Deuterium labelled steroid hormones: syntheses and application in quantitation and endocrinology

The evolution of methods for urinary steroid metabolomics in clinical investigations particularly in childhood

The metabolites of cortisol, and the intermediates in the pathways from cholesterol to cortisol and the adrenal sex steroids can be analysed in a single separation of steroids by gas chromatography (GC) coupled to MS to give a urinary steroid profile (USP). Steroids individually and in profile are now commonly measured in plasma by liquid chromatography (LC) coupled with MS/MS. The steroid conjugates in urine can be determined after hydrolysis and derivative formation and for the first time without hydrolysis using GC-MS, GC-MS/MS and liquid chromatography with mass spectrometry (LC-MS/MS). The evolution of the technology, practicalities and clinical applications are examined in this review. The patterns and quantities of steroids changes through childhood. Information can be obtained on production rates, from which children with steroid excess and deficiency states can be recognised when presenting with obesity, adrenarche, adrenal suppression, hypertension, adrenal tumours, intersex condition and early puberty, as examples. Genetic defects in steroid production and action can be detected by abnormalities from the GC-MS of steroids in urine. New mechanisms of steroid synthesis and metabolism have been recognised through steroid profiling. GC with tandem mass spectrometry (GC-MS/MS) has been used for the tentative identification of unknown steroids in urine from newborn infants with congenital adrenal hyperplasia. Suggestions are made as to areas for future research and for future applications of steroid profiling. As routine hospital laboratories become more familiar with the problems of chromatographic and MS analysis they can consider steroid profiling in their test repertoire although with LC-MS/MS of urinary steroids this is unlikely to become a routine test because of the availability, cost and purity of the internal standards and the complexity of data interpretation. Steroid profiling with quantitative analysis by mass spectrometry (MS) after chromatography now provides the most versatile of tests of adrenal function in childhood.

Synthetic procedures for the preparation of deuterium-labeled analogs of naturally occurring steroids

The object of this article is to review the procedures that have been published concerning the preparation of deuterium-labeled analogs of naturally occurring steroid hormones. In combination with mass spectrometric methods, these stable isotope-labeled compounds should be applicable for human metabolism studies or as internal standards. Deuteration techniques for the elucidation of stereochemical problems, procedures for the preparation of monodeuterated steroids, and synthesis of deuterated analogs of nonbiologic steroids have therefore not been included in this review.

Deuterium labelled steroid hormones: tracers for the measurement of androgen plasma clearance rates in women

A method employing stable isotope-labelled tracers and gas chromatograph-mass spectrometry (GC-MS) analysis has been used to measure the plasma clearance rates (PCR's) of androstenedione (A) and testosterone (T) in normal women and women with androgen abnormalities including hirsutism and polycystic ovary syndrome. A solution of deuterium-labelled A and T is infused at a constant rate and blood samples taken at 2 and 2.25 h. Solvent extracts of the derived plasma samples, to which an internal standard has been added, are derivatized with pentafluoropropionic anhydride and the endogenous steroid and deuterated steroid are quantitated after an injection of the derivatization mixture into a capillary column GC-MS. The concentration of the deuterated steroid in the infusion mixture is measured and the PCR is calculated. In premenopausal normal women the PCRA is 1950 +/- 184 1/24 h (n = 5) and the PCRT is 484 +/- 82 1/24 h (n = 7).

Determination of oestradiol-17 beta in human serum by isotope dilution-mass spectrometry. Definitive methods in clinical chemistry, II

A definitive method is described for the measurement of oestradiol-17 beta in human serum. The method is based on the principle of isotope dilution-mass spectrometry. The analytical procedure consists of the following steps: addition of [4-14 C]oestradiol-17 beta to the plasma sample; extraction of the 14C-labelled and the non-labelled oestradiol-17 beta with dichloromethane; purification of the oestradiol-17 beta fraction by column chromatography on Sephadex LH-20; formation of the 3,17 beta-diheptafluorobutyric ester of oestradiol-17 beta; selected ion monitoring at m/z-values 664 and 666 by gas liquid chromatography-mass spectrometry. The accuracy of the method is based on the high specificity of mass spectrometry and on the exact control of recovery employing the principle of isotope dilution. Coefficients of variation from day to day varied between 1.0% and 2.5% in the range of 0.319 to 3.53 nmol/l. The lower limit of detection (ratio of signal to noise 3:1) is 5 pg oestradiol-17 beta per sample.

Synthesis of [2H8] estradiol, [2H7] estrone, [2H6] 2-hydroxyestrone and [2H6] 4-hydroxyestrone as internal standards for selected ion monitoring

The synthesis of [2H8] estradiol, [2H7] estrone, [2H6] 2-hydroxyestrone and [2H6] 4-hydroxyestrone from estrone (as a source) is described. The high isotopical purity renders the labelled compounds as suitable carriers and internal standards for quantitative gas chromatography - mass spectrometry. The content of protonium-form (i.e. natural) estrogens in the labelled derivatives ranged from 0.12% to 2.58%. The performance of these compounds in quantitative assays using selected ion monitoring has been established; and this allows the determination of estrogens from biological material in the lower picogram range.