Details

Autor(en) / Beteiligte

• Eisenhofer, Graeme

Titel

New Way Forward for the Diagnosis and Management of Gastroenteropancreatic Neuroendocrine Tumors with an LC-MS/MS Panel of Indole Biomarkers

Ist Teil von

• Clinical chemistry (Baltimore, Md.), 2019-11, Vol.65 (11), p.1346-1347

Ort / Verlag

England: Oxford University Press

Erscheinungsjahr

2019

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Consequent enhancement of ionization efficiencies and improved signal-to-noise ratios enable small sample volume applications such as in neonatal pediatrics (8) or microdialysis (9). [...]the currently described method for indoles requires only 50 ¿L of platelet-rich plasma. [...]of most importance to the present application directed to patients with GEP-NETs, the nonpolar nature of derivatized analytes allows for a simpler sample clean-up procedure. [...]for tumors that express AADC, measurements of platelet-rich plasma serotonin, normalized to platelet count, and of its deaminated acid metabolite, 5-hydroxyindole acetic acid, provide complementary information, with the former measurements more clinically sensitive for diagnosis and the latter more useful for disease monitoring. [...]the panel of indoles also incorporates the amino acid tryptophan, which is derived from the diet; this source of tryptophan can be rate limiting as a building block in downstream metabolism, including for the synthesis ofnicotinic acid (niacin). Because patients with extensive GEP-NET disease burden can suffer from depletion of tryptophan and associated niacin deficiency (11-13), the additional measurement of tryptophan can be useful for treatment of patients in whom dietary supplementation can be important for clinical care.