Simultaneous Determination of Cyclosporine A, Tacrolimus, Sirolimus, and Everolimus in Whole-Blood Samples by LC-MS/MS

Objectives. Cyclosporine A (CyA), tacrolimus (TRL), sirolimus (SIR), and everolimus (RAD) are immunosuppressive drugs frequently used in organ transplantation. Our aim was to confirm a robust sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for determination of CyA, TRL, SIR, and RAD in whole-blood samples. Materials and Methods. We used an integrated online solid-phase extraction-LC-MS/MS system and atmospheric pressure ionization tandem mass spectrometry (API-MS/MS) in the multiple reaction monitoring (MRM) detection mode. CyA, TRL, SIR, and RAD were simultaneously analyzed in whole blood treated with precipitation reagent taken from transplant patients. Results. System performance parameters were suitable for using this method as a high-throughput technique in clinical practice. The high concentration of one analyte in the sample did not affect the concentration of other analytes. Total analytical time was 2.5 min, and retention times of all analytes were shorter than 2 minutes. Conclusion. This LC-MS/MS method can be preferable for therapeutic drug monitoring of these immunosuppressive drugs (CyA, TRL, SRL, and RAD) in whole blood. Sample preparation was too short and simple in this method, and it permits robust, rapid, sensitive, selective, and simultaneous determination of these drugs

ANTINEPHROLITHIATIC ACTIVITY OF PERSEA AMERICANA (AVOCADO) AND VIBURNUM OPULUS (GUELDER ROSE) AGAINST ETHYLENE GLYCOL-INDUCED NEPHROLITHIASIS IN RATS

Background: Nephrolithiasis is a severe health problem causing morbidity. Chemolisis, extracorporeal shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PNL), retrograde ureterorenoscopy (URS), and open and laparoscopic surgery are used for treatment with various success rates. Medical treatments with fewer complications were investigated thoroughly. Materials and Methods: In this study, we evaluated the effects of Persea americana (avocado) leaves and Viburnum opulus (guelder rose) fruits on nephrolithiasis in an animal model and used 42 rats. The groups received both low and high doses of Persea americana leaves and Viburnum opulus fruit ethanol extracts orally for 28 days. These two plants have been used for years in Turkey for their nephrolithiatic effect. Results: Avocado and guelder rose increased the urine volume and urine citrate levels, decreased urine cystine and oxalate levels, and lowered the crystal deposits in kidney tissue. Avocado and guelder rose also prevented oxidant damage and crystal formation in kidney tissue samples. Conclusion: The two plants that have been used for years for nephrolithiasis treatment in Turkey can safely be used for kidney stones