title: Novel heparan sulfate assay by using automated high-throughput mass spectrometry: Application to monitoring and screening for mucopolysaccharidoses.
abstract: Mucopolysaccharidoses (MPS) are caused by deficiency of one of a group of specific lysosomal enzymes, resulting in excessive accumulation of glycosaminoglycans (GAGs). We previously developed GAG assay methods using liquid chromatography tandem mass spectrometry (LC-MS/MS); however, it takes 4-5 min per sample for analysis. For the large numbers of samples in a screening program, a more rapid process is desirable. The automated high-throughput mass spectrometry (HT-MS/MS) system (RapidFire) integrates a solid phase extraction robot to concentrate and desalt samples prior to direction into the MS/MS without chromatographic separation; thereby allowing each sample to be processed within 10s (enabling screening of more than one million samples per year). The aim of this study was to develop a higher throughput system to assay heparan sulfate (HS) using HT-MS/MS, and to compare its reproducibility, sensitivity and specificity with conventional LC-MS/MS. HS levels were measured in the blood (plasma and serum) from control subjects and patients with MPS II, III, or IV and in dried blood spots (DBS) from newborn controls and patients with MPS I, II, or III. Results obtained from HT-MS/MS showed 1) that there was a strong correlation of levels of disaccharides derived from HS in the blood, between those calculated using conventional LC-MS/MS and HT-MS/MS, 2) that levels of HS in the blood were significantly elevated in patients with MPS II and III, but not in MPS IVA, 3) that the level of HS in patients with a severe form of MPS II was higher than that in an attenuated form, 4) that reduction of blood HS level was observed in MPS II patients treated with enzyme replacement therapy or hematopoietic stem cell transplantation, and 5) that levels of HS in newborn DBS were elevated in patients with MPS I, II or III, compared to those of control newborns. In conclusion, HT-MS/MS provides much higher throughput than LC-MS/MS-based methods with similar sensitivity and specificity in an HS assay, indicating that HT-MS/MS may be feasible for diagnosis, monitoring, and newborn screening of MPS.
authors.affiliation: Nemours/Alfred I duPont Hospital for Children, Wilmington, DE, USA.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Shimada
authors.affiliation: Agilent Technologies, Inc., Wakefield, MA, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Kelly
authors.affiliation: Agilent Technologies, Inc., Wakefield, MA, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: LaMarr
authors.affiliation: Laboratory of Genetic Metabolic Disease, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: Naomi
authors.initials: N
authors.lastname: van Vlies
authors.affiliation: Nemours/Alfred I duPont Hospital for Children, Wilmington, DE, USA.
authors.forename: Eriko
authors.initials: E
authors.lastname: Yasuda
authors.affiliation: Nemours/Alfred I duPont Hospital for Children, Wilmington, DE, USA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Mason
authors.affiliation: Nemours/Alfred I duPont Hospital for Children, Wilmington, DE, USA.
authors.forename: William
authors.initials: W
authors.lastname: Mackenzie
authors.affiliation: Nemours/Alfred I duPont Hospital for Children, Wilmington, DE, USA.
authors.forename: Francyne
authors.initials: F
authors.lastname: Kubaski
authors.affiliation: Medical Genetics Service, HCPA and Department of Genetics, UFRGS, Porto Alegre, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Giugliani
authors.affiliation: Department of Pediatrics, Faculty of Medicine University of the Ryukyus, Okinawa, Japan.
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Chinen
authors.affiliation: Department of Pediatrics, Shimane University, Izumo, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Yamaguchi
authors.affiliation: Medical Education Development Center, Gifu University, Gifu, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Kenji E
authors.initials: KE
authors.lastname: Orii
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fukao
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Tadao
authors.initials: T
authors.lastname: Orii
authors.affiliation: Nemours/Alfred I duPont Hospital for Children, Wilmington, DE, USA; Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan. Electronic address: stomatsu@nemours.org.
authors.forename: Shunji
authors.initials: S
authors.lastname: Tomatsu
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002853:Chromatography, Liquid; D059788:Dried Blood Spot Testing / Q000379:methods / Q000592:standards; D006025:Glycosaminoglycans / Q000097:blood; D006497:Heparan Sulfate / Q000097:blood*; D057166:High-Throughput Screening Assays; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D013058:Mass Spectrometry; D009083:Mucopolysaccharidoses / Q000097:blood* / Q000175:diagnosis*; D015997:Neonatal Screening / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results; D053719:Tandem Mass Spectrometry; D055815:Young Adult
chemical_list: D006025:Glycosaminoglycans; D006497:Heparan Sulfate
keywords: Automated high-throughput mass spectrometry; Biomarker; Heparan sulfate; Mucopolysaccharidoses; Newborn screening
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