Development of a two-site immunoassay of recombinant urate oxidase (SR 29142) and its use for determination of pharmacokinetic parameters in rats and baboons

A microfluidic approach for the detection of uric acid through electrical measurement using an atomically thin MoS2 field-effect transistor

There is a demand for biosensors working under in vivo conditions, which requires significant device size and endurance miniaturization in solution environments. We demonstrated the detection of uric acid (UA) molecules, a marker of diseases like gout, whose continuous monitoring is required in medical diagnosis. We used a field effect transistor (FET) composed of an atomically thin transition metal dichalcogenide (TMD) channel. The sensor detection was carried out in a solution environment, for which we protected the electrodes of the source and drain from the solution. A microfluidic channel controls the solution flow that can realize evaporation-free conditions and provide an accurate concentration and precise measurement. We detected a systematic change of the drain current with the concentration of the UA in isopropyl alcohol (IPA) solvent with a detection limit of 60 nM. The sensor behavior is reversible, and the drain current returns to its original value when the channel is washed with pure solvent. The results demonstrate the feasibility of applying the MoS2-FET device to UA detection in solution, suggesting its possible use in the solution environment.

Powerful Electron-Transfer Screen-Printed Platforms as Biosensing Tools: The Case of Uric Acid Biosensor

The use of carbon nanomaterials (CNMs) in sensors and biosensor realization is one of the hottest topics today in analytical chemistry. In this work, a comparative in-depth study, exploiting different nanomaterial (MWNT-CO₂H, -NH₂, -OH and GNP) modified screen-printed electrodes (SPEs), is reported. In particular, the sensitivity, the heterogeneous electron transfer constant (k⁰), and the peak-to-peak separation (ΔE) have been calculated and analyzed. After which, an electrochemical amperometric sensor capable of determining uric acid (UA), based on the nano-modified platforms previously characterized, is presented. The disposable UA biosensor, fabricated modifying working electrode (WE) with Prussian Blue (PB), carbon nanotubes, and uricase enzyme, showed remarkable analytical performances toward UA with high sensitivity (CO₂H 418 μA μM^-1 cm^-2 and bare SPE-based biosensor, 33 μA μM^-1 cm^-2), low detection limits (CO₂H 0.5 nM and bare SPE-based biosensors, 280 nM), and good repeatability (CO₂H and bare SPE-based biosensors, 5% and 10%, respectively). Moreover, the reproducibility (RSD%) of these platforms in tests conducted for UA determination in buffer and urine samples results are equal to 6% and 15%, respectively. These results demonstrate that the nanoengineered electrode exhibited good selectivity and sensitivity toward UA even in the presence of interfering species, thus paving the way for its application in other bio-fluids such as simple point-of-care (POC) devices.

Reduced Graphene Oxide-based Covalent Hybrid Film Electrode Self-assembled with Gold Nanoparticles for the Enzyme-Free Amperometric Sensing of Serum Uric Acid

Purine metabolism in the human body leads to the production of uric acid (UA) at the end. But an abnormal level of UA in the human body creates health problems. The sensing and quantification of UA is essentially required to prevent and diagnose hypertension, arthritis, gout, hyperuricemia or Lesch-Nyhan syndrome, etc. Herein, the development of a sensing platform for the measurement of UA using Au nanoparticle-based hybrid self-assembly is described. The self-assembling of a thiol-terminated silicate network functionalized graphene oxide hybrid on a polycrystalline Au surface yields a three-dimensional assembly. The oxygen functionalities of the self-assembly were partially reduced by an NaBH₄ treatment. The free -SH groups of the self-assembly were successfully used for the immobilization of Au nanoparticles by chemisorption. The nanoparticle-based hybrid self-assembly is highly sensitive toward UA, and shows a wide linear response with a detection limit of 40 nM UA (S/N = 7) without interference from co-exiting ascorbic acid. Its practical application was demonstrated using human serum samples.

An electrochemical Lab-on-a-CD system for parallel whole blood analysis

Lab-on-a-CD, as a main branch of Lab-on-a-chip technology, has led to several very successful commercial products. Most of these existing Lab-on-a-CD systems present complex system designs and thus are relatively expensive. In this work, we have developed a simple but robust Lab-on-a-CD system for parallel whole blood analyses. This Lab-on-a-CD system incorporates electrochemical bioanalysis and a simple blood sample separation mechanism into the centrifugal platform, and thus reduces the system's complexity. To demonstrate the applicability, the system was applied to perform basic metabolic panel tests, for example, the concentrations of glucose, lactate and uric acids of whole blood samples. Using only 16 μL of whole blood, within a few minutes, the Lab-on-a-CD system could produce results that agreed in general with the data by a conventional system. Therefore, this proof-of-concept Lab-on-a-CD system has demonstrated the potential to become a robust and simple-to-use device for parallel blood analyses.

