Kazunori Sugahara

Corticosteroid treatment of prolidase deficiency skin lesions by inhibiting iminodipeptide-primed neutrophil superoxide generation.

We studied the pathogenetic role of iminodipeptides, and the effects of corticosteroids on the skin lesions of two adult female siblings with prolidase deficiency. The elder sister had had severe skin ulcers and mental retardation since childhood, while the younger sister had shown milder clinical manifestations since late adolescence. The ulcers showed vascular wall thickening and neutrophil infiltration. Oral prednisolone at moderate doses was not effective, but corticosteroid pulse therapy followed by a moderate dose of prednisolone improved the preulcerative indurated lesions and ulcers. A 2‐year follow‐up of the younger patient indicated that N‐formyl methionyl leucyl phenylalanine‐induced neutrophil superoxide generation was elevated, in parallel with an increase in the serum iminodipeptide level, when the skin ulcers and preulcerative indurated lesions were most active. Corticosteroid pulse therapy downregulated the superoxide generation by neutrophils. The serum iminodipeptide level, however, did not decrease during 25 days after pulse therapy. These findings suggest that iminodipeptides may play an important part in aggravating the skin lesions by priming neutrophil superoxide generation, and that high‐dose corticosteroids improve the skin lesions, probably by inhibiting the infiltration, and superoxide generation by, neutrophils. Neutrophil superoxide generation was more prominent in the elder sister, suggesting that clinical severity may depend on the response of neutrophils to the iminodipeptides. Chronic stimulation by superoxide may cause thickening of cerebral blood vessels and eventual mental retardation.

Liquid chromatography-mass spectrometry for the qualitative analyses of iminodipeptides in the urine of patients with prolidase deficiency

Analyses of standard iminodipeptides and iminodipeptides in the urine of patients with prolidase deficiency have been demonstrated using liquid chromatography-mass spectrometry with an atmospheric pressure ionization interface system. The separation was carried out on a reversed-phase column using 0.1% aqueous trifluoroacetic acid-methanol (70:30 or 80:20). Very intense quasi-molecular ions [( M + H]+) of various standard iminodipeptides were observed by this method. The quasi-molecular ions [M + H]+ of various iminodipeptides were also observed in the urine samples of patients with prolidase deficiency, and Gly-Pro, Ala-Pro, Val-Pro, Leu-Pro, Ile-Pro, Ser-Pro, Thr-Pro, Glu-Pro, Asp-Pro, His-Pro, Lys-Pro, Pro-Pro and Tyr-Pro as iminodipeptides containing proline with C-terminal residue and Glu-Hyp, Pro-Hyp, Ile-Hyp and Gly-Hyp as iminodipeptides containing hydroxyproline with C-terminal residue were identified in the urine of patients with prolidase deficiency.

Determination of d,l-propargylglycine and N-acetylpropargylglycine in urine and several tissues of d,l-propargylglycine-treated rats using liquid chromatography—mass spectrometry

An experimental animal model with cystathioninuria was obtained by the injection of D,L-propargylglycine into rats. The concentrations of D,L-propargylglycine in urine, several tissues and serum at different times after the injection were measured by liquid chromatography-mass spectrometry. The propargylglycine accumulated rapidly in several tissues and serum of the rats, and reached its maximum level at about 2 h after the injection. Approximately 21.2% of the administered propargylglycine was excreted in urine. N-Acetylpropargylglycine was identified as a new metabolite of propargylglycine in urine. The concentration of propargylglycine was 100 times that of N-acetylpropargylglycine in urine.

Liquid chromatographic-mass spectrometric analysis of N-acetylamino acids in human urine.

Liquid chromatography-atmospheric pressure chemical-ionization mass spectrometry (LC-APCI-MS) was used for the analysis of N-acetylamino acids that could not be determined with an amino acid analyzer. LC-APCI-MS could directly detect the protonated molecular ions of various synthetic N-acetylamino acids, distinguishing N-acetylserine from O-acetylserine and N(alpha)-acetyllysine from N(epsilon)- acetyllysine. Furthermore, N-acetylasparagine, N-acetylaspartic acid, N-acetylglutamine and N-acetylglutamic acid were identified in normal human urine. The assay data for N-acetylaspartic acid agree with a previous report using gas chromatography-mass spectrometry. These results demonstrate the usefulness of the apparatus described above for the analysis of N-acetylamino acids in biological samples.

