II. Validity and reliability of liquid chromatography with electrochemical detection for measuring plasma levels of norepinephrine and epinephrine in man

doi:10.1016/0024-3205(81)90139-9

Life Sciences

Volume 28, Issue 5, 2 February 1981, Pages 467-475

https://doi.org/10.1016/0024-3205(81)90139-9 Get rights and content

Abstract

Liquid chromatography with electrochemical detection (LCEC) provides a rapid, sensitive, and specific technique for measuring human plasma norepinephrine (NE) and epinephrine (E) levels. We tested the reliability and validity of this technique against that of the catechol-O-methyl-transferase radioenzymatic (COMT-RE) assay. In healthy, resting humans, mean NE and E values were similar using the LCEC and COMT-RE techniques (311 vs. 300 pg/ml for NE; 57 vs. 52 pg/ml for E). In a series of 25 plasma samples obtained from a variety of sources, the correlation between the two methods was 0.99 for both NE and E. Coefficients of variation were similar for catecholamine levels above 100 pg/ml, but below this, the COMT-RE technique appeared to be more reliable. The advantages of the LCEC method are its speed, simplicity of sample preparation, low cost per assay, lack of use of radionuclides, and ease in trouble-shooting. The COMT-RE technique is preferable for small sample sizes or large numbers of samples. LCEC offers a reasonable alternative to the COMT-RE technique for measuring plasma norepineprhine and epinephrine.