Development of a new LC-MS/MS based enzyme activity assay for recombinant urate oxidase in plasma and its application to pharmacokinetics in human

A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the determination of recombinant urate oxidase in human plasma. This assay was based on the determination of enzyme reaction product, (15)N-allantoin, and phenacetin was used as an internal standard (IS). Separation was achieved on a C18 column by the mobile phase of 30% water (containing 0.5% formic acid) and 70% methanol. Quantification was done using multiple reaction monitoring (MRM) mode to monitor the precursor-to-product ion transitions of m/z 161 → m/z 118 for (15)N-allantoin and m/z 180 → m/z 110.1 for IS at positive ionization mode. The calibration curve was established over the range of 2.077-42.06 U/l and the correlation coefficient was larger than 0.99. The intra-day and inter-day relative standard deviations were less than 10.6%. Accuracy determined at three concentrations ranged between 98.6% and 109.2%. This method was successfully applied to a pharmacokinetic study of intravenous recombinant urate oxidase produced from Escherichia coli in Chinese healthy volunteers.

An Amperometric Biosensor for Uric Acid Determination Prepared From Uricase Immobilized in Polyaniline-Polypyrrole Film

A new amperometric uric acid biosensor was developed by immobilizing uricase by a glutaraldehyde crosslinking procedure on polyaniline-polypyrrole (pani-ppy) composite film on the surface of a platinum electrode. Determination of uric acid was performed by the oxidation of enzymatically generated H₂O₂ at 0.4 V vs. Ag/AgCl. The linear working range of the biosensor was 2.5×10-6 - 8.5×10-5 M and the response time was about 70 s. The effects of pH, temperature were investigated and optimum parameters were found to be 9.0, 55 oC, respectively. The stability and reproducibility of the enzyme electrode have been also studied.

Use of Single-Dose Rasburicase in an Obese Female

OBJECTIVE:

To report the use of single-dose rasburicase in an obese patient.

CASE SUMMARY:

A 53-year-old obese African American woman weighing 136 kg (ideal body weight [IBW] 55 kg) with new-onset chronic myelomonocytic leukemia in leukocytic blast crisis was treated with hydroxyurea 5 g daily. In addition, she received allopurinol 300 mg daily for prevention of tumor lysis syndrome (TLS). The following day, allopurinol was discontinued and rasburicase was administered at a dose of 0.2 mg/kg of IBW for a serum uric acid level of 11.9 mg/dL. The patient's serum uric acid level decreased to 1.9 mg/dL 48 hours after a single dose.

DISCUSSION:

Rasburicase is indicated for the initial management of elevated plasma uric acid levels in patients with hematologic and solid tumor malignancies who are at risk for TLS. This case is unique because the patient received one dose of rasburicase followed by allopurinol rather than 5 daily doses of rasburicase. Additionally, the dose was based on IBW rather than actual body weight. Efficacy of this approach is apparent from the uric acid levels and the lack of hemodialysis requirements.

CONCLUSIONS:

A single dose of rasburicase (based on IBW) followed by allopurinol can effectively prevent TLS based on serum uric acid concentration. This approach resulted in a substantial cost savings.

Rasburicase: a potent uricolytic agent

Rasburicase (Fasurtec, Elitek, Sanofi-Synthelabo) is a new recombinant urate oxidase developed for the prevention and treatment of hyperuricaemia. It has a half-life of 17-21 h and produces rapid (within 4 h) and pronounced reductions in plasma uric acid concentrations. To date, rasburicase has been tested in four clinical trials conducted in patients with cancer (primarily haematological malignancies). It successfully alleviated hyperuricaemia in 98% of patients and prevented this complication in 99.6% of those who were at risk. In a stratified, randomised trial, rasburicase was more effective than allopurinol. Most patients had improved or stabilised renal function during rasburicase treatment, despite ongoing chemotherapy-induced tumour lysis. Except for occasional instances of haemolytic anaemia and methemoglobinaemia in patients with glucose-6-phosphate dehydrogenase deficiency, rasburicase was well-tolerated, with a low frequency of mild adverse events. Rasburicase is a safe and effective agent in the prevention or treatment of hyperuricaemia in cancer patients.

