Determination of Lipid a and Endotoxin in Serum by Mass Spectroscopy (Ft-Hydroxymyristic Acid/Gas Chromatography-Mass Spectrometry/Gram-Negative Sepsis) SHYAMAL K
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Proc. Nati. Acad. Sci. USA Vol. 75, No. 8, pp. 3993-3997, August 1978 Medical Sciences Determination of lipid A and endotoxin in serum by mass spectroscopy (ft-hydroxymyristic acid/gas chromatography-mass spectrometry/Gram-negative sepsis) SHYAMAL K. MAITRA*t, MICHAEL C. SCHOTZtf, THOMAS T. YOSHIKAWA*t, AND LUCIEN B. GUZE*tl * Research Service, Veterans Administration, Wadsworth Hospital Center, Los Angeles, California 90073; * Departments of Medicine, Harbor General Hospital, Torrance, California 90509; and t UCLA School of Medicine, Los Angeles, California 90024 Communicated by William N. Valentine, June 1, 1978 ABSTRACr A quantitative technique for determining lipid tography-mass spectrometry. Mass spectrometry has been used A content of endotoxin added to serum by combined gas chro- successfully in the past to detect various biological compounds matography-mass spectrometry is described. This technique uses (26). This procedure is highly specific and very sensitive. detection of the -hydroxymyristic acid content of Salmonella The minnesota R595 lipopolysaccharide by selected ion monitoring method described in this communication quantitates nanogram at atomic mass unit of 315.4 The fatty acids produced on hy- quantities of lipid A and endotoxin in serum. drolysis of serum containing lipopolysaccharide were extracted and the methyl esters were made. Silica gel chromatography was MATERIALS AND METHODS used to separate methyl esters of hydroxy fatty acids from other Serum Samples. New Zealand white rabbits weighing ap- fatty acid methyl esters. Trimethylsilyl ether derivatives of the proximately 2 kg, and not fed overnight, were used. Blood was hydroxy fatty acid methyl ester fraction were quantitated by this technique. As little as 200 fmol of fi-hydroxymyristic acid obtained by heart puncture under sterile conditions. Blood was could be detected. also obtained aseptically from human volunteers by veni- puncture. Serum was separated by centrifugation and stored Gram-negative bacillary sepsis continues to be an important in pyrogen-free tubes at -200. clinical entity with a high mortality rate (1-3). Based primarily Solvents. All solvents were either freshly distilled or were on animal studies (1, 3-6), it appears that many of the physio- liquid chromatography grade and purchased from Burdick and logical consequences of gram-negative bacteremia are causally Jackson Co. related to the presence of bacterial lipopolysaccharides, namely, Determination of #(OH) Myristic Acid Content of Lipid endotoxin. Endotoxin is a complex substance located in the cell A. Varying amounts of Salmonella minnesota R595-lipid A or wall of Gram-negative bacteria and is composed of o-specific Escherichia coli 0127:B8 endotoxin in 5 ml of pyrogen-free side chains, a core polysaccharide, and a lipid moiety called 0.85% wt/vol NaCl or in 3-5 ml of rabbit or human serum were lipid A (7-14). Extensive studies by several investigators (9, 10, hydrolyzed with 5 ml of 8 M HCI for 4.5 hr at 1100. The free 15) have suggested that the "toxic'' component of endotoxin fatty acids of the hydrolysate were extracted three times with resides in this lipid-A moiety. Lipid A has a molecular weight 10 ml of diethyl ether. The ether extracts were pooled, washed of approximately 1700, with its major constituents being with 5 ml of pyrogen-free water, and dried under nitrogen. The glucosamine (20-30%), phosphate (2%), and long-chain fatty extracted free fatty acids were methylated by the procedure acids (60-70%) (10, 11, 16). fl-Hydroxy [,B(OH)] fatty acids of Schlenk and Gellerman (27), dried under nitrogen, dissolved comprise the major fatty acids and are unique in that they have in 0.5 ml of pentane, and applied to a dry silica gel column not been reported in significant amounts in normal human 60-200 mesh (0.5 X 3 cm). The column was eluted with 3% serum (17). The most commonly occurring ,B(OH) fatty acid ether in pentane to remove saturated and unsaturated methyl in Gram-negative bacteria is fl-hydroxymyristic acid, which esters of fatty acids (28). The remaining polar fatty acids, in- is present in lipid A or endotoxin (14). Thus, this unique com- cluding hydroxy fatty acid methyl esters, were eluted quanti- pound could be useful as a "marker" for the presence of lipid tatively with 20% ether in pentane and dried under nitrogen. A or endotoxin (18). After addition of 0.25 ml of trimethylsilyl reagent (MesSi im- Previous attempts at determining endotoxin activity have idazole, Applied Science), the samples were shaken on a Vortex been dependent on biological assay systems. These include the mixer. After 2 min, 1 ml of water was added. The Me3Si ethers pyrogen test (19), fever index (20), animal lethality (21), epi- of hydroxy fatty acid methyl esters were extracted three times nephrine skin test (22), and synovial