A paramiloidose em Portugal: reflexão sobre o paradigma da transplantação hepática motivada por um caso clínico

A Polineuropatia Amiloidótica Familiar de tipo português (PAF) ou ATTR V30M é uma doença hereditária cuja prevalência em Portugal é elevada, sendo diagnosticados cerca de 60 novos casos todos os anos. Uma doente com PAF submeteu-se a um segundo transplante hepático de um dador cadavérico depois de se ter constatado que o primeiro dador era portador de TTR V30M. Com este artigo breve pretende-se realizar uma reflexão sobre o interesse, a prática e o enquadramento legal que condicionam a realização de testes genéticos preditivos em dadores de fígado na transplantação de doentes com paramiloidose. A determinação da presença (ou não) de proteína mutada no soro do segundo dador foi realizada por espectrometria de massa precedida de imunoprecipitação da proteína transtirretina. A realização de testes genéticos que permitam determinar a condição de portador de TTR V30M em dadores de fígado, deveria ser considerada no quadro das políticas de transplante em Portugal.

Speciation analysis of Arsenic in fish and rice samples using liquid chromatography-inductively coupled plasma mass spectrometry

Chemical speciation in foodstuffs is of uttermost importance since it is nowadays recognized that both toxicity and bioavailability of an element depend on the chemical form in which the element is present. Regarding arsenic, inorganic species are classified as carcinogenic while organic arsenic, such as arsenobetaine (AsB) or arsenocholine (AsC), is considered less toxic or even non-toxic. Coupling a High Performance Liquid Chromatographer (HPLC) with an Inductively Coupled Plasma Mass Spectrometer (ICP-MS) combines the power of separation of the first with the selectivity and sensitivity of the second. The present work aims at developing a method, using HPLC-ICP-MS technique, to identify and quantify the chemical species of arsenic present in two food matrices, rice and fish. Two extraction methods, ultrasound and microwave, and different settings were studied. The best method was chosen based on recovery percentages. To ensure that no interconversion of species was occurring, individual spikes of each species of arsenic were made in both matrices and recovery rates were calculated. To guaranty accurate results reference material BCR-627 TUNA FISH, containing certified values for AsB and DMA, was analyzed. Chromatographic separation was achieved using an anion exchange column, HAMILTON-PRP X-100, which allowed to separate the four arsenic species for which standards were available (AsB, dimethylarsenic (DMA), arsenite (AsIII), arsenate (AsV). The mobile phase was chosen based on scientific literature and adjusted to laboratory conditions. Different gradients were studied. As a result we verified that the arsenic species present in both matrices were not the same. While in fish 90% of the arsenic present was in the form of arsenobetaine, in rice 80% of arsenic was present as DMA and 20% as inorganic arsenic.