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2021, Brazilian Journal of Anesthesiology (English Edition)
Unhealthy teeth can seriously affect general health and increase the risk of death in elderly people. There has been no confirmation of which device is most effective for elderly patients with teeth loss. Therefore, we compared four intubation devices in elderly patients with partial and total tooth loss aiming to reduce risk during anesthesia.
Two hundred patients were randomized to undergo tracheal intubation with the Macintosh laryngoscope, the Glidescope, the Fiberoptic bronchoscope or the Lightwand as part of general anesthesia. A unified protocol of anesthetic medications was used. HR and BP were measured at T₀, T₁, T₂, T₃, T₄ and T₅. Catecholamine (epinephrine and norepinephrine) blood samples were drawn at T₀, T₁ and T₂. Intubation time and postoperative complications, including dental damage and losses, were recorded.
Reduced fluctuations in HR, DBP, and SBP were observed in the Lightwand group. Intubation time was significantly shorter in the Lightwand group (p < 0.05). There was no statistically significant difference between the groups in epinephrine levels, but norepinephrine levels were less volatile in the Fiberoptic bronchoscope and Lightwand groups. Fewer patients in the Lightwand group experienced dental damage and other postoperative complications than in the other three groups. Although a higher success rate on the first attempt was as high as in the Fiberoptic bronchoscope group, shorter intubation time was observed only in the Lightwand group.
The Lightwand offers less hemodynamic stimulation than the Macintosh laryngoscope, Glidescope, and Fiberoptic bronchoscope. Because it had the shortest intubation time, the Lightwand caused the least damage to the teeth and throat of elderly patients. Our findings showed that tracheal intubation with the Lightwand was advantageous for preventing cardiovascular stress responses with short intubation times and fewer postoperative complications.
Evidence for altered brain reactivity to norepinephrine in Veterans with a history of traumatic stress
2018, Neurobiology of Stress
Increases in the quantity or impact of noradrenergic signaling have been implicated in the pathophysiology of posttraumatic stress disorder (PTSD). This increased signaling may result from increased norepinephrine (NE) release, from altered brain responses to NE, or from a combination of both factors. Here, we tested the hypothesis that Veterans reporting a history of trauma exposure would show an increased association between brain NE and mental health symptoms commonly observed after trauma, as compared to Veterans who did not report a history of trauma exposure, consistent with the possibility of increased brain reactivity to NE after traumatic stress.
Using a convenience sample of 69 male Veterans with a history of combat-theater deployment, we examined the relationship between trauma-related mental health symptoms and the concentration of NE in cerebrospinal fluid (CSF). CSF NE levels were measured by HPLC in CSF from morning lumbar puncture. Behavioral symptoms associated with diagnoses of PTSD, depression, insomnia, or post-concussive syndrome (PCS), which together cover a wide variety of symptoms associated with alterations in arousal systems, such as sleep, mood, concentration, and anxiety, were assessed via self-report (PTSD Checklist [PCL] for PTSD, Patient Health Questionnaire 9 [PHQ9] for depression, Pittsburgh Sleep Quality Index [PSQI] for sleep problems including insomnia, and Neurobehavioral Symptom Inventory [NSI] for PCS) and structured clinical interview (Clinician-Administered PSTD Scale [CAPS]). Individuals meeting criterion A of the DSM-IV diagnostic criteria for PTSD were considered trauma-exposed. Linear regression models were used to quantify the association between CSF NE and symptom intensity in participants with and without a history of trauma exposure, as well as in participants with a history of trauma exposure who were currently taking the noradrenergic receptor antagonist prazosin.
Fifty-two Veterans met criteria for a history of trauma exposure; of these, 36 met criteria for PTSD. CSF NE levels were not significantly different in Veterans with a history of trauma compared to those without, nor in Veterans with PTSD as compared to those without. Veterans with a history of trauma and who were not using the medication prazosin demonstrated a significantly more positive correlation between CSF NE and behavioral symptom expression than Veterans who had not experienced traumatic stress. No relationship between CSF NE and behavioral symptom expression was found in Veterans who had experienced traumatic stress and were taking prazosin at the time of the assessments.
These results are consistent with increased central nervous system responsiveness to noradrenergic signaling in individuals with a history of traumatic exposure, raising the possibility that there may be long-lasting physiologic effects of trauma-exposure that exist independently of whether an individual meets criteria for PTSD at any given point in time. Exploration of the mechanism by which brain responsiveness to NE is modulated following trauma holds the possibility of finding new strategies for both preventing and treating PTSD.
Norepinephrine levels in children with single ventricle circulation
2017, Progress in Pediatric Cardiology
Citation Excerpt :
Samples were collected in cold heparinized tubes and transported on ice and immediately centrifuged. The plasma fraction was stored at − 20 °C until batch measurement of norepinephrine levels by conventional high-pressure liquid chromatography methodology [7]. Invasive hemodynamics at time of catheterization, echocardiogram results closest to catheterization, and all pertinent clinical data, including determining whether the patients had manifestations of heart failure as notated in the medical records were collected through March 2012.
