Roboz J
Department of Neoplastic Diseases, Mount Sinai School of Medicine, New York, NY 10029.
Chirality. 1994;6(2):51-7. doi: 10.1002/chir.530060203.
Disseminated candidiasis, a devastating disease with high morbidity and mortality in immunosuppressed patients, is difficult to diagnose because of the protean nature of symptoms and the lack of rapid and reliable laboratory diagnostic procedures. The subject of this review is the status of gas chromatographic-mass spectrometric techniques for the determination of D-arabinitol, a unique metabolite of pathogenic Candida species, in serum and urine. The enantiomers are separated by chiral chromatography followed by specific and sensitive detection using chemical ionization and selected ion monitoring. Using D/L-arabinitol ratios, instead of individual concentrations, eliminates the need for knowing the volume of samples and for calibration curves. A new filter paper technique requires only an unmeasured drop of whole blood (venous or finger/heel puncture) or urine; paper spots are mailable. Parallel determinations of D/L-arabinitol ratios in serum and urine in normal subjects and cancer patients with both normal and increased D/L-arabinitol ratios revealed constant (1.2-1.3 range) ratios of serum D/L-arabinitol/urine D/L-arabinitol for all populations studied. Analyzing two body fluids taken at the same time increases reliability by reducing false positives.
播散性念珠菌病在免疫抑制患者中是一种具有高发病率和死亡率的毁灭性疾病，由于症状的多变性以及缺乏快速可靠的实验室诊断程序，其诊断较为困难。本综述的主题是气相色谱 - 质谱技术在测定血清和尿液中D - 阿拉伯糖醇（致病念珠菌属的一种独特代谢产物）方面的现状。对映体通过手性色谱分离，然后使用化学电离和选择离子监测进行特异性和灵敏检测。使用D/L - 阿拉伯糖醇比率而非个体浓度，无需知道样品体积和校准曲线。一种新的滤纸技术仅需一滴未测量的全血（静脉血或手指/足跟穿刺血）或尿液；滤纸条可邮寄。对正常受试者以及D/L - 阿拉伯糖醇比率正常和升高的癌症患者的血清和尿液中的D/L - 阿拉伯糖醇比率进行平行测定，结果显示，在所研究的所有群体中，血清D/L - 阿拉伯糖醇/尿液D/L - 阿拉伯糖醇的比率恒定（在1.2 - 1.3范围内）。同时分析两种体液可通过减少假阳性来提高可靠性。