Liquid chromatography—mass spectrometry for simultaneous analyses of iminodipeptides containing an N-terminal or a C-terminal proline

Simultaneous analyses of synthetic iminodipeptides containing an N-terminal proline or a C-terminal proline have been demonstrated using liquid chromatography-mass spectrometry with an atmospheric pressure ionization interface system. The separation of iminodipeptides was carried out on a reversed-phase high-performance liquid chromatographic column using 0.1% aqueous trifluoroacetic acid-methanol (75:25, v/v, pH 2.0) as mobile phase. Very intense protonated molecular ions [M + H]+ of various synthetic iminodipeptides, Pro-Gly, Gly-Pro, Pro-Ala, Ala-Pro, Pro-Val, Val-Pro, Pro-Leu and Leu-Pro, were observed. Pro-Gly (Pro-X) and Gly-Pro (X-Pro) have the same protonated molecular ion (m/z 173), but the peaks of these compounds on the mass chromatograms were clearly distinguished by the differences of the retention times and mass spectra. The synthetic iminodipeptides containing an N-terminal proline added to urine samples from a patient with prolidase deficiency were also distinguished from iminodipeptides containing a C-terminal proline in urine samples from a patient with prolidase deficiency by scanning the [M + H]+ ion of each iminodipeptide. We established the method to measure simultaneously the various iminodipeptides containing an N-terminal or a C-terminal proline in biological samples.

Determination of cystathionine and perhydro-1,4-thiazepine-3,5-dicarboxylic acid in the urine of a patient with cystathioninuria using column liquid chromatography—mass spectrometry

A method for the measurement of cystathionine and perhydro-1,4-thiazepine-3,5-dicarboxylic acid in the urine of a patient with cystathioninuria has been developed, using column liquid chromatography-mass spectrometry. Cystathionine and perhydro-1,4-thiazepine-3,5-dicarboxylic acid were determined by scanning the [M + H]+ ions of each compound. The recoveries were 80-92.4% for cystathionine and 80-100% for perhydro-1,4-thiazepine-3,5-dicarboxylic acid after ion-exchange treatment. The results agreed well with those obtained using an amino acid analyser. The concentrations found for cystathionine and perhydro-1,4-thiazepine-3,5-dicarboxylic acid were 1.289 +/- 0.099 mg/ml and 0.310 +/- 0.0067 mg/ml, respectively.

The Use of Liquid Chromatography-Mass Spectrometry for the Identification and Quantification of Urinary Iminodipeptides in Prolidase Deficiency

It has been reported that the urine of patients with prolidase deficiency contains various iminodipeptides with a carboxyl-terminal proline (hydroxyproline). These iminodipeptides have hitherto been detected indirectly by acid hydrolysis or enzymatic digestion, followed by amino acid analysis. In the present study, it was shown that X-Pro could be distinguished from Pro-X when the iminodipeptides were analysed directly by liquid chromatography coupled with atmospheric pressure ionization mass spectrometry (LC/API-MS), with scanning of the protonated molecule ions ([M+H]+). The same procedure also successfully quantified urinary iminodipeptides from patients with prolidase deficiency. A quantitative investigation of two siblings with prolidase deficiency revealed that the patient with severe clinical symptoms excreted more iminodipeptides than the other who did not have serious symptoms. LC/API-MS also revealed iminodipeptides (Gly-Hyp and Pro-Hyp) in the urine of the mother of the patients and in normal volunteers. Patients excreted much more Pro-Hyp than normal volunteers, whereas no quantitative differences were found between the mother and controls. In patients, the excretion of large quantities of X-Pro is due to their very low prolidase activity towards this type of substrate. In the erythrocytes of patients, prolidase activity towards X-Hyp was extremely low; even in the mother and normal volunteers, it was remarkably low in comparison with the activity against X-Pro.

Identification of cyclic cystathionine sulfoxide and N-acetylcyclic cystathionine in the urine of a patient with cystathioninuria using liquid chromatography-mass spectrometry with an atmospheric pressure chemical ionization interface system

Perhydro-1,4-thiazepine-4,5-dicarboxylic acid sulfoxide (cyclic cystathionine sulfoxide [cyclic cystaSO]) and N-acetylperhydro-1,4-thiazepine-3,5-dicarboxylic acid (NAc-cyclic cysta) have been identified in the urine of a patient with cystathioninuria as new metabolites of cystathionine for the first time using liquid chromatography-mass spectrometry with an atmospheric pressure chemical ionization interface system (LC/APCI-MS). The concentrations of cyclic cystaSO and NAc-cyclic cysta in the urine of a patient with cystathioninuria have also been determined for the first time using this method: 18.24 +/- 0.79 and 25.23 +/- 0.83 mg/g creatinine, respectively.

Liquid chromatographic—mass spectrometric analysis for screening of patients with cystinuria, and identification of cystine stone

Analyses of amino acids in the urine of a normal human and of patients with heterozygous and homozygous cystinuria have been carried out, using liquid chromatography-mass spectrometry with an atmospheric pressure ionization interface system. A kidney cystine stone was also analysed by this system. Very intense quasi-molecular ions ([M + H]+) of standard cystine, arginine, lysine and ornithine were observed on mass chromatograms as base peaks. Mass chromatograms of the urine samples from a normal human and from patients with heterozygous and homozygous cystinuria were easily distinguishable. The retention times in the mass chromatogram and mass spectrum of kidney stone cystine was almost the same as that of authentic cystine.