Elevated plasma norepinephrine levels are a strong independent predictor of mortality in adults with heart failure with systolic dysfunction, and provide the mechanistic basis to its therapeutic paradigm. The pathogenesis of heart failure in the single ventricle circulation is unknown. It remains controversial whether conventional neurohormonal blockade in this population is beneficial. We hypothesize that norepinephrine levels can be elevated in children with single ventricle circulation and that it is associated with a poor outcome.
Norepinephrine levels were collected from 22 consecutive single ventricle and 7 control patients at the time of catheterization. The disease group was followed for the development of heart failure and a composite outcome of death or transplant.
Median age at norepinephrine level was 2.4 years (interquartile range 93 days–16.8 years) and follow-up duration was 9.8 years (range 75 days–10.5 years), during which 5 patients (23%) met a composite outcome of either death (n = 4) or transplantation (n = 1). While ventricular dysfunction and individual invasive hemodynamic parameters were not predictive of subsequent composite outcome, a norepinephrine level > 369 pg/mL at time of catheterization was associated with a decreased freedom from the composite outcome.
In this study of children with single ventricle circulation, elevated norepinephrine levels were observed and were associated with a poor outcome. Consideration should be given to the further study of the role of neurohormonal activation and potentially its blockade, currently used for heart failure from systolic dysfunction, in the management of this high risk congenital heart disease population.
Endovascular Renal Denervation in End-Stage Kidney Disease Patients: Cardiovascular Protection—A Proof-of-Concept Study
2017, Kidney International Reports
Citation Excerpt :
The data was sampled at 10 kHz with an analog-to-digital converter (PL3508/P; ADInstruments) and recorded via software (Labchart Pro v7.3; ADInstruments) for offline analysis by blinded observers (by NAH and LCW) to obtain MSNA burst frequency (MSNAfrequency; bursts/min) and incidence (MSNAincidence; bursts per 100 heart beats).36–38 Venous blood samples were procured, processed, and stored for future batched norepinephrine and epinephrine analysis (Christchurch Heart Institute, New Zealand).39–41 Endovascular RDN was performed using a multipolar EnligHTN catheter and GEN2 radiofrequency generator, which is capable of delivering 4 ablations simultaneously over 60 seconds (St. Jude Medical, Inc., Minneapolis, MN); procedures were performed via the right femoral artery and an 8-F sheath in all patients.42
Sympathetic neural activation is markedly increased in end-stage kidney disease (ESKD). Catheter-based renal denervation (RDN) reduces sympathetic overactivity and blood pressure in resistant hypertension. We investigated the effect of RDN on sympathetic neural activation and left ventricular mass in patients with ESKD.
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Catheter-based RDN significantly reduced MSNA and LV mass as well as systemic BP in this group of patients with ESKD.
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2014, Pharmacology and Therapeutics
Citation Excerpt :
Catecholamines oxidize when they are exposed to even a weak oxidizing potential. This is a basis for liquid chromatography with electrochemical detection for assaying catecholamines (Goldstein et al., 1981). The effluent from the liquid chromatographic column is subjected to oxidation at a low oxidizing potential.
Several neurodegenerative diseases involve loss of catecholamine neurons—Parkinson disease is a prototypical example. Catecholamine neurons are rare in the nervous system, and why they are vulnerable in PD and related disorders has been mysterious. Accumulating evidence supports the concept of “autotoxicity”—inherent cytotoxicity of catecholamines and their metabolites in the cells in which they are produced. According to the “catecholaldehyde hypothesis” for the pathogenesis of Parkinson disease, long-term increased build-up of 3,4-dihydroxyphenylacetaldehyde (DOPAL), the catecholaldehyde metabolite of dopamine, causes or contributes to the eventual death of dopaminergic neurons. Lewy bodies, a neuropathologic hallmark of PD, contain precipitated alpha-synuclein. Bases for the tendency of alpha-synuclein to precipitate in the cytoplasm of catecholaminergic neurons have also been mysterious. Since DOPAL potently oligomerizes and aggregates alpha-synuclein, the catecholaldehyde hypothesis provides a link between alpha-synucleinopathy and catecholamine neuron loss in Lewy body diseases. The concept developed here is that DOPAL and alpha-synuclein are nodes in a complex nexus of interacting homeostatic systems. Dysfunctions of several processes, including decreased vesicular sequestration of cytoplasmic catecholamines, decreased aldehyde dehydrogenase activity, and oligomerization of alpha-synuclein, lead to conversion from the stability afforded by negative feedback regulation to the instability, degeneration, and system failure caused by induction of positive feedback loops. These dysfunctions result from diverse combinations of genetic predispositions, environmental exposures, stress, and time. The notion of catecholamine autotoxicity has several implications for treatment, disease modification, and prevention. Conversely, disease modification clinical trials would provide key tests of the catecholaldehyde hypothesis.
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Current conceptsII. Validity and reliability of liquid chromatography with electrochemical detection for measuring plasma levels of norepinephrine and epinephrine in man

Abstract

Life Sciences

Life Sciences

Life Sciences

Am. J. Med. Sci.

Circ. Res.

Current concepts
II. Validity and reliability of liquid chromatography with electrochemical detection for measuring plasma levels of norepinephrine and epinephrine in man