CLINICAL EVALUATION OF ACETYLCYSTEINE AS A MUCOLYTIC AGENT IN CYSTIC FIBROSIS

Enantioseparation of N-acetyl-dl-cysteine as o-phtaldialdehyde derivatives obtained with various primary aliphatic amine additives on polysaccharide-based chiral stationary phases

A sensitive and rapid high-performance liquid chromatography (HPLC) method was developed to enantioseparation of N-acetyl-dl-cysteine after precolumn derivatization using o-phthaldialdehyde and primary aliphatic amines. Seven polysaccharide-based chiral columns were tested in a reversed phase mode. Under the optimal chromatographic conditions, N-acetyl-dl-cysteine derivatives were completely enantioseparated on Chiralcel OZ-3R column with the resolution more than 2.5. The impact of various primary aliphatic amine additives as co-reagents (ethyl-, 1-propyl-, 1-butyl-, 1-pentylamine, (R)-sec-butylamine, tert-butylamine, isobutylamine, cyclopropyl-, cyclobutyl-, cyclopentyl and cyclohexylamine) used in precolumn derivatization step on the retention behavior (retention factor, selectivity and column efficiency) of N-acetyl-dl-cysteine derivatives was investigated. The effect of chromatographic conditions including acetonitrile content in the mobile phase, mobile phase pH, salt concentration in the mobile phase and column temperature on the retention and selectivity was investigated. The developed method was properly validated in terms of linearity, sensitivity (limit of detection and limit of quantification), accuracy, precision, intermediate precision and selectivity according to International Council for Harmonisation (ICH) of Technical Requirements for Pharmaceuticals for Human Use guidelines using internal normalization procedure. Proposed HPLC method was successfully applied to the determination of optical purity in commercially available N-acetyl-L-cysteine samples.

A comparison of four sputum pre-extraction preparation methods for identifying and characterising Mycobacterium tuberculosis using GCxGC-TOFMS metabolomics

In many pulmonary diseases, sputum is a valuable sample material for use in disease characterisation and diagnostics. However, due to its high viscosity and uneven consistency (lumpiness), it is difficult to obtain reproducible/repeatable results during compound extraction and analysis. We subsequently investigated and compared four sputum pre-extraction preparation methods using: 1) Sputolysin; 2) a combination of N-acetyl-l-cysteine and sodium hydroxide (NALC-NaOH); 3) NaOH alone, and 4) a simple ethanol homogenisation method, prior to sputum extraction and metabolomics analyses. The simple ethanol homogenisation approach proved to be the comparatively superior sputum pre-extraction preparation method, considering its repeatability, the number of characteristic compounds extracted, its ability to extract those compounds best differentiating the sample groups (Mycobacterium tuberculosis-spiked and clinically confirmed TB-positive patient samples from each of the controls respectively), and its detection limit. This developed methodology subsequently allows for accurate GC based analyses of sputum, and hence, could contribute significantly to the better characterisation or diagnostics of not only tuberculosis, but also potentially other pulmonary diseases, including, interstitial lung disease, cystic fibrosis, lung cancer, pneumonia and any other bacterial induced pulmonary diseases producing sputum.

Laryngotracheal obstruction complicating tracheostomy or endotracheal intubation with assisted respiration. A critical review

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