Summary
A method is described to measure biochemical markers of neonatal hypoxia-ischemia. The approach utilizes high pressure liquid chromatography (HPLC) and Gas Chromatography Mass Spectrometry (GC/MS).
Abstract
Neonatal hypoxia ischemia is characterized by inadequate blood perfusion of a tissue or a systemic lack of oxygen. This condition is thought to cause/exacerbate well documented neonatal disorders including neurological impairment 1-3. Decreased adenosine triphosphate production occurs due to a lack of oxidative phosphorylation. To compensate for this energy deprived state molecules containing high energy phosphate bonds are degraded 2. This leads to increased levels of adenosine which is subsequently degraded to inosine, hypoxanthine, xanthine, and finally to uric acid. The final two steps in this degradation process are performed by xanthine oxidoreductase. This enzyme exists in the form of xanthine dehydrogenase under normoxic conditions but is converted to xanthine oxidase (XO) under hypoxia-reperfusion circumstances 4, 5. Unlike xanthine dehydrogenase, XO generates hydrogen peroxide as a byproduct of purine degradation 4, 6. This hydrogen peroxide in combination with other reactive oxygen species (ROS) produced during hypoxia, oxidizes uric acid to form allantoin and reacts with lipid membranes to generate malondialdehyde (MDA) 7-9. Most mammals, humans exempted, possess the enzyme uricase, which converts uric acid to allantoin. In humans, however, allantoin can only be formed by ROS-mediated oxidation of uric acid. Because of this, allantoin is considered to be a marker of oxidative stress in humans, but not in the mammals that have uricase.
We describe methods employing high pressure liquid chromatography (HPLC) and gas chromatography mass spectrometry (GCMS) to measure biochemical markers of neonatal hypoxia ischemia. Human blood is used for most tests. Animal blood may also be used while recognizing the potential for uricase-generated allantoin. Purine metabolites were linked to hypoxia as early as 1963 and the reliability of hypoxanthine, xanthine, and uric acid as biochemical indicators of neonatal hypoxia was validated by several investigators 10-13. The HPLC method used for the quantification of purine compounds is fast, reliable, and reproducible. The GC/MS method used for the quantification of allantoin, a relatively new marker of oxidative stress, was adapted from Gruber et al 7. This method avoids certain artifacts and requires low volumes of sample. Methods used for synthesis of MMDA were described elsewhere 14, 15. GC/MS based quantification of MDA was adapted from Paroni et al. and Cighetti et al. 16, 17. Xanthine oxidase activity was measured by HPLC by quantifying the conversion of pterin to isoxanthopterin 18. This approach proved to be sufficiently sensitive and reproducible.
Protocol
Discussion
The methods described here permit the evaluation of neonatal hypoxia ischemia. This protocol combines the measurements of markers of energy (ATP) deprivation, oxidative stress, oxidative damage, and enzyme activity to gain an overall biochemical picture of the presence or even the degree of hypoxic ischemia. Despite the usefulness of this method, there are potential limitations. Firstly, it takes roughly 1-2 ml of blood to collect enough plasma to run all of the assays. This will not be a problem in adults or childre…
Disclosures
The authors have nothing to disclose.
Acknowledgements
This work is funded by National Institutes of Health R01 NR011209-03
Materials
| Name of the reagent | Company | Catalogue number | Comments (optional) |
|---|---|---|---|
| 6ml K3E EDTA K3 tube | Fisher Scientific | 2204061 | |
| 5702R centrifuge | Fisher Scientific | 05413319 | With 13&16MM adaptor |
| 1.5ml microcentrifuge tube | USA Scientific | 1615-5599 | |
| 2-Aminopurine | Sigma-Aldrich | A3509 | |
| Varian Cary 100 spectrophotometer | Agilant Technologies | 0010071500 | |
| Savant SpeedVac | Thermo Scientific | SC210A-115 | |
| Micron centrifugal filter device | Fisher Scientific | UFC501596 | |
| Supelcosil LC-18-S Column | Sigma-Aldrich | 58931 | |
| Supelcosil LC-18-S Supelguard cartridge and holder | Sigma-Aldrich | 59629 | |
| HPLC | Waters | ||
| GCMS Vial | Fisher Scientific | 03376607 | |
| DL-Allantoin-5-13C;1-15N | CDN Isotopes | M-2307 | Lot #L340P9 |
| MTBSTFA | Thermo Scientific | 48920 | |
| Pyridine | Sigma-Aldrich | 270970 | |
| 5973E GC/MSD | Agilent Technologies | G7021A | Part # for 5975E GC/MS |
| 3-Ethoxymethacrolein | Sigma-Aldrich | 232548 | |
| Sodium Hydroxide | Sigma-Aldrich | S5881 | |
| Dichloromethane | Sigma-Aldrich | 270997 | |
| Benzene | Sigma-Aldrich | 401765 | |
| Diisopropyl ether | Sigma-Aldrich | 38270 | |
| BHT | Sigma-Aldrich | B1378 | |
| Ethanol | Sigma-Aldrich | 459844 | |
| Phenylhydrazine | Sigma-Aldrich | P26252 |
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