13C Basal Abundance of Expired CO2 -Definition of Pre-Requisites for Kinetic Breath Tests

Abstract

A sufficiently stable rate of ¹³CO₂ exhalation is necessary when the diagnostic ¹³CO₂ breath tests are performed in healthy subjects and patients. The aim of the research was to define prerequisite conditions for kinetic breath tests in order to ensure a stable ¹³CO₂ background. A 3-part protocol was developed. Part I: a study of the one-day variation of ¹³CO₂ abundance in expired CO₂ confirmed that shifts of the basal ¹³C abundance in breath are inherent in nature. Part II: a study of the variations of ¹³C enrichment after the ingestion of different meals and beverages showed that ingestion of food items containing C₄ plant sugars, such as maize, induces a significant increase in isotopic abundance. Part III: a new test breakfast containing rice grain cereal, milk and orange juice was tested. This test meal induces no significant change on the basal ¹³CO₂ abundance in healthy subjects. This new finding allows to avoid the fasting period normally required prior to a breath test which is sometimes difficult for children and pregnant women.     

Zum Stand der Stoffwechselforschung mit 15N- und 13C-markierten Tracersubstanzen in der Kinderheilkunde (Protein Turnover Research Using 15N and 13C Labelled Substrates in Pediatrics)

Abstract

Measurements in protein turnover and in metabolism of amino acids and their degradation products by means of stable isotope labelled substrates have been increasingly applied in clinical research over the last years. In spite of numerous studies dealing with this topic, quite a few important insufficiently clarified methodical aspects remain. This refers, for instance, to the choice of suitable tracer substances, the difficulties in the determination of the excretion plateau and the validation of the oxidation rates as measured with individual-labelled amino acids with regard to the whole body protein synthesis. Such problems may become of decisive importance in special subjects, such as preterm infants and critically-ill patients.

Investigations into these issues conducted by our group have revealed that the protein turnover in the very small preterm infant is by no means as intensive as previously claimed. The utilisation of urea nitrogen for the whole body protein synthesis of the infant may assume substantial proportions under the conditions of marginal protein intake and of catchup-growth. Studies conducted by means of ¹⁵N-labelled bifidobacteria have pointed at the intensive substrate exchange existing between microflora and host.

Pediatric research has to be non-invasive. Consequently, methods based on arterio-venous differences in tracer concentrations and on muscle biopsies do not have very high priority in pediatric research. A search for references published in the last five years has shown, that ¹⁵N-glycine is still the most frequently used tracer substance. There is a tendency towards a further increase of cell culture experiments run with stable isotope labelled amino acids.

Clinical research groups increasingly turn their attention to stable isotopes and mass spectrometry. This impressively demonstrates the continuing importance of tracerkinetic methods in all branches of medicine.     

Significance of Diagnostic Parameters in [13C]Octanoic Acid Gastric Emptying Breath Tests*

Abstract

Two novel characteristic parameters, the latency time (t _lat) and the ascension time (t _asc), are proposed for evaluation of non-invasive [¹³C]octanoic acid breath tests for assessment of the gastric emptying of solids. In breath tests performed in control subjects (n = 30) and diabetic patients (n = 100), the usefulness of these parameters was compared to conventional parameters, i.e., gastric half emptying-time t _1/2,b ) and lag phase (t _lag,b ). The proposed parameters were only loosely correlated (controls, r = 0.199; diabetics, 0.616). A strong correlation was found between the conventional parameters (controls, r = 0.891; diabetics, r = 0.962). Based on the conventional method, 36 patients were suspicious of delayed gastric emptying including 24 patients which exhibited a simultaneous delay in both parameters. Using the new parameters, a total of 46 patients were suspicious of delayed gastric emptying with 15 and 20 having isolated delay in t _lat and t _asc, respectively. We conclude that the novel parameters may be more appropriate for examination of the different phases of gastric emptying and for evaluation of gastric emptying disturbances in diabetic patients than the parameters conventionally used for this purpose.     

