays an important role in mediating immune response. Accurate measurement of tryptophan and kynurenine is critical for monitoring the activity of IDO/TDO. Experimental: Surrogate analytes ([15N2]-Tryptophan and [13C6]-Kynurenine) were used for preparation of calibration standard and quality control. A fit-for-purpose validation using an approach of surrogate analyte and authentic matrix was carried out. Results: Acid precipitation was used in sample preparation, which yielded good recovery without significant matrix effect. Precision and accuracy results were well within the acceptance criteria. The assay demonstrated successful application to a clinical study to confirm a transient depletion of kynurenine upon IDO inhibition. Conclusion: A robust, specific and simple LC–MS/MS method was developed and validated with a fit-for-purpose style for measuring tryptophan and kynurenine in human plasma samples.

HIPK2 polymorphisms rs2058265, rs6464214, and rs7456421 were associated with kidney stone disease in Chinese males not females

BACKGROUND AND AIM

Recent studies have shown that genetic factors are involved in the development of kidney stone disease (KSD). A case-control association analysis was performed to investigate the association between homeodomain-interacting protein kinase 2 (HIPK2; OMIM *606868) polymorphisms and KSD.

METHODS

A total of 890 KSD patients and 920 healthy subjects were analyzed. Polymorphisms were genotyped using SNPscanTM high-throughput SNP classification technology. The genotypic and allelic frequencies in KSD patients and healthy individuals were analyzed using a Chi-square test.

RESULTS

The genotype and allele distributions of the three polymorphisms (rs2058265, rs6464214, and rs7456421 in HIPK2) displayed strong associations with KSD in males (rs2058265: odds ratio [OR] 2.480,95%confidence interval [CI] 1.205-5.106, p = 0.014; rs6464214: OR 2.466, 95%CI 1.198-5.078, p = 0.014; rs7456421: OR 2.846, 95%CI 1.362-5.947, p = 0.005; perallele: r2058265T, OR 1.357, 95%CI 1.073-1.715, p = 0.011; rs6464214G, OR 1.340, 95%CI 1.060-1.693, p = 0.014; rs7456421C, OR 1.356, 95%CI 1.073-1.713, p = 0.011). Patients carrying the T allele of rs2058265, the G allele of rs6464214, or the C allele of rs7456421 showed higher systolic blood pressure, creatinine, and uric acid levels compared with wild-genotype individuals after adjusting for age, gender, and body mass index (p < 0.005).

CONCLUSION

The association of HIPK2 gene polymorphisms with KSD was only observed in males but not in females. HIPK2 gene polymorphisms were also involved in the changes of KSD-related metabolic traits.

A sensitive and accurate method to simultaneously measure uric acid and creatinine in human saliva by using LC-MS/MS

AIM

To establish a method to simultaneously measure uric acid (UA) and creatinine (Cr) in human saliva.

MATERIALS & METHODS

By using HPLC-MS/MS, we developed and validated a fast, sensitive and accurate method to simultaneously determine UA and Cr in human saliva. The determination range for Cr and UA is of 10-5000 ng/ml with the R2 for both calibration curves over 0.999. The accuracy, precision and recovery of Cr and UA were all acceptable. By using the established method, the Cr and UA levels in saliva from 28 healthy volunteers were measured as 2.9 ± 0.8 µM and 46.8 ± 18.2 µM, respectively.

CONCLUSION

This method can simultaneously determine Cr and UA in saliva for clinical and translational study.

Urinary profiling of tryptophan and its related metabolites in patients with metabolic syndrome by liquid chromatography-electrospray ionization/mass spectrometry

Tryptophan (Trp) is an essential amino acid that plays an important role in protein synthesis and is a precursor of various substances related to diverse biological functions. An imbalance in Trp metabolites is associated with inflammatory diseases. The accurate and precise measurement of these compounds in biological specimens would provide meaningful information for understanding the biochemical states of various metabolic syndrome-related diseases, such as hyperlipidemia, hypertension, diabetes, and obesity. In this study, we developed a rapid, accurate, and sensitive liquid chromatography-tandem mass spectrometry-based method for the simultaneous targeted analysis of Trp and its related metabolites of the kynurenine (Kyn), serotonin, and tryptamine pathways in urine. The application of the developed method was tested using urine samples after protein precipitation. The detection limits of Trp and its metabolites were in the range of 0.01 to 0.1 μg/mL. The method was successfully validated and applied to urine samples from controls and patients with metabolic syndrome. Our results revealed high concentrations of Kyn, kynurenic acid, xanthurenic acid, and quinolinic acid as well as a high Kyn-to-Trp ratio (KTR) in patients with metabolic syndromes. The levels of urine Kyn and KTR were significantly increased in patients under 60 years old. The profiling of urinary Trp metabolites could be a useful indicator for age-related diseases including metabolic syndrome. ᅟ.

