Lanvers-Kaminsky Claudia, Westhoff Petra Schulze, DʼIncalci Maurizio, Zucchetti Massimo, Boos Joachim
*Department of Pediatric Hematology and Oncology, University Children's Hospital of Muenster, Muenster, Germany; and †Laboratory of Cancer Pharmacology, Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Ther Drug Monit. 2014 Aug;36(4):549-52. doi: 10.1097/FTD.0000000000000030.
Monitoring of asparagine (ASN) during asparaginase (ASE) treatment directly links to the antileukemic effect of ASE but is challenging because of ASE-induced ex vivo hydrolysis of ASN. Assuming that ASE is not active at 4°C, immediate cooling of blood samples became the accepted method for ASN determination during ASE therapy.
To evaluate the effect of immediate sample cooling on the ex vivo hydrolysis of ASN by ASE the degradation of C4-ASN in whole blood, spiked with different ASE concentrations were analyzed HPLC-MS. C4-ASN and ASE were added either to blood at 4°C or to blood at 37°C, which was instantly cooled down to 4°C.
Immediate cooling did not prevent the ex vivo hydrolysis of ASN by ASE. The rate of ASN degradation to aspartic acid depended on the amount of ASE, ASE preparation, and time. Spiked into blood at 4°C 100 U/L native E. coli ASE already immediately degraded 100% of C4-ASN, whereas 10 U/L reduced the amount of C4-ASN by 30%. Spiked into blood at 37°C, which was immediately cooled thereafter, 10 U/L native E. coli ASE hydrolyzed 60% of C4-ASN and 1 U/L between 5% and 10% of C4-ASN. Concentrations of aspartic acid increased in parallel with ASN degradation. In addition, the ex vivo hydrolysis also affected concentrations of glutamine and glutamic acid.
Cooling of blood samples did not inactivate ASE. Thus, to evaluate the precise pharmacodynamics of ASE, alternative methods for effective ASE inactivation at the time of blood withdrawal are needed.
在天冬酰胺酶(ASE)治疗期间监测天冬酰胺(ASN)与ASE的抗白血病作用直接相关,但由于ASE诱导的ASN体外水解,这一监测具有挑战性。假设ASE在4°C时无活性,血液样本的立即冷却成为ASE治疗期间ASN测定的公认方法。
为了评估立即冷却样本对ASE体外水解ASN的影响,采用高效液相色谱-质谱法分析了添加不同浓度ASE的全血中C4-ASN的降解情况。将C4-ASN和ASE添加到4°C的血液中或添加到37°C的血液中,然后立即冷却至4°C。
立即冷却并不能阻止ASE对ASN的体外水解。ASN降解为天冬氨酸的速率取决于ASE的量、ASE制剂和时间。在4°C添加到血液中时,100 U/L天然大肠杆菌ASE立即降解了100%的C4-ASN,而10 U/L使C4-ASN的量减少了30%。在37°C添加到血液中并随后立即冷却,10 U/L天然大肠杆菌ASE水解了60%的C4-ASN,1 U/L水解了5%至10%的C4-ASN。天冬氨酸的浓度与ASN的降解平行增加。此外,体外水解还影响谷氨酰胺和谷氨酸的浓度。
血液样本的冷却并未使ASE失活。因此,为了评估ASE的精确药效学,需要在采血时采用其他有效使ASE失活的方法。