Low-temperature sealed tube combustion of gaseous,liquid and solid organic compounds for 13C/12C and 14C analysis

A new, low-temperature sealed tube technique for combustion of organic carbon prior to subsequent off-line isotope analysis is proposed. Complete oxidation is achieved with potassium peroxodisulfate and silver permanganate as oxidants at temperatures not exceeding 500 °C. The combustion of gaseous (methane), solid (cane sugar, vanilla, N-thiazolyl-2-sulfamide, ascorbic acid, phenanthrene, thiourea, polyethylenefilm, tetrafluoropolyethylene, polyetheretherketone, graphite, and Suwannee River Fulvic Acid), and liquid (tetrachloroethene, toluene, and oil) model compounds and international standards was tested. A 24 h combustion at 500 °C was sufficient for complete oxidation in all cases. The time required for complete oxidation of Suwannee River Fulvic Acid, typical of refractory freshwater dissolved organic carbon, as a function of combustion temperature was 2 h at 500 °C, 6 h at 400 °C, and 24 h at 300 °C. Preparation of saline solution parallels of cane sugar, vanilla, N-thiazolyl-2-sulfanilamide, and ascorbic acid gave consistent results. For reproducible δ¹³C analyses using a Thermoquest MAT 252 MS, a minimum of 5 µg C had to be combusted. Reliable ¹⁴C results, measured at an accelerator mass spectrometer facility, were obtained from coal and from cane sugar combusted for 24 h at 500 °C by the proposed method.     

[13C]Aminopyrine and [13C]Caffeine Breath Test: Influence of Gender,Cigarette Smoking and Oral Contraceptives Intake

Abstract

The [¹³C]aminopyrine breath test ([¹³C]ABT) measures the global activity of cytochrome P450 in vivo and is a sensitive indicator of liver metabolic dysfunction. The present study aims to determine whether gender and cigarette smoking influence the results of [¹³C]ABT as well as to confirm the effect of oral contraceptive steroids (OCS) intake on this metabolic test. Hundred and ten healthy subjects, including men and women, smoker and non-smoker, women taking OCS or not, were phenotyped for CYP1A2 using the [¹³C]caffeine breath test and underwent a [¹³C]ABT. Both tests showed large inter-individual variations in accordance with that of CYP450 liver content. [¹³C]ABT was sensitive enough to point out a significant induction or inhibition related to cigarette smoking habits or OCS. The combined effect of smoking and OCS resulted in an overall unchanged metabolic activity. Consequently, the impact of the studied conditions on the [¹³C]ABT parameters must be considered by clinicians or clinical investigators.     

L-[1-13C]phenylalanine breath test in patients with chronic liver disease of different etiologies

The aim of this study was to compare the oxidation of l-[1-¹³C]phenylalanine (¹³C-PheOx) in patients with chronic liver failure due to different etiologies using l-[1-¹³C]phenylalanine breath test. Breath samples were collected before the administration of 100 mg l-[1-¹³C]phenylalanine, and every 10 min thereafter until completion of 1 h. Control subjects (n=9) presented a larger cumulative percentage of ¹³C dose recovery (CPDR) than patients (n=124) with chronic liver disease, regardless of the etiology (7.5±0.7 vs. 4.2±0.2, p=0.001). No differences in CPDR were found considering the Child-Pugh (CP) class or etiology: alcoholic (CP A=7.7±0.7, CP B=4.1±0.5, CP C=2.0±0.3), hepatitis C virus (CP A=5.4±0.5, CP B=4.0±0.2, CP C=2.2±0.3), hepatocellular carcinoma (CP A=5.5±1.6, CP B=3.6±1.8, CP C=2.2±1.0); or cryptogenic cirrhotic patients (CP A=7.4±1.5, CP B=4.4±0.4, CP C=2.1±0.7). Results confirm that ¹³C-PheOx decreases in patients with cirrhosis with respect to controls, notwithstanding the etiology.     

