Name: absolute quantification of a&#946;1-42 in csf using a mass spectrometric reference measurement procedure
Uploaded: 2017-03-21T14:00:00
Description: Watch this Scientific Journal Video about Absolute Quantification of AÎ²1-42 in CSF Using a Mass Spectrometric Reference Measurement Procedure at JoVE.com

This work was performed on behalf of the International Federation of Clinical Chemistry Working Group on CSF Proteins, which has the following composition: Kaj Blennow (Chair) and Henrik Zetterberg, Gothenburg University, Sweden; Les Shaw and Magdalena Korecka, University of Philadelphia, PA, USA; Ingrid Zegers, Institute for Reference Materials and Measurements, Geel, Belgium; Piotr Lewczuk, Universit&#228;tsklinikum Erlangen, Germany; and Rand Jenkins, PPD Bioanalytical Laboratory, Richmond, VA, USA; Randall Bateman, Washington University, MO, USA; and H Vanderstichele, Innogenetics NV, Ghent, Belgium. This work was also part of the Global Consortium for Biomarker Standardization CSF Reference Methods Working Group, which is led by Maria C. Carrillo, Ph.D., Senior Director, Medical &amp; Scientific Relations, Alzheimer's Association. The study was supported by The Swedish Research Council (grants #14002, #521-2011-4709, and #2013-2546); the Knut and Alice Wallenberg Foundation; Demensf&#246;rbundet; and Emil and Wera Cornell's, Aina Wallstr&#246;m and Mary-Ann Sj&#246;blom's, Gun and Bertil Stohne's, Magnus Bergvall's, and Gamla Tj&#228;narinnor's Foundations.

NOTE: This protocol requires aliquots of at least 50 &#181;L, with a concentration of 50 &#181;g/mL for each A&#946; peptide, as starting material. The A&#946; peptides should be dissolved in 20% acetonitrile (ACN) and 4% concentrated ammonia solution in deionized water (v/v) and stored at 80 &#176;C.
Caution: See Table 1 for safety information.
1. Preparation of the Solutions
<ol>
	<li>Prepare 100 mL of 20% ACN and 4% concentrated ammonia solutio...

