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Steroid Profiling in Urine of Intact Glucuronidated and Sulfated

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Steroid Profiling in Urine of Intact Glucuronidated and Sulfated CORE Metadata, citation and similar papers at core.ac.uk Provided by Ghent University Academic Bibliography Journal of Chromatography A 1624 (2020) 461231 Contents lists available at ScienceDirect Journal of Chromatography A journal homepage: www.elsevier.com/locate/chroma Steroid profiling in urine of intact glucuronidated and sulfated steroids using liquid chromatography-mass spectrometry ∗ Laurie De Wilde , Kris Roels, Pieter Van Renterghem, Peter Van Eenoo, Koen Deventer 1 Doping Control Laboratory (DoCoLab), Ghent University (UGent), Department Diagnostic Sciences, Technologiepark 30B, B-9052 Zwijnaarde, Belgium a r t i c l e i n f o a b s t r a c t Article history: Detection of endogenous anabolic androgenic steroids (EAAS) misuse is a major challenge in doping con- Received 26 November 2019 trol analysis. Currently, a number of endogenous steroids, which constitute the steroid profile, are quanti- Revised 6 May 2020 fied using gas chromatography (GC). With this methodology, only the sum of the free and glucuronidated Accepted 10 May 2020 steroids is measured together. A dilute-and-shoot LC-MS method, which is compliant with the quality Available online 23 May 2020 requirements for measuring EAAS established by the World Anti-Doping Agency (WADA), was devel- Keywords: oped and validated containing glucuronidated and sulfated steroids in order to gain some extra infor- Doping mation and to expand the existing steroid profile. The developed method is, to the best of our knowl- Urine edge, the first method to combine both steroid glucuronides and sulfates, which is compliant with the Steroid profile quality standards of the technical document on EAAS, established by WADA. The first advantage of this Intact conjugates new steroid profile is the reduced sample preparation time, as it is a direct injection method of diluted Dilute-and-shoot urine. A second advantage is the ability of the used gradient to separate 5 α-androstane-3 α,17 β-diol- 3-glucuronide (5 ααβdiol3G), 5 α-androstane-3 α,17 β-diol-17-glucuronide (5 ααβdiol17G), 5 β-androstane- 3 α,17 β-diol-3-glucuronide (5 βαβdiol3G) and 5 β-androstane-3 α,17 β-diol-17-glucuronide (5 βαβdiol17G) allowing to gain specific information on these isomers, which cannot be accomplished in GC-MS screen- ing due to hydrolysis. This steroid profile also contains free testosterone, 5 α-androstane-3,17-dione and 5 β-androstane-3,17-dione as markers of degradation. In total, 17 compounds and 10 isotopically labelled internal standards are included in this method. © 2020 Elsevier B.V. All rights reserved. 1. Introduction trations of EAAS, which makes population limits insufficient to confirm whether an elevated concentration is a result of steroid Endogenous anabolic androgenic steroids (EAAS) are substances abuse. To circumvent this problem, the athlete’s steroidal pass- produced in the human body and are related to the metabolic port was introduced, as a part of the athlete’s biological pass- pathways of testosterone. In the clinical field, the measurement of port (ABP), which contains basal concentrations of EAAS and ra- steroids is very important for therapeutic drug monitoring, the di- tios among them, with the testosterone/epitestosterone ratio (T/E) agnosis and monitoring of endocrine disorders and cancers (e.g., as the most important marker [ 8 , 9 , 11 , 16–21 ]. By using the adaptive breast, prostate and endometrium). Highly sensitive and specific model, individual reference limits can be established which allow methods are needed for an accurate diagnosis and the measure- the comparison of a measured value with results from previous ment of low concentrations of steroids. The most common matri- tests [ 8 , 9 , 11 , 16–19 , 21 ]. When suspicious results are found, a con- ces for steroid analysis are serum, plasma, urine and saliva [1–4] . firmation by gas chromatography-combustion-isotope ratio mass As the use of EAAS can enhance sports performances, it is pro- spectrometry (GC-C-IRMS) is performed to confirm the endoge- hibited by the World Anti-doping Agency (WADA) [5] . An abuse nous or exogenous origin of the steroids [ 9 , 11 , 13 , 15–17 , 19 , 20 , 22 ], with this class of doping substances is difficult to track down be- although eventually the ABP could also by itself be used to prose- cause these steroids are also formed endogenously [6–19] . Fur- cute a doping infraction. thermore, there is a large inter-individual variation in concen- The extensive metabolism of EAAS is divided into two phases. In phase I, oxidations and reductions occur to inactivate the com- pound and to facilitate its elimination. In phase II, the steroid is ∗ Corresponding author. coupled to glucuronic acid or a sulfate group by conjugation re- E-mail address: [email protected] (L. De Wilde). actions, making the steroid more polar, which also facilitates its 1 Doping Control Laboratory (DoCoLab), Ghent University, Department Diagnostic urinary excretion [ 7–9 , 14 , 15 , 17 , 22–27 ]. For example, 3 α-hydroxy Sciences, Technologiepark 30 B, B-9052 Zwijnaarde, Belgium. https://doi.org/10.1016/j.chroma.2020.461231 0021-9673/© 2020 Elsevier B.V. All rights reserved. 