Simultaneous measurement of monoamine metabolites and 5-methyltetrahydrofolate in the cerebrospinal fluid of children

Clin Chim Acta. 2017 Feb:465:5-10. doi: 10.1016/j.cca.2016.12.005. Epub 2016 Dec 7.

Abstract

Background: We describe a new method for simultaneous measurement of monoamine metabolites (3-O-methyldopa [3-OMD], 3-methoxy-4-hydroxyphenylethyleneglycol [MHPG], 5-hydroxyindoleacetic acid [5-HIAA], and homovanillic acid [HVA]) and 5-methyltetrahydrofolate (5-MTHF) and its use on cerebrospinal fluid (CSF) samples from pediatric patients.

Methods: Monoamine metabolites and 5-MTHF were measured by high-performance liquid chromatography with fluorescence detection. CSF samples were prospectively collected from children according to a standardized collection protocol in which the first 1-ml fraction was used for analysis.

Results: Monoamine metabolites and 5-MTHF were separated within 10min. They showed linearity from the limit of detection to 1024nmol/l. The limit of quantification of each metabolite was sufficiently low for the CSF sample assay. In 42 CSF samples after excluding cases with possibly altered neurotransmitter profiles, the concentrations of 3-OMD, MHPG, 5-HIAA, HVA, and 5-MTHF showed significant age dependence and their ranges were comparable with the reference values in the literature. The metabolite profiles of aromatic l-amino acid decarboxylase deficiency, Segawa disease, and folate receptor α defect by this method were compatible with those in the literature.

Conclusions: This method is a simple means of measuring CSF monoamine metabolites and 5-MTHF, and is especially useful for laboratories not equipped with electrochemical detectors.

Keywords: 3-O-methyldopa; 3-methoxy-4-hydroxyphenylethyleneglycol; 5-hydroxyindoleacetic acid; 5-methyltetrahydrofolate; Aromatic l-amino acid decarboxylase deficiency; Cerebral folate deficiency; Folate receptor α defect; Homovanillic acid; Neurotransmitters.

MeSH terms

  • Aromatic-L-Amino-Acid Decarboxylases / cerebrospinal fluid
  • Aromatic-L-Amino-Acid Decarboxylases / deficiency
  • Chromatography, High Pressure Liquid / methods
  • Dihydroxyphenylalanine / analogs & derivatives*
  • Dihydroxyphenylalanine / cerebrospinal fluid
  • Dystonic Disorders / cerebrospinal fluid
  • Fluorescence
  • Folate Receptor 1 / cerebrospinal fluid
  • Folate Receptor 1 / deficiency
  • Folate Receptor 1 / genetics
  • Homovanillic Acid / cerebrospinal fluid*
  • Humans
  • Hydroxyindoleacetic Acid / cerebrospinal fluid*
  • Limit of Detection
  • Methoxyhydroxyphenylglycol / cerebrospinal fluid*
  • Neuroaxonal Dystrophies / cerebrospinal fluid
  • Reference Values
  • Reproducibility of Results
  • Tetrahydrofolates / cerebrospinal fluid*
  • Tyrosine / analogs & derivatives

Substances

  • FOLR1 protein, human
  • Folate Receptor 1
  • Tetrahydrofolates
  • Tyrosine
  • Methoxyhydroxyphenylglycol
  • Hydroxyindoleacetic Acid
  • Dihydroxyphenylalanine
  • Aromatic-L-Amino-Acid Decarboxylases
  • DDC protein, human
  • 5-methyltetrahydrofolate
  • 3-methoxytyrosine
  • Homovanillic Acid

Supplementary concepts

  • Dystonia, Dopa-responsive
  • Neurodegeneration Due To Cerebral Folate Transport Deficiency