<ol>
	<li>Querfurth, H. W., LaFerla, F. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Alzheimer's+disease.">Alzheimer's disease.</a> N Engl J Med. 362 (4), 329-344 (2010).</li><li>Braak, H., Braak, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evolution+of+the+neuropathology+of+Alzheimer's+disease.">Evolution of the neuropathology of Alzheimer's disease.</a> Acta Neurol Scand Suppl. 165, 3-12 (1996).</li><li>Blennow, K., de Leon, M. J., Zetterberg, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Alzheimer's+disease.">Alzheimer's disease.</a> Lancet. 368 (9533), 387-403 (2006).</li><li>Dubois, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Advancing+research+diagnostic+criteria+for+Alzheimer's+disease:+the+IWG-2+criteria.">Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria.</a> Lancet Neurol. 13 (6), 614-629 (2014).</li><li>Blennow, K., Hampel, H., Weiner, M., Zetterberg, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cerebrospinal+fluid+and+plasma+biomarkers+in+Alzheimer+disease.">Cerebrospinal fluid and plasma biomarkers in Alzheimer disease.</a> Nat Rev Neurol. 6 (3), 131-144 (2010).</li><li>Buchhave, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cerebrospinal+fluid+levels+of+beta-amyloid+1-42,+but+not+of+tau,+are+fully+changed+already+5+to+10+years+before+the+onset+of+Alzheimer+dementia.">Cerebrospinal fluid levels of beta-amyloid 1-42, but not of tau, are fully changed already 5 to 10 years before the onset of Alzheimer dementia.</a> Arch Gen Psychiatry. 69 (1), 98-106 (2012).</li><li>Olsson, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CSF+and+blood+biomarkers+for+the+diagnosis+of+Alzheimer's+disease:+a+systematic+review+and+meta-analysis.">CSF and blood biomarkers for the diagnosis of Alzheimer's disease: a systematic review and meta-analysis.</a> The Lancet Neurology. 15 (7), 673-684 (2016).</li><li>Bjerke, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Confounding+factors+influencing+amyloid+Beta+concentration+in+cerebrospinal+fluid.">Confounding factors influencing amyloid Beta concentration in cerebrospinal fluid.</a> Int J Alzheimers Dis. , (2010).</li><li>Dumurgier, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intersite+variability+of+CSF+Alzheimer's+disease+biomarkers+in+clinical+setting.">Intersite variability of CSF Alzheimer's disease biomarkers in clinical setting.</a> Alzheimers Dement. 9 (4), 406-413 (2013).</li><li>Mattsson, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CSF+biomarker+variability+in+the+Alzheimer's+Association+quality+control+program.">CSF biomarker variability in the Alzheimer's Association quality control program.</a> Alzheimers Dement. 9 (3), 251-261 (2013).</li><li>Kang, J. H., Korecka, M., Toledo, J. B., Trojanowski, J. Q., Shaw, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+Utility+and+Analytical+Challenges+in+Measurement+of+Cerebrospinal+Fluid+Amyloid-beta1-42+and+tau+Proteins+as+Alzheimer+Disease+Biomarkers.">Clinical Utility and Analytical Challenges in Measurement of Cerebrospinal Fluid Amyloid-beta1-42 and tau Proteins as Alzheimer Disease Biomarkers.</a> Clin Chem. 59 (6), 903-916 (2013).</li><li>Mattsson, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reference+measurement+procedures+for+Alzheimer's+disease+cerebrospinal+fluid+biomarkers:+definitions+and+approaches+with+focus+on+amyloid+beta42.">Reference measurement procedures for Alzheimer's disease cerebrospinal fluid biomarkers: definitions and approaches with focus on amyloid beta42.</a> Biomark Med. 6 (4), 409-417 (2012).</li><li>Ahmadkhaniha, R., Shafiee, A., Rastkari, N., Kobarfard, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Accurate+quantification+of+endogenous+androgenic+steroids+in+cattle's+meat+by+gas+chromatography+mass+spectrometry+using+a+surrogate+analyte+approach.">Accurate quantification of endogenous androgenic steroids in cattle's meat by gas chromatography mass spectrometry using a surrogate analyte approach.</a> Anal Chim Acta. 631 (1), 80-86 (2009).</li><li>Jemal, M., Schuster, A., Whigan, D. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Liquid+chromatography/tandem+mass+spectrometry+methods+for+quantitation+of+mevalonic+acid+in+human+plasma+and+urine:+method+validation,+demonstration+of+using+a+surrogate+analyte,+and+demonstration+of+unacceptable+matrix+effect+in+spite+of+use+of+a+stable+isotope+analog+internal+standard.">Liquid chromatography/tandem mass spectrometry methods for quantitation of mevalonic acid in human plasma and urine: method validation, demonstration of using a surrogate analyte, and demonstration of unacceptable matrix effect in spite of use of a stable isotope analog internal standard.</a> Rapid Commun Mass Spectrom. 17 (15), 1723-1734 (2003).</li><li>Leinenbach, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mass+spectrometry-based+candidate+reference+measurement+procedure+for+quantification+of+amyloid-beta+in+cerebrospinal+fluid.">Mass spectrometry-based candidate reference measurement procedure for quantification of amyloid-beta in cerebrospinal fluid.</a> Clin Chem. 60 (7), 987-994 (2014).</li><li>Li, W., Cohen, L. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitation+of+endogenous+analytes+in+biofluid+without+a+true+blank+matrix.">Quantitation of endogenous analytes in biofluid without a true blank matrix.</a> Anal Chem. 75 (21), 5854-5859 (2003).</li><li>Perret-Liaudet, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cerebrospinal+fluid+collection+tubes:+a+critical+issue+for+Alzheimer+disease+diagnosis.">Cerebrospinal fluid collection tubes: a critical issue for Alzheimer disease diagnosis.</a> Clin Chem. 58 (4), 787-789 (2012).</li><li>Lewczuk, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+sample+collection+tubes+on+cerebrospinal+fluid+concentrations+of+tau+proteins+and+amyloid+beta+peptides.">Effect of sample collection tubes on cerebrospinal fluid concentrations of tau proteins and amyloid beta peptides.</a> Clin Chem. 52 (2), 332-334 (2006).</li><li>Pannee, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reference+measurement+procedure+for+CSF+amyloid+beta+(A&#946;)1-42+and+the+CSF+A&#946;1-42+/A&#946;1-40+ratio+-+a+cross-validation+study+against+amyloid+PET.">Reference measurement procedure for CSF amyloid beta (A&#946;)1-42 and the CSF A&#946;1-42 /A&#946;1-40 ratio - a cross-validation study against amyloid PET.</a> J Neurochem. 139 (4), 651-658 (2016).</li><li>Thienpont, L. M., Van Houcke, S. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Traceability+to+a+common+standard+for+protein+measurements+by+immunoassay+for+in-vitro+diagnostic+purposes.">Traceability to a common standard for protein measurements by immunoassay for in-vitro diagnostic purposes.</a> Clin Chim Acta. 411 (23-24), 2058-2061 (2010).</li><li>Vesper, H. W., Thienpont, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Traceability+in+laboratory+medicine.">Traceability in laboratory medicine.</a> Clin Chem. 55 (6), 1067-1075 (2009).</li></ol>

For the described method, instead of using a surrogate matrix, we used the surrogate analyte approach13,14,15,16, which enables calibration in human CSF. The surrogate analyte approach involves two different isotopically labeled standards. One (15NA&#946;142) is used to generate the calibration curve in human CSF, while another (13CA&#946;142) is used...