Use of the optogalvanic effect (OGE) for isotope ratio spectrometry of 13CO2 and 14CO2

The use of isotopic carbon dioxide lasers for determination of carbon (and oxygen) isotope ratios was first demonstrated in 1994. Since then a commercial device called LARA^?, has been manufactured and used for Helicobacter pylori breath tests using ¹³C-labelled urea. The major advantages of the optogalvanic effect compared with other infrared absorption isotope ratio measurement techniques are its lack of optical background and its high sensitivity resulting from a signal gain proportional to laser power. Continuous normalisation using two cells, a standard and sample, lead to high accuracy as well as precision. Recent advances in continuous flow measurement of ¹³C/¹²C ratios of CO₂ in air and extensions of the technique to ¹⁴C, which can be analysed as a stable isotope, are described.     

A Dual 13C and 15N Long Term Labelling Technique to Investigate Uptake and Translocation of C and N in Beech (Fagus sylvatica L.)

Abstract

A continuous dual ¹³CO₂ and ¹⁵NH₄ ¹⁵NO₃ labelling experimental set-up is presented that was used to investigate the C and N uptake and allocation within 3-year old beech (Fagus sylvatica L.) during one growing season. The C and N allocation pattern was determined after six, twelve and eighteen weeks of growth. The carbon uptake was distinctly different in the three phases examined: The first six weeks after budbreak were dedicated to leaf growth with a R/S (root to shoot) ratio of 0.14 for the new carbon. The second growth phase showed a balanced R/S ratio of C allocation and after week 13, the root compartment was the main carbon sink (R/S = 6.97).

Nitrogen allocation was more basipetal as compared to carbon. In the second growth phase, R/S of N_new was 5.57 but fell to 3.54 for the third growth phase probably due to formation of reserves in buds and stem.     

NMR Studies in the Heterocyclic Series. XXIII. - 13C Spectra of Indazole and 3-Azido-Indazole in Acidified Dimethylsulfoxid Solutions

We reported previously the ¹³C NMR spectra of indazole 1 ² and 3-azido-indazole 2 ³.     

Determining the content and 13C abundance of total dissolved carbon in water samples by TOC analyser-mass spectrometer coupling

A combined system consisting of a TOC analyser connected to a quadrupole MS was recently described as a way of measuring the N content and the ¹⁵N abundance of total dissolved nitrogen in aqueous samples. This work examines whether this combination of instruments can also be used for the ¹³C determination of the total dissolved carbon in aqueous samples. A level of precision good for ¹³C-enriched samples was achieved with a relative standard deviation of <3%. By using an isotope ratio MS instead of the quadrupole MS employed here, TOC-MS coupling also ought to be suitable for determining natural ¹³C abundances.     

A Sensitive Isotope Selective Nondispersive Infrared Spectrometer for 13CO2 and 12CO2 Concentration Measurements in Breath Samples

We present a nondispersive infrared spectrometer (NDIRS) for the measurement of the ¹³CO₂/¹²CO₂-ratio in breath samples. A commercial NDIR spectrometer for CO₂ concentration measurements in industrial process control was modified using two separate optical channels for the ¹³CO₂ and ¹²CO₂ detection. Cross interference due to overlapping absorption lines of both isotopic gases was successfully eliminated. The sensitivity of this device is ± 0.4‰ of the ¹³CO₂/¹²CO₂-ratio in a range of 2.5 to 5% of total CO₂. This is sufficient for biomedical applications. Our spectrometer is small in size, cheap and simple to operate and thus a true alternative to isotope ratio mass spectrometers (IRMS). Several biomedical applications with breath samples were demonstrated and were compared in very good agreement with IRMS.     

Biomedical Application of an Isotope Selective Nondispersive Infrared Spectrometer for 13CO2 and 12CO2 Concentration Measurements in Breath Samples

A newly developed isotope selective nondispersive infrared (NDIR) spectrometer for the measurement of ¹³CO₂ and ¹²CO₂ concentrations in breath samples was applied as a low cost and very simple to operate alternative to isotope ratio mass spectrometry (IRMS). We used this device for several biomedical applications ([¹³C]urea breath test, [¹³C]leucine metabolism, [¹³C]methacetin catabolism of rats) and found that the results agree very well with IRMS.     

