1.Multi-Parameter MRI for Evaluating Glymphatic Impairment and White-Matter Abnormalities and Discriminating Refractory Epilepsy in Children
Lu QIU ; Miaoyan WANG ; Surui LIU ; Bo PENG ; Ying HUA ; Jianbiao WANG ; Xiaoyue HU ; Anqi QIU ; Yakang DAI ; Haoxiang JIANG
Korean Journal of Radiology 2025;26(5):485-497
Objective:
To explore glymphatic impairment in pediatric refractory epilepsy (RE) using multi-parameter magnetic resonance imaging (MRI), assess its relationship with white-matter (WM) abnormalities and clinical indicators, and preliminarily evaluate the performance of multi-parameter MRI in discriminating RE from drug-sensitive epilepsy (DSE).
Materials and Methods:
We retrospectively included 70 patients with DSE (mean age, 9.7 ± 3.5 years; male:female, 37:33) and 26 patients with RE (9.0 ± 2.9 years; male:female, 12:14). The diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index as well as fractional anisotropy (FA), mean diffusivity (MD), and nodal efficiency values were measured and compared between patients with RE and DSE. With sex and age as covariables, differences in the FA and MD values were analyzed using tract-based spatial statistics, and nodal efficiency was analyzed using a linear model. Pearson’s partial correlation was analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the discrimination performance of the MRI-based machine-learning models through five-fold cross-validation.
Results:
In the RE group, FA decreased and MD increased in comparison with the corresponding values in the DSE group, and these differences mainly involved the callosum, right and left corona radiata, inferior and superior longitudinal fasciculus, and posterior thalamic radiation (threshold-free cluster enhancement, P < 0.05). The RE group also showed reduced nodal efficiency, which mainly involved the limbic system, default mode network, and visual network (false discovery rate, P < 0.05), and significantly lower DTI-ALPS index (F = 2.0, P = 0.049). The DTI-ALPS index was positively correlated with FA (0.25 ≤ r ≤ 0.32) and nodal efficiency (0.22 ≤ r ≤ 0.37), and was negatively correlated with the MD (-0.24 ≤ r≤ -0.34) and seizure frequency (r = -0.47). A machine-learning model combining DTI-ALPS, FA, MD, and nodal efficiency achieved a cross-validated ROC curve area of 0.83 (sensitivity, 78.2%; specificity, 84.8%).
Conclusion
Pediatric patients with RE showed impaired glymphatic function in comparison with patients with DSE, which was correlated with WM abnormalities and seizure frequency. Multi-parameter MRI may be feasible for distinguishing RE from DSE.
2.Multi-Parameter MRI for Evaluating Glymphatic Impairment and White-Matter Abnormalities and Discriminating Refractory Epilepsy in Children
Lu QIU ; Miaoyan WANG ; Surui LIU ; Bo PENG ; Ying HUA ; Jianbiao WANG ; Xiaoyue HU ; Anqi QIU ; Yakang DAI ; Haoxiang JIANG
Korean Journal of Radiology 2025;26(5):485-497
Objective:
To explore glymphatic impairment in pediatric refractory epilepsy (RE) using multi-parameter magnetic resonance imaging (MRI), assess its relationship with white-matter (WM) abnormalities and clinical indicators, and preliminarily evaluate the performance of multi-parameter MRI in discriminating RE from drug-sensitive epilepsy (DSE).
Materials and Methods:
We retrospectively included 70 patients with DSE (mean age, 9.7 ± 3.5 years; male:female, 37:33) and 26 patients with RE (9.0 ± 2.9 years; male:female, 12:14). The diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index as well as fractional anisotropy (FA), mean diffusivity (MD), and nodal efficiency values were measured and compared between patients with RE and DSE. With sex and age as covariables, differences in the FA and MD values were analyzed using tract-based spatial statistics, and nodal efficiency was analyzed using a linear model. Pearson’s partial correlation was analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the discrimination performance of the MRI-based machine-learning models through five-fold cross-validation.