Alzheimer&#39;s disease (AD) is the most common form of dementia and affects about 35 million people worldwide1. The neuropathological hallmarks of the disease widely believed to lie at the core of AD pathogenesis are intracellular neurofibrillary tangles of hyperphosphorylated tau protein2 and extracellular plaques consisting of aggregated amyloid-beta (A&#946;) peptides3. In line with this, the assessment of plaque pathology in vivo by biomarkers has recently been included in the research diagnostic criteria for AD4. For CSF measurements of A&#946;1-42, several immunoassays are available and are used in many clinical laboratories5. The concentration of A&#946;1-42 in CSF is approximately 50% lower in AD patients than in the cognitively normal elderly, reflecting the deposition of the peptide in plaques in the brain6,7.
These biomarkers are mainly analyzed using immunoassays (i.e., antibody-based techniques), but these assays may be influenced by matrix effects8. The use of immunoassays on different technology platforms and the lack of assay standardization9,10 makes the introduction of global cut-off concentrations difficult11,12. An analytically validated RMP would permit the uniform calibration of different assay platforms, ideally resulting in better comparability across analytical platforms and in better control of factors contributing to the overall measurement variability.
The absolute quantification of A&#946;1-42 using the developed LC-MS/MS method overcomes many of the issues associated with antibody-based techniques. The method, listed as an RMP by the Joint Committee for Traceability in Laboratory Medicine (JCTLM database identification number C11RMP9), will be used to determine the absolute concentration of A&#946;1-42 in a Certified Reference Material (CRM) to harmonize CSF A&#946;1-42 measurements across techniques and analytical platforms. The described workflow should be of relevance for the development of candidate reference methods for peptides and proteins within other areas of medicine.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Eppendorf Protein LoBind microcentrifuge tubes, 0.5 mL</td>
			<td>Eppendorf</td>
			<td>022431081</td>
			<td></td>
		</tr>
		<tr>
			<td>Eppendorf Protein LoBind microcentrifuge tubes, 1.5 mL</td>
			<td>Eppendorf</td>
			<td>022431081</td>
			<td></td>
		</tr>
		<tr>
			<td>Eppendorf Protein LoBind microcentrifuge tubes, 2 mL</td>
			<td>Eppendorf</td>
			<td>022431102</td>
			<td></td>
		</tr>
		<tr>
			<td>Eppendorf Protein LoBind microcentrifuge tubes, 5 mL</td>
			<td>Eppendorf</td>
			<td>0030 108.310</td>
			<td></td>
		</tr>
		<tr>
			<td>Eppendorf Protein LoBind Deepwell Plates 96</td>
			<td>Eppendorf</td>
			<td>951032905</td>
			<td></td>
		</tr>
		<tr>
			<td>Micronic 0.75 mL polypropylene tubes, V-bottom</td>
			<td>Micronic</td>
			<td>MPW32071BC3</td>
			<td>Tubes used for collecting SPE eluate, but other collection devices can be used such as 96-well plates.</td>
		</tr>
		<tr>
			<td>Micronic Split TPE Capcluster for 96 ind. tubes</td>
			<td>Micronic</td>
			<td>MP53026</td>
			<td>Caps for Micronic tubes.</td>
		</tr>
		<tr>
			<td>Micronic Loborack-96 white w high cover bar coded</td>
			<td>Micronic</td>
			<td>MPW51015BC3</td>
			<td>Holder for Micronic tubes.</td>
		</tr>
		<tr>
			<td>Biohit Optifit tips 1.2 mL</td>
			<td>Sartorius</td>
			<td>791210</td>
			<td>Used to reach all the way to the bottom of the LoBind deepwell plates (96-well). Other narrow tips might work as well.</td>
		</tr>
		<tr>
			<td>Waters Oasis MCX 96-well &#181;Elution Plate</td>
			<td>Waters</td>
			<td>186001830BA&#160;</td>
			<td></td>
		</tr>
		<tr>
			<td>Waters Plate manifold reservoir tray</td>
			<td>Waters</td>
			<td>WAT058942</td>
			<td></td>
		</tr>
		<tr>
			<td>Waters Extraction Plate Manifold for Oasis 96-Well Plates</td>
			<td>Waters</td>
			<td>186001831</td>
			<td></td>
		</tr>
		<tr>
			<td>Ammonium hydroxide solution, puriss. p.a., reag. ISO, reag. Ph. Eur., ~25% NH3 basis</td>
			<td>Sigma-Aldrich</td>
			<td>30501-1L-D</td>
			<td></td>
		</tr>
		<tr>
			<td>Acetonitrile, Far UV HPLC Gradient grade, 2.5 L</td>
			<td>Fisher Scientific</td>
			<td>A/0627/17X</td>
			<td></td>
		</tr>
		<tr>
			<td>ortho-Phosphoric acid 85%, ACS,ISO,Reag. Ph Eur</td>
			<td>Merck Millipore</td>
			<td>1005731000</td>
			<td></td>
		</tr>
		<tr>
			<td>Guanidine Hydrochloride, 500 g</td>
			<td>Thermo Scientific</td>
			<td>24110</td>
			<td></td>
		</tr>
		<tr>
			<td>Thermo Scientific Q-exactive Hybrid Quadrupole Orbitrap Mass Spectrometer</td>
			<td>Thermo Scientific</td>
			<td>IQLAAEGAAPFALGMAZR</td>
			<td>With bundled Dionex Ultimate 3000 LC &#38; autosampler.</td>
		</tr>
		<tr>
			<td>Dionex ProSwift RP-4H Monolith Column (1.0 x 250mm)</td>
			<td>Dionex</td>
			<td>066640</td>
			<td></td>
		</tr>
		<tr>
			<td>Bovine Serum Albumin, lyophilized powder, suitable for (for molecular biology), Non-acetylated</td>
			<td>Sigma-Aldrich</td>
			<td>B6917</td>
			<td></td>
		</tr>
		<tr>
			<td>Beta-Amyloid (1-42), Ultra Pure, TFA</td>
			<td>rPeptide</td>
			<td>A-1002-2</td>
			<td></td>
		</tr>
		<tr>
			<td>15N Beta-Amyloid (1-42), Uniformly labeled</td>
			<td>rPeptide</td>
			<td>A-1102-2</td>
			<td></td>
		</tr>
		<tr>
			<td>13C Beta-Amyloid (1-42), Uniformly labeled</td>
			<td>rPeptide</td>
			<td>A-1106-2</td>
			<td></td>
		</tr>
		<tr>
			<td>Microplate shakers, TiMix 2</td>
			<td>Edmund B&#252;hler</td>
			<td>6110 000</td>
			<td></td>
		</tr>
	</tbody>
</table>

absolute quantification of a&#946;1-42 in csf using a mass spectrometric reference measurement procedure

