Acute Effects of Single Versus Combined Inhaled ß2-Agonists Salbutamol and Formoterol on Time Trial Performance, Lung Function, Metabolic and Endocrine Variables.

BACKGROUND: High prevalence rates of ß2-agonist use among athletes in competitive sports makes it tempting to speculate that illegitimate use of ß2-agonists boosts performance. However, data regarding the potential performance-enhancing effects of inhaled ß2-agonists and its underlying molecular basis are scarce. METHODS: In total, 24 competitive endurance athletes (12f/12m) participated in a clinical double-blinded balanced four-way block cross-over trial to investigate single versus combined effects of ß2-agonists salbutamol (SAL) and formoterol (FOR), to evaluate the potential performance enhancement of SAL (1200 µg, Cyclocaps, Pb Pharma GmbH), FOR (36 µg, Sandoz, HEXAL AG) and SAL + FOR (1200 µg + 36 µg) compared to placebo (PLA, Gelatine capsules containing lactose monohydrate, Pharmacy of the University Hospital Ulm). Measurements included skeletal muscle gene and protein expression, endocrine regulation, urinary/serum ß2-agonist concentrations, cardiac markers, cardiopulmonary and lung function testing and the 10-min time trial (TT) performance on a bicycle ergometer as outcome variables. Blood and urine samples were collected pre-, post-, 3 h post- and 24 h post-TT. RESULTS: Mean power output during TT was not different between study arms. Treatment effects regarding lung function (p < 0.001), echocardiographic (left ventricular end-systolic volume p = 0.037; endocardial global longitudinal strain p < 0.001) and metabolic variables (e.g. NR4A2 and ATF3 pathway) were observed without any influence on performance. In female athletes, total serum ß2-agonist concentrations for SAL and FOR were higher. Microarray muscle gene analysis showed a treatment effect for target genes in energy metabolism with strongest effect by SAL + FOR (NR4A2; p = 0.001). Of endocrine variables, follicle-stimulating hormone (3 h Post-Post-TT), luteinizing hormone (3 h Post-Pre-TT) and insulin (Post-Pre-TT) concentrations showed a treatment effect (all p < 0.05). CONCLUSIONS: No endurance performance-enhancing effect for SAL, FOR or SAL + FOR within the permitted dosages compared to PLA was found despite an acute effect on lung and cardiac function as well as endocrine and metabolic variables in healthy participants. The impact of combined ß2-agonists on performance and sex-specific thresholds on the molecular and cardiac level and their potential long-term performance enhancing or health effects have still to be determined. TRIAL REGISTRATION: Registered at Eudra CT with the number: 2015-005598-19 (09.12.2015) and DRKS with number DRKS00010574 (16.11.2021, retrospectively registered).

Two dimensional chromatography mass spectrometry: Quantitation of chiral shifts in metabolism of propranolol in bioanalysis.

In this study a heart-cutting 2D-LC method was successfully developed and optimized in order to discriminate and quantitate (S)-propranolol, (R)-propranolol, and its hydroxy metabolites, namely the isomeric (S)-4'­hydroxy propranolol, (R)-4'­hydroxy propranolol, (S)-5'­hydroxy propranolol, (R)-5'­hydroxy propranolol, (S)-7'-hydroxy propranolol, and (R)-7'­hydroxy propranolol in one chromatographic run. Thereby, experiments investigating chiral discrimination in ring hydroxylation of propranolol were made feasible. Analysis of human urine samples after administration of a single oral dose of 40 mg of propranolol clearly revealed considerable chiral shifts in propranolol and its 4'-, 5'-, and 7'-hydroxy metabolites. Furthermore, the excretion rates of the individual (S)- and (R)-enantiomers were continuously monitored over 24 h post administration. Studies were performed utilizing a 2D-LC system hyphenated to a triple quadrupole mass spectrometer. The chromatographic system was endued with a reversed phase column (phenyl-hexyl) in first dimension and a teicoplanin based chiral column in second dimension. The method was basically validated and successfully evaluated as robust. Calibration was performed achieving accuracy between 80% and 120%. Maximal excretion rates of (S)-propranolol, (R)-propranolol, (S)-4'­hydroxy propranolol, (R)-4'­hydroxy propranolol, (S)-5'­hydroxy propranolol, (R)-5'­hydroxy propranolol, and (R)-7'­hydroxy propranolol were 237 ng/min, 281 ng/min, 4 ng/min, 4 ng/min, 1 ng/min, 9 ng/min, and 3 ng/min, respectively.

SFC for chiral separations in bioanalysis.

This review covers literature investigating methods for enantioselective chromatography using supercritical fluids as mobile phase constituents (SFC) in the field of bioanalysis. It provides an overview on method development and screening approaches published in scientific literature 2014-2018. Chiral stationary phases are used to create a chiral environment that allows for discrimination of enantiomers. Especially polysaccharide-based stationary phases are used in methods of recent investigations. In comparison to HPLC chiral SFC separation provides more selective cavity effects of inclusion-type chiral separation phases. Modifier and additive choices as well as further operating conditions like backpressure, temperature and flow rate are summarized and critically discussed. Further on, observed sample pretreatment and possible detection techniques are presented. SFC hyphenated to mass detection was found of major relevance and is therefore further discussed. Coupling of SFC with different detectors allows for straightforward use in bioanalysis. Interfacing MS detectors is generally performed including a make-up pump. Thus, applied make-up conditions were also reviewed. While most of the chiral separations in HPLC are performed in normal phase mode, and thus, challenge MS hyphenation, SFC-MS hyphenation can be easily achieved. This allows for convenient application in chiral trace analyses, often required in bioanalysis. Even worse in enantioseparation than in achiral chromatography, method development in SFC suffers from a lack of knowledge in separation mechanisms and thus approaches are often quite unique and most often achieved by screening using a One-Factor-at-a-Time (OFAT) design. Broad screening experiments with methodical approaches still appear as method of choice for now.