Results:
In the RE group, FA decreased and MD increased in comparison with the corresponding values in the DSE group, and these differences mainly involved the callosum, right and left corona radiata, inferior and superior longitudinal fasciculus, and posterior thalamic radiation (threshold-free cluster enhancement, P < 0.05). The RE group also showed reduced nodal efficiency, which mainly involved the limbic system, default mode network, and visual network (false discovery rate, P < 0.05), and significantly lower DTI-ALPS index (F = 2.0, P = 0.049). The DTI-ALPS index was positively correlated with FA (0.25 ≤ r ≤ 0.32) and nodal efficiency (0.22 ≤ r ≤ 0.37), and was negatively correlated with the MD (-0.24 ≤ r≤ -0.34) and seizure frequency (r = -0.47). A machine-learning model combining DTI-ALPS, FA, MD, and nodal efficiency achieved a cross-validated ROC curve area of 0.83 (sensitivity, 78.2%; specificity, 84.8%).
Conclusion
Pediatric patients with RE showed impaired glymphatic function in comparison with patients with DSE, which was correlated with WM abnormalities and seizure frequency. Multi-parameter MRI may be feasible for distinguishing RE from DSE.
3.Multi-Parameter MRI for Evaluating Glymphatic Impairment and White-Matter Abnormalities and Discriminating Refractory Epilepsy in Children
Lu QIU ; Miaoyan WANG ; Surui LIU ; Bo PENG ; Ying HUA ; Jianbiao WANG ; Xiaoyue HU ; Anqi QIU ; Yakang DAI ; Haoxiang JIANG
Korean Journal of Radiology 2025;26(5):485-497
Objective:
To explore glymphatic impairment in pediatric refractory epilepsy (RE) using multi-parameter magnetic resonance imaging (MRI), assess its relationship with white-matter (WM) abnormalities and clinical indicators, and preliminarily evaluate the performance of multi-parameter MRI in discriminating RE from drug-sensitive epilepsy (DSE).
Materials and Methods:
We retrospectively included 70 patients with DSE (mean age, 9.7 ± 3.5 years; male:female, 37:33) and 26 patients with RE (9.0 ± 2.9 years; male:female, 12:14). The diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index as well as fractional anisotropy (FA), mean diffusivity (MD), and nodal efficiency values were measured and compared between patients with RE and DSE. With sex and age as covariables, differences in the FA and MD values were analyzed using tract-based spatial statistics, and nodal efficiency was analyzed using a linear model. Pearson’s partial correlation was analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the discrimination performance of the MRI-based machine-learning models through five-fold cross-validation.
Results:
In the RE group, FA decreased and MD increased in comparison with the corresponding values in the DSE group, and these differences mainly involved the callosum, right and left corona radiata, inferior and superior longitudinal fasciculus, and posterior thalamic radiation (threshold-free cluster enhancement, P < 0.05). The RE group also showed reduced nodal efficiency, which mainly involved the limbic system, default mode network, and visual network (false discovery rate, P < 0.05), and significantly lower DTI-ALPS index (F = 2.0, P = 0.049). The DTI-ALPS index was positively correlated with FA (0.25 ≤ r ≤ 0.32) and nodal efficiency (0.22 ≤ r ≤ 0.37), and was negatively correlated with the MD (-0.24 ≤ r≤ -0.34) and seizure frequency (r = -0.47). A machine-learning model combining DTI-ALPS, FA, MD, and nodal efficiency achieved a cross-validated ROC curve area of 0.83 (sensitivity, 78.2%; specificity, 84.8%).
Conclusion
Pediatric patients with RE showed impaired glymphatic function in comparison with patients with DSE, which was correlated with WM abnormalities and seizure frequency. Multi-parameter MRI may be feasible for distinguishing RE from DSE.