Alzheimer's disease (AD) is the most common neurodegenerative disease among the elderly and accounts for 60-80% of all cases of dementia. Currently, the diagnosis of AD is based on cognitive tests and mental state exams, but the peptide amyloid-beta (A&#946;) in cerebrospinal fluid (CSF) is increasingly used in clinical trials and settings. As for most protein and peptide biomarkers, quantification is performed using antibody-based techniques, such as enzyme-linked immunosorbent assay (ELISA). However, intra- and inter-laboratory variability in these assays hamper its use as a diagnostic marker in clinical routine.
An antibody-independent Reference Measurement Procedure (RMP) was developed based on solid-phase extraction (SPE) and liquid chromatography (LC)-tandem mass spectrometry (MS/MS), where stable, isotope-labeled A&#946; peptides were used as internal standards, enabling absolute quantification. A high-resolution quadrupole-orbitrap hybrid instrument was used for the measurements. The method allows for the quantification of CSF A&#946;1-42 between 150-4,000 pg/mL.

The plate setup in Figure 1 is used for a full plate of samples. If fewer unknown samples are to be analyzed, the second calibrator, RF, and QC sets should be placed after the first half of the unknown samples.
As seen in Figure 2, the calibrators are close to the regression line, with low standard deviations. This method has a lower level of quantification of 150 pg/mL and an upper level of qua...

Watch this Scientific Journal Video about Absolute Quantification of AÎ²1-42 in CSF Using a Mass Spectrometric Reference Measurement Procedure at JoVE.com

Absolute Quantification of A&amp;#946;&lt;sub&gt;1-42&lt;/sub&gt; in CSF Using a Mass Spectrometric Reference Measurement Procedure

A reference measurement procedure for the absolute quantification of A&#946;1-42 in human CSF based on solid-phase extraction and liquid chromatography tandem mass spectrometry is described.

Absolute Quantification of A&#946;1-42 in CSF Using a Mass Spectrometric Reference Measurement Procedure

Alzheimer's disease (AD) is the most common neurodegenerative disease among the elderly and accounts for 60-80% of all cases of dementia. Currently, the ...