C3 or C4 Macrophytes: A Specific Carbon Source for the Development of Semi-Aquatic and Terrestrial Arthropods in Central Amazonian River-Floodplains According to δ13C Values

Abstract

C₄ plant species were proposed to generally represent inferior food sources compared to C₃ plants thus are avoided by herbivores, particularly insects. This was tested in semi-aquatic and terrestrial arthropods from Amazonian river-floodplains by carbon isotope discrimination (δ¹³C). Two semi-aquatic grasshopper species (Stenacris f. fissicauda, Tucayaca gracilis—Acrididae) obtain their carbon during development from specific C₄ macrophytes and two semi-aquatic species (Cornops aquaticum—Acrididae, Paulinia acuminata—Pauliniidae) from specific C₃ macrophytes. The terrestrial millipede Mestosoma hylaeicum (Paradoxosomatidae) obtains about 45% of its carbon from roots of one C₄ macrophyte during the development of immatures whereas adults use other food sources, including C₃ trees. Results suggest, that (1) both C₄ and C₃ plants represent distinct hosts for terrestrial arthropods in Amazonia; (2) immatures may use plant species with a different photosynthetic pathway than adults.     

Analysis of 13C-mixed Triacylglycerol in Stool by Bulk (Ea-IRMS) and Compound Specific (GC/MS) Methods

Abstract

This paper was presented in poster form at the 17th International Congress of Nutrition, August 27-31, Vienna. Austria (Annals of Nutrition & Metabolism 2001; 45(Suppl.1):349). Some of the data were also presented in poster form at the British Society of Gastroenterology Meeting, March 18-21, Glasgow, UK (Gut 2001; 48(Suppl.1):A91).

The ¹³C-mixed triacylglycerol (MTG) breath test is used to measure intraluminal fat digestion. In normal digestion. 20–40% of the ingested ¹³C label is recovered in breath CO₂. We aimed to identify the proportions of ingested label excreted in stool, as well as breath following ingestion of ¹³C-MTG by children with impaired exocrine pancreatic function and healthy controls. ¹³C enrichment of breath samples was measured by continuous flow isotope ratio mass spectrometry (IRMS) and cumulative percent dose recovered (cPDR) in 10 h was calculated. Total ¹³C of a faecal fat extract from each stool was measured by elemental analyser-IRMS, and ¹³C enrichment and concentration of the TBDMS derivative of octanoic acid was measured by GC/MS after hydrolysis of the fat extract. Stool 5-day cPDR was calculated. Mean breath cPDR was 35%. Mean cPDR in stool by combustion-IRMS and GC/ MS, respectively, was 0.8% and 1.0%. Therefore, the remaining 64% of the ¹³C label must remain in the body and variability in breath cPDR is due to postabsorptive rather than predigestive factors.     

Estimation of Urea Production Rate With [15N2]Urea and [13C]Urea to Measure Catabolic Rates in Diabetes Mellitus

Abstract

For verifying catabolic states in insulin-dependent patients and dogs the method estimating urea production rates with ¹³C and with doubly ¹⁵N labeled urea, respectively, has been established. For a fast steady state of urea tracer dilution, a prime of 600 times the continuous infusion rate had to be injected. Urea was isolated from plasma samples by protein precipitation and cation exchange chromatography with a consecutive derivatization of the dried urea fraction (trimethylsilyl derivatives). The masses of the fragment ions m/z 189 (¹⁴N¹⁴N), 190 (¹⁴N¹⁵N) and 191 (¹⁵N¹⁵N) urea are monitored to estimate the [¹⁵N₂]urea frequency in the overall body urea pool in mol percent excess (MPE). 1 to 15 ng of derivatized urea were measured efficiently. An excellent correlation between expected standard and measured MPE (r = 0.9977) was achieved from solutions containing 1 to 7% [¹⁵N₂]urea. The interassay coefficient of variation amounted to < 10% for a [¹⁵N₂]urea portion of ≥ 3%.