4.Multi-Parameter MRI for Evaluating Glymphatic Impairment and White-Matter Abnormalities and Discriminating Refractory Epilepsy in Children
Lu QIU ; Miaoyan WANG ; Surui LIU ; Bo PENG ; Ying HUA ; Jianbiao WANG ; Xiaoyue HU ; Anqi QIU ; Yakang DAI ; Haoxiang JIANG
Korean Journal of Radiology 2025;26(5):485-497
Objective:
To explore glymphatic impairment in pediatric refractory epilepsy (RE) using multi-parameter magnetic resonance imaging (MRI), assess its relationship with white-matter (WM) abnormalities and clinical indicators, and preliminarily evaluate the performance of multi-parameter MRI in discriminating RE from drug-sensitive epilepsy (DSE).
Materials and Methods:
We retrospectively included 70 patients with DSE (mean age, 9.7 ± 3.5 years; male:female, 37:33) and 26 patients with RE (9.0 ± 2.9 years; male:female, 12:14). The diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index as well as fractional anisotropy (FA), mean diffusivity (MD), and nodal efficiency values were measured and compared between patients with RE and DSE. With sex and age as covariables, differences in the FA and MD values were analyzed using tract-based spatial statistics, and nodal efficiency was analyzed using a linear model. Pearson’s partial correlation was analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the discrimination performance of the MRI-based machine-learning models through five-fold cross-validation.
Results:
In the RE group, FA decreased and MD increased in comparison with the corresponding values in the DSE group, and these differences mainly involved the callosum, right and left corona radiata, inferior and superior longitudinal fasciculus, and posterior thalamic radiation (threshold-free cluster enhancement, P < 0.05). The RE group also showed reduced nodal efficiency, which mainly involved the limbic system, default mode network, and visual network (false discovery rate, P < 0.05), and significantly lower DTI-ALPS index (F = 2.0, P = 0.049). The DTI-ALPS index was positively correlated with FA (0.25 ≤ r ≤ 0.32) and nodal efficiency (0.22 ≤ r ≤ 0.37), and was negatively correlated with the MD (-0.24 ≤ r≤ -0.34) and seizure frequency (r = -0.47). A machine-learning model combining DTI-ALPS, FA, MD, and nodal efficiency achieved a cross-validated ROC curve area of 0.83 (sensitivity, 78.2%; specificity, 84.8%).
Conclusion
Pediatric patients with RE showed impaired glymphatic function in comparison with patients with DSE, which was correlated with WM abnormalities and seizure frequency. Multi-parameter MRI may be feasible for distinguishing RE from DSE.
5.Multi-Parameter MRI for Evaluating Glymphatic Impairment and White-Matter Abnormalities and Discriminating Refractory Epilepsy in Children
Lu QIU ; Miaoyan WANG ; Surui LIU ; Bo PENG ; Ying HUA ; Jianbiao WANG ; Xiaoyue HU ; Anqi QIU ; Yakang DAI ; Haoxiang JIANG
Korean Journal of Radiology 2025;26(5):485-497
Objective:
To explore glymphatic impairment in pediatric refractory epilepsy (RE) using multi-parameter magnetic resonance imaging (MRI), assess its relationship with white-matter (WM) abnormalities and clinical indicators, and preliminarily evaluate the performance of multi-parameter MRI in discriminating RE from drug-sensitive epilepsy (DSE).
Materials and Methods:
We retrospectively included 70 patients with DSE (mean age, 9.7 ± 3.5 years; male:female, 37:33) and 26 patients with RE (9.0 ± 2.9 years; male:female, 12:14). The diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index as well as fractional anisotropy (FA), mean diffusivity (MD), and nodal efficiency values were measured and compared between patients with RE and DSE. With sex and age as covariables, differences in the FA and MD values were analyzed using tract-based spatial statistics, and nodal efficiency was analyzed using a linear model. Pearson’s partial correlation was analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the discrimination performance of the MRI-based machine-learning models through five-fold cross-validation.