The overall goal of this reference measurement procedure is to harmonize measurements of a beta in human CSF. This method can help standardize assays for the measurement of CSF a beta 42 which is a biomarker for central amyloid pathology and neuropathologic hallmark of Alzheimer's disease. The main advantage of this technique is that it is thoroughly validated and doesn't use antibodies for quantification of AVR 142.The implications of this technique extend toward therapy of Alzheimer's disease because it would be used to harmonize assays and facilitate the introduction of general cut off levels in clinical trials. While this method can provide insight into amyloid pathology in humans, it can also be applied to other mortal organisms such as transgenic mice and nonhuman primates to invenerate new drugs. Generally, individuals new to this method will struggle because AVR 142 is very hydrophobic and can easily stick to surfaces such as pipet tips and tubes.First, add 40 microliters of N15 a beta peptide to 0.46 milliliters of 20%acetonitrile and 4%concentrated ammonia in a 0.5 milliliter microcentrifuge tube. Mix the peptide solution on a vortex mixer for one minute. Add 50 microliters of the peptide solution to 1.95 milliliters of 20%acetonitrile and 4%concentrated ammonia in a two milliliter microcentrifuge tube.Mix the peptide solution on a vortex mixer for one minute. Next, prepare six calibrator solutions by mixing the appropriate volumes of each solution in microcentrifuge tubes. After mixing the calibrator solutions, prepare the final calibrators in duplicate by mixing the appropriate volumes of the corresponding calibrator solutions and human CSF in 0.5 milliliter microcentrifuge tubes.Mix each solution on a vortex mixer for one minute. To prepare the internal standard, first add 32 microliters of 13C a beta peptide to 1.968 milliliters of 20%acetonitrile and 4%concentrated ammonia in a two milliliter microcentrifuge tube. Mix the peptide solution on a vortex mixer for one minute.Next, add 0.1 milliliters of the peptide solution to 4.9 milliliters of 20%acetonitrile and 4%concentrated ammonia in a five milliliter microcentrifuge tube. Mix the peptide solution on a vortex mixer for one minute. To prepare the response factor sample, add 40 microliters of native a beta peptide to 0.46 milliliters of 20%acetonitrile and 4%concentrated ammonia in a 0.5 milliliter microcentrifuge tube.After mixing, add 20 microliters of the peptide solution and 20 microliters of four micrograms per milliliter, 15N a beta peptide to 1.96 milliliters of 20%acetonitrile and 4%concentrated ammonia in a two milliliter microcentrifuge tube. Mix the peptide solution on a vortex mixer for one minute. Following this, add 20 microliters of the peptide solution to 0.38 milliliters of artificial CSF in a 0.5 milliliter microcentrifuge tube.After preparing duplicates, mix each solution on a vortex mixer for one minute. After thawing the samples on a roller, add 0.18 milliliters of each calibrator, response factor and unknown sample to a one milliliter protein 96 deep well plate, making sure to add the samples in or close to the bottom of the wells. Now, add 20 microliters of internal standard to each well by releasing a drop of the standard on the side of the well close to the surface of the sample without submerging the pipet tip.Then, add 0.2 milliliters of five molar guanadine hydrochloride to each well. Place the sample plate on a microplate shaker and mix the samples for 45 minutes at 1100 rpm. After mixing, add 0.2 milliliters of 4%phosphoric acid to each well.Then, place the sample plate on the microplate shaker and mix briefly at 1000 rpm. Place a reservoir tray for waste under a mixed mode cation exchange 96 well solid phase extraction, or SPE plate in the extraction plate manifold chamber. Next, condition the SPE sorbent by adding 0.2 milliliters of methanol to each well.Then, equilibrate the sorbent by adding 0.2 milliliters of 4%phosphoric acid to each well. Using an eight channel pipet, transfer all samples from the deep well plate to the SPE plate. Following this, wash the sorbent twice after the samples have passed through by adding 0.2 milliliters of 4%phosphoric acid to each well.After the washing solvent has eluted from the sorbent, replace the reservoir tray with tubes. Now, elute the sample from the sorbent by adding two 50 microliter aloquats of 75%acetonitrile and 10%concentrated ammonia, noting that this solution requires a very low vacuum to pass through the sorbent. Dry the eluates by using vacuum centrifugation without applying heat.Finally, seal the tubes and freeze them at 80 degrees celsius until analysis. The calibrators are close to the regression line with low standard deviations. If calibration is nonlinear, the run should be discarded and the deviation is most likely due to incorrect pipetting techniques and/or errors in the dilution of calibrators.The coefficient of variation of replicates should preferably be below 10%The native 15N and 13C a beta elute from the LC column simultaneously with close to symmetrical peaks and without significant tailing. At least 10 measurements should be performed for each peak and can be adjusted with a maximum injection time in the method. The peptides can be measured simultaneously during the MS analysis unless the method sensitivity is suboptimal, in which only peptides of interest should be measured for each injection.Once mastered, this technique can be done in four hours if it's performed properly. While attempting this procedure, it's important to remember to always saturate the pipet tips before transferring the peptide solution. It's also important to use tubes with as little void volume as possible.After its development, this technique paved the way for researchers in the field of Alzheimer's disease to explore concordance with other methods, such as amyloid PET imaging. It has also been used to assigned a beta 142 concentrations to CSF based reference materials. After watching this video, you should have a good understanding of how to prepare calibrators in human CSF and using solid phase extraction prior to LCMS analysis to measure the absolute concentration of a beta 142 in samples.Don't forget that working with human CSF can be extremely hazardous and precautions such as gloves, protective glasses and other safety measures should always be taken while performing this procedure.

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during normoxia (inspired O2, fraction (FIO2) = 0.21) hypoxia (FIO2 = 0.125), and hyperoxia 
(FIO2 = 1.00). In addition, the physiological responses of the subject are monitored in the MR scan environment. MR images 
were obtained on a 1.5 T GE MRI scanner during a breath hold from a sagittal slice in the right lung at functional residual capacity. An arterial 
spin labeling sequence (ASL-FAIRER) was used to measure the spatial distribution of pulmonary blood flow 1,2 and a multi-echo fast 
gradient echo (mGRE) sequence 3 was used to quantify the regional proton (i.e. H2O) density, allowing the quantification 
of density-normalized perfusion for each voxel (milliliters blood per minute per gram lung tissue). 
With a pneumatic switching valve and facemask equipped with a 2-way non-rebreathing valve, different oxygen concentrations 
were introduced to the subject in the MR scanner through the inspired gas tubing. A metabolic cart collected expiratory gas via expiratory tubing. Mixed expiratory O2 and CO2 concentrations, oxygen consumption, carbon dioxide production, respiratory exchange ratio, 
respiratory frequency and tidal volume were measured. Heart rate and oxygen saturation were monitored using pulse-oximetry. 
Data obtained from a normal subject showed that, as expected, heart rate was higher in hypoxia (60 bpm) than during normoxia (51) or hyperoxia (50) and the arterial oxygen saturation (SpO2) was reduced during hypoxia to 86%. Mean ventilation was 8.31 L/min BTPS during hypoxia, 7.04 L/min during normoxia, and 6.64 L/min during hyperoxia. Tidal volume was 0.76 L during hypoxia, 0.69 L during normoxia, and 0.67 L during hyperoxia. 
Representative quantified ASL data showed that the mean density normalized perfusion was 8.86 ml/min/g during hypoxia, 8.26 ml/min/g during normoxia and 8.46 ml/min/g during hyperoxia, respectively. In this subject, the relative dispersion4, an index of global heterogeneity, was increased in hypoxia (1.07 during hypoxia, 0.85 during normoxia, and 0.87 during hyperoxia) while the fractal dimension (Ds), another index of heterogeneity reflecting vascular branching structure, was unchanged (1.24 during hypoxia, 1.26 during normoxia, and 1.26 during hyperoxia). 
Overview. This protocol will demonstrate the acquisition of data to measure the distribution of pulmonary perfusion noninvasively under conditions of normoxia, hypoxia, and hyperoxia using a magnetic resonance imaging technique known as arterial spin labeling (ASL). 
Rationale: Measurement of pulmonary blood flow and lung proton density using MR technique offers high spatial resolution images which can be quantified and the ability to perform repeated measurements under several different physiological conditions. In human studies, PET, SPECT, and CT are commonly used as the alternative techniques. However, these techniques involve exposure to ionizing radiation, and thus are not suitable for repeated measurements in human subjects.

