Contemporary clinical usage of LC/MS: analysis of biologically important carboxylic acids.
OBJECTIVE
This review summarizes the current role of LC/MS in the diagnosis and screening of clinical conditions involving the analysis of biologically important carboxylic acids.


METHODS
Carboxylic acids are divided into six logical categories of acid size and function. Details of chromatographic separation methods and modes of mass spectrometer operation are described for each category.


RESULTS
The use of LC/MS in clinical applications such as the diagnosis of inherited and acquired metabolic disorders, gastrointestinal disorders, cancer and diabetes and therapeutic drug monitoring is discussed.


CONCLUSIONS
The mild conditions, speed and sensitivity advantages of LC/MS analysis, over alternatives, are highlighted. The sensitivity and specificity afforded by the combination of tertiary and quaternary ammonium derivatives and tandem mass spectrometry for the analysis of carboxylic acids is emphasized. Potential for a greater range of LC/MS carboxylic analyses, including stereoisomeric intermediates, is predicted.
Johnson
David W
DW
Department of Genetic Medicine, Women's and Children's Hospital, 72 King William Rd, North Adelaide, South Australia 5006, Australia. david.johnson@adelaide.edu.au
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000032:analysis; D001095:Arachidonic Acids / Q000032:analysis; D001647:Bile Acids and Salts / Q000032:analysis; D002264:Carboxylic Acids / Q000032:analysis*; D002853:Chromatography, Liquid / Q000379:methods*; D005227:Fatty Acids / Q000032:analysis; D006801:Humans; D013058:Mass Spectrometry / Q000379:methods*; D008661:Metabolism, Inborn Errors / Q000175:diagnosis
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001095:Arachidonic Acids; D001647:Bile Acids and Salts; D002264:Carboxylic Acids; D005227:Fatty Acids