Results:
In the RE group, FA decreased and MD increased in comparison with the corresponding values in the DSE group, and these differences mainly involved the callosum, right and left corona radiata, inferior and superior longitudinal fasciculus, and posterior thalamic radiation (threshold-free cluster enhancement, P < 0.05). The RE group also showed reduced nodal efficiency, which mainly involved the limbic system, default mode network, and visual network (false discovery rate, P < 0.05), and significantly lower DTI-ALPS index (F = 2.0, P = 0.049). The DTI-ALPS index was positively correlated with FA (0.25 ≤ r ≤ 0.32) and nodal efficiency (0.22 ≤ r ≤ 0.37), and was negatively correlated with the MD (-0.24 ≤ r≤ -0.34) and seizure frequency (r = -0.47). A machine-learning model combining DTI-ALPS, FA, MD, and nodal efficiency achieved a cross-validated ROC curve area of 0.83 (sensitivity, 78.2%; specificity, 84.8%).
Conclusion
Pediatric patients with RE showed impaired glymphatic function in comparison with patients with DSE, which was correlated with WM abnormalities and seizure frequency. Multi-parameter MRI may be feasible for distinguishing RE from DSE.
6.Analysis of Alleviating Effect of Calcium Cyanamide on Replanting Problems of Rehmannia glutinosa
Lianghua LIN ; Hengrui ZHANG ; Haoxiang YU ; Fan YANG ; Yufei WANG ; Caixia XIE ; Tao GUO ; Zhongyi ZHANG ; Liuji ZHANG ; Bao ZHANG ; Suiqing CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(22):212-222
ObjectiveTo investigate the alleviating effect of calcium cyanamide (CaCN2) soil fumigation on replanting problems of Rehmannia glutinosa. MethodsNewly soil (NP) was used as the control group, while three treatment groups were established: replanted soil (RP), newly soil treated with CaCN2 (120 g·m², tillage depth 25 cm) (NPCC), and replanted soil treated with CaCN2 (RPCC). R. glutinosa was cultivated in all groups. At harvest, the tuber agronomic traits (number of enlarged roots, maximum root diameter, fresh weight, dry weight) were measured. The content of catalpol and rehmannioside D was quantified by ultra-high-performance liquid chromatography (UPLC) to evaluate medicinal quality. Rhizosphere soil available nutrients and enzyme activities were analyzed by assay kits. The community structure and composition of fungi and bacteria in rhizosphere soil were assessed via internal transcribed spacer 2 (ITS2) sequencing and 16S rDNA sequencing, respectively. ResultsCompared with NP, the RP group showed obviously reduced in tuber agronomic traits and quality indicators (P0.05). However, the RPCC group showed significant improvement in agronomic traits and a notable increase in rehmannioside D content compared to RP (P0.05). The contents of available phosphorus and potassium in RPCC and NP groups were obviously lower than those in RP (P0.05). The polyphenol oxidase soil (S-PPO) activity in RP was obviously lower than in NP (P0.05), while sucrose soil (S-SC), acid phosphatase soil (S-ACP), and S-PPO activities in RPCC were obviously higher than in RP (P0.05). Microbial richness and diversity in RP were obviously higher than in NP (P0.05), whereas no significant differences were observed between the RPCC and NP. The relative abundances of fungal genera Nectria, Myrothecium, Tomentella, and bacterial genus Skermanella were obviousl lower in RPCC and NP than in RP (P0.05). Correlation analysis that S-ACP activity was positively correlated with the content of rehmannioside D (P0.05). Fungal genera Engyodontium and Alternaria, and bacterial genera Pir4 lineage, Pirellula, Methyloversatilis, Brevundimonas, Ralstonia, and Acidibacter were obviously positively correlated with tuber dry weight (P0.05). Conversely, fungal genera Pseudaleuria, Nectria, Haematonectria, Ceratobasidium, and bacterial genera Streptomyces, Skermanella, RB41, Gemmatimonas, and Bacillus were obviously negatively correlated with dry weight (P0.05). The fungal genus Alternaria and bacterial genera Brevundimonas, Ralstonia, Acidibacter, and Dongia showed positive correlations with medicinal quality of R.glutinosa tuber, while fungal genera Pseudaleuria, Nectria, Stachybotrys, Fusarium, Gibberella, Ceratobasidium, and bacterial genera Sphingomonas, Skermanella, RB41, Gemmatimonas, and Bacillus were obviously negatively correlated (P0.05). ConclusionCaCN2 soil fumigation can significantly improve enzyme activities in replanted Rehmannia rhizosphere soil, enhance the utilization of available nutrients, reshape microbial community structure of replanted R.glutinosa at the family and genus level, and notably improve tuber agronomic traits and medicinal quality. This study provides a novel approach to alleviating replanting problems and offers insights for the integrated development of standardized cultivation techniques, including soil disinfection, nutrient-targeted regulation, and microbial inoculant application.