A MR imaging method to study the distribution of pulmonary blood flow under a variety of physiological conditions, in this case exposure to three different inspired oxygen concentrations: hypoxia, normoxia, and hyperoxia, is described. This technique utilizes human pulmonary physiology research techniques in an MR scanning environment.

This demonstrates a MR imaging method to measure the spatial distribution of pulmonary blood flow in healthy subjects 
during normoxia (inspired O2, ...

Segmentation and Measurement of Fat Volumes in Murine Obesity Models Using X-ray Computed Tomography

Obesity is associated with increased morbidity and mortality as well as reduced metrics in quality of life.1 Both environmental and genetic factors are associated with obesity, though the precise underlying mechanisms that contribute to the disease are currently being delineated.2,3 Several small animal models of obesity have been developed and are employed in a variety of studies.4 A critical component to these experiments involves the collection of regional and/or total animal fat content data under varied conditions.
Traditional experimental methods available for measuring fat content in small animal models of obesity include invasive (e.g. ex vivo measurement of fat deposits) and non-invasive (e.g. Dual Energy X-ray Absorptiometry (DEXA), or Magnetic Resonance (MR)) protocols, each of which presents relative trade-offs. Current invasive methods for measuring fat content may provide details for organ and region specific fat distribution, but sacrificing the subjects will preclude longitudinal assessments. Conversely, current non-invasive strategies provide limited details for organ and region specific fat distribution, but enable valuable longitudinal assessment. With the advent of dedicated small animal X-ray computed tomography (CT) systems and customized analytical procedures, both organ and region specific analysis of fat distribution and longitudinal profiling may be possible. Recent reports have validated the use of CT for in vivo longitudinal imaging of adiposity in living mice.5,6 Here we provide a modified method that allows for fat/total volume measurement, analysis and visualization utilizing the Carestream Molecular Imaging Albira CT system in conjunction with PMOD and Volview software packages.

Fat content analysis is routinely conducted in studies utilizing murine obesity models. Emerging methods in small animal CT imaging and analysis are providing for longitudinal detail rich fat content analysis. Here we detail step by step procedures for performing small animal CT imaging, analysis, and visualization.

Obesity is associated with increased morbidity and mortality as well as reduced metrics in quality of life.1 Both environmental and genetic factors are ...

Epidural Intracranial Pressure Measurement in Rats Using a Fiber-optic Pressure Transducer

Elevated intracranial pressure (ICP) is a significant problem in several forms of ischemic brain injury including stroke, traumatic brain injury and cardiac arrest. This elevation may result in further neurological injury, in the form of transtentorial herniation1,2,3,4, midbrain compression, neurological deficit or increased cerebral infarct2,4. Current therapies are often inadequate to control elevated ICP in the clinical setting5,6,7 . Thus there is a need for accurate methods of ICP measurement in animal models to further our understanding of the basic mechanisms and to develop new treatments for elevated ICP.
In both the clinical and experimental setting ICP cannot be estimated without direct measurement. Several methods of ICP catheter insertion currently exist. Of these the intraventricular catheter has become the clinical 'gold standard' of ICP measurement in humans8. This method involves the partial removal of skull and the instrumentation of the catheter through brain tissue. Consequently, intraventricular catheters have an infection rate of 6-11%9. For this reason, subdural and epidural cannulations have become the preferred methods in animal models of ischemic injury. 
Various ICP measurement techniques have been adapted for animal models, and of these, fluid-filled telemetry catheters10 and solid state catheters are the most frequently used11,12,13,14,15. The fluid-filled systems are prone to developing air bubbles in the line, resulting in false ICP readings. Solid state probes avoid this problem (Figure 1). An additional problem is fitting catheters under the skull or into the ventricles without causing any brain injury that might alter the experimental outcomes. Therefore, we have developed a method that places an ICP catheter contiguous with the epidural space, but avoids the need to insert it between skull and brain. 
An optic fibre pressure catheter (420LP, SAMBA Sensors, Sweden) was used to measure ICP at the epidural location because the location of the pressure sensor (at the very tip of the catheter) was found to produce a high fidelity ICP signal in this model. There are other manufacturers of similar optic fibre technologies13 that may be used with our methodology. Alternative solid state catheters, which have the pressure sensor located at the side of the catheter tip, would not be appropriate for this model as the signal would be dampened by the presence of the monitoring screw. 
Here, we present a relatively simple and accurate method to measure ICP. This method can be used across a wide range of ICP related animal models.

A novel technique to record the pressures within the skull is described. The minimally invasive method uses a fibre-optic pressure sensing system to accurately measure intracranial pressure (ICP) in anaesthetized rats without causing significant brain trauma. The technique may be used in a wide range of experimental models.

Elevated intracranial pressure (ICP) is a significant problem in several forms of ischemic brain injury including stroke, traumatic brain injury and ...