Reusable potentiometric screen-printed sensor and label-free aptasensor with pseudo-reference electrode for determination of tryptophan in the presence of tyrosine

Analysis of L-tryptophan (Trp) in biological samples has great importance for biomedical studies. Amino acid tyrosine (Tyr) that usually coexist with Trp in biological fluids can significantly interfere with reliable determination of Trp. In the current study, we demonstrate the development of two ultra-sensitive electrochemical sensor and label-free aptasensor for selective analysis of Trp in biological samples (i.e., cow's milk and human plasma, saliva and urine samples). In addition, without using AgCl/KCl, an Ag pseudo-reference screen printed electrode (Ag-PR-SPE) was exploited as a reference electrode. To prepare the engineered Trp sensor/aptasensor, a gold SPE was first modified with multiwall carbon nanotube (MWCNT-AuSPE) and then armed with Trp aptamer molecules (Apt-MWCNT-AuSPE). The prepared sensors were characterized using constant current-potentiometric stripping analysis (CC-PSA) and electrochemical impedance spectroscopy (EIS). The MWCNT-AuSPE and Apt-MWCNT-AuSPE were compared with respect to the linear detection range, limit of detection (LOD), accuracy, precision, repeatability. MWCNT-AuSPE and Apt-MWCNT-AuSPE demonstrate fast near-Nernstian response for PSA of Trp over the concentration ranging from 1.0 × 10(-9) to 2.0 × 10(-4) mol L(-1) and 1.0 × 10(-11) to 1.0 × 10(-4) mol L(-1) with detection limits of 3.6 × 10(-10) mol L(-1) and 4.9 × 10(-12) mol L(-1), respectively. Common interfering species present in the biological fluids (i.e., tyrosine, uric acid, ascorbic acid) showed no effects on the determination of Trp using CC-PSA. MWCNT-AuSPE and Apt-MWCNT-AuSPE represented well reproducibility and great precision with relative standard deviation (RSD) of 2.9% and 5.3% respectively. In comparison with the MWCNT-AuSPE, Apt-MWCNT-AuSPE provided higher sensitivity, selectivity and accuracy of Trp detection in real samples. Based on these findings, we propose the developed Apt-MWCNT-AuSPE as a simple detection method for analysis of Trp in biological samples.

Salivary uric acid as a noninvasive biomarker for monitoring the efficacy of urate-lowering therapy in a patient with chronic gouty arthropathy

BACKGROUND

Monitoring blood uric acid (UA) is important in all patients on urate-lowering therapy so that the selection of the effective drugs and dosage adjustments could be made until the target level is reached. The issue is that frequent needle jabs are unacceptable. Reported mean levels of salivary UA were 185-240 μmol/l in healthy adults. A linear correlation was demonstrated between UA concentrations in saliva and plasma. We monitored salivary UA instead of plasmatic UA in a patient with gout.

METHODS

Allopurinol and benzbromarone were used as the therapeutic drugs. Salivary UA; urinary UA and creatinine; and plasmatic UA, creatinine, kynurenine and tryptophan were measured by HPLC.

RESULTS

Salivary UA indicated the efficacy of therapy accurately and conveniently. After eight weeks therapy, the weekly mean levels of salivary UA were reduced and maintained to <300 μmol/l, which was equivalent to <360 μmol/l of plasmatic UA according to the salivary UA/plasmatic UA ratio of this patient.

CONCLUSION

Measurement of salivary UA is a noninvasive and useful way for monitoring the status of hyperuricemia and the therapeutic efficacy of urate-lowering therapy. It has value for the management of hyperuricemia and gout.