7.Observation of the effect of Yanghe Pingchuan granules on the homing of BMSCs in asthma based on FTO regulation of Notch1 pathway.
Kun WANG ; Haoxiang FANG ; Xiaomei CAO
Chinese Journal of Cellular and Molecular Immunology 2025;41(7):585-592
Objective To observe the effect of m6A methylation regulation on Notch1 pathway on the homing of BMSCs in asthma, and the intervention study of traditional Chinese medicine compound Yanghe Pingchuan Granules. Methods Rat bone mesenchymal stem cells(BMSC)and bronchial epithelial cells were cocultured. The extracted cells were divided into: bronchial epithelial cell group, asthma bronchial epithelial cell+mesenchymal stem cell co-culture group (co-culture group), co-culture cell+normal serum group, coculture cell+serum containing optimal drug group, siRNA FTO+normal serum group, siRNA FTO-NC+normal serum group, and siRNA FTO+serum containing optimal drug group. The vitality and cell cycle changes of co-cultured cells were detected. The level and markers of homing BMSC were detected by immunofluorescence staining. The expression of Notch1 pathway related genes were detected by qRT-PCR. The expression of Notch1 pathway related proteins were detected by Western blot. Results Compared with bronchial epithelial cell group, the co-cultured cell group showed an increase in the homing level of BMSCs and the expression of C-X-C motif chemokine receptor 4 (CXCR4), stromal cell-derived factor 1 (SDF-1), Notch1, transcription factor recombination signal binding protein-J (RBP-J), and hairy enhancer of split 1 (Hes1) proteins. Compared with the co-cultured cell group and co-cultured cell+normal serum group, the co-cultured cell+serum containing optimal drug group showed an increase in the homing level of BMSCs and the expressions of CXCR4 and SDF-1, while the protein and mRNA levels of Notch1 and Hes1 decreased. Compared with the siRNA FTO-NC+normal serum group, the siRNA FTO+normal serum group showed an increase in the levels of Notch1, activated Notch1, RBP-J, Hes1 protein, and cell viability, while the level of homing BMSC decreased. Compared with siRNA FTO+normal serum group, the levels of Notch1, RBP-J mRNA, activated Notch1, and Hes1 protein decreased, while the level of homing BMSCs increased in siRNA FTO+serum containing optimal drug group. The levels of Notch1, RBP-J, and Hes1 mRNA were reduced in the co-cultured cells+serum containing optimal drug group. Compared with siRNA FTO+serum containing optimal drug group, the expressions of Notch1, activated Notch1, RBP-J, Hes1 protein and cell viability decreased, while the level of homing BMSCs increased in the co-cultured cells+serum containing optimal drug group. Conclusion Yanghe Pingchuan Granules may promote the homing of BMSCs in asthma and alleviate asthma inflammation by upregulating the expression of FTO and inhibiting the expression of downstream genes in the Notch1 signaling pathway.