Normoglycemic diabetic patients who were treated with insulin overnight showed significantly higher urea production compared to healthy controls (9.22 ± 2.07 vs. 5.4 ± 0.32 μmol·kg^?1 · min^?1; p < 0.05). Measurements in chronic diabetic dogs proved an increased rate of amino acid catabolism (+ 20% urea production) in systemic versus portal application of insulin in paired studies. This increased nitrogen load in diabetics may accelerate progression of diabetic nephropathy. - Thus, the established stable isotope technique may serve as a sensitive and useful indicator of amino acid catabolism in clinical and experimental research.     

Evaluation of Water Removal and Memory Effect in 13CO2 Breath Tests by Isotope Ratio Mass Spectrometry

The usefulness of different ways of water removal in off-line sample preparation of human breath samples for ¹³CO₂ breath tests was examined and compared. Cryogenic water trapping and water removal with common desiccants like silicagel blue, Mg(ClO₄)₂, and molecular sieves were checked for reliability and reproducibility. With silicagel blue and Mg(ClO₄)₂ memory effects for ¹³C content were observed. The use of molecular sieve 4 Å and 5 Å led to tremendous carbon isotope fractionation. Molecular sieve 3 Å was found to be an excellent alternative to the established use of Mg(ClO₄)₂ and of cryogenic water trapping.     

蚕丝蛋白的NMR研究Ⅱ.桑、柞蚕丝及其丝素的13C CP-MAS NMR研究

本文在Bruker AC-250和MSL-400谱仪上,首次测试了河南桑蚕茧、丝素及柞蚕黄茧、人工白茧和丝素的固态¹³C CP MAS NMR谱,归属了¹³C NMR谱线,并揭示了白茧和黄茧二级结构的差异。     

Evaluation of the oral 13C-bicarbonate tracer technique for the estimation of CO2 production and energy expenditure in dogs during rest and physical activity

For feeding of working dogs during their daily life, illness, routine jobs or sporting activities, an accurate determination of their nutritional requirements is essential to ensure their optimal health and performance. To predict the appropriate guidelines about how to feed dogs, it appears essential to determine the energy expenditure (EE) in a reliable and feasible way. In the present experiment, the non-invasive oral ¹³C-bicarbonate tracer technique (o¹³CT), i.e. collection of breath samples after oral administration of NaH¹³CO₃, was used for the estimation of CO₂ production and EE in dogs. Measurements were conducted during two days of rest, and during three days with 3 h of exercise per day. Average EE was 483 and 876 kJ kg^?0.75 d^?1 during rest and exercise, respectively. The o¹³CT seems appropriate to use as a minimal restrictive and non-invasive method to obtain reliable estimates of EE in dogs at different activity levels under near natural conditions.     

1H, 13C and 19F NMR Studies of the Diels-Alder Adduct of p-Fluoranil with Phencyclone. II. Hindered Phenyl Rotations and Anisotropic Effects in a Model Compound for Drugs

Abstract

The Diels-Alder adduct of phencyclone, compound 1, with p-fluoranil, compound 3, has been prepared in refluxing toluene. The adduct, compound 2, has been examined by ¹H, ¹³C and ¹⁹F NMR spectroscopy at 300, 75 and 282 MHz, respectively. At ambient temperature, the unsubstituted bridgehead phenyl groups in adduct 2 are found to exhibit hindered rotation, resulting in slow exchange limit (SEL) ¹H NMR spectra. Full aryl proton assignments are made based on 1D and 2D (COSY45) NMR. The ¹⁹F NMR (proton coupled) reveals one of the two ¹⁹F signals to be a triplet. This resonance collapses to a singlet in the proton decoupled ¹⁹F spectrum, implying an unexpected long range ¹H-¹⁹F coupling. For the ¹³C NMR spectrum, tentative assignments are presented. Data for compound 2 as a model compound for drugs are discussed in terms of the hindered aryl rotation and evidence of magnetic anisotrppic effects.