Orexin-A measurement in narcolepsy: A stability study and a comparison of LC-MS/MS and immunoassays.


Journal

Clinical biochemistry
ISSN: 1873-2933
Titre abrégé: Clin Biochem
Pays: United States
ID NLM: 0133660

Informations de publication

Date de publication:
Apr 2021
Historique:
received: 20 07 2020
revised: 18 01 2021
accepted: 19 01 2021
pubmed: 5 2 2021
medline: 30 6 2021
entrez: 4 2 2021
Statut: ppublish

Résumé

Orexin-A and -B are neuropeptides involved in sleep-wake regulation. In human narcolepsy type 1, this cycle is disrupted due to loss of orexin-producing neurons in the hypothalamus. Cerebrospinal fluid (CSF) orexin-A measurement is used in the diagnosis of narcolepsy type 1. Currently available immunoassays may lack specificity for accurate orexin quantification. We developed and validated a liquid chromatography mass spectrometry assay (LC-MS/MS) for CSF orexin-A and B. We used CSF samples from narcolepsy type 1 (n = 22) and type 2 (n = 6) and non-narcoleptic controls (n = 44). Stable isotope-labeled orexin-A and -B internal standards were added to samples before solid-phase extraction and quantification by LC-MS/MS. The samples were also assayed by commercial radioimmunoassay (RIA, n = 42) and enzymatic immunoassay (EIA, n = 72) kits. Stability of orexins in CSF was studied for 12 months. Our assay has a good sensitivity (10 pmol/L = 35 pg/mL) and a wide linear range (35-3500 pg/mL). Added orexin-A and -B were stable in CSF for 12 and 3 months, respectively, when frozen. The median orexin-A concentration in CSF from narcolepsy type 1 patients was <35 pg/mL (range < 35-131 pg/mL), which was lower than that in CSF from control individuals (98 pg/mL, range < 35-424 pg/mL). Orexin-A concentrations determined using our LC-MS/MS assay were five times lower than those measured with a commercial RIA. Orexin-B concentrations were undetectable. Orexin-A concentrations measured by our LC-MS/MS assay were lower in narcolepsy type 1 patients as compared to controls. RIA yielded on average higher concentrations than LC-MS/MS.

Sections du résumé

BACKGROUND BACKGROUND
Orexin-A and -B are neuropeptides involved in sleep-wake regulation. In human narcolepsy type 1, this cycle is disrupted due to loss of orexin-producing neurons in the hypothalamus. Cerebrospinal fluid (CSF) orexin-A measurement is used in the diagnosis of narcolepsy type 1. Currently available immunoassays may lack specificity for accurate orexin quantification. We developed and validated a liquid chromatography mass spectrometry assay (LC-MS/MS) for CSF orexin-A and B.
METHODS METHODS
We used CSF samples from narcolepsy type 1 (n = 22) and type 2 (n = 6) and non-narcoleptic controls (n = 44). Stable isotope-labeled orexin-A and -B internal standards were added to samples before solid-phase extraction and quantification by LC-MS/MS. The samples were also assayed by commercial radioimmunoassay (RIA, n = 42) and enzymatic immunoassay (EIA, n = 72) kits. Stability of orexins in CSF was studied for 12 months.
RESULTS RESULTS
Our assay has a good sensitivity (10 pmol/L = 35 pg/mL) and a wide linear range (35-3500 pg/mL). Added orexin-A and -B were stable in CSF for 12 and 3 months, respectively, when frozen. The median orexin-A concentration in CSF from narcolepsy type 1 patients was <35 pg/mL (range < 35-131 pg/mL), which was lower than that in CSF from control individuals (98 pg/mL, range < 35-424 pg/mL). Orexin-A concentrations determined using our LC-MS/MS assay were five times lower than those measured with a commercial RIA. Orexin-B concentrations were undetectable.
CONCLUSIONS CONCLUSIONS
Orexin-A concentrations measured by our LC-MS/MS assay were lower in narcolepsy type 1 patients as compared to controls. RIA yielded on average higher concentrations than LC-MS/MS.

Identifiants

pubmed: 33539807
pii: S0009-9120(21)00025-4
doi: 10.1016/j.clinbiochem.2021.01.009
pii:
doi:

Substances chimiques

Orexins 0

Types de publication

Journal Article Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

34-39

Informations de copyright

Copyright © 2021 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Auteurs

Mikael Lindström (M)

HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: mikael.lindstrom@helsinki.fi.

Mink Schinkelshoek (M)

Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Sleep-Wake Centre, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands.

Pentti J Tienari (PJ)

HUS Neurocenter, Helsinki University Hospital, Helsinki, Finland; Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Finland.

Jyrki P Kukkonen (JP)

Department of Pharmacology, Institute of Biomedicine, University of Helsinki, Helsinki, Finland.

Risto Renkonen (R)

HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland.

Rolf Fronczek (R)

Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Sleep-Wake Centre, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands.

Gert Jan Lammers (GJ)

Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Sleep-Wake Centre, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands.

Outi Itkonen (O)

HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

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Classifications MeSH