title: Quantification of key red blood cell folates from subjects with defined MTHFR 677C>T genotypes using stable isotope dilution liquid chromatography/mass spectrometry.
abstract: Red blood cell (RBC) folate levels are established at the time of erythropoiesis and therefore provide a surrogate biomarker for the average folate status of an individual over the preceding four months. Folates are present as folylpolyglutamates, highly polar molecules that cannot be secreted from the RBCs, and must be converted into their monoglutamate forms prior to analysis. This was accomplished using an individual's plasma pteroylpolyglutamate hydrolase by lysing the RBCs in whole blood at pH 5 in the presence of ascorbic acid. Quantitative conversion of formylated tetrahydrofolate derivatives into the stable 5,10-methenyltetrahydrofolate (5,10-MTHF) form was conducted at pH 1.5 in the presence of [(13)C(5)]-5-formyltetrahydrofolate. The resulting [(13)C(5)]-5,10-MTHF was then used as an internal standard for the formylated forms of tetrahydrofolate that had been converted into 5,10-MTHF as well any 5,10-MTHF that had been present in the original sample. A stable isotope dilution liquid chromatography-multiple reaction monitoring/mass spectrometry method was validated and then used for the accurate and precise quantification of RBC folic acid, 5-methyltetrahydrofolate (5-MTHF), tetrahydrofolate (THF), and 5,10-MTHF. The method was sensitive and robust and was used to assess the relationship between different methylenetetrahydrofolate reductase (MTHFR) 677C>T genotypes and RBC folate phenotypes. Four distinct RBC folate phenotypes could be identified. These were classified according to the relative amounts of individual RBC folates as type I (5-MTHF >95%; THF <5%; 5,10-MTHF <5%), type II (5-MTHF <95%; THF 5% to 20%; 5,10-MTHF <5%), type III (5-MTHF >55%; THF >20%; 5,10-MTHF >5%), and type IV (5-MTHF <55%; THF >20%; 5,10-MTHF >5%).
authors.affiliation: Center for Cancer Pharmacology, University of Pennsylvania School of Medicine, 854 BRB II/III, 421 Curie Boulevard, Philadelphia, PA 19104-6160, USA.
authors.forename: Yuehua
authors.initials: Y
authors.lastname: Huang
authors.forename: Stefanie
authors.initials: S
authors.lastname: Khartulyari
authors.forename: Megan E
authors.initials: ME
authors.lastname: Morales
authors.forename: Anna
authors.initials: A
authors.lastname: Stanislawska-Sachadyn
authors.forename: Joan M
authors.initials: JM
authors.lastname: Von Feldt
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Whitehead
authors.forename: Ian A
authors.initials: IA
authors.lastname: Blair
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D002851:Chromatography, High Pressure Liquid; D004247:DNA / Q000737:chemistry; D004912:Erythrocytes / Q000737:chemistry*; D005260:Female; D005494:Folic Acid Deficiency / Q000097:blood; D005838:Genotype; D006801:Humans; D007201:Indicator Dilution Techniques; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000097:blood / Q000235:genetics*; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D011624:Pteroylpolyglutamic Acids / Q000032:analysis*; D021241:Spectrometry, Mass, Electrospray Ionization / Q000379:methods*; D014803:Vitamin B Complex / Q000032:analysis*
chemical_list: D015415:Biomarkers; D011624:Pteroylpolyglutamic Acids; D014803:Vitamin B Complex; D004247:DNA; D042965:Methylenetetrahydrofolate Reductase (NADPH2)