Quantification of Breast Cancer Cell Invasiveness Using a Three-dimensional (3D) Model

It is now well known that the cellular and tissue microenvironment are critical regulators influencing tumor initiation and progression. Moreover, the extracellular matrix (ECM) has been demonstrated to be a critical regulator of cell behavior in culture and homeostasis in vivo. The current approach of culturing cells on two-dimensional (2D), plastic surfaces results in the disturbance and loss of complex interactions between cells and their microenvironment. Through the use of three-dimensional (3D) culture assays, the conditions for cell-microenvironment interaction are established resembling the in vivo microenvironment. This article provides a detailed methodology to grow breast cancer cells in a 3D basement membrane protein matrix, exemplifying the potential of 3D culture in the assessment of cell invasion into the surrounding environment. In addition, we discuss how these 3D assays have the potential to examine the loss of signaling molecules that regulate epithelial morphology by immunostaining procedures. These studies aid to identify important mechanistic details into the processes regulating invasion, required for the spread of breast cancer.

Quantification of Breast Cancer Cell Invasiveness Using a Three-dimensional 3D Model

This article provides detailed methodologies for the use of three-dimensional (3D) assays to quantify breast cancer cell invasion. Specifically, we discuss the procedures required to set up such assays, quantification, and data analysis, as well as methods to examine the loss of membrane integrity that occurs when cells invade.

It is now well known that the cellular and tissue microenvironment are critical regulators influencing tumor initiation and progression. Moreover, the ...

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

The calcineurin inhibitor tacrolimus is the cornerstone of most immunosuppressive treatment protocols after solid organ transplantation in the United States. Tacrolimus is a narrow therapeutic index drug and as such requires therapeutic drug monitoring and dose adjustment based on its whole blood trough concentrations. To facilitate home therapeutic drug and adherence monitoring, the collection of dried blood spots is an attractive concept. After a finger stick, the patient collects a blood drop on filter paper at home. After the blood is dried, it is mailed to the analytical laboratory where tacrolimus is quantified using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) in combination with a simple manual protein precipitation step and online column extraction.
For tacrolimus analysis, a 6-mm disc is punched from the saturated center of the blood spot. The blood spot is homogenized using a bullet blender and then proteins are precipitated with methanol/0.2 M ZnSO4 containing the internal standard D2,13C-tacrolimus. After vortexing and centrifugation, 100 &#181;l of supernatant is injected into an online extraction column and washed with 5 ml/min of 0.1 formic acid/acetonitrile (7:3, v:v) for 1 min. Hereafter, the switching valve is activated and the analytes are back-flushed onto the analytical column (and separated using a 0.1% formic acid/acetonitrile gradient). Tacrolimus is quantified in the positive multi reaction mode (MRM) using a tandem mass spectrometer.
The assay is linear from 1 to 50 ng/ml. Inter-assay variability (3.6%-6.1%) and accuracy (91.7%-101.6%) as assessed over 20 days meet acceptance criteria. Average extraction recovery is 95.5%. There are no relevant carry-over, matrix interferences and matrix effects. Tacrolimus is stable in dried blood spots at RT and at +4 &#176;C for 1 week. Extracted samples in the autosampler are stable at +4 &#176;C for at least 72 hr.

Here we describe a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) assay to quantify the immunosuppressant tacrolimus in dried blood spots using a simple manual protein precipitation step and online column extraction.

The calcineurin inhibitor tacrolimus is the cornerstone of most immunosuppressive treatment protocols after solid organ transplantation in the United ...

Quantitative Mass Spectrometric Profiling of Cancer-cell Proteomes Derived From Liquid and Solid Tumors

In-depth analyses of cancer cell proteomes are needed to elucidate oncogenic pathomechanisms, as well as to identify potential drug targets and diagnostic biomarkers. However, methods for quantitative proteomic characterization of patient-derived tumors and in particular their cellular subpopulations are largely lacking. Here we describe an experimental set-up that allows quantitative analysis of proteomes of cancer cell subpopulations derived from either liquid or solid tumors. This is achieved by combining cellular enrichment strategies with quantitative Super-SILAC-based mass spectrometry followed by bioinformatic data analysis. To enrich specific cellular subsets, liquid tumors are first immunophenotyped by flow cytometry followed by FACS-sorting; for solid tumors, laser-capture microdissection is used to purify specific cellular subpopulations. In a second step, proteins are extracted from the purified cells and subsequently combined with a tumor-specific, SILAC-labeled spike-in standard that enables protein quantification. The resulting protein mixture is subjected to either gel electrophoresis or Filter Aided Sample Preparation (FASP) followed by tryptic digestion. Finally, tryptic peptides are analyzed using a hybrid quadrupole-orbitrap mass spectrometer, and the data obtained are processed with bioinformatic software suites including MaxQuant. By means of the workflow presented here, up to 8,000 proteins can be identified and quantified in patient-derived samples, and the resulting protein expression profiles can be compared among patients to identify diagnostic proteomic signatures or potential drug targets.

In-depth analyses of cancer cell proteomes facilitate identification of novel drug targets and diagnostic biomarkers. We describe an experimental workflow for quantitative analysis of (phospho-)proteomes in cancer cell subpopulations derived from liquid and solid tumors. This is achieved by combining cellular enrichment strategies with quantitative Super-SILAC-based mass spectrometry.

