Amitriptyline in man: decreased formation of central 5-hydroxyindoleacetic acid.
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The accumulation of 5-HIAA and HVA in cerebrospinal fluid (CSF) was studied in eight healthy volunteers after oral administration of probenecid. Simulation indicated that a dose of 4.5 g probenecid should be used to achieve probenecid plasma concentrations between 200 and 400 micrograms/ml. Almost complete inhibition of the active transport of the acidic metabolites was assumed to be obtained at these concentrations. Probenecid 4.5 g was administered in two doses (2.5 g and 2 g), separated by 4 h. Plasma samples were drawn at varying intervals over a period of 46 h and lumbar puncture (LP) was performed at either 14 h or 20 h after the first administration of probenecid. The concentration of probenecid, 5-HIAA and HVA in CSF was estimated and the probenecid-induced accumulation of 5-HIAA and HVA was compared with their baseline values. There were no statistically significant differences (P greater than 0.05) in the accumulation of the monoamine metabolites between the two LP (14 h and 20 h), neither were there any differences in CSF concentrations of probenecid at the time of LP. There were only small differences in probenecid plasma concentrations, although statistically significant. Due to maximum blockade of the active transport system no correlation was observed between the CSF concentration of probenecid and the induced accumulation of 5-HIAA and HVA, respectively. The range of probenecid-induced accumulation for 5-HIAA and HVA in these volunteers was 156-429% and 183-600%, respectively. The suggested monitoring of probenecid plasma levels is proposed as a suitable model to investigate central neuronal activity of dopamine and serotonin in the central nervous system.
The influence of probenecid administration on 5HIAA and HVA concentrations in the CSF of depressed patients, was studied before and after treatment with imipramine or ECT. The average increase of the two metabolites in the CSF after probenecid was similar in the untreated depressed patients and in the same patients improved after both imipramine or ECT treatment. The treatment determined a significant increase in the CSF concentration of the acid metabolites also before the probenecid administration.
The volume of the lumbar sac measured in 4 subjects was found to be 15.5 ml. Exactly 15 ml of lumbar cerebrospinal fluid (L-CSF) was permitted to flow freely out during a lumbar puncture in 20 neurological patients and small samples of the L-CSF were collected in the beginning (sample 1), at the middle (sample 2), and at the end (sample 3) of this procedure either for 5-HIAA or HVA measurement. The concentrations of 5-HIAA and HVA increased in an exponential manner from sample 1 to sample 3. These results indicate that CSF in the lumbar sac is not a homogeneous fluid as is generally believed and that certain rules have to be followed in the sampling of the L-CSF to obtain reproducible biochemical data.
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A simple and flexible isocratic HPLC procedure was developed for the measurement of catecholamines and their abundant metabolites ( e.g. nor- metanephrine, metanephrine, methoxy-tyramine, vanillylmandelic acid, homovanillic acid) and 5-hydroxyindolacetic acid by ion-pair reversed phase chromatography on C18 columns, using a single mobile phase containing both sodium octane sulphonate and diethylamine as ion-pairing reagents.
CSF from neurological and other patients was analyzed for its content of tryptophan, 5-HIAA and homovanilic acid (HVA). The gradients of concentration of these substances from ventricular spaces to lumbar sac indicate that tryptophan and 5-HIAA probably enter the CSF from all levels of the nervous system, but that HVA originates entirely in the brain. A study of CSF tryptophan in patients with hepatic cirrhosis provided no support for theories which implicate abnormal tryptophan metabolism as a cause of hepatic coma.
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The effects of phencyclidine (PCP) on the levels of serotonin (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) in discrete brain areas of mouse were investigated. Following a single administration, PCP significantly increased at 60 min the level of 5-HT but not 5-HIAA in the cortex. However, acute administration of PCP induced no changes of 5-HT and 5-HIAA levels in other brain areas investigated. On the other hand, chronic treatment of PCP produced a significant increase the striatal 5-HT and 5-HIAA levels by about 30% and 20%, respectively. These increased levels were gradually returned to the control levels, and there was no difference of these levels between the control group and the 48 hr withdrawal group. The changes of 5-HT level in the hypothalamus were similar to those in the striatum. These results suggest that the pharmacological actions of PCP and tolerance development to PCP may be related to the functional changes of serotonergic neuronal activity.
The determination of serotonin and 5-hydroxyindoleacetic acid in urine is described. The compounds are separated by means of reversed-phase chromatography using tri-n-butylphosphate as the stationary phase and a mobile phase containing perchlorate as an ion-pairing agent. Detection is performed fluorimetrically. The compounds can be assayed directly, using two mobile phases with different pH values. Alternatively, both compounds can be determined with the same mobile phase after urine extraction on a small XAD-2 column for clean-up of serotonin. Two different approaches were evaluated for this XAD-2 extraction, viz.: (i) desorption of serotonin with a methanol-rich solvent after a washing step with an aqueous solvent; (ii) direct desorption of serotonin in the washing step using a solvent with a small percentage of methanol. Only the latter approach proved to be successful. The linearity of the method was investigated by standard additions to urine. The method was applied to the determination of both compounds in urine. The stability of the compounds in standard solutions and in urine was investigated under various storage conditions.
Using native fluorescence detection, 5-hydroxytryptamine (5-HT), 5-hydroxyindoleacetic acid (5-HIAA) and tryptophan were resolved from themselves and other naturally occurring compounds using reversed-phase HPLC within 5 min. Deproteinated platelet-poor plasma (PPP) and crude diluted urine were injected directly into the chromatograph. Careful selection of the HPLC column is important and various octadecyl silica (ODS) and base deactivated silic (BDS) columns were evaluated. Pre-treatment of an ODS column with tetrabutylammonium ions gave good selectivity. Between pH 5 and 6 the compounds were well resolved from each other. The limit of quantitative detection of 5-HT and 5-HIAA was 3.5 nmol/L. The overall chromatogram obtained using native fluorescence is cleaner than that obtained with the more commonly employed electrochemical (EC) systems although the chromatography is effectively the same. For analysis of 5-HT in plasma, collection in EDTA was more efficient than lithium heparin. Plasma 5-HT in healthy volunteers was mean 61 (SD = +/- 73) nmol/L, n = 20; urine 5-HIAA gave mean 28.95 (SD = +/- 0.98) mumol/L, (n = 12). Whole blood 5-HT analysis is unreliable in comparison with platelet-poor plasma.
A simple rapid method for the determination of 5-hydroxytryptophan, serotonin (5-hydroxytryptamine), and 5-hydroxyindoleacetic acid in brain is presented. Brain proteins are precipitated with Zn(OH)2. The indoles in the supernatant are separated by HPLC in less than than 8 min on a reverse phase column and detected electrochemically. As little as 38 fmol of hydroxyindole compound can be detected and quantitated. Because the method is rapid and uncomplicated many samples can be processed in a day.