Animals
;
Receptor, Notch1/genetics*
;
Mesenchymal Stem Cells/cytology*
;
Asthma/genetics*
;
Drugs, Chinese Herbal/pharmacology*
;
Signal Transduction/drug effects*
;
Rats
;
Coculture Techniques
;
Alpha-Ketoglutarate-Dependent Dioxygenase FTO/genetics*
;
Epithelial Cells/metabolism*
;
Rats, Sprague-Dawley
;
Cells, Cultured
;
Male
8.Inhibiting miR-155-5p promotes proliferation of human submandibular gland epithelial cells in primary Sjogren's syndrome by negatively regulating the PI3K/AKT signaling pathway via PIK3R1.
Yuru ZHANG ; Lei WAN ; Haoxiang FANG ; Fangze LI ; Liwen WANG ; Kefei LI ; Peiwen YAN ; Hui JIANG
Journal of Southern Medical University 2025;45(1):65-71
OBJECTIVES:
To investigate the mechanism mediating the regulatory effect of miR-155-5p on proliferation of human submandibular gland epithelial cells (HSGECs) in primary Sjogren's syndrome (pSS).
METHODS:
Dual luciferase reporter assay was used to verify the targeting relationship between miR-155-5p and the PI3K/AKT pathway. In a HSGEC model of pSS induced by simulation with TRAIL and INF-γ, the effects of miR-155-inhibitor-NC or miR-155 inhibitor on cell viability, cell cycle, apoptosis and proliferation were evaluated using CKK8 assay, flow cytometry and colony formation assay. ELISA and RT-PCR were used to detect the expressions of inflammatory cytokines and miR-155-5p mRNA in the cells; Western blotting was performed to detect the expressions of proteins in the PI3K/AKT signaling pathway.
RESULTS:
Dual luciferase assay showed that miR-155-5p targets the PI3K/AKT pathway via PIK3R1 mRNA. The HSGEC model of pSS showed significantly decreased cell viability, cell clone formation ability and expressions IL-10 and IL-4 and increased cell apoptosis, cell percentage in G2 phase, expressions of TNF‑α, IL-6, miR-155-5p and PIK3R1 mRNA, p-PI3K/PI3K ratio, p-Akt/AKT ratio, and PIK3R1 protein expression. Treatment of the cell models with miR-155 inhibitor significantly increased the cell viability, G1 phase cell percentage, colony formation ability, and expressions of IL-10 and IL-4 levels, and obviously reduced cell apoptosis rate, G2 phase cell percentage, expressions of TNF-α, IL-6, miR-155-5p and PIK3R1 mRNA, p-PI3K/PI3K ratio, p-AKT/AKT ratio, and PIK3R1 protein expression.
CONCLUSIONS
In HSGEC model of pSS, inhibition of miR-155-5p can promote cell proliferation and reduced cell apoptosis by targeting PI3K1 mRNA to negatively regulate the overexpression of PI3K/AKT signaling pathway.
