Quantification of vanillylmandelic acid, homovanillic acid and 5-hydroxyindoleacetic acid in urine using a dilute-and-shoot and ultra-high pressure liquid chromatography tandem mass spectrometry method.

BACKGROUND: Urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) are biomarkers for the diagnosis and follow-up of neuroblastoma, whereas urinary 5-hydroxyindoleacetic acid (5-HIAA) is used to assess a carcinoid tumor. These analytes are conventionally analyzed in a single run by chromatography (LC) coupled with electrochemical detection (LC-ECD) using commercial kits. A rapid dilute-and-shoot LC tandem mass spectrometry (LC-MS/MS) assay was validated in order to replace the LC-ECD method and therefore improve analytical specificity and throughput. METHODS: Sample preparation was carried out by dilution of the urine sample with a solution containing the deuterated internal standards. The separation was achieved on an ultra-high pressure LC system with MS detection using a triple quadrupole mass spectrometer. The method was validated according to the current EMA and FDA guidelines. RESULTS: The full chromatographic run was achieved in 8 min. The method validation showed excellent linearity (r2>0.999 for all three analytes), precision (CV <15%), negligible matrix effect (recoveries >90%), low carryover (<1%) and LLOQ of 0.25, 0.4 and 0.4 µM for VMA, HVA and 5-HIAA, respectively. Deming fits and Bland-Altman analyses showed no significant differences between the values obtained between the two assays. CONCLUSIONS: The LC-MS/MS method proposed in this study is fast and robust, and the simple sample preparation saves time and avoids the additional costs of dedicated kits used for the LC-ECD assays by switching to LC-MS/MS. Additionally, the near-perfect correlation observed herein between both assays allows the previously established reference ranges to be maintained.

Fluorescence polarization immunoassay of urinary vanillylmandelic acid.

This rapid fluorescence polarization immunoassay for urinary vanillylmandelic acid (VMA) involves use of our previously described antiserum and label and the program for 5-hydroxyindoleacetic acid in the Abbott TDx fluorimeter. Urine samples were measured directly, without pretreatment. The minimum detectable concentration was 0.3 mg/L, and the range of the standard curve was 0.3-200.0 mg/L. Precision, analytical recovery, and correlation of results with those by the Pisano method (Clin Chim Acta 1962;7:285-91) were all satisfactory. With this procedure one can determine the VMA concentration in 10 urine sample in 22 min. This is the first report of a clinical immunoassay for VMA and should greatly simplify screening for neural crest tumors.

The assay of 4-hydroxy-3-methoxymandelic acid in urine by HPLC with electrochemical detection using bonded-phase silica sorbents for rapid, simple and selective extraction.

A method is reported for the determination of 4-hydroxy-3-methoxymandelic acid (HMMA) by HPLC with electrochemical detection. The preparation of sample prior to HPLC has been studied and an efficient and selective extraction procedure described. Bonded-phase silica extraction columns and a vacuum manifold were used for the simple and rapid processing of batches of urine samples. Combining a reverse-phase C18 and an anion exchange column ensures selective isolation of HMMA. This simplified greatly the subsequent chromatography. The method was combined into a simple scheme for the routine analysis of urine HMMA, catecholamines and 5-hydroxyindole-3-acetic acid. The HPLC was standardised such that a single mobile phase was used with minor modification for each of the assays.