In-depth analyses of cancer cell proteomes are needed to elucidate oncogenic pathomechanisms, as well as to identify potential drug targets and diagnostic ...

Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control seizures. However, a significant minority of patients continues to exhibit post-operative seizures, even in those cases in which the suspected source of seizures has been correctly localized and resected. The protocol presented here combines a clinical procedure routinely employed during the pre-operative evaluation of temporal lobe epilepsy (TLE) patients with a novel technique for network analysis. The method allows for the evaluation of the temporal evolution of mesial network parameters. The bilateral insertion of foramen ovale electrodes (FOE) into the ambient cistern simultaneously records electrocortical activity at several mesial areas in the temporal lobe. Furthermore, network methodology applied to the recorded time series tracks the temporal evolution of the mesial networks both interictally and during the seizures. In this way, the presented protocol offers a unique way to visualize and quantify measures that considers the relationships between several mesial areas instead of a single area.

This protocol describes a procedure to track the evolution of mesial network measures in temporal lobe epilepsy (TLE) patients. It is based on the combination of intracranial recordings with a novel numerical technique for data analysis. Specifically, we present a protocol for network analyses of foramen ovale recordings.

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control ...

Spatial Quantification of Drugs in Pulmonary Tuberculosis Lesions by Laser Capture Microdissection Liquid Chromatography Mass Spectrometry (LCM-LC/MS)

Tuberculosis is still a leading cause of morbidity and mortality worldwide. Improvements to existing drug regimens and the development of novel therapeutics are urgently required. The ability of dosed TB drugs to reach and sterilize bacteria within poorly-vascularized necrotic regions (caseum) of pulmonary granulomas is crucial for successful therapeutic intervention. Effective therapeutic regimens must therefore contain drugs with favorable caseum penetration properties. Current LC/MS methods for quantifying drug levels in biological tissues have limited spatial resolution capabilities, making it difficult to accurately determine absolute drug concentrations within small tissue compartments such as those found within necrotic granulomas. Here we present a protocol combining laser capture microdissection (LCM) of pathologically-distinct tissue regions with LC/MS quantification. This technique provides absolute quantification of drugs within granuloma caseum, surrounding cellular lesion and uninvolved lung tissue and, therefore, accurately determines whether bactericidal concentrations are being achieved. In addition to tuberculosis research, the technique has many potential applications for spatially-resolved quantification of drugs in diseased tissues.

Spatial Quantification of Drugs in Pulmonary Tuberculosis Lesions by Laser Capture Microdissection Liquid Chromatography Mass Spectrometry LCM-LC/MS

Here, we describe a protocol using laser capture microdissection coupled with LC/MS analysis to spatially-quantify drug distributions within pulmonary tuberculosis granulomas. The approach has broad applicability to quantifying drug concentrations within tissues at high spatial detail.

Tuberculosis is still a leading cause of morbidity and mortality worldwide. Improvements to existing drug regimens and the development of novel ...

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment

A smartphone app has been developed to perform the automated photographic Hirschberg test for objective measurement of ocular misalignment. By computing the difference in corneal reflection generated by the phone camera flash relative to the iris center based on high resolution images, the app can measure misalignment with a much higher precision than the naked eye performing the Hirschberg test. It has been validated in a previous clinical evaluation study by comparing to the clinical gold standard-prism and alternate cover test. The goal of this article is to describe the testing techniques regarding how to use the app to measure ocular alignment for different fixation distances, without or with cover to break fusion, as well as angle kappa, so that users can use the app to perform equivalent tests typically done in clinic using prisms.

We present a protocol of using a smartphone app to perform Hirschberg test for measuring manifest and intermittent ocular misalignment (strabismus) under near and far fixation conditions.

A smartphone app has been developed to perform the automated photographic Hirschberg test for objective measurement of ocular misalignment. By computing ...

Using a Chemical Biopsy for Graft Quality Assessment

Kidney transplantation is a life-saving treatment for a large number of people with end-stage renal dysfunction worldwide. The procedure is associated with an increased survival rate and greater quality of patient&#8217;s life when compared to conventional dialysis. Regrettably, transplantology suffers from a lack of reliable methods for organ quality assessment. Standard diagnostic techniques are limited to macroscopic appearance inspection or invasive tissue biopsy, which do not provide comprehensive information about the graft. The proposed protocol aims to introduce solid phase microextraction (SPME) as an ideal analytical method for comprehensive metabolomics and lipidomic analysis of all low molecular compounds present in kidneys allocated for transplantation. The small size of the SPME probe enables performance of a chemical biopsy, which enables extraction of metabolites directly from the organ without any tissue collection. The minimum invasiveness of the method permits execution of multiple analyses over time: directly after organ harvesting, during its preservation, and immediately after revascularization at the recipient&#8217;s body. It is hypothesized that the combination of this novel sampling method with a high-resolution mass spectrometer will allow for discrimination of a set of characteristic compounds that could serve as biological markers of graft quality and indicators of possible development of organ dysfunction.

The protocol presents utilization of the chemical biopsy approach followed by comprehensive metabolomic and lipidomic analysis for quality assessment of kidney grafts allocated for transplantation.

Kidney transplantation is a life-saving treatment for a large number of people with end-stage renal dysfunction worldwide. The procedure is associated ...