A randomized comparison between rasburicase and allopurinol in children with lymphoma or leukemia at high risk for tumor lysis

Standard therapy in the United States for malignancy-associated hyperuricemia consists of hydration, alkalinization, and allopurinol. Urate oxidase catalyzes the enzymatic oxidation of uric acid to a 5 times increased urine soluble product, allantoin. Rasburicase is a new recombinant form of urate oxidase available for clinical evaluation. This multicenter randomized trial compared allopurinol to rasburicase in pediatric patients with leukemia or lymphoma at high risk for tumor lysis. Patients received the assigned uric acid-lowering agent for 5 to 7 days during induction chemotherapy. The primary efficacy end point was to compare the area under the serial plasma uric acid concentration curves during the first 96 hours of therapy (AUC(0-96)). Fifty-two patients were randomized at 6 sites. In an intent-to-treat analysis, the mean uric acid AUC(0-96) was 128 +/- 70 mg/dL.hour for the rasburicase group and 329 +/- 129 mg/dL.hour for the allopurinol group (P <.0001). The rasburicase versus allopurinol group experienced a 2.6-fold (95% CI: 2.0-3.4) less exposure to uric acid. Four hours after the first dose, patients randomized to rasburicase compared to allopurinol achieved an 86% versus 12% reduction (P <.0001) of initial plasma uric acid levels. No antirasburicase antibodies were detected at day 14. This randomized study demonstrated more rapid control and lower levels of plasma uric acid in patients at high risk for tumor lysis who received rasburicase compared to allopurinol. For pediatric patients with advanced stage lymphoma or high tumor burden leukemia, rasburicase is a safe and effective alternative to allopurinol during initial chemotherapy.

Recombinant urate oxidase for the prophylaxis or treatment of hyperuricemia in patients With leukemia or lymphoma

PURPOSE

To improve the control of hyperuricemia in patients with leukemia or lymphoma, we tested a newly developed uricolytic agent, recombinant urate oxidase (SR29142; Rasburicase; Sanofi-Synthelabo, Inc, Paris, France), which catalyzes the oxidation of uric acid to allantoin, a highly water-soluble metabolite readily excreted by the kidneys.

PATIENTS AND METHODS

We administered Rasburicase intravenously, at 0.15 or 0.20 mg/kg, for 5 to 7 consecutive days to 131 children, adolescents, and young adults with newly diagnosed leukemia or lymphoma, who either presented with abnormally high plasma uric acid concentrations or had large tumor cell burdens. Blood levels of uric acid, creatinine, phosphorus, and potassium were measured daily. The pharmacokinetics of Rasburicase, the urinary excretion rate of allantoin, and antibodies to Rasburicase were also studied.

RESULTS

At either dosage, the recombinant enzyme produced a rapid and sharp decrease in plasma uric acid concentrations in all patients. The median level decreased by 4 hours after treatment, from 9.7 to 1 mg/dL (P =.0001), in the 65 patients who presented with hyperuricemia, and from 4.3 to 0.5 mg/dL (P =.0001) in the remaining 66 patients. Despite cytoreductive chemotherapy, plasma uric acid concentrations remained low throughout the treatment (daily median level, 0.5 mg/dL). The urinary excretion rate of allantoin increased during Rasburicase treatment, peaking on day 3. Serum phosphorus concentrations did not change significantly during the first 3 days of treatment, decreased significantly by day 4 in patients presenting with hyperuricemia (P =.0003), and fell within the normal range in all patients by 48 hours after treatment. Serum creatinine levels decreased significantly after 1 day of treatment in patients with or without hyperuricemia at diagnosis (P =.0003 and P =.02, respectively) and returned to normal range in all patients by day 6 of treatment. Toxicity was negligible, and none of the patients required dialysis. The mean plasma half-lives of the agent were 16.0 +/- 6.3 (SD) hours and 21.1 +/- 12.0 hours, respectively, in patients treated at dosages of 0.15 or 0.20 mg/kg. Seventeen of the 121 assessable patients developed antibodies to the enzyme.

CONCLUSION

Rasburicase is safe and highly effective for the prophylaxis or treatment of hyperuricemia in patients with leukemia or lymphoma.