Humans
;
MicroRNAs/genetics*
;
Cell Proliferation
;
Signal Transduction
;
Proto-Oncogene Proteins c-akt/metabolism*
;
Sjogren's Syndrome/pathology*
;
Epithelial Cells/cytology*
;
Submandibular Gland/cytology*
;
Phosphatidylinositol 3-Kinases/metabolism*
;
Apoptosis
;
Class Ia Phosphatidylinositol 3-Kinase
;
Cells, Cultured
9.Discussing the Staged Treatment of Progressive Fibrosing Interstitial Lung Disease Based on the Theory of "Opening-Closing-Pivoting"
Haoxiang ZHANG ; Jin'e WANG ; Xiao XIA ; Yanyi LIU ; Yujin DING ; Yingzi TIAN ; Kun XIA ; Guangxi LI
Journal of Traditional Chinese Medicine 2024;65(18):1882-1887
Progressive fibrosing interstitial lung disease (PF-ILD) has a complex etiology, and is classified as lung impediment stage, impediment-atrophy combination stage, and lung atrophy stage according to the different clinical manifestations during the progression of disease. Based on the theory of opening-closing-pivoting to analyse the characteristics of yin and yang disease mechanism and the idea of prescriptions in the three stages. For lung impediment stage, main as three-Yang fail to keep inside, disharmony between Ying qi (营气) and Wei qi (卫气), shaoyin impairment, treatment should use Mahuang (Ephedra sinica) and Guizhi (Neolitsea cassia) flexibly to form a formula, or choose pungent-dispersing formulas like Baidu Powder (败毒散) to move qi and save yang, and diffuse and disperse impediment pathogen, meanwhile combining saving-shaoyin medicinals like Fuzi (Aconitum carmichaelii) and Shudihuang (Radix Rehmanniae Praeparata) to reinforce healthy qi and dispel pathogen; for impediment-atrophy combination stage, rooted as yangming impairment and progressed by over-movement of qi, treatment should use Mahuang Shengma Decoction (麻黄升麻汤) to resolve and decrease over-activities, emphasis on both opening and closing, and improve impediment and atrophy; for lung atrophy stage with three-Yin in a bad condition simultaneously and poor prognosis, treatment should use modified Jinshui Liujun Decoction (金水六君煎) to consolidate qi and save yin, disperse phlegm and stasis, to improve the quality of life for patients with PF-ILD.
10.Monitoring Concentration of Nirmatrelvir and Ritonavir by Ultra High Performance Liquid Chromatography-tandem Mass Spectormetry Method
Jing FAN ; Haoxiang TANG ; Yinghui WANG ; Weibin FAN ; Jiao XIE ; Bin LIN
Herald of Medicine 2024;43(2):190-195
Objective To establish a highly sensitive,stable,and universally applicable ultra-high-performance liquid mass spectrometry tandem method(UPLC-MS/MS)for simultaneous determination of nirmatrelvir and ritonavir blood concentrations in human plasma.Methods The separation was performed on an ACQUITY UPLC BEH C18 column(2.1 mm× 50 mm,1.7 μm)with gradient elution,and the mobile phase consisted of 0.1%formic acid-water and 100%acetonitrile at the flow rate of 0.3 mL·min-1.The column temperature was 45℃,and the injection volume was 2 μL.Electrospray ionization as ion source(ESI+)was used as the ion source and multiple reactions monitoring mode(nirmatrelvir m/z 500.20→319.10,nirmatrelvir-D9 m/z 508.59→328.10,ritonavir m/z 721.30→426.10,13C,2H3-ritonavir m/z 725.30→426.10)was adopted.Thirty patients with coronavirus disease 2019(COVID-19)treated with nirmatrelvir and ritonavir at the People's Hospital of Changxing County in Jan.2023 were selected to measure their steady-state trough concentrations of nirmatrelvir and ritonavir after 3 days of treatment.Results The linear range of nirmatrelvir was 0.100-10.0 μg·mL-1(R2=0.997 2),and the linear range of nirmatrelvir was 0.050-5.00 μg·mL-1(R2=0.995 2).The recovery rates of nirmatrelvir and lopinavir were both>90%and the intra-batch and inter-batch precision relative standard deviations(RSDs)were both<10%.Additionally,the recovery ranges for nirmatrelvir and lopinavir were 91.5%-97.0%,and the matrix effects ranged from 92.4%to 97.7%.The results of clinical samples showed that the plasma concentrations of nirmatrelvir and ritonavir in patients with COVID-19 varied greatly among individuals.Conclusion The method for simultaneous determination of nirmatrelvir and ritonavir concentrations in human plasma established in this study is convenient,highly specific,highly accurate,with high precision,which is suitable for monitoring the concentrations of nirmatrelvir and ritonavir in patients.

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