Determination of epimers 22R and 22S of budesonide in human plasma by high-performance liquid chromatography-atmospheric pressure chemical ionization mass spectrometry

A highly sensitive and selective method has been developed for the simultaneous quantification of 22R- and 22S-epimers of budesonide in human plasma. The drug was isolated from human plasma using C₁₈ solid-phase extraction cartridges and was acetylated with a mixture of 12.5% acetic anhydride and 12.5% triethylamine in acetonitrile to form the 21-acetyl derivatives. Deuterium-labelled budesonide was synthesized and determined to have an isotopic purity > 99%. This was used as the internal standard. Epimers were quantified by automated liquid chromatography-atmospheric pressure chemical ionization mass spectrometry, operating in selected ion mode at m/z 473.2 and m/z 476.2. Linear responses were observed for both epimers over the range 0.25 to 10.0 ng/ml. The average recoveries of 22R- and 22S-epimers of budesonide from human plasma were 87.4% and 87.0%, respectively. The lower limit of quantification for each epimer was 0.25 ng/ml, corresponding to 50.0 pg of analyte on column. Within- and between-day coefficients of variation were 8.6% and 4.0%, respectively.     

糖皮质激素在脓毒症治疗中的研究进展

脓毒症是由致病微生物感染引发的全身炎症反应综合征（SIRS),合并血压降低且经快速液体复苏后血压仍不能恢复正常者 称为脓毒性休克（Septic shock),其中一部分患者发展为多器官功能障碍综合症(MODS)。脓毒症病死率居高不下。每10 万人口中 约50-300 人会发生严重脓毒症,其短期死亡率达20%-25%,当发展为脓毒性休克时其死亡率达50%。整合消灭致病微生物、阻断 炎症介质和处理MODS等措施的" 集束化"治疗并未显著降低脓毒症患者的病死率。糖皮质激素具有强大的抗炎作用,但诸多 的临床研究对糖皮质激素疗效的评价褒贬不一,糖皮质激素是否有利于脓毒症的转归一直饱受争议[3]。本文仅就糖皮质激素在 严重脓毒症及脓毒性休克中的治疗进展综述如下,并希望能进一步探讨发生严重脓毒症及脓毒性休克时,机体对糖皮质激素反 应复杂性的原因,以及在以后的研究中对相对肾上腺皮质功能不全的诊断标准及对糖皮质激素用药和停药时机的选择更加明确。     

Seasonal changes in plasma testosterone and glucocorticosteroids in free-living male yellow-pine chipmunks and the response to capture and handling

We measured plasma levels of testosterone, corticosterone, and cortisol in free-living male yellow-pine chipmunks to demonstrate the patterns of seasonal variation and to assess the effects of capture and handling on hormone levels. We achieved the latter by modifying our standard trapping technique (blood samples collected within 1–3 h of capture) to obtain blood samples that allowed measurement of hormone levels within 3 min of capture (basal) and again 30 min later. By alternating the modified and standard trapping techniques over 7 months of the active season we demonstrated that seasonal patterns of variation in steroid hormone levels can be accurately described with the simpler, standard trapping technique. Basal and 30-min post-capture testosterone levels were high during mating and dropped to a persistently low level thereafter. Conversely, both cortisol and corticosterone were at their seasonal low during mating and climbed to peak levels in June following reproduction. Plasma glucocorticosteroid levels increased during the 30 min after capture and handling at all times of the active season, and these elevated levels were similar to the levels obtained by standard trapping. Testosterone levels during the mating period also increased in response to capture and handling. The contrasting patterns of seasonal variation in glucocorticosteroid and testosterone levels and the changes induced by capture and handling suggest that when testosterone concentration is high, adrenocortical activity is suppressed. Accepted: 17 February 2000