Abstract:
A spectrophotometric assay for quantitative determination of 5-hydroxyindoleacetic acid in fluid samples. 3-methyl-2-benzthiazolone hydrazone is oxidized with sodium periodate to the corresponding diazonium salt. The resulting diazonium salt adds electrophilically to activated positions on indole ring of 5-hydroxyindoleacetic acid to yield azo dyes which absorb light at 510 nm.

Description:
This invention relates to the determination of a marker for malignant carcinoid tumors. More particularly, this invention relates to a colorimetric method for determination of 5-hydroxyindoleacetic acid (&#34;5-HIAA&#34;) in urine. 
     BACKGROUND OF THE INVENTION 
     5-HIAA is a tryptophan metabolite that is excreted in large quantities in the urine of individuals with malignant carcinoid tumours. Sjoederson, A., &#34;Clinical And Laboratory Features Of Malignant Carcinoid&#34;, Arch. Intern. Med. 102, 136 (1958). 5-HlAA is used as a diagnostic marker for the disease. Normal values should not exceed 6 mg of 5-HIAA excreted in 24 hours. Goldenberg, H., &#34;Specific Photometric Determination Of 5-Hydroxyindoleacetic Acid In Urine&#34;, Clin. Chem., 19, 38 (1973). 
     Methods for determining levels of HIAA are known. The most widely used method is that of Undenfriend et al., &#34;The Identification Of 5-Hydroxy, 3-Indoleacetic Acid In Normal Urine And A Method for Its Assay&#34;, J. Biol. Chem., 216, 499-505 (1955), as modified by Goldenberg, supra. Goldenberg&#39;s modification of the method of Undenfriend et al. is based on oxidative coupling of 5-HIAA to α-nitroso, β-napthol in a reaction catalyzed by nitrous acid to yield a purple complex which can be monitored spectrophotometrically at 540 nm. Because α-nitroso, β-napthol also absorbs at the same wavelength as the detected species 540 nm it is necessary to remove unreacted α-nitroso, β-napthol prior to measurement. The latter step may result in some loss of the detected species, as well as necessitating additional steps in the procedure. 
     Accordingly, it is desirable to develop a simplified spectrophotometric assay for 5-HIAA which avoids the necessity of separating the detected species from other reactants used in the assay prior to spectrophotometric determination. That improvement will facilitate development of automated test equipment for determining 5-HIAA. 
     SUMMARY OF THE INVENTION 
     A spectrophotometric assay for quantitative determination of 5-HIAA in fluid samples. 3-methyl-2-benzothiazolone hydrazone is oxidized with sodium periodate to the corresponding diazonium salt. The resulting diazonium salt adds electrophilically to activated positions on indole ring of 5-HIAA to yield azo dyes with absorbance at 510 nm. 
     DETAILED DESCRIPTION 
     All procedures are performed at room temperature. 5-HIAA is extracted from samples of urine with I N HCL and diethyl ether. Recovery of 5-HIAA is typically in excess of 90% of that present in samples. Phosphate buffer [pH 7.0]is added. 5-HIAA is recovered with the buffer phase. 3-methyl-2-benzahiazolone hydrazone (&#34;MBTH&#34;) and an oxidizing agent are added to an aliquot of extraction solution together with borate buffer. In the presently preferred embodiment, the oxidizing agent is sodium periodate. It is to be expected that other periodate salts will also be effective. In addition, other oxidizing agents, such as ferric chloride or ceric sulfate can also be used. However, ferric chloride produces a lower rate of reaction, and is less useful than sodium periodate because it absorbs in the same region as the detected species. After incubation for 5 minutes, anhydrous methanol is added to clarify the reaction solution. The mixture is allowed to stand for another 5 minutes. The concentration of 5-HIAA in the sample is determined from the absorbance at 510 nm. The molar absorbtivity at this wavelength is 32.3×10 4  L mole -1 . 
    
    
     EXAMPLE 1 
     5 ml samples of urine were extracted with acidified (5 ml I N HCl in saturated NaCl) diethyl ether (25 ml). The solution was centrifuged for 2 minutes and the ether (upper) layer removed. 4 ml sodium phosphate buffer (0.lM, pH 7.0) were added to the ether phase and the mixture was shaken. The aqueous (upper) layer was removed. 
     0.5 ml borate buffer (1.4 g in 200 ml deionized water, titrated with 4 N NaOH to pH 8.2); 0.5 ml of MBTH solution (135 mg/dl, in deionized water) were added to 0.5 ml of the aqueous extract. The mixture was vortexed for 10 seconds and incubated for 3 minutes at room temperature. 1 ml of sodium periodate (35 mg/dl) solution was added, and the mixture again vortexed. After allowing the mixture to stand for 5 minutes, the mixture was diluted with 5 ml anhydrous methanol and allowed to stand for another 5 minutes. The absorbance of the complex was measured at 510 nm using a Beckman DV-30 spectrophotometer. All procedures were carried out at room temperature. 
     EXAMPLE 2 
     A series of five different aqueous solutions of 5-HIAA were prepared ranging in concentration from 0-100 mg/ml. Spectrophotometric determination of colored complexes revealed a linear relation between absorbance at 510 nm and concentration of 5-HIAA over a range of 0-50 mg/ml. This surpasses the range required for clinical application of the assay. 
     EXAMPLE 3 
     Ten urine specimens from ten different patients with suspected carcinoid tumors were assayed by the method of the present invention and Goldenberg&#39;s, supra, method. A correlation plot of the two sets of results revealed excellent agreement between the methods (r =0.99). Linear regression analysis by the method of least squares gave Y(invention) =0.975(Goldenberg method)+0.06. 
     EXAMPLE 4 
     The precision and reproducibility of the method of the present invention have been found to be high. The 24 hour urine sample of a patient was divided into 40 aliquots. Twenty of these aliquots were analyzed serially on the same day. (i.e., a within runs trial) The mean obtained was 2.44 mg/ml, with a standard deviation of 0.07 mg/ml and coefficient of variation of 3 percent. Another 20 samples were analyzed on each of twenty successive days to examine the between runs variability. The mean obtained was 2.39 mg/ml, with a standard deviation of 0.09 mg/ml and a coefficient of variation of 3.8%. We conclude that the method is reproducible. 
     EXAMPLE 5 
     Because the method of the present invention involves the oxidative coupling of a diazonium salt to an activated aromatic compound, 5-HIAA, the possibility of interference by other aromatic compounds was tested. Neither salicilate nor tyrosine was found to interfere with the absorbance at 510 nm of the azo dyes formed between oxidized MBTH and 5-HIAA in any of the patient samples analyzed, using the correlation method described in Example 3. 
     Although the present invention has been disclosed in terms of specific embodiments, those embodiments are meant to be illustrative only. The scope of the invention is set forth by the claims which are appended hereto.