2 L. De Wilde, K. Roels and P. Van Renterghem et al. / Journal of Chromatography A 1624 (2020) 461231 steroids are conjugated with glucuronic acid, while 3 β-hydroxy androsterone sulfate, androsterone sulfate-d4 (AS-d4), epitestos- steroids are conjugated as sulfates [ 7 , 17 , 28 ]. Glucuronidation and terone glucuronide (EG), epitestosterone glucuronide-d3 (EG-d3), sulfatation at the 17 β-hydroxy group are well known for testos- epitestosterone sulfate (ES), epitestosterone sulfate-d3 (ES-d3), terone. The major metabolites of AAS are glucuronidated, however etiocholanolone glucuronide (EtioG), etiocholanolone sulfate, some EAAS are also excreted as sulfates [ 7 , 14–18 , 22 , 25 ]. etiocholanolone sulfate-d5 (EtioS-d5), testosterone-d3 (T-d3), In the current steroid profile, constituted by concentrations of testosterone glucuronide (TG), testosterone glucuronide-d3 (TG- EAAS and ratios among them, only glucuronidated steroids are in- d3), testosterone sulfate (TS) and testosterone sulfate-d3 (TS-d3) cluded, as T is mainly conjugated by UGT2B17 and mainly excreted were bought from NMI (Pymble, Australia). 5 α-androstane- in a glucuronidated form [ 11 , 13 , 16–18 , 20 , 22 , 24 , 29 ]. Hence, conven- 3,17-dione was purchased from Steraloids (Newport, R. I.), 5 β- tional sample preparation methods include an enzymatic hydrol- androstane-3,17-dione and testosterone from Sigma-Aldrich ysis step to release the aglycones, whereby information on the (Bornem, Belgium). Dehydroepiandrosterone sulfate (DHEAS) and free or sulfoconjugated fraction is lost. Subsequently, the samples dehydroepiandrosterone sulfate-d5 (DHEAS-d5) were bought from are preconcentrated and analysed by GC-MS after derivatisation Cerilliant (Round Rock, Texas). Epiandrosterone sulfate (EpiAS) was [ 8 , 9 , 13 , 15–18 , 20 , 22–25 , 27 ]. These steps can be time-consuming purchased from TRC (Toronto, Canada). and a source of variation, technical errors and inaccuracy [ 17 , 21 ]. As some people have a decreased glucuronidation of steroids, 2.2. Instruments and consequently a lower T/E because of a deletion/deletion (del/del) polymorphism in UGT2B17, it would be interesting to ex- The LC-MS/MS system consists of a Thermo Scientific Ultimate pand the steroid profile, to gain some information on free steroids 30 0 0, with a heated column compartment thermostated at 55 °C and to include the sulfoconjugated steroids [ 8 , 9 , 11 , 16 , 18 , 19 , 24 , 28 ]. and an XRS open autosampler, connected to a TSQ Vantage (both Previously, the group of Dehennin et al. suggested the ratio be- from Thermo Fisher Scientific). The separation of the compounds tween TG and the sum of EG and ES [ 9 , 28 ] and the ratio be- was performed on a Zorbax Eclipse Plus (C18 2.1 × 100 mm; 1.8 tween EG and ES [9] to distinguish between a physiologically and μm, Agilent Technologies). a pharmacologically high T/E, which was contradicted by the work of Borts et al. [27] . Another advantage of the addition of sulfate 2.2.1. LC gradient conjugates is the improvement of detection windows [ 11 , 19 , 24 , 30 ]. The mobile phases consisted of (A) water and (B) methanol Previous studies have shown the usefulness of epiandrosterone sul- both containing 0.01 % HCOOH/5 mM NH OOCH. A gradient elu- fate (EpiAS), which is known to be only excreted as a sulfoconju- 4 tion program started with 0 % B for 0.1 min after which it was gate [ 19 , 31–33 ]. Androsterone sulfate (AS) and etiocholanolone sul- immediately increased to 35 %. After 1 min of 35 % B, the gradient fate (EtioS) were also highlighted as promising markers after oral was further increased to 45 % B in 5 min, where it was kept for 5 testosterone undecanoate intake [ 8 , 9 ]. min and was then increased to 50 % in 19 min. For 4.5 min, the Unfortunately, inclusion of the sulfoconjugated steroids into the gradient increased to 90 % B, after which it increased to 100 % in existing GC-MS methods is difficult to achieve due to hydrolysis 0.5 min. This condition was kept for 2 min. The gradient decreased and extraction problems [ 6 , 22–24 , 27 ]. Additionally, hydrolysis of to starting conditions in 0.1 min and was kept for 0.9 min. the sulfonjugates yields the same aglycones as glucuronides and information on the phase II metabolites is lost. Previously, LC-MS has proven to be the ideal technique to anal- 2.2.2. MS parameters yse phase II metabolites of EAAS without the need to hydrolyse Detection of the steroids was carried out by electrospray ion- [ 6 , 8 , 9 , 11 , 12 , 14 , 15 , 18–20 , 23 , 25 , 27 , 34 ]. Some research groups anal- ization (ESI) in the selective reaction mode (SRM) and tuned S- ysed intact glucuronides [12] , intact sulfates [ 6 , 11 , 19 ] or a com- lens values were used.
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