inflammatory response with 1 ml of pentane. The pentane extracts were pooled and (23). Also, the Limulus lysate gelation test has been developed dried carefully under a nitrogen stream at 300. The dried Me3Si as a means for detecting circulating endotoxin (24). Disap- ethers were dissolved in 0.1 ml of acetonitrile, mixed on a pointingly, the clinical correlation with this last assay has been Vortex, and filtered through pasteur pipettes plugged with si- unsatisfactory because of the significant incidence of false- lanized glass wool. positive and false-negative results (25). Moreover, like the other Two to five microliters of the acetonitrile solution were in- bioassay systems, the Limulus lysate test fails to measure en- jected into a gas chromatograph-mass spectrometer (model dotoxin directly but rather attempts to quantitate some bio- 5992 A, Hewlett-Packard, Palo Alto) equipped with a mem- logical effect. On the basis of the chemical structure of lipid A, brane separator. The relative abundance at 315.4 atomic mass we have developed a method to detect endotoxin in serum by unit was determined by using a selected ion monitoring pro- quantitating f3(OH) myristic acid by means of gas chroma- gram in conjunction with a six-ion data acquisition program available from Hewlett-Packard. The glass column (2 mm inner The costs of publication of this article were defrayed in part by the diameter X 1.8 m) was packed with 3% Silar-lOC on 100/120 payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 U. S. C. §1734 solely to indicate Abbreviations: #(OH), fl-hydroxy; Me3Si, trimethylsilyl; Me3Si-Me- this fact. fl(OH)C14, trimethylsilyl ether of ,B(OH) methyl myristate. 3993 Downloaded by guest on September 27, 2021 3994 Medical Sciences: Maitra et al. Proc. Natl. Acad. Sci. USA 75 (1978) gas chrom Q (Applied Science Laboratories). The column and at concentrations below 1000 fmol was less than 1% and was not injection port temperatures were 180' and 2400, respectively). significant at higher concentrations. When an equimolar Zero helium (Liquid Carbonic) was used as a carrier gas at a mixture of both derivatives was diluted from 1:10,000 to 1: flow rate of 30 ml/min. The electron multiplier voltage setting 1,000,000, the observed ratio (1.415) of nondeuterated to was 2800. pentadeuterated derivative remained unchanged. Fragmentation Pattern of Me3Si Ether of #(OH) Methyl Internal Standard. A pentadeuterated (3(OH) myristic acid Ester of Myristic Acid [Me3Si-Me-i(OH)C14J and Its Penta- was used as our internal standard. The five deuterium atoms deuterated Derivative. A Hewlett-Packard 5992A gas chro- are located on carbons 2, 3, and 4. Initially, the internal stnard matograph-mass spectrometer with a peak finding program was added prior to hydrolysis of serum. However, our experi- was used. MeSi-Me-#(OH)CA4 showed mass fragmentation of mental data showed that this deuterated standard was partially high abundance at atomic mass units of 315.4 and 175 (Fig. 1). destroyed during hydrolysis. The kinetics of this reaction will We have obtained a pentadeuterated (3(OH) myristic acid from need further study to minimize the loss. In the present study Merck, Sharp & Dohme, Canada Ltd. Montreal, Canada. The the internal standard was added after hydrolysis. Thus, the mass fragmentation pattern of this derivative is also shown in values obtained are minimum values for #(OH) myristic acid Fig. 1. The pattern is essentially identical to the nondeuterated content of serum. derivative except the major mass peak is at 320.4 rather than Extraction and Separation of Serum Lipids. Three milli- at 315.4 and the second major peak is seen at 178. liters of serum were extracted with chloroform/methanol/ Standard Curve and Cross Talk. Known concentrations of water 8:4:3 vol/vol (29). The aqueous extract was removed and both the nondeuterated and pentadeuterated Me3Si-Me- washed with chloroform. The organic phase was removed and fl(OH)CA4 were prepared and the relative abundance at 315.4 dried under nitrogen. The lipids were separated by silica gel for the nondeuterated and at 320.4 for the pentadeuterated column chromatography (0.5 X 6 cm), with chloroform, ace- derivative were measured. These standard curves were linear tone, and methanol as eluting solvents. The eluted lipids and when plotted on double logarithmic graph paper for both de- the remaining silica gel were dried and used for further anal- rivatives. The range covered in these experiments was 200 ysis. fmol-1000 pmol (Fig. 1). At the lower limit, 200 fmol produced Liquid Chromatography. Fatty acid methyl esters were a relative abundance of about 350 at m/e 315.4. The back- separated with a liquid chromatograph (model ALC/GLC 200, ground under these conditions was less than 50. Cross talk Waters Associates). This instrument was equipped with a model (overlap of 315.4 from 320.4 or vice versa) for both derivatives 6000 solvent delivery system, a model U6K Universal Injector, and a Micro-Bondapak C18 column (30 cm X 4 mm), all ob- tained from Waters Associates.